Helminth fauna of the northern white-breasted hedgehog (Erinaceus roumanicus) in Serbia.

The result of helminthological examination of 28 hedgehogs died at traffic accident and 12 samples of feces collected from pets hedgehogs during 2013-2015 were presented. Three species of helminths were found: Crenosoma striatum, Hymenolepis erinacei and Aonchotheca erinacei. This is the first research of parasitic fauna of hedgehogs in Serbia.

Low back pain among nurses in Slovenian hospitals: cross-sectional study.

AIM: The study investigated the prevalence and factors predicting low back pain among nurses in Slovenian hospitals. BACKGROUND: The risk factors for low back pain are physical and psychosocial. Implementation of interventions for reducing low back pain calls for management support, accessible equipment, education, knowledge and risk assessment. INTRODUCTION: Low back pain prevalence and incidence among healthcare workers is very high compared to the general population and is a strong risk factor for long-term sickness absence. METHODS: A cross-sectional study design was utilized. We used validated instruments: Nordic Musculoskeletal Disorder Questionnaire, Stanford Presenteeism Scale and Perceived Stress Scale. The sample included 1744 nursing employees from 16 Slovenian hospitals, ranging from practical nurses, registered nurses, nurses with a bachelor's degree and those with a master's degree. FINDINGS: Results revealed a prevalence of low back pain among 85.9% of respondents. Relevant risk factors included female gender, age, length of employment, years in current position, shift work and the number of nurses per shift. In the regression model, factors predicting low back pain included presenteeism with a negative effect on work, presenteeism and maintaining work productivity, inability to control daily life, number of nurses per shift and respondents' age. CONCLUSIONS: Future activities should be oriented towards eliminating or reducing risks for low back pain incidents and towards different strategies, guidelines and actions which empower individuals and provide knowledge to manage and prevent low back pain. IMPLICATIONS FOR MANAGEMENT AND HEALTH POLICY: Slovenian healthcare system planning needs a national strategy to successfully promote LBP preventive and controlling strategies. Management can plan preventive and curative measures to reduce low back pain prevalence among nursing personnel. Management should also implement policies reflecting research findings.

Evidence-based practice among nurses in Slovenian Hospitals: a national survey.

AIMS: To identify the extent of evidence-based practice implementation among nurses in Slovenian hospital settings, to establish nurses' beliefs on evidence-based practice and to identify possible explanatory factors. BACKGROUND: Conducting and applying research are fundamental nurses' tasks and an essential expectation in nursing practice. INTRODUCTION: Despite verified benefits of evidence-based practice, research evidence across different countries has shown extremely limited implementation of this practice among nurses. METHODS: A cross-sectional research design was employed. Standardized instruments Evidence-Based Practice Beliefs and Implementation Scale were used. The sample included 534 nurses from 19 Slovenian hospitals. The obtained data were analysed using descriptive statistics, correlation and factor analysis, and linear regression. RESULTS: Nurses in Slovenian hospitals have positive beliefs about evidence-based practice, but exhibit a low level of implementation. The beliefs were explained by perceived knowledge on research, job satisfaction and length of employment, whereas a low level of implementation was explained by poor perceived knowledge on research, evidence-based practice and job satisfaction level. DISCUSSION: Nurses in Slovenian hospitals have positive beliefs about evidence-based practice, but exhibit a low level of implementation. According to the results, some resources required for improved implementation are not made sufficiently available. LIMITATIONS: A low response rate; the sample not being balanced for educational achievement; and the accuracy of self-report survey methods. CONCLUSION: In addition to the perceived knowledge and education provided, an important factor is also job satisfaction, which points to the instrumental role of management workers in determining nurses' professional development. IMPLICATIONS FOR NURSING AND HEALTH POLICY: Nursing managers in Slovenian hospitals should promote the development of head nurses in research and evidence-based care, thereby fostering a culture of evidence-based practice.

Prevalence of Bovine herpesvirus type 4 in aborting dairy cows.

Bovine herpesvirus type 4 (BHV-4) is related to many different conditions: infertility, postpartal metritis, vulvovaginitis, mastitis, encephalitis, calf pneumonia, keratoconjunctivitis, cutaneous lesions, digital dermatitis and abortion. In this study a retrospective PCR examination of 100 extracted DNA samples from aborting cows was performed in order to determine: prevalence of BHV-4 in abortive cattle, whether coinfections BHV-4 with other abortifacient pathogens are present in the same sample and to determine the month of gestation when BHV-4 associated abortions were detected. Out of 100 examined samples, the BHV-4 genome was detected in 21 samples (21%). In two samples we detected coinfection of BHV-4 with bovine viral diarrhea virus (BVDV) and in one with Neospora caninum. Most of the BHV-4-associated abortions were detected during the seventh month of gestation. It was concluded that an active BHV-4 infection was present among cows that aborted on the farms examined. The high prevalence of the BHV-4 genome in abortion material suggests that this virus may have cause the abortions. Further studies and examinations are needed to establish causative connection between presence of BHV-4 and abortion.

