Krešimir Šantić

Histopathological placental inflammation provides objective evidence of intrauterine inflammatory exposure in preterm birth, but placental histopathology i

To analyse placental changes in infants’ gestational age < 34 weeks and its correlation to short-term respiratory outcomes or death until hospital discharge. Information regarding all in-house born preterm infants born before 34 weeks gestation and born from January 2009 until December 2014 were collected and included among others, placental pathology and relevant data on demographics and outcomes of infants. Placental abnormalities was found in 157/253 (65.05%) cases. Acute placental inflammation was found to be the most common in both groups of premature neonates, followed by maternal vascular underperfusion. Maternal vascular underperfusion was significantly more common in GA ≤ 27 weeks compared to infants GA 28–33 weeks (35.2% vs. 13.7%; p = 0.018). Similarly, chronic placental inflammation was more common in infants GA ≤ 27 weeks compared to infants GA 28–33 weeks (14.3% vs. 3.3%; p = 0.014). Infants with placental pathology had a lower median birth weight (1460g vs. 1754g; p = 0.001, and were of shorter median GA at birth (31 vs. 32; p = 0.001). Infants with any placental disease had higher rates of death until hospital discharge (10.2% vs. 3.1%; p = 0.039) and higher rates of any stage of bronchopulmonary dysplasia (41.4% vs. 26.0%; p = 0.013). There were no significant differences in mechanical ventilation rates, duration of mechanical ventilation and duration of supplemental oxygen therapy. Identifiable placental abnormalities were found in most infants born < 34 weeks gestation. Placental pathology is associated with increased rates of bronchopulmonary dysplasia and death until hospital discharge.

Introduction: Saul Wilson syndrome (SWS) is a rare congenital syndrome characterized by a variety of symptoms, mostly skeletal changes. Saul and Wilson were the first to describe children with extremely short stature and craniofacial dysmorphism. Case report: We present a case of a 15-years-old boy with clinical and radiological characteristics of SWS. Genetic examination identified a pathogenic heterozygous variant in the COG4 gene. Magnetic resonance imaging revealed a critical stenosis of the cranio-cervical junction (CCJ) which required surgical treatment to attempt sufficient neurological decompression. The patient underwent decompression of CCJ under general anesthesia. There was no significant radiological and clinical improvement during the postoperative period. Conclusions: SWS is presented as an extremely rare congenital disease in children. The clinical condition of our patient confined surgical possibilities, therefore further treatment in such patients should be appropriately evaluated.

Fetal hydrops is an accumulation of fluid in more than one extravascular space. Congenital chylothorax is a rare cause of non-immune fetal hydrops, and the prognosis is generally very poor. There is no consensus on the optional treatment of congenital chylothorax. Conservative treatments (low-fat high-protein diets with medium-chain triglycerides, total parenteral nutrition) and surgical interventions are performed. There is mounting evidence for the use of octreotide (a somatostatin analog) in cases nonresponsive to conservative treatment, but no specific recommendation as to the dose and the length of therapy exist so far. We report a male, late preterm newborn, with a birth weight of 3600 grams, born to a Caucasian 28-year-old secundigravida via cesarean section because of poor fetal biometric markers at 35 3/7 week gestation. Neonate was born with congenital chylothorax and severe non-immune hydrops. After the therapeutic failure of enteral low long-chain triglyceride formula and full parenteral nutrition in reducing chyle leak, the patient was treated with octreotide and shown rapid improvement. We conclude that octreotide treatment is a plausible therapeutic option before surgical treatment in patients with congenital chylothorax.

Background: The stigmatization of viral patients is primarily a negative attitude and a common opinion about people suffering from various infectious diseases of the viral etiology and their consequences. The belief and the attitude that individuals are not socially acceptable because potentially spreading contagion for the outcome has negative discrimination in our society. Often such persons are excommunicated, which extends through all the social layers and ages. Methods: The PubMed, ScienceDirect, and SpringerLink databases were used for the research. Keywords stigma, viral infection, infected patient, discrimination, isolation were entered to identify papers dealing with a viral infection, and stigmatization. Results: After screening available databases in the last five years according to the selected keywords, the PubMed database yielded nine articles, the ScienceDirect identified initially 87 articles, SpringerLink identified 42 articles. Viral infection and stigmatization are of interest to numerous scientists. Conclusion: The availability of information should create empathy and ensure openness to diversity. Following the available literature, we understand that the biggest problem today is the social exclusion of people due to their viral illness, but equally the self-isolation of those infected due to the fear of being rejected and the misunderstanding of people from the environment.