HEALTH CARE OF INVOLUNTARILY HOSPITALIZED PSYCHIATRIC PATIENTS

Duševni poremećaj je bolest sa psihološkim ili ponašajnim očitovanjima, povezanim s oštećenjem funkcioniranja zbog bioloških, socijalnih, psiholoških, genetskih, fizikalnih te kemijskih smetnji. Određuje se kao odstupanje od nekog normativnog koncepta. Duševni su bolesnici od samog početka civilizacije imali poseban, svakako lošiji društveni status. Odnos prema duševnom bolesniku još i danas se sporo mijenja. Duševna bolest često pobuđuje strah u ljudi, javnost zazire od duševnog bolesnika i još uvijek postoje negativni stavovi prema psihijatriji. Duševni bolesnik često nema uvid u svoje stanje. On ne shvaća da je bolestan i odbija liječenje. Ukoliko je zbog svoje bolesti opasan za sebe ili okolinu potrebno ga je hospitalizirati protiv njegove volje. Prisilna hospitalizacija regulirana je pravnim propisima (Zakon o zaštiti osoba s duševnim smetnjama). Zdravstvena njega psihijatrijskog bolesnika prelazi okvire jednostavnih praktičnih vještina. Medicinska sestra je uključena u opći program unapređenja duševnog zdravlja. Ona pomaže pojedincu u razvijanju zdravih stilova življenja, suprotstavljanju stresu i frustracijama, razvijanju samopoštovanja i samopouzdanja, zdravstveno-odgojno djeluje u cilju prevencije duševnih poremećaja, aktivno sudjeluje u procesu cjelovitog i učinkovitog liječenja (koje se ne može zamisliti bez adekvatne zdravstvene njege) te pomaže u otklanjanju posljedica duševnih bolesti i što potpunijeg oporavka.Mental disorder is a disease with psychological or behavioral manifestations associated with impaired functioning due to biological, social, psychological, genetic, physical and chemical interference. It is defined as a deviation from a normative concept. Mental patients from the beginning of civilization had a special, certainly inferior social status. The attitude towards mentally ill person is still slowly changing. Mental illness often arouses fear in people, public aversion to the mentally ill and there are still negative attitudes toward psychiatry. Mental patient often has no insight into his condition. He does not realize that he is ill and he refuses the treatment. If the mental patient is dangerous to himself or to the environment because of his illness, he needs to be hospitalized against his will. Compulsory hospitalization is regulated by legislation (Protection law of Persons with Mental Disorders). Health care of psychiatric patients go beyond simple practical skills. The nurse is included in the general program for the improvement of mental health. She helps the individual to develop healthy lifestyles, countering stress and frustration, developing self-esteem and self-confidence, she actively participates in educational work for the prevention of mental disorders, she is actively involved in the process of a complete and effective treatment (which can not be imagined without adequate health care) and assists the elimination of the consequences of mental illness and full recovery

HEALTH CARE OF INVOLUNTARILY HOSPITALIZED PSYCHIATRIC PATIENTS

Duševni poremećaj je bolest sa psihološkim ili ponašajnim očitovanjima, povezanim s oštećenjem funkcioniranja zbog bioloških, socijalnih, psiholoških, genetskih, fizikalnih te kemijskih smetnji. Određuje se kao odstupanje od nekog normativnog koncepta. Duševni su bolesnici od samog početka civilizacije imali poseban, svakako lošiji društveni status. Odnos prema duševnom bolesniku još i danas se sporo mijenja. Duševna bolest često pobuđuje strah u ljudi, javnost zazire od duševnog bolesnika i još uvijek postoje negativni stavovi prema psihijatriji. Duševni bolesnik često nema uvid u svoje stanje. On ne shvaća da je bolestan i odbija liječenje. Ukoliko je zbog svoje bolesti opasan za sebe ili okolinu potrebno ga je hospitalizirati protiv njegove volje. Prisilna hospitalizacija regulirana je pravnim propisima (Zakon o zaštiti osoba s duševnim smetnjama). Zdravstvena njega psihijatrijskog bolesnika prelazi okvire jednostavnih praktičnih vještina. Medicinska sestra je uključena u opći program unapređenja duševnog zdravlja. Ona pomaže pojedincu u razvijanju zdravih stilova življenja, suprotstavljanju stresu i frustracijama, razvijanju samopoštovanja i samopouzdanja, zdravstveno-odgojno djeluje u cilju prevencije duševnih poremećaja, aktivno sudjeluje u procesu cjelovitog i učinkovitog liječenja (koje se ne može zamisliti bez adekvatne zdravstvene njege) te pomaže u otklanjanju posljedica duševnih bolesti i što potpunijeg oporavka.Mental disorder is a disease with psychological or behavioral manifestations associated with impaired functioning due to biological, social, psychological, genetic, physical and chemical interference. It is defined as a deviation from a normative concept. Mental patients from the beginning of civilization had a special, certainly inferior social status. The attitude towards mentally ill person is still slowly changing. Mental illness often arouses fear in people, public aversion to the mentally ill and there are still negative attitudes toward psychiatry. Mental patient often has no insight into his condition. He does not realize that he is ill and he refuses the treatment. If the mental patient is dangerous to himself or to the environment because of his illness, he needs to be hospitalized against his will. Compulsory hospitalization is regulated by legislation (Protection law of Persons with Mental Disorders). Health care of psychiatric patients go beyond simple practical skills. The nurse is included in the general program for the improvement of mental health. She helps the individual to develop healthy lifestyles, countering stress and frustration, developing self-esteem and self-confidence, she actively participates in educational work for the prevention of mental disorders, she is actively involved in the process of a complete and effective treatment (which can not be imagined without adequate health care) and assists the elimination of the consequences of mental illness and full recovery

