Darbo tikslas: įvertinti hemodializuojamų pacientų slaugos ypatumus. Metodika. Tyrimo metu Kauno medicinos universiteto klinikų detoksikacijos skyriuje atlikta anketinė tiriamųjų apklausa. Naudotos dvi anoniminės anketos. Viena anketa buvo skirta hemodialize gydomiems pacientams, kita - slaugytojoms. Anketoje pateikti klausimai skirti įvertinti tiriamųjų sociodemografinius duomenis, nuomonę apie pacientų žinias apie ligą, miegą, prisitaikymą prie pasikeitusio gyvenimo režimo, sveikatos problemų sprendimo būdus, bendravimą su slaugos personalu, jo teikiamą informaciją. Pacientams skirtoje anketoje klausta nuomonės apie jų sveikatą ir jos reikšmę kasdieninei veiklai („Health Survey for Dialysis Patients (SF36)). Apskaičiuojant kiekybinių dydžių vidurkius, po jų nurodytos standartinės paklaidos. Statistinė duomenų analizė atlikta kompiuteriu, naudojant duomenų analizės SPSS (Statistical Package for Social Science) programos paketą. Duomenų skirtumai laikyti reikšmingais, jei reikšmingumo lygmuo p<0,05. Rezultatai. Tyrime dalyvavo 54 hemodializuojami pacientai (34 vyrai ir 20 moterų) nuo 21 m. iki 81 m. amžiaus (vidurkis 58,37±2,072 m.) bei 30 slaugytojų moterų nuo 25 iki 50 metų (vidutinis amžius 37,5±1,45 m.). 40,7 proc. pacientų atvykimas į dializės centrą nesukelia jokių problemų, 40,7 proc. kyla sveikatos problemų, o 18,6 proc. patiria finansinius sunkumus. Kuo mažesnis atstumas nuo pacientų gyvenamosios vietos iki dializės centro, tuo mažiau problemų kyla pacientams (p=0,00... [toliau žr. visą tekstą] / Goal of the work: to assess the nursing peculiarities of hemodialysis patients. Methods. The survey of respondents was performed in performing the research at Kaunas University Hospital. Two anonymous questionnaires were applied. One questionnaire was prepared for hemodialysis patients and another for nurses. The questions in the questionnaire were targeted for evaluation of social demographic data of the researched persons, for the analysis of patient knowledge on their illness, sleep, adaptation to the changed mode of life, methods of solving the health problems, communication with the nursing staff and information provided by it. The questionnaire for patients contained questions on their opinion on their health and its meaning to daily activities („Health Survey for Dialysis Patients (SF36)). While calculating the mean values of the quantitative values, the standard deviations are specified next to them. The statistic data analysis was performed by computer, by using the Statistical Package for Social Science software package. The date the difference was disregarded if the meaning level was p<0.05. Results. 54 hemodialysis patients took part in the research (34 men and 20 women) from 21to 81 year age (average 58.37±2.072 years) and 30 nurses - women from 25 to 50 year age (average 37.5±1.45 years). For 40.7 percent of patients their arrival to the dialysis centre causes no problems, 40.7 percent have health problems, and 18.6 percent have financial difficulties. The less... [to full text]

Intracellular calcium is a major determinant of a wide variety of cell functions and thus of organ function. In order to get a clear picture of the intracellular calcium status it is preferable to assess the content of the various intracellular calcium pools as well as the characteristics of the transmembrane calcium movements, Le., the magnitude of the transmembrane Ca2+ flux upon stimulation and the rate of the subsequent return to baseline levels. The first aim of this study was to establish and evaluate the methods in the laboratory. The methods investigated include atomic absorption spectrometry, graphite furnace atomic absorption spectrometry and inductively coupled plasma mass spectrometry for the determination of the total cell calcium content, fluorescence spectrophotometry for the determinations of intracellular free Ca2+ and transmembrane Ca2+ movements and transmission electron microscopy for the localisation of intracellular calcium. The methods eventually identified as feasible included fluorescence spectrophotometry for the determination of intracellular free Ca2+ and transmembrane Ca2+ movements and transmission electron microscopy for the localisation of intracellular calcium. The newly developed fluorescent calcium indicator, fura-PE3, was presently shown to be the most reliable fluorescent indicator for the intracellular free Ca2+ determinations. The best method for the calcium localisation by transmission electron microscopy was an adaptation of the antimonate precipitation technique. The following objectives were set in order to contribute to the knowledge in chronic renal failure; examination of the intracellular free Ca2+ content in the neutrophils of end stage renal failure patients on maintenance haemodialysis treatment, as the result of renal failure, dialysis treatment and medication combined; examination of the characteristics of the transmembrane Ca2+ movements; investigation of the intracellular calcium distribution in the neutrophils; exploration of a possible link between the alterations in intracellular calcium status and factors known to influence the calcium status, including the lipid composition of the membrane, the oxidative status as reflected by anti-oxidant vitamin levels, as well as the levels of parathyroid hormone, and ionised serum calcium. This study involved 14 chronic renal failure patients on maintenance haemodialysis. An increase in intracellular free Ca2+, the magnitude of the transmembrane Ca2+ flux upon fMLP stimulation and an increase in the rate of the subsequent decrease in intracellular free calcium were found. In separating the patients into those receiving rHuEPO and those not receiving rHuEPO, it was seen that the significance in the increase in intracellular free Ca2+ could be ascribed to the values obtained in those patients receiving rHuEPO - despite the fact that they were the only patients receiving calcium channel blockers. No overt indications of oxidative stress could be detected by anti-oxidant vitamin levels. Nevertheless, a decrease in the content of specific membrane fatty acids occurred, supporting the previous suggestions of the presence of a mild chronic inflammatory condition in the chronic renal failure patient on maintenance haemodialysis treatment. These results suggest that factors other than those associated with uraemia, such as rHuEPO administration, might result in an increase in intracellular free Ca2+ in cells of CRF/MHT patients. The magnitude of the rHuEPD-induced increase in intracellular free Ca2+ and the effects of the various calcium channel blockers need urgent further investigation as ineffective counteraction of the rHuEPO effect, as indicated by the relative ineffectivity of Norvasc, may have serious side-effects. / Dissertation (MSc)--University of Pretoria, 2000. / Physiology / unrestricted