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U radu je obrađena tema teškoća u razvoju i ICT asistivnih tehnologija za pomoć djeci s različitim teškoćama. Kod djece s oštećenjem vida, sluha, govorno-glasovnim teškoćama, motoričkim teškoćama, zdravstvenim teškoćama, poremećajima u ponašanju i neurološkim oštećenjima primjenjuju se asistivni alati i pomagala. Kako je tehnologija napredovala, tako su i medicina i asistivne tehnologije držale korak s njom. Teškoće se ranije i češće otkrivaju zbog napretka tehnologije, a na isti način sve su se više razvijale i asistivne tehnologije. Međutim, glavni nedostatak većine asistivnih tehnologija jest njihova cijena, no prednost je mnogo veća, a to je mogućnost inkluzije djece s teškoćama u razvoju kako bi im se omogućili redovni uvjeti života. Cilj rada je prikazati pojedine asistivne alate odnosno tehnologiju za djecu s različitim teškoćama u razvoju koji su podrška u nastavnom procesu, kao i pregled literature s kritičkim osvrtom u tom smislu. This paper deals with the topic of developmental disabilities and ICT assistive technologies to help children with various disabilities. Assistive tools and aids are used for children with visual impairment, hearing impairment, speech and voice difficulties, motor difficulties, health difficulties, behavioral disorders and neurological impairments. As technology has advanced, medicine and assistive technologies have kept pace with it. Difficulties are detected earlier and more often due to the progress of technology, and in the same way assistive technologies have been increasingly developed. However, the main disadvantage of most assistive technologies is their price, but the advantage is much greater, which is the possibility of including children with developmental disabilities in order to provide them with regular living conditions. The aim of this paper is to present certain assistive tools or technology for children with various developmental disabilities that are a support in the teaching process, as well as a literature review with a critical review in this sense.

Cilj istraživanja Cilj je ovog specijalističkog rada analizirati regulatorne smjernice Europske agencije za lijekove vezane za razvoj lijeka koji se primjenjuje udisanjem u pluća, proizvodnju, provjeru kakvoće i ispitivanja stabilnosti u postupku davanja odobrenja za stavljanje lijeka u promet na području Europske unije. Materijali i metode Literatura će biti pretraživana prema temi istraživanja, predmetu istraživanja, autorima i časopisu. Pretraživati će se od općih prema specijaliziranim člancima pri čemu će se odabirati članci relevantni za problematiku ovoga specijalističkog rada. Ciljana pretraga provedena je putem baza ScienceDirect, PubMed, Agencije za lijekove i medicinske proizvode. Regulatorne smjernice detaljno su istražene pretraživanjem baze Europske agencije za lijekove. Rezultati Farmaceutski oblici za primjenu lijeka udisanjem u pluća koji se koriste za liječenje astme i kronične opstruktivne bolesti pluća dostupni su više od 50 godina na tržištu. Veliki je interes farmaceutske industrije razvijati lijekove koji se primjenjuju udisanjem u pluća zbog velikog broja bolesnika koji boluju od astme i kronične opstruktivne plućne bolesti. Lijekovi koji se primjenjuju udisanjem u pluća dostavljaju se točno na mjesto djelovanja i mogu djelovati već unutar 5 minuta. Prednost ovih lijekova je način primjene, izravno u donje dišne putove gdje djelatna tvar ima učinak u relativno niskim dozama, dok je u isto vrijeme sustavna primjena lijeka minimalna čime su smanjene moguće nuspojave lijeka. Primjenom lijekova udisanjem u pluća izbjegava se metabolizam prvog prolaza kroz jetru, osigurava se djelovanje lijeka na mjestu upale, te se izbjegavaju sistemske nuspojave. Lijekovi koji se primjenjuju udisanjem u pluća dijele se u tri kategorije: stlačeni inhalati, prašci inhalata i pripravci za atomizator. Svi ovi lijekovi su kombinacija same formulacije lijeka i uređaja za inhaliranje. Formulacija lijeka je dizajnirana da pruži namijenjenu učinkovitost pacijentu, da postigne svoj cilj i da bude kompatibilna s inhalatorom. Inhalator mora pružiti dosljednu dozu sadržaja uz odgovarajuću aerodinamičku distribuciju čestica kako bi se osigurala dostava lijeka u pluća. Dobro dizajniran inhalator mora uzeti u obzir upotrebljivost za pacijenta u smislu da inhalator ne bude robustan, da bude jednostavan za korištenje, prenosiv i prikladan za sve uzraste. Svaki tip inhalatora ima posebnu formulaciju lijeka i kliničke prednosti. Zaključak Zahtjev za davanje odobrenja za lijekove koji se primjenjuju udisanjem u pluća u Europskoj uniji može biti podnesen prema Article 8(3) Direktive 2001/83/EC (cjelovita dokumentacija) ili prema Article 