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Volume 39, Issue 1, 2025

Online ISSN: 3042-3511

ISSN: 3042-3503

Volume 39 , Issue 1, (2025)

Published: 31.03.2025.

Open Access

Welcome to Issue 39, No. 1 – the first of our two annual publications for this year. Inside, you'll find a curated selection of articles. Start your year with the essential knowledge and perspectives offered in this timely edition

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01.12.2021.

Actual

Ugradnja prvog trajnog pejsmejkera u Kliničko bolničkom Centru Zemun

Srdjan Raspopović, Ivan Stanković, Snežana Vidanović, Nenad Tiljev, Mijodrag Miljković, Dragan Petrović, Ljilja Dundjerović, Ratko Tomašević, Nebojša Mitrović, Dragoš Stojanović, Miloš Panić, Siniša U. Pavlović, Nikola Jagić, Aleksandar N. Nešković

01.12.2021.

Seminars

Uloga medicinske sestre i tehničara u lečenju onkoloških pacijenata

Tumor nije moguće apsolutno korektno definisati. Tumori se prepoznaju po jednom parametru, a to je abnormalni rast ćelija, tako da se one razlikuju od normalnih ćelija po tome što više ne reaguju na normalne mehanizme kontrole rasta. Tumori se karakterišu stalnom, patološkom i autonomnom proliferacijom ćelija. Po biološkim karakteristikama dele se u dve velike grupe: benigni i maligni tumori. Maligni tumori rastu brzo, vrše razaranje okolnog tkiva i ukoliko se na vreme ne otkriju i ne leče, dovode do smrti. Najveći broj karcinoma nastaje spontano, kao odgovor na nepoznati stimulus, ali za nekolicinu su odgovorni sledeći faktori: hemijski ili fizički karcinogeni agensi, virusi, nasledna predispozicija, hormonski poremećaji i dugotrajne hronične bolesti. Maligni tumori mogu da budu dobro, srednje ili loše diferentovani. Ukoliko su građeni od nediferentovanih ćelija, grupišu se u anaplastične tumore. Maligni tumori rastu brzo, uz infiltraciju, invaziju i destrukciju okolnog tkiva. Nemaju kapsulu, nisu jasno ograničeni i retko se odstranjuju u potpunosti. Pored metastaziranja, invazivnost je druga najvažnija karakteristika malignih tumora. Postoje tri osnovna pristupa lečenju malignih tumora: hirurška ekscizija, zračenje i hemioterapija, a uloga pojedinačnih pristupa zavisi od tipa i stadijuma razvoja tumora1 .

Medicinske sestre i tehničari koji rade sa pacijentima obolelim od malignih tumora vrše procenu stanja pacijenta, edukaciju, menadžment simptoma i negu pacijenta. Onkološki pacijent spada u grupu pacijenata kojima bi trebali pristupati samo kvalitetno edukovani medicinski radnici2,3.

U radu je analizirana uloga medicinske sestre i tehničara u pripremi citostatske terapije, kao i klinički problemi i intervencije sa kojima se susreću i obavljaju medicinske sestre i tehničari prilikom lečenja onkoloških pacijenata.

Svetlana Banović, Natalija Vejnović

01.12.2021.

Seminars

Manuelne tehnike u rehabilitaciji skočnog zgloba

Skočni zglob je često izložen povređivanju zbog svoje statičke i dinamičke uloge. Uganuće skočnog zgloba je značajna mišićno-skeletna povreda, kako kod fizički aktivne tako i kod opšte populacije1 , dok prelom gornjeg skočnog zgloba prednjači u povredama koštano-zglobnog sistema2 . Kod velikog broja povređenih osoba (10% do 60%) zabeležena je funkcionalna nestabilnost kao rezidualni problem3 . Većina stručnjaka ukazuje da se nakon povrede skočnog zgloba, naročito uganuća, razvija hronična nestabilnost. Ovo stanje karakteriše osećaj nestabilnosti zgloba, sa periodičnim ponovnim uganućem4 , a često je prisutno ograničenje obima pokreta dorzifleksije, povezano sa sa bolom3 . Povreda skočnog zgloba može biti preduslov za razvoj sindroma vezanih za stopalo i potkolenicu, kao što su plantarna fasciopatija, sindrom iliotibijalne trake, patelofemoralni sindrom, sindrom medijalnog tibijalnog stresa5 . Pored toga, pojava posttraumatskog osteoartritisa skočnog zgloba pronađena je čak kod 78% osoba sa hroničnom nestabilnošću zgloba4 . Kod osoba kod kojih je došlo do pojave kalcifikacija javlja se niz strukturalnih i senzomotornih simptoma6 , usled čega opada nivo fizičke aktivnosti7 i kvalitet života8 .

Marija Trajkov, Dragana Kljajić, Dejan Mitrašinović, Gordana Grbić

01.12.2021.

