Collegium antropologicum
-
Collegium antropologicum · Jun 2009
Acute stress and depression 3 days after vaginal delivery--observational, comparative study.
During the first month postpartum, 85% of women experience some form of mood disorders. The most common are: postpartum blues, non-psychotic postpartum depression, puerperal psychosis. Delivery of a child can be traumatic for some women. ⋯ A statistically significant difference has been found between the control (n=42) and the peripartal complications (n=61) groups in both the mean IES-R (4.67 +/- 5.43 and 13.50 +/- 14.12, respectively, p < 0.01) as well as in the mean EPDS (3.85 +/- 2.76 and 7.03 +/- 3.90, respectively, p < 0.01) scores. Additionally, while there were 4 cases of acute stress reactions and 3 cases of acute depressive state in the peripartal complications group there were no cases of these states in the control group. Based on our findings we conclude that using IES-R and EPDS questionnaires as early as three days after delivery could provide an early detection of previously healthy mothers with greater risk for development of postpartum psychiatric disorders.
-
Collegium antropologicum · Jun 2009
Randomized Controlled TrialPerioperative management with glucose solution and insulin.
The objective of this study was to analyze how preoperative glucose treatment influences the blood glucose level as a measured exponent of surgical stress and to establish the best postoperative replacement considering glucose solutions and insulin. This prospective clinical trial involved 208 non-diabetic patients with normal glucose tolerance, who underwent major surgical procedures and needed 24 hours ICU monitoring postoperatively. Patients were randomly given 5% glucose solution (1000 mL) one day before surgery or after overnight fasting. ⋯ All data were processed with descriptive statistics, chi-square test, parametric ANOVA test and ANOVA test with repeated measure, non parametric Kruskal-Wallis test and Mann-Whitney U-test. Statistically significant change was accepted with p < 0.05. Preoperative glucose infusion decreased metabolic and endocrine response only during surgery; the smallest increase of postoperative blood glucose level was noticed after administering postoperative non-glucose crystalloid solutions; there is no clinical evidence that one specific postoperative replacement is better than the other; there is no clinical evidence that postoperative use of insulin can decrease or attenuate surgical induced insulin resistance.
-
Collegium antropologicum · Jun 2009
Research of urinary tract infections in family medicine physicians' offices--empiric antimicrobial therapy of urinary tract infections--Croatian experience.
In the period between October 1st and November 30th, 2006, we investigated a total of 3188 episodes of UTI (802 among males; 2386 among females) recorded in 108 family medicine offices in 20 cities in Croatia. The most common UTIs in women were acute uncomplicated cystitis (62%), complicated UTIs - cystitis and pyelonephritis (14%), urethritis (9%), acute uncomplicated pyelonephritis (6%), recurrent cystitis (5%), asymptomatic bacteriuria (3%) and recurrent pyelonephritis. The most common UTIs in men were complicated UTIs - cystitis and pyelonephritis (48%), urethritis (25%), prostatitis (24%) and asymptomatic bacteriuria (3%). ⋯ Antimicrobial drug was administered in 2939 (92.19%) UTI episodes, in 1940 (66.01%) as empirical therapy, and in 999 (34%) as targeted antimicrobial therapy. The most commonly administered drug in empirical therapy for acute uncomplicated cystitis, recurrent cystitis and urethritis in women was cephalexin, for acute uncomplicated pyelonephritis and complicated UTIs in women co-amoxiclav, and for UTIs in males ciprofloxacin. The results of this research of 3188 UTI episodes in family medicine physicians' offices provide a confirmatory answer to question whether empirical antimicrobial therapy of UTI prescribed by Croatian family practitioners is in accordance with the national guidelines.
-
Collegium antropologicum · Jun 2009
The relationships between self-esteem, emotional reactions and quality of life in pediatric locomotory trauma patients.
The main aim of this study was to establish the relationships between several psychosocial characteristics in children and adolescents differently treated for isolated long tubular bones' fractures. Examined variables were: self-esteem, basic emotional reactions toward illness or injury including depression and anxiety, as well as perception of quality of life and social support during the treatment. Whole sample comprehends 135 patients, both gender, 10-18 years of age, treated for mentioned fractures in period 2003-2005 at the Departments of Pediatric Surgery of 3 hospitals: University Hospital Centre in Rijeka and Clinical Children's Hospital in Zagreb, both in Croatia and University Hospital in Mostar, BiH. 73 patients were treated conservatively (CT), 40 of them underwent Elastic Stable Intramedullary Nailing (ESIN) and 22 of them underwent other surgical techniques (OST). ⋯ Perception of quality of life in whole sample in summary measures was statistically significant at level p < 0.01 correlated positively with self-esteem and negatively with depression and anxiety, thus connection with perception of social support was statistically significant only in sibdomain of physical pain. There was also statistically significant difference in self-perception of quality of life related to psychosocial variables according to the type of treatment (F = 3.27; p = 0.01). Results of this study suggest that there are strong connections between physical trauma and different psychosocial variables in patients which point at need of understanding locomotory trauma in children in wider context including physical state and social functioning of the patient as well as the choice of type of treatment of fractures which influences complete process of healing.