Biomedical subjects

Boris Dzelalija

Publications and source records attributed to Boris Dzelalija.

9 recordsLinked to original sources

PubMed2006

High prevalence of antibodies to lymphocytic choriomeningitis virus in a murine typhus endemic region in Croatia.

A retrospective serological survey was carried out by the indirect immunofluorescence assay (IFA) and complement fixation (CF) test in a sample of 425 healthy residents (240 females and 185 males) to investigate whether Lymphocytic choriomeningitis virus (LCMV) circulates in the rural area of the northern Croatian island of Vir, which is known to be endemic for murine typhus. The overall prevalence of LCMV antibodies detected by IFA was found to be 36% (155 out of 425) and 13% (54 out of 425) by CF. No significant difference in the LCMV seroprevalence was observed with respect to age and gender by any of the methods used. The results show that inhabitants in the area studied are clearly being exposed to LCMV and the infection of the population occurs in the first 10 years of life. Equal prevalence of IgG and especially of short-lived CF antibodies in the elderly in comparison to other age groups and children can be explained by reinfections and boosting of antibodies through permanent contact with the virus. To the best of our knowledge this study reports the first evidence of endemic LCMV in Croatia and one of the highest LCMV human prevalence reported worldwide to date. The epidemiological association between LCMV and other zoonoses which can be expected in this community as well as the etiology of summer influenza-like illness along the coastal area of Croatia has to be explored further.

Adolescent↗

PubMed2006

The effect of propofol and fentanyl as compared with sevoflurane on postoperative vomiting in children after adenotonsillectomy.

Postoperative vomiting (PV) after adenotonsillectomy in children is a common problem with an incidence as high as 40-80%. Only few studies in the recent literature compared the effect of different anesthetic techniques concerning PV in children. The aim of this study was to compare the incidence of PV in two groups of children who underwent two different general anesthesia techniques in order to determine what type of anesthetic technique is more related to less PV. The clinical trial included 50 children (physical status ASA I, 3-12 years old) divided into 2 groups and monitored for PV 24 hours following the surgery. Group one (G1) consisted of 25 children who underwent general anesthesia with gas mixture 60% nitrous oxide and 40% oxygen and anesthetic propofol, opioid fentanyl and muscle relaxant vecuronium intravenously and group two (G2) included 25 children to whom volatile anesthesia with sevoflurane in the same gas mixture was given. Demographic characteristics (gender, age, weight, history of motion sickness and earlier PV) as well as surgical data (length of surgery and anesthesia, intraoperative blood loss) were recorded. There were no significant differences considering demographic characteristics and surgical data between the investigated groups. The incidence of PV was relatively low 3 children (12%) in G1 group and 5 children (20%) in G2 group. Statistically there was no significant difference between the groups regarding the incidence of PV and both anesthetic techniques can be used equally safe regarded to PV.

Adenoidectomy↗

PubMed2006

[Rash and purulent lymphadenitis in cat scratch disease].

We present a case of a cat-scratch disease (CSD) presenting with typical (primary lesion and regional lymphadenitis) and rare (purulent lymphadenitis and maculopapular rash) symptoms and positive epidemiological data. Laboratory blood test showed normal values for routine parameters, except for mild leukocytosis (L 12.4 x 10(9)), elevated erythrocyte sedimentation rate (SE 65/h) and moderately elevated asparta e-aminotransferase and alanine-aminotransferase values (AST/ALT 48/90), fibrinogen (5.3 g/L) and C-reactive protein (CRP 85 mg/L). Cytological analysis of lymph node content revealed granulomatous inflammation in the first sample, and purulent inflammation in the second sample. In paired serum samples, collected on the 15th and 29th day from the onset of disease, antibodies IgG (titre 4096/8192) and IgM (titre 80/40) to Bartonella henselae were detected by using an indirect immunofluorescence assay (IFA). Antibiotic therapy with azithromycin (1 x 500 mg per os/5 days) was administered. Purulent lymphadenitis and rash, although a rare clinical manifestation in CSD, are significant clinical findings in differentiating CSD from other febrile illnesses accompanied with rash and lymphadenitis.

Cat-Scratch Disease↗

PubMed2005

Q fever epidemic among employees in a factory in the suburb of Zadar, Croatia.

AIM: To examine the role of wind in the spread of Q fever (Coxiella burnetii) from the source of infection (sheep on the pastures) to the factory where there was an outbreak of Q fever among the employees. METHODS: We performed clinical (fever, coughing, myalgias, arthralgias), laboratory (complete blood test, aminotransferases, antibodies to Coxiella burnetii), radiographic (chest X-ray), and epidemiological (questionnaire) analysis on 47 of 110 employees of the plant in a suburb of Zadar. Sera of 182 sheep were tested for antibody to C. burnetii by complement fixation reaction. RESULTS: During the first half of March 2004, 14 of 110 employees of a factory in a suburb of Zadar were diagnosed with Q fever on the basis of clinical and laboratory findings. In three sections of the plant, directly exposed to the north wind, a diagnosis of Q fever was confirmed in 14 of 110 employees by clinical, laboratory, and X-ray analysis, whereas there were no sick employees in the other four sections. North of the plant there were pastures where many flocks of sheep grazed. Antibodies to C. burnetii were found in 20 out of 182 sheep sera. Employees who were exposed to the north wind, had a significantly higher possibility of acquiring Q fever than did those working in sections protected from the wind. CONCLUSION: North wind (bura) containing the aerosolized C. burnetii likely influenced the Q fever outbreak in persons far from the source of the infection.

