Clinical and epidemiological aspects of respiratory syncytial virus lower respiratory tract infections

This paper has analyzed respiratory syncytial virus lower respiratory tract infections in 201 hospitalized children. In children with wheezing, erythrocyte sedimentation rate (ESR) was significantly higher in those with pneumonia than with syndroma pertussis, while the white blood cell (WBC) count was significantly lower in patients with bronchitis than in those with bronchiolitis and syndroma pertussis. Bronchodilatators were applied in 75.6% and corticosteroids in 20% of patients. Ten patients were ventilated. Fatal disease outcome was observed in one infant. Twelve consecutive-year study of respiratory syncytial virus (RSV) infections showed that 27.3% of these diseases were bronchiolitis and pneumonia.     

Two outbreaks of typhoid fever related to the war in Bosnia and Herzegovina

Two outbreaks of typhoid fever caused by Salmonella typhi of the same phagotype (A, biotype II) and antibiotic susceptibility are reported. Both occurred during the war in Bosnia and Herzegovina. The first outbreak appeared among the refugees from the town of Jajce. The second outbreak appeared among the inhabitants in the village of Vidosi near Livno. This report describes main clinical, epidemioloigcal and laboratory findings for 22 patients treated in Split University Hospital, Croatia, in the period November 1992–January 1993. Possible epidemiological connections between those two outbreaks are discussed.     

Ureaplasma urealyticum infection in newborns: Three case reports

We report three newborns with different manifestations ofUreaplasma urealyticum infection; a term newborn with acute neonatal pneumonia and two very low birth weight infants with bronchopulmonary dysplasia and osteomyelitis of the femur, respectively. The association ofU. urealyticum with acute and chronic respiratory disease in term and preterm newborns has recently been reported. Our two cases are similar to other case reports from the literature, but we were unable to find any previous reports of osteomyelitis due toU. urealyticum in the premature babies. Isolation ofU. urealyticum in pure culture from the blood was considered to be related to local infection in all three patients. All patients were cured by erythromycin.     

Dead-time correction in dynamic radionuclide studies by computer

Several methods for the measurement of dead time and for evaluation of the dependencies required to correct dynamic studies for dead-time losses are described. Two program variants were written to produce time-activity curves in the selected areas of interest of the dynamic studies with computer's correction of dead-time losses; these variants are part of the system of programs for complex processing of scintigraphic studies set up for a Clincom instrument. The first variant performs correction on the basis of the registered count rate in the whole image, while the second variant makes use of the additional reference source positioned on the periphery of the camera visual field.     

SORB-GEL method of analysis of 99mTc-labelled compounds

A SORB-GEL method has been worked out for analysing ^99mTc-labelled compounds which (in a few minutes) enables the pertechnetate content to be determined in a preparation. The method is based upon a different tupe of behaviour of ^99mTc-labelled compound, pertechnetate in the columns packed with Sephadex G-10, and with alumina during elution with saline.Polythene syringes 4.7 cm long and 1 cm in diameter were used as chromotographic columns. A syringe packed with Sephadex G-10 transferred 0.1 ml of ^99mTc-labelled compound into the column, and the activity of the column was then measured in the ionisation chamber. Using a syringe, 20 ml of saline was foreced through this column. The eluate was then removed. Using an injection needle, a second column, packed with alumina, was connected with the first. Similarly, a third column, packed with Sephadex G-10, was connected to the second. Through all of them 40 ml of saline was forced. The third column containing Sephadex G-10 was then disconnected and its activity was measured in the ionisation chamber. The pertechnetate content in the preparation was then calculated from the measured values.The method is suitable for determinating the free pertechnetate content in strong and weak chelate compounds and in particle preparations.     