10(3) Direktive 2001/83/EC (hibridna aplikacija). Najveći izazov u razvoju generičkih/hibridnih lijekova koji se primjenjuju udisanjem u pluća je dokazivanje terapijske ekvivalencije. Terapijsku ekvivalentnost je potrebno dokazati kroz odgovarajuća klinička ispitivanja ako ekvivalentnost nije dokazana u skladu s in vitro zahtjevima te ako nije dokazana sistemska sigurnost i odlaganje čestica u pluća kroz farmakokinetičke studije. Klinička ispitivanja provode se kako bi se ispitala djelotvornost i sigurnost lijeka te se trebaju temeljiti na rezultatima o sigurnosti dobivenih u prijašnjim kliničkim ispitivanjima, kao i na podatcima dobivenim u nekliničkim ispitivanjima. Izostavljanje kliničkih ispitivanja je opravdano u slučaju kada hibridni lijek koji se primjenjuje udisanjem u pluća u usporedbi s referentnim lijekom zadovolji sva propisana in vitro ispitivanja. Objectives The aim of this paper is to describe biopharmaceutical peculiarities of inhaled medicinal products and contribute to the understanding of guidelines for preparation of documentation for marketing authorization laid down by the European Medicines Agency (EMA), which are related to drug development, production, quality control and stability testing. Materials and Methods Literature search was done by topic and subject of research, authors and journals, from general to specialized articles and guidelines relevant to the issues of this paper. The targeted search was carried out via the on-line databases such as ScienceDirect, PubMed, medicinal products database of the Agency for Medicinal Products and Medical Devices of Croatia. The regulatory guidelines have been detailed searched through the European Medicines Agency database. Results Inhalation drug products have been widely accepted for localized treatment for pulmonary diseases such as asthma and chronic obstructive pulmonary disease and they are available for over 50 years in the market. It is a major interest of the pharmaceutical industry to develop inhalation drug products due to the large number of patients suffering from asthma and chronic obstructive pulmonary disease. For local activities, the orally inhaled drugs are delivered directly to the site of action in the lung, providing fast onset action within 5 minutes. The advantage of these drugs products is the route of administration, directly in the lower respiratory tract where the active substance has effect at relatively low doses, while at the same time the systemic absorption of the drug is minimal, thereby reducing the possible side effects of the drug. By using the inhalation drug product, the first pass metabolism through the liver is avoided, the drug action is provided directly to the site of action, and systemic side effects are avoided. Inhalation drug products are commonly classified into three categories: pressurized metered dose inhaler (pMDI), dry powder inhaler (DPI) and nebulizer. All these inhalation drug products are a combination of formulation and device. The formulation is designed to provide intended efficacy for patients, and to achieve this goal, it needs to be compatible and works together with a device. An inhalation product should be able to provide consistent dose content, along with suitable aerodynamic particle size distribution, to ensure that the drugs can be efficiently delivered to the target sites in the lung. A well designed inhaler must also consider its usability for patients use in terms of features such as robustness, ease of use, portability, and suitability for all ages in order to achieve good patient compliance with the technique instructions. Each type of inhaler has its specific formulation, device and clinical advantages. Conclusion Application for granting marketing authorization for inhaled medicinal products in EU can be submitted according to Article 8(3) of Directive 2001/83/EC (full dossier) or according to Article 10(3) of Directive 2001/83/EC (hybrid application). The greatest challenge in the development of generic / hybrid inhaled medicinal products is the demonstration of therapeutic equivalence between two inhaled products. Therapeutic equivalence should be demonstrated by means of appropriate clinical studies when equivalence is not shown according in vitro requirements and if it is not shown convincingly by investigation of systemic safety and pulmonary deposition. Clinical studies are conducted to examine the efficacy and safety of the inhaled medicinal product and should be based on the safety results obtained in previous clinical studies as well as data obtained in non-clinical studies. Exclusion of clinical studies is justified in cases where the hybrid inhaled medicinal product compared to the reference product satisfies all in vitro requirements.

