[The effect of hemodialysis on endothelin-1 plasma levels in children with terminal renal insufficiency]. / Uticaj hemodijalize na nivo endotelina-jedan u plazmi dece s terminalnom insuficijencijom bubrega.

We analysed the effect of hemodialysis (HD) on endothelin (ET) plasma level in children with terminal renal failure. Twenty-five patients (pts) and 27 healthy children as controls were included in the study. There was no difference in ET plasma levels in pts before HD (1.97 +/- 1.45) and controls (2.08 +/- 1.47), but ET increased in plasma of pts after HD (4.10 +/- 3.66). To estimate the relationship of volume depletion or depuration on ET plasma level changes in pts during HD, ET was measured at three time points of HD (before ultrafiltration-UF, after UF, and after HD without fluid removal) in 10 pts. ET level was not significantly changed after UF (1.93 +/- 2.25 vs 1.71 +/- 1.50; ns), but was significantly increased after depuration (4.46 +/- 3.56; p < 0.05). There was no correlation between ET and blood pressure in controls and pts in either period of testing, neither with plasma renin activity, left ventricular mass index, and body weight changes during HD.

[Continuous blood pressure monitoring over a 24-hour period in children with terminal renal failure treated with hemodialysis]. / Kontinuisano pracenje krvnog pritiska u toku 24 sata kod dece s terminalnom insuficijencijom bubrega, lecenih hronicnim hemodijalizama.

Recent evidence suggests that circadian blood pressure changes are common in patients with impaired renal function and has excellent correlation with end-organ damage. The aim of this paper was to: 1) evaluate if children with end-stage renal failure have altered circadian blood pressure rhythm; 2) assess whether pre- or postdialytic blood pressure is representative for the average interdialytic blood pressure; 3) assess whether pre- or postdialytic blood pressure is representative for the average interdialytic blood pressure; 3) determine influence of pre-, post and interdialytic blood pressure. Ambulatory blood pressure monitoring was performed in two groups of patients: group A-13 children with end-stage renal failure, aged 15.15 +/- 5.58 years, on chronic haemodialysis from 2 to 156 (mean 45.3) months, 4 of whom were hypertensive and 9 normotensive; group B-19 children with chronic hypertension (essential or renal hypertension) aged 15.28 +/- 2.27 years. 84.62% of children from group A and 31.58% from group B (p = 0.0037) had blunted circadian blood pressure rhythm (a nocturnal reduction of blood pressure is less than 10% of daytime values). Pre- and postdialytic systolic, diastolic and mean arterial blood pressure did not differ significantly and were in correlation with interdialytic blood pressure (r = 0.9; p < 0.01). Pre-, post- and interdialytic blood pressures correlated well with left ventricular mass index (r = 0.6; p < 0.05), but were not in correlation with the degree of hypervolemia (p < 0.05).

[Echocardiographic evaluation of left ventricular size and function in children with arterial hypertension on hemodialysis]. / Ehokardiografska procena velicine i sistolne funkcije leve komore kod dece s arterijskom hipertensijom na hemodijalizi.

In order to evaluate the effects of hypertension on left ventricular (LV) anatomy and function, we investigated children on long-term hemodialysis using two-dimensional and M-mode echocardiography. The following echocardiographic estimations were made: indexed left atrial diameter (LAi) LV and diastolic diameter (LVDDi), inter ventricular septum (IVSi) and I.V posterior wall (PWi), with calculations of the LV mass index (massi), ejection fraction (EF), fractional shortening (FS), the velocity of circumferential fiber shortening (VCF) and wall stress (WS). LAi, LVEDDi, IVSi, PWi and massi were significantly higher in hypertensive patients than in normotensive and healthy children. EF and FS were significantly lower in both groups of dialyzed patients. The best correlation with mean arterial pressure had massi (r = 0.624), IVSi (r = 0.576) and PWi (r = 0.575). Those results suggest an important correlation between hypertension and concentric LV hypertrophy in long-term dialyzed patients.

[Prevention, care and screening of hips of newborn infants]. / Prévention, soins et surveillance des hanches de bébés.

The frequency of C.D.H. and the indications for surgical treatment have been considerably reduced. Since a 3-part prevention protocol has been initiated: screening of newborns, prophylactic triple-diapering in slight flexion-abduction, aided by the availability of the equipment, and repeated examinations of infants.

[Wrapping in abduction of newborns in maternity wards]. / Siroko povijanje novorodencadi u porodilistu.

Triple prevention of the congenital dysplasia of the hip comprises detection in newborns, general wrapping in abduction, and detection in infants. It starts already in obstetric institutions and is legalized as an obligatory form of health protection of the population. Baby-packages for prophylactic wrapping with the thigh in abduction and flexion, are provided for each newborn free of change and distributed in the maternity wards. Already in prenatal consultations and later in the maternity ward mothers are taught how to apply wrapping in abduction to normal children and how to use therapeutic pants in children suspect of a pathologic hip.

[Current results and methods in eradication of typhus fever on the Serbian territory excluding autonomic provinces]. / Dosadasnji rezultati i metode u eradikaciji pegavog tifusa na teritoriji Srbije van autonomnih pokrajina

Since 1969 Serbia has been conducting the programme of eradication louse-borne typhus. To this effect of Law on the eradication of communicable diseases has been passed. In addition to Republic Commission, as well as 6 regional commissions, and 18 communal commissions in whose territory the disease is being eradicated, have been formed. The operations consist of four phases: preparatory attack, consolidation and final phase. The methods and measures applied under the programme include the measures concerned with the control of vectors, i.e. lousiness, measures to detect the source of infection, respectively patients with louse-borne typhus and Brill-Zinsser disease. The control of louseiness effected through the impregnation of underwears and bed linens by means of syntheic insecticides (DDT, Maltox), as well as through health education activities, has yielded good results, so that the highest rate of lousiness: 9.08% (Sjenica, Tutin 4.37%), was reduced to less than 1% in 1972. To detect the source of infection, both active and pasiive investigation has been carried out. Active investigation included regular control of the health state through thermometry applied to registered households with lice. Passive investigation is carried out trough out -patient units and residential services which take care of all febrile patients coming from endemic areas. The results obtained from the three-year operations indicate that the percentage of dected patients with Brill-Zinsser amounts to 0--4--3.9%, as well as that it is still lagging behind with respect to the immunity acquired through previous affections in the endemic areas. The distribution of detected patients with Brill-Zinsser especially indicates that a small number of patients from endemic ares has been detected. The paper presents the criteria for the evaluation of results, making a proposal that a professional body should be formed at the federal level to coordinate the methods and programmes of operations. In addition that body's task would be to expand the operations to all endemic areas in the country.