Dihalni premori (ali apnoične atake, pavze, apneje) zaradi nedonošenosti so ena najpogosteje postavljenih diagnoz v neonatalnih intenzivnih enotah. Dihalni premori so prehodne narave in nastanejo ...zaradi motnje v prilagoditvi dihalnega centra in dihal na zunajmaternično življenje ter nezrelosti receptorjev, ki zaznavajo delne tlake kisika in ogljikovega dioksida. Pomembno podaljšujejo trajanje hospitalizacije ter imajo lahko škodljive dolgoročne posledice.V preglednem prispevku opredeljujemo dihalne premore zaradi nedonošenosti. Predstavljamo klasifikacijo, epidemiologijo, patofiziološko ozadje in nadzorovanje srčno-dihalnih funkcij nedonošenčkov. Opisujemo, kako postaviti diagnozo dihalnih premorov zaradi nedonošenosti, sekundarne vzroke apneje in diferencialnodiagnostične možnosti ter nekatera stanja, ki so povezana z dihalnimi premori zaradi nedonošenosti. Velik del prispevka je namenjen predstavitvi možnih terapevtskih ukrepov, med njimi tudi takih, ki še niso prodrli v splošno klinično prakso, saj so za potrditev njihove učinkovitosti potrebne nadaljnje raziskave. Sklepni del članka ponuja pregled raziskav, v katerih so proučevali genetsko podlago dihalnih premorov zaradi nedonošenosti in predstavitev njihovih rezultatov.
Heart rhythm disorders (HRD) are often present in patients visiting their family physician (FP). Dealing with their problems is not always simple, efficient and cost effective. The aim of this paper ...is to review the existing literature about the use and experience of telecardiology in patients experiencing HRD.
We conducted a review of literature in PubMed biographical databases (MeSH thesaurus), Web of Science and Cochrane, between 1995 and 2019. We included original articles in English that describe the use of telecardiology at primary and secondary healthcare levels. Exclusion criteria are those publications that discuss heart failure or observation of the activity of pacemakers or defibrillators and the age of patients under 18 years. A total of 19 papers met the inclusion criteria, thirteen of them were original scientific articles and we included them in the analysis.
Use of telemedicine can shorten the time from diagnosis to the necessary treatment (2/13), telemedicine can reduce mortality in patients with acute myocardial infarction (4/13), it can shorten the time to diagnose atrial fibrillations (4/13), it can help determine the diagnosis for patients complaining about heart rhythm disorders which were not detected on the standard ECG recording (2/13) and can also help identify cardiac causes for syncope or collapse (2/13). All studies have confirmed that the use of telecardiology significantly reduces the number of unnecessary referrals to a cardiologist or hospitalization, and shortens the time needed to treat patients with life-threatening conditions.
The use of telecardiological techniques increases the quality and safety of work in managing patients with cardiovascular disease in FP practice. Usage of telecardiologic devices can also save money and bridge the gap between the primary and secondary healthcare levels.
Mood disorders are becoming one of the major public health problems and care for good mental health is substantially affecting almost all dimensions of our lives. However, the lay and professional ...public have the most contrasting attitudes and beliefs about mental disorders compared to other chronic non-communicable diseases. Persisting stereotypes and myths about mental disorders as a rule hinder professional help-seeking, interest and belief in their effective treatment. This problematic is discussed in the multi-authored monograph ('More Knowledge about Mood Disorders for Escaping the Labyrinth: Experiences and Reflections'). In the 21 scientific and professional essays, the authors of various academic backgrounds reflect upon mental health issues, focusing on contemporary mood disorders. Moreover, the first results of the newly introduced and innovative mental health promotion programme in Slovenia - With Raised Mental Health Literacy to Better Managing Mood Disorders (acronym OMRA) - are presented, as well. The monograph is good food for thought for the lay and professional public.
Medically unexplained symptoms and chronic functional syndromes are common but few healthcare professionals have had formal training about their connection to psychosocial issues. A systematic ...approach to diagnosis and treatment based on experience with over 7000 of these patients is described. Outcomes improve with assessment for and treatment of current life stresses, the prolonged impact of adversity in childhood and somatic presentations of depression, post-traumatic stress, and anxiety disorders.
Aim. The aim of this paper is to compare the prevalence of voice disorders and the risk factors for them in different occupations with a vocal load in Slovenia.
