Uvod: Aplikacija intramuskularne injekcije predstavlja najpogosteje uporabljen način aplikacije injekcij. Namen raziskave je bil preučiti najnovejše ugotovitve s področja priprave vbodnega mesta in ...aplikacije intramuskularne injekcije. Metode: Izveden je bil sistematični pregled znanstvene in strokovne literature v mednarodnih podatkovnih bazah CINAHL, PubMed, The Cochrane Library ter ScienceDirect. Uporabili smo naslednje ključne besede: intramuscular injection, instramuscular vaccination, injection site, skin disinfection, injection technique. Pri iskanju smo uporabili tudi Boolove operatorje AND (IN) in OR (ALI). Iskanje literature je potekalo marca in aprila 2021. Za oceno kakovosti posameznih raziskav smo uporabili orodje Critical Appraisal Skills Programme. Rezultati: Izmed 4.208 identificiranih zadetkov je bilo v končno analizo vključenih 13 člankov. Ugotovitve smo združili v štiri vsebinske kategorije: (1) izbira vbodnega mesta, (2) tehnike intramuskularne injekcije, (3) razkuževanje vbodnega mesta, (4) aspiracija. Diskusija in zaključek: Med zaključki raziskav ni enotnega mnenja glede varne in strokovne aplikacije intramuskularne injekcije. Kot kažejo raziskave, je najprimernejše mesto aplikacije ventroglutealno področje. Razkuževanje vbodnega mesta pred aplikacijo v izvenbolnišničnem okolju ni potrebno, medtem ko je aspiracija priporočljiva zgolj na dorzoglutelnem mestu. Priporoča se aplikacija s tehniko trakcija kože – pritisk – hitro sproščanje mišic, z izbiro igle ob upoštevanju debeline podkožnega maščevja, mesta za aplikacijo in gostote zdravila. Potrebna bi bila izvedba dodatnih raziskav, s katerimi bi lahko oblikovali priporočila za optimalno tehniko intramuskularne injekcije.
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Človeški (humani) papilomavirusi (HPV) so heterogena skupina virusov, ki jih etiološko povezujemo z benignimi in malignimi novotvorbami ploščatoceličnega epitela. Prav tako pa se vpletajo tudi v ...karcinogenezo adenokarcinomov. Zmotno je prepričanje, da je okužba s HPV povezana zgolj z rakom materničnega vratu. Številne raziskave so potrdile povezavo med okužbo s HPV in nastankom anogenitalnih bradavic, papilomatoze grla, raka glave in vratu ter nenazadnje novotvorb zunanjega spolovila, nožnice, anusa in penisa. Okužba s HPV je danes v razvitih državah poznana kot najpogostejša spolno prenosljiva bolezen. Z njo se okuži večina spolno aktivnih ljudi vsaj enkrat v življenju. Pred okužbo se lahko zaščitimo s splošnimi ukrepi, kot so manjše število spolnih partnerjev, kasnejši začetek spolnega življenja ter varno in odgovorno vedenje. Trenutno ne poznamo specifičnega protivirusnega zdravljenja okužbe s HPV. Najuspešnejša metoda, s katero lahko preprečimo okužbo s HPV, je cepljenje. Z obstoječimi cepivi lahko preprečimo večino hujših predrakavih sprememb in raka materničnega vratu ter druge benigne in maligne neoplazme, povzročene z okužbo z virusi HPV.
