bluuebunny/crossref_metadata_2025 huggingface dataset:
This is a review paper on the most signifi cant social problem that aims to raise interest and motivate the society to revitalize Gorski Kotar, respecting the objective value of the area popularly called Mala Švica (Little Switzerland), now known as the ‘
Authors: Grgurić Josip , Ivica Knežević Ivica x , Malatestinić Đulija , Ivanišević Goran , Ortynski Dubravka , Marač Dragica , Krpes Snježana , Mustajbegović Jadranka , Bauer Andro , Trošić Daniel , Glad Dragica
Published: November 2024

Pregledni rad o najznačajnijem društvenom problemu koji ima za cilj zainteresirati i pokrenuti društvo radi revitalizacije Gorskogkotara, ali na objektivnoj vrijednosti jednoga kraja koji su nazivali „Mala Švica“ (mala Švicarska), a danas ga zovu „Zeleno srce Hrvatske“. Slijedom takvih slogana koji idealiziraju jedan kraj, a stvarnost je depopulacija tog područja, pitanje je kako zaustaviti ta negativna kretanja. Odgovor je jednoznačan, treba krenuti od djece.
Nasljedna nepodnošljivost fruktoze – pregled literature i prikaz dvoje bolesnika
Authors: Paponja Kristina , Rahelić Valentina , Mesarić Nikola , Žigman Tamara , Škaričić Ana , Bilandžija-Kuš Iva , Pavić Eva , Senečić-Čala Irena , Peršić Mladen , Vuković Jurica , Barić Ivo , Ramadža Danijela Petković
Published: November 2024

Nasljedna nepodnošljivost fruktoze ili fruktozemija je autosomno recesivno nasljedni poremećaj koji nastaje zbog nedostatne aktivnosti enzima fruktoza-1-fosfat aldolaze (aldolaze B). Bolest se klinički, u dotad naizgled zdravog dojenčeta, očituje nakon uvođenjanamirnica koje sadrže fruktozu, saharozu ili sorbitol. Najčešći simptomi bolesti su povraćanje, bljedilo, drhtavica, somnolencija, akatkad i konvulzije (većinom kao posljedica hipoglikemije, odnosno neuroglikopenije). Može se razviti i akutno zatajenje jetre, a akose dijete pravilno ne zbrine, takva kriza može završiti smrću. Pošto se fruktoza, saharoza i sorbitol isključe iz prehrane, simptomi bolesti se brzo i spontano povlače. Ako bolest ostane neprepoznata, dugoročno može uzrokovati ponavljajuće bolove u trbuhu,povraćanje, kroničnu bolest jetre, tubulopatiju, rahitis te zaostajanje u rastu i razvoju. Anamnestički podatci o pojavi simptoma nakon uvođenja voća i povrća u dohranu i/ili odbojnost prema slatkoj hrani ključni su za postavljanje sumnje na ovu bolest. Laboratorijski nalazi koji podupiru dijagnozu, a česti su u akutnom pogoršanju, su hipoglikemija, hipofosfatemija, hiperuricemija, metabolička acidoza i povišene aktivnosti aminotransferaza. Dijagnoza se potvrđuje nalazom bialelnih patogenih mutacija gena ALDOBili mjerenjem aktivnosti enzima u tkivu jetre ili crijeva, što se danas rjeđe primjenjuje. Pravodobno postavljanje dijagnoze ključno jeza dobar ishod. Ako se spriječi unos fruktoze u organizam, prognoza je izvrsna. Cilj ovog rada je predočiti klinička obilježja nasljednenepodnošljivosti fruktoze prikazom dvoje bolesnika, jednog s akutnim, a drugog sa subakutnim kliničkim tijekom, te tako upozoritina ovu rijetku, a lječivu nasljednu metaboličku bolest.
Prepoznavanje čimbenika rizika u pedijatrijskoj populaciji za razvoj kardiovaskularnih bolesti u odrasloj dobi
Authors: Šakić Dragica , Jovančević Milivoj , Šakić Zrinka , Jurin Ivana , Armano Giovana , Oković Sonja
Published: November 2024

Bolesti srca i krvnih žila glavni su uzrok smrti u Hrvatskoj. Jedan od čimbenika rizika za nastanak kardiovaskularnih bolesti je abdominalna pretilost. U novije vrijeme kao pouzdanija metoda za utvrđivanje te pretilosti primjenjuje se omjer opsega struka i visine, tzv.WHtR kriterij. Prema dosadašnjim istraživanjima problem debljine počinje već od pete godine života. Radovi koji su obuhvaćali i ovudobnu skupinu primijenili su vrijednosti WHtR ≥ 0,5 kao povišenu za sve dobne skupine i oba spola. No najnovija istraživanja ograničena su na djecu od 6. do 18. godine i definiraju WHtR graničnu vrijednost za djevojčice ≥ 0,459, a za dječake ≥ 0,473. Cilj ovogistraživanja bio je utvrditi u kojoj su mjeri kod djece prisutni čimbenici rizika, prepoznaju li ih njihovi roditelji te jesu li svjesni potreberazvijanja zdravih životnih navika radi prevencije kardiovaskularnih bolesti u odrasloj dobi. Istraživanjem je obuhvaćeno 1418-erodjece, 730 dječaka i 688 djevojčica u dobi od 5 do 15 godina, koji se nalaze u pedijatrijskoj skrbi triju ordinacija Doma zdravlja Zagrebzapad. Prema WHtR kriteriju ≥ 0,5, 7,3% dječaka i 8,8% djevojčica ima povećan zdravstveni rizik za kardiovaskularne bolesti. Noprema najnovijim WHtR kriterijima takvih je 25,1% djevojčica i 21,4% dječaka. Čak 79,6% roditelja ne prepoznaje čimbenike rizika zapojavu kardiovaskularnih bolesti kod vlastite djece. Rezultati našeg istraživanja slični su rezultatima drugih istraživanja te pokazujukako većina roditelja nije svjesna problema pretilosti, pa samim time ni potrebe za odgovarajućom promjenom životnih navikavlastite djece. Iz svega ovoga zaključujemo da bi bilo nužno poduzeti dodatne edukacijske mjere kako u ordinacijama primarnepedijatrijske skrbi tako i u odgojno-obrazovnim ustanovama, radi pravodobne i učinkovite intervencije koja bi očekivano pridonijelasmanjenju pobola i smrtnosti u odrasloj dobi.
Quality of life and level of physical activity in primary school children with juvenile idiopathic arthritis in Primorje-Gorski Kotar County
Authors: Kezele Tanja Grubić , Medjimurec Slaven , Bukarica Marcel , Čorapović Antonela , Fužinac-Smojver Ariana
Published: November 2024

