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  • About
  • The Global ETD Search service is a free service for researchers to find electronic theses and dissertations. This service is provided by the Networked Digital Library of Theses and Dissertations.
    Our metadata is collected from universities around the world. If you manage a university/consortium/country archive and want to be added, details can be found on the NDLTD website.
81

Perceptions of African families about traumatic brain injury : implications for rehabilitation

Mokhosi, Mota Thomas. 11 1900 (has links)
The study aimed at giving a thick description of African families' experiences, views, cultural beliefs and interpretations of traumatic brain injury (TBI), and making recommendations for rehabilitation. It was conducted from the qualitative research paradigm, adopting a phenomenological research method. Twenty-two pairs of participants (patients and their caregivers )were interviewed about their perception of TBI. The semi-structured interviews were conducted at the participants' homes in Sesotho, and where necessary in their home languages. The consequences of TBI were found to follow universal trends (Oddy, 1984). However, participants' perceptions, as shaped by their experiences, views and cultural beliefs, were found to be unique. On analysing the gathered data, using inductive data analysis, it was found that African families' interpretations of TBI were based on beliefs about witchcraft, thwasa, Satanism, ancestral anger and God's wish. Based on these findings, rehabilitation services in the form of education, advocacy, networking and family therapy are recommended. / Psychology / M.A.(Clinical Psychology)
82

Forensic medicine in Scotland, 1914-39

Duvall, Nicholas January 2013 (has links)
This thesis examines the practice of forensic medicine in Scotland in the period 1914 to 1939. This was a time of significant dynamism for the discipline, in which it enjoyed a high public profile and played an important role in the investigation of crime. The project focuses in particular on medico-legal practice at an elite level, based in specialist departments in the universities of Edinburgh and Glasgow. As well as producing a significant amount of research and textbook material, and thus constituting authorities within the discipline, representatives of these institutions gave expert evidence in a number of high-profile trials. Thus, an examination of their work can show how medico-legal knowledge was constructed, presented and challenged. To this end, four main areas of forensic medical practice are analysed, including the post-mortem examination, the laboratory analysis of trace evidence, the investigation of shootings and the use of photography. The development of the techniques contained within these categories is charted, as is the range of situations to which they were applied and the various ways in which their use was challenged in court by hostile legal counsel. Sources including textbooks and journal articles, medical case reports, photograph albums and trial transcripts are used. A fifth section explores an area of the public face of the discipline, specifically the popular output of two of its most famous practitioners, Sydney Smith and John Glaister Jr. Both produced memoirs and newspaper serials after retirement. These are used to explore the ways they reflected on their careers and spun their legacies, portraying themselves as impartial servants of science and justice. The thesis argues that the place of forensic medicine in wider institutional, investigative and geographical networks was central to its existence. The discipline collaborated extensively, both with representatives of other areas of the medical profession and with external authorities, professions and trades. Means of communication, such as written reports and samples taken at autopsy, allowed experts in the universities to lend their expertise to the non-specialists in peripheries by providing expert opinions based on materials sent to them. The scrutiny of post-mortem reports produced by peripheral generalists allowed medico-legists’ expertise to be spread over a wide geographical area. The thesis also reflects on the ways in which medico-legists guarded against error. Techniques derived from other areas of medicine and science were not adopted for use in court until their reliability could be demonstrated satisfactorily, and controls and standards were built in to procedures.
83

Reliability and a Measure of Sexual Interest: Examining the Temporal Stability of Scores on Affinity 2.5

Hansen, Kristina S. Withers 13 July 2011 (has links) (PDF)
Affinity 2.5 is a computer-based instrument designed to measure sexual interest using viewing time of images depicting fully-clothed males and females of different ages. Participants are asked to rate the sexual attractiveness of the person in the image according to a 15-point scale while their viewing time of each image is surreptitiously monitored. The validity of viewing time as a measure of sexual interest is based on social cognition theory and is established in the review of literature. The number of images comprising Affinity 2.5 represents a 42.9% increase from the previous version of the assessment, Affinity 2.0. The purpose of this study was to examine the temporal stability of scores on Affinity 2.5 for a sample of exclusively heterosexual, nonpedophilic males and females. Viewing time data from 63 males and 84 females were analyzed using a chi-square procedure. Results of this analysis indicate that 86% of responses from the male participants and 88% of responses from the female participants were consistent from time one to time two. As suspected, these percentages represent an increase in reliability over the temporal stability of the shorter Affinity 2.0.
84

