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Atherosclerosis, one of the leading causes of death in developed countries is characterized by lumen reduction of blood vessels due to local thickening of internal blood vessels caused by plaque/atheroma. It begins in childhood, goes for a long time without manifesting symptoms, increasing with age it begins to seriously threaten health. The most important risk factors for the development of atherosclerotic disease are: hyperlipidemia, hypertension, smoking, diabetes, high fibrinogen, excessive weight, increased level of homocysteine, physical inactivity, heredity and immune response in some diseases. The primary intention of prevention is to preclude the occurrence of risk factors for atherosclerosis, and the secondary is to prevent the development or aggravation of the illness along with the reduction or control of existing risks. There is an increasing number of studies that show that children are overweight, which in adolescence is certainly a risk factor for the onset of many chronic diseases, namely: cardiovascular, type 2 diabetes, orthopedic, and psychological diseases. The obesity epidemic is one of the most serious health problems of today affecting individuals of all ages. Atherosclerosis demands action with the aim of early detection and treatment as well as the reduction of development of risk factors for coronary artery diseases. Finding the most effective preventive measures for obesity in each country requires precise epidemiological data on the number of obese children and youth, as well as on their eating and activity habits.
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OBJECTIVES: This study aimed to determine the status of training of adult congenital heart disease (ACHD) cardiologists in Europe. METHODS: A questionnaire was sent to ACHD cardiologists from 34 European countries. RESULTS: Representatives from 31 of 34 countries (91%) responded. ACHD cardiology was recognised by the respective ministry of Health in two countries (7%) as a subspecialty. Two countries (7%) have formally recognised ACHD training programmes, 15 (48%) have informal (neither accredited nor certified) training and 14 (45%) have very limited or no programme. Twenty-five countries (81%) described training ACHD doctors 'on the job'. The median number of ACHD centres per country was 4 (range 0-28), median number of ACHD surgical centres was 3 (0-26) and the median number of ACHD training centres was 2 (range 0-28). An established exit examination in ACHD was conducted in only one country (3%) and formal certification provided by two countries (7%). ACHD cardiologist number versus gross domestic product Pearson correlation coefficient=0.789 (p<0.001). CONCLUSION: Formal or accredited training in ACHD is rare among European countries. Many countries have very limited or no training and resort to 'train people on the job'. Few countries provide either an exit examination or certification. Efforts to harmonise training and establish standards in exit examination and certification may improve training and consequently promote the alignment of high-quality patient care.
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Cardiologistas , Cardiologia , Cardiopatias Congênitas , Humanos , Adulto , Cardiopatias Congênitas/diagnóstico , Cardiopatias Congênitas/epidemiologia , Cardiopatias Congênitas/terapia , Cardiologia/educação , Qualidade da Assistência à Saúde , Europa (Continente)/epidemiologiaRESUMO
Background: CVD remains a leading cause of death in Europe and worldwide accounting for 3.9 million deaths each year in Europe alone. Even with well-known risk factors and the current standards of health care, improvement of health and quality of life of CVD patients are still remains one of the biggest public health challenges we must overcome. Objective: The aim of this narrative review is to provide a brief overview of the recent and relevant documents of good practice in prevention, diagnostic and therapeutic approaches of Cardiovascular diseases that should be consider as milestones for the health authorities in the Federation of BiH. Cardiovascular diseases stil represent a worldwide public health problem, with some new dimensions caused by challenges caused through pandemic of COVID-19. The wellknown cardiovascular risk factors require new and more efficient public health approaches to the prevention and control. Conclusion: Due to the recently developed cardiovascular guidelines that were made by the European Society of Cardiology and World Heart Federation, key priority for health authorities should be is to update the existing CVD guidelines in the Federation of BiH in accordance with the international good practice.
