Suchergebnisse

Početak razvoja Kliničkoga bolničkog centra u Osijeku vezanje uz Huttler Kohlhoffer Monspergerovu zakladnu bolnicu, osnovanu 1874. godine, koja je tada bila najmodernija bolnica na jugoistoku Europe. Naredbom Vlade 1895. godine postaje "Sveobća i javna Huttler Kohlhoffer-Monspergerova zakladna bolnica pod Zemaljskom upravom u Osieku". U vrijeme Prvoga svjetskog rata Zakladna bolnica skrbi o ranjenima i bolesnima. Poslije Prvoga svjetskog rata otvaraju se novi bolnički odjeli. Osim Kirurgije i Interne medicine, novi su odjeli Oftalmologija, Otorinolaringologija, Dermatovenerologija, Epidemiološkohigijenski zavod i Dispanzer za tuberkulozu. Daljnji razvoj prekinuo je Drugi svjetski rat. U teškim prilikama razvijen je poseban način medicinskoga rada, osobito u pogledu zbrinjavanja ranjenika i bolesnika, poduzimanja protuepidemijskih mjera, medicinskog opskrbljivanja i si. Nakon Drugoga svjetskog rata obnavlja se Opća bolnica Osijek i započinje moderan ustroj kao temelj razvoja buduće kliničke bolnice. U razdoblju 1980. - 1990. godine provode se stručna usavršavanja na svim područjima, objavljuju se brojni znanstveni i stručni radovi, razvija izdavačka djelatnost, što pridonosi stvaranju obrazovno nastavne djelatnosti i znanstveno-istraživačkoga rada. Posebno treba istaknuti razdoblje Domovinskoga rata u kojem je bolnica časno izvršila sve svoje zadaće u liječenju ranjenih i bolesnih. Stoga joj je dodijeljena nagrada "Medicina . Godine 1992. stekla je naslov Klinička bolnica Osijek. Daljnjim razvojem, izgradnjom, opremanjem i napredovanjem djelatnika u znanstvena, nastavna, znanstveno nastavna i stručna zvanja, 2009. godine postaje Klinički bolnički centar. Klinike i odjeli Kliničkoga bolničkog centra u Osijeku nastavna su baza Medicinskoga fakulteta Sveučilišta J. J. Strossmayera u Osijeku. ; Beginnings of the University Hospital Centre in Osijek were related to Huttler Kohlhoffer Monsperger Foundation Hospital, which was founded in 1874 and was the most modern hospital in the south-east Europe at the time. By the Government legislation in 1895 it became "General and public Huttler Kohlhoffer Monsperger Foundation Hospital under Country's management in Osiek". Foundation hospital was taking care of the wounded and sick during the World War 1. New hospital departments were opened after the World War I. Apart from Surgery and Internal Department; new departments were Ophthalmology, Otorhinolaryngology, Dermatovenereology, Epidemiological and Hygienic Institute and Tuberculosis Clinic. Further development was interrupted by the World War II. A special way of performing medical work developed in those hard times, especially regarding taking care of the wounded and sick, taking epidemic precaution measures, medical supplying, etc. After the World War II General Hospital Osijek was renovated and modern organization began, which was a basis for development of the future university hospital. In the period 1980 - 1990 professional educations in all areas were implemented, many scientific and professional papers were published, publishing developed, what contributed to creating educational and teaching activities, as well as scientific and research work. Period of the War for Croatian Independence, in which the hospital honourably performed all its duties regarding treating wounded and sick, especially needs to be pointed out. For those activities it was rewarded with "Medicine" reward. In 1992 it became University Hospital Osijek. By further development, construction, and equipment and by promoting its employees to scientific, teaching, scientific teaching and professional titles, it became University Hospital Centre in 2009. Clinics and Departments of the University Hospital Centre in Osijek are the teaching base of the Faculty of Medicine, Josip Juraj Strossmayer University of Osijek.

Zbog specifične izgradnje bolnice i njezina smještaja, hrvatska je vlada odlučila da će Klinička bolnica Dubrava u potpunosti biti pretvorena u ustanovu za liječenje pacijenata oboljelih od bolesti COVID-19 za sjevernu Hrvatsku. U ožujku 2020. godine transformacija je započela stavljajući brojne izazove pred zaposlenike, posebno medicinske sestre. Transformacija je započela prilagodbom prostora i razvojem mnogih protokola, smjernica i radnih uputa vezanih za kretanje pacijenata i bolničkog osoblja unutar ustanove, pravilnu upotrebu osobne zaštitne opreme i rješavanje različitih situacija povezanih s COVID-19 bolesti. Operacijske medicinske sestre imale su velik doprinos u ovoj borbi radom u promijenjenim uvjetima, dislociranim operacijskim dvoranama, edukacijom medicinskog i nemedicinskog bolničkog osoblja o ispravnoj upotrebi osnovnih zaštitnih sredstava (OZS) te upravljanjem i raspolaganjem s OZS-om. Na valovima pandemije COVID-19 izazovno je brzo se prilagođavati učestalim promjenama u smjernicama i pratiti potrebe pacijenata te se istovremeno pripremati za mogući treći val pandemije i slične buduće scenarije. ; Due to the specific construction of the hospital and its location, the Croatian government decided that Clinical Hospital Dubrava will be fully converted into an institution for the treatment of COVID-19 positive patients for Northern Croatia. In March 2020 the transformation began bringing many challenges in front of employees, especially nurses. The transformation started with the conversion of space and the development of many protocols, guidelines, and work instructions related to the movement of patients and hospital staff within the institution, proper use of PPE, and dealing with various situations related to COVID-19. Operating nurses largely contributed to this fight by working in changed conditions, in dislocated operating rooms, by educating medical and non-medical hospital staff to correct use of PPE and management and disposition of PPE. In the time of the COVID-19 pandemic, it is challenging to adapt quickly to frequent changes in guidelines and monitor patient needs while preparing for a possible third pandemic wave and similar future scenarios.

