Purpose: The aim of this study is to investigate the spectrum of neurological triad improvement in patients with diffuse intrinsic pontine glioma (DIPG) treated by reirradiation (re-RT) at first progression. Methods: We carried out a re-analysis of the SIOP-E retrospective DIPG cohort by investigating the clinical benefits after re-RT with a focus on the neurological triad (cranial nerve deficits, ataxia, and long tract signs). Patients were categorized as “responding” or “non-responding” to re-RT. To assess the interdependence between patients’ characteristics and clinical benefits, we used a chi-square or Fisher’s exact test. Survival according to clinical response to re-RT was calculated by the Kaplan–Meier method. Results: As earlier reported, 77% (n = 24/31) of patients had any clinical benefit after re- RT. Among 25/31 well-documented patients, 44% (n = 11/25) had improvement in cranial nerve palsies, 40% (n = 10/25) had improvement in long-tract signs, and 44% (11/25) had improvement in cerebellar signs. Clinical benefits were observed in at least 1, 2, or 3 out of 3 symptoms of the DIPG triad, in 64%, 40%, and 24%, respectively. Patients irradiated with a dose ≥20 Gy versus <20 Gy may improve slightly better with regard to ataxia (67% versus 23%; p-value = 0.028). The survival from the start of re-RT to death was not different between responding and non-responding DIPG patients (p-value = 0.871). Conclusion: A median re-irradiation dose of 20 Gy provides a neurological benefit in twothirds of patients with an improvement of at least one symptom of the triad. DIPG patients receiving ≥20 Gy appear to improve slightly better with regard to ataxia; however, we need more data to determine whether dose escalation up to 30 Gy provides additional benefits.

This study was designed to determine the effectiveness of group activity therapy as a school based intervention with fourth and fifth grade preadolescents with learning disabilities experiencing behavior problems. The group activity therapy intervention followed humanistic principles and was designed to address the cognitive and social emotional needs of this population. The preadolescents were provided a variety of developmental appropriate materials and activities to encourage self expression and group interaction. The 24 volunteer preadolescents were randomly assigned to the experimental group (n=12) and to the control group (n=12). The treatment group preadolescents were divided into groups of three and participated in group activity therapy one hour per week for 12 weeks. The participants were assigned to groups according to individual needs and personality traits. The control group received no treatment during the study. Pre and post test data were collected from parents using the Child Behavior Checklist (CBC) and the Behavior Assessment Scale for Children (BASC). Analysis of Covariate (ANCOVA) was utilized to determine statistical significance between the treatment group and the control group on the post-test means for each hypothesis. In each case, the post-test specified in each hypothesis was used as the dependent variable and the pre-test as the covariate. Specifically, the preadolescents in the treatment group showed statistically significant decreases in total behavior problems on the BASC (p=.05) and decreases in internalizing problems on both the BASC and CBC (p=.03, p=.05, respectively). While not statistically significant, positive trends were noted on the CBC total behavior scale (p=.08) and on the CBC externalizing scale (p=.09). In addition, Cohen's d effect size was calculated for each hypothesis and post hoc analysis of the subscales to determine practical significance of the treatment on the experimental group when compared to the control group. A large treatment effect size was found on the BASC (d=.91) and CBC (d=.82) total behavior problems scales and on the BASC (d=1.03) and CBC (d=.90) internalizing problems scales. A moderate to large treatment effect size (d=.78) was found on the CBC externalizing problems scale and a medium treatment effect size (d=.53) was found on the BASC externalizing problems scale. Qualitative data was also examined to determine clinical significance of the intervention. This study determined that group activity therapy is an effective intervention for preadolescents diagnosed with a learning disability.

