Cilj ove retrospektivne studije bila je analiza učestalosti, rizičnih faktora, primjene preventivnih mjera te antimikrobnog liječenja nozokomijalnih infekcija stečenih u ranom poslijeoperacijskom ...razdoblju u 392 odrasla kardiokirurška bolesnika liječena u Jedinici intenzivnog liječenja (JIL) kardiokirurških bolesnika Klinike za anesteziologiju i intenzivno liječenje Kliničkog bolničkog centra (KBC) Rijeka od 1. siječnja do 31. prosinca 2015. Kriteriji za proglašenje nozokomijalne infekcije uključivali su tri skupine pacijenata: pacijente s pozitivnim mikrobiološkim kulturama uzetim rutinski prilikom prijma u JIL
(urinokultura, bris nosa, VAT), pacijente s pozitivnim mikrobiološkim kulturama nakon 24 sata od prijma u JIL uz dinamsku nestabilnost, Clinical Pulmonary Infection Score (CPIS skor) 1-6 ili zbog znakova infekcije sternalne rane te pacijente s negativnim mikrobiološkim kulturama, ali sa CPIS skorom većim >6. Učestalost nozokomijalnih infekcija u JIL iznosila je 10 %, s mortalitetom of 7,5 %. Najčešći rizični faktori razvoja nozokomijalne infekcije bili su: pozitivna prijeoperacijska
mikrobiološka nadzorna kultura, Sequentional Organ Failure ssessment score (SOFA) pri prijmu u JIL jednak ili >6, invazivna mehanička ventilacija dulja od 72 sata, trajanje operacije dulje od 240 min, liječenje u JIL dulje od 72 sata, poslijeoperacijska hemodinamska nestabilnost 24 sata od operacije, primjena izvantjelesnog krvotoka i hitne operacije. Studija je pokazala kako je u ovih bolesnika najčešće zabilježena infekcija respiratornog trakta čemu je pridonijela činjenica da je 6 % bolesnika pristupilo elektivnoj operaciji s pozitivnim prijeoperacijskm brisom nosa i urinokulturom, pri čemu je najčešće bio izoliran Staphylococcus aureus. Dobiveni rezultati govore u prilog potrebi primjene prijeoperacijskih mjera dekontaminacije nosa intranazalnim apliciranjem mupirocina i odgode elektivnog zahvata do izliječenja uroinfekcije. Kako bi se smanjila pojavnost nozokomijalnih infekcija nužno je i adekvatno perioperacijsko doziranje antimikrobne profi lakse s obzirom na tjelesnu težinu, stupanj krvarenja, trajanje operacije i primjenu izvantjelesnog krvotoka.
Apical periodontitis represents a chronic inflammation and destruction of periradicular tissue caused by polymicrobial infection of endodontic origin. The aim of this systematic review was to make an ...update on findings related to Epstein-Barr virus (EBV) and human cytomegalovirus (HCMV) presence in periapical pathoses and to correlate these findings with clinical, histopathological and radiographic features of periapical lesions. Methods were based on the preferred reporting items for systematic reviews and meta-analyses (PRISMA) statement. A search was performed using PubMed, Web of Science and SCOPUS. Search key words included the following medical subjects heading terms: (periapical disease OR apical periodontitis OR periapical lesions OR periapical abscess) AND (viruses OR herpesvir*). A manual search involved references from articles retrieved for possible inclusion. The search, evaluation, and critical appraisal of articles were performed by two independent judges. Collected data were analyzed using the measures of descriptive statistics. The final review has included twenty nine articles related to herpesviral presence periapical pathoses. Qualitative analysis indicated that EBV HCMV, and HHV-8 were the most prevalent species in periapical pathoses. Our findings suggest that there is wide variety of herpesviruses detection rates in periapical pathoses in relation to their clinical, histopathological and radiographic features.
The largest outbreak of hemorrhagic fever with renal syndrome (HFRS) to date occurred in Croatia in the year 2002. The epidemic started in winter, lasted throughout spring to summer months, ending ...not earlier than November.
The aim of this study was to investigate and analyze the basic epidemiologic and clinical features of HFRS in Croatia by uniform and standardized prospective-retrospective analysis of all patients affected by the epidemic.
When the epidemic started, a patient questionnaire with questions on the basic demographic data, site of infection and other epidemiologic characteristics, clinical symptoms, disease severity and laboratory results was designed. Data on 401 patient with a clinical diagnosis of HFRS were collected. The etiologic diagnosis of the disease was confirmed by ELISA, and in some patients by indirect immunofluorescence test (IFT). The results were analyzed using a descriptive statistical method.
