State school – polyclinic in Petrinja (1925–1945)

Na temelju arhivskih dokumenata i literaturnih podataka istraženo je i rekonstruirano djelovanje Državne školske poliklinike u Petrinji u razdoblju od njezina osnutka 1925. do prestanka postojanja 1945. i apostrofirani su ključni nositelji njezine djelatnosti. Osnovana kao jedna od prvih školskih poliklinika u Hrvatskoj, petrinjska Državna školska poliklinika razvila je cjelovitu preventivnu i kurativnu zdravstvenu djelatnost kod petrinjske školske populacije i učenika seoskih škola petrinjskog kotara. Njezino neprekidno dvadesetogodišnje djelovanje na zdravstvenoj zaštiti školske populacije uspjela je sinteza preventivnih i kurativnih zdravstvenih načela utemeljenih na naprednim idejama socijalne medicine Andrije Štampara, promotora i reformatora javnoga zdravstva na našim prostorima. Promičući cjelovitu zdravstvenu skrb, čuvajući i unaprjeđujući tjelesno i duševno zdravlje djece i mladeži petrinjskih i okolnih škola, podignula je ugled petrinjskog zdravstva i pridonijela razvoju hrvatske školske medicine.What has been researched and reconstructed, based on archival documents and data from professional literature, is the activity of the State school-polyclinic in Petrinja, from its foundation in 1925 to its termination in 1945. Key figures taking part in its activity have also been highlighted. Founded as one of the first school-polyclinics in Croatia, the State school-polyclinic in Petrinja developed complete preventive and curative health activities aimed at school population in Petrinja as well as at pupils from the village schools in Petrinja County. These activities were based on carrying out thorough check-ups, giving school children vaccination, and taking other counter-epidemic measures, providing health and sanitary education, exercising sanitary supervision of schools and pupils’ homes, implementing remedial measures in the field, taking extra care of socially handicapped children, providing regular diet and healthy meals for the poorest (who got prescription glasses for free, as well as medicines, fish-liver oil, who got their teeth filled, hair cut and were given the opportunity to recuperate in the youth holiday camps at the seaside and in the mountains.) The activities also encompassed the efficient treatment of the sick, among whom the various infectious and internist diseases (anaemia, undernourishment, struma, rickets) and dental caries were prevalent. Its twenty-year-old continuous activity aimed at providing school population with health care represents a successful synthesis of preventive and curative health principles based on progressive ideas of social medicine promoted by Andrija Štampar, who was a promoter and reformer of public health service in our regions. Due to being well-organized and the professional enthusiasm of its managers and staff, the State school-polyclinic in Petrinja efficiently promoted public hygiene and addressed the specific health needs of the school population. While promoting integral health care, maintaining and improving physical and mental health of children and youth in the schools in Petrinja and the other schools nearby, it raised the reputation of health care in Petrinja and contributed to the development of the Croatian school of medicine

Clinical significance nontuberculous mycobacteria isolation in patients treated for pulmonary tuberculosis