The aim of this cross sectional study was to assess the quality of life (QOL) and level of physical activity in primary school children with juvenile idiopathic arthritis (JIA) in the Primorje-Gorski Kotar County as compared to healthy peers, and to identify the most pronounced differences in QOL between them. The study included 13 children with JIA recruited from the paediatric rheumatology clinic and 17 healthy children from primary school. The children were aged 8-14 years. All participants, including their parents, completed questionnaires to assess the level of their physical activity (Physical Activity Questionnaire for Children; PAQ-C) and QOL (Pediatric Quality of Life Inventory (PedsQLTM) Generic Core and Rheumatology Module scales). Study results showed statistically significant differences in the QOL associated with physical functioning/health (p=0.033), school activities (p=0.008) and psychosocial health (p=0.033) between JIA and control groups. Responses in the rheumatologic questionnaire revealed a statistically significant difference in the QOL associated with pain (p=0.041), daily activities (p=0.011), treatment (p=0.002), concern (p=0.0006) and communication (p=0.0002) between JIA and control groups. The JIA group showed a significantly lower level of physical activity (p=0.008). There was a statistically significant (p=0.0000) correlation between the QOL associated with pain and the QOL associated with physical functioning/health (r=0.94), emotional functioning (r=0.71), social functioning (r=0.74), school functioning (r=0.56) and psychosocial health (r=0.80). In conclusion, study results suggested JIA to affect QOL in almost all domains in the affected primary school children, with the greatest differences from their healthy peers being recorded in the QOL associated with worrying and communicating about their illness. Key words: ARTHRITIS, JUVENILE; EXCERCISE; QUALITY OF LIFE; SCHOOLS; CHILD
Endocrine disruptors (EDs) are exogenous chemicals that alter the endocrine system function and have adverse effects on animal and human health. Synthesized compounds such as pesticides, industrial chemicals and their by-products, natural mycotoxins and p
Authors: Dodig Slavica , Dodig Daniela Čepelak , Pavić Ivan
Published: November 2024

Endokrini disruptori (ED) egzogene su kemikalije koje mijenjaju funkciju endokrinog sustava, čime dovode do štetnih učinaka nazdravlje životinja i ljudi. U skupinu trajno prisutnih štetnih spojeva ubrajaju se sintetizirani pesticidi, industrijske kemikalije i njihovinusproizvodi, prirodni mikotoksini i fitoestrogeni. Drugu skupinu ED-a čine proizvodi s kojima se u kontakt dolazi povremeno (proizvodi široke potrošnje, farmaceutski agensi). Štetno djelovanje ED-a ispituje se na životinjama koje obitavaju u prirodi, na laboratorijskim životinjama, staničnim kulturama te u humanim epidemiološkim i kliničkim istraživanjima. Posljedice rane izloženosti ED-udokazane su u poremećajima reproduktivnog i endokrinog sustava, pojavi metaboličkih poremećaja i bolesti, neurološkim poremećajima. Neke od posljedica prenose se na sljedeće generacije.U ranoj dječjoj dobi važno je otkriti i istražiti indikatore fetalne izloženosti, identificirati skupine velikog i malog rizika izloženosti ED-u,kako bi se mogla provesti prospektivna istraživanja korelacije izloženosti s kliničkim posljedicama tijekom novorođenačkog i dojenačkog razdoblja, djetinjstva i adolescencije.
Introduction: Hypertrophic stenosis of the pylorus is one of the most common surgical conditions in children, which is commonly detected within the first 12 weeks of life. There is no known aetiology, but it is assumed that genetic factors and the environ
Authors: Petračić Ivan , Čerfalvi Iris , Višnjić Stjepan , Gliha Andro , Lesjak Nikica
Published: November 2024

Hipertrofična stenoza pilorusa jedno je od najčešćih kirurških stanja u djece, koje se obično otkriva unutar prvih 12 tjedana života.Nepoznate je etiologije, ali se smatra da veliki utjecaj imaju genski čimbenici i okoliš, uz hipergastrinemiju i hiperaciditet želuca.Češća je u muške novorođenčadi s omjerom 4-6:1. Hipertrofija i hiperplazija mišićnog sloja pilorusa uzrokuju opstrukciju lumena, štorezultira karakterističnim povraćanjem u mlazu bez primjesa žuči. Zlatni standard u postavljanju dijagnoze je ultrazvuk. Terapija jekirurška, a prije operacije potrebna je nadoknada tekućine i elektrolita radi sprječavanja perioperativnih komplikacija.Cilj: Svrha ovog rada je prikazati korelaciju promjene acidobaznog statusa i ultrazvučne debljine mišića u novorođenčadi s kongenitalnom hipertrofičnom stenozom pilorusa te povezanost duljine trajanja simptoma i nastanka težih metaboličkih poremećaja.Metode: Provedeno je retrospektivno istraživanje u kojem je promatrano 41 dijete hospitalizirano zbog sumnje na stenozu pilorusa.Podatci su obrađeni metodama deskriptivne statistike u programu TIBCO Statistica 13.4. Rezultati: Pokazalo se da nema statističkiznačajne povezanosti između ultrazvučno izmjerene debljine mišića i stupnja alkaloze. Duljina trajanja simptoma i promjena pHvrijednosti nisu linearno povezane, ali je u dvoje djece s višim stupnjem alkaloze zamijećena teža hipokloremija, pa je to dvoje bolesnika imalo i komplikacije nakon kirurškog zbrinjavanja.Zaključak: Iako je hipertrofična stenoza pilorusa stanje koje može dovesti do teških metaboličkih poremećaja, oni se u današnje vrijeme rijetko javljaju zbog ranog postavljanja dijagnoze, korekcije elektrolita i kvalitetne zdravstvene skrbi.
Validation of photograph series as a portion size measurement aid in dietary assessment in children
Authors: Rumbak Ivana , Sokolić Darja , Blažok Tena , Šakić Dragica , Vukman Diana , Niseteo Tena , Barić Irena Colić
Published: November 2024

