Pub Date : 2014-10-01DOI: 10.6016/SLOVMEDJOUR.V83I9.1279
Urška Močnik, M. Gradisar, Luka Tomat
Background : Steady increase in the numbers of patients seeking medical assistance has recently been observed at the emergency department of the health center under study. This has led to increases in waiting times for patients. The management of the health center has been considering to implement certain measures to remedy this situation. One proposed solution is to add an additional physician to the emergency department. A computer model was constructed to simulate waiting lines and analyze the economic feasibility of employing an additional physician. Aim : This paper analyzes the waiting lines at the emergency department and performs an economic feasibility study to determine whether adding an additional physician to the department would be economically justified. Methods : Data about waiting times at the emergency department were collected to study the situation. For each patient, the arrival time at the waiting room and the starting and ending times of the examination were registered. The data were collected from 13 June 2011 to 25 September 2011. The sample included data on 65 nightly standbys, nine standbys on Saturdays, and 16 standbys on Sundays. Due to incomplete entries, data for nine weekly standbys and six Saturday standbys were excluded from the sample. Based on the data collected, we calculated the waiting and examination times per patient, average number of patients, average waiting time, average examination time, share of active standby teams in total standby time, and number of patients in different time periods. The study involved 1,039 patients. Using a synthesis method, we designed a computer model of waiting lines and economic feasibility. The model was validated using comparative analysis. A what-if analysis was performed using various computer simulations with various scenarios to consider the outcomes of decision alternatives. We applied economic analysis to select the best possible solution. Results : The research results show that emergency department teams face overcrowding at certain periods. This is particularly challenging for employees performing 24-hour standbys, when they are working at the limit of their capacity. The results show that the total cost of waiting lines with two physicians is higher in all cases. The introduction of an additional channel or employing an additional physician increases the total cost by 35 to 50 %. Employing an additional physician is therefore not economically justified. Conclusion : This study showed how a computer model can be used to improve the information basis for decision-making in healthcare organization management. Based on quantitative data obtained by using a model with alternative scenarios, we developed an economic analysis of alternatives and made a decision. The cost analysis of potentially employing an additional physician showed that the cost would exceed the benefits obtained in all scenarios analyzed. The proposed decision-support method can be implemented at a v
{"title":"Analysis of emergency department waiting lines","authors":"Urška Močnik, M. Gradisar, Luka Tomat","doi":"10.6016/SLOVMEDJOUR.V83I9.1279","DOIUrl":"https://doi.org/10.6016/SLOVMEDJOUR.V83I9.1279","url":null,"abstract":"Background : Steady increase in the numbers of patients seeking medical assistance has recently been observed at the emergency department of the health center under study. This has led to increases in waiting times for patients. The management of the health center has been considering to implement certain measures to remedy this situation. One proposed solution is to add an additional physician to the emergency department. A computer model was constructed to simulate waiting lines and analyze the economic feasibility of employing an additional physician. Aim : This paper analyzes the waiting lines at the emergency department and performs an economic feasibility study to determine whether adding an additional physician to the department would be economically justified. Methods : Data about waiting times at the emergency department were collected to study the situation. For each patient, the arrival time at the waiting room and the starting and ending times of the examination were registered. The data were collected from 13 June 2011 to 25 September 2011. The sample included data on 65 nightly standbys, nine standbys on Saturdays, and 16 standbys on Sundays. Due to incomplete entries, data for nine weekly standbys and six Saturday standbys were excluded from the sample. Based on the data collected, we calculated the waiting and examination times per patient, average number of patients, average waiting time, average examination time, share of active standby teams in total standby time, and number of patients in different time periods. The study involved 1,039 patients. Using a synthesis method, we designed a computer model of waiting lines and economic feasibility. The model was validated using comparative analysis. A what-if analysis was performed using various computer simulations with various scenarios to consider the outcomes of decision alternatives. We applied economic analysis to select the best possible solution. Results : The research results show that emergency department teams face overcrowding at certain periods. This is particularly challenging for employees performing 24-hour standbys, when they are working at the limit of their capacity. The results show that the total cost of waiting lines with two physicians is higher in all cases. The introduction of an additional channel or employing an additional physician increases the total cost by 35 to 50 %. Employing an additional physician is therefore not economically justified. Conclusion : This study showed how a computer model can be used to improve the information basis for decision-making in healthcare organization management. Based on quantitative data obtained by using a model with alternative scenarios, we developed an economic analysis of alternatives and made a decision. The cost analysis of potentially employing an additional physician showed that the cost would exceed the benefits obtained in all scenarios analyzed. The proposed decision-support method can be implemented at a v","PeriodicalId":49350,"journal":{"name":"Zdravniski Vestnik-Slovenian Medical Journal","volume":"20 1","pages":"587-596"},"PeriodicalIF":0.0,"publicationDate":"2014-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"87599104","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2014-04-01DOI: 10.6016/SLOVMEDJOUR.V83I3.1139
