Maida Mulić, Marijana Sreckovic, D. Backović, Nadina Nuhbegovic
Purpose: The incidence of sexually transmitted disease (STDs) is being increased in the MaÄva district. The aim of this study is to investigate differences in sexual behaviors, knowledge and attitudes related to STDs among female students of health and non-medical studies.Materials and Methods: In the cross-sectional study, an anonymous questionnaire was used specifically designed for the purpose of this investigation, among female students of health and non-medical studies.Results: A total of 394 students of health and non-medical studies (120 and 274, respectively). The majority (94.3%) had heard of STDs, and 76.6% knew STDs could be present without symptoms (90% students of health and 62% non-medical studies; p=0.000). Among the sexually-active students (81.5%), 36.3% reported having used a condom. Most of students (71.9%) were aware that using condoms for STDs prevention was important. One fifth of students of health study were tested for STDs, while the percentage of tested non-medical students was three times lower (p=0.000). Previous education and faculty type were strongly associated with knowledge level and attitudes among students. The primary and secondary school teachers were the main source of information for one-third of students (51.7% medical and 25.2% non-medical).Conclusion: There is a need to revise the existing STD education curriculum in both schools and universities and implement targeted educational measures.Key words: sexually transmitted diseases, attitudes, female students, health education, condom
{"title":"Knowledge, Attitude and Practice towards Sexually Transmitted Diseases among Medical and Non-medical Female Students of Academy of Professional Studies Šabac, Serbia","authors":"Maida Mulić, Marijana Sreckovic, D. Backović, Nadina Nuhbegovic","doi":"10.5457/ams.v52i1-2.597","DOIUrl":"https://doi.org/10.5457/ams.v52i1-2.597","url":null,"abstract":"Purpose: The incidence of sexually transmitted disease (STDs) is being increased in the MaÄva district. The aim of this study is to investigate differences in sexual behaviors, knowledge and attitudes related to STDs among female students of health and non-medical studies.Materials and Methods: In the cross-sectional study, an anonymous questionnaire was used specifically designed for the purpose of this investigation, among female students of health and non-medical studies.Results: A total of 394 students of health and non-medical studies (120 and 274, respectively). The majority (94.3%) had heard of STDs, and 76.6% knew STDs could be present without symptoms (90% students of health and 62% non-medical studies; p=0.000). Among the sexually-active students (81.5%), 36.3% reported having used a condom. Most of students (71.9%) were aware that using condoms for STDs prevention was important. One fifth of students of health study were tested for STDs, while the percentage of tested non-medical students was three times lower (p=0.000). Previous education and faculty type were strongly associated with knowledge level and attitudes among students. The primary and secondary school teachers were the main source of information for one-third of students (51.7% medical and 25.2% non-medical).Conclusion: There is a need to revise the existing STD education curriculum in both schools and universities and implement targeted educational measures.Key words: sexually transmitted diseases, attitudes, female students, health education, condom","PeriodicalId":53635,"journal":{"name":"Acta Medica Saliniana","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-02-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48288910","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
M. Tabaković, Fahir Baraković, Z. Karasalihović, Sergej Markovic, M. Tabaković
Accurate information on the cause of death is obtained from expert teams based on pathological or forensic expertise. Reliable information can be obtained from physicians in hospital settings if the deceased person has been treated in such an institution and has previously been diagnosed with an illness (intrahospital mortality). Intrahospital mortality analysis provides reliable data that can be used in the planning of a bed fund, the amount of medication purchased, the purchase of equipment, the organization and creation of highly specialized medical teams (resuscitation team), the number of resuscitation procedures, the number of pathologists required for autopsy procedures, etc. The aim of the study was to determine the total number of deaths, to identify the most common causes of death and 10 leading diagnoses of deceased patients at the Internal Medicine Clinic, University Clinical Center Tuzla (UKC) during one calendar year (2011). Material and methodes: Archive material (case histories and reports of deceased patients of the Internal Medicine Clinic) were used. Results: During this period, 6 488 patients were treated at the Internal Medicine Clinic and 451 patients died. According to the analyzed data, the most common diagnoses and causes of death at the Internal Medicine Clinic were: cerebrovascular incidents 104 (20.84%), cardiogenic shock in 24 (5.31%), heart failure 59 (10.86%), hepatic coma with cirrhosis of the liver 25 (5.33%), sudden cardiac death 30 (6.53%), respiratory failure 15 (3.32%), myocardial infarction 41 (9.99%), multiorgan failure 18 (4.00%) , pulmonary edema 14 (3.10%), sepsis 6 (1.38%), pulmonary emboli 17 (3.82%), valvular heart disease 9 (1.92%), cardiorespiratory arrest 9 (1.92%) , malignant abdominal neoplasms in 23 (5.28%), pancreatitis 2 (0.44%), hematemesis 8 (1.76%), diabetes mellitus 4 (0.88%), lung tumor 1 (0.22%), chronic renal insufficiency 12(2.54%), suicidal intoxication 4 (0.88%), ileus 4 (0.88%), cachexia 3 (0.66%), restrictive cardiomyopathy 2 (0.44%), mesenteric thrombosis arteries 2 (0.44%), disseminated lupus erythematosus 2 (0.44%), coffee vein thrombosis inferior 2 (0.44%), and 1 (0.22%) died of an aneurysm aortic abdominalis, ventricular septal defect, amyloidosis, disseminated intravascular coagulation, systemic sclerosis, rheumatoid arthritis and breast tumors. Conclusion: During the analyzed period, 6488 patients were treated at the Internal Medicine Clinic and a total of 451 patients died. The most common cause of death in hospitalized patients is cardiovascular disease (n = 208; 41.68% of deaths), with cerebrovascular disease (n = 104; 20.84% of deaths) totaling 312 (62.25%) of deaths from cardio and cerebrovascular disease.