Klinički aspekt izolacije netuberkuloznih mikobakterija iz uzoraka respiratornog sustava (iskašljaj, aspirat bronha, bronhoalveolarni lavat) u bolesnika s plućnom tuberkulozom u Hrvatskoj još uvijek nije dovoljno poznat. Cilj rada je utvrđivanje učestalosti i kliničkog značaja koizolacije, te naknadne izolacije netuberkuloznih mikobakterija (NTM) u bolesnika od aktivne tuberkuloze pluća u Sisačko – moslavačkoj županiji, koja zadnja dva desetljeća ima najveću incidenciju tuberkuloze u Hrvatskoj. Retrospektivno su analizirani podaci za 285 bolesnika s pozitivnim kulturama uzoraka iz dišnoga trakta na Mycobacterium tuberculosis, koji su od 2007. do 2016. liječeni bolnički i kontrolirani ambulantno zbog aktivne tuberkuloze pluća na Odjelu za plućne bolesti OB „Dr. Ivo Pedišić“ Sisak – lokacija Petrinja, a kod kojih su porastom na kulturi identificirane i NTM. Za određivanje kliničkog značaja izolata NTM korišteni su revidirani kriteriji Američkog torakalnog društva (ATS) i Američkog društva za infektivne bolesti (IDSA) iz 2007. godine. Ovom prvom kliničkom analizom navedenog fenomena u Hrvatskoj, registrirana su četiri bolesnika koji su imali koizolaciju NTM (1,4%) i dva bolesnika kod kojih su izolati NTM identificirani po završenom liječenju (0,7%). Troje bolesnika imalo je dvostruke (50%), a troje jednostruke izolate NTM. Kod nijednog od njih nisu bili ispunjeni cjeloviti kriteriji ATS/IDSA za plućnu mikobakteriozu i kod svih je nastupila spontana konverzija sputuma na NTM. Zaključuje se da se u svim slučajevima radilo o kolonizaciji dišnog sustava NTM bez razvoja klinički značajne plućne infekcije.The clinical aspect of the isolation of Nontuberculous Mycobacteria from samples taken from the respiratory tract (expectorate, bronchial aspirate, bronchoalveolar lavage) in patients with pulmonary TB in Croatia is still not known enough. The aim of the paper is to define the frequency and the clinical significance of the co-isolation as well as the subsequent isolation of Nontuberculous Mycobacteria (NTM) in patients with active pulmonary TB in Sisak-Moslavina county, which has had the highest incidence of TB in Croatia for the last two decades. There has been a retrospective analysis of data derived from positive sample cultures from the respiratory tract on Mycobacterium Tuberculosis in 285 patients, who, due to active pulmonary TB, underwent hospital treatment alongside with being checked as outpatients in the Pulmonary Ward of GH “Dr Ivo Pedišić” Sisak – location in Petrinja, and in whom NTM, too, were identified in their culture. What was used to determine the clinical relevance of the NTM isolate were the revised criteria of the American Thoracic Society (ATS) and Infectious Diseases Society of America (IDSA) from 2007. This first clinical analysis of the stated phenomenon in Croatia resulted in the registration of four patients with NTM isolation (1.4%) and two patients in whom the NTM isolates were identified after treatment had been completed (0.7%). Three patients had two-fold (50%), and three patients had one-fold NTM isolates. The complete ATS/IDSA criteria for pulmonary mycobacteriosis were not met in neither one of them and in all of them a spontaneous conversion of sputum to NTM developed. It can be concluded that the issue in all the cases was the colonization of the respiratory tract by NTM without the development of clinically relevant pulmonary infection

State school – polyclinic in Petrinja (1925–1945)

Na temelju arhivskih dokumenata i literaturnih podataka istraženo je i rekonstruirano djelovanje Državne školske poliklinike u Petrinji u razdoblju od njezina osnutka 1925. do prestanka postojanja 1945. i apostrofirani su ključni nositelji njezine djelatnosti. Osnovana kao jedna od prvih školskih poliklinika u Hrvatskoj, petrinjska Državna školska poliklinika razvila je cjelovitu preventivnu i kurativnu zdravstvenu djelatnost kod petrinjske školske populacije i učenika seoskih škola petrinjskog kotara. Njezino neprekidno dvadesetogodišnje djelovanje na zdravstvenoj zaštiti školske populacije uspjela je sinteza preventivnih i kurativnih zdravstvenih načela utemeljenih na naprednim idejama socijalne medicine Andrije Štampara, promotora i reformatora javnoga zdravstva na našim prostorima. Promičući cjelovitu zdravstvenu skrb, čuvajući i unaprjeđujući tjelesno i duševno zdravlje djece i mladeži petrinjskih i okolnih škola, podignula je ugled petrinjskog zdravstva i pridonijela razvoju hrvatske školske medicine.What has been researched and reconstructed, based on archival documents and data from professional literature, is the activity of the State school-polyclinic in Petrinja, from its foundation in 1925 to its termination in 1945. Key figures taking part in its activity have also been highlighted. Founded as one of the first school-polyclinics in Croatia, the State school-polyclinic in Petrinja developed complete preventive and curative health activities aimed at school population in Petrinja as well as at pupils from the village schools in Petrinja County. These activities were based on carrying out thorough check-ups, giving school children vaccination, and taking other counter-epidemic measures, providing health and sanitary education, exercising sanitary supervision of schools and pupils’ homes, implementing remedial measures in the field, taking extra care of socially handicapped children, providing regular diet and healthy meals for the poorest (who got prescription glasses for free, as well as medicines, fish-liver oil, who got their teeth filled, hair cut and were given the opportunity to recuperate in the youth holiday camps at the seaside and in the mountains.) The activities also encompassed the efficient treatment of the sick, among whom the various infectious and internist diseases (anaemia, undernourishment, struma, rickets) and dental caries were prevalent. Its twenty-year-old continuous activity aimed at providing school population with health care represents a successful synthesis of preventive and curative health principles based on progressive ideas of social medicine promoted by Andrija Štampar, who was a promoter and reformer of public health service in our regions. Due to being well-organized and the professional enthusiasm of its managers and staff, the State school-polyclinic in Petrinja efficiently promoted public hygiene and addressed the specific health needs of the school population. While promoting integral health care, maintaining and improving physical and mental health of children and youth in the schools in Petrinja and the other schools nearby, it raised the reputation of health care in Petrinja and contributed to the development of the Croatian school of medicine