Darinka Purg, A. Markota, Matej Berhardt
Lactate is a product of anaerobic metabolism, which can be used to detect the critically ill. Rapid recognition, early appropriate treatment and control of treatment success are paramount in that population. Lactate levels need to be available as soon as possible if they are to be of assistance at the bedside. Point-of-care analyzers enable rapid determination of lactate. The role of point-of-care lactate analyzers in the treatment of the critically ill, different analysis techniques and limitations of point-of-care lactate analyzers are presented. The use of point-of-care lactate analyzers is demonstrated in two cases of patients with sepsis. The first patient is a 73-year-old female, where point-of-care lactate was determined immediately. Septic shock with multi-organ failure developed. She was successfully treated and discharged after 14 days to home care. The second patient is a 62-year old male, where elevated lactate was detected after three hours. The patient died after a total of 5 months of treatment in the intensive care unit. Lactate can be an important tool in early recognition and treatment of the critically ill.
{"title":"Point-of-care lactate testing in emergency room.","authors":"Darinka Purg, A. Markota, Matej Berhardt","doi":"10.6016/SLOVMEDJOUR.V83I3.1139","DOIUrl":"https://doi.org/10.6016/SLOVMEDJOUR.V83I3.1139","url":null,"abstract":"Lactate is a product of anaerobic metabolism, which can be used to detect the critically ill. Rapid recognition, early appropriate treatment and control of treatment success are paramount in that population. Lactate levels need to be available as soon as possible if they are to be of assistance at the bedside. Point-of-care analyzers enable rapid determination of lactate. The role of point-of-care lactate analyzers in the treatment of the critically ill, different analysis techniques and limitations of point-of-care lactate analyzers are presented. The use of point-of-care lactate analyzers is demonstrated in two cases of patients with sepsis. The first patient is a 73-year-old female, where point-of-care lactate was determined immediately. Septic shock with multi-organ failure developed. She was successfully treated and discharged after 14 days to home care. The second patient is a 62-year old male, where elevated lactate was detected after three hours. The patient died after a total of 5 months of treatment in the intensive care unit. Lactate can be an important tool in early recognition and treatment of the critically ill.","PeriodicalId":49350,"journal":{"name":"Zdravniski Vestnik-Slovenian Medical Journal","volume":"44 1","pages":"265-269"},"PeriodicalIF":0.0,"publicationDate":"2014-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"90624100","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2014-04-01DOI: 10.6016/SLOVMEDJOUR.V83I3.1134
Andrej Baričič, A. T. Salaj
Background : The present article addresses the links between the real-estate factors of the workspace on employee satisfaction and their impact on the overall health of employees. The purpose of the research is to facilitate the improvement of employee health through the application of base parameters, and consequently, the changes of workspace and work processes. The research tests two hypotheses: real-estate factors have a significant impact on employee satisfaction with the workspace; and that satisfaction of employees with the workspace has a significant impact on the overall health of employees. Methodology : We carried out a quantitative research with a broad range of different questions, scales and differentials, whereby the majority of instruments was originally constructed with suitable measurement characteristics. Testing of the questionnaire with the method of internal consistency showed that the questionnaire demonstrates a high level of consistency. The entire questionnaire includes 163 variables divided into content sections: general questions, business building and workspace, workspace design, habits, conditions in the workspace, organisational culture, health care, physical health condition, mental health condition. In July and August 2010, the questionnaire was completed by 1,036 employees from entities in the service sector, i.e. the financial sector, health sector, civil service and others. All the respondents included in the research sample worked in offices. The questionnaire was anonymous in accordance with ethical standards. The results were statistically analysed with the application of factor analysis, which served as a basis for identifying the important factors, while we applied structural equation modelling for verifying the statistically significant mutual effects. Furthermore, we analysed the results and carried out statistical calculations to test the hypotheses. Results : The results show that real-estate factors of the workspace – both in terms of the assessment of business building and position of the employee, as well as the workspace design – have an impact on the satisfaction of employees, and consequently, their assessment of health. On the basis of solutions of structural equation modelling, we established that: the cleanliness of the workspace, lighting of the workspace, orientation of the workspace, regulation of lighting and regulation of air-conditioning in the premises, have a statistically significant impact on the satisfaction of employees with the workspace. With the aid of factor analysis and analysis of the structural equation modelling, as well as in accordance with the set hypotheses, we tested whether the ‘employment satisfaction’ factor affects the ‘overall health’ factor. We established a significant negative link between these two factors. Conclusions : We established a statistically significant impact of real-estate factors of the workspace on the satisfaction of employees, and consequently,
