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Ediba Čelić-Spužić

Društvene mreže:

Amer Ovčina, Lejka Jamak, Belma Tukić, Ediba Čelić-Spužić, Vedran Đido

Introduction: The World Health Organization states that health care is a science and art that requires a lot of understanding and practical application of knowledge and skills that are specific and based on research derived from biological, social, and humanistic sciences, and management.Aim: The main goal of this study is to determine the extent to which nurses implement the health care process based on scientific and professional evidence and evidence from clinical practice. Materials and methods: The study is quantitative, descriptive, cross-sectional, and comparative. The author's questionnaire was created based on a review of professional and scientific literature and evidence from practice was used for the research.Results: Analysis of knowledge about the meaning of evidence-based health care shows that 140 (61.4%) respondents answered correctly to this question “Providing health care based on scientific research, professional literature, and good practice”. Almost 80% of respondents (181) correctly answered that evidence-based health care should be provided by nurse technicians of all levels of education who work in the health care process.Conclusion: The results of this research support the statement that nurses-technicians implement the health care process based on scientific and expert evidence, evidence from clinical practice, and this is supported by the fact that evidence-based health care is applied fully or partially by 221, or 96, 6%, of respondents.

Introduction: With the continuous aging of the population of Western societies, an increase is expected not only in the number of patients with diabetes but also in the number of patients with comorbidities. Population studies suggest that most patients with diabetes have at least one comorbidity. Comorbidities can profoundly impact a person’s ability to care for himself/herself and can present barriers to adherence to lifestyle changes and compliance with therapy. Methods: The research was conducted in the Public Institution Health Centre of Sarajevo Canton - Health Center Hadžići and Health Center Novi Grad. It included 161 patients diagnosed with diabetes; 96 women and 65 men.The respondents were between 18 and 65 years old (the upper age limit for the working population for both genders). The instruments for conducting the research were a questionnaire on the socio-demographic characteristics of the respondents and Ferrans and Powers index of quality of life, a version for diabetes. Results: The research included 43.48% of respondents with diabetes mellitus (DM) Type II, 31.06% with DM Type I, while even 25.46% of respondents did not know which type of diabetes they suffered from. There were no statistically significant differences in the Total Quality of Life Index (TQLI) (p=0.328) between respondents with different types of diabetes. The average TQLI value in the group with diabetes duration from 1 to 5 years was 22.07 +/- 5.10; in the group from 6 to10 years was 21.23 +/- 6.0; in the group from 11 to 20 years was 21.86 +/- 4.82; in the group from 21 to 30 years was 19.20 +/- 6.81; and in the group with diabetes duration >30 years, was 23.36 +/- 5.46. High blood pressure was present in 60.24% of respondents, followed by elevated blood fats in 51.55% of respondents, and heart/brain blood vessel diseases, in 43.48% of respondents. Neuropathies were present in 38.5%, visual impairment in 26.08%, and malignant diseases were present in a total of 14.28% of respondents. Conclusion: The average value of the quality of life of respondents with 1 comorbidity was 21.30; with 2 comorbidities 20.91; and with 3 comorbidities was 21.94. There was no statistically significant difference in the quality of life of diabetes patients about the presence of one, two, or more comorbidities (p=0.537). The presence of a greater number of comorbidities in patients with diabetes does not contribute to poor quality of life.

Introduction: Surgical intervention and anesthesia procedure lead to a series of hormonal changes in the organism, which is mainly attributed to catecholamine response to stress. Surgical intervention is resulting in significant changes in neuroendocrine regulation, metabolism and physiological functions, as part of the overall response to stress. Research aim: The aim of this study was to determine and evaluate the levels of hormones in patients undergoing transvesical prostatectomy under general or local anesthesia. Material and methods: The study included a total of 100 patients from the Clinic of Urology, Clinical Center of Sarajevo who underwent surgery by technique of transvesical prostatectomy (BPH) in which the indicators were set:: a) repeated urinary retention; b) calculosis and diverticulosis of the urinary bladder; c) urinary infection, d) repeated massive hamaturia and e) the distal obstruction that can lead to uremia. Results: General anesthesia may limit the perception of stimuli from injury, but does not eliminate the full response to noxious stimuli, even with deep anesthesia. All intravenous agents andvolatile anesthetics in normal doses have little effect on the endocrine and physiological functions. Neural blockade induced by regional anesthesia or local anesthetics have a direct impact on endocrine and metabolic response. Regional anesthesia with the present consciousness, but with sympathetic blockade caused a greater suppression of hormonal responses than the general balanced anesthesia. In our research we obtained: a) a significant increase in prolactin intraoperatively, for respondents under general anesthesia; b) a significant increase in TSH values intraoperatively for respondents under general anesthesia; c) a significant drop in T4 intraoperatively in patients with regional anesthetic technique; d) a significant increase in cortisol values 24 hours postoperatively in patients with regional anesthetic technique.

INTRODUCTION Hypovolemia and pain are direct stimulators of hormonal response to trauma. Thus, neuroendocrine, metabolic and inflammatory aspects of the injury are part of an overall "stress response". In particular, it manifests in patients undergoing surgical intervention. These reactions can occur with trauma, burns, severe infections and physical exertion. Metabolic and neuroendocrine response to surgical intervention depends on several factors, such as severity and duration of the surgical trauma, patient's age, type of anesthesia and surgical techniques. GOAL The aim of this study was to determine and evaluate levels of hormones in patients undergoing transvesical prostatectomy under general or local anesthesia: ACTH, PRL, TSH, T3, T4, cortisol, and to determine the influence of consciousness (in local-regional anesthesia) in relation to the unconscious state in the general balanced anesthesia on hormonal response measured values above mentioned levels of hormones. Determined the level of hormone values during three time periods: before anesthesia, during surgery in enucleation of prostate glandular tissue and 24 hours after surgery. PATIENTS AND METHODS The study included a total of 100 patients from the Clinic of Urology, Clinical Center of Sarajevo who underwent surgery by technique oftransvesical prostatectomy. According to the criteria defined the subjects were divided into two test groups: Group I (n = 50)--patients underwent surgery under general anesthesia, Group II (n = 50)--patients underwent surgery in local-regional anesthesia. The first blood sample was taken at screening purposes just before the introduction of general anesthesia or loco regional anesthesia. The second sample was taken during surgery during enucleation of prostate gland tissue. A third blood sample was taken 24 hours after surgery. RESULTS Increased levels of ACTH intraoperative in both anesthesia techniques applied, with a slightly larger increase in the value of the respondents with technique of general anesthesia. The values of ACTH after 24 hours showed a return to preoperative values in case of both techniques of anesthesia. Increased levels of PRL intraoperative in both anesthesia techniques applied, with larger peak values registered in patients under technique of general anesthesia (3554microIJ/L). High levels of PRL are maintained and postoperatively after 24 hours with both techniques applied anesthesia. Increased intraoperative levels of TSH in both anesthetic techniques, with higher maximum values in patients with technique of general anesthesia (7.20 mU/L). The values of TSH postoperatively after 24 hours showed a return to baseline in case of both applied technique of anesthesia. Low intraoperative values of T3 in both anesthetic techniques. Lower values of T3 are still continuing after 24 hours postoperatively in both applied techniques of anesthesia. The values of T4 hormone in subjects under general anesthesia did not show major deviations intraoperatively or postoperatively. CONCLUSIONS Regional anesthesia with the present consciousness, but with sympathetic blockade caused a greater suppression of hormonal responses, than the general balanced anesthesia.

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