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1.
Dynamics of capillary lactate levels in patients with out-of-hospital cardiac arrest
Vitka Vujanović, Vesna Borovnik Lesjak, Dušan Mekiš, Matej Strnad, 2023, izvirni znanstveni članek

Opis: Background and Objectives: An effective strategy for cardiopulmonary resuscitation should be based on tissue perfusion. Our primary aim was to determine the association between capillary lactate values and initial rhythm as well as the probability of the return of spontaneous circulation in out-of-hospital cardiac arrest patients. Materials and Methods: This prospective observational cohort study included all patients with non-traumatic out-of-hospital cardiac arrest, older than 18 years, resuscitated by a prehospital emergency medical team between April 2020 and June 2021. Capillary lactate samples were collected at the time of arrival and every 10 min after the first measurement until the time of the return of spontaneous circulation (ROSC) or, if ROSC was not achieved, at the time of declaring death on the scene. Results: In total, 83 patients were enrolled in the study. ROSC was achieved in 28 patients (33.7%), 21 were admitted to hospital (26.3%), and 6 (7.23%) of them were discharged from hospital. At discharge, all patients had Cerebral Performance Category Scale 1 or 2. Initial capillary lactate values were significantly higher in patients with a non-shockable rhythm compared to the group with a shockable rhythm (9.19 ± 4.6 versus 6.43 ± 3.81; p = 0.037). A significant difference also persisted in a second value taken 10 min after the initial value (10.03 ± 5,19 versus 5.18 ± 3.47; p = 0.019). Capillary lactate values were higher in the ROSC group and non-ROSC group at the time of restored circulation (11.10 ± 6.59 and 6.77 ± 4.23, respectively; p = 0.047). Conclusions: Capillary lactate values are significantly higher in patients with a non-shockable first rhythm in out-of-hospital cardiac arrest (OHCA). There is also a significantly different rise in capillary lactate levels in patients with ROSC.
Ključne besede: cardiopulmonary resuscitation, out-of-hospital cardiac arrest, lactate, return of spontaneous circulation
Objavljeno v DKUM: 16.04.2024; Ogledov: 75; Prenosov: 0
.pdf Celotno besedilo (1,17 MB)
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The Importance of Monitoring the Work-Life Quality during the COVID-19 Restrictions for Sustainable Management in Nursing
Mateja Lorber, Mojca Dobnik, 2023, izvirni znanstveni članek

Opis: The aim of this study was to investigate the work-life quality and related workplace factors of nursing employees working in hospitals during the COVID-19 restrictions. Employees in nursing carry out nursing care at various levels of healthcare. Work-life quality refers to an individual’s feelings concerning work and outcomes and depends on different working characteristics and conditions. Quantitative research based on a cross-sectional study was used. This cross-sectional study included 486 employees in nursing from four Slovenian acute care hospitals. The results showed that most employees in nursing assessed the work-life quality on a moderate level: 76% were satisfied with their work, and 89% assessed their well-being at the workplace as positive. Considering the leaders’ support, the number of patients, adequate information, teamwork, working position, use of days off, and equipment for safe work, we can explain the 53.5% of the total variability of work-life quality. We also found that work-life quality had an essential effect on well-being at the workplace (β = 0.330, p < 0.001) and work satisfaction (β = 0.490, p < 0.001) of employees in nursing. Work-life quality refers to an employees’ feelings about their workplace, and its monitoring is important for higher employees’ well-being and health. For management and policymakers in nursing, it is important to design strategies to ensure an adequate number of competent employees and establish a supportive leadership system. Work-life quality is an important factor in the recruitment and retention of the nursing workforce. Flexible working conditions and policy changes can improve work-life quality and balance. Nursing management must understand the influencing factors of work-life quality to improve nursing employee retention strategies.
Ključne besede: hospital, work-life quality, nursing, well-being, COVID-19
Objavljeno v DKUM: 27.11.2023; Ogledov: 362; Prenosov: 17
.pdf Celotno besedilo (308,59 KB)
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4.
Diagnosis and treatment of osteoporosis in patients with osteoporotic hip fracture
Mateja Krajnc, Vojislav Ivetić, 2021, izvirni znanstveni članek

Ključne besede: osteoporosis, osteoporotic hip fracture, family medicine, regional hospital
Objavljeno v DKUM: 22.01.2023; Ogledov: 493; Prenosov: 41
.pdf Celotno besedilo (339,10 KB)
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5.
Psychiatric clinic in Podgorica
Jovana Vuletić, 2019, magistrsko delo

