Papers by Miroslav Vukadin
Acta Chirurgica Iugoslavica, 2009
Indian Journal of Pediatrics, Mar 1, 2015
Objective The survival rate in newborns with congenital esophageal atresia (EA) is about 85-90 %,... more Objective The survival rate in newborns with congenital esophageal atresia (EA) is about 85-90 %, and it raises over 95 % in the developed countries. The survival rate in developing countries is much lower and the authors describe their experience with 60 newborns. Methods Medical records of 60 newborns (40 boys and 20 girls) with congenital EA were reviewed for the prognostic factors and mortality. Results The birth weight, mean Apgar score (AS) value, gestational age and birth-operative treatment time had significant influence on the mortality of treated patients (p<0.05). Thirty five percent newborns had aspirational pneumonia at the moment of hospitalization and 86.7 % of them were operated during the first 48 h. The presence of associated anomalies considerably affected the death rate of treated patients (p<0.05). The incidence of postoperative complications was similar to those in developed countries but the total mortality was higher (28.3 %); sepsis being the main cause of mortality. The postoperative complications and sepsis significantly influenced the mortality of patients (p<0.05). Conclusions Total mortality in newborns with EA was high; sepsis being the most frequent cause of death. The high total mortality was also caused by prematurity, delay in diagnosis, increased incidence of the aspiration pneumonia and shortage of qualified nurses.
Journal of Pediatric and Adolescent Gynecology, Apr 1, 2023
Turkish journal of urology, Oct 8, 2019
Congenital prepubic fistula is a very rare congenital anomaly that manifests as a punctiform open... more Congenital prepubic fistula is a very rare congenital anomaly that manifests as a punctiform opening in the midline of the pubic region. According to Campbell, congenital prepubic fistulae are duplicates of the dorsal urethra. Recent investigations have shown that this problem may have a complex etiology. We report a case of a congenital prepubic fistula in 2-month old female neonate, which manifested as a simple punctiform opening in the pubic region, with purulent secretion that resulted from applying pressure to the region. The surgical treatment was successful, and the infant had an uneventful postoperative course of healing.
Introduction. Transverse colon volvulus is an uncommon cause of bowel obstruction in general. Pre... more Introduction. Transverse colon volvulus is an uncommon cause of bowel obstruction in general. Predisposing factors are mental retardation, dysmotility disorders, chronic constipation and congenital megacolon. Case report. We presented transverse colon volvulus in a 16-year-old boy with cerebral palsy. Chronic constipation in neurologicaly impaired patient was a risk factor predisposing to volvulus. The patient was admitted to the hospital with enormous abdominal distension and acute respiratory insufficiency. A boy was emergently taken to the operating room for exploratory laparotomy. During the surgery, a 360º clockwise volvulus of the transverse colon was found. After reduction of volvulus, an enormous transverse colon was resected and colostomy was formed. In the postoperative period, despite the good functioning of stoma and intraabdominal normotension, numerous and long lasting respiratory problems developed. The patient was discharged from our institution after 8 months. Conclusion. Though very rare in pediatric group, the possibility of a transverse colon volvulus must be considered in the differential diagnosis of acute large bowel obstruction.
Molecules
Recent scientific data recognize the B7-H3 checkpoint molecule as a potential target for immunoth... more Recent scientific data recognize the B7-H3 checkpoint molecule as a potential target for immunotherapy of pediatric solid tumors (PSTs). B7-H3 is highly expressed in extracranial PSTs such as neuroblastoma, rhabdomyosarcoma, nephroblastoma, osteosarcoma, and Ewing sarcoma, whereas its expression is absent or very low in normal tissues and organs. The influence of B7-H3 on the biological behavior of malignant solid neoplasms of childhood is expressed through different molecular mechanisms, including stimulation of immune evasion and tumor invasion, and cell-cycle disruption. It has been shown that B7-H3 knockdown decreased tumor cell proliferation and migration, suppressed tumor growth, and enhanced anti-tumor immune response in some pediatric solid cancers. Antibody-drug conjugates targeting B7-H3 exhibited profound anti-tumor effects against preclinical models of pediatric solid malignancies. Moreover, B7-H3-targeting chimeric antigen receptor (CAR)-T cells demonstrated significant...
