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Coronavirus disease 2019 (COVID-19), caused by the late 2019 outbreak of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), causes a respiratory disease which could put myasthenia gravis (MG) patients at a greater risk of developing severe disease course, since infections and some drugs are a well-recognized trigger of symptom exacerbation in MG patients. Out of ten most commonly used past and present drugs used in COVID-19 treatment, two (quinolone derivatives and azithromycin) are known to worsen MG symptoms, whereas another two (tocilizumab and eculizumab) might have positive effect on MG symptoms. Colchicine, remdesivir, lopinavir, ritonavir and favipiravir seem to be safe to use, while data are insufficient for bamlanivimab, although it is also probably safe to use. Considering MG treatment options in patients infected with SARS-CoV-2, acetylcholine esterase inhibitors are generally safe to use with some preliminary studies even demonstrating therapeutic properties in regard to COVID-19. Corticosteroids are in general safe to use, even recommended in specific circumstances, whereas other immunosuppressive medications (mycophenolate mofetil, azathioprine, cyclosporine, methotrexate) are probably safe to use. The only exception is rituximab since the resulting B cell depletion can lead to more severe COVID-19 disease. Concerning plasmapheresis and intravenous immunoglobulins, both can be used in COVID- 19 while taking into consideration thromboembolic properties of the former and hemodynamic disturbances of the latter. As current data suggest, all known COVID-19 vaccines are safe to use in MG patients., Koronavirusna bolest 2019 (COVID-19) uzrokovana širenjem virusa SARS-CoV-2 izaziva respiracijsku bolest koja potencijalno može dodatno ugroziti pacijente koji boluju od mijastenije gravis. Uz infekcije, egzacerbaciju simptoma mijastenije gravis mogu uzrokovati i neki lijekovi. Od deset najčešće primjenjivanih skupina lijekova za liječenje COVID-19, dvije skupine lijekova (kinoloni i azitromicin) mogu uzrokovati pogoršanje simptoma mijastenije gravis, a dvije skupine lijekova (tocilizumab i ekulizumab) imaju pozitivne učinke na simptome mijastenije gravis. Kolhicin, remdesivir, lopinavir, ritonavir i favipiravir nemaju učinka na simptome mijastenije gravis, dok su podatci za bamlanivimab nedostatni, no isti je vjerojatno siguran za upotrebu u bolesnika s mijastenijom gravis. Što se tiče primjene lijekova za mijasteniju gravis kod bolesnika zaraženih virusom SARS-CoV-2, inhibitori acetilkolinestaraze su u pravilu sigurni za primjenu; neke studije su čak dokazale i terapijske mogućnosti navedenih lijekova u liječenju COVID-19. Kortikosteroidi su uglavnom sigurni za primjenu, a čak se i preporučaju u određenim okolnostima, dok su ostali imunosupresivi (mikofenolat mofetil, azatioprin, ciklosporin i metotreksat) sigurni za primjenu. Jedina iznimka je rituksimab učinak kojega na B-staničnu imunost može rezultirati težom kliničkom slikom bolesti COVID-19. Plazmafereza i intravenski imunoglobulini, dvije najčešće primjenjivane terapijske opcije liječenja akutnih egzacerbacija mijastenije gravis, mogu se primijeniti kod bolesnika s COVID-19 uzimajući u obzir tromboembolijske učinke intravenskih imunoglobulina, odnosno hemodinamske učinke plazmafereze. Sva cjepiva COVID-19, koliko je poznato, sigurna su za primjenu u bolesnika s mijastenijom gravis.

Epilepsija je najčešća kronična neurološka bolest i za sada jedina koja se lijekovima može u potpunosti staviti pod kontrolu. Pa ipak, liječenje epilepsije u više od polovice bolesnika je dijagnostički i terapijski izazov. U svakodnevnom kliničkom radu ponekad je prva dilema kada započeti antiepileptičku terapiju. Nadalje oko 50% bolesnika s epilepsijom zadovoljavajuće reagira na prvi antiepileptik (AEL). Prvi korak u ovakvim slučajevima nije promjena terapije već ponovno ispitivanje anamneze i heteroanamneze radi provjere postavljene dijagnoze. Naime, više od trećine farmakorezistentnih bolesnika uopće nema epilepsiju već neepileptičke napadaje različite geneze, ali se nažalost godinama neuspješno i nepotrebno liječe AEL. Nakon potvrde dijagnoze preporučljivo je umjesto rane politerapije pokušati zamjensku monoterapiju najprikladnijim lijekom. Budući da se u većine bolesnika koji dobro reagiraju na prvi AEL, zadovoljavajući učinak postiže srednjim ili malim dozama, princip započinjanja liječenje je doista "start low and go slow", odnosno uvođenje AEL u niskim dozama i spora titracija do zadovoljavajućeg učinka. Oluka o izboru AEL ovisi o nizu čimbenika, a među najbitnijima su vrsta epilepsije/sindroma, spol, komorbiditet, komedikacija , dob, zanimanje te također niz drugih individualnih čimbenika.

The demographic profile of the Republic of Croatia is changing intensively. According to published research, it is estimated that soon every fourth resident in Croatia including the City of Zagreb will be older than 65 years. Increased number of the elderly also increases the need for elderly care. Long-term care services make people dependent on someone else's help over a longer period. Help most usually involves satisfying basic daily activities such as feeding, bathing, dressing, moving, maintaining personal hygiene, doing housework, and other similar activities. The aim of this work was to determine the functional status of the elderly in the City of Zagreb, and to investigate whether there are differences in self-assessed personal quality of life and functional status depending on whether the health care in the home of the elderly is provided. The study was conducted on elderly of both sexes (N = 100) from the City of Zagreb divided into the group of those who receive health care at home and those who have no need for such care. Structured questionnaire with sociodemographic issues of WHOQOL-BREF and scale of Bartel's daily activity index were assessed. The study showed statistically significant differences in functional ability between the observed groups. The elderly receiving home health care have grater functional disability compared to the group of elderly not receiving home health care despite no statistically significant differences between groups in self- assessed quality of life.

The aim of our study was to estimate the burden and current patterns of migraine in Croatia. This was public health study conducted from April to June 2013 in Croatia. A questionnaire with 10 qustions was sent to 2750 e-mail addresses, randomly chosen from various internet sites. Out of 2750 sent questionnaires, 246 respondents declared having migraine ; 209 (85%)were women(56.5% aged 18-49 years ; 28.7% aged 46-65 years) ; 37 (15%) were men (8.1% aged 18-45 years and 6.5% aged 46-65 years).Migraine in under-treated and represents a major public health problem.

The aim of this study was to investigate the efficacy of acute and prophylactic migraine therapy in a group of patients with 10 migraines per month. ALL patients with migraine who attended the outpatient care service due to headache during 2011 were analysed. Migraine was diagnosed according to the ICHD II criteria. More attention should be given to patients with frequent attacks in order to provide them with a more efficient therapy.

Aim of this study was to investigate the diagnoses and treatment patterns of patients with chief compalint of headache in a tertiary outpatient care of the university-affiliated hospital center in Zagreb.All consecutive patients with headache that attended one single tertiary outpatient care service during 2011 were analysed. The type of headache eas diagnosed according to the ICHD II criteria. A total of 478 patient charts were analyzed ; 398 (81.4%) women, of average age of 44 years and 89 (18.6%)men of average age of 42 years.The majority of migraine patients was taking triptans, and was satisfied with their therapy. One third of the patients require prophylactic therapy.