Determining children’s food consumption is challenging and requires dietetic methods that provide adequate specificity for describing,but also for quantifying food intake. To help survey respondents indicate food portion sizes, photograph series can be used, butthese must be validated in a nationally representative sample of the population. The aim of the present study was to validate photographseries as a portion size measurement aid during dietary assessment of children in Croatia. This study involved 28 mothers ofchildren aged 3 months to 10 years, who were asked to select one of four photographs in a series that best represented the quantityof food served to them. Of the 21 series tested, 17 were found to be appropriate for assessing food portion sizes. Participants wereworst at assessing portion sizes of banana (29.3%), porridge (22.8%), hot dogs (20,3%) and plain yoghurt (19.1%). Further studies areneeded to determine why these foods are poorly recognized so that photographs can be modified accordingly and validated.Key words: FOOD; VALIDATION STUDIES; PORTION SIZE; CHILDREN
Tetanus in a child as a result of the vaccination schedule violation – a case report
Authors: Pavlyshyn Halyna , Horishna Ivanna , Slyva Viktoriia
Published: November 2024

A clinical case of generalized tetanus in a preschooler with vaccination schedule noncompliance was analyzed. Clinical signs ofgeneralized severe tetanus are presented. Modern approaches to the treatment of such patients, effectiveness and promises oftherapyare shown.Key words: TETANUS; CHILDREN; TREATMENT
Difficult airway management – an old challenge: a case report
Authors: Črnjar Ksenija , Kralik Sandra , Sorić Ivana Kerovec , Bekavac Ivan , Barčot Zoran , Butković Diana
Published: November 2024

Introduction: Obtaining a secured airway is a vital aspect during reconstructive surgery in patients with extensive post-burn mentosternalscar contractures. Such contractures can potentially lead to a “can’t intubate, can’t ventilate” scenario, otherwise rare butlife-threatening situation. We present a case of successful management of a paediatric case of anticipated difficult airway due toburn injury.Case description: A 14-year-old boy presented for repair of an extensive skin contracture of the neck, thorax and face due to mutilatingscarring. The boy was treated for 80% burn caused by gasoline flame 14 months prior to this surgery. Burn healing and scarringresulted in massive distortion of the facial and cervical anatomy, all implying difficult airway with a high probability of “can’t intubate,can’t ventilate” situation. Flexible fiberoptic bronchoscope with loaded cuffed endotracheal tube N° 6.0 was used for visualisationof vocal cords through the mouth in light sedation with spontaneous breathing. After visualisation of the vocal cords, fentanyl(Fentanyl, GlaxoSmithKline) and thiopental (Thiopental, Rotexmedica) were administered and the trachea was intubated at the firstattempt. Balanced general anaesthesia was initiated and planned surgical procedure was successfully completed. The trachea wasextubated on the first postoperative day without any complication.Conclusion: Difficult paediatric airway and particularly “can’t intubate, can’t ventilate” situation is a problem associated with significantrisks and complications. Anticipating a difficult airway, having a structured approach with appropriate preparation, andunderstanding of difficult airway management algorithms are essential for success.Key words: airway management; burns; intubation
Artroskopije gležnja u djece i adolescenata
Authors: Dimnjaković Damjan , Tućin Krešimir , Smoljanović Tomislav , Bojanić Ivan
Published: November 2024

U današnje je vrijeme artroskopija gležnja uobičajen zahvat, a njihov broj kontinuirano raste. Ciljevi ovog istraživanja bili su utvrditikoliki je udio artroskopija gležnja u djece i adolescenata u ukupnom broju artroskopskih zahvata na gležnju te utvrditi postoji li razlika u postotnom udjelu dijagnoza radi kojih se činila artroskopija gležnja između skupine djece i adolescenata i skupine odraslihosoba. Pretraživanjem operacijskih protokola Klinike za ortopediju KBC-a Zagreb i Medicinskog fakulteta Sveučilišta u Zagrebu pronađeno je da je u petogodišnjem razdoblju u 533-je bolesnika učinjena artroskopija gležnja, a 90-ero od njih je u trenutku zahvatabilo mlađe od 18 godina. Medicinsku dokumentaciju, koja je bila dostupna u elektroničkoj i papirnatoj bazi podataka Klinike za ortopediju, pregledao je liječnik koji nije sudjelovao u njihovom liječenju. U pedijatrijskoj populaciji bolesnika indikacija za artroskopski zahvat najčešće je postavljena ili radi sindroma anterolateralnog sraza ili radi koštano-hrskavičnog oštećenja kupole talusa,dok je u odraslih to bio sindrom prednjeg sraza. U svih je 90-ero ispitanika operacijski zahvat protekao bez komplikacija. U ranomposlijeoperacijskom praćenju zamijećene su samo dvije komplikacije. S obzirom na rezultate ovog istraživanja možemo zaključiti daje artroskopija gležnja pouzdana i učinkovita operacijska metoda liječenja različitih ozljeda i oštećenja gležnja u djece i adolescenata. Pritom valja istaknuti da su u toj populaciji bolesnika vodeće indikacije različite od vodećih indikacija u odraslih bolesnika.
Generalized edema with hypoproteinemia as initial presentation of celiac disease in a 3-year-old boy: case report
Authors: Ahel Ivona Butorac , Dežulović Mirna Šubat , Palčevski Goran
Published: November 2024

