11 research outputs found
ACUTE BRUCELLA HEPATITIS ā CASE REPORT
Bruceloza je vjerojatno najÄeÅ”Äa antropozoonoza u svijetu, ali je u razliÄitim aspektima velika enigma. Prikazan je sluÄaj 64-godiÅ”njeg muÅ”karca s akutnim hepatitisom uzrokovanim brucelom, koji zahtijeva pažnju, jer je rijedak u literaturi. Etiologija bolesti je dokazana pozitivnom hemokulturom i seroloÅ”kim testom (ELISA IgM). Biljezi virusnog hepatitisa i imunoloÅ”ki biljezi autoimunog hepatitisa bili su negativni. Brucelozu treba uzeti u obzir u diferencijalnoj dijagnozi vruÄice i hepatitisa kod osoba koje žive ili su posjetili endemska podruÄja, posebno ako je bolesnikov posao s visokim rizikom za stjecanje bruceloze.Brucellosis is probably the most common anthropozoonosis in the world, but in various aspects remains an enigma. A case is reported of a 64-year-old man with acute brucella hepatitis, which requires attention because it is rare in the literature. The etiology of the disease was proven by positive blood cultures and serologic test (ELISA IgM). Viral hepatitis markers and immunologic markers of autoimmune hepatitis were negative. Brucellosis should be considered in the differential diagnosis of fever and hepatitis in those who live or have visited endemic areas, especially if the patientās job is associated with a high risk of acquiring brucellosis
Acute hepatitis caused by methyldopa
Prikazan je sluÄaj 35-godiÅ”nje bolesnice sa slikom akutnog hepatisa, koja je zbog hipertenzije za vrijeme trudnoÄe i u puerperiju, lijeÄena metildopom. Nakon prekida terapije doÅ”lo je do potpunog oporavka.
HepatotoksiÄnost lijekova je unatoÄ brojnim kliniÄkim i toksikoloÅ”kim istraživanjima Äesto prisutna i predstavlja diferencijalno dijagnostiÄki problem u infektoloÅ”koj praksi.The case of a 35-year-old patient has been shown as a manifestation of acute hepatitis, which is due to hypertension during pregnancy and puerperium treated with methyldopa. After therapy interruption, there
was a full recovery. Drug hepatotoxicity is still present and represents a differential diagnostic problem in infectology practice, despite of numerous clinical and toxical researches
Zoonoze u ZeniÄko-dobojskoj županiji i Federaciji Bosne i Hercegovine
Ciljevi istraživanja bili su: ukazati na znaÄaj zoonoza u ljudi te istražiti koje se zoonoze u ljudi najÄeÅ”Äe javljaju u ZeniÄko-dobojskoj županiji (ZDŽ) i Federaciji Bosne i Hercegovine (FBiH), tijekom desetogodiÅ”njeg razdoblja (2010. ā 2019. godine). Materijal i metode. U svrhu istraživanja koriÅ”teni su podatci o osam najuÄestalih zoonoza (salmoneloze, bruceloza, leptospiroza, Q-groznica, hemoragijska groznica s renalnim sindromom, borelioza, ehinokokoza, listerioza), temeljem prijava Instituta za zdravlje i sigurnost hrane Zenica i Federalnog zavoda za javno zdravstvo. Dijagnoze su postavljene kliniÄki, mikrobioloÅ”ki i/ili epidemioloÅ”ki. Rezultati. Tijekom desetogodiÅ”njeg razdoblja u ZDŽ prijavljena je 871 zoonoza. NajviÅ”e (191/871; 21,9%) prijavljenih bilo je 2019. godine. NajuÄestalija zoonoza bila je salmoneloza (343/871; 39,4%; 95,3/100.000 stanovnika), a zatim slijedi bruceloza (323/871; 37,1%; 87,7/100.000). NajÄeÅ”Äa zoonoza u FBiH je salmoneloza (2.764/5.219; 53%; 125,6/100.000). Na drugom mjestu je bruceloza (1.505/5.219; 28,8%; 68,4/100.000). Leptospiroza (386/5.219; 7,4%; 17,5/100.000), Q-groznica (203/5.219; 3,9%; 9,2/100.000) i hemoragijska groznica s renalnim sindromom (164/5.219; 3,1%; 7,5/100.000) javljaju se povremeno, u vidu manjih ili veÄih epidemija. Ostale zoonoze javljaju se sporadiÄno. ZakljuÄak. Zoonoze su od posebnoga javnozdravstvenog znaÄaja i zahtijevaju blisku interdisciplinarnu suradnju razliÄitih profila struÄnjaka (iz podruÄja medicine, veterine, Å”umarstva, biologije, zoologije, ekologije), poduzimanje uÄinkovitih mjera u nadzoru i suzbijanju te prouÄavanju i znanstvenom istraživanju tih bolesti
