[Guidelines on hand hygiene in health care institutions]. / Smjernice za higijenu ruku u zdravstvenim ustanovama.

Healthcare associated infections (HCAI) are huge problem all over the world, and 5-10% of all hospitalized patients will develop infection during hospitalization. From the times of I. P. Semelweiss we know that clean hands are the most important single factor that can decrease the number of HCAI. World Health Organization (WHO) has recognised this problem and developed Guidelines for hand hygiene in healthcare institutions. This also was the reason of developing Croatian national Guidelines. The main goal of the Guidelines was to decrease number of HCAI associated with the hands of healthcare workers. These Guidelines are meant for all healthcare workers and other hospital staff who come to the direct contact with patients. An interdisciplinary team of experts developed these Guidelines using WHO Guidelines, other existing guidelines and literature reviews for hand hygiene. Grades of evidence for specific recommendations were determined using CDC/HICPAC grading system. Categorization is based on existing data, theoretical basis, applicability and economic impact. After a broad discussion in different professional societies, Guidelines were accepted. Guidelines include recommendations for hand hygiene indications, hand hygiene technique, surgical hand preparation, choosing hand hygiene preparations, skin care, nails, glove use, patients and visitors hand hygiene, role of education, as well as role of healthcare institution and role of government. Furthermore, in the Guidelines the concept of "Five moments for hand hygiene" is explained in detail, and main literature data are presented.

[Gastrointestinal tuberculosis--case report]. / Tuberkuloza gastrointestinalnog trakta--prikaz bolesnice.

Isolated tuberculosis of gastrointestinal tract is a very rare disease most commonly localized in the ileo-cecal region (over 85% of the cases). The main object of surgical therapy is intraperitoneal tuberculosis (IP-TB), which leads to complications such as bowel obstruction, perforation, fistulation and bleeding. Since gastrointestinal tuberculosis can mimic symptoms found in Crohns' disease and ileocecal cancer, definitive diagnosis can only be obtained by the finding of Mycobacterium tuberculosis in tissue and stool sample as well as by positive microbacterial cultivation. A 35 year old female patient was admitted to surgical ward with clinical and radiological signs of ileus. From personal medical history as well as previous medical documentation we learned that the patient had been treated in 1995 for lung and larynx tuberculosis at Jordanovac Hospital in Zagreb. After preoperative preparation, the patient underwent surgery during which we found numerous stenoses in the region of terminal ileum and cecum. Due to the patient's general condition, surgical treatment was performed in two acts. In the first we established an L-L ileotransverse anastomosis, and in the second we made the resection. The diagnosis was confirmed by histological findings of Mycobaterium tuberculosis in stool and tissue samples as well as in resection material during operation. The early postoperative period proceeded free from complications and after surgical treatment the patient was referred to the Klenovnik Special Hospital for Pulmonary Diseases. On follow up 18 months after the surgery, there were no signs of gastrointestinal involvement.