Cilj Procijeniti prediktivnu vrijednost testa uspinjanja uza stube za razvitak poslijeoperacijeskih
komplikacija u bolesnika s rakom pluća koji su odabrani za elektivnu operaciju, a u kojih je
...forsirani izdisajni volumen u prvoj sekundi (FEV1) manji od 2 L.
Postupci Prospektivno složeno istraživanje provedeno je u 101 bolesnika redom kako su dolazili,
pod uvjetom da su imali FEV1<2 L i bili odabrani za elektivnu resekciju pluća zbog plućnoga
zloćudnog tumora. Preoperacijski pregled obuhvatio je anamnezu i fizikalni pregled, ispitivanje
plućnih funkcija, EKG, laboratorijske testove i rendgensku sliku pluća. Svi su prije operacije
podvrgnuti testu uspinjanja uza stube s pulsnom oksimetrijom gdje im je mjeren broj stuba koje su
svladali i vrijeme potrebno za dovršenje testa. Zasićenje krvi kisikom i frekvencija pulsa mjereni su
svakih 20 stuba. Poslijeoperacijske komplikacije procijenjene su u odnosu na davanje kisika,
produljenje mehaničke ventilacije i ranu smrtnost.
Rezultati Najmanje jedna poslijeoperacijska komplikacija pojavila se u 87 (86%) bolesnika. Vrsta
operacije bila je značajno povezana s poslijeoperacijskim komplikacijama (25.5% bolesnika s
lobektomijom nije imalo ranih poslijeoperacijskih komplikacija), a dob, spol, pušenje cigareta,
poslijeoperacijska oksigenacija i mehanička ventilacija nisu. Više je komplikacija bilo nakon većih i
ozbiljnijih operacija (P<0,001). Test uspinjanja uza stube izazivao je značajno sniženje zasićenja
krvi kisikom (-1%) i povišenje frekvencije pulsa (10/minute) nakon svladanih svakih 20 stuba. Test
je upućivao na poslijeoperacijske komplikacije samo u bolesnika s lobektomijom, pri čemu je
najjači prediktor bio kvocijent zasićenja kisikom nakon 40 stuba i trajanje testa (+omjer
vjerojatnosti likelihood ratio, LR, 2,4; 95% raspon pouzdanosti confidence interval, CI, 1,71-
3,38; -LR, 0,53; 95% CI, 0,38-0,76). Jedini značajan prediktor za incidentne poslijeoperacijske
komplikacije u bolesnika s drugim vrstama operacije bio je broj dana provedenih na mehaničkoj
ventilaciji (P=0,006).
Zaključak Test uspinjanja uza stube treba primijeniti u rutinskoj kliničkoj praksi kao standardni
test za procjenu rizika i predviđanje razvoja poslijeoperacijskih komplikacija u bolesnika s rakom
pluća koji su odabrani za elekrivnu resekciju pluća (lobektomiju). Za razliku od spirometrije, taj test
otkriva ozbiljnije poremećaje prijenosa kisika koji su osnova susljednom razvitku
kardiopulmonarnih poslijeoperaciskih komplikacija u toj podskupini bolesnika.
Celotno besedilo
Dostopno za:
DOBA, IZUM, KILJ, NUK, PILJ, PNG, SAZU, SIK, UILJ, UKNU, UL, UM, UPUK
23.
Sexual Life after Cervical Carcinoma Buković, Damir; Strinić, Tomislav; Habek, Mario ...
Collegium antropologicum,
06/2003, Letnik:
27, Številka:
1
Paper
Odprti dostop
The aim of this study is to determine the differences in sexual life of women with cervical
cancer after surgery and radiation therapy. A total of 210 patients treated for cervical
cancer at the ...Department of Obstetrics and Gynecology, School of Medicine, University
of Zagreb, Croatia between March 2001 and March 2003 were asked to fill in the
questionnaire. Sexual life had worsened in 42.86% of the surgical patients, as had in
25.00% of irradiated patients (p<0.01). The main reason of sex life impairment was fear
of pain (55.55% and 42.86%, respectively (p>0.05)). More than 80% of patients didn’t notice
any changes in their partner’s behavior. Almost every third woman felt certain
change in her »body image«, similar in both groups (p>0.05). Need for consultations regarding
sex life after diagnosis were recognized by 71.43% of patients. In conclusion we
can say that considerable amount of attention should be given to psychological and sexual
aspects of recovery of patients, because those aspects can significantly influence patients
rehabilitation and prognosis.
Published data indicate that during the last decades there is a possible change in the pattern of sensitization to different
aeroallergens in adult population with atopy. The aim of this ...investigation was based on the hypothesis that during
last 15 years there has been a change in the structure of prevalence of sensitization to different aeroallergens in adult population
of Zagreb and its surroundings with atopy. Medical records from outpatient allergy clinic were screened for the
period 1991.–2004.We included 794 patients during years 1991–1994, 814 patients during years 1995–1999, and 969 patients
during years 2000–2004. Following data were analyzed: age, gender, education level, residence, referral diagnosis,
dominant symptoms, results of skin-prick test (SPT), total and specific serum immunoglobulin E. As risk factors for allergic
sensitization we determined the decade of birth (p<0.0001), male gender (p<0.008), level of education (p<0.0001),
and place of residence (p<0.05). Proportion of sensitized individuals to pollen significantly increased from the period
1991–1994 towards 2000–2004 (p<0.001 for the trend) with a significant increase in the proportion of sensitized individuals
to weed pollen (p=0.002 for the trend) while the proportion of sensitized to other two groups of pollen (grasses and
trees) was not significantly different. A significant increase in the proportion of sensitized individuals was determined
for sensitization to ragweed pollen (p=0.004 for the trend), and to mugwort (p=0.005 for the trend). Despite all its limitations
primarily based on the selection bias the results of this study are conclusive about the significant change in the proportion
of sensitization to different aeroallergens and different pollen groups and individual pollen species during the
investigated 15-year time interval.