Ovo je nastojanje da se ukratko zabilježi vrijeme i rad Ratnog stacionara i pričuvne ratne bolnice u Donjem Miholjcu. Stara poslovica kaže: »Verba volant - scripta manent«, tj. riječi lete, ali zapisano ostaje, ili - ono što nije zapisano, nije ni postojalo. Vrijeme neumitno prolazi, a sjećanja blijede. Ne želimo da nam ovo naše iskustvo opet zatreba, ali će mo biti spremni ako zatreba da ga opet primijenmo. ; The work of the war-time military hospital in Donji Miholjac has been brieflay described. There is an old Roman proverb: »Verba volant, scripta manent«., i. e. »The words fly, the written materials remain«, or in other words: »That what has not been described has not happened«. The time is inexorably passing and memories are fading. We do not want to use our experiences again. However, if it is necesary we are prepared to do it.

Uvod: U Republici Hrvatskoj zakon ne predviđa darovanje organa nakon cirkulacijske smrti iako je ono često u pojedinim drugim državama. Cilj: utvrditi koliko je mogućih darovatelja bubrega nakon cirkulacijske smrti bilo u jednogodišnjem razdoblju (2012.) u Kliničkome bolničkom centru Osijek (KBCO). Nacrt istraživanja: presječno istraživanje. Ispitanici i postupci: ispitanici su bili preminule osobe (N=1652) primljene na Zavod za patologiju KBCO tijekom 2012. Procjenjivalo se zadovoljavaju li Maastrichtske kriterije za darovanje organa nakon cirkulacijske smrti. Podaci su preuzeti iz medicinske dokumentacije i statistički obrađeni u SPSS-u. Rezultati: Maastrichtske kriterije zadovoljilo je 215 ispitanika (13 %), 53 od tih ispitanika isključeno je zbog kontraindikacija za transplantaciju (TX), te je konačan broj mogućih darovatelja bio 162 (10 %). Medijan dobi bio je 72 godine (42-91), a 83 od 162 (51 %) bilo je muškoga spola. Najčešći su uzroci smrti srčanožilne bolesti (78 %), a najviše mogućih darovatelja nakon cirkulacijske smrti preminulo je na Klinici za internu medicinu (42 %). Najčešće zadovoljeni Maastrichtski kriterij je bio drugi (88 %, neuspješna reanimacija). Nije utvrđena statistički značajna udruženost pojedinih Maastrichtskih kriterija sa spolom niti s dobi. U značajno ranijoj životnoj dobi preminuli su muški ispitanici. Zaključak: broj mogućih darovatelja bubrega nakon cirkulacijske smrti tijekom godine dana u KBCO bio je 162. Mogućnost darovanja nakon cirkulacijske smrti mogla bi povećati broj mogućih darovatelja bubrežnih presadaka i još više poboljšati uspjeh TX u Republici Hrvatskoj. Na razini KBCO može se reći da bi se broj TX s mogućim darovateljima mogao povećati i do 27 puta (otprilike je aktualno 12 TX godišnje, uz mogućnost po dvije bubrežne TX od jednoga darovatelja), premda bi vjerojatno manje tih darovatelja bilo i ostvareno, s obzirom na njihovu stariju životnu dob te moguće protivljenje obitelji darovanju organa. ; Introduction: In the Republic of Croatia organ donation after circulatory death (DCD) is not regulated by law, although this practice is well represented in some other countries. Goal of the research: To determine how many potential donors after circulatory death were eligible during the one-year period (2012) at University Hospital Centre Osijek (UHCO). Study design: cross-sectional study. Examinees and methods: The examinees included 1652 deceased persons who were admitted to the Department of Pathology of the UHCO during 2012. They were assessed for meeting the Maastricht criteria for organ DCD. Data were taken from medical documentation and statistically analyzed by SPSS. Results: 215 examinees met the Maastricht criteria (13 %), 53 of them were excluded due to the contraindications for donation, thus the final number of potential DCD was 162 (10 %). The median age was 72 years (range 42-91), and 83 (51 %) of 162 were males. The most common causes of death were cardiovascular diseases (78 %), and the highest number of potential DCD died at the Department of Internal Medicine (42 %). The most commonly met Maastricht criterion was the criterion 2 (88 %, unsuccessful resuscitation). Only one examinee met Maastricht criteria 1. Statistically significant association of particular Maastricht criteria with sex or age was not found. The examinees of male gender died at an earlier age. Conclusion: the number of potential DCD in a single year at the UHCO was 162, of which 161 were for kidney donation. Transplantation (TX) from DCD would increase the number of potential donor kidney transplants and further enhance the success of TX in Croatia. At the level of UHCO the number of kidney TX with those donors could increase up to 27 times (considering 12 kidney TX annually so far and 2 possible kidneys from a single DCD), although in reality probably less of those DCD would be realized, due to their old age and possibility of their families refusing the organ donation.