Универзитет у Београду, Jul 14, 2015
Journal of Pediatric and Adolescent Gynecology, Apr 1, 2023
Journal of Pediatric and Adolescent Gynecology
Journal of Pediatric and Adolescent Gynecology
Cilj: Uvažavajući činjenicu da je atrezija jednjaka tipa „long gap“ kongenitalna anomalija koja j... more Cilj: Uvažavajući činjenicu da je atrezija jednjaka tipa „long gap“ kongenitalna anomalija koja je najteža za dijagnostiku i lečenje u poređenju sa svim ostalim tipovima atrezije jednjaka (AJ) postavljeni ciljevi su bili sledeći: 1) Odrediti indikacije na osnovu kojih se odlučuje o tipu operativne metode kod atrezije jednjaka tipa “long gap“; 2) Uporediti uspeh lečenja atrezije jednjaka tipa „long gap“ operativnim metodama primarne odložene anstomoze i zamene jednjaka gastričnim tubusom; 3) Uporediti uspešnost primenjenih operativnih metoda na osnovu zajedničkih kriterijuma; 4) Oceniti relativni značaj prisustva komorbiditeta za uspeh lečenja artrezije jednjaka tipa „long gap“. Metodologija: Sprovedena studija se sastojala iz dva dela. Prvi deo studije se odnosio na vremenski period od 1999. do 2009. godine, obuhvatao je 60 pacijenata sa atrezijom jednjaka (sa ili bez traheoezofagealne fistule) kod kojih su praćeni sledeći parametri: uzrast pacijenta, telesna masa na rođenju, ocena ...
Parasitology International, 2010
Cystic echinococcosis (CE) is a public health problem in countries having such endemic areas. Epi... more Cystic echinococcosis (CE) is a public health problem in countries having such endemic areas. Epidemiological studies of CE, especially pediatric, are rare. The aim of this study was to evaluate epidemiological and clinical characteristics of CE in children in Serbia. Data were obtained retrospectively from the case records of patients under the age of 18 years admitted for surgical treatment of CE at two large pediatric medical institutions in the period 1990-2006. Patients' age, number of cysts and their anatomic location were evaluated in relation to differences by patients' gender and socio-geographic status (urban or rural origin). The study included 149 children with 272 hydatid cysts. The mean age of patients was 10.1 ± 3.8 years. There were no significant differences in the number of patients in relation to gender and urban: rural origin. There were no significant differences in patients' age at the time of surgery or the number of cysts per patient when patients' gender or socio-geographic status was evaluated. The anatomic location of cysts was as follows: liver (N = 165; 60.7%), lungs (N = 82; 30.1%), and other locations (N = 25; 9.2%). Multiple cysts, and combined liver/lung involvement were identified in 34.2% (N = 51), and 6.0% (N = 9) of patients, respectively. Hepatic cysts were significantly more common in girls than in boys. There were no significant differences in anatomic location of cysts between socio-geographic groups. The large number of infected children during a long period of investigation indicates an active transmission of disease and a lack of program for control and prevention of CE in Serbia.
Annali italiani di chirurgia, 2016
The aim of this study was estimation of clinical value of gastric tube esophagoplasty in children... more The aim of this study was estimation of clinical value of gastric tube esophagoplasty in children based on one single center experience. Forty-nine patients with diagnosis of EA (n=22) and caustic esophageal injury (n=27) had undergone reverse gastric tube esophagoplasty during 25 years at our institution. Almost all EA patients received initially gastrostomy and cervical esophagostomy. Majority of CS patients had initially repeated dilatation therapy. Demographics, preoperative features (initial condition, initial treatment and nutritional status) and postoperative features (leakage, stenosis, nutritional status and disease-specific symptoms) were retrospectively reviewed and analyzed. Mean follow up time was 8.2 years. Of 49 patients, 2 patients died and gastric tube failed in one patient. The most common complications were anastomotic leak (52%) and anastomotic stricture (47,8%). Disease-specific symptoms (dysphagia and reflux symptoms) with important clinical manifestations were...
Vojnosanitetski Pregled, 2021
Introduction. Annular pancreas is a rare congenital anomaly in which a band of pancreatic tissue,... more Introduction. Annular pancreas is a rare congenital anomaly in which a band of pancreatic tissue, in continuity with pancreatic head, completely or incompletely surrounds the descending part of duodenum. An abnormal pancreatic development can cause complete annular pancreas, partial annular pancreas and pancreas divisum. Complete annular pancreas is diagnosed in newborns, while the diagnosis of partial annular pancreas is more frequently established in adults. The most reliable diagnostic methods are computed tomography and magnetic resonance cholangiopancreatography. The anomaly is treated surgically, using bypass procedures. Case report. A 12-year-old girl presented malnourished, with occasional feeding problems, vomiting, heartburn and pain from infancy. Upper gastrointestinal series showed extremely dilated stomach, the first and the second part of the duodenum. Endoscopic exam revealed the dilated stomach, pilorus, the first and the second part of the duodenum with retained con...
