bluuebunny/crossref_metadata_2025 huggingface dataset:
Čimbenici ishoda liječenja atrezije jednjaka u novorođenčadi operirane u Zavodu za dječju kirurgiju KBC Split od 1991.-2014. godine
Authors: Pogorelić Zenon , Konstatinović Ivan , Jukić Miro , Furlan Dubravko , Kovačević Tanja , Jurić Ivo , Milunović Klaudio Pjer , Furlan Ivanka Antončić , Biočić Mihovil
Published: November 2024

Atrezija jednjaka je anomalija koja hitnoćom, osjetljivim poslijeoperacijskim vođenjem i potrebom za dugotrajnim liječenjem odskače od ostalih anomalija. Cilj ovog istraživanja je odrediti epidemiološke, demografske i kliničke karakteristike bolesnika operiranihzbog atrezije jednjaka te ih usporediti s ostalim relevantnim studijama. U vremenskom razdoblju od siječnja 1991. do rujna 2014.retrospektivno su pregledane povijesti bolesti 46-ero bolesnika operiranih zbog atrezije jednjaka. Podatke smo prikupili istraživanjempisanog protokola Zavoda za dječju kirurgiju, Odjela za neonatologiju, JILD-a KBC Split te arhive povijesti bolesti. Svakom ispitanikuanalizirani su sljedeći parametri: datum rođenja, spol, tjelesna masa pri porođaju, operacijski zahvat, tip anomalije, preživljenje, ranei kasne komplikacije. Atrezija jednjaka bila je češća kod ispitanika ženskog spola (60%). Najčešći tip atrezije jednjaka prema Vogtovojklasifi kaciji bio je 3B tip (92%). Ukupni mortalitet iznosio je 35%, uz napomenu da je prije uvođenja intenzivnog poslijeoperacijskogliječenja on iznosio 80%, a nakon uvođenja 14%. Upala pluća bila je najčešća rana komplikacija, dok su najčešće kasne komplikacijebile disfagija (76%) i striktura anastomoze (26%). Kardiovaskularne anomalije su najčešća kongenitalna popratna malformacija ičine 45% svih pridruženih anomalija, a prisutne su u 30% djece s atrezijom jednjaka. Rano prepoznavanje ove anomalije od izuzetnog je značenja, prvenstveno stoga što ona ugrožava život, a rana dijagnoza i operacijski zahvat smanjuju komplikacije te poboljšavaju ishod. Za djetetovo preživljenje nužan je multidisciplinski pristup i prepoznavanje pridruženih anomalija. Osim rane dijagnostike i samog operacijskog zahvata za preživljenje je od presudne važnosti intenzivna poslijeoperacijska skrb.
Povezanost alergija i kroničnog sekretornog otitisa u djece
Authors: Klančnik Marisa , Grgec Maja , Lozić Bernarda
Published: November 2024

Upala srednjeg uha s izljevom (OME) česta je bolest u djece s prevalencijom koja doseže do 20% i s utjecajem na provodni gubitaksluha, zakašnjeli razvoj govora i oštećenje sluznice srednjeg uha. Cilj ove studije je utvrditi povezanost alergija i perzistirajućih upalasrednjeg uha s izljevom (OME) u djece. U istraživanje je uključeno sedamdeset šestero (76) djece između 2 i 14 godina s dijagnozomperzistirajuće upale srednjeg uha s izljevom, koja su podvrgnuta operativnom zahvatu postavljanja aerizacijskih cjevčica. Sedamdeset šestero (76) zdrave djece slične dobi koja su podvrgnuta različitim neotorinolaringološkim operativnim zahvatima uključena suu kontrolnu skupinu. Pozitivna anamneza alergijskog rinitisa, rezultati intradermalnih kožnih testova i vrijednosti ukupnog i specifi čnog IgE-a su dokumentirani.U skupini s dijagnozom upale srednjeg uha s izljevom 58-ero djece (76,3%) imalo je pozitivnu anamnezu alergijskog rinitisa, a njih 45-ero (59,2%) imalo je pozitivne nalaze intradermalnog kožnog testiranja. Vrijednosti ukupnog IgE-abile su povišene u 46-ero djece (60.5%), a vrijednosti specifi čnog IgE-a bile su povišene u njih 39-ero (51,3%) u OME skupini.U kontrolnoj skupini 12-ero djece (15,8%) imalo je pozitivnu anamnezu alergijskog rinitisa, njih 10-ero (13,2%) imalo je pozitivnenalaze intradermalnog kožnog testiranja, vrijednosti ukupnog IgE-a bile su povišene u 17-ero djece (22,4%) iz kontrolne skupine, anjih 9-ero (11,8%) imalo je povišene vrijednosti specifi čnog IgE-a. Rad pokazuje značajno veću prevalenciju alergija u skupini djece supalom srednjeg uha s izljevom u usporedbi s kontrolnom skupinom. Značajno veći broj pozitivnih nalaza alergoloških testiranjanalazimo u skupini djece s upalom srednjeg uha s izljevom u odnosu na kontrolnu skupinu.
adolescent
Authors: Strizić Helena , Herceg-Čavrak Vesna , Batinica Maja
Published: November 2024