Hepatitis D: report of two patients
Infekcija virusom hepatitisa D (HDV) javlja se samo u HBsAg pozitivnih osoba. Oko 350 milijuna ljudi u svijetu zaraženo je virusom hepatitisa B (HBV), a oko 5% njih ima i HDV infekciju. Prikazana su prva dva prijavljena sluÄaja hepatitisa D u Bosni i Hercegovini. Bolesnici su lijeÄeni u Službi za zarazne bolesti Kantonalne bolnice Zenica, tijekom 2013. i 2014. godine. SeroloÅ”ki testovi na HDV raÄeni su u Klinici za mikrobiologiju KliniÄkog centra Sarajevo. Kod prvog, 67-godiÅ”njeg muÅ”karca radilo se o akutnoj HBV-HDV koinfekciji, s teÅ”kim, produženim kliniÄkim tijekom i povoljnim ishodom bolesti: negativnim HBsAg, HDVAg i anti-HDV. Kod drugog, 34-godiÅ”njeg muÅ”karca radilo se o superinfekciji hepatitis D virusom, na terenu kroniÄnog hepatitisa B. Potrebno je podiÄi svijest zdravstvenih djelatnika o opasnosti od udružene HBV i HDV infekcije i osigurati bolju dostupnost HDV dijagnostici.Hepatitis D virus (HDV) infection occurs only in HbsAg positive persons. About 350 million persons are infected with hepatitis B virus (HBV) worldwide and about 5% of them are infected with HDV. We present the first two reported cases of hepatitis D in Bosnia and Herzegovina. Patients were treated at the Department of Infectious Diseases, Cantonal Hospital Zenica during 2013 and 2014. Serological tests for HDV were performed at the Clinical Microbiology Department, Clinical Center Sarajevo. The first patient was a 67-year-old male with acute HBV-HDVcoinfection with severe, prolonged clinical course and favorable disease outcome: negative HBsAg, HDVAg and anti-HDV. The second patient was a 34-year-old male with chronic hepatitis B and HDV superinfection. It is necessary to raise awareness among health workers about the threats of combined HBV and HDV infection and provide better availability of HDV diagnostics
ACCIDENTAL POISONING WITH A PLANT COLCHICUM AUTUMNALE: REPORT OF TWO CASES
Otrovanja kolhicinom teÅ”ka su i veoma opasna stanja koja nastaju kao posljedica otrovanja hranom s biljkama koje sadržavaju ovaj alkaloid ili predoziranja lijekom koji sadržava kolhicin. LiÅ”Äe jestivoga medvjeÄeg luka (srijemuÅ”a) zbog svoje se sliÄnosti Äesto zamijeni s vrlo otrovnim listovima mrazovca (lat. Colchicum autumnale) koji uzrokuju otrovanja. Opisana su dva sluÄaja otrovanja hranom s mrazovcem, koji su imali sliÄne simptome u poÄetnoj fazi, ali razliÄit kliniÄki tijek i ishod. Znakovi otrovanja zahtijevaju rano prepoznavanje i intenzivnu potpornu terapiju, Å”to poveÄava izglede za preživljavanje.Colchicine poisonings are serious and highly fatal conditions that occur as a result of food poisoning from plants that contain this alkaloid or overdose with drug containing colchicine. The leaves of edible wild garlic because of their similarity are often replaced with highly poisonous leaves of autumn crocus, causing poisoning. Described are two cases of food poisoning with Colchicum autumnale, who had similar symptoms in the initial stage, but different clinical course and outcome. Signs of poisoning require early identification and intensive supportive therapy, which increases the chances of survival
Rare routes of transmission of hepatitis C
