21 research outputs found
QUALITY OF LIFE AND PERSONALITY TRAITS IN PATIENTS WITH COLORECTAL CANCER
Background: The aim of this study was to determine whether it is possible to predict quality of life in patients with colorectal
cancer on the basis of personality dimensions from the Five-factor model.
Subjects and methods: The study included 56 patients with colorectal cancer (40 men and 16 women), aged 48-87. The
following instruments were used: the Questionnaire on General Information and Lifestyle Habits, the Quality of Life Scale, and the
Neo Five-Factor Inventory.
Results: The results of overall quality of life estimations of colorectal cancer patients were comparable to those of healthy
people. Contrary to expectations, extraversion was not a significant quality of life predictor. Neuroticism as a personality trait was
the only variable which consistently proved to be highly significant across analyses in the prediction of total quality of life,
satisfaction with past life, future expectations, and comparison with others. Key determinants of neuroticism are a proneness to
experiencing negative affects which makes adaptation difficult, a proneness to irrational ideas, reduced impulse control, ineffective
coping strategies, the perception of poor control over oneself and others, and deeming oneās own resources to be insufficient to
adequately cope with stress, thus resulting in a more negative quality of life estimation.
Conclusion: These results support the conclusion that cognitive-behavioral interventions aimed at changing negative
attributions, reducing tension and negative affects, acquiring more effective coping strategies, strengthening perceived personal
control, redefining and re-conceptualizing quality of life, and seeking/receiving more adequate social support could lead to an
improved quality of life in patients with colorectal cancer
History of the first hospice department in Croatia
U proljeÄe 1991. godine Službi za neurologiju i psihijatriju požeÅ”ke bolnice pridružen je novi odjel Äija je organizacija dijelom inspirirana "St Christopherās Hospice" pokretom. Namijenjen je prije svega za palijativnu skrb bolesnika u krajnjem stadiju bolesti, te za pružanje pomoÄi obitelji u ophoÄenju sa oboljelim u zavrÅ”nom stadiju bolesti. Bio je otvoren za sve stanovnike bez obzira na dob, spol, vjeru i moguÄnost plaÄanja. Tijekom domovinskog rata teÅ”koÄe su u financiranju hospicija i osipanje srednjeg medicinskog kadra dostigle kritiÄnu toÄku, Å”to je rezultiralo raspuÅ”tanjem hospicijskog odjela nakon godinu dana ozbiljnog i humanog rada. NaÅ”e iskustvo može biti veoma korisno u analizi problema kako dio hospitala pretvoriti u hospicij u želji da se postigne struÄna medicinska i psiholoÅ”ka pomoÄ bolesnicima i Älanovima njihove obitelji u krajnjem stadiju bolesti.In the spring of 1991 a new department, inspired by the "St Christopherās Hospice" movement, was added to the Neuropsychiatric Service of the District General Hospital in Požega. The purpose of this new hospice was palliative care for the patients in terminal stages of illness. It was also intended to help the family communicate with the patient in the last stages of illiness. The department was open to all, regardless of sex, age, religion or ability to pay. During the war in Croatia the Hospitalās financial problems and a lack of nurses reached a critical point, which resulted in the closure of the hospice after a year of dedicated service. Our experience could be helpful in discussing how to transform a part of a hospital into a hospice, in order to provide better medical and psychological care for the patients in terminal stages of illiness and their families
Professional and scientific papers published by the doctora of Požega hospital from 1936-1996
Prva požeÅ”ka bolnica otvorena je 1836. godine, a danaÅ”nja moderna bolnica 1936. godine. Prvi struÄni rad, nastao u požeÅ”koj bolnici, objavio je u LijeÄniÄkom vjesniku 1939. godine njen ravnatelj, kirurg dr. Artur Horvat. Od tada je objavljeno 89 struÄnih radova, obranjen jedan doktorat i 11 magisterija, te za kontinuirani struÄni rad dodijeljeno pet primarijata. Danas OpÄa županijska bolnica Požega ima 56 specijalista razliÄitih medicinskih grana i 16 specijalizanata, te vrlo visoki standard glede prostora i medicinske opreme.The hospital in Požega was first founded in 1836 and the present day modern hospital was opened in 1936. Its principal and surgeon Dr. Antun Horvat published the first professional paper made at Požega Hospital in LijeÄniÄki vjesnik in 1939. Since then, 89 professional papers were published and one Ph.D. dissertation as well as 11 MA these was defended. Five doctors were awarded the title of primarius for continous professional work. Today Požega Hospital employs 56 specialists in different fields of medicine and 16 residents. It sets very high standards for hospital rooms and medical equipment
Minimalno invazivne metode u lije^enju raka dojke: pregled protokola
One can find an increasing number of articles with minimally invasive methods in current literature concerning local treatment of breast cancer. The methods can be divided in two groups: percutaneous excision methods and thermal ablation methods. Thermal ablation methods are based on the premise that malignant tissue is more sensitive to hyperthermia than normal cells.
