Pavlovic Momcilo - Academia.edu (original) (raw)
Vol.4, Issue 1 by Pavlovic Momcilo
Efficacy of Prednisone in Children with Acute Nonspecific Mesenteric Lymphadenitis: A Pilot Study, 2022
A B ST R AC T Background: Acute nonspecific mesenteric lymphadenitis (ANML) is a common cause of ... more A B ST R AC T Background: Acute nonspecific mesenteric lymphadenitis (ANML) is a common cause of acute abdominal pain in children with no specific treatment. Methods: A total of 13 patients (6 boys, 7 girls) aged 7.3 (5-13.5) years with severe acute abdominal pain were evaluated using ultrasonography and laboratory tests to establish the diagnosis of ANML. They were treated with prednisone 1 mg/kg (max 40 mg daily) for a maximum of 5 days. The intensity of abdominal pain was evaluated before and after treatment using a numeric rating scale. Results: All patients had pain scores above 6/10 before, and below 4/10 after treatment with prednisone. Intensity of abdominal pain after treatment for 1-5 days decreased significantly (p < 0.001), with no recurrence at follow-up within 3 months. All other pre-existing signs and symptoms, such as nausea, vomiting, anorexia, fever, diarrhea, and constipation were found to disappear with no adverse effects of corticosteroid therapy. Conclusion: These results suggest that the treatment with prednisone in selective patients with ANML can reduce the duration of abdominal pain.
World Journal of Clinical Cases, 2017
Celiac disease (CD) is a common and well defined autoimmune disorder caused by gliadin and relate... more Celiac disease (CD) is a common and well defined
autoimmune disorder caused by gliadin and related
proteins of wheat, rye, and barley. Epidemiologic
studies confirmed that CD is highly associated with
other autoimmune diseases and with Down syndrome
(DS). The symptomatic form of CD in patients with DSis more frequent than asymptomatic forms. However,
growth impairment, anemia, intermittent diarrhea,
and constipation are symptoms and signs typically of
children with DS without CD. Late identification of the
disease can lead to various complications, sometimes
even very severe. Therefore, systematic screening for
CD is essential in the management of children and
adolescents with DS. Many medical organizations recommend
screening in this group of patients. However,
current policy statements vary in their recommendations
for screening and there is still a need for establishing
uniform diagnostic criteria.
Open Access Macedonian Journal of Medical Sciences (OAMJMS), 2020
BACKGROUND: Acute nonspecific mesenteric lymphadenitis refers to a common pediatric problem that ... more BACKGROUND: Acute nonspecific mesenteric lymphadenitis refers to a common pediatric problem that has no specific treatment.
Open Access Macedonian Journal of Medical Sciences, 2020
BACKGROUND: Acute nonspecific mesenteric lymphadenitis refers to a common pediatric problem that ... more BACKGROUND: Acute nonspecific mesenteric lymphadenitis refers to a common pediatric problem that has no specific treatment.
CASE REPORT: In our study, we describe seven children presenting with abdominal pain as the main symptom of a disease. All patients were treated with prednisone 1 mg/kg (max 40 mg daily) for a maximum of 5 days. In addition, we evaluated the intensity of the pain using a numeric rating scale and achieved a clinically important difference in acute pain relief of 85.3%. After administering corticosteroid therapy, the abdominal pain resolved after 1.7 (1–4) days in all children without any other disturbances.
CONCLUSION: In selective patients with mesenteric lymphadenitis, prednisone can be used as an acceptable form of treatment to reduce the duration of abdominal pain.
BACKGROUND: Acute nonspecific mesenteric lymphadenitis refers to a common pediatric problem that ... more BACKGROUND: Acute nonspecific mesenteric lymphadenitis refers to a common pediatric problem that has no specific treatment.
Open Access Macedonian Journal of Medical Sciences, 2020
BACKGROUND: Acute nonspecific mesenteric lymphadenitis refers to a common pediatric problem that ... more BACKGROUND: Acute nonspecific mesenteric lymphadenitis refers to a common pediatric problem that has no specific treatment.
