The effect of psychoactive substances (drugs) on the presence and frequency of oral Candida species and Candida dubliniensis.

THE GOAL: The goal of this study was to determine the effect of psychoactive substances (drugs) on the presence and frequency of oral Candida species and Candida dubliniensis. MATERIALS AND METHODS: For the purpose of achieving the set goals, we chose a sample. Sixty bed-ridden patients from the Institute for Alcoholism and Other Addictions in Sarajevo Canton, both males and females between 18 and 60 years of age, were included in the research and assigned to two different groups (alcohol addicts and opiate addicts). After extensive anamnesis and a clinical examination, samples of oral epithelia were taken for microbiological identification. Two confirmatory methods were used for the identification of Candida species: the blastesis test and cultivation in a chromatophilic medium (Chrom agar). A yeast assimilation test (API test) was used for the identification of non-albicans Candida. A separate test was used to identify Candida dubliniensis (PAL agar). RESULTS: The results of the microbiological analysis confirmed the frequency of Candida albicans (43%) in psychoactive substance addicts, as well as an increase in non-albicans Candida regardless of the type of addiction (34%). The presence of Candida dubliniensis was proven in psychoactive substance addicts (23%) and it was confirmed that the frequency of bacterial adherence of Candida dubliniensis is directly proportional to the duration of the drug-addiction. CONCLUSION: The abuse of psychoactive substances has an effect on the frequency of albicans and non-albicans species of oral Candida. Based on the findings, we have concluded that psychoactive substances (opiates and alcohol) lead to an increase in oral Candida dubliniensis regardless of the type of addictions.

Application of a diode laser in the reduction of targeted periodontal pathogens.

INTRODUCTION: Periodontal disease belongs to a group of diseases with more than one cause, it is a disease of a multifactorial etiology. Although bacteria are the main cause of the disease, immunoinflammatory reaction of the host is responsible for the majority of destructive changes in periodontal tissue. The main issue in the evaluation of the success of periodontal therapy is the pluralism of the bacteria and their dynamic changes during the duration, on the one hand, and the possible inaccuracy of classical microbiological analysis in determination of the dominant role of a microorganism, or the success of its reduction or elimination, on the other. Thanks to advances of microbiology and technological development, it is possible to make an assessment of specific microorganisms in a large number of samples of sub-gingival plaque with extreme precision, using checkerboard DNA-DNA hybridization and method of polymerase chain reaction (PCR). The development of laser technology and the discovery of its significant antimicrobial effects have introduced and presented this treatment modality as a possible auxiliary method of periodontitis treatment. MATERIALS AND METHODS: The sample for the study estimating the efficiency of application of diode lasers in the reduction of periodontal pockets consisted of 1164 periodontal pockets in 24 subjects of both sexes. For laser irradiation of periodontal pockets a diode laser was used, a low-power laser (SmilePro 980, Biolitec, Germany), working in a mode precisely tuned for treatment of periodontal pockets. All subjects underwent: general anamnesis, periodontal status, and orthopantogram radiograph analysis. Following a standard periodontal preparation, a sample of subgingival plaque was collected for molecular-biological analysis (real-time PCR method) prior to laser irradiation of periodontal pockets, immediately following the irradiation, and during the control examination 3 months after irradiation. RESULTS: The results of the molecular-biological analysis of target periodontal pathogens Actinobacillus (Aggregatibacter) actinomycetemcomitans (AA) and Porphyromonas gingivalis (PG) isolated from periodontal pockets prior to laser irradiation, immediately after laser irradiation, and at the control examination after 3 months were processed statistically (using real-time PCR method). The results showed that there was a statistically significant decrease in CT values for the tested bacteria immediately after treatment and the control examination, compared with the level of CT values for the same bacteria before treatment. CONCLUSIONS: Based on the obtained results, we concluded that diode laser irradiation reduces the number of active periodontal pathogens. We believe that the use of diode lasers, as a supplementary method in the treatment of periodontal disease, is extremely useful and efficient, and can be recommended as part of standard clinical practice.

Detection of mycoplasma genitalium in female cervical samples by multitarget real-time PCR.

