Aim: This study sought to assess whether the volume and osmolarity of contrast media (CM) influences the occurrence of contrast induced nephropathy (CIN) following coronarography procedure. CIN can be defined as an increase in the serum concentration of creatinine greater than a 25% from baseline during the period of 12 to 48 hours after the administration of radiocontrast media. Material and methods: We examined 100 patients without diabetes with serum creatinine concentration from 45 mmol/l to 141 mmol/l and 100 patients with diabetes with serum creatinine concentration from 46 mmol/l to 161 mmol/l who underwent coronary angiography. During procedure they received iso-osmolar contrast medium, Visipaque 320 (iodixanol-320), for group without diabetes from 40 to 340 ml and for group with diabetes from 49 to 310 ml. Results: CIN occurred in 27 (13,5%) of the 200 study patients. There was a trend toward higher prevalence of CIN (16% vs.11%, p = 0.086) in the diabetic group compared with the non-diabetic group. Patient with diabetes received less contrast media, they are younger but number patients with CIN are higher. Conclusion: Increasing contrast media dose is associated with the occurrence of CIN following coronarography. But, another risk factors like diabetes mellitus, old age, male sex and preexisting kidney disease have influence of developing CIN after coronarography.

Purpose – This study aims to explore how two Norwegian national online newspapers, Dagbladet and Aftenposten, have framed halal food in the past 6 years (2008-2014), a period conflating with a rise in Muslim demographics in Norway. Design/methodology/approach – A mixed-methods approach is used. Employing among others a Hallidayan transitivity analysis and other approaches from critical discourse analysis (CDA), clausal semantic structures, collocations and nominalizations were explored with a view toward fleshing out ideological significance. Particular attention was given to the neologism – “covert-Islamization” – popularized by the populist right-wing Progress Party. Findings – The findings reveal that Dagbladet refracts halal food through a discourse of crime and other dubious frames tapping into topoi of Islamophobia. Halal is, in this manner, transformed into a synecdoche for deviance. This is contrasted with Aftenposten’s more “halal-friendly” gaze which inter alia is attributed to greater access fo...

Aim: The aim of this study is to present the first total number of tested children in the Federation of Bosnia and Herzegovina and the number of children with positive sweat test. During the study we determined the number of ill children, the median age of children with cystic fibrosis, date of initial diagnosis, an average amount of chloride in the sweat. Material and methods: The study was a retrospective, conducted at the Department of Pulmonology Pediatric Clinic of University Clinical Center of Sarajevo. Results: In the period from March 2003 to December 2014, we have tested 625 children. 351 child were from Sarajevo Canton and 272 children from other cantons. Female children were more affected then male children, in the ratio of 1: 1,105. An average age of female children was 4.19±4.26 years, and the male 2.15±3.11 years. The median concentration of chloride in the sweat measured by sweat test was for male children 103.05±21.29 mmol/L, and for the female children 96.05±28.85 mmol/L. Conclusion: Most of children in Federation of Bosnia and Herzegovina have ∆F508 gene mutation. In the post-war period we started to use a sweat test. Male children tend to live longer than female children with CF.

Objective: To present the epidemiological features of bronchiolitis in a one-year period in patients of Pediatric Clinic, Clinical Centre of Sarajevo University. Introduction: Bronchiolitis is the most common respiratory infection of early infant age. The disease is one the most common reason for hospitalization of children under the age of six months. The disease is characterized by occurrences in the winter season November–March. For daily diagnosing of severe forms of bronchiolitis as a clinical syndrome, often sufficient are the knowledge of the epidemiological data, age of the patient, clinical examination and insight into the risk factors. Patients and methods: The history of the disease in 155 infant patients, who were clinically treated because of bronchiolitis in the period from February 2013 to February 2014 in the Department of Pediatric Pulmonary Clinic in Sarajevo was retrospectively analyzed. Results: The majority of patients were aged less than 6 months (87.7%). The monthly distribution of bronchiolitis had a peak in January and February. Almost 50% of patients had a risk factors for the development of severe forms of bronchiolitis out of which the most common were artificial diet (53.5%), low birth weight below 2500g (17%), prematurity (16.1%), congenital heart anomalies (14.2%), bronchopulmonary dysplasia (1.9%). 46,5% of patients were on natural nutrition. 46 patients (29.6%) were serologically or by respi-strip test in nasopharyngeal lavage positive on respiratory syncytial virus (RSV). There were no patients who required mechanical ventilation. Conclusion: During the one-year period, bronchiolitis was the most common diagnose in the early infantile period up to 6 months, with a peak incidence in January and February. Risk factors such as prematurity, low birth weight, congenital heart anomalies and bronchopulmonary dysplasia have been less present in the studied period compared to the period before the introduction of RSV chemoprophylaxis. The epidemiological data obtained have facilitated the diagnosis, and accordingly the timely and appropriate treatment of bronchiolitis.

