Zdravniski Vestnik-Slovenian Medical Journal最新文献

{"title":"Occupational stress and heart rate variability.","authors":"M. Rauber, M. Bilban, R. Starc","doi":"10.6016/SLOVMEDJOUR.V84I1.1063","DOIUrl":"https://doi.org/10.6016/SLOVMEDJOUR.V84I1.1063","url":null,"abstract":"Brief description of the article: This article considers heart rate variability as a measurable parameter of stress reaction and present recent studies that examined the impact of occupational stress on heart rate variability and thus autonomic nervous system. ABSTRACT Stress is a complex psychoneuroendocrinological and immune response of an individual to stressogenic factor. The most important contemporary stressogenic factors are mental, psycho-social and socio-economic stressors. This especially holds true for occupational stress. Many symptoms and signs of disease are associated with chronic occupational stress. Among those are cardiovascular diseases, metabolic and psychiatric disorders. This article describes different stressogenic factors that lead to occupational stress and two conceptual models of occupational stress (Karasek’s Demand/Control Model and Siegrist’s Effort-Reward Imbalance Model). Reaction to stress can be measured in various ways. This article summarizes the physiology of heart beat regulation and presents heart rate variability as a measurable parameter of stress reaction. Heart rate variability gives us an insight into autonomic modulation of the heart and functioning of the entire autonomic nervous system. This article presents the latest results of larger studies that examined the impact of occupational stress on heart rate variability and various mechanisms that lead to end-organ damage due to changes in autonomic nervous system as a result of work stress. Subjects exposed to chronic stress have significantly lower heart rate variability compared with subjects unaffected by stress. Researches have shown that reduced heart rate variability reliably predicts mortality among health adults, as well as morbidity and mortality in patients after acute myocardial infarction, in patients with chronic heart failure and mortality in patients with chronic kidney disease.","PeriodicalId":49350,"journal":{"name":"Zdravniski Vestnik-Slovenian Medical Journal","volume":"62 1","pages":"47-58"},"PeriodicalIF":0.0,"publicationDate":"2015-03-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"90252953","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Stres na delovnem mestu in variabilnost srčne frekvence","authors":"Martin Rauber, Marjan Bilban, Radovan Starc","doi":"10.6016/ZDRAVVESTN.1063","DOIUrl":"https://doi.org/10.6016/ZDRAVVESTN.1063","url":null,"abstract":"Brief description of the article: This article considers heart rate variability as a measurable parameter of stress reaction and present recent studies that examined the impact of occupational stress on heart rate variability and thus autonomic nervous system. ABSTRACT Stress is a complex psychoneuroendocrinological and immune response of an individual to stressogenic factor. The most important contemporary stressogenic factors are mental, psycho-social and socio-economic stressors. This especially holds true for occupational stress. Many symptoms and signs of disease are associated with chronic occupational stress. Among those are cardiovascular diseases, metabolic and psychiatric disorders. This article describes different stressogenic factors that lead to occupational stress and two conceptual models of occupational stress (Karasek’s Demand/Control Model and Siegrist’s Effort-Reward Imbalance Model). Reaction to stress can be measured in various ways. This article summarizes the physiology of heart beat regulation and presents heart rate variability as a measurable parameter of stress reaction. Heart rate variability gives us an insight into autonomic modulation of the heart and functioning of the entire autonomic nervous system. This article presents the latest results of larger studies that examined the impact of occupational stress on heart rate variability and various mechanisms that lead to end-organ damage due to changes in autonomic nervous system as a result of work stress. Subjects exposed to chronic stress have significantly lower heart rate variability compared with subjects unaffected by stress. Researches have shown that reduced heart rate variability reliably predicts mortality among health adults, as well as morbidity and mortality in patients after acute myocardial infarction, in patients with chronic heart failure and mortality in patients with chronic kidney disease.","PeriodicalId":49350,"journal":{"name":"Zdravniski Vestnik-Slovenian Medical Journal","volume":"29 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2015-03-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"73827753","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Urogenital