Lenticulostriate vasculopathy (LSV) is a relatively common fi nding in routine cranial ultrasound examination that has been associated with many infectious and non-infectious conditions. The aim of this review was to provide a better understanding of LSV ultrasound fi nding, as well as the need for further laboratory and imaging examinations in infants. The most of the published studies represented small series, with few prospective long-term studies involving the control groups. Authors have mostly found an association between LSV, especially higher-grade (although there is no universally accepted classifi cation) with congenital cytomegalovirus (CMV) infection, classifying those children as at risk for sensorineural hearing loss. In contrast, some authors pointed out that LSV could be found relatively often, and believe that isolated LSV, especially lower-grade, is not predictive for an unfavourable outcome and a long-term prognosis. Therefore, although 35 years have passed since the first publication of LSV, there is still no consensus among experts on the clinical signifi cance of isolated LSV, but caution is certainly needed given the fact that most infants with congenital CMV are asymptomatic.

Introduction: Adequate prenatal and postnatal care for preterm neonates not only affects the survival rate, but also the occurrence of chronic diseases, and in the future also affects the quality of life of that children. Aim: To examine the influence of independent predictors (weeks of gestation, body weight, sex) on the outcome of the disease and to analyze the influence of the applied ventilatory mode on the final outcome of treatment. Material and methods:  The study included neonates (n = 248) born prematurely who were treated in the neonatal intensive care unit for a period of one year due to immaturity-related difficulties. Results: The mean age of male neonates (n = 119) at birth was 31.13 ± 3.3 weeks of gestation (WG), and females (n = 129) 31.59 ± 3.2 WG. Weeks of gestation have a statistically significant effect on survival (p = 0.0001), for each more week of gestation, the chances of survival increase by 21%. There was no significant difference between birth weight and sex (p = 0.289), and the birth weight of the neonates had a statistically significant effect on survival (p = 0.0001). For every 10 grams of body weight, in our sample, the chance of survival increases by 2%. Ventilation mode showed a statistically significant effect on neonatal survival (p < 0.05), and intubation mode was used as an indicator. If neonates are switched from non-invasive to invasive ventilation mode, the chance of survival in our sample is reduced by 88%. Conclusion: Weeks of gestation, birth weight, and the use of a noninvasive mode of ventilation are predictors of a positive outcome for preterm neonates.

Introduction: Neural tube defects (NTDs) are multifactorial congenital anomalies of the central nervous system that results from failed neural tube closure between the 3rd and 4th weeks of embryonic development. Numerous clinical and experimental studies indicate that supplementation with folic acid before and during early pregnancy reduces the development of these anomalies. The present study examined the incidence and risk factors for NTDs and evaluated the effects of folic acid supplementation.Methods: This cross-sectional study included all children with NTDs who were hospitalized at the Pediatric Clinic, Clinical Centre University of Sarajevo during the period from January 01, 2008 to December 31, 2012. Data were collected retrospectively from the medical histories of hospitalized children. The study included children in pediatric clinics from four cantons (Sarajevo, Zenica–Doboj, Unsko–Sanski, and Central Bosnia) of the Federation of Bosnia and Herzegovina. The number of live births for the specified period in each of the four cantons was taken from a report by the Cantonal Ministry of Health.Results: Among the 69,096 live births recorded during the study period, 39 children had verified NTDs, with an overall incidence of 0.56:1,000 (or 5.6:10,000) in all four cantons. The most common NTDs were myelomeningocele with hydrocephalus (22/39, 56.4%), followed by isolated myelomeningocele (9/39, 23.1%), spina bifida occulta (7/39, 17.9%), and occipitocele (1/39, 2.6%). A total of 33.3% (13/39) of mothers took folic acid, but only one began supplementation prior to pregnancy, while 67.7% (26/39) of mothers did not take folic acid during pregnancy. NTDs were found more frequently in primiparas (53.8%), women with low education (basic school, 64.1%), and unemployed women (82.1%).Conclusion: It is important to make national recommendations for folic acid supplementation for women of reproductive age, but also change the public health policy that includes mandatory fortification of basic foods as this is the best measure for primary prevention of NTDs in the whole population regardless of employment and education status. Additional comprehensive studies are required to assess the incidence and risk factors throughout Bosnia and Herzegovina.

