Detecting functional disabilities in elderly persons with cardiovascular diseases using the self-reporting method

The ability to perform basic activities of daily living (ADL) and instrumental ADL (IADL) is an essential indicator of the level of functional capacity in old age. The purpose of this paper was to evaluate reliability and validity of the self - reporting method in detecting functional difficulties among elderly persons with cardiovascular diseases. The Groningen Activity Restriction Scale was used to assess the limitations in functional capacity. The sample consisted of patients over the age of 65 with hypertensive disease, angina pectoris, ischaemic heart disease, degenerative valvular disorders, peripheral arterial disease, cardiac arrhythmias, cardiomyopathy and heart failure. The Cronbach’s alpha internal consistency coefficient was calculated for the total result. Differences in outcome with respect to age, educational level, marital status, and medical diagnoses of participants were compared by means of a t-test or one-way ANOVA. In the group of ADL, participants reported difficulties in climbing stairs (M=2.14, SD=1.07) and caring for feet and toenails (M=2.17, SD=1.27), while in the group of IADL, difficulties were present in performing heavier household chores (M=2.51, SD=1.31) as well as ironing and washing clothes (M=2.20, SD=1.29). Calculation of the Cronbach’s alpha coefficient points to a high degree of internal consistency for this scale on a chosen sample (α=0.95). The use of a validated self-reporting tool may be a valuable and reliable way for assessing the functional capacity of elderly persons with chronic diseases. The findings of this study indicate the possibility of using this method for prognostic purposes in patients with cardiovascular diseases. Introduction of instrumental support measures in a timely manner has a crucial role in delaying the progression of functional dependence

Relationship between functional capacity and the occurrence of adverse events during healthcare utilization

Introduction: Adverse events, safety incidents, and medical errors in healthcare can be avoided only by understanding the causes of their occurrence, and by applying the knowledge gained from the analysis of similar previous events. Since it is known that most adverse events do not originate from a single cause, most important is timely identification of numerous contributory states that can give us the opportunity to define a number of possible solutions to correct process errors and deficiencies in the system itself. The aim of this paper is to investigate the association between functional capacity of elderly living with cardiovascular diseases and the occurrence of adverse events during use of health-care services.Methods: Assessment of functional limitations was done using the Groningen Activity Restriction Scale (GARS). The presence of adverse events was evaluated after interviews with subjects and review of medical records. Differences in continuous numerical values between inpatient and outpatient service users were analyzed by the Mann–Whitney U-test. Spearman’s correlation coefficients of the number of actual adverse events with the presence of restrictions in daily activities were calculated. Fisher’s exact test or Fisher-Freeman-Halton test (in cases of table sizes larger than 2 × 2 format) analyzed the differences in category variables.Results: The total number of adverse events was 30 (10.1% of the total number of subjects), while there were 12 actual adverse events (40.0% of the total number of adverse events). No statistically significant correlation was found between the limitations in performing daily activities and the occurrence of actual adverse events (p = 0.173).Conclusion: The research conducted in this paper showed that the functional capacity of the elderly with chronic disease is not exclusively related with the occurrence of adverse events associated with health-care utilization

Application of rapid antigen tests in the prevention of the transmission of SARS-COV-2 in a hospital setting

Introduction: The pandemic of Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) presented a major challenge to health-care systems around the world. To ensure the continuity of hospital care for patients with cardiovascular diseases, the clinic has formulated the strategy for prevention of transmission of SARS-CoV-2 across the hospital environment. The purpose of this paper is to present the strategy for the prevention of transmission of SARS-CoV-2 in a healthcare facility, using Antigen Rapid Diagnostic Tests (Ag-RDTs).Methods: A description of the work from the hospital committee for the prevention and control of the SARS-CoV-2 epidemic is presented. The hospital has adopted the zero-case strategy. Each positive Ag-RDTs test was sent for confirmation by real-time Reverse Transcription Polymerase Chain Reaction (RT-PCR).Results: During the observed period, 6569 tests were performed at the Magdalena Clinic. Of these, a total of 6100 Ag-RDTs were performed, while 469 were recorded by RT-PCR test. Of these tests, a total of 181 tests showed a positive result, which is a share of 2.75% of all tests performed, of which 144 (2.19%) positive findings were detected among staff. In Ag-RDTs alone, a total of 86 positive people were detected, which is 1.41% of those tested on this type of test.Conclusion: The use of antigen rapid diagnostic tests is an effective and reliable method for the early detection of asymptomatic individuals infected with SARS-CoV-2 in a hospital setting. This strategy can significantly contribute to the insurance of uninterrupted healthcare, providing regular workflow processes, and the care of patients in the safest possible way

Central nervous system complications of systemic chemotherapy and of targeted therapy agents

V zadnjih desetletjih smo priča intenzivnemu razvoju sistemskega zdravljenja raka. Z zgodnejšo diagnostiko in daljšim ter vse intenzivnejšim zdravljenjem se je razširil tudi obseg nevroloških zapletov sistemskega zdravljenja. Neželeni učinki zdravljenja s kemoterapijo in s tarčnimi zdravili so lahko akutni ali kronični. Neželeni učinki na možgane obsegajo vse od akutne zmedenosti, halucinacij, motenj zavesti, žilno-okluzivnih dogodkov, epileptičnih napadov in cerebelarnih simptomov do kronične levkoencefalopatije in kognitivnega upada. Prizadetost hrbtenjače je pogosto akutna in se kaže kot longitudinalna transverzna mielopatija. Po intratekalni aplikaciji kemoterapevtikov se lahko razvije aseptični meningitis. Mehanizmi nevroloških zapletov, ki prizadenejo centralni živčni sistem, niso povsem pojasnjeni, zato za enkrat nimamo na voljo niti specifičnih metod zdravljenja, niti smernic za zdravljenje teh zapletov