We are comparing advantages and disadvantages of current minimally invasive methods for treatment of early stage breast cancers, showing differences and advantages over breast-conserving surgery. Available published studies and protocols are overviewed.
Most of the published works emphasize advantages over classic breast surgery such as: lower costs, less trauma for patients and smaller invasiveness. All methods involving thermal procedures require surgical excision afterwards for evaluation of necrosis and patohistological evaluation of the lesion.
The effect of these treatment methods should be safety, painlessness, good cosmetic results and lower treatment costs. If results of such methods are to be comparable to BCS, we can expect their integration in clinical practice.U suvremenom pristupu lokalnog lijeÄenja tumora dojke sve viÅ”e prostora u struÄnim publikacijama zauzimaju izvjeÅ”Äa o primjeni tzv. minimalno invazivnih metoda, meÄu kojima su dvije osnovne skupine: perkutane ekscizijske metode i termalne ablacijske metode. Temelj termalnih ablacijskih postupaka u lijeÄenju tumora dojke leži u Äinjenici da tumori pokazuju veÄu senzitivnost na hipertermiÄka oÅ”teÄenja od normalnih stanica.
U radu se nastoje komparacijom prednosti i nedostataka ovih suvremenih minimalno invazivnih metoda u lijeÄenju tumora dojke nižih stadija, utvrditi razlika i eventualna prednost tih postupaka prema poÅ”tednim kirurÅ”kim zahvatima . Pregledani su dostupni publicirani protokoli i iskustva u provoÄenju perkutanih bioptiÄkih metoda i nekih termalnih ablacijskih metoda u minimalno invazivnoj kirurgiji dojke.
U veÄini pregledanih publikacija i protokola, naglaÅ”ena je prednost opisanih metoda nad klasiÄnom kirurgijom dojke, koja je izražena u nižim troÅ”kovima, smanjenju psihiÄkih trauma lijeÄenih bolesnica i niskom razinom invazivnosti. U gotovo svim pregledanim protokolima koji se odnose na tzv. termalne metode uoÄena je potreba za naknadnom kirurÅ”kom ekscizijom radi procjene stupnja nekroze i patohistoloÅ”ke provjere lezije.
UspjeÅ”nost lijeÄenja tumora dojke ovim metodama bi se trebala temeljiti na sigurnosti, bezbolnosti, dobrim kozmetiÄkim rezultatima i nižim troÅ”kovima lijeÄenja. Ove bi metode mogle doživjeti punu primjenu u kliniÄkoj praksi ako se njima postigne rezultat ekvivalentan onome koji se postiže sa poÅ”tednim kirurÅ”kim zahvatima (BCS)
Pregnancy and Vaginal Delivery in Epidural Analgesia in Woman with Cerebrospinal Fluid Shunt
Hydrocephalus is a medical condition characterized by enlargement of cerebral ventricles due to abnormal cerebro- spinal fluid accumulation. Hydrocephalic women with cerebrospinal fluid (CSF) shunts are now surviving to reproduc- tive age, but still there are doubts regarding the mode of delivery, analgesia and anesthesia. Postpartal complications are more frequently described in deliveries ended by cesarean section than in spontaneous vaginal deliveries. We present a case of labor in the 32-year old woman, with congenital hydrocephalus and a preexisting ventriculoperitoneal (VP) shunt. After thorough review of current literature, we came to conclusion that without absolute neurosurgical indication or acute development of listed symptoms (headaches, irritability, light sensitivity, hyperesthesia nausea, vomiting, ver- tigo, migraines, seizures, weakness in the arms or legs, strabismus and double vision) the best way to finish the preg- nancy of woman with VP shunt is spontaneous vaginal delivery with the use of epidural analgesia, mediolateral episiotomy and vacuum extraction
POUZDANOST GINEKOLOŠKOG PREGLEDA U DIFERENCIJALNOJ DIJAGNOSTICI UPALE CRVULJKA ŽENA REPRODUKTIVNE DOBI
