INTRODUCTION Catheter-associated urinary tract infections (CAUTI) are the most common nosocomial infections. The worldwide data show the increasing resistance to conventional antibiotics among urinary tract pathogens. AIM To evaluate the adequacy of initial antimicrobial therapy in relation to the antimicrobial resistance of pathogens responsible for CAUTI in Clinical Center of Banja Luka. METHODS A retrospective study on major causes of CAUTI, antibiotic resistance and treatment principles was conducted at four departments of the Clinical Center of Banja Luka from January 1st, 2000 to April 1st, 2003. RESULTS The results showed that 265 patients had developed CAUTI. The seven most commonly isolated microorganisms were, in descending order: E. coil (31.0%), Pseudomonas aeruginosa (13.8%), Proteus mirabilis (12.9%), Gr. Klebsiella-Enterobacter (12.3%), Enterococcus spp. (5.2%), Pseudomonas spp. (4.3%), Serratia spp. (4.0%). The most common pathogens were highly resistant to ampicillin (64-100%), gentamycin (63-100%), and trimethoprim-sulfamethoxazole (68-100%), while some bacterias, like Pseudomonas aeruginosa and Serratia spp. showed rates of ciprofloxacin resistance as high as 42.8% and 72.7%, respectively. In 55.5% of the cases, the initial antibiotic therapy was inadequate, and was corrected latter on. There were no standard therapeutic protocols for this type of nosocomial infections. CONCLUSION The results of this study emphasized an urgency of the prevention and introduction of clinical protocols for better management of CAUTI. Treatment principles should better correspond to the antibiotic sensitivity of uropathogens.

OBJETIVO: Verificar, do ponto de vista tensional e morfologico, o efeito do extrato aquoso de aroeira-do-sertao a 10% na anastomose colonica, na vigencia de colite induzida por acido acetico a 10%, em ratos Wistar. METODOS: Foram utilizados 48 ratos da linhagem Wistar, distribuidos em dois grupos. Todos os animais foram submetidos a inducao da colite por solucao aquosa de acido acetico a 10%. Vinte e quatro horas apos, os animais foram submetidos a laparotomia, colotomia transversa total e anastomose termino-terminal com fio de polipropileno 5-0. Grupo A (veiculo), animais tratados com veiculo a base de carboximetilcelulose. Grupo B (aroeira), animais tratados com extrato aquoso de aroeira a 10%. Ambos tratamentos foram sob a forma de enema. Os grupos A e B foram distribuidos em subgrupos A3, A7, A14 e A21; B3, B7, B14 e B21, respectivamente, conforme a data prevista para a eutanasia (3, 7, 14 e 21 dias). Nas respectivas datas, os animais foram relaparotomizados, o segmento colonico contendo a anastomose foi ressecado, submetido ao teste de pressao e em seguida a analise histologica. Para o estudo morfologico, as lâminas foram coradas com hematoxilina-eosina e avaliou-se a condicao de cicatrizacao baseado numa tabela de escores que variava de 0 a 16. Quanto maior o escore melhor o grau de cicatrizacao. RESULTADOS: Na avaliacao do estudo morfologico, que quantifica a evolucao e o grau de cicatrizacao, como resultado final do processo cicatricial, o grupo aroeira foi superior ao grupo veiculo (p<0,05) no vigesimo primeiro dia, mostrando maior rapidez na reparacao tecidual que se da por regeneracao e nao por fibrose. Com relacao ao teste de tensao, houve diferenca estatisticamente significante no dia 3, com predominância do grupo aroeira sobre o grupo veiculo (p<0,05). CONCLUSAO: O extrato aquoso de aroeira-do-sertao a 10%, tem atividade cicatrizante na anastomose colonica na vigencia de colite induzida por acido acetico a 10%. Melhora a resistencia a tensao na zona da anastomose colonica no 3o dia.

The inadequacy of the optical trapping model based on ray optics in the case of describing the optical trapping performance of annular and doughnut laser beams is discussed. The inadequacy originates from neglecting the complex focused field distributions of such beams, such as polarization and phase, and thus leads to erroneous predictions of trapping force. Instead, the optical trapping model based on the vectorial diffraction theory, which considers the exact field distributions of a beam in the focal region, needs to be employed for the determination of the trapping force exerted on small particles. The theoretical predictions of such a trapping model agree with the experimentally measured results.

Histological changes of sciatic nerve in adult dogs 7 days after single application of 2% lidocaine (4 ml dose, speed of injection 3 ml/min) and measurement of the application pressure was studied, with a goal to investigate structural changes of the nerve in relation to the established pressure values. The application pressure was determined by using Bio Bench software. In intrafascicular puncture an average application pressure of 198.23 +/- 52 kPa was found, and in interfascicular puncture its average value was 53.3 +/- 17.9 kPa, with a note that individual differences are regularly present. Seven days after the injection, a nerve dissection was performed and serial sections covering the region of injection's puncture and bordering proximal and distal zones, in the total length of 3 cm, were prepared. The found changed show the presence of nerves' fibers lesions with a strong reactivity of Schwann's cell, as well as the change of interstitial structure concerning hypercellularity and occurrence of cellular extravasation. The covering system of the nerve in the zone of epineurium manifests changes of inflammatory process and in perineurium a decomposition of lamella layers and the alteration of their tinctorial properties were noticed. A comparison of the found nerve reactivities in intra- and interfascicular application showed their one-way alteration, although the lesions were more noticeable in the conditions of intrafascicular application. The damages were mostly expressed in the zone of local application of anesthetic, than distally from it, while the damage to the structure in the proximal part is of the smallest degree.

Ductal dependent congenital heart diseases represent 14-20% of all congenital heart diseases. A primary goal of the treatment of these diseases is to retain ductus open until the final cardiosurgical treatment. Prostaglandins are presently the only medicaments, which have a capability to keep ductus open. By means of a retrospective study in a period from January, 2000 until December, 2002 at the Paediatric clinic of the Clinical centre of the University in Sarajevo, 14 patients (treated with prostaglandins) diagnosed with ductal dependent congenital heart diseases were analyzed. In our sample, there are 9/14 male patients (64.3%), 11/14 (78.6%) were full-term newborns, while 10/14 (71.4%) were eutrophic at birth. An average saturation increase, after the prostaglandin therapy, measured in blood from the capillaries is 29, and measured transcutanlly is 32 units. Duration of prostaglandin therapy in our study was on average 17.2 days. The most common cause of death was insufficientia cardiorespiratoria (4 out of 11), but sepsis/infection (3 out of 11) and insufficientia renalis were also common. 78.6% (11 out of 14) patients died partly because of the complexity of these diseases, but also because a cardiosurgical treatment is delayed. A goal of this study is evaluation of saturation with oxygen before and after the prostaglandin therapy.