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Uvod: Rak ustne votline spada v skupino rakov glave in vratu. Gre za heterogeno skupino malignih bolezni, ki se pojavljajo v področju zgornjega dela dihalne in prebavne poti. Za celovit nadzor nad rakom je kirurško zdravljenje s kemoterapijo oziroma brez nje ali obsevanja glavni način zdravljenja. Namen: Namen diplomskega dela je opredeliti pomen in vlogo zdravstvene nege ter predstaviti intervencije medicinske sestre pri pacientu po kirurški odstranitvi raka v ustni votlini. Metode dela: V diplomskem delu smo uporabili deskriptivno metodo dela s kritičnim pregledom slovenske in tuje strokovne ter znanstvene literature. Opravili smo vsebinsko analizo znanstvenih in strokovnih člankov s področja zdravstvene nege pacienta po kirurški odstranitvi raka v ustni votlini. Iskanje literature je potekalo prek spletnega portala Digitalne knjižnice Univerze v Ljubljani (DiKUL) v mednarodnih spletnih bazah Medline, ScienceDirect, PubMed, Google učenjak ter s pomočjo vzajemne kataloške baze podatkov COBIB.SI. Napredno iskanje literature je potekalo s pomočjo ključnih besed oziroma besednih zvez v slovenskem jeziku: usta, novotvorbe, operativni poseg, zdravljenje, vloga medicinske sestre, v angleškem jeziku pa: mouth, neoplasm, surgery, treatment, nurse role. Uporabljeni so bili Boolovi operatorji: nursing care AND cancer AND oral cavity AND surgery. Vključitveni kriteriji za izbor ustrezne literature so članki in literatura v angleškem in slovenskem jeziku, objavljeni med letoma 2011 in 2021, prosta dostopnost do celotnega besedila ter članki, ki se neposredno ali posredno nanašajo na obravnavano vsebino ter se povezujejo z zastavljenimi cilji. V kvalitativno končno vsebinsko analizo smo vključili 29 enot znanstvene in strokovne literature. Rezultati: Glede na rezultate pregleda zdravstvena nega po kirurški odstranitvi raka v ustni votlini zahteva celosten, individualen pristop in je pomemben del obravnave pacienta. Medicinska sestra mora s svojim strokovni znanjem in sposobnostmi prepoznati vse potrebe pacienta in biti aktivno vključena v multidisciplinaren tim. Poznati mora anatomijo, fiziologijo in patologijo ustne votline ter potek kirurškega zdravljenja in možne zaplete. Medicinska sestra mora izvajati intervencije zdravstvene nege za čim hitrejše okrevanje pacienta in biti usposobljena za čim boljšo komunikacijo s pacientom, ki temelji na nadaljnjem načrtovanju in izvajanju zdravstvene nege pri temeljnih življenjskih aktivnostih in psihosocialnem zdravju. Razprava in zaključek: Medicinska sestra sodeluje pri pripravi pacienta na operacijo, v nadaljevanju, po operaciji, ustrezno vključuje in povezuje sodelavce z različnim strokovnim znanjem, podprtim z dokazi. Zavedati se mora, da je poleg fizičnega zdravja pomembno tudi pacientovo psihično odzivanje. Pomembno je pravočasno vključevanje svojcev in opolnomočenje pacienta. Osredotočiti se je treba na komunikacijo in sodelovanje s pacientom in njegovo družino ter na sodelovanje v strokovnem timu. Rak ustne votline je velik javnozdravstveni problem po vsem svetu. Na podlagi zbranih rezultatov je na tem področju potrebna kakovostna in učinkovita zdravstvena nega, predvsem v sklopu preventive, ki je na tem področju ključnega pomena. Introduction: Oral cancer belongs to a group of cancers of the head and neck. It is a heterogeneous group of malignant diseases that occur in the upper respiratory and/or digestive tract. For a complete cancer removal, surgical treatment with or without chemotherapy or radiation is the main treatment. Aim: The aim of the thesis is to define the importance and the role of nursing and nurse intervention in a patient after surgical cancer removal in the oral cavity. Methods: In our research, we have used a descriptive method with a critical review of Slovenian and foreign professional and scientific literature. We have performed analysis of professional scientific articles of patient nursing after surgical cancer removal in the oral cavity. We have searched for relevant articles in the international online databases such as Medline, ScienceDirect, PubMed, Google Scholar and catalog database COBIB.SI. Advanced literature search has been performed with keywords or phrases such as mouth, neoplasm, surgery, treatment, nurse role, where an appropriate Boolean operator AND was used. Inclusion criteria for the selection of relevant literature represent articles and literature in English and Slovenian, published between 2011 and 2021, free availability to the full text as well as articles that directly or indirectly relate to the content under consideration and are connected to our goals. We have included 29 units of scientific and professional articles in the qualitative final content analysis. Results: According to the examination results, nursing