Dengue is acute viral disease transmitted to humans by Aedes mosquitoes (Ae. aegypti, Ae. albopictus). Dengue virus belongs to the family Flaviviridae, genus Flavivirus. There are four dengue virus ...serotypes (1-4) which are maintained endemically. The disease is endemic in tropical and subtropical areas between latitudes 35 degrees N and 35 degrees S. Infections may be asymptomatic or may produce a wide spectrum of diseases: non-specific febrile illness, dengue fever, dengue haemorrhagic fever or dengue shock syndrome. For the first time in Croatia, Ae. albopictus was registered in Zagreb in October 2004. In autumn 2005, additional records of Ae. albopictus presence were made in many places along the Adriatic coast. During 2007, two cases of imported dengue fever were reported in Croatia, after which similar imported cases appeared continually. In August 2010, the first autochthonous case of dengue fever was recorded on the peninsula Peljesac. Though Croatia is not endemic for dengue, the existence of a corresponding vector and a latent threat by imported dengue cases demand state-of-the-art and timely diagnostics. The most commonly used methods in laboratory diagnosis of dengue infections involve detection of viral RNA, antigen detection and serologic methods (detection of antibodies).
Early diagnosis of leptospirosis Babic-Erceg, Andrea; Karlovic-Martinkovic, Diana; Santini, Marija ...
Infectious disease reports,
06/2014, Letnik:
6, Številka:
2
Journal Article
Recenzirano
Odprti dostop
A 25-years old man from Zagreb, Croatia, was admitted to the University Hospital for Infectious Diseases four days after the onset of symptoms such as fever, intense pain in the calves and anuria. ...The patient owned a rabbit and, before the onset of the disease, repaired some rubber pipes damaged by rodents. At admission, he had a severe clinical picture with fever, hypotension, jaundice, immobility, and pain in leg muscles. Treatment with ceftriaxone was initiated in combination with volume restitution. Renal failure soon ensued. Consequently continuous venovenous hemodiaphiltration therapy was performed. Due to acute respiratory distress syndrome, the patient was mechanically ventilated. The patient’s condition gradually improved and he recovered fully from multi-organ failure. Diagnosis was confirmed by a microscopic agglutination test (MAT) covering 15 leptospira serovars and real-time polymerase-chain reaction (PCR). The first serum sample taken on day 6 tested negative for leptospira, while PCR showed positive results for leptospiral DNA. The second serum sample taken on day 13 tested positive for serovar Canicola serogroup Canicola, serovar Patoc, serovar Grippotyphosa serogroup Grippotyphosa and serovar Tarassovi serogroup Tarassovi (titre 4000, 4000, 1000 and 2000, respectively), while PCR was negative. This report highlights the benefits of combining MAT and PCR methods in early diagnosis of leptospirosis.
National public health information system Erceg, Marijan; Stevanović, Ranko; Babić-Erceg, Andrea
Acta medica Croatica,
2005, Letnik:
59, Številka:
3
Journal Article
Information production and its communication being a key public health activity, developing modern information systems is a precondition for its fulfilling these assignments. A national public health ...information system (NPHIS) is a set of human resources combined with computing and communication technologies. It enables data linkage and data coverage as well as undertaking information production and dissemination in an effective, standardized and safe way. The Croatian Institute of Public Health LAN/WAN modules are under development. Health Safety System, Health Workers Registry, and Digital Library are among the Institute's developmental priorities. Communication between NPHIS participants would unfold over the Internet by using every relevant data protection method. Web technology-based applications would be run on special servers. Between individual applications, use would be made of the transaction module of communication through an exchange of the HL7 standard-based xml messages. In the conditions of transition, the health system must make an optimal use of the resources, which is not feasible without applying modern information and communication technologies.
The influence of torsion (τ ⩽ 30π/m) and tensile stress (σ ⩽ 45 MPa) on the process of magnetization and the domain structure of as-quenched amorphous Fe80B20 and Fe73.5Cu1Nb3Si15.5B7 alloys has been ...studied by means of the direct (JD) and alternating (J) currents following along the ribbon. The application of the model for the influence of field Hp, generated by the core current, on the process of magnetization (the dM/dt vs. H curves and the M-H loops) shows that torsion increases both the average angle 〈δ〉 between the magnetizations (I) of the domains participating in the process of magnetization and the ribbon axis and the strength 〈Su〉 of the domain wall pinning centers within the ribbon, whereas the tensile stress reduces both 〈δ〉 and 〈Su〉. Initially both stresses increase the maximum magnetization Mm0 (at the given field amplitude H0) which implies that sizable fraction of domains does not contribute to magnetization along the ribbon axis in the unstressed state. This provides an insight into the magnetic properties of the as-quenched magnetostrictive ribbons in the unstressed state.
