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Search Results: 1 - 10 of 292 matches for " Mijailovi? ?eljko "
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Weil’s syndrome (Leptospiral infection): A case report
Mijailovi? ?eljko,?anovi? Predrag,Gajovi? Olgica
Medicinski Pregled , 2007, DOI: 10.2298/mpns0710493m
Abstract: Introduction. Leptospirosis is an acute zoonotic infection, caused by spirochetes of the genus Leptospira. It is characterized by extensive vasculitis. It is usually transmitted indirectly, per contaminated water, rarely directly, through contact with infected animals. Leptospira bacteria commonly enter the body through damaged skin or mucous membranes. The clinical syndromes may vary from a subclinical infection and mild febrile condition to severe clinical symptoms with jaundice and renal failure. Case report. This is a case report of a patient with leptospirosis (Weil's disease) whose clinical manifestations included: icterus, renal failure, hemorrhagic syndrome and disturbances of consciousness. After the use of antibiotics, symptomatic and substitution therapy, all symptoms resolved completely. However, in our patient, hemodialysis was necessary due to renal failure, as a palliative measure. Discussion. Weil’s syndrome is a severe form of leptospirosis, which can be fatal. Early clinical diagnosis of the disease, as well as serologic verification of infection, are very important prerequisites, followed by antibiotic and other symptomatic therapy, as soon as possible. Conclusion. This is a case report of a patient with rare clinical manifestations of leptosirosis. Although presenting with severe symptoms, thanks to palliative therapeutic measures, complete and fast recovery was achieved. We especially point out the role of hemodialysis in the treatment of this patient. .
Incidence, risk factors and outcome of nosocomial pneumonia in patients with central nervous system infections
Gajovi? Olgica,Todorovi? Zoran,Mijailovi? ?eljko,?anovi? Predrag
Srpski Arhiv za Celokupno Lekarstvo , 2011, DOI: 10.2298/sarh1108476g
Abstract: Introduction. Pneumonia is the most frequent nosocomial infection in intensive care units. The reported frequency varies with definition, the type of hospital or intensive care units and the population of patients. The incidence ranges from 6.8-27%. Objective. The objective of this study was to determine the frequency, risk factors and mortality of nosocomial pneumonia in intensive care patients. Methods. We analyzed retrospectively and prospectively the collected data of 180 patients with central nervous system infections who needed to stay in the intensive care unit for more than 48 hours. This study was conducted from 2003 to 2009 at the Clinical Centre of Kragujevac. Results. During the study period, 54 (30%) patients developed nosocomial pneumonia. The time to develop pneumonia was 10±6 days. We found that the following risk factors for the development of nosocomial pneumonia were statistically significant: age, Glasgow Coma Scale (GCS) score <9, mechanical ventilation, duration of mechanical ventilation, tracheostomy, presence of nasogastric tube and enteral feeding. The most commonly isolated pathogens were Klebsiella-Enterobacter spp. (33.3%), Pseudomonas aeruginosa (24.1%), Acinetobacter spp. (16.6%) and Staphylococcus aureus (25.9%). Conclusion. Nosocomial pneumonia is the major cause of morbidity and mortality of patients with central nervous system infections. Patients on mechanical ventilation are particularly at a high risk. The mortality rate of patients with nosocomial pneumonia was 54.4% and it was five times higher than in patients without pneumonia.
Reiter's syndrome after salmonella infection
?anovi? Predrag S.,Gajovi? Olgica M.,Mijailovi? ?eljko D.
Srpski Arhiv za Celokupno Lekarstvo , 2004, DOI: 10.2298/sarh0404104c
Abstract: Two patients with Reiter's syndrome, after Salmonella infection were treated on the Infections disease ward at Clinical hospital center in Kragujevac. In the first patient, ten days after the onset of Salmonella infection, signs of edema and pain in the right ankle occurred, accompanied by expressed conjunctivitis. Within next two months consecutive metatarsophalanges changes joint of the right foot have appeared. In the second patient, two weeks after the onset of Salmonella infection, edema of the left hand joints and a week later edema of the right hand and right ankle joints appeared. In both patients inflammatory syndrome was expressed (high erythrocyte sedimentation rates, fibrinogen, C-reactive protein) along with negative rheumatoid factors and positive antigen HLA-B27. Outcome of the disease in both cases was favorable upon receiving nonsteroid antirheumatic therapy. Signs of arthritis disappeared after three months. No signs of recurrent arthritis have been seen during the next four years in the first and next two years in the second patient.