{"title":"The impact of office workspace on the satisfaction of employees and their overall health - research presentation.","authors":"Andrej Baričič, A. T. Salaj","doi":"10.6016/SLOVMEDJOUR.V83I3.1134","DOIUrl":"https://doi.org/10.6016/SLOVMEDJOUR.V83I3.1134","url":null,"abstract":"Background : The present article addresses the links between the real-estate factors of the workspace on employee satisfaction and their impact on the overall health of employees. The purpose of the research is to facilitate the improvement of employee health through the application of base parameters, and consequently, the changes of workspace and work processes. The research tests two hypotheses: real-estate factors have a significant impact on employee satisfaction with the workspace; and that satisfaction of employees with the workspace has a significant impact on the overall health of employees. Methodology : We carried out a quantitative research with a broad range of different questions, scales and differentials, whereby the majority of instruments was originally constructed with suitable measurement characteristics. Testing of the questionnaire with the method of internal consistency showed that the questionnaire demonstrates a high level of consistency. The entire questionnaire includes 163 variables divided into content sections: general questions, business building and workspace, workspace design, habits, conditions in the workspace, organisational culture, health care, physical health condition, mental health condition. In July and August 2010, the questionnaire was completed by 1,036 employees from entities in the service sector, i.e. the financial sector, health sector, civil service and others. All the respondents included in the research sample worked in offices. The questionnaire was anonymous in accordance with ethical standards. The results were statistically analysed with the application of factor analysis, which served as a basis for identifying the important factors, while we applied structural equation modelling for verifying the statistically significant mutual effects. Furthermore, we analysed the results and carried out statistical calculations to test the hypotheses. Results : The results show that real-estate factors of the workspace – both in terms of the assessment of business building and position of the employee, as well as the workspace design – have an impact on the satisfaction of employees, and consequently, their assessment of health. On the basis of solutions of structural equation modelling, we established that: the cleanliness of the workspace, lighting of the workspace, orientation of the workspace, regulation of lighting and regulation of air-conditioning in the premises, have a statistically significant impact on the satisfaction of employees with the workspace. With the aid of factor analysis and analysis of the structural equation modelling, as well as in accordance with the set hypotheses, we tested whether the ‘employment satisfaction’ factor affects the ‘overall health’ factor. We established a significant negative link between these two factors. Conclusions : We established a statistically significant impact of real-estate factors of the workspace on the satisfaction of employees, and consequently,","PeriodicalId":49350,"journal":{"name":"Zdravniski Vestnik-Slovenian Medical Journal","volume":"39 1","pages":"217-231"},"PeriodicalIF":0.0,"publicationDate":"2014-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"86322632","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2014-03-01DOI: 10.6016/SLOVMEDJOUR.V83I2.1097
M. Rems, Vlado Jurekovič, Polona Studen Pauletič
Background : Enhanced recovery after surgery (ERAS) protocol is a model of perioperative patient management where process optimisation helps to shorten patients’ recovery time. Application of ERAS protocol in colorectal cancer surgery is a demanding process, challenging our professional and organisational measures. Methods : A questionnaire regarding ERAS was sent to all thirteen heads of departments performing surgical treatment of colorectal cancer patients in Slovenia. The questionnaire was analyzed using Microsoft Excel Program. Results : There is a strong agreement among all the respondents that ERAS is a relevant clinical concept. Only seven clinical departments have developed a clinical pathway consistent with ERAS protocol, but principles of ERAS are followed at least partly or completely in twelve clinical departments. The most obvious is lack of activity before surgery, and particularly the educational interview with a dietitian and a physiotherapist. Less than half of the patients drink the glucose drink before surgery, and the same applies to the prophylaxis of nausea and vomiting. More than two thirds of patients are still subjected to mechanical bowel preparation before surgery. More than half of them have a central line and are admitted to intensive care unit (ICU) after surgery. More than 75 % of the patients do not sit up in bed or stand up on day 1 after surgery. More than half of them still have the nasogastric tube. Laparoscopy is used more frequently for colon and less for rectal surgery. Conclusions : Comparing this analysis with the one done in 2004, we can conclude that there is an important shortening of average planned hospital stay. Nevertheless, still the majority of patients are not managed according to the ERAS protocol. The implementation of ERAS concept in Slovenia is rather poor, contrary to what we would expect considering evidence-based positive effects, but nevertheless comparable to other’s experience.