Prevalencija primarne arterijske hipertenzije (AH) u djece je u porastu. Iako je hipertenzija u pedijatrijskoj dobi većinom asimptomatska, već se registriraju subkliničke promjene ciljnih organa. Cilj istraživanja je bio analizirati čimbenike rizika za AH i kliničke značajkeadolescenata s primarnom hipertenzijom. Retrospektivno su analizirani podatci 153-oje bolesnika u dobi od 10 do 18 godina (117M, 36 Ž) s dijagnozom primarne AH-a, hospitaliziranih u tercijarnoj zdravstvenoj ustanovi tijekom desetogodišnjeg razdoblja. Razdijeljeni su u tri skupine - djeca s prehipertenzijom, hipertenzijom I. stupnja (HT I.) i hipertenzijom II. stupnja (HT II.). Za statističkuanalizu primijenjen je Studentov t-test, razina značajnosti p<0,05. HT I. imalo je 27,5%, HT II. 65,4%, prehipertenziju 7,1% djece. Pozitivnu obiteljsku anamnezu za hipertenziju imalo je 89,8%, športski aktivnih bilo je 37,3%. Indeks tjelesne mase (ITM) iznad 95. centileimalo je 41,2%, iznad 30 kg/m2 18,9% ispitanika. Djeca s HT-om II. bila su deblja nego djeca s HT-om I. (p=0,005). U obje hipertenzivne skupine prevladava nepovoljniji, neopadajući obrazac tlaka “non dipper”. Hipertrofi ja lijeve klijetke bila je prisutna u 15% djece.Usporedbom laboratorijskih vrijednosti GUK-a, urata, ukupnog kolesterola i triglicerida između skupina s HT-om I. i HT-om II. nijenađena statistički značajna razlika. Steatozu jetre imalo je 5,9%, hipertenzivne promjene očne pozadine 1,6% ispitanika, oboje uskupini s HT-om II. Antihipertenzivna terapija je uvedena kod 20,3% pacijenata, većinom inhibitori angiotenzin-konvertirajućeg enzima. Značajan broj naših adolescenata s primarnom hipertenzijom je adipozan i ima pozitivnu obiteljsku anamnezu za hipertenziju. Prevencija hipertenzije trebala bi početi već u djetinjstvu.
Subacute metacarpal osteomyelitis in a child
Authors: Kaziz Hamdi , Mouelhi Thabet , Osman Walid , Triki Mohamed Amine , Naouar Nader , Ayeche Mohamed Laziz Ben
Published: November 2024

Subacute osteomyelitis is a rare aff ection. Clinical presentation is often unclear and can lead to delay in diagnosis. As a matter of fact, subacute metacarpal osteomyelitis is usually missed at fi rst, so that some complications may occur, e.g., brachymetacarpia or loss of motion. We report on a 10-year-old boy with subacute metaphyseal osteomyelitis of the second right metacarpal bone. Radiological features can mimic various benign or malignant bone tumors and non-pyogenic infections. Histologic confi rmation is necessary to avoid delay in diagnosis. Treatment was based on antibiotics and surgical debridement. No infectious agent was found on bacteriologic testing. At 1-year follow up, no complications were reported and the fi nger showed normal range of motion. X-ray views showed bone reconstruction with fi brosis of the ulnar part of the metaphysis, without length discrepancy.
Tourist pediatric morbidity during their visit to Split-Dalmatia County
Authors: Nuić Marija , Šabašov Ivana Unić , Petrić Marin
Published: November 2024

The aim was to determine morbidity of foreign children during their tourist visit to Split-Dalmatia County, Croatia. The study included medical documentation of 233 foreign children tourists aged under 18 years, hospitalized at Clinical Department of Pediatrics, Split University Hospital Center in the period from January 2007 to December 2013. Demographic data were statistically analyzed. Of 233 children tourists hospitalized at our department, 134 (57.5%) were boys. Most of the children tourists (51.1%) were aged 0-5 years. According to nationality, they were from 30 countries from all over the world, but mostly from Europe (97.9%). The highest number of children tourists were from Germany (14.2%). The highest percentage of children tourists (92.7%) were hospitalized during summer months. The mean length of hospital stay was 4.4±3.3 days. According to the reason for hospitalization, children tourists were mostly admitted to our hospital for nervous system symptoms (32.6%); 43.4% of these had febrile seizures and 39.5% epilepsy. The nervous system symptoms were followed by injury and poisoning (14.6%), respiratory symptoms (14.1%), submersion and heat injuries (9.9%), and digestive symptoms (9.4%). In conclusion, we describe foreign pediatric population hospitalized in the Split University Hospital Center during their vacation in the Split-Dalmatia County, Croatia. The largest number of children tourists were from Germany and the nervous system symptoms were the most common reason for hospitalization. Therefore, we suggest cooperation between the Croatian health care system and Croatian National Tourist Board for developing prevention strategies regarding morbidity in pediatric tourist population. In particular, prevention and fi rst line therapy for cerebral seizures should be broadly available, such as in hotels, apartments, and even on beaches.
Oral manifestations in human immunodefi ciency virus infected pediatric patients receiving and not receiving antiretroviral therapy: a cross sectional study
Authors: Divakar Darshan Devang , Kheraif Abdulaziz Abdullah Al , Ramakrishnaiah Ravikumar , Khan Aftab Ahmed , NC Sandeepa , Alshahrani Obaid Abdullah , Alahmari Ali
Published: November 2024

The aim of the study was to assess and compare oral manifestations of human immunodefi ciency virus (HIV) infected pediatric patients undergoing antiretroviral therapy (ART) and those not undergoing ART. A cross sectional study included HIV positive children (receiving and not receiving ART) aged 5-15 years, registered at the District Hospital ART Centre, Udaipur, and HIV negative schoolchildren. HIV related oral lesions were diagnosed according to the World Health Organization criteria. Sociodemographic and other related information were also recorded. CD4+ cell count was determined in all study subjects. The χ2-test, stepwise multiple linear regression and logistic regression were used on statistical analysis. In all tests, confi dence interval and p-value were set at 95% and ≤0.05, respectively. A greater proportion of HIV patients receiving treatment had CD4+ cell count of more than 750 cells/mm3. The majority of HIV patients receiving ART for more than three years and only 20% of those not receiving ART were free from any oral lesions. The results of the present study demonstrated ART to be eff ective in reducing the prevalence of HIV related oral lesions, as already described in the literature; however, unlike previous studies, the present paper reports more valid fi ndings for having included most of the confounding variables.
Body composition in Iranian boys with autism spectrum disorders
Authors: Salehi Hamideh , Aghanoori Mohammad Reza , Shahmohammadlu Samieh , Hosseini Banafshe , Mitchell Sharon E. , Mahmudi Mahmud , Djafarian Kurosh
Published: November 2024

