Background/Aim: Clinical research nursing is a well-known concept in Europe and other countries. The purpose of this study was to investigate the nurses' knowledge and attitudes towards clinical research and their opinions and self-evaluation about clinical research nursing and factors affecting them. Methods: A cross sectional study was conducted at the University Clinical Centre of the Republic of Srpska (UCCRS). A questionnaire included 50 questions/ statements was created in order to address the aims of the research and afterwards distributed to 120 nurses from 6 departments. Results: Response rate was 91.6 %. Most of the respondents showed a low level of knowledge, but positive attitude related to clinical research. Nurses who participated in clinical research were confident in their competencies according to their self-evaluation. Conclusion: Systematic approach to the additional nurses education could have a significant impact on a success of clinical research.

Introduction/Objective. Unintentional injuries is a global health issue among children and adolescents. The aim of this study was to examine the characteristics of unintentional injuries divided according to different age groups and sex among the children and adolescents who have been hospitalised in public hospitals of the Republic of Srpska, Bosnia and Herzegovina. Methods. A retrospective analysis of the e-base of the Agency for certification, accreditation and health care quality improvement of the Republic of Srpska data were collected from 10 public hospitals for patients aged ?19 years, who have been hospitalised for unintentional injuries in the period of January 2018 and December 2020. Results. The study identified 1,336 patients who were hospitalised for unintentional injuries, most of whom were boys (67.4%). Falls were the most frequent cause of hospitalisation in children of all age categories (aged 1 (70.6%), 1 to 4 (59.1%), 5 to 9 (68.5%)) and adolescents aged 10-14 (64.1%), while road traffic injuries were the leading cause of hospitalisation in adolescents aged 15 to 19 (62.6%). The cause of injury for the hospitalised patients were significantly related to age (p < 0.001) and sex (p < 0.05) groups. According to the nature of the injury in relation to the area of the body, the most frequent injuries were to the head (41.1%), caused by traffic accidents and falls. Conclusion. Since falls and road traffic injuries were the leading causes of hospitalisation, preventive measures should be taken to reduce the frequency of these injuries.

Background/Aim: Unintentional injuries among children and adolescents have become a common issue in public healthcare. The study objective was to analyse the characteristics and identify predictors associated with unintentional injuries in children and adolescents treated in emergency medical services (EMS) in the Republic of Srpska, Bosnia and Herzegovina. Methods: A cross-section study with retrospective analysis of WebMedic e-database from 14 EMS, in the period between January 2018 and December 2020 was conducted. Research included patients with unintentional injuries, aged ≤ 19 years, of both sexes. For comparison between groups, Chi-squared and multivariate logistic regression were used in risk factor analysis. Results: A total of 1,856 cases were identified, most injuries resulted from falls (46.7 %) and traffic injuries (26.9 %). Boys were significantly more affected by injuries than girls (p < 0.001). Falls were the major cause for reporting to EMS among age groups of children (0-9 years) and adolescents (10-14 years), whereas injuries in traffic were dominant in adolescents aged 15 to 19. The most common injuries were head injuries (35.7 %). Risk factors of unintentional injuries were age (p < 0.001), sex (p = 0.046), weekday (p = 0.016), winter (p = 0.014), body region (head, abdomen, lower and upper limbs (p < 0.001), thorax (p = 0.009)). Conclusions: There were significant differences in characteristics of unintentional injuries according to age and sex. Chances for occurrence of unintentional injuries among children increased with their age, especially for boys. These differences might indicate areas where preventive measures should be undertaken.