Symptoms of tuberculous orchiepididymitis in a 39-year-old male started with swelling of left scrotum, followed by fistula formation with suppurative discharge. There was no any improvement produced ...by antibiotics. Surgical extirpation of inflammatory destroyed testicle and epidydimis was performed. Presence of tubercle bacilli was not shown by bacteriological analysis of testicle tissue. Tuberculous etiology was suggested after histopathological examination of testis and epididymis. Exudate from surgical wound was examined on presence of Mycobacterium tuberculosis DNA. Etiology of orchiepididymitis was proved by positive assay and inflammatory process was completely cured by antituberculotics therapy. By this report it was clearly shown that sometimes only molecular methods could confirm etiology of inflammatory process.
Laceracija dušnika je rijetka, ali ozbiljna komplikacija koja se može javiti nakon endotrahealne intubacije. Pojavljuje se s incidencijom od 0,01 do 0,37 % ovisno o izvoru (1-4). Prikazujemo slučaj ...61-godišnjeg bolesnika koji je primljen u jedinicu intenzivnog liječenja kirurških bolesnika u Kliniku za anesteziologiju, reanimatologiju i intenzivno liječenje Kliničkog bolničkog centra Zagreb nakon operacije karcinoma završnog dijela debelog crijeva. Bolesnik se pola sata nakon dolaska
naglo klinički pogoršava uz sinus tahikardiju, hipotenziju, hipoksiju te abdominalnu distenziju. Ultrazvukom prsnog koša dokaže se tenzijski pneumotoraks koji se inicijalno zbrinjava perkutanom dekompresijskom iglom. Na rendgenogramu prsnog koša pokaže se pneumotoraks obostrano. Kompjuteriziranom tomografi jom prsnog koša se dodatno pokaže pneumomedijastinum i suspektna laceracija dušnika koja se na bronhoskopiji vidi kao blagi eritem sluznice. Pacijent je u jedinici intenzivnog liječenja proveo 4 dana, uz primjenu antibiotika širokog spektra i cijelo vrijeme boravka bio stabilan.
Zika virus (ZIKV) izoliran je 1947. godine iz majmuna na području šume Zika u Ugandi. Do 2007. godine virus se održavao u enzootskom ciklusu na području Afrike uz sporadične humane slučajeve. Nakon ...epidemije 2007. godine na mikronezijskom otoku Yap bilježe se epidemije na pacifi čkim otocima, a 2015. godine virus je unesen u Brazil odakle se proširio Srednjom i Južnom Amerikom. U prirodnom se ciklusu ZIKV održava između majmuna i različitih vrsta komaraca roda Aedes. U urbanom su ciklusu rezervoar ljudi, a vektori komarci Ae. aegypti i Ae. albopictus. Interhumani prijenos moguć je transfuzijom krvi, presatkom organa, spolnim putem te sa zaražene majke na dijete transplacentno/tijekom poroda. U većine zaraženih osoba (~80 %), ZIKV infekcija prolazi asimptomatski. Klinički se infekcija u >95 % oboljelih očituje kao blaga bolest praćena subfebrilnom temperaturom, osipom, mialgijom, artralgijom te konjunktivitisom. Infekcija nastala tijekom trudnoće može rezultirati spontanim pobačajem ili kongenitalnim malformacijama (mikrocefalija). Najčešće opisana neurološka komplikacija je Guillain-Barreov sindrom. Dijagnostika se potvrđuje detekcijom ZIKV RNA ili ZIKV protutijela. Zbog mogućih križnih reakcija s ostalim fl avivirusima, inicijalno reaktivne rezultate testa ELISA potrebno je potvrditi neutralizacijskim testovima. Na području Hrvatske do sada je testirano ukupno 106 povratnika iz endemskih područja, od kojih je u tri potvrđena klinički manifestna ZIKV infekcija.
U radu prikazujemo slučaj krpeljnog encefalitisa (KE) kod profesionalno izložene osobe (šumar) koja je oboljela tri godine nakon uredno provedenog primarnog cijepljenja. Pacijent je naveo višestruke ...ugrize krpelja, od kojih je posljednji bio osamnaest dana prije početka bolesti. Dijagnoza KE potvrđena
je prema kriterijima Europskog centra za kontrolu bolesti (ECDC) na temelju kliničkih (meningitis), epidemioloških (izloženost krpeljima u endemskom području) te laboratorijskih kriterija (dokaz specifičnih IgM i IgG protutijela za KE u uzorcima seruma i cerebrospinalnog likvora). Prikazani slučaj naglašava
potrebu za promišljanjem o mogućoj pojavi KE i kod osoba kod kojih je provedeno kompletno cijepljenje, osobito profesionalno izloženih osoba te onih izloženih čestim ugrizima krpelja.
PDF