Hemorrhagic fever with renal syndrome during pregnancy: Case report
Todorovi? Zoran,?anovi? Predrag,Gajovi? Olgica,Mijailovi? ?eljko
Medicinski Pregled , 2010, DOI: 10.2298/mpns1004280t
Abstract: Introduction Hemorrhagic fever with renal syndrome (HFWRS) is an acute infectious disease with abrupt onset, high fever, renal failure and frequent hemorrhages. HFWRS during the pregnancy has relatively low occurrence, with only few described cases mostly in the region of the former Soviet Union. Although, according to the data from the literature, the disease is less severe during the pregnancy, the eclampsy, stillbirth and fetal infection were also described. Material and methods During the summer period, June-September 2002 in the area of nort-heast Montenegro, and mainly among people whose job was connected with rural areas, the HFRS was observed more frequently. In that area during the stated period , 12 patients underwent treatment whose disease was confirmed by the I I F method at the Torlak Institute of Virology in Belgrade. Among the patients there were two pregnant women aged 23 and 29 (both in their second pregnancies), in the 23rd and 26th gestational week, respectively. The aim of this study is to present 2 case studies and to show the disease impact on fetal development. Results The patients aged 23 and 29 yrs, were previously healthy women in their second pregnancies (23rd and 26th gestational week, respectively). The disease had typical beginning. The predictions made according to the laboratory abnormalities and the level of oliguria were that the disease would have a less severe course. Hemorrhagic syndrome was less prominent, and the laboratory analyses were normalized after 15 to 18 days. The monitoring of pregnancy during the disease period and after recovering showed no fetal suffering. The patients had PV delivery, in 39-th an 40-th, respectively. The newborns blood testing on Hantan viruses was done by ELISA method in Torlak Institute, Belgrade. Only the IgG antibodies (1/ 512), were detected, the IgM antibodies were not found. Two years later the tests were repeated, and showed negative results.
Epstein-Barr virus hepatitis associated withicterus: A case report
?anovi? Predrag S.,Gajovi? Olgica,Todorovi? Zoran,Mijailovi? ?eljko
Medicinski Pregled , 2006, DOI: 10.2298/mpns0604179c
Abstract: Introduction. Primary Epstein-Barr virus infection (EBVI) in children is usually asymptomatic with seroconversion. If primary infection occurs in adolescents or in adulthood, the most common manifestation is acute infectious mononucleosis. The diagnosis of acute infectious mononucleosis is made by virus and serologic tests. The most important evidence of primary EBV infection includes IgM class antibodies detected by using EBV virus-capsidantigen (EBV VCA) which appears at the beginning of illness and usually lasts 1 to 2 months. Paul Bunnell Davidson test, although non-specific, is still in use today in diagnosis of infectious mononucleosis and for detection of heterophile antibodies. Case report. Acute hepatitis with icterus is a rare clinical manifestation in primary EBV infection. However, sometimes it is the only manifestation of the disease. This is a case report of a patient with EBV hepatitis and icterus associated with long-lasting fever without pharyngitis and lymphadenopathy, which are characteristics of infectious mononucleosis. The etiologic diagnosis was confirmed by positive Paul Bunnell Davidson test and by detection of specific antibodies (class IgM) to EBV VCA in patient's serum. Discussion. The pathogenetic mechanism which causes destruction of hepatic cells and provokes cholestasis during EBV infection, has not been cleared yet. It is supposed that EBV has no direct cytocide effects on hepatic cells, yet destruction of these cells is caused by toxic action of free radicals through lipid peroxidation. Patients with infectious mononucleosis have autoantibodies directed against enzyme superoxide-dismutase which neutralizes enzyme's antioxidant action. As a result of this action, free radicals accumulate in hepatic cells and cause their damage. Conclusion. Icteric forms of EBV infection are rare. In differential diagnosis of icterus caused by infectious agents, one should not forget EBV. .
Nosocomial infections in patients with acute central nervous system infections
Gajovi? Olgica,?anovi? Predrag,Mijailovi? ?eljko,Lazi? Zorica
Medicinski Pregled , 2007, DOI: 10.2298/mpns0702012g
Abstract: Due to current increase in the rate of nosocomial infections, our objective was to examine the frequency, risk factors, clinical presentation and etiology of nosocomial infections in patients with central nervous system infections. 2246 patients with central nervous system infections, treated in the intensive care units of the Institute of Infectious and Tropical Diseases, Clinical Center of Serbia in Belgrade and at the Department of Infectious Diseases of the Clinical Hospital Center Kragujevac, were included in this retrospective and prospective study. Clinical manifestations of nosocomial infections were registered in 180 (12.7%) patients. Direct risk factors for nosocomial infections were: venous lines, urinary catheter, length of stay over 20 days, inhibitors of gastric secretion, consciousness disorders and coma, endotracheal intubation, tracheotomy and controlled ventilation for 5 days or more. The most frequent clinical presentations of nosocomial infections were: tract urinary infections, bacteriemia/sepsis and nosocomial pneumonia. Significantly higher frequency of death outcomes was registered in patients with nosocomial infections.