Mikobakterioza pluća uzrokovana mycobacterium kansasii kao prethodnica u kroničnu plućnu aspergilozu: prikaz slučaja

Aim: To present a patient suffering from chronic pulmonary aspergillosis and in whom a prolonged use of corticosteroids due to chronic obstructive pulmonary disease represented a serious risk factor in the development and progression of the infection. Case report: We present a case of a 52-year-old cachectic, HIV seronegative potator and smoker who, having recovered from pulmonary mycobacteriosis caused by Mycobacterium kansasii, developed a chronic cavitary pulmonary aspergillosis (CCPA) which was confirmed by radiological, microbiological (positive culture findings on Aspergillus fumigatus in sputum samples, bronchial aspirate and bronchoalveolar lavage) and blood findings (IgG antibodies and a positive galactomannan antigen for Aspergillus).Granulomatous reaction without a hyphal invasion was confirmed by transbronchial lung biopsy. Despite being treated with peroral and intravenous antifungal medicines, the patient died, most probably due to the development of a more invasive form of pulmonary aspergillosis. Conclusion: Due to the lack of unambiguous diagnostic and therapeutic criteria, chronic pulmonary aspergillosis poses a considerable challenge to the clinician, because it is the case of a continuous disease which shows different forms of clinical and radiological presentation in its evolution. Its relatively high morbidity and mortality rate , despite targeted antifungal therapy, proves the need for further researches, particularly those which refers to the identification of certain presentations of the disease and efficacy of therapeutic methods.Cilj: Prikazati pacijenta koji boluje od kronične plućne aspergiloze i kod kojega je dugotrajna primjena kortikosteroida zbog kronične opstruktivne plućne bolesti predstavljala važan faktor rizika u nastanku i razvoju infekcije. Prikaz slučaja: Prikazujemo slučaj 52-godišnjeg pacijenta, kahektičnog, HIV seronegativnog potatora i pušača, koji je nakon preboljele plućne mikobakterioze uzrokovane Mycobacterium kansasii zadobio kroničnu kavitarnu aspergilozu pluća koja je dokazana na temelju radioloških, mikrobioloških (pozitivne kulture Aspergillus fumigatusa u uzorcima sputuma, aspiratu bronha i bronhoalveolarnom lavatu) i krvnih nalaza (IgG protutijela i pozitivan galaktomananski antigen na Aspergillus). Transbronhalnom biopsijom pluća dokazana je granulomska reakcija bez hifalne invazije. Unatoč tretmanu peroralnim i intravenskim antifungicima slučaj je završio letalnim ishodom, najvjerojatnije zbog razvoja invazivnije forme plućne aspergiloze. Zaključak: Zbog nedostatka nedvosmislenih dijagnostičkih i terapijskih kriterija, kronična plućna aspergiloza predstavlja nemali izazov za neposrednog kliničara, tim više što je riječ o kontinuiranoj bolesti koja u svojoj evoluciji iskazuje različite oblike kliničke i radiološke prezentacije. Njen relativno visok morbiditet i mortalitet, unatoč ciljanoj antifungalnoj terapiji, ukazuje na potrebu daljnjih proučavanja, prioritetno onih koji se odnose na identifikaciju pojedinih prezentacija bolesti i efikasnost terapijskih postupaka

