Physical activity is an important factor for primary and secondary stroke prevention. The process of stroke rehabilitation includes early and late physical activity and exercise, which prevents ...further stoke and improve patients’ quality of life. MY WAY project, an ERASMUS+ SPORT program, is aimed at analyzing and developing or transferring best innovative practices related to physical activity and exercise enhancing health in poststroke patients. The aim of the study was to identify, analyze, and present the good practices and strategies to encourage participation in sport and physical activity and engage and motivate chronic stroke patients to perform physical activity changing their lifestyle and to maintain a high adherence to long-term exercise-based rehabilitation programs. Our results demonstrated that unified European stroke long-term exercise-based rehabilitation guidelines do not exist. It seems that low training frequency with high aerobic exercise intensity may be optimal for improved physical performance and quality of life in combination with a high adherence. It is important to optimize the training protocols suitable for each patient. The continuous education and training of the specialized professionals in this field and the presence of adequate structures and cooperation between different healthcare centers are important contributors. The clear objective for each country should be to systematically make the necessary steps to enhance overall exercise-based stroke rehabilitation attendance in the long term. Long-term interventions to support the importance of physical exercise and lifelong exercise-based rehabilitation in chronic stroke patients should be created, what coincides with the goal of the MY WAY project.
Europski forum o životu nakon moždanog udara Jurlina, Hrvoje; Budinčević, Hrvoje; Bartolović Vučković, Jelena
Logopedija,
12/2023, Letnik:
13, Številka:
2
Journal Article, Paper
Odprti dostop
Moždani udar (MU) jedan je od vodećih uzroka invaliditeta u svijetu, a u proces neurorehabilitacije uključen je multidisciplinarni tim. Završetkom institucionalne neurorehabilitacije, poteškoće kao ...što su disfagija, deficiti pažnje i koncentracije, afazija, poteškoće u kretanju, emocionalna inkontinencija, depresija (…), perzistiraju i utječu na kvalitetu života oboljelog, članova obitelji i neformalnih njegovatelja. Europski akcijski plan za moždani udar (SAP-E) uz prevenciju, akutnu skrb, rehabilitaciju djeluje i na poboljšanje kvalitete skrbi u životu nakon moždanog udara. U ovom stručnom radu prikazana su multidisciplinarna postignuća prezentirana na „Europskom forumu o životu nakon moždanog udara“ u raznim aspektima života nakon MU, kao što su sekundarna prevencija MU i teškoće asimilacije u socijalnu okolinu, problemi u intimnosti, mobilnost nakon MU, sustavi pomoći i samopomoći. Dodatni naglasak je na potrebi daljeg razvoja rehabilitacijskih postupaka, koji pružaju dugotrajnu podršku oboljelima i njihovim neformalnim skrbnicima i/ili članovima obitelji, kao i za podizanjem općedruštvene svijesti o posljedicama i utjecaju MU na život oboljelih.
Stroke is one of the leading causes of disabilities worldwide, and the rehabilitation process includes a multidisciplinary team. At the end of the formal, institutional neurorehabilitation process, diagnoses such as dysphagia, attention and concentration deficits, aphasia, motoric movement impairments, emotional incontinence, depression (…) persist and have a great influence on the quality of life of stroke survivors, caregivers, and family members. Stroke Action Plan for Europe (SAP-E) has multiple goals, including Life after stroke. This paper presents accomplishments in multidisciplinary approaches to Life after stroke that were shown during the “European Life After Stroke Forum” and includes a variety of aspects and approaches within life after stroke, such as secondary prevention of stroke, difficulties in social inclusion, intimacy well-being, driving after stroke, general care, and self-care systems. Additional attention was made to the need for the development of rehabilitation procedures that would include long-term support for stroke survivors and their caregivers/family members as well as the need for raising awareness regarding the difficulties and influence of stroke on the life of stroke survivors.
COVID-19 pandemija – neurološki aspekti bolesti Budinčević, Hrvoje; Vidaković, Dorotea; Jurlina, Hrvoje ...