Isoniazid-resistant Mycobacterium kansasii in an HIV-positive patient, and possible development of immune reconstitution inflammatory syndrome after initiation of highly active antiretroviral therapy: case report.

Non-tuberculous mycobacteria are rare but important causes of infection in HIV-positive individuals. A 28-year-old HIV-positive male presented with a high fever, non-productive cough, right subcostal pain, splenomegaly, a very low CD4 count, elevated C-reactive protein and erythrocyte sedimentation rate, and a normal white blood cell count. The suspicion of tuberculosis (TB) was very high, and sputum samples were positive for acid-fast bacilli. Standard quadruple anti-TB therapy was initiated, but once culture of the sample revealed Mycobacterium kansasii, pyrazinamide was withdrawn. Highly active antiretroviral therapy (HAART) was initiated soon after, consisting of abacavir/lamivudine and efavirenz. The patient's general condition deteriorated 2 weeks after HAART initiation, which could have been due to the development of immune reconstitution inflammatory syndrome (IRIS). The patient recovered and was discharged in good condition. However, the results of resistance testing of the isolated organism arrived after discharge, and showed isoniazid and streptomycin resistance. This is the first case report of M. kansasii infection from Serbia and shows the difficulties encountered during the course of treatment.

[FLS - three letters alter secondary fracture prevention]. / FLS - Drei Buchstaben verändern die sekundäre Frakturprävention.

The increasing importance of preventive measures in the field of orthopedics and trauma surgery becomes apparent because of the demographic changes and the high risk for secondary fractures following osteoporotic fractures. Within the fracture treatment chain, orthopedics and trauma surgery are in the "pole position" to initiate these measures in geriatric patients. In the past orthopedists and trauma surgeons have constantly accused of neglecting secondary fracture prevention in fragility fracture patients. There are several reasons that speak in favor of us undertaking a role in secondary fracture prevention: osteoporosis medication is highly effective in fracture prevention when correctly indicated, the positive effects of osteoporosis therapy on fracture healing and legal issues. Arguments that have been used to justify neglect of secondary fracture prevention are undesired side effects related to osteoporosis medications, such as atypical femoral fractures and osteonecrosis of the jaws, interference of some specific drugs with fracture healing and the working conditions in emergency departments. These run contrary to the consideration of chronic diseases such as osteoporosis, secondary osteoporosis and the underlying disease could be overlooked and the increasing complexity of medicinal osteoporosis therapy. In the first part of the article these arguments are weighed against each other. In the second part the concept of a fracture liaison service (FLS) is discussed. The FLS framework now allows an active role to be taken with respect to secondary fracture prevention despite the busy daily routine schedule. Implementation of an FLS is facilitated by dedicated instruction protocols and programs. Self-financing of an FLS is currently possible only in some specific healthcare systems. In healthcare systems in German-speaking areas a cross-financing must be available and the value of an FLS indirectly presented. Apart from the financial aspects, implementation of a FLS is also worthwhile because it can be looked on as the future driving force of innovation.

The microbiological diagnosis of tuberculous meningitis: results of Haydarpasa-1 study.

We aimed to provide data on the diagnosis of tuberculous meningitis (TBM) in this largest case series ever reported. The Haydarpasa-1 study involved patients with microbiologically confirmed TBM in Albania, Croatia, Denmark, Egypt, France, Hungary, Iraq, Italy, Macedonia, Romania, Serbia, Slovenia, Syria and Turkey between 2000 and 2012. A positive culture, PCR or Ehrlich-Ziehl-Neelsen staining (EZNs) from the cerebrospinal fluid (CSF) was mandatory for inclusion of meningitis patients. A total of 506 TBM patients were included. The sensitivities of the tests were as follows: interferon-γ release assay (Quantiferon TB gold in tube) 90.2%, automated culture systems (ACS) 81.8%, Löwenstein Jensen medium (L-J) 72.7%, adenosine deaminase (ADA) 29.9% and EZNs 27.3%. CSF-ACS was superior to CSF L-J culture and CSF-PCR (p <0.05 for both). Accordingly, CSF L-J culture was superior to CSF-PCR (p <0.05). Combination of L-J and ACS was superior to using these tests alone (p <0.05). There were poor and inverse agreements between EZNs and L-J culture (κ = -0.189); ACS and L-J culture (κ = -0.172) (p <0.05 for both). Fair and inverse agreement was detected for CSF-ADA and CSF-PCR (κ = -0.299, p <0.05). Diagnostic accuracy of TBM was increased when both ACS and L-J cultures were used together. Non-culture tests contributed to TBM diagnosis to a degree. However, due to the delays in the diagnosis with any of the cultures, combined use of non-culture tests appears to contribute early diagnosis. Hence, the diagnostic approach to TBM should be individualized according to the technical capacities of medical institutions particularly in those with poor resources.