Glasgow Rent Strikes 1915: The Struggle for Decent Housing / The Glasgow Rent Strikes, 1915: Their Contribution and That of John Wheatly and Patrick Dollan to the Longer Struggle for Decent Working-Class Housing

McQueen, Matthew, J. 25 July 2017 (has links)
From the 1850s Glasgow was a major industrial, commercial and mercantile city, with notoriously poor working-class housing. During the 1915 Rent Strike many women physically resisted rent increases and prevented evictions from the tenements. The strikes ended when the Government passed the Rent Restrictions Act 1915, which returned rents to pre-war levels. This was in response to a political and working-class struggle that challenged the rule of law. Rather than focussing narrowly on the role of the women alone, or on the strike as inspiration for anti-capitalist resistance, the 2015 Centenary seemed opportune to examine why the Rent Strike was successful, its place in the longer struggle for decent housing, the role of the Independent Labour Party (ILP) and its leaders, and their collaborations with labour and women’s organisations. From the 1890s the ILP was central to labour’s campaign in elections and in fostering political collaboration with many groups representing labour. John Wheatley and Patrick Dollan, former miners, were leaders in strengthening the ILP organisation and its community relations. This collaborative structure supported the women leading the rent resistance in the tenements. It was also the platform for Wheatley and Dollan, nationally and municipally, to continue their life-long work to improve the housing and living standards of working people. Wheatley became Minister of Health in 1924 in Britain’s first Labour Government, and Dollan was Lord Provost in Glasgow’s first majority Labour Council in 1938. Glasgow’s systemic anti-Irish and anti-Catholic prejudice has, surprisingly, remained unexamined in relation to the Rent Strike. Two historians claimed, without presenting evidence, that bigotry was overcome or briefly transcended. The evidence reviewed here indicated that it did not go away, but that it had no impact on the Rent Strike as it simply offered no stimulus or opportunity to express the existing racist or religious prejudice. / Thesis / Master of Arts (MA) / Glasgow, with notoriously poor working-class housing, was a major centre in 1915 for British engineering, munitions and shipbuilding industries during the First World War. Women who lived in Glasgow’s tenements organised rent strikes and physically resisted rent increases and evictions. They were supported by the Independent Labour Party and the collaborations it developed before and during the war with organisations representing the interests of women and labour. These strikes, the rent agitations in England, and the threat of industrial action in Glasgow, forced the Government to pass the Rent Restrictions Act 1915, which limited rents to pre-war levels. Two former miners, John Wheatley and Patrick Dollan, were leaders in organising this class victory. They recognised the Act’s limitations and then worked nationally and municipally in the longer struggle for better working-class housing. Glasgow’s systemic anti-Irish and anti-Catholic bigotry did not disappear but played no significant role during the Rent Strike.
85

Sistemski prediktivni faktori ishoda lečenja kod povređenih sa teškim traumatskim moždanim oštećenjem / Systemic Predictive Factors for Treatment Outcome in Patients with Severe Traumatic Brain Injury