ABSTRACT Introduction: Due to the geographical position of Bosnia and Herzegovina and its socio economic momentum even though the standard vaccination program is carried out, the child population continues to suffer from pulmonary tuberculosis in significant percentage. Material and methods: The study was retrospective and included patients who were in the period from January 1, 2004 to December 31, 2013 (or the 10 years period) hospitalized at the Department of Pulmonology Pediatric Clinic dually diagnosed with lung TB and start treatment. Data were adopted from available medical records (history of disease). Goal: The aim of the study was to determine the epidemiological and clinical characteristics of tuberculosis of the lungs in children who were hospitalized at the Pediatric Clinic. Results: In the period from January 1, 2004 to December 31, 2013 there were hospitalized a total of 50 children with a proven active infection with MBT, where it was initiated treatment with a specific therapy. From this number 44% of patients were aged from 5 to 10 years, 22% of patients were aged younger than 5 years. Peak incidence was in 2009. About 66% of patients had a positive history of sick close relative, while 10% of them had a history of contact with other sick person. From baseline 28% of patients were referred to the Department with suspicion of a specific process. From the total 70% of respondents were regularly vaccinated, and 29% of them had a visible BCG scar. In 55% of cases there was anamnestic information - decresed body weight, in 82% of cases the presence of cough, of which 52% of the occurrence of expectoration. In 78% of cases we had positive auscultatory findings of the lungs. In 14% of cases on X-ray of the lungs was noticed changes in terms of the primary complex positive. In this material we had one cavernous and one miliary TB of the lungs. Sputum or gastric lavage was positive in 62% of cases, and Quantiferon because of the lack of the same (in the past) was positive in 34% of cases. All subjects at the time of discharge were classified as recovered. In that period we had proven resistant TB. Conclusion: Bosnia and Herzegovina belongs to the group of countries with still present and evident TB. In the investigated period of ten years from the pediatric pulmonary TB, usually have suffered small children and adolescents. At moment of discharge, all patients were classified as recovered. In the teste material we did not have proven resistant TB.

Summary This paper describes the utility of flexible bronchoscopy in a sick child diagnosed with dermatomyositis, celiac disease. Mucus plug is a common medical cause of lung atelectasis. Due to deteriorated respiratory condition, the child was highly febrile, cyanotic, liver 6-7 cm, palpable under the right rib arch. We described a child with dermatomyositis and lung atelectasis. Atelectasis causes difficulty breathing and decreased oxygen saturation, so the child was intubated and put on a complete mechanical ventilation. Before intubation, the number of respirations exceeded 40/min, O2 saturation on the pulse oximeter fell under 73%. Pulse rate was 173/min, blood pressure 94/37 mmHg. Before intubation, the gas analysis of blood showed: Ph below 7.30 and pCO2 9 kPa, pO2 in the blood below 4.9 kPa. After flexible bronchoscopy was performed, therapeutic and diagnostic, lung re-expansion was enabled. After performed bronchoalveolar lavage with 0.9% NaCL 1 ml per kg TT, twice repeated, corticosteroids were introduced at the site of the changed mucus membrane. Mechanical ventilation parameters: Fio2, number of respirations and inspiratory pressure decreased. Values of gas analysis: ph improvement above 7.30 Pco2 3.6kPa, pO2 in the blood 11. O2 saturation 