Zarazne bolesti kao hitni slučajevi na dječjem odjelu za bolesti uha, grla i nosa

Infectious diseases are the leading cause of emergency hospital admission for children treated at ENT department. The aim of this retrospective study was to investigate the rate of emergency admission for particular infectious diseases, bacterial etiology and treatment modalities, especially surgical. The study included 83 emergency patients admitted to the Pediatric Division of ENT Department, Sestre milosrdnice University Hospital, Zagreb, over the period from January 1999 through May 2001. In the majority of cases, the pathology was due to upper respiratory tract infections. Otitis media, peritonsillary abscess and acute sinusitis were most common diagnoses. The most frequently isolated pathogenic bacteria were Streptococcus pneumoniae, Haemophilus influenzae and Staphylococcus aureus. All patients were treated with antibiotics and nearly all of them by surgery.Zarazne su bolesti glavna indikacija za hitan prijam na odjel dječje otorinolaringologije. Unatoč tome, broj kliničkih istraživanja koja se bave tom problematikom vrlo je mali. Cilj je ove retrospektivne studije bio istražiti učestalost pojedinih dijagnoza infektivnih bolesti, bakterijsku etiologiju i načine konzervativnog i poglavito kirurškog liječenja djece koja su hitno zaprimljena na Dječji odjel Klinike za otorinolaringologiju i cervikofacijalnu kirurgiju Kliničke bolnice “Sestre milosrdnice” u razdoblju od siječnja 1999. do svibnja 2001. godine. Većina je bolesnika primljena u hitnoj službi. Gotovo su sve dijagnoze povezane s infektivnim upalama gornjih dišnih putova. Najčešća je dijagnoza bila upala srednjeg uha, peritonzilarni apsces i akutni sinusitis. Najčešće izolirane patogene bakterije iz uzetih obrisaka bile su Streptococcus pneumoniae, Haemophilus influenzae i Staphylococcus aureus. Svi su bolesnici liječeni antibioticima, a gotovo svi i kirurški. Najčešće davani antibiotik bio je amoksicilin s klavulonskom kiselinom. Kirurško se liječenje uglavnom temeljilo na pravilu ubi pus ibi evacuo, tako da su najčešći zahvati bile incizije i drenaže, odnosno miringotomija i implantacija ventilacijske cjevčice

Mechanisms of HBO-Induced Vascular Functional Changes in Diabetic Animal Models

The mechanisms by which HBO exerts its potentially beneficial effects are not completely clear. Interactions of mechanisms affecting endothelial dysfunction, NO synthesis, EETs and HETE formation, CYP expression changes, oxidative stress and antioxidant defense system changes, and multiple effects on inflammation take place that might be considered as mediating factors for the observed positive (or negative) clinical effects in diabetes mellitus (for instance in chronic diabetic wounds). Studies on vasculature in diabetic animal models can provide us with more information that can help us understand its effects on blood vessel function. This chapter discusses the most relevant studies that have assessed the potential mechanisms of HBO-induced vascular functional changes in diabetic animal models

Zarazne bolesti kao hitni slučajevi na dječjem odjelu za bolesti uha, grla i nosa

