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Strategies for Reducing Rationed Nursing Care: Qualitative Secondary Analysis 减少定量护理的策略:定性二次分析
Pub Date : 2021-12-01 DOI: 10.2478/acm-2021-0014
Kalankova Dominika, Bartonickova Daniela, Ziaková Katarina, Kosutova Dominika
Abstract Introduction: Nursing students spend a meaningful part of their professional training in clinical practice. However, to a significant extent, they actively or passively contribute to the occurrence of rationed nursing care in clinical practice. Therefore, it is crucial that they actively participate in implementing targeted strategies to reduce rationed nursing care. Aim: To explore nursing students′ experience with strategies focusing on the reduction of rationed nursing care. Methods: We chose a qualitative secondary analysis to address unpublished data related to nursing students′ experience with strategies focusing on reducing rationed nursing care. The data included a set comprising of 148 pages with transcribed verbatim of 18 semi-structured interviews. The data were analyzed by a deductive content analysis. Results: Based on the outcome of the secondary analysis, we identified two meaningful categories: Preventive strategies in clinical practice and Importance and meaning of preventive strategies. These two categories reflected nursing students′ experience with targeted strategies to reduce rationed nursing care in clinical practice. Conclusion: Proposal and subsequent implementation of preventive strategies are essential for reducing rationed nursing care phenomenon from the clinical practice environment. The perspective of nursing students is vital due to their intensive perception of rationed nursing care in clinical practice. Students may identify areas that work-place staff may not explicitly focus on and consider important but jeopardize the quality of care or patient safety.
摘要导读:护理专业学生在临床实践中度过了他们专业训练中有意义的一部分。然而,他们在很大程度上主动或被动地促成了定量护理在临床实践中的发生。因此,至关重要的是,他们积极参与实施有针对性的战略,以减少配给护理。目的:探讨护生对减少定量护理策略的体会。方法:我们选择了一个定性的二次分析,以解决与护理学生的经验有关的未发表的数据,重点是减少配给护理。数据包括一套148页的资料,其中逐字抄录了18次半结构化访谈。数据通过演绎内容分析进行分析。结果:根据二次分析的结果,我们确定了两个有意义的类别:临床实践中的预防策略和预防策略的重要性和意义。这两个类别反映了护生在临床实践中有针对性地减少定量护理的经验。结论:从临床实践环境来看,预防策略的提出和后续实施是减少定量护理现象的关键。护生的观点是至关重要的,因为他们在临床实践中对定量护理有深刻的认识。学生可以识别工作人员可能没有明确关注和认为重要但危及护理质量或患者安全的领域。
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引用次数: 0
What is a Therapeutic Potential of N-Acetylcysteine in Lung Silicosis? n -乙酰半胱氨酸在肺矽肺中的治疗潜力是什么?
Pub Date : 2021-12-01 DOI: 10.2478/acm-2021-0011
A. Jana, M. Daniela
Abstract Lung silicosis is a serious pulmonary disease caused by an exposure of lung to inhaled silicon dioxide (SiO2) or silica. Although pathomechanisms of the disease have not been fully elucidated, oxidative stress has been recognized as a fundamental factor triggering a fibrotizing inflammation leading to irreversible changes in lung tissue. Based on this knowledge, therapeutic potential of various antioxidants has been intensively discussed. Among them, N-acetylcysteine with its multiple anti-inflammatory and antioxidant actions and a long-term experience with its clinical use in various diseases appears as a very promising choice. The purpose of this article is to review the therapeutic effects of N-acetylcysteine particularly in relation to a lung injury and to point out a potential of N-acetylcysteine in the treatment of lung silicosis.