Rickettsiae and rickettsioses in Portugal

The only rickettsiae recorded in Portugal till now were Rickettsia conorii and Coxiella burnetii. Boutonneuse fever is one of the most important transmissible diseases in Portugal. Though the annual number of cases is not exactly known, it is estimated to be not far from 20,000 in some years. Q fever is the other rickettsiosis widely disseminated throughout the country. The serological prevalence and the incidence of those rickettsioses in Portugal are presented in this communication. In recent research in southern Portugal, about 4,000 adult ticks of nine species were screened by the haemocyte test for rickettsiae and rickettsia-like organisms (RLO). In addition to R. conorii three microscopically different RLO were observed. Two of them, i.e. ovoid and bacillary-like, were positive in the immunofluorescence test with spotted fever (R. conorii) antiserum. The first occurred mainly in Rhipicephalus sanguineus ticks, the second one also in other tick species. The latter agent was cultivated in half-engorged R. sanguineus females and in Vero cells. The third organism was found in R. sanguineus, where it exhibited a massive infestation in haemocytes resembling that seen in experimentally infected ticks with C. burnetii, but not being this agent. The investigation of the isolates and their identification and characterization are being continued.Presented at the 4th International Symposium on Rickettsiae and Rickettsial Diseases, Pietany, C.S.F.R., 1–6 October, 1990.     

Cystoid macular edema in anterior chamber lens implantation following posterior capsule rupture

By comparing the incidence of cystoid macular edema (CME) in three groups of patients having different surgical procedures, we attempted to assess the role of vitreous loss as a risk factor for CME development. In the first group (n = 470), the surgical procedure was extracapsular cataract extraction followed by implantation of posterior chamber lens (EC-CE + PC-IOL). The second group (n = 42) had extracapsular cataract extraction which was complicated by posterior capsule rupture, and therefore anterior vitrectomy followed by implantation of anterior chamber lens had to be performed (ECCE + anterior vitrectomy + AC-IOL). In the third group (n = 22) the surgery was intracapsular cataract extraction followed by anterior chamber lens implantation (ICCE + AC-IOL). The third group was included in this follow up study to assess the role of AC-IOL as a possible causative factor for development of CME in uncomplicated cases of ICCE and AC-IOL. The difference of incidences of CME in the second and third group would therefore depend mostly on the vitreous loss. The incidence of CME diagnosed by fluorescein angiography in the first, second and third group was 1.5% (7/470), 35.7% (15/42) and 9.0% (2/22), respectively. All patients who developed CME were treated with combination of corticosteroid-antibiotic drops, dexamethasone retrobulbarly (40 mg/day) and peroral indomethacine (25 mg/day/6 weeks). This therapeutic regime resulted in only moderate improvement of visual acuity.Abbreviations AC-IOL anterior chamber intraocular lens - CME cystoid macular edema - ECCE extracapsular cataract extraction - ICCE intracapsular cataract extraction - IOL intraocular lens - PC-IOL posterior chamber intraocular lens     

No interference of rheumatoid factor(s) with toxoplasmosis IgM determination in infancy

Sera from 263 newborns and infants suspected of congenital toxoplasmosis were tested for the presence of rheumatoid factor (RF) by the latex agglutination test, of which 40 were also tested by the enzyme-linked immunosorbent assay (ELISA). RF was detected in only one serum sample (0.38%), suggesting that false-positive results of the IgM-indirect fluorescent antibody test and the IgM-ELISA due to RF is most unusual in infancy.     

Duodenal and jejunal atresia with agenesis of the dorsal mesentery: "apple peel" small bowel.

Two newborn infants with duodenal and jejunal atresia and agenesis of the dorsal mesentery represent our surgical experience with "apple peel" small bowel or "christmas tree" demormity. The first patient had the typical appearance of this condition. The postoperative course was complicated by hyperbilirubinemia, septicemia, and disseminated intravascular coagulation. The infant is in satisfactory condition 1.5 years after operation. The second patient had agenesis of the dorsal mesentery without spiraling of the bowel around its vascular stalk. The child died after 1 month, with complete absence of extrahepatic bile ducts as seen at a second laparotomy. Neither child had been subjected to gastrostomy.