Ongoing mumps outbreak in Novi Sad, the autonomous province of Vojvodina, Serbia, January to April 2012

From 16 January to 30 April 2012, a total of 119 cases of mumps were notified in Novi Sad, Serbia. Of these cases, 89 (75%), were among students. The average age of cases was 22 years-old (range 3-37). The outbreak is still ongoing in Novi Sad and is spreading to other parts of the Vojvodina province. As of 30 April, 209 cases have been notified in the province among those 119 from Novi Sad.

Ongoing mumps outbreak in Novi Sad, the autonomous province of Vojvodina, Serbia, January to April 2012

From 16 January to 30 April 2012, a total of 119 cases of mumps were notified in Novi Sad, Serbia. Of these cases, 89 (75%), were among students. The average age of cases was 22 years-old (range 3-37). The outbreak is still ongoing in Novi Sad and is spreading to other parts of the Vojvodina province. As of 30 April, 209 cases have been notified in the province among those 119 from Novi Sad.

A biofilm exists on healthy mucosa of the paranasal sinuses: a prospectively performed, blinded, scanning electron microscope study

OBJECTIVES

Based on our hypothesis that biofilm is nothing else but normal, otherwise abundantly colonised mucosal mucous blanket, the aim of this study was to check out whether bacterial biofilm exists exclusively at the diseased mucosal surfaces or at healthy mucosa of paranasal sinuses as well.

DESIGN

Prospective and blinded.

SETTING

Tertiary academic hospital.

PARTICIPANTS

The patients suffering from the diseases not related to the chronic inflammation of the paranasal sinuses. Mucosal tissue samples from healthy sphenoid sinuses were taken from 48 patients who underwent pituitary gland surgery and from ethmoidal sinuses mucosa of the 17 patients who underwent endonasal endoscopic orbital decompression because of Graves' disease.

MAIN OUTCOME MEASURES

The samples were submitted blindly along with similar samples from patients with chronic rhinosinusitis to two scanning electron microscope experts. In all samples the looked for the main signs of biofilm presence of: the 'towers', rod-shaped bacteria and water channels.

RESULTS

Signs of biofilm presence were found in 45 out of 48 pituitary gland surgery patients (94%) and in all of 17 EEOD patients (100%).

CONCLUSIONS

Our study showed the presence of the biofilm at the surface of the healthy mucosa of the paranasal sinuses. This suggests that perhaps so called bacterial biofilm is nothing else but regular respiratory mucosal blanket, a part of the mucociliary system itself, containing a great number of bacteria.

[Off-pump myocardial revascularization (OPCAB) in patients with post-infarction unstabile angina, low ejection fraction and renal disfunction]

The purpose of this study is to present our experience in off-pump myocardial revascularization in patients with post-infarction unstable angina, left ventricular low ejection fraction and renal dysfunction.

MATERIAL AND METHODS

From January 1998. until march 2002, at the Institute for Cardiovascular Diseases in Clinical Centre of Serbia, we have operated 20 patients with post infarction unstable angina, echocardiographicaly proved low ejection fraction (less than 30%) and renal dysfunction (Serum Creatinin 150 micrograms per liter) using this method. All patients were male and they were between 52 and 79 years old. Preoperative characteristics, surgical treatment and postoperative course are presented.

RESULTS

There was no hospital mortality, as well as important morbidity. There was no worsening of the renal and myocardial function. Postoperative ICU stay was from 1 to 2 days. Postoperative hospital stay was between 3 and 7 days.

CONCLUSION

Off-pump myocardial revascularization is safe and effective procedure in all patients with left ventricular low ejection fraction and renal dysfunction.