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Aim To investigate the frequency of consumption of sweet and salty snacks among children aged 2-18 years in relation to their mothers' education level. Methods A descriptive epidemiological study was conducted in five dental practices at the School of Medicine of the University of Mostar from May to October 2022. The data were collected from medical records. Results: Out of a total of 477 children, 172 (36.1%) had mothers with a high school education, while 305 (63.9%) had mothers with a university degree. In the group of preschool children (aged 2-6 years), there were 42 mothers with high school education and 105 with university degree. In the group of school children (age 7-18 years) there were 130 mothers with high school education and 200 with university degree. The difference in the consumption of sweetened beverages among children of mothers with high school and university was not statistically significant. Similar results were found for the consumption of salty snacks, lollipops, caramels and candies. The frequency of the consumption of biscuits, chocolate and cakes (several times a day) was statistically significantly higher among the children of mothers with high school education (p=0.04), especially among school children. Eating habits of children, regardless of the level of education of their mothers, differed significantly only in the consumption of lollipops, caramels, and candies (p=0.03), which were consumed once a day by 79 (63.7%) schoolchildren and 45 (36.3%) of pre-schoolers. Conclusion A higher level of education among mothers does not necessarily equate to proper nutritional knowledge.
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OBJECTIVE: The aim of this study was to present data on the prevalence of seropositive children tested in the laboratory of the Eurofarm polyclinic in Sarajevo, from September 2020 to May 2021. MATERIALS AND METHODS: Peripheral blood samples were collected and anti-SARS-CoV-2 antibodies were detected using an electrochemiluminescence immunoassay. RESULTS: In the total of 762 tested children, 187 were positive (24.5%), based on cut-off value. Of all the positive cases 42.8% were female while 57.2% were male. There were 10.1% of positive children in the first age group (0-5 years), 44.4% in the second group (6-13 years), and 45.5% in the third group (14-18 years). There was no statistically significant difference in seroprevalence between age groups and gender. The lowest seroprevalence (3.6%) was observed in October 2020 after the first pandemic wave, and the highest seroprevalence (60.3%) was observed in April 2021, corresponding to the third pandemic wave. CONCLUSION: The results of our study showed that the seroprevalence in children was low, especially during the first year of the pandemic. In the second year of the pandemic, there was an evident statistically significant increase in the number of seropositive children. Similar data have been shown in studies for adults.
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COVID-19 , Adulto , Humanos , Criança , Feminino , Masculino , Recém-Nascido , Lactente , Pré-Escolar , COVID-19/epidemiologia , Pandemias , Estudos SoroepidemiológicosRESUMO
BACKGROUND: Limited data exist on training of European paediatric and adult congenital cardiologists. METHODS: A structured and approved questionnaire was circulated to national delegates of Association for European Paediatric and Congenital Cardiology in 33 European countries. RESULTS: Delegates from 30 countries (91%) responded. Paediatric cardiology was not recognised as a distinct speciality by the respective ministry of Health in seven countries (23%). Twenty countries (67%) have formally accredited paediatric cardiology training programmes, seven (23%) have substantial informal (not accredited or certified) training, and three (10%) have very limited or no programme. Twenty-two countries have a curriculum. Twelve countries have a national training director. There was one paediatric cardiology centre per 2.66 million population (range 0.87-9.64 million), one cardiac surgical centre per 4.73 million population (range 1.63-10.72 million), and one training centre per 4.29 million population (range 1.63-10.72 million population). The median number of paediatric cardiology fellows per training programme was 4 (range 1-17), and duration of training was 3 years (range 2-5 years). An exit examination in paediatric cardiology was conducted in 16 countries (53%) and certification provided by 20 countries (67%). Paediatric cardiologist number is affected by gross domestic product (R2 = 0.41). CONCLUSION: Training varies markedly across European countries. Although formal fellowship programmes exist in many countries, several countries have informal training or no training. Only a minority of countries provide both exit examination and certification. Harmonisation of training and standardisation of exit examination and certification could reduce variation in training thereby promoting high-quality care by European congenital cardiologists.
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Cardiologia , Humanos , Adulto , Criança , Cardiologia/educação , Certificação , Currículo , Bolsas de Estudo , Europa (Continente)RESUMO
BACKGROUND: Infantile hemangiomas (IH) are the most common vascular, benign tumors of childhood with a prevalence of 4-5%. Due to intense vasculogenesis, they proliferate during infancy, then involute at an unpredictable rate, extent of involution, and quality of residual tissue. Depending on the location, they may be associated with anomalies of other organ systems (PHACE, PELVIS syndroms). In recent decades, knowledge about hemangiomas has improved, and therefore therapeutic possibilities have improved. Today, the non-selective beta blocker-propranolol is considered the drug of first choice in the treatment of infantile hemangiomas. It is desirable to start treatment in the proliferative phase of hemangioma growth for the best possible effect. The dynamics of drug administration, time interval of dose increase and monitoring of patients during treatment vary from one Institution to another and are still the subject of discussion. OBJECTIVE: We presented the case of a child with infantile hemangioma of the lumbo-sacral region, treated with combination therapy with systemic propranolol and topical timolol, with satisfactory effect in the end. CONCLUSION: Propranolol is considered a drug with well-studied side effects and a safety profile. During 6 months of treatment, it leads to complete or almost complete withdrawal of the hemangioma. Treatment should be started in the hemangioma proliferation phase for the best possible therapeutic effect.