Kada govorimo o suradljivosti bolesnika (engl. compliance), razlikujemo dva pojma koje hrvatski možemo nazvati ustrajnost (engl. persistence), te adherencija odnosno pridržavanje (engl. adherence). Iako se navedeni izrazi rabe kao sinonimi, obično se za njih rabi izraz suradljivost. Posebno je problem kod kroničnih bolesnika koji moraju godinama uzimati više lijekova, a istraživanja su pokazala da bolesnici na kroničnoj hemodijalizi (HD) uzimaju i do 19 raznih tableta na dan, te je njihova suradljivost vrlo loša. Ciljevi rada su: utvrditi postoji li povezanost dobi i spola s redovitim uzimanjem propisane terapije, utvrditi postoji li povezanost redovitog uzimanja propisane terapije s dobro reguliranim krvnim tlakom. Kao instrument istraživanja uporabljen je anketni upitnik koji je sadržavao demografske podatke o dobi, spolu, te standardizirani upitnik od 8 pitanja vezana za redovito uzimanje terapije, Morisky Medication Adherence Scale (MMAS-8), preveden na hrvatski kao Upitnik o pridržavanju terapiji (UOPT). Istraživanje je provedeno na 61 ispitaniku, od kojih je 28 (45,9 %) žena i 33 (54,1 %) muškaraca. Medijan dobi bio je 67 godina (interkvartilni raspon 58–74), a značajno su bile starije žene (Mann-Whitneyev test, P=0,004). Nije nađena statistički značajna razlika između žena i muškaraca u pridržavanju redovitog uzimanja propisane terapije prema MMAS-8 testu. Prema upitniku o pridržavanju uzimanja propisane terapije, njih 14 (23 %) ima nisko pridržavanje uzimanja terapije, njih 31 (50,8 %) ima srednje pridržavanje, a 16 (26,2 %) ima visoko pridržavanje uzimanja propisane terapije. Također, ovo istraživanje nije utvrdilo da postoji značajna razlika u regulaciji krvog tlaka prema spolu i pridržavanju uzimanja propisane terapije. Istraživanjem je utvrđeno da postoji statistička značajnost u broju bodova dobivenih MMAS-8 upitnikom i pridržavanja uzimanja propisane terapije (P=0,001, Kruskal-Wallisov test). Kod bolesnika koji se liječe HD-om kao jednim od oblika nadomjesne bubrežne funkcije osobito je nužno redovito uzimanje propisane im terapije. ; When we talk about patient compliance, we distinguish between two concepts which may be called persistence and adherence, i.e. compliance. Although the said terms are used interchangeably as synonyms, usually for their use of the term compliance. It is especially a problem in chronic patients who have to take several drugs for years, and studies have shown that patients on chronic haemodialysis (HD) take up to 19 different tablets a day, and their compliance is very bad. The objectives of this paper are: to determine whether there is a correlation between age and sex with a regular taking of prescribed therapy, to determine whether there is a connection between regular taking of prescribed therapy with well-controlled blood pressure. The survey instrument used was a questionnaire containing demographic information on age, sex, education, and the standardized questionnaire containing eight questions related to the regular use of therapy, Morisky Medication Adherence Scale (MMAS-8), translated into Croatian. The study was conducted on 61 subjects, of whom 28 (45.9%) women and 33 (54.1%) men. The median age was 67 years (interquartile range 58-74), and women were significantly older (Mann-Whitney test, P = 0.004). There was no statistically significant difference between women and men in compliance with the regular intake of prescribed therapy according to MMAS-8 test. According to the questionnaire on compliance of taking the prescribed therapy, 14 of them (23%) showed a low adherence to treatment, 31 (50.8%) sowed moderate adherence, and 16 (26.2%) showed a high compliance to taking the prescribed therapy. Furthermore, this study did not find that there is a significant difference in blood pressure regulation by sex and compliance with taking the prescribed therapy. During the research it has been found that there is statistical significance in a number of points obtained by the MMAS-8 questionnaire and compliance with taking prescribed therapy (P = 0.001, Kruskal-Wallis test). In patients treated with HD as a form of replacement of renal function, regular taking of prescribed treatment is especially important.

