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Biomedical subjects

J Begovac

Publications and source records attributed to J Begovac.

At least 19 recordsLinked to original sources
PubMed2001

Meningitis and endocarditis caused by group B streptococcus in a human immunodeficiency virus (HIV) infected patient.

We present a case of meningitis and endocarditis caused by Streptococcus agalactiae (group B streptococcus) in an adult patient with human immunodeficiency virus (HIV) infection. To our knowledge, only four other cases of meningitis, none of which had concomitant endocarditis, have been reported so far. A 45-year-old homosexual patient presented with fever, confusion, and signs of meningeal irritation. Streptococcus agalactiae was cultured from the blood, urine, and cerebrospinal fluid (CSF). Diagnosis of meningitis caused by streptococcus agalactiae was made. On day 35, a heart murmur was noticed, and patient developed cardiac decompensation. Echocardiography revealed vegetations on the mitral and aortic valve. After nine weeks of antibiotic treatment, the patient was discharged from the hospital in good general condition, with improved CSF and echocardiographic findings.

Endocarditis, Bacterial↗
PubMed2001

Biological, epidemiological and clinical basis of understanding human immunodeficiency virus infection.

Human immunodeficiency virus (HIV) causes a chronic infection beginning in most individuals with an acute syndrome followed by an asymptomatic stage and progresses in untreated adults over a median of 10 years to the late stage called AIDS. The virus rapidly and enormously replicates from the initiation of infection. The principal immunodeficiency caused by HIV is depletion in the subset of T lymphocytes referred to as helper T cells. New anti-HIV drugs given in potent combination regimens have demonstrated impressive efficacy by both clinical and laboratory measures, and have provided evidence that drugs can suppress HIV replication and disease manifestations. HIV/AIDS is still uncommon in Croatia. In the period from 1986 to 2000, 171 patients with AIDS have been reported of whom 101 (59%) died. The incidence of AIDS in 2000 was about 4 cases per million inhabitants. Recent testing of injection drug users at a needle exchange program (Help, Split) revealed an HIV incidence of about 1%.

Acquired Immunodeficiency Syndrome↗
PubMed2000

Evaluation of phenotypic characteristics for differentiation of enterococcal species using an example based algorithm.

A computer based rule-generation system of Inductive Learning by Logic Minimization (ILLM) was used to determine the sufficient set of biochemical reactions and necessary conditions that have to be fulfilled for correct differentiation of enterococci recovered from humans. The simplest combination of physiological tests for differentiation Enterococcus faecalis from all other enterococcal species consisted of only 3 reactions. Reactions that tested the ability of acidification D-xylose, mannitol, L-arabinose and Na-pyruvate were useful for delineation of both E. faecalis and E. faecium from all other enterococci. For differentiation of all 12 currently known clinically significant species of enterococci any one of 3 sets of nine tests suggested by ILLM could be used. The tests suggested by ILLM were applied to 153 isolates of enteroccoci recovered at our Department of Microbiology and all E. faecalis (138, 90.2%), E. faecium (13, 8.5%) and E. avium strains (2, 1.3%) were correctly differentiated.

Algorithms↗
PubMed2000

Hepatitis B and HIV/AIDS in Zagreb: a district level analysis.

This study examines the presence of hepatitis B as a possible precursor marker for HIV/AIDS in 10 districts of Zagreb, Croatia. There were a total of 931 cases of hepatitis B in Zagreb in the period 1979-1995, the annual rate ranging from 3.1 to 15.4 per 10,000. The highest relative risk for hepatitis B for the 1979-1995 period was in the Pescenica district (Relative risk (RR): 1.4). There were 108 cases of HIV/AIDS diagnosed in Croatia in the period 1986-1996, with 34% from Zagreb. The highest relative risk for HIV/AIDS was within the Pescenica district (RR: 2.3). Pescenica had also a significantly higher incidence of hepatitis B when compared to other districts (p = 0.005). The cumulative incidence of hepatitis B in Zagreb was directly related to levels of neighborhood discomfort as determined by an index including unemployment, inflation and housing conditions (p = 0.005). This research demonstrates that the poor areas of the city with higher incidence of hepatitis B hold the greatest threat for the spread of HIV/AIDS.

Acquired Immunodeficiency Syndrome↗
PubMed2000

Survival of AIDS patients in Croatia prior to the introduction of combined antiretroviral therapy with protease inhibitors.

