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Psychiatric clinic in Podgorica
Jovana Vuletić, 2019, master's thesis

Abstract: 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.
Keywords: psychiatry, arhitecture, psyhiatric hospital, deinstitucionalization, stigmatization, clinic centre Montenegro
Published: 05.02.2019; Views: 650; Downloads: 149
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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, original scientific article

Abstract: 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.
Keywords: vasopressin, antidiuretic hormone, ADH, out-of-hospital cardiopulmonary resuscitation, ventricular fibrillation, pulseless ventricular tachycardia
Published: 29.06.2017; Views: 1022; Downloads: 110
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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, original scientific article

Abstract: 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.
Keywords: out-of-hospital cardiac arrest, cardiopulmonary resuscitation, CPR, partial pressure of end-tidal carbon dioxide, PetCO2
Published: 29.06.2017; Views: 942; Downloads: 79
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Hospital textiles, are they a possible vehicle for healthcare-associated infections?
Sabina Fijan, Sonja Šostar-Turk, 2012, review article

Abstract: 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?
Keywords: textile hygiene, disinfection, hospital-acquired infections, inanimate surfaces, infection transmission vehicles
Published: 21.06.2017; Views: 640; Downloads: 300
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Comparison of methods for detection of four common nosocomial pathogens on hospital textiles
Sabina Fijan, Sonja Šostar-Turk, Urška Rozman, 2014, original scientific article

Abstract: 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.
Keywords: health care associated infections, hospital textiles, Staphylococcus aureus, Klebsiella pneumoniae, Pseudomonas aeruginosa, Clostridium difficile, Morapex
Published: 05.04.2017; Views: 996; Downloads: 295
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Real-time polymerase chain reaction for quantitative assessment of common pathogens associated with healthcare-acquired infections on hospital textiles
Urška Rozman, Sabina Fijan, Sonja Šostar-Turk, Vid Mlakar, 2013, original scientific article

Abstract: A hospital environment may act as a significant reservoir for potential pathogens that can be transmitted with hospital textiles, which could represent a source of healthcare-acquired infections. Quantitative assessment of nosocomial pathogens with real time polymerase chain reaction (qPCR) on textiles can serve to verify the achievement of standards for textile hygiene of hospital laundry that assess the risk for acquiring hospital infection frominappropriately disinfected textiles. The aim of the study was to establish qPCR for quantitative assessment of selected common nosocomial pathogens (Clostridium difficile, Staphylococcus aureus, Klebsiella pneumoniaeand Pseudomonas aeruginosa) on hospital textiles and to compare the efficiency of the molecular method to the standard procedures for evaluating the bio burden of textiles in hospitals. This study demonstrated that presenceof nosocomial pathogens on hospital textiles can be confirmed with qPCR even where conventional techniques do not give any results. qPCR offers apossibility to confirm the presence of microorganisms in dead or viable but non-culturable states that cannot be detected by conventional sampling techniques but may still pose a hazard to public health.
Keywords: healthcare-acquired infections, hospital textiles, Clostridium difficile, Staphylococcus aureus, Klebsiella pneumoniae, Pseudomonas aeruginosa
Published: 10.07.2015; Views: 932; Downloads: 98
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Antimicrobial disinfection effect of a laundering procedure for hospital textiles against various indicator bacteria and fungi using different substrates for simulating human excrements
Sabina Fijan, Srečko Koren, Avrelija Cencič, Sonja Šostar-Turk, 2007, original scientific article

Abstract: Recent studies confirm the increase of nosocomial infections and microbial resistance. One of the possible causes is infected textiles due to inappropriate laundering procedures. Most Slovenian laundries use thermal laundering procedures with high energy and water consumption to disinfect hospital textiles. In addition to this fact, there is an increasing number of hospital textiles composed of cotton/polyester blends that cannot endure high temperatures of thermal disinfection. On the other hand, decreasing the temperature of laundering procedures enhances the possibility of pathogenic microorganisms to survive the laundering procedure. In our research, we determined the antimicrobic laundering effect by simulating a common laundering procedure for hospital textiles in the laboratory washing machine at different temperatures by the use of bioindicators. Enterococcus faecium, Staphylococcus aureus, Mycobacterium terrae, Enterobacter aerogenes, and Pseudomonas aeruginosa were used for determining the antibacterial laundering effect. Candida albicans was used for determining the antifungal laundering effect. Swine blood, artificial sweat, and swine fat were used as substrates for simulating human excrements and were inoculated together with the chosen microorganisms onto cotton pieces to simulate real laundering conditions. It was found that E. faecium, S. aureus, E. aerogenes, and P. aeruginosa survivedat 60 °C, but no microorganisms were found at 75 °C.
Keywords: textile care, hospital laundry, laundry hygiene, micro-organisms, bioindicators, disinfection effect, hospital-acquired disease prevention, sanitary measures
Published: 01.06.2012; Views: 2131; Downloads: 92
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Rotaviral RNA found on various surfaces in a hospital laundry
Sabina Fijan, Andrej Steyer, Mateja Poljšak-Prijatelj, Avrelija Cencič, Sonja Šostar-Turk, Srečko Koren, 2008, original scientific article

Abstract: The aim of this investigative study was to determine the presence of rotaviral RNA at various control points (CP) of a hospital laundry. One of the possible sources of hospital infections is inappropriately laundered and disinfected hospital textiles. RT-PCR and nested PCR for gene amplification using specific primers following RNA isolation were used to determine the presence of rotaviral RNA on swabs. In addition, rotavirus suspensions were inoculated on marked surfaces as positive controls for different surfaces (cotton textiles, folding table and industrial dryer). Rotaviral RNA was found on various laundry surfaces: technical equipment, storage shelves, transport vehicles, personnel's hands, damp textiles, and folded laundry. Rotaviral RNA was also detected at all positive controls on tested surfaces after 24 h. Based on the results, it is very important to take into consideration the proper handling of textiles after washing as one of the precautions against hospital-acquired infections. This paper reports the presence of rotaviral RNA for the first time on surfaces in laundries and equipment, as well as textiles.
Keywords: laundry hygiene, rotaviruses, hospital-acquired disease prevention, sanitary measures, occupational health
Published: 01.06.2012; Views: 2091; Downloads: 70
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