Palliatiivne ravi: printsiibid ja eesmärgid

Palliatiivne ravi keskendub kaugelearenenud haigusest tingitud füüsiliste ja psühhosotsiaalsete kaebuste leevendamisele. Ravi peamine eesmärk on raskest haigusest hoolimata haigele võimalikult kvaliteetse/elamisväärse elu võimaldamine. Palliatiivse ravi alla kuuluvad toetusravi, sümptomaatiline ravi ja terminaalravi. Tegemist on interdistsiplinaarse erialaga, mille tähtsus tänapäeva meditsiinis on kasvamas. Käesolevas ülevaateartiklis käsitletakse palliatiivse meditsiini terminoloogiat, printsiipe ja põhitunnuseid. Eesti Arst 2008; 87(3):205−20

New Estonian records: Lichenicolous fungi

Lichenodiplis lichenicola Dyko & D. Hawksw, the third Lichenodiplis (Chaetothyriales, Eurotiomycetes) species found from Estonia besides L. lecanorae and L. pertusariicola (syn. Laeviomyces pertusariicola)

Vähihaigete koduse toetusravi 12 aasta kogemus Eestis

Palliatiivne ravi on lähenemisviis, mille keskmes on valu ning teiste kaebuste õigeaegne avastamine, hindamine ja ravi kannatuste ennetamiseks ja leevendamiseks. Sellise ravi eesmärgiks on parandada kaugelearenenud haigusega patsientide ja nende lähedaste elukvaliteeti. Palliatiivne ravi võib toimuda nii kodus kui ka haiglas. Eestis on vähihaigete koduse palliatiivse toetusravi kogemust 12 aastat. Üle Eesti tegutseb 15 vastava ravi keskust. Üks meeskond koosneb õdedest, arstidest ja vabatahtlikest tugiisikutest. Oluline pole mitte ainult sümptomite leevendamine, vaid koostöö patsiendi ning tema pereliikmetega turvatunde andmiseks. Patsiendile on ravi tasuta, vajalik on saatekiri. Viimastel aastatel on suurenenud koduvisiitide arv ning küsitluste andmeil hindavad nii patsiendid kui ka nende pereliikmed kodust toetusravi kõrgelt. Eesti Arst 2009; 88(10):682−68

The species of the former Toninia coeruleonigricans group in Estonia

The Estonian specimens originally named Toninia coeruleonigricans auct. (= Toninia caeruleonigricans), formally revised as Toninia sedifolia were checked again recently. Two species, T. physaroides (Opiz) Zahlbr. and T. sedifolia (Scop.) Timdal were recognized. A key for determination of sterile specimens of the closely related taxa T. opuntioides (Vill.) Timdal, T. physaroides and T. sedifolia is provided.

A Methodological Framework for Co-Creation of Government-Research-Industry Innovation

Government, industry, and research collaboration is important. Governments are developing instruments for stimulating innovation within small and medium-sized enterprises (SMEs). Researchers are expected to focus on solving economic, environmental, and social problems. Enterprises need new solutions to survive in global markets. Traditionally, co-creation is a tool for collaborating between researchers and industry during the innovation development process. In this study, a methodological framework for government-research-industry co-creation in the pre-competitive innovation phase was developed and tested. It was piloted with a group of six researchers and nine enterprises from Latvia co-creating solutions for sustainable food packaging. The experiment was a targeted intervention by a public administration body to facilitate industry-research collaboration, thus strengthening SMEs competitiveness. The study demonstrated that the developed methodological framework is a useful tool for professionals involved in the day-to-day facilitation of collaboration between researchers and businesses, such as business support and development professionals and innovation project managers. It is appropriate for laying the groundwork for more in-depth industrial research or experimental development between researchers and businesses. Professional moderation is critical in the co-creation process, and it is more enriching if the pool of participating enterprises consists of SMEs and larger enterprises covering the value chain of the explored topic. The bridging co-creation phase is appropriate for an online environment, whereas the experimental co-creation phase would benefit more from taking place in a physical setting. To achieve better results, it is important to choose narrower and more clearly defined problems. The co-creation process aids in the development of collaborative communication skills, the generation of ideas in a diverse group, and overall digital literacy

Excluded species of lichenized and lichenicolous fungi

Since the publishing of the Second checklist of Estonian lichenized and allied fungi (Randlane & Saag, 1999), and its updates, fifteen species have been excluded as misidentifications (Randlane et al., 2008).

Estonian Mycological Society: 60 years!

Sixty years ago, on December 23, 1963, 15 members of the Estonian Naturalists’ Society decided to establish a separate unit within the society – a section of mycology. The initiative came from Erast Parmasto (1928–2012), whose idea was to establish an organization that would consolidate and coordinate activities of professional mycologists from various institutions and fungal enthusiasts in Estonia in order to promote exploration of local mycobiota

The mycological collection of G. C. Girgensohn from the middle of the 19th century