THE ROLE AND CONTRIBUTION OF CHIEF PHYSICIAN MATIJA PERAK (1914‑1992) TO THE FOUNDATION AND DEVELOPMENT OF PHTISIOLOGY IN PETRINJA (1946‑1978)

U radu je prezentiran doprinos Matije Peraka razvoju ftizeološke djelatnosti u Petrinji i suzbijanju tuberkuloze u sisačko-banijskoj regiji u razdoblju od 1946. do 1978. godine. Temeljem arhivskih dokumenata rekonstruirano je njegovo kurativno i preventivno djelovanje na suzbijanju pobola i pomora od tuberkuloze. Istaknut je njegov organizacijsko-rukovodni, stručno-znanstveni i publicistički rad te njegova uloga u preorijentaciji struke na kronične netuberkulozne bolesti i edukaciji novih generacija petrinjskih ftizeologa.The study shows the contribution of Matija Perak to the development of phthisiological service in Petrinja and the suppression of TB in the Sisak - Banija region in the period from 1946 to 1978. Having obtained data from the archive documents, it was possible to reconstruct his curative and preventive activities in the suppression of morbidity and mortality from TB in the Sisak - Banija region. His organizational and managerial, professional-scientific and publicistic work is highlighted, as well as his role in the reorientation of the profession towards chronic non-TB diseases and the education of new generations of phthisiologists in Petrinja

THE CONTRIBUTION OF THE FIBEROPTIC BRONCHOSCOPY IN DIAGNOSING OF SMEAR NEGATIVE PULMONARY TUBERCULOSIS

U radu su analizirane uloga i važnost fiberbronhoskopije u ranoj i konačnoj dijagnozi aktivne tuberkuloze pluća u 102 bolesnika liječena u razdoblju od 1. siječnja 2007. do 31. prosinca 2012. godine na Odsjeku za plućne bolesti Opće bolnice »Dr. Ivo Pedišić« u Sisku – lokacija Petrinja, a čiji su inicijalni uzorci sputuma bili direktno negativni na acido­rezistentne bacile. Analizirana je dijagnostička uspješnost pojedinih bronhoskopskih procedura, kao i njihovih kombina­cija. Rana dijagnoza aktivne tuberkuloze pluća postavljena je kod 31 bolesnika (30,39%), a konačna dijagnoza kod 67 bolesnika (65,68%). Dijagnoza aktivne plućne tuberkuloze postavljena je jedino na bazi uzoraka uzetih tijekom fiber­bronhoskopije kod 28 bolesnika (9,65%). Statistički značajan broj bolesnika u kojih je dijagnoza postavljena fiberbronho­skopijom ističe važnost ove metode u dijagnostici aktivne tuberkuloze pluća u bolesnika čiji su sputumi mikroskopski ­direktno negativni i/ili u onih koji ne mogu spontano iskašljati primjeren uzorak.The study has analysed the role and significance of fibrobronchoscopy in the early and definitive diagnosis of active pulmonary tuberculosis in 102 patients treated on the Pulmonary Ward of ‘Dr Ivo Pedišić’ hospital in Sisak – location Petrinja from 1st January 2007 to 31st December 2012 and whose initial sputum specimens directly tested negative for acid resistant bacilli. What has been analysed is the diagnostic efficiency of particular bronchoscopic procedures themselves and their combinations. An early diagnosis of active tuberculosis has been made in 31 patients (30,39%), and definitive diagnosis in 67 patients (65,68%). The etiological diagnosis of active pulmonary tuberculosis has been made only on the basis of specimens taken during fibrobronchoscopy in 28 patients (9,65%). A statistically significant number of patients in whom diagnosis has been made by fibrobronchoscopy emphasizes the importance of this method in the etiological diagnostics of active pulmonary TB in those patients whose sputum samples are microscopically directly negative and/or in those who cannot spontaneously expectorate valid sputum

