Aortic coarctation surgery in pediatric patients requires the placement of two arterial cannulas to monitor pressure gradients and surgical correction adequacy. Near-infrared spectroscopy (NIRS) monitoring provides insight into regional blood flow. This study aimed to investigate the correlation between NIRS values and invasive arterial pressures, exploring NIRS monitoring as a potential substitute for arterial cannulation. In a cohort of 21 consecutive pediatric patients undergoing aortic coarctation surgery, recordings of NIRS and invasive arterial pressure values were evaluated at various time intervals. Pearson correlation evaluated the relationship between NIRS values and invasively measured arterial pressures. Moderate to strong correlations were observed between the mean arterial pressure (MAP) of the upper and lower arteries and cerebral (rSO₂-C) and somatic (rSO₂-S) NIRS values 5 min after cross-clamp placement (r = 0.621, p = 0.003; r = 0.757, p < 0.001). Strong correlations were found 15 min after cross-clamp placement (r = 0.828, p = 0.002; r = 0.783, p = 0.004). Before transfer to the ICU, a strong correlation existed between the upper artery MAP and rSO₂-C (r = 0.730, p < 0.001), but there was no correlation between the lower artery MAP and rSO₂-S. These findings are promising, but further studies are required to validate it as a reliable substitute for invasive pressure monitoring in this patient population.

In general pediatric surgical population, the incidence of perioperative 30-day mortality is low. A child's physical status at the time of elective surgery and the presence of comorbidities can notably impact the perioperative risk. In order to provide quality care, preoperative evaluation should be undertaken in a timely and thorough manner. In preoperative period, it is highly important to be able to identify the patients who are at a higher risk, with the premise that early identification of these patients will allow for additional care to be provided, thereby minimizing possible complications. The main objectives of adequate preoperative assessment are to evaluate patients' readiness for the procedure, optimize patients' health status before surgery, reduce surgical morbidity, and help patients regain their usual functions postoperatively. Routine prescription of additional tests in children should be replaced by selective and rational prescriptions, based on the patients' history and performed clinical evaluation. Surgical and anesthetic complications can have adverse effects on patients' health, and they have also been proven to be associated with increased inpatient and postoperative costs. Each member of the surgical team plays a vital role in the safe care of pediatric patients. Well known risk factors for critical events in the perioperative period in pediatric population are as follows: ASA physical status, age, emergency surgery, and the existence of an underlying disease. This review highlights potential risks encountered in children and directs preoperative assessment towards selecting essential tests based on identified individual risk factors.

Introduction: Thyroid gland cancer is a rare malignancy in the male population, accounting for up to 2% of all cancers, but it is the most common cancer of the endocrine system, making up to 95% of all estimated new endocrine cancer cases each year. Recent studies suggested an important role of both environmental and genetic factors in cancerogenesis. 3-Phosphoglycerate dehydrogenase (3-PHGDH) gene overexpression is associated with pathogenesis of human cancer and contributes to cell proliferation. Aim: To asses the association of PHGDH gene polymorphism in the group of patients with thyroid gland cancer and the control group of healthy men. Materials and methods: The study encompassed 80 men diagnosed with thyroid gland cancer in Center for Endocrine Surgery, Clinic for Endocrinology, Diabetes and Metabolic Diseases, Clinical Center of Serbia and 100 healthy male volunteers. The DNA was isolated from the peripheral blood with solting out method. The genotypes of 3-PHGDH polymorphism were determined by Polimerase Chain Reaction (PCR) and Restriction Fragment Lenght Polymorphism (RFLP). Gel-electrophoresis was used to separate DNA fragments. Results: There was a statistically highly significant difference between frequencies for genotype distribution of rs541503 polymorphism in patients with thyroid gland cancer and healthy volunteers (χ2 = 38.924; p=0.001). We found that in patients with thyroid gland cancer, the most common genotype is TT and in the control group TC. Major Allele Frequency (MAF (C)) in the control group in our study was 0.61. In patients with carcinoma of the thyroid gland MAF (C) was almost twice lower at 0.31. Allele frequencies in a group of patients with thyroid gland carcinoma compared to the control group showed a statistically significant difference (χ2 = 18.1159; p = 0.001). Conclusion: C allele could be a protective factor in the prevention of the thyroid gland cancer. People with TT genotype are six times more likely to develop thyroid cancer compared to those with the CC genotype.