Izhodišče: V začetku leta 2023 smo v okviru klicnega centra vzpostavili zdravstveno svetovanje z namenom opolnomočenja in podpore bolnikov ter njihovih bližnjih. V raziskavi smo analizirali pogostost ...in stopnjo pojavljanja simptomov, povezanih z boleznijo in zdravljenjem, z uporabo ocenjevalnega protokola in nadaljnjih napotitev glede na izraženost težav. Metode: Izvedena je bila retrospektivna analiza telefonskih klicev na linijo zdravstvenega svetovanja v klicnem centru od 1. 10. 2023 do 31. 1. 2024. Za zbiranje podatkov o klicateljih je bilo potrjeno in uporabljeno ocenjevalno orodje v podatkovni bazi Redcap. Za izračun odstotnih deležev smo uporabili program Microsoft® Excel® for Office 365 in opisno statistiko. Rezultati: Vzorec je vključeval 144 telefonskih klicev, kar je predstavljalo 60 % telefonskih klicev bolnikov in 39 % klicev bolnikovih bližnjih. Vzrok telefonskih klicev je bil v 60,4 % posledica neželenih učinkov sistemskega zdravljenja, ki so bili najpogostejši do tedna dni od prejetja zadnjega zdravljenja. V analizi telefonskih klicev so bili najpogosteje izraženi simptomi bolečina (10 %), slabost (10 %), izguba apetita (7 %), driska (7 %). Na podlagi tega je bilo izvedenih 144 zdravstvenih svetovanj, 87 napotitev na osebnega zdravnika ali lečečega onkologa in 14 napotitev na nujno medicinsko pomoč. Zaključek: Zdravstveno svetovanje na daljavo je treba uporabiti kot priložnost za zagotavljanje dostopnosti do informacij in pravočasne zdravstvene oskrbe prek informacijskih in telekomunikacijskih sistemov, saj vpliva na spodbujanje samooskrbe, zmanjšanje števila hospitalizacij, znižanje stroškov zdravstvene oskrbe in nenazadnje na kakovost življenja onkoloških bolnikov.
OBRAVNAVA OTROKA Z NUJNIM STANJEM Vrankar, Ana; Primec, Maja; Fujs, Nada ...
Slovenska pediatrija,
12/2021, Letnik:
28, Številka:
4
Journal Article
Recenzirano
Odprti dostop
Nujna stanja se pri otroku kažejo kot odpovedovanje ene ali več življenjskih funkcij in bi brez takojšnjega ukrepanja vodila v hujšo prizadetost ali celo v smrt. Pomembni nalogi medicinske ...sestre/zdravstvenega tehnika sta prepoznavanje življenjsko ogrožujočega stanja ter hitro in pravilno ukrepa-nje. Na Pediatrični kliniki Univerzitetnega Kliničnega centra Ljubljana od leta 2010 deluje Oddelek urgentne pediatrije kot 24-urni sprejemni center klinike. Otrok, ki pride v urgentno ambulanto brez napotnice ali z napotnico zdravnika druge specialnosti, se zglasi v sprejemni ambulanti, kjer poteka triaža. Triažo po načelih Manchesterskega triažnega sistema v urgentni pediatriji izvajajo medicinske sestre/zdravstveni tehniki s posebnimi znanji. Nujna stanja v pediatriji so številna. V prispevku predstavljamo najpogostejša življenje ogrožajoča stanja, kot so epileptični status, akutna dihalna stiska, paroksizmalna supravetrikularna tahikardija in diabetična ketoacidoza. Predstavljamo vlogo medicinske sestre/zdravstvenega tehnika pri obravnavi otroka z nujnim stanjem, lestvice za ocenjevanje bolečine in vlogo medicinske sestre/zdravstvenega tehnika pri obravnavi otroka z bolečino. Obravnava nujnih stanj je velik izziv za vsak zdravstveni tim ter zahteva od medicinskih sester/zdravstvenih tehnikov nenehno izobraževanje in obnavljanje pridobljenih veščin.
Kirugija glave in vratu med pandemijo covida-19 Zore, Sara Bitenc; Šifrer, Robert; Mavrič, Ajda ...