AIM: The aim of the present paper was to identify prognostic factors for relapse and mortality in... more AIM: The aim of the present paper was to identify prognostic factors for relapse and mortality in patients with hospital-acquired infections caused by Clostridium difficile. MATERIAL AND METHODS: This study included 133 patients with healthcare facility-associated disease caused by C. difficile. The medical records of all patients with their clinical history and laboratory data were analyzed. RESULTS: Patients with one onset of disease were 105 (78.9%), 28 (21.1%) experienced a relapse and seven (5.2%) patients not survived infection. The average age in our patients was over 65 years (64.5 years in the survived patients and 78.8 in patient who died, p = 0.01). All of patients had received antibiotic treatment (cephalosporins – 83.4%, aminoglycosides – 21.5% and penicillins – 20.3%) and 40.6% of patients received acid-reducing therapy. There was no difference between patients with one onset of disease/patients with relaps; and survived/died in number of administered antibiotics, duration of administration, administration of acid-reducing treatment or length of hospital stay (p > 0.05). CRP levels were significantly higher in the group of patients who died compared with recovered (p < 0.001). CONCLUSION: C. difficile-associated diarrhea is a common nosocomial disease with high relapse, and significant mortality rate particularly in the elderly.
Hypervitaminosis D occurs in infants due to increased intake of vitamin D and results in hypercal... more Hypervitaminosis D occurs in infants due to increased intake of vitamin D and results in hypercalcemia and hypercalciuria. We present the case of a 4.5-month old infant with signs of vitamin D intoxication, which occurred due to supplementation for the purpose of rickets prevention and diet with vitamin D-fortified milk. The clinical manifestations were constipation, vomiting and failure to thrive. After excluding hormonal, tumoral and malformative (Williams syndrome) causes, treatment included hyperhy-dration, loop diuretics and prednisone. This case highlights the need for proper informing of parents on the manners of vitamin D supplementation during the first year of life in order to avoid dangers of parental dosing errors. Riketsin Önlenmesinden Vitamin D Zehirlenmesine ÖZET İnfantlarda D vitamin fazlalığı artmış vitamin D alımı neticesinde olur ve hiperkalsemi ve hiperkalsiüri ile sonuçlanır. Biz, vitamin D intoksikasyonu bulguları olan 4.5 aylık bir infant vakası sunuyoruz. Bu vakada vitamin D fazlalığı, riketsden korumak amacıyla diy-ette vitamin D ile takviye edilmiş süt kullanılması ile oluşmuştu. Klinik belirtiler kabızlık, kusma ve gelişme geriliğiydi. Hormonal, tümöral ve malformatif (Williams syndrome) sebepler dışlandıktan sonra,hiperhidrasyon, loop diüretikleri ve prednison ile tedavi edildi. Sunulan vaka, parenteral doz hatalarının tehlikelerini önlemek için yaşamın ilk yılında vitamin D suplementasyon metodları hakkında ebeveynlerin bilgilendirilmesinin ne kadar önemli olduğunu göstermektedir.
Celiac disease (CD) is an immune-mediated enteropathy induced by gliadin and related prolamins. T... more Celiac disease (CD) is an immune-mediated enteropathy induced by gliadin and related prolamins. This study was designed to evaluate the correlation between the degree and uniformity of mucosal damage and forms of CD. The study included a total of 85 children (33 boys and 52 girls, mean age 6.59 years) hospitalized due to CD. Patients were assigned to one of three groups based on their form of disease manifestation: (1) patients with classical form; (2) patients with atypical form; and (3) patients with asymptomatic celiac disease. The diagnosis of CD was based on positive CD specific antibodies, HLA typing and histological analysis of multiple biopsy samples. Histological changes were classified using modified Marsh criteria. Forty one patients had classical form, 32 had atypical form, while 12 patients had asymptomatic form of celiac disease. There was no difference in the degree of damage on small bowel samples between different clinical forms of celiac disease (p=0.079). The frequency of uniformity of enteropathy does not depend on clinical form of the disease (p=0.882). Uniform small bowel mucosal damage was more common in cases of severe degree of mucosal damage (p=0.017). The degree of damage and uniformity of changes in duodenal biopsy specimens did not correlate with mode of presentation, while uniform mucosal damage increased with severity of enteropathy.