HFRS was clinically diagnosed in 401 patients from all over Croatia. A total of 320 (79.8%) cases were reported to the Epidemiology Service of the National Institute of Public Health. The majority of patients (n = 128) were registered in June. Males were three times more affected than females. Apart from its long duration, this epidemic was characteristic for the involvement of general population, with only a small number of the affected from the potential risk groups (forestry workers 28, soldiers 14, farmers 18). The epidemic spread almost throughout inland Coratia. At least 44 patients were infected in the Plitvice Lakes area, 32 in Slunj, 27 on Sljeme, 24 in Velika, and at least 19 in the area of Kutjevo. The youngest patient was aged 4 and the oldest 80 years. The majority of patients were treated in Zagreb (University Hospital for Infectious Diseases--110, Zagreb University Hospital Center--3), followed by Karlovac (71 inpatients and 39 outpatients), Pozega (n = 79), and Rijeka (n = 37). Serologic analysis (ELISA method) detected Puumala virus in 161 and Dobrava virus in only 17 patients. The disease was confirmed by immunofluorescence method in 53 patients (mostly in Kariovac). During the 2002 outbreak, HFRS clinically manifested mostly in a milder form with general symptoms and transitory renal insufficiency, while hemorrhages were rarely recorded. According to our disease severity score, a mild form of the disease was recorded in 65%, moderately severe in 28%, severe in 5% and extremely severe form in 2% of the patients. One patient died. Two thirds of the patients were hospitalized during the febrile stage of the disease. All patients had fever, whereas headache and pain in the lumbar region were recorded in more than 90% of cases, polyuria in 75%, oliguira and vomiting in approximately 50%, respiratory symptoms in 35%, and hemorrhages (mostly on the skin and mucous membranes), vision disturbances, conjunctivitis and diarrhea in approximately 25% of patients. ESR was elevated in 64% and CRP in 93% of patients. Leukocytosis was recorded in 25% and thrombocytopenia in 70% of patients. Increased values of urea and creatinine and signs of liver damage were recorded in approximately 50% of the patients.
The largest outbreak of HFRS occurred in Croatia in 2002, with more than 400 diseased throughout Croatia. This epidemic confirmed our previous assumption that the whole Croatia, apart from its narrow coastline area and islands, is a natural focus of HFRS with different causative types of hantaviruses. Efforts should be made to conduct a comprehensive ecologic and mammologic study on hantaviruses and their biologic characteristics in these areas.
The aim of this study was to analyze gender and age differences in physical inactivity in Croatia and physical inactivity pattern changes during the five-year period. The study is based on the data ...obtained from the Croatian Adult Health Cohort Study which was carried out in 2003 and 2008. The prevalence of physical inactivity in 2008 was 37.7%, 36.8% in men and 38.1% in women. In both study waves the prevalence was increasing with age in both men and women. The
prevalence is statistically significantly higher in subjects older than 64 years than in younger age groups. The incidence of physical inactivity in the five-year period in total was 29.9%, 27.2% in men and 31.1% in women. The increase in prevalence of physical inactivity despite the number of preventive activities carried out periodically emphasizes the need for systematic and comprehensive approach in increasing the number of regularly physically active individuals.
Balneoterapija/hidroterapija neizostavni je dio rehabilitacije bolesnika s
upalnim reumatskim bolestima. Kako se njena učinkovitost često dovodi
u pitanje, cilj rada je bio utvrditi učinkovitost ...balneoterapije/hidroterapije
na funkcionalne sposobnosti, aktivnosti i kvalitetu života bolesnika s
reumatoidnim artritisom (RA). U kliničku studiju su uključena 113 bolesnika
s RA-om, 79 žena i 34 muškarca, koji su liječeni u Specijalnoj bolnici za
medicinsku rehabilitaciju Varaždinske Toplice, u prosječnom trajanju 14 dana.
Prije i poslije balneoterapije, pacijenti su ispunili upitnik o procjeni zdravlja
HAQ (Health assessment questionnaire) i upitnik o kvaliteti života bolesnika s
Izvorni znanstveni članak
Original scientific article
ISSN 1846-1867 reumatoidnim artritisom QoL-RA (Quality of life RA). Ocjena aktivnosti bolesti
DAS 28 korištena je za mjerenje djelovanja bolesti prije i poslije balneoterapije/
hidroterapije. Pronašli smo značajno poboljšanje funkcionalne sposobnosti u
bolesnika s RA-om. Prosječna ocjena HAQ-a prije balneoterapije/hidroterapije
je 1,07 + / - 0,61, i 0,84 + / - 0,55, nakon balneoterapije/hidroterapije, što je
statistički značajno niži (p <0,05). DAS 28 nakon balneoterapije/hidroterapije
je i statistički značajno niži od DAS 28 prije balneoterapije/hidroterapije:
srednja vrijednost DAS 28 prije balneoterapije/hidroterapije bila je 6,30 + / -
0,81 i nakon balneoterapije/hidroterapije 5,45 + / - 0,75 (p <0,01). Kvaliteta
života značajno je poboljšana nakon balneoterapije/hidroterapije: srednja
vrijednost QoL-RA prije balneoterapije/hidroterapije je bila 5,38 + / - 1,62
i nakon baleoterapije/hidroterapije 7,37 + / - 1,81 (p <0,05). Zaključno,
balneoterapija/hidroterapija, kada se pravilno dozira, učinkovita je terapija u
liječenju bolesnika s RA-om. Balneoterapija/hidroterapija ima pozitivan utjecaj
na funkcionalne sposobnosti, aktivnosti bolesti i kvalitetu života bolesnika s
reumatoidnim artritisom.
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