Introduction: Unintentional falls are the leading cause of traumatic injuries, without fatal consequences, with significant morbidity in the population of children and adolescents. Goal: The main goal of this research was to analyze the manner of falling in relation to age and gender, and to assess the type of injury and the anatomical region of the body affected by the injury sustained during a fall in patients ≤19 years of age treated in the emergency medical services in the Republic of Srpska. Material and methods: A cross-section study with retrospective analysis of the national e-database WebMedic from 11 emergency medical services between January 2018 and December 2020 was conducted. Research included patients with diagnosis of unintentional injury caused by a fall, aged ≤19 years. Descriptive statistics and the Chi-square test were used for comparisons between groups. Results: During the observed period, 857 cases of unintentional falls were identified, where 87.5% were referred for hospitalization. The group of children aged 0 to 9 years (55.7%) was more often treated for falls (p<0.001), and boys were affected 6.7 times more often than girls (p<0.001). Falls from the same level caused different types of injuries depending on the age and gender of the children (p<0.001). According to the type of injury, superficial injuries (36.8%) and open wounds (29.4%) were most often identified, and the most frequently affected body region was the head (52.0%). Conclusion: The group of children up to the age of nine and males were more often affected by superficial injuries and open wounds, with head injuries being predominant in all age groups. These results could indicate the necessity of creating programs with targeted prevention.

Hydrops fetalis is a serious condition indicating a bad prognosis of affected fetuses. Incidence of immune hydropsfetalis is significantly decreasing, whereas more and more non-immune hydropsfetalisis are identified. We described a case of the most difficult manifestation of hemolytic disease of a newborn due to rhesus incompatibility. Immune hydrops fetalis occurred due to inadequate immune prophylaxis. While treating the newborn, we applied exchange transfusion, additional transfusion and immunoglobulin therapy. With sensitized pregnant patients, it is necessary to regularly monitor the condition of fetus and titer of mother’s antibodies. Considering a difficulty of affected fetuses’ disease, it is necessary to strengthen preventive measures by application of rhesus immunoglobulin with affected Rh negative mothers.

Introduction/Objective. Benign transient hyperphosphatasemia (BTH) is a pathogenetic insufficiently clear clinical entity that is mostly seen in infants and young children. The objective of this paper is to present our experience regarding the age of occurrence, the conditions of the discovery, and the length of duration of BTH in children. Methods. The study was realized on a sample of 18 children, nine boys and nine girls, aged 10?42 (21.06 ? 9.35) months with BTH. The diagnosis of BTH is based on the absence of bone and hepatobiliary diseases, and its spontaneous disappearance over the course of several months. Results. One patient was in the first year, 13 in the second, three in the third, and one in the fourth. Isolated high activity of serum alkaline phosphatase, which was 2.04?21.9 (8.05 ? 5.31) times above the upper reference value for the corresponding age, in 14 cases it was found during the acute diarrhea, and in four with acute rhinopharyngitis, of which in two complicated with otitis media. The cause of diarrhea in six cases was rotavirus, in two Campylobacter, and in one adenovirus, and otitis media in one case was caused by Streptococcus pneumoniae, while in others, etiologic factors of infection were not identified. Spontaneous normalization of serum alkaline phosphatase activity was recorded between one and three months after the onset. Conclusion. BTH is a harmless biochemical disorder that spontaneously subsides within three months after initial observation. It is found randomly as a routine laboratory finding most often within the treatment of acute gastrointestinal and respiratory infections.

Introduction/Objective Isolated hypertransaminasemia (IHTS) is a common, benign, and transient appearance in patients with celiac disease (CD). The aim of this study is to determine the frequency of IHTS in children up to two years old with clinically classical CD, as well as its connection with the onset of the first symptoms of the disease, the age of diagnosis, the clinical and laboratory nutritional parameters, and the degree of damage of small intestinal mucosa. Methods The study was based on a sample of 82 children, 55 female and 27 male, ages 7?24 (14.28 ? 4.41) months. The diagnosis of CD was based on the revised ESPGHAN criteria and the activity of serum alanine aminotransferase (ALT) and aspartate aminotransferase (AST) by standard laboratory methods. Results IHTS was found in 39 (47.56%) patients, 27 of whom (69.23%) had elevated levels of both transaminases and 12 of only one ? eight of AST and four of ALT. The increase in relation to the aforementioned reference value for ALT was 1.1?10.08 (1.67 ? 1.73), and for AST it was 1.08?7.91 (1.56 ? 1.29) times. In patients with IHTS compared to those with normal transaminasemia, the age of onset of CD was significantly lower (9.83 ? 3.69 vs. 12.95 ? 4.43 months, p = 0.001), as well as the age of diagnosis (12.97 ? 3.88 vs. 15.47 ? 4.56 months; p = 0.01), while the differences in the other observed parameters were not significant. Conclusions IHTS occurs in almost half of children up to two years old with classical CD. Hypertransaminasemia is in most cases mild and significantly more frequent in patients with earlier clinical expression of the CD.

