55 research outputs found
Palliatiivne ravi: printsiibid ja eesmÀrgid
Palliatiivne ravi keskendub kaugelearenenud haigusest tingitud fĂŒĂŒsiliste ja psĂŒhhosotsiaalsete kaebuste leevendamisele. Ravi peamine eesmĂ€rk on raskest haigusest hoolimata haigele vĂ”imalikult kvaliteetse/elamisvÀÀrse elu vĂ”imaldamine. Palliatiivse ravi alla kuuluvad toetusravi, sĂŒmptomaatiline ravi ja terminaalravi. Tegemist on interdistsiplinaarse erialaga, mille tĂ€htsus tĂ€napĂ€eva meditsiinis on kasvamas. KĂ€esolevas ĂŒlevaateartiklis kĂ€sitletakse palliatiivse meditsiini terminoloogiat, printsiipe ja pĂ”hitunnuseid.
Eesti Arst 2008; 87(3):205â20
Estonian Mycological Society: 60 years!
Sixty years ago, on December 23, 1963, 15 members of the Estonian Naturalistsâ Society decided to establish a separate unit within the society â a section of mycology. The initiative came from Erast Parmasto (1928â2012), 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 (1786â1872) compiled a collection of 109 specimens of fungi and myxomycetes sampled from the Livonian Governorate, mostly from the vicinity of Tartu, in years 1844â1859. Girgensohnâs 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 ascomycetesâcoprophilous 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 collectionâs 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 Girgensohnâs 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 18â75 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 1.18â2.72), being less careful as usual (OR 1.81; 95% CI 1.26â2.60), and having pain that extremely interfered with their normal work (OR 2.50; 95% CI 1.33â4.70) in comparison with non-depressed patients. Also depressed patients were more days on sick-leave (OR 1.00; 95% CI 1.00â1.01) 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
Valmis uus ravijuhend âGeneraliseerunud Ă€revushĂ€ire ja paanikahĂ€ire (agorafoobiaga vĂ”i ilma) kĂ€sitlus perearstiabisâ
Ravijuhend âGeneraliseerunud Ă€revushĂ€ire ja paanikahĂ€ire (agorafoobiaga vĂ”i ilma) kĂ€sitlus perearstiabisâ valmis Eesti Perearstide Seltsi, Eesti PsĂŒhhiaatrite Seltsi ja Eesti Haigekassa koostöös. Selle koostamises osalesid perearstid, psĂŒhhiaatrid, kliinilised psĂŒhholoogid, pere- ja eriĂ”ed, tervishoiukorralduse spetsialistid ning patsientide ja haigekassa esindajad.Eesti Arst 2015; 94(1):46â4
PatsiendikĂŒsimustike ja kaugteenuste kasutamine perearstikeskustes: perearstide ja pereĂ”dede kĂŒsitlusuuring
Taust. Ăigete raviotsuste tegemiseks on tervishoiutöötajal vaja patsiendi seisundit hinnata ja selle ĂŒks vĂ”imalusi on kasutada erinevaid patsiendikĂŒsimustikke, mis vĂ”ivad olla kasutusel osana kaugteenusest.EesmĂ€rk. Hinnata perearstide ja pereĂ”dede kogemust, ootusi ja vĂ”imalikke takistusi patsiendikĂŒsimustike ja kaugteenuste kasutamisel.Metoodika. Perearstikeskuste töötajatele korraldati veebipĂ”hine ankeetkĂŒsitlus. Tervishoiutöötajate erialast ja töökogemusest tulenevate arvamuste analĂŒĂŒsimiseks kasutati kirjeldavaid statistikuid, hii-ruut-testi ja T-testi.Tulemused. KĂŒsitlusele vastas 123 perearsti, 75 pereĂ”de ja 7 peremeditsiini arst-residenti. Tervishoiutöötajate hinnangul kulub neil ĂŒhel vastuvĂ”tul keskmiselt 11,0 minutit patsiendi kĂŒsitlemisele pöördumise pĂ”hjuse ja probleemi olemuse mĂ”istmiseks. Vastanutest 65% arvas, et patsiendi poolt enne visiiti tĂ€idetud kĂŒsimustik muudaks nende töö lihtsamaks. Valdavalt sooviti, et patsient oleks kĂŒsimustiku tĂ€itnud enne vastuvĂ”ttu ja elektroonselt. 83% vastanutest tunnistas, et neil on jÀÀnud ravijuhendites soovitatud kĂŒsimustikud kasutamata, selle peamine pĂ”hjus on olnud ajapuudus. Tervishoiutöötajad arvasid, et vĂ€hemalt kolmandiku vastuvĂ”ttudest saaks lahendada kaugvastuvĂ”tu teel. Enim on kasutusel suhtlemine patsiendiga telefoni ja e-kirja vahendusel. Ligi pooltel vastanutest oli esinenud tehnilisi probleeme kaugvastuvĂ”ttude tegemisel.JĂ€reldused. Praeguste patsiendikĂŒsimustike kasutusvĂ”imalused ei vasta tervishoiutöötajate ootustele ja kĂŒsimustikud jÀÀvad sageli kasutamata. Perearstid ja pereĂ”ed ootavad tööd lihtsustavaid ja kĂ€ttesaadavaid digilahendusi ning kaugteenuseid
