Background: To investigate the total survival of low birth weight infants (LBWIs) in the Federation of Bosnia and Herzegovina (FB and H) and selected by subgroups of birth weight (BW) and gestational age (GA). Methods: This cross-sectional study included newborns of both genders, GA of 22–42 weeks and BW of less than 2500 g of 10 cantons territory of the FB and H. In the examined period, 22,897 children were born in the FB and H, of which 669 (2.9%) had BW less than 2500 g. Results: Surviving of LBWIs in the FB and H out of the 669 LBWIs in the first level perinatal healthcare institutions (PHI) was 29 (4.3%), the second level was 286 (42.8%), and the third level was 354 (52.9%). The total stillborn rate was 3.9%. The overall perinatal mortality rate for all levels of PHI was 8.6%. The overall rate of early neonatal mortality of LBWIs in all three levels of PHI in the FB and H was 12.7%. By the end of the first month of life (up to 28 days) and to the end of the neonatal period, 385 (57.5%) of LBWIs survived, and 284 (42.4%) died. The LBWIs by subgroups of BW up to 28 days had lower survival rates in second-level PHI than infants of the same BW subgroups (500–999 and 1000–1499) treated in third-level PHI (P = 0.0089 and P = 0.004). Conclusions: Our results show that B and H belongs to developing countries according to perinatal mortality. A unique database system is necessary to follow progress and trends.

Systemic lupus erythematosus (SLE) and antiphospholipid syndrome (APS) are associated with an increased risk of developing cardiovascular diseases as a result of complex interaction between traditional risk factors, chronic inflammation and specific impact of antibodies on endothelium. There are very limited data regarding level of physical activity (PA) in APS patients.To analyze different domains of PA in Serbian APS patients and their possible relationship to clinical and laboratory criteria of the main disease.From a large Serbian APS database comprehending 527 APS patients (371 Primary – PAPS, and 156 APS associated with other autoimmune diseases, predominantly systemic lupus erythematosus (SLE)) we interviewed 51 APS patients, age range of 15-69 years: 29 patients with primary APS (PAPS), 25 women, 4 men, age 44±11.50, and 22 APS/SLE, 18 women, 4 men, age 48.41±11.75, using a long form of The International Physical Activity Questionnaire (IPAQ), translated onto Serbian language. Data on last seven days of PA divided onto leisure time PA, domestic and gardening (yard) activities, work-related PA and transport-related PA were acquired, and proposed scoring method was used. Based on the level of PA, patients were categorized to low, moderate or high level of PA. For the purpose of insight into atherosclerotic progression, we performed color Doppler scan of carotid arteries in all patients and presence of atherosclerotic plaques has been notified.Average total PA score was 7706.18±11771.97 MET-minutes/week. The greatest average values for different PA domains were for work (2733.21±6158.66 MET-minutes/week) and domestic/garden/yard (2522.31±3847.24 MET-minutes/week) and the lowest scores achieved in leisure time (500.87±695.45 MET-minutes/week). Majority of Serbian APS patients had low or moderate level of PA (37.3%, 43.1%, respectively) whereas lowest percentage was in high category of PA (19.6%). All domains of PA were significantly negatively correlated to age and BMI. There were no significant difference regarding PA scores between PAPS and APS/SLE patients. Although higher percentage of PAPS patients had high level of PA (27.65 compared to 9.1% of SLE/APS), the overall difference was not significant. There was no significant difference regarding antiphospholipid antibody (aPL) type or thrombotic/obstetric events presence. Significant difference occurred regarding presence of carotid arteries plaques. APS patients with lower PA scores had significantly higher prevalence of carotid arteries plaque especially for PA in transportation (p=0.004), and total PA (p=0.025)Serbian APS patients at younger age, tend to have low or moderate level of PA, with the lowest level of activity in leisure time. Low level of PA was undoubtedly related to progression of atherosclerosis in these patients, emphasizing a need for PA promotion in APS.Aleksandra Djokovic Speakers bureau: KRKA, Astra Zeneca, Actavis, Ljudmila Stojanovich: None declared, Natasa Stanisavljevic: None declared, Gordana Bogdanovic: None declared, Sandra Djokic: None declared