Edema is defined as abnormal accumulation of fluid in the interstitium. Diff erential diagnosis of generalized edema is very broad. Most often, renal and cardiac causes lead to generalized edema. The potential gastrointestinal causes of edema are liver failure and protein losing enteropathy including celiac disease and protein malnutrition. Generalized edema is rarely an initial manifestation of celiac disease. Hereby, we present a case of a 3-year-old boy with celiac disease, initially presented with generalized edema and hypoproteinemia.
Primjena slobodne fetalne DNA-a iz krvi majke za probir aneuploidija: prednosti i ograničenja
Authors: Wagner Jasenka
Published: November 2024

Prenatalna dijagnostika obuhvaća niz dijagnostičkih postupaka kojima ispitujemo postojanje bolesti ili patološkog stanja kod ploda. Metode koje se primjenjuju radi prenatalne dijagnostike dijele se na invazivne i neinvazivne. Otkrićem prisutnosti slobodne fetalne DNA u cirkulaciji trudnice 1997.g., neinvazivna prenatalna dijagnostika postala je jedno od najdinamičnijih područja istraživanjau medicini. Primjena analize slobodnog DNA-a iz majčine krvi za detekciju fetalnog rhesus D antigen statusa i fetalnog spola rasprostranjena je dijagnostička metoda u europskim kliničkim laboratorijima. Za razliku od spomenutih, neinvazivno prenatalno testiranje ploda na aneuploidije i dalje se smatra naprednom metodom probira, a ne dijagnostičkim testom. Kao i svaka druga laboratorijska tehnika, i ova ima svoje prednosti i ograničenja. S obzirom na to da je riječ o prenatalnoj dijagnostici, iznimno je važno damogućnosti ovih testova i područje njihove primjene razumiju medicinsko osoblje i budući roditelji. Brzi razvoj tehnologije u skorojbudućnosti omogućit će neinvazivnu detekciju i fetalnih submikroskopskih aneuploidija, monogenskih poremećaja ili čak analizučitavog fetalnog genoma. Prije uvođenja analize slobodnog fetalnog DNA-a u rutinsku praksu, potrebno je regulirati etička pitanjapoput autonomije i prava nerođenog djeteta, dostupnosti testiranja i mogućnost selekcije spola iz nemedicinskih razloga.
Utjecaj željeza na rast i učestalost infekcija u dojenčadi
Authors: Kranjčec Izabela , Roganović Jelena
Published: November 2024

Sideropenična anemija najčešća je defi citarna anemija u svijetu. Zahvaljujući brojnim primarnim i sekundarnim preventivnim mjerama, njena prevalencija u razvijenim zemljama je u značajnom padu, dok je u nerazvijenom svijetu i dalje veliki javnozdravstveniproblem. Pozitivan utjecaj željeza na djetetov rani psihomotorički razvoj desetljećima je poznat, dok utjecaj na linearni rast i učestalost infekcija ostaje kontroverzan. Rezultati našeg istraživanja upućuju na relativno visoku prevalenciju sideropenične anemije upopulaciji hrvatske dojenčadi (19,7% u dobi od 4 mjeseca, 32,4% u dobi od 6-9 mjeseci i 16,4% u dobi od 12 mjeseci). Željezo primijenjeno u profi laktičnim dozama, sukladno važećim smjernicama, ne utječe na linearni rast i učestalost infekcija (p>0,05), stogaje pouzdana i poželjna prevencija. S obzirom na dokazane negativne učinke sideropenične anemije, potrebno je podizati svijest roditelja o važnosti adekvatne prevencije i terapije anemije te poticati pedijatre na razini primarne zdravstvene zaštite na sustavnoprovođenje primarne i sekundarne prevencije
Sleep disorders in children with cerebral palsy
Authors: Juraški Romana Gjergja , Sabol Zlatko , Turkalj Mirjana , Nenadić Nataša , Marušić Ivana , Kučić Darija , Miloš Marija , Vukmir Vlašić Vukmir x
Published: November 2024

Recent studies on children with cerebral palsy indicate that this population is at a higher risk of sleep disorders. Although sleep dysfunction seems to be frequent in cerebral palsy, there are few studies assessing sleep dysfunction and its risk in children. Also, the prevalence of sleep apnea has not been formally assessed in children with cerebral palsy. Risk factors for sleep dysfunction include comorbid epilepsy, mental retardation, visual impairment and degree of functional motor impairment. Contractures and spasticity can adversely contribute to positioning during sleep. We analyzed motor, cognitive and functional impairment, as well as the existence of comorbidity and results of brain imaging and electroencephalography in 21 children with cerebral palsy and correlated them with the presence of sleep disorders. Sleep disorder was evaluated by electroencephalography/polysomnography. About 57% of children in our study had sleep disorders. The most common motor impairment was spastic diplegia. Most children had peri ventricular hyperintensities and cortical atrophy on neuroimaging. Diffi culty in initiating and maintaining sleep (microarousals), fragmented sleep, and sleep breathing disorders were frequently identifi ed problems and were evaluated by polysomnography. Children with abnormal electroencephalography had more sleep disturbances than those with normal electroencephalography. Disorders of initiation and maintenance of sleep were more frequent in children with spastic quadriplegia. It is known that the consequences of sleep disorders in children aff ect both the child and the family. Prospective studies in a larger sample and proper methodology are needed to determine whether improvement in sleep quality of children with cerebral palsy leads to improvement in their life quality.
Evaluation of awake electroencephalography findings in children with attention deficit hyperactivity disorder before psychostimulant treatment
Authors: Bayram E. , Topcu Y. , Karaarslan D. , Akinci G. , Yis U. , Akay A. , Hiz S.
Published: November 2024