Methods. A meta-analysis of six ...different Slovenian studies involving teachers, physicians, salespeople, catholic priests, nurses and speech-and-language therapists (SLTs) was performed. In all six studies, similar questions about the prevalence of voice disorders and the causes for them were included.
Results. The comparison of the six studies showed that more than 82% of the 2347 included subjects had voice problems at some time during their career. The teachers were the most affected by voice problems. The prevalent cause of voice problems was the vocal load in teachers and salespeople and respiratory-tract infections in all the other occupational groups. When the occupational groups were compared, it was stated that the teachers had more voice problems and showed less care for their voices than the priests. The physicians had more voice problems and showed better consideration of vocal hygiene rules than the SLTs. The majority of all the included subjects did not receive instructions about voice care during education.
Conclusions. In order to decrease the prevalence of voice disorders in vocal professionals, a screening program is recommended before the beginning of their studies. Regular courses on voice care and proper vocal technique should be obligatory for all professional voice users during their career. The inclusion of dysphonia in the list of occupational diseases should be considered in Slovenia as it is in some European countries.
Cilj. Primerjati prevalenco glasovnih motenj in dejavnikov tveganja za njihov nastanek pri različnih poklicih v Sloveniji.
Metode. Narejena je bila meta analiza šestih različnih raziskav v Sloveniji, ki so vključevale zdravnike, učitelje, prodajalce, duhovnike, medicinske sestre in logopede. V vseh študijah so bili uporabljeni podobni vprašalniki, ki so zajemali vprašanja o pojavu glasovnih motenj in razlogih zanje.
Rezultati. Primerjava raziskav je pokazala, da je 82% od 2.347 vključenih že imelo glasovne težave v svoji karieri. Največ težav z glasom so imeli učitelji. Glavni vzrok hripavosti pri učiteljih in prodajalcih je bila glasovna obremenitev, pri preostalih poklicih pa akutne respiratorne okužbe. Primerjava poklicev je pokazala, da imajo učitelji več glasovnih težav kot duhovniki, manj tudi skrbijo za svoj glas. Primerjava zdravnikov in logopedov je pokazala, da imajo zdravniki več glasovnih motenj, čeprav bolje skrbijo za svoj glas. Večina vprašanih ni dobila navodil glede skrbi in rabe glasu med svojim študijem.
Zaključki. Za zmanjšanje pojava glasovnih motenj bi bili potrebni presejalni pregledi kandidatov za poklice z glasovno obremenitvijo še pred začetkom študija. Poklicni govorniki bi se morali tudi med opravljanjem svojega poklica dodatno izobraževati o skrbi za glas in pravilni vokalni tehniki. Glasovne motnje bi morali vključiti v seznam poklicnih bolezni, tako kot je to urejeno že ponekod v Evropi.
Namen raziskave. Pri mladih s sladkorno boleznijo tipa 1 je prisotno večje tveganje za razvoj depresivne motnje, pogosto pa ti bolniki poročajo tudi o obremenjenosti s sladkorno boleznijo. Zato se ...priporoča psihološko presejalno testiranje. V letu 2012 smo presejalno testiranje za mladostnike in mlade odrasle uvedli tudi v Sloveniji ter prve rezultate predstavili v tej raziskavi.
Aim. Youth and young adults with type 1 diabetes are at a great risk for developing depression and diabetes specific distress, therefore, systematic psychological screening is recommended. Routine ...psychological screening was implemented in Slovene diabetes clinic for children, adolescents and young adults in 2012. One-year results are presented.
Methods. Adolescents and young adults (N = 159, aged 11 - 25 years), attending the obligatory yearly educational outpatient visit at University Children’s Hospital, Ljubljana, Slovenia, were examined using questionnaires measuring depression (depression scale from Slovene version of Trauma Symptom Checklist for Children) and diabetes distress (Diabetes Distress Screening Scale). Six additional items were included to assess the fear of hypoglycemia and family support. Socio-demographic and diabetes-related data were collected. Questionnaires were analyzed by a psychologist, and the patients that scored above cut-off point were invited to an individual psychological assessment.