care after surgical cancer removal in the oral cavity requires a holistic and also an individual approach, which is an important part of a patient's treatment. Nurses should, with their expertise, identify all of the patient's needs and be actively involved in the multidisciplinary team. They should be well educated in the anatomy, physiology, and pathology of the oral cavity as well as in the course of surgical treatment and possible complications. Nurses should be trained to properly communicate with a patient and be able to perform nursing interventions for a patient to recover as quickly as possible. Discussion and conclusion: A nurse first participates in patient's preparations for the surgery, and then, after surgery, appropriately involves and connects the medical staff using a variety of evidence-based expertise. In addition to being responsible for observing the physical health, he or she must also pay attention to patient's mental response. A crucial point in recovery is also timely involvement of relatives and empowerment of cancer patients. Cancer is a major public health problem worldwide. Based on the results collected here, quality and effective health care is required in this area, especially in the context of prevention, which is one of the key priorities.

Oboljeli od poremećaja u jedenju (PUJ) razvijaju brojne medicinske komplikacije koje zahvaćaju sve organske sustave. Promjenama je zahvaćena i usna šupljina u kojoj se javlja niz promjena, a prisutne su i promjene u volumenu i sastavu sline te u razinama elektrolita. Cilj ovog rada bio je utvrditi razlike u učestalosti promjena u usnoj šupljini, količini sline i koncentraciji ukupne amilaze i elektrolita u slini i serumu te utvrditi razlike u stupnju uhranjenosti između pedijatrijskih bolesnika s poremećajima u jedenju i kontrolne skupine. Ispitivalo se postoji li korelacija između pojavnosti promjena i stupnja uhranjenosti. I konačno, utvrđivali su se glavni čimbenici koji utječu na pojavnost promjena u usnoj šupljini u pedijatrijskih bolesnika s poremećajima u jedenju. U istraživanje je bila uključena 101 ispitanica prosječne životne dobi 14,34 ± 1,99 godina, od toga 50 ispitanica s poremećajem u jedenju i 51 ispitanica kontrolne skupine. Bolesnice s PUJ-om bile su značajno slabije uhranjene i imale su učestalije, izraženije i brojnije promjene u usnoj šupljini nego ispitanice kontrolne skupine. U bolesnica s PUJom utvrđena je viša koncentraciju anorganskih fosfata u slini te više koncentracije magnezija, albumina, feritina i vitamin B12 u serumu. Ostali ispitavani parametri nisu su se značajno razlikovali među ispitivanim skupinama. Istraživanje je pokazalo da postoji povezanost između promjena u usnoj šupljini, životne dobi, trajanja poremećaja i stupnja uhranjenosti te koncentracija nekih od ispitivanih parametara u slini i serumu. Prepoznavanje oralnih promjena od strane stomatologa te rano upućivanje na liječenje zasigurno bi doprinjelo sprječavanju daljnjih komplikacija uzrokovanih bolešću. Numerous changes involving all organ systems are developing as a result of dysfunctional eating behavior in patients with eating disorders (ED). The changes also affect the oral cavity, in which a number of changes occur, and there are also changes in the volume and composition of saliva and in electrolyte levels. The aim of this study was to determine the differences in the frequency of changes in the oral cavity, the amount of saliva and the concentration of total amylase and electrolytes in saliva and serum, and to determine differences in nutritional status between pediatric patients with eating disorders and control groups. It was examined whether there was a correlation between the occurrence of changes and the degree of nutrition. And finally, the main factors influencing the occurrence of changes in the oral cavity in pediatric patients with eating disorders were identified. The study included 101 subjects with a mean age of 14.34 ± 1.99 years, of which 50 subjects with eating disorders and 51 subjects in the control group. Patients with PUJ were significantly malnourished and had more frequent, more pronounced and numerous changes in the oral cavity than the subjects of the control group. Higher serum concentrations of inorganic phosphates and serum magnesium, albumin, ferritin and vitamin B12 were found in patients with PUJ. Other examined parameters did not differ significantly between the examined groups. The study showed that there was an association between the changes in the oral cavity, age, duration of the disorder and the degree of nutrition, and the concentration of some of the examined parameters in saliva and serum. Recognition of oral changes by the dentist and early referral for treatment would certainly help to prevent further complications caused by the disease.

