Green Extraction Approach for Isolation of Bioactive Compounds in Wild Thyme (Thymus serpyllum L.) Herbal Dust-Chemical Profile, Antioxidant and Antimicrobial Activity and Comparison with Conventional Techniques

The aim of this study was to provide a chemical profile and determine the antioxidant and antimicrobial activity of the essential oil (EO) and lipid extracts of Thymus serpyllum L. herbal dust obtained via conventional (hydrodistillation (HD) and Soxhlet extraction (SOX)) and novel extraction techniques (supercritical fluid extraction (SFE)). In addition, a comparative analysis of the chemical profiles of the obtained EO and extracts was carried out, as well as the determination of antioxidant, antibacterial and antifungal activity of the lipid extracts. According to the aforementioned antioxidant and antimicrobial activities and the monoterpene yield and selectivity, SFE provided significant advantages compared to the traditional techniques. In addition, SFE extracts could be considered to have great potential in terms of their utilization in the pharmaceutical and cosmetic industries, as well as appropriate replacements for synthetic additives in the food industry.

Phytochemical Composition of Different Red Clover Genotypes Based on Plant Part and Genetic Traits

Red clover (Trifolium pratense L.) is an important legume that is also known as a rich source of isoflavones, which are compounds with mild estrogenic activity. Therefore, this plant is often used as a raw material in the production of dietary supplements recommended in menopause. Many factors can influence isoflavone content, but those genetically related are considered to be the most important. Therefore, the aim of this study was to evaluate the phytochemical profile of different plant parts of 30 red clover genotypes grouped according to ploidy and country of seed origin by analyzing the content of dominant isoflavones, total phenolic content (TPC) and antioxidant activity. It was found that there are significant differences in the examined traits among plant parts. Red clover leaves had the highest total isoflavone content, with biochanin A as the dominant compound, while flower extracts had the highest TPC and antioxidant activity. Diploid and tetraploid genotypes were significantly different concerning the content of daidzein, genistein, formononetin and TPC with higher quantities in tetraploid samples. On the other hand, seed origin was not a useful separating factor for the analyzed samples. The results of this research indicate that ploidy, as a previously poorly studied factor, could influence isoflavone content in red clover.

Optimization of rheological characteristics of bread dough supplemented with defatted wheat germ

Optimization of bread dough formulation with defatted wheat germ (DWG) in terms of dough rheological properties was the objective of this study. Fractional factorial design 2 V 5 - 1 was applied in order to investigate influence of DWG granulation (<150 µm and 150-1000 µm), DWG content (10 and 20%), addition of gluten (0 and 5%), ascorbic acid (0.004 and 0.008%) and combined improver (0.1 and 0.3%) on farinograph and extensograph parameters. Responsive variables were water absorption and the degree of softening, obtained by farinograph, and resistance to extension and extensibility as well as their ratio, obtained by extensograph analysis. Gluten addition expressed dominant positive effect on water absorption and the degree of softening. The most pronounced negative effect on dough resistance exhibited DWG content (contribution of 57%). The combination of DWG with smaller particle size and 5% of gluten addition increased both resistance and extensibility, but R/E ratio was not affected. The optimal values for DWG granulation, DWG content, gluten content, ascorbic acid content and combined improver content were: < 150 µm, 14.24%, 4.83%, 0.004% and 0.1%, respectively, while predicted values for desired responsible variables were: water absorption 65.90%, degree of softening 84.05 FU, resistance 301.30 EU, extensibility 108.55 mm and R/E 2.5.

Physico-chemical and microbiological changes during the cabbage hybrid bravo heads fermentation: Salt, temperature and starter culture influence

The influence of temperatures (18, 22 and 26°C), salt (60, 70 and 80 g/kg) and starter culture (0, 0.025 and 0.050 g/kg) on physico-chemical and microbiological changes during fermentation in cabbage heads were investigated. The experiment was set up in industrial conditions, samples were taken after 0, 5, 12, 27 and 62 days in order to determine the changes in color, texture, biogenic amines content, microbiological parameters, pH, a_w, total sugar content, total acidity and salt content. Analysis of variance and Principal component analysis were applied to get a better overview of differences between samples and the similarities between different fermentation conditions. Significant color changes and softening of cabbage tissue did not occurred during the entire fermentation process. Cadaverine was not detected in samples containing starter culture, also the results were in range for maximum allowed putrescine and cadaverine doses for all cabbage samples. Total number of molds increased, contrary to number of yeasts on the last examined day in comparison with raw cabbage sample. Enterobacteriaceae were not detected after 5^th fermentation day, while sharp increase of lactic acid bacteria number occurred until 12^th day, and on the 12^th fermentation day was in range of 7.82 to 9.84 log cfu/g. The fermentation process led to decrease in pH, a_w and total sugar content, meanwhile total acidity 0.54%-0.89% and salt content 2.08%-3.19% in the cabbage heads increased, in comparison with raw sample where results for total acidity and salt content were 0.13% and 0.05%, respectively. Additionally, according Principal component analysis, temperature of fermentation had the greatest influence on the fermentation process, followed by the application of starter culture and then concentration of added salt.

