The aim of this study was to examine the influence of very low socioeconomic status, physical inj... more The aim of this study was to examine the influence of very low socioeconomic status, physical injury and psychological trauma on the menarchal age of deported girls who lived in besieged Srebrenica, a town that had a highly disrupted environment from the end of 1992 to mid 1995. The Srebrenica girls had a significantly higher mean menarchal age compared with a control group who lived mainly in peaceful communities in the unoccupied territory of Bosnia and Herzegovina. Our results show that psychological trauma, physical injury and low socioeconomic status, which provoked by the events of war, delay the age of menarche.
The aim of this study was to determine the success of an increase in the level of salt iodization... more The aim of this study was to determine the success of an increase in the level of salt iodization which was increased to 20-30 mg iodine per kilo of salt, 2 yr after the introduction of the new mandatory salt iodination. This prospective study was performed at level of Federation of Bosnia and Herzegovina (FBH). We singled out 60 cluster school-based surveys (6 cluster surveys in each canton) with equal representation of urban and rural areas. Within each cluster, between 10 to 30 subjects (both males and females) aged 11, 12, 13 and 14 were randomly selected. The study included a total of 962 schoolchildren. The mean iodine level per 1 kg of salt for whole FBH was 21.4+/-5.2. It ranged from 2.1 to 41.3 mg/kg. A significant improvement in urinary iodine excretion medians was detected in the current survey in all cantons and on the entire territory of FBH, compared to results from a previous study conducted in 1999. The urinary iodine excretion in schoolchildren in the whole FBH varied from 50.6 to 303.8 mug/l with a median of 139.5 mug/l. Values of urinary iodine <100.0 mug/l were found in 15.9% of samples of schoolchildren, whereas no values <50.0 mug/l were found. In conclusion, the results of the study indicate that increased iodine supplementation of salt in 2001 was successful and that FBH is presently iodine sufficient. In the future, however, program for monitoring of iodine prophylaxis has to have two major aims: firstly, control of iodine content in salt at different levels especially at retail shops and at imported salt and secondly, iodine deficiency disorders control. Also, a periodic measurement of urinary iodine excretion needs to be planned together with the neonatal TSH screening and the establishment of a notification system for cases of hyperthyroidism.
Aim: This study was to evaluate the impact of the family socioeconomic status (SES) on health-rel... more Aim: This study was to evaluate the impact of the family socioeconomic status (SES) on health-related quality of life (HRQOL) in children with type 1 diabetes mellitus (T1DM). Methods: The cross-sectional study included 65 consecutive children T1DM between ages 5 and 18 years and their mothers. The control group was formed by random selection by matching each patient with one or two healthy control subjects. To evaluate generic HRQOL in children with T1DM we used the PedsQL™ 4.0 Generic Core Scales which include both a parent proxy-report and a child self-report with age-appropriate versions. To categorize the families' SES, the parents' education level and current employment were recorded and analyzed using the Hollingshed two-factor index of social position. None of the diabetic children in the sample came from families of upper social classes, so we categorized our diabetic children into the lower and middle social classes. Results: Physical health (P=0.02), social functioning (P=0.04), and school activities (P=0.0003) were lower in T1DM children with middle SES families than in controls from middle SES families. Parental reports revealed statistically significantly poorer HRQOL in children from low SES families in total scale score (P=0.005) and in terms of physical (P=0.0126), and psychosocial health (P=0.0246) as compared with the control group with lower SES. Also the parental proxy reports for middle scores of family SES were statistical significantly lower in the total score (P=0.0001), psychosocial health (P=0.0001), emotional functioning (P=0.0006), and school functioning (P=0.0001) compared with the middle group of the control. Conclusion: The current findings suggest that low and middle SES of families in children with T1DM is associated with lower generic HRQOL as compared to control children with similar SES of families.
In the paper it was identified firstly the short stature, then importance of anamnesis, physical ... more In the paper it was identified firstly the short stature, then importance of anamnesis, physical examination, anthropometric measurements and calculated parameters of growth. Then followed the classification of causes for short stature with a specific review on differentiation of normal from pathologic variants. Further in the text it was pointed out the importance of observing normal variants of short stature since between 84% and 87% children are with height under the 3rd percentile. Then followed tables showing pathologic causes of the short stature, and then diagnostic and therapeutic approach to the child with proportionately short stature and short stature associated with dysmorphic features.
