The aim of this study was to compare two adjunct therapies in the treatment of childhood rotavirus gastroenteritis (RVGE). We compared the recommended treatment, probiotic
DSM 17938 (BioGaia®), vs. a ...novel treatment, enterosorbent polymethylsiloxane polyhydrate (Enterosgel®).
This was an open-label, randomized, clinical controlled trial at the University Hospital for Infectious Diseases (UHID) in Zagreb, Croatia. A total of 149 children aged 6-36 months with acute rotaviral gastroenteritis over a period of <48 h, with no significant chronic comorbidity, were randomized to receive the standard therapy with
DSM 17938 (hereafter
) or polymethylsiloxane polyhydrate (hereafter PMSPH) therapy, during 5 days. The primary end point was time to recovery in days in both groups. The recovery was defined as absence of fever and vomiting and either the first firm stool, absence of stool for more than 24 h, or return of usual bowel habit.
A total of 75 children were randomized into the
group and 74 were randomized into the PMSPH group; after excluding missing data, the data from 65 children in each group were analyzed. There was no significant difference in the treatment efficacy between the two regimens with an estimated median time of recovery of 6 days in both groups (
= 0.754). No significant side effects were observed in either group.
Novel enterosorbent PMSPH had a similar efficacy to probiotic
in the treatment of rotaviral gastroenteritis in preschool children.
ClinicalTrials.gov Identifier: NCT04116307 October 3, 2019 (retrospectively registered). https://clinicaltrials.gov/show/NCT04116307.
The era of pediatric HIV-infection in Croatia began in 1987 when the first child from an HIV-infected mother was born. The authors present some medical data of children diagnosed as HIV-infected or ...observed because of maternal HIV-infection in Croatia until the end of 2005. Although the number of HN-infected children in Croatia is still relatively small, in the last two decades the Croatian society was confronted with many ethical and social issues regarding HIV-infection and discrimination. There were many obstacles in providing proper care and integrating HIV-infected children in the Croatian society. Stigmatisation, fear and lack of knowledge were major contributors. For the first time, the integration of an HIV-infected child with revealed HIV-status into school was described. Changes in attitudes towards HIV-infected people can only be achieved through planned permanent educational programs.
Svrha rada bila je prikazati dječaka kod kojeg je tijekom adenovirusne infekcije otkrivena mezijalna temporalna skleroza, uz razvoj Miller Fisherovog sindroma drugog dana bolesti. Razvio je i ...aseptički meningitis kao nuspojavu terapijske primjene intravenskog imunoglobulina. Postupno dolazi do regresije neuroloških simptoma te se liječenje mezijalne temporalne skleroze nastavilo u drugoj ustanovi.
We compared the survival of patients following the first AIDS event in Croatia from the period 1986-1996 to the period 1997-2000. A total of 72 (81.8%) out of 88 patients from 1986-1996 and 18 ...(32.1%) out of 56 from 1997-2000 died. Survival following the first AIDS-defining illness markedly improved in the period 1997-2000 compared to the period 1986-1996 (adjusted Hazard Ratio (HR) for patients surviving more than 6 months: 0.11, 95% confidence interval (95% CI) = 0.04-0.29). A CD4+ cell count of < 100 x 10(6)/L was an independent risk factor for patients surviving up to 2 years (adjusted HR = 1.96, 95% CI = 1.1-3.43, p = 0.02). Patients with tuberculosis or fungal infections had a longer survival when compared to other diagnosis (adjusted HR = 0.53, 95% CI = 0.32-0.90, p = 0.01). However, despite dramatic survival benefit of combination antiretroviral therapy, mortality at six months following the first AIDS event was similar in the two study periods and the one-year probability of death was still substantial (27.2%) in the period 1997-2000.
