This study aimed to provide additional information on the influence of perinatal factors on fecal (f)-calprotectin values in preterm infants. Calprotectin was determined from the first spontaneous stool (analyzed on the Alegria device by using the enzyme-linked immunosorbent assay [ELISA] method) obtained from neonates at a mean age of 3.41 ± 2.44 days of life. We analyzed 114 subjects who had a body weight of 1847.67 ± 418.6 g and were born at a gestational age of 32.6 ± 2.43 weeks, without intestinal and other congenital anomalies or any diseases other than those related to premature birth. The values of f-calprotectin are in a positive correlation with female subjects, intrauterine growth restriction, significant ductus arteriosus, enteral feeding intolerance, postnatal prolonged use of broad-spectrum antibiotics, and values ​​of bicarbonates (analyzed in a sample of capillary arterial blood). Measurement of f-calprotectin in the first 7 days after birth can help to early detect the intestinal distress or early staging of necrotizing enterocolitis in premature infants.

Children born with the epidermolysis bullosa (so-called “butterfly children”) can eat only liquid or soft food due to the blisters on their mouth, tongue and esophagus. Due to their inactivity and permanent wounds, their fingers are curved and grown with a fist. Their eyes, anus and genitals are not spared either. The digestion is usually poor, so they often suffer from the constipation, and sometimes the intestine discharge can be performed only surgically. Due to frequent and numerous wounds, infections may develop, which can lead to sepsis. Wounds are caused by any kind of the pressure and re-bandaging of wounds is the most painful. These children can later be susceptible to other diseases, especially the skin cancer. More than 80% of children diagnosed with this disease become disabled in the first years of their lives, and some of them pass away immediately after birth. The average lifespan of the diseased is about 28 years. Here we have presented a rare case of a newborn male infant with a dystrophic epidermolysis bullousa, a congenital skin aplasia on the right leg and a nail dystrophy. Based on a typical clinical presentation, we think that it is Bart’s syndrome.

Thromboses are considered to be rare disorders in the pediatric population. However, they occur more frequently during the neonatal period. Potential risk factors for thrombosis onset include frequent use of peripheral, umbilical or central venous / arterial catheters, inflammation, disseminated intravascular coagulation, liver disorders, hypovolemia, asphyxia, congenital heart disease, polycythemia and dehydration. On the seventh day of life in male premature infant born in 29th / 30th gestation week, we noticed an increased level of inflammatory parameters. The patient’s right leg was edematous and cold with immeasurable pulse and pressure over the femoral artery, mottled skin and no spontaneous mobility. In the following days, edema becomes generalized and abdominal meteorism with bile vomiting appeared. Vascular surgeon established a diagnosis of the acute femoral artery stenosis (CW Doppler). We initiated continuous infusion of unfractionated heparin, but due to the development of hemorrhagic syndrome, next day we replaced it with low molecular weight heparin. The hemorrhagic disease was treated with tranexamic acid, fresh frozen plasma and concentrated platelets of the corresponding blood group. Signs of recirculation were registered with a palpable femoral pulse. CW Doppler confirmed complete recovery. In spite of the fact that antithrombotic therapy can cause numerous complications, it should be considered in vital indications.

One of the succes factors of biomedically assisted fertilization is the regular maturation of one or more oocytes. The quality of the oocytes is significantly influenced by the environment in which it is located, the so-called „microenvironment” that includes cumulus cells, follicular fluid in which hormones and growth factors involved in its growth and development are secreted. The main aim was to examine whether the concentration of steroid hormones in the follicular fluid affects the rate of fertilization and the outcome of the in vitro fertilization process itself. The study included 31 patients who were included in vitro fertilization procedure at the Department for Biomedically Assisted Fertilization, Clinic for Gynecology and Obstetrics, Clinical Center Kragujevac. We used follicular fluid as biological material for analysis. Examination of the obtained follicular fluid and collection of oocytes under a stereomicroscope was done in the embryological laboratory at the Department. Biochemical parameters of follicular fluid were analyzed in the Department for Laboratory Diagnostics, Clinical Center Kragujevac. In vitro fertilization (IVF) or intracytoplasmic sperm injection (ICSI) methods were used as the fertilization method. The criteria of the Istanbul Consensus of Clinical Embryologists were used as a reference framework for embryo quality assessment. Pregnancy was confirmed by a positive serum level of the hormone β-hCG 14 days after embryo transfer. A software package ЅРЅЅ 20 was used for statistical data processing. The results of the analysis of follicular fluid samples show that there was no statistically significant difference in the concentration of estradiol, progesterone and testosterone in follicular fluid in relation to fertilization rate and the outcome of in vitro fertilization. Based on our results, it can be concluded that the concentration of steroid hormones did not affect fertilization rate and the outcome of in vitro fertilization.

strana / page 75 1 3 ( 2 ) : 7 5 -7 9Jelena Cekovic, Olivera Laban APSTRAKT Ekstrofija mokraćne bešike je teška i retka kongenitalna malformacija. Javlja se u tri klinička oblika: inkompletna, kompletna ili klasična (extrophio -epispadio complex) i treća, najteža, kloakalna ekstrofija, koja je često inkopatibilna sa životom zbog pridruženosti sa anomalijama drugih organskih sistema. Iako je modernizacija ultrazvučnih aparata omogućila veliki napredak u dijagnostici, a veliki broj kontrola i adekvatan nadzor trudnice, postoje i danas posebne okolnosti kada je limitirana vizualizacija fetusa. Važno je, međutim, vešto voditi porođaj bez dodatnih akušerskih komplikacija kao i da neonatološko zbrinjavanje deteta bude adekvatno jer od njegove vitalnosti (osim od same anomalije) zavisi i krajnji operativni ishod. Prikazan je slučaj ženskog deteta rođenog u Ginekološko -akušerskoj Klinici u Kragujevcu sa klasičnom ekstrofijom mokraćne bešike i epispadijom koje smo pratili do trećeg meseca života. Zahvaljujući timskom radu ginekolog -neonatolog -dečji hirurg -pedijatar može se obezbediti uspešan operativni ishod uz očekivane manje komplikacije. Najvažnije je da dete ima ocuvan psihomotorni razvoj i izvesnu mogućnost kvalitetnog života.Ključne reči : eurogenitalne abnormalnosti; ekstrofija bešike; epispadija. ABSTRACTBladder exstrophy is difficult and rare congenital malformations. Occurs in three clinical forms: incomplete, complete or classic (exstrophy-epispadias complex) and third, cloacal exstrophy which is a much more severe abnormality, with significant involvement of other organ systems. The modern ultrasound devices allow great advances in the diagnosis, a large number of controls and adequate monitoring of pregnant women. However, there are still special circumstances without appropriate visualisation of the fetus. It is important to keep delivery without additional obstetric complications as well as neonatology care . The final outcome of operation depends of child vitality and the anomaly itself. The case shows of a female child born in Gynecology-Obstetrics clinic in Kragujevac with classic bladder exstrophy and epispadias that we followed until third month of life. Team of gynecologist -neonatologist -pediatric surgeon -pediatrician can provide successful surgical outcome and prevent complications. The most important is that the child has preserved psychomotor development and the possibility of certain quality of life.