Serum concentration of immunoglobulin G (IgG) of new-born child, at the birth, which reach the co... more Serum concentration of immunoglobulin G (IgG) of new-born child, at the birth, which reach the concentration of an adult persons, are the origin of mother and transferred by active and passive transport, by placenta. Immunoglobulin M (IgM) and Immunoglobulin A (IgA), do not pass the placenta because of their structure. Main condition for passing of IgG are normal period of pregnancy and regular function of placenta. Social-economic status (SES), and also immunologic status of a pregnant woman, an affect on the immunological status of new-born child. 120 pregnant woman and 120 of their new-born children were studied. Pregnant woman were at age of 18-34 years, and during the pregnancy they were healthy. Gestational age of new-born children was from 38 to 40 weeks, and birth weight was from 3000 grams to 4000 grams. The new-born children were from monofertile pregnancies, without visible anomalies and signs of intrauterine suffer. They were divided into 2 groups, 60 patients in every group, in comparison of SES families of a mother, in which she lived during the pregnancy. From every new-born child at the birth, from the blood of a navel it was determined the concentration of serum IgG, IgM and IgA. The values of IgG from the group with bad SES, were significantly lower (p < 0.001), in compare with a group with good SES. There was not statistically important difference between middle values of mentioned parameters among the different sex in the studied groups. Concentrations of IgM in new-born children were below the level of determination or just above it, so they could not be analysed anymore. Immunoglobulins A were not found in both groups, A and B groups.
Iodine deficiency which causes the wide spectrum of disorders for all ages, is one of the signifi... more Iodine deficiency which causes the wide spectrum of disorders for all ages, is one of the significant public health problem worldwide. From the ancient times different iodine deficiency disorders were noticed in Bosnia and Herzegovina and in its some areas the goiter existed in endemic form. These facts confirm that its soil bas been iodine deficient and that necessity for iodine prophylaxis is obvious on its territory. The study was based on 5,523 children, of both sex boys and girls school age from 7 to 14 years, randomly selected with the equal participate subjects in relation to the age. The sample is representative and it has been assessed based on: total number of school children aged from 7 to 14 years, anticipated prevalence of goiter 5% level of probability 95%, relative punctuality 30% and the factor called "design effect" which is 3. The study was carried out in whole ten cantons in the schools with equal representation among cities and villages. In examining of prevalence of giter we used inspection and palpation. Determination of iodine concentration in urine was carried out by the method is based on Sandel-kolthof's reaction. The technique used for determination of concentration of iodine in salt was iodinemetric titration. The prevalence of goiter was 27.6% in Federation of Bosnia and Heryegovina. The highest prevalence of goiter was in Bosnia Podrinje Canton (51.20%) while the lowest was in West Herzegovina Canton (12.90%). The urinary iodine excretion in investigated children varied from 1 to 208 *mg/L with median of 77.6 *mg/L. Iodine contetn in household salt samples was from 3 to 29.8 mg/kg, range 14.4 + 5.9 mg/kg. The results of our study show the persistence of mild to moderate iodine deficiency in Bosnia and Herzegovine Federation. Therefore according to the recommendations of the World Health Organisation, UNICEF and International Council for Control of Iodine Deficiency Disorders, the salt for human, and animal consumption as well as for food industry which is consuming on its teritory, has to be iodinated on the place of its production without looking back whether or not it is produced or imported in Bosnia and Herzegovina Federation, lodination has to be performed with 20 to 30 mg KI per one kg of salt, thereby an average the iodine content has to be 25 mg per kg. In this way it will be prevented the wide spectrum of disorders, which we often are not aware for that its are caused by iodine deficiency. In addition it will be prevented many very important socioeconomical consequences of iodine deficiency.
According to the clinical findings, the activity of serum asparate aminotransferase (EC 2.6.1.1),... more According to the clinical findings, the activity of serum asparate aminotransferase (EC 2.6.1.1), alanine aminotransferase (EC 2.6.1.2) and the level of total bilirubin, 45 children with acute viral hepatitis A were divided into two groups: with mild and moderately severe degree of disease. By determining the products of the peripheral thyroxine metabolism-T3 and rT3, as well as the other thyroid parameters (T4, FT4, TSH and TBG) we have found significantly lower T3 level and significantly higher T4 and TBG levels in both groups of patients in comparison with control group. At the same time, the level of biologically less active rT3 was increased in patients with moderately severe form of disease, while no differences were found in the values of TSH between the ill and control patients. TRH induced TSH release was normal in all patients. The results of this study point to the development of euthyroid sick syndrome or low T3 syndrome in children with viral hepatitis A.
