[Antimicrobial treatment of Haemophilus influenzae meningitis in childhood]. / Antimikrobno lijecenje Haemophilus influenzae meningitisa u djecjoj dobi.

Antimicrobial treatment of bacterial meningitis should be done by antibiotic to which the causative agent is susceptible, which attained serum levels ensure adequate penetration across the blood-brain barrier and which bactericidal levels in cerebrospinal fluid are achieved. A total number of 61 child in age from 2 months to 7 years with bacteriologically proved Haemophilus influenzae meningitis was included in the study. The possibility and usefulness of application of various antibiotics used in the treatment of this disease as well as the results attained have been discussed. A total number of 40 patients was treated with only one antibiotic (ampicillin 6, chloramphenicol 6, cefuroxime 3, cefotaxime 18, ceftazidime 7) and 21 patients were treated with combinations of antibiotics (ampicillin + chloramphenicol 14, cefuroxime + chloramphenicol 7). The causative agent was susceptible to the applied antibiotic in all cases. The agent susceptibility was estimated qualitatively by disk diffusion method and quantitatively by methods of minimal inhibitory concentration (MIC) and minimal bactericidal concentration (MBC). Even 31.1% of H. influenzae strains were resistant to ampicillin. Penetration across the blood-brain barrier was monitored by estimation of antibiotic concentration in sera and liquor. Antibiotic concentrations in liquor attained the bactericidal levels. The same good results were attained with any of single applied antibiotics. In cases of delayed initiation of the antimicrobial therapy the appearance of neurological complications was more frequent, the outcome of the disease was worse and the duration of treatment was longer.(ABSTRACT TRUNCATED AT 250 WORDS)

[Nasopharyngeal secretions in patients as the clinical material in viral respiratory infections]. / Nazofaringalni sekret bolesnika kao klinicki materijal kod virusnih respiratornih infekcija.

The method of taking away the nasopharyngeal secretion (NPS) in patients with signs of respiratory infections is presented. The virological value of clinical material in 269 NPS-s is examined. Out of 269 examined NPS-s, 253 or 94% of clinical materials showed the satisfactory number of cells in the slide. Since the respiratory viruses can multiply only in ciliated epithelial cells, the clinical material rich with cells is the necessary prerequisite condition of each exact direct virological diagnostics. In accordance with the other authors this work also presents that NPS-s are superior to the throat swab due to a larger number of virus target cells in it.

[Ovulation induction using clomiphene and human gonadotropins in combined therapy]. / Indukcija ovulacije kombiniranom terapijom klomifenom i humanim gonadotropinima.

Stimulation of ovulation combined with the clomiphene therapy and human gonadotropins is presented. Follicular maturation was followed by changes of the cervical score and ultrasonic folliculometry from the tenth day of the stimulating cycle. Ovulation was proved by the change of quality of the cervical mucus, the increase of the BBT, the increase of the progesterone concentration in serum, then by ultrasonically proved changes inside the follicle and in endometry, and finally by pregnancy. With the combined therapy the authors stimulated ovulation in a group of 14 females, altogether 21 cycles. In all the patients, before the application of the combined therapy, induction of ovulation with clomiphane alone through at least 6 cycles proved unsuccessful. Ovulation was proved in the 20 cycles of the combined stimulation. Altogether 11 pregnancies of all induced cycles were obtained: 6 pregnancies with term delivery, 2 extrauterine pregnancies, 1 spontaneous abortion in the 24th week, 1 missed abortion, and 1 blighted ovum. Two twin pregnancies were recorded. In one patient the syndrome of hyperstimulation of the first degree occurred, while in the others there were no complications at all.

[Our approach to the diagnosis and treatment of the causes of infertility]. / Nas pristup dijagnostici i lijecenju uzroka infertiliteta.

The authors put forward their own scheme of investigating possible causes of infertility. In everyday clinical routine the results of such investigations are limited. Most useful data are obtained by a detailed anamnesis, hysterosalpingography, bacteriological analysis, and cytogenetics. In the therapy of spontaneous abortion strict rest is recommended. Gestagen therapy is applied in bleeding in the first trimester only when fetal life is proved (ultrasound). Early protecting cerclage is to be performed between the 14th and the 16th gestation week. The importance of a positive psychological relation between physician and patient is emphasized.

[Endocrinological aspect of galactorrhea and lactation in relation to the cytology of breast secretion]. / Endokrinoloski aspekt galaktorije i laktacije uz citoloski pregled eksprimata dojki.

The concentration of prolactin in the plasma and the cytologic smears of the mammary extraction were analysed in 67 patients with galactorrhea. In 38 patients galactorrhea was couple with amenorrhea. Out of 67 patients with galactorrhea, 32 had hyperprolactinemia (68.6 +/- 14.4 ng/ml) along with low estrogen (14.6 +/- 3.8 ug/24 hours) and aonadotropin (FSH 6.2 +/- 2.0, LH 8.5 +/- 2.6 mIU/ml) values. In 48 out of 67 patients galactorrhea seceded under the therapy of Parlodel (bromocriptine). Out of 13 patients waiting pregnancy, 9 showed a restitution ofa the ovulatory cycle and 2 became pregnant. In the group of parturients it proved possible to suppress ablactation by estrogenic-and androgenic preparations (Ablacton) without a decrease in the prolactin concentration, while Parlodel brought about ablactation with a decrease of the prolactin concentration to normal values as early as 24 hours following the application of its first dose. In 6 patients with hyperprolactinemia and low estrogaen and gonatropin values an increase in the concentration of LH and FSH after 100 micrograms LH--RH i. m. was observed. In the cytologic smears of the mammary excretion there were no atypical or malignant cells.