tuberculosis - a case report.","authors":"T. Smrkolj, B. Likar, D. Galič","doi":"10.6016/slovmedjour.v84i1.1046","DOIUrl":"https://doi.org/10.6016/slovmedjour.v84i1.1046","url":null,"abstract":"Izvlecek V razvitih državah je urogenitalna tuberkuloza redka. Znacilne so stevilne in nespecificne uroloske težave: simptomi spodnjih secil, hematurija, ledvene bolecine, tipne spremembe na modih in obmodku in splosni simptomi. Poleg mikrobioloske diagnostike kužnin pri uroloski obravnavi urogentialne tuberkuloze uporabljamo tudi slikovne in endoskopske preiskave. Vloga kirurskega zdravljenja urogenitalne tuberkuloze se je z razvojem modernih antituberkuloznih zdravil precej spremenila. Kirursko zdravljenje pride v postev v napredovalih fazah, njegov namen pa je popraviti posledice brazgotinjenja in zastoja v votlem sistemu, le izjemoma tudi odstraniti okuženo tkivo. V prispevku so opisani posegi za razbremenitev votlega sistema, kirurski posegi na ledvici, secevodu, secniku, prostati in secnici ter modu in obmodku.","PeriodicalId":49350,"journal":{"name":"Zdravniski Vestnik-Slovenian Medical Journal","volume":"5 1","pages":"77-83"},"PeriodicalIF":0.0,"publicationDate":"2015-02-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"88788181","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Healthcare process analysis and improvement at the department of abdominal surgery, University medical centre Ljubljana.","authors":"Nadja Damij, Talib Damij, F. Jelenc","doi":"10.6016/ZDRAVVESTN.1022","DOIUrl":"https://doi.org/10.6016/ZDRAVVESTN.1022","url":null,"abstract":"Background: Healthcare processes in hospitals, like processes in companies or governmental organizations, may accumulate problems and obstacles over time, which consequently cause the processes to become ineffective. BPM is an approach for process modeling, improvement and automating, which has been used with great success for process improvement. Methods: This work was to examine the possibility of carrying out healthcare process improvement using BPM. To implement BPM ideas, a revised TAD methodology was developed, representing an important contribution to the BPM. The first three phases of the TAD methodology were introduced in a step-by-step approach. The first phase deals with process identification, the second develops the \"as-is\" model, and the third phase discusses process improvement by developing the \"to-be\" model. Results: We found that (a) the Surgery process is efficient and well organized; (b) patient stay in the clinic could be shortened; however for humane and social reasons the leadership prefers to leave the residence time as it is; (c) the process is connected to some time-consuming activities which are perfrmed in other departments and represent the bottleneck of the process. Conclusions: The following were concluded (a) BPM proved to be a suitable approach for carrying out healthcare process improvement; (b) the revised TAD methodology showed to be consistent and efficient in performing BPM approach; (c) The Surgery process discussed was found to be an effective one and no changes or improvements are needed; (d) Concerning time-consuming activities, the leadership decided to discuss this problem with the management of the departments where the activities are executed.","PeriodicalId":49350,"journal":{"name":"Zdravniski Vestnik-Slovenian Medical Journal","volume":"42 1","pages":"26-37"},"PeriodicalIF":0.0,"publicationDate":"2015-02-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"77819664","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Urogenitalna tuberkuloza – klinični primer","authors":"Tomaž Smrkolj, Boštjan Likar, Dejan Galič","doi":"10.6016/ZdravVestn.1046","DOIUrl":"https://doi.org/10.6016/ZdravVestn.1046","url":null,"abstract":"Urogenital tuberculosis is uncommon in developed countries. Numerous and nonspecific urologic complaints are characteristic, e.g. lower urinary tract symptoms, haematuria, renal pain, palpable lesions in testis and epididymis and constitutional symptoms. Microbiological diagnostic tests together with imaging and endoscopy are indicated in urogenital tuberculosis. The role of surgery has changed in the era of modern antimycobacterial agents. Surgery is used in advanced stages and is reconstructive rather than ablative for removal of infected tissue. Article describes procedures for treatment of urinary obstruction, surgical procedures on kidney, ureter, bladder, prostate and urethra and testis with epididymis. Case report presents 69 year old man who presented with left side epididymitis, however after initial diagnostic tests tumour of left testis and epididymis and right kidney with liver metastasis was suspected. Computer tomography of thorax diagnosed miliary tuberculosis. Patient was transferred to pulmonary department, where tuberculosis was