{"title":"Death in hospital conditions","authors":"M. Tabaković, Fahir Baraković, Z. Karasalihović, Sergej Markovic, M. Tabaković","doi":"10.5457/ams.v50i1-2.555","DOIUrl":"https://doi.org/10.5457/ams.v50i1-2.555","url":null,"abstract":"Accurate information on the cause of death is obtained from expert teams based on pathological or forensic expertise. Reliable information can be obtained from physicians in hospital settings if the deceased person has been treated in such an institution and has previously been diagnosed with an illness (intrahospital mortality). Intrahospital mortality analysis provides reliable data that can be used in the planning of a bed fund, the amount of medication purchased, the purchase of equipment, the organization and creation of highly specialized medical teams (resuscitation team), the number of resuscitation procedures, the number of pathologists required for autopsy procedures, etc. The aim of the study was to determine the total number of deaths, to identify the most common causes of death and 10 leading diagnoses of deceased patients at the Internal Medicine Clinic, University Clinical Center Tuzla (UKC) during one calendar year (2011). Material and methodes: Archive material (case histories and reports of deceased patients of the Internal Medicine Clinic) were used. Results: During this period, 6 488 patients were treated at the Internal Medicine Clinic and 451 patients died. According to the analyzed data, the most common diagnoses and causes of death at the Internal Medicine Clinic were: cerebrovascular incidents 104 (20.84%), cardiogenic shock in 24 (5.31%), heart failure 59 (10.86%), hepatic coma with cirrhosis of the liver 25 (5.33%), sudden cardiac death 30 (6.53%), respiratory failure 15 (3.32%), myocardial infarction 41 (9.99%), multiorgan failure 18 (4.00%) , pulmonary edema 14 (3.10%), sepsis 6 (1.38%), pulmonary emboli 17 (3.82%), valvular heart disease 9 (1.92%), cardiorespiratory arrest 9 (1.92%) , malignant abdominal neoplasms in 23 (5.28%), pancreatitis 2 (0.44%), hematemesis 8 (1.76%), diabetes mellitus 4 (0.88%), lung tumor 1 (0.22%), chronic renal insufficiency 12(2.54%), suicidal intoxication 4 (0.88%), ileus 4 (0.88%), cachexia 3 (0.66%), restrictive cardiomyopathy 2 (0.44%), mesenteric thrombosis arteries 2 (0.44%), disseminated lupus erythematosus 2 (0.44%), coffee vein thrombosis inferior 2 (0.44%), and 1 (0.22%) died of an aneurysm aortic abdominalis, ventricular septal defect, amyloidosis, disseminated intravascular coagulation, systemic sclerosis, rheumatoid arthritis and breast tumors. Conclusion: During the analyzed period, 6488 patients were treated at the Internal Medicine Clinic and a total of 451 patients died. The most common cause of death in hospitalized patients is cardiovascular disease (n = 208; 41.68% of deaths), with cerebrovascular disease (n = 104; 20.84% of deaths) totaling 312 (62.25%) of deaths from cardio and cerebrovascular disease.","PeriodicalId":53635,"journal":{"name":"Acta Medica Saliniana","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2021-11-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42649089","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Đana Granov, D. Bekić, El-Jesah Đulić, A. Ljubović
Objectives: Anaerobic bacteria may cause numerous infections in different locations through human body. Those infections can be life-threatening with significant mortality. Wounds represent a suitable habitat for colonization of anaerobic bacteria. Their proliferation contributes to moist and warm environment, hypoxic and necrotic tissue.Methods:A retrospective study was conducted at the Clinical Centre University of Sarajevo from 2015-2017. The study involved wound swab samples, sampled from hospitalized patients. The anaerobic bacteria were isolated using standard procedures.Results: During the period from 01.01.2015. to 31.12.2017, 8386 samples were analyzed on anaerobic bacteria and 872 (10.4%) of specimen were positive. In 2015, 332 (15%) specimens were positive, while during 2016 and 2017, 244 (7,8%) and 296 (9.9%) respectively. Bacteroides spp. was the most common isolate during three year period: 2015-227 (55.5%); 2016-139 (48%); 2017-161 (42,5%). It was followed by Peptococcus spp.: 2015-70 (17.1%); 2016-40 (13.9%); 2017-66 (17.4%), Clostridium spp.: 2015 – 32 (7.8%); 2016-21 (7.3%); 2017- 35 (9.2%), Fusobacterium spp.: 2015 – 49 (11.9%); 2016-32 (11.1%); 2017- 45 (11.9%).VITEK 2 Compact has identified to the level of species 48 isolates which were in pure culture.The largest number of anaerobic bacteria were isolated from the samples received from the Abdominal surgery. The overview of antimicrobial sensitivity showed highest sensitivity to metronidazole (99,9%) and carbapenems (99,9%), respectively.Conclusions The most commonly isolated anaerobic bacteria was Bacteroides spp.Highest number of positive isolates was from abdominal surgery since intra-abdominal infections reflect the microflora of the resected organ. Metronidazole remains the antibiotic of choice in the treatment of anaerobic infections.