Factors associated with depressive episode among first year University students in Serbia

Background

Some findings indicate that university students are at higher risk of depression despite being a socially advantaged population, showing that 15 to 25% of them develop some type of mental disorder during graduation, and depression is one of the most prevalent. The aim of this study was to investigate the prevalence of depressive symptoms and its association with gender, material status, social health, and behavioral factors among university students.

Methods

The research represents a cross-sectional study conducted at the University of Novi Sad, Serbia. The research involved 455 first-year students. The average age of participants was 19.3 years (72.1% girls and 27.9% boys). Patient Health Questionnaire (PHQ-9) was used to measure depressive symptoms (cut point for depressive episode ≥10). Additional questions were focused on self-assessed material status, social health, and behavioral factors (smoking and alcohol use). The binary logistic regression model was used to estimate the association between depression and observed independent variables.

Results

The prevalence of moderate to severe depressive episode among students was 18.0%, with no gender differences. Out of the total, 11.0% of students had suicidal thoughts or thoughts of hurting themselves. Multivariable logistic regression showed that self-assessed poor material status (OR = 2.04; 95%CI: 1.06-3.89), self-assessed poor social health (OR = 8.9; 95%CI:4.87-16.42) and smoking (OR = 2.18; 95%CI: 1.09-4.39) were significant predictors of depression among first-year university students.

Conclusions

High prevalence of depressive episode among university students call for the action for the promotion of mental health, particularly among those of lower socioeconomic status, and points out the importance of social health and social network in the prevention of mental disorders.

Key messages

Students on the first year of University should be screened for depressive symptoms. It is important to educate students on how to create a strong support network and to implement intervention programs for improving mental health through fostering healthy lifestyles change.

Antioxidant and enzyme-inhibitory activity of peppermint extracts and essential oils obtained by conventional and emerging extraction techniques

Peppermint is widely used medicinal plant with distinguished bioactive potential, therefore, the aim of present work was to develop novel peppermint extracts with high activity by application of traditional and emerging separation techniques. Conventional hydrodistillation and microwave-assisted hydrodistillation (MWHD) were applied for recovery of essential oil (EO), while organic solvent extraction using Soxhlet apparatus, microwave-assisted and ultrasound-assisted process and supercritical fluid extraction (SFE) were applied for non-selective recovery of peppermint lipophilic extracts. Extracts were characterized in terms of terpenoids profile with special emphasis on content of major compounds (mentol, menthone, isomenthol and eucalyptol). Antioxidant activity (DPPH, ABTS, CUPRAC, FRAP, chelating and phosphomolybdenum assay) and enzyme-inhibitory assays (acetylcholinesterase, butyrylcholinesterase, tyrosinase, amylase and glucosidase inhibition) were used for screening of peppermint bioactivity. MWHD was recognized as alternative for traditional process in EO recovery, while SFE extracts were useful for green production of solvent-free peppermint extracts rich in terpenoids and other lipophilic bioactives.

Defatted wheat germ application: Influence on cookies’ properties with regard to its particle size and dough moisture content

The introduction of agro-food industry by-products rich in bioactive compounds represents major challenge in food industry sector. The influence of wheat germ particle size (<150 µm, 150–1000 µm, and 800–2000 µm), wheat germ content (5, 10, and 15%), and dough moisture content (20, 22, and 24%) on chemical, textural, and sensory characteristics of cookies was investigated using the Box–Behnken experimental design. The substitution of wheat flour with wheat germ increased the protein, fat, mineral, and fiber content of the cookies. The particle size of wheat germ affected the textural properties of cookies. As the particle size of wheat germ increased, the hardness of cookies decreased. The color of the cookie was most influenced by the interaction of dough moisture content and wheat germ particle size. Wheat germ level up to 15% had no significant effect on the sensory characteristics of cookies. A suitable combination of defatted wheat germ level, its particle size, and dough moisture content can improve the nutritional value of cookies, without causing a negative effect on the cookies’ sensory characteristics.