The Museum of the History of Health Care in Croatia, as the first such museum in the southeastern... more The Museum of the History of Health Care in Croatia, as the first such museum in the southeastern part of Europe, was established by the Croatian Medical Association in Zagreb in 1944. Beside Vladimir Ćepulić (1891 - 1964) the head of the Croatian Medical Association, epidemiologist Stanko Sielski (1891 - 1958), was one of the most prominent personalities to be credited for realizing this project. He was born in Gracanica into a family of Polish origin. After his graduation in Vienna in 1919, he worked as an epidemiologist in Konjic, Prozor, Glamoc and other places in the area of Bosnia, mostly involved in typhoid fever and variola eradication. At the beginning of the Second World War he was in Banja Luka where he was given the duty of director of the Department of Endemic Syphilis Eradication. During 1942 and 1943 his correspondence took place with Vladimir Ćepulić, which is today preserved in the Section of the History of Medicine of the Croatian Academy of Sciences and Arts in Zagreb. On the basis of this material it was possible to trace the circumstances of the foundation of the Museum of the History of Health Care, how items were collected for its first exhibition, and the role of Stanko Sielski in preserving the medical heritage and dissemination of knowledge of the history of medicine to a broader audience.
The aim of this study was to evaluate preoperative and postoperative growth in children with cong... more The aim of this study was to evaluate preoperative and postoperative growth in children with congenital heart disease (CHD) when cardio-surgical treatment is delayed. Growth data were analysed on 116 children with various types of CHD (cyanotic lesions (Group 1), left to right shunt (Group 2) and obstructive lesions (Group 3)), who underwent cardiac surgery after a certain period of waiting. Preoperatively, during the time (median 1.13 (0.55-2.39)) years of waiting for surgery, their mean weight z-score decreased from -1.38 (+/- 1.19) to -1.41 (+/- 1.28), and their mean height z-score from -0.65 (+/- 1.41) to -0.81 (+/- 1.36). Children in Group 1 developed a significant linear growth deficit, in Group 2 weight was more affected than height, while in Group 3 both growth parameters were gradually slowly, but not significantly reduced. Postoperatively weight and height z scores, although they showed a linear trend of improvement for all three groups, remained significantly reduced for two years after surgery. At the time of the last examination at the age 9.11 (5.66-13.10) years, the mean height z score -0.16 (+/- 1.28), was significantly reduced p < 0.0001, than predicted height 0.23 (+/- 0.82). Growth catch-up was related to age at surgery and preoperative growth deficit. Delayed cardiac surgery in children with CHD aggravated growth deficit and caused slow and incomplete postoperative growth catch-up.
The aim of this study was to examine the influence of very low socioeconomic status, physical inj... more The aim of this study was to examine the influence of very low socioeconomic status, physical injury and psychological trauma on the menarchal age of deported girls who lived in besieged Srebrenica, a town that had a highly disrupted environment from the end of 1992 to mid 1995. The Srebrenica girls had a significantly higher mean menarchal age compared with a control group who lived mainly in peaceful communities in the unoccupied territory of Bosnia and Herzegovina. Our results show that psychological trauma, physical injury and low socioeconomic status, which provoked by the events of war, delay the age of menarche.
The aim of this study was to determine the success of an increase in the level of salt iodization... more The aim of this study was to determine the success of an increase in the level of salt iodization which was increased to 20-30 mg iodine per kilo of salt, 2 yr after the introduction of the new mandatory salt iodination. This prospective study was performed at level of Federation of Bosnia and Herzegovina (FBH). We singled out 60 cluster school-based surveys (6 cluster surveys in each canton) with equal representation of urban and rural areas. Within each cluster, between 10 to 30 subjects (both males and females) aged 11, 12, 13 and 14 were randomly selected. The study included a total of 962 schoolchildren. The mean iodine level per 1 kg of salt for whole FBH was 21.4+/-5.2. It ranged from 2.1 to 41.3 mg/kg. A significant improvement in urinary iodine excretion medians was detected in the current survey in all cantons and on the entire territory of FBH, compared to results from a previous study conducted in 1999. The urinary iodine excretion in schoolchildren in the whole FBH varied from 50.6 to 303.8 mug/l with a median of 139.5 mug/l. Values of urinary iodine &lt;100.0 mug/l were found in 15.9% of samples of schoolchildren, whereas no values &lt;50.0 mug/l were found. In conclusion, the results of the study indicate that increased iodine supplementation of salt in 2001 was successful and that FBH is presently iodine sufficient. In the future, however, program for monitoring of iodine prophylaxis has to have two major aims: firstly, control of iodine content in salt at different levels especially at retail shops and at imported salt and secondly, iodine deficiency disorders control. Also, a periodic measurement of urinary iodine excretion needs to be planned together with the neonatal TSH screening and the establishment of a notification system for cases of hyperthyroidism.