Kronični rinosinuitis je upalni proces koji zahvaća sluznicu nosa i paranazalnih sinusa i česta je kronična bolest s negativnim utjecajem na kvalitetu života oboljelih. Prema EPOS-ovim smjernicama (eng. European position paper on rhinosinusitis and nasal polyps) dijagnoza se postavlja ako simptomi poput nosne opstrukcije, nosne sekrecije, postnazalnog slijeva, boli/pritiska u licu te smetnji njuha traju duže od 12 tjedana. Dva su klinički različita oblika kroničnog rinosinuitisa, s prisutnim nosnim polipima i bez prisutne polipoze. ----- Kako se pokazalo da oboljeli od kroničnog rinosinuitisa često imaju astmu kao komorbiditet, postavili smo pitanje u kojoj mjeri ona utječe na simptome i kvalitetu života oboljelih. U istraživanju je sudjelovalo 256 ispitanika diferenciranih u dvije skupine, s astmom (65 ispitanika) i bez astme (185 ispitanika). Za svakog od 65 ispitanika s astmom tražili smo para iz skupine bez astme ujednačenog po spolu, dobi, prisutnosti polipa i alergijskom statusu što je rezultiralo s ukupno 60 parova starosti između 23 i 78 godina. Svi su bili kandidati za kiruruško liječenje te su prije CT snimanja ispunili SNOT-22 upitnik kao i ocjenu simptima na vizualno analognoj skali. ----- Rezultati su pokazali da nema statistički značajne razlike između parova u ocjeni CT nalaza prema Lund Mackayu (p, Chronic rhinosinusitis (CRS) is an inflammatory process affecting the nose and paranasal sinuses and is one of more common chronic diseases with a negative impact on the quality of life (QOL) in people suffering from this illness. According to the EPOS criteria (European position paper on rhinosinusitis and nasal polyps) it is diagnosed by having symptoms such as nasal obstruction, nasal secretion, postnasal drip, facial pain and hyposmia for more than 12 weeks. It is manifested in two different clinical phenotypes: chronic rhinosinusitis with nasal polyps (CRSwNP) and chronic rhinosinusitis without nasal polyps (CRSsNP). As asthma shows higher prevalence in those affected with CRS it is reasonable wondering the proportions of its impact on the health-related quality of life (HRQOL) in those patients. ----- This study included 256 CRS patients, differentiated in two groups, those with asthma comorbidity and those not affected with asthma. Each of 65 asthma patients was matched with its pair not having asthma by the age, gender and polyp criteria. Before undergoing CT scanning all of the examinees filled in SNOT-22 (Sino-nasal Outcome Test-22) and VAS (visual analog scale) questionnaire which evaluated their symptoms. ----- Statistical analysis of the collected data was carried out and no significant difference was found in Lund Mackay score between asthma and non asthma group (p

Astma i KOPB su upalne bolesti respiratornog sustava. Kronična opstruktivna bolest pluća je jedna od najraširenijih bolesti i jedna od vodećih uzroka smrtnosti u svijetu. Nepravilno liječenje astme povećava morbiditet, mortalitet i povisuje troškove liječenja koje snosi pojedinac i zajednica. Ispravno liječenje astme i KOPB-a je ključno za pravilnu skrb nad pacijentom i pad smrtnosti. Inhalatori su uobičajena i široko primijenjena metoda liječenja u astmi i KOPB-u. Farmakološke skupine lijekova koje se propisuju su: agonisti beta-2-receptora, antagonisti muskarinskih receptora i kortikosteroidi. Postoje brojne vrste uređaja dostupne za dostavu lijeka: inhaleri koji sadrže suhi prašak, aerosol ili maglicu te inhalacijski uređaj. Svaki uređaj ima svoje prednosti i mane koje utječu na način korištenja, sklonost nastavku