Olfactory disorders during SARS-CoV-2 infection

At the end of 2019 in Wuhan, China, a novel coronavirus, Severe Acute Respiratory Syndrome Corona virus 2 (SARS-CoV-2), was considered as the cause of some lower respiratory tract infections. On February 11th 2020, the new disease caused by the SARS-CoV-2 virus was officially termed “COVID-19” by the WHO. Transmission from person to person occurs mainly by direct contact or droplets spread by coughing or sneezing by an infected individual with SARS-CoV-2. The most common symptoms are fever, cough, fatigue, headache, and dyspnea. In the most severe cases, patients may develop pneumonia, acute respiratory failure, distress syndrome, and acute heart problems. The most common ENT symptoms are cough, anosmia/hyposmia, sore throat, ageusia, nasal congestion, runny nose, postnasal discharge, hoarseness, otalgia, tinnitus, gingivitis, Bell’s palsy, and sudden hearing loss. Literature data showed that olfactory disorders were found in 35% to 84.6% of patients. From March to November 2021, in Zadar General Hospital 2582 patients were hospitalized with SARS-CoV-2 virus infection. Anosmia/hyposmia was found in 1110 (43%) patients. In most patients with olfactory disturbances after fourteen days, the epithelium showed signs of recovery, but it had not yet returned to normal. The infection made desquamation of the olfactory epithelium and the preference for the virus for sustentacular cells rather than neuronal cells and the intense recruitment of immune cells. Damage to sustentacular cells and Bowman cells directly affects the perception of odors, not by the transmission of the virus to olfactory receptor neurons but by impairing some of its functions that are necessary for the functional metabolism of these neurons. Damage to Bowman cells would cause an interruption in the production of nasal mucus, necessary for the dissolution of odorous particles

Olfactory disorders during SARS-CoV-2 infection

At the end of 2019 in Wuhan, China, a novel coronavirus, Severe Acute Respiratory Syndrome Corona virus 2 (SARS-CoV-2), was considered as the cause of some lower respiratory tract infections. On February 11th 2020, the new disease caused by the SARS-CoV-2 virus was officially termed “COVID-19” by the WHO. Transmission from person to person occurs mainly by direct contact or droplets spread by coughing or sneezing by an infected individual with SARS-CoV-2. The most common symptoms are fever, cough, fatigue, headache, and dyspnea. In the most severe cases, patients may develop pneumonia, acute respiratory failure, distress syndrome, and acute heart problems. The most common ENT symptoms are cough, anosmia/hyposmia, sore throat, ageusia, nasal congestion, runny nose, postnasal discharge, hoarseness, otalgia, tinnitus, gingivitis, Bell’s palsy, and sudden hearing loss. Literature data showed that olfactory disorders were found in 35% to 84.6% of patients. From March to November 2021, in Zadar General Hospital 2582 patients were hospitalized with SARS-CoV-2 virus infection. Anosmia/hyposmia was found in 1110 (43%) patients. In most patients with olfactory disturbances after fourteen days, the epithelium showed signs of recovery, but it had not yet returned to normal. The infection made desquamation of the olfactory epithelium and the preference for the virus for sustentacular cells rather than neuronal cells and the intense recruitment of immune cells. Damage to sustentacular cells and Bowman cells directly affects the perception of odors, not by the transmission of the virus to olfactory receptor neurons but by impairing some of its functions that are necessary for the functional metabolism of these neurons. Damage to Bowman cells would cause an interruption in the production of nasal mucus, necessary for the dissolution of odorous particles

1st International Meeting One Health in Zadar: Global Approach to Global Health Abstract book

1st International Meeting One Health in Zadar: Global Approach to Global Health Zadar, 3rd June 201