95%, pulse rate 120/min. The five-year-old child patient was extubated five days after bronchoscopy and was transferred to the standard Pulmonology Ward. Blood derivatives were obtained on several occasions. The condition improved, methotrexat therapy was introduced, with corticosteroids once a week, 3x40 mg i.v., on other week days Pronison 5 mg 4x1. Sažetak Ovaj rad ukazuje na značaj fleksibilne bronhoskopije kod obolelog deteta sa dijagnozom dermatomyositis, coeliakia. Sluzni čep u bronhu je čest medicinski uzrok atelektaze kod ovih bolesnika. Usled pogoršanog respiratornog stanja, obolela deca mogu imati visoku temperaturu, cijanozu, uvećanu jetru do 6- 7 cm. Prikazujemo dete sa dermatomiozitisom, koje je imalo atelektazu pluća. Atelektaza pluća uzrokuje otežano disanje, smanjenje saturacije, zbog čega je obolelo dete intubirano i priključeno na totalnu mehaničku ventilaciju. Broj respiracija pre intubacije prelazio je 40 min, saturacija oksigena saturacija na oksimetru pulsa pada ispod 73%. Puls 173/min, krvni pritisak 94/37 mmHg. Pre intubacije vrednosti plinova u krvi - pH obično su ispod 7,30 i pCO2 9 kPa, pO2 u krvi ispod 4,9 kPa. Posle izvedene fleksibilne bronhoskopije, dijagnostičke i terapijske sa bronhoalveolarnom lavažom, nastupa reekspanzija pluća. Posle izvedene bronhoalveolarne lavaže sa 0,9% NaCL 1 ml/kg TT, dva puta ponovljene, uvedeni su kortikosteroidi na mestu promene na sluznici obolelog bronha. Parametri mehaničke ventilacije: FiO2, smanjen broj respiracija i vrednosti inspiratornog pritiska. Vrednosti pH arterijske krvi se popravljaju iznad 7,30 Pco2 3,6 kPa, pO2 u krvi 11. Saturacija kiseonikom 95%, puls 120/min. Petogodišnja devojčica je pet dana kasnije ekstubirana i premeštena na standardno odeljenje pulmologije. Krvni derivati su uključeni u nekoliko navrata. Stanje se poboljšalo, tako da je methotreksat uveden u terapiju, sa kortikosteroidima jednom sedmično, 3x40 mg i.v., a drugim danima u sedmici Pronison 5 mg 4x1.

Objective. Ionized water aerosols have been suggested to exert beneficial health effects on pediatric allergic asthma. Their effect was evaluated in a randomized controlled clinical trial as part of a summer asthma camp. Methods. Asthmatic allergic children (n = 54) spent 3 weeks in an alpine asthma camp; half of the group was exposed to water aerosol of an alpine waterfall for 1 hour per day, whereas the other half spent the same time at a “control site”. Immunological analysis, lung function testing, and fractional exhaled nitric oxide (FeNO) testing were performed during the stay, and sustaining effects were evaluated 2 months later. Symptom score testing was done over a period of 140 days. Results. The water aerosol group showed a significant improvement in all lung function parameters, whereas only the peak expiratory flow improved in the control group. All patients showed a significant improvement in symptom score and a significant decrease in FeNO after the camp. Only the water aerosol group exhibited a long-lasting effect on asthma symptoms, lung function, and inflammation in the follow-up examination. Induction of interleukin (IL)-10 and regulatory T (Treg) cells was measured in both groups, with a pronounced increase in the water aerosol group. IL-13 was significantly decreased in both groups, whereas IL-5 and eosinophil cationic protein were decreased only in the water aerosol group. Conclusions. Our findings confirm the induction of Treg cells and reduction in inflammation by climate therapy. They indicate a synergistic effect of water aerosols resulting in a long-lasting beneficial effect on asthma symptoms, lung function, and airway inflammation. Martin Gaisberger and Renata Šanović as well as Markus Ritter and Arnulf Hartl contributed equally to this work.