Mycoplasma genitalum (MG) is associated with variety of urogenital infections such as nongonococcal urethritis (NGU), endometritis and cervicitis. The objective of this study was to demonstrate and evaluate a research polymerase chain reaction (PCR) assay, for the detection of MG in cervical samples of a tested population of women attending gynecology clinics in Bosnia and Herzegovina. The Multitarget Real-Time (MTRT) PCR, utilizing the ABI 7900HT, the sequence detection system, was performed for the detection of MG. Cervical samples (N=97) from females were divided into three types of patient groups: Group 1: patients who had known abnormal clinical cytology reports (N=34); Group 2: patients who reported a history of genitourinary infections (N=22); and Group 3: patients not in either groups 1 or 2 (N=41). Overall, 14,43% (14/97) of those tested were positive for MG. A positive sample was defined as having a cycle threshold cross point (Ct) < 40,0 with a fluorescent detection comparable to the low positive control utilized during the run. This study validated the use of MTRT PCR as a reliable method for the detection of MG in clinical specimens and should facilitate large-scale screening for this organism.

Human Coxiella burnetii infections in regions of Bosnia and Herzegovina, 2002.

Acute infections in humans and animals caused by Coxiella burnetii (C. burnetii) are becoming an important medical problem for Bosnia and Herzegovina (B&H). From a clinical and epidemiological aspect, Q fever represents a complex medical problem, considering that one of the highest incidence rates of Q fever in Europe has been recorded during the last few years in B&H. The first case of this disease in B&H was described in 1950, by Muray et al., and the first epidemic, with 16 infected individuals, was recorded the same year. Confirmed animal infections by C. burnetii in B&H were first reported in 1985 when, of all tested sheep, positive results were found in 12.4%. During 2001, 2.11% of tested sheep and goats were found to have a positive result, which was also confirmed by studies from the following years in particular regions of B&H. These studies suggest that endemic loci of infected animals are established in particular geographic regions in B&H, which is important to emphasize for better understanding of the sources and routes of C. burnetii transmission to the human population. This conclusion is based on the studies from 2000, when 2.17% of positive cattle, 1.85% of positive sheep, and 0.27% of positive goats were registered. During the same period, in B&H, in 6 different regions, 156 individuals with Q fever were registered as were 3 separate epidemics with 115 infected individuals. Official data on the number of detected animal C. burnetii infections during 2002 suggest that 10 positive cattle and 88 positive sheep or goats were registered. During 2003, 24 positive cattle, 29 positive goats, and 167 positive sheep were detected, while in 2004, 71 positive cattle, 4 positive goats, 37 positive sheep, and 72 positive animals from the sheep-goat group were registered. According to official reports from 2001, 19 individuals with Q fever were registered in B&H, while in 2002, the number of infected individuals increased to 250. In five cantons in B&H, 43 infected individuals were registered during 2002, while in Republika Srpska of B&H, 207 infected individuals in the region of Banja Luka were registered. From 1998 to 2003, 373 individuals with Q fever were reported in B&H, whereof 265 individuals (71.04%) were infected during epidemics, and 108 (28.95%) sporadically. Q fever incidence rates in B&H were high during 1998 (5.68%ooo) and very high in 2000, with 115 individuals with an acute clinical form and an incidence rate of 6.95%ooo. The incubation time varied between 9 and 28 days.

[Hospital sepsis and aggressive medical interventions]. / Bolnicka sepsa i agresivni medicinski zahvati.

AIM: To find out do the aggressive medical interventions have an effect on appearance of gram positive and gram negative hospital sepsis among 200 patients with positive clinical and laboratorial signs of sepsis and who have proved monomicrobial blood isolates. METHODS: Samples of septic patients were analyzed statistically by using x2 test and coefficient of contingency C. RESULTS: After we put gram negative so as gram positive sepsis to a correlation with the aggressive medical treatments, which proceeded, we got statistically significant results. CONCLUSIONS: Aggressive medical interventions impute hospital sepsis and etiology.

Eradication of typhus exanthematicus in Bosnia and Herzegovina.

Typhus exanthematicus in Bosnia and Herzegovina held in endemic areas from which especially quickly began spread after 1945. That year, in 1945, one hundred epidemics of typhus fever appeared, with the highest incidence rate in Europe of 215.04 per 1,000. Directions of unique program in the world were to eradicate lice of the body, but also establish monitoring of the recidivism, Brill-Zinsser disease. Since 1971, typhus exanthematicus (classical typhus) hasn't appeared in Bosnia and Herzegovina, so epidemic typhus can considered as an eradicated communicable disease.