{"title":"Prevalence and susceptibility pattern of anaerobic bacteria isolated from wound swabs in Clinical Centre University of Sarajevo","authors":"Đana Granov, D. Bekić, El-Jesah Đulić, A. Ljubović","doi":"10.5457/ams.v49i0.523","DOIUrl":"https://doi.org/10.5457/ams.v49i0.523","url":null,"abstract":"Objectives: Anaerobic bacteria may cause numerous infections in different locations through human body. Those infections can be life-threatening with significant mortality. Wounds represent a suitable habitat for colonization of anaerobic bacteria. Their proliferation contributes to moist and warm environment, hypoxic and necrotic tissue.Methods:A retrospective study was conducted at the Clinical Centre University of Sarajevo from 2015-2017. The study involved wound swab samples, sampled from hospitalized patients. The anaerobic bacteria were isolated using standard procedures.Results: During the period from 01.01.2015. to 31.12.2017, 8386 samples were analyzed on anaerobic bacteria and 872 (10.4%) of specimen were positive. In 2015, 332 (15%) specimens were positive, while during 2016 and 2017, 244 (7,8%) and 296 (9.9%) respectively. Bacteroides spp. was the most common isolate during three year period: 2015-227 (55.5%); 2016-139 (48%); 2017-161 (42,5%). It was followed by Peptococcus spp.: 2015-70 (17.1%); 2016-40 (13.9%); 2017-66 (17.4%), Clostridium spp.: 2015 – 32 (7.8%); 2016-21 (7.3%); 2017- 35 (9.2%), Fusobacterium spp.: 2015 – 49 (11.9%); 2016-32 (11.1%); 2017- 45 (11.9%).VITEK 2 Compact has identified to the level of species 48 isolates which were in pure culture.The largest number of anaerobic bacteria were isolated from the samples received from the Abdominal surgery. The overview of antimicrobial sensitivity showed highest sensitivity to metronidazole (99,9%) and carbapenems (99,9%), respectively.Conclusions The most commonly isolated anaerobic bacteria was Bacteroides spp.Highest number of positive isolates was from abdominal surgery since intra-abdominal infections reflect the microflora of the resected organ. Metronidazole remains the antibiotic of choice in the treatment of anaerobic infections.","PeriodicalId":53635,"journal":{"name":"Acta Medica Saliniana","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2019-09-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45649739","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Background: Healthcare professionals, including medical and dental students, are at high risk of acquiring hepatitis B infection.Aim: The aim of this study was to examine and compare the knowledge and attitudes of the students of medicine and dental medicine of Faculty of Medicine, University of Mostar, about hepatitis B. Subjects and Methods: The examinees in this study were students of the first and second grade of medical studies and studies of dental medicine. The sample included 105 (71.4%) students of medicine and 42 (28.6%) students of dental medicine. The study was conducted at the Faculty of Medicine, University of Mostar, through the attached questionnaire. Results: Overall, the medical students and dental medicine students showed good knowledge about hepatitis B. Medical students showed much more positive attitudes towards hepatitis B positive patients than dental medicine students. Dental medicine students are more concerned about possible infections and general interactions with infected patients, and would statistically significantly reject to provide healthcare services to hepatitis B positive patients compared to the medical students.Conclusion: It was established that dental medicine students showed a little bit more understanding of the transmission patterns and symptoms of hepatitis B than the medical students. By contrast, medical students showed much more positive attitudes towards patients with hepatitis B than dental medicine students.
{"title":"Coparison of knowledge and attitudes regarding hepatitis B among students of Faculty of medicine, University of Mostar","authors":"Mile Planinić, S. Grgic, J. Nikolić","doi":"10.5457/ams.v49i2.518","DOIUrl":"https://doi.org/10.5457/ams.v49i2.518","url":null,"abstract":"Background: Healthcare professionals, including medical and dental students, are at high risk of acquiring hepatitis B infection.Aim: The aim of this study was to examine and compare the knowledge and attitudes of the students of medicine and dental medicine of Faculty of Medicine, University of Mostar, about hepatitis B. Subjects and Methods: The examinees in this study were students of the first and second grade of medical studies and studies of dental medicine. The sample included 105 (71.4%) students of medicine and 42 (28.6%) students of dental medicine. The study was conducted at the Faculty of Medicine, University of Mostar, through the attached questionnaire. Results: Overall, the medical students and dental medicine students showed good knowledge about hepatitis B. Medical students showed much more positive attitudes towards hepatitis B positive patients than dental medicine students. Dental medicine students are more concerned about possible infections and general interactions with infected patients, and would statistically significantly reject to provide healthcare services to hepatitis B positive patients compared to the medical students.Conclusion: It was established that dental medicine students showed a little bit more understanding of the transmission patterns and symptoms of hepatitis B than the medical students. By contrast, medical students showed much more positive attitudes towards patients with hepatitis B than dental medicine students. ","PeriodicalId":53635,"journal":{"name":"Acta Medica Saliniana","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2019-09-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44601791","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Introduction: Anti-vaccination movements exist in Europe and it may reduce adherence to international vaccination.Objectives:To evaluate attitudes on vaccination among Portuguese travelers and Brazilian migrants in Portugal.Material and Methods:Between May and June 2019 a cross-sectional survey was carried out in the Travel Clinic of the Institute of Hygiene and Tropical Medicine of Lisbon. A self-administered questionnaire was applied after medical consultation. Travelers were asked about their attitudes to vaccines. An anonymous web-based survey was sent to Brazilian migrants living in Portugal for at least 6 months.Results: 55 Portuguese (P) travelers and 22 Brazilian (B) migrants answered the questionnaire. 47.3% of Portuguese travelers were male; the mean age was 33 years; reason for travel: tourism (43.6%) or business (30.9%). 31.8% of Brazilian migrants were male and the mean age was 44 years; 71.4% were living in Portugal for ≤ 2 years. Attitudes towards vaccines: 64.8% P and 68.2% B prefer to vaccine even when the risk of acquire a disease is low; 64.1% P and 95.5% B consider that the resistance acquired by disease is better than resistance acquired by vaccine; 75.5% P and 77.3% B prefer to vaccine even when diseases are not severe; 5.6% P and 13.6% B don’t take vaccines because they are afraid of side effects.About the reasons to accept a vaccine, travelers/migrants consider very important to trust in the doctor (100% P, 95.4% B), and the excellent protective effect of a vaccine (98.1% P, 90.9% B).Conclusions: Portuguese travelers and Brazilian migrants in Portugal seem to have a favorable attitude towards vaccination, despite the anti-vaccination movements in Europe. They believe that trust in the doctor and excellent protection of the vaccines are reasons to accept it. The quality of traveler's advice may maintain/increase adherence to vaccination.