Introduction/Objective. Anemia is the most common extraintestinal manifestation of celiac disease (CD) in children. The aim of this study was to determine the frequency, severity and type of anemia in children with a classical CD, as well as the differences between anemic and non-anemic patients in their age, duration of illness, percentile body length or height, percentage of body weight (BW) deviation compared to ideal, and the degree of damage to the small intestine mucosa. Methods. The study was based on a sample of 90 children, 56 females and 34 males, ages 7?90 (18.23 ?} 12.7) months with classical CD. The diagnosis of CD is based on the ESPGHAN criteria from 1990 and 2012, and of anemia on the 2011 WHO reference values. Results. Anemia was found in 47 (52.22%) patients, of which it was mild in 23 cases [hemoglobin (Hb) 100?109 g/L] and moderately severe in 24 (Hb 70?99 g/L), in 34 (72.34%) it was microcytic [mean cell volume (MCV) < 70 fl] and normocytic (MCV 70?87 fl) in 13 patients. Low serum iron levels (< 10.7 ?mol/L) were found in 68 (75.56%), and hypoferritinemia (< 16 ng/ml) in 77 (85.56%) patients. Except for a greater deficit of BW in patients with anemia compared to those without anemia (-14.64 ? 9.60 vs. -8.56 ? 11.87%, p < 0.01), differences in other defined features were not significant. Conclusion. Mild or moderate iron deficiency anemia occurs in slightly more than half of children with a classical type CD. In anemic compared to non-anemic patients, there is a significantly higher BW deficit, while differences in other characteristics typical for this type of disease are not significant. This article has been corrected. Link to the correction 10.2298/SARH1910649E

Introduction: Asthma is a global health problem that negatively affects various aspects of the quality of a person's life. The aim of the study was to examine the quality of life in children and adolescents with asthma and the correlation between the degree of asthma control and the quality of life.Methods: The cross-sectional study included 100 children and adolescents with asthma over a six-month period in 2015. The study used: Standardized Pediatric Asthma Quality of Life Questionnaire (PAQLQ(S)) for the assessment quality of life and the questionnaires for the assessment of asthma control for two age groups: Asthma Control Test (ACT) for adolescents and Childhood Asthma Control Test (C-ACT).Results: 62 boys and 38 girls aged 7−17, whose average age was 11.2 (s = 2.7) years were included in the study. The overall PAQLQ(S) score ranged between 3.30 and 7.00 with an average mean value of 5.95. The findings have showed that most children with asthma estimated their overall PAQLQ(S) on the positive end of the scale. The children reported more impairment in the domain of 'Emotion' (x = 5.84) than in 'Activities' and 'Symptoms'. The percentage of adolescents in the category of poor control (12.5 %) was significantly lower than in the group of children (25.0 %). In both groups of children, the sub-scale 'Symptoms' was in highest correlation with the degree of asthma control (r = 0.915, p < 0.01).Discussion and conclusion: In this study the children and adolescents with asthma showed an overall good quality of life. Control of asthma symptoms in children and adolescents positively influenced their quality of life.

