Background Healthcare professionals (HCPs), patients and families are often faced with ethical dilemmas. The role of healthcare ethics committees (HECs) is to offer support in these situations. Aim ...The primary objective was to study how often HCPs encounter ethical dilemmas. The secondary objective was to identify the main types of ethical dilemmas encountered and how HCPs solve them. Subjects and methods We conducted a cross-sectional, survey-based study among HCPs in 14 Slovenian hospitals. A questionnaire was designed and validated by HCPs who were selected by proportional stratified sampling. Data collection took place between April 2015 and April 2016. Results The final sample size was n = 485 (385 or 79.4%, female). The response rates for HCPs working in secondary and tertiary level institutions were 45% and 51%, respectively. Three hundred and forty (70.4%) of 485 HCPs (very) frequently encountered ethical dilemmas. Frequent ethical dilemmas were waiting periods for diagnostics or treatment, suboptimal working conditions due to poor interpersonal relations on the ward, preserving patients' dignity, and relations between HCPs and patients. Physicians and nurses working in secondary level institutions, compared to their colleagues working in tertiary level institutions, more frequently encountered ethical dilemmas with respect to preserving patients' dignity, protecting patients' information, and relations between HCPs and patients. In terms of solutions, all HCPs most frequently discussed ethical dilemmas with co-workers (colleagues), and with the head of the department. According to HCPs, the most important role of HECs is staff education, followed by improving communication, and reviewing difficult ethical cases. Conclusions Waiting periods for diagnostics and treatment and suboptimal working conditions due to poor interpersonal relations are considered to be among the most important ethical issues by HCPs in Slovenian hospitals. The most important role of HECs is staff education, improving communication, and reviewing difficult ethical cases.
Celotno besedilo
Dostopno za:
DOBA, IZUM, KILJ, NUK, PILJ, PNG, SAZU, SIK, UILJ, UKNU, UL, UM, UPUK
Background:
With the increasing availability and advances in brain imaging, pineal cyst lesions (PCL) are becoming a common finding in the pediatric population. In the absence of evidence-based ...guidelines, optimal diagnostic and therapeutic approaches have not been established, and there is a risk of under- or overtreatment of these patients.
Objectives:
The aim of our study was to evaluate the clinical presentation and radiological features of PCL in a cohort of pediatric patients and to identify clinical parameters more commonly associated with neoplasms in the pineal region. In addition, the prevalence of PCL in the pediatric population of Slovenia was estimated.
Methods:
In this observational, cohort study, children treated at University Children's Hospital, Ljubljana, Slovenia in the period 1997–2016 were included if PCL was found on brain imaging. We analyzed indications for referral to a neurologist, clinical signs and symptoms, radiological features, treatment and outcome.
Results:
The cohort consisted of 143 children with PCL. Pineocytoma was suspected in 31 children (21.7%). Six children underwent surgery – pineocytoma was confirmed in two cases and germinoma in one (2/3 of these children had signs of increased intracranial pressure (ICP), while PCL was benign in the remaining 4 cases. Only 2 PCL enlarged during the study period, both <2mm, none of these children developed neoplasm. Two children had PCL >20mm in diameter; both showed signs of increased ICP, one patient was found to have a germinoma of the pineal region, while the other had no neoplasm.
Conclusions:
Most PCL do not change their features during radiological follow-up and even atypical PCL are very rarely associated with a malignant neoplasm of the pineal region. A PCL larger than 20 mm and signs of increased ICP were identified as potential markers for selecting patients at risk.
INFEKCIJSKE BOLEZNI PRI OTROKU Jagodic Bašič, Veronika; Berkopec, Tanja; Prodanović, Nina ...
Slovenska pediatrija,
05/2022, Letnik:
29, Številka:
2
Journal Article
Recenzirano
Odprti dostop
Nalezljive bolezni povzroča širjenje mikroorganizmov (bakterij, virusov, gliv ali parazitov) ali prionov na ljudi z drugih ljudi, živali ali okolja. Okužbe se prenašajo kontaktno, kapljično ali ...aerogeno. Prenašajo se neposredno s človeka na človeka, preko okuženih predmetov, z uživanjem kontaminirane hrane ali pijače, s stikom s kontaminiranimi telesnimi tekočinami in z ugrizom ali pikom živali. V prispevku opisujemo zdravstveno obravnavo pri Lymski boreliozi in klopnem meningoencefalitisu, mišji mrzlici, ter okužbah povzročenih z virusom ošpic ter virusom varicella zoster virus. Številne nalezljive bolezni, kot so ošpice in norice, lahko preprečimo s cepivi. V bolnišničnem okolju moramo izvajati postopke aerogene izolacije. če okuženi ne potrebuje hospitalizacije, se mora izolirati v domačem okolju. Pri boleznih, ki jih prenašajo živali, upoštevamo preventivne ukrepe. Ozaveščanje prebivalcev o pomembnosti zaščite pred vbodom klopa in dosledno samopregledovanje sta ključnega pomena za zmanjševanje šte-vila okuženih z Lymsko boreliozo in klopnim meningoencefalitisom. Preventivno ravnanje proti mišji mrzlici je zaščita pred vdihovanjem aerosolov. Za zaščito proti klopnemu meningoencefalitisu je na voljo cepivo, ki ga priporočamo otrokom od prvega leta dalje. Zaradi vojne v Ukrajini in velikega števila razseljenih je možen porast okužb s tuberkulozo in ošpicami ter multirezistentnimi bakterijami. Pri bolnišnični obravnavi oseb s tega področja upoštevamo z zdravstveno oskrbo povezane ukrepe za preprečevanje in obvladovanje okužb.