Objective: Ionized water aerosols have been suggested to exert beneficial health effects on pediatric allergic asthma. Their effectwas evaluated in a controlled randomized clinical trial as part of a summer asthma camp. Methods: Asthmatic allergic children (n=54) spent three weeks in an alpine asthma camp; half of the group was exposed to water aerosol for one hour per day, whereas the other half spent the same time at a “control site”. Immunological analysis, lung function and FeNO testing was performed during the stay, and sustaining effects were evaluated after 2 months. Symptom score testing was done over a period of 140 days. Results: The water aerosol group showed a significant improvement in all lung function parameters whereas the control group only in peek expiratory flow. All patients showed significant improvement in symptom score and significant decrease of FeNO after the camp. Only the water aerosol group exhibited a long lasting effect on asthma symptoms, lung function and inflammation in the follow-up examination. Induction of IL-10 and regulatory (Treg) cells was measured in both groups, with a pronounced increase in the water aerosol group. IL-13 was significantly decreased in both groups, whereas IL-5 and eosinophil cationic protein were decreased only in the water aerosol group. Conclusion: Our findings confirm the induction of Treg cells and reduction of inflammation by climate therapy. They indicate a synergistic effect of water aerosols resulting in a long lasting beneficial effect on asthma symptoms, lung function and airway inflammation.

printing supported by . Visit Chiesi at Stand B2.10 MONDAY, SEPTEMBER 3RD 2012 bronchial hyperresponsiveness, airway obstructive damage, newly diagnosed 46 cough variant asthma patients and 57 bronchial asthma patients naive to oral or inhaled corticosteroids and free of asthma execerbation were subjected to spirometry, impulse oscillometry (IOS), bronchial hyperesponsiveness test, induction of sputum, and measurement of fractional exhaled nitric oxide (FeNO). Spirometry revealed lower values of FEV1.0/FVC, FEV1.0%pred, V50%pred, and V25%pred in patients with BA than in those with CVA (p<0.01). Both IOS parameters and FeNO values were significantly higher in patients with BA than in those with CVA (p<0.01). The log PC20 was significantly lower in patients with BA than in those with CVA (p<0.05). Induced sputum eosinophil counts were significantly higher in patients with BA than in those with CVA for both central and peripheral airways (p<0.001). However, the values of IOS, PC20, FeNO, and induced sputum eosinophil counts did not differ significantly between patients with mild intermittent asthma and those with CVA. All measures of central and peripheral airway obstruction, eosinophilic inflammation, and airway hyperresponsiveness were milder in patients with CVA than in those with BA but paralleled with intermittent asthma. Our data suggest that CVA is an allergic and inflammatory precursor of BA. P2342 Effects of budesonide/formoterol combination therapy versus budesonide on airway dimensions in asthma Makoto Hoshino. Department of Respiratory Medicine, Atami Hospital, International University of Health and Welfare, Atami, Shizuoka, Japan Background: The combination of inhaled corticosteroids and long-acting β2agonists results in improved asthma symptom control compared with inhaled corticosteroids alone, but the effects of combination therapy on airway structural changes and inflammation are still unknown. Aims and objectives: The aim of the study was to compare the effects of budesonide/formoterol versus budesonide on airway dimensions and inflammation in asthma. Methods: Fifty asthmatic patients were randomized to treatment with budesonide/formoterol (200/6 μg, two inhalations bd) or budesonide (200 μg, two inhalations bd) for 24 weeks. Airway dimensions were assessed by CT, and wall area corrected for body surface area (WA/BSA), percentage wall area (WA%), wall thickness (T)/ √ BSA, and luminal area (Ai)/BSA at the right apical segmental bronchus were measured. The percentage of eosinophils in induced sputum, pulmonary function, and Asthma Quality of Life Questionnaire (AQLQ) were also evaluated. Results: Significantly decreases in WA/BSA (p < 0.05), WA% (p < 0.001) and T/ √ BSA (p < 0.05), and increases in Ai/BSA (p < 0.05), and improvements in the AQLQ scores were observed in patients treated with budesonide/formoterol compared with budesonide. The reduction in sputum eosinophils and increase in FEV1% were greater for budesonide/formoterol compared with budesonide. The changes in WA% were significantly correlated with changes in sputum eosinophils and FEV1% (r = 0.84 and r = 064). Conclusions: Budesonide/formoterol combination is more