Attention deficit hyperactivity disorder is one of the most common neuropsychiatric disorders in childhood. Electroencephalographic abnormalities may be observed but it is controversial to perform electroencephalography before starting the treatment. Awake electroencephalography findings, demographic and psychometric variables of patients with attention deficit hyperactivity disorder treated between January 2005 and December 2010 were retrospectively evaluated. The study included 386 patients aged 4-18 (mean 9.61±3.04) years, who were diagnosed with attention deficit hyperactivity disorder according to the DSM-IV-TR (2000) diagnostic criteria. Epileptiform electroencephalography pattern was observed in 22/386 (5.7%) patients. Seven of 386 (1.8%) patients had a history of epilepsy diagnosis and antiepileptic medication. When patients with seizure history (with or without epilepsy diagnosis) and those with epileptic abnormalities on electroencephalography were excluded, the incidence of epileptiform abnormalities in attention deficit hyperactivity disorder patients was 12/386 (3.1%). After psychostimulant medication, epileptic seizures occurred in only three patients with epilepsy. The prevalence rate of epileptiform discharges on awake electroencephalography, observed in attention deficit hyperactivity disorder patients before psychostimulant treatment is similar to that in healthy schoolchildren. Since the seizures increased only in epileptic patients, we do not recommend routine awake electroencephalography evaluation in children with attention deficit hyperactivity disorder before psychostimulant medication.
Home intervention in children with autism spectrum disorder
Authors: Medved K. , Begovac I.
Published: November 2024

Development of children with autistic spectrum disorder and improving their quality of life require interventions and therapies that should best start at an early age. This study provides an insight into therapeutic interventions at home in children with autistic spectrum disorders and their effectiveness and impact on children and their families. In search of related articles, we used the PubMed database accessible via the Internet. Articles were selected by the following keywords: child, autism, and home intervention, taking in consideration those published in the last 10 years, yielding a total of 50 articles. Of 50 articles, the articles that did not meet inclusion criteria were excluded, thus 15 articles were reviewed. Excluded were articles that did not meet the following inclusion criteria: 1) behavioral therapy conducted; 2) diagnosed with autistic spectrum disorders; 3) number of participants in the study more than 10; 4) original research work; and 5) participants were children. All studies indicated an improvement in the development of children, especially if therapy started at an early age, although some studies show a negative impact on the families of children with autism. The review demonstrated predominantly positive effects.
Unusual presentaton of menkes disease in a boy with a quite prolonged survival
Authors: Šojat Lj. Cvitanović , Žigman T. , Malenica M. , Juraški R. Gjergja , Stanojević M. , Vugrinec M.
Published: November 2024

Menkes disease, an X-linked recessive neurodegenerative disorder, results from a mutation in the ATP7A gene. We describe clinical presentation, evolution of the disease and follow up. This is a longitudinal case study illustrating the history of the disease and results of good care. The family history was uneventful, with normal pregnancy and delivery after 36 weeks of gestation. Neonatal jaundice was treated by phototherapy. Feeding problems, hypotonia, failure to thrive and inguinal hernia developed shortly after neonatal period; 3 intracranial ultrasounds were normal. At the age of 9.5 months, the first neuropediatric examination was done because of developmental delay and clinical picture of infantile spasms. There was no electroencephalogram abnormality, plasma copper and ceruloplasmin were low; other investigations were normal including cerebrospinal fluid and hair microscopy, with white matter reduction on computerized tomography. The frameshift mutation c.1003_1004insGCAT in exon 4 of ATP7A gene confirmed the diagnosis. Because of pronounced neurologic changes, copper-histidine treatment would not have been beneficial. Focal discharges were seen at the age of 23 months. The parents refused therapy with valproic acid, and lamotrigine was introduced. At 24 months, subdural hemorrhage in the left frontal lobe was observed, with spontaneous resorption after a few months. Magnetic resonance of the brain at 4 years confirmed cortical and cerebellar atrophy with leukodystrophy. Tonic seizures, myoclonic jerks and multifocal epileptiform activity on EEG lasted until the age of 6 years. Although sometimes myoclonic fits are still observed, EEG is without epileptiform activity until today. Now, the boy has 10 years and his weight, length and head circumference correspond to a boy of 4.5 years, with spasticity and weakness of the extremities, without spontaneous movements; but he smiles. The main clinical manifestations in our patient with Menkes disease are progressive nerve damage, cerebral and cerebellar atrophy, infantile spasms and later myoclonic and focal jerks with multifocal EEG abnormalities. At the age of 10 years, our patient is in vegetative and cachexic stage. Long survival is unusual for this diagnosis and can be attributed to good care.
Foreign body ingestion in children: 6-year experience
Authors: Vuković J. , Perica M. , Paležac L. , Dujšin M. , Grizelj R. , Omerza L. , Grčić B. Filipović , Brkić T. , Pulanić R.
Published: November 2024

The aim of this study was to present our series of patients diagnosed with foreign body ingestion, to compare our results with those from the literature, and to determine whether our management plan followed the established local guidelines. The study included 53 patients diagnosed with foreign body ingestion and admitted to pediatric emergency department of the Zagreb University Hospital Center between January 2004 and December 2009. There were 34 (64.15%) boys and 19 (35.85%) girls. The majority of ingested foreign bodies were localized distal to the esophagus (87.5%). Esophagus is the only localization that requires emergent or urgent intervention. Most of the foreign bodies were found in the stomach, as it is expected according to available data. In comparison with worldwide experience (10%-20%), we performed emergent or urgent endoscopy more frequently (67.92% of all patients; Fisher exact test, p=0.001). Such a frequent use of endoscopy is unnecessary. The risk of numerous complications by far exceeds the benefits, and it is reasonable to reduce the number of interventions. Our results confirm that observation is as good and efficient approach for the majority of cases of foreign body ingestion (except for sharp and long objects) in which foreign body is localized distal to the esophagus (χ2-test with Yates’ correction 0.73; p=0.394).
Birth weight of iranian children with phenylketonuria
Authors: Rohani F. , Alaei M. , Totonchi GA. , Azargashb E.
Published: November 2024