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Antagonistas Adrenérgicos beta/uso terapêutico , Hemangioma/tratamento farmacológico , Propranolol/uso terapêutico , Região Sacrococcígea/patologia , Timolol/administração & dosagem , Timolol/uso terapêutico , Vasodilatadores/uso terapêutico , Administração Tópica , Bósnia e Herzegóvina , Feminino , Humanos , Lactente , Resultado do TratamentoRESUMO
BACKGROUND: Persistent Ductus Arteriosus (PDA) is a vascular structure that connects the pulmonary artery and the descending aorta. It plays an important role in the fetal blood flow pattern. OBJECTIVE: The aim of this paper is to present two cases from Neonatology of Cantonal hospital in Bihac, with hemodynamically significant ductus, different "timing" of treatment and different therapeutic options. RESULTS AND DISCUSSION: The ductus closes functionally within the first 72 to 96 hours after the birth. Its anatomical closure follows in the next 14 days. If it remains open after the third month of life, it is treated as a congenital heart anomaly with a left-right shunt. Approximately 10% of all congenital heart defects are PDA with an incidence of 2-4 per 1000 live births. It has been clinically proven that PDA is present in 45% of premature babies with a birth weight of less than 1750 g and in about 80% of premature babies with a birth weight below 1200 g. As criteria for the application of drug therapy (in this case we use Paracetamol) for ductal closure, we took into account clinical parameters and echo parameters that indicated that it was a hemodynamically significant ductal shunt. Prerequisites for treatment were normal liver function confirmed by laboratory tests, normal platelet count, no intracranial hemorrhage, normal gastrointestinal function, normal coagulation parameters, normal renal function, calm parameters of inflammation. CONCLUSION: The diagnosis of PDA in the early, asymptomatic phase, in premature babies, is made by early echocardiographic examination. The decision on treatment should be based on clinical and echocardiographic criteria. Paracetamol is an alternative in the treatment of this cardiac problem of premature infants and could be more effective if used in early, presymptomatic phase.
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Permeabilidade do Canal Arterial , Canal Arterial , Doenças do Prematuro , Canal Arterial/diagnóstico por imagem , Permeabilidade do Canal Arterial/diagnóstico por imagem , Permeabilidade do Canal Arterial/tratamento farmacológico , Humanos , Lactente , Recém-Nascido de Baixo Peso , Recém-Nascido , Recém-Nascido PrematuroRESUMO
INTRODUCTION: The objective of this study was to determine the oral health condition Down syndrome (DS) children in Bosnia and Herzegovina, by analizing oral health of Down syndrome individuals in two largest regions, Sarajevo and Tuzla Canton. PATIENTS AND METHODS: Caries and oral health status of Down syndrome children aged 6-18 years were examined and assessed according WHO 1997 criteria. DS individuals were divided in to four age groups: I (0-6 yrs); II (7-12 yrs); III (13-18 yrs). RESULTS: The mean dmft/DMFT index for age group I is (6,40±6,05); II (2,05±2,04) and III (10,30±6,80). The analysis of oral hygiene of Down syndrome children by using the debris index, it was found that 43,9% have very good oral hygiene, 33,3% respondents have good oral hygiene, 15,8% were with poor oral hygiene, while the very poor hygiene had 7% subjects. By using Pearson's correlation to the value of DMFT, debris index and age of examinees with Down syndrome, it is established a statistically significant positive correlation between analyzed variables. Values of CPI index according to age groups were as follows: I (0,1); II (0,17) and III group (0,4).