Conjonctions de subordination de temps tant que/aussi longtemps que, jusqu’à ce que, dok : analyse contrastive français-croate

Cette étude se propose de comparer la distribution et l’utilisation de certaines conjonctions de subordination temporelles en français et en croate (français : tant que/ aussi longtemps que, jusqu’à ce que ; croate : dok). Tout en étant universelle, la catégorie grammaticale du temps donne lieu à des conceptualisations langagières tout à fait comparables mais différentes. Notre expérience linguistique du français et du croate et notamment l’expérience de l’enseignement du français aux croatophones nous ont permis de remarquer que les différences dans leurs conceptualisations respectives suscitent certaines divergences entre les deux systèmes, et sont par conséquent susceptibles d’entraîner des difficultés dans l’apprentissage du français par les croatophones. Le but de cette étude est de mettre en évidence quelques différences dans l’utilisation de ces conjonctions de subordination temporelles françaises et leurs équivalents croates en tenant compte des temps, modes et aspects ainsi que des rapports chronologiques entre le procès de la proposition principale et celui de la subordonnée introduite par la conjonction temporelle. Nos observations sur la sémantique de la temporalité s’appuieront sur des exemples puisés à des grammaires et à un corpus parallèle (de textes littéraires français et leurs traductions croates et inversement)

Sinkroni adenokarcinom rektuma i bilateralni karcinom bubrega tipa svijetlih stanica

A 69-year-old man was admitted for resection of rectal adenocarcinoma diagnosed by colonoscopy. Preoperative computed tomography scan and abdominal ultrasonography revealed bilateral renal tumors measuring up to 2 and 2.8 cm in largest diameter, respectively. Th e patient underwent partial colectomy and bilateral partial nephrectomy. Microscopically, rectal adenocarcinoma penetrated the submucosa, without invasion of the muscularis propria. Both renal tumors were clear cell renal carcinomas of Fuhrmann nuclear grade 2. To our knowledge, this is the first case of synchronous adenocarcinoma of the rectum and bilateral clear cell renal cell carcinoma described in the literature to date.U radu je prikazan slučaj bolesnika kojemu je kolonoskopski dokazan adenokarcinom rektuma. U prijeoperacijskoj obradi kompjutorskom tomografijom su dijagnosticirani obostrani tumori bubrega promjera do 2,8 cm. Bolesnik je podvrgnut lijevostranoj hemikolektomiji, a u istom aktu je učinjena resekcija obaju bubrega. Patohistološki nalaz na oba bubrega je bio karcinom svijetlih stanica. Budući da simultano pojavljivanje karcinoma rektuma i bubrega nije tako rijetko, želimo upozoriti na potrebu proširene dijagnostičke obrade u bolesnika s karcinomom rektuma i/ili bubrega

