35 research outputs found
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 āCOVID-19ā 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,
Bellās 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 āCOVID-19ā 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,
Bellās 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
KroniÄni kaÅ”alj kod odraslih i djece
KroniÄni kaÅ”alj jedan je od najÄeÅ”Äih simptoma bolesti u populaciji, s prevalencijom od 12%. Po definiciji, kaÅ”alj je kroniÄan ako traje dulje od osam tjedana kod odraslih osoba, odnosno dulje od Äetiri tjedna kod djece. NajÄeÅ”Äi uzroci kaÅ”lja u odrasloj populaciji su sindrom gornjih diÅ”nih putova, ranije poznat kao sindrom postnazalnog dripa (26-87%), astma (24-29%), neastmatski eozinofilni bronhitis (10-20%), lijeÄenje ACE- inhibitorima (5-35%), te gastro-laringo-ezofagealni refluks (0-73%). Kod djece u dobi od Å”este do Äetrnaeste godine, najÄeÅ”Äi uzroci kroniÄnog kaÅ”lja su astma, protrahirani bakterijski bronhitis, te sindrom gornjih diÅ”nih putova. U rijetke uzroke spadaju gastro-laringo-ezofagealni refluks, strano tijelo nosa i bronha, te cistiÄna fibroza. U dijagnostici i lijeÄenju bolesnika s kroniÄnim kaÅ”ljem potrebna je suradnja otrinolaringologa, pulmologa i gastroenterologa. Ovisno o kliniÄkom nalazu, kod veÄine bolesnika uz rutinsku laboratorijsku obradu, biti Äe potrebno uÄiniti spirometriju, ventolinski i metakolinski test, alergoloÅ”ku obradu, radioloÅ”ku obradu pluÄa i paranazalnih Å”upljina, fiberendoskopiju gornjih diÅ”nih putova, fleksibilnu bronhoskopiju, mikrobioloÅ”ku pretragu sputuma i nazofaringealnog aspirate, te pH-metriju. Ovisno o kliniÄkom nalazu, te nalazima dijagnostiÄke obrade, kod svakog bolesnika, provodi se odgovarajuÄa ciljana terapija. U terapiji se koriste lijekovi iz grupe antibiotika, antihistaminika, bronhodilatatora, antagonista leukotrijena, kortikosteroida, antikolinergika, te inhibitora protonske pumpe.
ZakljuÄak: KroniÄni kaÅ”alj je Äest simptom razliÄitih bolesti i znaÄajan javnozdravstveni problem. Neophodna je detaljna obrada svakog bolesnika, uz multidiscplinarni pristup u dijagnostici i lijeÄenju, kako odraslih bolesnika, tako i djece s kroniÄnim kaÅ”ljem
Covid-19 pandemija: kratki pregled dosadaŔnjih spoznaja
Corona virus (virus SARS-CoV-2) je novi soj virusa koji je uzrokovao Covid-19 pandemiju. Å irenje bolesti u Europi prvenstveno je uzrokovano kapljiÄnim prijenosom s Äovjeka na Äovjeka. Osim prijenosa s bolesnih ljudi, virus se prenosi i s asimptomatskih bolesnika. Razdoblje inkubacije iznosi do 14 dana nakon izlaganja uzroÄniku, s prosjeÄnom inkubacijom od Äetiri do pet dana.
Oboljeli su najÄeÅ”Äe u petom desetljeÄu života. NajÄeÅ”Äi simptomi bolesti su poviÅ”ena temperatura, slabost i suhi kaÅ”alj. ViÅ”e od 90% bolesnika hospitalizira se radi pneumonije. Od laboratorijskih nalaza kod oboljelih najÄeÅ”Äa je limfocitopenija, trombocitopenija, leukopenija, te poviÅ”ene vrijednosti C ā reaktivnog proteina. Visoki rizik od teÅ”kog oblika bolesti i smrtnog ishoda imaju stariji bolesnici, te bolesnici s komorbiditetnim bolestima, kao Å”to su kardiovaskularne bolesti, kroniÄna pluÄna bolest, dijabetes, oboljeli od zloÄudnih bolesti, te bolesnici s poviÅ”enim krvnim tlakom. Po dosadaÅ”njim podacima lijeÄenja oboljelih u Kini, oko 5% bolesnika lijeÄeno je u jedinicama intenzivnog lijeÄenja. U Italiji je taj broj znatno viÅ”i i iznosi oko 16%. Broj umrlih bolesnika u Kini kreÄe se od 2-3%, dok je trenutna smrtnost u Italiji iznad 8%.
