6 research outputs found
Naravna povijest bruceloze u endemskom području kroz različita vremenska razdoblja
The aim of the study was to determine the evolution and outcome of human brucellosis in an endemic region in relation to time interval. Retrospective analysis was employed to compare demographic, epidemiological, clinical, laboratory features and the outcome of patients with brucellosis, treated at University Department of Infectious Diseases in Skopje during two different periods of time. A series of 159 patients were studied in the first (1990-1991) and 138 in the second (2003-2005) study period. Patients treated in the second period were older (34.6±20.9 vs. 30.0±17.7 years; P=0.041) and acquired brucellosis less frequently on ingestion of incriminated food (34.8% vs. 47.2%; P=0.031). Focal forms were more evident in the second period (66.7% vs. 50.3%; P=0.004), mainly due to osteoarticular localization. Post-treatment follow up was more efficient in the second group (76.1% vs. 61%; P=0.005). There was no difference according to disease outcome in spite of different therapeutic trials during the two study periods. In conclusion, the established differences showed an improvement in the understanding of the disease by the general population as well as upgrading of some aspects considering medical activities. Nevertheless, this endemic region still lacks the most important measure, i.e. development and implementation of an appropriate national program for efficient control of the disease.Cilj studije bio je utvrditi razvoj i ishod bruceloze kod ljudi u jednom endemskom području u odnosu na vremenski pomak. Demografski, epidemiološki, klinički i laboratorijski podaci te ishodi u bolesnika s brucelozom liječenih na Klinici za infektivne bolesti u Skopju kroz dva vremenska razdoblja uspoređeni su retrospektivnom analizom. U prvom razdoblju (1990.-1991.) ispitano je 159 bolesnika, a u drugom razdoblju (2003.-2005.) 138 bolesnika. Bolesnici iz drugog razdoblja bili su stariji (34,6±20,9 prema 30,0±17,7 godina; P=0,041) i rjeđe su obolijevali od bruceloze zbog unosa određene hrane (34,8% prema 47,2%; P=0,031). Žarišni oblici bili su očitiji u drugom razdoblju (66,7% prema 50,3%; P=0,004), uglavnom zbog koštano¬zglobne lokalizacije. Praćenje nakon liječenja bilo je bolje u drugoj skupini (76,1% prema 61,0%; P=0,005). Usprkos različitim terapijskim pristupima tijekom ispitivanih razdoblja nije zabilježena nikakva razlika u ishodu bolesti. Dakle, utvrđene razlike pokazale su napredak u vidu boljeg razumijevanja bolesti u općoj populaciji, kao i poboljšanja u nekim vidovima medicinskih postupaka. Ipak, u ovom endemskom području jo. uvijek nedostaje najvažnija mjera, a to je stvaranje i provedba boljeg nacionalnog programa za kontrolu ove bolesti
Characteristics of an Outpatient Cohort with HBeAg-Negative Chronic Hepatitis B
Introduction: Patients with hepatitis Be antigen negative chronic hepatitis B (HBeAg-negative CHB) and patients inactive carriers (IC) have similar laboratory and serologic characteristics and are not always easy to distinguish.
Aim: To characterize hepatitis Be antigen (HBeAg) negative chronic hepatitis B cohort based on their laboratory and virology evaluations at one point of time.
Material and Methods: A prospective non-randomized study was conducted on 109 patients with HBeAg negative chronic hepatitis B treated as outpatients at the Clinic for infectious disease and febrile conditions. All patients underwent laboratory and serology testing, quantification of HBV DNA and HBs antigen (qHBsAg).
Results: 56 patients were inactive carriers (IC) and 53 patients had HBeAg-negative CHB (AH). The mean values of ALT, HBV DNA and qHBsAg in IC were 29,13 U/L; 727,95 IU/ml and 2753,73 IU/ml respectively. In the AH group the mean values of ALT, HBV DNA and quantitative HBsAg were 50,45 U/L; 7237363,98 IU/ml and 12556,06 IU/ml respectively. The serum value of ALT was more influenced by qHBsAg than HBV DNA in both IC and AH groups (R=0.22 vs R=0.15) (p>0.05).
Conclusion: patients with inactive and active HBeAg-negative CHB have similar laboratory and serology profile. It is necessary to combine analysis of ALT, HBV DNA and qHBsAg for better discrimination between patients IC and patient swith HBeAg- negative CHB.
Key words: chronic hepatitis B, inactive carriers, ALT, HBeAg, HBV DNA, quantitative HBsAg
BACKGROUND: Patients with hepatitis Be antigen-negative chronic hepatitis B (HBeAg-negative CHB), and patients' inactive carriers (IC) have similar laboratory and serologic characteristics and are not always easy to distinguish.