Kronični kašalj kod odraslih i djece

Kronični kašalj jedan je od najčešćih simptoma bolesti u populaciji, s prevalencijom od 12%. Po definiciji, kašalj je kroničan ako traje dulje od osam tjedana kod odraslih osoba, odnosno dulje od četiri tjedna kod djece. Najčešči uzroci kašlja u odrasloj populaciji su sindrom gornjih dišnih putova, ranije poznat kao sindrom postnazalnog dripa (26-87%), astma (24-29%), neastmatski eozinofilni bronhitis (10-20%), liječenje ACE- inhibitorima (5-35%), te gastro-laringo-ezofagealni refluks (0-73%). Kod djece u dobi od šeste do četrnaeste godine, najčešći uzroci kroničnog kašlja su astma, protrahirani bakterijski bronhitis, te sindrom gornjih dišnih putova. U rijetke uzroke spadaju gastro-laringo-ezofagealni refluks, strano tijelo nosa i bronha, te cistična fibroza. U dijagnostici i liječenju bolesnika s kroničnim kašljem potrebna je suradnja otrinolaringologa, pulmologa i gastroenterologa. Ovisno o kliničkom nalazu, kod većine bolesnika uz rutinsku laboratorijsku obradu, biti će potrebno učiniti spirometriju, ventolinski i metakolinski test, alergološku obradu, radiološku obradu pluća i paranazalnih šupljina, fiberendoskopiju gornjih dišnih putova, fleksibilnu bronhoskopiju, mikrobiološku pretragu sputuma i nazofaringealnog aspirate, te pH-metriju. Ovisno o kliničkom nalazu, te nalazima dijagnostičke obrade, kod svakog bolesnika, provodi se odgovarajuća ciljana terapija. U terapiji se koriste lijekovi iz grupe antibiotika, antihistaminika, bronhodilatatora, antagonista leukotrijena, kortikosteroida, antikolinergika, te inhibitora protonske pumpe. Zaključak: Kronični kašalj je čest simptom različitih bolesti i značajan javnozdravstveni problem. Neophodna je detaljna obrada svakog bolesnika, uz multidiscplinarni pristup u dijagnostici i liječenju, kako odraslih bolesnika, tako i djece s kroničnim kašljem

Covid-19 pandemija: kratki pregled dosadašnjih spoznaja

Corona virus (virus SARS-CoV-2) je novi soj virusa koji je uzrokovao Covid-19 pandemiju. Širenje bolesti u Europi prvenstveno je uzrokovano kapljičnim prijenosom s čovjeka na čovjeka. Osim prijenosa s bolesnih ljudi, virus se prenosi i s asimptomatskih bolesnika. Razdoblje inkubacije iznosi do 14 dana nakon izlaganja uzročniku, s prosječnom inkubacijom od četiri do pet dana. Oboljeli su najčešće u petom desetljeću života. Najčešći simptomi bolesti su povišena temperatura, slabost i suhi kašalj. Više od 90% bolesnika hospitalizira se radi pneumonije. Od laboratorijskih nalaza kod oboljelih najčešća je limfocitopenija, trombocitopenija, leukopenija, te povišene vrijednosti C – reaktivnog proteina. Visoki rizik od teškog oblika bolesti i smrtnog ishoda imaju stariji bolesnici, te bolesnici s komorbiditetnim bolestima, kao što su kardiovaskularne bolesti, kronična plućna bolest, dijabetes, oboljeli od zloćudnih bolesti, te bolesnici s povišenim krvnim tlakom. Po dosadašnjim podacima liječenja oboljelih u Kini, oko 5% bolesnika liječeno je u jedinicama intenzivnog liječenja. U Italiji je taj broj znatno viši i iznosi oko 16%. Broj umrlih bolesnika u Kini kreće se od 2-3%, dok je trenutna smrtnost u Italiji iznad 8%. Osobnu zaštitu zdravstvenih djelatnika u radu s oboljelima čine: pregača, gumene rukavice, naočale, zaštitna maska, te zaštitno odijelo. Tijekom zahvata pri kojima se stvara aerosol, poput ručne ventilacije bolesnika, trahealne intubacije, traheotomije, te tijekom kardiopulmonalne reanimacije, fiberskopije i bronhoskopije, za zaštitu medicinskog osoblja, potrebno je koristiti zaštitne maske N95, FFP3 i P100. S obzirom na to da je SARS-CoV-2 virus stabilan i virulentan na plastičnim površinama tijekom 72 sata, a na metalnima tijekom 48 sati, potrebna je redovita dezinfekcija ovakvih površina otopinom klora u koncentraciji od 1000 mg/L