The chemical composition of some Lauraceae essential oils and their antifungal activities

The antifungal activity of Aniba rosaeodora, Laurus nobilis, Sassafras albidum and Cinnamomum zeylanicum essential oils were investigated against 17 micromycetes. Among the tested fungal species were food poisoning, spoilage fungi, plant and animal pathogens. In order to determine fungistatic and fungicidal concentrations (MIC and MFC) macrodilution and microdilution tests were used. Linalool was the main component in the essential oil of A. rosaeodora, while 1.8-cineole was dominant in L. nobilis. In sassafras essential oil safrole was the major component and in the oil of C. zeylanicum the main component was trans-cinnamaldehyde. The essential oil of cinnamon showed the strongest antifungal activity.

The role of nitric oxide in treatment of acute lung injury after surgery with extracorporeal circulation

Postoperative acute lung injury (ALI) compromises oxygen transfer across alveolar-capillary membrane with consecutive hypoxia, one of its indicators being reduction of oxygenation index PaO2/FiO2 below 40 kPa (300 mm Hg). Management of ALI includes different procedures like mechanical lung ventilation (MLV), drugs and others. One of the new possibilities for treatment of ALI is nitric oxide (NO) inhalation. The aim of this prospective study was to examine the role of NO inhalation in treatment of ALI. 14 patients with ALI developed immediately after operation with extracorporeal circulation (ECC) were included in the study. Group A (n = 8) inhaled NO and group B (n = 6) did not inhale NO during treatment of ALI. All other therapeutic measures were the same in both groups. The groups were similar in relation to demographic data, type of surgery and duration of ECC. PaO2/FiO2 was calculated before operation (T1), immediately after surgery (T2) and after lung recovery, when the need for MLV stopped (T3). The duration of MLV was also registered. PaO2/FiO2 (kPa) in referent times was in group A 54,9 ? 1,6, 33,8 ? 1,2 and 46,2 ? 0,8 and in group B 52,2 ? 1,1, 33,5 ? 1,5 and 47,3 ? 0,9, respectively. There was a statistically significant decrease of PaO2/FiO2 in T2 and T3 vs T1 in both groups (p < 0,05), while the difference between the groups was not statistically significant. The duration of MLV (h) in group B (28,5 ? 1,6) was statistically significantly shorter than in group A (63,1 ? 8,7) (p < 0,01). According to the results of this study we conclude that NO inhalation during ALI after surgery with ECC significantly reduces the duration of MVL and improves pulmonary recovery .

[Interleukin-8 serum levels in patients with various types of open heart surgical procedures performed under extracorporeal circulation]

Serum concentrations of proinflammatory cytokine interleukin-8 (IL-8) in 15 patients with surgically revascularized myocardium by triple venous cardiopulmonary bypass (CPB x 3) and in 10 patients with implanted artificial aortic valves (AV) were measured. Average IL-8 concentrations in (CPB x 3) patients and in those with artificial aortic valve were 7.3 +/- 11.6 pg/mL 24 hours before surgery, i.e. 3.3 +/- 3.4 pg/mL; six hours after surgical procedure 32.7 +/- 71.4 pg/mL, i.e. 8.9 +/- 9.9 pg/mL; and 24 hours after surgery 10.9 +/- 9.7 pg/mL, i.e. 8.3 +/- 4.6 pg/mL. Extracorporeal circulation (ECC) caused significant increase of IL-8 serum concentration in both investigated groups six hours after surgery. Comparing preoperative values of the both groups, as well as those of 6 and 24 hours after surgery, no significant values of IL-8 were found. Various types of open heart surgical procedures had no influence on the extent of the production and secretion of proinflammatory IL-8 cytokine measured in patients during 24 hours after surgery.

Photopolymerization of composite resins with plasma light

Everyday improvements in components and characteristics of composite materials have induced faster development of curing units. Besides standard halogen curing units and soft-start photopolymerization light sources, some experiments with argon and pulsed laser light and low intensity blue superbright light emitting diodes have been made. On the other hand, rapid polymerization with strong plasma light is also clinically applicable. The aim of this study was to measure the degree of conversion and temperature rise for three restorative composite materials: Tetric Ceram (Vivadent, Schaan, Liechtenstein), Pertac II (ESPE, Seefeld, Germany) and Z100 (3M Dental Products, St Paul, MN, USA) during polymerization with plasma light Apollo 95E (DMDS, Dental/Medical Diagnostic Systems, Fleury d'Aude, France) and compare it with the results of polymerization with a halogen curing unit, Elipar Trilight (ESPE, Seefeld, Germany). The results revealed the degree of conversion values in the case of polymerization with plasma light to be almost equal to those obtained by curing with the halogen curing unit, whereas the temperature rise was almost negligible.

