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1.
UPORABA ENOTE HELIKOPTERSKE NUJNE MEDICINSKE POMOČI PRI OBRAVNAVI BOLNIKOV Z AKUTNIM KORONARNIM SINDROMOM
Gorazd Bregant, 2009, diplomsko delo

Opis: V diplomskem delu smo predstavili enoto HNMP v Sloveniji, njeno delovanje in zgodovino. Obravnavali smo učinkovost njenega delovanja na vzorcu 252 bolnikov z akutnim koronarnim sindromom, ki jih je enota oskrbela po principih sodobnih smernic oskrbe takšnih bolnikov in prepeljala v prvih petih letih delovanja službe (16.7.2003 — 16.7.2008). Uporabili smo deskriptivno metodo s študijem literature za področje AKS. Uporabili smo retrospektivno metodo (študija izpolnjenih protokolov intervencij). Podatke smo analizirali (grafi). Prepeljanih je bilo 252 bolnikov z AKS, od tega 139 (55,15%) bolnikov z STEMI, 10 bolnikov (3.96%) z nestabilno angino pektoris, in 12 bolnikov (4,76l%) z NSTEMI. Za 91 bolnikov (36,11%) se zdravniki niso natančno opredelili o vodilni diagnozi. Ugotovili smo skupno število prepeljanih bolnikov in razloge za intervencijo, izračunali povprečne odzivne čase enote HNMP glede na prevoznika, skupne povprečne čase od klica do prihoda do bolnika, čas od klica do prihoda z bolnikom v bolnišnico ter čas od pristanka na pristajališču Roška do prihoda v bolnišnico z reševalnim vozilom. Na zemljevidu Slovenije smo grafično prikazali kraje posredovanja enote HNMP. Preučevali smo oskrbo bolnikov z akutnim koronarnim sindromom. Ugotovili smo, da nudi služba HNMP dobro oskrbo bolnikom, da so kadri enote na visokem nivoju, da je oprema, ki jo uporabljajo ustrezna in sodobna, in da služba HNMP skrbi za stalno dodatno izobraževanje svojega kadra. Ugotovili smo tudi pomanjkljivosti pri umeščenosti službe HNMP v Sloveniji, omejenost na dnevni čas delovanja, omejen način aktivacije, dolgi časi aktivacije in do prihoda bolnika v zdravstveno ustanovo, izguba časa zaradi neurejenega helioporta v Univerzitetnem kliničnem centru Ljubljana in neurejenega dispečerstva v zdravstvu. Ugotovili smo, da enota nima stalne posadke prevoznika, da se dnevno menja tip helikopterja s katerim posreduje, da so vsi helikopterji nenamenski in omejeno uporabni, in da ena enota v Sloveniji ni dovolj učinkovita za vse prebivalce Slovenije.
Ključne besede: - AKS (akutni koronarni sindrom) - AVPU (alert, verbal, pain, unresponsive) - CIIM (Center za intenzivno interno medicino) - EKG (elektrokardiogram) - ERC (European Resuscitation Council) - GCS (Glasgow coma scale) - GRZS (Gorska reševalna zveza Slovenije) - HEMS (Helicopter emergency medical service) - HNMP (Helikopterska nujna medicinska pomoč) - IPP (Internistična prva pomoč) - LKB (levokračni blok) - LPE (Letalska policijska enota) - MONA (morfij, kisik, nitroglicerin, aspirin) - NAP (
Objavljeno: 15.07.2009; Ogledov: 2849; Prenosov: 404
.pdf Celotno besedilo (17,00 MB)

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PRVA POMOČ PRI OSKRBI PONESREČENCA V PROMETNIH NEZGODAH
Mitja Ločičnik, 2009, diplomsko delo

