Browsing by Author "Miolski, Jelena (57193727710)"

Objectives: This study aims to show the distribution of angiotensin-converting enzyme (ACE) rs1799752 (I>D) gene insertion/deletion (I/D) polymorphism and angiotensin II receptor type 1 (AGTR1) rs5186 (A>C) gene polymorphism in adolescents with hypertension (HT) and type 1 diabetes (T1D), as well as its association with hypertension and the diurnal variation of mean blood pressure (dipping phenomenon). Methods: A cross-sectional study was conducted involving 118 adolescents diagnosed with T1D who underwent clinical and laboratory investigations, genetic analyses, and 24 h ambulatory blood pressure monitoring. The genotype frequencies were compared between adolescents with HT and those with normal blood pressure. Additionally, the genotype frequencies were compared between dippers and non-dippers. Results: Patients with HT were more likely to be female and exhibited significantly poorer glycemic control and higher triglycerides, along with increased body mass index and daily insulin dosage. The prevalence of ACE rs1799752 genotypes in the hypertensive group was 20% II, 66.7% ID, and 13.3% DD, which did not significantly differ from the normal blood pressure group with 29.1% II, 53.4% ID, and 17.5% DD (p = 0.625). The prevalence of AGTR1 rs5186 genotypes in the hypertensive group was 53.3% AC, 40% AA, and 6.7% CC, which also did not significantly differ from the normal blood pressure group with 39.8% AC, 52.4% AA, and 7.8% CC (p = 0.608). A total of 46% of the patients exhibited non-dipping phenomena. The prevalence of non-dippers among the ACE genotypes was 13% DD, 33.3% II, and 53.7% ID (p = 0.369), while for the AGTR1 genotypes, it was 50% AA, 42.6% AC, and 7.4% CC (p = 0.976). Conclusions: Our results indicate that in our adolescents with T1D, clinical and metabolic factors such as higher body mass index, triglycerides, suboptimal glycemic control, and female gender are more indicative of the development of hypertension than ACE and AGTR1 gene polymorphisms. A potential reason for this finding could be the young age of the patients or the relatively small size of the study group. Future research involving larger sample sizes is needed to further investigate the genetic predisposition for the development of hypertension. © 2025 by the authors.

Objectives: This study aims to show the distribution of angiotensin-converting enzyme (ACE) rs1799752 (I>D) gene insertion/deletion (I/D) polymorphism and angiotensin II receptor type 1 (AGTR1) rs5186 (A>C) gene polymorphism in adolescents with hypertension (HT) and type 1 diabetes (T1D), as well as its association with hypertension and the diurnal variation of mean blood pressure (dipping phenomenon). Methods: A cross-sectional study was conducted involving 118 adolescents diagnosed with T1D who underwent clinical and laboratory investigations, genetic analyses, and 24 h ambulatory blood pressure monitoring. The genotype frequencies were compared between adolescents with HT and those with normal blood pressure. Additionally, the genotype frequencies were compared between dippers and non-dippers. Results: Patients with HT were more likely to be female and exhibited significantly poorer glycemic control and higher triglycerides, along with increased body mass index and daily insulin dosage. The prevalence of ACE rs1799752 genotypes in the hypertensive group was 20% II, 66.7% ID, and 13.3% DD, which did not significantly differ from the normal blood pressure group with 29.1% II, 53.4% ID, and 17.5% DD (p = 0.625). The prevalence of AGTR1 rs5186 genotypes in the hypertensive group was 53.3% AC, 40% AA, and 6.7% CC, which also did not significantly differ from the normal blood pressure group with 39.8% AC, 52.4% AA, and 7.8% CC (p = 0.608). A total of 46% of the patients exhibited non-dipping phenomena. The prevalence of non-dippers among the ACE genotypes was 13% DD, 33.3% II, and 53.7% ID (p = 0.369), while for the AGTR1 genotypes, it was 50% AA, 42.6% AC, and 7.4% CC (p = 0.976). Conclusions: Our results indicate that in our adolescents with T1D, clinical and metabolic factors such as higher body mass index, triglycerides, suboptimal glycemic control, and female gender are more indicative of the development of hypertension than ACE and AGTR1 gene polymorphisms. A potential reason for this finding could be the young age of the patients or the relatively small size of the study group. Future research involving larger sample sizes is needed to further investigate the genetic predisposition for the development of hypertension. © 2025 by the authors.

