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Introduction: By providing a course to nurses on non-invasive ventilation, do we have positive results about the success of the course. Aims: To see and compare the performance of the course delivered through a lecture, workshop, and examination of the acquired knowledge in the exam. Method: A total of 5 courses were held at the Dept. for Respiratory Diseases, UHC Zagreb, Croatia and at the General Hospital Koprivnica, Croatia in 2017. The course consisted of five theoretical lectures and a two-part workshop. Before and after the course, the students had completed an examination containing 20 questions and filled out an evaluation sheet assessing the theoretical part and workshops with grades 1-5. This course in the form of an e-course is posted on the web site of the Croatian Chamber of Nurses, with five lectures and a knowledge exam. Results: A total of 89 nurses attended the course. Before the course, the clearance rate was 68% and after the course 90%. E-course 2017/2018 was attended by 810 students and successfully passed by the 80.3% course. The students filled out evaluation sheets in which they assessed the course leaders with a grade of 5. Conclusion: The purpose of the course was to educate staff on the application of the NIV for increasing application beyond the intensive care unit. The success of the course was expressed in a 90% pass rate after the course was held.

Introduction: Is the number of invasively ventilated patients reduced by the timely application of non-invasive mechanical ventilation Aims: To see whether the number of patients undergoing invasive mechanical ventilation has decreased since the initiation of non-invasive ventilation. Method: At the Department for Respiratory Diseases, ICU we monitored patients who used non-invasive ventilation from year 2012 to year 2018. The parameters we recorded are the diagnosis under which the patient was admitted, the time spent on mechanical ventilation, the type of interface the patient uses, the change of interface and the reason for the change, the range of saturation, the state of consciousness, and the evaluation. Results: In 2012, out of a total of 613 patients in the intensive care unit, 2% of patients used non-invasive ventilation, 11.4% of patients used invasive mechanical ventilation, and 1.1% of patients used the combination of invasive and non-invasive. The number of invasive ventilated patients decreases over the years and the number of non-invasively ventilated patients increases. In 2018, out of a total of 510 patients, 7.6% were invasively mechanically ventilated, a combination of invasive and non-invasive was performed by 3.3% of patients, and 10.2% of patients were non-invasively ventilated. Conclusion: In six years we can conclude that the use of non-invasive ventilation reduces the number of invasive ventilation. The success of NIV therapy increases with the growth of the overall team experience.

Background: Hospitalization and occurrence of anxiety and depression are closely linked, what role sociodemographic characteristics have in the development of these conditions Aims: Are there statistically significant differences in sociodemographic characteristics with levels of anxiety and depression in hospitalized patients with COPD. Method: A study was conducted at the Clinic for lung diseases on a sample of hospitalized patients with COPD(N=50), in order to determine presence of anxiety and depression and it’s correlation with sociodemographic characteristics. These are the results from May to July 2016. Criteria for the selection of COPD patients: monitored by our clinic and 40 – 80 years of life. For the study were used the following measuring instruments: Hospital Anxiety and Depression Scale (HADS). Questions that were additionally included in the questionnaire are general sociodemographic data, and data on the basic characteristics and duration of the disease Results: A large number of respondents had anxiety (56%) and border anxiety (26%) ; presence of depression (28%) and border depression (48%) (N=50). Respondents who were divorced, singles or widows and under the age of 60 were statistically significantly more anxious. There were no statistically significant differences between the sexes and the employment status. Conclusion: According to the obtained data, we can conclude that the certain sociodemographic characteristics present negatively affect on the health and quality of life, therefore it is necessary to include family members, friends, support groups and if necessary to ensure professional, psychological help.

Background: Are there statistically significant differences in anxiety and depression between the COPD patients admitted in ICU and hospital ward Aims: To compare presence of anxiety and depression in hospitalized patients with COPD and to determine the correlation of the data between the patients admitted in ICU and hospital ward. Method: A prospective trial was conducted at the Clinic for lung diseases on a sample of hospitalized patients with COPD in ICU(N=35), and hospital ward (N=15), in order to determine presence of anxiety and depression and compare data between the patients admitted in ICU and hospital ward. These are the results from May to July 2016. Criteria for the selection of COPD patients: monitored by our clinic and 40 – 80 years of life. For the study were used the following measuring instruments: Hospital Anxiety and Depression Scale (HADS). Questions that were additionally included in the questionnaire are general sociodemographic data, and data on the basic characteristics and duration of the disease. Results: There were no statistically significant differences on the presence of anxiety and depression, regardless of the number of days of hospitalization. Subjects who were in the ICU ward, a statistically significant were more anxious than those subjects who were in hospital ward. On mechanical ventilation, were 6 subjects (12%) (N=35). Subjects who were mechanically ventilated statistically were more anxious. Conclusion: According to the obtained data, we can conclude during admission COPD patients to the ICU there was a higher risk of developing anxiety and depression, additionally in those on mechanical ventilation increases the likelihood of developing the same discomfort.

Background: Nephrotic syndrome (NS) is one of the most frequent glomerular diseases among children. While most of the children with primary NS respond to steroid treatment, 10 to 20% of the patients are steroid-resistant, and the best therapy for such cases has never been defined. Objective: The present study aimed to evaluate steroid-resistant nephrotic syndrome (SRNS) patients. Materials and methods: Our research included 50 children (56% female and 44% male) with NS. NS was defined as the presence of edema, massive proteinuria, hypoalbuminemia and hyperlipidemia. Patients with NS were treated according to international protocol. SRNS was diagnosed in patients with idiopathic NS based on lack of complete remission despite treatment with steroids. Renal biopsy was performed in 22 patients with SRNS at the Pediatric Clinic II of the University Clinical Center in Sarajevo (UCCS). Histopathologic analyzes of renal biopsy were performed at the Department of Pathology, University Clinical Center in Tuzla (UCCT). Patients with SRNS, after kidney biopsy were treated with nonsteroidal immunosuppressantÂ’s. Results: Eight (36.4%) of the 22 patients who had undergone renal biopsies had minimal change disease (MCNS) and seven (31.8%) had focal segmental glomerulosclerosis (FSGS). The immunosuppressive drugs used in SRNS were Cyclosporine (CsA), Cyclophosphamide (CYC), Mycophenolat mofetil (MMF) and Rituximab (RTX). Three patients (13.6%) did not respond to any treatment and had developed end - stage renal disease (ESRD). Conclusion: With current treatments, some children will ultimately achieve a sustained remission with one of the second line or third line of the proposed drugs. Patients with refractory NS will go to progression towards ESRD. The rapid development of molecular genetics will give a new contribution to the pathogenesis and treatment of this disease.