ABSTRACT
BACKGROUND: Palliative therapy represents active care for patients whose illness has such nature that is not responding to the curative treatment. The palliative care aims to provide comfort and prevention from the suffering of the patients at the end of their life. Treatment of the pain presents an important integral part of palliative care. AIM: This article aims to discuss and answer to some of the analgesic regimes and therapeutic dilemmas. RESULTS: Pain control, in addition to the other treatments such as alleviation of psychological, sociological and spiritual problems, has a priority. The proper pain management can achieve a better quality of life for the patients and their families. CONCLUSION: It can be concluded that because of the different origin of the pain, the use of analgesic therapy should be individualised and adapted to the real need of every person. Finally, only a good organisation and institutionalisation of the palliative care in one society could permit better prevention of suffering at the end of the life.
ABSTRACT
AIM: To determine average personal exposure to nitrous oxide for anaesthesiologists and nurses working in operating rooms (ORs) and intensive care units (ICU) in Clinical Hospital in Shtip, ENT University Clinic in Skopje and General Hospital in Kochani. METHODS: To determine TWA exposure nitrous oxide concentration was continuously measured over 8 hours shift within breathing zone of the subjects involved, using the handheld electrochemical instrument with data logging option. Results obtained were statistically processed. RESULTS: Highest TWA exposures (well above RELs) were found for nurses and anaesthesiologists in ORs in CH - Shtip, because of high workload in substandard conditions. TWA exposures in CH - Kochani were found to be significantly lower although in substandard conditions, mostly due to lower workload. TWA exposures found in ORs in ENT UC - Skopje is within RELs due to good work practices and proper ORs equipment. CONCLUSIONS: Study indicated significant exposure of personal working in substandard ORs in CH - Shtip. Applying proper work practices and maintain control equipment (general ventilation and scavenging systems) in operation, could provide for safe work environment.
ABSTRACT
AIM: To show certain health effects associated with acute and chronic exposure to nitrous oxide of staff of the Department of Anaesthesiology and Intensive Care at the Clinical Hospital in Shtip. METHODS: A transversal study was conducted, that include 43 health workers (23 - exposed and 20 - unexposed). Personal exposure to nitrous oxide for this group members was assessed through continuous measurement over 8 hours shift within breathing zone of the subjects involved, using handheld electrochemical instrument with datalogging option direct. In order to determine presence of possible health effects associated with acute and chronic exposure to nitrous oxide in ORs and ICUs, a specially designed questionnaire was prepared and distributed to be anonymously filled out, by all the examinees from both examined groups. Data were statistically tested for normality and also quantitative and qualitative assessment was performed. RESULTS: From the results obtained, a significant difference in several health effects between exposed and unexposed groups can be noted, including headaches, dizziness, nausea and vomiting, euphoria and tachycardia. Regarding the excitement, the appearance of depression, the feeling of numbness and tingling of the hands and feet, the differences between the two examined groups were not significant. CONCLUSION: It can be concluded that chronic exposure to nitrous oxide is associated with the adverse health effects.
ABSTRACT
AIM: To present a chronological overview of the most important events and actors that have marked the history of anaesthesiology and intensive treatment in R. Macedonia since its beginnings in the 1950s. METHOD: Retrospective study based on archive materials, published literature and jubilee publications, as well as the memories of individuals who have worked in the field of anaesthesiology in the past period. RESULTS: Between the two World Wars the first anaesthesia procedures were handled by surgeons. After World War II, the development of anaesthesia in R. Macedonia could be divided into two periods: before 1965 and after 1965. Before 1965 anaesthesia was mainly given by technicians trained on courses, and after this year anaesthesiology was taken over by anaesthesiologists who had specialized at the Faculty of Medicine in Skopje. In 1985 the number of anaesthesiologists was 100, and today it exceeds 250. The most important figures in the history of Macedonian anaesthesiology are: Dr. Risto Ivanovski, who worked from 1954-78, and Prof. Dr. Vladimir Andonov, who worked as an anaesthesiologist from 1965-99. Both of them are doyens who contributed a lot to the development of the anaesthesiology service and education of anaesthesiologists in R. Macedonia. Intensive treatment had started in 1955, but in real terms it has been performed since 1966, when artificial ventilators were introduced. The modern Intensive Care Department was opened at the Surgical Clinic in 1995 and it was followed in other hospitals in the state. The Department of Anaesthesiology has existed since 1975, and it has made a huge contribution to the education of professionals who apply modern principles in emergency medicine and intensive care. CONCLUSION: From modest beginnings in the 1950s, anaesthesiology today in R. Macedonia has developed well organized activity that successfully follow the trends of modern medicine in the field of anesthesiology, resuscitation, intensive care and pain treatment.
