: The COVID-19 disease has significantly burdened the healthcare system, including all units of severe patient treatment. Non-intensive care units were established to rationalize the capacity within ...the Intensive Care Unit (ICU) and to create a unit where patients with Acute Respiratory Distress Syndrome (ARDS) could be treated with non-invasive Continuous Positive Air Pressure (CPAP) outside the ICU. This unicentric retrospective study aimed to assess the efficacy of NIV Treatment in Patients of the fourth pandemic wave and how its application affects the frequency and mortality of ICU-treated patients at University Hospital Rijeka compared to earlier waves of the COVID-19 pandemic. Furthermore, the study showcases the effect of the Patient/Nurse ratio (P/N ratio) on overall mortality in the ICU.
: The study was conducted on two groups of patients with respiratory insufficiency in the second and third pandemic waves, treated in the COVID Respiratory Centre (CRC) (153 patients). We also reviewed a cohort of patients from the fourth pandemic wave who were initially hospitalized in a COVID-6 non-intensive unit from 1 October 2021 to 1 November 2022 (102 patients), and some of them escalated to CRC.
: The introduction of the CPAP non-invasive ventilation method as a means of hypoxic respiratory failure treatment in non-intensive care units has decreased the strain, overall number of admissions, and CRC patient mortality. The overall fourth wave mortality was 29.4%, compared to the 58.2% overall mortality of the second and third waves.
: As a result, this has decreased CRC patient admissions and, by itself, overall mortality.
Introduction Nutritional deficiency among the older adult is a widespread concern, significantly affecting their health. The prevalence of malnutrition increases with age, concurrent health ...conditions, and the level of care provided. Hospital stays can affect as 90% of the older adult. Malnutrition can hinder efforts to improve health and regain function in individuals undergoing rehabilitation. This study aims to assess the frequency of malnutrition among geriatric rehabilitation patients. Materials and methods A retrospective quantitative analysis was conducted on 357 patients admitted to the geriatric unit at Lucerne Cantonal Hospital Wolhusen in Switzerland. The patients’ nutritional status was evaluated using the standardized Mini Nutritional Assessment Long Form questionnaire. Results The initial analysis indicated a considerable prevalence of malnutrition among the geriatric population: 31.1% were identified as malnourished (MNA < 17), while an additional 35.8% were at risk of malnutrition (MNA 17–23.5), totaling 66.9% of patients. The Kruskal-Wallis ANOVA test revealed a statistically significant difference in MNA scores among different age groups ( p = 0.035). Statistical analysis also suggested a slightly higher prevalence of malnutrition among female patients. The duration of rehabilitation varied from 20.07 ± 6.93 to 22.20 ± 7.50 days, with longer durations associated with lower MNA scores. A correlation analysis between MNA values and body mass index (BMI) showed a positive correlation coefficient ( r = 0.56), indicating that lower MNA scores were associated with lower BMI and vice versa. Conclusion Malnutrition is prevalent among individuals over 65 years old, highlighting the importance of regular and timely nutritional assessments for geriatric patients to mitigate the complications and enhance prognoses in both acute care and rehabilitation settings. Such assessments can also improve the efficacy of rehabilitation programs and potentially reduce the duration of rehabilitation, thus carrying significant economic implications.
BACKGROUND This study of 60 patients with low back pain (LBP) aimed to compare outcomes following magnetotherapy, ultrasound therapy, laser therapy, and electrotherapy, with and without lumbosacral ...kinesiotherapy, and used the Roland-Morris Disability Questionnaire (RMDQ) and the Oswestry Low Back Pain Disability Questionnaire (OLBPDQ). This was a randomized actively controlled intervention trial of adding kinesiotherapy to a standard physiotherapy for LBP. MATERIAL AND METHODS The research included 60 participants with a diagnosis of chronic non-specific lumbar pain syndrome (CNSLPS) (mean±SD age 58.3±15.4 years, 37 women) LBP randomly assigned (1: 1) to 2 treatment groups. In Group 1, 30 patients were treated with magnetotherapy, ultrasound therapy, laser therapy, and electrotherapy. In Group 2, 30 patients received the same treatments as in Group 1, and also performed kinesiotherapy exercises affecting the lumbosacral spine and adjacent muscles. At baseline and at the end of the study, all participants completed the RMDQ and the OLBPDQ. RESULTS Both groups had significant improvement after therapy. Repeated-measures ANOVA indicated that at the end of treatment there was significantly greater progress and symptom reduction (P<0.001) in Group 2. Patients in Group 2 had a pain reduction of 52.5%, while Group 1 had 25.4% pain reduction (P=0.009). CONCLUSIONS For treatment of disability caused by CNSLPS, physical therapy combined with kinesiotherapy should be a treatment of choice.