{"title":"Attitudes on vaccination among Portuguese travelers and Brazilian migrans: A pilot study in Portugal","authors":"R. Igreja, Katy Barros, R. Teodósio","doi":"10.5457/ams.v49i2.515","DOIUrl":"https://doi.org/10.5457/ams.v49i2.515","url":null,"abstract":"Introduction: Anti-vaccination movements exist in Europe and it may reduce adherence to international vaccination.Objectives:To evaluate attitudes on vaccination among Portuguese travelers and Brazilian migrants in Portugal.Material and Methods:Between May and June 2019 a cross-sectional survey was carried out in the Travel Clinic of the Institute of Hygiene and Tropical Medicine of Lisbon. A self-administered questionnaire was applied after medical consultation. Travelers were asked about their attitudes to vaccines. An anonymous web-based survey was sent to Brazilian migrants living in Portugal for at least 6 months.Results: 55 Portuguese (P) travelers and 22 Brazilian (B) migrants answered the questionnaire. 47.3% of Portuguese travelers were male; the mean age was 33 years; reason for travel: tourism (43.6%) or business (30.9%). 31.8% of Brazilian migrants were male and the mean age was 44 years; 71.4% were living in Portugal for ≤ 2 years. Attitudes towards vaccines: 64.8% P and 68.2% B prefer to vaccine even when the risk of acquire a disease is low; 64.1% P and 95.5% B consider that the resistance acquired by disease is better than resistance acquired by vaccine; 75.5% P and 77.3% B prefer to vaccine even when diseases are not severe; 5.6% P and 13.6% B don’t take vaccines because they are afraid of side effects.About the reasons to accept a vaccine, travelers/migrants consider very important to trust in the doctor (100% P, 95.4% B), and the excellent protective effect of a vaccine (98.1% P, 90.9% B).Conclusions: Portuguese travelers and Brazilian migrants in Portugal seem to have a favorable attitude towards vaccination, despite the anti-vaccination movements in Europe. They believe that trust in the doctor and excellent protection of the vaccines are reasons to accept it. The quality of traveler's advice may maintain/increase adherence to vaccination. ","PeriodicalId":53635,"journal":{"name":"Acta Medica Saliniana","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2019-09-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46101083","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
T. Goletić, A. Gagić, V. Savić, E. Rešidbegović, Aida Kavazović, E. Šatrović, T. Harder, S. Prašović, H. Beširović, A. Alić
ABSTRACT Background: Towards preparation for a possible influenza pandemic, investigation of the molecular characteristics of the circulating avian H5N1 influenza virus strains is of crucial importance. These H5N1 viruses continue to spread, to infect animals and humans and to evolve and diversify providing so an ever-looming pandemic threat.Aim: To identify genetic structure and molecular biological characteristics of BiH's isolates of H5N1 HPAI as well as to assess the level of pathogenicity, phylogenetic origin and host- specificity of the isolates.Material and Methods: SPF embryonated chicken eggs were used for virus isolation. Viral RNA extracted using QIAamp viral RNA kit and manufacturer’s protocol (QIAGEN®) was used for PCR amplification. cDNA synthesis and PCR amplification of the coding region, using gene specific primer sets (primer sequences available on request), were carried out for all eight viral RNA segments separately. The Prism Big Dye Terminator v1.1 cycle sequencing kit (Applied Biosystems) was used and products were analyzed on an automatic ABI PRISM 3130 genetic analyzer (Applied Biosystems). Nucleotide sequences were analyzed using Bioedit software (v. 7.0.9.0) with an engine based on the ClustalW 1.4 algorithm. MEGA software (v. 4,0), using the neighbor joining tree inference analysis with the Tamura-Nei γ-model, was used to estimate phylogenies and calculate bootstrap values from the nucleotide sequences.Results: Full-length nucleotide sequences of the A/Cygnus olor/BIH/1/2006 (H5N1) strain were deposited in EMBL Nucleotide Sequence Database under accession nos. FN186008 to FN186014 and FM20943. The pathogenicity and host specificity of this strain, as polygenic traits, are determined in silico by the structure of its proteins, especially surface glycoproteins, HA and NA. Multibasic amino acid stretch PQGERRRKKR/GLF, marker of strains highly pathogenic to poultry, was present at the HA cleavage site of BiH strain. The RBS was typical for avian influenza viruses and contained Gln and Gly at positions 238 and 240 (H5 numbering) that is,226 and 228 according to H3 numbering with seven potential glycosylated sites but with increased binding to alpha2-6 sialoglycans thanks to substitutions, as follows, 110N, 171N, 171N, 172A, 205R and 251P. NA structure assigned this strain to the Z genotype, characterized also by the deletion of the five amino acid residues of the NS1 protein (positions 80-84). Amino acid residues, typical for the avian influenza viruses, were revealed in 40 out of 43 positions of M1, M2, NP, PA, PB2 and HA, determining the host range specificity. Phylogenetic analysis of the HA gene revealed that BiH isolates belonged to genetic clade 2.2., and presence of aspartic acid at the position of 403 of HA locate BiH isolates in 2.2.2. sub-clade.Conclusions: The BiH’s isolates were determined as HPAI virus with genes sequences closely related to A/Cygnus olor/Astrakhan/Ast05-2-10/2005 (H5N1). Three residues (M2 - 2