confirmed and medical antituberculous therapy was initiated. Adequate treatment response with regression of tuberculous lesions in urogenital tract was observed.","PeriodicalId":49350,"journal":{"name":"Zdravniski Vestnik-Slovenian Medical Journal","volume":"116 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2015-02-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"79279596","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Assessment of risk factors for difficult intubation in head and neck surgery","authors":"K. Režonja, J. Benedik","doi":"10.6016/ZDRAVVESTN.1084","DOIUrl":"https://doi.org/10.6016/ZDRAVVESTN.1084","url":null,"abstract":"The incidence of difficult intubation is more frequent in ear, nose and throat patients than in general surgery patients. Mallampati score correlates best with difficult intubation; however, in this group of patients there are specific factors influencing difficult intubation besides visualisation of larynx.","PeriodicalId":49350,"journal":{"name":"Zdravniski Vestnik-Slovenian Medical Journal","volume":"1 1","pages":"38-46"},"PeriodicalIF":0.0,"publicationDate":"2015-02-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"77261159","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Dabigatran and rivaroxaban in the patients with atrial fibrillation and venous thrombembolism: our first clinical experience","authors":"A. Mavri, M. Štalc","doi":"10.6016/SLOVMEDJOUR.V83I12.1036","DOIUrl":"https://doi.org/10.6016/SLOVMEDJOUR.V83I12.1036","url":null,"abstract":"ABSTRACT Background: The new oral anticoagulant drugs (NOAC) have shown promising results in the randomized trials in patients with atrial fibrillation (AF) and venous thromboembolism (VTE). The aim of this study was to assess the efficacy and safety of NOAK in the clinical practice. Methods: We included 1.215 patients, 914 with AF and 301 with VTE, who started NOAC. Data on the management and complications were obtained from the computer program Trombo. Results: Patients with AF were treated with either dabigatran 2x110 mg or 2x150 mg or rivaroxaban 1x15 or 1x20 mg and followed for approximately 6 months. Patients with VTE were treated with rivaroxaban and followed for approximately 4 months. Regarding the NOAC prescribed, there was 21–26% of minor bleeding, 1,2–1,9% of major bleeding and 0,4–0,9% of thromboembolic events in patients with AF. In patients with VTE, 13% of minor and 1% of major bleeding, and 0,3% recurrent VTE were observed. There was 154 periprocedural management of patients with AF on NOACs, 3 patients suffered bleeding (all after polypectomy) and 1 patient suffered thromboembolic event postoperatively. NOAC discontinuation due to adverse events or complication was as expected in treatment with rivaroxaban and higher than expected in treatment with dabigatran. Conclusions: Our first analysis of NOAC use in clinical practice showed acceptable safety and efficacy. Additional measures and cautions will be needed for treatment interruption during surgical procedures and complications.","PeriodicalId":49350,"journal":{"name":"Zdravniski Vestnik-Slovenian Medical Journal","volume":"1 1","pages":"849-856"},"PeriodicalIF":0.0,"publicationDate":"2015-01-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"84647787","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The effects of centre-based rehabilitation after acute myocardial infarction on exercise capacity and risk factors for coronary heart disease","authors":"Polona Mlakar, B. Salobir, B. Jug, Nusret Čobo, M. Terčelj, M. Šabovič","doi":"10.6016/slovmedjour.v83i10.718","DOIUrl":"https://doi.org/10.6016/slovmedjour.v83i10.718","url":null,"abstract":"Background Rehabilitation following acute myocardial infarction (AMI) is a crucial part of secondary prevention for coronary heart disease. The aim of our study was to determine the efficiency of our national in-patient rehabilitation program in improving exercise capacity and lowering risk factors for coronary heart disease. Methods 25 patients 3-9 weeks after AMI, undergoing 2 week in-patient cardiac rehabilitation, were included in our study. We performed exercise stress testing and measurement of classic risk factors before and after the rehabilitation. Classic risk factors were compared with 25 age matched adults without known risk factors for coronary heart disease. Results Patients after AMI had lower exercise capacity than healthy adults (p≤0.002 for double product, maximal load, systolic blood pressure, heart rate and time of load). Patients recieved appropriate drug therapy after myocardial infarction, which presented as lower diastolic and a trend to lower systolic blood pressure (p=0.002 and 0.080), lower total and LDL cholesterol values (both p<0.001) than healthy adults, but higher values of metabolic syndrome parameters (higher waist cifcumference p=0.045, higher