Browsing by Author "Brdareski, Zorica (24167783500)"

Introduction. Religious needs of patients are consistently being neglected in the clinical medicine. Pastoral care is a religious support which a religious patient receives from priests, chaplains, imams, rabbis or other religious authorities. Religious support, in terms of clinical medicine, is a spiritual support which religious patients obtain from religious and trained medical workers. The aim of this report was to present the effects of pastoral care and religious support in hospital treatment of a 73-year-old patient with the severe form of osteoarthritis. Case report. The 73-year-old, highly religious patient with severe form of osteoarthritis was admitted at the Clinic for Physical Medicine and Rehabilitation, Military Medical Academy in Belgrade, due to heterogeneous problems in the activities of daily living. The patient walked with difficulty using a stick, suffered pain, and was anxious and depressive. In order to objectively demonstrate effects of both pastoral care and religious support in this patient we performed multiple treatment with reversal design, in which the basic treatment consisting of hospital care, pharmacotherapy and physical therapy (the treatment A) was alternatively changed with the treatment that included combination of the basic treatment and religious support provided by religious physiatrist and physiotherapist (the treatment B) or combination of the basic treatment and pastoral care provided by military priest (the treatment C). The treatment A was applied three times and lasted two weeks, every time. Treatments B and C were applied once and lasted three weeks, each. The order of the treatments was: A→B→A→C→A. During the whole treatment period the patient’s condition was assessed by several measuring scale: the level of depression by The Hamilton Rang Scale for Depression and The Zung Self Rating Depression Scale; the level of anxiety by The Zung Self Rating Anxiety Scale; the functional capability of patient by The Barthel Index and The Functional Independent Measure. Measuring was carried out on a daily basis. In statistical analysis two nonparametric statistic were used: the percentage of non-overlapping data (PND) and the percentage of data points exceeding the median (PEM). PND and PEM values below 0.7 reflect questionable effectiveness of the treatment. The values between 0.7 and 0.9 reflect moderate effects. The values above 0.9 are considered as a highly effective treatment. The anxiety of the patient was moderately to significantly reduced after introducing religious support (treatment B: mean and mean deviation = 50.1 ± 10.89; variability = 4.598653; mean shift = 0.219626; PND = 0.6; PEM = 0.9) and pastoral care (treatment C: mean and mean deviation = 53.5 ± 5.90; variability = 9.062591; mean shift = 0.207407; PND = 0.9; PEM = 0.9). The patient’s depression was reduced after introducing pastoral care (treatment C: mean and mean deviation = 51.3 ± 4.66; variability = 10.99005; mean shift = 0.08881; PND = 0; PEM = 0.9). On the contrary, the patient’s functional capability was not significantly improved. Conclusion. In the highly religious patient with severe osteoarthritis pastoral care and religious support, applied along with the standard medical treatment of this condition, produced some beneficial effects on anxiety and depressive mood, but with no significant effect on patient’s functional capability. © 2017, Institut za Vojnomedicinske Naucne Informacije/Documentaciju. All rights reserved.

Background/Aim. Complications of breast augmentation, as one of the most common cosmetic surgery, may be different. Besides usual early, local postoperative complicatons, the most common late complication is capsular contracture. As a specific complication of skin functions after this operation only disturbance of sensibility is described. Since the skin has other functions as well, and because there are no literature data available, the aim of this research was measuring the skin temperature before and after surgery. Methods. A prospective intervential study was done in 49 adult women. Bilateral augmentative mammaplasty was performed for breast hypoplasia or on the personal request of a patient with autrophic breasts. Measuring the temperature of the breast skin was done in two points, before the operation, and seven days and three months after surgery. The temperature measurement was done by the infrared thermometer (Pyrometer TROTEC BP21). Statistically significant difference was determined using the t-test for related samples. Differences were considered statistically significant if p was less than 0.05. Eta squared coefficient was use to determine the import size and according to the Cohen criteria everything over 10:14 signified a major impact. The data were analyzed by the IBP SPSS Statistics v20. Results. In a majority of patients the breasts were hypoplastic (69.39%). The most commonly used implants were 275–500 mL volume (46.94%), and the least common implants were over 500 mL (16.33%). In a little less than 2/3 of the patients submammary incision was used (61.22%). In a majority of patients (67.35%) the prosthesis were placed subglandularly. The average value of the temperature before the operation at the point 1 was 34.49ºC, seven days after surgery 34.81ºC, and three months after surgery 34.10ºC; and at the point 2: 34.60 ºC, 34.91ºC and 34.19ºC in the same time intervals. In relation to the size of the breasts before operation and the size of the implant manufacturer, the localization of the incision and placement of the localization of the prosthesis, no statistically significant differences in the temperature of the skin of the breast before and after surgery was observed. Conclusion. Our results on the change of skin temperature after the breast augmentation could be significant preoperative information for the patients. Apstrakt Uvod/Cilj. Komplikacije augmentacije grudi, kao jedne od najčešćih estetskih operacija, su moguće i različite. Osim uobičajenih ranih, lokalnih postoperativnih komplikacija, najčešća kasna komplikacija je kapsularna kontraktura. Kao specifična komplikacija poremećaja funkcije kože posle ove operacije opisan je samo poremećaj senzibiliteta. S obzirom na to da koža ima i druge funkcije, kao i zbog toga što ne postoje podaci u literaturi, cilj istraživanja bio je merenje temperature kože dojke pre i posle operacije. Metode. Urađena je prospektivna intervencijska studija kod 49 punoletnih žena koje nisu rađale. Bilateralna augmentaciona mamoplastika je rađena zbog hipoplazije dojki ili na lični zahtev pacijenta sa eutrofičnim dojkama. Merenje temperature kože dojke je rađeno u dve tačke, pre operacije, sedam dana posle operacije i tri meseca posle operacije. Merenje temperature je učinjeno infracrvenim termometrom (Pyrometer BP21 TROTEC). Statistička značajnost razlike je određena korišćenjem t-testa za vezane uzorke. Razlike su smatrane statistički značajnim ukoliko je p < 0,05. Koeficijent eta kvadrat određivao je veličinu uticaja i prema kriterijumu Cohena, sve preko 0,14 označavalo je veliki uticaj. Dobijeni su analizirani programom IBM SPSS Statistics v20. Rezultati. Kod većine ispitanica dojke su bile hipoplastične (69,39%). Najčešće su korišćeni implantati zapremine 275–500 mL (46,94%), a najređe implantati zapremine preko 500 mL (16,33%). Kod nešto manje od 2/3 pacijenata primenjen je submamarni rez (61,22%). Kod većine pacijenata (67,35%), proteza je plasirana subglandularno. Prosečna vrednost temperature pre operacije u tački 1 bila je 34,49°C, sedam dana nakon operacije 34,81°C, a tri meseca nakon operacije 34,10°C, a u tački 2: 34,60°C, 34,91°C i 34,19°C u istim vremenskim intervalima. U odnosu na veličinu dojki pre operacije, veličinu i proizvođača implantata, lokalizaciju incizije i lokalizaciju plasiranja proteze, nisu nađene statistički značajne razlike u temperaturi kože dojke pre i posle operacije. Zaključak. Naši rezultati o promeni temperature kože dojke posle augmentacije mogli bi da imaju značaj u preoperativnom informisanju pacijenta. © 2019, Inst. Sci. inf., Univ. Defence in Belgrade. All rights reserved.

[No abstract available]