[Agglutination as screening test in routine diagnostic of listeriosis]. / Aglutinacija kao skrining test u rutinskoj dijagnostici Listerioze.

INTRODUCTION: The persons with weakened immunity, newborn infants and pregnant women are very much sensitive on infection with bacteria Listeria monocytogenes. Listeria can readily invade the placenta and precipitate premature labor and fetal death. To confirm diagnosis is very difficult because listeriosis is disease very similar to the others acute diseases. Serum threshold values above 1: 320 confirm think about listeriosis when the relevant clinical symptoms are present. Of greater diagnostic relevance is the detection of a rise in titer. Therefore, it is always desirable to test a second sample (collected 2 to 3 weeks later) together with the first sample (stored in the deep-freeze). AIM: The aim of the study is to confirm the advance agglutination as a screening test in routine diagnostic Listeriae monocytogenes. MATERIAL AND METHODS: In testing were included 60 women in the reproductive age to divide in experimental group and control group. By agglutination serologic methods we researched if there is any antibody on Listeria monocytogenes with Listeria antigen. RESULTS AND DISCUSSION: From a total of 60 patients positive samples were 18 (60.00%) in experimental group (30) and 8 (26.70%) in control group (30). CONCLUSION: due to simple way of performing screening test of agglutination the same one are giving adequate antibiotic therapy in a case of positive serological response.

Serotesting of human brucellosis on wider area of Bosnia and Herzegovina.

The study involved 286 individuals from different regions of Bosnia and Herzegovina, whose sera were tested in the Laboratory for specific diagnosis of human brucellosis in Microbiology Department of Medical Faculty of University in Sarajevo, during the period from 2000. to 2003. Sera were tested using Brucelloslide Test, qualitative agglutination test Rose Bengal. Using the agglutination test, we serologically confirmed a diagnosis of human brucellosis in 59 (20.62%) seropositive individuals, whereof 38 (64.40%) men and 21 (35.60%) women. Individuals with human brucellosis were the most present in the age group of 31-40 (22.03%) and 41-50 (22.03%). One serologically confirmed death case was registered. The most seropositive individuals were from Zenica-Doboj Canton (32.20%), Sarajevo Canton (28.82%), Herzegovina-Neretva Canton (23.73%), Central Bosnia Canton (13.55%) and Una-Sana Canton (1.70%). During our four-year study, it was serologically confirmed that human brucellosis is present in Bosnia and Herzegovina and, through seropositive testing, we revealed the level of general exposition to Brucella spp. on wider area of Bosnia and Herzegovina.

Listeria monocytogenes as the possible cause of the spontanous abortion in female of the fertile age.

Listeria monocytogenes is a Gram-positive, weakly pathogenic bacterium able to grow also at the temperature of 40 degrees C. A man most often gets affected by consuming contaminated food and water. Animals can carry bacteria although they have not to appear ill, then their meat and milk products are the source of infection of human being. The disease most often attacks with the weak immune system, newborns and pregnant women. That what is significant, listeria penetrates through the placenta and can lead to the fatal infection, which is characteristic by disseminated granulomatosis lesions of a newborn and micro abscess on the placenta. In a newborn can provoke the sepsis with the mortality of 50%. By the examination are encircled two groups of the reproductive age-totally 60. From these 30 had one or more spontaneous abortion, and 30 had no spontaneous abortion. By the serologic reaction the agglutination is discovered the presence of the antibodies in serum of the. The positive serologic answer was found in the first group in 18 (60%) and in that another group in 8 participants (26, 70%).

[Listeria monocytogenes in women of reproductive age]. / Zastupljenost Listerie monocytogenes kod zena fertilne dobi.

