The aim of this study is to evaluate epidemiological status of Balkan endemic nephropathy (BEN) patients on renal replacement therapy (RRT) in Bosnia from 2003 through 2005. Incidence and prevalence rates of BEN, diabetes mellitus (DM) and RRT population and proportion of BEN RRT population in total RRT population were tracked in renal units covering the entire BEN endemic region in Bosnia. BEN incidence and prevalence rates were 52; 34;48 and 262; 265, 292, respectively. DM incidence and prevalence rates were 7; 13; 8 and 20; 28; 33, respectively. Total RRT population incidence and prevalence rates were 89; 82; 79 and 424; 436; 473, respectively. Proportions of incident BEN RRT population in incident total RRT population and proportions of incident BEN RRT population in incident total RRT population when incident diabetics were subtracted from incident total RRT population were 0.58; 0.41; 0.61, and 0.63; 0.49; 0.67; respectively. Proportions of prevalent BEN RRT population in prevalent total RRT population and proportions of prevalent BEN RRT population in prevalent total RRT population when prevalent diabetics were subtracted from prevalent total RRT population were 0.62; 0.61; 0.62, and 0.65; 0.65; 0.66, respectively. Trend of BEN RRT population was stable in Bosnia from 2003 through 2005.

AIM To analyze the results of ultrasound guided percutaneous needle aspiration (PNA) and percutaneous catheter drainage (PCD) in the treatment of splenic abscess. METHODS Thirty-six patients (14 females and 22 males, with an average age of 54.1 +/- 14.1 years) with splenic abscess were treated with ultrasound guided PNA and/or PCD. Patients with splenic abscess < 50 mm in diameter were initially treated by PNA and those with abscess > or = 50 mm and bilocular abscesses were initially treated by an 8-French catheter drainage. The clinical characteristics, underlying diseases, organism spectra, therapeutic methods, and mortality rates were analyzed. RESULTS Twenty-seven patients had unilocular and 9 bilocular abscess. PNA was performed in 19 patients (52.8%), and 8 of them (42.1%) required PCD because of recurrence of abscess. In 17 patients (47.2%), PCD was performed initially. PCD was performed twice in six patients and three times in two. PNA was definitive treatment for 10 and PCD for 21 patients. One patient with PCD was referred for splenectomy, with successful outcome. In all 4 deceased patients, malignancy was the underlying condition. Twenty-one patients (58.3%) underwent 33 surgical interventions on abdomen before treatment. Cultures were positive in 30 patients (83.3%). Gram-negative bacillus predominated (46.7%). There were no complications related to the procedure. CONCLUSION Percutaneous treatment of splenic abscess is an effective alternative to surgery, allowing preservation of the spleen. This treatment is especially indicative for the patients in critical condition postoperatively. We recommend PNA as primary treatment for splenic abscesses < 50 mm, and PCD for those > or = 50 mm in diameter and for bilocular abscesses.

The aim of this study was to evaluate the results of single-session sclerotherapy with mixture of alcohol and polidocanol and a subsequent injection of albendazole for devisceration of hydatid cysts in the spleen. Eight patients (four women and four men, average age 22.9+/-11.4 with hydatid cyst in the spleen were treated with 10 minutes time of exposure to mixture of ethanol 95% and polidocanol 1%. After that, 2 to 5 ml of albendazole was injected into the cyst cavity. Two patients had 2 cysts. At follow-up the patients were examined with clinical and biochemical examinations, ultrasonography, and serologic test for echinococcal antibody titres. The mean hospital stay was 2.5+/-0.93 days. During the follow-up period, mean cyst diameter decreased from 46+/-16.4 mm to 13.6+/-16.26 mm. In all ten cysts, a reduction of post procedural recolection of fluid over 40% was observed. Five cysts (50%) disappeared during the follow-up period. All cysts (5) smaller then 50 mm in diameter disappeared during follow-up period. After an initial rise, the echinococcal-antibody titres fell progressively and at the last follow-up were negative (< 1: 160) in 7 (88%) patients. No complications were observed, except for pain, fever and urticaria during the first 24-hours after the procedure. Sclerotherapy using only one session and 10 min time of exposure to the mixture of ethanol and polidocanol, and a subsequent injection of albendasole solution represents an effective treatment of hydatid cysts in the spleen. This procedure is even more efficacious for hydatid cyst with diametar smaller then 50 mm.