Background: Borrelia burgdorferi and tick-borne encephalitis (TBE) virus are 2 types of tick-borne pathogens that can cause central nervous system infection. Routine diagnostics have so far included analysis of cerebrospinal fluid (CSF) cell numbers, CSF serology for Borrelia burgdorferi and serum serology for TBE virus. However, early diagnosis may be difficult based on antibody detection which takes time to analyze, and with the possibility of false negative results, thus delaying treatment. Cytokine analyses are becoming increasingly available in clinical routine care and may offer important information. Methods: Fifteen cytokines and chemokines were measured in the CSF from the diagnostic lumbar puncture of 37 children with TBE, 34 children with neuroborreliosis and 19 children without evidence of central nervous system infection, using Luminex technology. Results: Significantly higher levels of proinflammatory interleukin-6 were detected in the samples from TBE-infected children, when compared with neuroborreliosis or controls. In comparison, children with neuroborreliosis had significantly higher levels of interleukin-7, interleukin-8, interleukin-10, and interleukin-13 when compared with TBE infected or controls. Furthermore, the ratio between interleukin-6 and interleukin-10 was significantly different between the 2 types of tick-borne infections. Conclusions: The interleukin-6/interleukin-10 ratio can be used as a rapid diagnostic cue upon suspected tick-borne infection, enabling fast and correct treatment. Also, in serology-negative results, such information may strengthen a clinical suspicion.

Aim To compare the prevalence of premature rupture of membranes (PROM) and preterm premature rupture of membranes (PPROM) between adolescent and adult pregnancies, and the influence of gestational age and adolescent pregnancy on the frequency of occurrence of PROM and PPROM. Methods This prospective study included 300 pregnant patients, 13 to 35 years of age, divided into two groups. The first group consisted of 150 pregnant women aged 13-19 (experimental group) and the second group consisted of 150 pregnant women aged 20-35 (control group). Results There was a statistically significant higher incidence of both PPROM and PROM in the group of adolescent pregnant women compared to adult pregnant women (p<0.000001). Preterm delivery with PPROM was significantly more common in the group of adolescent pregnant women (p<0.004). Term delivery with PROM was statistically significantly more common in the adolescent pregnancy group than in the adult pregnancy group (p<0.001). Term delivery with PROM was statistically significantly more common than preterm delivery with PPROM in the group of adolescent pregnant women (p<0.0001). Conclusion Adolescent pregnancy has a greater impact on the frequency of PROM and PPROM.

Aim To investigate the prevalence and obstetrical characteristics of low birth weight infants (LBWIs) in ten Cantons of the Federation of Bosnia and Herzegovina (FBiH). Methods The prospective study included newborns of both genders, gestational age (GA) of 22 to 42 weeks and birth weight(BW) of less than 2,500 grams in the period 1 January 2009 to 31 December 2009. Results In the observed period, 22897 neonates were born, out of whom 669 (2.9%) had a BW less than 2500 grams (average BW was 1295 grams; SD ± 234.2; a coefficient of variation of 0.58). The average GA was 31.4 weeks of gestation. The average lifespan of mothers was 27.7 years (SD ± 1.2). The average Apgar scor (AS) in the first minute was 4.6 (SD ± 2.1) and in the fifth minute it was 6.6 (SD ± 1.9). The LBWIs were most commonly delivered by primiparas, 317 (47.5%). Of the 669 LBWIs, 411 (61.4%) were born per vias naturalis, with cephalic presentation. The highest number of LBWIs was born in Sarajevo Canton, 3.7%, and Central Bosnia Canton, 3.7%. The lowest prevalence was in Posavina Canton, 1.1%. The largest late fetal mortality was in Central Bosnia Canton, 7.7 ‰. Conclusion This study has determined a relatively low prevalence of LBWIs and other examined obstetrical characteristics that are in correlation with European and Global World data.

This work was carried out antimicrobial effect on seed dill. The survey was done by diffusion dilution method. By using MVC

Background: Antiphospholipid syndrome (APS) is an acquired autoimmune disorder defined by the presence of both clinical (thromboembolic events or pregnancy morbidity) and laboratory (antiphospholipid antibodies, aPL) manifestations. Despite their importance, several clinical manifestations strongly associated with APS such as livedo reticularis (LR), thrombocytopenia, sicca-ophthalmic(sicca), heart, or neurological manifestations are not included in the APS clinical classification criteria. Circulating immune complexes (CIC) formed by Beta-2-glycoprotein I (B2GPI) and aPL (B2-CIC) have been described and their presence has been related with thrombotic events. Methods: Cross-sectional and observational cohort study in APS patients with thrombotic symptomatology. Setting and Participants: Fifty-seven patients from the University Hospital Center Bezanijska Kosa (Belgrade, Serbia) who met the APS classification criteria (35 with primary APS and 22 with APS associated to systemic lupus erythematosus). This study aimed to determine the prevalence of B2-CIC in APS patients and to evaluate their association with clinical manifestations of APS not included in the classification criteria. Results: B2-CIC prevalence in APS patients was 19.3%. The presence of thrombocytopenia (OR:5.7), livedo reticularis (OR:5.6), sicca (OR:12.6), and leukopenia (OR:5.6) was significantly higher in patients with B2-CIC than in the rest of APS patients. C3 and C4 complement factor levels were significantly lower in B2-CIC positive patients, which suggests a greater consumption of complement. Patients with quadruple aPL positivity (triple aPL-positivity plus the presence of B2-CIC) showed a higher prevalence of thrombocytopenia, leucopenia and LR than those with single/double aPL-positivity. No significant differences were found in the frequencies observed in patients with triple-only vs. single/double aPL-positivity. There were no significant differences between patients with primary APS and lupus-associated APS regarding the prevalence of B2-CIC and outcomes. Conclusions: Presence of B2-CIC is strongly associated with several non-criteria clinical manifestations related to APS and to higher complement consumption. More studies are required to better understand the clinical significance of B2-CIC.