Lazukić Aleksandra 07 September 2018 (has links)
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Locked="false" Priority="19" SemiHidden="false" UnhideWhenUsed="false" QFormat="true" Name="Subtle Emphasis"/> <w:LsdException Locked="false" Priority="21" SemiHidden="false" UnhideWhenUsed="false" QFormat="true" Name="Intense Emphasis"/> <w:LsdException Locked="false" Priority="31" SemiHidden="false" UnhideWhenUsed="false" QFormat="true" Name="Subtle Reference"/> <w:LsdException Locked="false" Priority="32" SemiHidden="false" UnhideWhenUsed="false" QFormat="true" Name="Intense Reference"/> <w:LsdException Locked="false" Priority="33" SemiHidden="false" UnhideWhenUsed="false" QFormat="true" Name="Book Title"/> <w:LsdException Locked="false" Priority="37" Name="Bibliography"/> <w:LsdException Locked="false" Priority="39" QFormat="true" Name="TOC Heading"/> </w:LatentStyles></xml><![endif]--><!--[if gte mso 10]><style> /* Style Definitions */ table.MsoNormalTable{mso-style-name:"Table Normal";mso-tstyle-rowband-size:0;mso-tstyle-colband-size:0;mso-style-noshow:yes;mso-style-priority:99;mso-style-qformat:yes;mso-style-parent:"";mso-padding-alt:0in 5.4pt 0in 5.4pt;mso-para-margin-top:0in;mso-para-margin-right:0in;mso-para-margin-bottom:10.0pt;mso-para-margin-left:0in;line-height:115%;mso-pagination:widow-orphan;font-size:11.0pt;font-family:"Calibri","sans-serif";mso-ascii-font-family:Calibri;mso-ascii-theme-font:minor-latin;mso-hansi-font-family:Calibri;mso-hansi-theme-font:minor-latin;mso-bidi-font-family:"Times New Roman";mso-bidi-theme-font:minor-bidi;}</style><![endif]-->Uvod: Traumatsko moždano o&scaron;tećenje (TMO) predstavlja globalni zdravstveni problem koji pogađa oko 10 miliona ljudi godi&scaron;nje &scaron;irom sveta. Te&scaron;ka traumatska moždana o&scaron;tećenja (TTMO) čine 10% svih TMO i imaju visoku stopu mortaliteta i neizvestan oporavak. Ranije prepoznavanje sistemskih faktora koji utiču na ishod lečenja može da ima značajan uticaj na pravovremeno započinjanje terapijskih mera i smanjivanje morbiditeta i mortaliteta. Cilj istraživanja: Identifikovati sistemske faktore koji imaju značajan uticaj na ishod lečenja povređenih sa TTMO u Jedinici intenzivnog lečenja (JIL) tokom prvog dana hospitalizacije. Metodologija: Ispitivanje je sprovedeno kao retrospektivno-prospektivna studija koja je obuhvatila 115 povređenih ispitanika sa TTMO koji su hospitalizovani u JIL Urgentnog centra Kliničkog centra Vojvodine (UC KCV) u periodu od 1.01.2014.-1.10.2017. Iz medicinske dokumentacije, za svakog ispitanika uključenog u istraživanje su uzeti u razmatranje i analizu sledeći parametri u toku prvih 24 časa od momenta prijema u JIL: demografske i op&scaron;te karakteristike ispitanika od značaja za istraživanje i sistemski prediktivni faktori (sistolni i srednji arterijski pritisak- SAP/MAP, glikemija-&Scaron;UK, telesna temperatura-TT, pH, parcijalni pritisak kiseonika-PaO2 i parcijalni pritisak ugljem dioksida- PaCO2) registrovani u pet vremenskih tačaka (0h, 6h, 12h,18h, 24h). Svi gore navedeni podaci su posmatrani i analizirani kao prediktorski faktori tj. nezavisne varijable u odnosu na zavisnu varijablu &bdquo;ishod lečenja&ldquo; definisanu kao Glazgovska skala ishoda (Glasgow outcome scale-GOS) nakon otpusta povređenih iz JIL na Kliniku za neurohirurgiju KCV i GOS nakon otpusta iz Klinike za neurohirurgiju KCV i &bdquo;tok lečenja&ldquo; definisan kroz dužinu boravka povređenih u JIL UC KCV, dužinu boravka na Klinici za neurohirurgiju KCV, odnosno ukupno trajanje hospitalizacije u KCV, kao i otpust kući ili u odgovarajući rehabilitacioni centar. Statistička analiza je izvr&scaron;ena pomoću statističkog paketa IBM SPSS 23. Podaci su predstavljeni tabelarno i grafički, a statistička značajnost određivana je na nivou p &lt; 0,05. Prikupljeni podaci su obrađeni adekvatnim statističkim metodima. Rezultati: Sistemski faktori koji su se izdvojili kao prediktori smrtnog ishoda (GOS 1) kod povređenih sa TTMO tokom prvog dana boravka u JIL su upotreba vazoaktivne potpore i glikemija. Upotreba vazoaktivne potpore povećava verovatnoću za smrtni ishod 4,7 puta (OR=0,214; 95%CI: 0,096-0,479; p&lt;0,05). i vrednosti glikemije &gt; 10 mmol/l povećavaju verovatnoću za smrtni ishod u nultom satu (OR= 0,240, 95%CI: 0,087-0,662; p=0,05) i u 24 satu (OR=0,206, 95%CI: 0,037 &ndash; 0,929; p=0,05). Sa svakim porastom telesne temperature za jednu jedinicu u posmatranom intervalu raste verovatnoća za pozitivan ishod (OR =2,118 , 95%CI: 1,097 &ndash; 4,091; p&lt;0,05) i vrednosti glikemije u intervalu od 4-8 mmol/l povećavaju verovatnoću za pozitivan ishod 2,5 puta. Sistemski faktori koji su se izdvojili u smislu predikcije ishoda lečenja ispitanika nakon otpusta iz JIL su vrednosti glikemije i telesna temperatura. Vrednost glikemije na prijemu u intervalu od 6,9 do 7,4 mmol/l