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OBJECTIVE: To show the place and role of continuous electrocardiographic twenty-four-hour ECG monitoring in daily clinical practice of pediatric cardiologists. METHODS: According to protocol, 2753 patients underwent dynamic continuous ECG Holter monitoring (data collected from the "Register of ECG Holter monitoring" of Pediatric Clinic, UCC Sarajevo in period April 2003- April 2015). RESULTS: There were 50,5% boys and 49,5% girls, aged from birth to 19 years (1,63% - neonates and infants, 2,6% - toddlers, 9,95% - preschool children, 35,5% - gradeschoolers and 50,3% children in puberty and adolescence). In 68,1% of patients Holter was performed for the first time. Indications for conducting Holter were: arrhythmias in 42,2% cases, precordial pain in 23,5%, suspicion of pre-excitation and/or pre-excitation in 10%, crisis of consciousness in 8%, uncorrected congenital/acquired heart defects in 4,2%, operated heart defects in 3,7%, hypertension in 3,1% cases, control of the pacemaker in 1,63% and other causes in 3,5% cases. Discharge diagnosis after ECG Holter monitoring were: insignificant arrhythmias in 47,1% cases, wandering pacemaker in 21,3%, pre-excitation in 16,2%, benign ventricular premature beats in 6,3%, atrioventricular block in 3%, sinus pause in 2.2% cases and other arrhythmias in 3,5%. In mentioned period 57 cases of Wolf Parkinson White syndrome were registered, in 4,5% of patients antiarrhythmic therapy was administered. Radiofrequent ablation was performed in 23 cases. CONCLUSION: The development of pediatric cardiac surgery has initiated development of pediatric arrhythmology as imperative segment of pediatric cardiology. Continuous ECG Holter monitoring has become irreplaceable method in everyday diagnostics and therapy of arrhythmias in children.
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INTRODUCTION: The most common clinical sign in pediatric cardiology is a heart murmur (organic and inorganic). Organic are sign of heart disease, while inorganic (basically divided into accidental and functional) murmurs occur on anatomically healthy heart. AIM: To determine the justification of the application of the methods of cardiac treatment. PATIENTS AND METHODS: Study included 116 children aged from 1 to 15 years, who were referred due to cardiac treatment to Pediatric Clinic, of Sarajevo University Clinical Center. RESULTS: The first group consisted of children with innocent heart murmur, 97 (53 males). The second group consisted of patients with organic murmur, 19 (13 males). The average age of the first group was 7.69 (1.01-15.01) years old, and of the second group 3.15 (1.01- 8.06) years old, and there is a significant difference between these two groups (p <0.001). Medical history questions about potentially harmful habits of mother in pregnancy, found significant differences in the frequency of the existence of habits between the first and second groups of subjects (14.44% vs. 85.1%, p = 0.013). The values of the pulse of patients showed statistically significant difference (p = 0.012). The most common place of the murmurs' appearance is the second left intercostal space. In the first group, the most common were vibratory (32.3%) and ejection (31.9%) and in the second the most common were holosystolic (73.7%) murmur. Analyzing the R/S ratio of V1, a significant difference among the two groups was found (mean 0.78 vs. the values for 1.45, p = 0.003). There is a significance in terms of developed hypertrophy of the heart cavities (BVH) between the two groups. The most common accidental murmur was classic vibratory Still's murmurs (55.43%) and the most common congenital heart defects was ASD (36.8%). CONCLUSIONS: A heart murmur itself, should not be the purpose of auscultation. One of the tasks of pediatricians, pediatric cardiologists in particular would be to improve auscultation, as a sovereign method of heart murmurs assessment. Heart murmur assessment should be adapted to recognize whether heart murmur is innocent, or there is suspected or probable congenital heart defect.