Izbor operativne metode za liječenje primarnog vezikoureteralnog refluksa

Results of ureteral reimplantation in infants with primary vesicoureteral reflux (VUR) were retrospectively reviewed and evaluated. From January 1991 till December 2000, a total of 156 patients with primary VUR underwent ureteral reimplantation at University Department of Urology, Sestre milosrdnice University Hospital, Zagreb, Croatia. The indications for surgery were high-grade reflux, breakthrough urinary tract infections, and non-compliance with medical treatment. Ureteral reimplantation was performed according to Cohen.s method (134/156) and Gil-Vernet (22/156) transvesical method. Out of 156 patients treated for primary VUR, 57 patients presented with left sided VUR and 40 with right sided VUR, whereas 52 patients required treatment for bilateral VUR, giving a total of 219 VUR repairs. Five patients had ureteral duplication accompanied by one sided VUR, whereas two patients had ureteral duplication accompanied by bilateral VUR. Out of the 156 surgically treated patients 2 (1.28%) presented with recurrent VUR, 3 (1.93%) with contralateral VUR, 5 (3.2%) patients were treated for urinary tract infection postoperatively, and none of our patients presented with stenosis. The overall complication-free percentage of surgically treated VUR in our study was 93.6%, while 96.8% were successfully treated for VUR. The present results show that transvesical ureteral repairs in infants are safe and very effective for the prevention of urinary tract infections. After surgical treatment in infancy, the individual renal growth of children with primary VUR is stable.Proveden je retrospektivni pregled i procjena rezultata reimplantacije uretera u dojenčadi s primarnim vezikoureteralnim refluksom (VUR). Od siječnja 1991. do prosinca 2000. godine ukupno je 156 bolesnika s primarnim VUR podvrgnuto reimplantaciji uretera na Klinici za urologiju Kliničke bolnice Sestara milosrdnica u Zagrebu, Hrvatska. Indikacije za operaciju bile su refluks visokog stupnja, masivna infekcija mokraćnog sustava te nepridržavanje medikamentnog liječenja. Reimplantacija uretera provedena je prema Cohenovoj metodi (134/156) i Gil-Vernetovoj transvezikalnoj metodi (22/156). Od 156 bolesnika liječenih zbog primarnog VUR 57 ih je imalo lijevostrani VUR, a 40 desnostrani VUR, dok je 52 bolesnika imalo obostrani VUR, tj. ukupno 219 popravaka zbog VUR. Petoro bolesnika je imalo duplikaciju uretera praćenu jednostranim VUR, dok ih je dvoje imalo duplikaciju uretera praćenu jednostranim VUR. Od 156 kirurški liječenih bolesnika dvoje (1,28%) ih je došlo s ponovljenim VUR, troje (1,93%) s kontralateralnim VUR, petoro (3,2%) ih je poslijeoperacijski liječeno zbog infekcije mokraćnog sustava, dok se stenoza nije razvila ni u jednog od naših bolesnika. Sveukupni postotak kirurški liječenog VUR bez komplikacija u našoj studiji je iznosio 93,6%, dok je postotak uspješnog izlječenja VUR bio 96,8%. Ovi rezultati pokazuju kako je transvezikalni popravak uretera u dojenčadi siguran i vrlo učinkovit u sprječavanju infekcije mokraćnog sustava. Rast pojedinog bubrega u djece s primarnim VUR je stabilan nakon kirurškog liječenja u dojenačkoj dobi

Pozitivna povratna sprega cističnog cistitisa: uloga povratnih infekcija mokraćnog sustava u broju nodoznih čvorića u sluznici mokraćnog mjehura

The main purpose of this study was to demonstrate positive feedback loop between bladder wall nodules (nodules being one of the key diagnostic factors), bladder wall thickness, and recurrent urinary tract infections. Cystitis cystica was diagnosed in 115 prepubertal girls (mean age 7.79}3.05 years) by optic examination of bladder mucosal nodules and by ultrasonographic measurement of bladder wall thickness. Bladder wall thickness increased with the frequency of recurrent urinary tract infections as well as with the number of nodules on bladder wall mucosa (3.52}0.522 mm ≤5 nodules vs. 4.42}0.429 mm 6-10 nodules vs. 5.20}0.610 mm >10 nodules, respectively). Study results suggested that early control of urinary tract infections by chemoprophylaxis could prevent higher grades of bladder wall mucosal changes and consequently shorten the length of chemoprophylaxis.Osnovni cilj ove studije bio je prikazati pozitivnu povratnu spregu između broja nodula na sluznici mokraćnog mjehura (ključni čimbenik u dijagnozi), debljine sluznice mokraćnog mjehura i broja ponavljanih infekcija mokraćnog sustava. U 115 djevojčica srednje predpubertetske dobi od 7,79}3,05 godina dijagnoza cističnog cistitisa je postavljena cistoskopskim pregledom sluznice mokraćnog mjehura i ultrazvučnim mjerenjem njezine debljine. Debljina sluznice se progresivno povećavala s brojem nodula (3,52}0,522 mm ≤5 nodula prema 4.42}0.429 mm 6-10 nodula prema 5,20}0,610 mm >10 nodula) usporedno s povećenjem broja uroinfekcija. Smatramo da se ranom profilaksom uroinfekcija može spriječiti razvoj opsežnih promjena na sluznici mokraćnog mjehura s posljedičnim skraćenjem profilaktične primjene antibiotika/uroantiseptika

