Pouzdanost urodinamske obrade u potvrdi stresne inkontinencije mokraće u odnosu na Bonney test

According to the International Continence Society, stress (static) urinary incontinence is defined as any involuntary loss of urine on effort or physical exertion, due to which intravesical pressure overcomes urethral pressure, with no detrusor activity. Urodynamic testing accurately assesses the function of the bladder and urethra. The urodynamic assessment includes three tests: cystometry, uroflowmetry and profilometry (determination of urethral pressure profile). Prior to urodynamic assessment, it is mandatory to rule out urinary tract infection since it is an invasive test. Urethral profilometry is a technique that measures pressure in the urethra and bladder at rest, during stressful actions, and during the act of miction. Its main purpose is to evaluate the sphincter mechanism. During the examination, a special catheter is used, which is being slowly pulled out from the bladder neck throughout the urethra, with continuous recording of intraurethral pressure. In addition to measuring urethral pressures, stress urinary incontinence is also very successfully proven by the cough test and Bonney test. If, on forced cough, the urine escapes uncontrollably, and continence is restored by finger lifting the neck of the bladder, the diagnosis of static incontinence is confirmed. At our urogynecologic clinic, urodynamic examination is being routinely performed. In the present study, we included patients previously treated for urinary stress incontinence and compared their results of urodynamic assessment to the results of Bonney test. Of the 43 subjects in whom stress incontinence was proven with Bonney test, we recorded an appropriate profilometry result in 13 cases.Stresna (statička) inkontinencija mokraće definira se prema ICS-u kao neželjeno otjecanje mokraće kroz uretru istodobno s porastom intraabdominalnog tlaka zbog kojeg intravezikalni tlak nadvlada tlak u uretri, uz odsutnu aktivnost detruzora. Urodinamskom obradom precizno se procjenjuje funkcija mokraćnog mjehura i mokraćne cijevi. U urodinamsku obadu ubrajajmo tri metode: cistometriju, mikciometriju (uroflow) i profilometriju (određivanje profila uretralnog tlaka). Prije urodinamske obrade moramo uvijek isključiti infekciju mokraćnih kanala, jer se radi o invazivnoj pretrazi. Profilometrija uretre je tehnika kojom mjerimo tlak u uretri kod mokraćnog mjehura u mirovanju, tijekom stresnih radnja i samog akta mokrenja. Osnovna joj je namjena ispitivanje sfinkterskoga mehanizma. Pri pregledu rabi se specijalni kateter koji se malom brzinom povlači od vrata mjehura prema distalno uz kontinuirano bilježenje intrauretralnoga tlaka. Uz mjerenje tlakova uretre stresna inkontinencija mokraće se vrlo uspješno dokazuje i testom kašlja, odnosno Bonney testom. Ako kod forsiranog kašlja mokraća nekontrolirano otječe, a podizanjem vrata mokraćnog mjehura prstima ispitanica uspijeva zadržati mokraću u mjehuru, radi se o statičkoj inkontinenciji. U OB “Dr Josip Benčević’’ pri uroginekološkoj ambulanti radi se urodinamsko ispitivanje. U ovo istraživanje uključili smo samo ispitanice s liječenom stresnom inkontinencijom mokraće te smo usporedili njihove rezultate na urodinamskoj obradi u odnosu na rezultate Bonney testa. Od 43 ispitanice kojima smo stresnu inkontinenciju dokazali Bonney testom u 13 slučajeva zabilježili smo uredan nalaz profilometrije

Characteristics of the patients in the National Programme for Early Detection of Colorectal Cancer in Osijek – Baranja County, Croatia

