Objective – The present study was undertaken to determine alcohol consumption among adolescents attending state schools in the BrAko District of Bosnia and Herzegovina (BH). Participants and method – The subjects were pupils in the ninth grade of elementary school and all high school pupils. 4,188 pupils took part in the survey. The research was planned as a cross-sectional study, and it was conducted using the ESPAD questionnaire, which was adjusted for this research. Demographic data were collected through a specific question-form for each enrolled adolescent . Results – More than half the adolescents consumed alcohol. Boys did so more often, whilst there was no difference in alcohol consumption between those who lived in villages or towns. At the age of 14 years nearly half the adolescents had consumed alcohol, where boys had done so more often, as well as the adolescents from villages. The places where the adolescents most often consumed alcohol were discotheques, “at friends’ homes”, and in cafA©s. More than half the members of the adolescents’ households consume alcohol. Adolescents in the BrAko District of BH had consumed alcohol over the previous 30 days in a significantly higher percentage than pupils from the Republic of Srpska and the Federation of BH, and in a significantly lower percentage than pupils from Croatia, whilst the difference in comparison with Serbia was not significant. The frequency of alcohol intoxication in the BrAko District of BH was the lowest in comparison with the Republic of Srpska, the Federation of BH, Croatia and Serbia. Conclusion – Overall alcohol consumption amongst adolescents is becoming generally acceptable behaviour, which is tolerated by the community and parents, in that alcohol consumption is becoming a life-style, but it is not being systematically studied as a negative phenomenon, nor are there any long-term programmes to deter adolescents from consuming alcohol.

Iodine is an essential element to humans and animals. It is a constituent of the thyroid hormones and its deficiency causes goitre and may increase the risk for intellectual deficiency in affected populations. Iodine deficiency disorders represent a significant public health problem in 118 countries worldwide (Vitti et al., 2001). Among them, thirty-two European countries were still affected by mild to Abstract

www.paediatricstoday.com Introduction Adolescence is a period of dramatic biological change – occurring in the context of equally dynamic socio-environmental change with regard to the adolescent’s school, peer 1Government of Brčko District of Bosnia and Herzegovina, 2Academy of Sciences and Arts of Bosnia and Herzegovina, Sarajevo Bosnia and Herzegovina, 3Institute for Biostatistics and Medical Informatics Faculty of Medicine, Ljubljana, Slovenia

Objective – The objective of this study was to assess the health-related quality of life (HRQoL) in children with cerebral palsy (CP) in relation to socioeconomc status (SES) of family. Methods – The cross-sectional study included 75 children with CP between ages 5 and 18 years and their parents. The control group was formed by random selection by matching each patient with one or two healthy control participants. To evaluate the generic HRQoL in children with CP 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. SES was determined using a classification system based on the parents’ job and educational level. Results – Lower-SES children with CP showed significant lower medians of total scores, physical health, psychosocial health, and social functioning HRQoL than lower SES control participants and, middle SES children with CP showed significant lower medians of total scores, physical health, psychosocial health, than middle SES control participants. Parental reports revealed significantly poorer HRQoL in lower SES children with CP in total scores, physical health, psychosocial health, social functioning, and school functioning than lower SES control participants. Also, the parental proxy reports for middle SES children with CP were significantly lower in total scores, physical health, psychosocial health, and social functioning than middle SES control participants. Conclusions – This study showed that low and middle SES children with CP have lower HRQoL than low and middle SES healthy children. Our results call for the creation of socialeconomic and psychological programs which might have beneficial effects for children and adolescents with CP and their families.

Objective – Outbreaks of sepsis caused by multidrug-resistant Acinetobacter baumannii in neonatal intensive care units have been reported, but rarely from our country. We describe such an outbreak in the Department of Paediatrics of the University Clinical Centre Tuzla in 2012 to investigate risk factors, the mode of transmission and to assess control measures. Setting – An 18 bed, level 3 neonatal intensive care unit in a university affiliated teaching hospital. Patients and methods – Seventeen neonates who developed multidrug-resistant Acinetobacter baumannii nosocomial infection were matched to 17 neonates who were admitted to the same unit without infections, during the outbreak period. Cases and controls were compared for possible risk factors (birth weight, gender, intubation, antibiotic use, etc.). Surveillance cultures were collected from health care personnel and the environment. Results – Six out of the 17 neonates (35.3%) died. Surveillance cultures were negative. Seventeen isolates from newborns had the same patterns of resistance. Multidrug-resistant Acinetobacter baumannii was brought into the unit by an infected infant who was transferred from the neurosurgery hospital. Risk factors significantly associated with the infection were: incubator care (OR 6.66; p =0.034), exposure to a central venous catheter (OR 13.75; p=0.004), mechanical ventilation (OR 5.25;p =0.031) and exposure to a patient with Acinetobacter baumannii infection (OR 38.40; p =0.02). Conclusion – Surveillance cultures for all newborns transferred from other hospitals and isolation measures are important to prevent nosocomial infections and outbreak. Negative environmental and health care worker cultures have to be meticulously analyzed. Cohorting of affected newborns and nursing staff, contact isolation, and environmental cleaning are crucial to control the outbreak.

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.

This is a brief review of the hyperphenylalaninemia and their classifi cation. The classical phenylketonuria is described in some details, along with procedures for treatment and follow up of patients. The other forms of hyperphenylalaninemia are briefl y reviewed, with some more details of the form due to tetrahydrobiopterin defi ciency. In addition, the procedures for the analysis of the results of neonatal screening for phenylketonuria are delineated.

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.

No abstract available.

Abstract Aim: The aim of the study is to assess the association of overweight/obesity and early menarcheal age. Patients and methods: The study comprised 2127 healthy girls aged 9 to 16 years. Menarcheal age was estimated by status quo method. The girls’ body weight and height were measured and their body mass index (BMI) calculated. The diagnostic criteria of the WHO were used to define overweight and obesity. Girls with a BMI in the range of 1–2 for age and sex were considered overweight. Girls with a BMI >2 standard deviation (SD) for age and sex were considered obese. Girls with a BMI >1 SD for age and sex were considered overweight/obese. Social and economic status was analyzed according to years of education completed, parents’ occupations, and the number of children in the family. Results: Median menarcheal age was 12.83 years; 25% girls had menarche before 11.98 years and 75% by 13.69 years. By 11.21 years, 10% of girls had had menarche, and 95% by 14.91 years. Girls who had menarche before 11.98 years had higher body weight values (48.5 vs. 40.2 kg) (p<0.001), height (159.3 vs. 149.2 cm) (p<0.001), and BMI (18.9 vs. 17.8 kg/m2) (p=0.003) than their peers without menarche. Girls with menarche before 11.98 years had significantly higher BMI values than girls with menarche after 13.69 years (18.94 vs. 17.84 kg/m2) (p=0.008). Girls with menarche before 11.98 years and those after 13.69 years differ significantly in distribution of thinness (3.4% vs. 2.54%), normal weight (85.3% vs. 91.8%), and overweight/obesity (11.2% vs. 5.7%) (p=0.002). Conclusions: Girls who experienced early menarche are significantly more often overweight/obese. Overweight/obesity may be considered as one of the predictors for the early occurrence of menarche.