Results. Of the sample, 1.3 % reached the threshold for elevated depressive symptoms, and 32.7 % reported significant diabetes distress. The need for psychological support from a specialist was expressed by 5.0 %. There were statistically significant associations between all psychological variables; moreover, better glycemic control was associated with lower diabetes distress and better family support. Nine patients (5.7 %) started with psychological treatment according to the referrals after screening.
Conclusions. The results after one year of psychological screening in Slovene type 1 diabetes population displayed small rates of depression and a large proportion of diabetes distress. Only a small percentage of patients attended the offered individual psychological assessment.
Namen raziskave. Pri mladih s sladkorno boleznijo tipa 1 je prisotno večje tveganje za razvoj depresivne motnje, pogosto pa ti bolniki poročajo tudi o obremenjenosti s sladkorno boleznijo. Zato se priporoča psihološko presejalno testiranje. V letu 2012 smo presejalno testiranje za mladostnike in mlade odrasle uvedli tudi v Sloveniji ter prve rezultate predstavili v tej raziskavi.
Metode. Rednega letnega edukacijskega pregleda na Kliničnem oddelku za endokrinologijo, diabetes in bolezni presnove Pediatrične klinike se je udeležilo 175 mladostnikov in mladih odraslih, starih od 11 do 25 let. Od teh jih je 159 rešilo presejalni vprašalnik, ki je ocenjeval depresivne simptome (lestvica depresije iz vprašalnika o travmatiziranosti otrok in mladostnikov) in obremenjenost s sladkorno boleznijo (presejalna lestvica za oceno obremenjenosti s sladkorno boleznijo). Dodanih je bilo šest postavk za oceno strahu pred hipoglikemijo in podporo družine. Zbrali smo podatke o sladkorni bolezni in sociodemografskem ozadju. Psiholog je pregledal vprašalnike in podal kratko mnenje, mladostnike in odrasle, ki so presegli kritično število točk, pa smo povabili na posvet in dodatno obravnavo k psihologu.
Rezultati. Rezultate, ki pomenijo povečano tveganje za depresijo, je doseglo 1,3 % udeležencev, 32,7 % udeležencev pa je poročalo o pomembni obremenjenosti s sladkorno boleznijo. Željo po psihološki obravnavi je izrazilo 5 % preiskovanih. Prisotna je bila statistično pomembna povezanost med vsemi psihološkimi parametri. Dobra presnovna urejenost je bila povezana z manjšo obremenjenostjo s sladkorno boleznijo in boljšo podporo družine. Devet (5,7 %) mladih je po presejalnem psihološkem testiranju pričelo obravnavo pri psihologu.
Zaključki. Prvo leto presejalnega psihološkega testiranja mladih s sladkorno boleznijo tipa 1 je pokazalo nizek delež udeležencev z depresivnimi simptomi in visok delež pacientov, ki so izrazito obremenjeni s sladkorno boleznijo. Le majhen delež udeležencev se je odzval na povabilo na obravnavo pri psihologu in začel obravnavo.
Uvodni in zaključni odstavek zaslužita posebno pozornost, saj močno vplivata na učinek celotnega pisnega sestavka. Naloga uvodnega odstavka je, da napove glavno misel sestavka, pa tudi, da pri bralcu ...zbudi zanimanje in ga tako prepriča, naj prebere celotno besedilo. V zaključku pisec bralca še enkrat spomni na glavno temo sestavka, hkrati pa poskrbi za zaključne misli, ki bodo bralcu ostale v spominu tudi potem, ko besedilo odloži. Članek obravnava težave, s katerimi se pri pisanju uvodnih in zaključnih odstavkov srečujejo dijaki in študentje angleščine. Razdeljene so v tri skupine: motnje v koherenci, neustrezna dolžina in neustrezen slog. Članek vsebuje tudi tipe vaj, s pomočjo katerih lahko študentje opisane težave uzavestijo in postopno odpravijo.
ADHD in children and adolescents is a neurodevelopmental disorder, which is recognized by the clinicians all over the world. ADHD is a clinical diagnosis based on reliable history, reports from home ...and school and a physical examination to rule out any other underlying medical conditions. ADHD can cause low self-esteem in the child and impair quality of life for the child and the family. It is known that ADHD is a chronic illness and that clinicians needed to use chronic illness principles in treating it. The last 10 years have seen an increase in the number of medications that have been approved for the treatment of ADHD. This book has tried to address some of the issues in ADHD.
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