Seminars

Ultrazvučni pregled bubrega: normalan nalaz i najčešće anomalije kao kontrast patološkim nalazima

Ultrazvučni pregled je prvi pregled pri sumnji na bolesti urogenitalnog sistema. Ima visoku dijagnostičku vrednost, ne koristi štetno jonizujuće zračenje i relativno je jeftin, a nedostatak je što zavisi od iskustva radiologa i kvaliteta uređaja. Bolesti bubrega čine veliku grupu oboljenja različitog uzroka, toka, kliničke slike i prognoze. Ova oboljenja najčešće su izazvana infekcijama, metaboličkim poremećajima, toksinima i drugim uzrocima, a manifestuju se kao upale bubrega (glomerulonefritis, pijelonefritis, nefrotski sindrom) i akutna, odnosno hronična smanjena funkcija bubrega (bubrežna insuficijencija).

Ultrazvuk je standardna dijagnostička metoda kod hroničnih bolesti bubrega. Omogućava prikaz parenhima i kolektornog sistema bubrega. Pored ultrazvučnog pregleda, razvijene su i druge dijagnostičke metode, kao što su intravenska urografija, magnetna kompjuterizovana tomografija i magnetna rezonanca, mešutim ultrazvučni pregled i dalje je prva i nezamenljiva dijagnostička procedura kod obojenja urogenitalnog sistema, odnosno bubrega pre svega.

Najčešće indikacije za ultrazvučni pregled bubrega su: bol u slabinama, palpabilne mase u slabinama, hematurija, abnormalni laboratorijski nalazi koji ukazuju na oboljenja urinarnog trakta, evaluacija veličine bubrega, evaluacija obstrukcije urinarnog trakta, trauma u lumbalnoj regiji, učestalo mokrenje, smanjenje klirensa urina, pečenje tokom mokrenja ili groznica, evaluacija transplantiranih bubrega, biopsija i interventne procedure, neurogena bešika i kod pacijenata koji u alergični na kontrastno sredstvo, a imaju smetnje koje nesumnjivo potiču od strane urotrakta.

Radi jasnog formulisanja patološkog nalaza od nalaza u fiziološkim granicama neophodno je poznavanje normalnog ultrazvučnog nalaza, ali i anatomskih varijeteta odnosno bubrežnih anomalija koje u suštini nisu patološki nalaz. Ovaj pregledni rad obuhvata opis ultrazvučne anatomije bubrega, tehnike ultrazvučnog pregleda bubrega kao i pregled najčešćih anatomskih varijeteta odnosno bubrežnih anomalija koje u suštini nisu patološki nalaz.

Živorad Savić, Andor Nađ

01.05.2021.

Case Reports

Arrhythmic mitral valve prolapse: case report

Mitral valve prolapse is the most common cause of primary mitral regurgitation. Arrhythmic mitral valve prolapse is a special entity that is characterised by ventricular arrhythmia and increased risk for sudden cardiac death. We present a 48-year old patient that was referred to our Department of Cardiology for elective invasive coronary angiography because of significant number of premature ventricular contractions observed on 24h-ECG ambulatory monitoring. Echocardiography and cardiac MRI revealed signs of arrhythmic mitral valve prolapse.

Radosava Cvjetan, Ivona Vranic, Marina Zlatkovic, Ivan Stankovic, Predrag Milicevic, Zoran Stajic, Natasa Rakonjac

01.05.2021.

Original Articles

Scoliosis operations: the role of the nurse in the postoperative course and prevention of complications

The aim of our study was to determine the frequency of scoliosis operations in the period from September 1, 2018 to March 1, 2019. year at the Institute of Orthopedic Surgery “Banjica”, the distribution of patients by sex and age, the most common complications and physiological responses of patients in the postoperative course, as well as the importance of the participation of nurses in this process. Scoliosis is a deformity of the spine in the frontal plane. The role of the nurse in the preoperative and postoperative course is very demanding and defined by clear protocols. In our study, we found that the majority of patients were female 57 (71%), and that the largest number of respondents 55 (72%) were aged 11 to 13 years. The largest number of patients 57 (71%) did not have comorbidity. When analyzing the physiological response of patients, we determined on the basis of the Numerical Scale that the largest number of patients 75 (96%) had a need for opioid analgesics in the first 4 hours after surgery. In relation to the length of stay of patients in JIN, the largest number of patients 69 (86%) remained in JIN 24 hours after surgery. Based on our study, we believe that continuous medical education of nurses is necessary in acquiring the necessary skills for the care of patients who have undergone scoliosis surgery. The emphasis should be on communication skills with this, especially vulnerable, population.

Sava Mitic, Milos Vojinovic, Marija Ivezic

01.05.2021.