Opis: The theme of this master’s project is research on the significance and influence of the architecture of psychiatric facilities on the process of treatment of people with mental disorders. The capital of Montenegro, Podgorica, has been struggling with a lack of adequate facilities for its Psychiatric Clinic, which has not had the capacity to hospitalise, or provide treatment and rehabilitation services to mentally ill persons for years. With the aim of gaining an understanding of the best practices that could be transferred to the new Psychiatric Clinic, this paper delves into the historic development of psychiatry, treatment and types of hospitals, as well as the position of patients in the society. The great revolution or milestone in psychiatry, the deinstitutionalisation process, caused the closing-down of many psychiatric clinics around the world. Mental health centres that do not force long-term hospitalisation on patients, but offer a wide range of therapeutic, rehabilitation and recreational activities, started to emerge as an alternative. The main goal of this project is to create a clinic in Podgorica that would use a modern architectural language and concept to break environmental prejudices, while providing patients with all the necessary contents for a pleasant and safe stay. The project aims to create a clinic that would respect the function and dynamics of the site, while maintaining its own irreplaceability and uniqueness within that environment.
Ključne besede: psychiatry, arhitecture, psyhiatric hospital, deinstitucionalization, stigmatization, clinic centre Montenegro
Objavljeno v DKUM: 05.02.2019; Ogledov: 1480; Prenosov: 323
.pdf Celotno besedilo (73,20 MB)

6.
Vasopressin improves outcome in out-of-hospital cardiopulmonary resuscitation of ventricular fibrillation and pulseless ventricular tachycardia: a observational cohort study
Štefek Grmec, Štefan Mally, 2006, izvirni znanstveni članek

Opis: Introduction: An increasing body of evidence from laboratory and clinical studies suggests that vasopressin may represent a promising alternative vasopressor for use during cardiac arrest and resuscitation. Current guidelines for cardiopulmonary resuscitation recommend the use of adrenaline (epinephrine), with vasopressin considered only as a secondary option because of limited clinical data. Method: The present study was conducted in a prehospital setting and included patients with ventricular fibrillation or pulseless ventricular tachycardia undergoing one of three treatments: group I patients received only adrenaline 1 mg every 3 minutes; group II patients received one intravenous dose of arginine vasopressine (40 IU) after three doses of 1 mg epinephrine; and patients in group III received vasopressin 40 IU as first-line therapy. The cause of cardiac arrest (myocardial infarction or other cause) was established for each patient in hospital. Results: A total of 109 patients who suffered nontraumatic cardiac arrest were included in the study. The rates of restoration of spontaneous circulation and subsequent hospital admission were higher in vasopressin-treated groups (23/53 [45%] in group I, 19/31 [61%] in group II and 17/27 [63%] in group III). There were also higher 24-hour survival rates among vasopressin-treated patients (P < 0.05), and more vasopressin-treated patients were discharged from hospital (10/51 [20%] in group I, 8/31 [26%] in group II and 7/27 [26%] group III; P = 0.21). Especially in the subgroup of patients with myocardial infarction as the underlying cause of cardiac arrest, the hospital discharge rate was significantly higher in vasopressin-treated patients (P < 0.05). Among patients who were discharged from hospital, we found no significant differences in neurological status between groups. Conclusion: The greater 24-hour survival rate in vasopressin-treated patients suggests that consideration of combined vasopressin and adrenaline is warranted for the treatment of refractory ventricular fibrillation or pulseless ventricular tachycardia. This is especially the case for those patients with myocardial infarction, for whom vasopressin treatment is also associated with a higher hospital discharge rate.
Ključne besede: vasopressin, antidiuretic hormone, ADH, out-of-hospital cardiopulmonary resuscitation, ventricular fibrillation, pulseless ventricular tachycardia
Objavljeno v DKUM: 29.06.2017; Ogledov: 1793; Prenosov: 188
.pdf Celotno besedilo (159,29 KB)
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7.
Partial pressure of end-tidal carbon dioxide successful predicts cardiopulmonary resuscitation in the field - a prospective observational study
Miran Kolar, Miljenko Križmarić, Petra Klemen, Štefek Grmec, 2008, izvirni znanstveni članek