Submitted by SBI Biblioteca Digital (sbi.bibliotecadigital@puc-campinas.edu.br) on 2017-02-15T13:09:03Z No. of bitstreams: 1 FERNANDA SEYR POZZA.pdf: 3157840 bytes, checksum: 13e75c72246a5b3271c74c20cb5bf791 (MD5) / Made available in DSpace on 2017-02-15T13:09:03Z (GMT). No. of bitstreams: 1 FERNANDA SEYR POZZA.pdf: 3157840 bytes, checksum: 13e75c72246a5b3271c74c20cb5bf791 (MD5) Previous issue date: 2016-12-05 / Coordena??o de Aperfei?oamento de Pessoal de N?vel Superior - CAPES / Background: For any intervention in a population, we need to understand its characteristics and needs. Monitoring of health in childhood and adolescence can be done by the Body Mass Index (BMI). In anthropometry, this index is used due to its low cost, ease of obtaining and other factors. The School Health Program (PSE) is a federal proposal for the improvement of the population quality of life by integrating health and education areas, to address vulnerabilities that affect the development of students from public schools. Early health monitoring can alert to prevent the progression of excess weight in adulthood, as in Brazil the nutrition transition is occurring as already occurred in developed countries. Objective: To evaluate the nutritional status of children and adolescents accompanied by the School Health Program in Itatiba-SP, in 2014. Methods: Cross-sectional study about the prevalence of nutritional status, with 6.829 schoolchildren aged 0-15 years who participated in the PSE. We made comparisons between gender, age and location. We elaborated specific BMI curves for this sample, which were compared to the WHO BMI reference curves. Results: In the sample, 50.3% were female. In children younger than 5 years, the prevalence of overweight was 37.9%, between ? 5 to <10 years it was 33.9%, and ? 10 years was 34.0%. In females, there was a higher prevalence of overweight (18.2%), whereas in males, obesity and severe obesity were more prevalent, 10.7% and 3.7%, respectively, compared to girls (9.5% and 1.9%) (p<0.001). For older children, preteens and teenagers, we found that girls of 11, 13 and 14 years old had higher mean BMI compared to boys of the same age (p <0.05). Regarding location, it was found that the region with the highest income showed higher prevalence of excess of weight. Considering the WHO BMI reference curves, the cutoff point from underweight to eutrophic, was similar to the standard BMI curve of our sample. However, at cutoff points between normal weight and overweight, the curve showed a higher standard. Conclusion: From our results, we found that simple anthropometric data (weight and height of students), could contribute to the assessment of nutritional status of schoolchildren, as well as providing health monitoring, and assisting in making public health decisions, also serving as comparison to other scientific studies. / Introdu??o: Para qualquer interven??o a um grupo populacional necessita-se compreender suas caracter?sticas e necessidades. O acompanhamento do estado nutricional na inf?ncia e na adolesc?ncia pode ser feito pelo ?ndice de Massa Corporal (IMC). Este ?ndice ? utilizado pelo baixo custo, simplicidade de realiza??o e outros fatores. O Programa Sa?de na Escola (PSE) ? uma proposta federal para a melhoria da qualidade de vida da popula??o brasileira ao integrar a educa??o ? sa?de, para enfrentar as vulnerabilidades que comprometem o desenvolvimento dos escolares da rede p?blica de ensino. O acompanhamento da sa?de precocemente alerta para evitar a progress?o do desvio nutricional na vida adulta, uma vez que no Brasil ocorre a transi??o nutricional. Objetivo: Avaliar o estado nutricional de crian?as e adolescentes acompanhados pelo PSE em Itatiba-SP em 2014. M?todo: Estudo transversal sobre preval?ncia dos Estados Nutricionais, com 6.829 escolares de 0 a 15 anos pertencentes ao PSE. Foram feitas compara??es entre g?nero, idade e localiza??o. Curvas de IMC espec?ficas dessa amostra foram comparadas com as curvas de refer?ncia da Organiza??o Mundial da Sa?de. Resultados: Na amostra, 50,3% eram do g?nero feminino. Nas crian?as menores que 5 anos, a preval?ncia de excesso de peso foi de 37,9%, entre ? 5 e < 10 anos foi de 33,9% e nos ? 10 anos foi de 34,0%. No g?nero feminino houve maior preval?ncia de sobrepeso (18,2%), ao passo que, no g?nero masculino, a obesidade e a obesidade grave estiveram mais presentes, 10,7% e 3,7%, respectivamente, se comparados ?s meninas (9,5% e 1,9%) (p<0,001). Para as crian?as mais velhas, pr?-adolescentes e adolescentes, encontramos que as meninas de 11, 13 e 14 anos apresentaram m?dia de IMC mais elevada se comparadas aos meninos de mesma idade (p<0,05). Em rela??o ? localiza??o, verificou-se que a regi?o com maior rendimento apresentou maior preval?ncia de excesso de peso. Considerando as curvas de refer?ncia da OMS, no ponto de corte de magreza para eutrofia, a curva padr?o da amostra estudada foi semelhante. No entanto, no ponto de corte entre eutrofia e sobrepeso, a curva apresentou um padr?o mais elevado. Conclus?o: A partir dos resultados pode-se verificar que dados de relativa simplicidade para aferi??o (peso e altura de escolares) contribuem na constata??o do estado nutricional, proporcionam o monitoramento da sa?de e auxiliam no subs?dio para tomadas de decis?es em sa?de p?blica ? comunidade, bem como servem como base de compara??o aos demais estudos cient?ficos.