肺矽肺病是由肺部吸入二氧化硅(SiO2)或二氧化硅引起的严重肺部疾病。虽然该病的病理机制尚未完全阐明,但氧化应激已被认为是引发纤维化炎症的基本因素,导致肺组织发生不可逆的变化。基于这一认识,各种抗氧化剂的治疗潜力得到了深入的讨论。其中,n -乙酰半胱氨酸具有多种抗炎和抗氧化作用,在临床治疗多种疾病方面有着长期的应用经验,是一个很有前景的选择。本文旨在综述n -乙酰半胱氨酸在肺损伤中的治疗作用,并指出n -乙酰半胱氨酸在肺矽肺治疗中的潜力。
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引用次数: 0
Obturation of Root Canals By Vertical Condensation of Gutta-Percha – Benefits and Pitfalls Percha垂直冷凝堵塞根管——好处和缺点
Pub Date : 2021-12-01 DOI: 10.2478/acm-2021-0013
Calkovsky Bruno, Slobodnikova Ladislava, Bacinsky Martin, Janickova Maria
Abstract Vertical condensation of gutta-percha is one of the frequently used techniques of hermetic and three-dimensional obturation of root canal system which is one of the primary goals of endodontic tooth treatment. Techniques for filling root canals have been described since ancient Egypt and have undergone dynamic development in recent decades. The aim of the article is to analyze the technique of obturation of root canals using vertical condensation of guttapercha and to point out its benefits and pitfalls. The poor-quality treatment of the tooth deteriorates its prognosis, function, and long-term survival in the oral cavity; thus, the hermetic obturation of the root canals is one of the most important pillars of the complex tooth treatment. Obturation of the root canals by vertical condensation of warm gutta-percha is nowadays considered in the correct indications as one of the most commonly used techniques in the excellent dental practices. Even though it is quite technologically challenging and time-consuming it enables to reach high level of predictability and clinical success. Currently, the obturation technique based on master gutta-percha cone combined with the calcium-silicate based sealer is emerging. However, long term results of clinical studies and follow-up are needed to make a significant improvement in the area of endodontics.
摘要牙胶垂直浓缩是根管系统封闭、三维封闭的常用技术之一,也是根管治疗的主要目的之一。根管充填技术自古埃及以来就有记载,近几十年来经历了动态发展。本文的目的是分析垂直冷凝法根管堵塞技术,并指出其优点和缺点。牙齿治疗质量差会恶化其预后、功能和在口腔中的长期生存率;因此,根管的封闭是复杂牙齿治疗的重要支柱之一。通过垂直冷凝温热的牙胶来封闭根管目前被认为是良好牙科实践中最常用的技术之一。尽管它在技术上相当具有挑战性和耗时,但它能够达到高水平的可预测性和临床成功。目前,以牙胶锥为主的充填技术和硅酸钙基封闭剂相结合的充填技术正在兴起。然而,需要长期的临床研究和随访结果来显著改善牙髓病领域。
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引用次数: 0
Distribution of Metastases in Ent Area – Comparison of Theory and Practice Ent区转移瘤的分布——理论与实践的比较
Pub Date : 2021-08-01 DOI: 10.2478/acm-2021-0008
E. Behanova, H. Pedan, P. Hanzel, A. Hajtman, V. Calkovsky
Abstract In head and neck cancers the occurrence of nodal metastases is the most important prognostic factor. Their early diagnosis is crucial for proper treatment. Detection of early metastases is still very difficult. Predictive diagnostic methods such as the sentinel lymph node detection is limited by the occurrence of skip metastases. At our Clinic we prefer a selective neck dissection based on a surgical treatment of predilected lymphatic spread area for each type of head and neck tumor with a preservation of non-lymphatic structures of the neck. The main objective of this article is to analyze the distribution of neck metastases and to study the frequency of skip metastases in head and neck cancer.