Original Articles

The role and tasks of the nurse in patients with hypertension in primary health care

The aim of the study was to gain insight and determine the incidence of arterial hypertension in the study population over a 10-year period with special reference to the role of the nurse in the treatment of hypertensive patients in primary health care. Hypertension is the leading cause of premature death worldwide. The method of descriptive study was applied using data from the medical documentation of the Health Center “Vračar” in Belgrade for the period from 2010- 2019. The study included all patients who were treated for arterial hypertension during this period. A comparison of total mortality and patients with arterial hypertension was performed. The total number of reviewed histories for patients treated for arterial hypertension in the Health Center “Vracar” in Belgrade for the period 2010- 2019 was 72343. Compared to the total number of patients treated for hypertension in this period, the number of patients was significantly higher in 2010 ( 18.84%) and 2011 (14.88%), and the least treated was 2013 (7.23%). Comparing the percentage of patients with and treated for arterial hypertension in relation to the total number of treated patients, we found that during 10 years, on average, out of the total number of treated patients (712,360 patients), 10.16% and 72,343 patients were treated for arterial hypertension. Today, it is considered that the prevention of the disease is the most important, so the main goals of nursing are health promotion and prevention of the disease, especially in people with increased risk factors for the occurrence of hypertensive disease.

Vesovic Dusan, Svetlana Basara

01.05.2021.

Original Articles

Significance and role of the nurse in the treatment of patients with pulmonary thromboembolism

The aim of our research was to determine the demographic profile of health workers (gender, age, length of service and level of education), and then to assess the essential education for elementary activities of nurses in the treatment and care of patients with pulmonary embolism. Venous thromboembolism (VTE) is a term that encompasses deep vein thrombosis (DVT) and pulmonary embolism (PE). Based on the results of current studies, the level of knowledge about thromboprophylaxis among nurses varies and depends on education, years of work experience, continuing education and job. The study was conducted in KBC Zvezdara in the period from September 25, 2021. to 01.10.2021. years. A descriptive study was conducted where a specially designed Survey was used as a research instrument. The questionnaire was filled out by 20 nurses. The group of respondents was mostly female (16), aged between 20-30, most respondents had completed high school and most respondents had been employed for more than 5 years. 75% of respondents said that thromboembolism is very common, 95% of respondents said that the use of oxygen is a mandatory therapeutic procedure, 85% of respondents said that hemodynamically unstable patients need to start thrombolytic therapy with streptokinase immediately, and 90% of respondents answered that maintaining airway patency and monitoring the pulse is very important in patients with pulmonary thromboembolism. The largest number of respondents (90%) answered that they measure vital parameters in patients with thromboembolism every hour. All respondents (100%) answered that monitoring the intake and excretion of food and fluids is necessary, and a total of 85% of respondents stated that physical activity and regular movement while avoiding prolonged sitting or lying down is one of the methods to prevent thromboembolism. Managing VTE, which offers nurses the opportunity to provide intensive care, is an essential professional competence of licensed nurses. It is necessary to improve the continuous education of nurses and encourage nurses to be educated at higher levels of academic education

Ljiljana Isakovic, Bojan Jasovic, Dragana Stankovic

01.05.2021.

Case Reports

Cerebralni vasculitis caused by Toxocara canis: Case report

We present a case of cerebral vasculitis and suspicious retinal vasculitis of a thirty-five- year old, HIV-negative woman. Toxocara canis is a ubiquitous parasite found worldwide. She can only complete lifecycle in dogs, and humans are accidental hosts. Among the neurological and neuropsychological disturbances produced by Toxocara infection, in humans, the most representative are meningitis, encephalitis, myelitis and cerebral vasculitis. Predominant symptoms were trembling and tingling in the left side of the body, tremor of the hands and weakness of the extremities, more to the left, fever and visual disturbance. MR imaging of the brain showed obliterative endarteritis to the left. Visual acuity was impaired, the optic nerve was swollen and macula was thickened. Antibodies to Toxocara canis were detected by ELISA test. Antiparasitic therapy with corticosteroids has led to the reduction of symptoms and clinical findings.

Sladjana Pavic, Zeljko Kaganovic

01.12.2021.

Case Reports

Pulmonary valve blood cyst in an adult patient: a case report

In this paper, we describe the case of an adult male with a pulmonary valve blood cyst. Blood cysts are benign primary heart tumors, common in neonates, but very rare in adults, mostly asymptomatic, and detected incidentally. Ultrasound (transthoracic transephophageal echocardiography) is crucial in detecting lesion, with the help of other diagnostic methods (MRI, CT). Further treatment, conservative or surgical, depends on the effect of the cyst on heart function. Although the diagnosis of cardiac lesions using routine imaging is available, definitive diagnosis is possible only by pathohistological and immunohistochemical analysis of the surgical sample.

Marija M Milinkovic, Vesna Bozic, Svetislav Tatic, Mladen Kocica

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