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Publications (14)27.56 Total impact

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    ABSTRACT: Background The most common illness caused by parvovirus B19 infection is ‘fifth disease’, a mild rash illness that occurs most often in children. The infection often results in no obvious illness. It commonly infects children and typically causes a mild rash that may resemble a “slapped-cheek”. Other symptoms that can occur include joint pain (arthralgia), fever and general flu-like symptoms. Methods Children who are at risk of severe parvovirus complications might benefit from blood tests that can help determine if they’re immune to parvovirus or if they’ve recently become infected. Most cases of slapped cheek syndrome diagnosed by making a visual examination of the distinctive rash. No further testing was usually required in children during three years period 2009–2011 in capital town of Bosnia, Sarajevo. Results Parvovirus infection in children with anemia may stop the production of red blood cells and cause an anemia crisis. Children with severe anemia may need to be hospitalized and receive blood transfusions. Percentage of hospitalized of parvivirus infections in children with anaemia is 19% in Bosnian preschool children, what is only less 1% of complications in this disease. Conclusions Fifth disease can cause fetal anemia, which if undetected can have severe consequences. Several days after the appearance of early symptoms, a distinctive bright red facial rash may appear usually on both cheeks. In most children, parvovirus infection is mild and requires little treatment. Slapped cheek is actually the Parvovirus B19 that only affects humans, especially younger children.
    Archives of Disease in Childhood 11/2012; 97(2 suppl):A242. · 3.05 Impact Factor
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    ABSTRACT: Background : Examples of semi-contact sports include karate and its benefite influence on asthma in childhood. Specific treatment for asthma will be determined by pediatrician based on children age, overall health, medical history, extent of the disease, tolerance for specific medications, procedures, or therapies and expectations for the course of the disease. Aims: A target of this article is showing benefit of karate training in preschool ages on asthma management and course of disease. Methods: To verify the efficacy of karate on asthma, a complex psychomotor activity that enhances pulmonary capacity and lungs volume, and breathing regulations, as an intervention for asthma curing, ten children with asthma, ranging in age from five to seven years, and meeting diagnostic criteria for children asthma disorder were studied during two years period 2010-2011. Comparative groups were another ten children with in same age with similiar physical characteristics but without sport activity. The data analysis was performed at the Karate Clubs Sarajevo, Sports for Children. Results: A higher prevalence of asthma has been reported in athletes specially in karate clubs for younger children but with better control of asthma. Risk ofasthma decreased with number of years of training (odds ratio 2.02; 95% confidence interval 1.60–3.03 ; P<0.0001), number of hours per week (odds ratio 1.74; CI 1.11–2.21; P=0.015) and rank, specifically brown green belt versus lower belts (odds ratio3.53; CI 2.82–6.28; P=0.007). Conclusions: Karate is a relatively safe sport for preschool children and younger schoolers when properly taught and optimize for asthma management. These training principles are perhaps most useful early in a children patient's course when the setting of appropriate expectations is important in minimizing restrictions from both, disease and its treatment and karate activity.