Alergija na hranu predstavlja cest i kontinuirano rastuci problem. Iako je prisutna u svim životnim dobima, najcesce pogađa decu do tri godine, a posebno nasledno predisponiranu odojcad na vestackoj ishrani. Sklonost neadekvatnoj imunskoj reakciji je neselektivnog karaktera, te je nutritivna alergija cesto multipla i u visokom stepenu udružena sa inhalacionom i/ili kontaktnom hipersenzitivnoscu. Zbog antigenske bliskosti nekih vrsta hrane alergijska reakcija može biti i unakrsna, kao sto je to slucaj sa kikirikijem, leguminozama i jezgrastim vocem ili kravljim, ovcjim i kozjim mlekom. Glavni nutritivni alergeni, odgovorni za preko 90% neželjenih reakcija ovog tipa, su proteini kravljeg mleka, jaja, kikirikija, jezgrastog voca, soje, psenicnog brasna, ribe i morskih mekusaca, zglavkara i cefalopoda. Alergiju na hranu karakterise veoma sirok spektar klinickih manifestacija. Moguce su i veoma teske sistemske reakcije, nekad i fatalne. Dijagnoza alergije na hranu se zasniva na detaljnoj licnoj i porodicnoj anamnezi, kompletnom klinickom pregledu i odgovarajucim laboratorijskim i drugim ispitivanjima prilagođenim tipu hipersenzitivnosti i karakteru tegoba ispitanika, a terapija na eliminacionoj dijeti. Znacajan doprinos dijagnozi ima i pozitivan efekat eliminacione dijete. Mada je alergija na hranu kod dece u vecini slucajeva prolazna, na neke od namirnica, kao sto su kikiriki, jezgrasto voce, riba i morski mekusci, zglavkari i cefalopode, ona je najcesce doživotna.

1Univerzitet u Banja Luci, Medicinski fakultet, Studij zdravstvene njege, Save Mrkalja 14, 78000 Banja Luka, Bosna i Hercegovina 1University of Banja Luka, Faculty of Medicine, Study of health care, Save Mrkalja 14, 78000 Bania Luka, Bosnia and Herzegovina 2Univerzitetski klinički centar Banja Luka, Dvanaest beba bb,78000 Banja Luka, Bosna i Hercegovina 2University Clinical Centre Banja Luka SG/NJ 2017;22:224-9 DOI: 10.11608/sgnj.2017.22.043

Introduction: Preterm delivery remains a burning issue all over the world, especially in Serbia because of the rate of negative natural increase. IL-6 can stimulate the release of prostaglandins and cause premature contractions and premature labor. Aim of the Study: The aim of this research is to examine the importance of infection in the occurrence of premature contractions and to examine whether the preterm labor is associated with increased concentrations of IL-6 in patients with intact fetal membranes. Patients and Methods: We examined 83 pregnant women. The age range was between 15 and 43 years. The experimental group had 53 pregnant women and a control group was consisted of 30 pregnant women. All pregnant women had singleton pregnancies. The age of pregnancy in both groups was between the 21st and 35th week of gestation. The experimental group was divided into three groups according to the localization of infection: bacterial vaginosis, an infection of the cervix and urinary tract infections. The laboratory identification of IL-6 was performed as a double sandwich ELISA method. The reagents used for the identification of IL-6 were manufactured by Beckman-Coulter and were strictly intended for the research. Results: There were 34 pregnant women or 64% with infection of the cervix, 26 pregnant women or 49% had a positive urine culture, while bacterial vaginosis was present in 47 pregnant women or 89%. A positive finding on all localization was found in 14 pregnant women or 26%. In the experimental group, IL-6 was detected in 37 pregnant women or 70%. The mean value of IL-6 proven in the experimental group was 20.6 pg/ml (SD=18.2, n=53). Conclusion: This research demonstrated a direct link between a bacterial infection and preterm delivery. IL-6 can be used as a serological marker of bacterial infection and preterm delivery.

In this article we present the results of treatment for 24 children with acute lymphoblastic leukaemia (ALL) who were treated on the hematooncology ward of the Children’s clinic, Clinical Center Banja Luka in the period from January 1st 1990 to the end of 2005. The chil dren were divided into two groups, according to the therapy protocol they received. In the first group were children treated with protocol Yu ALL 0187 in the period from January 1st 1990 until December 31 st 1995. In the second group were the children treated with protocol Yu 0195 (introduction of high doses of methotrexate). We compared results by the following criteria at the time of establishment of diagnosis: symptomatology, duration of symptoms, clinical and laboratory findings, and also the survival rate of the patients. The survival rate for the period of follow-up of the patients for the first group (protocol Yu ALL 0187) was 61.5%. For the second group (protocol Yu ALL 0195) the survival rate was 84% which is statistically significant, and it speaks in favour of the improvement of therapy by the introduction of methotrexate as consolidation therapy.