Myopericarditis during acute Epstein-Barr virus infection: A case report
Mijailovi? ?eljko,?anovi? Predrag,Gajovi? Olgica,Toma?evi? Svetlana
Medicinski Pregled , 2006, DOI: 10.2298/mpns0610490m
Abstract: Introduction. Complications associated with infectious mononucleosis are rare, but occasionally they can occur involving hematological, neurological, cardiological and pulmological complications, as well as liver and spleen disorders, sometimes with lethal outcome. The most important cardiac complications are myocarditis and pericarditis. Case report. An 18-year-old male patient was admitted to the Department of Infectious Diseases with clinical picture of infectious mononucelosis, while symptoms appeared 7 days before admission. He was under observation and treatment for nineteen days when clinical, radiographic and echocardiographic findings revealed development of myopericarditis and he was transferred to the Cardiology Department. He was treated with non-steroidal antiinflammatory drugs, beta-blockers, antibiotics and other symptomatic therapy. He became afebrile 35 days after admission, and was discharged on the 50th day in good condition. Discussion. Myocarditis may develop as a complication of an infectious disease, and is usually caused by a direct viral infection, as well as, toxic and autoimmune mechanisms. Myocarditis attributed to Epstein-Barr virus infection is probably caused by autoimmune mechanisms: autoantibodies activate the complement or cause cellular cytotoxicity. Conclusion. Myopericarditis is not a common complication of acute Epstein-Barr virus infection. Transvenous endomyocardial biopsy is an established method required for exact diagnosis. In this case it was not done, due to some technical reasons. Thus, there is a high probalitiy that this patient had myopericarditis. .
Changes in plasma osmolality in food poisoning
?anovi? Predrag,Ne?i? Ljiljana,Gajovi? Olgica,Mijailovi? ?eljko
Medicinski Pregled , 2006, DOI: 10.2298/mpns0608365c
Abstract: Introduction. Changes in plasma osmolality may occur during acute intestinal infections due to dehydration (loss of water and/or electrolytes). Depending on whether the water and electrolyte deficit is primary, or a proportional loss of water and electrolytes, dehydration can be classified into three categories: hypertonic, hypotonic and isotonic. Material and methods. Thirty (30) patients with food poisoning were included in this research. All patients were hospitalized because of frequent vomiting, with resultant dehydration. A diagnosis of food poisoning was made based on the clinical picture, short incubation period and positive epidemiological history. Plasma osmolality was measured by a freezing point depression with an osmometer, while effective plasma osmolality was determined by using the following formula: EPO (eff. plasma osmolality) = 2 x serum sodium concentration + serum glucose level. Apart from plasma osmolality, other parameters were also measured in patients' sera: sodium, chloride, potassium, urea, glucose and hematocrit. In order to follow-up the changes in these parameters, they were also measured after treatment of the gastrointestinal disorder. Statistical analysis was performed using the equality of mean values for 2 basic groups. Results. The statistical results showed that the values of total and effective plasma osmolality (TPO and EPO) among patients with gastrointestinal disorders were not significantly higher than values after the alimentary infection. Discussion. Such results suggest that food poisoning is associated with disorders of water and electrolyte metabolism, that is isotonic type of dehydration. .
Characteristics of radiological changes in lungs during varicella zoster viral infection
eljko Mijailovi,Predrag ?anovi?,Zoran Todorovi?,Olgica Gajovi?
Medicinski Glasnik , 2011,
Abstract: The objective of this research was to analyse the varicella patients’ data in order to determine the following: general frequency of pneumopathies and types of lung changes according to X-ray presentation and the changes on the computed tomography. It examined 101 patients with the clinical presentation of varicella and some of the X-ray entities of varicella pneumopathies. Radiological techniques included chest X-ray and CT scans. Familiarity with clinical, laboratory and radiological characteristics of the disease may be of utmost importance for early recognition.
Risk factors and disposition in development of the nervous system infections
Ne?i? Ljiljana,?anovi? Predrag,Mijailovi? ?eljko,?okovi? Jelena
Medicinski Pregled , 2009, DOI: 10.2298/mpns0910461n
Abstract: Introduction. Although well protected, brain is not resistant to infection agents. Acute infections of our nervous system appear more often in children and in persons who have medical history data about previous disorders, especially disorders of the nervous system. It is difficult to list possible risk factors which can be responsible for the appearance of infections of CNS and the resulting conditions. It is often difficult or impossible to determine what previous neural damage was (trauma, anoxic damages etc.) from those appearing during infections of CNS. All-inclusive anamnestic research reduces the possibility of approximate judgments. Material and methods. The research was based on the retrospective analysis of medical documentation of 275 patients. All patients were divided into three groups according to the final diagnosis. The first group consisted of 125 patients who were treated for acute virus encephalitis, the second group consisted of 125 patients who were treated for acute bacterial meningoencephalitis and the third group consisted of 25 patients who were treated for cerebritis. Discussion. In our studies sample, the youngest patient was 3 years old and the oldest was 87 years old. The highest number of patients with virus infection of the CNS was in the group under 25 years of age (45.6%). The highest number of patients with bacterial infections of the CNS and cerebritis was in the group of patients over 45 years of age (64%, 37%). Conclusion. Risk factors were more present in bacterial infections of the nervous system and cerebrit thanin virus infection of CNS. In virus infections of the CNS, 28% of patients had some risk factor, most often-chronic ethylism, diabetes mellitus and acquired heart diseases. In bacterial infections of the CNS, 64% of patients had some predisposed factor. The most frequent factor of risk in these patients were chronic otitis (21.6%) and craniotrauma (14.4%). In cerebritis, risk factors were present in 76% of patients and they were: sepsis (20%), chronic otitis (12%) and systemic lupus erythematosus (8%).
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