Opis: V diplomskem delu smo predstavili ekipo NMP v Sloveniji in njeno delovanje. Predstavili smo postopke in posege, tehnike in sisteme reševanja pri oskrbi poškodovancev na terenu, z vključitvijo vseh ostalih služb, ki pomagajo oziroma sodelujejo pri reševanju ponesrečencev v prometnih nezgodah na območju Šaleške regije. Obravnavali smo prometne nezgode, pri katerih je bila aktivirana ekipa NMP zdravstvenega doma Velenje. Analizirali smo 258 ponesrečencev v prometnih nezgodah, pri katerih je bila aktivirana ekipa NMP na vzorcu 205 protokolov od 1. 1. 2007 do 11. 11. 2009. Uporabili smo deskriptivno metodo s študijem literature za področje NMP in oskrbe ponesrečencev v prometnih nezgodah. Uporabili smo retrospektivno metodo (študija izpolnjenih protokolov nujnih intervencij). Podatke smo analizirali (grafi). V prometnih nezgodah je bilo udeleženih 258 ponesrečencev, od tega 163 moških (63,2 %) in 95 žensk (36,8 %). Mladoletnih oziroma starih do 21 let je bilo 79 (30,6 %), nad 21 let pa 179 ponesrečencev (69,4 %). V tem obdobju je v prometnih nesrečah umrlo 13 ponesrečencev (5 %), 57 ponesrečencev (22,1 %) je bilo hudo poškodovanih, 147 ponesrečencev (57 %) je utrpelo lažje poškodbe, 41 ponesrečencev (15,9 %) ni utrpelo vidnih poškodb. Pri 13 ponesrečencih (5 %) je bilo ugotovljeno uživanje alkohola, 6 ponesrečencev je uživalo psihoaktivne snovi (2,3 %), pri 2 ponesrečencih (0,8 %) je bil podan sum poizkusa samomora. Ugotovili smo, da je bilo udeleženih v prometnih nezgodah več kot 60 % moških, v večini stari nad 21 let. Ekipa NMP je Zdravstvenem domu Velenje zelo dobro organizirana, prav tako v celotni Sloveniji. V veliki meri sta za to zaslužna zelo dobra in sodobna opremljenost reševalnih vozil in pa strokovno izobraževan kader, ki se neprestano dodatno izpopolnjuje na seminarjih. Veliko pomanjkljivost smo odkrili pri kadru in sicer pri skupno vseh intervencijah je sodelovalo samo 34 (16,6 %) diplomiranih zdravstvenikov oziroma diplomiranih medicinskih sester, kajti zaposlena sta samo dva diplomirana zdravstvenika, oziroma zadnje leto le eden. V veliki večini so zdravstveni tehniki oziroma srednje medicinske sestre in pa vozniki s posebnim tečajem. Ugotovili smo tudi pomanjkljivost pri službi HNMP v Sloveniji, saj je omejena na dnevni čas delovanja, dolgi čas aktivacije in do prihoda bolnika v zdravstveno ustanovo, kar smo tudi dokazali na zemljevidu.
Ključne besede: - ABCDE: Airway, breathing, circulation, disability, exposure - AF: Atrijska fibrilacija - ASY: Asistolija - ATLS: Dodatni postopki obravnave (oživljanja) poškodovancev - AVPU: Ocenjevanalna lestvica (Alert- buden; Verbal- odziven na verbalni poziv; Pain- odziven na bolečino; Unresponsive- neodziven) - EKG: Elektrokardiogram - ETI: Endotrahealna intubacija - GCS: Glasgowska lestvica kome - GRS: Gorska reševalna služba - HNMP: Helikopterska nujna medicinska pomoč
Objavljeno: 15.02.2010; Ogledov: 3300; Prenosov: 623
.pdf Celotno besedilo (13,74 MB)

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The correlation between pain perception among patients with six different orthodontic archwires and the degree of dental crowding
Evgenija Marković, Janko Ferčec, Ivana Ščepan, Branislav Glišić, Nenad Nedeljković, Jovana Juloski, Rebeka Rudolf, 2015, izvirni znanstveni članek

Opis: Introduction: Forces generated in orthodontic treatment with fixed appliances create tension and compression zones in the periodontal ligament resulting in a painful experience for patients. In the first phase of orthodontic treatment, when leveling of teeth is needed, nickel-titanium (NiTi) archwires can be completely engaged in brackets, even in the cases of extreme crowding, exerting small forces. There is a great individual variation in the pain perception related to the application of orthodontic forces. Objective: The aim of this study was to investigate the pain perception among patients with dental crowding after insertion of six different NiTi orthodontic archwires as a part of fixed appliances in the first stage of orthodontic treatment. Methods: The study was conducted on a sample of 189 orthodontic patients receiving one of six different either superelastic or heat activated NiTi archwires, in the first phase of orthodontic treatment. Pain perception was evaluated in groups of patients with different degree of crowding. The modified McGill Pain Questionnaire with Visual Analogue Scale was used to evaluate the quality and intensity of pain. Statistical analysis was performed using simple descriptive statistics, and Pearson`s chi-square test with statistical significance of p<0.05. Results: Majority of patients reported pain as discomfort or pressure of moderate intensity caused by chewing or biting, started within 12 hours, carried on for 3-4 days, and decreased over time without self-medication. Conclusion: No correlation was found between pain perception among patients with different types of NiTi archwires and the degree of crowding.
Ključne besede: nickel-titanium archwires, pain, dental crowding, orthodontics
Objavljeno: 04.08.2017; Ogledov: 268; Prenosov: 81
.pdf Celotno besedilo (258,88 KB)
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8.
Predictors of health-related quality of life and disability in patients with chronic nonspecific low back pain
Zalika Klemenc-Ketiš, 2011, izvirni znanstveni članek