Summary
In this study to identify prognostic biomarkers for ischemic stroke (IS) outcome, we monitored monocyte number and monocyte chemoattractant protein (MCP-1) concentration in peripheral blood ...of 44 patients with IS during the week following IS. According to the severity of IS, patients were allocated to three groups: patients with transient ischemic attack (TIA), patients with National Institute of Health Stroke Scale (NIHSS) score ≤ 12, and patients with NIHSS > 12. In patients with NIHSS > 12 statistically significant increased number of monocytes was observed on day 7. MCP-1 plasma concentration initially increased, decreased at day 3 in patients with NIHSS > 12 and increased and restored on day 7. A negative correlation between the number of monocytes and MCP-1 concentration was observed on day 3 after IS. Higher day-7 MCP-1 level was associated with higher modified Rankin Scale (mRS) value (indicating worse outcome) at 90 days post-IS in patients with NIHSS > 12. Our findings suggest that number of monocytes and plasma MCP-1 level could be clinical prognostic biomarkers as early predictors of disease outcome in patients with IS.
Cilj: Cilj rada je predstaviti rezultate ispitivanja studentskih stavova o fizici i njihove povezanosti s usvajanjem koncepata u fizici. Ispitanici i metode: U istraživanju je sudjelovalo 89 ...studenata prve godine Preddiplomskog stručnog studija Fizioterapija, Fakulteta zdravstvenih studija Sveučilišta u Rijeci. Ovom istraživanju, prethodilo je ispitivanje učenika sedmih i osmih razreda jedne riječke osnovne škole (N = 92). Upitnik je sadržavao tvrdnje kojima su izražavani stavovi ispitanika studenata o fizici. Drugi dio upitnika činile su tvrdnje među kojima su bile i česte miskoncepcije u fizici. Miskoncepcije smo podijelili na one koje nastaju zbog jezičnog miješanja pojmova iz svakodnevnog života i znanosti, one koje proizlaze iz korištenja neispravnih pretpostavki za objašnjenje svakodnevnog iskustva te one koje se temelje na nerazumijevanju znanstvenih pojmova i koncepata. Rezultati: Studenti u najvećoj mjeri imaju neutralan stav prema fizici. Postoji statistički značajna razlika u zastupljenosti miskoncepcija prema uzroku njihova nastanaka (Hi-kvadrat; P < 0,001). Najzastupljenijima su se pokazale miskoncepcije nastale poistovjećivanjem izraza iz svakodnevnog života i znanosti, tzv. žargonske miskoncepcije (58 % slučajeva). Utjecaj studentskih stavova na učestalost miskoncepcija pokazao se statistički značajnim za stavove koji ukazuju na to da su ispitanici više usmjereni na memoriranje gradiva i kvantitativne manipulacije nego na uspješno usvajanje znanstvenih pojmova i koncepata. Zaključci: Primjena napredne tehnologije u terapiji i dijagnostici u okviru medicinske skrbi ukazuje na sve veću potrebu za znanjem iz fizike kod studenata zdravstvenih i medicinskih studija. Studenti shvaćaju važnost fizike u svojem obrazovanju i većinom ne iskazuju negativan stav prema fizici. Određene vrste miskoncepcija zadržavaju se tijekom čitavog obrazovnog procesa. Zato treba sprječavati nastanak neznanstvenih koncepata, odnosno ako oni već postoje, treba ih što ranije detektirati i aktivno raditi na njihovom uklanjanju.
Objective: The aim of the paper is to present the results of the study of students’ attitudes towards physics and their relationship with the acquisition of concepts in physics. Subjects and Methods: Eighty-nine students of the first year of undergraduate studies in physiotherapy at the Faculty of Health Studies, University of Rijeka, participated in the study. This study was preceded by a survey of seventh and eighth grade students of an elementary school in Rijeka (N=92). The questionnaire contained statements expressing the attitude of the surveyed students towards physics. The second part of the questionnaire consisted of statements that included common misconceptions in physics. We divided the misconceptions into those that arise from the linguistic mixing of terms from everyday life and science, those that result from the use of incorrect assumptions to explain everyday experiences, and those that are based on a misunderstanding of scientific terms and concepts. Results: Students have predominantly neutral attitudes toward physics. There is a statistically significant difference in the prevalence of misconceptions according to the cause of their occurrence (chi-square; P<0.001). The most prevalent misconceptions were those arising from the identification of expressions used in everyday life and science, the so-called jargon misconceptions (58% of cases). The influence of student attitudes on the frequency of misconceptions proved statistically significant for attitudes indicating that respondents focus more on memorising data and quantitative manipulations than on successfully acquiring scientific terms and concepts. Conclusions: The application of advanced technologies in therapy and diagnostics in the context of medical care indicates an increasing need for physics knowledge among students in health and medical programmes. Students are aware of the importance of physics to their education and, for the most part, do not have negative attitudes toward physics. Certain types of misconceptions persist throughout the educational process. Therefore, the emergence of unscientific concepts should be prevented, but if they already exist, they should be identified as early as possible and active efforts should be made to eliminate them.