{"title":"Molecular determinants of pathogenicity and host specificity of highly pathogenic h5N1 BiH isolates","authors":"T. Goletić, A. Gagić, V. Savić, E. Rešidbegović, Aida Kavazović, E. Šatrović, T. Harder, S. Prašović, H. Beširović, A. Alić","doi":"10.5457/ams.v49i2.519","DOIUrl":"https://doi.org/10.5457/ams.v49i2.519","url":null,"abstract":"ABSTRACT Background: Towards preparation for a possible influenza pandemic, investigation of the molecular characteristics of the circulating avian H5N1 influenza virus strains is of crucial importance. These H5N1 viruses continue to spread, to infect animals and humans and to evolve and diversify providing so an ever-looming pandemic threat.Aim: To identify genetic structure and molecular biological characteristics of BiH's isolates of H5N1 HPAI as well as to assess the level of pathogenicity, phylogenetic origin and host- specificity of the isolates.Material and Methods: SPF embryonated chicken eggs were used for virus isolation. Viral RNA extracted using QIAamp viral RNA kit and manufacturer’s protocol (QIAGEN®) was used for PCR amplification. cDNA synthesis and PCR amplification of the coding region, using gene specific primer sets (primer sequences available on request), were carried out for all eight viral RNA segments separately. The Prism Big Dye Terminator v1.1 cycle sequencing kit (Applied Biosystems) was used and products were analyzed on an automatic ABI PRISM 3130 genetic analyzer (Applied Biosystems). Nucleotide sequences were analyzed using Bioedit software (v. 7.0.9.0) with an engine based on the ClustalW 1.4 algorithm. MEGA software (v. 4,0), using the neighbor joining tree inference analysis with the Tamura-Nei γ-model, was used to estimate phylogenies and calculate bootstrap values from the nucleotide sequences.Results: Full-length nucleotide sequences of the A/Cygnus olor/BIH/1/2006 (H5N1) strain were deposited in EMBL Nucleotide Sequence Database under accession nos. FN186008 to FN186014 and FM20943. The pathogenicity and host specificity of this strain, as polygenic traits, are determined in silico by the structure of its proteins, especially surface glycoproteins, HA and NA. Multibasic amino acid stretch PQGERRRKKR/GLF, marker of strains highly pathogenic to poultry, was present at the HA cleavage site of BiH strain. The RBS was typical for avian influenza viruses and contained Gln and Gly at positions 238 and 240 (H5 numbering) that is,226 and 228 according to H3 numbering with seven potential glycosylated sites but with increased binding to alpha2-6 sialoglycans thanks to substitutions, as follows, 110N, 171N, 171N, 172A, 205R and 251P. NA structure assigned this strain to the Z genotype, characterized also by the deletion of the five amino acid residues of the NS1 protein (positions 80-84). Amino acid residues, typical for the avian influenza viruses, were revealed in 40 out of 43 positions of M1, M2, NP, PA, PB2 and HA, determining the host range specificity. Phylogenetic analysis of the HA gene revealed that BiH isolates belonged to genetic clade 2.2., and presence of aspartic acid at the position of 403 of HA locate BiH isolates in 2.2.2. sub-clade.Conclusions: The BiH’s isolates were determined as HPAI virus with genes sequences closely related to A/Cygnus olor/Astrakhan/Ast05-2-10/2005 (H5N1). Three residues (M2 - 2","PeriodicalId":53635,"journal":{"name":"Acta Medica Saliniana","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2019-09-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46466838","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Objectives/Aim: Urinary tract infections (UTI) are a serious public health problem and caused by many pathogens, most often by Escherichia coli and Klebsiella pneumoniae.Aim of this study was to show the frequency and antimicrobial susceptibility pattern of E. coli and K. pneumoniae in hospital isolates, following the GLASS methodology.Methods: This is a retrospective study that was conducted in the Laboratory for Urinary Infections OU Clinical Microbiology CCUS in the period from January till December 2018.A total of 13760 urine samples were processed, using standard laboratory methods, in which significant bacteriuria was detected in 3218 (23.4%) of specimens.Results: Out of the total number of positive samples, E. coli was isolated in 1166 (36.2%) and K. pneumoniae at 341 (10.6%) patients. The presence of E. coli and K. pneumoniae isolates is dominant in females (1103/73.2%) and age group 60 and older (812/54.7%). Out of the total E. coli isolates, the ESBL strain was presented with 79 (6.8%) and K. pneumoniae with 145 (42.5%). The proportion of carbapenemase (CPE) produced by K. pneumoniae isolates was 8 (2.4%). The ESBL strain distribution analysis on clinics showed the highest prevalence of both isolates at the Clinic for Nephrology: K. pneumoniae 26/17,9%; E. coli: 12/15.4%. Isolated E. coli showed the highest resistance to ampicillin 673/1166 (57,7%), trimethoprim-sulfamethoxazole 454/1166 (38.9%) and ciprofloxacin 253/970 (26.1%), while K. pneumoniae to ciprofloxacin and trimethoprim-sulfamethoxazole with 151/285 (53.0%) and 164/341 (48.1%), respectively.Conclusions: Our study has shown that the most common cause of urinary infections in hospital settings are E. coli and K. pneumoniae. Data analysis showed that the presence of ESBL isolates was significantly higher in K. pneumoniae than E. coli. CPE isolates of K. pneumoniae were also detected.