{"title":"Enhanced recovery after surgery in patients with colorectal cancer in Slovenia 2012","authors":"M. Rems, Vlado Jurekovič, Polona Studen Pauletič","doi":"10.6016/SLOVMEDJOUR.V83I2.1097","DOIUrl":"https://doi.org/10.6016/SLOVMEDJOUR.V83I2.1097","url":null,"abstract":"Background : Enhanced recovery after surgery (ERAS) protocol is a model of perioperative patient management where process optimisation helps to shorten patients’ recovery time. Application of ERAS protocol in colorectal cancer surgery is a demanding process, challenging our professional and organisational measures. Methods : A questionnaire regarding ERAS was sent to all thirteen heads of departments performing surgical treatment of colorectal cancer patients in Slovenia. The questionnaire was analyzed using Microsoft Excel Program. Results : There is a strong agreement among all the respondents that ERAS is a relevant clinical concept. Only seven clinical departments have developed a clinical pathway consistent with ERAS protocol, but principles of ERAS are followed at least partly or completely in twelve clinical departments. The most obvious is lack of activity before surgery, and particularly the educational interview with a dietitian and a physiotherapist. Less than half of the patients drink the glucose drink before surgery, and the same applies to the prophylaxis of nausea and vomiting. More than two thirds of patients are still subjected to mechanical bowel preparation before surgery. More than half of them have a central line and are admitted to intensive care unit (ICU) after surgery. More than 75 % of the patients do not sit up in bed or stand up on day 1 after surgery. More than half of them still have the nasogastric tube. Laparoscopy is used more frequently for colon and less for rectal surgery. Conclusions : Comparing this analysis with the one done in 2004, we can conclude that there is an important shortening of average planned hospital stay. Nevertheless, still the majority of patients are not managed according to the ERAS protocol. The implementation of ERAS concept in Slovenia is rather poor, contrary to what we would expect considering evidence-based positive effects, but nevertheless comparable to other’s experience.","PeriodicalId":49350,"journal":{"name":"Zdravniski Vestnik-Slovenian Medical Journal","volume":"99 1","pages":"115-126"},"PeriodicalIF":0.0,"publicationDate":"2014-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"85912368","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2014-01-01DOI: 10.6016/SLOVMEDJOUR.V83I1.1078
J. Ambrožič, J. Toplišek, Ivana Knežević, M. Bunc, D. Stajer
Izvlecek Kronicna ishemicna mitralna regurgitacija (IMR) je napaka mitralne zaklopke, ki je posledica primarne okvare levega prekata zaradi koronarne bolezni. Nastane zaradi okvare krcenja in/ali preoblikovanja levega prekata, ki posredno onemogocata pravilno zapiranje mitralne zaklopke. Kronicna IMR ni posledica spremembe strukture mitralne zaklopke, prav tako ne stejemo za IMR akutne mitralne regurgitacije po infarktu. Kronicna IMR nastane v kronicnem obdobju srcnega infarkta pri okoli 20–50 % bolnikov, njena prevalenca v populaciji narasca. Prisotnost IMR je poleg oslabelega krcenja levega prekata najpomembnejsi negativen napovedni znak za preživetje po srcnem infarktu. Prognosticno je pomembna že regurgitacija, ki bi jo pri organski bolezni mitralne zaklopke steli za blago.