povećavaju verovatnoću boljeg oporavka (GOS 4-5 vs. GOS 2-3). Niže vrednosti glikemiije u narednim vremenskim tačkama (6h, 12h, 18h) takođe povećavaju verovatnoću za bolji oporavak. Ukoliko je telesna temperatura u 6-om i 12-om satu, vi&scaron;a od 36,5 &deg;C veća je verovatnoća za bolji neurolo&scaron;ki oporavak, prilikom otpusta iz JIL, odnosno Klinike za neurohirurgiju KCV. Ispitanici koji su imali vi&scaron;e vrednosti telesne temperature su imali duže trajanje hospitalizacije (OR=4,096; 95%CI; 0,709-7,483;p&lt;0,05). Na dužinu boravka u JIL, kao i na otpust kući ili odgovarajući rehabilitacioni centar nije imao uticaj nijedan posmatrani sistemski faktor. Zaključak: Sistemski prediktivni faktori toka i ishoda lečenja povređenih sa TTMO su upotreba vazoaktivne potpore, glikemija i telesna temperatura.</p> / <p>Introduction: Traumatic brain injury (TBI) is a global health problem that affects about 10 million people worldwide annually. Severe traumatic brain injury (STBI) account for 10% of all TBI and has high morbidity and unreliable recovery. Early recognition of systemic factors that affect the treatment outcome can have a significant impact on the timely initiation of therapeutic measures and the reduction of morbidity and mortality. The objective of the research: to identify systemic factors that have a significant impact on the treatment outcome of the STBI patients in the Intensive Care Unit (ICU) during the first day of hospitalization. Methodology: The study was conducted as a retrospective-prospective study that included 115 injured patients with STBI who were hospitalized in the ICU, Emergency Center (EC) of the Clinical Center of Vojvodina (CCV) in the period from 01.01.2014 to 1.10.2017. From the medical documentation, for each participant involved in the research, the following parameters within the first 24 hours after the admission were considered and analyzed: demographic and general characteristics of the participants of importance for research and systemic predictive factors (systolic and mean arterial pressure-SAP / MAP, glycemia, body temperature -TT, pH, partial pressure of oxygen-PaO2 and partial pressure of carbon dioxide-PaCO2) registered at five time points (0h, 6h, 12h,18h, 24h). All of the above data were observed and analyzed as predictors, ie, independent variables in relation to the dependent variable &quot;treatment outcome&quot; defined as the Glasgow Outcome Scale (GOS) after the transfer from the ICU to the Clinic of neurosurgery of the CCV and GOS after discharge from a Clinic of neurosurgery and &quot;treatment course&quot; defined by length of stay in ICU, or the total duration of hospitalization in CCV, as well as the release to the home or the appropriate rehabilitation center. Statistical analysis was performed using the IBM SPSS 23 statistical package. The data are presented in tables and graphs, and the statistical significance was determined at p &lt;0.05. The collected data were processed with adequate statistical methods. Results: Systemic factors that had predictive value for the lethal outcome (GOS 1) in STBI during the first day of ICU stay were the use of vasopressors and glycemia. The use of vasopressors increases the likelihood of fatal outcome 4.7 times (OR= 0,214; 95%CI: 0,096-0,479; p&lt;0,05) and glycemic values &gt; 10 mmol/l increase the likelihood of fatal outcome on admission (OR=0,240, 95%CI: 0,087-0,662; p=0,05) and after 24 hours (OR=0,206, 95%CI: 0,037 &ndash; 0,929; p=0,05). With each increase in body temperature for one unit in the observed interval, the probability of a positive outcome increases (OR=2,118, 95%CI: 1,097 &ndash; 4,091;p&lt;0,05) and glycemic values in the range 4-8 mmol/l increase the probability of a positive outcome 2.5 times. Systemic factors that predict the treatment outcome of the patients after their discharge from ICU are glycemia and body temperature. The blood sugar on admission in the ICU in the range from 6.9 to 7.4 mmol/l increases the opportunity of a better recovery (GOS 4-5 vs. GOS 2-3). Lower glycemic values at the next time points (6h, 12h, 18h) also increase the opportunity of a better recovery. If the body temperature in the 6th and 12th-hour postadmission is higher than 36.5&deg; C, the greater opportunity for better neurological improvement when the patient is discharged from ICU, or from the Clinic of neurosurgery. Participants who had higher values of body temperature had a longer duration of hospitalization (OR 4.096; 95% CI; 0.709-7.483;p&lt;0,05). The length of the stay in ICU, as well as the release to the home or the appropriate rehabilitation center, was not affected by any observed systemic factor. Conclusion: Systemic predictive flow factors and outcome of treatment factors with STBI use of vasopressors, glycemia and body temperature.</p>
86