{"title":"Frequency and antimicrobial susceptibility pattern of hospital isolates of Escherichia coli and Klebsiella pneumoniae in urine samples","authors":"I. Jukić, D. Topić, El-Jesah Đulić, A. Ljubović","doi":"10.5457/ams.v49i0.527","DOIUrl":"https://doi.org/10.5457/ams.v49i0.527","url":null,"abstract":"Objectives/Aim: Urinary tract infections (UTI) are a serious public health problem and caused by many pathogens, most often by Escherichia coli and Klebsiella pneumoniae.Aim of this study was to show the frequency and antimicrobial susceptibility pattern of E. coli and K. pneumoniae in hospital isolates, following the GLASS methodology.Methods: This is a retrospective study that was conducted in the Laboratory for Urinary Infections OU Clinical Microbiology CCUS in the period from January till December 2018.A total of 13760 urine samples were processed, using standard laboratory methods, in which significant bacteriuria was detected in 3218 (23.4%) of specimens.Results: Out of the total number of positive samples, E. coli was isolated in 1166 (36.2%) and K. pneumoniae at 341 (10.6%) patients. The presence of E. coli and K. pneumoniae isolates is dominant in females (1103/73.2%) and age group 60 and older (812/54.7%). Out of the total E. coli isolates, the ESBL strain was presented with 79 (6.8%) and K. pneumoniae with 145 (42.5%). The proportion of carbapenemase (CPE) produced by K. pneumoniae isolates was 8 (2.4%). The ESBL strain distribution analysis on clinics showed the highest prevalence of both isolates at the Clinic for Nephrology: K. pneumoniae 26/17,9%; E. coli: 12/15.4%. Isolated E. coli showed the highest resistance to ampicillin 673/1166 (57,7%), trimethoprim-sulfamethoxazole 454/1166 (38.9%) and ciprofloxacin 253/970 (26.1%), while K. pneumoniae to ciprofloxacin and trimethoprim-sulfamethoxazole with 151/285 (53.0%) and 164/341 (48.1%), respectively.Conclusions: Our study has shown that the most common cause of urinary infections in hospital settings are E. coli and K. pneumoniae. Data analysis showed that the presence of ESBL isolates was significantly higher in K. pneumoniae than E. coli. CPE isolates of K. pneumoniae were also detected.","PeriodicalId":53635,"journal":{"name":"Acta Medica Saliniana","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2019-09-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42215159","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Ljiljana Pašić, D. Kasapović, M. Petrović, Zdravka Kezić, A. Verhaz, Snežana Ritan
Introduction: Infectious mononucleosis is one of the most common syndromes in our clinical practice. It is characterized by elevated temperature, pharyngitis and generalized lymphadenopathy.Objectives: To describe a clinical charachteristics of infectious mononucleosis (IM) caused by the Epstein Barr virus (EBV) in splenectomized patients since in the literature we found insufficient data.Subjects and Methods: Retrospective analysis of medical documentation of the patient treated in the Clinic for Infectious Diseases of the University Clinical Center of Republic of Srpska.Results: We have described the case of infectious mononucleosis, caused by Epstein Barr virus in a splenectomized patient. In support of acute EBV viral infection were the presence of lymphadenopathy, pharyngitis, hepatomegaly, as well as the occurrence of a typical generalized maculopapulous rash, and positive ELISA EBV VCA IgM and anti EBV VCA / EA IgG, were reported. According to the aforementioned patient, it fulfilled most criteria for setting the diagnosis of acute EBV infectious mononucleosis. Our patient showed some atypical signs such as absence of fever during hospitalization, marked leukocytosis with lymphocytosis (with a maximum increase in leukocyte count at 37.3 x 109, in the differential blood sample dominated lymphocytes with 29.96 x 109 (reference values 1.1-3.35), i.e. 80.3% (Ref. 20.0-46.0). Due to the maintenance of leukocytosis with lymphocytosis, the range of clinical has been extended trials (US abdomen, US neck, CT neck, chest, abdomen and pelvis, sternal puncture, hematologists' consultation). Based on the aforementioned hematologists' consultation, and post-release and recovery monitoring it is concluded that there has been no sign of acute hematologic disease but it has been just EBV-IM.Conclusion: Because of insufficient data on clinical presentation of Epstein Barr viral infections in splenectomized this we believe that this is one of the clinical variants although the possibility of individual variation cannot be excluded. Briefly, we can conclude that the immune system in the splenectomized patient can greatly modify the clinical presentation of Epstein barr viral infection, with the pathogenic mechanism that are still unclear.. However, due to the variety of clinical syndromes and the oncogenic potency of the Epstein-Barr virus, we should be extremely cautious and sometimes expand the diagnostic range beyond conventional examinations.