OBJECTIVE: Listeria monocytogenes (LM) is gram-positive bacteria linear shaped which grows good also at refrigerator temperature (4 degrees C). The bacteria is resistant on high and low temperatures. This bacteria can be found in the dirt, rotted vegetation, vegetables and fruit, milk and dairy products, and also in the meat and processed meat. This bacteria cause disease called Listeriosis. This bacteria attacks at first people with weak immune system like infants, pregnant women, people with chronic diseases, people with HIV and people who are 60 and over. Pregnant women can transfer Listeria through the placenta, from mother to child and that can cause premature delivery, premature birth, early rupture of placenta or still born. GOAL: Find out if there is serological respond by female patients in the reproductive age who had spontaneous abortion and female patients in the reproductive age who never had the spontaneous abortion. By agglutination serologic method it had been researched if there is any antibody on Listeria monocytogenes. RESULTS: Two groups were included in testing: experimental and control group with a total of 60 patients. In experimental group there were 18 (60%) positive samples. In control group there were 8 (26.70%) positive samples. CONCLUSION: The results investigations have shown that there is serological respond to Listeria monocytogenes in the women of reproductive age. The number of positive patients was greater in women who had spontaneous abortion compared to women who never had the spontaneous abortion.

[Coxiella burnetii infections as the public-health problem]. / Coxiella burnetii infekcije kao javnozdravstveni problem.

THE AIM OF WORK: To evaluate the incidence of human Q-fever in individual regions of Bosnia and Herzegovina, to determine the prevalence and areas at risk of Q-fever incidence, to assess Q-fever seroprevalence and to demonstrate seroprevalence ratings in regard to relevant criteria (sex, age, location of residence). METHODS: The research has involved 708 individuals from different cantons, whose sera were tested in Laboratory for Specific Diagnosis of Human Q-fever on the Microbiology Desk of Medical Faculty of University in Sarajevo, during the period from July 2000-December 2003. Sera were tested by Indirect Immunofluorescence Assay (IFA), using commercial test kit, reagents for Q-fever IFA IgM and IFA IgG for in vitro diagnostic use (Focus technologies). THE RESULTS: Specific anti-C. burnetii antibodies were detected in 249 (35.2%) individuals, whereof 75 (30.12%) female individuals, and 174 (69.9%) male individuals. Individuals suffering from Q-fever were mostly included in 31-40 aged group (26.8%). Most seropositive individuals were from Zenica-Doboj Canton (35.4%), then from Herzegovinian-Neretvian Canton (22.9%), from Sarajevo Canton (14.5%), from Una-Sana Canton (11.6%), and from Middle-Bosnian Canton (11.6%). CONCLUSIONS: In our four-year study, it is serologically demonstrated that Q-fever is imminent in Bosnia and Herzegovina and that it is going to be the actual concern of public health. The number and distribution of seropositive individuals suggest that Q-fever is endemic phenomenon in Bosnia and Herzegovina.

[Detection of Chlamydia trachomatis in cervical smear samples with determined HPV]. / Detekcija chlamydia trachomatis u cervikalnim uzorcima sa dokazanim HPV.

OBJECTIVE: Chlamydia trachomatis (CT) causes infertility, ectopyc pregnancy, pelvic inflammatory disease (PID) and conjunctivitis. Human Papilloma Virus (HPV) is a virus with broad spectrum effects. This particularly refers to HPV of high oncogenic potential (HPV - HR) because of its participation in cervical oncogenesis. The authors wanted to determine correlation between cervical HPV infection and detection of CT taken from female patient's smear of different levels of cervical intraepithelial neoplasm (CIN I - III) and ASCUS (Atypical Squamous Cells of Uncertain Significance) modifications. METHODS: Cytological analysis was used for 94 cervical samples--Papanicolaou method. The samples were presented in accordance with valid Bethesda Classification. The samples were treated by HPV DNA assay (Digene Hybrid Capture II). RESULTS: Out of 64 HPV positive samples, detected CT was found in 24 (37.5%) samples. Out of 50 HPV positive group samples with high degree risk ( HPV - HR), 18 (36%) contained CT. Frequency of CT was registered in ASCUS modifications in 55.6%, CIN I 16.7%, CIN II 16.7% and CIN III 11.0% samples. We found 3 (10.0%) of detected CT in HPV negative control group. CONCLUSION: Research results showed correlation between HPV cervical infection and CT. The higher the level of cell dedifferentiation (ASCUS CIN I - III) is, the higher number of cervical infections with CT is.

[Electron microscopy study and clinical characteristics of rotavirus disease]. / Elektronskomikroskopsko ispitivanje i klinicke karakteristike rotavirusne bolesti.