To assess whether birth weight is affected in Iranian patients with phenylketonuria, birth weights of 118 patients with phenylketonuria were compared with 264 healthy controls matched by gestational age and sex, and with patients unaffected siblings. The mean (±SD) birth weight of phenylketonuria patients and control group was 3199.5 (±554.5) and 3260.3 (±483.2) grams, respectively. The mean birth weight of phenylketonuria patients was by 60.7 lower as compared with controls (p=0.27). There was no significant correlation between disease severity and phenylketonuria patient birth weight (p=0.55). The mean (±SD) birth weight of 59 phenylketonuria patients and their siblings was 3193.2 (±568.6) and 3083.9 (±514.0)g, respectively. The mean birth weight of phenylketonuria patients was by 109 g greater as compared with their siblings (p=0.271). Birth weight of Iranian phenylketonuria patients was not significantly lower as compared with their healthy siblings and normal population. Although control infants had a slightly greater birth weight than phenylketonuria infants and phenylketonuria infants had a slightly greater birth weight than their unaffected siblings, the difference was not statistically significant. Furthermore, birth weight was not affected by the disease severity.
Reflections of learning perspective on behavior management strategies during dental treatments of pediatric patients
Authors: Caglar E. , Kuscu O. O. , Erdogan S. A. , Sandalli N.
Published: November 2024

Many children perceive a visit to pediatric dentist as a stressful event. Children respond to things that happen to them in their daily lives. If this reality is also taken to a pediatric dentist’s chair, the consequences of children’s behavior should be experienced through learning theories. Today, two main themes of learning in modern psychology are behaviorism (Classical & Operant Conditioning) and social-learning theory (deals with observational imitation). Through these learning theories, fear and phobias are believed to be learned behaviors, and therefore might also be forgettable. The aim of the present paper is to observe the nature of learning theories on how children learn to behave, with bullet point cases of pediatric dentistry settings. By this way, the application of learning theories to our daily practice will encourage us to better understand and serve the child patient.
Obesity in children
Authors: Bralić I.
Published: November 2024

In this study, obesity in children and adolescents is considered from a public health and clinical points of view. Obesity is analyzed as an immediate health problem in children. The indirect effects of excessive body mass on changes in the structure and functions of various organ systems are presented. The possibility of diagnostic and therapeutic approaches is assessed, and guidelines are given for primary, secondary and tertiary prevention of obesity.
The approach to incomplete Kawasaki disease in infants
Authors: Bakalli I. , Sallabanda S. , Foto E. , Kola E. , Lluka R. , Gjyzeli E. , Vula A.
Published: November 2024

The manifestations of Kawasaki disease in infants are often subtle and many times infants with this condition do not meet full diagnostic criteria. The approach to incomplete Kawasaki disease remains a challenge for physicians because clinical features may be mistaken for symptoms of other conditions. Young infants are at an extremely high risk of developing coronary arterial abnormalities compared to older children, probably due to the delay in diagnosis and the fact that only a small number receive intravenous immunoglobulin (IVIG) during the first 10 days of illness. We present a 5-month-old boy treated at our pediatric intensive care unit. The boy presented with fever lasting for more than five days, unresponsive to antibiotic therapy, changes in extremities (erythema, edema and desquamation), polymorphous rash, changes in the lips and oral cavity, seizures, irritability, pyuria, anemia, leukocytosis and raised titer of acute phase reactants. The presence of rash was initially mistaken for a reaction to antibiotics administered for a presumed urinary tract infection. All bacterial cultures and serologic tests were negative. Echocardiography showed no abnormality, but according to the criteria for incomplete Kawasaki disease published by the American Academy of Pediatrics and American Heart Association, we decided to treat the child with IVIG. With this report, we would like to highlight the importance of a high degree of clinical suspicion of Kawasaki disease in infants in whom the presentation is often incomplete, while prompt IVIG therapy is crucial to avoid serious cardiac complications.
Clinical significance of electroencephalographic changes in children with tick-borne meningoencephalitis
Authors: Majerus Lj. Mišić , Sabol Z. , Poje R. , Mršić M. Toth , Bujić N. , Rode O. Đaković
Published: November 2024

Compared to adult population, children are less frequently affected by tick-borne encephalitis (TBE) and have a much more favorable clinical course of the disease with less permanent consequences, but more frequently exhibit electroencephalography (EEG) changes. The aim of the study was to determine the prevalence and characteristics of abnormal EEG findings in children with TBE, as well as their correlation with clinical manifestation of the disease. Patients and methods: A retrospective study over a 30- year period (1979-2009) included 103 children (77 boys and 26 girls) aged 2 to 14 years, with confirmed acute infection with tickborne encephalitis virus (TBEV). In the majority of children (70.0%), EEG was performed during the acute stage of the disease. Clinically, the disease manifested with viral meningitis in 68/103 (66.0%) and meningoencephalitis (ME) in 35/103 (34.0%) children, of biphasic course in 86 (83.4%) children. EEG finding was normal in 23/72 (32.0%), borderline with nonspecific changes in 2/72 (3.0%) and pathologic in 47/72 (65.0%) children. Abnormal finding most frequently presented as slow diffuse dysrhythmia in 31/72 (43.1%) patients, then as slow focal dysrhythmia in 14/72 (19.4%) and paroxysmal generalized slow dysrhythmia in 2/72 (2.8%) patients. Normalization of EEG finding occurred 1 to 3 months from initial evaluation in 38/47 (81.0%) patients. Follow up EEG was performed in nine (19.1%) children, but not up to normalization of the finding. Slow diffuse dysrhythmia is the most frequent type of EEG changes in children with TBE. There was no significant correlation between EEG finding and clinical manifestation of the disease.
Impact of baby friendly hospital initiative on breastfeeding rates in Đakovo
Authors: Konjarik Z. , Bošnjak A. Pavičić
Published: November 2024