Composite conversion and temperature rise using a conventional, plasma arc, and an experimental blue LED curing unit

The objective of this study was to evaluate the degree of conversion and temperature rise in three different composite materials when illuminated by an experimental light source [blue superbright light emitting diodes (LEDs)] and compared with plasma light and traditional photopolymerization unit. The degree of conversion and temperature rise were measured using Fourier transform infrared (FTIR) spectroscopy and digital multimeter, respectively. The results revealed significantly higher degree of conversion values in case of conventional curing than with other two light sources whereas temperature rise was significantly lower when blue LEDs and plasma light were used. There were great differences in light intensities between blue LEDs of only 9 mW cm-2 compared with plasma light of 1370 mW cm-2 and Elipar II of 560 mW cm-2. Better match of LED spectral distribution peak to camphorquinone absorption distribution peak probably explains much lower intensities used for similar photopolymerization effect like in the case of rapid plasma lamp curing.

[Stability of myocardial perfusion during revascularization under propofol anesthesia]

During coronary artery bypass grafting surgery (CABGS) there are many factors which may disturb myocardial oxygen balance with consequent irreversible myocardial damage. Anesthesiologists are expected to use drugs with tendency to optimize hemodynamics and myocardial oxygen balance, making in that way conditions for preserving myocardial perfusion. In this study, performed on 19 patients undergoing CABGS under dominant propofol anesthesia, there were no signs of intraoperative ischemia manifested by statistically significant dislocation of ST segment in EKG leads D11, V5 and aVL.

[Comparative analysis in the use of natural and artificial vascular grafts on hematologic characteristics in patients]

Investigation of two groups of patients was performed. Both male and female patients, 34 to 69 years old, in which extracorporeal circulation was established in the course of open heart and ascendental aorta surgeries were included in the investigation. The first group consisted of 20 patients with surgically revascularized miokard by triple venous grafts, and the second included 20 patients with partial replacement of ascendental aorta using synthetic dacron graft. It was concluded that extracorporeal circulation leads to a significant decrease of platelet count and agreability after surgery, as well as decrease of red blood cell count and hemoglobin and hematocrit value. However, contact of circulating blood with the synthetic dacron graft surface, in surgical procedures on ascendental aorta, leads consequently to a significantly higher decrease of platelet count and agreability, with the significant decrease of red blood cell count and decrease of hemoglobin and hematocrit value. Based on the obtained results it is possible to plan requirements for allogenous blood/red blood cells which are significantly higher in patients undergoing partial replacement of ascendental aorta using artificial dacron graft compared with patients after surgical revascularization of miocard with triple venous graft.

Degree of conversion and temperature rise during polymerization of composite resin samples with blue diodes

To ensure an adequate clinical composite filling light source for photopolymerization is of great importance. In everyday clinical conditions commonly used unit for polymerization of composite material is halogen curing unit. The development of new blue superbright light emitting diodes (LED) of 470 nm wavelengths comes as an alternative to standard halogen curing unit of 450-470 nm wavelengths. The purpose of this study was to compare the degree of conversion (DC) and temperature rise of four hybrid composite materials: Tetric Ceram, Pertac II, Valux Plus and Degufill Mineral during 40 s illumination with standard halogen curing unit Heliolux GTE of 600 mW cm(-2) intensity, Elipar Highlight soft-start curing unit of 100 mW cm(-2) (10 s) and 700 mW cm(-2) (30 s) intensity and 16 blue superbright LED of minimal intensity of 12 mW cm(-2) on the surface and 1 mm depth. The results revealed only a little bit higher DC values in case of polymerization with even 66 times stronger halogen curing units which showed twice higher temperature than blue diodes. Temperature and DC obtained are higher on the surface than on 1 mm depth regardless on the light source used.

