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1دورية أكاديمية
المؤلفون: Vujić Ana, Obradović Slobodan, Igrutinović Zoran, Protrka Zoran, Janković Marijana, Radovanović Marija, Stajić Nataša, Medović Raša, Janković Sveta
المصدر: Vojnosanitetski Pregled, Vol 80, Iss 3, Pp 270-274 (2023)
مصطلحات موضوعية: cerebrovascular disorders, diagnosis, magnetic resonance imaging, moyamoya disease, mutation, neurologic manifestation, Medicine (General), R5-920
الوصف: Introduction. Schimke immuno-osseous dysplasia (SIOD) is a rare autosomal recessive multisystem disorder associated with biallelic mutations of the SMAR-CAL1 gene. Vascular central nervous system complications in the form of Moyamoya syndrome (MMS) have been reported as a comorbidity in nearly half of the patients clinically presenting with severe migraine-like headaches, transient ischemic attacks (TIA), and ischemic or hemorrhagic infarctions. We present an illustrative case of an infantile form of SIOD with MMS, with a review of the latest diagnostic possibilities, as well as current diagnostic and therapeutic dilemmas in managing SIOD. Case report. We present a female patient with the infantile form of SIOD. The proband was born small for gestational age in the 34th gestation week with characteristic dysmorphic features. Genetic testing found a biallelic, nonsense mutation c.2542G>T in the SMARCAL1 gene. The patient presented early with TIA, seizures, and recurrent ischemic strokes. Magnetic resonance imaging (MRI) confirmed the presence of progressive brain atrophy with bilateral occlusion/stenosis of middle cerebral artery and anterior cerebral artery and a smoke-like collateral vessel appearance consistent with the MMS. At the age of 5 years and 9 months, the patient developed a high fever and cough with unknown cause, with a low erythrocyte and white blood cell count during four weeks, with a poor therapeutic response to antibiotics, transfusion of red blood cells, and granulocyte growth factor. She later died. Conclusion. Patients with SIOD may present progressive cerebral vascular changes and clinical neurologic deterioration early in the course of the disease. In such patients, early diagnosis and preventive revascularization surgery are of paramount importance. In diagnosing MMS, MRI angiography can be an appropriate substitute for standard invasive cerebral angiography.
وصف الملف: electronic resource
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2دورية أكاديمية
المؤلفون: Kostić Gordana, Medović Raša, Marković Slavica, Rašković Zorica, Igrutinović Zoran, Ćupurdija Vojislav, Petrović Marina
المصدر: Vojnosanitetski Pregled, Vol 75, Iss 5, Pp 516-520 (2018)
مصطلحات موضوعية: tuberculosis, pleural effusion, child, diagnosis, risk factor, IFN-gamma release assay, Medicine (General), R5-920
الوصف: Introduction. After the contact with a patient suffering from tuberculosis (TB), previously healthy children have 1%–16% possibility to develop the disease. TB diagnosis in children is not easy to confirm so 15%–25% of cases remain undiagnosed. Case report. A 15-yearold- boy was hospitalized with productive cough, pain in the right flank area, fever, and fatigue, loss of appetite and night sweats. One of the boy's uncles was cured of tuberculosis, another uncle had active tuberculosis and both of them were in contact with the boy, but they did not live in the same household. During the physical examination, the child was febrile, with dyspnea, pale, with profuse sweating, debilitate. BCG (Bacillus Calmette – Guérin) scar was present. The auscultatory findings of the lungs showed quiet breathing from the scapula to the right lung base and chest radiography suggested massive right sided pleuropneumonia. The parameters of the inflammation were high and Mycobacterium tuberculosis (MTB) was not found in the samples of sputum and gastric lavage. Pleural puncture revealed exudative nature in the aspirated fragment. Cytology was nonspecific, the MTB was not found and the planted surfaces on Lowenstein-Jensen remained sterile. Tuberculin skin test (TST) – Mantoux was positive (+ 10 mm), Interferon Gamma Release Assay (QuantiFERON- TB GOLD In-Tube) was negative. The boy was unsuccessfully treated with broad spectrum antibiotics. By video-assisted thoracoscopy, the pleural tissue clip confirmed the benign chronic granulomatous process, while histochemical staining did not show MTB. The treatment with anti-TB medication led to clinical and radiographic recovery. The boy is now in good general condition, without consequences of the disease. Conclusion. This case report pointed out the importance of risk factors and difficulties in diagnosing TB in children.