EPIDEMIOLOGICAL AND CLINICAL ASPECTS OF PULMONARY MYCOBACTERIOSIS IN SISAK-MOSLAVINA COUNTY

S opadanjem incidencije tuberkuloze i broja izolata Mycobacterium tuberculosis u Republici Hrvatskoj povećava se broj izolata netuberkuloznih mikobakterija (NTM). Određivanje kliničkog značenja izoliranih vrsta NTM-a složen je i zahtjevan proces koji uključuje istodobnu analizu kliničkih, mikrobioloških i radioloških nalaza te njihovu korelaciju s cjelovitim dijagnostičkim kriterijima prema smjernicama Američkoga torakalnog društva (ATS) i Američkog društva za zarazne bolesti (IDSA). Regionalne razlike u distribuciji vrsta NTM-a i njihovoj kliničkoj relevanciji relativiziraju općenitost zaključaka o kliničkoj prezentaciji tih vrsta. Budući da u Hrvatskoj još ne postoje podaci o bakteriološkoj distribuciji i prevalenciji vrsta NTM-a te incidenciji plućne mikobakterioze u pojedinim regijama, u ovoj, prema našim saznanjima prvoj regionalnoj studiji, analizirane su najčešće vrste NTM-a izoliranih iz uzoraka dišnog trakta 48 bolesnika u Sisačko-moslavačkoj županiji (SMŽ) u razdoblju od 1. siječnja 2007. do 31. prosinca 2017. godine te je procijenjeno njihovo kliničko značenje temeljem cjelovitih dijagnostičkih kriterija ATS/IDSA. Bakteriološka identifikacija NTM-a u regionalnom okružju ima važno kliničko i prognostičko značenje jer delegira terapijske opcije i važan je alat neposrednom kliničaru pri donošenju odluke o antibiotskom liječenju, praćenju terapijske uspješnosti i procjeni relapsa bolesti. Prema mikrobiološkim kriterijima, 21 bolesnik (40,4%) imao je izolate koji su prediktirali moguću plućnu mikobakteriozu. Primjenom cjelovitih dijagnostičkih kriterija, prema smjernicama ATS/IDSA, vjerojatna bolest dijagnosticirana je kod 12 bolesnika (57,1%), od kojih je tretirano njih petero (23,8%), a ostali su bolesnici praćeni radiološki i bakteriološki bez antibiotske terapije. Temeljem cjelovitih kriterija srednja godišnja incidencija vjerojatne plućne mikobakterioze u SMŽ-u iznosi 0,69 bolesnika na 100.000 stanovnika, a dokazane bolesti 0,29 na 100.000 stanovnika. Od sedam izolacijskih epizoda M. kansasii prava plućna mikobakterioza dokazana je kod tri bolesnika (43%), od tri epizode M. xenopi u jednog bolesnika (33%), a jedina epizoda izolacije M. avium izazvala je klinički važnu bolest (100%). Regionalne razlike u distribuciji i relevantnosti vrsta NTM-a upućuju na važnost ekoloških čimbenika okoliša u incidenciji i kliničkim manifestacijama plućne mikobakterioze pa bi ih stoga trebalo sustavnije istraživati i proučavati.While tuberculosis incidence and the number of Mycobacterium tuberculosis isolates have been decreasing in the Republic of Croatia, the number of nontuberculous mycobacteria isolates has been on the increase. Determination of clinical significance of the isolated NTM strains is a complex and demanding process which comprises a simultaneous analysis of clinical, microbiological and radiological findings as well as their correlation with the complete diagnostic criteria following the guidelines of the American Thoracic Society (ATS) and the Infectious Diseases Society of America (IDSA). Regional differences in the distribution of NTM strains and their clinical relevance relativize the generality of conclusions about their clinical presentation. Since in Croatia there are still no data on bacteriological distribution and NTM strains prevalence as well as the incidence of pulmonary mycobacteriosis in certain regions, in this, as far as we know, first regional study, the commonest strains of NTM have been analysed. The strains were isolated from samples taken from the respiratory tract in 48 patients in Sisak – Moslavina county (SMC) in the period from 1st January 2007 to 31st December 2017 and their clinical significance estimated following the complete diagnostic criteria of ATS/IDSA. Bacteriological identification of NTM in a region has a great clinical and diagnostic significance since it helps choose treatment options and is an important tool to a clinician in making a decision on antibiotic treatment, checking the treatment effectiveness and estimating the relapse. According to microbiological criteria, 21 patients (40.4%) had isolates which predicted a possible pulmonary mycobacteriosis. By applying the complete diagnostic criteria following the guidelines of ATS/IDSA, a probable disease was established in 12 patients (57.1%), out of whom five were treated (23.8%), while the others were checked radiologically and bacteriologically without an antibiotic therapy. Following the complete criteria, the mean annual incidence of the possible pulmonary mycobacteriosis in S – M county is 0.69 cases in 100,000 inhabitants, and of confirmed ones 0.29 cases. Out of seven isolating episodes M. kansasii, the genuine pulmonary mycobacteriosis was established in three patients (43%), out of three episodes M. xenopi in one patient (33%), and the only one episode of M. avium isolation caused a clinically significant disease (100%). Regional differences in the distribution and relevance of NTM strains point to the significance of ecological factors of the environment in the incidence and clinical manifestations of pulmonary mycobacteriosis, so they ought to be more systematically researched and studied

