Background and Objectives: There are limited data regarding the incidence and risk factors for hypoglycemia, hyperglycemia, and unstable glycemia in preterm infants. The aim of the present study was ...to determine the incidence and risk factors associated with neonatal hypoglycemia, hyperglycemia, and unstable glycemia in preterm infants during the first seven days of life. Materials and Methods: This prospective study included preterm infants <37 weeks of gestation, admitted to the Neonatal Intensive Care Unit between January 2018 and December 2020. Based on blood glucose levels in the first week of life, infants were divided into the following four groups: normoglycemic, hypoglycemic, hyperglycemic, and unstable. Blood glucose levels were measured from capillary blood at the 1st, 3rd, 6th, and 12th hour of life during the first 24 h, and at least once a day from days 2 to 7, prefeed. Results: Of 445 enrolled infants, 20.7% (92/445) were categorized as hypoglycemic, 9.9% (44/445) as hyperglycemic, and 2.9% (13/445) as unstable, respectively. Hypoglycemia was most commonly observed among infants ≥34 weeks (27.9%), and hyperglycemia was most common among preterm infants <28 weeks (50%). Female gender increased the chances of developing hypoglycemia by three times. The decrease in gestational age by one week increased the chance of developing hyperglycemia by 1.9 times. Sepsis increased the chance of developing hyperglycemia seven times, respiratory distress syndrome five times, and mechanical ventilation three times, respectively. Conclusions: Glucose disturbances in the early neonatal period in preterm infants are common and mostly asymptomatic. Therefore, careful blood glucose level monitoring is required in those infants, especially in late preterm infants, in order to prevent possible neurological complications.
Impairments of the genes that encode enzymes that are involved in one-carbon metabolism because of the presence of gene polymorphisms can affect the methylation pattern. The altered methylation ...profiles of the genes involved in cardiogenesis may result in congenital heart defects (CHDs). The aim of this study was to investigate the association between the
rs1801133,
rs1801131,
rs1801394,
rs2228611,
rs1550117,
rs1569686, and
rs2424913 gene polymorphisms and congenital heart defects in Down syndrome (DS) individuals. The study was conducted on 350 participants, including 134 DS individuals with CHDs (DSCHD+), 124 DS individuals without CHDs (DSCHD-), and 92 individuals with non-syndromic CHD. The genotyping was performed using the PCR-RFLP method. A statistically significant higher frequency of the
rs2424913 TT in the DSCHD+ individuals was observed. The
rs2424913 TT genotype, as well as the T allele, had significantly higher frequencies in the individuals with DS and atrial septal defects (ASDs) in comparison with the individuals with DS and other CHDs. Furthermore, our results indicate a statistically significant effect of the
rs1569686 TT genotype in individuals with non-syndromic CHDs. The results of the study suggest that the
rs2424913 TT genotypes may be a possible predisposing factor for CHDs in DS individuals, and especially those with ASDs.
Prijevremeno rođeno novorođenče (nedonošče) tek je porođeno dijete koje je nošeno kraće od punih 37 tjedana trudnoće, odnosno kraće od 259 dana, računajući od prvog dana posljednje menstruacije ...majke. Patofiziološke osobitosti prijevremeno rođenog novorođenčeta najvećim su dijelom odraz funkcijske nezrelosti organa i organskih sustava, koja stvara poteškoće u prilagodbi na izvanmaternični život. Komplikacije prematuriteta mogu biti uzrokovane samim prijevremenim porodom, nezrelošću organskih sustava i primjenom potrebne terapije, a rizik za njihov nastanak povećava se sa smanjenjem gestacijske dobi i porođajne mase. Dijelimo ih na kratkoročne i dugoročne. Od kratkoročnih komplikacija najizraženije i najčešće su respiratorni distres sindrom, bronhopulmonalna displazija, perzistirajući arterijski duktus, intraventrikularno krvarenje, periventrikularna leukomalacija, nekrotizirajući enterokolitis, poteškoće hranjenja, prematurna retinopatija i infekcije. Iz skupine dugoročnih komplikacija ističu se poremećaj rasta i razvoja (neurorazvojna odstupanja i kronične bolesti) te poteškoće u psihosocijalnom i emocionalnom funkcioniranju.