First implementation of the WHO/UNICEF Baby Friendly Hospital Initiative (BFHI) in Đakovo during 1996 significantly increased breastfeeding rates. Objective is to evaluate the effects of BFHI on breastfeeding rates in infants born in 2004 (before second BFHI) and 2008 (after second BFHI). Retrospective analysis included 356 mother-infant dyads. Breastfeeding rates at 1, 3, and 6 months were collected for 182 term infants born in 2004 and 174 term infants born in 2008. From 2004 to 2008, the rate of breastfeeding at 1, 3 and 6 months of age increased from 63.7% to 90.8%, from 40.1% to 61.5% and from 20.3% to 39.1%, respectively (P<0.001 all). On multivariate logistic regression, BFHI increased the likelihood of breastfeeding at 6 months 2.8 times. BFHI proved effective in changing breastfeeding rates at 1, 3 and 6 months in Đakovo.
Current diagnosis and treatment of childhood leukemia
Authors: Konja J. , Petković I. , Batinić D. , Rajić Lj. , Bilić E. , Femenić R. , Stepan J. , Bonevski A. , Lasan R. , Nakić M. , Aničić M.
Published: November 2024

In the past ten years, great success has been made in the diagnosis and treatment of malignant diseases in children, in particular in the management of childhood leukemia, so that most of these children can now be cured. The principles of diagnosis and treatment of childhood leukemia are presented.
Acute longitudinally extensive transverse myelitis in a six year old child
Authors: Delin S. , Pavešić K. , Tešović G. , Knezović I. , Miše B. , Lujić L.
Published: November 2024

Acute transverse myelitis (ATM) is a rare disease in childhood and adolescence. In the United States ATM has an incidence of 1-4 new cases per million people per year, but there is no specific evaluation of pediatric incidence. ATM is characterized by bilateral spinal cord dysfunction presenting as lower extremity weakness with sensory symptoms and bladder dysfunction. We describe a case of a boy with typical ATM in childhood, with rapid, changing onset of paralysis and progression within a few hours. The diagnosis was made on the basis of the clinical features and course of disease, cerebrospinal fluid (CSF) analysis, electrophysiological tests as well as magnetic resonance imaging (MRI) findings of a longitudinally extensive lesion in spinal cord. In spite of early implemented intravenous high-dose steroid treatment and plasmapheresis the recovery is still poor after three months. He is undergoing intensive physical therapy with continuous follow up.
Advantages of functional stabilization of buckle distal radius fractures in children with semi-rigid and rigid synthetic material
Authors: Leko M. , Ivelj R. , Bumči I. , Škalic M. , Roić G. , Župančić B.
Published: November 2024

A study of the possible advantages of the use of synthetic material for functional stabilization of buckle distal radius fractures in children was undertaken in our hospital. Our aim was to test some of the characteristics of synthetic material and to compare them with the characteristics of plaster of Paris (PoP). A total of 58 children were included in this study, 23 of them were treated with PoP, and 35 of them were treated with synthetic material. The patients were checked during the first follow-up, that is on the fourth day after the injury and once again after the removal of immobilization, that is on the twenty-first post-injury day. This check-up confirmed some advantages of the use of synthetic material in the treatment of buckle distal radius fractures in children. This material provides children with more comfort and independence in their daily activities. Also, there are obvious advantages for parents, considering their time and availability.
Long term mechanicaly ventilated children: our experience
Authors: Mikecin L. , Popović Lj. , Meštrović J. , Novak M. , Galić S. , Čulić V. , Andrić I. Mihelčić , Stoini E. , Richter D. , Čubelić S. , Tiljak M. Kujundžić , Pušeljić S.
Published: November 2024

The number of children with chronic respiratory insufficiency needing mechanical ventilation is rising. Our objective was to determine the number of such children in the Republic of Croatia, what diseases they suffer from, how long they have been mechanically ventilated, and where they are accommodated. Between 1st of January and 31st of December 2007, we sent questionnaires to 22 medical centers in the Republic of Croatia. The respondents were children between the ages of 0 and 18 undergoing long-term mechanical ventilation. We defined long-term mechanical ventilation as ventilation going on continuously for three months or longer. Our results show that there were 16 children on long-term mechanical ventilation in the Republic of Croatia in 2007. The most common diagnosis was spinal muscular atrophy, from which seven of the children suffered. Eight children were treated at the Children’s Hospital Zagreb. The advance of technology and intensive treatment have produced a new category of patients, whose vital functions depend on mechanical support. The increasing number of such patients results in ethical, economic and medical problems. It is of great significance to determine the number of children on long-term mechanical ventilation because it requires adjustment of the health and social care system.
Bilateral postpneumococcal pneumatoceles in a one year 7 month old boy: case report and review of literature
Authors: Bazina M. , Raos M. , Bazina A. , Milković Đ. , Nogalo B. , Turkalj M.
Published: November 2024

We report on a one year and 7 months old boy who presented clinically with ascending pneumococcal pneumonia. He was successfully treated with beta-lactam antibiotics. On the control chest radiogram two bilateral pneumatoceles were seen during the resolution of pneumococcal pneumonia. The bilateral cystic lesions seen on the control chest X-ray prompted us to present our case as interesting, as well as to review the literature on this issue. However, there is no previous report of bilateral pneumatocele as an isolated complication, without any signs of empyema and/or effusion in pneumococcal pneumonia in children.
Snp cytokine polymorphysms, perinatal infection and cerebral palsy
Authors: Sabol Lj. Kipke , Vidak F. Sabol H. Kapitanović , Grubešić Z. , Kapitanović S.
Published: November 2024