Papers by Pavlovic Momcilo
Acta Medica (Hradec Kralove, Czech Republic)
Background: Acute nonspecific mesenteric lymphadenitis (ANML) is a common cause of acute abdomina... more Background: Acute nonspecific mesenteric lymphadenitis (ANML) is a common cause of acute abdominal pain in children with no specific treatment. Methods: A total of 13 patients (6 boys, 7 girls) aged 7.3 (5–13.5) years with severe acute abdominal pain were evaluated using ultrasonography and laboratory tests to establish the diagnosis of ANML. They were treated with prednisone 1 mg/kg (max 40 mg daily) for a maximum of 5 days. The intensity of abdominal pain was evaluated before and after treatment using a numeric rating scale. Results: All patients had pain scores above 6/10 before, and below 4/10 after treatment with prednisone. Intensity of abdominal pain after treatment for 1–5 days decreased significantly (p < 0.001), with no recurrence at follow-up within 3 months. All other pre-existing signs and symptoms, such as nausea, vomiting, anorexia, fever, diarrhea, and constipation were found to disappear with no adverse effects of corticosteroid therapy. Conclusion: These results...
AIM To report the effects of greater occipital nerve (GON) blocks on refractory chronic migraine ... more AIM To report the effects of greater occipital nerve (GON) blocks on refractory chronic migraine headache. METHODS Nine patients who were receiving the conventionally accepted preventive therapies underwent treatment with repeated GON block to control chronic migraine resistant to other treatments. GON blocking with lidocaine and normal saline mixture was administered by the same physician at hospital once a month (for three times in total). Patients were assessed before the injection and every month thereafter for pain frequency and severity, number of times analgesics were used and any appearant side effects during a 6 mo follow-up. RESULTS Eight of nine patients reported a marked decrease in frequency and severity of migraine attacks in comparison to their baseline symptoms; one reported no significant change (not more than 50%) from baseline and did not accept the second injection. GON block resulted in considerable reduction in pain frequency and severity and need to use analgesics up to three months after the injection in the present cases. The patients did not report any adverse effects. CONCLUSION Hereby we noticed a remarkable success with refractory chronic migraine patients. We believe that this intervention can result in rapid relief of pain with the effects lasting for perhaps several weeks or even months. Further controlled clinical trials are warranted to evaluate the effect of GON block in the treatment of refractory migraine cases.
AIM To report the effects of greater occipital nerve (GON) blocks on refractory chronic migraine ... more AIM To report the effects of greater occipital nerve (GON) blocks on refractory chronic migraine headache. METHODS Nine patients who were receiving the conventionally accepted preventive therapies underwent treatment with repeated GON block to control chronic migraine resistant to other treatments. GON blocking with lidocaine and normal saline mixture was administered by the same physician at hospital once a month (for three times in total). Patients were assessed before the injection and every month thereafter for pain frequency and severity, number of times analgesics were used and any appearant side effects during a 6 mo follow-up. RESULTS Eight of nine patients reported a marked decrease in frequency and severity of migraine attacks in comparison to their baseline symptoms; one reported no significant change (not more than 50%) from baseline and did not accept the second injection. GON block resulted in considerable reduction in pain frequency and severity and need to use analgesics up to three months after the injection in the present cases. The patients did not report any adverse effects. CONCLUSION Hereby we noticed a remarkable success with refractory chronic migraine patients. We believe that this intervention can result in rapid relief of pain with the effects lasting for perhaps several weeks or even months. Further controlled clinical trials are warranted to evaluate the effect of GON block in the treatment of refractory migraine cases.