The aim of this study was to assess body composition of boys with autism and also to investigate the association of demographic factors, autism severity and drug therapy with their body composition. We recruited 85 boys aged 7-14 years by stratifi ed random sampling in autism-specifi c schools in Tehran. Body composition was measured using bioelectrical impedance analysis. The study revealed that 9.4% of participants were underweight and 47.3% were suff ering from overweight and obesity. The mean total body fat percentage and fat mass index were 23.46% and 4.8, respectively. A high rate of obesity was found in Iranian children and adolescents with autism. Furthermore, boys whose mothers had higher educational levels may have less chance of being within the normal weight ranges in comparison with sons of lower-educated mothers (p=0.002), while father’s educational level had no eff ect on the child’s body mass index. In conclusion, a high prevalence of overweight and obesity was observed in Iranian male children and adolescents suff ering from autism according to their body mass index and body fat percentage.
Uloga nacionalnog registra u zbrinjavanju djece oboljele od kroničnih upalnih bolesti crijeva
Authors: Ivković Lana , Hojsak Iva , Trbojević Tena , Kolaček Sanja
Published: November 2024

Kroničnim upalnim bolestima crijeva u djece, za razliku od odraslih, svojstven je teži tijek i prošireniji oblik bolesti te negativan utjecajna rast i razvoj. U posljednjih nekoliko desetljeća zamijećen je trend porasta incidencije kroničnih upalnih bolesti crijeva, najviše naračun Crohnove bolesti. Uzimajući u obzir sve navedeno, ali i činjenicu da se upalne bolesti crijeva u djece pojavljuju u razdobljunjihovog ubrzanog rasta i razvoja, svi pedijatrijski bolesnici iziskuju dugoročno praćenje koje je moguće jedino putem nacionalnogregistra. U ovom preglednom članku raspravljamo o ulogama, ciljevima i metodama rada nacionalnih registara, koji imaju za ciljpraćenje različitih varijabli u djece s kroničnim upalnim bolestima crijeva, ali naglašavamo i važnost osnivanja takvog registra uRepublici Hrvatskoj
Geni i celijakija
Authors: Čizmarević Nada Starčević , Mijandrušić-Sinčić Brankica , Licul Vanja , Kapović Miljenko , Ristić Smiljana
Published: November 2024

Celijakija je bolest poremećenog imunosnog odgovora potaknutog glutenom koja se javlja u genetički predisponiranih osoba. Svrhaovog rada je prikazati dosadašnje spoznaje iz genetike celijakije. Genska podloga celijakije vezana za lokus humanih leukocitnihantigena kao dominantnog genetičkog elementa detaljno je razjašnjena. No postoji i velik broj gena izvan ove regije koji pridonoseetiopatogenezi bolesti, a samo su dijelom zajednički pojedinim bolesnicima, što upućuje na genetičku heterogenost bolesti. Uz to jeopaženo da su mnogi od tih rizičnih lokusa u celijakiji zajednički s lokusima za druge autoimunosne bolesti. Značajan doprinosnovim spoznajama daju recentne cjelogenomske asocijacijske studije, ali tek treba istražiti velik dio još i sad nepoznate heritabilnostiu celijakiji.
Kongenitalna miotonička distrofi ja – prikaz bolesnika
Authors: Delin Sanja , Pavić Linda , Sasso Antun , Barbarić Irena , Krakar Goran , Nađ Ida
Published: November 2024

Miotonička distrofi ja ili Steinertova bolest druga je po učestalosti mišićna distrofi ja u djetinjstvu, odmah nakon progresivnih mišićnih distrofi ja (Duchenne i Becker). Incidencija u općoj populaciji iznosi 1:8000 u Europi, 1:30000 u Hrvatskoj. Nasljeđuje se autosomno dominantno, gen je lociran na dugom kraku 19. kromosoma (19q13), a genski produkt je miotonin proteinska kinaza. Bolestnastaje zbog patološkog umnažanja sljedova identičnih trinukleotida CTG unutar nekodirajuće sekvencije gena za miotonin proteinkinazu (DMPK). U zdravih osoba broj ponavljanja tripleta CTG iznosi 5-34 i ostaje stabilan tijekom generacija. Kod bolesnih osobaslijed je produljen i sadržava od 50 do nekoliko tisuća trinukleotida CTG, a težina kliničke slike i vrijeme javljanja bolesti koreliraju sveličinom produljenog slijeda. Osobe s brojem tripleta 35-49 zdravi su prenositelji bolesti. Mutacija se češće prenosi preko majke, asvaka sljedeća generacija nosi molekulski i klinički težu mutaciju. Bolest se očituje simptomima više organskih sustava: zahvaćeni suproprečnoprugasti mišići i glatki mišići crijeva, miokard i njegov provodni sustav, endokrini i imunološki sustav, razvija se katarakta,djeca intelektualno zaostaju, a postoje i neurološki defi citi. Prikazujemo muško novorođenče s generaliziranom hipotonijom, facijalnom dismorfi jom, oskudnom mimikom, poteškoćama hranjenja i deformitetima stopala. Iz obiteljske anamneze se saznaje da jesedmogodišnjem bratu postavljena klinička sumnja na facioscapulohumeralnu mišićnu distrofi ju. Ciljani neurološki pregled majkeotkrio je slabost mišića lica, nemogućnost čvrstog zatvaranja očiju, akcijsku miotoniju ruku i perkusijsku miotoniju jezika. Zbog togasmo se odlučili učiniti molekularno genetičku analizu kojom je utvrđen alel s punom mutacijom. Potrebno je obaviti i genetičkoispitivanje cijele obitelji.
Comprehensive management of severe epilepsies in small countries with limited resources
Authors: Ravnik Igor Mihael , Krajnc Natalija , Perković Mirjana Benedik , Gosar David , Vranič Andrej
Published: November 2024