Introduction. Breastfeeding is the most important way to feed a newborn, infant and a young child. Lactogenesis is the ability of secreting milk from the mammary gland and includes secretory initiation and activation. The birth of the placenta and decrease in progesterone levels stimulate an increase in prolactin levels and the secretion of milk from the breast. Human milk contains carbohydrates, lipids, proteins, vitamins, minerals, fatty acids, amino acids and trace elements. In addition, numerous cells, macrophages, bacteria, chemokines, cytokines, immunoglobulins, hormones, growth factors, and mucin are present. The composition of milk differs depending on the phase of secretion. Colostrum is secreted for the first five days after birth, then comes transitional milk, and mature milk two weeks after birth. During the very act of breastfeeding, there is a difference between pre-milk and last milk. In pre-milk, the fat content is low and increases with the duration of lactation, and in breast milk it is relatively high. Aim: To point out the importance of milk composition and factors that are influential for breastfeeding. Conclusion: Maternal parity, age or socioeconomic status and education can affect the concentration of certain components of breast milk. Adequate social policy and support, along with education related to early breastfeeding experiences, can be the key factors in initiating and maintaining breastfeeding. Besides the mother and the child, the entire social community would benefit from that. © 2022 Sciendo. All rights reserved.

Introduction/Aim. Those born small for gestational age are all newborns whose weight, length and head circumference deviate by more than minus two standard deviations in relation to the same parameters of average children of the same sex, corresponding gestational age and population. The goal is their early recognition and adequate treatment. They should be clearly distinguished from premature babies, children born before the 37th week of gestation, and it should be noted that all children born small for gestational age are always born after intrauterine growth arrest. Poor and economically underdeveloped countries show a higher prevalence of children small for gestational age. At birth, these children have a higher risk of asphyxia, infections, neurological disorders, and in the later period of life, low growth, cognitive dysfunctions, disorders of pubertal development and metabolic syndrome. If they have not achieved growth compensation by the age of four and their height is less than minus 2.5 standard deviations, treatment with recombinant growth hormone is suggested. The recommended starting dose of growth hormone is 35 μg/kg of body weight per day. Adequate adjustment of the dose is achieved by monitoring the growth rate at 6-12 and IGF-1 at 3-6 months after starting therapy, and then once a year. The treatment is stopped in the period of adolescence, when the growth rate is < 2 cm per year. Conclusion. Early recognition of children born small for gestational age provides the opportunity to avoid numerous complications later in life with adequate and timely treatment. © 2023 Sciendo. All rights reserved.

Diabetic ketoacidosis is an acute complication in children with type 1 diabetes mellitus. It is diagnosed if the sugar value is > 11 mmol/l, pH <7.3, HCO3-≤ 15 mmol/l, with ketonemia or ketonuria. Based on serum pH and bicarbonate values it could be mild, moderate, and severe. It is manifested by rapid breathing, abdominal pain, nausea, vomiting, altered state of consciousness. Early recognition of symptoms prevents the possibility of serious complications. Treatment includes fluid replacement, rehydration, insulin therapy, electrolyte replacement, glucose correction. This paper presents female patients, aged 2.5 to 15.3 years, with different symptoms. Clinical findings and laboratory test results indicated diabetic ketoacidosis. After starting urgent therapy, they were referred to intensive care units in tertiary centers, where it was concluded that the resulting condition was a newly-diagnosed type 1 diabetes mellitus. Such patients require early recognition of symptoms, urgent care, and treatment in intensive care units, in order to prevent possible complications. © 2021, Serbian Medical Society. All rights reserved.