International Journal of Celiac Disease, 2016
Celiac disease (CD) is an immune-mediated enteropathy induced by gliadin and related prolamins. T... more Celiac disease (CD) is an immune-mediated enteropathy induced by gliadin and related prolamins. This study was designed to evaluate the correlation between the degree and uniformity of mucosal damage and forms of CD. The study included a total of 85 children (33 boys and 52 girls, mean age 6.59 years) hospitalized due to CD. Patients were assigned to one of three groups based on their form of disease manifestation: (1) patients with classical form; (2) patients with atypical form; and (3) patients with asymptomatic celiac disease. The diagnosis of CD was based on positive CD specific antibodies, HLA typing and histological analysis of multiple biopsy samples. Histological changes were classified using modified Marsh criteria. Forty one patients had classical form, 32 had atypical form, while 12 patients had asymptomatic form of celiac disease. There was no difference in the degree of damage on small bowel samples between different clinical forms of celiac disease (p=0.079). The frequency of uniformity of enteropathy does not depend on clinical form of the disease (p=0.882). Uniform small bowel mucosal damage was more common in cases of severe degree of mucosal damage (p=0.017). The degree of damage and uniformity of changes in duodenal biopsy specimens did not correlate with mode of presentation, while uniform mucosal damage increased with severity of enteropathy.
European Journal of General Medicine, 2014
Hypervitaminosis D occurs in infants due to increased intake of vitamin D and results in hypercal... more Hypervitaminosis D occurs in infants due to increased intake of vitamin D and results in hypercalcemia and hypercalciuria. We present the case of a 4.5-month old infant with signs of vitamin D intoxication, which occurred due to supplementation for the purpose of rickets prevention and diet with vitamin D-fortified milk. The clinical manifestations were constipation, vomiting and failure to thrive. After excluding hormonal, tumoral and malformative (Williams syndrome) causes, treatment included hyperhydration, loop diuretics and prednisone. This case highlights the need for proper informing of parents on the manners of vitamin D supplementation during the first year of life in order to avoid dangers of parental dosing errors.
Open Access Macedonian Journal of Medical Sciences, 2020
BACKGROUND: Acute nonspecific mesenteric lymphadenitis refers to a common pediatric problem that ... more BACKGROUND: Acute nonspecific mesenteric lymphadenitis refers to a common pediatric problem that has no specific treatment. CASE REPORT: In our study, we describe seven children presenting with abdominal pain as the main symptom of a disease. All patients were treated with prednisone 1 mg/kg (max 40 mg daily) for a maximum of 5 days. In addition, we evaluated the intensity of the pain using a numeric rating scale and achieved a clinically important difference in acute pain relief of 85.3%. After administering corticosteroid therapy, the abdominal pain resolved after 1.7 (1–4) days in all children without any other disturbances. CONCLUSION: In selective patients with mesenteric lymphadenitis, prednisone can be used as an acceptable form of treatment to reduce the duration of abdominal pain.
Open Access Macedonian Journal of Medical Sciences, 2014
AIM: The aim of the present paper was to identify prognostic factors for relapse and mortality in... more AIM: The aim of the present paper was to identify prognostic factors for relapse and mortality in patients with hospital-acquired infections caused by Clostridium difficile.MATERIAL AND METHODS: This study included 133 patients with healthcare facility-associated disease caused by C. difficile. The medical records of all patients with their clinical history and laboratory data were analyzed.RESULTS: Patients with one onset of disease were 105 (78.9%), 28 (21.1%) experienced a relapse and seven (5.2%) patients not survived infection. The average age in our patients was over 65 years (64.5 years in the survived patients and 78.8 in patient who died, p = 0.01). All of patients had received antibiotic treatment (cephalosporins – 83.4%, aminoglycosides – 21.5% and penicillins – 20.3%) and 40.6% of patients received acid-reducing therapy. There was no difference between patients with one onset of disease/patients with relaps; and survived/died in number of administered antibiotics, durati...
