Childhood and Coress model of carcinogenesis.

INTRODUCTION: In the last fifty years the incidence of gastric cancer in developed countries is a constant trend, but mortality in all countries remains at the same level and ranks second behind lung cancer. In the case of gastric cancer has a far more important the role the early diagnosis compared to prevention. MATERIAL AND METHODS: The sample included 200 subjects aged 7-18 years treated at the Pediatric Clinic, University Clinic Tuzla and Pediatric Clinic and the Clinic for Child Surgery of Clinical Center of Sarajevo University who had endoscopic and histologically verified gastritis. The method of processing the tissue preparations of histologic sections of paraffin-fixed and paraffin tissue by hematoxylin-eosin method and Helicobacter pylori, using Giemsa. RESULTS AND DISCUSSION: Pathological analysis of the sample of patients with gastritis found that in 91% of patients had chronic superficial gastritis, while in 9% of patients were found atrophic changes, with or without intestinal metaplasia. Atrophic changes with or without intestinal metaplasia was found in 10.2% of H. pylori-positive patients with gastritis. The same analysis in a significant percentage of 5.7% of H. pylori-negative patients was atrophic changes, with or without intestinal metaplasia. Analysis of activity of the inflammatory process, we have found that the symptoms matched a statistically significant percentage (86.5%) with the active phase of the disease, which speaks against thinking that H. pylori infection is asymptomatic condition, which is often cited in the literature. CONCLUSION: Gastric mucosal lesion caused H. pylori infection is a reversible process and the eradication of this infection not only stops the activity of the inflammatory process, but also restores the mucous membranes. Eradication leads to a significant drop in the incidence of recurrence of gastritis and peptic ulcer disease, and can lead to prevention of malignant disease in 70-80% of cases, even, and perhaps more.

Early and correct diagnosis of celiac disease in the prevention of growth disorders and child development.

Coeliac, in ordinary people known as "flour allergy" and in medicine world known as gluten enteropathy which means enteric damage caused by gluten. Data about incidence of gluten enteropathy is different in different countries around the World and depend on is it or is it not the right diagnosis for enteric disorder. Sometimes, this disease is unrecognized because of unspecific clinical signs. This disease is happening in every moment of a lifetime, most common during the childhood when the children try to eat any food which contains gluten. Anyway, if children had no symptoms it doesn't¢t mean that disease not exists, and that¢is because we have to do diagnostic tests to confirm gluten enteropathy. Gluten intolerance is chronic disease and demand use of the specific non gluten food during the lifetime. Early diagnosis is right way to prevent unregularly growth. Aim of this study was to show the influence of early diagnostic about growth. For each patient we had a permission of parents and we showed our original results for three month we investigated.

[Ultrasonographic guidance of percutaneous drainage as a new method of treatment of echinococcal cysts]. / Perkutana drenaza pod kontrolom ultrazvuka novi nacin lijecenja ehinokokne ciste.

UNLABELLED: The aim of this work is to show possibilities of treating echinococcus cyst, with special emphasis on PAIR method, showing two different cases (hydatid and multilocular cyst). MATERIAL AND METHODS: In the period of three years in our department it has been treated 7 children who had cystic echinococcosis of different type, different localization, different number of cystic changes as well as different curing methods. Four patients were treated by PAIR method. Prior to all these patients were treated as per certain therapy scheme, conservatory by albendazole and then exposed to PAIR method. RESULTS: Two completely cured (Echinococcus granulosus), third(Echinococcus multilocularis) in final phase and fourth at the early beginning of cure treatment (E. granulosus). There were no complications such as febrile, rupture and possible dissemination. CONCLUSION: Hydatidosis is still primarily surgical disease but open surgical procedures are rapidly losing on their importance in therapy sense, comparing with new treating methods of percutaneous aspiration under sonographic and CT guidance, with pre-medication with albendazole.

[Association between chronic gastritis in childhood, Helicobacter pylori and ABO blood groups]. / Povezanost hronicnog gastritisa u djetinjstvu sa Helicobacter pylori i ABO krvnim grupama.

Gastritis can be defined in the simplest way such as inflammation of gastric mucous membrane. There are numerous causes of gastritis and the most often is Helicobacter pylori infection. Studying of the blood groups also includes the question of their connection with certain diseases. Up to date it has been explained the role that blood groups have in haemolytic disease of newborn infant but for other diseases we know little, it is insufficient or we know nothing. The aim of this work was to analyze connection of chronic gastritis in childhood, Helicobacter pylori and ABO blood groups. It has been treated 68 patients out of which 57 (83%) were Helicobacter pylori positive (Hp+) and 11 (17%) were Helicobacter pylori negative (Hp-). Thirty patients had chronic gastritis out of which 22 (73%) were Hp+ and 8 (27%) Hp-. It prevailed blood group A and O, comparing with other blood group phenotypes connected with gastritis.

[Monitoring fluid balance in pediatric intensive care]. / Monitoring bilansa tecnosti u pedijatriskoj intenzivnoj njezi.

The dynamic metabolism as far as bigger amount of water versus solid tissues in child demand much better skilfulness in calculating liquid input and excretion in intensive care. It is very important fact in prevention of life threatening conditions in children and adults, especially in conditions with multiorganic disorders, because their treatment is reciprocally opposite. Considering experiences of ICU UZ Gent-Belgium we made in Paediatric intensive care unit at Paediatric clinic in Tuzla unique method of monitoring liquid balance in children within specific conditions in which standard method of monitoring just the amount of planed liquid, body weight and diuresis is not reliable enough. With this new monitoring we prescribe dynamics of parenteral input of crystalloid and colloids as well as peroral income much more precise and much more confidence in positive result and prevention of harder disorders as well. In this paper we present our own method of observation as well as results in period July 1999. Till September 2002. We did the intensive volume control in 88 or 45 of total number of 2255 patients treated in PICU in this period. We followed the liquid balance 399 days or 9576 hours. Primary nephrologic diseases were indication for balance in 17 or 19.3% children, while in other 71 or 80.6% children, were other diseases like cardiac failure, diabetic ketoacidosis, chronic systemic diseases, the Toxic shock syndrome, the conditions of intracranial hypertension. We notice the signs of threatening renal failure in 7 or 7.9% of children and signs of manifesting renal failure in 10 or 11.3%. Our experiences tell that the model we made is applicable in working conditions of ICU. Evidence of organism responds the planned input is much better and safer than in standard way of observation. The possibility of in time intervention against threatening renal failure as well as other organic disorders is much greater. We recommended this model for all life threatening conditions in Paediatric intensive care units.