terapije te na klinički ishod liječenja. Željeni ishod liječenja može se postići samo pravilnom primjenom i točno određenom tehnikom inhaliranja. U ovom radu naglasak je na greškama koje se javljaju rijekom korištenja različitih vrsta inhalera koji su registrirani u Republici Hrvatskoj. Tijekom korištenja inhalera aerosola uočene greške su: nedovoljno protresivanje inhalera, korištenje inhalera bez skinutog poklopca, nepotpun izdisaj prije inhaliranja, prebrz udah, nedovoljno zadržavanje daha, pritisak pumpice više puta, nedovoljno obuhvaćen nastavak za usta i držanje uređaja naopačke. Učestalost i značenje svake pogreške je objašnjena u radu. Tipične greške koje vežemo uz uređaje koji sadrže suhi prašak su: protresanje DPI, nepotpuni izdisaj prije inhaliranja, izdisanje u uređaj ili neposrednu blizinu, sporo udisanje, pogrešna priprema uređaja za inhaliranje, krivo namještanje doza ili nemogućnost dubokog udisaja. Pogreška koja je najčešća i zajednička svim vrstama inhalera je nepotpun izdisaj prije inhaliranja koja dovodi do poddoziranja lijeka. Pacijenti često dolaze ljekarnicima po svoju terapiju. Ljekarnici koji su dovoljno kompetentni i stručni mogu podići kvalitetu skrbi za pacijenta te imaju važnu ulogu u sanaciji problema i troškove koje ima društvo zbog oboljelih. Asthma and COPD are inflammatory diseases of respiratory system. Chronic obstructive pulmonary disease is one of the most prevalent diseases and the leading cause of disability and death worldwide. Improper asthma management leads to increased morbidity as well as economic burden to individuals and societies. Better asthma and KOPB management and care is essential for effective patient care reducing the morbidity and mortality of the disease overall in the country. Inhalers are the common and widely used treatment modality in the asthma and KOPB management. Pharmacological groups which are prescribed are:beta-2-receptor agonists, muscarinic receptor antagonists and corticosteroids. There are numerous inhaler devices available for the drug delivery in patients with asthma and chronic obstructive pulmonary disease: dry-powder inhalers (DPIs), pressurized metered-dose inhalers, soft mist inhalers and nebulizers. Each inhaler has advantages and disadvantages that may influence a patient’s use, satisfaction and compliance with therapy, and ultimately affect clinical outcomes. Desired effects can only be achieved by proper usage with correct technique. In this paper, the emphasis is on the errors that occur while patients use different commercially available inhaler in Croatia. Detected errors while using MDI include: not shaking inhaler before use, not removing the recover peace, incomplete gasp before inhalation, breading too fast, insufficient retention of breath, pressure pump more times, insufficiently covered the mouthpiece and hold the device upside down. The frequency and importance of each error is listed in the paper. Typical mistakes that we associate with DPI are: shaking DPI, incomplete gasp before inhaling, exhaling into the device, slow inhalation, wrong preparation of the inhaler device, the wrong dose adjustment or inability of deep breaths. The most common error and common to all types of inhaler is incomplete gasp before inhalation. All pharmacists encounter patients with respiratory diseases often during their professional career. Competent and knowledgeable pharmacists can raise the standards of patient care and satisfaction within the community and may play an important role to overall disease burden in the society.