Serbian Journal of Experimental and Clinical Research, 2012
Efficacy of Prednisone in Children with Acute Nonspecific Mesenteric Lymphadenitis: A Pilot Study, 2022
A B ST R AC T Background: Acute nonspecific mesenteric lymphadenitis (ANML) is a common cause of ... more A B ST R AC T Background: Acute nonspecific mesenteric lymphadenitis (ANML) is a common cause of acute abdominal pain in children with no specific treatment. Methods: A total of 13 patients (6 boys, 7 girls) aged 7.3 (5-13.5) years with severe acute abdominal pain were evaluated using ultrasonography and laboratory tests to establish the diagnosis of ANML. They were treated with prednisone 1 mg/kg (max 40 mg daily) for a maximum of 5 days. The intensity of abdominal pain was evaluated before and after treatment using a numeric rating scale. Results: All patients had pain scores above 6/10 before, and below 4/10 after treatment with prednisone. Intensity of abdominal pain after treatment for 1-5 days decreased significantly (p < 0.001), with no recurrence at follow-up within 3 months. All other pre-existing signs and symptoms, such as nausea, vomiting, anorexia, fever, diarrhea, and constipation were found to disappear with no adverse effects of corticosteroid therapy. Conclusion: These results suggest that the treatment with prednisone in selective patients with ANML can reduce the duration of abdominal pain.
World Journal of Clinical Cases, 2017
Celiac disease (CD) is a common and well defined autoimmune disorder caused by gliadin and relate... more Celiac disease (CD) is a common and well defined
autoimmune disorder caused by gliadin and related
proteins of wheat, rye, and barley. Epidemiologic
studies confirmed that CD is highly associated with
other autoimmune diseases and with Down syndrome
(DS). The symptomatic form of CD in patients with DSis more frequent than asymptomatic forms. However,
growth impairment, anemia, intermittent diarrhea,
and constipation are symptoms and signs typically of
children with DS without CD. Late identification of the
disease can lead to various complications, sometimes
even very severe. Therefore, systematic screening for
CD is essential in the management of children and
adolescents with DS. Many medical organizations recommend
screening in this group of patients. However,
current policy statements vary in their recommendations
for screening and there is still a need for establishing
uniform diagnostic criteria.
Open Access Macedonian Journal of Medical Sciences (OAMJMS), 2020
BACKGROUND: Acute nonspecific mesenteric lymphadenitis refers to a common pediatric problem that ... more BACKGROUND: Acute nonspecific mesenteric lymphadenitis refers to a common pediatric problem that has no specific treatment.
Open Access Macedonian Journal of Medical Sciences, 2020
BACKGROUND: Acute nonspecific mesenteric lymphadenitis refers to a common pediatric problem that ... more BACKGROUND: Acute nonspecific mesenteric lymphadenitis refers to a common pediatric problem that has no specific treatment.
CASE REPORT: In our study, we describe seven children presenting with abdominal pain as the main symptom of a disease. All patients were treated with prednisone 1 mg/kg (max 40 mg daily) for a maximum of 5 days. In addition, we evaluated the intensity of the pain using a numeric rating scale and achieved a clinically important difference in acute pain relief of 85.3%. After administering corticosteroid therapy, the abdominal pain resolved after 1.7 (1–4) days in all children without any other disturbances.
CONCLUSION: In selective patients with mesenteric lymphadenitis, prednisone can be used as an acceptable form of treatment to reduce the duration of abdominal pain.
BACKGROUND: Acute nonspecific mesenteric lymphadenitis refers to a common pediatric problem that ... more BACKGROUND: Acute nonspecific mesenteric lymphadenitis refers to a common pediatric problem that has no specific treatment.
Open Access Macedonian Journal of Medical Sciences, 2020
BACKGROUND: Acute nonspecific mesenteric lymphadenitis refers to a common pediatric problem that ... more BACKGROUND: Acute nonspecific mesenteric lymphadenitis refers to a common pediatric problem that has no specific treatment.