Staphylococcus sciuri as a part of skin, nasal and oral flora in healthy dogs.

The coagulase-negative species Staphylococcus sciuri is widespread in nature and is associated with a variety of domestic and wild animals. However, the occurrence of S. sciuri in dogs has received little attention so far. In the present study, we established the prevalence of S. sciuri in a large population of healthy dogs, and characterized isolated strains. Samples from two mucous membrane sites (anterior nares and mouth), and two hair-coated sites (head and withers) were taken from 122 dogs and inoculated into STS agar, a novel selective medium that was introduced and tested in the study. In total, 116 isolates of S. sciuri were obtained from 488 specimens. S. sciuri was isolated from 56 out of 122 (46%) dogs. The occurrence of S. sciuri in the anterior nares and mouth were significantly higher than those in withers and head. No significant association of S. sciuri occurrence in dogs and factors such as sex, age, and living environment (indoor/outdoor) was found. Out of 56 dogs, which tested positive for S. sciuri, 30 (54%) would have it as a resident flora. Thus, we showed that S. sciuri was frequently present as a part of skin, nasal and oral flora in healthy dogs both as a resident and transient carriage.

Occupational risk of tuberculosis among health care workers at the Institute for Pulmonary Diseases of Serbia.

SETTING: The Institute for Pulmonary Diseases of Serbia, which specialises in diagnosis and treatment of lung diseases in a region with approximately 550-600 TB admissions per year. OBJECTIVE: To assess the occupational risk of tuberculosis (TB) among health care workers (HCWs) employed at this institution. DESIGN: Retrospective analysis of morbidity of TB among HCWs over a 12-year period (1986-1997). The incidence of TB among HCWs was estimated by the frequency of bacteriologically or histologically confirmed active disease. All HCWs at our institution underwent routine pre-employment screening, consisting of verification of BCG vaccination, PPD tuberculin reactivity, chest X-ray and laboratory evaluation. RESULTS: Of an average 267 employed HCWs, pulmonary TB occurred in nine (six nurses and three laboratory technicians). Cumulative incidence for HCWs was 3451/100,000, compared to 454/100,000 in the general population, for an incidence rate ratio of 7.6. CONCLUSION: The risk of TB among HCWs employed at the Institute for Pulmonary Diseases of Serbia in Belgrade is 7.6 times higher than that observed in the general population, suggesting occupational acquisition of TB.

Staphylococcus sciuri: recommendation for simple identification.

We report the isolation of Staphylococcus sciuri, primarily animal species, from samples taken from hospitalised patients. Considering that Staphylococcus sciuri often remains unrecognised in routine laboratory practice, we propose the criteria for simple identification of this bacterium.

A modified microtiter-plate test for quantification of staphylococcal biofilm formation.

The tube test and the microtiter-plate test are the most frequently used techniques for quantifying biofilm formation, an important indicator for the pathogenicity of staphylococci. The purpose of the present study was to develop a modified microtiter-plate technique for quantification of biofilm formation. This technique involves fixing the bacterial film with methanol, staining with crystal violet, releasing the bound dye with 33% glacial acetic acid, and measuring the optical density (OD) of the solution at 570 nm by using an enzyme immunosorbent assay reader. Biofilm formation of 30 Staphylococcus strains was estimated by the tube test, the standard microtiter-plate test and the modified microtiter-plate test. The modified microtiter-plate test, as a quantitative assay, is superior to the tube test in terms of objectivity and accuracy. It is also superior to the standard microtiter-plate test because it enables indirect measuring of bacteria attached both to the bottom and to the walls of the wells, while in the standard test only the dye bound to the bacteria adhered to the bottom of the wells is spectrophotometrically registered. Highly significant differences between OD values obtained by the standard microtiter-plate test and those obtained by the modified test suggest that large number of bacteria were attached to the walls of the wells. Therefore, the modification of the standard microtiter-plate test by introduction of an additional step of decolorization by acetic acid seems to be a useful improvement of the technique.

Evaluation of polymerase chain reaction, tuberculostearic acid analysis, and direct microscopy for the detection of Mycobacterium tuberculosis in sputum.