SUDAN GRASS - ENERGY CROP FOR BIOGAS PRODUCTION

Zbog izrazito visokog prinosa zelene mase, sudanska trava (Sorghum sudanense L.) postaje zanimljiva kultura koja može zamijeniti silažni kukuruz u bioplinskim postrojenjima. Sudanska trava je jednogodišnja visoka trava, daje izuzetno visoke prinose kvalitetne zelene mase koju možemo koristiti kao zelenu krmu, sjenažu ili silažu. U provedenim istraživanjima ostvarena je proizvodnja sudanske trave od 82 tone po hektaru. Zbog visokog prinosa sudanske trave moguće je ostvariti istu proizvodnju silaže na samo 60% površina koje smo koristili kod proizvodnje kukuruzne silaže. Pomoću sudanske trave ostvariv je veći prinos biomase nego uzgojem kukuruza a energetski potencijal u proizvodnji bioplina je isti. Svinjskoj gnojovki dodano je 10% sudanske trave (ST) a kontrolnu skupinu (K) čini svinjska gnojovka bez dodataka. Sve skupine su postavljene u tri ponavljanja. Proces anaerobne fermentacije odvijao se u diskontinuiranom procesu pri mezofilnim uvjetima (40 °C) uz retencijsko trajanje od 60 dana. Prosječna ukupna proizvodnja bioplina kod supstrata s dodatkom ST iznosi 13.720 ml l-1 , a ostvarena proizvedena količina bioplina u kontrolnoj skupini iznosi 9.320,00 ml l-1. Proizvodnjom sudanske trave neće se ugroziti proizvodnja hrane i proizvodnja krmnih kultura jer ostvaruje veći prinos biomase nego kukuruz i dobra je kultura za postrne uvjete. Dokazano je da se dodavanjem sudanske trave, radi poboljšanja svojstava gnojovke, a u cilju proizvodnje bioplina, povećana je količina proizvedenog bioplina za 32%. Statistički značajne razlike u koncentraciji metana između skupina nisu utvrđene, tj. dodavanjem biomase ne ugrožava se energetska kakvoća bioplina.Because of its distinctly high yield, Sudan grass (Sorghum sudanense L.) has become an interesting crop which can replace silage corn in biogas production plants. Sudan grass is an annual tall grass which gives distinctly high green mass yields that can be used as green fodder, hayage or silage. In conducted research, Sudan grass production amounted to 82 t/ha. Due to its high yield, it is possible to produce the same amount of silage on only 60% of land used for corn silage production. Sudan grass gives higher biomass yield than corn, and energetic potential for biogas production is the same. Pig manure was supplemented with 10% of Sudan grass (ST), and the control group (K) was pig manure without additives. All groups were set up in three repetitions. Anaerobic fermentation process proceeded discontinuously in mesophillic conditions (40 °C) with retention time lasting 60 days. Average total biogas production for substrate with addition of ST amounted to 13720 ml/l, and biogas production in the control group was 9320 ml/l. Sudan grass production will not jeopardize food production nor fodder crop production, because it gives produces higher biomass yield than corn and is suitable for stubble fields. It was determined that Sudan grass utilization for improvement of manure in biogas production increased the amount of biogas by 32%. Significant differences in methane content between groups were not determined, i.e. biomass addition did not jeopardize biogas energetic value

Racionalno liječenje infekcija mokraćnog sustava kod djece u Hrvatskoj

Resistance to chemotherapeutics used in the treatment of urinary tract infection is increasing throughout the world. Taking into account clinical experiences, as well as current bacterial resistance in Croatia and neighboring countries, the selection of antibiotic should be the optimal one. Treatment of urinary tract infection in children is particularly demanding due to their age and inclination to severe systemic reaction and renal scarring. If parenteral antibiotics are administered initially, it should be switched to oral medication as soon as possible. Financial aspects of antimicrobial therapy are also very important with the main goal to seek the optimal cost/benefit ratio. Financial orientation must appreciate the basic primum non nocere as a conditio sine qua non postulate as well.Otpornost na antibiotike u liječenju infekcija mokraćnog sustava sve se više povećava. Optimalan izbor antibiotika postiže se objedinjavanjem kliničkog iskustva s poznavanjem otpornosti na uobičajene bakterijske uzročnike mokraćnih infekcija kako u Republici Hrvatskoj tako i u državama njenog okruženja. Liječenje mokraćnih infekcija u djece je naročito zahtjevno zbog njihove dobi i sklonosti prema sistemskoj reakciji i ožiljčenju bubrega. Ako je primijenjena, parenteralnu primjenu antibiotika potrebno je što prije zamijeniti oralnim antibiotikom. Također nije uputno zanemariti niti financijski aspekt liječenja kojega je cilj postizanje optimalnog učinka uz minimalnu cijenu liječenja. Pritom se nikako ne smije zanemariti osnovni medicinski postulat primum non nocere kao conditio sine qua non