Uvod: Moždani udar ima visoku smrtnost kako u svjetskim okvirima tako i kod nas. Značajno financijski opterećuje kako republički tako i županijske zavode za zdravstveno osiguranje. Glavnina bolesnika ostaje trajnim invalidima, a uz velika financijska izdvajanja i upornu fizikalnu terapiju oporavi se mali broj bolesnika (jedna trećina). Osim medicinskog osoblja koje sudjeluje u tretmanu bolesnika oboljelih od MU, veliku ulogu u oporavku imaju obitelj i bolesnikovo šire i daljnje okruženje. Cilj rada: je utvrditi broj i distribuciju bolesnika liječenih od moždanog udara u 2017. godini, procijeniti ishode liječenja te utvrditi vrstu antikoagulantne terapije na otpustu. Definirati i analizirati faktore rizika s osvrtom na primarnu i sekundarnu prevenciju. Procijeniti postojeću skrb bolesnika, uz definiranje mjesta i uloge medicinske sestre. Metode: Ciljni parametri prikupljeni su iz medicinske dokumentacije koja je nastala tijekom liječenja bolesnika. Varijable, prikupljene iz elektronskih otpusnih pisama unesene su u elektronički zapis ispitanika u program Microsoft Excel, po posebno izrađenoj tablici podataka. Rezultati: Sudjelovalo je 167 bolesnika, 86 žena (51,50%) i 81 muškaraca (48,50%). Najzastupljeniji faktori rizika bili su hiperlipidemija i hipertenzija, fibrilacija atrija i dob iznad 70 godina. Od moždanog udara 2017. god. umrlo je 45 bolesnika (26,90%), više muških (53,30%), s neurološkim deficitom ostalo je 56 bolesnika (33,50%), više muških (53,60%), a djelomično ili potpuno oporavljenih je bilo 66 (27,00%), više kod žena (59,00%). U tretmanu fibrilacije atrija (67,00%), mali dio bolesnika je na Warfarinu i NOACs, 88 njih (52,30%) u odnosu na 134 na acetilsalicilnoj kiselini (80,20%). Postoji statistički značajna razlika u vrsti i broju čimbenika rizika MU u odnosu na dob i spol ispitanika. Stariji bolesnici skloniji su većoj smrtnosti. Muški spol je faktor rizika i među muškarcima veća je ukupna smrtnost. Zaključak: Prepoznavanje i sustavno provođenje politike unaprjeđenja i očuvanja zdravlja uz aktivnosti na području primarne, specijalističke i bolničke zdravstvene zaštite osnovni su preduvjeti postizanja uspjeha u prevenciji moždanog udara. U stvaranju takvog okruženja nužna je suradnja zdravstva s drugim strukturama javnog života. ; Introduction: Stroke has high mortality both in the world and in us. Significantly financially burdens both the republic and county health insurance bureaus. The majority of the patients remain with permanent invalids, and with a small amount of financial resources and persistent physical therapy, a small number of patients (one-third) recover. In addition to the medical staff involved in the treatment of patients with MU, a major role in recovery has the family and the patient's wider and further environment. Aim: The aim of the study was to determine the number and distribution of stroke patients in 2017, to evaluate the outcomes of the treatment and to determine with whom the patients were relieved from the department (antiagregation, new oral anticoagulants, warfarin). Also, risk factors will be defined and analyzed with reference to primary and secondary stroke prevention. Existing patient care will be evaluated, along with the definition of the nurses' place and role in the treatment of this type of patient. Methods: Target parameters were collected from medical documentation that was generated during patient treatment. Variables, collected from electronic resignation letters were submitted to the electronic record of the respondents in the Microsoft Excel program by a specially made data table. Results: A total of 167 patients, 86 women (51.50%) and 81 males (48.50%) participated in the study. The most frequent risk factors were hyperlipidemia and hypertension, more frequent in the male population, while atrial fibrillation and age over 70 were more common in women. From a stroke in 2017, 45 patients (26.90%), more males (53.30%) died, with 56 (33.50%), more male (53.60%), and partially or completely recovered, with a neurological deficit 66 (27.00%), more in women (59.00%). In the atrial fibrillation treatment (67.00%), as the most frequent risk factor, a small part of the patients were on Warfarin and NOAC, 88 (52.30%) versus 134 on acetylsalicylic acid (80.20%). Research has shown that there is a statistically significant difference in the type and number of stroke risk factors in relation to age and sex of respondents. It has been found that elderly patients with greater comorbidity are more likely to be more mortally affected. It was also found that the male gender risk factor in the investigated population and that in the male population the total mortality was higher. Conclusion: Recognizing and systematically implementing a general policy of improving and preserving health as well as activities in the area of primary, specialist and hospital health care are the basic preconditions for achieving success in the prevention of cerebrovascular diseases. In creating such an environment, it is necessary to co-operate with other sectors of public life.

Medicinski centar n Slavonskom Brodu bio je za vrijeme rata u Hrvatskoj pošteđen izravnih razaranja i mogao je u relativno mirnim okolnostima obaviti svoje zadatke u primarnoj zdravstvenoj zaštiti i u Bolnici bez većih problema. U tome periodu naša Bolnica bila je najveća pozadinska bolnica u Slavoniji u kojoj su se liječili ranjenici s vinkovačke i novogradiške fronte kao i velik broj prognanika i izbjeglica. Rat u Bosni koji počinje u ožujku 1992. godine širi se na cijelu južnu Slavoniju, Bolnicu u Slavonskom Brodu stavlja u neposrednu blizinu fronte. U dosadaš­ njim napadima na zdravstvene objekte i Bolnicu poginula su 4 čovjeka (od čega dva naša radnika) a troje je ranjeno (od čega su također dva naša radnika). Pričinjena je velika materijalna šteta na bolničkim zgradama kao i ambulantama u selima i u gradu. Žrtve rata i dalje svakodnevno stižu u našu ustanovu. Do sada ih je bilo 5 910 (zaključno s 28. kolovozom 1992.) od čega 665 smrtno stradalih i 5 245 ranjenih. To je naravno samo dio žrtava rata u Posavini, jer znatan broj ranjenih i mrtvih nisu prošli kroz našu ustanovu. Medicinski radnici i ostalo osoblje ove ustanove velikim zalaganjem u teškim okolnostima slijede svjetle primjere drugih ustanova u Hrvatskoj koje su bile u sličnim okolnostima za vrijeme rata u Hrvatskoj, znajući daje to ono najviše što mogu dati u ovoj borbi za slobodu svog naroda. ; Medical tradition in Slavonski Brod is about 300 years old. From the beggining of the 18th century there was in the town Military hospital with pharmacy and mortuary. In the Military hospital civilians were cured as well. After Military Frontier had been abolished Civil hospital was founded. Medical service was organized in so called Medical centre which incorporated all services: primary protection and hospital. The hospital in Slavonski Brod is one of the bigger in Croatia. Before homeland war it contained 800 beds and developed all specialist services. There were modern diagnostics with endoscopic, supersonic vibrations, laboratory, X-rays even computorized tomography services. There were adequate number of experts, too. Out of hospital services are: general medicine, labour medicine, medicine for school children, epidemiology, dentistry and First-aid services. During the homeland war in Croatia, hospital and out-of hospital services didn't bear remarkable destroying and they could work normally behind the front lines in Slavonia. Hard circumstances began with the outburst of the war in Bosnia in March 1992. From this time on the hospital functions only in cellars and works with half a capacity. About 300 beds is always prompt for the needs of war surgery and Intensive care service. All the services of the Primary health prevention of the Medical centre adapted their work to war conditions. The majority of services worked in reserve departments. In majorty of cases they were situated in cellars of children day-care centres in areas out of enemy's reach. Out-of-hospital services were dislocated so that they were nearer to possible patients to lessen the risk of wounding and killing them from enemy gun attacks. Although in difficult conditions, medical staff did all that was needed to give full medical care to patients and other inhabitants of our community. In artillery attacks on the Medical centre four people perished (two of them were our workers) and three were wounded (two were our workers, too). There were big damages on hospital buildings and out ofhospital departments in the town and in the countryside. The victims of the war came every day to Medical centre and up to August 28th, 1992, there were 5910 patients of which 665 perished and 5245 wounded. Of the total number of wounded there were 21,3% civilians, and the percentage of deceased civilians was even bigger. In our town more than 75% dead were civilians and even 20 of them were children younger of 15 years. All that is only a partial number of war victims in Posavina because many wounded and perished were not accepted in our Medical centre.