    Archives of Disease in Childhood 11/2012; 97(2 suppl-97):A480. · 3.05 Impact Factor
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    ABSTRACT: BACKGROUND: Pneumonia is typically caused by an infection but there are a number of other causes. Confirming the underlying cause can be difficult in children , however, with no definitive test able to distinguish between bacterial and not-bacterial origin. With treatment, most types of bacterial pneumonia can be cleared within two to four weeks and mortality is very low in children. METHODS: A retrospective study was performed with children ≤14 years of age who were evaluated in the pneumonia during three years period 2008-2010, were found to take nasopharyngeal specimens,laboratory data and had chest radiography performed because of possible pneumonia. Historical features and examination findings were collected by treating physicians before knowledge of the chest radiograph results. Antibiotics were prescribed according to standard practices on pulmonolgy unit. RESULTS: Nasopharyngeal specimens were obtained from 502 children, representing 10-25% of children population groups in the different areas. Pneumococci were carried by 250 (49.8%) of the children, 7 (2.8%) of the isolates being resistant to penicillin or multiresistant. Other commonly isolated bacteria include: Haemophilus influenzae in 51 (20.4 %), Chlamydophila pneumoniae in 28 cases (11.2%), Mycoplasma pneumoniae in 9( 3.6%), Staphylococcus aureus, Moraxella catarrhalis, Legionella pneumophila and gram-negative bacilli. Acute atypical bacterial infection was identified in 146 children (29.1%). Other were atypical bacterial infections. We excluded viral pneumonia infections in 99 (19.7%) hospitalized children cases. CONCLUSIONS: The most common types of hospitalized pneumonia infectious in children were bacteria and viruses with it being less commonly due to fungi or parasites. There was no significant difference in the efficacy of the different treatment regimens followed by children with S. pneumoniae infection, whereas clinical failure occurred significantly more frequently among children with atypical bacterial or mixed infection who were not treated with a macrolide.
    International Journal of Infectious Diseases 06/2012; 16(Supplement):e158–e316. · 2.36 Impact Factor
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    ABSTRACT: BACKGROUND: Pneumonia is typically caused by an infection but there are a number of other causes. Confirming the underlying cause can be difficult in children , however, with no definitive test able to distinguish between bacterial and not-bacterial origin. With treatment, most types of bacterial pneumonia can be cleared within two to four weeks and mortality is very low in children. METHODS: A retrospective study was performed with children ≤14 years of age who were evaluated in the pneumonia during three years period 2008-2010, were found to take nasopharyngeal specimens,laboratory data and had chest radiography performed because of possible pneumonia. Historical features and examination findings were collected by treating physicians before knowledge of the chest radiograph results. Antibiotics were prescribed according to standard practices on pulmonolgy unit. RESULTS: Nasopharyngeal specimens were obtained from 502 children, representing 10-25% of children population groups in the different areas. Pneumococci were carried by 250 (49.8%) of the children, 7 (2.8%) of the isolates being resistant to penicillin or multiresistant. Other commonly isolated bacteria include: Haemophilus influenzae in 51 (20.4 %), Chlamydophila pneumoniae in 28 cases (11.2%), Mycoplasma pneumoniae in 9( 3.6%), Staphylococcus aureus, Moraxella catarrhalis, Legionella pneumophila and gram-negative bacilli. Acute atypical bacterial infection was identified in 146 children (29.1%). Other were atypical bacterial infections. We excluded viral pneumonia infections in 99 (19.7%) hospitalized children cases. CONCLUSIONS: The most common types of hospitalized pneumonia infectious in children were bacteria and viruses with it being less commonly due to fungi or parasites. There was no significant difference in the efficacy of the different treatment regimens followed by children with S. pneumoniae infection, whereas clinical failure occurred significantly more frequently among children with atypical bacterial or mixed infection who were not treated with a macrolide.
    International journal of infectious diseases: IJID: official publication of the International Society for Infectious Diseases 06/2012; 16(1s-16):p196. · 2.17 Impact Factor
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    ABSTRACT: BACKGROUND Ulcerative colitis is idiopathic inflammatory bowel disorder. While there is no cure currently available, ulcerative colitis can usually be controlled with home treatment and medication. Ulcerative colitis is a disease characterized by remitting and relapsing inflammation of the large intestine in children. PURPOSE: The aim of this study was to investigate the clinical polymorphisms and distribution of diseases in a small cohort of Bosnian ulcerative colitis kids patients. METHODS: Ulcerative colitis is diagnosed by a complete medical history and physical examination along with medical tests. A colonoscopy or sigmoidoscopy are the most accurate methods for making a diagnosis of ulcerative colitis and ruling-out other possible conditions. MATERIALS: Routine generally screening for blood stools and pathologic biopsy made for all suspected children. The pediatrics division maintains several databases that prospectively abstract information from medical records of children with ulcerative colitis who were admitted to the Gatrointestinal Department. RESULTS: Two of every 100,000 children are affected, and 23% of all cases of ulcerative colitis occur in children aged 19 years or younger in Bosnia and Herzegovina. It affects boys and girls equally and appears to run in some families. CONCLUSIONS: Ulcerative colitis is an intermittent disease, with periods of exacerbated symptoms, and periods that are relatively symptom-free. Most children with ulcerative colitis have the same symptoms adults do, and the disease is diagnosed in the same way. Currently, no medical cure exists for ulcerative colitis, but effective medical treatment can suppress the inflammatory process, permit healing of the colon and relieve the symptoms.