effective than budesonide for reducing airway wall thickness and inflammation in asthma. P2343 Effects of breast feeding on the prevalence rates of asthma, rhinitis and eczema in Chinese school children Ning Song, Mohammed Shamssain, Jin Zhang, Shuting Hao, Jianling Wu, Chunling Fu, Xixin Yan. Respiratory Medicine, The Second Hospital of Hebei Medical University, Shijiazhuang, Hebei, China School of Health Sciences, University of Sunderland, United Kingdom Respiratory Medicine, The Second Hospital of Shijiazhuang, Shijiazhuang, Hebei, China Background: Exclusive breastfeeding for at least 4 months is recommended by many governments and allergy organizations to prevent allergic disease. There is conflicting evidence concerning the relationship between breast feeding and asthma, wheezing illness and allergic disorders. The objective of this study was to investigate whether there is any association between breast feeding and asthma and allergic disorders in Chinese schoolchildren. Methods: Study subjects comprised 10824 randomly selected 6 to 18 year-old schoolchildren from Shijiazhuang in Hebei Province in China. Information on breast feeding, asthma, rhinitis and eczema was gathered by parental questionnaire using the Chinese version of ISAAC questionnaire. Results: Children who have been breastfed had significantly lower prevalence rates of exercise-induced wheezing, asthma ever, and rhinitis ever than those who have not been breastfed (3.1% vs 4.2%, p<0.05; 1.0% vs 1.6%, p<0.05; and 13.3% vs 15.8%, p<0.01; respectively).There was a similar trend with chronic rash ever. Children who have been breastfed more than or equal to 12 months had lower prevalence rates of ever wheezed, wheeze in the past year, exercise-induced wheezing, persistent cough past year, ever had rhinitis, and ever had eczema than those who have been breastfed less than 12 months (5.3% vs 6.8%, P<0.05; 1.6% vs 2.7%, P<0.05; 2.9% vs 3.9%, P<0.05; 10.7% vs 12.4%, P<0.05; 12.5% vs 16.2%, P<0.001 and 11.4% vs 13.2%, P<0.05, respectively). The present study confirms the protective effect of breastfeeding on symptoms of asthma, rhinitis and eczema. P2344 Effects of water aerosol on pediatric allergic asthma Martin Gaisberger1, Renata Sanovic1, Heidemarie Dobias1, Predrag Kolarz2, Angelika Moder1, Josef Thalhamer3, Amina Selimovic4, Isidor Huttegger5, Markus Ritter1, Arnulf Hartl1 . 1Institute of Physiology and Pathophysiology, Paracelsus Medical University, Salzburg, Austria; 2Institute of Physics, University of Belgrade, Serbia; 3Department of Molecular Biology, University of Salzburg, Austria; 4Clinical Centre, University of Sarajevo, Bosnia and Herzegowina; 5Department of Pediatrics, University Hospital Salzburg, Paracelsus Medical University, Salzburg, Austria Objective: Ionized water aerosols have been suggested to exert beneficial health effects on pediatric allergic asthma. Their effectwas evaluated in a controlled randomized clinical trial as part of a summer asthma camp. Methods: Asthmatic allergic children (n=54) spent three weeks in an alpine asthma camp; half of the group was exposed to water aerosol for one hour per day, whereas the other half spent the same time at a “control site”. Immunological analysis, lung function and FeNO testing was performed during the stay, and sustaining effects were evaluated after 2 months. Symptom score testing was done over a period of 140 days. Results: The water aerosol group showed a significant improvement in all lung function parameters whereas the control group only in peek expiratory flow. All patients showed significant improvement in symptom score and significant decrease of FeNO after the camp. Only the water aerosol group exhibited a long lasting effect on asthma symptoms, lung function and inflammation in the followup examination. Induction of IL-10 and regulatory (Treg) cells was measured in both groups, with a pronounced increase in the water aerosol group. IL-13 was significantly decreased in both groups, whereas IL-5 and eosinophil cationic protein were decreased only in the water aerosol group. Conclusion: Our findings confirm the induction of Treg cells and reduction of inflammation by climate therapy. They indicate a synergistic effect of water aerosols resulting in a long lasting beneficial effect on asthma symptoms, lung function and airway inflammation. P2345 Simultaneous analysis of clinical markers for predicting increased lung function fluctability in stable asthma Kazuto Matsunaga, Atsushi Hayata, Tsunahiko Hirano, Masakazu Ichinose. Third Department of Internal Medicine, Wakayama Medical University, School of Medicine, Wakayama, Japan Background: Airway hyperresponsiveness (AHR) has been shown to be associated with the loss of asthma control. Predicting the increased fluctuation