AIM: The aim of the present paper was to identify prognostic factors for relapse and mortality in... more AIM: The aim of the present paper was to identify prognostic factors for relapse and mortality in patients with hospital-acquired infections caused by Clostridium difficile. MATERIAL AND METHODS: This study included 133 patients with healthcare facility-associated disease caused by C. difficile. The medical records of all patients with their clinical history and laboratory data were analyzed. RESULTS: Patients with one onset of disease were 105 (78.9%), 28 (21.1%) experienced a relapse and seven (5.2%) patients not survived infection. The average age in our patients was over 65 years (64.5 years in the survived patients and 78.8 in patient who died, p = 0.01). All of patients had received antibiotic treatment (cephalosporins – 83.4%, aminoglycosides – 21.5% and penicillins – 20.3%) and 40.6% of patients received acid-reducing therapy. There was no difference between patients with one onset of disease/patients with relaps; and survived/died in number of administered antibiotics, duration of administration, administration of acid-reducing treatment or length of hospital stay (p > 0.05). CRP levels were significantly higher in the group of patients who died compared with recovered (p < 0.001). CONCLUSION: C. difficile-associated diarrhea is a common nosocomial disease with high relapse, and significant mortality rate particularly in the elderly.
Hypervitaminosis D occurs in infants due to increased intake of vitamin D and results in hypercal... more Hypervitaminosis D occurs in infants due to increased intake of vitamin D and results in hypercalcemia and hypercalciuria. We present the case of a 4.5-month old infant with signs of vitamin D intoxication, which occurred due to supplementation for the purpose of rickets prevention and diet with vitamin D-fortified milk. The clinical manifestations were constipation, vomiting and failure to thrive. After excluding hormonal, tumoral and malformative (Williams syndrome) causes, treatment included hyperhy-dration, loop diuretics and prednisone. This case highlights the need for proper informing of parents on the manners of vitamin D supplementation during the first year of life in order to avoid dangers of parental dosing errors. Riketsin Önlenmesinden Vitamin D Zehirlenmesine ÖZET İnfantlarda D vitamin fazlalığı artmış vitamin D alımı neticesinde olur ve hiperkalsemi ve hiperkalsiüri ile sonuçlanır. Biz, vitamin D intoksikasyonu bulguları olan 4.5 aylık bir infant vakası sunuyoruz. Bu vakada vitamin D fazlalığı, riketsden korumak amacıyla diy-ette vitamin D ile takviye edilmiş süt kullanılması ile oluşmuştu. Klinik belirtiler kabızlık, kusma ve gelişme geriliğiydi. Hormonal, tümöral ve malformatif (Williams syndrome) sebepler dışlandıktan sonra,hiperhidrasyon, loop diüretikleri ve prednison ile tedavi edildi. Sunulan vaka, parenteral doz hatalarının tehlikelerini önlemek için yaşamın ilk yılında vitamin D suplementasyon metodları hakkında ebeveynlerin bilgilendirilmesinin ne kadar önemli olduğunu göstermektedir.
Celiac disease (CD) is an immune-mediated enteropathy induced by gliadin and related prolamins. T... more Celiac disease (CD) is an immune-mediated enteropathy induced by gliadin and related prolamins. This study was designed to evaluate the correlation between the degree and uniformity of mucosal damage and forms of CD. The study included a total of 85 children (33 boys and 52 girls, mean age 6.59 years) hospitalized due to CD. Patients were assigned to one of three groups based on their form of disease manifestation: (1) patients with classical form; (2) patients with atypical form; and (3) patients with asymptomatic celiac disease. The diagnosis of CD was based on positive CD specific antibodies, HLA typing and histological analysis of multiple biopsy samples. Histological changes were classified using modified Marsh criteria. Forty one patients had classical form, 32 had atypical form, while 12 patients had asymptomatic form of celiac disease. There was no difference in the degree of damage on small bowel samples between different clinical forms of celiac disease (p=0.079). The frequency of uniformity of enteropathy does not depend on clinical form of the disease (p=0.882). Uniform small bowel mucosal damage was more common in cases of severe degree of mucosal damage (p=0.017). The degree of damage and uniformity of changes in duodenal biopsy specimens did not correlate with mode of presentation, while uniform mucosal damage increased with severity of enteropathy.