Introduction: Neural tube defects (NTDs) are multifactorial congenital anomalies of the central nervous system that results from failed neural tube closure between the 3rd and 4th weeks of embryonic development. Numerous clinical and experimental studies indicate that supplementation with folic acid before and during early pregnancy reduces the development of these anomalies. The present study examined the incidence and risk factors for NTDs and evaluated the effects of folic acid supplementation.Methods: This cross-sectional study included all children with NTDs who were hospitalized at the Pediatric Clinic, Clinical Centre University of Sarajevo during the period from January 01, 2008 to December 31, 2012. Data were collected retrospectively from the medical histories of hospitalized children. The study included children in pediatric clinics from four cantons (Sarajevo, Zenica–Doboj, Unsko–Sanski, and Central Bosnia) of the Federation of Bosnia and Herzegovina. The number of live births for the specified period in each of the four cantons was taken from a report by the Cantonal Ministry of Health.Results: Among the 69,096 live births recorded during the study period, 39 children had verified NTDs, with an overall incidence of 0.56:1,000 (or 5.6:10,000) in all four cantons. The most common NTDs were myelomeningocele with hydrocephalus (22/39, 56.4%), followed by isolated myelomeningocele (9/39, 23.1%), spina bifida occulta (7/39, 17.9%), and occipitocele (1/39, 2.6%). A total of 33.3% (13/39) of mothers took folic acid, but only one began supplementation prior to pregnancy, while 67.7% (26/39) of mothers did not take folic acid during pregnancy. NTDs were found more frequently in primiparas (53.8%), women with low education (basic school, 64.1%), and unemployed women (82.1%).Conclusion: It is important to make national recommendations for folic acid supplementation for women of reproductive age, but also change the public health policy that includes mandatory fortification of basic foods as this is the best measure for primary prevention of NTDs in the whole population regardless of employment and education status. Additional comprehensive studies are required to assess the incidence and risk factors throughout Bosnia and Herzegovina.

Introduction: adequate prenatal and postnatal care for preterm neonates not only affects the survival rate, but also the occurrence of chronic diseases, and in the future also affects the quality of life of that children. Aim: To examine the influence of independent predictors (weeks of gestation, body weight, sex) on the outcome of the disease and to analyze the influence of the applied ventilatory mode on the final outcome of treatment. Material and methods: The study included neonates (n = 248) born prematurely who were treated in the neonatal intensive care unit for a period of one year due to immaturity-related difficulties. Results: The mean age of male neonates (n = 119) at birth was 31.13 ± 3.3 weeks of gestation (WG), and females (n = 129) 31.59 ± 3.2 WG. Weeks of gestation have a statistically significant effect on survival (p = 0.0001), for each more week of gestation, the chances of survival increase by 21%. There was no significant difference between birth weight and sex (p = 0.289), and the birth weight of the neonates had a statistically significant effect on survival (p = 0.0001). For every 10 grams of body weight, in our sample, the chance of survival increases by 2%. Ventilation mode showed a statistically significant effect on neonatal survival (p < 0.05), and intubation mode was used as an indicator. if neonates are switched from non-invasive to invasive ventilation mode, the chance of survival in our sample is reduced by 88%. Conclusion: Weeks of gestation, birth weight, and the use of a noninvasive mode of ventilation are predictors of a positive outcome for preterm neonates.

Background: Cohort studies are useful in determining how risk factors and outcomes differ among regions, populations and available resources. The aim of this five-year cohort study of premature infants from Bosnia and Herzegovina was to examine the impact of mode of delivery and administration of prenatal corticosteroids on key neonatal outcomes. Methods: This cohort study included 734 infants with gestational age 24 32 weeks, admitted to the neonatal intensive care unit of the Pediatric Hospital in Sarajevo from 1 Jan 2012 to 31 Dec 2016, including both inborn infants and infants transported from the smaller hospitals throughout the country. We also examined the subgroup of 225 infants with gestational age 24 28 weeks for the same outcomes. Results: In the full cohort, cesarean delivery was associated with a lower incidence of severe intraventricular hemorrhage (IVH) [6.5% (cesarean section, CS) vs. 13% (vaginal delivery) OR 0.45, 95% CI: 0.26 0.78 (p < 0.01)], but not with increased survival to discharge. Administration of prenatal corticosteroids was associated with decreased mortality [13% (yes) vs 21% (no) OR 0.53, 95% CI: 0.33 0.84 (p < 0.01)]. In the subgroup of extremely premature infants, CS was associated with a higher incidence of respiratory distress syndrome and surfactant administration, and prenatal steroid administration was associated with a lower mortality rate. Multiple regression analysis showed birth weight to be a significant predictor of survival to discharge and both birth weight and delivery type to be significant predictors of severe IVH. In this model, antenatal steroid administration was not a significant predictor of survival or severe IVH. Conclusion: In this cohort of premature infants born in Bosnia and Herzegovina, survival was not influenced by delivery type. In the full cohort, CS was associated with decreased risk of severe IVH but this association was not seen in the subgroup of more premature infants. We found an association between prenatal corticosteroids and decreased mortality, but this did not remain significant with multiple regression analysis.

