Koronavirusna bolest u 2019. godini (COVID-19) uzrokovana je novootkrivenim korona virusom tipa 2 koji uzrokuje teški akutni respiratorni sindrom (SARS-CoV-2). Virus je otkriven u prosincu 2019. godine, a od strane Svjetske zdravstvene organizacije je, zbog broja oboljelih i proširenosti širom svijeta, proglašena pandemija. Klinička prezentacija COVID-19 varira od asimptomatskog do teškog oblika i smrtnog ishoda. Iako kliničkom slikom dominiraju respiratorne smetnje, mnogobrojne studije ukazuju na pojavu akutnih i kroničnih neuroloških komplikacija u skoro trećine oboljelih. Najčešći neurološki simptomi akutne faze COVID-19 su glavobolja, gubitak njuha i okusa, poremećaji stanja svijesti, encefalopatije, encefalitisi, moždani udar, bolovi u mišićima, epileptički napadaji, poliradikulopatije (GBS) te pojačan umor i netolerancija napora, poremećaji vegetativnih funkcija, kognitivne i psihičke smetnje u postinfekcijskoj fazi oboljenja. Potencijalni patofiziološki mehanizam nastanka neuroloških poremećaja u akutnoj fazi uključuje koagulopatije s udruženim hipoksično-ishemijskim oštećenjima, poremećajem krvno-moždane barijere, endoteliopatijama i neuroinvazijom virusa, udruženom s neuro-imunim odgovorom. Cilj ovog članka je prikazati najčešće akutne i kronične neurološke poremećaje vezane uz COVID-19 kod odraslih bolesnika kao i potencijalni patofiziološki mehanizam nastanka neuroloških poremećaja, a buduće epidemiološke studije o bolesnicima s COVID-19 bi trebali utvrditi pravu incidenciju neuroloških komplikacija COVID-19, razgraničiti specifične neurološke sindrome, postaviti dijagnostičke i terapijske protokole ta razjasniti mehanizam nastanka poremećaja.
<p><strong>Aim</strong> <br />To assess trends in thrombolysis rates and door-to-needle times in University Hospital Mostar.<br /><strong>Methods</strong> <br />Data from the University Hospital Mostar Registry were used. Information on the number of ischaemic stroke patients, intravenous thrombolysis rates and &bdquo;door-to-needle times&ldquo; (DNT) were collected between January 2013 and December 2021.<br /><strong>Results</strong> <br />Out of the total of 3100 ischaemic stroke patients, alteplase was given to 130 patients giving a thrombolysis rate of 4.2%.<br />The mean hospital thrombolysis rate increased from 2.4% in 2013 to 10.6% in 2021.<br /><strong>Conclusion</strong> <br />Although the hospital thrombolysis rate more than quadrupled, there is still a low proportion of acute ischaemic stroke<br />patients who received intravenous thrombolysis therapy. Education and interventions indicating the importance of recognition and treatment of acute ischemic stoke are necessary for all physicians.</p>
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