Angiotensin II administration in severe thrombocytopenia and chronic venous thrombosis: A case report.

Background: The initial trials on angiotensin II (AT II) administration indicated a high incidence of thrombocytopenia and thrombosis, as well as a positive correlation between hyperreninemia and response to the medication.

Case Summary: We describe a case of a patient presenting with catecholamine resistant septic shock, thrombocytopenia, deep vein thrombosis, and normal renin concentration who responded immediately to AT II treatment. We observed no worsening of thrombocytopenia and no progression of thrombosis or additional thromboses during treatment.

In Vitro Antibiofilm Activity of Fosfomycin Alone and in Combination with Other Antibiotics against Multidrug-Resistant and Extensively Drug-Resistant .

Background: Due to its rapid resistance development and ability to form biofilms, treatment of infections is becoming more complicated by the day. Drug combinations may help reduce both resistance and biofilm formation.

Methods: Using the microtiter plate assay, we investigated the in vitro inhibition of biofilm formation and the disruption of preformed biofilms in multidrug-resistant and extensively drug-resistant clinical isolates of in the presence of peak plasma levels of eight antipseudomonal antibiotics alone and in combination with fosfomycin: ceftazidime, piperacillin/tazobactam, cefepime, imipenem, gentamicin, amikacin, ciprofloxacin and colistin.

In vitro killing of multidrug/extensively drug-resistant by fosfomycin alone or in combination with antipseudomonal antibiotics.

is a leading cause of nosocomial infections. Given the constant rise in resistance, adequate therapy is increasingly demanding. Fosfomycin recently became an appealing treatment option of bacterial infections due to multidrug-resistant bacteria (MDR).

Self-poisoning as a cause of admission in a medical intensive care unit and a question of misuse of prescription medications.

Background: Self-poisoning accounts for between 3 and 17% of intensive care unit (ICU) admissions.

Objectives: To display the misused substances, intention, and outcome of patients admitted to the ICU due to self-poisoning.

Methods: A retrospective review of ICU admissions using an electronic patient database was performed.

Gram-negative bacteria as causative agents of ventilator-associated pneumonia and their respective resistance mechanisms.

Ventilator-associated pneumonia (VAP) is a serious and common complication in patients admitted to intensive care unit (ICU) and contributes to mortality. Multidrug Gram-negative bacteria such as , and are frequently associated with VAP in ICU. A prospective study was set up in three ICUs of the University Hospital Center Zagreb and one ICU in General Hospital Pula from September 2017 to March 2018.

FALSE POSITIVE PHENOTYPIC DETECTION OF METALLO-BETA-LACTAMASES IN .

Phenotypic detection of metallo-β-lactamases (MBLs) in is a serious challenge to clinical microbiologists. MBLs are inhibited by metal chelators such as ethylenediaminetetraacetic acid) (EDTA). Production of MBLs cannot be recognized based on resistance phenotype.

Experience with fosfomycin in the treatment of complicated urinary tract infections caused by extended-spectrum beta-lactamase-producing Enterobacteriaceae.

Background: The aim of this study was to evaluate the efficacy of fosfomycin in the treatment of complicated urinary tract infections (cUTIs) caused by extended-spectrum beta-lactamase (ESBL) producing Enterobacteriaceae.

Methods: We retrospectively evaluated 42 ambulatory patients with cUTIs caused by ESBL-producing Enterobacteriaceae at the Outpatient Internal Medicine Clinic of the University Clinical Hospital Centre Zagreb in the period from June 2012 to June 2014. ESBL production was confirmed by double disk synergy test according to Jarlier.

Incidence, etiology, predictors and outcomes of suspected drug hypersensitivity reactions in a tertiary care university hospital's emergency department : A retrospective study.

Background: Allergic drug reactions are adverse drug reactions that result from a specific immunologic response to a medication. Considering the epidemiological and clinical importance of drug allergy, this retrospective analysis focused on drug hypersensitivity in a tertiary care university hospital emergency department (ED).