{"title":"Chronic ischemic mitral regurgitation - a diagnostic and therapeutic challenge.","authors":"J. Ambrožič, J. Toplišek, Ivana Knežević, M. Bunc, D. Stajer","doi":"10.6016/SLOVMEDJOUR.V83I1.1078","DOIUrl":"https://doi.org/10.6016/SLOVMEDJOUR.V83I1.1078","url":null,"abstract":"Izvlecek Kronicna ishemicna mitralna regurgitacija (IMR) je napaka mitralne zaklopke, ki je posledica primarne okvare levega prekata zaradi koronarne bolezni. Nastane zaradi okvare krcenja in/ali preoblikovanja levega prekata, ki posredno onemogocata pravilno zapiranje mitralne zaklopke. Kronicna IMR ni posledica spremembe strukture mitralne zaklopke, prav tako ne stejemo za IMR akutne mitralne regurgitacije po infarktu. Kronicna IMR nastane v kronicnem obdobju srcnega infarkta pri okoli 20–50 % bolnikov, njena prevalenca v populaciji narasca. Prisotnost IMR je poleg oslabelega krcenja levega prekata najpomembnejsi negativen napovedni znak za preživetje po srcnem infarktu. Prognosticno je pomembna že regurgitacija, ki bi jo pri organski bolezni mitralne zaklopke steli za blago.","PeriodicalId":49350,"journal":{"name":"Zdravniski Vestnik-Slovenian Medical Journal","volume":"26 1","pages":"54-69"},"PeriodicalIF":0.0,"publicationDate":"2014-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"84053950","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2014-01-01DOI: 10.6016/SLOVMEDJOUR.V83I5.1213
Tonka Poplas-Susič, Z. Klemenc-Ketiš, J. Kersnik
Background : The Patient information leaflet (PIL) is an important source of information for every patient. Little is known about whether patients read the PIL and whether it contains useful information. Other sources of drug-related information are professionals (a family practitioner, a pharmacist and a nurse). Informing patients on drugs improves their compliance. The aim of the study was to identify the usefulness of PIL from the perspective of the patient, to assess professionals as a source of drug-related information and to suggest changes that can improve informing and therefore patients’ compliances. Methods : Four focus group interviews were conducted across different primary health care centres in the North East of Slovenia. Focus groups were composed of randomly selected patients (in total 20) who were willing to express their views on PILs, on other drug information sources and on possible improvements. A qualitative analysis of the data was based of the transcription of the audiotapes. Results : Patients read the PILs selectively. They were most interested in side effects, contraindications and the purpose of the prescribed drug. Participants reported that the language in PILs is too scientific. In the case they do not understand PILs or they recognise some of the side effects, a majority of participants decide to contact a family physician first, and less frequently a pharmacist or a nurse. A family physician is considered to be the most trustworthy source of information and patients think that pharmacists could play a more active role in patients’ education. Conclusion : Current PILs offer enough partial information to patients but need some improvements in terms of better legibility and access to the most crucial information. PIL does not enable a comprehensive information with respect to patient’s health status. Most reliable source of information is considered to be a family practitioner. Pharmacists could play a more active role in the education of patients.
{"title":"Usefulness of the patient information leaflet (PIL) and information on medicines from professionals: A patients’ view. A qualitative study","authors":"Tonka Poplas-Susič, Z. Klemenc-Ketiš, J. Kersnik","doi":"10.6016/SLOVMEDJOUR.V83I5.1213","DOIUrl":"https://doi.org/10.6016/SLOVMEDJOUR.V83I5.1213","url":null,"abstract":"Background : The Patient information leaflet (PIL) is an important source of information for every patient. Little is known about whether patients read the PIL and whether it contains useful information. Other sources of drug-related information are professionals (a family practitioner, a pharmacist and a nurse). Informing patients on drugs improves their compliance. The aim of the study was to identify the usefulness of PIL from the perspective of the patient, to assess professionals as a source of drug-related information and to suggest changes that can improve informing and therefore patients’ compliances. Methods : Four focus group interviews were conducted across different primary health care centres in the North East of Slovenia. Focus groups were composed of randomly selected patients (in total 20) who were willing to express their views on PILs, on other drug information sources and on possible improvements. A qualitative analysis of the data was based of the transcription of the audiotapes. Results : Patients read the PILs selectively. They were most interested in side effects, contraindications and the purpose of the prescribed drug. Participants reported that the language in PILs is too scientific. In the case they do not understand PILs or they recognise some of the side effects, a majority of participants decide to contact a family physician first, and less frequently a pharmacist or a nurse. A family physician is considered to be the most trustworthy source of information and patients think that pharmacists could play a more active role in patients’ education. Conclusion : Current PILs offer enough partial information to patients but need some improvements in terms of better legibility and access to the most crucial information. PIL does not enable a comprehensive information with respect to patient’s health status. Most reliable source of information is considered to be a family practitioner. Pharmacists could play a more active role in the education of patients.","PeriodicalId":49350,"journal":{"name":"Zdravniski Vestnik-Slovenian Medical Journal","volume":"18 1","pages":"368-375"},"PeriodicalIF":0.0,"publicationDate":"2014-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"73955968","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2014-01-01DOI: 10.6016/SLOVMEDJOUR.V83I2.1110
M. Arnež, A. Gros
The article provides recommendations for evaluation and treatment of children with cochlear implants. An illustrative case of an infant with Haemophylus influenzae type e bacterial meningitis eighteen days following cochlear implant placement is reported. Indications for implantation and criteria to be fulfilled before implantation of cochlear implants are described. The importance of appropriate vaccination of children with cochlear implants as well as treatment of both acute otitis media and bacterial meningitis in these children is stressed.