The essential oil composition of Thymus tosevii and Thymus macedonicus from Bulgaria

Essential oils composition of Thymus tosevii Velen. and Thymus macedonicus (Deg. et Ur.) Ronn. from Bulgaria were examined by analytical GC and GC-MS techniques. 39 components were separated in the oil of T. tosevii and 22 of them were identified, representing 94.37% of the oil. The most abundant constituents were: terpinyl acetate (43.59%), thymol (11.43%) and nerol (11.72%). More than 70 components were separated in the essential oil of T. macedonicus, 35 were identified, representing 96.03% of the oil. The major components were geranyl acetate (30.00%) and terpinyl acetate (17.30%), followed by lower amounts of nerol (14.25%), linalool (12.94%) and thymol (4.14%). Both examined taxa contained essential oils composed mainly from monoterpene oxygenate compounds while the fractions of monoterpene hydrocarbons as well as sesquiterpene components were very low.

Guaianolides from Centaurea nicolai: antifungal activity

A new guaianolide, 3-deacetyl-9-O-acetylsalograviolide A, along with four known closely related lactones, salograviolide A, 9-O-acetylsalograviolide A, kandavanolide and salograviolide B were detected in the aerial parts of the flowering plant Centaurea nicolai. Antifungal tests performed on salograviolide A and its 9-O-acetyl and 3-O-deacetyl-9-O-acetyl derivatives revealed inhibitory activity against Aspergillus niger, A. ochraceus, Penicillium ochrochloron, Cladosporium cladosporoides, Fusarium tricinctum and Phomopsis helianthi. Neither of them was active against Trichoderma viride.

Composition of the essential oil from Thymus moesiacus from Macedonia

Composition of the essential oil of Thymus moesiacus Velen. from Macedonia was examined by GC and GC-MS methods. The main constituents of the oil were geraniol, linalool, geranyl acetate, and terpenyl acetate.

A stereological investigation of rat endocrine pancreas after a long-term low-protein diet

Stereological analysis of rat endocrine pancreas was carried out after 4 months of low-protein intake. Thirty make Wistar rats, aged 2 months at the beginning of the experiment, were divided into three groups. The control group (NP) received a standard laboratory diet. The experimental group (LP) received a low-protein diet, and the pair-fed animals also received a standard laboratory diet, as the NP rats did, but restricted to the amounts consumed by the LP group. All groups were offered drinking water ad lib. Weibel's multipurpose lattice was used to determine the volume fraction of cells and numerical density of islets in the endocrine pancreas. The results showed that the long-term low-protein diet decreased the volume fraction of B-cells and increased that of A-cells. Numerical density of islets was significantly increased, whereas the absolute number was decreased. The mean number of B-cells per islet was found to be decreased and that of D-cells increased. The mean radius of the islets was decreased, as was the mean surface area.

[The effect of food containing various quantities of fats on the level of fatty acids in rat liver tissue]

We studied the influence of different quantities of fat in the diet (sunflower oil, pork fat) on the fat content in hepatic tissues of the rat. 20g of fat were given comprising 44% of the total energetic value of the diet. The study was done in male rats of the Wistar strain, 2 months old at the commencement of the experiment. The study lasted 6 months. The results showed that the saturated fatty acid content of the liver (16:0; 18:0) was higher in animals who were fed with sunflower oil. The content of unsaturated fatty acids (18:2; 18:3, 20:4) was higher in the liver of animals fed on pork fat. The content in dokosaheksaenic fatty acid (22:6) was higher in the hepatic tissue of the animals fed with pork fat.