The Dear Green Place ? Régénération urbaine, redéfinition identitaire et polarisation spatiale à Glasgow - 1979-1990.

Jeannier, Fabien 28 September 2012 (has links) (PDF)
Glasgow fut une ville pionnière en Grande-Bretagne dans la mise en place au début des années quatre-vingt d'une politique de régénération urbaine, sociale et économique basée sur les arts et la culture, exemplifiant le tournant vers une gestion entrepreneuriale de la ville. Les arts et la culture sont ainsi devenus le levier principal de sa reconversion déterminée vers une économie de services et de tourisme. Ce travail de recherche se propose de démontrer que cette politique, qui s'installe de manière irréversible pendant la période de gouvernement conservateur de M. Thatcher, a non seulement engendré des transformations économiques et physiques de grande ampleur mais qu'elle a également très clairement œuvré dans le sens d'une transformation tout aussi radicale de l'identité de la ville. Il apparaît que c'est un processus voulu par les élites travaillistes de la ville et revendiqué, assumé, organisé de façon consciente et méthodique qui puise ses fondements idéologiques dans une vision néolibérale du développement économique et du rôle de la culture. Nous tentons également de démontrer que, en dépit de la mise en place de partenariats public-privés sous la forme de sociétés locales de développement, ce processus n'a guère réussi à inverser une dynamique de relégation en périphérie des populations les plus défavorisées déjà fortement ancrée depuis les décennies précédentes. Enfin, nous montrons que ce processus de régénération urbaine a provoqué diverses formes d'opposition et de résistance qui renvoient indiscutablement au passé de luttes industrielles et de politique radicale de la ville, éléments majeurs de son identité.
87

Tracing the shadow of 'No Mean City' : aspects of class and gender in selected modern Scottish urban working-class fiction