Zdravniški vestnik (Ljubljana, Slovenia : 1992),
02/2022, Letnik:
91, Številka:
1-2
Journal Article
Recenzirano
Odprti dostop
Kirurgija glave in vratu med pandemijo covida-19 je za zdravstveni sistem velik izziv. Pred kirurškimi posegi je potrebna ustrezna priprava in poznavanje vseh možnosti zdravljenja, da bolnik in ...zdravstveni delavci ne tvegajo okužbe. Treba je odložiti vse posege, katerih odložitev ne ogroža bolnikovega zdravja. Operacijske posege glede na nujnost delimo v tri skupine – v prvo skupino sodijo urgentni, neodložljivi posegi, v drugo skupino posegi, ki jih lahko odložimo za največ štiri tedne, in v tretjo skupino posegi, katerih odložitev za šest do osem tednov ne vpliva na izid zdravljenja. Pred predvideno operacijo je treba ugotoviti status okužbe bolnika z virusom SARS-CoV-2, razen ob urgentnih posegih, ki jih opravimo ne glede na status okužbe bolnika. Kirurški posegi glave in vratu se med seboj razlikujejo glede na možnost prenosa okužbe z virusom SARS-CoV-2 s pozitivnega bolnika na zdravstvenega delavca; pri tem upoštevamo predvsem verjetnost tvorbe aerosola med posegom. Med posege največjega tveganja sodijo endoskopske preiskave zgornjih dihal in prebavil ter žlez slinavk in operacije v tem področju, ki prekinejo sluznice. Te so: traheotomija, laringektomija, faringektomija, operacija raka ustne votline, transoralna laserska mikrokirurgija, transoralna robotska kirurgija. V skrbi za zdravje zdravstvenega osebja in bolnikov je med kirurškimi posegi nujna dosledna uporaba osebne varovalne opreme ne glede na okuženost bolnika.
Uvod: Kategorizirane udeležence (paciente) množične nesreče je treba označiti, da bodo njihove prioritete prepoznali ostali udeleženci v verigi reševanja. Cilj raziskave je bil proučiti uporabnost ...triažnega kartona, ki je pri množičnih nesrečah v Republiki Sloveniji predpisan s Pravilnikom o službi nujne medicinske pomoči.Metode: Podatki so bili zbrani s pomočjo strukturiranega vprašalnika. V raziskavo je bilo zajetih sedem enot nujne medicinske pomoči na primarni ravni zdravstvene dejavnosti (Gorenjska regija). Med zaposlene v nujni medicinski pomoči je bilo razdeljenih 136 vprašalnikov, pravilno izpolnjenih je bilo 94. Podatki so bili obdelani z opisno in bivariatno statistiko.Rezultati: Raziskava je pokazala, da anketiranci niso prepričani v svojo usposobljenost za uporabo predpisanega triažnega kartona (x = 3,26) ter da triažni karton ni popolnoma neuporaben triažni pripomoček, a ima pomanjkljivosti (x = 3,43). Anketiranci menijo, da bi triažni karton moral imeti možnost označevanja po barvi triažne kategorije (x = 4,00) ter možnost spreminjanja kategorije pacienta, če se le-ta med obravnavo spremeni (x = 3,99). Glede na čas delovanja anketirancev na področju nujne medicinske pomoči se razlikujejo njihova mnenja o potrebnosti triažnih kartonov (p = 0,05) ter usposobljenosti za izvajanje in dokumentiranje triaže (p = 0,04). Anketiranci z daljšo delovno dobo so izrazili statistično značilno večje strinjanje z obema trditvama.Diskusija in zaključek: V prihodnosti bo treba izboljšati raven usposobljenosti izvajalcev nujne medicinske pomoči za uporabo predpisanega triažnega kartona. V Sloveniji potrebujemo vrsto triažnega kartona, ki bo zadostovala trenutnim smernicam posredovanja ob množičnih nesrečah. Raziskava pokaže smiselnost nadaljnjega raziskovanja tega področja.
Some novel triaza Schiff base metal(II) complexes were synthesized and characterized by various spectral techniques. The synthesized compounds were screened for their in vitro antibacterial activity. ...The stoichiometries and formation constants of complexes were determined spectrophotometrically. Density functional theory calculations at different level of DFT and basis set were carried out to investigate the optimized geometry of the ligands and their complexes.
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•Metal (II) Schiff base complexes containing N3 donor system were synthesized.•Spectrophotometric methods were applied to explain the complex formation.•The optimized geometrical parameters were obtained using by DFT calculations.•The antibacterial activity of the synthesized compounds was screened.
Some novel Ni(II), Cu(II) and Zn (II) metal complexes with new triaza Schiff base ligand (N-(2quinolylmethylidene)-4X-2-aminobenzene)imine (where X = Me, Cl, NO2)) have been synthesized. Various spectral techniques such as elemental analysis, magnetic susceptibility, conductivity, 1HNMR, IR, UV–Vis spectra, Mass spectrometry, powder XRD and EDX were used to confirm the structures. It has been found that the Schiff base behaves as a tridentate ligand forming chelates with 1:1 metal:ligand stoichiometry. The prepared Schiff base compounds were screened in vitro for their antibacterial activity against a number of pathogenic Gram positive and Gram negative bacteria, namely S.aureas and E.coli. The complexes show more potent activities than their free ligands. Spectrophotometric method and SQUAD program were applied to extract thermodynamic parameters to explain the complex formation behavior in solution at 25 °C in constant ionic strength (I = 0.1 M NaClO4). Also, density functional theory calculations at different level of DFT and basis set were employed to investigate optimized geometry, vibrational frequency analysis, electronic structure (energy of the HOMO and LUMO, Mulliken atomic charge, dipole moment, hardness and softness, electrophilicity and spectral properties) of the prepared Schiff base compounds. The DFT results showed that proposed structure and stability in ligands and their complexes are in accord with the experimental outcomes.