Cerebral palsy (CP) is the most common neurological disorder in children attributed to non-progressive disturbances in the developing fetal or infant brain. The cause and pathogenesis of CP is multifactorial and continues to be poorly understood. Prematurity is considered to be the leading risk factor for the development of CP. In recent times, intrauterine infection/inflammation has been identified as the most common cause of preterm delivery and neonatal complications. Microorganisms or their products stimulate the production of cytokines and a systemic response termed FIRS (Fetal Inflammatory Response Syndrome) in the fetus. Activation of the cytokine network and elevated levels of proinflammatory cytokines can cause white matter brain damage and preterm delivery, as well as the future development of CP. The balance between pro- and anti-inflammatory cytokines in the neonatal brain is likely to be critical in determining the initiation, development and consequences of cerebral injury. Individual infants display a spectrum of severity of damage following apparently comparable insults. Such variation may depend on the complicated interaction of the multiple etiological factors and on the genetic susceptibility of the individual including polymorphisms in pro- and anti-inflammatory cytokine genotypes.
Cerebral palsy in children with congenital cytomegalovirus infection
Authors: Mejaški-Bošnjak V. , Krakar G. , Lončarević D.
Published: November 2024

Congenital cytomegalovirus (CMV) infection is the most common transplacentary transmitted viral infection, affecting 1% live born neonates but clinically symptomatic in only 10%. Both symptomatic and asymptomatic infected neonates may develop a wide range of neurodevelopmental disorders, the most severe being sensorineuronal hearing loss, cerebral palsy (CP), mental retardation (MR) and epilepsy. We present 6 children suffering cerebral palsy and their magnetic resonance/computer tomography findings in the examined group of 39 children in total with proven congenital CMV infection.Out of these 39 children, 14 were symptomatic at neonatal age. The remaining 25 asymptomatic infants were referred after neonatal age (1,5-18 months), for deviant neurological signs, accompanied by microcephaly and/or gastrointestinal problems.Two children were sent due to deafness. In all children examined CMV infection was proven by specific serology, PCR for CMV DNA and /or isolation of virus in the urine. All 39 children had prospective neurodevelopmental follow up for 2-11 years, undergoing repeated neurological, hearing tests, ophthalmologic, developmental assessment including speech and behaviour. Classification of CP was done according to the Surveillance of Cerebral Palsy in Europe (SCPE) proposal, including functional grading: the gross motor function classification system (GMFCS) and bimanual fine motor function (BFMF) criteria. Out of 14 symptomatic children, 5 were multihandicapped . All of them were microcephalic. One out of 25 asymptomatic children with CP was multihandicapped and microcephalic. Out of 6 children with cerebral palsy 4 have dyskinetic CP, two of them GMFCS and BFMF grade V, and two GMFCS IV and BFMF IV. Two children have bilateral spastic CP, GMFCS III and BFMF III. Cranial MRI/CT was performed in all 6 children with CP. In two multicandicaped children MRI demonstrated complex brain malformations: polymicrogyria, hypoplastic cerebellum, callosal hypoplasia. The other two multihandicapped children have multifocal leukoencephalopathy with temporal cysts. One multihandicapped child underwent cranial CT showing pacygyria, paraventricular cyst and calcification. In one asymptomatic multihandicapped child repeated MRI demonstrated brain atrophy, hypomyelination and calosal hypoplasia. Conclusion: 6/39 children examined with congenital CMV infection have CP accompanied by additional severe neurodevelopmental disorders. 5/39 children with CP had symptomatic CMV infection. Cranial MRI and CT demonstrated various brain abnormalities: two children have complex brain malformations (severe cortical dysgenesis, cerebellar hypoplasia, callosal hypoplasia), two widespread leukoencephalopathy with temporal cysts, and one diffuse brain atrophy. The spectrum of brain abnormalities in children with CP is related to the onset of congenital infection .
Speech and language disorders in children with neurofibromatosis type 1 (NF1)– study of 112 patients
Authors: Mimica A. Dembitz , Sabol Z.
Published: November 2024

Introduction: NF1 is both clinically and genetically clearly defined as an autosomal dominant hereditary disease whose organic neurobiological processes have been examined for over a century. The relationship between NF1 and speech and language disorders has been relatively less well investigated. Aim: To show the frequency of speech and language disorders in children with NF1. Patients and methods: We selected a group of 112 children (54 girls and 58 boys) from our personal registry that covers 202 children with NF1. The selected children were longitudinally monitored by a speech pathologist. The age of children on initial examination varied between 1 year 9 months and 16 years 3 months. Semantic-syntactic structure and modalities of speech were analysed. Articulation was tested with the Vuleti} test of articulation, while prosody and resonance were evaluated subjectively and then objectified with an acoustic analysis of the speech spectrum. Results: 22% of patients had some degree of delayed early speech development. Speech disorders presented most often as disorders of resonance (81.2%) – hyperrhinophonia and rhinophonia mixta (79.5%) and hyporhinophonia (1.8%). Articulation disorders were diagnosed in 59.8% of patients and they were most often manifested as distortions (51.8%). Subjective evaluation of the voice found hoarseness in 50.9% of cases. Prosody was disrupted on the level of rhythm of speech with inter- and intraverbal blockades in 38.4% of children with NF1. Evaluation of reading and writing in 87 children with NF1 showed a high frequency of disorders – unspecific reading (19.5%) and writing (17.2%) errors. Conclusion: The significant frequency of speech and language disorders in children with NF1 could have an important role in the appearance of learning disorders that are found in 50-60% of patients.