U ovom radu, sustavnim pregledom literature, cilj je bio pronaći istraživanja o utjecaju aerobnog treninga na osobe oboljele od astme. Pregled se provodio na internetskim bibliografskim bazama PubMed, Scopus i Google Scholar. Zbog pojave duplikata i većeg broja nedostupnosti radova u cjelini zaključeno je da Google Scholar baza automatski pretražuje ostale baze. Kriterij selekcije ishodio je 17 detaljno opisanih i primijenjenih istraživanja u ovom radu. Pretragom su uočene različite vrste i modaliteti aerobnih treninga. Traka za trčanje i bicikl ergometar najčešće su korištene, zatim vježbe disanja, rekreativne aktivnosti i sport-specifične aktivnosti. Mjerenjem parametara plućne funkcije, indikatora stanja astme i kvalitete života ispitanika istraživao se utjecaj ranije navedenih aktivnosti. Rezultati provedenih istraživanja pokazuju pozitivan utjecaj aerobnog treninga na osobe oboljele od astme. Poboljšanje kvalitete života i smanjeno korištenje lijekova zabilježeno je kod svih navedenih radova koje su mjerili te parametre. U nekim istraživanjima indikatori stanja (Bronhijalna hiper-reaktivnost - BHR, srčana frekvencija - HR, frakcija izdahnutog dušikovog oksida - FeNO, citokini, eozinofili, histamin) i plućna funkcija zabilježili su poboljšanje. Primjena tehnika disanja poboljšala je stanje pacijenata s astmom u većini istraživanja. Aerobni trening bi trebao biti sastavni dio života osoba oboljelih od astme. Preciznijim i individualiziranim aerobnim trenažnim programom treba unaprijediti njegove pozitivne učinke., In this study, by systematically reviewing available literature, the goal was to research the impact of aerobic exercise on the helath status of people with asthma. The search was conducted using the online bibliographic databases: PubMed, Scopus and Google Scholar. Due to findings of duplicates and a large number of unavailable papers as a whole, it was observed that Google Scholar database automatically searches through other databases. The selection criteria resulted with 17 studies described in detail and applied in this study. Different types of aerobic exercise are found to be used. Treadmill and bicycle ergometer were modalities used the most, as well as breathing exercises, recreational activities and sport-specific activities. The application of these activities was compared using lung function parameters , indicators of asthma and the quality of life of the subjects. The results of these studies showed a positive relationship between aerobic exercise and asthma. Improvement in life quality and reduced use of medication was recorded in all found studies that measured these parameters. Condition indicators (BHR, FeNO, cytokines, eosinophils, histamine) and lung function parametars showed improvement, but not in all found studies. The use of breathing techniques has improved the condition of asthma patients in some of the studies. Aerobic exercise should be an integral part of the life for people suffering from asthma. This positive effect of aerobic exercise on patients with asthma should be enhanced by a more precise and individualized aerobic training program.