Cilj istraživanja: Usporediti udio patoloških nalaza (naprednih adenoma i karcinoma) ispitanika NP-a s nalazima pacijenata koji su kolonoskopski pregled obavili ambulantnim putem, s posebnim osvrtom na udio rizičnih čimbenika za nastanak bolesti u obje skupine. Nacrt studije: Istraživanje slučajeva i kontrola Ispitanici i metode: Istraživanje je provedeno u Osječko-baranjskoj županiji (OBŽ), od prosinca 2013. do srpnja 2017. godine. Skupinu slučajeva činili su sudionici Nacionalnoga programa otkrivanja raka debeloga crijeva (NP), dobi od 50 - 74 godine s patohistološkim nalazima naprednih adenoma i karcinoma. Kontrolnu skupinu činili su ambulantni pacijenti koji su kolonoskopski pregled obavili redovnim putem, zbog prisutnih simptoma. Prema zadanim kriterijima uparivanja pronašli smo 90 osoba istih karakteristika koje su se mogle uspoređivati s osobama iz našega uzorka (spol, dob te vremenski period obavljanja kolonoskopskoga pregleda). Podaci su prikupljani iz anketnoga upitnika sudionika NP-a, a podaci ambulantnih pacijenta prikupljeni su iz kartona LOM-a. Analizirani su kolonoskopski i patohistološki nalazi ispitanika obje skupine. Rezultati: Rezultati analize rizičnih čimbenika pokazali su da je među sudionicima NP-a značajno manji udio pušača (P = 0,03) te je značajno manja količina konzumiranih cigareta dnevno (P = 0,02). Sudionici NP-a u statistički značajno većem postotku konzumiraju alkohol (P = 0,04), ali manju dnevnu količinu (P = 0,06) u usporedbi s ambulantnim pacijentima. Muškarci u značajno većem postotku konzumiraju alkohol (P < 0,001). Ambulantni pacijenti u značajno su većem postotku neaktivni (P = 0,04). Podjednak je postotak ispitanika koji imaju dijagnosticiran adenom, odnosno karcinom, i konzumiraju alkohol (P = 0,92), cigarete (P = 0,16), razlike nema niti po pitanju tjelesne aktivnosti (P = 0,76). Najčešća dijagnoza istraživanja je tubularni adenom, prisutna kod 53,3 % ispitanika. Prema skupinama, kod sudionika NP-a značajno je češća dijagnoza tubularni adenom (P < 0,001), a hemoroidi su se značajno češće javili kod ambulantnih pacijenata (P < 0,001). Najčešći simptom istraživanja je „krv u stolici“, prisutan kod 23,3 % ispitanika. Zaključak: Ambulantni pacijenti u značajno većem postotku imaju prisutne rizične čimbenike, u odnosu na sudionike NP-a. Nije otkrivena značajna povezanost dijagnoza kolorektalnih adenoma i karcinoma s promatranim ponašajnim čimbenicima rizika.Aim: The aim of this study was to compare the proportion of pathological findings (advanced adenomas and cancers) of the participants in the National Programme (NP) with the findings obtained in patients who underwent colonoscopy in outpatient clinic, taking specifically into account the proportion of risk factors for desase development present in both groups of patients. Study design: Case study and control group Subjects and methods: The study was carried out in Osijek – Baranja County (OBC), from December 2013 to July 2017. The examined subjects included the participants of the National Programme for Early Detection of Colorectal Cancer (NP) in the 50-74 age range who had pathohistological findings of advanced adenomas and cancers and the control group. The control group consisted of patients referred to outpatient clinic for colonoscopy due to presence of symptoms. According to pre-set criteria (gender, age and when the colonoscopy was performed), there were 90 subjects in the control group having the same characteristics, who were compared with the subjects from the NP sample group. The data for the NP particiants were taken from the NP questionnaire, while the data for the outpatients were taken from patients' medical records. Colonoscopy and pathohistological results were analysed for both groups of subjects. Results: Risk factors analysis showed that the proportion of smokers was significantly lower among the NP participants (P=0.03) than in the outpatients. Also, the number of cigarettes consumed daily was significantly lower (P=0.02) in this group. However, significantly higher percentage of the NP participants consumed alcohol (P=0.04), although in smaller daily amounts (P=0.06) in comparison to outpatients. Significantly higher percentage of men consumed alcohol (P<0.001), while significantly higher percentage of outpatients was inactive (P=0.04). Approximately the same percentage of subjects with diagnosed adenomas or cancers consumed alcohol (P=0.92) and cigarettes (P=0.16). The results were similar regarding physical activity in both groups (P=0.76). The most common diagnosis in the research was tubular adenoma, in 53.3 % of subjects. However, tubular adenoma was significantly more commonly diagnosed in the NP participants (P=0.001), while hemorrhoids were more common in outpatients (P<0.001). Blood in stool was the most common symptom in the research, evident in 23.3 % of subjects. Conclusion: Risk factors were present in outpatients in significantly higher percentage than in NP participants. There was no significant correlation between colorectal adenoma and cancer diagnoses and analysed behavioral risk factors