Diss. (sammanfattning) Umeå : Umeå universitet, 2005. / Härtill 4 uppsatser. S. 77-87: Bibliografi.

Diss. (sammanfattning) Umeå : Umeå universitet, 2005. / Härtill 4 uppsatser. S. 72-83: Bibliografi.

Dissertation (Ph.D.)--University of South Florida, 2008. / Title from PDF of title page. Document formatted into pages; contains 118 pages. Includes vita. Includes bibliographical references.

Thesis (Ph.D. in Epidemiology) -- University of Colorado Denver, 2007. / Typescript. Includes bibliographical references (leaves 95-109). Free to UCD affiliates. Online version available via ProQuest Digital Dissertations;

214f. / Submitted by Suelen Reis (suziy.ellen@gmail.com) on 2013-04-30T16:47:16Z No. of bitstreams: 2 Tese Aldalice Alves2.pdf: 555642 bytes, checksum: 71f62edba99b5f6382554a598bc6aa0c (MD5) Tese Aldalice Alves1.pdf: 5330422 bytes, checksum: 996a664ffdeca89995ec1aebb1131aab (MD5) / Approved for entry into archive by Rodrigo Meirelles(rodrigomei@ufba.br) on 2013-06-06T19:03:08Z (GMT) No. of bitstreams: 2 Tese Aldalice Alves2.pdf: 555642 bytes, checksum: 71f62edba99b5f6382554a598bc6aa0c (MD5) Tese Aldalice Alves1.pdf: 5330422 bytes, checksum: 996a664ffdeca89995ec1aebb1131aab (MD5) / Made available in DSpace on 2013-06-06T19:03:08Z (GMT). No. of bitstreams: 2 Tese Aldalice Alves2.pdf: 555642 bytes, checksum: 71f62edba99b5f6382554a598bc6aa0c (MD5) Tese Aldalice Alves1.pdf: 5330422 bytes, checksum: 996a664ffdeca89995ec1aebb1131aab (MD5) Previous issue date: 2009 / A presente pesquisa teve como objetivo verificar o efeito de um atendimento pedagógico, desenvolvido por equipe formada por profissionais de saúde e professores de escolas, junto a crianças e/ou adolescentes internados em um hospital do município de Itabuna-Bahia. Buscou-se a reafirmação empírica do papel dessas intervenções na atenção ao bem estar biopsicossocial da criança, na promoção da aprendizagem e na diminuição de agravos à saúde decorrentes de sua hospitalização prolongada. Trabalhamos com um grupo de vinte crianças e/ou adolescentes hospitalizados e implantamos um programa de ações educativas (intervenção), objetivando observar alterações em seus quadros gerais. Avaliamos o grupo antes e após a intervenção, em um processo que, assim, se estendeu do mês de março de 2004 ao mês de março de 2006. Alguns teóricos que nos inspiraram nesse estudo foram: Wallon (1972); Piaget (1969); Lipp (2000); Lucarelli (2000); Haeussler e Milicic (1999); Damásio (2000); Morin (2000) ; Ceccim (1999); Ortiz (2001); Freitas (2001). Utilizamos na tragetória metodológica, uma abordagem qualitativa. Tratou-se de uma pesquisa quase-experimental, com avaliação “antesdepois”, com um único grupo. Na descrição dos dados coletados nas entrevistas, utilizamos a análise de conteúdo de Bardin (1977, p. 37). A análise dos dados nos mostrou que as crianças e/ou adolescentes hospitalizados mudaram o seu comportamento, graças à intervenção, confirmando a hipótese que norteou o trabalho. Antes demonstravam apatia, tristeza e, após as práticas realizadas, a emoção que vigorou foi a alegria, o sorriso presente e a aceitação ao tratamento. Concluímos, nesta pesquisa, que a existência no hospital, de uma equipe pedagógica ampliada, englobando o pessoal de saúde e o pessoal da escola, mantendo o ambiente, tanto quanto possível, de acordo com a necessidade da criança e/ou adolescente, propicia-lhes uma melhor adaptação ao meio hospitalar, contribuindo para o aumento do seu bem-estar e, assim, promovendo a recuperação e/ou minimização do seu problema de saúde. Este estudo se insere como um esforço para auxiliar a criança e/ou adolescente hospitalizado, tanto quanto a equipe do hospital e da escola que cuidam deles, as quais podem/devem aproveitar a situação de hospitalização como possibilidade de aprendizagem significativa, orientando-os no aprendizado escolar e para o desenvolvimento de consciência e responsabilização referentes aos seus processos de vida e saúde. / Salvador