Infectious diseases are the leading cause of emergency hospital admission for children treated at ENT department. The aim of this retrospective study was to investigate the rate of emergency admission for particular infectious diseases, bacterial etiology and treatment modalities, especially surgical. The study included 83 emergency patients admitted to the Pediatric Division of ENT Department, Sestre milosrdnice University Hospital, Zagreb, over the period from January 1999 through May 2001. In the majority of cases, the pathology was due to upper respiratory tract infections. Otitis media, peritonsillary abscess and acute sinusitis were most common diagnoses. The most frequently isolated pathogenic bacteria were Streptococcus pneumoniae, Haemophilus influenzae and Staphylococcus aureus. All patients were treated with antibiotics and nearly all of them by surgery.Zarazne su bolesti glavna indikacija za hitan prijam na odjel dječje otorinolaringologije. Unatoč tome, broj kliničkih istraživanja koja se bave tom problematikom vrlo je mali. Cilj je ove retrospektivne studije bio istražiti učestalost pojedinih dijagnoza infektivnih bolesti, bakterijsku etiologiju i načine konzervativnog i poglavito kirurškog liječenja djece koja su hitno zaprimljena na Dječji odjel Klinike za otorinolaringologiju i cervikofacijalnu kirurgiju Kliničke bolnice “Sestre milosrdnice” u razdoblju od siječnja 1999. do svibnja 2001. godine. Većina je bolesnika primljena u hitnoj službi. Gotovo su sve dijagnoze povezane s infektivnim upalama gornjih dišnih putova. Najčešća je dijagnoza bila upala srednjeg uha, peritonzilarni apsces i akutni sinusitis. Najčešće izolirane patogene bakterije iz uzetih obrisaka bile su Streptococcus pneumoniae, Haemophilus influenzae i Staphylococcus aureus. Svi su bolesnici liječeni antibioticima, a gotovo svi i kirurški. Najčešće davani antibiotik bio je amoksicilin s klavulonskom kiselinom. Kirurško se liječenje uglavnom temeljilo na pravilu ubi pus ibi evacuo, tako da su najčešći zahvati bile incizije i drenaže, odnosno miringotomija i implantacija ventilacijske cjevčice

Kliničke upute za dijagnozu, liječenje i praćenje odraslih bolesnika oboljelih od glioma središnjega živčanog sustava [Clinical guidelines for diagnosing, treating and monitoring of adult patients with gliomas of central nervous system]

Gliomas of the central nervous system are glial cell tumors that are divided in low and high grade group. Multidisciplinary approach to treatment consists of surgery, radiotherapy and chemotherapy. The type and order of treatment depend on the characteristics of the tumor and the patient. We present the clinical guidelines for diagnostic procedures, surgical treatment, oncological treatment and follow up of patients with this type of tumor in the Republic of Croatia

CLINICAL GUIDELINES FOR DIAGNOSING, TREATING AND MONITORING OF ADULT PATIENTS WITH GLIOMAS OF CENTRAL NERVOUS SYSTEM

Gliome središnjega živčanog sustava čine tumori glijalnog podrijetla niskog i visokoga gradusa. Liječe se multidisciplinarnim pristupom kirurški, radioterapijom i kemoterapijom. Vrsta i redoslijed liječenja ovise o osobitostima tumora i bolesnika. U tekstu koji slijedi nalaze se kliničke upute za dijagnostičke postupke, operativno liječenje, onkološko liječenje i praćenje bolesnika s ovom vrstom tumora u Republici Hrvatskoj. Smjernice su pisane u ime Hrvatskoga onkološkog društva Hrvatskoga liječničkog zbora. Cilj je smjernica postići izjednačenost liječenja gliomskih tumora u onkološkim centrima Republike Hrvatske.Gliomas of the central nervous system are glial cell tumors that are divided in low and high grade group. Multidisciplinary approach to treatment consists of surgery, radiotherapy and chemotherapy. The type and order of treatment depend on the characteristics of the tumor and the patient. We present the clinical guidelines for diagnostic procedures, surgical treatment, oncological treatment and follow up of patients with this type of tumor in the Republic of Croatia

CLINICAL GUIDELINES FOR DIAGNOSING, TREATING AND MONITORING OF ADULT PATIENTS WITH GLIOMAS OF CENTRAL NERVOUS SYSTEM

Gliome središnjega živčanog sustava čine tumori glijalnog podrijetla niskog i visokoga gradusa. Liječe se multidisciplinarnim pristupom kirurški, radioterapijom i kemoterapijom. Vrsta i redoslijed liječenja ovise o osobitostima tumora i bolesnika. U tekstu koji slijedi nalaze se kliničke upute za dijagnostičke postupke, operativno liječenje, onkološko liječenje i praćenje bolesnika s ovom vrstom tumora u Republici Hrvatskoj. Smjernice su pisane u ime Hrvatskoga onkološkog društva Hrvatskoga liječničkog zbora. Cilj je smjernica postići izjednačenost liječenja gliomskih tumora u onkološkim centrima Republike Hrvatske.Gliomas of the central nervous system are glial cell tumors that are divided in low and high grade group. Multidisciplinary approach to treatment consists of surgery, radiotherapy and chemotherapy. The type and order of treatment depend on the characteristics of the tumor and the patient. We present the clinical guidelines for diagnostic procedures, surgical treatment, oncological treatment and follow up of patients with this type of tumor in the Republic of Croatia