{"title":"Infant with fever and cochlear implant.","authors":"M. Arnež, A. Gros","doi":"10.6016/SLOVMEDJOUR.V83I2.1110","DOIUrl":"https://doi.org/10.6016/SLOVMEDJOUR.V83I2.1110","url":null,"abstract":"The article provides recommendations for evaluation and treatment of children with cochlear implants. An illustrative case of an infant with Haemophylus influenzae type e bacterial meningitis eighteen days following cochlear implant placement is reported. Indications for implantation and criteria to be fulfilled before implantation of cochlear implants are described. The importance of appropriate vaccination of children with cochlear implants as well as treatment of both acute otitis media and bacterial meningitis in these children is stressed.","PeriodicalId":49350,"journal":{"name":"Zdravniski Vestnik-Slovenian Medical Journal","volume":"26 1","pages":"192-198"},"PeriodicalIF":0.0,"publicationDate":"2014-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"74734530","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2014-01-01DOI: 10.6016/SLOVMEDJOUR.V83I6.1243
Tina Pretnar, N. Hren, K. Rener-Sitar
Background : Implant-prosthodontic rehabilitation improves oral health related quality of life (OHRQoL), but the presence of systemic diseases can also affect the well-being of an individual. The study was carried out to determine the relationship between systemic diseases and OHRQoL after implant-prosthodontic rehabilitation on the basis of psychometric testing by a standardized questionnaire »Oral Health Impact Profile« (OHIP). Methods : 130 patients, who received one to eight Ankylos® implants (on average 2.6 ± 1.8) were included in this retrospective study in which all aspects of the OHRQoL construct were evaluated with a Slovenian version of the OHIP questionnaire. Data on all present systemic diseases were obtained from the existing health records. Dental status and dental restorations were identified on the basis of orthopantomographic images. Results: The majority of subjects had a cardiovascular disease (N = 37; 28.5 %), followed by a headache (N = 15, 11.5 %), allergies and asthma (n = 13, 10 %), and a rheumatic disease (N = 11, 8.5 %). Only osteoporosis was statistically significantly related to OHRQoL after implant-prosthodontic rehabilitation (p = 0.024). The best multiple linear regression model for the summary score for the questionnaire »Oral Health Impact Profile« for Slovenia (OHIP), and taking into account gender and age as confounding factors, included the number of remaining teeth and the presence of osteoporosis (p = 0.003, adjusted R2 = 0.104). Conclusions : The total number of remaining teeth in the oral cavity (p = 0.031), the presence of osteoporosis (p = 0.024), and taking into account the subject’s gender and age, are the most important clinical factors that affect the functioning of the SGS as well as psychosocial behavior of the patients after an implant-prosthodontic rehabilitation (adjusted R2 = 0.104). Other systemic diseases (cardiovascular disease, headache, allergies and asthma, rheumatic disease, obesity, gastritis, diabetes, thyroid disease) did not statistically significantly correlate with the OHRQoL concept.