AIM: To characterise hepatitis Be antigen (HBeAg) negative chronic hepatitis B cohort based on their laboratory and virology evaluations at one point of time.
METHODS: A prospective non-randomized study was conducted on 109 patients with HBeAg negative chronic hepatitis B treated as outpatients at the Clinic for Infectious Diseases and Febrile Conditions. All patients underwent laboratory and serology testing, quantification of HBV DNA and HBs antigen (qHBsAg).
RESULTS: A group of 56 patients were inactive carriers (IC), and 53 patients had HBeAg-negative CHB (AH). The mean values of ALT, HBV DNA and qHBsAg in IC were 29.13 U/L; 727.95 IU/ml and 2753.73 IU/ml respectively. In the AH group, the mean values of ALT, HBV DNA and quantitative HBsAg were 50.45 U/L; 7237363.98 IU/ml and 12556.06 IU/ml respectively. The serum value of ALT was more influenced by qHBsAg than HBV DNA in both IC and AH groups (R = 0.22 vs R = 0.15) (p > 0.05).
CONCLUSION: patients with inactive and active HBeAg-negative CHB have similar laboratory and serology profile. It is necessary to combine analysis of ALT, HBV DNA and qHBsAg for better discrimination between patient's IC and patient with HBeAg-negative CHB
The changing pattern of fever of unknown origin in the Republic of North Macedonia
Introduction. The study aimed to compare the etiologic spectrum of diseases causing fever of unknown origin (FUO) and methods for definitive diagnosis in a tertiary care hospital in the Republic of North Macedonia during two different time periods
Human Brucellosis in Macedonia – 10 Years of Clinical Experience in Endemic Region
Aim To present our 10-year clinical experience with brucellosis
patients at the University Clinic for Infectious Diseases
and Febrile Conditions in Skopje, Republic of Macedonia.
Methods A total of 550 patients with brucellosis treated
between 1998 and 2007 were retrospectively assessed for
their demographic, epidemiological, and clinical characteristics
and outcomes.
Results Of the 550 patients, 395 (72%) were male. The median
age was 34.5 years (range, 1-82). Direct contact with
infected animals was recorded in 333 (61%) patients and
positive family history in 310 (56%). The most frequently
seen symptoms were arthralgia (438, 80%), fever (419,
76%), and sweating (394, 72%). The most common signs
were fever and hepatomegaly, which were verified in 357
(65%) and 273 (50%) patients, respectively. Focal brucellosis
was found in 362 patients (66%) and osteoarticular in
299 (54%). Therapeutic failures were registered in 37 (6.7%)
patients. Of the 453 (82%) patients who completed a follow-
up period of at least 6 months, relapses occurred in
60 (13%).
Conclusion Due to non-specific clinical manifestation
and laboratory parameters, brucellosis should be considered
one of the differential diagnoses of any patient suffering
from obscure involvement of various organs in a brucellosis-
endemic region. High percentage of relapses and
therapeutic failures in spite of the use of currently recommended
therapeutic regimens indicates the seriousness of
this zoonosis and the need to control it
Prevalence of Gastrointestinal Symptoms in Severe Acute Respiratory Syndrome Coronavirus 2 Infection: Results of the Prospective Controlled Multinational GI-COVID-19 Study
INTRODUCTION: Gastrointestinal (GI) symptoms in coronavirus-19 disease (COVID-19) have been reported with great variability and without standardization. In hospitalized patients, we aimed to evaluate the prevalence of GI symptoms, factors associated with their occurrence, and variation at 1 month. METHODS: TheGI-COVID-19 is a prospective,multicenter, controlled study. Patientswith and without COVID-19 diagnosis were recruited at hospital admission and asked for GI symptoms at admission and after 1 month, using the validated Gastrointestinal Symptom Rating Scale questionnaire. RESULTS: The study included 2036 hospitalized patients. A total of 871 patients (575 COVID1and 296 COVID2) were included for the primary analysis. GI symptoms occurred more frequently in patients with COVID-19 (59.7%; 343/575 patients) than in the control group (43.2%; 128/296 patients) (P < 0.001). Patients with COVID-19 complained of higher presence or intensity of nausea, diarrhea, loose stools, and urgency as compared with controls. At a 1-month follow-up, a reduction in the presence or intensity of GI symptoms was found in COVID-19 patients with GI symptoms at hospital admission. Nausea remained increased over controls. Factors significantly associated with nausea persistence in COVID-19 were female sex, high body mass index, the presence of dyspnea, and increased C-reactive protein levels. DISCUSSION: The prevalence of GI symptoms in hospitalized patients with COVID-19 is higher than previously reported. Systemic and respiratory symptoms are often associated with GI complaints. Nausea may persist after the resolution of COVID-19 infection