Using the breakage matrix approach for monitoring the break release in the wheat flour milling process

BACKGROUND

The breakage matrix approach is a mathematical tool to relate input and output particle size distribution from a milling operation. Adjustment of the break release in the flour milling process is extremely important because it affects granulation and quality characteristics of the stock and hence the total results and balance of the mill. In this study the breakage matrix approach has been used for the purpose of controlling the release on the front passages of the break system in the flour milling process.

RESULTS

It has been established that, for any particle size distribution of wheat, it is possible to predict break releases together with the distribution of the release size fractions by using the breakage matrices. Also, the reversibility of this approach is examined, that is the possibility to identify the wheat particle size distribution that would result in desired break releases and/or the desired yields of different sized intermediate stocks under the given set of milling conditions.

CONCLUSION

It is confirmed that the breakage matrix approach can be successfully used to predict the break releases. The reverse breakage matrix concept allows the determination of the wheat particle size distribution which would result in a targeted break release. © 2016 Society of Chemical Industry.

Possibilities for preservation of coarse particles in pelleting process to improve feed quality characteristics

Poultry diets are mainly used in pelleted form because pellets have many advantages compared to mash feed. On the other hand, pelleting causes reduction of feed particle size. The aim of this research was to investigate the possibility of increasing the content of coarse particles in pellets, and, at the same time, to produce pellets with satisfactory quality. In this research, the three grinding treatments of corn were applied using hammer mill with three sieve openings diameter: 3 mm (HM-3), 6 mm (HM-6) and 9 mm (HM-9). These grinding treatments were combined in pelleting process with three gaps between rollers and the die of pellet press (roller-die gap, RDG) (0.30, 1.15 and 2.00 mm) and three moisture contents of the pelleted material (14.5, 16.0 and 17.5%). The increased coarseness of grinding by the hammer mill resulted in the increased amount of coarse particles in pellets, especially when the smallest RDG was applied (0.30 mm), but pellet quality was greatly reduced. Increasing of RDG improved the quality of pellets produced from coarsely ground corn, but reduced the content of coarse particles in pellets and increased specific energy consumption of the pellet press. Increasing the moisture content of material to be pelleted (MC) significantly reduced energy consumption of the pellet press, but there was no significant influence of MC on particle size after pelleting and on the pellet quality. The optimal values of the pelleting process parameters were determined using desirability function method. The results of optimization process showed that to achieve the highest possible quantity of coarse particles in the pellets, and to produce pellets of satisfactory quality, with the lowest possible energy consumption of the pellet press, the coarsest grinding on hammer mill (HM-9), the largest RDG (2 mm) and the highest MC (17.5%) should be applied.

Using the eight-roller mill in the purifier-less mill flow

Double grinding of mill streams without intermediate sieving, i.e. the eight-roller milling system provides opportunities for significant reduction of capital cost compared to conventional wheat flour milling system. In this study the effects of using the eight-roller mill in the purifier-less mill flow were investigated. Middlings from the break system of commercial flour mill, which would be sent to the purification system, were intercepted and employed in the experiments. Milling results obtained with double grinding of middlings were compared with the results obtained by conventional system with intermediate sifting before regrinding of stock. At the same roll gap setting and under the same sieving conditions, the eight-roller system produced less flour compared to the conventional system. Results showed that the most efficient way to increase flour yield in the eight-roller milling system is to increase the upper size limit of flour by increasing the sieve aperture. This is not followed by the deterioration of flour quality as determined by ash content. Increase of the upper size limit of flour particles is followed by the decrease of the flour ash content suggesting that it is possible to implement the eight-roller mills in the purifier-less mill flow.