    Evidence-Based Child Health A Cochrane Review Journal 07/2011; 6(4-Supplement July 2011):PP097.
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    ABSTRACT: INTRODUCTION: Children involved in sports should be encouraged to participate in a variety of different activities and develop a wide range of skills. The growing sports participation rate of children and the large number of pediatric primary , secondary and tertiary care visits for sport-related injuries become every day practice. PURPOSE: This study demonstrates the usefulness of injury surveillance in identifying potential prevention strategies METHODS: The eight sports with more then ten injuries in the three years of our surveillance were analyzed ( basketball, handball, voleyball, biking, football, skating, skying and atheltics) in children of age seven to fourteen years. A longitudinal cohort study was performed to determine the effect of risk factors for children in sports during last three years 2007 to 2010 of Canton Sarajevo. RESULTS: Sports are the leading injury-related cause for pediatric primary care visits. Participation of greater numbers of urban youth in organized sports may explain in part the larger proportion of urban hospitalizations. No significant differences in head, knee, or shoulder trauma were observed between playing surfaces. Numerous injuries have been attributed to playing on artificial turf. CONCLUSIONS: Parental or adult supervision of children's activity is usually considered to be desirable. Regular physical activity can help reduce the risk of many adult health problems, including diabetes, obesity, and heart disease. Sport is related a common injury in children and other illnesses.
    Evidence-Based Child Health A Cochrane Review Journal 06/2011; 6(4-Supplement July 2011):FC01.
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    ABSTRACT: BACKGROUND: Inflammation is recognized as an important component in the pathogenesis of asthma. Fluticasone propionate is a synthetic, trifluorinated glucocorticoid with potent anti-inflammatory activity. This medication must be used regularly to prevent the wheezing and shortness of breath caused by asthma or obstructive bronchitis, or some rare types of emphysema in children. AIM: To determine if the early use of inhaled fluticasone propionate in wheezy preschooler children older helps to prevent loss of lung function and progression of asthma later in school-childhood. METHODS: This study was a randomized, double-blind, placebo-controlled prospective trial using other therapy from golden rules and guidelines GINA modificied for children . Spirometry and induced sputum for differential cell counts and albumin, 2-macroglobulin and blood eosinophil and, interleukins factor levels were obtained before treatment and two, six and twenty four hours after treatment in children with asthma in age between 2 to 7 years of ages during first decade of new millenium. RESULTS:When glucocorticoids are discontinued, asthma stability may persist for several days or longer. The total clearance of fluticasone propionate is high , with renal clearance accounting for less than 0.02% of the total. This medication does not work immediately,becouse it is preventive and prolonged action The most children (99.5%) older than two years in Bosnia and Herzegovina using this medication do not have serious side effects. Preschoolers with recurrent wheezing or asthma had less wheezing or asthma exacerbations and improve their symptoms and lung function during treatment with inhaled corticosteroids in thme most cases (98%) in our ten years study. DISCUSSION: The precise mechanisms of glucocorticoid action in asthma are unknown. The safety and effectiveness of Fluticasone propionate inhalation aerosol in children below two years of age have not been established. It is a better avoid exposure to chickenpox or measles infection while taking this medication. CONCLUSION: Fluticasone propionate inhalation aerosol is contraindicated in the primary treatment of status asthmaticus or other acute episodes of asthma where intensive measures are required. The authors concluded that inhaled fluticasone given twice daily over a 6-month period improved asthmatic symptoms and had no significant adverse effects on growth.
