Antun Kljenak

Children's Hospital Zagreb, Zagrabia, Grad Zagreb, Croatia

Are you Antun Kljenak?

Claim your profile

Publications (9)7.08 Total impact

  • [Show abstract] [Hide abstract]
    ABSTRACT: Epidermolysis bullosa is a group of inherited disorders characterized by blister formation on the skin and mucous membrane as the result of molecular defects in genes coding for different structural proteins. They present with a wide clinical spectrum of manifestations because of a variety of molecular defects. Therapy depends on the form of the disease, severity and extent of skin involvement and extracutaneous manifestations, and consists of supportive skin care and supportive care for other organ systems. Skin care includes protection against trauma, proper skin care, treatment of blisters and erosions, and regular dermatological controls for early detection of skin cancer.
    Acta medica Croatica: c̆asopis Hravatske akademije medicinskih znanosti 10/2012; 66 Suppl 1:119-22.
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: To assess the efficacy of the procedural consolidation concept (PCC) at reducing the number of sessions of general anesthesia necessary for treating children with epidermolysis bullosa (EB). We examined the records of children treated at Children's Hospital of Zagreb between April 1999 and December 2007. Children treated before the introduction of PCC in January 2005 (n=39) and after (n=48) were analyzed in order to determine the effect of PCC on the occurrence of complications, days of hospitalization, and number of hospitalizations. During the study period, 53 patients underwent 220 sessions of general anesthesia for a total of 743 surgical interventions per session. Before the introduction of PCC (n=39 patients, 83 sessions), the median number of interventions per session was 2 (range 1-5), and after the introduction of PCC (n=48 patients, 137 sessions) it was 4 (range 3-7, P<0.001). After the introduction of PCC, the median number of complications per anesthesia session increased from 2 (range 0-10) to 3 (range 0-10) (P=0.027), but the median number of complications per surgical procedure decreased from 1 (range 0-10) to 0.6 (range 0-2.5) (P<0.001). PCC lengthened each anesthesia session from a median of 65 minutes (range 35-655) to 95 minutes (range 50-405), (P<0.001). Total length of hospitalization was similar before (median 1, range 1-4) and after (median 1, range 1-3) introduction of PCC (P=0.169). The number of hospitalization days per procedure was 3 times lower after the introduction of PCC (median 0.3, range 0.2-3) than before (median 1, range 0.75-1.7) (P<0.001). PCC should be considered an option in the surgical treatment of children with EB.
    Croatian Medical Journal 08/2011; 52(4):520-6. · 1.25 Impact Factor
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: The aim of this retrospective study was to assess a ten-year experience in the treatment of rare complications of ventriculoperitoneal shunting--intraabdominal cerebrospinal fluid pseudocysts. At this time there are no data about incidence, clinical course and treatment of these complications in Croatia. Cerebrospinal fluid (CSF) abdominal pseudocyst is an uncommon but important complication of ventriculoperitoneal shunts. Retrospective data were obtained from 5 children with abdominal CSF pseudocysts, treated between 1996 and 2007. The incidence of intraabdominal CSF pseudocysts in our study is 2.9%. All patients were girls ranged in age from 4 to 12 years old (mean 8.8 years). In most cases etiology of hydrocephalus was congenital, idiopathic. Abdominal pain and distension were the most frequent clinical finding (4/5). Although infection has been reported as responsible for pseudocyst formation, we did not found it in our series. Laparotomy with cyst wall excision and catheter replacement was performed in 2/5 cases, and only cyst fluid aspiration with catheter replacement in 3/5 cases. Recurrence of the abdominal cyst was observed in one girl who was in terminal stadium of anaplastic ependymoma. It is our opinion that only catheter replacement and cyst fluid evacuation, as one of the treatment modalities, may be successful, even in large CSF intraperitoneal pseudocysts.
    Collegium antropologicum 12/2010; 34(4):1397-400. · 0.61 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: We report a rare case of a child with epidermolysis bullosa simplex (EBS) with plectin deficiency but without muscular dystrophy, with severe lesions of the oral cavity, oropharyngeal, hypopharyngeal, laryngeal, tracheal and bronchial mucosa. Case report and a review of the world literature are used. The literature review revealed only five similar patients with EBS without muscular dystrophy complicated by respiratory involvement. This paper highlights the potentially serious complications of the EB in the form of breathing, swallowing and speech difficulties and describes the specific problems encountered in the treatment of this patient. Epidermolysis bullosa (EB) is a group of severe hereditary diseases, primarily of the skin, but which can also involve the respiratory and gastrointestinal tract mucosa. Respiratory tract involvement is usually only found in certain types of EB. The oral cavity and oropharynx are involved more frequently than the hypopharynx, larynx and trachea. Involvement of laryngeal and tracheal mucosa is generally associated with an increased morbidity and mortality, numerous complications and therapeutic difficulties, and is more common in junctional EB and dystrophic EB than in EBS. We present a rare case of a child with EBS and plectin deficiency with pronounced lesions of respiratory tract mucosa from the oral cavity to the bronchi and even extending into the trachea. Deciding on tracheotomy requires thorough consideration and should not be taken lightly.