A new mode of carbene‐catalyzed heteroatom activation and asymmetric reactions is disclosed. The reaction starts with addition of a carbene catalyst to a (benz)imidazole‐derived aldimine substrate. ...Subsequent oxidation and proton transfer lead to the formation of a catalyst‐bound triaza‐diene as the key intermediate, in which the nitrogen atom at a site remote to the catalyst‐substrate bond is activated. This unusual triaza‐diene intermediate then undergoes highly enantioselective reactions with activated ketones through a concerted asynchronous pathway, as supported by mechanistic studies and preliminary density function theory calculation.
A new mode of carbene‐catalyzed activation and reaction of nitrogen atom is disclosed. The reaction starts with the addition of the carbene catalyst to imine to form an aza‐Breslow intermediate to eventually form NHC‐bound triaza‐diene as the key intermediate. This triaza‐diene intermediate then undergoes highly enantioselective reactions with activated ketones through a concerted asynchronous pathway.
Four novel alkaloids of the aaptamine class have been isolated in addition to the known aaptamine, isoaaptamine, demethyl(oxy)aaptamine and its dimethylketal from an unidentified species of ...Indonesian marine sponge of the genus
Xestospongia. Their structures were elucidated on the basis of detailed 1D and 2D NMR spectroscopic data. Their antimicrobial activity was tested towards Gram (+) (
S. aureus), Gram (−) (
E. coli,
V. anguillarum) bacterial strains, a fungus (
C. tropicalis); their cytotoxic activity was evaluated against KB cells.
Four novel alkaloids of the aaptamine class have been isolated from a
Xestospongia sp.
A series of Pt(0)‐η2‐olefin complexes bearing 1,3,5‐triaza‐7‐phosphaadamantane (PTA) or N‐heterocyclic carbenes are prepared following different synthetic strategies depending on the nature of ...coordinated alkene and spectator ligands. These new platinum(0) derivatives have been tested in vitro as anticancer agents toward three different tumor (human ovarian cancer A2780 and A2780cis and K562 myelogenous leukemia) and one non‐tumor (Hacat keratinocytes) cell lines, proving to be in several cases highly and selectively cytotoxic against ovarian cancer cells. Furthermore, this antiproliferative effect is associated with the activation of an apoptosis process.
In particular, complexes equipped with PTA as spectator ligand give comparable IC50 values on A2780 (cisplatin sensitive) and A2780cis (cisplatin resistant) cell lines, indirectly proving that these new Pt(0) substrates act with a mechanism of action conceivably different from cisplatin. This hypothesis is also confirmed by the fact that our compounds, in contrast to cisplatin, are not able to promote erythroid‐differentiation activity on the K562 myelogenous leukemia cell line.
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•Ten inhibitors of the phenyl vinyl sulfone or ethyl acrylate chemotype were prepared.•The potency against four human cathepsins was examined.•The thiol reactivity under physiological ...conditions was estimated.•Compound 6c was identified as a potent cathepsin S inactivator.
A series of inhibitors targeting human cathepsins have been designed and synthesized following a combinatorial approach. The compounds bear an α,β-unsaturated phenyl vinyl sulfone or ethyl acrylate warhead and a peptidomimetic portion aligned to the non-primed binding region. Biochemical evaluation toward four human cathepsins was carried out and the kinetic characterization confirmed an irreversible mode of inhibition. Compound 6c combining the most advantageous building blocks for cathepsin S inhibition was identified as a potent cathepsin S inactivator exhibiting a second-order rate constant of 30600 M−1 s−1.
In the present paper, we have described the synthesis and biological activity of the novel derivatives of imidazo4,5-
bpyridines and triaza-benzo
cfluorenes (
7–
21,
24–
26,
28–
29). A preponderance ...of these compounds exerted strong cytostatic effects on the panel of seven human tumour cell lines in a dose-dependent manner. In particular, imidazo4,5-
bpyridines and triaza-benzo
cfluorenes including 2-imidazolinyl derivatives showed the most potent antitumour activity. Similarly, triaza-benzo
cfluorenes
18 and
20 induced strong growth inhibition of tested tumour cell lines, and showed low cytotoxicity in normal human fibroblasts. DNA interaction studies of these compounds demonstrated that
N-methylated
16 and 2-imidazolinyl
28 triaza-benzo
cfluorenes bind to DNA in an intercalative mode.
A preponderance of imidazo4,5-
bpyridines exerted strong cytostatic effects in a dose-dependent manner. Derivatives bearing 2-imidazolinyl substituent showed the most potent antitumour activity. DNA interaction studies demonstrated that compounds
16 and
28 bind to DNA in an intercalative mode.
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► Novel imidazo4,5-
bpyridine and triaza-benzo
cfluorene derivatives. ► Strong cytostatic effects on the panel of seven human tumour cell lines in a dose-dependent manner. ► Intercalation into ds DNA in direct relation with concentration depended induction of apoptosis observed in SW620 and MiaPaCa-2 cells. ► High potential of some derivatives as novel leads with anticancer potentials for further
in vivo evaluation.
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