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AIM: The aim of this research is to show why is it important in diagnosing children with lung infiltrates. METHODS: Our study included 50 children with lung infiltrates during period 2005-2012, and was conducted on Pediatric Clinic of the University Clinical Center Sarajevo. We sent all cytological BAL analyses to the University Clinical Center Sarajevo. Cytology was performed by direct microscopy. BAL cytology was performed by the principle of sending samples for centrifuging, 12000 revolutions during a 10 min Shandon-cyto spin. Then the centrifuged sample is dried in the air during 1-2 hours, and is then dyed under the May-Grünwald-Giemsa staining, and analyzed under the Olympus BX41 microscope. RESULTS: Nosocomial pneumonia has occurred in 32% children, acquired pneumonia in 38%, and 30% children had a lung infiltrates. 6 (12%) of children were younger then 1 year old, 23 (46%) children were between 1 to 5 years, 14 (28%) of children were between 5 to 10 ages, and 7 (14%) of children were between 10-15 ages. The most of the changes in observed children took place on the right lung, 34%, while 26% occurred on the left side, 22% were normal and 18% changes have affected both lungs, right and left. Percentage of cells in cytological smear in children with BAL were: cylindrical cells 28%, lung macrophage 26%, lymphocytes 17%, detritus 17% and phlegm 12%. Erythrocyte sedimentation rate (ESR) in children with BAL was up to 10-52%, to 50-30%, while ESR after first hour was above 50-18 %. CONCLUSION: Clinical parameters and local inflammation of the affected lobe are associated with positive bronchoalveolar cytology lavage findings.
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Líquido da Lavagem Broncoalveolar/citologia , Infecção Hospitalar/diagnóstico , Pneumonia Bacteriana/diagnóstico , Adolescente , Líquido da Lavagem Broncoalveolar/microbiologia , Estudos de Casos e Controles , Criança , Pré-Escolar , Infecção Hospitalar/microbiologia , Diagnóstico Diferencial , Feminino , Hospitais Pediátricos , Hospitais Universitários , Humanos , Lactente , Masculino , Pneumonia Bacteriana/microbiologia , Valor Preditivo dos Testes , Sensibilidade e EspecificidadeRESUMO
Microdeletion syndromes are caused by chromosomal deletions of less than 5 megabases which can be detected by fluorescence in situ hybridization (FISH). We evaluated the most commonly detected microdeletions for the period from June 01, 2008 to June 01, 2015 in the Federation of Bosnia and Herzegovina, including DiGeorge, Prader-Willi/Angelman, Wolf-Hirschhorn, and Williams syndromes. We report 4 patients with DiGeorge syndromes, 4 patients with Prader-Willi/Angelman, 4 patients with Wolf-Hirschhorn syndrome, and 3 patients with Williams syndrome in the analyzed 7 year period. Based on the positive FISH results for each syndrome, the incidence was calculated for the Federation of Bosnia and Herzegovina. These are the first reported frequencies of the microdeletion syndromes in the Federation of Bosnia and Herzegovina.
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Deleção de Genes , Doenças Genéticas Inatas/epidemiologia , Doenças Genéticas Inatas/genética , Hibridização in Situ Fluorescente/métodos , Bósnia e Herzegóvina/epidemiologia , Criança , Deleção Cromossômica , Países em Desenvolvimento , Síndrome de DiGeorge/genética , Humanos , Incidência , Síndrome , Síndrome de Williams/genéticaRESUMO
INTRODUCTION: The objective of this study was to determine the oral health condition Down syndrome (DS) adults in Bosnia and Herzegovina, by analyzing oral health of Down syndrome individuals in two largest regions, Sarajevo and Tuzla Canton. PATIENTS AND METHODS: Caries and oral health status of 33 Down syndrome adults aged 19-45 years were examined and assessed according WHO 1997 criteria. RESULTS: The mean DMFT index is 15,96±8,08. The analysis of oral hygiene of Down syndrome children by using the debris index, is found that 42,4% have very good oral hygiene, 21,2% respondents have good oral hygiene, 27,3% are with poor oral hygiene, while the very poor hygiene have 9,1% subjects. The Value of CPI index is 0,82.
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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.
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Fibrose Cística/epidemiologia , Adolescente , Bósnia e Herzegóvina/epidemiologia , Cetilpiridínio/análise , Criança , Pré-Escolar , Fibrose Cística/diagnóstico , Feminino , Humanos , Lactente , Recém-Nascido , Masculino , Estudos Retrospectivos , Fatores Sexuais , Suor/químicaRESUMO
OBJECTIVE: Endocarditis can have profound and devastating neurological consequences, with the vast majority of these complications in patients with left-sided valvular disease. The approach to the acute management of stroke in children with infective endocarditis is limited by the inadequacy of published data on their clinical course and outcome. CASE REPORT: This case report presents a 12 year old girl with diagnosed endocarditis, complicated with intracranial hemorrhage, due to the rupture of an aneurysm of the peripheral branch medial cerebral artery and gradient therapeutic approach, with an excellent final result. CONCLUSION: Congestive heart failure resulting from valvular insufficiency required mitral valve replacement, after cerebral aneurysm clipping.