Characteristics of the patients in the National Programme for Early Detection of Colorectal Cancer in Osijek – Baranja County, Croatia

Cilj istraživanja: Usporediti udio patoloških nalaza (naprednih adenoma i karcinoma) ispitanika NP-a s nalazima pacijenata koji su kolonoskopski pregled obavili ambulantnim putem, s posebnim osvrtom na udio rizičnih čimbenika za nastanak bolesti u obje skupine. Nacrt studije: Istraživanje slučajeva i kontrola Ispitanici i metode: Istraživanje je provedeno u Osječko-baranjskoj županiji (OBŽ), od prosinca 2013. do srpnja 2017. godine. Skupinu slučajeva činili su sudionici Nacionalnoga programa otkrivanja raka debeloga crijeva (NP), dobi od 50 - 74 godine s patohistološkim nalazima naprednih adenoma i karcinoma. Kontrolnu skupinu činili su ambulantni pacijenti koji su kolonoskopski pregled obavili redovnim putem, zbog prisutnih simptoma. Prema zadanim kriterijima uparivanja pronašli smo 90 osoba istih karakteristika koje su se mogle uspoređivati s osobama iz našega uzorka (spol, dob te vremenski period obavljanja kolonoskopskoga pregleda). Podaci su prikupljani iz anketnoga upitnika sudionika NP-a, a podaci ambulantnih pacijenta prikupljeni su iz kartona LOM-a. Analizirani su kolonoskopski i patohistološki nalazi ispitanika obje skupine. Rezultati: Rezultati analize rizičnih čimbenika pokazali su da je među sudionicima NP-a značajno manji udio pušača (P = 0,03) te je značajno manja količina konzumiranih cigareta dnevno (P = 0,02). Sudionici NP-a u statistički značajno većem postotku konzumiraju alkohol (P = 0,04), ali manju dnevnu količinu (P = 0,06) u usporedbi s ambulantnim pacijentima. Muškarci u značajno većem postotku konzumiraju alkohol (P < 0,001). Ambulantni pacijenti u značajno su većem postotku neaktivni (P = 0,04). Podjednak je postotak ispitanika koji imaju dijagnosticiran adenom, odnosno karcinom, i konzumiraju alkohol (P = 0,92), cigarete (P = 0,16), razlike nema niti po pitanju tjelesne aktivnosti (P = 0,76). Najčešća dijagnoza istraživanja je tubularni adenom, prisutna kod 53,3 % ispitanika. Prema skupinama, kod sudionika NP-a značajno je češća dijagnoza tubularni adenom (P < 0,001), a hemoroidi su se značajno češće javili kod ambulantnih pacijenata (P < 0,001). Najčešći simptom istraživanja je „krv u stolici“, prisutan kod 23,3 % ispitanika. Zaključak: Ambulantni pacijenti u značajno većem postotku imaju prisutne rizične čimbenike, u odnosu na sudionike NP-a. Nije otkrivena značajna povezanost dijagnoza kolorektalnih adenoma i karcinoma s promatranim ponašajnim čimbenicima rizika.Aim: The aim of this study was to compare the proportion of pathological findings (advanced adenomas and cancers) of the participants in the National Programme (NP) with the findings obtained in patients who underwent colonoscopy in outpatient clinic, taking specifically into account the proportion of risk factors for desase development present in both groups of patients. Study design: Case study and control group Subjects and methods: The study was carried out in Osijek – Baranja County (OBC), from December 2013 to July 2017. The examined subjects included the participants of the National Programme for Early Detection of Colorectal Cancer (NP) in the 50-74 age range who had pathohistological findings of advanced adenomas and cancers and the control group. The control group consisted of patients referred to outpatient clinic for colonoscopy due to presence of symptoms. According to pre-set criteria (gender, age and when the colonoscopy was performed), there were 90 subjects in the control group having the same characteristics, who were compared with the subjects from the NP sample group. The data for the NP particiants were taken from the NP questionnaire, while the data for the outpatients were taken from patients' medical records. Colonoscopy and pathohistological results were analysed for both groups of subjects. Results: Risk factors analysis showed that the proportion of smokers was significantly lower among the NP participants (P=0.03) than in the outpatients. Also, the number of cigarettes consumed daily was significantly lower (P=0.02) in this group. However, significantly higher percentage of the NP participants consumed alcohol (P=0.04), although in smaller daily amounts (P=0.06) in comparison to outpatients. Significantly higher percentage of men consumed alcohol (P<0.001), while significantly higher percentage of outpatients was inactive (P=0.04). Approximately the same percentage of subjects with diagnosed adenomas or cancers consumed alcohol (P=0.92) and cigarettes (P=0.16). The results were similar regarding physical activity in both groups (P=0.76). The most common diagnosis in the research was tubular adenoma, in 53.3 % of subjects. However, tubular adenoma was significantly more commonly diagnosed in the NP participants (P=0.001), while hemorrhoids were more common in outpatients (P<0.001). Blood in stool was the most common symptom in the research, evident in 23.3 % of subjects. Conclusion: Risk factors were present in outpatients in significantly higher percentage than in NP participants. There was no significant correlation between colorectal adenoma and cancer diagnoses and analysed behavioral risk factors

