[The role of zinc in the initial treatment of Wilson's disease in children]. / Uloga cinka u inicijalnom lijecenju Wilsonove bolesti u djece.

Wilson's disease (WD) is an inherited disease of copper accumulation, caused by a failure of biliary excretion of excess copper. Accumulated copper causes tissue damage. The chelating drugs penicillamine and trientine have been the mainstay of therapy and most patients with WD were treated with the potentially toxic cupriuretic agents. A more recent approach has used zinc, which blocks the absorption of copper and increases copper excretion in the stool, and long term administration induces a negative copper balance. Until recently, most patients have been treated initially with cupriuretic agents to remove excess of copper, and then maintained with oral zinc. Recently, zinc has been used for initial treatment as well and for treatment of the presymptomatic patients. So far, zinc therapy has demonstrated exceptional efficacy and lack of toxicity. In this article we present our data on the long-term follow-up of three children with WD, whose initial as well as consecutive treatment was zinc sulphate. The results demonstrate the efficacy of zinc therapy in treating the presymptomatic patient and in initial treatment of symptomatic children with WD. Our data also indicate low toxicity. However, pediatric patients must be closely monitored due to tendency to stop the treatment when becoming asymptomatic.

Home-made modular diet versus semi-elemental formula in the treatment of chronic diarrhoea of infancy: a prospective randomized trial.

UNLABELLED: Considerable success in the management of chronic diarrhoea has been reported using a modular diet (MD), with gradual increments in every nutrient toward a full-strength formula. As the commercially prepared constituents are unavailable in Croatia, we have developed a home-made MD based on boiled minced chicken meat, sunflower oil emulsion, sucrose and cornflour. A full range of vitamins and minerals are added. The value of this MD was compared to a semi-elemental formula (SF) Pregomin. Eighteen infants with severe chronic diarrhoea were randomly assigned to receive either MD of SF. Both groups were comparable with respect to sex, age, and degree of malnutrition. Duration of diarrhoea, feed tolerance, anthropometry, and biochemistry were compared after 4 weeks of treatment. RESULTS: (1) diarrhoea was significantly shorter (3 vs 7 days; P < 0.01) and nutritional recovery started earlier (5 vs 9 days; P < 0.01) in MD group; (2) median weight gain in the SF group was 100 g/week, compared to 171 g/week in MD group (P < 0.05); (3) in two patients from the SF group, diarrhoea persisted, but they achieved complete recovery when changed to MD. CONCLUSION: A MD made in the hospital kitchen was superior to a SE formula in the treatment of chronic diarrhoea of infancy.

[Toxic effects of lead in children in 2 case reports]. / Toksicno djelovanje olova u djece uz prikaz dvaju bolesnika.

The authors present the diagnostic examinations used in two boys 12 and 14 years of age exposed to lead in an unusual way. No specific treatment was required except the removal from the further exposition to lead. The information provided by this presentation may form a reminder to general practitioners on possible etiologic part of lead intoxication in numerous non-typical, subclinical forms of diseases. Therefore, diagnostic methods, staging of the disease, specific treatment, and prevention are also discussed.

[The behavior of children with nocturnal enuresis and children with recurrent abdominal pain]. / Ponasanje djece s nocnim nehotimicnim mokrenjem i djece s ponavljanim trbusnim bolima.

By means of the questionnaire including 38 questions, 68 mothers and their children suffering from repeated abdominal pains and 89 mothers and their children urinating involuntarily at night, were examined. Six questions revealed important statistical difference while the others did not. Children urinating involuntarily at night were longer awaited by their mothers. They had better appetite when infants. They were also less obedient, more aggressive, less timid and recognized their mother's temper better than children suffering from repeated abdominal pains.