V državah z dobro vzpostavljenimi cepilnimi programi je cepljenje “žrtev lastnega uspeha”, saj je nizka pojavnost bolezni, ki jih preprečujemo s cepljenjem, zmanjšala izkušnjo njihovega bremena in s ...tem očitnost koristi cepljenja. Povečevanje števila staršev, ki zavračajo cepljenje svojih otrok, je že ogrozilo t. i. skupnostno imunost oz. jo zmanjšalo celo do mere, da so se ponovno začeli pojavljati izbruhi prej obvladanih nalezljivih bolezni. V prispevku predstavljamo sistematični pristop k etičnim vprašanjem glede cepljenja otrok skozi štiri principe biomedicinske etike (tj. spoštovanje posameznikove avtonomije, neškodovanje, dobrodelnost in pravičnost), ki je razumljiv model za razmislek o tovrstnih vprašanjih. Pediatrom na primarni ravni, ki se najpogosteje srečujejo z dilemami glede obravnave otrok, katerih starši zavračajo cepljenje, je lahko sistematičnost opisanega pristopa v pomoč pri etičnem razmisleku, odločanju in iskanju lastne vloge v tovrstnih situacijah. Utemeljujemo iskanje “etičnega ravnovesja”, kar pomeni, da stopnja spoštovanja avtonomije staršev ni stalna, ampak odvisna od ravni vzpostavljene skupnostne imunosti. če moralna dolžnost posameznikov, da prispevajo k imunosti populacije, ni izpolnjena, je upravičeno s strani države pred-pisano obvezno cepljenje. Država je namreč odgovorna za varovanje skupnostne imunosti, ki jo moramo razumeti kot javno dobro in zato potrebuje posebno državno zaščito.
HPV AND CERVICAL CANCER PREVENTION Marjetka Uršič-Vrščaj; Milan Bašković; Sonja Bebar ...
Zdravniški vestnik (Ljubljana, Slovenia : 1992),
02/2018, Volume:
78
Journal Article
Peer reviewed
Open access
Background: The causal role of human papilloma virus (HPV) in all cancers of the uterine cervix has been firmly established biologically and epidemiologically. HPV types 16 and 18 account for about ...70 % of the cases worldwide. HPV has been recognized as a necessary cause of cervical cancer, meaning that in the absence of the persistent presence of HPV DNA in the cervical cells, cervical cancer will not occur. Thus preventive strategies based on HPV testing in screening programmes or HPV type-specific vaccination are based on solid ground. Most cancers of the vagina and anus are likewise caused by HPV 16, as are a siteable fraction of cancers of the vulva, the penis and the oropharynx. Cervical cancer screening can be a highly effective secondary intervention. In the developing countries these programmes are either not available or are ineffective. HPV vaccination represents the most effective intervention in that scenario. Prophylactic vaccination with human papillomavirus (HPV) virus-like particle (VPL) vaccines against HPV 16 and HPV 18, has transformed our prospects for reducing the in- cidence of cervical cancer on global scale. HPV vaccines are immunogenic, well tolerated and show remarkable efficacy. Screening will have to continue, as two of the 15 oncogenic HPV types are in the vaccines and for two to three decades at least unvaccinated sexually active women still remain at risk for the disease. Conclusions: If vaccination, screening and HPV testing are combined then the virtual elimination of cervical cancer is possible.
In Slovenia national strategies to prevent hepatitis B virus (HBV) infection in children were introduced in the mid-nineties. The aim of the present study was to analyze the epidemiological ...characteristics of chronic hepatitis B infection in children in Slovenia after the introduction of mandatory HBV vaccination of children and mandatory screening of pregnant women for HBV surface antigen (HBsAg) with consecutive active and passive immunization of newborns of HBsAg-positive mothers.
Children from all regions of Slovenia whose blood samples tested positive for HBsAg at the national reference laboratory for viral hepatitis between January 1997 and December 2010 were included. Demographic, epidemiological and virological data were reviewed retrospectively. Statistical evaluation of the patients' characteristics was performed and possible trends during the observation period determined.
Among 52 HBsAg-positive children, there were 22 (42.3%) girls and 30 (57.7%) boys. Among 40 children tested for HBeAg, 17 were positive (42.5%). The most frequent risk factor for acquiring HBV infection was "presence of HBV infection within the family" (24/35; 68.8%). A significant association between the presence of HBeAg and a viral load of >20,000 IU/ml was found (p=0.001). The difference in the proportion of children of Slovenian origin born before 1994 and after was statistically significant (p=0.039). A statistically significant negative linear trend of the number of diagnosed children in the observed period was found (p=0.006).
Prevention strategies adopted in the mid-nineties have resulted in the elimination of chronic hepatitis B in children of Slovenian origin born in Slovenia.
