Browsing by Author "Minić, Predrag (6603400160)"

Candida bloodstream infections (BSI) are a significant cause of mortality in intensive care units (ICU), hereof the prospective 12-months (2014-2015) hospital- and laboratory-based survey was performed at the Serbian National Reference Medical Mycology Laboratory (NRMML). Candida identification was done by a matrix-assisted laser desorption/ionisation time-of-flight mass spectrometry and a susceptibility test, according to the Clinical and Laboratory Standards Institute methodology. Among nine centres (265 beds; 10 820 patient admissions), four neonatal/paediatric (NICU/PICUs) and five adult centres (ICUs) participated, representing 89 beds and 3446 patient admissions, 166 beds and 7347 patient admissions respectively. The NRMML received 43 isolates, 17 from NICU/PICUs and 26 from adult ICUs. C. albicans dominated highly in NICU/PICUs (~71%), whereas C. albicans and C. parapsilosis were equally distributed within adults (46%, each), both accounting for ~90% of received isolates. The resistance to itraconazole and flucytosine were 25% and 2.4% respectively. In addition, the 2 C. albicans were azole cross-resistant (4.6%). The overall incidence of CandidaBSI was ~3.97 cases/1000 patient admissions (4.93 in NICU/PICU and 3.53 in adult ICU). The 30-day mortality was ~37%, most associated with C. tropicalis and C. glabrataBSI. Data from this national survey may contribute to improving the Balkan and Mediterranean region epidemiology of CandidaBSI within ICUs. © 2017 Blackwell Verlag GmbH

Introduction It has been suggested that asthmatic patients may have a higher risk for oral diseases, both as a result of the medical condition and effects of medications. Objective The aim of the study was to determine the oral health status of children with asthma and to evaluate the oral health parameters according to the medications and severity of the disease. Methods The study group consisted of 158 children with asthma and 100 healthy control subjects aged 2-18 years. The diagnosis of dental caries was performed using the Decayed, Missing, and Filled Teeth (DMFT/dmft) criteria. The oral hygiene, periodontal status and gingival health were assessed with the Simplified Oral Hygiene Index (Greene-Vermillion), Community Periodontal Index of Treatment Needs and Gingival Index (Loe-Silness), respectively. Results Thirty (19%) patients with asthma and 43 (43%) healthy children were caries-free (p<0.001). There were no significant differences between asthmatic and control children in caries experience (for children with asthma mean DMFT=2.1±1.8, mean dmft=4.2±3.3; for healthy children mean DMFT=2.5±0.9, mean dmft=5.2±1.3). Level of asthma control did not have influence on dental health, while dose of inhaled corticosteroid had impact on primary dentition. Periodontal status and gingival health did not differ between asthmatic and control children. However, children with asthma had poorer oral hygiene (p<0.001). Conclusion Results of the study do not show a relationship between asthma and oral diseases. However, further improvement could be made in educating children and parents on the importance of good oral hygiene and prevention of oral diseases. © 2015 Serbia Medical Society. All rightsreserved.