Chemometric optimization of the robustness of the near infrared spectroscopic method in wheat quality control

A chemometric approach was applied for the optimization of the robustness of the NIRS method for wheat quality control. Due to the high number of experimental (n=6) and response variables to be studied (n=7) the optimization experiment was divided into two stages: screening stage in order to evaluate which of the considered variables were significant, and optimization stage to optimize the identified factors in the previously selected experimental domain. The significant variables were identified by using fractional factorial experimental design, whilst Box-Wilson rotatable central composite design (CCRD) was run to obtain the optimal values for the significant variables. The measured responses included: moisture, protein and wet gluten content, Zeleny sedimentation value and deformation energy. In order to achieve the minimal variation in responses, the optimal factor settings were found by minimizing the propagation of error (POE). The simultaneous optimization of factors was conducted by desirability function. The highest desirability of 87.63% was accomplished by setting up experimental conditions as follows: 19.9°C for sample temperature, 19.3°C for ambient temperature and 240V for instrument voltage.

The effects of temperature and scopolamine on N-methyl-D-aspartate antagonist-induced neuronal necrosis in the rat

The effects of temperature and scopolamine on dizocilpine maleate-induced neuronal necrosis in the rat cingulate/retrosplenial cortex, entorhinal/olfactory cortices and the dentate gyrus were studied. Mild, protracted hypothermia (48 h at a brain temperature of 34 degrees C), induced by a servo-controlled "exposure technique" in the awake female rat, significantly reduced dizocilpine maleate (5.0 mg/kg, i.p.)-induced neuronal death in the cingulate/retrosplenial and entorhinal/olfactory cortices seven days following drug administration. Scopolamine (0.25 mg/kg, i.p.), putatively neuroprotective [Olney J. W. et al. (1991) Science 254, 1515-1518], did not reduce injury in the cingulate/retrosplenial cortex of female rats following one injection, but did following two and three doses. Scopolamine had no significant effect in the other brain regions. A temperature elevation of only 1 degree C above baseline for 48 h in awake female rats increased dizocilpine maleate-induced damage. Finally, the sex differences in N-methyl-D-aspartate antagonist toxicity were replicated and extended to other structures, and found not to be due to temperature differences. Our data show that dizocilpine maleate neurotoxicity is temperature sensitive. Scopolamine treatment needed to be prolonged in order to reduce injury, and even then was only efficacious in one of three brain regions. The results underscore the importance of using neuronal necrosis in several brain regions as the endpoint and for the use of prolonged therapeutic interventions. Furthermore, given the potential hypothermic action of other putative neuroprotective drugs, a mechanistic re-evaluation of N-methyl-D-aspartate antagonist-induced injury is needed, with precise brain temperature measurement.

[Problems and perspectives in child health care]

Health care protection of children in Vojvodina is of particular importance regarding the negative natural birth rate. In spite of difficult economic situation, health care of children in Vojvodina is permanently carried out and would be significantly better in quality if the education of subspecialized personnel, space facilities, technological innovations, computerization and continuous education were available. Introduction of microanalytic laboratory techniques is essential for monitoring of prematures. Propagation of natural nutrition is an obligation of pediatricians. Respiratory diseases are still on the top of morbidity pyramid but tuberculosis is evidently in increase. An important health care problem is the expansion of allergic diseases. The progressive incidence of insulin-dependent diabetes is also evident. The spheres of juvenile gynecological endocrinology and andrology are still underdeveloped and that also applies to adolescent medicine. Toxicology remains an ongoing problem in pediatrics due to an increased number of accidental poisoning. Pediatricians-gastroenterologists are lacking while paediatric hepatology should be brought into more advanced state. Bone marrow and stem cells transplantation is in the responsibility of the Centre for haematology and oncology. Nephrology department lacks children's haemodialysis, ultrasound biopsy of kidneys, urodynamic analyses and new staff facilities. The increased number of survivals in case of children with with sequeles inevitably asks for better development of rehabilitation, prolonged treatment and teamwork. Intensive care and therapy department requires new staff and high technology capacities. Development of children's surgery department inevitably means the reconstruction of space facilities, modern equipment and new subspecializations. Preventive outpatient service is performed through systematic examinations. ultrasound diagnostics of hips, auditive screening and educational program activities related to addiction and veneral diseases. Genetic health of the population is supremely covered by the Center for Medical Genetics, with the tendenca for development of molecular genetics. It is necessary to develop rehabilitation service, prolonged treatment and teamwork. Diagnostic of convulsive conditions should be advanced with more refined diagnostic methods.