We report our experience on survival of adults with AIDS, treated at the University Hospital of Infectious Diseases, Zagreb, Croatia from October 1986 to December 1998. The median survival of our 116 patients was 15.8 months. Multivariate analysis showed that factors independently associated with survival were type of presenting AIDS indicator disease and CD4+ cell count.

Acquired Immunodeficiency Syndrome↗
PubMed1999

Short-term treatment of pertussis with azithromycin in infants and young children.

A prospective, open, noncomparative study was conducted to assess the efficacy and safety of azithromycin given once daily for 3 or 5 days to eradicate Bordetella pertussis from the upper respiratory tract of infants and young children. Seventeen children received azithromycin in a dose of 10 mg/kg on day 1 followed by 5 mg/kg once daily for four consecutive days, and 20 were given 10 mg/kg once daily for 3 days. Seven days after the initiation of therapy, 33 of 35 (94.3%) patients had negative cultures for Bordetella pertussis. On day 14, cultures from all 34 evaluable patients were negative. These findings suggest that a controlled, comparative study of erythromycin versus short-term administration of azithromycin is justified.

Anti-Bacterial Agents↗
PubMed1999

Urinary tract infections in HIV disease.

HIV-positive patients are liable to acquire opportunistic infections. Their liability to acquire other common infectious conditions is less frequently reported. In order to determine the frequency of urinary tract infections (UTI) in HIV-positive patients, we performed a retrospective analysis. The control group was formed from patients with community acquired pneumonia. We reviewed charts of 96 HIV-positive patients and of 314 patients in the control study group. The analysis has shown that patients with HIV had a UTI more frequently than the controls. Besides the difference in the frequency, we observed the difference in the etiology. Enterococci were the most frequent isolates in patients with HIV disease, whereas Escherichia coli was most frequently isolated in the controls. These facts should be taken into consideration when treatment of a UTI with suspected bacteremia in AIDS patients is initiated.

AIDS-Related Opportunistic Infections↗
PubMed1998

[Selection of phenotype characteristics in differentiation of various species of enterococci using an inductive mathematical program].

In this paper a novel computer example-based learning system (Inductive learning by logic minimization) was used to determine the sufficient set of biochemical reactions and necessary conditions that have to be fulfilled for the correct identification of enterococci isolated from human specimens. Several combinations for accurate identification of Enterococcus faecalis and Enterococcus feacium from other enterococci were found. The simplest combination set for E. faecalis identification consists of 3 reactions: growth in 0.04% K-tellurite, mannitol acidification, failure to acidify raffinose. The simplest set for E. faecium differentiation from other enterococcal species is performed by the following 3 reactions: failure to acidify D-xylose and Na-pyruvate, and acidification of L-arabinose. Only 4 tests are sufficient (acid from D-xylose, mannitol, L-arabinose and Na-pyruvate) for the correct identification of these two, the most frequently isolated species. If it is necessary to analyze all enterococcal species, then even three combinations of 9 tests for the correct differentiation of any of them, are available.

Artificial Intelligence↗
PubMed1998

Comparison of lymphocyte subpopulations in the peripheral blood of patients with infectious mononucleosis and human immunodeficiency virus infection: a preliminary report.

The aim of this study was to analyse the lymphocyte subpopulations in the peripheral blood of HIV-1-infected adults to compare them with four patients with acute EBV infection. Lymphocyte subsets in 15 healthy controls, 40 HIV-1-infected adults and 4 EBV-infected patients with infectious mononucleosis were analysed by flow cytometry. The immunophenotyping of HIV-1-infected patients in different stages of disease showed a significant reduction in the percentage and absolute count of CD4+ T-lymphocytes, significantly increased percentage of CD8+ T-lymphocytes, inverted CD4/CD8 ratio and an increase in the expression of activation marker HLA-DR compared to controls. The immuno-phenotyping profiles of HIV and EBV infection share some similarities as they both result in the decreased percentage of CD4+ T-lymphocytes, increased CD8+ T-lymphocytes and an inverted CD4/CD8 ratio. Patients with HIV infection could be distinguished from patients with EBV infection by the absolute lymphocytosis and increased expression of HLA-DR seen in the patients with infectious mononucleosis. In conclusion, both HIV-1 and EBV profoundly change the distribution of lymphocyte subpopulations in the peripheral blood. It is our opinion that flow cytometry could be an aid in the rapid distinguishing of patients with suspected primary HIV-1 infection from those with infectious mononucleosis (before serology data are available).