Opis: Introduction: The prognosis among patients who suffer out-of-hospital cardiac arrest is poor. Higher survival rates have been observed only in patients with ventricular fibrillation who were fortunate enough to have basic and advanced life support initiated early after cardiac arrest. The ability to predict outcomes of cardiac arrest would be useful for resuscitation. Changes in expired end-tidal carbon dioxide levels during cardiopulmonary resuscitation may be a useful non-invasive predictor of successful resuscitation and survival from cardiac arrest, and help in the termination of cardiopulmonary resuscitation in the field. Methods: This is a prospective observational study of 737 cases of victims who suffered sudden out-of-hospital cardiac arrest. The patients were intubated and the measurements of end-tidal carbon dioxide were performed. Data according to the Utstein criteria, demographic information, medical data and partial pressure of end-tidal carbon dioxide (petCO2) values were collected for each patient in cardiac arrest, by the emergency physician. We presumed that an end-tidal carbon dioxide level of 1.9 kPa (14.3 mmHg) or more after 20 minutes of standard advanced cardiac life support would predict restoration of spontaneous circulation (ROSC). Results: Partial pressure of end-tidal carbon dioxide after 20 minutes of advanced life support averaged 0.92+/- 0.29 kPa (6.9mmHg +/- 2.2 mmHg) in patients who did not have ROSC and 4.36 +/-1.11 kPa (32.8 mmHg +/- 9.1 mmHg) in those who did (p<0,001). End-tidal carbon dioxide values of 1.9 kPa (14.3 mmHg) or less discriminated between the 402 patients with ROSC and 335 patients without ROSC. When a 20-minute end-tidal carbon dioxide value of 1.9 kPa (14.3 mmHg) or less was used as a screening test to predict ROSC, the sensitivity, specificity, positive predictive value, and negative predictive value were all 100 percent. Conclusions: Measurements of end-tidal carbon dioxide levels of more than 1.9 kPa (14.3 mmHg) after 20 minutes should be used to accurately predict ROSC. End-tidal carbon dioxide levels should be monitored during cardiopulmonary resuscitation and considered a useful prognostic value for determining the outcome of resuscitative efforts and termination of cardio-pulmonary resuscitation in the field.
Ključne besede: out-of-hospital cardiac arrest, cardiopulmonary resuscitation, CPR, partial pressure of end-tidal carbon dioxide, PetCO2
Objavljeno v DKUM: 29.06.2017; Ogledov: 1834; Prenosov: 158
.pdf Celotno besedilo (290,02 KB)
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8.
Hospital textiles, are they a possible vehicle for healthcare-associated infections?
Sabina Fijan, Sonja Šostar-Turk, 2012, pregledni znanstveni članek

Opis: Textiles are a common material in healthcare facilities; therefore it is important that they do not pose as a vehicle for the transfer of pathogens to patients or hospital workers. During the course of use hospital textiles become contaminated and laundering is necessary. Laundering of healthcare textiles is most commonly adequate, but in some instances, due to inappropriate disinfection or subsequent recontamination, the textiles may become a contaminated inanimate surface with the possibility to transfer pathogens. In this review we searched the published literature in order to answer four review questions: (1) Are there any reports on the survival of microorganisms on hospital textiles after laundering? (2) Are there any reports that indicate the presence of microorganisms on hospital textiles during use? (3) Are there any reports that microorganisms on textiles are a possible source infection of patients? (4) Are there any reports that microorganisms on textiles are a possible source infection for healthcare workers?
Ključne besede: textile hygiene, disinfection, hospital-acquired infections, inanimate surfaces, infection transmission vehicles
Objavljeno v DKUM: 21.06.2017; Ogledov: 1486; Prenosov: 378
.pdf Celotno besedilo (137,40 KB)
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9.
Comparison of methods for detection of four common nosocomial pathogens on hospital textiles
Sabina Fijan, Sonja Šostar-Turk, Urška Rozman, 2014, izvirni znanstveni članek

Opis: Introduction: Although the most common vehicle for transmission of health-care acquired infections is the personto- person transmission route, the role of environment should not be ignored and hospital linen may contribute to the spreading of nosocomial infections. The contact plate method and swabbing are common methods for sampling microorganisms on textiles; however, results are available after two days as they are based on incubation followed by phenotypeidentification. An important alternative is using quick wash-off methods followed by PCR detection, which shortens the identification process from two days to a few hours. Methods: The following test microorganisms at different concentrations were inoculated onto textile swatches and dried overnight: Staphylococcus aureus, Klebsiella pneumoniae, Pseudomonas aeruginosa and Clostridium difficile. RODAC plate sampling as well as a non-destructive wash-off method for capturing microorganisms from the textilesusing a Morapex device were used. The elution suspension from the Morapex device was used for two methods. In the first method, classical incubation on selective media followed by phenotypic identification was used and in the second method DNA was extracted from the elution suspension followed by amplification and agarose gel electrophoresis to visualize amplified products. Conclusions: All chosen bacteria were found using all methods. However, the most sensitive proved to be detection using PCR amplification as we detected the sample with initial concentration of 102 cfu/mL inoculated onto the textile surface before drying. The final detectablerecovered bacterial concentration on textiles was up to 10 cfu/mL.
Ključne besede: health care associated infections, hospital textiles, Staphylococcus aureus, Klebsiella pneumoniae, Pseudomonas aeruginosa, Clostridium difficile, Morapex
Objavljeno v DKUM: 05.04.2017; Ogledov: 2034; Prenosov: 407
.pdf Celotno besedilo (811,70 KB)
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10.
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