Introduction: A Holter blood pressure monitoring is a basic method for the diagnosis and evaluation of hypertension therapy. Hypertension in children and adolescents is defined as an increase of systolic/diastolic pressure, which is equal, or above 95th percentile blood pressure for sex, age, and height. Aim: The aim of this study is to analyze the etiology of arterial hypertension (AH) in the pediatric population. Methods: Research had descriptive and retrospective character. During the period from March 2006 to April 2020, 1527 registered continuous Holters of blood pressure were analyzed. Data were taken from the medical documentation of patients that were hospitalized on Pediatric Clinic (register of continuous Holter of blood pressure). Results: Out of the total number of registered and analyzed patients 833 were male (54.5%) with dominant age 15–19 years of life 774 (50.6%), school-age children 660 (43.2%), preschool children 93 (6.1%). We had 902 (59%) first registrations and 626 (41%) control registrations. AH was verified in 52 patients (387 records of continuous Holter of blood pressure were performed to them). Primary AH was verified in 27 patients and secondary AH in 25 patients. Forty patients (76.9%) were treated with monotherapy while combined therapy was used in 12 (23.1%) of cases. Renal cause was in 28% patients, endocrine in 24%, cardiovascular in 24%, neurological in 16%, and rheumatic in 8% of patients with secondary AH. Conclusion: Continuous Holter of blood pressure represents useful diagnostic method and method of control of high blood pressure in children and adolescents. It should be routine method in everyday pediatric clinical practice especially in pediatric cardiology.

Long QT syndrome (LQTS) is a rare (1:2500–1:10,000) inherited disorder characterized by the onset of arrhythmogenic syncope, polymorphic ventricular tachycardia, and sudden cardiac death. The aim of this article was to describe an unexpected success with an unusual therapeutic modality of a patient diagnosed with LQTS syndrome (suspected Romano–Ward syndrome) during an 8-year period. A 59-year-old female patient was admitted to the hospital due to chest pain and nausea, and after diagnostic and therapeutical approach, a permanent dual-chamber rate-modulated (DDDR) pacemaker was implanted instead of the implantable cardioverter defibrillator (ICD). During the 8-year period, the patient remained stable, without rhythm disorder. Romano–Ward syndrome as a congenital LQTS carries a high risk of sudden cardiac death and presents an indication for ICD. In this patient, for objective reasons, this could not be performed. Implantation of a DDDR with an appropriate pharmacological therapy, including propranolol, in this case, proved to be a successful therapeutic modality.

Introduction: The head-up tilt table test is noninvasive diagnostic procedure, which is used in the diagnosis of syncope. Syncope presents a benign short-term disorder of cerebral circulation with the sudden loss of consciousness and muscle tone. Aim: The aim is to present not only the role and importance of orthostatic tests in the daily clinical practice of pediatric cardiology, neuropediatrics but also pediatrics in general. Patients and Methods: This study has retrospective descriptive character and included the period from April 1997 to June 2020, during which the registration and analysis of orthostatic stability tests (head-up/tilt table test, tilt table test) was performed. Medical documentation of outpatient and hospitalized patients on the Paediatric Clinic of Clinical Center University of Sarajevo (Register of Tilt Table Test) was used. Results: During this period, 1029 tests were registered and analyzed. Modification test (head-up) was performed in 132 (12.8%) patients, and since 2008, classic tilt table test was performed in 897 (87.1%) patients. Patients were 6.5–19 years old, with a predominance of female patients 611 (59.4%). There were 519 (50.4%) patients who were 15–19 years old and 510 (49.6%) patients who were under 15 years of age. Indications were syncope or suspected syncope in 671 (65.2%) patients, cardiovascular etiology (arrhythmias, chest pain, congenital heart defects [CHDs], surgically corrected CHDs, hypotension, and hypertension) in 195 (19%) patients, neuropediatric pathology (epilepsia, suspected epilepsia, headache, vertigo) in 101 (9.8%) patients, and other indications in 62 (6.03%) patients. From the total number of tests, 862 were first tests (83.4%) and 167 were control tests (16.3%). The positive test was found in 538 (52.3%) patients, most often vasovagal syncope (473 patients or 87.9%). Conclusion: Tilt table test is a reliable diagnostic tool in examining the etiology of syncope, primarily vasovagal, and is an extremely important method primarily in cardiopediatric and neuropediatric daily diagnostics.