In this paper it is been described method of electronic microscopy applied for discovering characteristic morphology of rotaviruses in samples of stools of infected and hospitalized patients. To have electronic microscopy as standard method it is necessary to know morphology or structure of the researched microorganism. In the second part of the paper we have made clinical epidemiological analysis of the rotavirus infection on the examined samples, and made comparison with result of other researches. Out of 78 patients with diarrhea, in 15 or 19.2% have been proofed presents of rotaviruses in the stool samples. All hospitalized patients had diarrhea (100%), vomiting was present in 90.9%, high temperature to 39C in 63.6% and over 39C in 36.4% patients. Stomachache was registered in 36.3% and blood in stool has not been found. Majority of the hospitalized had some respiratory syndromes. Time of hospitalization was between 6 to 13 days with average of 9.5 days. Death of hospitalized was not registered.

[Importance of timely diagnostics of hepatotropic viruses]. / Znacaj pravovremene dijagnostike hepatotropnih virusa.

The epidemiologic model for the estimation of the incidence growth step of the acutely diseased from the hepatotroic virus with the emphasize on HBV and HCV infections, as well as worryingly high step of carriers of these viruses requires sure and the official methods by which will be over common of the infections, to prevent the development of the chronic phase and will lead to its recovery. The timely detection of HBV and HCV by serologic-virusologic techniques enable the safe etiologic diagnosis, the immunologic patients status, the prognosis of the disease and the rate of the contamination.

Demonstration of different endocervical staining methods and their usefulness in the diagnosis of the chlamydial infection in exfoliated cells advantages and disadvantages.

Microscopic demonstration of chlamydial inclusions within cells offered the first laboratory procedure supporting the clinical diagnosis of chlamydial infection. Our aim is to evaluate the usefulness of different endocervical staining methods in diagnosis of Chlamydia trachomatis (CT) infection within exfoliated cells of the endocervix. The cytological test for the detection of chlamydial inclusions in genital tract infection, though not as sensitive and specific as isolation in the cell culture monolayers, is still of the diagnostic value. The present study discusses the collection of clinical smears for microscopic examination, their preparation; fixation and staining of slides by a variety of staining methods that have been used to detect Chlamydia in clinical smears and biopsies. Most of these methods such as Giemsa stain, Papanicolaou, iodine, and immunofluorescence (IF) using monoclonal antibodies, are based on the combination of dyes designed to obtain optimum differentiation of the various structures. The utilization of different endocervical smear stains together with the clinical information can be used to identify women at high risk for CT infection.

Significance of the interferon (IFN) in the therapy.

Interferons belong to the group of the regulatory glycoproteins, of low molecular mass. They are the products of infected cell-genome, but not virus, as a consequence of the cause answer by different inductors. Human IFN are divided on the sequence of amino-acids into three groups: Alpha, Beta and Gamma interferons. Recently are discovered new types of IFNs: Omega and Tau, but bigger than alpha molecules. Also, has been performed the division into two types: I and II. Besides the antiviral and antiproliferative effects, they have also the effect in the treatment of malignant diseases, and act protectively against the radiation.

Clinical characteristics of rotaviruses disease.

Rotaviruses are the major causes of viral gastroenteritis in infant and the young children. There are a wide spectrum of clinical signs and symptoms of rotavirosis. Rotavirus infection is fecal-oral infection. Rotaviruses prove with Latex agglutination test and electron microscopy. In a four year period 943 stool samples out of 527 hospitalized patients had been analyzed. A presence of rotavirus is proved with a LA and EM tests at 170 (32,2%) patients age 0-7 years, in their stool samples. Analyzing age groups of these patients, it was found that the rotaviruses infection the most frequently occurred at age group from 7-24 months. From 170 positive patients, 122 or 71,8% were in this age group. At all patients was found diarrhea, vomiting in a 90,5% cases. Mild fever had 65,5% patients, signs of a respiratory infection appeared at 60,7% patients, abdominal pain at 13,3% patients. Severe dehydration had 49,9% patients and metabolic acidosis had 79,2% cases. Macroscopically blood in stool had 6,4% patients, slime in a stool 46,0% patients was found, and aholic stool had 8,4% patients. In all hospitalized patients disease lasted in average 12,6 days, and the hospitalization in average 10,2 days. None of the patient had any kind of complication, all of them very successfully cured. These results confirm that rotaviruses are important health problem among infant and the young children in Bosnia and Herzegovina.