Prematurity is defined as a birth that occurs before completed 37th gestational week. Immaturity of a preterm infant is the underlying reason for their adverse postnatal adaptation and specific pathophysiological characteristics. In preterm survivors there is a significant rate of short and long-term health complications. Risk of such complications increases with the decrease of gestational age at the time of delivery and the birth weight. Most common short-term complications that accompany preterm birth are respiratory distress syndrome, bronchopulmonary dysplasia, persistent arterial duct, intraventricular hemorrhage, periventricular leukomalacia, necrotizing enterocolitis, feeding difficulties, premature retinopathy, and infections. Long term complications include growth impairment, neurodevelopmental disturbances, chronic health conditions, difficulties in psychosomatic and emotional functioning.
Aim: To report the clinical courses of two patients with intestinal obstruction caused by duodenal web, who were diagnosed with this rare congenital anomaly at Clinical Hospital Center Rijeka in a ...span of 5 months. Case report: One of the patients was prenatally suspected to have duodenal obstruction due to ultrasonographic findings, while the other showed signs of obstruction by not tolerating oral intake from the second day of life (DOL). Ceasing enteral feeding, placing a nasogastric tube and introducing intravenous hydration and parenteral nutrition was performed as initial management. Abdominal ultrasonography, abdominal radiography, upper gastrointestinal contrast study and contrast enema were performed but showed no signs of obstruction. Both patients showed improvement in tolerating oral intake over the next few days. However, the first patient did not tolerate meals exceeding 15 mL of infant formula, and the second patient again did not tolerate any oral intake from the 15th day of life. A broad diagnostic workup was repeated but did not show conclusive evidence of obstruction regarding the first patient. Esophagogastroduodenoscopy found duodenal obstruction of unknown origin regarding the second patient. Laparotomy was performed on the 19th and 25th DOL, respectively. Duodenal web was visualized and excised in both patients following duodenotomy. Postoperative recovery was orderly with minor nonsurgical complications. The patients were discharged from hospital on the 21st and 36th postoperative day, respectively. Conclusions: Diagnosing a perforated duodenal web is often challenging because of possible intermittent nature of its symptoms. Exploratory laparotomy is sometimes required to reach diagnosis.
Cilj: Prikazati klinički tijek dviju djevojčica s kongenitalnom crijevnom opstrukcijom uzrokovanom duodenalnom membranom, liječenih od ove rijetke anomalije u Kliničkom bolničkom centru Rijeka u razmaku od pet mjeseci. Prikaz slučaja: Kod prve je djevojčice sumnja na duodenalnu opstrukciju postavljena zbog prenatalnog ultrazvučnog nalaza, dok je kod druge sumnja na opstrukciju postavljena postnatalno jer od drugog dana života nije tolerirala oralni unos hrane. U sklopu inicijalnog zbrinjavanja u obje je djevojčice obustavljena enteralna i uvedena parenteralna prehrana, postavljena je nazogastrična sonda te uvedena parenteralna nadoknada volumena. Ultrazvuk abdomena, radiografija abdomena, pasaža crijeva i irigografija nisu pokazali znakove gastrointestinalne opstrukcije. Obje djevojčice ubrzo su počele sve bolje tolerirati enteralni unos. Međutim, prva djevojčica nije tolerirala obroke veće od 15 mL instant-formule, a druga nakon 15. dana života ponovno nije tolerirala enteralni unos hrane. Ponovljena je široka dijagnostička obrada koja u prve djevojčice nije dokazala duodenalnu opstrukciju. U druge je djevojčice ezofagogastroduodenoskopijom utvrđena duodenalna opstrukcija nepoznate etiologije. U 19., odnosno 25. danu života provedena je laparotomija. Intraoperativno, nakon duodenotomije, u oba je slučaja vizualizirana duodenalna membrana koja je potom ekscidirana. Poslijeoperacijski oporavak bio je uredan s manjim nekirurškim komplikacijama. Djevojčice su otpuštene iz bolnice 21., odnosno 36. poslijeoperacijskog dana. Zaključci: Postavljanje dijagnoze duodenalne membrane često je vrlo složeno zbog intermitentne prirode simptoma. Eksplorativna laparotomija katkad je nužna kako bi se postavila konačna dijagnoza.