Methods: In this study 74,929 ED records obtained from March 2012 to March 2015 were reviewed to determine the incidence, etiology, predictors and clinical features of drug hypersensitivity.

NDM-1-producing Enterobacter aerogenes isolated from a patient with a JJ ureteric stent in situ.

Urinary tract infections after JJ stent insertion are among the most common complications, and the associated microorganisms carry more antibiotic resistance determinants than those found in urine prior to stent insertion. In line with the trends in healthcare epidemiology which implicate multi-resistant microorganisms in a plethora of healthcare-associated infections, prosthetic stent material also represents an ideal milieu for biofilm formation and subsequent infection development with resistant bacterial agents. Here we describe a case of a 73-year-old Caucasian woman presenting with urinary tract infection after JJ ureteric stent insertion due to ureteric obstruction and hydronephrosis of her left kidney.

Activity of fosfomycin against nosocomial multiresistant bacterial pathogens from Croatia: a multicentric study.

Aim: To determine in vitro susceptibility of multiresistant bacterial isolates to fosfomycin.

Methods: In this prospective in vitro study (local non-random sample, level of evidence 3), 288 consecutively collected multiresistant bacterial isolates from seven medical centers in Croatia were tested from February 2014 until October 2016 for susceptibility to fosfomycin and other antibiotics according to Clinical and Laboratory Standards Institute methodology. Susceptibility to fosfomycin was determined by agar dilution method, while disc diffusion was performed for in vitro testing of other antibiotics.

12th WINFOCUS world congress on ultrasound in emergency and critical care.

A1 Point-of-care ultrasound examination of cervical spine in emergency departmentYahya Acar, Onur Tezel, Necati SalmanA2 A new technique in verifying the placement of a nasogastric tube: obtaining the longitudinal view of nasogastric tube in addition to transverse view with ultrasoundYahya Acar, Necati Salman, Onur Tezel, Erdem CevikA3 Pseudoaneurysm of the femoral artery after cannulation of a central venous line. Should we always use ultrasound in these procedures?Margarita Algaba-Montes, Alberto Oviedo-García, Mayra Patricio-BordomásA4 Ultrasound-guided supraclavicular subclavian vein catheterization. A novel approach in emergency departmentMargarita Algaba-Montes, Alberto Oviedo-García, Mayra Patricio-BordomásA5 Clinical ultrasound in a septic and jaundice patient in the emergency departmentMargarita Algaba-Montes, Alberto Oviedo-García, Mayra Patricio-BordomásA6 Characterization of the eyes in preoperative cataract Saudi patients by using medical diagnostic ultrasoundMustafa Z.

Online learning applied to a course on rational therapeutics: an international comparison between final year students of two medical schools.

Introduction: Poor prescribing is probably the most common cause of preventable medication errors and many of these events involve junior doctors. In 2009, an electronic problem-based therapeutics course developed at the University of Michigan Medical School (UMMS) was translated and adapted for use at the University of Zagreb Medical School (UZMS).

Methods: After students from both schools took the course in 2010, we compared their responses with an online questionnaire addressing the course quality and its effectiveness.

Distributed lags time series analysis versus linear correlation analysis (Pearson's r) in identifying the relationship between antipseudomonal antibiotic consumption and the susceptibility of Pseudomonas aeruginosa isolates in a single Intensive Care Unit of a tertiary hospital.

The relationship between antibiotic consumption and selection of resistant strains has been studied mainly by employing conventional statistical methods. A time delay in effect must be anticipated and this has rarely been taken into account in previous studies. Therefore, distributed lags time series analysis and simple linear correlation were compared in their ability to evaluate this relationship.

Risk behaviors for getting HIV infection among the Croatian men who have sex with men.

This study was conducted with the aim of obtaining the very first information on the sexual risk behavior of Croatian men who have sex with men (MSM). There were 1127 respondents recruited at four venues: three physical meeting places of the Croatian MSM population (disco club, bar and sauna) in Zagreb and one virtual (gay oriented web-site) meeting place of the Croatian MSM population. The overall response rate was only 19%.