Rad Hrvatske akademije znanosti i umjetnosti (1991). Medicinske znanosti,
06/2020
543=50-51
Journal Article
Odprti dostop
Bolest uzrokovana virusom teškog akutnog respiratornog sindroma 2 dovela je do pandemije. Ova globalna javno-zdravstvena prijetnja slična je prethodnim epidemijama sindroma teškog respiratornog ...sindroma (SARS) I bliskoistočnog respiratornog sindroma (MERS). Cilj ovog rada je pružiti pregled vodećih kliničkih i neuroloških manifestacija ove nove zarazne bolesti, nazvane Coronavirusna bolest 2019 (COVID-19). Glavne kliničke manifestacije ove bolesti povezane su s dišnim sustavom, ali mogući su neurološki simptomi i bolesti zbog neuroinvazivnog potencijala virusa. Većina slučajeva COVID-19 ima blage kliničke simptome i oporavlja se bez komplikacija, ali 5% slučajeva zahtijeva intenzivno liječenje. Najčešći neurološki simptomi su glavobolja, vrtoglavica, hiposmija i hipogeuzija. Neurološke bolesti povezane s COVID-19 su moždani udar, encefalopatija, meningoencefalitis i akutni poliradikuloneuritis (Guillain Barre-ov sindrom). Preventivne mjere najučinkovitije su za suzbijanje COVID-19. Te mjere uključuju metode izolacije i tjelesnog distanciranja, metode sprječavanja širenja bolesti kapljičnim putem (pokrivanje lica pri kašljanju i kihanju) te učestalo pranje ruku sapunom i vodom ili korištenje sredstva za dezinfekciju ruku, kao i izbjegavanje javnih skupova. Nažalost, ova bolest nema specifičnih antivirusnih lijekova ili cjepivo. Novi virus ulazi u stanicu putem receptora za angiotenzin konvertirajući enzim 2, radi čega je u znanstvenoj zajednici postavljeno pitanja uporabe inhibitora renin-angiotenzin-aldosteronskog sustava. Prema najnovijim podacima većina profesionalnih društava preporučila je nastavak uporabe inhibitora renin-angiotenzin-aldosteronskog sustava.
COVID-19 Pandemic – Neurological Aspects of the Disease Budinčević, Hrvoje; Vidaković, Dorotea; Jurlina, Hrvoje ...
Rad Hrvatske akademije znanosti i umjetnosti (1991). Medicinske znanosti,
2020, Letnik:
543, Številka:
50-51
Journal Article
The aim of our retrospective study was to analyze distribution of histological types, age of patients and hormonal dependency of breast cancer cases in the period 1980-2000 using computer database ..."Thanatos". This period was divided with regard to the war into a pre-war (1980-1990), war (1991-1995) and post-war period (1996-2000). We also paid attention to the Chernobyl accident (pre-Chernobyl from 1980-1986 and post-Chernobyl from 1987-2000). Special attention was focused on the period during the war mainly due to the fact that very little data exist in literature dealing with the war as a stress factor that may have induced and promoted carcinogenesis. During this twenty-one year period 2296 patients were diagnosed with breast cancer. In the female population of 2274, 2228 (98%) of these were ductal and only 46 (2%) were invasive lobular carcinomas. In all of the male cases (22) the cancer was pathohistologically verified as the invasive ductal type. The male:female ratio was 1:103. Comparing the pre-war and war periods we found a more than double increase in the male:female ratio (from 1:131 to 1:66). We observed similar results when we looked at the period after the Chernobyl incident where the ratio increased from 1:139 to 1:79. When we analyzed the distribution of histological types we found a significant increase in lobular carcinomas during the post-war period, from 1.1% to 5.5%; this increase was less significant for the post-Chernobyl period (1.0% to 3.3%). The average age of the patients with invasive ductal carcinomas increased from 56.7 yrs during the pre-war period to 59.7 yrs during the war and finally to 61.1 yrs during the post-war period. The average age of males with breast cancer decreased from 63.6 and 63.5 during the pre-war and war periods to 58.8 yrs during the post-war period. These results suggest that the war could have influenced the shift in the age of occurrence of breast cancer in both sexes appearing in younger males and in females in their postmenopausal period. The most commonly diagnosed stage of invasive ductal carcinoma during the war and post-war periods was T1N0MX, but in the controlled pre-war period the most frequently diagnosed stage was T2N1MX. With this we see that the increase in the age of the patient is not due to a more advanced pTNM stage which suggests that the increased age of our patients seeking medical help is not due to the incapacitating effects that the war may have on people needing medical attention. Our results showed that most of the patients were ER positive (72% throughout the twenty-one year period) and their average rate and number increase with the age of the patient. We found a significant drop in hormone dependent tumors in the period from 1991-95, which could mean that tumors in a war environment manifest a more aggressive phenotype. Our results show that the war within our region most likely had an effect on some clinical parameters involving breast cancer patients. Possible effects caused by "Chernobyl" could not be proved due to the overwhelming effect that war had upon the patients within this region.