Acta Medica (Hradec Kralove, Czech Republic)
Background: Acute nonspecific mesenteric lymphadenitis (ANML) is a common cause of acute abdomina... more Background: Acute nonspecific mesenteric lymphadenitis (ANML) is a common cause of acute abdominal pain in children with no specific treatment. Methods: A total of 13 patients (6 boys, 7 girls) aged 7.3 (5–13.5) years with severe acute abdominal pain were evaluated using ultrasonography and laboratory tests to establish the diagnosis of ANML. They were treated with prednisone 1 mg/kg (max 40 mg daily) for a maximum of 5 days. The intensity of abdominal pain was evaluated before and after treatment using a numeric rating scale. Results: All patients had pain scores above 6/10 before, and below 4/10 after treatment with prednisone. Intensity of abdominal pain after treatment for 1–5 days decreased significantly (p < 0.001), with no recurrence at follow-up within 3 months. All other pre-existing signs and symptoms, such as nausea, vomiting, anorexia, fever, diarrhea, and constipation were found to disappear with no adverse effects of corticosteroid therapy. Conclusion: These results...
AIM To report the effects of greater occipital nerve (GON) blocks on refractory chronic migraine ... more AIM To report the effects of greater occipital nerve (GON) blocks on refractory chronic migraine headache. METHODS Nine patients who were receiving the conventionally accepted preventive therapies underwent treatment with repeated GON block to control chronic migraine resistant to other treatments. GON blocking with lidocaine and normal saline mixture was administered by the same physician at hospital once a month (for three times in total). Patients were assessed before the injection and every month thereafter for pain frequency and severity, number of times analgesics were used and any appearant side effects during a 6 mo follow-up. RESULTS Eight of nine patients reported a marked decrease in frequency and severity of migraine attacks in comparison to their baseline symptoms; one reported no significant change (not more than 50%) from baseline and did not accept the second injection. GON block resulted in considerable reduction in pain frequency and severity and need to use analgesics up to three months after the injection in the present cases. The patients did not report any adverse effects. CONCLUSION Hereby we noticed a remarkable success with refractory chronic migraine patients. We believe that this intervention can result in rapid relief of pain with the effects lasting for perhaps several weeks or even months. Further controlled clinical trials are warranted to evaluate the effect of GON block in the treatment of refractory migraine cases.
AIM To report the effects of greater occipital nerve (GON) blocks on refractory chronic migraine ... more AIM To report the effects of greater occipital nerve (GON) blocks on refractory chronic migraine headache. METHODS Nine patients who were receiving the conventionally accepted preventive therapies underwent treatment with repeated GON block to control chronic migraine resistant to other treatments. GON blocking with lidocaine and normal saline mixture was administered by the same physician at hospital once a month (for three times in total). Patients were assessed before the injection and every month thereafter for pain frequency and severity, number of times analgesics were used and any appearant side effects during a 6 mo follow-up. RESULTS Eight of nine patients reported a marked decrease in frequency and severity of migraine attacks in comparison to their baseline symptoms; one reported no significant change (not more than 50%) from baseline and did not accept the second injection. GON block resulted in considerable reduction in pain frequency and severity and need to use analgesics up to three months after the injection in the present cases. The patients did not report any adverse effects. CONCLUSION Hereby we noticed a remarkable success with refractory chronic migraine patients. We believe that this intervention can result in rapid relief of pain with the effects lasting for perhaps several weeks or even months. Further controlled clinical trials are warranted to evaluate the effect of GON block in the treatment of refractory migraine cases.