Srpski arhiv za celokupno lekarstvo
Introduction. Esophageal achalasia is a neurodegenerative motility disorder, which is characteriz... more Introduction. Esophageal achalasia is a neurodegenerative motility disorder, which is characterized by ineffective or absent esophageal peristalsis and the lack of hypertonic lower esophageal sphincter relaxation. Achalasia causes failure to thrive in children and can have serious respiratory complications. Achalasia is a very rare condition in pediatric population, and usually misdiagnosed as gastroesophageal reflux. The treatment of choice is Heller esophagocardiomyotomy. The aim of this paper is to present a rare case of a two-year-old child with achalasia, diagnostic procedures, and successful operative treatment. Case outline. The patient?s problems started at the age of six months, with audible breathing and respiratory stridor. The child was admitted at a local hospital at seven months of age, dismissed with dietary advices, again admitted at the age of 19 months, and transferred to our institution. Upper gastrointestinal series and computed tomography revealed findings chara...
Vojnosanitetski pregled
Introduction. Tracheoesophageal fistula (TEF) as a complication of balloon dilatation (BD) of cor... more Introduction. Tracheoesophageal fistula (TEF) as a complication of balloon dilatation (BD) of corrosive esophageal stricture is a very rare and serious condition. Life threatening aspiration pneumonia requests urgent lungs' protection, but overall treatment strategy is not clearly defined. Case report. Twenty-month-old female child accidentally ingested a household bleach. Caustic injury of esophagus was healing with development of strictures of cervical and proximal thoracic esophagus. TEF was developed during the third BD. Healing of TEF and pulmonary infection was achieved by exclusion of the esophagus (pharyngostoma and feeding gastrostomy together) with prolonged tracheobronchial intubation and toilette. Retrosternal colon interposition was performed a year later, with excellent functional results over four-year follow-up. Conclusion. Esophageal exclusion in the first stage, and pharyngoesophageal reconstruction in the second stage, is a useful therapeutic option in the tre...
Türk Üroloji Dergisi/Turkish Journal of Urology
Srpski arhiv za celokupno lekarstvo
Introduction. Extraskeletal Ewing sarcoma (ES), is highly malignant neoplasm occurring most commo... more Introduction. Extraskeletal Ewing sarcoma (ES), is highly malignant neoplasm occurring most commonly in the thoracic wall and paravertebral region. ES belongs to the group of small round cell tumors and displays pathognomonic structural abnormalities of EWS gene. The aims of this article was to present extraskeletal ES in extremely rare anatomic location, an unusual clinical presentation, and modified treatment strategy. Case outline. A 15-year-old boy was admitted to the hospital with acute abdominal pain in the right iliac region. During urgent operation, because of suspected appendicitis with periappendicular infiltrate, partly haemorrhagic tumor tissue was discovered in the preperitoneal space. Histopathological and immunohistochemical analyses revealed tumor resembling extraskeletal ES. Postoperative CT scan has shown the tumor rest, which was completely removed in the second operation. The molecular genetic analysis confirmed extraskeletal ES by finding of the EWSR1-FLI1 fusio...
Annali italiani di chirurgia, 2016
The aim of this study was estimation of clinical value of gastric tube esophagoplasty in children... more The aim of this study was estimation of clinical value of gastric tube esophagoplasty in children based on one single center experience. Forty-nine patients with diagnosis of EA (n=22) and caustic esophageal injury (n=27) had undergone reverse gastric tube esophagoplasty during 25 years at our institution. Almost all EA patients received initially gastrostomy and cervical esophagostomy. Majority of CS patients had initially repeated dilatation therapy. Demographics, preoperative features (initial condition, initial treatment and nutritional status) and postoperative features (leakage, stenosis, nutritional status and disease-specific symptoms) were retrospectively reviewed and analyzed. Mean follow up time was 8.2 years. Of 49 patients, 2 patients died and gastric tube failed in one patient. The most common complications were anastomotic leak (52%) and anastomotic stricture (47,8%). Disease-specific symptoms (dysphagia and reflux symptoms) with important clinical manifestations were...
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Papers by Miroslav Vukadin