引言：传染性单核细胞增多症是临床上最常见的综合征之一。其特征是体温升高、咽炎和全身淋巴结病。目的：描述由EB病毒（Epstein-Barr virus，EBV）引起的脾切除患者感染性单核细胞增多症（IM）的临床特征，因为我们在文献中发现的数据不足。受试者和方法：回顾性分析在塞族共和国大学临床中心传染病诊所接受治疗的患者的医疗文件。结果：我们描述了一例脾切除患者因EB病毒引起的传染性单核细胞增多症。支持急性EBV病毒感染的是淋巴结病、咽炎、肝肿大，以及典型的全身性斑丘疹的发生，并报告了阳性的ELISA EBV VCA IgM和抗EBV VCA/EA IgG。根据上述患者的说法，它符合诊断急性EB病毒感染性单核细胞增多症的大多数标准。我们的患者表现出一些非典型症状，如住院期间没有发烧，明显的白细胞增多伴淋巴细胞增多（白细胞计数最大增加为37.3 x 109，差异血样中以淋巴细胞为主的淋巴细胞为29.96 x 109（参考值1.1-3.35），即80.3%（参考文献20.0-46.0）。由于淋巴细胞增多伴白细胞增多，临床试验的范围已经扩大（US腹部、US颈部、CT颈部、胸部、腹部和骨盆、胸骨穿刺、血液学家咨询）。基于上述血液学家的咨询，以及释放后和康复监测得出的结论是，没有急性血液病的迹象，但只是EB病毒感染。结论：由于脾切除后Epstein-Barr病毒感染的临床表现数据不足，我们认为这是临床变异之一，尽管不能排除个体变异的可能性。简言之，我们可以得出结论，脾切除术患者的免疫系统可以极大地改变Epstein-barr病毒感染的临床表现，其致病机制尚不清楚。。然而，由于临床综合征的多样性和EB病毒的致癌能力，我们应该非常谨慎，有时会将诊断范围扩大到常规检查之外。
{"title":"Infectious mononucleosis in splenectomised patient","authors":"Ljiljana Pašić, D. Kasapović, M. Petrović, Zdravka Kezić, A. Verhaz, Snežana Ritan","doi":"10.5457/ams.v49i0.520","DOIUrl":"https://doi.org/10.5457/ams.v49i0.520","url":null,"abstract":"Introduction: Infectious mononucleosis is one of the most common syndromes in our clinical practice. It is characterized by elevated temperature, pharyngitis and generalized lymphadenopathy.Objectives: To describe a clinical charachteristics of infectious mononucleosis (IM) caused by the Epstein Barr virus (EBV) in splenectomized patients since in the literature we found insufficient data.Subjects and Methods: Retrospective analysis of medical documentation of the patient treated in the Clinic for Infectious Diseases of the University Clinical Center of Republic of Srpska.Results: We have described the case of infectious mononucleosis, caused by Epstein Barr virus in a splenectomized patient. In support of acute EBV viral infection were the presence of lymphadenopathy, pharyngitis, hepatomegaly, as well as the occurrence of a typical generalized maculopapulous rash, and positive ELISA EBV VCA IgM and anti EBV VCA / EA IgG, were reported. According to the aforementioned patient, it fulfilled most criteria for setting the diagnosis of acute EBV infectious mononucleosis. Our patient showed some atypical signs such as absence of fever during hospitalization, marked leukocytosis with lymphocytosis (with a maximum increase in leukocyte count at 37.3 x 109, in the differential blood sample dominated lymphocytes with 29.96 x 109 (reference values 1.1-3.35), i.e. 80.3% (Ref. 20.0-46.0). Due to the maintenance of leukocytosis with lymphocytosis, the range of clinical has been extended trials (US abdomen, US neck, CT neck, chest, abdomen and pelvis, sternal puncture, hematologists' consultation). Based on the aforementioned hematologists' consultation, and post-release and recovery monitoring it is concluded that there has been no sign of acute hematologic disease but it has been just EBV-IM.Conclusion: Because of insufficient data on clinical presentation of Epstein Barr viral infections in splenectomized this we believe that this is one of the clinical variants although the possibility of individual variation cannot be excluded. Briefly, we can conclude that the immune system in the splenectomized patient can greatly modify the clinical presentation of Epstein barr viral infection, with the pathogenic mechanism that are still unclear.. However, due to the variety of clinical syndromes and the oncogenic potency of the Epstein-Barr virus, we should be extremely cautious and sometimes expand the diagnostic range beyond conventional examinations. ","PeriodicalId":53635,"journal":{"name":"Acta Medica Saliniana","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2019-09-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42154459","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Azra Čamdžić, A. Ljubović, Kamelija Madacki Todorović
Introduction: Intensive unit microflora mainly consists of organism capable of surviving in moist media, such as gram-negative bacteria, skin-colonizing microorganisms, those with the ability to adhere to medical devices, and microorganisms resistant to conventional antibiotics. Therefore, cleansing and disinfection of intensive care units is of great importance in the prevention and control of hospital infections.Material and Methods: The use of the device was demonstrated in the isolation room of the intensive care unit after a patient colonized with hospital bacterial strains was discharged. The first sampling was carried out immediately after the patient was discharged, the second after the standard medical cleansing of the equipment and space, and the third after the disinfection with the “SterisafePro”. The analysis of the smears was performed at the OU Clinical Microbiology. Quantitative method analyses was performed according to standard operative procedure (SOP). The results of the analysis are calculated according to the formula and expressed in the values of CFU / cm2.Results: After the patient was discharged and the area cleaned mechanically, the Acinetobacter baumanii was isolated in three samples, coagulase negative staphylococci in one, while two smears remained sterile. Acinetobacter baumanii and coagulase negative staphylococci were isolated in three samples. After using the disinfecting device, all swabs were sterile.Conclusion: Disinfection of the hospital with the “Sterisafe”Pro” device has proved to be very successful. The advantages of using the “Sterisafe”Pro” device are that is uses no chemicals, has a low labor and usage costs, is harmless to the patients and staff, and is very easy to use.