Bryce, Sylvia January 2005 (has links)
This Ph.D. dissertation examines the influence of Alexander McArthur and H. Kingsley Long's novel No Mean City (1935) on the representation of working-class subjectivity in modem Scottish urban fiction. The novel helped to focus literary attention on a predominantly male, working-class, urban and realistic vision of modern Scotland. McArthur and Long explore - in their representations of destructive slum-dwelling characters - the damaging effects of class and gender on working-class identity. The controversy surrounding the book has always been intense, and most critics either deplore or downplay the full significance of No Mean City's literary impact. My dissertation re-examines one of the most disliked and misrepresented working-class novels in modern Scottish literary history. McArthur and Long's literary legacy, notwithstanding its many detractors, has become something to write against. Through examination of works by James Barke, John McNeillie, Edward Gaitens, Robin Jenkins, Bill McGhee, George Friel, William McIlvanney, Alan Spence, Alasdair Gray, James Kelman, Irvine Welsh, Janice Galloway, Agnes Owens, Meg Henderson and A.L. Kennedy, the thesis outlines how the challenge represented by No Mean City has survived the decades following its publication. It argues that contrary to prevailing critical opinion, the novel's influence has been instrumental, not detrimental, to the evolution of modern Scottish literature. Ultimately I hope to pave the way toward a fuller, more nuanced understanding of No Mean City's remarkable impact, and to demonstrate how pervasive its legacy has been to Scottish writers from the 1930s to the 1990s.
88

"Is She Going to Die or Survive with Her Baby?": The Aftermath of Illegitimate Pregnancies in the Twentieth Century American Novels

Liu, Li-Hsion 08 1900 (has links)
This dissertation is mainly based on the reading of three American novels to explore how female characters deal with their illegitimate pregnancies and how their solutions re-shape their futures and affect their inner growth. Chapter 1 discusses Dorinda Oakley's premarital pregnancy in Ellen Glasgow's Barren Ground and draws the circle of limits from Barbara Welter's "four cardinal virtues" (purity, submissiveness, domesticity, and piety) which connect to the analogous female roles (daughter, sister, wife, and mother). Dorinda's childless survival reconstructs a typical household from her domination and absence of maternity. Chapter 2 examines Ántonia Shimerda's struggles and endurance in My Ántonia by Willa Cather before and after Ántonia gives birth to a premarital daughter. Ántonia devotes herself to being a caring mother and to looking after a big family although her marriage is also friendship-centered. Chapter 3 adopts a different approach to analyze Charlotte Rittenmeyer's extramarital pregnancy in The Wild Palms by William Faulkner. As opposed to Dorinda and Ántonia who re-enter domesticity to survive, Charlotte runs out on her family and dies of a botched abortion. To help explain the aftermath of illicit pregnancies, I extend or shorten John Duvall's formula of female role mutations: "virgin>sexually active (called whore)>wife" to examine the riddles of female survival and demise. The overall argument suggests that one way or another, nature, society, and family are involved in illegitimately pregnant women's lives, and the more socially compliant a pregnant woman becomes after her transgression, the better chance she can survive with her baby.
89

Statistical and Machine Learning for assessment of Traumatic Brain Injury Severity and Patient Outcomes

Rahman, Md Abdur January 2021 (has links)
Traumatic brain injury (TBI) is a leading cause of death in all age groups, causing society to be concerned. However, TBI diagnostics and patient outcomes prediction are still lacking in medical science. In this thesis, I used a subset of TBIcare data from Turku University Hospital in Finland to classify the severity, patient outcomes, and CT (computerized tomography) as positive/negative. The dataset was derived from the comprehensive metabolic profiling of serum samples from TBI patients. The study included 96 TBI patients who were diagnosed as 7 severe (sTBI=7), 10 moderate (moTBI=10), and 79 mild (mTBI=79). Among them, there were 85 good recoveries (Good_Recovery=85) and 11 bad recoveries (Bad_Recovery=11), as well as 49 CT positive (CT. Positive=49) and 47 CT negative (CT. Negative=47). There was a total of 455 metabolites (features), excluding three response variables. Feature selection techniques were applied to retain the most important features while discarding the rest. Subsequently, four classifications were used for classification: Ridge regression, Lasso regression, Neural network, and Deep learning. Ridge regression yielded the best results for binary classifications such as patient outcomes and CT positive/negative. The accuracy of CT positive/negative was 74% (AUC of 0.74), while the accuracy of patient outcomes was 91% (AUC of 0.91). For severity classification (multi-class classification), neural networks performed well, with a total accuracy of 90%. Despite the limited number of data points, the overall result was satisfactory.
90