The aim of the study was to examine the differential-diagnostical reliability of gynaecological examination in women of reproductive age who have shown clinical symptoms of acute abdomen in the lower right quadrant, with a dilemma whether this was due to acute appendicitis or acute gynaecological disease. Patients and methods. During the 15-year period (from 1988 to 2003), there were 530 women of reproductive age who underwent surgery for suspected acute appendicitis at County Hospital in Požega. Case histories, intraoperative findings, pathohistological findings, as well as consultative gynaecological findings were analysed retrospectively. For statistical analysis .2 test was used, with measuring confidence intervals at the level of 95% (p<0.05). Results. Out of 530 women of reproductive age included in the study, 159 of them were referred to a gynaecological examination (group A) and 371 of them were not (group B). In the group A (n=159), 34 (21.4%) women were diagnosed with a gynaecological disease intraoperatively even though the previous palpatory gynaecological findings were normal. In the group B (n=371), 22 (5.9%) patients were diagnosed with a gynaecological disease intraoperatively but these patients were not referred to a gynaecologist at all. Among all the women at 34 was diagnosed an ovarian cyst, at 12 a tubo-ovarian abscess, at 9 a pelvic inflammatory disease and at 1 an ovarian torsion. A significant (p<0.05, .2=26.516; odds ratio=4.31; CI 95%=2.43ā7.65) unreliability of bimanual gynae-cological examination was found in diagnosing an acute gynaecological pathology in female patients who were referred to a consultation by a surgeon. Conclusion. The results of this study suggest a significant unreliability of bimanual gynaeco-logical examination in differential diagnosis of acute abdomen in women of reproductive age. Clinical work should, at any rate, include other diagnostical methods (US; CT; laparoscopy, MRI), aiming at a more precise diagnosis, which would then lead to the application of a more adequate therapy.Cilj rada bio je istražiti diferencijalno dijagnostiÄku pouzdanost ginekoloÅ”kog pregleda kod žena reproduk-
tivne dobi koje imaju kliniÄku sliku akutnog abdomena desnog donjeg kvadranta uz postojanje dileme radi li se o akutnoj upali crvuljka ili akutnoj ginekoloÅ”koj bolesti. Bolesnici i metode. U 15 godiÅ”njem razdoblju (od 1988. do 2003. godine) u OpÄoj županijskoj bolnici Požega operirano je 530 žena reproduktivne dobi zbog sumnje na akutni apendicitis. Retro-spektivno su analizirane povijesti bolesti, intraoperacijski nalaz, patohistoloÅ”ki nalaz, te konzilijarni ginekoloÅ”ki nalaz. StatistiÄka analiza uÄinjena je .2 testom uz mjerenje intervala pouzdanosti na razini od 95% (p<0,05). Rezultati. Od 530 žena reproduktivne dobi ukljuÄenih u studiju, 159 je bilo upuÄeno na ginekoloÅ”ki pregled (skupina A), a 371 nije (skupina B). U skupini A (N=159) intraoperacijski je kod 34 žene naÄena ginekoloÅ”ka bolest iako je prethodni palpatorni ginekoloÅ”ki nalaz bio uredan. U skupini B (N=371) intraoperacijski je kod 22 bolesnice naÄena ginekoloÅ”ka bolest, ali te bolesnice nisu bile upuÄene ginekologu. Od svih 530 žena u 34 naÄena je rupturirana ovarijalna cista, tubo-ovarijalni absces u 12 bolesnica, u 9 upalni proces u maloj zdjelici i torzija ovarija u 1 bolesnice. NaÄena je znaÄajna (p<0,05, .2=26,516; odds ratio=4,31, CI 95%=2,43ā7,65) nepouzdanost bimanualnog ginekoloÅ”kog pregleda radi utvrÄivanja akutne ginekoloÅ”ke patologije kod pacijentica upuÄenih na konzultaciju kirurga. ZakljuÄak. Rezultati ovog rada upuÄuju na znaÄajnu nepouz-danost bimanuelnog ginekoloÅ”kog pregleda u diferencijalnoj dijagnostici akutnog abdomena kod žena reproduktivne dobi. Svakako treba u kliniÄkom radu ukljuÄiti druge dijagnostiÄke metode (UZV, CT, laparoskopija, MRI) zbog postavljanja sigurnije dijagnoze, pa time i primjenjivanja adekvatnije terapije
Minimalno invazivne metode u lije^enju raka dojke: pregled protokola
One can find an increasing number of articles with minimally invasive methods in current literature concerning local treatment of breast cancer. The methods can be divided in two groups: percutaneous excision methods and thermal ablation methods. Thermal ablation methods are based on the premise that malignant tissue is more sensitive to hyperthermia than normal cells.