Introduction. An ectopic pelvic kidney is an anatomical anomaly in the position of the kidney. In the stage of metanephros, its movement, rotation, and lifting from the pelvis to the lumbar area are absent. Due to vascular or other abnormalities, the kidney does not reach its usual anatomical position and therefore remains ectopic. The position in which it can be placed is retroperitoneal, abdominal, or thoracic, with numerous variations. Case report: A three-month-old male infant underwent kidney screening during an ultrasound examination of the hips. There had been a positive family history in the mother and maternal aunt of the existence of an ectopic, left pelvic kidney, without complications and accompanying symptoms. The clinical findings of the infant's systems were normal, he was developing in terms of body mass. The analyzes of urine, biochemistry, and urine culture did not show any pathological findings. Ultrasound examination showed that the left renal lobe was completely filled with spleen, without visualization of the left kidney. In the right lumbar box, there was the right kidney, with regular dimensions, clear edges and normal thickness of the parenchyma. Inferior to the right kidney, in the area of the right lumbar region, facing inwards, there was the left kidney with regular ultrasonographic characteristics. Urinary bladder was properly positioned, with normal dimensions and wall thickness. The infant was advised to see a pediatric nephrologist. Conclusion: This is another case of an ectopic kidney recorded during an echosonographic examination of the hips, thus demonstrating the importance of routine ultrasound examinations of the abdomen, in order to increase the possibility of early detection of anomalies of the abdominal organs. © 2022, Serbian Medical Society. All rights reserved.

Introduction Perforation of the sigmoid colon is rare in children and its descriptions in medical literature are infrequent. Case Outline In a 13-year-old boy with acute lymphoblastic leukemia, a ten-month course of chemotherapy was accompanied by many complications: parasitic infestation (Enterobius vermicularis), lung candidiasis, esophageal candidiasis, steroid diabetes, anaphylactoid reaction to L-asparaginase, febrile neutropenia, mucositis, anemia, thrombocytopenia, enterocolitis, and respiratory distress syndrome. During reinduction treatment, consisting of dexamethasone, vincristine, doxorubicin, and crisantaspase, he complained of abdominal pain and, upon radiographic examination, was found to have pneumoperitoneum. Because of suspicion of abdominal hollow organ perforation, he was subjected to explorative laparotomy, which yielded the diagnosis of perforation of the sigmoid colon. Conclusion After an extensive review of the published reports on sigmoid perforation, all associated conditions that could possibly induce perforation - such as Hirschsprung’s disease or foreign body - were systematically excluded in our patient. Although typhlitis was the first diagnostic hypothesis, this was excluded by intraoperative findings, histopathology, and perforation site. To the best of our knowledge, this is the first report of a spontaneous perforation of the sigmoid colon in a child with acute lymphoblastic leukemia. © 2017, Serbia Medical Society. All rights reserved.

The task of public health is to encourage the mother to initiate and maintain breastfeeding of her child. The main proponents of early breastfeeding should be pediatricians and gynecologists in maternity hospitals. Early "skin-to-skin" contact means that after birth, in the first ten minutes, the newborn is placed in close contact with the mother. After it is born and cries, it is transferred to the bare chest of the mother, who is comfortably placed in bed with her head elevated. The child is placed in a longitudinal position in relation to her, between and above her breasts. The child's head is turned to the side with mandatory monitoring of breathing, and both are covered with a clean, dry sheet. The basis of the mechanism is hormonal. With this kind of mutual contact, oxytocin is released in the mother, and catecholamine concentrations increase in the newborn. The first two hours after birth, the newborn is awake, active, sensitive to touch, smell and temperature simulations that he receives from the mother, which is why this period is the best for starting breastfeeding. The advantages of this method for the mother are: easier and faster stopping of bleeding after childbirth, earlier expulsion of the placenta, greater calmness and relaxation, as well as greater self-efficacy in breastfeeding. The advantages for the newborn are: reduction of postpartum stress and anxiety, less crying, better control of reaching optimal body temperature, importance in establishing microcolonization of the intestinal flora and more effective breastfeeding with earlier discharge from the hospital to home. The application of this method is simple and economically profitable, and short-term and long-term effects are achieved for both the mother and the child. © 2022, Serbian Medical Society. All rights reserved.