THE CONTRIBUTION OF THE FIBEROPTIC BRONCHOSCOPY IN DIAGNOSING OF SMEAR NEGATIVE PULMONARY TUBERCULOSIS

U radu su analizirane uloga i važnost fiberbronhoskopije u ranoj i konačnoj dijagnozi aktivne tuberkuloze pluća u 102 bolesnika liječena u razdoblju od 1. siječnja 2007. do 31. prosinca 2012. godine na Odsjeku za plućne bolesti Opće bolnice »Dr. Ivo Pedišić« u Sisku – lokacija Petrinja, a čiji su inicijalni uzorci sputuma bili direktno negativni na acido­rezistentne bacile. Analizirana je dijagnostička uspješnost pojedinih bronhoskopskih procedura, kao i njihovih kombina­cija. Rana dijagnoza aktivne tuberkuloze pluća postavljena je kod 31 bolesnika (30,39%), a konačna dijagnoza kod 67 bolesnika (65,68%). Dijagnoza aktivne plućne tuberkuloze postavljena je jedino na bazi uzoraka uzetih tijekom fiber­bronhoskopije kod 28 bolesnika (9,65%). Statistički značajan broj bolesnika u kojih je dijagnoza postavljena fiberbronho­skopijom ističe važnost ove metode u dijagnostici aktivne tuberkuloze pluća u bolesnika čiji su sputumi mikroskopski ­direktno negativni i/ili u onih koji ne mogu spontano iskašljati primjeren uzorak.The study has analysed the role and significance of fibrobronchoscopy in the early and definitive diagnosis of active pulmonary tuberculosis in 102 patients treated on the Pulmonary Ward of ‘Dr Ivo Pedišić’ hospital in Sisak – location Petrinja from 1st January 2007 to 31st December 2012 and whose initial sputum specimens directly tested negative for acid resistant bacilli. What has been analysed is the diagnostic efficiency of particular bronchoscopic procedures themselves and their combinations. An early diagnosis of active tuberculosis has been made in 31 patients (30,39%), and definitive diagnosis in 67 patients (65,68%). The etiological diagnosis of active pulmonary tuberculosis has been made only on the basis of specimens taken during fibrobronchoscopy in 28 patients (9,65%). A statistically significant number of patients in whom diagnosis has been made by fibrobronchoscopy emphasizes the importance of this method in the etiological diagnostics of active pulmonary TB in those patients whose sputum samples are microscopically directly negative and/or in those who cannot spontaneously expectorate valid sputum