International Journal of Celiac Disease, 2016
Celiac disease (CD) is an immune-mediated enteropathy induced by gliadin and related prolamins. T... more Celiac disease (CD) is an immune-mediated enteropathy induced by gliadin and related prolamins. This study was designed to evaluate the correlation between the degree and uniformity of mucosal damage and forms of CD. The study included a total of 85 children (33 boys and 52 girls, mean age 6.59 years) hospitalized due to CD. Patients were assigned to one of three groups based on their form of disease manifestation: (1) patients with classical form; (2) patients with atypical form; and (3) patients with asymptomatic celiac disease. The diagnosis of CD was based on positive CD specific antibodies, HLA typing and histological analysis of multiple biopsy samples. Histological changes were classified using modified Marsh criteria. Forty one patients had classical form, 32 had atypical form, while 12 patients had asymptomatic form of celiac disease. There was no difference in the degree of damage on small bowel samples between different clinical forms of celiac disease (p=0.079). The frequency of uniformity of enteropathy does not depend on clinical form of the disease (p=0.882). Uniform small bowel mucosal damage was more common in cases of severe degree of mucosal damage (p=0.017). The degree of damage and uniformity of changes in duodenal biopsy specimens did not correlate with mode of presentation, while uniform mucosal damage increased with severity of enteropathy.
European Journal of General Medicine, 2014
Hypervitaminosis D occurs in infants due to increased intake of vitamin D and results in hypercal... more Hypervitaminosis D occurs in infants due to increased intake of vitamin D and results in hypercalcemia and hypercalciuria. We present the case of a 4.5-month old infant with signs of vitamin D intoxication, which occurred due to supplementation for the purpose of rickets prevention and diet with vitamin D-fortified milk. The clinical manifestations were constipation, vomiting and failure to thrive. After excluding hormonal, tumoral and malformative (Williams syndrome) causes, treatment included hyperhydration, loop diuretics and prednisone. This case highlights the need for proper informing of parents on the manners of vitamin D supplementation during the first year of life in order to avoid dangers of parental dosing errors.
Open Access Macedonian Journal of Medical Sciences, 2020
BACKGROUND: Acute nonspecific mesenteric lymphadenitis refers to a common pediatric problem that ... more BACKGROUND: Acute nonspecific mesenteric lymphadenitis refers to a common pediatric problem that has no specific treatment. CASE REPORT: In our study, we describe seven children presenting with abdominal pain as the main symptom of a disease. All patients were treated with prednisone 1 mg/kg (max 40 mg daily) for a maximum of 5 days. In addition, we evaluated the intensity of the pain using a numeric rating scale and achieved a clinically important difference in acute pain relief of 85.3%. After administering corticosteroid therapy, the abdominal pain resolved after 1.7 (1–4) days in all children without any other disturbances. CONCLUSION: In selective patients with mesenteric lymphadenitis, prednisone can be used as an acceptable form of treatment to reduce the duration of abdominal pain.
Open Access Macedonian Journal of Medical Sciences, 2014
AIM: The aim of the present paper was to identify prognostic factors for relapse and mortality in... more AIM: The aim of the present paper was to identify prognostic factors for relapse and mortality in patients with hospital-acquired infections caused by Clostridium difficile.MATERIAL AND METHODS: This study included 133 patients with healthcare facility-associated disease caused by C. difficile. The medical records of all patients with their clinical history and laboratory data were analyzed.RESULTS: Patients with one onset of disease were 105 (78.9%), 28 (21.1%) experienced a relapse and seven (5.2%) patients not survived infection. The average age in our patients was over 65 years (64.5 years in the survived patients and 78.8 in patient who died, p = 0.01). All of patients had received antibiotic treatment (cephalosporins – 83.4%, aminoglycosides – 21.5% and penicillins – 20.3%) and 40.6% of patients received acid-reducing therapy. There was no difference between patients with one onset of disease/patients with relaps; and survived/died in number of administered antibiotics, durati...
Serbian Journal of Experimental and Clinical Research, 2012