(1) Background: A Monteggia fracture is an infrequent injury in children. It can be missed during an initial consultation in 20–50% of patients. Chronic radial head dislocation may lead to several complications. Thus, surgical reconstruction of chronic Monteggia injuries is justified. The aim of this study is to analyze the single tertiary center experience in the treatment of neglected Monteggia fractures. (2) Methods: A retrospective study of patients treated for missed Monteggia fractures was conducted. Hospital records, operative charts, follow-up records and a set of X-rays were analyzed for each patient. Radiographic results were graded as good, moderate or poor. The functional status of elbows was estimated using the Mayo Elbow Performance Index. (3) Results: A total of 13 patients (8 boys and 5 girls) aged 4–12 years (mean 7.15) were treated during the study period. An angulation osteotomy of the ulna was performed in ten patients and a radial shortening osteotomy in three patients. A Bell–Tawse annular ligament reconstruction was performed in five patients, and a direct repair was performed in two patients. Eight patients had radiocapitellar trans-fixation. There were nine good radiographic results, three moderate and one poor. The functional result was excellent in nine patients, good in three and poor in one. (4) Conclusions: Our work has many limitations (only 13 patients and different types of operations), and conclusions should be drawn very carefully from such a small and diverse group. The surgical reconstruction of neglected Monteggia fractures in children should be attempted in all patients. Angulation and elongation osteotomies of the ulna are suitable for most patients. If there is a marked overgrowth of the radius, gradual ulnar lengthening and radial head reduction using the Ilizarov method may be a better option. Annular ligament reconstruction is not mandatory.

Objectives: We aimed to identify characteristics of juvenile idiopathic arthritis (JIA) patients associated with good self-management skills in the transition readiness process and to investigate the readiness of JIA patients and their families for the transition into the adult healthcare system. Patients and methods: Between March 2021 and June 2021, a total of 44 JIA patients (9 males, 35 females; median age: 15.1 years; range, 12.3 to 19.3 years) admitted to the pediatric rheumatology outpatient and inpatient clinics and their parents were included. Transition Readiness Assessment Questionnaire (TRAQ) was cross-culturally adapted. The TRAQ was administered to all JIA patients and their parents at one point. Demographic and clinical data were collected. Results: Fourteen (31.8%) of 44 JIA patients had a concomitant disease, while 10 (22.7%) of them had uveitis. Eleven (25%) of them had a family history of autoimmune diseases. In total, 21 (47.7%) of JIA patients were receiving biologics. There was a strong correlation between older age and total TRAQ scores among patients (ρ=0.799, p

Background and Objectives: The immunological function of the appendix, as part of the gut-associated lymphoid tissue, and its immunological importance in developing and maintaining the intestinal immune system are not yet clearly understood. Therefore, we sought some answers by analyzing the lymphocyte population in appendiceal specimens and inflammatory markers from peripheral blood. Materials and Methods: After histopathological examination of appendiceal specimens, immunohistochemical analysis of lymphocyte subtypes CD8, CD19, and CD20 in appendiceal specimens was performed, and a panel of commercially available mouse monoclonal antibodies was used to detect immunopositivity. hematological and biochemical parameters were analyzed from peripheral blood samples, and results were correlated with immunohistochemical findings. Results: The study included 100 patients: n = 20 in the control group, where the appendix was removed during some other abdominal surgical procedure, n = 35 patients with simple appendicitis in Group A, and n = 45 with complicated appendicitis in Group B. There were 65.0% male patients, and the mean age at surgery was 10.8 ± 4.0 years. CD19 B-lymphocytes were significantly more present in the appendiceal specimens of patients with complicated appendicitis (p = 0.014 and p = 0.007), and CD8 T-lymphocytes in patients with simple appendicitis (p < 0.001). Also, there were significantly fewer CD8 T-lymphocytes in patients with complications (p = 0.024). Conclusions: The number of CD8 T-lymphocytes is increased in simple appendicitis and is considerably lower in patients who develop postoperative complications. CD19 lymphocytes were more present in complicated appendicitis.

Gastric teratoma is a extremely infrequent tumor and accounts for less than 1% of all teratomas among children population with male predominance. Herewith is described a case of mature gastric teratoma in a three months-old female infant associated with malrotation, hypotonia, torticollis and fusion of labia minoria. Due to the abdominal distension, the child was admitted to the Paediatric Surgery Department. On physical examination, a large lump was palpable, and laboratory findings were normal. Computed tomography (CT) showed a major heterogeneous solid formation within the right hemi-abdomen, extending to pelvis and crossing the midline. The infant underwent surgery and complete excision of tumor originating from lesser curvature of the stomach was made. Tumor was weighing 600 gr and was 10 x 14 x 8 cm large. The histopathological examination finding pointed to mature gastric teratoma. The post-operative course and further follow-up were eventless. As soon as the diagnosis is made, the surgery is of paramount importance, especially in cases of immature teratomas, where malignant alteration is possible.

Violence against children is a complex socio-medical phenomenon with potential lifetime consequences. Therefore, it is very important to recognize the first signs of violence, as medical staff are quite often the only witnesses of child maltreatment. The objective was to determine types of abuse and neglect in the pediatric population, which children are most susceptible to abuse and neglect, the kinds and severity of injuries, and the required management. A retrospective study was conducted on all patients admitted to two different hospitals due to suspicion of abuse and neglect, with the involvement of a social worker, over a 6-year period. This study included 473 patients; their average age was 8.03 ± 6.01 years; the majority of children were aged 0 to 3 years (35.0%), and 67.2% were boys. Of them, 82.4% were hospitalized because of injuries and other medical conditions caused by neglect. A total of 17.6% were hospitalized due to suspected abuse: peer violence was present in 59.3% of the cases, 22.1% of the children were abused by their parents, and the least number of patients were abused by unknown persons, 18.6%. Minor injuries were present in 55.39% of the cases. In total, 232 children underwent surgical treatment due to injuries from abuse or neglect. The majority of children were neglected, not abused, and among the abused children peer violence was predominant. The most susceptibile to neglect and abuse were the youngest members of the pediatric population.

The transition process to adulthood is a challenging but crucial period for the future well-being of patients with chronic diseases. The objective of this study was to evaluate whether specific clinical variables and disease activity status are associated with improved transition readiness among patients with juvenile idiopathic arthritis (JIA) and their parents. JIA patients aged 12–18 years were enrolled in this cross-sectional study. Patient characteristics and laboratory data were collected, and disease activity was assessed using the Juvenile Arthritis Disease Activity Score (JADAS-10 and JADAS-27). All patients and their parents completed the Serbian version of the Transition Readiness Assessment Questionnaire (TRAQ)simultaneously. A total of 91 JIA patients (including 27 males and 64 females; median age 15.32 years, range 11.58–18 years), along with their respective parents, were enrolled in the study. Our results demonstrated that increased patient age and the use of biologic therapy, particularly etanercept, were significantly associated with higher TRAQ scores and improved transition readiness in both JIA patients (p < 0.001; p = 0.038) and their parents (p < 0.001; p = 0.035). Patient and parent TRAQ scores showed a strong positive correlation (ρ = 0.676, p < 0.001). No significant associations were found between other clinical variables (gender, JIA disease subtype, disease duration, disease activity status, extraarticular comorbidities, and autoimmune diseases in the patient’s family) and transition readiness. Older patient age and the use of biologic therapy, particularly etanercept, are positively associated with transition readiness in both JIA patients and their parents.