Since 1844, vouchers of mycological specimens collected from the territory of the historic Baltic provinces of the Russian Empire have been preserved in Estonian natural history collections. A pedagogue and an amateur bryologist, Gustav Carl Girgensohn (1786–1872) compiled a collection of 109 specimens of fungi and myxomycetes sampled from the Livonian Governorate, mostly from the vicinity of Tartu, in years 1844–1859. Girgensohn’s collection, which is kept in the fungarium of the Estonian University of Life Sciences, is introduced here for the first time. Among his specimens there are two notable ascomycetes—coprophilous Poronia punctata (Xylariaceae, Sordariomycetes), recently evaluated in Estonia as Critically Endangered according to IUCN criteria, and Microstoma protractum (Sarcoscyphaceae, Pezizomycetes), recently evaluated as Endangered. The collection’s eleven quite well-preserved specimens of myxomycetes represent six species, the least common of which is Diderma radiatum. In addition, the article introduces nine lichen specimens and one fungal specimen from Girgensohn’s bryophyte collection at the Natural History Museum of the University of Tartu. The most remarkable species among this collection is Lobaria pulmonaria (Lobariaceae, Lecanoromycetes), red-listed and protected in many countries

Patients with depressive disorder, their co-morbidity, visiting rate and disability in relation to self-evaluation of physical and mental health: a cross-sectional study in family practice

<p>Abstract</p> <p>Background</p> <p>High prevalence of depression among primary care patients has increased the need for more research in this field. The objectives of our study were to analyse how depressed patients evaluate their health; which co-morbid diseases are associated with depression; how depression influences the patients' consultation rate in family practice (FP); how disability is associated with depression; and how depression influences the patients' working ability.</p> <p>Methods</p> <p>A cross-sectional study, part of the PREDICT study. The study group was formed of 1094 consecutive patients from 23 FPs across Estonia, aged 18–75 years, attending a FP to consult the family doctor (FD). Occurrence of major depression during six months was estimated using the Depression Section of the Composite International Diagnostic Interview. The medical records of all patients were analysed concerning co-morbid diseases, number of visits to the FD, and disability. Every patient filled in questionnaires to assess health-related risk factors for depression, and the SF-12 Health Survey to assess functioning and the perception of health.</p> <p>Results</p> <p>Depression was found in 230 (21%) of the patients. Depressed patients reported less accomplishment owing to emotional problems (OR 1.80; 95% CI 1.18–2.72), being less careful as usual (OR 1.81; 95% CI 1.26–2.60), and having pain that extremely interfered with their normal work (OR 2.50; 95% CI 1.33–4.70) in comparison with non-depressed patients. Also depressed patients were more days on sick-leave (OR 1.00; 95% CI 1.00–1.01) than non-depressed patients. However, analysis of the medical records did not indicate that depressed patients consulted the FD more or had more co-morbid diagnoses than the non-depressed patients.</p> <p>Conclusion</p> <p>Depressed patients may have low self-reported functioning due to emotional problems, pain, and their working ability may have decreased; however, the patients of both groups have an equal number of co-morbid diagnoses and their consultation rate is similar.</p

Perbedaan Clinical Disease Activity Index (CDAI) pada Pasien Rheumatoid Arthritis Terhadap Penggunaan Disease Modifying Anti Rheumatoid Drugs (DMARD)

Rheumatoid arthritis adalah penyakit autoimun yang biasa dikaitkan dengan kecacatan progresif dan komplikasi sistemik. Rheumatoid arthritis ditandai dengan adanya inflamasi dan hyperplasia sinovial, produksi autoantibodi, kerusakan pada tulang dan tulang rawan. Salah satu penilaian aktivitas penyakit rheumatoid arthritis adalah Clinical Disease Activity Index (CDAI). Rheumatoid arthritis dapat dicegah dengan pemberian terapi yang tepat. Salah satu terapi utama rheumatoid arthritis adalah Disease Modifying Antirheumatic Drugs (DMARD). Penelitian ini bertujuan untuk mengetahui karakteristik sosiodemografi pasien, melihat pola penggunaan obat, serta mengetahui perbedaan nilai CDAI sebelum dan sesudah pemberian obat. Penelitian ini merupakan penelitian deskriptif dan analitik, dengan pendekatan secara retrospektif. Jumlah pasien yang masuk dalam kriteria inklusi sebanyak 61 pasien. Hasil penelitian menunjukkan bahwa pasien rheumatoid arthritis yang menerima terapi DMARD paling banyak adalah perempuan sebesar 96,72%, berusia 46-55 tahun (lansia awal) sebesar 31,1%, pendidikan terakhir adalah SMA sebesar 49,2%, dan pekerjaan adalah ibu rumah tangga sebesar 45,9%. Pada pola penggunaan DMARD, presentasi penggunaan monoterapi DMARD adalah 11,5%, kombinasi DMARD dengan kortikosteroid adalah 21,3%, kombinasi DMARD dengan NSAID adalah 4,9%, dan kombinasi DMARD, kortikosteroid, NSAID adalah 62,3%. Berdasakan penelitian dapat disimpulkan adanya perbedaan signifikan nilai CDAI saat sebelum dan sesudah pemberian DMARD pada pasien rheumatoid arthritis di RSUP Dr. M. Djamil Padang. Baik itu pada penggunaan monoterapi DMARD, kombinasi DMARD dan kortikosteroid, kombinasi dmard dan NSAID, serta kombinasi DMARD, kortikosteroid dan NSAID. Untuk nilai sesudah pemberian terapi DMARD rata-rata lebih kecil daripada sebelum pemberian terapi