High professional expertise organized in multidisciplinaryteams is needed to provide comprehensive epilepsy care. InEurope, 54 million people live in 24 countries with a populationof less than 5 million and 12.5 millions live in countrieswith a population of less than 3 million. Adjusted solutionsare needed for severely aff ected people with epilepsy insmall health systems.Living with epilepsy in a small country is a unique challengefor the patient, and so is implementing comprehensive carefor people with epilepsy by health providers. Small populationsrequire adjusted systems of care, often hard to realizedue to limitations in economy and politics. Small populationalso means fewer patients referred and limited professionalexpertise that may adversely aff ect the quality of care.National languages spoken by small populations make useof foreign facilities diffi cult. Linguistic issue becomes evenmore important when neuropsychological and psychiatricproblems are dealt with outside the area exclusively dependingon one language. There is also a risk to neglect patientsaff ected by rare syndromes requiring specifi c treatments.Comparing models of practice may be a useful exercise:systems of care extrapolated from large to smallpopulations may not be most appropriate. Models eff ectivein small health systems may at times be applicable to largerpopulations.
Causes and prevalence of dental and oral soft tissue injuries in school children in Zagreb, Croatia
Authors: Vuletić Marko , Škaričić Josip , Soldo Mirko , Trampuš Zdenko , Čuković-Bagić Ivana , Jurić Hrvoje
Published: November 2024

The purpose of this study was to identify the etiology and types of traumatic dental injuries in permanent teeth, as well as the presence of oral soft-tissue injuries among school children in Zagreb, Croatia. A retrospective study was conducted at Department of Pediatric Dentistry, University Dental Clinic in Zagreb, Croatia using documentation on 319 patients (203 male and 116 female) aged 7 to 16 years with injuries of permanent teeth recorded between February 2009 and January 2013. Trauma was seen in 542 permanent teeth, yielding a mean of 1.7 injured permanent teeth per child. The majority of children sustained tooth injury at the age of nine. The most frequently aff ected teeth were maxillary central incisors (81%), followed by maxillary lateral incisors and mandibular central incisors as least often aff ected. Traumatic dental injuries involved hard dental tissue and pulp tissue that were twice as frequently aff ected as periodontal tissue. The most commonly observed traumatic dental injuries of the hard dental tissue and pulp was enamel-dentin fracture without pulp exposure, while subluxation was the most common type of periodontal tissue injury. The main cause of tooth injury was fall and the majority of injuries occurred at school. Of all patients included in the study, 132 (41.4%) had also oral soft-tissue injuries. Comparing the group of children with traumatic dental injuries and soft-tissue injuries and the group of children with traumatic dental injuries without soft-tissue injuries, a statistically signifi cant diff erence was found in the time that had elapsed from the injury to initial treatment (P<0.01).
Kakvoća komunikacije na Zavodu za dječju kirurgiju KBC Zagreb
Authors: Stilinović Marina , Pipinić Ivana Sabolić , Antabak Anko , Ćavar Stanko , Bogović Marko , Medančić Suzana Sršen , Tandara Ruža , Luetić Tomislav
Published: November 2024

Istraživanje je provedeno kako bi se ispitalo zadovoljstvo i utvrdilo iskustvo roditelja hospitalizirane djece s različitim aspektima komunikacije s medicinskim osobljem za vrijeme bolničkog liječenja. U istraživanju je sudjelovalo osamdeset pet roditelja djece hospitalizirane na Zavodu za dječju kirurgiju i urologiju Klinike za kirurgiju KBC Zagreb. Za potrebe istraživanja primijenjen je prilagođeni„Upitnik o iskustvima roditelja djece s teškoćama u razvoju u komunikaciji s medicinskim osobljem“. Upitnik su ispunjavali roditelji nadan djetetova otpusta iz bolnice. Roditelji medicinsko osoblje najčešće ocjenjuju kao profesionalno, ljubazno i empatično. Informacije koje su dobili u razgovoru bile su im razumljive, a to su provjerili liječnici. Najviše informacija dobili su o djetetovom trenutnomstanju i o tijeku i postupcima liječenja. Svi roditelji smatraju važnim da na Zavodu postoji stručna osoba koja pruža psihosocijalnupotporu. Najveći broj ispitanih roditelja izjavio je da su im od medicnskog osoblja najveću potporu pružili liječnik i medicinske sestre.Na pitanje o zadovoljstvu s komunikacijom s medicinskim osobljem općenito, većina ispitanika izjasnila se kao vrlo zadovoljni (75%ih je vrlo zadovoljno s komunikacijom s liječnikom, 82% ih je vrlo zadovoljno s komunikacijom s medicinskim sestrama). Odnosmedicinskog osoblja i obitelji važan je u procesu liječenja djece i adolescenata. Primjerena komunikacija medicinskog osoblja i roditelja umanjuje stres roditelja zbog bolesti i liječenja i unapređuje tijek i rezultate liječenja.
Biopsija korionskih resica
Authors: Vičić Ana , Stipoljev Feodora
Published: November 2024

Biopsija korionskih resica je invazivna metoda prenatalne dijagnostike koja se izvodi u prvom tromjesečju trudnoće, radi određivanjakromosomskih i genskih poremećaja ploda. Rutinski se provodi u većini tercijarnih centara te je uz amniocentezu najčešće primjenjivana invazivna metoda prenatalne dijagnostike. Biopsija korionskih resica kao metoda koja se provodi u prvom tromjesečjutrudnoće, svakako je prvi izbor u slučajevima visokog rizika za kromosomske abnormalnosti, psihičkog opterećenja trudnice zbogprethodne trudnoće s kromosomopatijom te kod obitelji s genskim ili metaboličkim poremećajem poznatog molekularnog defektas visokim rizikom rađanja bolesnog potomstva. Nalazi dobiveni u ranoj fazi trudnoće od iznimne su važnosti za roditelje, jer smanjujunapetost dugotrajnog iščekivanja rezultata, omogućavaju roditeljima dovoljno vremena za donošenje odluke o daljnjem tijekutrudnoće te u konačnici omogućuju prekid trudnoće u njenoj vrlo ranoj fazi.
Akutne dišne infekcije u djece uzrokovane adeno i parainfl uenca virusima
Authors: Mlinarić-Galinović Gordana , Tomić Gorana Šulentić , Sim Renata , Markovinović Leo , Tešović Goran , Čepin-Bogović Jasna , Ivković-Jureković Irena
Published: November 2024