<p>UVOD: Hronične inflamatorne bolesti se ispoljavaju kao Kronova bolest i ulcerozni kolitis. Njihova značajnost ogleda se u hronicitetu kao i u stepenu u kom ograničavaju rast i razvoj dece i omladine. Brojne su posledice ovih oboljenja: dugotrajno izostajanje sa nastave, ograničavanje životnih aktivnosti i pojava komplikacija koje neretko zahvataju i druge organske sisteme. Etiologija je i dalje nerazja&scaron;njenja navodeći kao značajan hronični inflamatorni proces u genetski uslovljenih pojedinaca a provociranih nekim infektivnim agensom. Početkom 21. veka genetska istraživanja su otkrila osnovu nasleđivanja hroničnih inflamatornih oboljenja povezanih sa NOD2 genom. Kako je u pitanju organskim sistem koji je ograničeno pristupačan kliničkom pregledu, osnovu dijagnostike čine radiolo&scaron;ke metode. Kako je potrebno sprečiti kontinuirano izlaganje &scaron;tetnom dejstvu rendgenskog zračenja istraživanja se usmeravaju ka UZ i magnetnoj rezonanca. Na&scaron;e istraživanje se baziralo na mogućnostima ovih dveju metoda u svakodnevnom radu za dijagnostiku i dalje praćenje hroničnih inflamatornih bolesti creva. CILJEVI: Utvrditi senzitivnost i specifičnost ultrazvučne dijagnostike i magnetne resonance kod upalnih oboljenja creva u dečjem i adolescentnom uzrastu. Definisati i uporediti prednosti i ograničenja ultrazvučne dijagnostike sa dijagnostikom magnetne rezonace kod upalnih obolenja creva u dečjem i adolescentnom uzrastu. MATERIJAL I METODE: U istraživanje je uključeno 62. dece i adolescenata u toku prvog ataka bolesti ili ponovljenim fazama bolesti ili tokom redovnog praćenja u remisiji. Obuhvaćeni uzrast je od 4. do 18. godina. Potom su razvrstani u grupe na osnovu vrste pregleda i prisustva zadebljanja crevnog zida na A i B (pregled UZ), gde je A grupa imala zabeleženo zadebljanje crevnog zida preko 3 mm, a kod dece u grupi B debljina crevnog zida je bila između 2,5-3 mm. Sa druge strane na osnovu pregleda magnetnom rezonancom podeljeni su u A1 i B1 grupe, takođe po kriterijumu zadebljanja crevnog zida većeg od 3 mm (A1), odnosno između 2,5-3 mm (B1). Istraživanje je sprovedeno na Institutu za zdravstvenu za&scaron;titutu dece i omladine Vojvodine i Institutu za radiologiju Kliničkog centra Vojvodine. Prvi pregled načinjen je UZ a potom je načinjen pregled magnetnom rezonanacom. Podaci su obrađivani retrospektivno i prospektivno. Kriterijumi za uključivanje u studiju pored uzrasta bili su radiolo&scaron;ki: zadebljanje crevnog zida &gt;3mm, postojanje naru&scaron;ene arhitektonike crevnog zida, zadebljanje pojedinih crevnih segmenata-dužina segmenta, znaci fibroze, odsustvo peristaltike, izražena hiperemija na kolor Doppleru, transmuralni znaci upale, uvećani mezenterijalni limfni nodusi kao i kontrolni pregledi kod dece sa ranije ustanovljenom dijagnozom. Načinjena je endoskopija sa biopsijom radi postavljanja definitivne dijagnoze, potom se pristupilo statističkoj obradi dobijenih podataka. Izračunate su prosečne i standardne devijacije i frekvencije kao i pripadajući procenti. Određivane su maksimalne i minimalne vrednosti, medijane i interkvartalni raspon. Dobijeni podaci prikazani su u grafikonima i tabelama. Za parametrijske varijable upotrebljavan je Man &ndash; Vitni U test. Za kategoričke vrednosti upotrebljeni su &chi;2 i Fi&scaron;erov test. Nadalje su određivane senzitivnost, specifičnost kao i pozitivne i negativne prediktivne vrednosti. Veze između dva parametra uspostavljene su pomoću Pirsonove korelacione analize i linearnim regresionim modelom. Upotrebljen je program za obradu podataka SPSS 21 Statistics,a kao statistički značajne vrednosti uzete su vrednosti p&lt;0,05. REZULTATI: Nakon statističke obrade nije zabeležena signifikantnost u pogledu zastupljenosti hroničnih inflamatornih bolesti među polovima. Statistička značajnost pronađena je u pogledu uzrasta dece u akutnoj fazi kao i remisiji bolesti. Statistička značajnost je dobijena za posmatranu debljinu crevnog zida, hiperemiju creva, prisustvo fibroze u digestivnom traktu. Primećeno je da UZ bolje razgraničava decu sa akutnim oboljenjem po pitanju zahvaćenosti segmenata. Ostala posmatrana obeležja nisu nakon statističke obrade imala statistički značaju razliku kada se procenjuju ultrazvučno ili magnetnom rezonancom. ZAKLJUČAK: Inicijalne hipoteze ovog istraživanja su nakon obrade podataka i potvrđene. Određivanjem senzitivnosti i specifičnosti UZ i MR dobijene su sledeće vrednosti: senzitivnost UZ je 88,4% naspram 92,3% koliko ima pregled magnetnom rezonancom. U pogledu specifičnosti UZ ima 88% a magnetna rezonanca 91,6%. Verifikovano je da magnetna rezonanca bolje razvrstava decu u akutnoj fazi bolesti kao i decu u remisiji. Rezultati pozitivnih i negativnih verovatnoća odnosa ne predviđaju neuspeh nijednim od ova dva pregleda.