We are comparing advantages and disadvantages of current minimally invasive methods for treatment of early stage breast cancers, showing differences and advantages over breast-conserving surgery. Available published studies and protocols are overviewed.
Most of the published works emphasize advantages over classic breast surgery such as: lower costs, less trauma for patients and smaller invasiveness. All methods involving thermal procedures require surgical excision afterwards for evaluation of necrosis and patohistological evaluation of the lesion.
The effect of these treatment methods should be safety, painlessness, good cosmetic results and lower treatment costs. If results of such methods are to be comparable to BCS, we can expect their integration in clinical practice.U suvremenom pristupu lokalnog lijeÄenja tumora dojke sve viÅ”e prostora u struÄnim publikacijama zauzimaju izvjeÅ”Äa o primjeni tzv. minimalno invazivnih metoda, meÄu kojima su dvije osnovne skupine: perkutane ekscizijske metode i termalne ablacijske metode. Temelj termalnih ablacijskih postupaka u lijeÄenju tumora dojke leži u Äinjenici da tumori pokazuju veÄu senzitivnost na hipertermiÄka oÅ”teÄenja od normalnih stanica.
U radu se nastoje komparacijom prednosti i nedostataka ovih suvremenih minimalno invazivnih metoda u lijeÄenju tumora dojke nižih stadija, utvrditi razlika i eventualna prednost tih postupaka prema poÅ”tednim kirurÅ”kim zahvatima . Pregledani su dostupni publicirani protokoli i iskustva u provoÄenju perkutanih bioptiÄkih metoda i nekih termalnih ablacijskih metoda u minimalno invazivnoj kirurgiji dojke.
U veÄini pregledanih publikacija i protokola, naglaÅ”ena je prednost opisanih metoda nad klasiÄnom kirurgijom dojke, koja je izražena u nižim troÅ”kovima, smanjenju psihiÄkih trauma lijeÄenih bolesnica i niskom razinom invazivnosti. U gotovo svim pregledanim protokolima koji se odnose na tzv. termalne metode uoÄena je potreba za naknadnom kirurÅ”kom ekscizijom radi procjene stupnja nekroze i patohistoloÅ”ke provjere lezije.
UspjeÅ”nost lijeÄenja tumora dojke ovim metodama bi se trebala temeljiti na sigurnosti, bezbolnosti, dobrim kozmetiÄkim rezultatima i nižim troÅ”kovima lijeÄenja. Ove bi metode mogle doživjeti punu primjenu u kliniÄkoj praksi ako se njima postigne rezultat ekvivalentan onome koji se postiže sa poÅ”tednim kirurÅ”kim zahvatima (BCS)
Uporaba piezoelektriÄnog svojstva u poboljÅ”anju kvalitete instrumenata i sigurnosti bolesnika u laparoskopskoj kirurgiji
The piezoelectric properties of some natural crystals and polymers can also be used in surgery. For this purpose, a prototype of an endoscopic instrument was constructed with piezoelectric material attached to its working end with the aim of recognizing pulsating blood vessels during laparoscopic surgery. To test the properties of the new instrument in laboratory conditions, simulated blood circulation was used with the possibility of changing pressure and frequency. The instrument was tested in the pressure range of 40-180 mm Hg at constant frequency of 72/min and frequency range of 36-130 beats per minute at constant pressure of 120 mm Hg. Test results showed that the instrument with certainty recognized a pulsating āblood vesselā in the expected pressure ranges and at different blood pump frequencies. Given the piezoelectric materialās very small dimensions and flexible form, it can be installed at the working end of most standard laparoscopic instruments and thus significantly increase certainty in the recognition of arteries during surgery, which would reduce the possibility of their injury or accidental ligation.PiezoelektriÄna svojstva nekih prirodnih kristala i nekih polimera moguÄe je koristiti i u kirurgiji. U tu svrhu konstruiran je prototip endoskopskog instrumenta na Äijem je radnom dijelu ugraÄen piezoelektriÄni materijal s ciljem prepoznavanja pulzirajuÄih krvnih žila tijekom laparoskopskih operacija. Za ispitivanje svojstava novoga instrumenta u laboratorijskim uvjetima koriÅ”ten je simulirani krvotok s moguÄnoÅ”Äu mijenjanja tlaka i