Browsing by Author "Vujovic, Dragana (56513813700)"

Objective − The aim of this study was to evaluate interstitial cells of Cajal (ICC) in Hirschsprung disease (HD), especially in children who had postsurgical problems. Material and Methods − The study included tissue samples of normoganglionic (NZ) and transitional zone (TZ) of 33 HD pediatric patients. Samples of bowel from 10 autopsy controls who did not have dysmotility were also analyzed. Hematoxylin-eosin (H&E) and immunohistochemical (MAP-2 and c-Kit (CD117)) staining were performed. Myenteric ganglia were analyzed at 5 microscopic fields H&E and MAP-2 stained sections (magnification 400×). The diameters of the submucosal nerves were measured at 3 microscopic H&E fields (magnification 400×). The ICC were analyzed on c-Kit im-munostained slides at 3 microscopic fields per each bowel layer (magnification 200×): deep submucosa, circular and longitudinal muscular layer and zone of myenteric plexus. Results − The myenteric ganglion cell count was significantly lower in TZ of all children with HD, while there were no significant differences in NZ between the study group and age-matched controls. The ICC network was affected in all cases of HD. The total ICC count was significantly lower in NZ than in control (P<0.001). A criti-cally lower ICC count (<50% of minimal ICC count in the control group) in the NZ was found in patients with postoperative problems (constipation and enterocolitis). Conclusion − Decreased count of the ICC in the NZ could be the cause of intestinal motility difficulties in the postoperative period in children with HD. © 2020 by the University Clinical Centre Tuzla, Tuzla, Bosnia and Herzegovina.

The benign cystic mesothelioma of the peritoneum is a rare lesion that occurs predominatly in women of reproductive age and has a high propensity for local recurrence. It is very rare in childhood, especially in boys, being reported in only 4 cases. A new case of benign cystic mesothelioma of the peritoneum in an 11-year-old boy is reported. The lesion occupied the entire left abdomen, arising from the transverse mesocolon, and it was accompanied by 4 small cysts. The patient had a coexistent right-sided renal agenesis. The mesothelial nature of the cysts epithelial lining cells was confirmed by immunopositivity for calretinin, cytokeratin 5/6, HBME1, and epithelial membrane antigen (EMA). No recurrence of the lesion was noted in the 7-month follow-up. Pathologists and clinicians should be aware of the existence of this rare entity in childhood to establish an accurate diagnosis and provide close follow-up after the surgery. © 2012 Elsevier Inc. All rights reserved.

Background/Aim. Infantile hypertrophic pyloric stenosis (IHPS) is the most common cause of surgery in newborns and young infants. Conservative treatment of IHPS is of great importance because it spares the newborn from stress caused by surgery and general anesthesia. The aim of this study was to evaluate the impact of various oral administration regimens of atropine on its efficacy in treating IHPS. Methods. The study included 45 patients with IHPS, conservatively treated by atropine sulfate in the period from 2006 to 2016. Clinical examination, laboratory analysis, and ultrasonography were performed on all patients on admission. The efficacy of treatment with different oral dosage regimens was analyzed and potential predictive factors of the negative outcome were defined. The evaluation of the success of the treatment was statistically analyzed by the method of the multivariate logistic regression model. Results. Out of 45 patients, 36 (80%) were successfully cured (p = 0.0008, without the need for surgery and without any complications. Gender prevalence, age, birth weight, body weight on admission, duration of symptoms, pyloric muscle thickness, and length had no statistically significant individual effect on the success of the atropine treatment. Patients who received a progressively increased dose of atropine had an 18 times higher risk of surgery, patients with hypochloremic alkalosis (HCA) had a 15 times higher risk, while others, with more than 5 vomitings within the first three days of the therapy, were 9 times more likely to be surgically treated. Conclusion. High success rate and no side effects represent an orally administered atropine treatment as a valid alternative choice for non-operative management of IHPS. Administration of initially high doses was shown to be more effective in relation to gradually increased oral doses of atropine sulfate. HCA and continued vomiting are considered as potential predictive factors of negative outcomes of the atropine treatment. © 2021 Inst. Sci. inf., Univ. Defence in Belgrade. All rights reserved.

Aim Evaluation of the effectiveness of oral atropine versus surgical therapy for hypertrophic pyloric stenosis (HPS). Methodology A total of 66 consecutive patients with HPS were treated at the University Children's Hospital between January 2006 and December 2011. The diagnosis was initially based on medical history and confirmed by ultrasonography (US). The patients were divided into two groups according to the treatment preferred by their parents. The conservatively treated group, consisting of 33 boys and 7 girls, mean age 22.25 days, was given water-soluble atropine sulfate therapy at an initial dose of 0.05 mg/kg/day divided into 8 single doses, and administered after stomach decompression, 20 minutes prior to feeding. If vomiting persisted, the daily dose was progressively increased up to 0.18 mg/kg. If vomiting did not stop and full oral feeding was not reestablished in a week, surgery was done. The second group of 26 patients, mean age 20.86 days, underwent an operative procedure, Ramstedt extramucosal pyloromyotomy after the initial resuscitation. US evaluation was performed on days 7, 14, and 21. The outcome of the treatment was tested by Yates modification of the χ2 test. Results In the group of patients treated with atropine sulfate, 10 (25%) failed to respond to therapy, therefore, 8 boys and 2 girls underwent surgical treatment between the fifth and seventh day following institution of therapy. The remaining patients who received atropine sulfate (75%) were discharged when vomiting ceased, between the sixth and eighth day. They continued to take oral medication for 4 to 6 weeks, and were followed up by an ultrasound examination. The operated patients were discharged between the third and fifth day after surgery. There was a significant statistical difference between the groups regarding the outcome at a significance level of p < 0.05 (Yates χ2 = 5.839), with no complications regardless of the treatment option. However, at the significance level of p < 0.01 (Yates χ2 = 7.661), these methods demonstrate a difference in favor of surgical treatment. Conclusion Further investigation of oral, intravenous or combined atropine sulfate treatment may clarify its position as an alternative to pyloromyotomy. © 2013 Georg Thieme Verlag KG Stuttgart - New York.