Upitnik uvjerenja o lijekovima (BMQ) kod pacijenata s kroničnim bolom

The aim of this study was to identify demographic and disease characteristics associated with different medication beliefs of patients with chronic non-malignant pain and to investigate beliefs about medicines and their association with medicine adherence. Data were collected from 202 patients using the Beliefs about Medicines Questionnaire (BMQ) and the Numeric Rating Scale (NRS). According to four different attitudinal constructs, the results indicate that the majority of patients were Indifferent, followed by Distrustful and Mixed-feelings, whereas the lowest proportion of patients were In-favour. The highest patient age was found in the In-favour and Indifferent constructs. Primary education level was the most represented in the In-favour construct. The most patients in the In-favour, Indifferent and Distrustful constructs used a combination of non-steroidal anti-inflammatory drugs (NSAID) and opioids. In the Mixed-feelings construct, patients mostly used a combination of paracetamol and NSAIDs. Most patients in the In-favour and Mixed-feelings construct reported severe pain. In the Indifferent and Distrustful constructs, most patients reported moderate pain. The study results indicate am association between some demographic characteristics and medications beliefs and that constructs could be predictors of adherence. The BMQ can be used to identify patients who are at risk of non-adherence and can be used in multidisciplinary pain programs.Cilj ovog istraživanja bio je identificirati demografske karakteristike i karakteristike bolesti povezane s različitim stavovima pacijenata s kroničnom nemalignom boli o lijekovima, te istražiti uvjerenja o lijekovima i njihovu povezanost s pridržavanjem uzimanja lijekova. Podaci su prikupljeni od 202 pacijenta pomoću Upitnika stavova o lijekovima (BMQ) i Numeričke skale boli (NRS). Prema četiri različita konstrukta stava, rezultati pokazuju da je većina pacijenata Ravnodušna, zatim Nepovjerljiva i Ambivalentna, a najmanji udio pacijenata je pripada u Prihvatljivi konstrukt. S obzirom na prosječnu dob, najstariji pacijenti bili su u konstruktima Prihvaćajući i Ravnodušni. Razina osnovnog obrazovanja bila je najzastupljenija u konstruktu Prihvaćajućih. Većina pacijenata u konstruktima Prihvaćajući, Ravnodušni i Nepovjerljivi koristila je kombinaciju nesteroidnih protuupalnih lijekova i opioida. U konstruktu Ambivalentni pacijenti su uglavnom koristili kombinaciju paracetamola i nesteroidnih protuupalnih lijekova. Većina pacijenata u konstruktu Prihvaćajući i Ambivalentni izvještavalo je o jakoj boli, dok je u konstruktima Ravnodušni i Nepovjerljivi većina pacijenata procijenila bol umjerenom. Rezultati istraživanja ukazuju na povezanost pojedinih demografskih obilježja sa stavovima o lijekovima te da bi konstrukti mogli biti prediktori adherencije. BMQ se može koristiti za identificiranje pacijenata kod kojih postoji rizik od nepridržavanja te se može koristiti u multidisciplinarnom programu za liječenje boli