Smjernice za rano prepoznavanje, dijagnostiku i terapiju neurogene orofaringealne disfagije [Guidelines for early detection, diagnostics and therapy of neurogenic oropharyngeal dysphagia]

Guidelines for the early detection, diagnostics and therapy of neurogenic oropharyngeal dysphagia have been made as a result of collaboration of clinicians of different backgrounds who are dealing with patients with neurogenic oropharyngeal dysphagia (NOD). These guidelines have been written by the representatives of the Croatian Society of Clinical Nutrition, Croatian Medical Association, Croatian Neurological Society, Croatian Medical Association, Croatian Society of Gastroenterology and Croatian Society of Nutritionists and Dietitians. The aim of these guidelines is to raise the awareness about NOD that is encountered in acute and chronic neurological diseases, especially in patients with stroke, extrapyramidal diseases, neuromuscular and demyelinisation diseases and dementia. We provide a detailed description of diagnostics of dysphagia, and we recommend the establishment of a multidisciplinary team for dysphagia involving neurologists, internists, speech therapists, dietitians, pharmacists and nurses with special competences for the management of NOD. An educated team member conducts diagnostics and rehabilitation in accordance with the validated tools, classifications and categorizations shown in these guidelines to allow a systematic and consistent treatment. The guidelines also provide detailed algorithms for introducing nutritional support – from the application of modified texture foods, proper hydration to artificial nutrition (enteral and parenteral nutrition)

GUIDELINES FOR EARLY DETECTION, DIAGNOSTICS AND THERAPY OF NEUROGENIC OROPHARYNGEAL DYSPHAGIA

Smjernice za rano prepoznavanje, dijagnostiku i terapiju neurogene orofaringealne disfagije nastale su suradnjom kliničara različitih disciplina koji se bave brojnim aspektima skrbi o bolesnicima s neurogenom orofaringealnom disfagijom (NOD). U izradi smjernica sudjelovali su predstavnici Hrvatskog društva za kliničku prehranu Hrvatskoga liječničkog zbora (HLZ-a), Hrvatskoga neurološkog društva HLZ-a, Hrvatskoga gastroenterološkog društva i Hrvatskog društva nutricionista i dijetetičara. Smjernice imaju cilj povećati svijest o NOD-u koji se javlja kod akutnih i kroničnih neuroloških bolesti, posebice kod moždanog udara, ekstrapiramidnih bolesti, neuromuskularnih i demijelinizacijskih bolesti te demencija. Nadalje, smjernice donose detaljan opis dijagnostike disfagije te preporučuju osnivanje multidisciplinarnog tima za disfagiju u kojem sudjeluju neurolozi, internisti, logopedi, dijetetičari, farmaceuti i medicinske sestre s posebnim kompetencijama na području NOD-a. Educirani član tima provodi dijagnostiku i rehabilitaciju u skladu s provjerenim alatima, klasifikacijama i kategorizacijama prikazanim u ovim smjernicama kako bi se omogućilo sustavno i izjednačeno postupanje. Smjernice donose i detaljne algoritme uvođenja nutritivne potpore – od primjene hrane promijenjene teksture, pravilne hidracije do artificijalne prehrane (enteralne i parenteralne).Guidelines for the early detection, diagnostics and therapy of neurogenic oropharyngeal dysphagia have been made as a result of collaboration of clinicians of different backgrounds who are dealing with patients with neurogenic oropharyngeal dysphagia (NOD). These guidelines have been written by the representatives of the Croatian Society of Clinical Nutrition, Croatian Medical Association, Croatian Neurological Society, Croatian Medical Association, Croatian Society of Gastroenterology and Croatian Society of Nutritionists and Dietitians. The aim of these guidelines is to raise the awareness about NOD that is encountered in acute and chronic neurological diseases, especially in patients with stroke, extrapyramidal diseases, neuromuscular and demyelinisation diseases and dementia. We provide a detailed description of diagnostics of dysphagia, and we recommend the establishment of a multidisciplinary team for dysphagia involving neurologists, internists, speech therapists, dietitians, pharmacists and nurses with special competences for the management of NOD. An educated team member conducts diagnostics and rehabilitation in accordance with the validated tools, classifications and categorizations shown in these guidelines to allow a systematic and consistent treatment. The guidelines also provide detailed algorithms for introducing nutritional support – from the application of modified texture foods, proper hydration to artificial nutrition (enteral and parenteral nutrition)