[Diagnosis of chlamydial infections--personal experience]. / Dijagnostika klamidijskih infekcija--nasa iskustva.

OBJECTIVES: In this paper we evaluated the difference of analytic sensitivity, specificity and predictive values using immunoassays based on antigen detection of Chlamydia trachomatis (Ct) in endocervical swab specimens. PATIENTS AND METHODS: 120 fertile female patients were tested for the presence of Ct in the endocervix during two years. The patients represented two risk groups: moderate risk, and low risk group. Three endocervical swab specimens per each patient were collected and each of specimens was analyzed with: DFA-Direct Fluorescence Assay; RIA-Rapid Immunoassay, EIA-Enzyme Immunoassay RESULTS: Total 8 (6.67%) patients were positive on Ct. Out of that 5 (8.33%) were from moderate risk (DFA and EIA), and 3 (5%) from low risk group (DFA and EIA, RIA). 4 (6.67%) out of 5 patients were found positive from moderate risk group by RIA, and 3 (5%) from low risk group (DFA and EIA, RIA). DFA has some results as EIA: sensitivity and specificity are 100%. RIA has sensitivity 87.5% and specificity 100%. Predictive values (PPV, NPV): PPV is the same for the three test assays, and it is 100%. NPV for RIA is 99.1% and for DFA and EIA is 100%. Total prevalence for RIA is 5.83% and for DFA and EIA is 6.66%. CONCLUSION: It was proved that there was some significant difference in validity of applicable immunoassays (DFA and EIA, and RIA), particularly in analytic sensitivity (100% DFA versus 87.5% RIA). With difference to RIA and EIA, DFA does not request confirmation using another method (WHO), which is of great importance for us. Therefore we consider DFA as a method of choice for our conditions.

Q-fever serologic diagnostics with inhabitants of Canton of Sarajevo 2001 year.

Q-fever is widely spread antropoozosis caused by Coxiellae burnetti, an intracellular compulsory microbe parasite. Two characteristics of Coxiellae burnetti are of crucial importance for appearance of Q-fever, especially in the circumstances when the cause of infection remains unclear. The first one is a high resistance of Coxiellae burnetti to environment changes and the second one is a small size of the infectious dose. The clinical manifestations of Q-fever can vary, so the making of diagnosis is still based on serology, with Phase I and Phase II antibodies and the difference between the acute and the chronic form of the disease. Serologic diagnostics presents the method of choice with Q-fever (IFT) in serums of patients with clinical suspicion to Coxiellae burnetti infection. We have tested the serums of patients from Canton of Sarajevo which were coming to our laboratory from January 2001-December 2001. Out of 58 processed serums the specific IgM antibodies were found in 10 serums and specific IgG antibodies in 27 serums.

[Serologic diagnosis of hemorrhagic fever with renal syndrome in Bosnia and Herzegovina in 2002]. / Seroloska dijagnostika hemoragijske vrucice s bubreznim sindromom u Bosni i Hercegovini 2002. godine.

AIM: Results of the serologic confirmation of hemorrhagic fever with renal syndrome (HFRS) in patients with clinical picture and overt symptoms of the disease from particular areas in Bosnia and Herzegovina during 2002 are presented. METHODS: A total of 146 sera from 100 clinically suspected patients were tested. The sera were tested for the presence of specific IgM antibodies to Hantaan and Puumala antigens by Elisa IgM "capture" test, and for the presence of specific antibodies to Hantaan, Puumala and Dobrava antigens by Elisa IgG test. DISCUSSION: Most of the positive IgM reactions were recorded as cross reactions to Hantaan and Puumala antigens, and most of the positive IgG reactions as cross reactions to Hantaan and Dobrava antigens. The finding of antibodies in the sera of patients from Europe that react with Hantaan antigen are not associated with the infection with Hantaan, but with the infection with viruses that are genetically related with Hantaan. To date, HFRS caused by Puumala and Dobrava viruses has been verified in Bosnia and Herzegovina. CONCLUSION: Using Elisa IgM "capture" test, acute hantavirus infection was serologically confirmed in 38% of clinically suspected patients with manifested symptoms from different areas of Bosnia and Herzegovina in 2002. The distribution of human hantavirus infection in Bosnia and Herzegovina was confirmed by the presence of specific hantavirus antibodies in patient sera.