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Aneurisma Infectado/complicações , Aneurisma Roto/complicações , Artérias Cerebrais/patologia , Endocardite Bacteriana/complicações , Insuficiência Cardíaca/cirurgia , Próteses Valvulares Cardíacas , Insuficiência da Valva Mitral/cirurgia , Criança , Feminino , Insuficiência Cardíaca/etiologia , Humanos , Insuficiência da Valva Mitral/complicaçõesRESUMO
OBJECTIVE: To estimate if an acute postasphyxial renal injury in newborns could indicate a neurological outcome. METHODS: We conducted a prospective clinical trial on 50 full-term newborns with 5-minute Apgar score <7 (asphyxiated group) and a control group of 50 full-term newborns with 5-min Apgar score ≥ 7 (non-asphyxiated group). Renal function was assessed on the third day of life by serum values of creatinine, cystatin C and ß2-microglobulin (ß2M) and glomerular filtration rate (GFR). All newborns had brain and renal ultrasonography at early stages and were followed by Amiel-Tison Neurological Assassment (ATNA) throughout the first year of life. RESULTS: Mean GFR was significantly lower in asphyxiated than in non-asphyxiated group (22.08 ± 6.66 ml/min/1, 73 m(2) versus 35.42 ± 2.26 ml/min/1, 73 m(2); p < 0.001) and serum values of creatinine, cystatin C and ß2M were significantly higher (1.13 versus 0.66 mg/dl; 3.92 versus 1.52 mg/l; 1.53 versus 0.99 mg/l; p < 0.001). In asphyxiated group ATNA results throughout the first year of life significantly correlated with renal function (p < 0.01). A correlation of ATNA with Apgar score at 5 min, Sarnat and Sarnat staging of hypoxic ischemic encephalopathy and brain and renal ultrasonography has also been significant (p < 0.01). CONCLUSIONS: Our study showed a significant correlation between early impairment of renal function due to neonatal asphyxia with neurological outcome at the end of the first year of life.
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Injúria Renal Aguda/etiologia , Asfixia Neonatal/complicações , Hipóxia-Isquemia Encefálica/diagnóstico , Injúria Renal Aguda/diagnóstico , Injúria Renal Aguda/fisiopatologia , Índice de Apgar , Estudos de Casos e Controles , Feminino , Seguimentos , Humanos , Hipóxia-Isquemia Encefálica/etiologia , Recém-Nascido , Testes de Função Renal , Masculino , Testes Neuropsicológicos , Prognóstico , Estudos ProspectivosRESUMO
OBJECTIVE: To determine the reliability of transthoracic echocardiography (TTE) and transesophageal echocardiography (TEE) in predicting the size of an atrial septal defect (ASD). MATERIAL AND METHODS: The study included 16 patients who underwent the catheter-based procedures to close an atrial septal defect between February 2008 and December 2011 at the Paediatrics Clinic, CCU Sarajevo, after clinical and TTE and TEE evaluation. In order to determine the assumed diameter of the balloon (A-SBD), we used the formula of quantification A-SBD=TTE defect diameter×1:09 + 3.9 mm and A-SBD=1.1× transesophageal diameter of ASD+2.0 mm. The ASD was examined using the long-axis view, the basal short-axis view, the apical four-chamber view and the subcostal view to observe its position, diameter and relation to neighbouring structures. The largest diameter was selected as the reference diameter. RESULTS: Of the total number of treated patients, 11 were female. Treatment was conducted by a foreign and local team of invasive cardiologists. The average age of the patients was 8.43 years (2 -17 years). Apart from a transient disturbance of rhythm in the youngest patients, there were no other intra and postprocedural complications. The obtained formulas represent "our" default size of the SBD, based on measurements of TTE and TEE: A-SBD (TTE)=6.02+0.86×TTE and A-SBD (TEE)=3.93+0.86×TEE. CONCLUSION: ASD diameter determined by TTE and TEE can reliably determine the appropriate size needed Amplatzer Septal Occluder device.