Cilj: prezentacija principa, tehnike i rezultata artroskopskog liječenja oštećene tetive subskapularisa. Ispitanici i metode: u razdoblju od 1. siječnja 2015. do 1. siječnja 2019. učinili smo 289 ...operacija ramena zbog oštećenja tetiva rotatorne manžete. Lezije tetive subskapularisa podijelili smo po Lafosseu i liječili artroskopski ili artroskopski asistirano. Analizirali smo rezultate isključivo artroskopskog liječenja 31 dostupnog pacijenta s lezijom tetive subskapularisa kojima je od operacije do procjene prošlo 6 i više mjeseci. Pacijenti su ispitani o prije i poslijeoperacijskim mogućnostima i tegobama po upitnicima Oxford shoulder score (OSS) i Subjective shoulder value (SSV). Rezultati: kod 89 slučajeva (30,79 %) našli smo oštećenje tetive subkapularisa od kojih 8 izoliranih (2,76 % svih lezija manžete) i 81 udružen s oštećenjem ostalih tetiva manžete. Kod 72 pacijenta (80,9 %) učinili smo artroskopsku operaciju, a u 17 slučajeva otvorenu uz artroskopsku asistenciju. 31 dostupan pacijent iz grupe artroskopski operiranih procijenjen je 17,96 ± 8,25 mjeseci od operacije upitnicima Oxford shoulder score i Subjective shoulder value (odziv 43,05 %). Oxford shoulder score značajno se povećao s 14,19 preoperativno na 36,74 postoperativno (p = 0,002). Subjective shoulder value također se značajno povećao s 27,32 na 82,33 (p << 0,001). Zaključak: artroskopsko liječenje oštećenja tetive subskapularisa, izolirano ili udruženo s ostalim lezijama manžete, predstavlja siguran i efikasan način liječenja s odličnim rezultatima.
Aim: presentation of principles, techniques and results of arthroscopic subscapularis tendon repairs. Patients and methods: In the period from 1st January 2015 until 1st January 2019 we performed 289 rotator cuff repair surgeries. The subscapularis tendon lesions were found, and sorted according to Lafosse classification and operated arthroscopically or arthroscopically assisted. After a minimum of 6 months after surgery we assessed and analysed the results of all arthroscopic treatments of 31 available patients with a subscapularis tendon lesion. The patients were examined for preoperative and postoperative capabilities and difficulties according to the Oxford shoulder score and Subjective shoulder value questionnaires. Results: In 89 cases (30.79%) we found subscapularis tendon tears from which 8 isolated (2.76% of all cuff tears) and 81 combined with other rotator cuff tears. In 72 cases (80.9%) we performed all arthroscopic repair and in 17 cases (19.1%) an open surgery with or without arthroscopic assistance. From all arthroscopic groups of patients, 31 of them were evaluated 17.96 ± 8.25 months postoperatively with patient-based Oxford shoulder score and Subjective shoulder value (response rate 43.05%). Oxford shoulder score improved significantly from 14.19 preoperatively to 36.74 postoperatively (p=0.002). Subjective shoulder value also increased significantly from 27.32 to 82.33 (p<<0.001). Conclusion: Arthroscopic repair of a subscapularis tendon tear, isolated or combined with other rotator cuff tears, represents a safe and effective a surgical method with an excellent outcome.
Invasive neurosurgical treatment or minimally invasive neurosurgical treatment are methods of choice for the treatment of patients with drug resistant epilepsy. The aim of this study was to evaluate ...the impact of neurosurgical treatment and the quality of life of patients with drug resistant epilepsy and to determine what are the potential predictors of quality of life of patients with drug resistant epilepsy one year after neurosurgical treatment.
The research was performed at the Referral Centre for Epilepsy, Department of Neurology, University Hospital Centre Zagreb from February 2015 to February 2020 with Ethics commitee approval. The study included 96 patients with drug resistant epilepsy who were examined for the quality of life before and one year after neurosurgical treatment using the form questionnaire "Quality of life in epilepsy" (QOILE-31) validated Croatian 1.0 version and the questionnaire to assess the degree of depression "Beck Depression Inventory I" (BDI-I) validated Croatian version.