    Allergy 06/2011; 66(94s-66):199. · 5.88 Impact Factor
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    ABSTRACT: • INTRODUCTION: Children of preschool age are subject to frequent infections and high fevers. Simple seizures are characterized by being less than 15 minutes duration and generalized. Simple febrile seizures in children with an unremarkable history and physical examination generally do not require further work-up or treatment. • AIMS: Family history of febrile seizures is a risk. Few children have more than three febrile seizures in their lifetime. • METHODS: The diagnosis of a seizure is made with a physical examination and diagnostic tests. Lumbar puncture is not needed for young children with first simple febrile seizure. Medical records of children between 6 months and 5 years of age admitted for simple febrile seizures in period from 1999 to 2009 were reviewed. • RESULTS: They most commonly occur in children between the ages of 6 months and 6 years and are twice as common in boys as in girls. Children with simple febrile seizures do not have increased mortality risk. Between 2.8% and 3.6 % of children had febrile seizures by their fifth birthday in Bosnia and Herzegovina during period of ten years. • DISCUSSION: Febrile seizures are to be distinguished from epilepsy which is characterized by recurrent nonfebrile seizures. All seizures with fever are not febrile seizures. • CONCLUSIONS: Febrile seizures are the most frequent neurologic disorder in children. Acute treatment such as rectal diazepam or oral are effective and can be given at home for a seizure lasting longer than 5 minutes. The seizure normally lasts for less than five minutes. Simple febrile seizures don't cause brain damage, mental retardation or learning disabilities.
    European journal of paediatric neurology: EJPN: official journal of the European Paediatric Neurology Society 05/2011; 15(1-15):s34. · 2.01 Impact Factor
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    ABSTRACT: BACKGROUND: Nonallergic rhinitis involves chronic sneezing or having a congested, drippy nose with no apparent cause. Rhinitis is defined as inflammation of the membranes lining the nose, characterized by nasal symptoms, including itching, rhinorrhea, and nasal congestion. AIMS: Alternative hypothesis work is the fact that there were significant, are evident difference between allergic rhinitis and nonallergic rhinitis in children. METHODS: A blood test made measures of children immune system's response to common allergens by measuring the amount of certain antibodies in bloodstream, known as immunoglobulin E (IgE) antibodies for establishing right diagnosis and cause of rhinitis. RESULTS: Authors reported a 19% frequency of nonallergic rhinitis among 1019 children selected for having a history that suggested allergic rhinitis. We determined that nonallergic rhinitis with eosinophilia syndrome (NARES) was found in 13%, blood eosinophilia nonallergic rhinitis syndrome (BENARS) in 3%, and elevated IgE in 11% children. DISCUSSION: . First-line treatment should include the safest therapies such as steam inhalation, nasal saline sprays, and an avoidance of irritants. Topical medical therapy is preferred to systemic. CONCLUSIONS: Nasal symptoms characteristic of nonallergic rhinitis are often indistinguishable from those that occur in allergic rhinitis, and, therefore, negative testing for IgE-mediated sensitivity to relevant aeroallergens is necessary to confirm this diagnosis. No specific test is available to diagnose vaso-motor rhinitis.