GUIDELINES FOR EARLY DETECTION, DIAGNOSTICS AND THERAPY OF NEUROGENIC OROPHARYNGEAL DYSPHAGIA

Smjernice za rano prepoznavanje, dijagnostiku i terapiju neurogene orofaringealne disfagije nastale su suradnjom kliničara različitih disciplina koji se bave brojnim aspektima skrbi o bolesnicima s neurogenom orofaringealnom disfagijom (NOD). U izradi smjernica sudjelovali su predstavnici Hrvatskog društva za kliničku prehranu Hrvatskoga liječničkog zbora (HLZ-a), Hrvatskoga neurološkog društva HLZ-a, Hrvatskoga gastroenterološkog društva i Hrvatskog društva nutricionista i dijetetičara. Smjernice imaju cilj povećati svijest o NOD-u koji se javlja kod akutnih i kroničnih neuroloških bolesti, posebice kod moždanog udara, ekstrapiramidnih bolesti, neuromuskularnih i demijelinizacijskih bolesti te demencija. Nadalje, smjernice donose detaljan opis dijagnostike disfagije te preporučuju osnivanje multidisciplinarnog tima za disfagiju u kojem sudjeluju neurolozi, internisti, logopedi, dijetetičari, farmaceuti i medicinske sestre s posebnim kompetencijama na području NOD-a. Educirani član tima provodi dijagnostiku i rehabilitaciju u skladu s provjerenim alatima, klasifikacijama i kategorizacijama prikazanim u ovim smjernicama kako bi se omogućilo sustavno i izjednačeno postupanje. Smjernice donose i detaljne algoritme uvođenja nutritivne potpore – od primjene hrane promijenjene teksture, pravilne hidracije do artificijalne prehrane (enteralne i parenteralne).Guidelines for the early detection, diagnostics and therapy of neurogenic oropharyngeal dysphagia have been made as a result of collaboration of clinicians of different backgrounds who are dealing with patients with neurogenic oropharyngeal dysphagia (NOD). These guidelines have been written by the representatives of the Croatian Society of Clinical Nutrition, Croatian Medical Association, Croatian Neurological Society, Croatian Medical Association, Croatian Society of Gastroenterology and Croatian Society of Nutritionists and Dietitians. The aim of these guidelines is to raise the awareness about NOD that is encountered in acute and chronic neurological diseases, especially in patients with stroke, extrapyramidal diseases, neuromuscular and demyelinisation diseases and dementia. We provide a detailed description of diagnostics of dysphagia, and we recommend the establishment of a multidisciplinary team for dysphagia involving neurologists, internists, speech therapists, dietitians, pharmacists and nurses with special competences for the management of NOD. An educated team member conducts diagnostics and rehabilitation in accordance with the validated tools, classifications and categorizations shown in these guidelines to allow a systematic and consistent treatment. The guidelines also provide detailed algorithms for introducing nutritional support – from the application of modified texture foods, proper hydration to artificial nutrition (enteral and parenteral nutrition)