hip-waist ratio, lower HDL cholesterol, both p<0.001, and a trend to higher body mass index). Although we observed significant increases in exercise capacity (higher, maximal load, systolic blood pressure,double product and time of load, all p≤0.003), no changes in classic risk factors during rehabilitaiton were demonstrated. Conclusions In-patient program of cardiac rehabilitation efficiently elevates exercise capacity in patients after AMI, but fails to influence classic risk factors for coronary heart disease, which might be due to lack of controlled cardioprotective diet during rehabilitation.","PeriodicalId":49350,"journal":{"name":"Zdravniski Vestnik-Slovenian Medical Journal","volume":"55 1","pages":"670-677"},"PeriodicalIF":0.0,"publicationDate":"2014-11-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"87447698","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Guidelines for antibiotic prophylaxis in abdominal surgery for adults","authors":"T. Pintar, B. Trotovšek, B. Beović","doi":"10.6016/SLOVMEDJOUR.V83I10.1127","DOIUrl":"https://doi.org/10.6016/SLOVMEDJOUR.V83I10.1127","url":null,"abstract":"Abstract: Background. Evidence based recommendations for antibiotic prophylaxis in abdominal surgery are prepared to reduce postoperative complications and to reduce inappropriate prophylactic antibiotic prescribing. The original guidline address risk factors for surgical site infection (SSI), benefits and risks of antibiotic profilaxis and  indications for surgical antibiotic profilaxis. Update of recommendations is an opportunity to expand and review the evidence supporting recommendations. Recommendations for common surgical procedures in abdominal surgery in adults are included in this guideline. Surgical antibiotic prophylaxis is and adjunct to, not a substitue for, good surgical tecnique. Antibiotic prophylactic should be regarded as one component of an effective policy for the control of healthcare-associated infection.","PeriodicalId":49350,"journal":{"name":"Zdravniski Vestnik-Slovenian Medical Journal","volume":"73 1","pages":"651-660"},"PeriodicalIF":0.0,"publicationDate":"2014-11-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"75250606","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical role of Ureaplasma parvum and Ureaplasma urealyticum presence in female lower urogenital tract : is there a place for routine screening and treatment?","authors":"M. Marovt, D. Keše, J. Miljković, M. Maticic","doi":"10.6016/SLOVMEDJOUR.V83I9.973","DOIUrl":"https://doi.org/10.6016/SLOVMEDJOUR.V83I9.973","url":null,"abstract":"Sexually transmitted infections represent major health problem in females all over the world if remained undiagnosed and untreated. They can have adverse influence on reproduction and health of a mother and a newborn. The development of molecular methods has permitted the detection of an array of microbes whose pathologic roles in urogenital infections need to be further studied. Ureaplasmas ( Ureaplasma spp.), being originally found in 1954 from male urogenital tract, are prokaryotic cells without a cell wall, ranging from 0.1 to 1 μm in length. Fourteen known Ureaplasma serovars have been divided in two species based on their phenotypic and genotypic features, Ureaplasma parvum and Ureaplasma urealyticum detected and identified separately using polymerase chain reaction assays. Both are generally considered as genital tract commensals. U. urealyticum is most probably associated with male urethritis which has not been found for U. parvum . Recent studies with supposedly healthy women reported their detection rate between 18-87 % for U. parvum and 6-10 % for U. urealyticum . Even though they have been found to be associated with chorioamnionitis, preterm birth and perinatal complications more commonly then other commensals in this region the rising question regarding their pathogenic role in females remains unsolved and the guidelines regarding the diagnostic screening and treatment are inconsistent. The aim of our paper is to review the microbiological characteristics, diagnostic methods and epidemiology of newly differentiated U. parvum and U. urealyticum , and to assess evidence speaking pro and contra their clinical role in causing lower urogenital tract infection in women. Since both bacteria are susceptible to antimicrobials it is of utmost importance for clinicians to decide whether or not to search for one or both of them routinely and treat accordingly in order to prevent ascending upper genital tract infection as well as complications in pregnancy and newborns.","PeriodicalId":49350,"journal":{"name":"Zdravniski Vestnik-Slovenian Medical Journal","volume":"69 1","pages":"629-637"},"PeriodicalIF":0.0,"publicationDate":"2014-10-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"83804693","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}