Background: Pulmonary renal syndrome (PRS), denoting the presence of diffuse alveolar hemorrhage and glomerulonephritis as manifestations of systemic autoimmune disease, is very rare in childhood. The coexistence of circulating anti-neutrophil cytoplasmic antibody (ANCA) and anti-glomerular basement membrane (GBM) disease in children affected by this syndrome is exceptional, with unfavorable outcome in five out of seven patients reported to date. We describe a child with PRS associated with both circulating anti-myeloperoxidase (anti-MPO) ANCA and anti-GBM disease on renal biopsy who was successfully treated with immunosuppressive therapy. Case presentation. A 10-year old girl presented with fever, fatigue, malaise, and pallor followed by hemoptysis and severe anemia. Diffuse alveolar hemorrhage was revealed on fiberoptic bronchoscopy. Renal findings consisted of microscopic hematuria, moderate proteinuria, and anti-GBM disease on renal biopsy. ANCA with anti-MPO specificity were present whereas anti-GBM antibodies were on borderline for positivity. Methyl-prednisolone pulses followed by prednisone led to cessation of hemoptysis, marked improvement of lung fuction, and normal finding on chest x-ray within 10 days. An immunosuppressive regimen was then given consisting of prednisone daily for 4 weeks with subsequent taper on alternate day, i.v. cyclophosphamide pulses monthly for 6 doses, followed by mycophenolate mofetil that resulted in normal lung function tests, hemoglobin concentration, and anti-MPO level within four subsequent weeks. During 10-months of follow-up she remained well, her blood pressure and renal function tests were normal, and proteinuria and hematuria gradually resolved. Conclusion: We report a child with an exceptionally rare coexistence of circulating ANCA and anti-GBM disease manifesting as PRS in whom renal disease was not the prominent part of clinical presentation, contrary to other reported pediatric patients. A review of literature on disease with double positive antibodies is also presented. Evaluation of a patient with PRS should include testing for presence of different antibodies. An early diagnosis and rapid institution of aggressive immunosuppressive therapy can induce remission and preserve renal function. Renal prognosis depends on the extent of kidney injury at diagnosis and appropriate treatment. © 2013 Bogdanović et al.; licensee BioMed Central Ltd.

Introduction. Tracheoesophageal fistula (TEF) as a complication of balloon dilatation (BD) of corrosive esophageal stricture is a very rare and serious condition. Life threatening aspiration pneumonia requests urgent lungs' protection, but overall treatment strategy is not clearly defined. Case report. Twenty-month-old female child accidentally ingested a household bleach. Caustic injury of esophagus was healing with development of strictures of cervical and proximal thoracic esophagus. TEF was developed during the third BD. Healing of TEF and pulmonary infection was achieved by exclusion of the esophagus (pharyngostoma and feeding gastrostomy together) with prolonged tracheobronchial intubation and toilette. Retrosternal colon interposition was performed a year later, with excellent functional results over four-year follow-up. Conclusion. Esophageal exclusion in the first stage, and pharyngoesophageal reconstruction in the second stage, is a useful therapeutic option in the treatment of TEF caused by balloon dilatation of corrosive esophageal stricture in children. © 2020 Inst. Sci. inf., Univ. Defence in Belgrade. All rights reserved.

Introduction/Objective Dysfunction of the axonemal structure leads to ciliopathies. Sensory and motile ciliopathies have been associated with numerous pediatric diseases, including respiratory diseases. Primary ciliary dyskinesia (PCD) is ciliopathy linked to the dysfunction of motile cilia. Motile ciliary dysfunction in childhood leads to chronic rhinosinusitis, persistent cough, neonatal respiratory distress, bronchiectasis, and situs inversus (SI) have 50% of patients. These symptoms are common among pediatric lung diseases, which additionally makes it difficult to establish the accurate diagnosis. The aim of the study was to point out the significance of genomic profiling for patients with suspected ciliopathies and to design a strategy for genomic analysis relevant for differential diagnosis of lung disease patients with suspected ciliopathies. Methods We conducted a bioinformatic analysis of data generated by New Generation Sequencing (NGS) approach of 21 patients with final or suspected diagnosis of PCD. It was analyzed 93 genes: 29 PCD genes, 45 genes related to individual symptoms of lung diseases, and 19 genes related to sensory ciliopathies. Results The algorithm we have designed, enabled us to establish the clinical and genetic diagnosis for 17/21 (80.95%) patients, among which 11/21 (52.38%) were PCD patients. In 3/21 (14.28%) patients we detected monoallelic variants in PCD disease-causing genes. In 6/21 (28.57%) patients, variants in genes for other pulmonary diseases were detected, and for one patient, genetic background of disease remained unclear. Conclusion An improved strategy for easier and faster establishment of final diagnosis of ciliopathies is mandatory and includes both, clinical and genetic confirmation of disease. © 2019 Serbia Medical Society. All rights reserved.