[Surgical treatment of aneurysms of the femoral artery]

The authors have presented the importance and technics of operative treatment of femoral aneurysms as the only correct method of treatment aiming at prevention of complications which are the consequence of the natural course of the disease. The majority of current operative technics involve total or partial resection of an aneurysm and reconstructive operative approach (graft interposition, bypass) aiming at establishment of the arterial continuity. In the same time the authors have emphasized the importance of echosonographic diagnostical procedure which has even some advantages over angiography, especially in cases with normal central recanalization of the clot.

[Treatment of patients with acute myeloid leukemia--use of Toronto criteria in evaluation of success in therapy]

Over the period from January 1, 1972 to January 1, 1982, a total of 320 patients with acute myeloblastic leukaemia (AML) was registered in our institution. Only 289 case histories were suitable for analysis. In this paper we present the distribution of patients according to the risk group denomination prepared by the Toronto Leukaemia Study Group of Canada. The effect of such stratification of patients with AML is evaluated in our patients. The results are here with discussed. 160 male (median age = 57.7 yr.) and 128 female (median age = 58.0 yr.) patients are presented. Distribution of these patients according to the age is compared to the distribution of similar patients included in the British AML-8 trials and with the total incidence of newly diagnosed AML in England and Wales, in one year (1983). It is shown that the cohort of patients, included in the recognized foreign trials, is not representative of the natural population with respect to morbidity and mortality from AML--similar conclusion concerns this group of patients which comprises the largest single-centre series reported hitherto in the Yugoslavia literature. Thus, the success of therapy of AML as reported in available literature from this country and elsewhere is necessarily, and perhaps incautiously, inflated and statistically distored. The number of complete remissions and the median survival-time of the patients presented varied significantly in our study in accordance with the exclusion steps performed. Without the exclusion of risk groups the percentage of complete remissions was 35.3 per cent and the median survival was 3.0 months. With all the substractions these values were 51.72 per cent and 7.0 months, respectively.

[Barium peritonitis caused by perforation of the colon and rectum]

Over the period from 1979 to 1988 the authors treated three patients with perforated colon and rectum, manifested during contrast barium X-ray examination. Perforation of the caecum occurred in one patient; perforation of the sigmoid flexure in the second subject and perforation of the ampulla recti in the third patient. Caecum perforation was spontaneous, and that of the rectum and the sigmoid flexure wall was due to rigid catheter during irigography. The patients were two women and one man. The youngest patient was 50 years old and the oldest was aged 75 years. Surgery of the perforated caecum and ampulla recti was carried out during the first 24 hours, and that of the sigmoid flexure on the seventh day. The following radical operations were performed: the right hemicholoctomy, sigmoid resection with temporary cholostoma, rectum amputation, manyfold drainage of abdominal cavity. Antibodies were also administered. One patient died.

[Bilateral trans-obturator bypass after graft infection in the aorto-bifemoral position]

The authors describe a patient in whom bilateral transobturatory bypass for revascularization of the lower extremities after infection of the preliminary implanted graft in aorto-bifemoral position, was carried out. The graft was implanted into aorto-bifemoral position after angiographic examination of the patient hospitalized for claudicatory disorders. A year later the patient was hospitalized for infection of the left distal anastomosis manifested by haemorrhage. After re-establishment of haemostasis (ligature of the arteries in the Scarpa's triangle and of the left branch with Y Dacron graft) the infected part was extirpated. Revascularization of the left leg was performed in another surgical act, with transobturatory iliaco-deep-femoral artery (jumping)--popliteal bypass with the use of 8 mm tubular DACRON graft. Three months later infection and haemorrhage appeared in the right inguinal region i.e. on the right distal anastomosis. This time the extirpation of the infected right branch of Y DACRON graft and revascularization of the right leg with right transobturatory aorto-popliteal bypass were performed in one surgical act. Tubular DACRON graft of 8 mm was also used. This case is one of the good examples of appropriate extra-anatomic transobturatory bypass in the revascularization of the lower extremities when it is not possible to treat a process in the inguinal region by usual procedures. The curiosity of this case is the bilateral transobturatory bypass.