{"title":"Impact of systemic diseases on oral health related quality of life after implant-prosthodontic rehabilitation.","authors":"Tina Pretnar, N. Hren, K. Rener-Sitar","doi":"10.6016/SLOVMEDJOUR.V83I6.1243","DOIUrl":"https://doi.org/10.6016/SLOVMEDJOUR.V83I6.1243","url":null,"abstract":"Background : Implant-prosthodontic rehabilitation improves oral health related quality of life (OHRQoL), but the presence of systemic diseases can also affect the well-being of an individual. The study was carried out to determine the relationship between systemic diseases and OHRQoL after implant-prosthodontic rehabilitation on the basis of psychometric testing by a standardized questionnaire »Oral Health Impact Profile« (OHIP). Methods : 130 patients, who received one to eight Ankylos® implants (on average 2.6 ± 1.8) were included in this retrospective study in which all aspects of the OHRQoL construct were evaluated with a Slovenian version of the OHIP questionnaire. Data on all present systemic diseases were obtained from the existing health records. Dental status and dental restorations were identified on the basis of orthopantomographic images. Results: The majority of subjects had a cardiovascular disease (N = 37; 28.5 %), followed by a headache (N = 15, 11.5 %), allergies and asthma (n = 13, 10 %), and a rheumatic disease (N = 11, 8.5 %). Only osteoporosis was statistically significantly related to OHRQoL after implant-prosthodontic rehabilitation (p = 0.024). The best multiple linear regression model for the summary score for the questionnaire »Oral Health Impact Profile« for Slovenia (OHIP), and taking into account gender and age as confounding factors, included the number of remaining teeth and the presence of osteoporosis (p = 0.003, adjusted R2 = 0.104). Conclusions : The total number of remaining teeth in the oral cavity (p = 0.031), the presence of osteoporosis (p = 0.024), and taking into account the subject’s gender and age, are the most important clinical factors that affect the functioning of the SGS as well as psychosocial behavior of the patients after an implant-prosthodontic rehabilitation (adjusted R2 = 0.104). Other systemic diseases (cardiovascular disease, headache, allergies and asthma, rheumatic disease, obesity, gastritis, diabetes, thyroid disease) did not statistically significantly correlate with the OHRQoL concept.","PeriodicalId":49350,"journal":{"name":"Zdravniski Vestnik-Slovenian Medical Journal","volume":"53 1","pages":"436-445"},"PeriodicalIF":0.0,"publicationDate":"2014-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"75174960","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2013-09-01DOI: 10.6016/SLOVMEDJOUR.V82I9.680
Bojana Avguštin Avčin, Nina Konečnik
Generalised anxiety disorder is characterised by persistent, excessive and difficult-to-control worry, which may be accompanied by several psychic and somatic symptoms, including suicidality. Generalized anxiety disorder is the most common psychiatric disorder in the primary care, although it is often underrecognised and undertreated. Generalized anxiety disorder is typically a chronic condition with low short- and medium-term remission rates. Clinical presentations often include depression, somatic illness, pain, fatigue and problems sleeping. The evaluation of prognosis is complicated by frequent comorbidity with other anxiety disorders and depression, which worsen the long-term outcome and accompanying burden of disability. The two main treatments for generalised anxiety disorder are medications and psychotherapy. Selective serotonin reuptake inhibitors and serotonin-norepinephrine reuptake inhibitors represent first-line psychopharmacologic treatment for generalised anxiety disorder. The most extensively studied psychotherapy for anxiety is cognitive behavioural therapy which has demonstrated efficacy throughout controlled studies.
{"title":"Generalised anxiety disorder","authors":"Bojana Avguštin Avčin, Nina Konečnik","doi":"10.6016/SLOVMEDJOUR.V82I9.680","DOIUrl":"https://doi.org/10.6016/SLOVMEDJOUR.V82I9.680","url":null,"abstract":"Generalised anxiety disorder is characterised by persistent, excessive and difficult-to-control worry, which may be accompanied by several psychic and somatic symptoms, including suicidality. Generalized anxiety disorder is the most common psychiatric disorder in the primary care, although it is often underrecognised and undertreated. Generalized anxiety disorder is typically a chronic condition with low short- and medium-term remission rates. Clinical presentations often include depression, somatic illness, pain, fatigue and problems sleeping. The evaluation of prognosis is complicated by frequent comorbidity with other anxiety disorders and depression, which worsen the long-term outcome and accompanying burden of disability. The two main treatments for generalised anxiety disorder are medications and psychotherapy. Selective serotonin reuptake inhibitors and serotonin-norepinephrine reuptake inhibitors represent first-line psychopharmacologic treatment for generalised anxiety disorder. The most extensively studied psychotherapy for anxiety is cognitive behavioural therapy which has demonstrated efficacy throughout controlled studies.","PeriodicalId":49350,"journal":{"name":"Zdravniski Vestnik-Slovenian Medical Journal","volume":"190 1","pages":"580-588"},"PeriodicalIF":0.0,"publicationDate":"2013-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"77748469","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2013-07-01DOI: 10.6016/SLOVMEDJOUR.V82I7.662