A case is presented of upper lip angiomyoma in a 36-year-old man. The tumor was painless, palpable and clinically visible. The operation was performed under local anesthesia in the Outpatient Department. There were no complications during the postoperative course. Current literature on the subject is listed in the introduction, followed by presentation of the case and histologic characteristics of the tumor. This case is described as one of the differential diagnostic possibilities in the diagnosis of soft tissue tumors of the lip. Also, through review of the literature, different clinical appearances of angiomyoma, histologic variations and immunohistochemical characteristics are discussed that can help identify this tumor., Autori prikazuju slučaj angiomioma gornje usne kod muškarca u dobi od 36 godina. Tumor je bio bezbolan, palpabilan i klinički vidljiv. Operacija je učinjena ambulantno u lokalnoj anesteziji. Poslijeoperacijski tijek je bio uredan. Postojeća literatura o temi je prikazana u uvodu te je potom popraćena prikazom slučaja kao i histološkim karakteristikama prikazanog tumora. Ovaj se slučaj opisuje kao jedna od diferencijalno dijagnostičkih mogućnosti kod mekotkivnih tumora usne. Također, kroz pregled literature pokazuju se različite kliničke i histološke varijacije tumora kako bi se što lakše dijagnosticirao.

Rad nudi novi pristup razumijevanju biblijske riječi לֵבlēb ( לֵבָבlēbāb) „srce“. Uz novi etimološki koncept ta bi se riječ izravno odnosila na osjetila sluha, vida i govora, što bi neizravno upućivalo na iznimno usku vezu srca i glave. Srce nužno ovisi o receptorima koje mu odašilju osjetila glave, pa prema tome njihova međuovisnost ne samo da je neupitna nego i ključna u cjelokupnoj ljudskoj dinamici jer poput baterije pretvara slušno vidne primljene informacije u svoje misaono logične, ali i osjećajno vjerske koncepte. Dvije su glavne podjele srca: dobro i loše. Dobro srce je samo ono koje je u suodnosu s Jahvom. Nema drugoga načina u cijeloj biblijskoj korespondenciji da srce bude pozitivno, aktivno i dobro ako nije privrženo, odano i podložno Božjim propisima koji se prvenstveno preko sluha slijevaju u ljudsko srce te blagotvorno i ljekovito djeluju ne njega. Problematika „iščašenog srca“ također se rješava izravnim Božjim interventom po kojemu srce koje je izišlo iz svojega ležišta ponovno zauzima svoj prvobitni položaj po kojemu je usmjereno isključivo na Boga. Samo takvo srce može donositi zdrave sudove, može rasuđivati razliku između dobra i zla i može upravljati cjelovitim čovjekom., There is a dominant view among exegetes that the heart in the Bible is the seat of intelligence and will. However, it seems that the heart is initially focused on human senses, especially the ear and the eye. This scientific paper offers a new approach to understanding the biblical word לֵבlēb ( לֵבָבlēbāb) “heart”. With a new etymological concept, the word may refer directly to the senses of hearing, sight, and speech, which would indirectly point to an extremely narrow connection between the heart and the head. The heart necessarily depends on the receptors in the head. Their interdependence is not only unquestionable; it is the key to human psycho-religious dynamics. The heart transforms audible and visual information into logical and religious concepts. These concepts of the heart can be twofold: positive and negative. Positive concepts of the heart are thoughts, emotions, and conclusions in the relationship with the Lord. There can be no other way in a comprehensive Biblical correspondence that the heart is positive, active, and good unless it is affectionate, devoted, and subject to the rules of God. God’s word, first and foremost, through the faculty of hearing, flows into the human heart. Only such a heart can bring about sound judgment, can discern the difference between good and evil, and govern the whole man. Therefore, in the light of contemporary vocabulary, the biblical heart signifies human judgment, or judgment that logically establishes the relationship between received information from the human audiovisual process. In the human heart, cognitive information is converted into judgments and conclusions. In the Old Testament, good judgments and conclusions are coherent with God’s commandments, while in the New Testament they depend on the Gospel.

