Browsing by Author "Radusinovic, Milica (57196457451)"

Objectives: The aim of this study was to assess the epidemiological, clinical, endoscopic, and pathohistological characteristics of pediatric eosinophilic esophagitis (EoE) in Serbia. Method: All children aged 0-18 years diagnosed with EoE in the period between 2010 and 2017 at the University Children's Hospital in Belgrade, Serbia, were retrospectively enrolled. Results: EoE was diagnosed in 35 children (12.45 ± 3.77 years) with a male predominance (74%). The median incidence rate was estimated to be 0.85 per 100,000 children per year with the highest rate estimated at 3.17 per 100,000 children in 2017. Dysphagia (71.4%) and food impaction (40%) were dominant symptoms. Inflammatory endoscopic changes were found in 74.3% and fibrostenotic changes in 62.9% of the children. The esophageal biopsy rate was low (6.8%), especially in children with reflux and nonspecific symptoms. Subepithelial fibrosis was found in only 20% of the patients. Since 2016, the number of biopsy samples has increased, but the sampling rate of lamina propria is still low (<50%). The correlation between the number of biopsies and lamina propria acquisition was strong (rs = 0.773, p < 0.05). In 2 immunocompetent adolescents, EoE was diagnosed after successful treatment of infectious esophagitis. Conclusions: An increase in the incidence of EoE in Serbian children is evident. The biopsy rate in children with nonspecific and reflux symptoms should be increased, as well as the number of biopsy samples for the detection of subepithelial fibrosis. In immunocompetent children with infectious esophagitis, EoE should be suspected and endoscopy may be recommended after successful treatment of infection. © 2019 The Author(s) Published by S. Karger AG, Basel.

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.