Prognostički značaj kliničkih i parametara kompjuterizovane tomografije kod pacijenata sa hroničnim subduralnim hematomom / Prognostic importance of clinical and computed tomography parameters in patients with chronic subdural hematoma

Juković Mirela 21 October 2014 (has links)
<p>Uvod: Hronični subduralni hematom (HSDH) je učestala i nezanemarljiva traumatska/netraumatska intrakranijalna lezija, naročito kod pacijenata starije životne dobi. Simptomi pacijenata sa HSDH su raznovrsni i često pogre&scaron;no protumačeni i lečeni. Zbog navedenih činjenica, HSDH predstavlja veliki izazov u dijagnostici i terapiji. Različiti autori ističu značaj radiolo&scaron;kih parametara tokom dijagnostike ovog oboljenja i povezanost sa kliničkom slikom I neurolo&scaron;kim statusom pacijenta, pa je ovo istraživanje bilo usmereno u preciznoj evaluaciji pomenutih parametara, njihovoj prediktivnoj vrednosti i uticaju na prognozu ishoda lečenja. Cilj: Generalni cilj istraživanja je bio da se ispita učestalost pacijenata sa hroničnim subduralnim hematomom na teritoriji Vojvodine u periodu od tri godine; da se analizira starosna dob pacijenata, polna distribucija oboljenja, uticaj komorbiditeta ili faktora rizika na nastanak HSDH; prisustvo ili odsustvo traume koja je doprinela nastanku HSDH, vremenski interval od traume do pojave simpotoma ili znakova bolesti i da se omogući praćenje efekta terapije pacijenata sa ovim oboljenjem. Specifični ciljevi su obuhvatili: 1. Da se utvrde parametri kompjuterizovane tomografije koji imaju prediktivni značaj u pozitivnom ishodu lečenja pacijenata sa hroničnim subduralnim hematomom. 2. Da se utvrde klinički parametri koji imaju prediktivni značaj u pozitivnom ishodu lečenja pacijenata sa hroničnim subduralnim hematomom. 3. Da se dobije model sa najvećom specifično&scaron;ću i senzitivno&scaron;ću za predikciju ishoda lečenja, kombinacijom kliničkih i parametrara kompjuterizovane tomografije kod pacijenata sa hroničnim subduralnim hematomom. Materijal i metode: Istraživanje je obavljeno kao prospektivna trogodi&scaron;nja studija u periodu od aprila 2010. do aprila 2013. godine u Kliničkom Centru Vojvodine- Centru za radiologiju i Klinici za neurohirurgiju i obuvatila je 83 pacijenata sa dijagnozom hroničnog subduralnog hematoma. Svi ispitanici su dijagnostikovani upotrebom kompjuterizovane tomografije glave (CT) i lečeni na Klinici za neurohirurgiju KCV. Izvori podataka su celokupna medicinska dokumentacija svakog pacijenta od perioda prve hospitalizacije do njihovog otpusta, a uključuje i podatke vezane za subjektivni osećaj o zdravstvenom stanju koje su pacijenti usmeno izneli &scaron;est meseci nakon hospitalnog otpusta. Rezultati: Rezultati istraživanja pokazuju da je Glasgow Coma Scala (GCS) tj. nivo svesti pacijenta na hospitalnom prijemu jedini parametar sa visokom prediktivnom vredno&scaron;ću za klinički ishod lečenja pacijenata sa HSDH procenjen preko Glasgow Outcome Scale (GOS). Preostali radiolo&scaron;ki i klinički parametri (&scaron;irina hematoma, pomeraj mediosagitalne linije, denzitet hematoma, starost pacijenta) nemaju visoku prediktivnu vrednost za klinički ishod pacijenata sa hroničnim subduralnim hematomom. Zaključak: Na osnovu grupe analiziranih pacijenata sa HSDH nije bilo moguće napraviti optimalan model za predikciju ishoda lečenja kombinujući radiolo&scaron;ke i kliničke parametre. Pojedinačno posmatrani radiolo&scaron;ki parametri nisu imali visoku prediktivnu vrednost za ishod lečenja pacijenata sa HSDH. Izolovan klinički parametar- GCS- je jedini visoko prediktivni faktor za ishod lečenja pacijenata sa HSDH. Kombinacija kliničkih i radiolo&scaron;kih parametara daje visoku vrednost predviđanja kliničkog ishoda lečenja, ali samo zahvaljujući izrazito visokoj prediktivnoj vrednosti GCS. Iz svega navedenog, kompjuterizovana tomografija (CT) ima veliki značaj u ranoj dijagnostici i praćenju terapije pacijenata sa HSDH, ali CT parametri ponaosob nemaju značaj u predviđanju ishoda lečenja.