</p> / <p>INTRODUCTION: Chronic inflammatory diseases are manifested through two clinical entities: Crohn&#39;s disease and ulcerative colitis. Their significance lies in the chronicity and the degree to which they restrict the growth and development of children and youth. There are many consenquences that come with the very nature of the disease, in addition to long-term absence from school, limiting life activities and the occurrence of complications that often affect other organ systems. The etiology of the disease has long been in favor of the theory that a chronic inflammatory process in genetically conditioned individual is provoking an inflammation due to a certain infectious agent. However, a step closer was made regarding the etiology of the disease - when the genetic basis of inheritance studies have revealed chronic inflammatory bowel diseases were associated with NOD2 gene. It is particularly important to prevent continuous exposure to the harmful effects of X-rays. Therefore, numerous studies have been made towards the validation of complementarity, accuracy and diagnostic capabilities of ultrasound and magnetic resonance imaging as noninvasive techniques. Our research was based on the capabilities of these two methods in their daily work for diagnosis and follow-up of chronic inflammatory bowel disease. OBJECTIVES: The objectives were to determine the sensitivity and specificity of ultrasound and magnetic resonance imaging in inflammatory bowel disease in children and adolescents. Furthermore, the aim was to define and compare the advantages and limitations between ultrasound diagnosis and magnetic resonance in inflammatory bowel disease in children and adolescents. MATERIAL AND METHODS: The study included 62 children and adolescents during the first attack of disease or recurrent stages of the disease, or during regular monitoring in remission. Patients included children of both sexes, aged 4-18. Then they were sorted into groups based on the type of the examination and the presence of a thickening of the intestinal wall into groups A and B - in these groups children were examined by ultrasound, A group had observed thickening of the intestinal wall &gt; 3 mm whereas children in group B had had thickening of the intestinal wall between 2,5-3 mm. Based on the review of MRI children were divided into groups A1 and B1, also according to the criterion of bowel wall thickening greater than 3mm (A1) and between 2,5-3mm (B1). The research was conducted at the Institute for Health Protection of Children and Youth and the Institute of Radiology, Clinical Center of Vojvodina. The first review was made by ultrasound, followed by the review of magnetic resonance. Data were analyzed retrospectively and prospectively. Criteria for inclusion in the study were: thickening of the intestinal wall greater than 3 mm, the existence of disturbed intestinal wall architectural structure, no clear distinction of layers, abnormal thickening of certain intestinal segments, signs of fibrosis, the absence of peristalsis, expressed hyperemia on color Doppler, transmural inflammation, increased mesenterial lymph nodes as well as check-ups for children with previously established diagnosis. Endosccopy with biopsy has made for the definitive diagnosis and then we approached statistical analysis of the data obtained. The data are presented in graphs and tables. For parametric variables we used Man - Whitney U test. For categorical values &chi;2 and Fisher&#39;s test were used. Further the sensitivity, specificity and positive and negative predictive values were determined. Relationship between these two parameters were established using Pearson correlation