To assess the differences in the way how Slovenian and Croatian health care professionals (HCPs) confront ethical dilemmas and perceive the role of hospital ethics committees (HECs).
This ...cross-sectional, survey-based study involved HCPs from three Slovenian and five Croatian university medical centers (UMC). The final sample sizes were 308 (244 or 79.2% women) for Slovenia and 485 (398 or 82.1% women) for Croatia.
Compared with Croatian physicians, Slovenian physicians reported a higher share of ethical dilemmas regarding waiting periods for diagnostics or treatment, suboptimal working conditions due to interpersonal relationships in the ward, and end-of-life treatment withdrawal, and a lower share regarding access to palliative care and patient information protection. Compared with Croatian nurses, Slovenian nurses reported a lower share of ethical dilemmas regarding the distribution of limited resources, recognizing the patient's best interests, and access to palliative care. Compared with Croatian other HCPs, Slovenian other HCPs reported a lower burden of ethical dilemmas regarding waiting periods for diagnostics or treatment, distribution of limited resources, and access to palliative care. When encountering an ethical dilemma, all HCPs in both countries would first consult their colleagues. Slovenian and Croatian HCPs recognized the importance of the HECs to a similar extent, but viewed their role differently.
Croatian and Slovenian HCPs are confronted with different ethical dilemmas and perceive the role of HECs differently.
Aim To identify the epidemiological and clinical features of acute viral lower respiratory tract infections (LRTI) caused by respiratory syncytial virus and other respiratory viruses, and to ...determine the risk factors for the severe disease among neonates. Methods We retrospectively reviewed the records of neonates aged up to 44 postconceptional weeks who were hospitalized at a tertiary referral hospital due to confirmed viral LRTI between January 2015 and December 2020. Results Of 228 neonates with viral LRTI, one-third were born prematurely. A seasonal distribution of LRTIs from December to March was noticed, peaking in February. Forty-two percent of neonates were treated in the neonatal intensive care unit. One third of these presented with complications and needed mechanical ventilation. The most detected viruses were respiratory syncytial virus and rhinovirus. Prematurity was identified as a risk factor for worse clinical course and more complications, while rhinovirus infection was associated with an increased risk of apnea. Conclusions The burden of respiratory syncytial virus LRTI in the neonatal period is high, although other respiratory viruses can also cause a severe respiratory disease. In preterm infants, rhinovirus infection presents an important risk factor for a severe course of LRTI with complications. Infection with two respiratory viruses leads to a more severe clinical course.
INFECTIOUS DISEASES IN CHILDREN Veronika Jagodic Bašič; Tanja Berkopec; Nina Prodanović ...
Slovenska pediatrija,
05/2022, Letnik:
29, Številka:
2
Journal Article
Recenzirano
Odprti dostop
Infectious diseases are diseases that are caused by spread of microorganisms (bacteria, viruses, fungus or parasites) or prions to the people from the humans, animals or environment. Infections have ...been transmitted by contacts, droplets or aero genus, directly from human to human, through infected objects, with consumption of contaminated food or beverage, contact with contaminated body liquids or with bite or peak of an animal. Healthcare management of infections caused by Lyme borrelia, tick – borne meningoencephalitis, hantaviruses, measles virus and varicella zoster virus are discussed. Many infectious diseases, such as measles and chickenpox, could be prevented with vaccines. The procedures of aerogenic isolation need to be applied in hospital environment; if however the infected person does not need to be hospitalized he (she) must be isolated at home environment. Raising of people awareness is very important for animal borne diseases. The awareness upon importance of protection against tick bites and consistent self-examination is crucial for diminishing of infections with Lyme borellia and tick – borne meningoencephalitis and protection against inhalation of aerosols while cleaning the abandoned areas against mouse fever. There is a vaccine against tick – borne meningoencephalitis which is recommended from the age of one year. Due to Ukrainian war and increased number of displaced persons an increase in infections with tuberculosis, measles and the emergence of multi- resistant bacteria is possible. All measures to prevent and control healthcare connected infections should be considered when treating individuals from this area.
Aim To identify the epidemiological and clinical features of
acute viral lower respiratory tract infections (LRTI) caused
by respiratory syncytial virus and other respiratory viruses, and to ...determine the risk factors for the severe disease
among neonates.
Methods We retrospectively reviewed the records of neonates aged up to 44 postconceptional weeks who were
hospitalized at a tertiary referral hospital due to confirmed
viral LRTI between January 2015 and December 2020.
Results Of 228 neonates with viral LRTI, one-third were
born prematurely. A seasonal distribution of LRTIs from
December to March was noticed, peaking in February. Forty-two percent of neonates were treated in the neonatal
intensive care unit. One third of these presented with complications and needed mechanical ventilation. The most
detected viruses were respiratory syncytial virus and rhinovirus. Prematurity was identified as a risk factor for worse
clinical course and more complications, while rhinovirus
infection was associated with an increased risk of apnea.
Conclusions The burden of respiratory syncytial virus LRTI
in the neonatal period is high, although other respiratory
viruses can also cause a severe respiratory disease. In preterm infants, rhinovirus infection presents an important
risk factor for a severe course of LRTI with complications.
Infection with two respiratory viruses leads to a more severe clinical course
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