Zbog pandemije bolesti COVID-19 uzrokovane virusom SARS-CoV-2, u proljeće 2020. godine u Republici Hrvatskoj nastupilo je potpuno zatvaranje koje je uključivalo i mjeru obaveze prelaska nastavnog ...procesa na svim razinama obrazovanja iz učioničke nastave u nastavu na daljinu. Obilježja koja je učenje u visokom obrazovanju poprimilo tijekom potpunog zatvaranja odgovaraju obilježjima karakterističnima za online učenje. S ciljem utvrđivanja stavova studenata Sveučilišta Josipa Jurja Strossmayera u Osijeku prema online učenju i čimbenika tih stavova, proveli smo kvantitativno istraživanje. Podatke smo pritom prikupljali metodom ankete na prigodnom uzorku (N = 327) putem interneta. Rezultati su pokazali da studenti imaju blago negativan stav prema online učenju, s tim da su pozitivnijeg stava bili studenti koji su se prije epidemije učestalije koristili alatima za online učenje. Primjenom modela prihvaćanja tehnologije potvrdili smo indirektnu povezanost percipirane lakoće korištenja alatima za online učenje i stava prema online učenju s jakim efektom medijacije percipirane korisnosti online učenja.
Due to COVID-19 pandemic caused by the virus SARS-CoV-2, in the spring of 2020 Republic of Croatia imposed a lockdown, which included a measure of transferring the educational process on all educational levels from classroom to distance education. Characteristics of learning in higher education during the lockdown were identical to those pertaining to online learning. Aiming to determine the attitudes of students of Josip Juraj Strossmayer University of Osijek towards online learning and the factors affecting their attitudes, we have conducted a quantitative research. In so doing, we have collected the data using the surveying method on a convenient sample (N = 327) via Internet. The results have shown that students have a slightly negative attitude towards online learning, provided that students who have used online learning tools more frequently before the pandemic have a more positive attitude towards it. By applying the technology acceptance model (TAM), we have confirmed the indirect correlation between the perceived ease of use of online learning tools and the attitude towards online learning with a strong mediation effect of perceived usefulness of online learning.
Background
Data from patients with post‐ablative dural defects reconstructed using a free temporalis muscle fascia graft (FTFG) after resection of anterior or central skull base tumors were ...retrospectively analyzed.
Methods
The primary predictor and outcome variables were the reconstructive methods for dural repair and postoperative cerebrospinal fluid (CSF) leakage rate, respectively.
Results
Eighty patients were included, and 94 postoperative dural reconstructions were performed using FTFG. The postoperative CSF leakage rate was 3.19%. The postoperative CSF leakage rates did not significantly differ between open and endonasal endoscopic surgeries (1.92% vs. 4.88%; p > 0.05). In cases completed using the endonasal endoscopic approach, the postoperative CSF leakage rate was significantly associated with the intraoperative CSF leak flow (p < 0.05).
Conclusions
Post‐ablative dural defect reconstruction using FTFG resulted in low postoperative CSF leakage and complication rates comparable to those of free fascia lata graft from available literature.
Objective:
In the last 5 years we regularly use free temporalis muscle fascia transplant as a reconstructive material for dural defects in both open and endoscopic surgical procedures. The objective ...of our investigation is to compare biomechanical characteristics of free temporalis muscle fascia and fascia lata transplant to those of dura.