of lung function might be useful to regulate the future risk of poor asthma control because peak expiratory flow (PEF) variability well correlates with AHR. Objective: We simultaneously analyzed the clinical markers for predicting increased PEF variability in stable asthma. Methods: We studied non-smoking asthmatic patients who were receiving conventional therapy and clinically stable for 8 weeks. Patient medical records were obtained and asthma control questionnaire (ACQ), spirometry, and exhaled nitric oxide fraction (FENO) were measured. Associations between these variables and PEF variability over a week (Min%Max) were prospectively assessed. Results: 52 of 297 asthmatics (17.5%) showed the increased PEF variability (Min%Max < 80%). These subjects were receiving more intensive therapy, but had more severe asthma symptoms, more airflow obstruction, and more evidence of airway inflammation. Especially, ACQ, forced expiratory volume in one second % of predicted (%FEV1), and FENO were identified to be independent predictors of Min%Max < 80%. When we combine baseline %FEV1 ≤ 85% and/or FENO ≥ 40 ppb, this index was associated with the highest combination of sensitivity (94.2%) and specificity (80.4%) for increased PEF variability. Conclusions: These results suggested that ACQ, %FEV1 and FENO can stratify risk for increased fluctuation of lung function among the clinically stable asthmatics. P2346 Impact of allergy diagnosis on patients’ perceptions and experience of HDM allergy: A European survey Christine Rolland, Michèle Lheritier-Barrand, Lisa Tauleigne, Marie David, Lise Lemonnier, Erkka Valovirta. Asthma & Allergie, Association, Boulogne, France Stallergenes, SA, Antony, France LT, Insight, Paris, France Stallergenes, SA, Antony, France Stallergenes, SA, Antony, France Allergy Clinic, Terveystalo Turku, Turku, Finland Background: We assessed allergy awareness and diagnosis in a survey in four European countries. A post-hoc analysis determined the impact of dia

Bronchoscopy and Bronchoalveolar Lavage in Children with Lower Airway Infection and Most Common Pathologic Microorganisms Isolated The study represents a review of most common pathologic microorganisms with persistent lung infiltrates in the bronchoalveolar lavage (BAL) of paediatric patients. The aim of the paper was to present the results of bronchoscopy and broncho-alveolar lavage in children with persistent lung infiltrates and most common pathologic microorganisms isolated in bronchoalveolar lavage. This is a prospective and retrospective study. Information on the paediatric findings and BAL results of bronchoscopy were obtained from the hospital records. The records of fifty patients were analyzed. All patients had persistent lung infiltrates (lower airway infection). BAL was performed in the middle lobe and lingula by bronchoscope (Olympus 3,5 mm) and sent for microbiological analysis. There was no serious desaturation during bronchoscopy. Bronchoscopy was performed under general anesthesia (sedation, propofol, midazolam, morphium). The most common pathologic microorganisms identified in BAL were: Streptococcus α haemoliticus (16%), Pseudomonas aeruginosa (12%) followed by Candida albicans (10%) and Klebsiella pneumoniae (8%). Our study results have shown that bronchoscopy with BAL is recommended for isolating bacteria as causes of lung infection and is particularly suitable for proving pneumonias caused by microorganisms. Bronhoskopija i bronhoalveolarna lavaža kod dece sa infekcijom donjih disajnih puteva i najčešće izolovanim patogenim mikroorganizmima Ova studija predstavlja pregled najčešćih patoloških mikroorganizama koji su uzročnici plućnih in-filtrata, izolovanih u bronhoalveolarnom lavatu (BAL) pedijatrijskih bolesnika. Cilj rada bio je da prikaže rezultate bronhoskopije i BAL-a kod dece sa perzistentnim plućnim infiltratima i izolovane patološke mikroorganizme kod BAL-a. Studija je prospektivna i retrospektivna. Analizirani su mikrobiološki nalazi u BAL-u kod 50 hospitalizovane dece. Sva ispitivana deca imala su perzistentne plućne infiltrate (infekcije donjih disajnih puteva). BAL je rađen u srednjem lobusu ili linguli sa bronhoskopom 3,5mm (Olympus). Bronhoskopija je rađena u opštoj anesteziji (sedacija propofol, midazolam, morfijum). Uzorak je dat na mikrobiološki pregled (biogram i antibiogram, bojenje po Gramu). Nije bilo ozbiljnijeg pada saturacije tokom izvođenja bronhoskopije. Najčešće izolovani mikrobiološki patogeni u BAL-u su: Streptococcus α haemoliticus (16%), Pseudomonas aeruginosa (12%), Candida albicans i Klebsiella pneumoniae (8%). Naši rezultati su pokazali da je bronhoskopija sa BAL-om metoda izbora za izolovanje bakterija koje su uzročnici plućnih infekcija donjih delova respiratornog trakta kod dece.