Quality of Life and Mental Distress in Patients with Chronic Low Back Pain: A Cross-Sectional Study

The aim of this study was to examine the levels of health-related quality of life (HRQoL), pain intensity, and mental distress in participants with chronic low back pain (CLBP), and to examine the differences in the HRQoL of participants with respect to mental distress and the correlations of the examined variables. Data were collected from 148 patients using the SF-36 Health Status Questionnaire (SF-36), the Clinical Outcomes in Routine Evaluation&ndash;Outcome Measure (CORE-OM) questionnaire, and the visual-analog pain scale (VAS). The results indicate poorer self-assessment of physical health (Me = 28.1) compared to mental health (Me = 39.4). Participants with higher levels of mental distress reported significant emotional limitations (p = 0.003), lower energy (p &lt; 0.001), poorer psychological health (p &lt; 0.001) and social functioning (p &lt; 0.001), more pain (p = 0.007), and, ultimately, poorer general health (p &lt; 0.001). The level of mental distress was related to the level of HRQoL, while a correlation with the level of pain of the participants was not found. The study results indicate a connection between the presence of mental distress and almost all aspects of HRQoL in participants with CLBP

Pre-Vaccination COVID-19 Vaccine Literacy in a Croatian Adult Population: A Cross-Sectional Study

Despite world-level efforts and the endeavors of scientists and medical professionals in suppressing the COVID-19 pandemic, inadequate levels of vaccine literacy of the general population can represent a grave obstacle. The aim of this study was to evaluate COVID-19 vaccine literacy in the Croatian adult general population before vaccination began. The specific objectives were to test differences regarding socio-demographic characteristics and to examine perceptions and attitudes about vaccination against COVID-19 considering the level of VL against COVID-19. A cross-sectional study with a translated and psychometrically tested questionnaire was conducted in 1227 participants before the start of vaccination, from 15 to 31 January 2021. The results show a medium level of vaccine literacy (M = 2.37, SD = 0.54) and a significant difference between functional and interactive-critical vaccine literacy (p &lt; 0.001). The level of vaccine literacy grew with the level of education (p = 0.031) and reduced with age (p &lt; 0.001). Participants who were employed, had chronic diseases, took medicine, or consumed alcohol daily had a lower level of vaccine literacy. There is room for progress in the COVID-19 VL level for the adult population in Croatia, especially at the interactive-critical VL, which could have an important role in people accepting the vaccine against the COVID-19 disease. A satisfactory level of vaccine literacy in the population is necessary because it can contribute to the fight against the pandemic