</p> / <p>Introduction: Chronic subdural hematoma (CSDH) is common traumatic/no traumatic intracranial lesion, especially in older patients. Symptomatology of this disease is variable and often is misdiagnosed and treated with specially challenges in diagnostic and therapy. Different authors pointed on importance of radiological parameters during diagnostic of this disease and connections with clinic and neurological status in patients with chronic subdural hematoma (CSDH), so this thesis was directed to evaluate radiological and clinical parameters of CSDHs and to show their predictive values and their significance on patient&rsquo;s outcome. Aim: General aim of this thesis was to examine frequency of patients with chronic subdural hematoma in Vojvodina, during the period of three years, to analyze the age of population with CSDHs, the gender distribution, an impact of comorbidity or risk factors for patients with CSDHs, the presence or absence of trauma which has contributed to CSDH, to determine time interval from trauma to appearance of symptoms and signs of disease, monitoring the effect of therapy. Specific aims were: 1. To determine clinical parameters with a positive predictive significance on patients outcome 2. To determine radiological parameters with a positive predictive significance on patients outcome 3. To determine optimal prognostic model with high specificity and sensitivity, using combination of radiological and clinical parameters for positive prediction outcome. Material and methods: The study was performed as three-year prospective study from April 2010 to April 2013 in Clinical Centre of Vojvodina, Centre for Radiology and Clinic of Neurosurgery and includes 83 patients with chronic subdural hematoma. All patients were diagnosed using computed tomography of the brain (CT scan) and all were treated in Clinic of Neurosurgery (KCV). Data sources included the medical records of each patient from the time of first hospitalization to period of their discharge and included data related to the subjective feeling of the health that patients verbally present six months after hospital discharge. Results: The results showed that the Glasgow Coma Scale (GCS) - a level of consciousness of the patient on the hospital admission was the only parameter with a high predictive value for clinical outcome of patients with CSDH assessed through Glasgow Outcome Scale (GOS). Other evaluated radiological and clinical parameters (width of the CSDH, mediosagital line displacement, a density of the CSDH, the age of the patient) did not have high predictive values for the clinical outcome in patients with chronic subdural hematoma. Conclusion: Based on the analyzed group of patients with CSDH it was not possible to make optimal predictive model for outcome by combining radiological and clinical parameters. Radiographic parameters did not have high predictive values for treatment outcome in patients with CSDH. Glasgow Coma Scale (GCS) is the only highly predictive factor for treatment outcome in patients with CSDH. The combination of clinical and radiological parameters gives high predictive value for clinical outcome, but only because of extremely high predictive value of GCS. Therefore, computed tomography (CT) is of great importance in early diagnosis and therapy monitoring of patients with CSDH, but CT parameters did not have the high predictive values for the patient&rsquo;s clinical outcome.</p>

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