Introduction: Bronchiolitis, a viral infection of the lower respiratory tract, is one of the most substantial health burdens for infants and young children worldwide. Despite the respiratory syncytial virus (RSV) being the most common causative agent of bronchiolitis, there is a number of established risk factors associated with development of severe bronchiolitis. The aim of this study was to investigate the prevalence of established risk factors for severe bronchiolitis among hospitalized infants during the first year of life, as well as to compare the diagnostic and treatment methods between pulmology and neonatology department. Material and methods: This epidemiological, case-controlled, retrospective-prospective study included all children aged one year or younger who were diagnosed with severe bronchiolitis and hospitalized in Pediatric Clinic of Clinical Center University of Sarajevo from 1 May 2017 to 30 April 2018 (12 months). Patient data was collected from the patients’ histories and through interviews with parents and filled in the previously designed questionnaire. Results: The research included 95 hospitalized infants diagnosed with bronchiolitis who were less than 12 months old. Sample size was homogenized by gender (p>0.05). Patients were predominantly term children younger than 6 months at the time of the hospitalization. Admission rate was highest during the first four mounts of the year (71.6%) with peak in March (23.3%). The findings show that significant risk factors are presence of viral disease in the family, smoking during pregnancy and smoking in the household. Most of the patients (87.3%) received antibiotic or corticosteroid treatment during hospitalization, with a significant difference in antibiotic and corticosteroid use between pulmology and neonatology department (p<0.05). Conclusion: Infants with comorbidities and negative gestational and socioeconomic factors more often develop severe form of bronchiolitis during the first year of life.

Aim To compare intraoperative hemodynamic and respiratory stability and postoperative emergence delirium between two anaesthesia regimens in children (caudal block with intravenous continuous analgosedation versus general endotracheal anaesthesia) and intensity of postoperative pain and quality of postoperative analgesia. Method Forty children aged 2-6 years who underwent lower abdominal surgery were randomized depending on performed anaesthesia into two groups: caudal block with analgosedation (group CB) and general endotracheal anaesthesia (group GA). Intraoperative hemodynamic and respiratory stability were evaluated measuring systolic blood pressure (SBP), diastolic blood pressure (DBP), mean arterial blood pressure (MAP), heart rate (HR) and arterial oxygen saturation (SaO2) in preinduction (t0), at the moment of surgical incision (t1), 10 minutes after surgical incision (t2) and at the time of skin suturing (t3). Postoperative emergence delirium was evaluated using Paediatric Anaesthesia Emergence Delirium score (PAED). Postoperative pain was evaluated by Children's and Infants' Postoperative Pain score (CHIPPS). Both scores were recorded every 5 minutes during first half hour postoperatively, additionally after 60 minutes postoperatively for CHIPPS score. Results SBP, DBP and MAP were lower at t1 (p<0.0001), t2 (p<0.05) and t3 (p<0.001) in the group CB. HR was lower at all studied time points (p<0.005) in the group CB. SaO2 was lower in the CB group but comparable with the GA group. PAED and CHIPPS scores were lower at 5, 10, 15, 20 and 25 minutes postoperatively (p<0.001) in the CB group. Conclusion Caudal block with analgosedation provides better control of intraoperative hemodynamic conditions, postoperative emergence delirium and postoperative pain than general endotracheal anaesthesia.

Aim To compare intraoperative hemodynamic and respiratory stability and postoperative emergence delirium between two anaesthesia regimens in children (caudal block with intravenous continuous analgosedation versus general endotracheal anaesthesia) and intensity of postoperative pain and quality of postoperative analgesia. Method Forty children aged 2-6 years who underwent lower abdominal surgery were randomized depending on performed anaesthesia into two groups: caudal block with analgosedation (group CB) and general endotracheal anaesthesia (group GA). Intraoperative hemodynamic and respiratory stability were evaluated measuring systolic blood pressure (SBP), diastolic blood pressure (DBP), mean arterial blood pressure (MAP), heart rate (HR) and arterial oxygen saturation (SaO2) in preinduction (t0), at the moment of surgical incision (t1), 10 minutes after surgical incision (t2) and at the time of skin suturing (t3). Postoperative emergence delirium was evaluated using Paediatric Anaesthesia Emergence Delirium score (PAED). Postoperative pain was evaluated by Children's and Infants' Postoperative Pain score (CHIPPS). Both scores were recorded every 5 minutes during first half hour postoperatively, additionally after 60 minutes postoperatively for CHIPPS score. Results SBP, DBP and MAP were lower at t1 (p<0.0001), t2 (p<0.05) and t3 (p<0.001) in the group CB. HR was lower at all studied time points (p<0.005) in the group CB. SaO2 was lower in the CB group but comparable with the GA group. PAED and CHIPPS scores were lower at 5, 10, 15, 20 and 25 minutes postoperatively (p<0.001) in the CB group. Conclusion Caudal block with analgosedation provides better control of intraoperative hemodynamic conditions, postoperative emergence delirium and postoperative pain than general endotracheal anaesthesia.