Of 96 patients with drug resistant epilepsy one year after neurosurgical treatment 46 (47.9%) patients remained completely free from epileptis seizures. Wilcoxon equivalent pair test showed that the number of epileptic seizures one year after neurosurgical treatment was significantly lower (median before neurosurgical treatment is 10; and after neurosurgical treatment is 1, p<0.001). The most informative potential statistically significant predictor variables of quality of life based on the criterion variables QOLIE-31 and BDI-I are: total disease duration in years (p=0.034), patient age (p=0.042), number of antiepileptics one year after neurosurgical treatment (p=0.001), the number of epileptic seizures per month (p=0.016), and social welfare rights (p=0.045).
Neurosurgical treatment of patients with drug resistant epilepsy significantly reduces the number of epileptic seizures which significantly improves their overall quality of life one year after neurosurgical treatment.
Neurosurgical treatment is one of important way to cure drug resistant epilepsy. After invasive EEG monitoring and the invasive neurosurgical treatment (resective surgery) there are possible ...complications (intracranial haemorrhage, cortical lesions and infections), however there are possible neuropsyhologic outcomes such as memory outcomes, language outcomes and psychiatric outcomes. The quality of life in epilepsy (QOLIE-31) scale is a self-completed questionnaire which contains seven subscales which address the following aspects: emotional well-being, social functioning, energy/fatigue, cognitive functioning, seizure worry, medication effects and overall quality of life. Our study aimed to examine the quality of life in patients with drug resistant epilepsy who had undergone invasive EEG monitoring and resective neurosurgical treatment through the application of the QOLIE-31 scale.
The study included 9 patients with drug resistant epilepsy who had undergone invasive EEG monitoring followed by resective neurosurgical treatment in the period from 2010 to 2016, and the control group of 15 patients with drug resistant epilepsy who had not undergone neurosurgical procedures. Clinical variables of interest for this study were obtained through phone contact, and the QOLIE-31 scale was applied.
In the domaine of seizure worry, patients in the examined group were more concerned about the seizures (54.7) compared to the examined group (80), as well as in the overal quality of life (examined group 57.5; control group 77.5). Patients in the control group complained more in the domain of antiepileptic therapy (score 70.7) than patients in the examined group (score 100). In the other domains: emotional well-being, energy/fatigue, cognitive functioning, and social functioning there were minor deviations between the examined and control groups.
There was no statistically significant difference between individual QOLIE-31 questionnaires, as well as between the two groups of respondents.
Cilj: Važnost istraživanja socioemocionalnog razvoja djeteta ogleda se u prevenciji rizika odstupanja u socioemocionalnom razvoju
s ciljem rane intervencije u radu s djecom koja odstupaju od urednog ...razvoja ili pripadaju skupini djece s neurorizikom. Cilj rada bio
je utvrditi valjanost i pouzdanost skale socioemocionalne procjene u svrhu standardizacije mjernog instrumenta u Republici Hrvatskoj i utvrditi stupanj socioemocionalnog razvoja dojenčadi s ciljem utvrđivanja eventualnih odstupanja od urednog razvoja i faktora koji utječu na socioemocionalni razvoj.
Metode: U istraživanju se primjenjivala skala socioemocionalne procjene kao mjerni instrument za procjenu socioemocionalnog
razvoja dojenčeta od 2-18 mjeseci kao instrument ranog prepoznavanja odstupanja u razvoju. U ispitivanju je sudjelovalo 63 roditelja s područja Primorsko-goranske županije.
Rezultati: Psihometrijske karakteristike socioemocionalne skale pokazale su da je instrument pouzdan za procjenu socioemocionalnog razvoja s Cronbach α=0,92. Faktorskom analizom je ispitana valjanost. Ne postoje statistički značajne razlike u socioemocionalnom razvoju djece s obzirom na porođajnu masu, tip trudnoće, vrijeme i tip poroda i stanje djeteta, što pokazuje da su roditelji djece
osigurali sve preduvjete poticanja urednog socioemocionalnog razvoja bez obzira na eventualne faktore rizika.
Zaključak: Kroz dobivene rezultate vidljivo je da upitnik za procjenu socioemocionalnog razvoja u ovom istraživanju valjan i pouzdan te da je pogodan za postupak standardizacije u Hrvatskoj. Istraživanja su jasno pokazala važnost rane procjene socioemocionalnog razvoja djeteta s ciljem rane intervencije u prevenciji odstupanja u razvoju. Važnost standardizacije upitnika osigurava njegovu primjenu u radu patronažnih sestara koje provode procjenu zdravstvenog stanja i razvoja dojenčeta u sklopu sveobuhvatne
patronažne skrbi za dojenče.
PDF