摘要在头颈部肿瘤中,淋巴结转移的发生是最重要的预后因素。早期诊断对正确治疗至关重要。早期转移的检测仍然非常困难。预测性诊断方法,如前哨淋巴结检测是有限的跳跃转移的发生。在我们的诊所,我们更倾向于选择性的颈部清扫,基于对每种类型的头颈部肿瘤的预先淋巴扩散区域的手术治疗,同时保留颈部的非淋巴结构。本文的主要目的是分析颈部转移的分布,研究头颈癌跳跃性转移的频率。
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引用次数: 0
Clinicopathological Study of Skin Adnexal Tumors: A Single Institute Experience 皮肤附件肿瘤的临床病理研究:单一研究所的经验
Pub Date : 2021-08-01 DOI: 10.2478/acm-2021-0009
V. Bartoš
Abstract Background: Skin adnexal tumors (SATs) encompass a very broad variety of rare dermatopathologic entities. Objective: The aim of the present study was to analyze an incidence and clinicopathological findings of patients with biopsy-proven ASTs. Material and Methods: A retrospective review of all consecutive cutaneous tumors that were diagnosed at the Martin Biopsy Center in Martin from July 2019 to March 2021 was carried out. ASTs have been searched for from this file and studied based on their histologic type and line of differentiation, anatomic distribution, age, and gender. Results: Among over 3,700 skin tumors a total of 38 ASTs in 38 individuals (21 males, 17 females) have been found. The age of the patients ranged from 22-89 years (mean 55.5 y.). The head and neck region was found to be the most common site affected (26/38; 68.4%), followed by extremities (8/38; 21.1%) and trunk (4/38; 10.5%). Tumors of hair follicle origin constituted the largest category (22/38; 57.9%), followed by sweat gland tumors (15/38; 39.5%) and tumors derived from sebaceous glands (1/38; 2.6%). Benign lesions accounted for all 38 cases. Trichoepithelioma was the most frequent lesion found in the category of follicular tumors and poroma was the most common among tumours with sweat gland differentiation. Conclusion: An overall incidence of ASTs is low and in this institutional study they constituted about 1% of all cutaneous neoplasms. ASTs display a marked phenotypic heterogeneity, that is why many published studies have provided divergent results concerning their clinicopathological features.
背景:皮肤附件肿瘤(SATs)包括非常广泛的各种罕见的皮肤病理实体。目的:本研究的目的是分析活检证实的ast患者的发病率和临床病理表现。材料和方法:对2019年7月至2021年3月在马丁马丁活检中心诊断的所有连续皮肤肿瘤进行回顾性研究。根据ast的组织学类型、分化线、解剖分布、年龄、性别等进行研究。结果:在3700多例皮肤肿瘤中,38例个体(男性21例,女性17例)共发现38例ast。患者年龄22 ~ 89岁,平均55.5岁。头颈部是最常见的受累部位(26/38;68.4%),其次是四肢(8/38;21.1%)和主干(4/38;10.5%)。发源于毛囊的肿瘤占比最大(22/38);57.9%),其次是汗腺肿瘤(15/38;39.5%)和皮脂腺肿瘤(1/38;2.6%)。38例均为良性病变。毛囊上皮瘤是滤泡性肿瘤中最常见的病变,而汗腺分化的肿瘤中最常见的是脓孔瘤。结论:ast的总体发病率很低,在本机构研究中,它们约占所有皮肤肿瘤的1%。ast表现出明显的表型异质性,这就是为什么许多已发表的研究对其临床病理特征提供了不同的结果。
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引用次数: 0
Biological Effects of a Low-Frequency Electromagnetic Field on Yeast Cells of the Genus Saccharomyces Cerevisiae 低频电磁场对酿酒酵母属酵母细胞的生物学效应
Pub Date : 2021-08-01 DOI: 10.2478/acm-2021-0006
K. Sladicekova, M. Bereta, J. Míšek, D. Parizek, J. Jakuš
Abstract Background: Although the scientific community is extensively concerned with the effects of the EMF, the unambiguous explanation of its effects on living structures is still lacking. Goals: The goal of the study was to evaluate the effect of a low-frequency (LF) electromagnetic field (EMF) on the growth and multiplication of the yeast Saccharomyces cerevisiae. Methods: Yeast cells were exposed to a frequency of 900 Hz and a magnetic flux density of 2.3 mT. The duration of each experiment was 8 hours, in the beginning of the measurement the value of frequency, rms (root mean square) value of electric current (2 A), and magnetic flux density were fixed set on the exposure device. A paired experiment was performed, a sample exposed to EMF, and a sample shielded from the field. Subsequently, samples were taken every two hours, the number of cells was recorded, and then the concentration of the yeast cells was evaluated at time points. The time points reflected the exposure time of the samples exposed to EMF. Results: The results indicate that LF EMF at given parameters has an inhibitory effect on the growth and multiplication of yeast cells. Conclusion: Exposure to EMF can cause the differences in growth dynamics between cells exposed to the field and the unexposed ones.