{"title":"Using disinfection devices in Intensive Care Units","authors":"Azra Čamdžić, A. Ljubović, Kamelija Madacki Todorović","doi":"10.5457/ams.v49i0.525","DOIUrl":"https://doi.org/10.5457/ams.v49i0.525","url":null,"abstract":"Introduction: Intensive unit microflora mainly consists of organism capable of surviving in moist media, such as gram-negative bacteria, skin-colonizing microorganisms, those with the ability to adhere to medical devices, and microorganisms resistant to conventional antibiotics. Therefore, cleansing and disinfection of intensive care units is of great importance in the prevention and control of hospital infections.Material and Methods: The use of the device was demonstrated in the isolation room of the intensive care unit after a patient colonized with hospital bacterial strains was discharged. The first sampling was carried out immediately after the patient was discharged, the second after the standard medical cleansing of the equipment and space, and the third after the disinfection with the “SterisafePro”. The analysis of the smears was performed at the OU Clinical Microbiology. Quantitative method analyses was performed according to standard operative procedure (SOP). The results of the analysis are calculated according to the formula and expressed in the values of CFU / cm2.Results: After the patient was discharged and the area cleaned mechanically, the Acinetobacter baumanii was isolated in three samples, coagulase negative staphylococci in one, while two smears remained sterile. Acinetobacter baumanii and coagulase negative staphylococci were isolated in three samples. After using the disinfecting device, all swabs were sterile.Conclusion: Disinfection of the hospital with the “Sterisafe”Pro” device has proved to be very successful. The advantages of using the “Sterisafe”Pro” device are that is uses no chemicals, has a low labor and usage costs, is harmless to the patients and staff, and is very easy to use. ","PeriodicalId":53635,"journal":{"name":"Acta Medica Saliniana","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2019-09-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48180481","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
M. Dimzova, M. Bosilkovski, M. Gasheva, Boban Toshevski, Biljana Petreska, Marija Cvetkova, D. Jakimovski
Background: The quantification of HBsAg provides different and complementary information that helps in determination of the different phases of chronic hepatitis B viral infection, evaluation and follow-up of liver disease progression as well as in treatment individualization.Aim: To evaluate the clinical significance of quantitative HBsAg (qHBsAg) in patients with HBeAg negative chronic hepatitis (CHB) and its correlation with the serum levels of alanine aminotransferase (ALT), quantitative HBV DNA and liver fibrosis.Subjects and Methods: The study included 53 treatment naïve patients with HBeAg negative chronic hepatitis B. All patients underwent complete laboratory and serology testing, quantification of HBV DNA and HBs antigen. The liver stiffness was measured with elastography. Patients’ demographic characteristics, viral and biochemical markers were recorded at one point of time.Results: Correlation analysis between the qHBsAg and ALT showed an significant, positive correlation between the parameters for R=0.42 and p<0.05; there was statistically non-significant positive correlation for R=0.25 and p>0.05 between qHBsAg and HBV DNA. There was a positive correlation between qHBsAg and liver fibrosis for R=0.08 and p>0.05. The serum levels of HBsAg had greater impact on the serum levels of ALT compared to that of HBV DNA for R=0.15 and p>0.05.Conclusion: Patients with higher ALT values and higher liver fibrosis score have higher qHBsAg; qHBsAg can reflect the serum HBV DNA levels.
{"title":"The clinical significance of quantitative HBSAG in patients with HBEAG negative chronic hepatitis B","authors":"M. Dimzova, M. Bosilkovski, M. Gasheva, Boban Toshevski, Biljana Petreska, Marija Cvetkova, D. Jakimovski","doi":"10.5457/ams.v49i2.517","DOIUrl":"https://doi.org/10.5457/ams.v49i2.517","url":null,"abstract":"Background: The quantification of HBsAg provides different and complementary information that helps in determination of the different phases of chronic hepatitis B viral infection, evaluation and follow-up of liver disease progression as well as in treatment individualization.Aim: To evaluate the clinical significance of quantitative HBsAg (qHBsAg) in patients with HBeAg negative chronic hepatitis (CHB) and its correlation with the serum levels of alanine aminotransferase (ALT), quantitative HBV DNA and liver fibrosis.Subjects and Methods: The study included 53 treatment naïve patients with HBeAg negative chronic hepatitis B. All patients underwent complete laboratory and serology testing, quantification of HBV DNA and HBs antigen. The liver stiffness was measured with elastography. Patients’ demographic characteristics, viral and biochemical markers were recorded at one point of time.Results: Correlation analysis between the qHBsAg and ALT showed an significant, positive correlation between the parameters for R=0.42 and p<0.05; there was statistically non-significant positive correlation for R=0.25 and p>0.05 between qHBsAg and HBV DNA. There was a positive correlation between qHBsAg and liver fibrosis for R=0.08 and p>0.05. The serum levels of HBsAg had greater impact on the serum levels of ALT compared to that of HBV DNA for R=0.15 and p>0.05.Conclusion: Patients with higher ALT values and higher liver fibrosis score have higher qHBsAg; qHBsAg can reflect the serum HBV DNA levels.","PeriodicalId":53635,"journal":{"name":"Acta Medica Saliniana","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2019-09-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44950430","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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