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1دورية 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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2دورية 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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3دورية 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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4دورية 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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5دورية أكاديمية
المؤلفون: Ješić Maja D., Milenković Tatjana, Mitrović Katarina, Todorović Slađana, Zdravković Vera, Ješić Miloš M., Bošnjović-Tucaković Tatjana, Marković Slavica, Vorgučin Ivana, Stanković Sandra, Sajić Silvija
المصدر: Vojnosanitetski Pregled, Vol 73, Iss 3, Pp 273-276 (2016)
مصطلحات موضوعية: diabetes mellitus, type 1, child, Serbia, schools, questionnaires, preventive health services, Medicine (General), R5-920
الوصف: Background/Aim. Children with type 1 diabetes typically spend one-third of the day in school and they should achieve the same level of diabetes management there as they do outside the school environment. The aim of this study was to identify problems in diabetes management in children with type 1 diabetes at school according to the perceptions reported by children and parents. Methods. This crosssectional survey was carried out at nine public hospitals in Serbia with a cohort of 6-18-year old children/adolescents. The parents were personally informed about the objectives of the survey and the necessity to involve their children. The self-reporting questionnaire included demographic information as well as some questions that helped to evaluate the general situation of children with type 1 diabetes at school. Results. The obtained results show that not all children test blood glucose levels at school (50% of children in the 6-10- year-old age group and 67.3% in the age group over 11 years) and that not all children receive insulin at school (81.1% vs 18.9%, and 57.7% vs 42.3%, respectively). The frequency of severe hypoglycemia was 2.7% in children and 3.3% in adolescents. A high proportion of teachers did not have diabetes training. Conclusion. This brief report about problems in children and adolescents with type 1 diabetes at school in Serbia indicates what happens in the school setting and suggests how to improve control of this disease and facilitate the complete integration of children with diabetes at school.
وصف الملف: electronic resource
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6دورية أكاديمية
المصدر: Srpski Arhiv za Celokupno Lekarstvo, Vol 143, Iss 3-4, Pp 146-152 (2015)
مصطلحات موضوعية: metabolic syndrome, child obesity, adolescent obesity, risk factors, Medicine
الوصف: Introduction. High prevalence of metabolic syndrome (MetS) in children and adolescents is a great concern of the modern society. Objective. Our aim was to determine the influence of previously investigated, but also and potentially novel risk factors for the development of metabolic syndrome in children and adolescents. Methods. Observational case-control clinical study was conducted involving children and adolescents with obesity/metabolic syndrome, treated on inpatient basis from January 2008 to January 2012 at the Pediatric Clinic of the Clinical Centre Kragujevac, Kragujevac, Serbia. The group of “cases” (n=28) included patients aged 10-16 years with the diagnosis of metabolic syndrome according to the International Diabetes Federation (IDF) criteria, while the control group included twice as many obese patients (n=56) matched to the compared group. Results. Presence of maternal gestational diabetes (ORadjusted: 39.426; 95% CI: 1.822-853.271; p=0.019), and/or lack of breastfeeding in the first six months of life (ORadjusted: 0.079; 95% CI: 0.009-0.716; p=0.024) were significant predictors for developing MetS. Also, microalbuminuria is associated with MetS in obese children and adolescents (ORadjusted: 1.686; 95% CI: 1.188-2.393; p=0.003). Conclusion. Presence of maternal gestational diabetes and/or lack of infant breastfeeding are considered as relevant factors that may contribute to the increased risk of developing MetS syndrome, while microalbuminuria is frequently associated with MetS in obese children and adolescents. [Projekat Ministarstva nauke Republike Srbije, br. 175007]
وصف الملف: electronic resource
العلاقة: https://doaj.org/toc/0370-8179Test
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7دورية 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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8دورية 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
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9دورية أكاديمية
المؤلفون: Igrutinović Zoran, Vuletić Biljana, Vujić Ana, Marković Slavica, Kostić Gordana
المصدر: Srpski Arhiv za Celokupno Lekarstvo, Vol 136, Iss 9-10, Pp 545-548 (2008)
مصطلحات موضوعية: malignant hyperthermia, children, dantrolene, Medicine
الوصف: INTRODUCTION Malignant hyperthermia is a rare disease which is mainly an inherited autosomal dominant trait. It is characteristic for muscle rigidity, metabolism or respiratory acidosis, high values of serum creatine kinase. Then appears myoglobinuria which can lead to tubular necrosis and acute renal failure. CASE OUTLINE The male child, ten years old, hospitalized because of the high temperature, exhaustion and cough. On the second day of hospitalization, he has hyperthermia (39.8°C), dyspnoea, tachypnoea, was somnolent, occasionally raving, exhausted with the pains in the muscles which were rigid and painfully sensitive. During the night, the urine was dark red, but the diuresis was well. The next day, laboratory analyses showed high values of aspartate aminotransferase (4263 IU/l), alanine aminotransferase (1311 IU/l), lactate dehydrogenase (11787 IU/l), while the values of serum creatine kinase were so high that they could not be registered. The urine analysis showed the negative result on gall colours and haematuria and positive on myoglobin. During the following days, the patient had normal skin temperature, the pains in the muscles were gradually weakened and the urine cleared up. On the third day, the value of creatine kinase was measured and it was 178700 IU/l. During the next two weeks, the clinical finding was gradually normalized while the laboratory values of serum enzyme were gradually normalized only in twenty days. CONCLUSION Malignant hyperthermia is a serious clinical syndrome which can be found with, until then, a clinically healthy child (without chronic myopathy) and it appears with the high temperature or during the surgical interventions with anesthetics, which is especially dangerous.
وصف الملف: electronic resource
العلاقة: https://doaj.org/toc/0370-8179Test
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10دورية أكاديمية
المصدر: Srpski Arhiv za Celokupno Lekarstvo, Vol 136, Iss 5-6, Pp 267-273 (2008)
مصطلحات موضوعية: valproates, haemostasis, peripheral blood count, children, Medicine
الوصف: INTRODUCTION Epilepsy is a highly prevalent disease affecting 0.5-1.5% of the world's population. One of the most frequently used antiepileptics are valproates. These medicines show a negative impact on haemostasis and peripheral blood count. OBJECTIVE The objective of the study was to examine the negative impact of valproates on haemostasis and peripheral blood count in children and to analyse whether these disturbances were dependent on the dosage of valproates and drug level in blood. METHOD A two-year research was conducted. The research included: 35 children using valproates, 12 children using the therapy of both valproates and carbamazepine and 30 healthy children. Complete peripheral blood count, screening tests of haemostasis (bleeding time, prothrombin time, prothrombin ratio, activated partial thromboplastin time, fibrinogen) and capacity of thrombocyte aggregation research were done in all the children. RESULTS We found significantly more common frequency of leukopenia and neutropenia in children using valproates in comparison with the healthy children group. We also found the more common frequency of eosinophilia in comparison with healthy children. The children with the valproate therapy have lower approximate values of the number of platelets, fibrinogen and platelet aggregation in comparison with healthy children, but they have a higher approximate value of bleeding time and prothrombin time. These disturbances are in correlation with the dosage and the level of the medicine in blood. CONCLUSION Valproates have a negative effect on certain blood count parameters and haemostasis in children. Drug dosage and blood drug level are correlated with their negative impact on haemostasis parameters.
وصف الملف: electronic resource
العلاقة: https://doaj.org/toc/0370-8179Test