Prospektivno su u oboljelih od hepatitisa C (HC) s nepoznatim putevima prijenosa (n = 119) i njihovih obiteljskih kontakata (n = 297) istražene moguÄnosti i naÄini obiteljske transmisije. PodruÄje istraživanja je ZeniÄko-dobojski kanton, 2008. ā 2009. godine. U 31,07% (119/383; P 0,05). NajznaÄajniji riziÄni faktori za nastanak bolesti (P 0,05). The major risk factors for the occurrence of disease (P < 0,00) were: a combination of two or more risk factors (OR 13,67; 95% CI 6,10ā30,64); a family member with HC (OR 7,28 and 95% CI 0,89ā59,22); members of the household who use drugs (OR 5,88; 95% CI 1,68ā20,60); the presence of a chronic illness in the household (OR 5,80; 95% CI 2,74ā12,77); sharing a razor (OR 4,45; 95% CI 2,36ā8,37); exposure to blood in the household (OR 3,57; 95% CI 1,91ā6,26). The frequency of HCV genotypes was significant (P < 0,00) for 1a (Ļ2 = 12,33) in the group with unknown routes, and for 1b (Ļ2 = 11,50) in the group of patients with known routes of disease transmission. Cumulative incidence of newly discovered HC within examined familial contacts is 1,35% (4/297). The total probability of the exposure in newly discovered familial contacts (OR 1,38; 95% CI 0,15ā12,48) is greater than in unexposed individuals. Anti-HCV point prevalence in examined familial contacts is 4,13%, and among the general population 2,42%. The results of this research suggest that the presence of a family member with HC is a significant risk factor. Therefore, for the purpose of disease prevention there is a need for a routine serological testing and continuous monitoring of all intrafamilial contacts of anti-HCV positive individuals
HBsAg SEROCONVERSION IN THE TREATMENT OF CHRONIC HEPATITIS B WITH PEGYLATED INTERFERON
Idealni cilj antivirusne terapije ili izljeÄenje kroniÄnog hepatitisa B jesu gubitak HBsAg i HBsAg-serokonverzija.
Prema suvremenim smjernicama svih udruga za bolesti jetre, pegilirani interferon alfa-2a i nukleoz(t)idni analozi (entekavir,
tenofovir) prvi su izbor u lijeÄenju kroniÄnog hepatitisa B. Cilj je rada bio ocijeniti uspjeh terapije bolesnika s
kroniÄnim hepatitisom B, koji su primali pegilirani interferon. Na kraju desetogodiÅ”njeg perioda HBV DNK < 50 IU/mL i
HBsAg-serokonverziju postigla su 4 (4/55; 7,00%) bolesnika. Svi su bili HBeAg-negativni. Dodatno je prikazan sluÄaj
bolesnika koji je nakon terapije imao najkraÄi period izljeÄenja. Bolesnik je muÅ”karac, u dobi od 47 godina, s novootkrivenim
HBeAg-negativnim kroniÄnim hepatitisom B i izraženom aktivnoÅ”Äu serumskih aminotransferaza. LijeÄen je pegiliranim
interferonom alfa-2a, 180 Ī¼g jednput na tjedan, tijekom 48 tjedana. Nakon antivirusne terapije bolesnik je HBV DNK
negativan, HBsAg-negativan i urednih aminotransferaza, a 12 mjeseci nakon zavrŔetka antivirusne terapije dolazi do
HBsAg-serokonverzije. Stupanj izljeÄenja kroniÄnog hepatitisa B, nažalost, ni do danas ne zadovoljava potpuno, s
izuzetkom rijetkih, pojedinaÄnih sluÄajevaThe ideal goal of antiviral therapy or cure of chronic hepatitis B is HBsAg clearance and HBsAg seroconversion.
According to modern guidelines of all Associations for liver diseases pegylated interferon alfa-2a and nucleos(t)ide
analogues (entecavir, tenofovir) are fi rst choice in the treatment of chronic hepatitis B. The aim of the study was to evaluate
the success of the treatment of patients with chronic hepatitis B who received pegylated interferon. At the end of ten year
period, HBV DNA <50 IU/ml and HBsAg seroconversion achieved 4 (4/55, 7.00%) patients. All were HBeAg negative.
Additionally, is presented the case of patients, who, after the treatment, had the shortest period of healing. Patient is a man,
aged 47 years, with the newly discovered HBeAg negative chronic hepatitis B and pronounced activity of serum aminotransferases.