Tuberculosis remains a major global cause of morbidity and mortality. There is an urgent need for improved bacteriologic diagnosis of Mycobacterium tuberculosis infection. Three methods for rapid identification of M. tuberculosis in sputum samples (direct microscopy, gas chromatography-mass spectrometry [GC-MS], and polymerase chain reaction [PCR]), were compared with culture on Lowenstein-Jensen medium. Growth of M. tuberculosis was observed in 38 of 145 sputum samples. Detection of acid-fast bacilli by direct microscopy gave a sensitivity of 66% and a specificity of 100%. Detection of tuberculostearic acid by GC-MS gave a sensitivity of 55% and a specificity of 87%. Amplification by PCR of a fragment of the insertion sequence IS6110 gave a sensitivity of 95% and a specificity of 93% compared with culture and a corrected specificity of 99% compared with both culture and clinical data. This study indicates that PCR can be adapted for clinical use and is the method of choice for rapid diagnosis of pulmonary tuberculosis.

[Characteristics of sexual offenders in our data]. / Karakteristike pocinitelja seksualnih delikata u nasem materijalu.

By analyzing two groups of sexual delinquents: those which have committed rape, attempted rape or committed rape with murder (the first group) and the commiters of indecent acts (the second group), it was established that the named groups are substantially different in relation to some of the studied parameters. In the first group of delinquents, there is considerably less of those who are married (35.48%), in relation to the second group (73.68%). Indecent acts are most often committed in the apartment of the sexual offender (63.16%), while this is the case in 22.58% of the offences from the first group. The victims of indecent acts were only minors. In both groups the most frequent psychiatric diagnosis was psychopathy. Alcoholic state at the time of committing the offence was considerably greater in the first group (87.10%), in relation to the other one (47.37%). There were no important differences relating earlier criminal offences, as well as the psychiatric estimates of accountability between the groups.

[Injuries of the wall of the thorax]. / Povrede zida grudnog kosa.

The mortality rate of chest injuries sustained in road accidents stands now at 15-20 per cent. The considerable force of the impact in road accident is, in 60-80 per cent of the cases responsible for chest injuries which involve other organs. Fractures of a single rib needs only analgetica or intercostal blockade. If a rib is broken in several places or if several rib are fractured instability of the chest wall is act to develop in 15-20 per cent of the cases. It manifest itself in paradoxical breathing and ensuing increase in dead space. In these cases required "internal pneumatic splitting" in form of positive pressure surgical stabilisation of the chest wall has regained favour. Wire or plate osteosynthesis screw-less rib plates and steel splints are being used. Primary stabilisation of the thoracis wall is indicated in the cases: with paradoxical breathing, with respiratory insufficiency or in the cases there are other reasons for thoracotomy. In these circumstances surgical intervention ensure that prolonged artificial ventilation and its attendant risks and complications and the demands made on the nursing staff are reduced to a minimum.

[The importance of experimental surgery]. / O znacaju eksperimentalne hirurgije u nasim uslovima.

Experimental surgery is an integral part of experimental medicine, and by rights should be present especially in the larger medical (clinic) centers that today have yet to be realized. In would provide the cadres that can enlighten scientific projects of fundamental and applicable significance. It would enable experimental research on a number of clinical and operational techniques and technical problems as well as introduce innovative methods and operational procedures. In terms of educating medical and other natural science students, it would open new perspectives for directly including these cadres, during the course of their studies, in the performance of a number of operations. And such experience provides the student with grounds, in a directional sense, for making future life decisions. Thus, experimental surgery could fill a noticeably empty space in the process of student education. The section formed in Novi Sad has obtained appropriate space. There is a keen interest among the cadres. The equipment is on the way toward completion. A surgeon is in charge of this section. During the course of his service as a representative, he will have the opportunity to acquire experience on an international level. This section has already developed a number of functions to perform. It offers cooperation with other similar sections in our country as well as with clinics and cadres interested in working in this field of medicine and surgery.

[The value of lung biopsy in the radiological stage of bihilar adenopathy of sarcoidosis (author's transl)]. / Die Bedeutung der Lungenbiopsie im radiologischen Stadium der bihilären Adenopathie der Sarkoidose.

The classification of intrathoracic sarcoidosis into stages is based on radiological criteria. As pulmonary involvement is often considered to be an indication for corticosteroid therapy a comparison was made between the X-ray picture and lung biopsy in stage I sarcoidosis. Non-caseating epitheloid granulomas were found in 9 of 12 patients. The material was obtained by open biopsy in 8 patients and by the transbronchial approach in one case. Open and transbronchial biopsy failed in 3 patients to demonstrate sarcoid granulomas. The results suggest that the presence of mottling in the chest roentgenogram does not provide the rationale for treatment. Further studies will show whether irreversible damage to lung tissue could be prevented if lung biopsies were taken and, consequently, steroid therapy initiated, at an earlier stage of the disease.