Adeno virusi i parainfl uenca virusi česti su uzročnici akutnih respiratornih infekcija u djece i odraslih u svim dijelovima svijeta. Ciljovog rada je prikazati epidemiološke karakteristike akutnih respiratornih infekcija u djece uzrokovanih adeno virusom i parainfl uenca virusom na području Zagreba i Zagrebačke županije. U istraživanju su sudjelovala hospitalizirana djeca mlađa od 10 godina spodručja Zagreba i Zagrebačke županije oboljela od akutnih respiratornih infekcija u razdoblju od 14. studenog 2008. do 14. studenog 2010. godine. Od svakog bolesnika je uzet nazofaringealni sekret u kojem su adeno virusi i parainfl uenca virusi dokazanimetodom izravne imunofl uorescencije. Infekciju uzrokovanu adeno virusom ili parainfl uenca virusom imalo je 528/2403 (21,97 %)bolesnika s akutnim respiratornim infekcijama. Od njih je 306/528 (58%) djece bilo muškog spola i 222/528 (42%) ženskog. Odnosukupnog broja muške naprama ženskoj djeci bio je 1:0,73. Adeno virusi su dokazani u 448/2403 (18,64%) bolesnika, a parainfl uencavirusi u njih 80/2403 (3,33%). Broj slučajeva infekcije adeno virusom ili parainfl uenca virusom značajno raste u dobi iznad 12 mjesecite postupno pada od navršene 2. godine. Adeno virusi su se u istraživanom razdoblju javljali tijekom cijele godine, s nešto manjomučestalošću u ljetnim mjesecima, dok su vrhunci učestalosti u proljeće (posebno mjesec ožujak). Najčešće infekcije adeno virusom iparainfl uenca virusom u dječjoj dobi su one gornjeg dišnog sustava (90%), druga po redu je pneumonija, a potom bronhiolitis,bronhitis te krup. Iz rezultata studije se vidi da su adeno virusne infekcije u djece češće od infekcija parainfl uenca virusom te da su ovadva virusa važni uzročnici infekcija gornjeg dijela dišnog sustava i pneumonija u dobi od 1.-5. godine života.
tongue
Authors: Zakanj Zora
Published: November 2024

Ankiloglosija ili prirastao jezik anomalija je karakterizirana kratkim frenulumom jezika, što može dovesti do kratkoročnih i dugoročnih ograničenja u pokretima jezika. U novorođenačkoj dobi uzrokuje teškoće hranjenja. Cilj rada je prikazati ankiloglosiju premakliničkoj i funkcionalnoj prezentaciji u inače zdrave novorođenčadi, utvrditi u kojoj mjeri ona s ankiloglosijom ima teškoće s dojenjemte procijeniti učinkovitost frenotomije. Retrospektivnom analizom obuhvaćeno je 2 872-je zdrave novorođenčadi. Klinički je procijenjena ankiloglosija, utvrđene su teškoće dojenja te učinkovitost frenotomije u novorođenčadi s teškim oblikom ankiloglosije.Učestalost ankiloglosije je 3,76%. Omjer dječaka i djevojčica je 3,1:1. Blaga ankiloglosija je nađena u 27-ero (25%) novorođenčadi, u32-je (29,63%) umjerena, dok ih je 49-ero (45,37%) imalo tešku ankiloglosiju. Prolazne teškoće s dojenjem u novorođenčadi s blagomi umjerenom ankiloglosijom otklonjene su pravodobnom stručnom pomoći pri dojenju, bez potrebe za frenotomijom. U 37,04% odukupnog broja djece s ankiloglosijom samo u novorođenčadi s teškom ankiloglosijom i s istodobnim teškoćama dojenja (40 od 49slučajeva) učinjena je frenotomija. Najzastupljenija teškoća je bol pri dojenju (75%), teškoće stavljanja na prsa u 22,5%, a oštećenjebradavica u 2,5%. Intenzitet boli prije frenotmije iznosio je 7,38±1,53, a poslije frenotomije 1,75±1,11 (p<0,0001). Pravilna procjenastupnja ankiloglosije i potrebe za frenotomijom u novorođenačkoj dobi mogu ukloniti najčešće teškoće s dojenjem. Frenotomija unovorođenačkoj dobi je poštedan, brz i siguran zahvat koji se može provesti u prvim danima života, a dugoročnu učinkovitost bitrebalo potvrditi kontroliranim randomiziranim studijama
child
Authors: Miočinović Ljiljana Popović , Nađ Katarina Bošnjak , Čikara Mirjana Mladin , Giljević Jasminka Stepan
Published: November 2024

Različite metode liječenja tumora mozga mogu djelovati proepileptički (kirurška lezija, kemoterapeutici: vinkristin, metotreksat) iliantiepileptički (kemoterapeutik temozolamid). Radioterapija može djelovati dvojako. Kemoterapeutici i neki konvencionalniantiepileptički lijekovi (fenitoin, karbamazepin, fenobarbiton, valproati) imaju isti metabolički put preko jetrenih enzima citokromaP450, što može dovesti do interakcije lijekova. Cilj je prikazati složenost liječenja epileptičkih napadaja u 11-godišnjeg bolesnika stumorom mozga. Sada 11- godišnji dječak bio je zdrav do 7. godine, osim što se u nekoliko navrata potužio na blažu glavobolju.Tada je dobio prvi epileptički napadaj, tipa grand mal, dijagnosticiran je pilocitni astrocitom hipotalamičke regije. Zbog opstruktivnog hidrocefalusa hitno je ugrađena V-P drenaža, a u drugom kirurškom zahvatu tumor je reduciran. Posljedično je nastupilasljepoća na desnom oku, a na lijevom oštećenje vida uz glaukom. Liječenje se nastavilo kemoterapeuticima (carboplatin, vinblastin,temozolamid) i antiepileptičkim lijekom (metilfenobarbital). Napadaje nije imao tri godine. U dobi od 10 godina dobiva sve učestalijeepileptičke napadaje, složene parcijalne. Izostavlja se metilfenobarbital, uvodi valproat i levetiracetam. Napadaji nisu prekinuti. Uzantiepileptički lijek i kemoterapeutik uzimao je i više vrsta drugih lijekova. Liječenje epileptičkih napadaja kod tumora mozga zahtijeva interdisciplinarni pristup. Kod djece koja se liječe kemoterapeuticima preporuča se primjenjivati lijekove koji ne induciraju/inhibiraju enzimski sustav jetre. To su levetiracetam, lamotrigin i gabapentin. Kod primjene valproične kiseline potreban je pojačan oprez
New recommendations for the assessment of disease activity, diagnosis and treatment of juvenile idiopathic arthritis
Authors: Jelušić M. , Malčić I.
Published: November 2024