M. M. Premru, B. Beović, V. Špik
Background :Sepsis is one of the most serious bacterial infections. The diagnosis of sepsis is clinical. Microbiologists can detect bacteremia, which however is not present in all septic patients, by the procedure called blood culture. Methods :Blood culture is a semi-automated procedure of culturing blood in liquid media to detect and identify the causative agents. It is important to take 2 to 3 blood cultures with adequate volume of blood. The new, faster methods for bacterial identification from positive blood cultures and molecular methods for the detection of bacterial DNA directly from a blood sample are also becoming available. Results :In the years 2006 to 2011, the number of blood cultures obtained from patients in the University Medical Centre in Ljubljana, Institute of Oncology and the General hospital of Trbovlje (from 2007) was constantly increasing, from 18,404 in 2006 to 25,214 in 2011. The number of patients with positive blood culture/s increased from 1,033 in 2006 to 1,396 in 2011. The rate of blood culture positivity ranged from 10.9 % to 12.3 %. The ratio between gram-positive and gram-negative bacteria was approximately 50:50 %. In all the years under study, Escherichia coliwas the most frequent pathogenic isolate (19.2 % to 22.9 %), followed by Staphylococcus aureus(15.3 % to 17.4 %). Klebsiellaspp. represented 5.3 % to 8.3 % of isolates, Pseudomonas aeruginosa1.8 % to 3.4 %, Streptococcus pneumoniae2.9 % to 4.7 %, Enterococcusspp. 5.4 % to 8.1 %, anaerobes 2.1 % to 3.2 %. Coagulase-negative staphylococci decreased from 23.3 % to 16.9 %. Today, bacteria are identified by the fast and accurate method of mass spectrometry. Bacteria can alternativelly be detected directly from blood by the molecular tests. Conclusions :Blood culture is a very common procedure, its rate of positivity is stable. Among bacteria, the number and the proportion of pathogenic bacteria such as E. coli, S. aureusand S. pneumoniaeis increasing and the proportion of contaminants is decreasing
{"title":"Microbiological procedures in the diagnostics of sepsis","authors":"M. M. Premru, B. Beović, V. Špik","doi":"10.6016/SLOVMEDJOUR.V82I7.662","DOIUrl":"https://doi.org/10.6016/SLOVMEDJOUR.V82I7.662","url":null,"abstract":"Background :Sepsis is one of the most serious bacterial infections. The diagnosis of sepsis is clinical. Microbiologists can detect bacteremia, which however is not present in all septic patients, by the procedure called blood culture. Methods :Blood culture is a semi-automated procedure of culturing blood in liquid media to detect and identify the causative agents. It is important to take 2 to 3 blood cultures with adequate volume of blood. The new, faster methods for bacterial identification from positive blood cultures and molecular methods for the detection of bacterial DNA directly from a blood sample are also becoming available. Results :In the years 2006 to 2011, the number of blood cultures obtained from patients in the University Medical Centre in Ljubljana, Institute of Oncology and the General hospital of Trbovlje (from 2007) was constantly increasing, from 18,404 in 2006 to 25,214 in 2011. The number of patients with positive blood culture/s increased from 1,033 in 2006 to 1,396 in 2011. The rate of blood culture positivity ranged from 10.9 % to 12.3 %. The ratio between gram-positive and gram-negative bacteria was approximately 50:50 %. In all the years under study, Escherichia coliwas the most frequent pathogenic isolate (19.2 % to 22.9 %), followed by Staphylococcus aureus(15.3 % to 17.4 %). Klebsiellaspp. represented 5.3 % to 8.3 % of isolates, Pseudomonas aeruginosa1.8 % to 3.4 %, Streptococcus pneumoniae2.9 % to 4.7 %, Enterococcusspp. 5.4 % to 8.1 %, anaerobes 2.1 % to 3.2 %. Coagulase-negative staphylococci decreased from 23.3 % to 16.9 %. Today, bacteria are identified by the fast and accurate method of mass spectrometry. Bacteria can alternativelly be detected directly from blood by the molecular tests. Conclusions :Blood culture is a very common procedure, its rate of positivity is stable. Among bacteria, the number and the proportion of pathogenic bacteria such as E. coli, S. aureusand S. pneumoniaeis increasing and the proportion of contaminants is decreasing","PeriodicalId":49350,"journal":{"name":"Zdravniski Vestnik-Slovenian Medical Journal","volume":"109 1","pages":"445-451"},"PeriodicalIF":0.0,"publicationDate":"2013-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"80621341","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
京公网安备 11010802042870号
京ICP备2023020795号-1
扫码关注我们
求助内容：
应助结果提醒方式：