Podloga: Dnevna bolnica (DB) je oblik organizacije, ali i način pružanja dijagnostičko-terapijskih postupaka izvanbolničkih bolesnika uz dnevni boravak u bolnici (u trajanju do 22 sata). Dnevna bolnica može se organizirati kao organizacijski dio pojedine djelatnosti u bolnici, poliklinici i trgovačkom društvu za obavljanje zdravstvene djelatnosti. Vlada Republike Hrvatske pravilnikom propisuje minimalne uvjete za rad u Dnevnoj bolnici, a Hrvatski zavod za zdravstveno osiguranje (HZZO) ugovara kirurške postelje, plaća usluge i prati iskorištenost ugovorenih kapaciteta. Metode: Autori u ovom radu dostupnom stručnom literaturom, pravilnicima i statističkim izvješćima analiziraju brojnost i iskorištenost posteljnih kapaciteta kirurških dnevnih bolnica u javnom zdravstvenom sustavu Republike Hrvatske. Analizirano je razdoblje od 2013. Do 2014. godine. Rezultati: Od ukupno 25 219 bolničkih postelja u Hrvatskoj, u 2015. godini HZZO je ugovorio 3811 postelja dječjih bolnica (278 za potrebe opće i 33 za potrebe dječje kirurgije). U 2014. godini bolnice su imale 155 ugovorenih postelja opće i 13 postelja dječje kirurgije. U 2013. godini, bilo je 20930 dana liječenja u dnevnim bolnicama opće kirurgije i 2844 dana u dječjoj kirurgiji, a u 2014. godini bilo je 22946 dana liječenja u dnevnim bolnicama opće kirurgije i 2488 dana u dječjoj kirurgiji. Zaključak: Ukupno sudjelovanje kirurških postelja dječjih bolnica u posteljnom kapacitetu naših bolnica je niska, a popunjenost tih kapaciteta na godišnjoj razini kreće se u rasponu 5487%. Postelje dječje kirurgije u dječjim bolnicama većim se postotkom koriste nego one opće kirurgije. Zakonodavac i HZZO učestalo mijenjaju pravilnike kojima propisuju okvire rada kirurške dnevne, a bolnice teško prate te zadane okvire minimalnih uvjeta. ; Background: Day Hospital (DH) is a type of organization for providing diagnostic and therapeutic outpatient procedures for patients who are hospitalized and discharged within one day (within 22 hours). It can be organized in a hospital, clinic or healthcare company. The government of the Republic of Croatia prescribes minimum requirements for work on an outpatient basis, and the Croatian Health Insurance Fund (HZZO) contracts the number of surgical beds, pays for the provided services and monitors the hospital bed usage. Methods: The authors, using available literature, regulations and statistical reports, analyzed the number and hospital bed usage in surgical DH units in the public health system in Croatia for the 2013/2014 period. Results: Of 25219 hospital beds in Croatia, in 2015 HZZO contracted 3811 DH beds (278 for general surgery and 33 for pediatric surgery). In 2014 there were 155 beds for general and 13 beds for pediatric surgery. In 2013 there were 20930 days of hospitalization in general day surgery and 2844 days in pediatric day surgery. In 2014 there were 22946 days of hospitalization in general day surgery and 2488 days in pediatric day surgery. Conclusion: The percentage of surgical DH beds in overall number of surgical beds in our hospitals is low, and the utilization of capacity ranges from 54 to 87%. Pediatric day surgery beds are utilized better than general surgery. The Government and HZZO often change regulations regarding DH facilities. This makes it difficult for hospitals to maintain minimal requirements for the organization of surgical DH units.