Juvenile idiopathic arthritis is an autoimmune disease which is not unique, but makes a group of similar diseases that have a different course, prognosis and outcome. This article sets out the latest guidelines from the American College of Rheumatology for treatment of different types of juvenile idiopathic arthritis based on various pathogenesis of the disease. We present a new approach to the assessment of disease activity which does not include only evaluation by the physician, but great importance is given to the perception of patients and their parents/guardians. Such an approach to the treatment of patients with chronic disease significantly improves the quality of cooperation between physicians and patients/parents and thus the quality of medical care, therapeutic effects of drugs and satisfaction with health condition. Through this publication we want to introduce readers to the latest diagnostic and therapeutic guidelines and assessment of the disease activity based on a large number of working groups; because of the global significance, they should be used in Croatian conditions.
A girl with an asymptomatic parietal encephalocele
Authors: Guid M. Todorovič , Vokač N. Kokalj , Varda N. Marčun
Published: November 2024

Encephalocele is a general term that denotes protrusion of cranial contents beyond the normal border of the skull. A female infant with a soft swelling on the head diagnosed as posterior parietal encephalocele at the age of 8 months is presented. The reason for late diagnosis was most likely her asymptomatic presentation. Neurosurgical repair was simple, as the lesion containing only cerebrospinal fluid was small. The postoperative period was also uncomplicated. Nevertheless, the child was followed up later on. In addition, genetic analysis by high-resolution micro-array technique was found to be normal.
Cryptorchidism – our results and treatment protocol
Authors: Varga J. , Živković D. , Vuković D. , Gajdobranski Đ. , Šarac D.
Published: November 2024

We analyzed patients operated on for cryptorchidism at the Pediatric Surgery Department during a 2-year period (2008-2009). We analyzed patient age, side of cryptorchidism, position of the testes, operative approach (open, laparoscopic), type of operative treatment (orchydopexy, orchydectomy with implantation of testicular prosthesis), and results of histopathologic analysis of testes that underwent biopsy. During the study period, 192 patients, mean age 5.62±3.78 years, underwent surgery for cryptorchidism. Unilateral cryptorchidism was present in 161 (83.9%) patients, 93 (57.8%) of them right-sided. A total of 223 testes underwent surgery, 22 (9.9%) of these in prescrotal position, 174 (78%) in inguinal position and 27 (12.1%) in intra-abdominal position. Laparoscopic exploration was performed in 37, orchydopexy in 27 and resection of testicular remnant with immediate implantation of testicular prosthesis in the remaining 10 patients. Intraoperative biopsy was done in 165 (74%) testes. Despite continuous education, the mean patient age of 5.62 years at the time of treatment was above the desired age of two years. It is commendable that an increasing number of patients undergo biopsy during orchydopexy.
Breastfeeding duration influences migraine headache onset
Authors: Pogančev M. Knežević , Jović N. , Bregun A. Doronjski , Šrek A. , Filipović D.
Published: November 2024

The objective of this study was to determine the influence of breastfeeding duration on migraine headache. The influence of breastfeeding duration on the manifestation of migraine headache and age at onset of migraine headache symptoms was assessed by analyzing history data on headache of 30 636 children aged 3-17 residing in Vojvodina and on nutrition in 24 011 of these subjects. Data were compared between children with migraine headache (8.63%) and other primary recurrent headaches (18.83%). Negative Pearson correlation ratio (0.07, p<0.01) clearly showed reciprocal influence of the duration of breastfeeding on the migraine headache onset and earlier onset of migraine in children who were breastfed for a shorter time (p<0.01). Defining the duration of breastfeeding as an early predisposing factor for migraine offers the possibility of very early migraine headache prevention, especially in children with positive heredity for migraine.
Vagus nerve stimulation in children with refractory epilepsy: age at implantation as a predictor of better efficacy
Authors: Lagae L. , Verstrepen A. , Jansen K.
Published: November 2024

In this study, the efficacy of vagus nerve stimulation treatment was analyzed in a cohort of 70 children with refractory epilepsy. Both children with partial (n=16) and generalized epilepsies (n=54) were included. Age at implantation varied between 19 months and 25 years. Overall, responder rate was 54% with 5.7% of the children becoming seizure free. The only factor in our analysis that could predict good outcome was age at implantation. In the youngest age group (<5 years), responder rate was 77% and this group also included 3 of the 4 seizure free children. These 3 seizure free children were known to suffer from tuberous sclerosis. There were no outcome differences comparing generalized with partial epilepsies.
Neurologic signs and symptoms associated with influenza infection in children
Authors: Kukuruzović M. , Šojat Lj. Cvitanović , Juraški R. Gjergja , Malenica M. , Kužnik K. , Štefanović I. Mihatov , Vugrinec M.
Published: November 2024

Influenza viruses are spread worldwide, and due to their very easy and rapid dissemination, they eventually cause pandemic disease as well as minor or major epidemics every winter. Influenza viruses cause predominantly respiratory illness accompanied by systemic symptoms, but are also responsible for numerous complications. The aim of the study was to describe clinical characteristics of influenza A/B in our patients presenting with neurologic symptoms and hospitalized at Neuropediatric Department, Sestre milosrdnice University Hospital Center from January 2008 to April 2011, and at the same time to raise general awareness of the neurologic complications of influenza in children.
Acute hematogenous osteomyelitis of pelvis in children
Authors: Gliha A. , Žganjer M. , Župančić B. , Cigit I. , Čizmić A. , Štampalija F.
Published: November 2024