Cilj diplomskog rada je pregled i sistematična analiza dosadašnjih spoznaja o učinkovitosti plivanja na čovjekovo zdravstveno stanje, u ovom slučaju na dišne puteve zbog okolnosti u kojima se odvija ovaj sport. Plivanje u globalu ima pozitivne učinke na plućnu funkciju, no zbog uvjeta u kojima se odvija, ti učinci su nekad smanjeni ili neprimjetni, no neke studije tvrde suprotno. Osobama s alergijskim i respiratornim bolestima često se preporučuje plivanje kao terapija za njihovo zdravstveno stanje jer se vjeruje kako zdravstvene dobrobiti plivanja u zatvorenom znatno nadmašuju rizike povezane s plivanjem u zatvorenom prostoru. U ovom radu provedeno je istraživanje anketnim upitnikom pod nazivom Promjene u plućnoj funkciji uzrokovane plivanjem. Upitnik je podijeljen na 3 dijela. Prvi dio odnosio se na opće informacije o stanju pojedinca, drugi dio bio je osnovni upitnik za astmu i pitanja su bila u vezi astme, dok je treći dio orijentiran na rinitis. Upitnik nije imao točnih i netočnih odgovora, stoga smo zamolili ispitanike da odgovaraju iskreno. Upitnik je ukupno ispunilo 205 plivača/plivačica. Trinaest upitnika ispalo je zbog nepotpne ispunjenosti upitnika pa je samim time ukupan broj ispitanika iznosio 193 (N = 193). Upitnici su bili podijeljeni na razvojim kampovima Hrvatskog plivačkog saveza (Regija 1, 2, 3 i 4), ali i u klubovima za vrijeme treninga. Broj ispitanika po regijama je: Regija 1 (N = 29), Regija 2 (N = 68), Regija 3 (N = 42), Regija 4 (N = 53). Od 193 ispitanika njih 8 se izjasnilo kako imaju astmu. U nastavku je izdvojeno 7 pitanja kako bi nam dala detaljniji uvid stanja plućnih funkcija hrvatskih plivača i plivačica. The aim of the thesis is a review and systematic analysis of current knowledge about the effectiveness of swimming on human health, in this case on the respiratory tract due to the circumstances in which this sport takes place. Global swimming has positive effects on lung function, but due to the conditions in which it takes place, the effects are sometimes reduced or imperceptible, but some studies claim the opposite. People with allergies and respiratory diseases are often recommended swimming as therapy for their health condition because the health benefits of indoor swimming are believed to far outweigh the risks associated with indoor swimming. In this paper, research was conducted using a questionnaire under the name Changes in lung function caused by swimming. The questionnaire is divided into 3 parts. The first part related to general information about the individual's condition, the second part was called the basic asthma questionnaire and the questions were related to asthma, while the third part was oriented towards rhinitis. The questionnaire did not have correct or incorrect answers, so we asked respondents to answer honestly. A total of 205 swimmers completed the questionnaire. Thirteen questionnaires were dropped due to incomplete completion of the questionnaire, so the total number was 193 respondents (n=193). Questionnaires were distributed at Croatian swimming association development camps (Region 1, 2, 3 and 4), but also in clubs during training. The number of respondents by region is: Region 1 (N = 29), Region 2 (N = 68), Region 3 (N = 42), Region 4 (N = 53). Out of 193 respondents, 8 of them declared that they have asthma. In the following, 7 questions are selected in order to give us a more detailed insight into the state of lung functions of Croatian male and female swimmers.