Iako intervencijska kardiologija u Hrvatskoj unatrag dvaju desetljeća bilježi napredak, ne nalazimo analizu broja intervencijskih kardioloških zahvata na nacionalnoj razini. Cilj je rada bila analiza broja koronarnih angiografija (CA) i perkutanih koronarnih intervencija (PCI) u razdoblju od 2010. do 2014. godine. Analizirani su dijagnostičko-terapijski postupci iz računa hospitaliziranih bolesnika u Hrvatskoj koji se odnose na CA i PCI u 13 hrvatskih centara. U promatranom je razdoblju prosječna stopa CA bila 4390 na milijun stanovnika godišnje uz porast od 8,5 % u promatranom razdoblju. Prosječna stopa PCI-ja bila je 2208 uz porast od 15 %. Omjer PCI/CA porastao je s 0,48 na 0,52. Od 47 470 PCI-ja učinjenih u Hrvatskoj od 2010. do 2014. godine 18,6 % učinjeno je u Klinici za kardiovaskularne bolesti Magdalena, 13,8 % u Kliničkom bolničkom centru (KBC) Zagreb, 11,9 % u KBC-u Rijeka i 11,3 % u Kliničkojbolnici Dubrava, dok su ostali centri imali udjele manje od 10 %. Prema broju PCI-ja, sedam hrvatskihcentara (54 %) ubrajamo u velike centre, a četiri (30,7 %) među srednje velike centre. Opća bolnica Dubrovnikod 2013. godine ima dovoljan godišnji broj PCI-ja (> 200), dok Opća bolnica Karlovac radi samo CA. Rezultati upućuju na izniman uspjeh hrvatske intervencijske kardiologije u zadnja dva desetljeća. Hrvatska je 2010. godine imala višu stopu PCI-ja od prosjeka članica Organizacije za ekonomsku suradnju i razvoj (OECD) i 21 zemlje članice Europske unije i veći prosječan godišnji rast (26,8 %) od svih analiziranih zemlja, osim Rumunjske. Stopa PCI-ja bila je viša od većine europskih zemalja, osim Njemačke, Belgije, Austrije i Norveške. Za daljnju analizu uspješnosti intervencijskih zahvata i planiranje daljnjeg razvoja nužno je formiranje unificiranoga Hrvatskog registra kardioloških procedura. ; Although there has been progress in interventional cardiology in Croatia over the last two decades, there has been no analysis of interventional cardiologic procedures at the national level. The aim of this article was to analyze of the number of coronary angiographies (CA) and percutaneous coronary interventions (PCI) in the period from 2010 to 2014. Diagnostic and treatment procedures were analyzed based on the CA and PCI hospital claims of Croatian patients in 13 Croatian centers. The average rate of CA in the observed period was 4 390 per million population annually, with a growth of 8.5% over the observed period. The average rate of PCI was 2 208 with an increase of 15%. The PCI/CA ratio grew from 0.48 to 0.52. Of the 47 470 PCI procedures performed in Croatia between 2010 and 2014, 18.6% were performed in the Magdalena Special Hospital for Cardiovascular Surgery and Cardiology, 13.8% in the University Hospital Centre Zagreb, 11.9% in the University Hospital Centre Rijeka, and 11.3% in the University Hospital Dubrava, while other centers had shares below 10%. Based on PCI numbers, 7 Croatian centers (54%) can be classified as high volume centers, and 4 (30.7%) as medium volume centers. The Dubrovnik General Hospital since 2013 had a sufficient annual number of PCIs (>200), while the Karlovac General Hospital only performed CA. Results indicate that Croatian interventional cardiology has achieved a great success over the last two decades: in 2010, Croatia already had an above average rate of PCIs compared with the Organization for Economic Co-operation and Development and 21 countries of the European Union, as well as a larger annual growth (26.8%) than all analyzed countries except Romania. PCI rates were higher than most European countries except Germany, Belgium, Austria, and Norway. Further analysis of the success of interventional procedures and further development plans require the formation of a unified Croatian Registry of Cardiologic Procedures.

The indicators of health condition and providing medical protection are necessary for making assessment of health condition at the level of population, improvement of the healthcare system and making health-related and political decision with an aim to improve the citizens' health. Qualitative and reliable original data is necessary for the preparation of indicators. According to the indicators of mortality and morbidity, cardiovascular diseases (CVD) are the prioritized public health problem in Croatia. They are the major cause of mortality, in men with a share of 42.6% and in women with a share of 56.4% in total mortality. In CVD hospital morbidity, they are represented in men in the first place with a share of 14.9% and in women, they take the second place with a share of 12.5% in total number of hospitalizations. Totally, more women die of CVD and men die of CVD more frequently at younger age, however, women are hospitalized less frequently.

U radu se raspravlja o fenomenu agresivnosti i nasilja kod čovjeka, s posebnim osvrtom na duševno oboljele. Krizno stanje i nasilno ponašanje ne događa se samo u psihijatriji. Ono se može dogoditi uvijek, a žrtva i počinitelj pod određenim okolnostima može biti svatko. Poznavanje multikauzalnosti i kompleksnosti te individualnih okolinskih i situacijskih čimbenika koji dovode do nasilnog ponašanja imaju malu snagu predikcije. Statistički pokazatelji mogu skrivati lažno pozitivne i negativne rezultate, pri čemu pogreška procjene može drastično povećati rizik da se neko ponašanje dogodi ili dovesti do neopravdanog suspendiranja ljudskoga prava na slobodu. Primjena prisile u psihijatriji nužna je samo iznimno i u ograničenom trajanju u situacijama kada se opasnim ponašanjem izravno ugrožava život i zdravlje osobe ili okoline. Pozitivna zakonska regulativa, posebice Zakon o zaštiti osoba s duševnim smetnjama (NN 76/2014) te Pravilnik o vrstama i načinu primjene mjera prisile prema osobama s težim duševnim smetnjama (NN 16/2015) dodatno štiti prava oboljelih i propisuje vrste i način primjene prisile kao i procedure za postupanje. Strukovna psihijatrijska društva dala su dodatne smjernice i strategije za postupanje. U radu se ističe potreba za boljim uvjetima, infrastrukturom i ljudskim resursima uz kontinuirano unaprjeđenje i evaluaciju kvalitete rada u psihijatriji. Zaključno, propituju se standardi i etička pitanja društva te širokog spektra aktivnosti, od destigmatizacije, preko bolje dostupnosti usluga do standarda života i socijalne uključenosti, koji posredno mogu dovesti do bitnog smanjenja nasilja u društvu. ; The article deals with phenomena of aggression and violence in humans with special attention to mental illnesses. Crisis and violent behaviour do not occur only in psychiatry. It can happen in any context or circumstance, and any person could either fall victim or be the perpetrator. Knowledge of multicausality and complexity as well as of individual environmental and situational factors that can lead ...

