Browsing by Author "Prokic, Dragan (6603769235)"

The etiology of upper gastrointestinal bleeding (UGIB) varies by age, from newborns to adolescents, with some of the causes overlapping between age groups. While particular causes such as vitamin K deficiency and cow's milk protein allergy are limited to specific age groups, occurring only in neonates and infants, others such as erosive esophagitis and gastritis may be identified at all ages. Furthermore, the incidence of UGIB is variable throughout the world and in different hospital settings. In North America and Europe, most UGIBs are nonvariceal, associated with erosive esophagitis, gastritis, and gastric and duodenal ulcers. In recent years, the most common causes in some Middle Eastern and Far Eastern countries are becoming similar to those in Western countries. However, variceal bleeding still predominates in certain parts of the world, especially in South Asia. The most severe hemorrhage arises from variceal bleeding, peptic ulceration, and disseminated intravascular coagulation. Hematemesis is a credible indicator of a UGI source of bleeding in the majority of patients. Being familiar with the most likely UGIB causes in specific ages and geographic areas is especially important for adequate orientation in clinical settings, the use of proper diagnostic tests, and rapid initiation of the therapy. The fundamental approach to the management of UGIB includes an immediate assessment of severity, detecting possible causes, and providing hemodynamic stability, followed by early endoscopy. Unusual UGIB causes must always be considered when establishing a diagnosis in the pediatric population because some of them are unique to children. Endoscopic techniques are of significant diagnostic value, and combined with medicaments, may be used for the management of acute bleeding. Finally, surgical treatment is reserved for the most severe bleeding. © The Author(s) 2023.

Objective. To determine the effects of the socioeconomic characteristics of Serbian families with coeliac children (education level, employment, number of family members, monthly family income) on a gluten-free diet outcomes, as measured by serologic tests (tTG). Methods. The sample included 116 parents and the same number of children and adolescents (N = 116) diagnosed with the coeliac disease who had followed a gluten-free diet for at least a year. Children were aged 5-18 years. The research was carried out at the University Children’s Hospital in Belgrade and the Institute of Mother and Child Health “Dr Vukan Cupic” in Belgrade. The research was conducted during the period April-December 2016. The instruments used in the research were the Socioeconomic Survey Questionnaire and the Documentation Sheet, both specially designed for the purpose of this study. Results. The results of our study have shown that the mean age of mothers was 39.6 years and fathers 43.4 years. Parent respondents reported completed secondary education in 58% (116) of all cases. 46.55% of mothers and 35.34% fathers of the examined children with coeliac disease were not permanently employed. 82.76% of parents were married. Four-member families were most common. Considering the specific needs, 51% of the parents perceived their income level as very low and low. Serologic tests confirmed the efficacy of the therapy in 25.86% (30/116) of the children. Conclusion. The poor success of a gluten-free diet in the coeliac children and adolescents pointed out to the major impact of a lower socioeconomic status of their families. Taking into account all the difficulties in the implementation of a gluten-free dietary restrictions for children in Serbia, it becomes clear that the engagement of the whole society, and not just the members of their families, is necessary. © 2017, Serbian Medical Society. All rights reserved.