A survey of the history of health care in Zadar

U radu je prikazan pregled povijesti zdravstva u Zadru i na zadarskom području tijekom stoljeća. Autori na osnovi podataka iz moderne historiografije prikazuju razvoj skrbi za bolesne i nemoćne na ovim prostorima od najranijeg doba. Prikazani podatci u ovom radu prilog su istraživanju povijesti zadarskog zdravstva.The paper offers a survey of the history of health care in Zadar and wider Zadar area throughout centuries. Based on modern historiographic data, the authors present the development of care for the sick and infirm there since the earliest days. In Roman era, there already were individuals in Zadar who practiced Greek medicine of that time. Diverse medical instruments dating from that era and found in the Zadar area witness thereto. It is particularly noteworthy that the first quarantine hospital was opened in Zadar as early as in 1348, much earlier than it was the case in the Dubrovnik Republic and Venice. In 1806, the French established a school of medicine and surgery in Zadar; this school was at that time entirely identical with medical faculties. In 1821, the first School for Midwives in these lands, which were then under Austro-Hungarian reign, was opened. Furthermore, Zadar was the first city in which – in March 1847 – the first ever ether narcosis in the eastern part of Europe was administered. In 1878, the first organisation of the Red Cross in Croatia, then named Domoljubna gospojenska zadruga, was established there. Health care in our lands evidently developed in the course of centuries, following thereby modern achievements in European and world medicine throughout all historic epochs. During the Liberation War, it was of particular importance. The data presented in this paper are a tribute to the research of this part of the history of health care in Zadar

Infekcije uha, grla i nosa u dječjoj dobi

Infekcije gornjih dišnih putova najčešće su akutne bolesti dječje dobi i uzrok su više od 50% svakodnevnih posjeta pedijatru u primarnoj zdravstvenoj zaštiti. U prvih pet godina života djeca imaju prosječno šest do devet takvih infekcija godišnje, a oko 10% djece ima ih i do dvanaest, osobito djeca koja pohađaju jaslice i vrtić. Detaljna anamneza i klinički pregled djeteta važni su u pedijatrijskoj praksi, čime se dolazi do brze dijagnoze bolesti, bez potrebe za opsežnom dijagnostičkom obradom. Klinički pregled uključuje otoskopiju za upalu srednjega uha, perforaciju bubnjića i iscjedak iz uha, pregled grla za tonzilitis ili faringitis i palpaciju glave i vrata. Kada je potrebno, provodi se radiološka, mikrobiološka i laboratorijska obrada. U djece predškolske dobi najčešći su kataralna, serozna i gnojna upala srednjega uha, upala grla i adenoida. U školske djece češći su rinosinuitisi, uz upale uha i grla. Najčešći simptomi su bol u uhu, kašalj, simptomi prehlade, te grlobolja. Visoka temperatura je čest simptom ovih infekcija u djece. Osobito je izražena u dojenčadi, koja često pokazuju i sustavne nespecifične simptome bolesti poput razdražljivosti, inapetencije, poremećenog općeg stanja. Iako su najčešći uzročnici ovih bolesti virusi, neka će djeca razviti naknadnu bakterijsku superinfekciju s komplikacijama. Unatoč tome što se antimikrobna terapija kod ovih bolesti neopravdano i prekomjerno koristi, neophodna je kod visokorizične djece, sumnje na komplikacije ili kod pogoršanja bolesti, unatoč simptomatskom liječenju. Upala srednjega uha, peritonzilarni apsces i akutni rinosinuitis najčešći su razlozi hitnog prijama djece u bolnicu. Zaključak: Pedijatar mora poznavati etiologiju, dijagnostiku, te smjernice za liječenje akutnih infekcija gornjih dišnih putova u djece. Važna je suradnja s otorinolaringolozima s obzirom da neke komplikacije, poput otoantritisa, apscesa paranazalnih šupljina, peritonzilarnog apscesa i apscesa parafarinksa i vrata, mogu biti i životno ugrožavajuće