frekvencije. Rad instrumenta je ispitivan u rasponu tlakova 40-180 mm Hg uz konstantnu frekvenciju 72/min, te u rasponu frekvencija 36-130 otkucaja u minuti uz konstantan tlak 120 mm Hg. Rezultati ispitivanja pokazuju da instrument sa sigurnoÅ”Äu prepoznaje pulzirajuÄu ākrvnu žiluā u oÄekivanom rasponu tlakova i pri razliÄitim frekvencijama rada krvne pumpe. S obzirom na to da se radi o vrlo malim dimenzijama i prilagodljivim oblicima piezoelektriÄkog materijala, moguÄe ga je postaviti na radni dio veÄine standardnih laparoskopskih instrumenata i time znaÄajno poveÄati sigurnost prepoznavanja arterija tijekom operacijskog zahvata, Å”to bi smanjilo moguÄnost njihove ozljede ili sluÄajnog podvezivanja
Synchronous caecal small-cell neuroendocrine carcinoma and adenocarcinoma of the rectum
Neuroendokrini karcinom malih stanica debeloga crijeva rijedak je entitet s najÄeÅ”Äe loÅ”om prognozom. OsamdesetogodiÅ”nja žena podvrgnuta je operaciji debeloga crijeva zbog sinkronog tumora rektuma i cekuma. PatohistoloÅ”ka analiza tumora cekuma pokazala je trabekularne i Ävrste nakupine, relativno uniformne male do srednje velike epitelne stanice, oskudne citoplazme, a u vezivnom tkivu bilo je dosta mitoza s veÄim podruÄjima nekroze. Imunohistokemija je bila pozitivna na kromogranin A. Tumor je dijagnosticiran kao neuroendokrini karcinom malih stanica cekuma. Osim toga, tumor rektuma pokazao je mikroskopske nalaze u skladu s IIA stadijem adenokarcinoma. Imunohistokemijski panel pokazao je da je tumor bio negativan na neuroendokrine markere. Nije bilo kliniÄkoga nalaza koji ukazuje na pojaÄanu sekreciju hormona. Metastaze karcinoma nisu naÄene. Provedena je postoperativna kemoterapija. Pacijentica je i dalje živa, dobrog opÄega stanja, bez znakova progresije tumora.Small-cell neuroendocrine colon carcinoma is a rare entity with a usually poor prognosis. An 80-year-old female had colon cancer surgery due to synchronous tumour of the rectum and caecum. Pathohystological analysis of the caecal tumour showed trabecular and solid clusters, relatively uniformed small to middle sized epithelial cells, deficient cytoplasm and there were a great number of mitosis with larger areas of necrosis in the connective tissue. The immunohistochemistry was positive for chromogranin A. The caecal tumour was diagnosed as a small-cell neuroendocrine carcinoma. In addition, the rectal tumour showed microscopic findings consistent with stage IIA adenocarcinoma. The immunohistochemical panel showed that the tumour was negative for neuroendocrine markers. There were no clinical findings suggestive of hormone hypersecretion. Cancer metastases were not found. Postoperative chemotherapy was applied. The patient is still alive, in good general condition and with no signs of tumour progression
Effect of Pesticides on Wound Contraction
Agricultural injuries are a complex surgical problem, especially because of frequently extensive skin lesions prone to infection
and delayed healing. The aim of the study was to assess the local effect of pesticides, chemical substances widely used in
agriculture, on wound healing, especially on wound contraction. Local effects of the combined herbicide composed of atrazine
and dual (Primextra) and insecticide alphametrin (Fastac 10% SC) on primary wound healing were assessed in a bioassay
performed in 18 New Zealand white rabbits. Relative size of the wound, measured on days 0, 1, 3, 6, 9 and 12 of wounding
was analyzed by two-factor analysis of variance with repeat measurements. The activity of the process of restoration was assessed
on histopathologic preparations obtained after the last measurement. Results of the study showed the final wound contraction
to be smaller and the process of healing slower in the experimental groups of animals. Histopathology revealed defects
of epithelialization, phasic delay in healing, infiltration with eosinophilic granulocytes, and decreased density of newly
formed collagen. Pesticides were concluded to have adverse local effects on the wound, causing impairment of the mechanisms
of healing