Frequency of Urinary Tract Infection When Diagnosing Vesico Uretheral Reflux in Children in Tuzla Canton.

Background: Vesicoureteral reflux (VUR) represents the return of urine from the bladder into the ureter and the renal canal system. Reflux can occur only on one or both kidneys. VUR most often occurs due to an incompetent ureterovesical junction, which consequently leads to hydronephrosis and dysfunction of the lower parts of the urinary system. Objective: The aim of the study was to determine the frequency of urinary infection when diagnosing vesicouretheral reflux in children in the Tuzla Canton, in the five-year period from 01.01.2016 to 01.01.2021. Methods: Through a retrospective study, we analyzed data from 256 children with vesiocouretheral reflux (VUR), examined in the Nephrology Outpatient Clinic, Clinic for Children's Diseases, University Clinical Center Tuzla, in the period from 01.01.2016 to 01.01.2021, from early neonatal to 15 years of age. The age and gender of children, the most common symptoms of urinary tract infections during the detection of VUR, and the degree of VUR were analyzed. Results: From 256 children with VUR, 54% were male and 46% female. The highest prevalence of VUR was in the age group 0-2 years, and the lowest in the age of children > 15 years. There was no statistically significant difference between the groups of our respondents in relation to age groups, nor in relation to the gender of the children. Statistically significantly more children were without nonspecific symptoms and with asymptomatic bacteriuria in the group without UTI symptoms in children with VUR compared to the group with UTI symptoms in children with VUR. Pathological urine culture between the groups was without a statistically significant difference. Conclusion: Although urinary tract infection in children is common, the possibility of permanent consequences should always be kept in mind if VUR is not diagnosed and treated in time.

Effectiveness of treating the renal anemia in chronic hemodialyzed patients by epoietin alpha and beta.

INTRODUCTION: Anemia is an early sign of chronic kidney dysfunction, caused by many different factors, but the insufficient erythropoietin synthesis is the crucial factor in its development. OBJECTIVES: The objective of our study was to compare effectiveness of epoietin alpha and beta application in the treatment of renal anemia in chronic hemodialyzed patients. PATIENTS AND METHODS: The group included 60 patients of both sexes, randomly chosen. Criteria for including patients into the study were: older than 18 years, haemodialyzed longer than three months and treated by epoietin beta, stable level of hemoglobin, between 9 and 11 g/dL at least two successive measurements and no malignant disease present. The patients were then randomized into groups: 20 patients were administered epoietin alpha intravenously instead of epoietin beta subcutaneously (experimental group); 20 patients were administered intravenously epoietin beta instead of epoietin beta subcutaneously (control group A), the rest of 20 patients were administered epoietin beta subcutaneously (control group B). All the testees were administered epoietin alpha or beta three times weekly after haemodialysis, intravenously or subcutaneously. RESULTS: Comparison among mean values of hematological and biochemical parameters before starting the treatment by erythropoietin, and third and sixth months after therapy in the studied groups, no significant difference was found (p > 0.05). CONCLUSION: Epoietin alpha and beta showed approximate degree of efficacy in renal anemia treatment of hemodialysis patients. The way of erythropoetin administration did not significantly effect the level of hemoglobin and hematocrit in six months research period.

[Clinical and laboratory characteristics at onset of type 1 diabetes mellitus in children]. / Klinicke i laboratorijske odlike dijabetesa tipa 1 u djece u vrijeme postavljanja dijagnoze.

The aim was to describe the clinical and laboratory characteristics of diabetes mellitus type 1 at its onset. The hospital records at Tuzla pediatric hospital were analysed of 109 children aged 0-14 who presented with diabetes between 1990 and 2005. The data base was divided into three age groups: 0-4.9, 5-9.9 and 10-14 years - referred to hereafter as the younger, middle and older age groups. We found the duration of symptoms prior to diagnosis to be significantly shortest in the younger age group. Polyuria, polydipsia and weight loss were the main presenting symptoms in all age groups. The median blood glucose value was 26.0 mmol/L and the pH value was 7.30. The incidence of diabetic ketoacidosis of 48.0% and the median HbA 1c value of 10.7% at diagnosis indicate that disease was not recognised long before diagnosis. Since our desire is to avoid the development of ketoacidosis, it is necessary to educate people who are in permanent contact with children about the symptoms of diabetes type 1. This could to a certain degree prevent the presentation of the life-threatening condition of diabetic ketoacidosis, if the occurrence of diabetes cannot be prevented.