Lymphocyte Subsets in Bronchoalveolar Lavage Fluid of Children with Lung Infiltrates The analysis of the subpopulation of lymphocytes - CD4+, CD8+ lymphocytes in bronchoalveolar lavage (BAL) of paediatric patients can provide useful information related the lung parenchyma. The aim of the paper was to analyze the results of bronchoscopy of patients presenting with persistent lung infiltrates and to find out of the diagnostic yield and complication rate of this procedure. The study is a retrospective one. The data related to paediatric findings and BAL results of the bronchoscopies were retrieved from the hospital records. BAL was performed in tracheobronchial airways (middle lobe) by bronchoscope and sent to analysis of CD4+, CD8+ lymphocytes. Bronchoscopy was performed under general anesthesia (sedation, propofol, midazolam, morphium). The records of seven patients were analyzed. All patients presented with persistent lung infiltrate (atelectasis and pneumonia). 71% of the patients with lung infiltrates in our study were below the age of 5. Our study results showed that CD4+, CD8+ lymphocytes in BAL in the studied group showed a small percentage of CD8+ lymphocytes as an immune response in 8-10% of patients, while the cellular response of CD4 +lymphocytes in the sample itself was present up to 14% in the entire group of the diseased children. There was no serious desaturation during bronchoscopy. Bronchoscopy with BAL findings of lymphocyte populations is important in the early identification of inflammation and it helps in therapeutic strategies and monitoring of inflammatory response to the given therapy. Subpopulacija limfocita u bronhoalveolarnoj lavaži kod pedijatrijskih bolesnika sa plućnim infiltratom Analiza subpopulacija limfocita u bronhoalveolarnoj lavaži (BAL) kod pedijatrijskih bolesnika može nam pružiti korisne informacije o dešavanju u parenhimu pluća. Cilj rada bio je analiza rezultata bronhoskopije i BAL-a kod bolesnika sa perzistentnim plućnim infiltratima i stope komplikacija kod ove procedure. Ovo je retrospektivna studija. Podaci o pedijatrijskim nalazima i rezultatima BAL bronhoskopija uzeti su iz bolničke evidencije. BAL je izvršena bronhoskopom unutar traheobronhalnog stabla (srednji lobus) i upućena na CD4+, CD8+ limfocita. Za vreme bronhoskopije nije zabeležena ozbiljnija desaturacija. Bronhoskopija je urađena u opštoj anesteziji (propofol, midazolam, morfijum). Analizirano je ukupno 17 istorija bolesti. Svi bolesnici imali su perzistentne plućne infiltrate (atelektazu i upalu pluća). 71% bolesnika sa plućnim infiltratima bili su mlađi od 5 god. Rezultati naše studije pokazali su da CD4+, CD8+ limfociti u BAL-u na datoj grupi pokazuju mali procenat CD8+ limfocita kao imunu reakciju kod 8-10% bolesnika, dok je ćelijska reakcija CD4+ limfocita u samom uzorku bila zabeležena kod 5%, odnosno 14% bolesnika u čitavoj grupi obolele dece. Bronhoskopija sa BAL-om je značajna metoda u identifikaciji imunog odgovora u plućima i primeni adekvatne terapije.