Osobnu zaÅ”titu zdravstvenih djelatnika u radu s oboljelima Äine: pregaÄa, gumene rukavice, naoÄale, zaÅ”titna maska, te zaÅ”titno odijelo. Tijekom zahvata pri kojima se stvara aerosol, poput ruÄne ventilacije bolesnika, trahealne intubacije, traheotomije, te tijekom kardiopulmonalne reanimacije, fiberskopije i bronhoskopije, za zaÅ”titu medicinskog osoblja, potrebno je koristiti zaÅ”titne maske N95, FFP3 i P100. S obzirom na to da je SARS-CoV-2 virus stabilan i virulentan na plastiÄnim povrÅ”inama tijekom 72 sata, a na metalnima tijekom 48 sati, potrebna je redovita dezinfekcija ovakvih povrÅ”ina 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 podruÄju tijekom stoljeÄa. Autori na osnovi podataka iz moderne historiografije prikazuju razvoj skrbi za bolesne i nemoÄne 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 ā in March 1847 ā 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 djeÄjoj dobi
Infekcije gornjih diÅ”nih putova najÄeÅ”Äe su akutne bolesti djeÄje dobi i uzrok su viÅ”e od 50% svakodnevnih posjeta pedijatru u primarnoj zdravstvenoj zaÅ”titi. U prvih pet godina života djeca imaju prosjeÄno Å”est do devet takvih infekcija godiÅ”nje, a oko 10% djece ima ih i do dvanaest, osobito djeca koja pohaÄaju jaslice i vrtiÄ. Detaljna anamneza i kliniÄki pregled djeteta važni su u pedijatrijskoj praksi, Äime se dolazi do brze dijagnoze bolesti, bez potrebe za opsežnom dijagnostiÄkom obradom. KliniÄki pregled ukljuÄuje otoskopiju za upalu srednjega uha, perforaciju bubnjiÄa i iscjedak iz uha, pregled grla za tonzilitis ili faringitis i palpaciju glave i vrata. Kada je potrebno, provodi se radioloÅ”ka, mikrobioloÅ”ka i laboratorijska obrada. U djece predÅ”kolske dobi najÄeÅ”Äi su kataralna, serozna i gnojna upala srednjega uha, upala grla i adenoida. U Å”kolske djece ÄeÅ”Äi su rinosinuitisi, uz upale uha i grla. NajÄeÅ”Äi simptomi su bol u uhu, kaÅ”alj, simptomi prehlade, te grlobolja. Visoka temperatura je Äest simptom ovih infekcija u djece. Osobito je izražena u dojenÄadi, koja Äesto pokazuju i sustavne nespecifiÄne simptome bolesti poput razdražljivosti, inapetencije, poremeÄenog opÄeg stanja. Iako su najÄeÅ”Äi uzroÄnici ovih bolesti virusi, neka Äe djeca razviti naknadnu bakterijsku superinfekciju s komplikacijama. UnatoÄ tome Å”to se antimikrobna terapija kod ovih bolesti neopravdano i prekomjerno koristi, neophodna je kod visokoriziÄne djece, sumnje na komplikacije ili kod pogorÅ”anja bolesti, unatoÄ simptomatskom lijeÄenju. Upala srednjega uha, peritonzilarni apsces i akutni rinosinuitis najÄeÅ”Äi su razlozi hitnog prijama djece u bolnicu.
ZakljuÄak: Pedijatar mora poznavati etiologiju, dijagnostiku, te smjernice za lijeÄenje akutnih infekcija gornjih diÅ”nih putova u djece. Važna je suradnja s otorinolaringolozima s obzirom da neke komplikacije, poput otoantritisa, apscesa paranazalnih Å”upljina, peritonzilarnog apscesa i apscesa parafarinksa i vrata, mogu biti i životno ugrožavajuÄe