Material and Methods:
Biomechanical study encompasses 80 fresh human cadaver autopsy specimens; 35 temporalis muscle fascia samples, 21 fascia late samples and 24 dural samples. All samples underwent stretching test within 24 hours after being harvested. Stretching test consisted of two sequences. First we have stretched 39 samples with the extension speed rate of 0.05 mm/s until limited extension of 6%, a threshold value for fascia lata, where it loses its elasticity. In the second part of the test we have stretched 41 samples with calculated average default dural strain at the threshold point where it loses its elasticity, with the 25%, 50%, 75% and 100% of that calculated default strain, consequently.
Results and Conclusion:
Temporalis muscle fascia has the best elastic properties in comparison to dura and fascia lata. It tolerates strain much better than dura and fascia lata, especially at lower values of default strain (25 and 50% of elastic limit of dura) which are the closest to physiologic forces during normal human activity. Fascia lata is the stiffest material of all three, while dura is somewhere in-between them. This proves that temporalis muscle fascia is the best reconstructive material because it produces the smallest force on the edge of defect due to its elasticity, and it tolerates extension much better than fascia lata. Its biomechanical characteristics are much closer to those of dura in comparison to fascia lata. These advantages are especially pronounced in endoscopic repair of dural defect where only adhesive forces keep reconstructive material in its place.
Na slučajnom uzorku od 50 timova obiteljske
medicine, proporcionalno raspoređenih po svim županijama,
ruralnim i urbanim područjima u Hrvatskoj, provedeno je istraživanje
subjektivne procjene ...kvalitete u djelatnosti obiteljske
medicine mjerenjem zadovoljstva osiguranika/pacijenata, korisnika
zdravstvenih usluga, ispunjavanjem upitnika EUROPEP
koji je 1999. godine proizvela radna skupina EQuiP za evaluaciju
primarne zdravstvene zaštite putem korisnika (pacijenata).
U istraživanju je aktivno sudjelovao 7.271 ispitanik (od ukupno
distribuiranih 15.000 upitnika, odaziv je bio 48,47%), i to 3.189
ispitanika iz gradskih naselja, 838 iz prigradskih naselja, 2.051
sa sela i 92 koji žive na osami. Najbolje su prosječno ocijenjena
pitanja “Čuva li liječnik osobne povjerljive podatke dobivene iz
razgovora?”, “Spremnost sestre u ambulanti da pomogne pacijentu?”
i “Dolazak na posao na vrijeme i pridržavanje radnog
vremena?”, s 95% i više odgovora “zadovoljni” i “jako zadovoljni”.
Najlošije su bila ocijenjena pitanja “Povezanost ambulante
s ostalim dijelovima zdravstvenog sustava (bolnica, specijalisti,
dijagnostika, ljekarne)?”, “Dostupnost ambulante javnim prijevozom?”
i “Medicinska opremljenost ordinacije?”, s oko 75%
odgovora “zadovoljni” i “jako zadovoljni”). Nešto lošije ocjene
od ostalih davali su ispitanici koji žive na selu. Bolje ocjene od
ostalih davali su ispitanici koji žive u prigradskom naselju. Slične
obrasce ocjenjivanja imale su sve četiri skupine ispitanika, s tim
da su skupine koje žive na selu i na osamljenom imanju davale
niže ocjene o zadovoljstvu od druge dvije. S područja subjektivne
procjene kliničke kvalitete najlošije ocjene od sve četiri
skupine ispitanika po tipu/mjestu stanovanja dobilo je pitanje
o zadovoljstvu ponudom preventivnih zdravstvenih usluga, a s
područja subjektivne procjene kvalitete organizacije, najlošije
ocjene dobilo je pitanje o povezanosti ordinacije s ostalim dijelovima
zdravstvenog sustava. Velik je udio pacijenata izrazio nesigurnost
kod prihvaćanja mišljenja općeg/obiteljskog liječnika
nasuprot mišljenju liječnika specijalista. Potrebne su posebne
poticajne mjere na razini sustava za navedena tri područja.
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