摘要背景:尽管科学界广泛关注EMF的影响,但对其对生活结构的影响仍缺乏明确的解释。目的:本研究的目的是评估低频(LF)电磁场(EMF)对酿酒酵母生长和增殖的影响。方法:将酵母细胞暴露于900Hz的频率和2.3mT的磁通密度下。每个实验的持续时间为8小时,在测量开始时,将频率值、电流(2A)的均方根值和磁通密度固定在暴露装置上。进行配对实验,将样品暴露于EMF,并将样品屏蔽在磁场之外。随后,每两小时取样一次,记录细胞数量,然后在各时间点评估酵母细胞的浓度。时间点反映了暴露于EMF的样品的暴露时间。结果:在一定参数下,低频电磁场对酵母细胞的生长和增殖有抑制作用。结论:暴露于电磁场可导致暴露于电磁场和未暴露于电磁场的细胞之间的生长动力学差异。
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引用次数: 6
How to Measure Patient Safety Culture? a Literature Review of Instruments 如何衡量患者安全文化?仪器的文献综述
Pub Date : 2021-08-01 DOI: 10.2478/acm-2021-0010
D. Bartoníčková, D. Kalánková, K. Žiaková
Abstract Introduction: Patient safety culture is described as employees’ shared values, attitudes, and behaviours in a healthcare organization. Its main goal is to improve patient safety. Assessment of patient safety culture in the hospital environment is most often carried out using self-assessment tools. Although several of these tools have been developed, their comprehensive overview is lacking in literature. Aim: To provide an overview of instruments measuring patient safety culture in a hospital setting. Methods: The study has a character of a narrative literature review. The search was performed in the scientific databases Scopus, ProQuest, and PubMed in January 2021. The search produced a total of 1,767 studies and was limited to language (English). The search and the retrieval process reflected PRISMA’s recommendations. The content analysis method was used in the data synthesis. Results: We identified 24 tools for assessing the patient safety culture in a hospital setting, of which seven were developed for specific workplaces; others are considered general. Eighteen tools might be utilized by all healthcare professionals within the hospital setting and only three were designated explicitly for nurses. The most commonly used instruments were the Hospital Survey on Patient Culture and the Safety Attitudes Questionnaire. Conclusion: Assessing a patient safety culture is considered one of the strategies for improving patient safety while increasing care quality. An appropriate tool’s choice depends on the target population, the instrument’s validity and reliability, and other aspects. Awareness of the various assessment tools can help hospitals choose the one that best suits their circumstances.
摘要简介:患者安全文化被描述为员工在医疗保健组织中的共同价值观、态度和行为。它的主要目标是提高病人的安全。医院环境中患者安全文化的评估通常使用自我评估工具进行。虽然这些工具中有几个已经开发出来,但文献中缺乏对它们的全面概述。目的:概述在医院环境中测量患者安全文化的仪器。方法:本研究具有叙事性文献综述的特点。检索于2021年1月在科学数据库Scopus、ProQuest和PubMed中进行。该搜索总共产生了1767项研究,并且仅限于语言(英语)。搜索和检索过程反映了PRISMA的建议。数据综合采用内容分析法。结果:我们确定了24种评估医院环境中患者安全文化的工具,其中7种是为特定工作场所开发的;其他的被认为是一般的。18种工具可供医院内的所有医疗保健专业人员使用,只有3种工具明确指定供护士使用。最常用的工具是医院患者文化调查和安全态度问卷。结论:评估患者安全文化被认为是改善患者安全同时提高护理质量的策略之一。一个合适的工具的选择取决于目标人群,工具的有效性和可靠性,以及其他方面。了解各种评估工具可以帮助医院选择最适合自己情况的评估工具。
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引用次数: 3
Detection of Subclinical Paroxysmal Atrial Fibrillation and Its Correlation with Candidate Genes in Patients with Cryptogenic Ischemic Stroke and TIA 隐源性缺血性脑卒中和TIA患者亚临床发作性心房颤动的检测及其与候选基因的相关性
Pub Date : 2021-08-01 DOI: 10.2478/acm-2021-0007
A. Petrovičová, E. Kurča, A. Andrášová, J. Bernatova, P. Blaško, T. Burjanivová, T. Duris, M. Grendár, J. Hasilla, B. Malicherová, V. Nosáľ, P. Obona, L. Pátrovič, Š. Sivák, P. Snopek, M. Svetlosak, P. Vahala, D. Čierný