analysis and linear regression model. For data processing we used the program SPSS Statistics 21, statistically significant values were taken p values &lt;0.05. RESULTS: After statistical analysis there was no for the number of chronic inflammatory diseases between the sexes. Statistical significance was found in terms of age of the children during the acute phase as well as remission. Statistical significance was obtained for the observed thickness of the intestinal wall, intestinal hyperemia, the presence of fibrosis in the digestive tract. It was noted that US better demarcates children with acute disease in terms of involvement of segments. Other features are not observed as significant after the statistical analysis. CONCLUSION: The initial hypothesis of this study, after data processing were confirmed. By determining the sensitivity and specificity of ultrasound MRI results we came to the following results: sensitivity of ultrasound was 88,4% versus 92,3%, for magnetic resonance. In terms of specifics UZ has a 88% and 91,6% of magnetic resonance imaging. The classification of children in the acute phase of the disease as well as children in remission was better when MRI was used. The results of positive and negative predictions do not predict the probability of failure in neither of these methods.</p>

<p>Uvod: Akutni apendicitis predstavlja jedno od najče&scaron;ćih abdominalnih hirur&scaron;kih oboljenja u dečjem uzrastu. Lečenje je operativno, primenom otvorene hirurgije ili primenom minimalno invazivne hirurgije tj. laparoskopske apendektomije. Iako je laparoskopska apendektomija, zbog svojih prednosti, stekla popularnost kod mnogih hirurga, jo&scaron; uvek nije &scaron;iroko primenjena metoda na na&scaron;im prostorima. Prednost izvođenja laparoskopske apendektomije u odnosu na otvorenu metodu u dečjem uzrastu je i dalje nedovoljno definisana i predmet je mnogih istraživanja. Cilj istraživanja je da se utvrdi da li je dužina hospitalizacije kod dece operisane laparoskopski zbog akutnog apendicitisa kraća u odnosu na otvorenu metodu, kao i da se utvrdi da li postoji razlika u pojavi postoperativnih komplikacija između ove dve hirur&scaron;ke metode. Pored toga, cilj istraživanja je i da se utvrdi uticaj obe metode lečenja na kvalitet života i brzinu uspostavljanja svakodnevnih aktivnosti. Metodologija: Na Klinici za dečju hirurgiju, Instituta za zdravstvenu za&scaron;titu dece i omladine Vojvodine, sprovedena je prospektivna, kontrolisana randomizirana studija, u trajanju od deset meseci, u koju su bili uključeni svi pacijenti sa akutnim apendicitisom, kod kojih je planirana apendektomija, a čiji roditelji su dali pismeni pristanak za uče&scaron;će u istraživanju. Svi ispitanici su podeljeni u dve osnovne grupe u odnosu na operativnu tehniku: otvorena i laparoskopska apendektomija. Potom su svi ispitanici podeljeni u tri podgrupe, u zavisnosti od stepena upaljenosti crvuljka (negativni, nekomplikovani i komplikovani apendicitis). Svaki ispitanik je imao svoj individualni protokol istraživanja gde su preoperativno zabeleženi: uzrast, pol, simptomi (vrsta i dužina), fizikalni pregled, laboratorijske analize (broj leukocita, hematokrit), ultrazvučni nalaz, procena op&scaron;teg stanja, udružena oboljenja, vreme od prijema do operacije, preoperativna antibiotska terapija. Intraoperativno je analizirano: vrsta hirurgije, nalaz na apendiksu, prisustvo peritonitisa, udružena patologija, dužina operacije i trajanje pneumoperitoneuma (kod laparoskopske apendektomije), patohistolo&scaron;ki nalaz apendiksa, bakteriolo&scaron;ki bris abdomena. Postoperativno su analizirani: antibiotska terapija (vrsta i dužina), započinjanje peroralnog unosa, utvrđivanje postoperativnog bola, febrilnost, uspostavljanje peristaltike creva, izgled rane, postoperativne komplikacije (infekcija rane, intraabdominalni apscesi, ileus) i dužina hospitalizacije. Posebno su analizirani kvalitet života pacijenata nakon operacije pomoću modifikovanog upitnika SF 10 za dečji uzrast, kao i uspostavljanje svakodnevnih aktivnosti pomoću Activity Assessment Scale (AAS), modifikovane za dečji uzrast, nakon svakog