Adult↗

PubMed2003

Latrodectus bites in northern Dalmatia, Croatia: clinical, laboratory, epidemiological, and therapeutical aspects.

AIM: To analyze clinical and epidemiological characteristics of the black widow spider (Latrodectus tredecimguttatus) bites and asses the impact of antitoxin administration after the bite on the intensity and duration of pain. METHOD: Retrospective analysis of clinical appearance, laboratory findings, and clinical assessment of the antitoxin administration efficacy in 32 patients with latrodectism treated at Zadar General Hospital between 1992 and 2002. RESULTS: All patients presented with generalized pain, profound perspiration, and burning in the sole of the foot. Laboratory findings revealed moderately increased serum glucose concentrations in half of the patients, concentrations of aspartate aminotransferase and alanine aminotransferase 2 to 3 times higher than normal in 8 of 32 patients, moderate leukocytosis in 16 of 32 patients, mature neutrophilia in 15 of 32 patients, and immature forms of leukocytes in 4 of 32 patients. In 21 patients who received the antitoxin, severe pain lasted 1-4 h (median, 1.2 h) after the antitoxin administration, moderate pain 1-5 h (median, 2.4 h), and hospitalization 1-5 days (median, 4 days). In patients who did not receive antitoxin, there was a statistically significant increase in duration of severe pain (median, 50 h; range, 24-72 h), moderate pain (median, 36 h; range, 24-48 h), and hospitalization (median, 6 days; range, 4-12 days) (p<0.05 for all, Kruskal-Wallis H test). Men were more often bitten by the venomous spider (20 men vs 12 women); adults more often than children (30 vs 2, respectively), domestic population more often than tourists (30 vs 2, respectively), and rural mainland inhabitants more often than islanders (21 vs 11, respectively). All biting incidents occurred between June and September, most often in July (17 patients). CONCLUSION: Latrodectism in Northern Dalmatia presents with severe clinical symptoms. Administration of the antitoxin is advisable in the treatment of all afflicted patients.

Adolescent↗

PubMed2003

[Hemorrhagic fever with renal syndrome: imported or native disease in the Zadar region].

AIM: The aim of the study is to warn of the need of clinical hemorrhagic fever with renal syndrome (HFRS) recognition and determination, and of the risk of its spread from a new focus of this natural zoonosis near Zadar (north Dalmatia), i.e., in the northern part (Lika) of the Zadar County. METHOD: Clinical and epidemiologic characteristics of HFRS were analyzed in four patients. Patient sera were analyzed for Puumala (PUU) and Hantaan (HTN) viruses by immunofluorescence test (IFT) and immunoenzyme test (ELISA). RESULTS: Epidemiologic studies confirmed the source of infection to be out of the area in three patients, whereas in one patient it was near Zadar area. Mild symptoms pointed to the disease. Pathologic findings showed pathologic leukocyte values (leukocytosis), two- to four-fold alanine aminotransferase, aspartate aminotransferase and creatinine increase in serum, proteinuria and erythrocyturia. A significant PUU antibody titer was found by serum IF and ELISA. CONCLUSION: The occurrence of HFRS in the Zadar area was confirmed by clinical description and laboratory evidence. The newly identified focus was in the vicinity of this area could imply a risk for the disease epidemic in the Zadar area.

Adult↗

PubMed2002

Randomized trial of azithromycin in the prophylaxis of Mediterranean spotted fever.

A randomized clinical trial was undertaken to compare clinical and serologic parameters of the efficacy of one-dose azithromycin in the prophylaxis of Mediterranean spotted fever (MSF) in 122 persons with a tick bite history. Antibodies to Rickettsia conorii (R. conorii) were detected by indirect immunofluorescence (IFA) assay in 55 (45.1%) of 122 subjects. Positive result was obtained in 19 (31.1%) of 61 subjects with azithromycin prophylaxis and in 36 (59.0%) of 61 subjects without prophylaxis. Clinical signs and symptoms of MSF were recorded in 6 (9.8%) and asymptomatic infection in 30 (49.2%) of 61 subjects without prophylaxis. In subjects with prophylaxis, clinical signs of the disease were not recorded at all, whereas asymptomatic infection was detected in 19 (31.1%) of 61 subjects. Based on the results obtained in our study, we assume that a single dose of azithromycin is promising in MSF prevention.

Adult↗

PubMed2002

Retropharyngeal abscess and acute inflammation of the maxillary sinus: transoral procedure as a surgical method of treatment.

A previously healthy man, 65 years of age, was hospitalized for clinical symptoms and signs of retropharyngeal abscess. Computed tomography showed an abscess of the retropharyngeal space and the presence of liquid content in the paranasal sinuses. The patient was completely treated by the administration of combined antibiotics, biopsy procedure and aspiration of the contents by the retropharyngeal transoral procedure.

Acute Disease↗

PubMedDate not supplied

[Lethal midline granuloma].

Lethal midline granuloma is a rare clinical syndrome. In clinical practice the destructive process of the facial midline may appear as a symptom of various infective, malignant or autoimmune diseases. A physician must have a good knowledge of the problem in order to make a rational approach to diagnosis. The present paper discusses the case of a 34-year old patient with destructive changes of midline, nose, perforating of palatal cleft and destruction of bone structure of nose, maxillary and ethmoid sinus. For histopathologic diagnosis of T-lymphoma it was necessary to make immunohistological study of the biopsy specimen. Irradiation therapy with total dose of 5600 cGy showed an extremely good therapeutic result. Three years after irradiation therapy the patient is still in a remission.

Adult↗