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Septo Interatrial , Oclusão com Balão/métodos , Ecocardiografia Transesofagiana/métodos , Ecocardiografia/métodos , Comunicação Interatrial , Adolescente , Septo Interatrial/diagnóstico por imagem , Septo Interatrial/patologia , Oclusão com Balão/efeitos adversos , Cateterismo Cardíaco/efeitos adversos , Cateterismo Cardíaco/métodos , Catéteres , Criança , Pré-Escolar , Ecocardiografia/normas , Ecocardiografia Transesofagiana/normas , Feminino , Comunicação Interatrial/diagnóstico por imagem , Comunicação Interatrial/patologia , Comunicação Interatrial/terapia , Humanos , Masculino , Complicações Pós-Operatórias , Reprodutibilidade dos TestesRESUMO
OBJECTIVE: To determine the incidence and distribution of neonatal sepsis in premature newborns with congenital heart disease (CHD) according to gestational and postnatal age, time of onset, and type and frequency of causing agents, and compare it with premature newborns without CHD. DESIGN, SETTING, PATIENTS: A clinical investigation on 80 premature newborns admitted to neonatal intensive care unit (NICU) of Pediatric Clinic University Medical Center Sarajevo, Bosnia and Herzegovina, between October 23, 2007 and March 18, 2009. We analyzed the incidence and distribution of neonatal sepsis in premature newborns with CHD according to gestational and postnatal age, time of onset, and type and frequency of causing agents, and compared it with premature NICU patients without CHD. RESULTS: Of the 80 premature newborns included in our study, 14 had CHD with patent ductus arteriosus as the most common type of anomaly. Culture-proven sepsis was diagnosed in 28.57% premature newborns with CHD and 12.12% premature newborns without CHD. The three most common causing agents were Staphylococcus aureus, Klebsiella species, and Serratia species. CONCLUSION: Premature newborns with CHD have a higher risk of acquiring sepsis during hospitalization in NICU, probably because of longer duration of hospitalization and need for invasive procedures such as mechanical ventilation, central venous catheters, and parenteral nutrition.
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Infecção Hospitalar/epidemiologia , Cardiopatias Congênitas/epidemiologia , Recém-Nascido Prematuro , Sepse/epidemiologia , Centros Médicos Acadêmicos , Bósnia e Herzegóvina/epidemiologia , Estudos de Casos e Controles , Infecção Hospitalar/microbiologia , Idade Gestacional , Humanos , Incidência , Recém-Nascido , Unidades de Terapia Intensiva Neonatal , Klebsiella/isolamento & purificação , Estudos Retrospectivos , Medição de Risco , Fatores de Risco , Sepse/microbiologia , Serratia/isolamento & purificação , Staphylococcus aureus/isolamento & purificação , Fatores de TempoRESUMO
Potential risk of sudden death during sports participation makes screening of competitive athletes of vital importance. Congenital cardiac anomalies and non-atherosclerotic, acquired myocardial conditions are primary causes underlying exercise-induced cardiac death in young patients. Since cardiovascular conditions are the leading causes of non-traumatic, exercise-induced cardiac events, cardiovascular screening preceding sports participation in mandatory. The objectives of this study were to determine prevalence of cardiac conditions through cardiovascular screening of young athletes and to establish preventive strategy. The study was conducted at the Sports Medicine Center of Sarajevo Canton and at the Pediatric Clinic of University of Sarajevo Clinics Centre in the period 2007-2009. The study was supported by Canton Sarajevo Ministry of Health and Ministry of sports, science and culture. The study targeted a group of 214 athletes, 8-18 years of age with average age being 15.26. The group was subdivided into five groups according to the age. After taking the anamnesis (family, personal and cardiological) patients were subjected to the measuring of body mass and height, blood pressure and heart rate and oxygen saturation, recording of 12-lead ECG, specialist examination (pediatrician, sports medicine specialist and cardiologist) and complete heart echocardiography. No examined athletes expressed subjective discomfort. Congenital cardiac anomalies were not diagnosed in any athlete. Also, cardiovascular abnormalities requiring additional evaluation, positive cardiac anamnesis, abnormal auscultatory findings, hypertension or abnormal ECG findings were not recognized in any patient. Moderate correlation was found among the left ventricle mass and heart rate (p<0.05). In order to minimalize or even possibly prevent the risk of sudden cardiac death it is necessary to establish an adequate strategy of cardiovascular screening of young athletes.