[Risk factors for the onset of vasospasm and rebleeding after spontaneous subarachnoid hemorrhage]. / Faktori rizika za nastanak vazospazma i rekrvarenja nakon spontane subarahnoidne hemoragije.

Retrospective study comprised 120 patients with spontaneous subarachnoid hemorrhage (SAH) and risk factors for vasospasm and rebleeding were analyzed. Rebleeding and vasospasm had the same incidence (26.7%). Vasospasm prolonged preoperative and postoperative hospital period (p > or = 0.05) and deteriorated the final treatment outcome (incidence of favorable outcome was decreased from 56.9% to 41.7%). Total rebleeding mortality rate was 62.5% and depended on the clinical state before rebleeding (p < 0.05). Risk factors for vasospasm were: poor clinical condition of a patient after the initial SAH, the period of 5-13 days after hemorrhage (p < 0.01) and aneurysm located on the anterior communicant artery (p < 0.01). Risk factors for rebleeding were: poor clinical condition of the patient after the initial SAH, the first 36 hours and the period of 8-11 days after the initial SAH, advanced age of the patient, severe arterial hypertension, vasospasm and aneurysm on the internal carotid artery.

[Diagnosis of subarachnoid hemorrhage]. / Dijagnostikovanje subarahnoidnog krvarenja.

OBJECTIVES AND METHODS: A total of 115 patients with subarachnoid hemorrhage were retrospectively analyzed with the aim to evaluate the timing and reliability of the applied diagnostic procedures. In the group of 63 patients the reliability of CT as the diagnostic procedure was investigated, and CT scan was correlated with the clinical status of the respective patient. In the group of 79 patients with operatively treated cerebral aneurysm the angiographic and intraoperative findings were mutually compared and discrepancies were analyzed. RESULTS: During the first 48 hours after the hemorrhage, only 35.2% of all the angiographies were performed, so the final diagnosis was late in 64.8% of patients. Hemorrhage was diagnosed by CT in 87.3% of the cases and pronounced correlation existed between CT and the clinical status of the patient. Discrepancies between angiographic and operative findings existed in 16.4% of patients. CONCLUSION: CT should be the initial procedure for the diagnosis of subarachnoid hemorrhage. In nonmoribund patients the early angiography should also be performed. The main reason for delaying in diagnosis is the overdue transfer of the patients to the referral hospitals.

Fungus-like hyphochytrids associated with human disease.

We report two cases, with liver and brain abscess, respectively, where fungus-like organisms belonging to the Hyphochytriomycota were found at the site of inflammation together with Peptococcus in the first and Cysticercus cellulosae in the second case. This is the first time these groups of organisms have been reported in human material. The role of hyphochytrids in human pathology remained uncertain as they were found together with already known human pathogens.