[Occurrence of thromboembolic complications in patients with dilated cardiomyopathy. Retrospective-prospective study]

The purpose of the present study was to determine the prevalence of thromboembolic events in patients with primary and secondary (ischemic) dilated cardiomyopathy (DC), with regard to basic rhythm, sinus or atrial fibrillation. Retrospectively, over three years, from January 1, 1989 to December 31, 1991, the case histories of 75 inpatients with DC, mean age 56.2 +/- 14.1 years, 41 in sinus rhythm and 34 in atrial fibrillation from Clinic Hospital Split were analyzed and compared to those of 75 controls (heart failure with no DC). The incidence of thrombi, embolisms and mortality in both subgroups was similar, while the prevalence of thromboembolic events was significantly higher in the analyzed than in the control group (decompensated patients with ischemic cardiomyopathy and without cardiomegaly) (9/75:1/75, p < 0.05). Prospectively, between 9 and 22 months, from December 1, 1991 to September 30, 1993 51 consecutive decompensated outpatients with DC, in NYHA class II and III, mean age 54.2 +/- 15 years, were followed-up. Bilirubin, lactic dehydrogenase, prothrombin time and activated partial thromboplastin time were determined. 1-D and 2-D transthoracic echocardiographic exam was performed and clinical status was assessed. There were 24 patients in sinus rhythm and 27 patients in atrial fibrillation. The prevalence of thromboembolic events, thrombi and mortality in both subgroups was similar. The laboratory findings, indicators of possible thrombogenesis or thrombolysis, did not show any significant difference in both subgroups. The incidence of thrombi in both parts of this study was low, amounted to only 9.5% (12/126) with no clear signs of thromboembolism (these patients were anticoagulated!). Altogether 12.6% (16/126) patients suffered thromboembolic events, 9 in retrospective and 7 in prospective part of the trial (more patients were anticoagulated in prospective then in retrospective study, 5 versus 19; p < 0.05). We conclude that thromboembolism in patients with decompensated DC are rare, but appear at significantly higher rate than in decompensated patients with ischemic cardiomyopathy and no cardiomegaly. The beneficial effects of anticoagulant therapy are to be expected in these patients regardless of the basal rhythm. This hypothesis must, however, be assessed in a prospective, multicentric trial.

[Significance of right ventricular dimensions in the differential diagnosis of primary and secondary dilated cardiomyopathy]

Numerous analyses are used in the differential diagnosis between primary and secondary dilated cardiomyopathy (PDC, SDC). The aim of this study was to assess the dimensions of heart cavities in patients with dilated cardiomyopathy (DC) by 1-D and 2-D echocardiography. Thirty-six consecutive patients who satisfied the PDC criteria, and 103 patients with criteria of SDC, were followed-up clinically, radiographically, electrocardiographically and by 1-D and 2-D echocardiography, in the period from December 1991 to April 1994, at the Department of Internal Medicine of the Clinical Hospital Split. The patients with PDC were significantly younger than those with SDC (44.4 +/- 10.4: 64.4 +/- 8.4 year). There were significantly more males than females in both DC subgroups. NYHA classification, sinus rhythm and atrial fibrillation did not differ considerably in both DC subcategories. The etiologic factor was ischaemic DC in 85.4% (88/103), systemic arterial hypertension in 11.6% (12/103), and thyrotoxicosis in 2.9% (3/103) of patients with SDC. Alcoholic DC in one patient, peripartal DC in two female patients and viral myocarditis in six patients with PDC were suspected. In the total of 75% (27/36) patients with PDC, a clear etiological factor in case histories was not defined. Left ventricular ejection fraction, diameter and myocardial thickness, as well as left atrium diameter, did not differ significantly in patients with PDC, at variance with SDC patients. Right ventricular enddiastolic diameter (31.55 +/- 4.8 mm: 26.62 +/- 8.6 mm, p < 0.05) and the ratio between enddiastolic diameters of the right and left ventricle were significantly larger in patients with PDC than in those with SDC (0.45 +/- 0.03: 0.37 +/- 0.05, p < 0.05). We conclude that right ventricle is significantly wider in PDC than in SDC patients. Compared with other noninvasive methods, 1-D and 2-D echocardiography is probably the method of choice (particularly in our environment) in the differentiation of primary and secondary DC.