postoperativnog dana, prvih sedam dana, nakon mesec dana, tri i &scaron;est meseci od operacije. Svi pacijenti su operisani u uslovima op&scaron;te anestezije. Klasična, otvorena apendektomija je vr&scaron;ena kroz naizmenični rez u desnoj ilijačnoj jami. Po otvaranju peritoneuma, cekum je izvučen i načinjena je klasična apendektomija. Laparoskopska apendektomija je vr&scaron;ena kroz tri 5 mm porta. Pneumoperitoneum je kreiran otvorenom metodom po Hasson-u, kroz infraumbilikalnu inciziju, a preostala dva porta su postavljena desno i levo ilijačno. Mezenteriolum je zbrinut pomoću ultrazvučnih makaza. Postavljene su intrakorporalne ligature i apendiks je odstranjen kroz desni port. Rezultati: Tokom perioda od deset meseci operisano je ukupno 125 pacijenata uzrasta od 2 do 18 godina, zbog akutnog apendicitisa. Laparoskopskom tehnikom je operisano 60 pacijenata (48%), a otvorenom metodom 61 (48,8%). Kod 4 pacijenta je načinjena konverzija, tj. promena operativne tehnike iz laparoskopske u otvorenu metodu. Nije bilo statistički značajne razlike između terapijskih grupa u odnosu na stepen upaljenosti apendiksa, vrstu i dužinu trajanja simptoma, u dijagnostičkim procedurama, kao ni u vremenu proteklom od prijema u bolnicu do operacije. Srednje operativno vreme je iznosilo 65 minuta (25-185 min) za laparoskopsku grupu i 45,49 minuta (25-90 min) za otvorene apendektomije (razlika je statistički značajna, p&lt;0,001). Crevna peristaltika, kao i započinjanje peroralnog unosa, se statistički značajno ranije uspostavljaju u grupi laparoskopsko operisanih. U grupi laparoskopskih apendektomija, postoperativne komplikacije (infekcija rana i formiranje intraabdominalnih apscesa) su se javile kod 8,33% ispitanika (5/60), a u otvorenoj grupi kod 4.91%, (3/61), &scaron;to nije bilo statistički značajno (c2 = 0,152; df = 1; p = 0,696). Dužina hospitalizacije kod dece operisane laparoskopski je iznosila 5,95 } 1,21 dana, a otvoreno 6,43 } 1,09 dana, &scaron;to je statistički značajna razlika (t = -2,206; p = 0,029). Rezultati Man-Vitnijevog U testa su pokazali statistički značajno bolji ukupni skor svakodnevnih aktivnosti za grupu laparoskopskih apendektomija (Z = -7,608; p = 0,000). U svim ispitivanim indikatorima kvaliteta života, deca laparoskopske grupe su imala veći skor. Deca sa akutnim apendicitisom operisana laparoskopski značajno ranije postižu visok stepen kvaliteta života (t = 2,407; p = 0,018). Zaključak: Prednost minimalno invazivne hirurgije u terapiji akutnog apendicitisa u dečjem uzrastu ogleda se u bržem uspostavljanju ponovnog funkcionisanja gastrointestinalnog trakta, kraćoj hospitalizaciji, a samim tim i bržem sveukupnom oporavku, vraćanju svakodnevnim aktivnostima i dobrom kvalitetu života. Postoperativne komplikacije se podjednako javljaju, kako kod otvorene, tako i kod laparoskopske operativne tehnike.</p> / <p>Introduction: Acute appendicitis is one of the most common abdominal surgical diseases in children. Operative treatment means open surgery or minimally invasive surgery (laparoscopic appendectomy). Although laparoscopic appendectomy, gained popularity among many surgeons, it is still not widely accepted in our region. The advantage of laparoscopic appendectomy compared to the open method in children is still not sufficiently defined and is the subject of further research. The aim of the research was to determine whether the length of hospital stay after laparoscopic surgery in children with acute appendicitis is shorter compared to the open method, as well as to determine whether there is a difference in the occurrence of postoperative complications after these two operative techniques. In addition, the aim of the research was to determine the effect of both methods of treatment on quality of life and everyday functioning. Methodology: This prospective, randomized controlled study was performed at the Clinic for Pediatric Surgery, Institute of Children and Youth Healthcare of Vojvodina, during a period of ten months. All patients with acute appendicitis, whose parents have given written consent, were included in research. All patients were divided into two basic groups, in relation