Aim: This study was to evaluate the impact of the family socioeconomic status (SES) on health-rel... more Aim: This study was to evaluate the impact of the family socioeconomic status (SES) on health-related quality of life (HRQOL) in children with type 1 diabetes mellitus (T1DM). Methods: The cross-sectional study included 65 consecutive children T1DM between ages 5 and 18 years and their mothers. The control group was formed by random selection by matching each patient with one or two healthy control subjects. To evaluate generic HRQOL in children with T1DM we used the PedsQL™ 4.0 Generic Core Scales which include both a parent proxy-report and a child self-report with age-appropriate versions. To categorize the families' SES, the parents' education level and current employment were recorded and analyzed using the Hollingshed two-factor index of social position. None of the diabetic children in the sample came from families of upper social classes, so we categorized our diabetic children into the lower and middle social classes. Results: Physical health (P=0.02), social functioning (P=0.04), and school activities (P=0.0003) were lower in T1DM children with middle SES families than in controls from middle SES families. Parental reports revealed statistically significantly poorer HRQOL in children from low SES families in total scale score (P=0.005) and in terms of physical (P=0.0126), and psychosocial health (P=0.0246) as compared with the control group with lower SES. Also the parental proxy reports for middle scores of family SES were statistical significantly lower in the total score (P=0.0001), psychosocial health (P=0.0001), emotional functioning (P=0.0006), and school functioning (P=0.0001) compared with the middle group of the control. Conclusion: The current findings suggest that low and middle SES of families in children with T1DM is associated with lower generic HRQOL as compared to control children with similar SES of families.
In the paper it was identified firstly the short stature, then importance of anamnesis, physical ... more In the paper it was identified firstly the short stature, then importance of anamnesis, physical examination, anthropometric measurements and calculated parameters of growth. Then followed the classification of causes for short stature with a specific review on differentiation of normal from pathologic variants. Further in the text it was pointed out the importance of observing normal variants of short stature since between 84% and 87% children are with height under the 3rd percentile. Then followed tables showing pathologic causes of the short stature, and then diagnostic and therapeutic approach to the child with proportionately short stature and short stature associated with dysmorphic features.
Serum concentration of immunoglobulin G (IgG) of new-born child, at the birth, which reach the co... more Serum concentration of immunoglobulin G (IgG) of new-born child, at the birth, which reach the concentration of an adult persons, are the origin of mother and transferred by active and passive transport, by placenta. Immunoglobulin M (IgM) and Immunoglobulin A (IgA), do not pass the placenta because of their structure. Main condition for passing of IgG are normal period of pregnancy and regular function of placenta. Social-economic status (SES), and also immunologic status of a pregnant woman, an affect on the immunological status of new-born child. 120 pregnant woman and 120 of their new-born children were studied. Pregnant woman were at age of 18-34 years, and during the pregnancy they were healthy. Gestational age of new-born children was from 38 to 40 weeks, and birth weight was from 3000 grams to 4000 grams. The new-born children were from monofertile pregnancies, without visible anomalies and signs of intrauterine suffer. They were divided into 2 groups, 60 patients in every group, in comparison of SES families of a mother, in which she lived during the pregnancy. From every new-born child at the birth, from the blood of a navel it was determined the concentration of serum IgG, IgM and IgA. The values of IgG from the group with bad SES, were significantly lower (p < 0.001), in compare with a group with good SES. There was not statistically important difference between middle values of mentioned parameters among the different sex in the studied groups. Concentrations of IgM in new-born children were below the level of determination or just above it, so they could not be analysed anymore. Immunoglobulins A were not found in both groups, A and B groups.
Iodine deficiency which causes the wide spectrum of disorders for all ages, is one of the signifi... more Iodine deficiency which causes the wide spectrum of disorders for all ages, is one of the significant public health problem worldwide. From the ancient times different iodine deficiency disorders were noticed in Bosnia and Herzegovina and in its some areas the goiter existed in endemic form. These facts confirm that its soil bas been iodine deficient and that necessity for iodine prophylaxis is obvious on its territory. The study was based on 5,523 children, of both sex boys and girls school age from 7 to 14 years, randomly selected with the equal participate subjects in relation to the age. The sample is representative and it has been assessed based on: total number of school children aged from 7 to 14 years, anticipated prevalence of goiter 5% level of probability 95%, relative punctuality 30% and the factor called "design effect" which is 3. The study was carried out in whole ten cantons in the schools with equal representation among cities and villages. In examining of prevalence of giter we used inspection and palpation. Determination of iodine concentration in urine was carried out by the method is based on Sandel-kolthof's reaction. The technique used for determination of concentration of iodine in salt was iodinemetric titration. The prevalence of goiter was 27.6% in Federation of Bosnia and Heryegovina. The highest prevalence of goiter was in Bosnia Podrinje Canton (51.20%) while the lowest was in West Herzegovina Canton (12.90%). The urinary iodine excretion in investigated children varied from 1 to 208 *mg/L with median of 77.6 *mg/L. Iodine contetn in household salt samples was from 3 to 29.8 mg/kg, range 14.4 + 5.9 mg/kg. The results of our study show the persistence of mild to moderate iodine deficiency in Bosnia and Herzegovine Federation. Therefore according to the recommendations of the World Health Organisation, UNICEF and International Council for Control of Iodine Deficiency Disorders, the salt for human, and animal consumption as well as for food industry which is consuming on its teritory, has to be iodinated on the place of its production without looking back whether or not it is produced or imported in Bosnia and Herzegovina Federation, lodination has to be performed with 20 to 30 mg KI per one kg of salt, thereby an average the iodine content has to be 25 mg per kg. In this way it will be prevented the wide spectrum of disorders, which we often are not aware for that its are caused by iodine deficiency. In addition it will be prevented many very important socioeconomical consequences of iodine deficiency.
