Is Bacterial Meningitis a Risk Factor for Developing Attention Deficit Hyperactivity Disorder.

INTRODUCTION: Bacterial meningitis is a severe disease with high morbidity. Many medical conditions are known to be associated with meningitis including Attention Deficit Hyperactivity Disorder (ADHD). The goal of the present study was to examine the frequency of ADHD in children who had had bacterial meningitis. An additional goal was to assess the odds ratio for ADHD in children who had had meningitis and children who had not had it. METHODS: The sample comprised 60 children who had had meningitis in the first year of their lives and 60 control children who had not had the disease. ADHD was assessed through the structural clinical interviews with parents according to the criteria set in DSM-IV. RESULTS: The total frequency of ADHD in children who had had meningitis was 62%, as compared to 5% in children who had not had the disease. The odds ratio for developing ADHD was 30.5 (95% CI = 8.5 to 109) in favor of children in the meningitis group. CONCLUSION: Meningitis is a significant risk factor for developing ADHD later in childhood. Children who had meningitis need to be monitored for timely detecting and treating ADHD symptoms.

Brucellosis in children in Bosnia and Herzegovina in the period 2000 - 2013.

AIM: To analyse clinical, laboratory and epidemiological characteristics of brucellosis in children in Bosnia and Herzegovina. METHODS: The study included 246 children aged 0-18 years, who were hospitalized in Clinics and Departments for Infectious Diseases in Tuzla, Sarajevo, Banja Luka, Zenica and Bihac in the period 2000-2013, in whom the diagnosis of brucellosis was established based on anamnestic data, clinical features and positive results from blood culture and/or positive results from one of the serological tests. RESULTS: In this period, a total of 2630 patients, 246 (9.35%) of whom were children, were treated from brucellosis at the Clinics and Departments in Bosnia and Herzegovina. In the majority of cases, the children were from rural parts of the country, 226 (91.87%);214 (87.04%) cases had direct contact with sick animals, sick family member or consumption of unpasteurized dairy products from farms where brucellosis had been already established. Male children predominated, 157 (63.82%). The most frequent clinical features in affected children were fever, 194 (78.86%) and joint pain, 158 (64.22%). The average duration of antimicrobial treatment was 42.85 ± 10.67 days. A total of 228 (92.68%) children were completely cured, while relapses occurred in 18 (7.32%) children. CONCLUSION: Since brucellosis is an endemic disease in Bosnia and Herzegovina, it is important that physicians in their daily practice consider brucellosis and establish proper diagnosis and therapy in children with prolonged fever, arthralgia, leukopenia and positive epidemiological data, especially in rural parts of the country.

[ACCIDENTAL POISONING WITH A PLANT COLCHICUM AUTUMNALE: REPORT OF TWO CASES]. / NENAMJERNO OTROVANJE BILJKOM MRAZOVCEM (COLCHICUM AUTUMNALE): PRIKAZ DVOJICE BOLESNIKA.

Colchicine poisonings are serious and highly fatal conditions that occur as a result of food poisoning from plants that contain this alkaloid or overdose with drug containing colchicine. The leaves of edible wild garlic because of their similarity are often replaced with highly poisonous leaves of autumn crocus, causing poisoning. Described are two cases of food poisoning with Colchicum autumnale, who had similar symptoms in the initial stage, but different clinical course and outcome. Signs of poisoning require early identification and intensive supportive therapy, which increases the chances of survival.

Morphometric changes of the lumbar intervertebral space following discectomy on one or two levels.

AIM: To investigate a potential difference in postoperative morphological changes of two-level lumbar disc surgery as compared to one level surgery. METHODS: The standard lateral radiographs of lumbar spine obtained preoperatively and postoperatively were used in the study . The morphological study included 60 adult patients of both sexes who had undergone the surgery in the period 2002-2006. The first group comprised patients operated on one level (L4/L5 and L5/ S1), and the second included patients operated on two levels (L3/ L4/L5; L4/L5/S1 and L5/S1/S2). Using lateral radiographs, after digitalization, the height of intervertebral disc space (HD), angle between vertebral bodies (A) and translation (T) were measured. RESULTS: Comparing preoperative and postoperative values, statistically significant difference has been found for HD in the first group and HD and A in the second group. In neither groups there was statistically significant difference for T, which is one of radiological signs of segmental instability. The comparison of postoperative values for both groups has not shown any statistically significant difference. CONCLUSIONS: The standard lumbar discectomy on two levels has not shown more pronounced morphological changes or changes suggesting an increased risk of segmental instability as compared to one level discectomy.

[Analysis of amoxicillin-clavulanic acid (Xiclav) efficacy and the possibility of early switch from parenteral to oral therapy in the treatment of infections]. / Analiza efikasnosti djelovanja antimikrobika Amoksicilina + klavulanska kiselina (XICLAV) i mogucnosti ranog prelaska s parenteralne na oralnu terapiju u lijecenju infekcija.

Early transition from parenteral to oral antibiotic therapy switch therapy play a major role in treatment because of adverse reactions of long parenteral therapy. In the prospective, comparative and randomized clinical study the efficacy of two treatment regimens were analyzed: XICLAV (amoxicillin + clavulanic acid): parenteral regiment with early transition to oral therapy and parenteral regimen in patients with bacterial infections without transition to the oral dosage form, on the other hand. In our study we've analyzed 240 hospitalized patients in the Clinic of infectious Diseases in Tuzla and Sarajevo too, so in the Institution for infectious diseases in Zenica. The mean age of our patients was 39.6 years, 70.8% females. The major (50.5%) patients had urinary or respiratory tract infectious (bacterial pneumonia 38.8%) but several patients have had skin infections and sepsis. The first 120 patients were initially treated by Xiclav administered parenterally i.v. (adults at a dose of 3 x 1.2 gr i.v.; the children at a dose of 3 x 30 mg/kg) with early oral switch therapy (adults at a dose of 3 x 625 mg per os; the children at a dose of 3 x 25-50 mg/kg); whereas the others (120 patients) were treated parenterally by the regimen mentioned above. The mean length of i.v. therapy and hospitalization in the i.v. group was 4.12/10.21 days respectively (p > 0.05). The clinical efficacy switch of both therapeutic regimens was comparable. The resolution of all clinical symptoms and laboratory signs of infections was noted at 69% patients of both groups, with significant improvements at noted at 69% patients of both groups, with significant improvements at 21% patients and at 10% patients showed clinical failure. The tolerability of Xiclav was very good. The adverse reactions during treatment were observed at 5.2% patients. This study noticed satisfied clinical and bacterial efficacy so did tolerability of Xiclav in the treatment of bacteriological infections. Xiclav apply early transition from parenteral to oral therapy.