    International journal of pediatric otorhinolaryngology 03/2010; 74(3):302-5. · 0.85 Impact Factor
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: To evaluate the role and our experience of injection sclerotherapy with cow milk in the treatment of rectal prolapse in children. In the last 30 years (1976-2006) we made 100 injections of sclerotherapy with cow milk in 86 children. In this study we included children who failed to respond to conservative treatment and we perform operative treatment. In our study we included 86 children and in all of the patients we perform cow milk injection sclerotherapy. In 95.3% (82 children) of patients sclerotherapy was successful. In 4 (4.7%) patients we had recurrent rectal prolapse where we performed operative treatment. Below 4 years we had 62 children (72%) and 24 older children (28%). In children who needed operative treatment we performed Thiersch operation and without any complications. Injection sclerotherapy with cow milk for treatment rectal prolapse in children is a simple and effective treatment for rectal prolapse with minimal complications.
    World Journal of Gastroenterology 03/2008; 14(5):737-40. · 2.55 Impact Factor
  • International Journal of Dermatology 10/2007; 46(9):955-9. · 1.34 Impact Factor
  • Source
    M Zganjer, A Kljenak
    [Show abstract] [Hide abstract]
    ABSTRACT: The aim of this case report was to analyse the efficiency of video-assisted thoracic surgery (VATS) in the treatment of spontaneous pneumothorax. Spontaneous pneumothorax occurs subsequently to a disruption of visceral pleura and escape of air into pleural space. A retrospective study was performed in 5 patients from December 2001 until May 2006. Four procedures for recurrent spontaneous pneumothorax and one procedure for primary spontaneous pneumothorax were performed. The main symptoms in our patients included chest pain (100%), shortness of breath (60%) and cough (10%) In all patients we made routine X-rays and CT scans. With CT scans in four patients we detected apical bullae. In one patient we had not appropriate diagnosis and we made VATS as diagnostic and later therapeutic procedure. In all patients bullae were in apical zone and resected with endostapler device. There was no postoperative mortality or any complications after VATS. The median duration of the operation was 75 minutes (65-120 minutes), and postoperative hospital stay was 6 days (range 5 to 8 days). On the basis of our results and results from literature we conclude that VATS allows effective, safe performance of standard surgical procedures, avoiding a formal thoracotomy incision (Ref. 15). Full Text (Free, PDF) www.bmj.sk.
    Bratislavske lekarske listy 02/2007; 108(4-5):200-2. · 0.47 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: Ewing sarcoma, a highly malignant primary bone tumor, was first described by James Ewing in 1921 (1). Ewing sarcoma usually presents in childhood or early adulthood, with its peak between 10 and 20 years of age, although it can occur in younger children and older adults. The most common areas in which it occurs are the pelvis, the femur, the humerus and the ribs. Ewing sarcoma is the second most common malignant bone tumor in young patients and it is the most lethal bone tumor. Tumor occurrence ranges from 0.3 cases per 1 000 000 children younger than 3 years to as high as 4.6 cases per 1 000 000 adolescents aged 15-19 years. The annual incidence rate averages less than 2 cases per 1 000 000 children. The male-to-female ratio is 1.5:1 (2-6). Survival rate is 60-70% with low-risk, in a localized tumor, intermediate risk (30%) when the tumor has spread to lungs and advanced risk (less than 10%) when the tumor has spread further to bone, bone marrow and/or other tissue (7, 8). We present an 8 year-old girl with Ewing sarcoma of the rib.
    Paediatria Croatica (martina.bosnjak@kdb.hr); Vol.51 No.1. 01/2007;
  • [Show abstract] [Hide abstract]
    ABSTRACT: Before starting treatment, the parents of a sick child may want another doctor to review the diagnosis and treatment plan. Getting a second opinion allows them not only to confirm the diagnosis, but also to gain a different perspective on the child’s treatment options. Some doctors are more conservative and others more aggressive. When parents are invited to make choices their clinicians need to explain about clinical uncertainty and how individual values and preferences may relate to treatment decisions for their child. The options should be communicated in a clear manner, differences in opinion should be acknowledged and the doctor's own preference stated. Parents need to be encouraged and supported to make their decision—whether or not it reflects their doctor's preference. There are a number of ways to find specialists to consult for a second opinion: The scope of this phenomenon is not well understood . Also it is not clear whether it is warranted or not. However sometimes second opinions can mean the difference between life and death.
    Paediatria Croatica (martina.bosnjak@kdb.hr); Vol.51 No.1. 01/2007;