Introduction: Patients with cerebral palsy (CP), besides the basic neurological damage, are also often undernourished. Adequate nutrition for children is very important during the period of intensive growth and development, which is of particular importance in patients with CP. Goal: To evaluate the nutritional status of patients with CP who are treated at the Pediatric Clinic, Clinical Centre of Sarajevo University and causes of malnutrition in these patients. Materials and Methods: Eighty patients with CP underwent anthropometric assessment (body weight, body height, body mass index, head circumference, subscapular skinfold thickness, triceps skinfold thickness and mid upper arm muscle circumference). Severity of CP was classified based on the Gross Motor Function Classification System (GMFCS). We compared the anthropometric parameters of our patients with normal values of healthy children, as well as with degree of motor impairment, oromotor dysfunction, feeding assistance, length of meals and daily feeding time. Results: There were significant differences in all monitored parameters in relation to normal values, with 38 (47.5%) malnourished patients in the total group, out of which 29 (63.0%) with severe motor impairment and with 9 (11.3%) obese patients in the total group. The presence of oromotor dysfunction and other monitored parameters had a significant impact on the nutritional status of these patients. Conclusion: In severely disabled patients with CP there is a risk of profound malnutrition. Early identification and treatment of these patients is very important for their growth, development and health.

Introduction: Plasmapheresis also known as a therapeutic plasma exchange (TPE) is extracorporeal procedure by which individual components of plasma that are harmful or blood cells can be removed from organism by using a blood separation technology. Aim: To present the results of the implementation of plasmapheresis in children in the Department of Pediatric Intensive Care of Pediatric Clinic, Clinical center of Sarajevo University, Bosnia and Herzegovina. Patients and methods: Research (period from December 2011 to June 2016) analyzed 66 plasmapheresis (11 patients–6 plasmapheresis per patient). Results: Out of 11 patients, 7 (63.6%) were girls and 4 (36.4%) were boys. The average age of patients was 11.6 ± 3.9 years (the youngest patient had 4 years and 7 months, while the oldest had 16 years and 10 months). Plasmapheresis were significantly more often done in the winter and summer. Underlying disease was in 54.5% of cases of neurological origin. The treatment was in form of receiving IVIG in 7 patients, or the application of mechanical ventilation in 6 patients. The most common complication was hypotension, which occurred in 45.5% of patients, followed by bleeding in 36.3%, hypercoagulability in 27.2% of patients and hematoma in 27.2% of patients. Lethal outcome occurred in 3 (27.2%) patients. Conclusion: Plasmapheresis represents an invasive method due to need for placement of centralized venous catheter that provides adequate blood flow during the procedure. Although complications can be serious, they are rare and are mainly related to the presence of central venous catheter, hemostasis disorders due to use of anticoagulant therapy, and hypotension of the cardiovascular system. It should be noted that for success of plasmapheresis in children multidisciplinary approach is necessary (children’s nephrologist, neuropediatrician, intensive care doctor) as well as well-trained team of doctors and nurses with the acquired knowledge and skills.

Objectives: Postmenopausal period is associated with the decline in antioxidant levels due to gradual loss of estrogen, increased body weight and central adiposity. The present study aimed to evaluate association of adiposity and regional fat distribution with total antioxidant capacity in postmenopausal women. Methods: This cross-sectional study included 90 apparently healthy postmenopausal women. We measured anthropometric indices including body mass index (BMI), waist circumference (WC) and waist-hip ratio (W/H ratio). Total fat mass (TFM), total lean mass (TLM), percentage fat mass (%FM), visceral fat diameter (VFD) and subcutaneous fat diameter (SFD) were measured using ultrasound. Serum total antioxidant capacity (TAC) was measured by quantitative colorimetric determination using Total antioxidant Capacity -QuantiCromAntioxidant Assay Kit (BioAssay systems, USA; DTAC-100). Results: Out of 90 postmenopausal women, 35.9% were overweight and 25.0% obese, while 60.9% had central obesity. Postmenopausal obese women had significantly lower median TAC level [308.3 (283.0-375.1)] mM Trolox equivalents compared to overweight [383.38 (356.5-389.4) mM Trolox equivalents; p<0.001] and normal weight women [376.3 (318.0-388.7) mM Trolox equivalents; p<0.005]. Serum logTAC level was inversely associated with BMI, TFM, TLM and WC in postmenopausal women. However, when stratified by central obesity, inverse associations between serum logTAC level and BMI (r=-0.503; p<0.001), TFM (r=-0.383, p=0.004) and WC (r=-0.408; p=0.002) were observed only in postmenopausal women with central obesity. Conclusion: Our results provide evidence that obesity and central obesity during postmenopausal period are associated with decreased total antioxidant capacity and depleted antioxidant defenses possibly due to elevated oxidative stress. Larger prospective studies are needed to evaluate whether obese postmenopausal women might benefit from antioxidants supplementation for the prevention of obesity related diseases. Keywords: total antioxidant capacity, oxidative stress, obesity, overweight

Haemodialysis is a fast and efficient meth-od for removing toxins from the body in a straightforward manner. This has been a regular practice at the Paediatric Clinic in Sarajevo, Department of Paediatric In-tensive Therapy since January 2009. By December 2014 there were 34 patients treated by haemodialysis, who had un-dergone 253 haemodialyses in total. There were 18 (52.9%) primary nephrologic pa-tients, while 16 (41.05%) were patients whose renal failure was caused by other etiology. The main objective of this paper is to present the most common conditions in childhood that require haemodialysis in its treatment. The Department of Paediat-ric Intensive Therapy for this period had hospitalized 1,226 patients in total. Out of this number 2.77% of patients required the application of haemodialysis in their treat-ment. The results show that the most common renal causes to perform haemodialysis are: haemolytic uremic syndrome (HUS), chronic renal failure, nephrotic syndrome and congenital bilateral nephrolithiasis. For the others, the most common non-renal causes are multiple organ dysfunc-tion syndrome (MODS) that occurs as a result of cardiac insufficiency, hepatic in-sufficiency or after surgeries, as well as in hemato-oncologic diseases.

Introduction: Application of a central venous catheter (CVC), as a temporary or permanent vascular access for hemodialysis, has been continuous practice at the Sarajevo Pediatric Clinic, Department of Pediatric Intensive Care. The main goal of the article is to present our experiences with central venous catheters in the treatment of these patients. Material and methods: In the period from January 2009 to December 2014 a total of 41 patients were treated and a total of 56 catheters were placed. Results: The results show the prevalence of the femoral venous catheter (69,64%), with significantly smaller participation of jugular (28,57%) and symbolic participation of subclavian catheters (1,78%). Frequency of infections of 8,92% in our article is lower than the percentage contained in the data of the National Nosocomial Infections Surveillance System, which provided data related to 17% of catheter related infections. The most common agents of the catheter related infections in our patients are gram-negative bacteria from the Klebsiella pneumoniae group. Conclusion: The issue of the higher complication percentage during the treatment is linked with hemostasis related to bleeding into or around the catheters in 28,57% of patients, and to clotting disorder in terms of thrombosis in 10,71% of patients.