SCL/TAL1 interrupting locus (STIL)‐T‐cell acute leukaemia (TAL1) fusion genes are present in approximately 11‐27% of children with paediatric T‐cell acute lymphoblastic leukaemia (T‐ALL), but the developmental timing of the rearrangement is still unknown. To investigate whether the fusion gene can be detected in neonatal blood spots (NBSs) from paediatric patients diagnosed with T‐cell ALL, we analysed DNA from 38 paediatric patients with T‐ALL by nested polymerase chain reaction and electrophoresis. The STIL‐TAL1 fusion gene was not detected in NBSs from any of the 38 patients with T‐ALL, suggesting that STIL‐TAL1 fusion genes are most probably postnatal events in paediatric T‐ALL.

Background Several manifestations strongly associated with APS have been excluded as classification criteria.1 2 Objectives The aim of this study was to investigate correlation between circulating immune-complexes of IgG or IgM antibodies bound to B2GPI (B2G-CIC and B2M-CIC) and clinical manifestations in Serbian cohort of APS patients. Methods A total of 57 patients with APS were evaluated: 35 with PAPS and 22 patients with SAPS. Mean age was 47.6±1.6 years; 36 (63.2%) were women. All patients have met the 2006 revised Sydney criteria for APSQuantification of B2G-CIC and B2M-CIC levels was performed as previously, for detect B2G-CIC was used anti-human IgG HRP-conjugate and for B2M-CIC human IgM HRP- conjugate, both from INOVA (INOVA Diagnostics Inc., San Diego, CA, USA). Results In our cohort Serbian APS patients the prevalence of CIC was 19.29% (11/57); 8 patients with B2M-CIC and the remain 3 patients with B2G-CIC. Livedo reticularis was diagnosed with higher prevalence in patients with CIC compared with patients without CIC; 63.6% and 23.9%, respectively (OR: 5.57, p=0.01). In patients with CIC, thrombocytopenia and leukopenia were more prominent; 54.4% vs 17.4% (OR: 5.70, p=0.01) and 45.5% vs 13.0% (OR: 5.56, p=0.01), respectively. Ophthalmic sicca was more prevalent in patients with CIC; 54.4% vs 8.7% (OR: 12.6, p<0.001). Although complement consumption was more frequent in patients with CIC (figure 1). Figure 1 Mean levels of C3 (A) and C4 (B) complement in groups. Mean levels of C3 (115.6±9.2 mg/dL and 140.9±4.3 mg/dL, group-1 and group-2 respectively) and mean levels of C4 (140.9±4.3 mg/dL and 30.8±1.6 mg/dL, group-1 and group-2, respectively). Conclusions B2G-CIC and B2M-CIC are strongly associated with clinical manifestations related to APS. Widening the APS spectrum is indispensable to better understand this syndrome. References [1] Stojanovich L, Kontic M, Djokovic A, Marisavljevic D, Ilijevski N, Stanisavljevic N, et al. Association between systemic non-criteria APS manifestations and antibody type and level: results from the Serbian national cohort study. Clin Exp Rheumatol. 2013 Mar-Apr;31(2):234–42. [2] Stojanovich L, Markovic O, Marisavljevic D, Elezovic I, Ilijevski N, Stanisavljevic N. Influence of antiphospholipid antibody levels and type on thrombotic manifestations: results from the Serbian National Cohort Study. Lupus. 2012Mar;21(3):338–45. Acknowledgements This work was supported by research grant number 175041, and TR 32040 for 2011–2018, issued by the Ministry of Science of the Republic of Serbia. Disclosure of Interest None declared