CILJ: Intraventrikularno krvarenje (IVH) jedno je od najznačajnijih uzroka oštećenja središnjeg živčanog sustava u prijevremeno rođene novorođenčadi. Niz je istraženih čimbenika rizika za nastanak ...IVH u prematurusa: genetski, prenatalni, faktori poroda, te čimbenici novorođenačkog razdoblja. Neki od njih jatrogene su prirode, što sugerira potrebu za znanstveno-istraživačkim pristupom u cilju detekcije istih.ISPITANICI I METODE: Retrospektivno su analizirani podaci iz medicinske dokumentacije Jedinice novorođenačkog intenzivnog liječenja, Klinike za ginekologiju i porodništvo, Kliničkog bolničkog centra Rijeka. Izdvojeni su podaci o prematurusima, u kojih je postavljena dijagnoza intraventrikularnog krvarenja (I.- IV. stupanj), tijekom 2013. i 2014. godine. Analizirani su podaci 60-ero djece koji se odnose na trudnoću, porod i novorođenačko razdoblje. Ispitanici su podijeljeni u skupine, u ovisnosti o stupnju IVH-a , a rezultati su statistički obrađeni.REZULTATI: Korioamnionitis majke u trudnoći, Apgar ocjene u 1. i 5 minuti, perinatalna asfiksija, gestacijska dob, prisutstvo respiratornog distresa, rodna masa, epizode hiper/hipokapnije, primjena reanimacije, svježe smrznute plazme (SSP), natrij-hidrogenkarbonata (NaHCO3) i filtriranih eritrocita (FE) u prvom tjednu života, pokazali su statistički značajnu razliku između grupa ispitanika s različitim stupnjevima IVH-a. Čimbenici koji su značajno utjecali na stupanj IVH jesu gestacijska dob (P=0,004) i primjena FE u 1. tjednu (P=0,001). Primjena FE u 1. tjednu života samostalno je doprinijela 11,74%, a gestacijska dob 7,80% u objašnjavanju stupnja IVH.ZAKLJUČCI: Osobito je važno da medicinsko osoblje, koje skrbi o prijevremeno rođenom novorođenčetu i trudnici, poznaje čimbenike rizika za javljanje IVH-a, posebice one jatrogene prirode, u cilju njihovog minimiziranja i/ili uklanjanja.
Korona pandemija pretvorila se u
globalnu ekonomsku krizu, dovodeći u opasnost prije svega zdravlje, prihode
milijuna ljudi diljem svijeta te radna mjesta. Svrha rada je razumijevanje
utjecaja korona ...pandemije na stabilnost radnih mjesta. Cilj rada je analizirati
utjecaj korona pandemije na stabilnost radnih mjesta u pet županija Istočne
Hrvatske. U istraživanje je uključena analiza anketnog upitnika koji su
popunila 615 ispitanika iz 5 županija Istočne Hrvatske te prikupljenih
statističkih podataka i relevantne stručne literature. Ograničenje rada je
činjenica da pandemija još uvijek traje, a dostupni podaci su još uvijek
ograničeni. Prema rezultatima istraživanja, anketirani ispitanici smatraju da
korona pandemija ima veliki utjecaj na nestabilnost radnih mjesta u Istočnoj
Hrvatskoj.
The corona
pandemic has turned into a global economic crisis, endangering above all health,
the incomes of millions of people around the world, and jobs. The purpose
of this paper is to understand the impact of the corona pandemic on job
stability. This
paper aims to analyze the impact of the corona pandemic on job stability in
five counties in Eastern Croatia. The research included the analysis of a questionnaire
completed by 615 respondents from 5 counties of Eastern Croatia and the
collected statistical data and relevant professional literature. The
limitation of the work is the fact that the pandemic is still going on and the
available data are still limited. According to the results of the research, the respondents
believe that the corona pandemic has a great impact on job instability in
Eastern Croatia.
The corona pandemic has turned into a global economic crisis, endangering above all health, the incomes of millions of people around the world, and jobs. The purpose of this paper is to understand ...the impact of the corona pandemic on job stability. This paper aims to analyze the impact of the corona pandemic on job stability in five counties in Eastern Croatia. The research included the analysis of a questionnaire completed by 615 respondents from 5 counties of Eastern Croatia and the collected statistical data and relevant professional literature. The limitation of the work is the fact that the pandemic is still going on and the available data are still limited. According to the results of the research, the respondents believe that the corona pandemic has a great impact on job instability in Eastern Croatia.
Chronic recurrent multifocal osteomyelitis (CRMO) is an extremely rare and most severe form of chronic nonbacterial osteomyelitis of unknown etiology. Here we present the first case of a six-year-old ...girl in which was observed that the stress fracture mimic osteomyelitic foci in the course of CRMO.
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