Acute Disease↗
PubMed1998

[Cytomegalovirus retinitis in patients with human immunodeficiency virus infection].

Cytomegalovirus retinitis (CMVR) is a common opportunistic infection and a major cause of blindness in patients with AIDS. The aim of this study was to determine the frequency, clinical course and outcome of CMVR in patients treated at the University Hospital of Infectious Diseases "Dr. Fran Mihaljević" in Zagreb in the period from January 1995 to April 1996. CMVR was diagnosed in 8 (27.5%) of 29 patients with AIDS. The median CD4 lymphocyte count in patients with CMVR was 44 per mm3, six patients had less than 50 per mm3. Five patients died during the study period, the mean survival being 5.5 months. CMVR was present in both eyes in 5 (62.5%) patients at the time of diagnosis. Blindness in both eyes developed in 3 (37.5%) patients. In order to recognize and promptly treat CMVR frequent ophthalmologic examinations should be performed in patients with advanced HIV disease.

AIDS-Related Opportunistic Infections↗
PubMed1996

Comparison of clinical characteristics of group A streptococcal bacteremia in children and adults.

This report reviews 55 cases of bacteremia due to group A streptococci (GAS) in patients treated at the University Hospital of Infectious Diseases, in Zagreb, Croatia, during the period 1974-1994. Clinical findings for 27 children (age, < 18 years) were compared with those for 28 adults. A clear predominance of the respiratory tract as a primary focus of infection in younger patients was observed (P = .00006). Children were more frequently colonized by GAS in their throats than were adults (P = .04). Suppurative osteoarticular metastatic foci were more often found in children (P = .02). Acute underlying conditions were more common in children (P = .04), whereas chronic underlying conditions were more common in adults (P = .00005). The case fatality rate was 23% among children (6 of 27) and 50% among patients aged > 60 years (5 of 10). The course of bacteremia due to GAS was benign in eight children (29.6%) and 12 adults (42.8%). Our experience suggests that there are significant differences in the presentation of bacteremia due to GAS in children and adults.

Adolescent↗
PubMed1993

Asymptomatic pharyngeal carriage of beta-haemolytic streptococci and streptococcal pharyngitis among patients at an urban hospital in Croatia.

In a one-year study at the University Hospital of Infectious Diseases in Zagreb, Croatia the rate of asymptomatic throat carriage of beta-haemolytic streptococci was investigated. Throat carriage was investigated in 1796 patients, none of whom had a sore throat nor signs and/or symptoms of a respiratory tract infection. The carrier rate of beta-haemolytic streptococci was 8.3%, for group A streptococci 6%, group B 1.3%, group C 0.3% and group F 0.1%. The highest rate was observed in the 6 to 14 year age group: 13.8% for all streptococcal groups, 11.7% for group A alone. The proportion of non-A streptococci was higher in older age groups. Tonsillectomised individuals were less frequently carriers. No sex or season-dependent variations were observed. In a four-month study of 629 patients with pharyngitis the throat cultures yielded: group A streptococci in 44.7%, group B in 1.7%, group C in 0.8%, and group G in 0.6% of the patients. Group A streptococci in 44.7%, group B in 1.7%, group C in 0.8%, and group G in 0.6% of the patients. Group A streptococcal rates in carriers compared to rates in patients with pharyngitis suggest that approximately one fourth of the schoolchildren with culture-positive pharyngitis actually are not truly infected, but only carriers currently having a sore throat of non-streptococcal etiology. Antibiotics were administrated to 605 (96.2%) patients with pharyngitis; in 571 (94.4%) of the cases before culture results became available. After culture-negative results were obtained the therapy was discontinued in only 28.5% of the cases.(ABSTRACT TRUNCATED AT 250 WORDS)

Acute Disease↗
PubMed1992

Production of pyrogenic exotoxins in group A streptococci isolated from patients in Zagreb, Croatia.

The pyrogenic exotoxin profiles were determined of group A streptococci isolated from patients in Zagreb, Croatia in the period 1989-1990. A total of 12 strains were studied, five from patients with serious infections and seven from patients with uncomplicated infections. Serotypes M1 and M3 were found in seven (58%) patients. Seven strains produced exotoxin A and ten strains exotoxin B. The proportion of exotoxin A and B producing strains in patients with severe infections (3 patients respectively) was similar to that found in patients with uncomplicated infections (4 and 7 patients respectively).

Adult↗