وصف الملف: electronic resource
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3دورية أكاديمية
المؤلفون: Vuletić Biljana, Ristanović Elizabeta, Marković Slavica, Rašković Zorica, Radlović Vladimir, Igrutinović Zoran
المصدر: Srpski Arhiv za Celokupno Lekarstvo, Vol 145, Iss 1-2, Pp 85-88 (2017)
مصطلحات موضوعية: Clostridium difficile, diarrhea, children, epidemiology, treatment, Medicine
الوصف: Clostridium difficile (CD) is the most common cause of nosocomial diarrhea in adults with high rates of morbidity and mortality. The epidemiology of CD infection (CDI) has changed in the last few decades associated with increasing severity of the infection rate related to the occurrence of NAP1 hypervirulent strain and the emergence of the disease among ambulatory patients and the wider community. Although little is known about CDI in pediatric patients, CD is surprisingly recognized as an important pathogen in children. In this review article, we direct attention to the recent findings on the incidence and epidemiology of pediatric CDI, including the risk factors for infection, with special emphasis on the importance of CDI in infants and a population of children suffering from chronic gastrointestinal diseases or cancer. Despite recent pharmacotherapeutic protocols successfully used in children with CDI, we would like to draw attention to precautionary and preventive measures in terms of both unnecessary testing and uncritical use of antibiotics as the most important risk factors.
وصف الملف: electronic resource
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4دورية أكاديمية
المؤلفون: Vuletić Biljana, Stojković Anđelka, Igrutinović Zoran, Stanković Lidija, Medović Raša, Dajić Katerina, Stojković Tanja, Janković Marijana, Janković Sveta, Vujić Ana
المصدر: Vojnosanitetski Pregled, Vol 74, Iss 7, Pp 693-698 (2017)
مصطلحات موضوعية: pneumococcal infections, streptococcus pneumoniae, child, meningitis, glomerulonephritis, diagnosis, Medicine (General), R5-920
الوصف: Introduction. Streptococcus pneumoniae is the second most common cause of meningitis in children, producing more serious complications than other bacteria. Streptococcus pneumoniae infections are a rare trigger of glomerulonephritis. We presented a case of glomerulonephritis developing concurrently with meningitis in a young male child. Case report. Gross haematuria, significant proteinuria, hypertension and decreased level of C3 alongside the signs of central nervous system involvement occurred in a male patient of 5 years and 3 months of age. Spontaneous resolution of renal affliction parameters followed the successful treatment of meningitis. The disease course was strongly suggestive of postinfectious glomerulonephritis, although it manifested at the same time as meningitis. The absence of the latent period might point to the development of IgA nephropathy, but since the renal function was stable, without any abnormalities in urine tests documented during follow-up, our opinion is that this was rather the case of postinfectious nephropathy. Conclusion. The presented case is a unique clinical form of postinfectious glomerulonephritis. An accurate diagnosis of this entity should ensure the adequate treatment and follow-up of these patients.
وصف الملف: electronic resource
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5دورية أكاديمية
المؤلفون: Medović Raša, Igrutinović Zoran, Radojević-Marjanović Ružica, Marković Slavica, Rašković Zorica, Simović Aleksandra, Tanasković-Nestorović Jelena, Radovanović Marija, Vuletić Biljana
المصدر: Srpski Arhiv za Celokupno Lekarstvo, Vol 144, Iss 1-2, Pp 56-62 (2016)
مصطلحات موضوعية: infectious mononucleosis, herpesvirus 4, human, children, Medicine
الوصف: Introduction. Infective mononucleosis is most commonly caused by Epstein-Barr virus (EBV), and in smaller percentage by cytomegalovirus (CMV). Objective. The aim of this paper was to determine the clinical and laboratory differences between EBV and CMV infectious mononucleosis in children. Methods. Cohort retrospective analytical research was conducted. We used data from medical history in six years period and monitored anamnestic data, frequency of inspection and palpation obtained data during physical examination, several laboratory tests, abdomen ultrasonography examination finding and emergence of disease complications. Statistical processing of data has been performed using SPSS 20. Results. Total number of examined children was 137, out of which 85.4% were with EBV and 14.6% with CMV infection. Affected children were most commonly younger than eight years. Boys were affected more often. There was no difference in frequency of high temperature, sore throat, bad breath, and respiratory symptomatology between examined children. Differences were discovered in frequency of stomachaches, eyelid swelling, skin rash and fatigue. Differences were not proven in the frequency of angina, lymphadenopathy and splenohepatomegaly between the groups. Values of transaminases and lactic dehydrogenases significantly decreased after seven days of hospitalization in both groups. In children with EBV, values of transaminases declined faster than in children with CMV. Anemia and bacterial superinfection of pharynx were most common disease complications. Thrombocytopenia was more common in children with CMV infection. Average duration of hospitalization was 6.7 days. Conclusion. In children with CMV abdominal pain, eyelid swelling, skin rash, fatigue and thrombocytopenia were more common. In children with EBV values of transaminases declined significantly faster.