Food choices, physical activity and metabolic health in obese patients
The aim of the current study was to analyse the food choices and physical activity of obese adult Estonian persons, and associations with the prevalence of metabolic syndrome. The study was carried out on 76 patients aged over 35 years whose body mass index was â„30 kg/m2. The subjects were recruited through family physicians. The subjectsâ consumption of three food groups (fruit, vegetables, whole-grain products) and physical activity based on the IPAQ questionnaire was compared with the prevalence of metabolic syndrome based on five indicators (waist circumference, triglycerides, HDL- cholesterol and fasting plasma glucose, blood pressure). The prevalence of metabolic syndrome was found to be 50%. The results of the study did not show statistically significant correlations between prevalence of metabolic syndrome and age or gender. Neither were there any significant age or gender differences in the subjectsâ nutritional and activity behaviour. Comparison of the nutritional behaviour of persons with and without the metabolic syndrome showed that daily consumers of fruit had a 4.48 times lower risk of metabolic syndrome than those who ate fruit more seldom. No statistically significant correlation was found between physical activity and prevalence of metabolic syndrome. Based on the current study, the daily consumption of fruit can be an essential protective factor against metabolic syndrome in obese patients and provides a simple recommendation physicians can give their patients to follow
Depressioon ja kaasuv somaatiline haigus esmatasandil
Depressioon on muutunud ĂŒheks sagedasemaks tervisehĂ€ireks tĂ€napĂ€eva meditsiinis. Enamik depressioonijuhtudest diagnoositakse ja ravitakse praegusajal esmatasandil. Perearsti poole pöörduvatel depressioonihaigetel on sageli mitmesuguseid kehalisi kaebusi, nad kardavad psĂŒĂŒhilise haiguse diagnoosi ning kaasuvalt on neil mitmeid somaatilisi haigusi. Depressioon ja somaatiline haigus aga sĂŒvendavad teineteist. Perearstide valmisolek depressiooniga tegelemiseks, usalduslik arsti-patsiendi suhe ja vĂ”imalus konsulteerida psĂŒhhiaatriga parandavad oluliselt depressiooni diagnostikat ja ravitulemusi esmatasandil.
Eesti Arst 2007; 86 (5): 329â33
Palliatiivne ravi kui esmatasandi tervishoiuteenus â definitsioon, normid ja tavad
Rahvusvaheline Hospiitsitöö ja Palliatiivravi Liit (IAHPC) korraldas 2018. aastal uuringu, kuhu kaasati ĂŒle 400 liikme 88 riigist, eesmĂ€rgiga arendada vĂ€lja konsensusepĂ”hine palliatiivse ravi definitsioon. Sarnaselt kĂ€ibel oleva Maailma Terviseorganisatsiooni (WHO) 2002. aasta definitsiooniga koosneb ka see definitsioon kahest osast: sissejuhatavast seisukohavĂ”tust ja alapunktidest. Kolmas osa sisaldab riiklikke soovitusi. KĂ€esolevas artiklis on tutvustatud definitsiooni eestikeelset tĂ”lget, mis ilmus esimest korda 2019. aastal, seletatud IHAPC palliatiivse ravi definitsioonis kasutatud mĂ”isteid ning tutvustatud palliatiivset ravi kui esmatasandi tervishoiuteenust olemasolevate normide ja tavade valguses
KokkuvĂ”te kliinilisest auditist âDepressiooni diagnostika ja ravi esmatasandilâ
Eesti Arst 2017; 96(2):69â7
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