[Comparison of auscultation findings using a classic stethoscope (Litmann 2120) and electronically amplified stethoscope (Medmax2)]

Heart auscultation has one of the key roles in beside diagnosis, especially in patients with cardiovascular diseases. Sometimes, because of the human cars' low sensitivity, a problem emerges in the proper evaluation of heart sounds and murmurs of lower frequencies. Our study compared two stethoscopes, the classic acoustic stethoscope (Littmann 2120) and an electronic one with the sound amplifier and the noise filtering system (Medmax2) in 10 patients examined by 10 physicians. Significantly better detection of low frequency sounds was found in favour of electronic stethoscope (chi 2 = 17.9; p < 0.0001). It is concluded that the selective amplificator improves the stethoscope performance and has its place in everyday bedside practice, especially in departments of cardiology.

Penetrating war injuries of the heart

Treatment of 12 penetrating heart war wounds were described. Ten wounded (83.3%) died on the spot or during transportation. Only two (16.7%) were brought to the clinic with signs of life, operated on and released from the hospital. The two wounded had not received any therapy before the arrival. The two cases described indicate the importance of a rapid transportation, adequate reanimation and the fastest possible cardiorrhaphy either by means of thoracotomy or medial sternotomy.

[Diagnostic characteristics of myxoma of the left atrium]

Three middle-aged patients (38, 40 and 41 years old; two women and one man) with left atrial myxoma diagnosed by echocardiography and successfully operated on are presented. Two patients had tumor embolus as the dominant presenting symptom. The time span between the first symptoms and the echocardiographic diagnosis was 6 months, 12 months, and 12 days, respectively. From that moment to surgery the average lag was 6.3 days only, including the complex transportation to distant surgical centres. All the patients are now alive, all with normal findings more than 2 years after the operation.

[Comparison of single and double doses of hydrochlorothiazide in the treatment of arterial hypertension with special emphasis on changes in vascular reactivity]

The hypotensive effects of 100 and 50 mg hydrochlorothiazide (HTZ) were evaluated in 30 mild-to-moderate hypertensives, divided into two groups, with diastolic pressure between 95 and 110 mmHg. In both groups, the average MAP reduction was 15% (P less than 0.05). There were no significant differences in antihypertensive effects between single (50 or 100 mg o.d.) and double (25 or 50 mg b.i.d.) doses of the same drug. Blood pressure control was better after two than after one month on each of the various dosing schedules. Side-effects were mild and well tolerated: observed was a significant increase in triglyceride level from 3.0 +/- 1.8 to 4.8 +/- 2.4 mmol/L under the treatment with 100 mg HTZ o.d. and a statistically significant decrease in potassium level from 4.4 +/- 0.3 mmol/L to 4.1 +/- 0.3 mmol/L after two months treatment with 50 mg HTZ o.d. Unexpectedly, these changes were not dose-related. The venous reflexes showed atenuated response to norepinephrine after HTZ treatment, while arterial inflow, venous capacity and venous outflow increased significantly (P less than 0.05). It is concluded that HTZ exhibits some direct vasodilator activity and that the pharmacokinetic features of this drug do not correlate with the pharmacodynamic ones. At least in the management of mild-to-moderate arterial hypertension single daily dosage is quite adequate.

Rapid dissolution of right atrial thrombus in a patient with congestive cardiomyopathy

The AA describe a patient with congestive cardiomyopathy, probably alcoholic, who exhibited signs and symptoms of congestive heart failure and a pericardial rub, due to a right atrial thrombus (4 X 2 cm). The thrombus dissolved completely and the symptoms decreased markedly after 14 days of oral anticoagulant therapy alone. We suggest that anticoagulant therapy should be considered before surgery, if an intracardiac mass with no signs of pulmonary embolism is found in a patient with cardiomyopathy.

Triple prevention of congenital dislocation of the hip

Triple prevention of congenital dislocation of the hip consists of (a) examining newborns so as to apply treatment as early as possible in symptomatic and suspected cases, (b) regular diapering in abduction of all presumably healthy hips by means of soft abduction pants so as to direct possible cases of dysplasia toward normal development, and (c) reexamination of these hips until the child can walk so as to discover missed cases. Primary treatment of diagnosed and suspected hip dislocations consists of immediate application of a Frejka splint and abduction exercises, followed by a radiograph at the age of 4 months. Persistence of any clinical symptom for 3 weeks requires intensification of treatment by use of the Pavlik harness.

Total gastrectomy in an infant with corrosive gastritis

An 18-month-old infant with necrosis of the entire stomach and subsequent stricture is presented. Two months after the ingestion of corrosive solution, the infant was admitted in poor condition. Total gastrectomy and oesophago-duodenal anastomosis were performed. Two years after the operation the child is in good condition.