وصف الملف: electronic resource
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6دورية أكاديمية
المؤلفون: Vuletić Biljana, Marković Slavica, Igrutinović Zoran, Radlović Vladimir, Rašković Zorica, Tanasković-Nestorović Jelena, Simović Aleksandra
المصدر: Srpski Arhiv za Celokupno Lekarstvo, Vol 144, Iss 1-2, Pp 90-93 (2016)
مصطلحات موضوعية: vitamin D deficiency, hypocalcemia, convulsions, Medicine
الوصف: Introduction. Hypocalcemic seizures are uncommon in the post-neonatal period. We report an infant with hypocalcemic seizures caused by severe deficiency of vitamin D. Case Outline. A five-month-old male infant was admitted to hospital in March 2013 with recurrent generalized afebrile seizures resistant to clonazepam therapy. At the clinical examination, the infant showed characteristic rachitic signs, so that after a blood sample was taken for laboratory testing, the infant was given infusion of 2 ml/kg of 10% of calcium gluconate at a rate of 0.5 ml/min. The treatment resulted in immediate termination of seizures and normalization of the consciousness of the infant. Blood sample analysis showed extremely low levels of free and total calcium (0.36/1.24 mmol/l) and 25(OH)D (
وصف الملف: electronic resource
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7دورية أكاديمية
المؤلفون: Simović Aleksandra M., Igrutinović Zoran, Obradović Slobodan, Ristić Dragana, Vuletić Biljana, Radovanović Marija
المصدر: Srpski Arhiv za Celokupno Lekarstvo, Vol 140, Iss 9-10, Pp 600-605 (2012)
مصطلحات موضوعية: hypoxic-ischemic encephalopathy, troponin I, newborn, prognosis, Medicine
الوصف: Introduction. In the last few years the use of cardiac troponin I and T, as diagnostic and prognostic factors of ischemic myocardial injury both in adult and neonatal medicine has been of great interest. Objective. The objective of our research was to investigate the significance of cardiac troponin I (sTnI) as an early indicator of the presence and severity of hypoxic-ischemic encephalopathy (HIE) in newborns. Methods. We analyzed 55 term newborns with HIE diagnosed based on clinical findings and ultrasonographic examination of the central nervous system. Serum concentration of sTnIultra was determined by immunoenzyme method during the first 24-48 hours after birth, and the obtained findings were compared with the values of identical parameter in 36 healthy term newborns. Results. During the first 24-48 hrs after birth, serum concentration of sTnI-ultra was significantly higher (r0.12 μg/l indicated the development of significant cerebral damage with the sensitivity of 75% and specificity of 72.2%, while the sTnI-ultra level of >0.13 μg/l was a significant mortality predictor with sensitivity of 76.9% and specificity of 73.8%. Conclusion. The second generation cardiac troponin I assay highly correlates with clinical and ultrasonographic findings in neonates with HIE, so that it can be used as a significant diagnostic and prognostic indicator of this pathological condition.