He was treated with pegylated interferon alfa-2a, 180 Ī¼g once a week, for 48 weeks. After antiviral therapy,
the patient is HBV DNA negative, HBsAg negative and neat aminotransferases, and 12 months after completion of antiviral
therapy comes to HBsAg seroconversion. The degree of cure of chronic hepatitis B, unfortunately, has not been entirely
satisfactory, with the exception of the few individual case
Rare routes of transmission of hepatitis C
Prospektivno su u oboljelih od hepatitisa C (HC) s nepoznatim putevima prijenosa (n = 119) i njihovih obiteljskih kontakata (n = 297) istražene moguÄnosti i naÄini obiteljske transmisije. PodruÄje istraživanja je ZeniÄko-dobojski kanton, 2008. ā 2009. godine. U 31,07% (119/383; P 0,05). NajznaÄajniji riziÄni faktori za nastanak bolesti (P 0,05). The major risk factors for the occurrence of disease (P < 0,00) were: a combination of two or more risk factors (OR 13,67; 95% CI 6,10ā30,64); a family member with HC (OR 7,28 and 95% CI 0,89ā59,22); members of the household who use drugs (OR 5,88; 95% CI 1,68ā20,60); the presence of a chronic illness in the household (OR 5,80; 95% CI 2,74ā12,77); sharing a razor (OR 4,45; 95% CI 2,36ā8,37); exposure to blood in the household (OR 3,57; 95% CI 1,91ā6,26). The frequency of HCV genotypes was significant (P < 0,00) for 1a (Ļ2 = 12,33) in the group with unknown routes, and for 1b (Ļ2 = 11,50) in the group of patients with known routes of disease transmission. Cumulative incidence of newly discovered HC within examined familial contacts is 1,35% (4/297). The total probability of the exposure in newly discovered familial contacts (OR 1,38; 95% CI 0,15ā12,48) is greater than in unexposed individuals. Anti-HCV point prevalence in examined familial contacts is 4,13%, and among the general population 2,42%. The results of this research suggest that the presence of a family member with HC is a significant risk factor. Therefore, for the purpose of disease prevention there is a need for a routine serological testing and continuous monitoring of all intrafamilial contacts of anti-HCV positive individuals
Znanje i stavovi zdravstvenih djelatnika Srednjobosanske županije (Federacije Bosne i Hercegovine) o HIV-infekciji, tijekom 2020. godine
Uvod: Zdravstveni djelatnici su riziÄna skupina za HIV-infekciju i imaju kljuÄnu ulogu u prevenciji HIV-a.
Cilj: Procijeniti znanje i stavove i korelaciju znanja i stavova zdravstvenih djelatnika o HIV-infekciji.
Ispitanici i metode. Ispitanici su zdravstveni djelatnici zaposleni u Domovima zdravlja: Bugojno, Donji i
Gornji Vakuf. Upitnik je samostalno izraÄen. Stavovi su ispitivani na osnovi modificirane Likertove ljestvice.
Procjena znanja i stavova napravljena je tako da viÅ”e od 50% toÄnih odgovora ukazuje na dobro znanje i
pozitivan stav. Za testiranje statistiÄke znaÄajnosti koriÅ”ten je ĻĀ² test (p <0.05). Za odreÄivanje korelacije
varijabli znanje i stavovi koriŔteni su Pearsonov i Spearmanov koeficijent korelacije.
Rezultati: U istraživanju je sudjelovao 81 zdravstveni djelatnik ā 57 (70%) žena i 24 (30%) muÅ”karca.
NajveÄi broj ispitanika bile su medicinske sestre (57%), prosjeÄne dobi 36 godina života i 13 godina radnoga
staža. VeÄina ispitanika pokazali su relativno dobro znanje o HIV-infekciji (73%) i pozitivne stavove prema
HIV-pozitivnim osobama (80%). Koeficijent korelacije za zbirne vrijednosti znanja i stavova iznosio je 0,336,
sa statistiÄkim znaÄajem 0,002.
ZakljuÄak: Da bi se poboljÅ”ala praksa, smanjila stigma i diskriminacija HIV-pozitivnih osoba u
zdravstvenim ustanovama, potrebno je provoditi kontinuiranu edukaciju svih zaposlenika