Acute hematogenous osteomyelitis (AHOM) is a bacterial infection of the skeleton. Typically, it involves tubular bones, but in rare cases, it can affect pelvic bones. It can occur after trauma, operation or by hematogenous diffusion. It is often misdiagnosed due to the anatomic complexity of the pelvis. The aim of this case report is to present unspecific clinical signs and difficulties encountered in the diagnosis of pelvic AHOM. We reviewed clinical signs, diagnostic methods and treatment. A case is presented of a 16-year-old boy admitted to our hospital with abdominal pain, limping, pain in the right hip and fever. After excluding acute abdomen and other possible causes of the mentioned symptoms, an accurate diagnosis was made several days later by scintigraphy. It was a rare case of a pelvic AHOM. Staphylococcus epidermidis was isolated in blood cultures. The patient responded well to antibiotic therapy and was discharged from the hospital without any difficulties. On follow up examinations there were no complications or clinical signs of osteomyelitis. In children with hip pain, limping and fever, pelvic AHOM should always be considered on differential diagnosis. The best diagnostic method is bone scintigraphy and magnetic resonance. Our patients outcome was excellent after antibiotic therapy.
Balanitis xerotica obliterans as a more common cause of penis foreskin stricture than generally presumed
Authors: Leko M. , Kralj R. , Krofak S. , Župančić B.
Published: November 2024

Balanitis xerotica obliterans is a disease that affects male reproductive organ and is considered to be a version of lichen sclerosus vulvae that is relatively common in the female external reproductive organ. In the last couple of years, a number of papers appeared stating that this condition is a more common cause of stricture of the penis foreskin than it has been assumed. Given the fact that balanitis xerotica obliterans is considered by the European Association of Urology to be a precancerous lesion for penile carcinoma, our intent is to remind the colleagues that every penis phimosis that is suspected to have occurred on the basis of balanitis xerotica obliterans requires histopathologic evaluation. We continue our research at our Department of Pediatric Surgery to confirm this notion.
Roentgenographic findings in bronchiolitis
Authors: Zalavani F. , Petrela R. , Dega S. , Lluka R. , Kola E. , Bakalli I. , Koja A. , Preza K.
Published: November 2024

Background. Acute bronchiolitis is a very frequent respiratory infection in infancy characterized by obstructive respiratory distress with crepitations and wheezing. The diagnosis of bronchiolitis is complex because characteristic radiological patterns are combined with each other. The aim of this study is to reveal radiologic changes in patients with acute bronchiolitis. Methods. One hundred and seventy-five children with bronchiolitis in their first wheezing episode were included in this study, who were admitted to the pediatric intensive care unit between 2000 and 2008. All patients underwent X-rays of the lungs in addition to other clinical and laboratory examinations. Results. Our results show that radiological changes were present in all cases: hyperinflation of the lungs in 175 children (100%), perihilar linear density and peribronchal thickening in 121 children (69.14%), bilateral bronchopneumonia in 44 children (25.14%), lobar pneumonia in 26 children (14.85%) and atelectasis in 28 children (16%). Usually radiological changes appear in combined forms: pulmonary hyperinflation and pulmonary trauma signs in 121 children (69.14%), pulmonary hyperinflation with bronchopneumonia and atelectasis in 31 children (17.71%), pulmonary hyperinflation with lobar pneumonia and atelectasis in 23 children (13.14%). Conclusions. We conclude that pulmonary hyperinflation and perihilar linear density are more evident when the auscultatory findings are poor. This fact has a practical value and is the main cause for the disappearance of alveolar consolidation. The differentiation between viral and bacterial bronchopneumonia as well as pneumonia and atelectasis is specially important. The radiological aspect gives us guidance for therapeutic follow up and treatment.
A boy with Asperger’s disorder, Crohn’s disease and epilepsy
Authors: Palčevski G. , Močenić I. , Korotaj Z. , Peršić M.
Published: November 2024

Asperger’s disorder (AD) is a pervasive developmental disorder that is part of autism spectrum disorders. It is characterized by daydreaming, hallucinations and disregard of external reality. The feeding habits of these patients are often peculiar and inadequate, and therefore frequently ascribed to the clinical features of pervasive developmental spectrum. Besides neurological disorders, these children often complain of gastrointestinal (GI) discomfort such as constipation, diarrhoea, abdominal pain and abdominal distension. Most of these signs are also present in chronic inflammatory bowel disease. Apart from neurological disorders, pathohistological changes in the GI tract of autistic children have also been described. On the basis of these findings the term “autistic enterocolitis” has been suggested as an independent diagnosis. However, recent studies question the reliability of this tenet. Here we describe a patient with AD, Crohn’s disease and epilepsy. This finding stresses the need for the completion of basic algorithm examinations in autistic children.
Flexible laryngotracheobronchoscopy (FLTB) in the diagnosis of children’s diseases: our experience
Authors: Babić I. , Tolić Z. , Bogović J. Čepin
Published: November 2024

The most frequent diseases of the respiratory system in children affect the airways. Airway problems usually start to occur at a very young age, in neonates, infants and children under 10 years of age. Airway endoscopy is of the utmost importance in the diagnosis of these conditions. Flexible laryngotracheobronchoscopy (FLTB) is a superior method currently used for this purpose. There are numerous indications for FLTB in children, to mention only the most common ones: congenital stridor, recurrent airway inflammation, impossible extubation, respiratory crisis, etc. In the present study, FLTB procedures performed under general anaesthesia by Zagreb University Children’s Hospital ENT specialists during the 2003-2008 period were analyzed retrospectively. Out of 102 FLTB procedures, 71 were the first ever procedures, whereas 31 were done as repeat FLTB (for follow up, lavage, sampling for analysis, etc.). Sixty four (62.7%) of 102 children were up to one year of age. The three most common indications for FLTB were congenital stridor, prolonged intubation, and follow up, whereas laryngomalacia was the most common diagnosis. The procedure was not associated with any complications. In conclusion, FLTB is a highly useful, first-choice and relatively safe method in the diagnosis of pathologic respiratory conditions and diseases in children.
Duration of breastfeeding and baby’s initiative to communicate with mother in refugee and displaced population
Authors: Jovančević M. , Knežević M. , Konjarik Z. , Knežević S.
Published: November 2024