وصف الملف: electronic resource
العلاقة: https://doaj.org/toc/0370-8179Test
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8دورية أكاديمية
المؤلفون: Igrutinović Zoran, Peco-Antić Amira, Radlović Nedeljko, Vuletić Biljana, Marković Slavica, Vujić Ana, Rašković Zorica
المصدر: Srpski Arhiv za Celokupno Lekarstvo, Vol 139, Iss 9-10, Pp 677-680 (2011)
مصطلحات موضوعية: pseudo-Bartter syndrome, congenital chloride diarrhoea, diagnostics, Medicine
الوصف: Introduction. Pseudo-Bartter syndrome encompasses a heterogenous group of disorders similar to Bartter syndrome. We are presenting an infant with pseudo-Bartter syndrome caused by congenital chloride diarrhoea. Case Outline. A male newborn born in the 37th gestational week (GW) to young healthy and non-consanguineous parents. In the 35th GW a polyhydramnios with bowel dilatation was verified by ultrasonography. After birth he manifested several episodes of hyponatremic dehydration with hypochloraemia, hypokalaemia and metabolic alkalosis, so as Bartter syndrome was suspected treatment with indomethacin, spironolactone and additional intake of NaCl was initiated. However, this therapy gave no results, so that at age six months he was rehospitalized under the features of persistent watery diarrhoea, vomiting, dehydration and acute renal failure (serum creatinine 123 μmol/L). The laboratory results showed hyponatraemia (123 mmol/L), hypokalaemia (3.1 mmol/L), severe hypochloraemia (43 mmol/L), alcalosis (blood pH 7.64, bicarbonate 50.6 mmol/L), high plasma renin (20.6 ng/ml) and aldosterone (232.9 ng/ml), but a low urinary chloride concentration (2.1 mmol/L). Based on these findings, as well as the stool chloride concentration of 110 mmol/L, the patient was diagnosed congenital chloride diarrhoea. In further course, the patient was treated by intensive fluid, sodium and potassium supplementation which resulted in the normalization of serum electrolytes, renal function, as well as his mental and physical development during 10 months of follow-up. Conclusion. Persistent watery diarrhoea with a high concentration of chloride in stool is the key finding in the differentiation of congenital chloride diarrhoea from Bartter syndrome. The treatment of congenital chloride diarrhoea consists primarily of adequate water and electrolytes replacement.
وصف الملف: electronic resource
العلاقة: https://doaj.org/toc/0370-8179Test
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9دورية أكاديمية
المؤلفون: Simović Aleksandra M., Knežević Jasmina, Igrutinović Zoran, Stojanović Nadežda, Kocić Sanja
المصدر: Vojnosanitetski Pregled, Vol 66, Iss 11, Pp 881-886 (2009)
مصطلحات موضوعية: troponin I, myocardial ischemia, asphyxia neonatorum, Medicine (General), R5-920
الوصف: Background/Aim. Myocardial cell lesion in newborns may be clinically occult. In recent years there has been shown growing interest in the use of cardiac troponin-I (cTnI) in relation to perinatal asphyxia and hypoxic myocardial lesion. The aim of this study was to determine a relationship between high cTnI levels and outcome in critically ill newborns with perinatal asphyxia. Methods. In this study 78 patients were divided into three groups. The group I included 39 newborns (15 term and 24 preterm) with perinatal asphyxia, with no deaths, only full or partial (with some neurological sequels) recovery. The group II included 10 newborns (6 preterm and 4 term), with perinatal asphyxia who died, with critical cardio-respiratory problems and multiorgan dysfunction. The group III included 29 healthy term newborns. A level of cTnI in all three groups was measured within 24-48 hours after delivery. Results. A statistically significant higher value of cTnI (0.082 μg/l ± 0.166) was found in group I than in the group III (healthy newborns). In the group I, 21/39 newborns required respiratory and 16/39 required pressure support. In the group II, the largest average value of cTnI of 0.425 ± 0.307 was found. All of the newborns in the group II required respiratory and pressure support. In the group III the lowest average value of cTnI (0.0186 μg/L ± 0.0286) was found. Conclusions. High cTnI levels could be used as markers of perinatal asphyxia and even as predictors of future outcomes and/or mortality.
وصف الملف: electronic resource
العلاقة: https://doaj.org/toc/0042-8450Test
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10دورية أكاديمية
المؤلفون: Marković Slavica, Kostić Gordana, Igrutinović Zoran, Vuletić Biljana
المصدر: Srpski Arhiv za Celokupno Lekarstvo, Vol 136, Iss 5-6, Pp 262-266 (2008)
مصطلحات موضوعية: autoimmune thyroid disease, Hashimoto's thyroiditis, children, goitre, Medicine
الوصف: INTRODUCTION Hashimoto's thyroiditis (HT) is a common cause of goitre and hypothyroidism in children and adolescents. Spontaneous remission may occur in up to 50% patients, but the development of hypothyroidism is possible. OBJECTIVE We investigated the clinical manifestations, course and long-term outcome of HT. METHOD We reviewed charts of 43 children (36 females) with HT, mean age at presentation 12.3 years, and mean follow-up duration 4.6 years. RESULTS HT is five times more common in females. The common complaints leading to referral were goitre in 19 children (44.3%), diffuse in 17 children (89.5%). As to the prevalence of goitre, it accounted for significantly more referrals in females (14 girls, and 5 boys; 73.7% vs 26.3%, t-test; p
وصف الملف: electronic resource
العلاقة: https://doaj.org/toc/0370-8179Test