    European Rhinitis and Asthma Meeting Symposium on Experimental Rhinology and Immunology of the Nose; 11/2010
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    ABSTRACT: BACKGROUND: Successful early management of extremely preterm infants with surfactant treatment followed by continuous positive airway pressure treatment at delivery, lowered oxygen saturation goals, and early amino acid supplementation is possible and is associated with reductions in the incidence and severity of bronchopulmonary dysplasia. Infections can inflame the underdeveloped lungs of premature infants. BPD is characterized by inflammation and scarring in the lungs. AIMS: The overarching goal for infants with BPD is to promote growth and development. The outlook for growth and development of babies with BPD varies. METHODS: Important factors in diagnosing BPD are prematurity, infection, mechanical ventilator dependence, and oxygen exposure. One center consisted of 3 separate hospitals that collaborated as a single center. Statistical significance was attributed to p <0,05. RESULTS: Mean birth weight (range: 1000–1999 g), postmenstrual age (29 weeks), and gender (54% male) were similar between three hospitals.The infants over 1,500 grams birth weight who develop BPD have severe respiratory failure in the first week of life which may continue for several weeks. Extremely premature infants weighing less than 1,500 grams at birth symptoms of BPD begin in the second week of life. DISCUSSION: Chronic aspiration of gastric contents may contribute in the pathogenesis of bronchopulmonary dysplasia. Our results indicated that preterm infants, who developed BPD or died with respiratory insufficiency had elevated concentrations of pepsin in their tracheal aspirate samples. CONCLUSIONS: Bronchopulmonary dysplasia is a chronic lung disease associated with premature birth and characterized by early lung injury. Despite the use of prenatal steroids and surfactant replacement therapy, the incidence of BPD has not changed significantly in the past decade in Bosnia and Herzegovina. Ours practices included a respiratory strategy of prophylactic surfactant administration followed by immediate extubation to nasal CPAP treatment in the delivery room, instead of placement on a mechanical ventilator.
    Early Human Development 11/2010; 86(1suppl-86):s59. · 2.02 Impact Factor
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    ABSTRACT: BACKGROUND: Oxygen is a highly reactive molecule that damages living organisms by producing reactive oxygen species. Cigarette smoke is a complex mixture of less then five thousand chemical compounds of which free radicals and other oxidants are present in high concentrations. The inflammatory response is triggered by proinflammatory cytokines, lipid mediators, and complement activation. METHODS: Oxidation of proteins caused introduction of carbonyl groups into the side chains of the protein, providing a convenient and relatively specific marker of oxidative damage. Authors studied the effects of two volatile components of cigarette smoke, acetaldehyde and acrolein, which are present at high concentrations in cigarette smoke on lungs of children. Vitamins A, C, and E as antioxidants led to the realization of the importance of antioxidants in the biochemistry of living organisms. RESULTS: These antioxidant defense elements offer promising chemoprevention targets that have the potential to reduce the burden of asthma. We have endeavored to diminish the generation of oxygen free radicals by decreasing the oxygen concentration in the resuscitating gas. The fall in antioxidant capacity also correlates with the increased release of oxygen radicals from circulating neutrophils in patients with exacerbations of asthma bronchale in children. Our study showed that some tocotrienol, retinol and ascorbic acid have significant anti-oxidant properties. CONCLUSIONS: The use of antioxidants with good bioavailability or molecules that have antioxidant enzyme activity may be treatments that not only protect against the direct injurious effects of oxidants. Vitamins antioxidants as therapeutic targets have important role in obstructive pulmonary disease in children. Direct oxidative damage to components of the lung matrix such as elastin and collagen can results from oxidants in cigarette smoke
    Basic & Clinical Pharmacology & Toxicology 07/2010; 1(P930-107):26-27. · 2.18 Impact Factor
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    ABSTRACT: INTRODUCTION: Tuberculous meningitis is the most common form of CNS tuberculosis. Tuberculosis of the central nervous system is a serious, often fatal disease that disproportionately affects young children. TB meningitis usually responds well to treatment, but TB cerebritis may require prolonged treatment up to two years. AIMS: Adequate and prompt antituberculosis, antimicrobial and supporative therapy, the chances for survival today are excellent, especially in children. METHODS:Diagnosis of TB meningitis is made by analysing cerebrospinal fluid collected by lumbar puncture in younger children. Clinical manifestations in younger children should be ruled out. RESULTS: Diagnosis of TB meningitis is even more difficult than with other forms of bacterial meningitis. In Bosnia and Herzegovina where TB prevalence is high, TB meningitis is most common in children aged 0 - 4 years. Mortality, even with rigorous treatment, has been shown to be more then 19%. DISCUSSION: The emergence of multidrug-resistant tuberculosis highlights the urgent need to understand the mechanisms of resistance to the drugs used to treat this disease. CONCLUSIONS: It is possible that shorter durations of therapy about six months may be sufficient to treat TB meningitis, but no clinical trial has addressed this issue. The different drugs in the regimen have different modes of action. Tuberculous meningitis is the most devastating form of tuberculosis in children.