Astma je kronična bolest kod koje dolazi do pojavljivanja akutne bronhoopstrukcije s mogućim izraženijim teškoćama u disanju koje se mogu javiti u bilo koje doba dana, a najčešće preko noći ili rano ujutro. Sama bolest jedna je od najčešćih kroničnih bolesti i smatra se da u svijetu boluje oko 300 milijuna ljudi te se smatra da će se do 2025. taj broj povećati za još 100 milijuna ljudi. Većina smrti koje se javljaju zbog astme razvijaju se kod osoba u siromašnijim zemljama. Po Globalnoj inicijativi za astmu, podijeljena je na trajnu i povremenu astmu. Trajna astma dijeli se na 3 stupnja bolesti, a to su blaga trajna, umjerena trajna i teška trajna astma. Za dijagnostiku astme koristi se anamnestički podaci, fizikalni pregled, testovi plućne funkcije, laboratorijski testovi, alergološki testovi i RTG pluća. Cilj liječenja je postići kontrolu bolesti kako se ne bi pojavljivali simptomi i egzacerbacije. Postoji podjela lijekova na dvije skupine: lijekovi koji se koriste kod dugotrajne primjene i lijekovi koji imaju brzo djelovanje kod smanjenja simptoma. Najčešće se koriste inhalacijski kortikosteroidi i bronhodilatatori, svaki u svoju svrhu liječenja. U radu je prikazano istraživanje čiji cilj rada je bio ispitati neke od aspekata kvalitete života oboljelih od astme. Istraživanje je provedeno preko Google obrasca i anketni upitnik su ispunjavali osobe s utvrđenom dijagnosticiranom astmom ili su odgovarali za člana svoje obitelji ukoliko mu je dijagnosticirana astma. Istraživanje je bilo anonimno i dobrovoljno te je sudjelovao 197 sudionika. Iz navedenih rezultata, kvaliteta života osoba s astmom ovisi od osobe do osobe i o težini same bolesti te sudionici imaju različite stavove o bolesti. Asthma is a chronic disease in which acute bronchial obstruction occurs with possible more severe breathing difficulties that can occur at any time of the day, most commonly over the night or early in the morning. The disease itself is one of the most common chronic diseases and is estimated that around 300 million people worldwide is ill from it, and it is estimated that by 2025 that number will increase by another 100 million people. Most asthma deaths occur in people in poorer countries. According to the Global Asthma Initiative, it is divided into permanent and intermittent asthma. Permanent asthma is divided into 3 stages of the disease, and these are mild permanent, moderate permanent and severe permanent asthma. Anamnestic data, physical examination, lung function tests, laboratory tests, allergy tests and X-rays of the lungs are used to diagnose asthma. The goal of treatment is to achieve disease control so that symptoms and exacerbations do not occur. There is a division of medicines into two groups: medicines used for long-term use and medicines that have a fast action in reducing symptoms. Inhaled corticosteroids and bronchodilators are most commonly used, each for its own purpose of treatment. The paper presents a study whose aim was to examine some aspects of the quality of life of patients with asthma. The study was conducted via a Google form and the study questionnaire was completed by people diagnosed with asthma or answered for a member of their family if this family member was diagnosed with asthma. The study was anonymous and voluntary and involved 197 participants. From these results, the quality of life of people with asthma depends on the person and the severity of the disease itself, and participants have different views on the disease.

Astma u djece najčešće počinje u ranoj dobi i ima varijabilan tijek i različitu kliničku pojavnost. U djece se astma očituje različitim fenotipovima koji se mogu preklapati, ući u remisiju, ali i perzistirati do odrasle dobi. Razlikovanje astme od ponavljanog piskanja povezanog s drugim bolestima u prvim godinama života nije jednostavno. Astma u školske djece i adolescenata značajno je češće povezana s alergijom nego astma u odraslih. Klinička ekspresija bolesti, važnost alergije i nespecifičnih čimbenika u pokretanju simptoma i egzacerbacija astme, dijagnostika, praćenje upalnih zbivanja u bronhima, kao i liječenje, u djece se razlikuju od astme u odraslih. Na temelju ovih spoznaja formirane su internacionalne i nacionalne smjernice usredotočene samo na dječju astmu. U ovom tekstu iznesene su suvremene postavke o posebnostima astme dječje dobi., Asthma in children usually occurs at an early age and has a variable course and a diff erent clinical appearance. In children, asthma exhibits different phenotypes, which may overlap, enter into remission, but also persist into adulthood. It is not easy to diff erentiate asthma from recurrent wheezing associated with other diseases in the first years of life. Asthma in school children and adolescents is significantly more often associated with allergies than asthma in adults. Clinical expression of the disease, the importance of allergy and nonspecific triggers in the initiation of symptoms and asthma exacerbations, diagnostics, monitoring of bronchial inflammation, as well as the treatment itself in children are diff erent from those found in adults. Based on these findings, international and national guidelines have been established, focusing exclusively on paediatric asthma. This paper presents contemporary standpoints on the specific features of asthma in children.