Usnu šupljinu nastanjuju mnogi virusi, gljive i bakterije. Dok se većina tih mikroorganizama može lako uzgojiti i identificirati klasičnim mikrobiološkim testovima, neki od njih se mogu identificirati samo metodama molekularne biologije, kao npr. humani papiloma virus. Neki mikroorganizmi su prisutni u premaloj količini pa se ne mogu utvrditi klasičnim metodama tako da i u tom slučaju molekularna dijagnostika postaje logična alternativa. Testovi molekularne biologije osjetljivi su, objektivni, lako izvodljivi i manje su zahtjevni od klasičnih mikrobioloških metoda, u smislu edukacije i osiguranja kvalitete. U ovom radu su opisane molekularne metode koje se najčešće koriste za dokazivanje mikroorganizama koji koloniziraju usnu šupljinu., Many viruses, fungi and bacteria inhabit the mouth. Most of these microorganisms can be easily cultured and identified by classical microbiological tests, but some of them, such as human papilloma virus, can only be identified by the methods of molecular biology. Some microorganisms are present in a very small amount and cannot be detected by classical tests; therefore, in this case, molecular diagnosis is also a logical alternative. Molecular biology assays are sensitive, objective, easy to perform and less demanding than conventional microbiological methods in terms of training and quality assurance. This paper describes the molecular methods that are commonly used for the detection of microorganisms that colonize the oral cavity.

Angioedema indicates acute subcutaneous edema that characterizes improperly restricted cutaneous or mucous membrane swelling, which can occur only once or be relapsing. Edema usually occurs in the periorbital area, lips, tongue, extremities and intestinal wall. It has turned out that angioedema is usually caused by the use of angiotensin-converting enzyme inhibitors (ACE) or allergies to certain allergens (allergic or IgE-mediated angioedema), followed by C1 inhibitor deficiency (hereditary and acquired angioedema), or the cause is unknown (idiopathic angioedema). It has been shown that patients with angioedema often have urticaria, which is noted in approximately 50% of cases. Usually there is a type I allergic reaction to some food allergens or drugs or insect stings. The most common causes of allergic angioedema are bee and wasp stings, reactions to medications or injections for sensitivity testing, and certain foods (especially eggs, shellfish and nuts). In diagnostic terms, it is important to determine the potential allergen, which is commonly performed with cutaneous tests, such as prick test, etc. The main risk of angioedema is swelling of the tongue, larynx and trachea, which can lead to airway obstruction and death, therefore tracheotomy is indicated in such cases. The initial treatment of patients with most forms of angioedema included administration of antihistamines and glucocorticoids, while epinephrine is given if there is fear from laryngeal edema., Angioedem označava akutni potkožni edem koji obilježava nepravilno ograničeno oticanje kože ili sluznice koje se javlja jednokratno ili opetovano. Edem se obično javlja u predjelu periorbite, usnica, jezika, udova i crijevne stijenke. Pokazalo se da je angioedem često izazvan uzimanjem inhibitora angiotenzin-konvertirajućeg enzima (ACE) ili alergijom na neke alergene (alergijski ili angioedem posredovan IgE-om), zatim deficijencijom C1 inhibitora (nasljedni i stečeni angioedem) ili je uzrok nepoznat (idiopatski angioedem). Pokazalo se da bolesnici s angioedemom često imaju i urtikariju, što se zapaža u oko 50% slučajeva. Najčešće se radi o alergijskoj reakciji tipa I. na neke alergene hrane ili lijekova ili na ubod insekata. Utvrđeno je da su najčešći uzroci alergijskog angioedema ubodi pčela i osa, reakcije na lijekove ili injekcije za testiranje preosjetljivosti te određena hrana (osobito jaja, školjke i orašasti plodovi). U dijagnostičkom pogledu važno je utvrditi potencijalni alergen, što se najčešće izvodi kožnim testovima, kao što je ubodni test i dr. Rizično kod angioedema je oticanje jezika, grkljana i dušnika, što može dovesti do začepljenja dišnih putova i smrti, pa je tada indicirana i traheotomija. Početno liječenje bolesnika u većini oblika alergijskog angioedema je uzimanje antihistaminika i glukokortikoida, dok se epinefrin daje ako postoji bojazan od edema grkljana.