Abstract Introduction: Cardioembolic etiology is assumed to be the most frequent cause of cryptogenic strokes. The detection of subclinical paroxysmal atrial fibrillation (AF) is important in the correct choice of preventive treatment. The aim of this prospective study was to detect the incidence of AF in patients with a cryptogenic stroke or transient ischemic attack (TIA) and to evaluate the association between the presence of AF and selected single-nucleotide polymorphisms (SNP). Methods: Patients with a cryptogenic stroke/ TIA (n=100) and a control group (n=15) of volunteers without significant cardiovascular disease were included in the study during the period of 2014 to 2019. To detect AF they underwent 12 months of ECG monitoring using an implanted loop recorder (ILR). Genotyping for SNPs rs10033464, rs2200733, rs225132, and rs2106261 was performed by a high resolution melting analysis. Results: We found AF to be present in 24 (24%) patients with a cryptogenic stroke/TIA, versus no subjects in the control group. The SNPs rs2106261, rs2200733, rs225132, and rs10033464 were not found to be associated with AF in our study (p=0.240; 1.000; 0.887; 0.589). However, a weak trend for a higher frequency of rs2106261 risk allele A homozygotes was observed in the patients with AF compared to the patients without AF (0.416 vs. 0.263, p=0.073). Homozygotes for allele A of rs2106261 were also present in a significantly higher frequency in AF patients compared to the controls (0.416 vs. 0.133, p = 0.012). Conclusion: In our study paroxysmal AF was a probable etiological factor in 24% of patients with cryptogenic ischemic stroke / TIA during the 12 months of monitoring. The homozygous allele A of rs2106261 was identified to be the possible genetic risk factor of AF, but this should be verified in larger cohorts. The study has been registered at www.clinicaltrials.gov, identifier NCT02216370.
摘要简介:心脏栓塞病因被认为是隐源性中风最常见的原因。亚临床阵发性心房颤动(AF)的检测对于正确选择预防性治疗至关重要。这项前瞻性研究的目的是检测隐源性中风或短暂性脑缺血发作(TIA)患者的房颤发生率,并评估房颤的存在与所选单核苷酸多态性(SNP)之间的关系。方法:2014年至2019年期间,将患有隐源性脑卒中/TIA的患者(n=100)和没有严重心血管疾病的志愿者对照组(n=15)纳入研究。为了检测房颤,他们使用植入的环路记录器(ILR)进行了12个月的心电图监测。通过高分辨率熔解分析对SNPs rs10033464、rs2200733、rs225132和rs2106261进行基因分型。结果:我们发现24例(24%)隐源性脑卒中/TIA患者存在房颤,而对照组中没有受试者。在我们的研究中,未发现SNPs rs2106261、rs2200733、rs225132和rs10033464与房颤相关(p=0.240;1.000;0.887;0.589)。然而,与非房颤患者相比,房颤患者rs2106261危险等位基因a纯合子的频率呈微弱趋势(0.416 vs.0.263,p=0.073)。与对照组相比,房颤动患者rs2106.261等位基因的纯合子频率也明显更高(0.416 vs 0.133,p=0.012)。结论:在我们的研究中,阵发性房颤可能是在监测的12个月内,24%的隐源性缺血性脑卒中/TIA患者的病因。rs2106261的纯合等位基因A被确定为AF的可能遗传风险因素,但这应该在更大的队列中得到验证。该研究已在www.clinicaltrials.gov上注册,标识符为NCT02216370。
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引用次数: 0
The Effect of Music on Heart Rate Variability (Review) 音乐对心率变异的影响(综述)
Pub Date : 2021-03-01 DOI: 10.2478/acm-2021-0001
D. Parizek, K. Sladicekova, I. Tonhajzerova, M. Veternik, J. Jakuš
Abstract Music therapy and the use of music in medical practice have now become rapidly advancing and promising areas of non-invasive alternative medicine. However, the opinions of physicians and therapists on the implementation of this complementary therapy, especially in the process of treating the patient, are constantly different. In addition, the effect of music and individual methodological procedures are not uniform and defined in detail. Therefore, this review study summarizes the results and conclusions of some selected high-quality publications over the last decade and makes suggestions for improvement and further research. It focuses mainly on the evaluation of changes in heart rate variability (HRV) as an indicator of the activity of the autonomic nervous system (ANS) in connection with the application of music in the process of passive music therapy.