Izloženost alergenima na radnom mjestu u današnje je vrijeme sve učestalija. Najčešće profesionalne alergijske bolesti za koje se može dokazati povezanost bolesti i radne ekspozicije, utvrditi oštećenje funkcije i/ili morfologije te dijagnostičkom obradom potvrditi bolest su: profesionalni alergijski rinitis, profesionalna astma, alergijski alveolitis te kontaktni alergijski dermatitis. U radu su opisani dijagnostički algoritmi diferencijalne dijagnoze radi potvrde dijagnoze profesionalne bolesti te poduzimanja mjera za očuvanje funkcionalne sposobnosti zaposlenika., Exposure to allergens at workplace is more frequent nowadays. The most common occupational allergic diseases with proven association of the disease and occupational exposure determining damage to function and/or morphology and confirming the disease by diagnostic workup are occupational allergic rhinitis, occupational asthma, allergic alveolitis and allergic contact dermatitis. This paper describes diagnostic algorithms of differential diagnosis to confirm the diagnosis of occupational disease and to take measures for preserving functional capacity of the employees.

Definirana kao strah od javljanja anksioznih simptoma i tjelesnih senzacija povezanih s anksioznošću, anksiozna osjetljivost ima značajnu kliničku primjenu ne samo u prevenciji i terapiji anksioznih poremećaja, već osobito u području zdravstvene psihologije i ispitivanja načina na koje se mladi pacijenti suočavaju s boli i bolesti. U ovom radu prikazani su rezultati istraživanja u kojem su sudjelovala ukupno 184 ispitanika u dobi od 10 do 15 godina, iz četiri uzorka: (1) uzorak djece koja boluju od glavobolje (N=43), (2) uzorak djece koja boluju od astme (N=46), (3) uzorak djece koja doživljavaju veći broj psihosomatskih simptoma (N=53) i (4) kontrolni uzorak djece bez zdravstvenih tegoba (N=42). Uspoređeni su rezultati ove četiri skupine ssva tri klinička i kontrolnog uzorka, dok između djece s glavoboljama, astmom i psihosomatskim simptomima nema značajne razlike. Djeca u navedena tri klinička uzorka imaju značajno više rezultate na skali anksiozne osjetljivosti. Nadalje, u kliničkim uzorcima djece utvrđeni su specifični obrasci povezanosti anksiozne osjetljivosti s ostalim aspektima anksioznosti (separacijskom, socijalnom, ispitnom, opsesivno-kompulzivnom i dr.). Rezultati ovog istraživanja pokazuju da je ispitivanje anksiozne osjetljivosti kod djece koja imaju različite zdravstvene tegobe od osobitog značenja za psihološki terapijski i preventivni rad., Anxiety sensitivity is described as the fear of anxiety symptoms and physical sensations associated with anxiety. Understanding this fear of fear has particular importance in prevention and therapy of anxiety disorders, and especially in health psychology and ways of coping with health problems and illness in children and adolescents. The paper presents the results of the research in the sample of 184 participants in the age between 10 and 15 years, divided in 4 samples: 1) children with headaches in pediatric care (N=43), 2) children with asthma in pediatric care (N=46), 3) children reporting significant number of psychosomatic symptoms (N=53), and 4) healthy controls (N=42). These four samples were compared according to the level of the reported anxiety sensitivity. Significant differences in anxiety sensitivity were found between three clinical samples and control sample, with children in clinical samples being more afraid of their anxiety symptoms. Differences in anxiety sensitivity were not found between clinical samples (children with headaches, asthma and psychosomatic symptoms). Furthermore, specific patterns of relations between anxiety sensitivity and other aspects of anxiety (separation anxiety, social anxiety, test anxiety, etc.). Results from this study indicate the importance of anxiety sensitivity in the prevention and therapy in helping children with health children.