Breastfeeding as an aspect of communication between mother and her baby was surveyed in 477 refugee/displaced mothers. Duration of breastfeeding was correlated with the child’s initiative to establish eye contact, spontaneously smile, touch and initiate play with its mother. The specific influence of the mother’s depression and post traumatic stress disorder (PTSD) on the duration of breastfeeding and early communication was also studied. The consistency of the correlation with breastfeeding for all monitored parameters (longer breastfeeding is followed by more child initiative) allows us to conclude that breastfeeding is an important factor in mother – infant communication. It is not possible to establish causal relation between breastfeeding and communication initiative by infants as shorter breastfeeding might be a sign of overall lack of responsiveness and other emotional problems in the mother that jointly reduce the level of signal interchange. Mothers with PTSD and depression breastfeed their babies longer than mothers without those symptoms.
Labial agglutination and infection in prepubertal girls
Authors: Dugić N. Šikanić , Pustišek N. , Hećej V. Hiršl , Grlić A. Lukić
Published: November 2024

Objectives: To assess the correlation of previous infections with the frequency of labial agglutination, to confirm the effectiveness of oestrogen therapy and the frequency of positive microbiological swabs after treatment. Methods: The study included 88 girls aged from 3 months to 10 years who have been examined at the Gynaecological outpatient unit of Children’s Hospital Zagreb from 2005-2007. Anamnestic data about previous infections were obtained from the parents. All girls were treated with an oestradiol cream twice a day. The patients were then re-examined 2 weeks and/or 4 weeks later. After the treatment, vaginal and vulvar smears were taken for microbiological analysis. Results: Twenty-eight (31.8%) girls were lost to follow up. Out of 60 girls in 27 (45%) girls we learned about a previous respiratory or urinary infection in the 3 months before our exam. 45/60 (60%) girls presented with complete agglutination, but without urine disturbances and 15/60 (25%) had partial fusion. After 2 weeks of treatment we found complete resolution in 16/60 (26.7%) cases, after 4 weeks in 30/60 (50%) cases, and after 4-6 weeks of local hormonal treatment in 14/60 (23.3%) cases. Out of 60 study patients’ culture in 27 (45%) the causative agents were isolated from the vaginal culture. Agglutination subsequently recurred in 20/60 children (33.3%), mostly in association with respiratory infection Conclusion: Topical oestrogen application is the method of choice in the treatment of labial agglutination, but for at least 4 weeks of application. Recurrence of agglutination is common and mostly associated with infection. It could be reduced by application of a lubricant to lysed surfaces for as long as 6 months after lysis and at the time of infection.
Lymphomas in childhood
Authors: Dominis M. , Gašparov S.
Published: November 2024

Lymphomas are derived from precursor lymphocytes by oncogenic changes that induce deregulation of growth factors. Lymphomas consist of clonal cells which are prone to further oncogenic changes. Clonal neoplastic expansions are often apparent as discrete masses and therefore these settings are the most challenging to recognize as lymphoma. Approximately seven types of childhood’s lymphomas are most frequent with clearly defined diagnostic criterias: lymphoblastic leukemia/lymphoma, large B- cell lymphoma (DLBCL) of the mediastinum, Burkitt’s lymphoma (BL), Hodgkin’s lymphoma(HL) and anaplastic large cell lymphoma – CD30+/ALK+(ALCL/CD30+/ALK+). However, some rare entities, i.e. a small cell variant of ALCLK CD30+/ALK+, hepatospenic and natural killer cell T-like lymphomas, require early diagnosis because of their highly aggressive clinical course. Therefore the components of diagnostic interpretation in pediatric hematopathology should be to establish a diagnosis that is appropriate for clinical setting that is timely and holds over time. To achieve that it is necessary to optimize tissue processing. The sophisticated studies available require sophisticated initial selection of tissue samples based either on clinical or gross examination. Finally, the most important thing is to maintain a collegial and professional relationship with clinicians. Clinical interpretation of symptoms, the distribution of disease and course of illness are invaluable in diagnosis and should always be taken into account in consideration of diagnosis.
Children’s eye injuries in Split-Dalmatian county, Croatia
Authors: Rogošić V. , Lakoš V. , Bojić L. , Pleština I. Borjan , Kovačić Ž. , Poljak K. , Titlić M. , Jukić I. , Duplančić D. , Rogošić L. Vanjaka
Published: November 2024

The aim of this study was a retrograde analysis of mechanical eye injuries data in children in the Split-Dalmatian county requesting hospital treatment at the Department of Ophthalmology, University Hospital, Split, in a three year period from 1st November 2005 to 31st October 2008. To establish the type and severity of mechanical eye injuries The Birgingham Eye Trauma Terminology (BETT) and International Ocular Trauma Classification (IOTC) were used. The results of eye injuries in children were compared with the results of other authors, from other countries, e.g.: Israel, Finland and Brazil. At the Department of Ophthalmology in Split over the three year period 7648 patients were admitted, 419 (5.45%) patients were treated for eye trauma. 110 (26.25%) of them were patients younger than 18 years. From the total of patients hospitalized in our Department, the average frequency of trauma was from 29 to 47 patients per year (26.36% to 42.73%). Patients treated as out-patients were not included in the study, nor those in other departments and clinics treated as craniotrauma or polytrauma. The results are classified according to age, sex, severity and type, time, cause and circumstances of injury and final visual outcome. Child eye trauma accounts for one third of the total of traumatized patients in the developed world. The percentage of injury could be decreased by better supervision, child education and organization of play in school and sports. The conclusions we made are results connected to the frequency of division, the cause and type of eye injury, to contribute to a better solution for disorders in our profession. The need for the adaptation of qualifications and registrations of eye injuries should be coordinated with the new national protocol and must be adapted to children of all ages.