Skautska organizacija na varaždinskoj Gimnaziji bila je utemeljena na inicijativu školskih vlasti početkom Prvog svjetskog rata, neposredno pred početak školske godine 1914./15. Njezina svrha bila je pružanje pomoći pri funkcioniranju vojnih i državnih službi u ratnim uvjetima. Pomažući gradskim i državnim službama, skauti su organizirali dežurstva i kurirsku djelatnost na biciklima. Vojnicima su osiguravali okrjepu pri prolasku kroz Varaždin i snalaženje pri boravku u gradu. Posebno značajna bila je pomoć skauta pri zbrinjavanju ranjenika. Nakon završenog bolničkog tečaja, tijekom prve ratne godine obavezno su pomagali pri prebacivanju ranjenika sa željezničkog kolodvora u bolnice, njegovanju i održavanju kontakata s obiteljima. U svrhu sprečavanja zaraza, prvo je obustavljena njihova pomoć pri zbrinjavanju ranjenika, a do kraja školske godine zamrla je njihova cjelokupna aktivnost. ; The Scout organization that operated in Gimnazija – Varaždin was founded upon the initiative of the educational authorities at the onset of World War I, at the very beginning of school year 1914/1915. Its purpose was to provide help with the operation of military and civil services during war period. By helping municipal and state services, the Scouts organized watches and courier activities on bicycles. They provided soldiers with refreshment while traversing Varaždin, as well as orientation assistance while they were stationed in the town. One of the most crucial services provided by the Scouts was helping wounded soldiers. Upon the completion of a healthcare course, during the first year of the War their basic duty was to assist with the transfer of casualties from the train station to hospitals, as well as to nurture the wounded soldiers and maintain contact with their families. In order to prevent the outbreak of diseases, at first their caretaking activity was discontinued, and by the end of the year their overall activity subsided.

Tijekom rata 1992. godine, prošlo je u Bosanskoj posavini 6.105 vojnika kroz razne oblike zdravstvene skrbi. Poginulo je u to doba 920, teže ranjeno 3.258, a lakše ranjeno 1.927 vojnika. Oni su zbrinuti na sanitetskim etapama organiziranim na razini borbene linije, borbenog područja i veznog područja. Temelj zdravstvene struke na borbenoj liniji činile su bataljunske postaje, a na razini borbenog područja Medicinski centar Slavonski Brod. Njegova uloga bila je ključna, kako zbog kirurške obrade 5.418 ranjenika, tako i zbog definitivnog zbrinjavanja većine osoba koje su zatražile pomoć. U okolici Slavonskog Broda formirana su oporavilišta, a širom Hrvatske korištene su specijalizirane zdravstvene ustanove i rehabilitacijski centri, u kojima je, po potrebi, završavan proces liječenja. Takvom organizacijom zdravstvene skrbi umro je u Medicinskom centru Slavonski brod tijekom liječenja 161 ranjenik, što predstavlja mortalitet od 3,0%. ; During military operations in Bosanska Posavina in 1992, 6,105 soldiers of the Croatian Defence Council (Bosnian Croats and Mosliems) were treated at various health care levels: 920 soldiers were killed, 3,258 were heavily wounded and 1,927 lightly wounded. The treatment was provided in medical units organized at the front line, in the combat area and in the communication area. At the front line, medical service was organized as battalion units, whereas the area in general was medically covered by the Slavonski Brod Medical Center in Croatia. Slavonski Brod played a key role with surgical treatment of 5,418 wounded and definite care was offered to most subject seeking medical aid. The scarcity of medical personnel at the front front lines and long lines of transportation resulted in a 6.5% death rate (354 patients) during transportation from Bosnian batterfields to Slavonski Brod. By contrast, the mortality rate in Slavonski Brod Hospital was 3.0% (161 patient). Convalescence homes were established and health rehabilitation centers throughout Croatia accommodated those needing advanced treatment.

