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Biomedical subjects

M Morovic

Publications and source records attributed to M Morovic.

6 recordsLinked to original sources

[Tuberculous orchiepididymitis and CNS complication].

INTRODUCTION: Hydrocephalus as a complication of tuberculous orchiepididymitis is extremely rare. In this reported case, hydrocephalus was the consequence of a disseminated tuberculous process. CASE REPORT: A 28-year-old man was treated for a left-sided orchiepididymitis. He developed the signs of increased intracranial pressure. Computer tomography (CT) of the brain showed a hydrocephalus. The diagnostics that followed confirmed disseminated tuberculosis (Tbc). CONCLUSIONS: Urogenital system is at the present rarely affected by Tbc. Especially rare is disseminated Tbc, which affects at the same time three different organ systems. Disseminated Tbc presented with many different but non-specific clinical symptoms, sometimes mimicking neoplasm. This makes diagnosis and therapy more difficult. We point out that in any case of orchiepididymitis not responding to standard antimicrobial therapy Tbc must be taken into consideration as the one of the differential diagnostic possibilities.

Adult↗

Antibiotic utilization at the university hospital after introducing an antibiotic policy.

OBJECTIVE: Antibiotic formulary restrictions are among the most popular methods to control antibiotic utilization in hospitals. The aim of the present survey was to investigate the influence of "reserve antibiotic" on antimicrobial utilization at the University Hospital Center (UHC) Rijeka. METHODS: At the UHC Rijeka, reserve antibiotic was implemented in July 1997. The antimicrobial drug consumption was monitored 6 months prior to and 6 months after the introduction of the method. Antimicrobial consumption was measured in defined daily doses (DDDs) among the major clinics. RESULTS: Reserve antibiotic has led to a decrease in total antibiotic consumption at the UHC Rijeka (45.9 DDDs/100 bed days vs 32.9 DDDs/100 bed days). Antibiotic utilization decreased in the second semester at most clinics: at the Clinic for Infectious Diseases 41%, at the Anesthesiology and Intensive Care Unit 30%, at the Clinic for Internal Medicine 18% and at the Surgical Clinic 12%. At the Clinic for Gynecology and Obstetrics, the antibiotic utilization remained the same, while at the Pediatric Clinic an increase of 28% in antibiotic utilization was noted. CONCLUSION: Our study indicates that restriction of usage of some antibacterial agents is a successful method to decrease antibiotic consumption and a way to bring cost savings and helps prevent emergence of resistant microorganisms in hospitals. To improve antimicrobial prescribing, additional methods such as education are required.

Academic Medical Centers↗

Opsoclonus-myoclonus syndrome in a child with neuroborreliosis.

Opsoclonus-myoclonus is a rare neurological syndrome affecting children and adults. In children it occurs as a parainfectious process or a paraneoplastic syndrome in association with neuroblastoma. Here we report it presenting as an unusual neurological manifestation of Lyme borreliosis. To our knowledge, this is the first report which describes recovery from this syndrome in a child.

Antibodies, Bacterial↗

Isolation of Rickettsia akari from a patient in a region where Mediterranean spotted fever is endemic.

Rickettsia akari was isolated from blood collected from a patient in Croatia in 1991. We believe this is the first human isolate of R. akari to be reported in more than 40 years and the first ever from southern Europe. The Croatian isolate was antigenically and genetically indistinguishable from the prototype American strain and a Ukrainian strain. In all probability, rickettsialpox would be diagnosed more frequently and over a wider geographic area if physicians gave greater consideration to the diagnosis and if laboratory diagnostic methods were better able to distinguish among spotted fever group rickettsioses.

Adult↗

Antigen-capture enzyme immunoassay: a comparison with other methods for the detection of spotted fever group rickettsiae in ticks.

To evaluate the prevalence of spotted fever group rickettsiae along the Adriatic Coast of Croatia, 832 ticks were examined by hemolymph test, direct immunofluorescence, antigen-capture enzyme immunoassay, and polymerase chain reaction. Very good agreement was observed among direct immunofluorescence, polymerase chain reaction, and antigen-capture enzyme immunoassay. Twelve ticks that were positive by hemolymph test and negative by both direct immunofluorescence and polymerase chain reaction presumably do not represent spotted fever group rickettsiae. By direct immunofluorescence, spotted fever group rickettsiae were present in 12% of Rhipicephalus bursa, 10.6% of Rh. sanguineus, and 7.8% of Dermacentor marginatus. From the 98 ticks containing rickettsia-like organisms by hemolymph test, seven spotted fever group rickettsial isolates were established in cell culture. Four isolates were identified as Rickettsia conorii. The antigen-capture enzyme immunoassay, which utilizes a monoclonal antibody to antigens of the 135-kD surface protein shared among many members of the spotted fever group, is recommended for primary screening of tick samples because it is reliable and yet less labor-intensive than the hemolymph and direct immunofluorescence tests. Although the polymerase chain reaction is too expensive for use as a screening method, it is recommended for confirmation of positive screening results. In addition to the technologic advance of the antigen-capture enzyme immunoassay, this study documented by contemporary methods that R. conorii is present along the eastern Adriatic Coast not only in the classic vector, Rh. sanguineus, but also in Rh. bursa and D. marginatus.

Animals↗

Prevalence of antibodies to spotted fever group rickettsiae along the eastern coast of the Adriatic sea.

A seroepidemiological survey in coastal Croatia detected antibodies reactive with Rickettsia conorii in 4.2% of sera by immunofluorescence assay and in 5.0% of sera by enzyme immunoassay. Western immunoblotting demonstrated antibodies to the 120-kDa surface protein in all 20 positive serum samples examined and to rickettsial lipopolysaccharide in 3 of these serum samples. Humans in this area are clearly being exposed to spotted fever rickettsiae.

Antibodies, Bacterial↗