The aim of this study was to determine and compare the incidence of various ophthalmlogic changes before anfd after the initiation of highly active antiretroviral therapy (HAART) in HIV-infected ...patients treated at the University Hospital for Infectious Diseases "Dr. Fran Mihaljević" in Zagreb. This retrospective longitudinal analysis included all adult patients with confirmed HIV-1 infection divided into two groups: period before HAART (1995-1997) and period after HAART (1998-2000). Only those patients who underwent at least two ophthalmologic examinations in any of the two or in both periods were considered eligible. In total, 85 patients were enrolled in the study, 50 during the 1995-1997 period and 47 in the period 1998-2000 (12 patients were monitored in both periods). The mortality rate was significantly lower in patients treated during the HAART era, with an average decrease in mortality rates of 59.3%. During the period of ophthalmologic monitoing from 1995 to 1997, only 9 (18%) patients received HAART, and 33 (70.2%) in the period 1998-2000. In total, 208 ophthalmic abnormalities were recorded, 132 (63.5%) in the first and 76 (36.5%) in the second period. Vascular changes were most frequently diagnosed (113/208 or 54.3% cases) of which cotton-wool exudates in 55 and microaneurysms in 54 cases. Cytomegalovirus (CMV) retinitis was most commonly diagnosed among infectious ocular complications (altogether 39 episodes). Changes in the anterior segment were observed in only 11/208 (5.3%) cases, while neuro-ophthalmic manifestations were sees in 39/208 patients (18.7%). The incidence of CMV-retinitis episodes in the first monitored period was 57.2 (95% CI, 38.5-86.6) per 100 years of follow-up and in the HAART era 7.6 (95% CI, 1.6-22.4; p<0.0001) per 100 years of follow-up. The visual acuity in patients from the HAART era was significantly more frequently preserved than in patients from the pre HAART era on follow-up examinations (p<0.001). Our study showed that the incidence of CMV-retinitis declined significantly in the period 1998-2000, while the decrease in the incidence rates of other ocular manifestations was less profound. In contrast to the pre HAART era, there was no worsening of visual acuity in the HAART era.
Tuberkuloza središnjeg živčanog sustava je rijedak oblik bolesti s visokom smrtnosti i rizikom trajnih neuroloških posljedica, ako se ne prepozna na vrijeme. Kliničke, laboratorijske i radiološke ...manifestacije su obično nespecifične, što odgađa donošenje ispravne dijagnoze i početak liječenja.
U radu je prikazano dijete s tuberkulozom središnjeg živčanog sustava koja se manifestirala netipičnim laboratorijskim nalazima i rijetkim milijarnim intrakranijskim tuberkulomima. Znakovi aktivne tuberkuloze izvan središnjeg živčanog sustava u kombinaciji s prikrivenim tijekom bolesti izazvali su sumnju na tuberkulozu. Antituberkulozno liječenje je odmah započeto, a bolesnica se oporavila u potpunosti, bez trajnih neuroloških posljedica.
We compared the survival of patients following the first AIDS event in Croatia from the period 1986–1996 to the period 1997–2000. A total of 72 (81.8%) out of 88 patients from 1986–1996 and 18 ...(32.1%) out of 56 from 1997–2000 died. Survival following the first AIDS-defining illness markedly improved in the period 1997–2000 compared to the period 1986–1996 (adjusted Hazard Ratio (HR) for patients surviving more than 6 months: 0.11, 95% confidence interval (95% CI)=0.04–0.29). A CD4+ cell count of <100 x 10*6/L was an independent risk factor for patients surviving up to 2 years (adjusted HR=1.96, 95% CI=1.1–3.43, p=0.02). Patients with tuberculosis or fungal infections had a longer survival when compared to other diagnosis (adjusted HR=0.53, 95% CI=0.32–0.90, p=0.01). However, despite dramatic survival benefit of combination antiretroviral therapy, mortality at six months following the first AIDS event was similar in the two study periods and the one-year probability of death was still substantial (27.2%) in the period 1997–2000.
The era of pediatric HIV-infection in Croatia began in 1987 when the first child from an HIV-infected mother was
born. The authors present some medical data of children diagnosed as HIV-infected or ...observed because of maternal
HIV-infection in Croatia until the end of 2005. Although the number of HIV-infected children in Croatia is still relatively
small, in the last two decades the Croatian society was confronted with many ethical and social issues regarding HIV-infection
and discrimination. There were many obstacles in providing proper care and integrating HIV-infected children
in the Croatian society. Stigmatisation, fear and lack of knowledge were major contributors. For the first time, the integration
of an HIV-infected child with revealed HIV-status into school was described. Changes in attitudes towards HIV-
-infected people can only be achieved through planned permanent educational programs.
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