    International journal of infectious diseases: IJID: official publication of the International Society for Infectious Diseases 07/2010; 14(2 suppl-14):S92. · 2.17 Impact Factor
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    ABSTRACT: Background: Obesity in childhood bodes ill for future cardiovascular risk. HMG-CoA reductase is an enzyme in the cholesterol biosynthetic pathway that catalyses the conversion of HMG-CoA to mevalonic acid. Statins are a class of drugs that lower the level of cholesterol in the blood by reducing the production of cholesterol by the liver. Aims: The most controversial change appears to have been the inclusion of statins as potential firstline pharmacologic agents in older children. Methods: High-risk children, include those who are obese or overweight and who also have high blood pressure, or diabetes, or a positive family history of either high cholesterol or early heart disease. The safety of statins in children and adolescents is based on trials that have ranged in duration from six months to one year. Results: Inhibition of this enzyme in the liver results in decreased cholesterol synthesis as well as increased synthesis of LDL receptors, resulting in an increased clearance of low-density lipoprotein (LDL) from the bloodstream. The first results can be seen after one week of use and the effect is maximal after four to six weeks. No serious laboratory adverse events were reported during follow-up, and statin treatment had no untoward effects on sexual maturation. Conclusion: The recommendation to use statins in childhood seems to have hit a collective nerve, perhaps awakening us to the fuller implications of the obesity epidemic. Statins exhibit action beyond lipid-lowering activity in the prevention of atherosclerosis.
    Pediatric Research 06/2010; 68(supplement-68):277. · 2.67 Impact Factor
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    ABSTRACT: INTRODUCTION: The use of tobacco products by adults has an enormous adverse impact on the health of children. Asthma is the most common chronic childhood illness. Some analysis of Roma minority group in Bosnia and Herzegovina indicate that this group, when compared to other minority ethnic groups in Bosnia and Herzegovina, is the biggest one, but Gypsies kids live in bad conditions with high number of asthma surrounding with tobacco smoke. METHODS AND MATERIALS: Authors compared the NHLBI and HEDIS measures of asthma severity in Gypsies preeschool kids as passive smokers by calculating the sensitivity and specificity of the HEDIS criteria in measuring persistent asthma. We used the NHLBI measure, a clinical assessment, as our gold standard. RESULTS: Exposure of children to ETS in the home increases the incidence of asthma, wheeze, cough, , bronchitis, bronchiolitis, pneumonia, impaired pulmonary function, middle ear disease and phlegm production and it has also been associated with snoring, adenoid hypertrophy, tonsillitis, and sore throats.. Asthma affects four hundred and fifty Bosnian preeschool kids in munipalicity Center of Sarajevo(11,63%), including nearly 89 Gypsies children, almost a fifteenth of the population (14, 85%) and one fifth of asthma kids patient ( 19.77%). DISCUSSION: Cotinine measurements provide a practical objective assessment of exposure to tobacco smoke. Spirometry is recommended for the screening, diagnosis, and monitoring of respiratory disease and is increasingly advocated in primary pediatrics care practice as a useful tool for the diagnosis and monitoring of kids with lung disease. CONCLUSIONS: Long term lung damage could occur due to passive exposure from tobacco products reaching the fetus via the placental circulation in utero, and through the air in infants and children . ETS increases both the prevalence and the severity of asthma. The study in Gypsies children show that reduced lung function continues into childhood in those with smoking parents or household (more than 80% smokers).
    II WORLD ASTHMA & COPD FORUM; 04/2009