Vaccination against seasonal influenza is recommended for all healthcare workers including physicians in Slovenia to protect vulnerable individuals and reduce transmission of influenza viruses. The ...aim of our study is to determine the uptake of seasonal influenza vaccination among Slovenian physicians, to identify factors associated with that vaccination and assess their attitudes and beliefs regarding vaccination and vaccine-preventable diseases.
A cross-sectional survey was performed among physician members of the Slovenian Medical Chamber. The link to the anonymous web-based questionnaire was sent to 8,297 physicians. We estimated the overall proportion of physicians who vaccinate against influenza, while the possible associations with collected explanatory variables were explored in univariate analyses.
The response rate to the survey was 10.8%. 75.9% (95% CI: 73.1-78.7%) physicians vaccinate themselves against influenza (regularly or occasionally) and 24.1% (95% CI: 21.2-26.8%) do not vaccinate (not any more or never). In univariate analysis only, the area of work was statistically significant when associated with vaccinating against influenza (p=0.002). Among physicians who expressed some misconceptions regarding vaccination and vaccine-preventable diseases (it is better to overcome disease naturally as vaccines pose a higher risk than disease) the proportion of vaccinated against influenza was low (43.2%; 95% CI: 27.9-58.4%, 27.3%; 95% CI: 7.1-47.5%).
Not trusting in vaccination or professional recommendations regarding vaccination and some misconceptions regarding vaccination and vaccine-preventable diseases may influence the decision to be vaccinated against seasonal influenza among Slovenian physicians.
Okužbe s humanimi virusi papiloma (HPV) so zelo pogoste spolno prenosljive bolezni, ki se značilno pojavijo kmalu po začetku spolne dejavnosti. Breme z njimi povezanih bolezni, rakavih in nerakavih, ...je veliko za ženske in moške. HPV, ki prinašajo veliko tveganje, visokotvegani ali onkogeni HPV pri ženskah povzročajo raka materničnega vratu, nožnice in zunanjega spolovila, pri moških pa raka penisa ter pomemben delež raka žrela in raka zadnjika pri ženskah in moških. Pred nekaj leti sta bili izdelani cepivi, ki preprečujeta okužbo z 2 genotipoma, ki povzročata raka (HPV 16 in 18). Pri neokuženih osebah v približno 95 % učinkovito preprečujeta bolezni, ki jih povzročata oba genotipa, ne zdravita pa okužbe. Profilaktični cepivi sta prvi, ki so ju naredili, da bi pri človeku preprečevali raka.
Uvod. V Sloveniji ima zdravnik družinske medicine pomembno vlogo pri izvajanju preventive. Delež cepljenih proti gripi je v Sloveniji nizek. Razlogi za to niso povsem jasni. Preučevali smo mnenje ...bolnikov glede cepljenja proti gripi pri njihovem družinskem zdravniku ter njihova stališča in prepričanja o gripi in cepljenju. Cilj naloge je bil odkriti dejavnike, ki vplivajo na odločitev o cepljenju v ambulanti družinske medicine.
In Slovenia, there is little data available on pneumococcal vaccination rates and no data on asymptomatic NPCR and serotypes in the population of nursing home residents in comparison to the elderly ...living in domestic environment, therefore the goal was to gain these data.
A cross sectional epidemiological study was performed. Nasopharyngeal swabs from 151 nursing home residents, 150 elderly living in domestic environment, and 38 adults less than 65 years old were collected twice (in two consecutive years). The swabs were analysed for pneumococcal identification and serotyping. Patient data were collected from medical files and medical history.
No statistically significant differences in NPCR were seen between compared groups in two consecutive years. An average NPCR in two consecutive years in nursing home residents was 1.45%, in the elderly living in domestic environment 0.85%, and in adults less than 65 years old 7.05%. Serotypes identified among nursing home residents were 6B and 9N, among the group of elderly living in domestic environment, 6A and among adults less than 65 years old, 35F, 18C and 3. Pneumococcal vaccination rates were low (3.3% in nursing home residents, 6% in the elderly from domestic environment and 0% in the group of adults less than 65 years old).
Our data suggests that NPCR and the proportion of people vaccinated with pneumococcal vaccine among the elderly are low. We identified different serotypes in all groups, only one person was a chronic carrier (serotype 35F).
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