Laparoskoopiline munajuhade läbitavuse taastamine 15 aastat pärast steriliseerimist ja sellele järgnev edukas rasedus I tüüpi suhkruhaigel

Viimase 15 aasta vältel on suhkruhaigete ravi ning jälgimine raseduse ajal märkimis väärselt paranenud. Artiklis on kirjeldatud haigusjuhtu, kus diabeedi tõttu steriliseeritud naisel taastati 15 aastat pärast steriliseeri mist muna juhade läbitavus ning patsient rasestus ja sünnitas terve lapse. Eesti Arst 2006; 85 (2): 129–13

Kaasasündinud südamerike ja rasedus

Viimastel aastakümnetel tõhustunud ravi abil jõuab täisikka üle 80% kaasasündinud südamerikkega lastest, kuid kaasasündinud südamerikkega naisele võib rasedus põhjustada lisariske nt rütmihäirete, insuldi, kopsuturse või ägeda südamepuudulikkuse näol. Samuti võib ema südamerike kujutada ohtu loote ja vastsündinu arengule (üsasisene kasvupeetus või surm, ajuhemorraagia, enneaegsus). Suurima riski naisele põhjustavad raske südamepuudulikkus, tsüanoos ja vasaku südametrakti obstruktsioon. Et rasedus kulgeks võimalikult tüsistustevabalt, on vajalik selliste naiste pidev ja hoolikas jälgimine ning nõustamine erinevate spetsialistide poolt nii raseduse ajal, sünnitusel kui ka sünnitusjärgses perioodis. Eesti Arst 2008; 87(2):116−12

Diagnosis and treatment of obstetric anal sphincter injuries

Aims: The aims of this study were to identify the risk factors for a failed primary repair of obstetric anal sphincter injury (OASI), to determine whether external phased-array magnetic resonance imaging (MRI) is suitable for the diagnosis of residual obstetric anal sphincter injury (ROASI), and to evaluate the effectiveness of sacral neuromodulation (SNM) for the treatment of faecal incontinence (FI) in women with a history of OASI. Patients and Methods: A total of 60 women with a history of OASI were analysed for factors influencing the failure of primary sphincter repair. Forty women who had been diagnosed with OASI underwent both MRI and three-dimensional endoanal ultrasound (3D EAUS) imaging 6–8 months postpartum. The results from these imaging studies were analysed. Data of all patients tested for SNM in Finland was gathered, patients with FI as the indication for SNM treatment were further analysed. Results: The risk factors for a failed primary sphincter repair were repairs executed by inexperienced personnel (p<0.001), or during on-call hours (p=0.039), end-to-end suturing of the external anal sphincter (p=0.030), and failure to prescribe antibiotics and laxatives (p<0.001). External phased-array pelvic MRI is comparable to 3D EAUS in detecting external anal sphincter (EAS) lesions (=0.510). SNM treatment outcomes were more successful in patients with obstetric FI, compared to patients with other types of FI (p=0.012). The presence of a sphincter lesion or previous sphincter repair had no effect on the SNM treatment outcome (p=0.425). Conclusions: There were clear risk factors that can affect the outcome of the primary repair of OASI. ROASI can be successfully imaged by external phased-array MRI. SNM treatment outcomes of patients with ROASI were comparable if not better than outcomes in patients with other causes of FI. A patent sphincter defect or previous sphincteroplasty (SP) had no effect on SNM treatment outcomes

Interim Evaluation of the European Lifelong Learning Programme 2007-2009: The National Report of Estonia

PRAXIS Working Paper No 3/2010This report summarizes the results of the interim evaluation of the European Lifelong Learning programme 2007-2009 in Estonia. The main objectives of the interim evaluation were: a) to analyse results of the LLP achieved hitherto and to identify lessons learned and good practices; b) to give recommendations for improving the execution of the current programme in the remaining stage of its implementation and; c) to give input for the preparation of the future programme in the field of lifelong learning. The analysis concentrated on the aspects of relevance, effectiveness and efficiency

Eesti ideoloogia 1970. aastate Välis-Eesti mõtteloos

Towards an Estonian Ideology:Debates among Estonians Abroad in the 1970sThe goal of this article is to trace articulations of Estonian ideologyin the 1970s among Estonians abroad. The term Estonian ideology isfar from monolithic; political scientist and Estonian diaspora scholarKarl Aun (1914–1995) carefully redefined it in 1979 in counterpointto the large number of „action programs“ and prognoses of the futureof Estonia as proposed in the mid-1970s by younger, radical diasporaintellectuals. These in turn responded to the most divisive politicalissue since the mid-1960s – the problem of visiting the homeland andentertaining cultural figures and other official visitors from SovietEstonia. Aun's article in the new periodical Aja Kiri, which beganpublication in Toronto in 1976 should be seen less as a contributionto the polemic around „communicating with the homeland“ andrather in relation to preceding debates in the periodical Vaba Eesti(1951–1964). Both periodicals sought and assumed an internationalaudience of Estonians.The first part of the article contextualizes and outlines Aun`s rhetoricalstrategy in defining „estology“ and the historical questions heraised. In the second part, the intellectual background and politicalformation of the readership of Aja Kiri is examined. Finally, questionsfor further research on the intellectual history of the Estoniandiaspora are set forth alongside a brief review of the challenges ofworking with diaspora archives

Eesti kutseõppeasutuste tugisüsteemide analüüs: olukorra kaardistus, võimalused ja väljakutsed tugisüsteemi rakendamisel katkestamise ennetusmeetmena

The aim of this analysis is to map the provision and organisation of support services in Estonian vocational education institutions (33) and to assess the effectiveness of these support services in the study process as a measure to reduce drop-out rates. For this, a systematic literature review and document analysis were carried out as well as an online survey among the leaders, teachers and support specialists in vocational education institutions. The aim of the online survey was to get an overview of overall satisfaction with support systems (in reducing drop -out rates) as well as gather best practices of providing effective support measures in vocational education institutions. 354 workers from 28 institutions participated in the survey.Eesti kutsehariduse üheks suuremaks probleemiks on õpingute katkestamine (katkestanute osakaal on ligi viiendik õppuritest). Katkestamiste põhjused on väga erinevad ja sageli kombineeritud, seetõttu on ka katkestamise vähendamiseks ja ennetamiseks väljapakutud erinevaid võimalusi. Nende hulgas tugiteenused õppuritele. Eestis on kutseõppeasutuses küll kohustus tagada tugiteenuste kättesaadavus, ent puudub ülevaade, kuidas seda kohustust täidetakse. Käesolev uuring annab ülevaate tugiteenuste pakkumisest kõigis Eesti kutseõppeasutustes ning hindab ka tugiteenuste rakendamise tulemuslikkust õppeprotsessis, sh katkestamist vähendava meetmena. Uuring tugineb süstemaatilisel kirjanduse ülevaatel, statistilistel andmetel (EHIS) ning kutseõppeasutustelt kogutud infol (uuringus osales kokku 354 kooli juhtkonna esindajat, õpetajat ja tugispetsialisti 28 koolist