Comorbidities in patients with chronic obstructive pulmonary disease

Cilj istraživanja: Utvrditi koji su najčešći i koliko prosječno komorbiditeta imaju ispitanici u skupini bolesnika s KOPB-om koji se liječe u KBC Osijek, te ispitati povezanost komorbiditeta s karakteristikama osnovne bolesti. Nacrt studije: Istraživanje je provedeno kao presječno. Ispitanici i metode: Ispitanike predstavljaju bolesnici oba spola s dijagnozom KOPB-a koji su se redovito kontrolirali i liječili u ambulantama Zavoda za pulmologiju KBC-a Osijek u razdoblju od 2018. do 2020. godine. Analizirani su podatci o karakteristikama bolesti dobiveni iz povijesti bolesti uključujući i komorbiditete, te metodama spirometrije, bioimpedancije, 6-minutnim testom hoda, i upitnicima (mMRC skala dispneje, CAT upitnik, BODE indeks i Charlson indeks o komorbiditetima). Rezultati: Istraživanje je provedeno na 40 bolesnika, prosječne dobi 67 godina, 68 % muškarci i 33 % žene. Kod 88 % bolesnika je dijagnosticirana prisutnost barem jednog komorbiditeta. Medijan broja prisutnih komorbiditeta je 2. Najčešći komorbiditeti su hipertenzija (63 %), GERB (25 %), depresija (20 %) te pretilost (18 %). Nađeno je da su osteoporozu statistički značajno više imali teški bolesnici koji su pripadali skupini D (p = 0,02). Nije nađena druga statistički značajna razlika u pogledu komorbiditeta između različitih skupina bolesnika prema mMRC stupnju dispneje, GOLD stupnju opstrukcije, skupinama rizika ABCD i skupinama prema BODE indeksu. Zaključak: Najčešći komorbiditeti među bolesnicima su hipertenzija, GERB, depresija te pretilost, a bolesnici prosječno imaju 2 komorbiditeta. Osteoporoza je nađena statistički značajno više u bolesnika skupine D, najtežih bolesnika koji imaju mnogo simptoma i egzacerbacije. Ostali komorbiditeti su bili ravnomjerno zastupljeni u bolesnika svih stupnjeva težine i karakteristika bolesti.Objectives: The aim of this study was to establish the most common comorbidities among subjects in a group of patients with COPD undergoing treatment in Clinical Hospital Centre Osijek, how many comorbidities subjects have on average, and whether they are connected with the characteristics of the underlying disease. Study design: Cross-sectional study. Patients and methods: The subjects are patients of both sexes with COPD diagnosis who have had regular check-ups and treatment in outpatient clinics of KBC Osijek Pulmonary Institute from 2018 to 2020. Data on the characteristics of a disease retrieved from case histories have been analysed, including comorbidities. Other methods deployed include spirometry, bioimpedance, the 6-minute walk test, and questionnaires (the mMRC Dyspnea Scale, CAT questionnaire, BODE Index and The Charlson Comorbidity Index). Results: Research has been conducted on 40 patients with the average age of 67, out of which 68 % were men and 33 % women. 88 % of the subjects have been diagnosed with the presence of at least one comorbidity. The median number of present comorbidities is 2. The most common comorbidities are hypertension (63 %), GERD (25 %), depression (20 %) and obesity (18 %). The results show that significantly more, according to statistics, osteoporosis affects patients belonging to risk group D (p = 0,02). Another statistically significant difference referring to comorbidity between different groups of patients according to the mMRC degree of Dyspnea, GOLD degree of obstruction, ABCD risk groups and groups according to BODE Index, has not been found. Conclusion: The most common comorbidities among patients are hypertension, GERD, depression and obesity. On average, patients have two comorbidities. Osteoporosis has been found in a statistically more significant percentage in patients in group D who have a lot of symptoms and exacerbations. Other comorbidities were evenly represented in patients suffering from diseases of all severity levels and disease characteristics