摘要音乐治疗和音乐在医学实践中的应用已经成为非侵入性替代医学的快速发展和有前景的领域。然而,医生和治疗师对这种补充疗法的实施,特别是在治疗患者的过程中,意见总是不同的。此外,音乐的效果和个人方法论程序并不统一,也没有详细定义。因此,本综述研究总结了过去十年来一些精选的高质量出版物的结果和结论,并提出了改进和进一步研究的建议。它主要侧重于评估心率变异性(HRV)的变化,作为自主神经系统(ANS)活动的指标,与音乐在被动音乐治疗过程中的应用有关。
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引用次数: 11
Ecstasy-Induced Malignant Hyperthermia with Fatal Outcome: A Case Report 摇头丸致恶性高热致死亡1例报告
Pub Date : 2021-03-01 DOI: 10.2478/acm-2021-0004
V. Rybárová, I. Kumičíková, F. Novomeský, Ľ. Straka, J. Krajčovič, M. Janík
Abstract 3,4-methylenedioxymetamphetamine (MDMA), also known as “ecstasy”, “tulips”, or “Molly”, is an increasingly used “recreational drug” particularly among teenagers and young adults along with the widespread conviction that MDMA is a “safe drug”. The reason for this substance being abused is a desire for closeness to other people, develop a greater tolerance of their views and feelings, and even to touch them physically. According to these effects MDMA is classified also as an “empatogenic” or “entactogenic”. Although MDMA is used for the above-mentioned socially acceptable purposes, in many individuals the drug usage is followed with side-effects varying from mild to severe, potentially even life-threatening. One of the most significant complication of MDMA intoxication is hyper-thermia in the consumer. Authors presented a case of MDMA toxicity with severe hyperthermia (42 ºC) with a fatal outcome to the ecstasy-influenced subject. The aim of this article is to describe the effects of ecstasy, the “recreational drug” widely used in local pubs, dance clubs, and during open air festivals, even in the Slovak Republic.
摘要:3,4-亚甲基二氧基苯丙胺(MDMA),也被称为“摇头丸”、“郁金香”或“莫利”,是一种越来越多的“娱乐性药物”,特别是在青少年和年轻人中,随着MDMA被广泛认为是一种“安全药物”。这种物质被滥用的原因是渴望与他人亲近,对他们的观点和感受产生更大的容忍度,甚至是身体上的接触。根据这些影响,MDMA也被归类为“共情性”或“内致性”。虽然MDMA用于上述社会可接受的目的,但对许多人来说,药物使用后会产生从轻微到严重的副作用,甚至可能危及生命。MDMA中毒最重要的并发症之一是消费者体温过高。作者报告了一例MDMA毒性伴严重高热(42ºC),对受摇头丸影响的受试者有致命的结果。这篇文章的目的是描述摇头丸的影响,摇头丸是一种“娱乐性药物”,在当地酒吧、舞厅和露天节日中广泛使用,甚至在斯洛伐克共和国也是如此。
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引用次数: 0
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Acta Medica Martiniana
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