Opis: Background: The quality of life in patients with chronic low-back pain is lower in comparison with that in general population. This seriously affects the functional ability and working status of young and adult population. The aim of this study was to determine the level of disability and the health-related quality of life in patients with chronic non-specific low back pain. Methods: We performed a cross-sectional study in 187 patients (45.5 % of men, mean age 50.1 years) with chronic non-specific low back pain attending physical therapy program. We used Visual Analog Pain Scale (VAS), Euroqol questionnaire (EQq), and Oswestry Disability Index (ODI). Results: Mean ODI score SD was 14.6 9.0. Mean score of EQ-5D was 3.6 1.6 points and of EQ-VAS 55.4 18.3 points. Mean score on VAS was 6.0 2.1 points. An independent factor associated with lower quality of life on EQ-VAS was higher level of chronic pain. Independent factors associated with a lower quality of life on EQ-5D were the presence of anxiety and depression, higher level of chronic pain, and the presence of chronic disease. Independent factors associated with greater disability measured on ODI were the presence of signs of anxiety and depression, higher level of chronic pain, and the presence of any chronic disease. Conclusions: Chronic low back pain can be the cause of greater disability and lower quality of life, especially in patients with somatic and mental co-morbidities, in female patients and in patients with higher levels of chronic pain. Doctors should focus on active search for signs of depression and anxiety and better pain management in patients with chronic low back pain, especially if somatic co-morbidities exist.
Ključne besede: quality of life, disability evaluation, low back pain, pain measurement
Objavljeno: 28.03.2017; Ogledov: 345; Prenosov: 28
.pdf Celotno besedilo (423,26 KB)
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Disability in patients with chronic non-specific low back pain
Zalika Klemenc-Ketiš, 2011, izvirni znanstveni članek

Opis: Aim: To validate the Slovene version of the Oswestry Disability Index. Method: A case series study of 129 adult patients with non-specific chronic low back pain attending a 10-day physical therapy programme. Visual Analog Pain Scale (VAS), Euroqol questionnaire (EQq), and Oswestry Disability Index (ODI) were used at the beginning and at the end of the physical therapy programme. Results: Cronbach's a of the Slovene ODI was 0.876 at the beginning of the physical therapy programme and 0.901 at the end of the programme. All items of the questionnaire loaded on the same factor. A significant positive correlation existed between the Slovene ODI and VAS, EQ-5D and EQ-VAS at the beginning of the physical therapy programme (r=0.630, p<0.001; r=0.657, p<0.001; r=-0.510, p<0.001, respectively), as well as at the end of the programme (r=0.491, p<0.001; r=0.725, p<0.001; r=-0.648, p<0.001, respectively). The difference between ODI scores obtained at the first and at the second interview was 2.7 ± 5.2 (p<0.001), and the difference between ODI disability scores was 5.4 ± 10.5 (p<0.001). The effect size of the Slovene ODI questionnaire was 0.30. Conclusions: The Slovene ODI questionnaire is a reliable and valid instrument for assessing outcomes of physical therapy in patients with chronic non-specific low back pain.
Ključne besede: disability evaluation, low back pain, physical therapy, validation studies, questionnaire
Objavljeno: 05.04.2017; Ogledov: 559; Prenosov: 69
.pdf Celotno besedilo (152,66 KB)
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10.
Factors associated with health-related quality of life among university students
Zalika Klemenc-Ketiš, Janko Kersnik, Ksenija Eder, Dušan Colarič, 2011, izvirni znanstveni članek

Opis: Introduction: University students are subjected to different kinds of stressors, i.e.academic pressures, social issues and financial problems. This can affect their academic achievements and quality of life. Objective: The aim of this study was to determine the health-related quality of life of university students, and how it is affected by the presence of chronic diseases, mental disorders comorbidity, and patterns of medical services' use. Methods: This web-based study included a sample of 1,410 Slovenian university students. We used a self-administered questionnaire, containing a sheet with demographic data, Zung's self-assessment inventories about anxiety and depression, and EQ-5D questionnaire. The main outcome measures were scores on EQ-5D part and VAS part of the EQ-5D questionnaire. Results: Independent factors associated with the health-related quality of life of university students, were the presence of chronic pain, the presence of depression and anxiety, need for urgent medical help and at least one visit to a clinical specialist in the past year. The independent factors associated with the health status of university students were the presence of chronic diseases, chronic pain, depression and anxiety, a visit to a clinical specialist, a need for urgent medical help and a visit to an emergency unit in the past year. Conclusion: Health-related quality of life of university students can be seriously affected by the presence of mental disorders and chronic pain. Appropriate health-related measures should be adopted to achieve early recognition of worse health-related quality of life, the presence of mental disorders and other chronic conditions, and to enable their effective treatment.
Ključne besede: quality of life, students, chronic disease, pain, depression, anxiety
Objavljeno: 04.08.2017; Ogledov: 225; Prenosov: 127
.pdf Celotno besedilo (192,97 KB)
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