Uvod: O povijesti sestrinstva u Karlovcu i podacima o školovanju i radu medicinskih sestara ima vrlo malo objavljenih radova. Većinom su ti radovi sastavni dio monografije bolnice i/ili organizacijskih jedinica zdravstvenih ustanova. Analizom pronađene povijesne građe u ovom radu pokušala se učiniti rekonstrukcija života, školovanja i rada medicinske sestre Sofije (Sonje) Škrobe. Metode: Polazište za izradu rada bili su dokumenti pohranjeni u pismohrani Opće bolnice Karlovac, arhivskim fondovima i zbirkama Hrvatskog državnog arhiva (HDA) i usmeno svjedočanstvo kćeri Sofije (Sonje) Škrobe. Kao dopuna ovim izvorima korišteni su do sada objavljeni radovi. Rezultati: Sofija (Sonja) Škrobe rođena je 8. veljače 1919. godine u Krasici. Završila je četiri razreda realne građanske škole u Karlovcu, dvije godine učiteljske domaćinske škole u Zagrebu i u doba punoljetnosti upisala i završila Školu za nudilje u Beogradu. Nakon položene službene prisege, dekretima nadležnih Ministarstava zdravstva i Oblasnih Narodnih odbora šalju je na rad na različita mjesta. Radila je u Zavodu za suzbijanje endemijskog sifilisa u Banjaluci, u Državnom domu za malu djecu u Zagrebu, Domu narodnog zdravlja u Karlovcu, Državnim dječjim kolonijama u Virju i Splitu, Antituberkuloznom dispanzeru u Dubrovniku te u Kotarskoj zdravstvenoj stanici u Karlovcu. Posljednjih deset godina prije umirovljenja radila je kao patronažna sestra u Karlovcu. Prema obrađenoj građi možemo pretpostaviti da je Sofija Škrobe prva civilna školovana medicinska sestra u Karlovcu. Umrla je u Karlovcu 28. listopada 2002. godine. Zaključak: Uvidom u dosje Sofije Škrobe možemo pratiti njezin profesionalni put po mnogim zdravstvenim ustanovama sukladno tadašnjoj socijalno-zdravstvenoj politici. Istovremeno se dobio uvid u zdravstvena, socijalna i politička zbivanja u državama opisanog vremena. Medicinske su sestre zajedno s liječnicima obilazile pacijente po kućama i/ili pružale skrb u pokretnim ambulantama. Provodile su aktivnosti usmjerene na suzbijanje i liječenje, kroničnih i zaraznih bolesti, podizale nivo higijene kod stanovništva i provodile zdravstveno prosvjećivanje ljudi. Razvidno je koliko je taj rad tražio osobnih odricanja, bio popraćen teškim radnim uvjetima rijetko uzimajući u obzir privatni život zdravstvenih djelatnika. U radu su navedena mnoga imena i dokumenti koji mogu poslužiti kao poticaj na daljnja istraživanja ili kao dopuna i/ili korekcija ovom radu. ; Introduction: There have been very few published texts on the history of nursing in Karlovac and few data on the education and work of nurses. They are mostly parts of the monograph of the hospitals and/or other departments at the health institutions. The summary of the life of Sofija (Sonja) Škrove, her education, and her work have been analyzed in this text using his-torical documents. Methods: The starting point for this text was the documents from the archives of the Kar-lovac General Hospital, the archives and collections of the Croatian State Archives (HDA), and the memories recounted by her daughter Sofia (Sonja) Škrobe. In addition, some previously published papers have also been used. Results: Sofija (Sonja) Škrobe was born on February 8, 1919 in Krasica. After finishing pri-mary school in Karlovac, she went to high school for teachers in Zagreb for two years and when she came of age she enrolled and finished high school for nurses in Belgrade. After she officially took oath she was sent by order of the Ministery of Health and Regional People's Committee to various places for work. She worked at the Institute for the Control of Endemic Syphilis in Banja Luka, at the State Orphanage for Young Children in Zagreb, the Public Health Center in Karlovac, the State Children's Camp in Virje and Split, the Antituberculosis Clinic in Dubrovnik, and the District Health Centre in Karlovac. For the last 10 years before retiring, she worked as a community nurse in Karlovac. We can assume that according to the analyzed data, Sofija Škrobe was the first qualified public nurse in Karlovac. She died in Karlovac on October 28, 2002. Conclusion: Looking at Sofija Škrobe's file, we can follow her professional career in many health institutions according to the social and health politics of that period. At the same time, we got an insight into the social, political, and health issues of the states of those times. Nurses, together with doctors, visited patients in their homes and provided care in mobile am-bulances. They were active at suppressing and curing, chronic and contagious diseases, raising the standards of hygiene and enlightening the people on health. It is apparent that such a work asked for personal sacrifices and that it was accompanied by difficult working conditions without consideration for the personal lives of the health professionals.

Suradnja kemičara, liječnika i urologa s Instituta Ruđer Bošković Zagreb, Instituta za medicinska istraživanja i medicinu rada Zagreb te Kliničke bolnice Osijek (danas Kliničkoga bolničkoga centra Osijek) započela je prije više od tridesetak godina na projektima povezanim s nastankom urolitijaze. Sama istraživanja pridonijela su novim spoznajama o različitim faktorima važnim za nastajanje kamenaca, dijagnosticiranje i liječenje urolitijaze. Više radova objavljeno je u znanstveno-stručnom časopisu Medicinski vjesnik (1984. i 1985.) te u knjizi Urolitijaza (1989.). U radu V. Babić-Ivančić i sur., objavljenom u Medicinskom vjesniku 2004. godine, danje detaljan pregled bazičnih, primijenjenih i kliničkih istraživanja do 2004. godine na zajedničkim projektima financiranim iz Hrvatske (MZOŠ) i na međunarodnim projektima (EZ, USA, TEMPUS) provedenim u trima suradnim ustanovama čiji su rezultati objavljeni u znanstvenim časopisima i/ili prezentirani na znanstvenim skupovima u zemlji i inozemstvu. U ovome radu dat će se osvrt na rezultate istraživanja, te suradnju u vremenskom razdoblju od 2004. godine do danas (2010.). Iz ranijih istraživanja te istraživanja u zadnjih šest godina dat će se viđenje o istraživanjima te problematike u budućnosti. ; Collaboration between chemists, physicians and urologists from the Ruđer Bošković Institute, the Institute for Medical Research and the Occupational Health and Clinical Hospital Osijek, has started more than 30 years ago through the projects in the filed of urolithiasis. Those investigations have contributed to new understandings of risk factors for kidney stones formation and also for diagnostic and therapy of urolithiasis. Several articles have been published in the journal "Medicinski vjesnik (1984 and 1985) and in the book "Urolitijaza (1989.). The article published in 2004 (Babić-Ivančić V, et al; Medicinski vjesnik presented the review of basic and clinical investigations which results have been published in scientific journals or presented at the scientific conferences til 2004 and financed by the Croatian Ministry of Science, European Union, USA or TEMPUS. This article presents the results of investigations from 2004 until today and also gives a vision about future scope in this issue.