According to the clinical findings, the activity of serum asparate aminotransferase (EC 2.6.1.1),... more According to the clinical findings, the activity of serum asparate aminotransferase (EC 2.6.1.1), alanine aminotransferase (EC 2.6.1.2) and the level of total bilirubin, 45 children with acute viral hepatitis A were divided into two groups: with mild and moderately severe degree of disease. By determining the products of the peripheral thyroxine metabolism-T3 and rT3, as well as the other thyroid parameters (T4, FT4, TSH and TBG) we have found significantly lower T3 level and significantly higher T4 and TBG levels in both groups of patients in comparison with control group. At the same time, the level of biologically less active rT3 was increased in patients with moderately severe form of disease, while no differences were found in the values of TSH between the ill and control patients. TRH induced TSH release was normal in all patients. The results of this study point to the development of euthyroid sick syndrome or low T3 syndrome in children with viral hepatitis A.
The Museum of the History of Health Care in Croatia, as the first such museum in the southeastern... more The Museum of the History of Health Care in Croatia, as the first such museum in the southeastern part of Europe, was established by the Croatian Medical Association in Zagreb in 1944. Beside Vladimir Ćepulić (1891 - 1964) the head of the Croatian Medical Association, epidemiologist Stanko Sielski (1891 - 1958), was one of the most prominent personalities to be credited for realizing this project. He was born in Gracanica into a family of Polish origin. After his graduation in Vienna in 1919, he worked as an epidemiologist in Konjic, Prozor, Glamoc and other places in the area of Bosnia, mostly involved in typhoid fever and variola eradication. At the beginning of the Second World War he was in Banja Luka where he was given the duty of director of the Department of Endemic Syphilis Eradication. During 1942 and 1943 his correspondence took place with Vladimir Ćepulić, which is today preserved in the Section of the History of Medicine of the Croatian Academy of Sciences and Arts in Zagreb. On the basis of this material it was possible to trace the circumstances of the foundation of the Museum of the History of Health Care, how items were collected for its first exhibition, and the role of Stanko Sielski in preserving the medical heritage and dissemination of knowledge of the history of medicine to a broader audience.
The aim of this study was to evaluate preoperative and postoperative growth in children with cong... more The aim of this study was to evaluate preoperative and postoperative growth in children with congenital heart disease (CHD) when cardio-surgical treatment is delayed. Growth data were analysed on 116 children with various types of CHD (cyanotic lesions (Group 1), left to right shunt (Group 2) and obstructive lesions (Group 3)), who underwent cardiac surgery after a certain period of waiting. Preoperatively, during the time (median 1.13 (0.55-2.39)) years of waiting for surgery, their mean weight z-score decreased from -1.38 (+/- 1.19) to -1.41 (+/- 1.28), and their mean height z-score from -0.65 (+/- 1.41) to -0.81 (+/- 1.36). Children in Group 1 developed a significant linear growth deficit, in Group 2 weight was more affected than height, while in Group 3 both growth parameters were gradually slowly, but not significantly reduced. Postoperatively weight and height z scores, although they showed a linear trend of improvement for all three groups, remained significantly reduced for two years after surgery. At the time of the last examination at the age 9.11 (5.66-13.10) years, the mean height z score -0.16 (+/- 1.28), was significantly reduced p < 0.0001, than predicted height 0.23 (+/- 0.82). Growth catch-up was related to age at surgery and preoperative growth deficit. Delayed cardiac surgery in children with CHD aggravated growth deficit and caused slow and incomplete postoperative growth catch-up.
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