Background: Sedentary behavior carries the risk of musculoskeletal problems, especially in the lumbosacral region of the spinal column.  According to modern lifestyle, this has begun to be a public health issue. Objective: To point to the health risks of working at the computer and present an ergonomic analysis of the typical and improved position of workers in front of the computer, thereby reducing the chances of emergence occupational diseases. Results:  Changing the position of the subjects led to a change in lumbar pressure from 2,818 N/m2 to 351 N/m2. Software analysis of the changed position indicates that this position is acceptable, both for the lumosacral region of the spine and for the abdominal muscles. Conclusions:  A change in body position will decrease lumbar moment and the load on the lumbosacral region of the spine. Work chair with lumbar support, the right desk height, setting the appropriate position of the monitor, selecting the optimal keyboard and mouse, dividing the workspace into appropriate zones, as well as changing lifestyle and habits should be part of the management of people who spend most of their working time in a sitting position.

Objective – The aim of the paper is to present a rare and complex congenital heart defect (CHD), congenitally corrected transposition of the great arteries of the heart (ccTGA) with associated anomalies, including ventricular septal defect (VSD), valvular and subvalvular pulmonary stenosis, dysplasia of the tricuspid valve, and atrial septal defect (ASD) with first-degree atrioventricular block, which was diagnosed, monitored and successfully treated with heart surgery in an infant. Case Report – A female infant was born with 3350 grams in weight, 50 cm in length, oxygen saturation of 98%, and heart rate of 170 beats per minute. The antenatal and perinatal period was normal. CHD was verified by ultrasound at the age of 3 days. Angiotensin-converting-enzyme inhibitors (ACE inhibitors) and diuretics were introduced in therapy after one month. Cardiac surgery (Senning-Rastelli procedure with placement of an 18-mm Contegra conduit) was performed at the age of 9 months. After the operation, the infant was stable on therapy with diuretics, antiaggregants, beta blockers, and antianemic therapy with vitamin D in prophylaxis. Conclusion – ccTGA with associated anomalies is a rare, life-threatening, congenital heart disease. After birth it demands correct diagnosis, adequate follow-up, and cardiac surgery in infancy.

Title of Days of AMNuBiH 2018” and “SWEP 2018” is “Ethical Dilemmas in Science Editing and Publishing”. Why? If one wants to create a scientific work, must have on his mind that creating a scientific work requires creativity and openness, honesty, trust, and obeying the ethical principles for writing a scientific paper. While working on a an biomedical research involving human subjects medical workers should have on mind that it is the duty of the physician to remain the protector of the life and health of that person on whom biomedical research is being carried out. The World Medical Association (WMA) has developed the Declaration of Helsinki as a statement of ethical principles to provide guidance to physicians and other participants in medical research involving human subjects.

The aim of this study was to present a patient (acute allograft dysfunction after a kidney transplantation) with previously detected minimum plaque on both iliac arteries by scintigram and afterward a pathological Color Doppler Ultrasound (CDU) record and to point on possibility of avoiding toxic computed tomography (CT) angiography in certain renal graft recipients. Ultrasound (US) findings showed normal graft size, whereas Doppler signals detected parvus-tardus waveforms pointing to arterial stenosis. Isotope perfusion scintigraphy registered a slow flow on both iliac arteries and normal graft perfusion. CT angiography has not been performed because of the possible toxic effects to the graft. We believe that favorable clinical and biochemical findings along with US and isotope ratio monitoring are sufficient to avoid CT contrast angiography.