Introduction. Splenic abscess is a very rare extra-intestinal complication of Salmonella infection in the post-antibiotic era with the incidence between 0.14% and 2%. It usually follows bacteremia due to varied etiologies such as trauma, infective endocarditis, intravenous drug abuse, immunodeficiency status (AIDS, diabetes mellitus). Case report. An 82-year-old woman presented with complaints of upper abdominal pain, fever and nausea for two weeks following abdominal trauma. Computed tomography scan of the abdomen showed hypodense lesion measuring 110 x 80mm (CCxLL), with minimal peripheral contrast enhancement, diagnosed as a splenic abscess. The patient underwent an ultrasound and X-ray guided percutaneous needle aspiration to collect a sample of pus for microbiological analyses, and in the next step, percutaneous drainage was performed. Salmonella enteritidis was isolated from the culture; the isolate was sensitive to ampicillin, ciprofloxacin, and third-generation cephalosporins. The initially started empiric therapy with amikacin was replaced by cefriaxone. After one month, the patient was discharged for home treatment. During the six-month followup, there were no recurrent symptoms and a follow-up CT scan showed a normal-sized spleen with thin, low-density zones under the capsule-sequels of inflammation. Conclusion. Only a few cases of splenic abscess caused by Salmonella enteritidis have been described in the literature and they were mostly treated with splenectomy. This case of a rare splenic abscess due to Salmonella enteritidis was treated successfully with a combination of percutaneous drainage, prolonged antibiotic therapy, and intensive care.
Introduction/Aim. Rhabdomyosarcoma (RMS) is the most common soft tissue sarcoma in pediatric population and adolescents. Limited data is available on the characteristics of RMS in Iraqi pediatric patients. The aim of the study was to examine the clinical and histological aspects of RMS in Iraqi children, with a focus on their response to treatment, prognosis, and survival. Methods. A retrospective cohort study was conducted at the Oncology Unit of Children's Welfare Teaching Hospital, Medical City, Baghdad, Iraq and included patients who were newly diagnosed with RMS and received treatment during the period between January 1, 2015, and December 31, 2019. The patients were followed up from the time of diagnosis until October 1, 2020. Results. A total of 59 patients were included with a median age of 3.5 years ranging between 1-12 years, with a male-to-female ratio of 3.2:1. The most frequent clinical presentation was urine retention in 15 patients (25.4%), followed by proptosis in 14 (23.7%) patients. However, the main sites of involvement were the head and neck in 23 (39%) patients, followed by the trunk and the genitourinary tract observed in 17 (28.8%) and 15 (25.4%) patients, respectively. The alveolar type, found in 11 (18.7%) patients, was the most prevalent histological variety, followed by the embryonal type reported in 42 (71.3%) patients, whereas six patients (9.7%) had other varieties. Of the 49 patients included in the prognosis assessment, 18 patients (36.7%) had a complete response, 20 patients (40.8%) died, and 11 patients abandoned treatment. The average duration of disease recurrence was 21.3 months, with a 7% recurrence rate. The overall survival rate was 36.7%, with a mean survival duration of 14.1 months. Conclusions. Pediatric RMS in Iraq is primarily prevalent in males. There is a significant delay in disease diagnosis from the onset of the symptoms. A high rate of advanced-stage disease may relate to patients reluctant to discontinue treatment. The low disease-free survival rate is due to impediments that hindered the effectiveness of therapy.
Introduction/Aim. Artificial intelligence (AI) offers transformative potential in healthcare management by enhancing predictive analytics, optimizing resource allocation, and supporting clinical decision-making. This study aims to examine the applications of AI in Serbian healthcare institutions, focusing on improving operational efficiency and patient outcomes. Methods. The research employed a cross-sectional survey conducted among 450 healthcare professionals from various levels of healthcare in Serbia (primary, secondary, and tertiary). Data were collected via an online survey during October and November 2024. Statistical analysis included methods such as ANOVA and regression analysis to evaluate the impact of AI on diagnostic accuracy, resource optimization, and patient satisfaction. Results. The study found that AI implementation positively impacts diagnostic accuracy (88% of respondents), resource optimization (82%), and patient satisfaction (79%). Differences were observed between urban and rural areas, as well as between public and private healthcare institutions. Major challenges identified include the lack of training (75%), data privacy concerns (68%), and limited infrastructure (70%). Conclusion. The study confirms that AI holds significant potential to improve healthcare in Serbia, particularly in urban and private institutions with better infrastructure. However, addressing challenges related to training, data privacy, and infrastructure is crucial, especially in rural areas. A phased approach to AI implementation is recommended, focusing initially on diagnostics and resource management to maximize healthcare performance.
Burns represent one of the leading causes of morbidity and mortality in children. Aim. Aim of this review is to gain better understand of the pathophysiological changes and assessment of the severity of burn injuries in different ages of pediatric patients, which may help in early implementation of appropriate therapeutic procedures and improvement of the outcome of these patients. Children are more likely to develop wider and deeper burns, greater fluid and heat loss in comparison to adults. Therefore, the initial assessment of the TBSA and the depth of the burns in children are crucial for their further treatment. The most important approach in the treatment of children with burn injuries includes the management of airways, effective fluid resuscitation, pain control, and prevention of infection. In the current review we sought to provide recommendations that might help improve the assessment of the severity of burns in children, which may be important for improving their recovery and reducing mortality rate. DOI of the original article: 10.5937/afmnai42-53854 Erratum DOI: 10.5937/afmnai41-62369
Introduction/Aim. Glioblastomas (GBMs) are among the most vascularized human tumors and the presence of microvascular proliferation is one of the diagnostic hallmarks of these malignancies. The aim of the present study was to investigate the extent of vascularization and its relation to proliferative activity and the p53 status in GBMs. Methods. Tissue samples from 100 selected primary GBMs were analyzed by immunohistochemistry for the expression of CD34 in vascular endothelial cells and Ki-67 antigen (using the MIB-1 antibody) and p53 in tumor cells. The microvessel density (MVD), a measure of the extent of tumor vascularization, was evaluated in CD34-immunostained sections in three hot spots and presented as the mean for each tumor specimen. Results. We found that the high MVD was more frequent in tumors showing the high MIB-1-labeling index (MIB-1 LI) as compared to those with the low MIB-1 LI, but the difference was not statistically significant. Also, the extent of vascularization did not differ significantly between p53-negative and p53-positive tumors. Both the level of MVD and the proportion of GBMs with low versus high MVD did not differ significantly in relation to the expression levels of p53 (low vs. high or overexpression). No association was found between MVD and tumor cell MIB-1 LI and the p53 status in primary GBMs. Conclusion. These data suggest that the effect of p53 on primary GBM vascularization failed to detect possibly due to the influence of certain factors, including the presence of other or additional molecular alterations in the tumor cells and the hypoxic microenvironment of tumors. They also support the hypothesis that the effect of p53 on angiogenesis may be tumor-type specific.