to the surgical technique: open or laparoscopic appendectomy. Then, all of them were divided into three groups, depending on the degree of appendicitis (negative, uncomplicated and complicated appendicitis). Each participant had their own individual research protocol where we recorded preoperatively: age, sex, symptoms (type and length), physical examination, laboratory tests (white blood cell count, hematocrit), ultrasound finding, general state (ASA classification), associated diseases, time from admission to surgery, preoperative antibiotic therapy. During the operation we analyzed: type of surgery, degree of the appendicitis, the presence of peritonitis, associated pathology, length of surgery and duration of pneumoperitoneum (in laparoscopic appendectomy), hystopathologic findings of the appendix, a bacteriology. Postoperatively we analyzed: antibiotic therapy (type and length), oral intake, postoperative pain, fever, establishing peristalsis, the appearance of postoperative complications (wound infections, intra-abdominal abscesses, ileus) and length of hospitalization. Especially, we analyzed the quality of life of patients after surgery using the modified questionnaire SF 10 for children; and the establishment of daily activities using Activity Assessment Scale (AAS), modified for children; after each postoperative day, the first seven days, one month, three and six months after surgery. All patients were operated under general anesthesia. Open appendectomy was performed through incision in the right iliac fossa. Peritoneum was opened, the cecum was pulled out and classic appendectomy was made. Laparoscopic appendectomy is performed through three 5 mm ports. Pneumoperitoneum was created by the Hasson techique, through the infraumbilical incision, and the remaining two ports are set at right and left iliac region. Mezenteriolum was ligated by ultrasonic scissors. After putting intracorporal ligature, appendix was removed through the right port. Results: Over a period of ten months we operated 125 patients , aged 2 to 18 years, due to acute appendicitis. Laparoscopic technique was performed in 60 patients (48%), and the open method in 61 (48,8%). In 4 patients the conversion was made (operative technique changed from laparoscopic to open method). There were no statistically significant differences between the treatment groups with respect to the degree of appendix inflammation, the type and duration of symptoms, the diagnostic procedures, as well as the time from hospital admission to the surgery. Medium operative time was 65 minutes (25-185 min.) for laparoscopic group and 45,49 minutes (25-90 min.) for open appendectomy (the difference is statistically significant, p&lt;0,001). Intestinal peristalsis, as well as the initiation of oral intake was significantly sooner established in the laparoscopic group. Postoperative complications (wound infections and intra-abdominal abscess formation In laparoscopic appendectomy) occurred after laparoscopy in 8,33% of patients (5/60), and in the open group in 4,91% (3/61), which was not statistically significant (c2 = 0,152, df = 1; p = 0,696). Length of hospital stay in children operated by laparoscopy was 5,95 } 1,21 days and by open technique 6,43 } 1,09 days, which is significantly longer (t = -2,206; p = 0,029). Results of the Mann-Whitney U test showed significantly better overall record of daily activities for a group of laparoscopic appendectomy (Z = -7,608; p = 0,000). In all tested indicators of quality of life, children from laparoscopic group had a higher score. Children with acute appendicitis treated by laparoscopic surgery achieved a high level of quality of life, significantly earlier (t = 2,407; p = 0,018). Conclusion: The advantage of minimally invasive surgery in the treatment of acute appendicitis in children is reflected in the faster re-establishment of functioning of the gastrointestinal tract, shorter hospitalization and therefore, a faster overall recovery, resuming normal activities and a good quality of life. Postoperative complications occur equally in both, open as well as in laparoscopic operative techniques.</p>