Childrens Hospital Srebrnjak

Zagreb, Croatia

Childrens Hospital Srebrnjak

Zagreb, Croatia

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Brcic Karaconji I.,Institute for Medical Research and Occupational Health | Zimic L.,Childrens Hospital Srebrnjak | Brajenovic N.,Institute for Medical Research and Occupational Health | Skender L.,Institute for Medical Research and Occupational Health
Journal of Separation Science | Year: 2011

A headspace solid-phase microextraction method (HS-SPME) followed by gas chromatography with mass spectrometric detection (GC/MS) has been developed for the determination of low concentrations of nicotine in hair. Parameters affecting the SPME procedure including type of fiber coating, extraction mode, extraction temperature and time, desorption time, stirring, and salt addition have been evaluated and optimised. The method provided good linearity (r 2≥0.9980) over the concentration range tested (0.2-20ng/mg) and low detection limit (0.02ng/mg). Precision expressed as relative standard deviation was <10%. The average accuracy was 95%. The proposed method was used to determine hair nicotine levels in 100 children in order to assess exposure to environmental tobacco smoke (ETS). The described HS-SPME procedure is fast, simple, sensitive, and solvent-free and is therefore suitable for studies involving ETS exposure assessment. Copyright © 2011 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.


Fucic A.,Institute for Medical Research and Occupational Health | Gamulin M.,University of Zagreb | Ferencic Z.,Childrens Hospital Srebrnjak | Katic J.,Institute for Medical Research and Occupational Health | And 3 more authors.
Environmental Health: A Global Access Science Source | Year: 2012

The role of steroids in carcinogenesis has become a major concern in environmental protection, biomonitoring, and clinical research. Although historically oestrogen has been related to development of reproductive system, research over the last decade has confirmed its crucial role in the development and homeostasis of other organ systems. As a number of anthropogenic agents are xenoestrogens, environmental health research has focused on oestrogen receptor level disturbances and of aromatase polymorphisms. Oestrogen and xenoestrogens mediate critical points in carcinogenesis by binding to oestrogen receptors, whose distribution is age-, gender-, and tissue-specific. This review brings data about cancer types whose eatiology may be found in environmental exposure to xenoestrogens. Cancer types that have been well documented in literature to be related with environmental exposure include the reproductive system, breast, lung, kidney, pancreas, and brain. The results of our data mining show (a) a significant correlation between exposure to xenoestrogens and increased, gender-related, cancer risk and (b) a need to re-evaluate agents so far defined as endocrine disruptors, as they are also key molecules in carcinogenesis. This revision may be used to further research of cancer aetiology and to improvement of related legislation. Investigation of cancers caused by xenoestrogens may elucidate yet unknown mechanisms also valuable for oncology and the development of new therapies. © 2012 Fucic et al; licensee BioMed Central Ltd.


Vukovic V.,University of Zagreb | Plavec D.,Childrens Hospital Srebrnjak | Pavelin S.,University of Split | Janculjak D.,University Hospital Osijek | And 2 more authors.
Neuroepidemiology | Year: 2010

Background/Aim: Population-based epidemiological studies about headaches, especially migraine, have been carried out in many countries. The aim of this study was to assess the 1-year prevalence of migraine, probable migraine and tension-type headache (TTH) in the Croatian population. Methods: The design of the study was a cross-sectional survey of an adult population sample using a self-completed questionnaire. Results: The 1-year crude prevalence of migraine without and with aura in this study was 7.5%, of probable migraine 11.3%, and of TTH 21.2%. The 1-year age- and sex-adjusted prevalence of migraine was 6.2%, of probable migraine 8.8%, and of TTH 20.7%; the prevalence of migraine combined with probable migraine was 15.0%. Total crude prevalence of headache (combination of migraine, probable migraine and TTH) was 39.9%. Prevalence of migraine was higher in continental than in Mediterranean areas of Croatia. Multivariate regression analysis showed that the highest risk of suffering from any kind of headache is observed for the following people: living in Dubrovnik, being female, having elementary or high school education, being married, employed and living in an urban or suburban area. Conclusion: The prevalence of migraine and probable migraine is similar as in other Western countries. Certain demographic characteristics differ among patients with and without headache. © 2010 S. Karger AG, Basel.


Cvetkovic V.V.,University of Zagreb | Plavec D.,Childrens Hospital Srebrnjak | Lovrencic-Huzjan A.,University of Zagreb | Strineka M.,University of Zagreb | And 2 more authors.
Cephalalgia | Year: 2014

Background: Headaches are often under-diagnosed in adolescents. The aim of this study was to examine the one-year prevalence of primary headaches among high school students in the city of Zagreb, the capital of Croatia. Methods: This was a population-based, cross-sectional study. A total of 2350 questionnaires consisting of questions on demographic data, the presence and clinical characteristics of headaches were distributed among students in eight high schools; 2057 (87.5%) questionnaires were eligible for analysis. Results: The mean age of the students was 17.2-1.2 years; 50.2% were female. The prevalence of recurrent headache was 30.1% (620/2057), girls 35.1%, boys 25.2%. Among students with headache, 291 (46.9%) had migraine, and 329 (53.1%) had tension-type headaches (TTHs). The mean frequency of headaches was 5.66 per month in girls and 4.42 in boys; mean duration of a headache attack was 8.94 hours in girls and 8.37 hours in boys (NS). Unilateral headache was present in 31.6%, throbbing quality in 22.6%, dull in 34.4% of students; 22.4% had severe intensity and 70.3% moderate. Nausea was present in 4.0% always and in 14.7% frequently (girls 18.8%), photophobia in 41.3%, phonophobia in 63.2%, osmophobia in 23.9% (NS among genders). Almost 30% of students were disabled and stayed at home, more frequently boys. Girls (33.4%) were more likely to take drugs for every attack; number per month was 3.7. The results of this study showed that the prevalence of migraine among adolescents in Croatia was 16.5% for girls and 11.8% for boys; the prevalence of TTH was 18.4% for girls and 13.4% for boys. Conclusions: The prevalence of self-reported headache among high school students in Zagreb is relatively high. Significant gender differences in frequency and clinical characteristics were observed. Primary headaches among adolescents are an important public health problem and should receive more attention from school and health authorities. © International Headache Society 2013.


Matkovic Z.,Clinical Hospital Dubrava | Zivkovic V.,Clinical Hospital Dubrava | Korica M.,Clinical Hospital Dubrava | Plavec D.,Childrens Hospital Srebrnjak | And 2 more authors.
Phytotherapy Research | Year: 2010

The study was designed to investigate efficacy and safety of Astragalus membranaceus (AM) in the treatment of patients with seasonal allergic rhinitis (SAR). AM is an active component in the herbal and mineral complex (HMC) registered in Croatia as a food supplement Lectranal®. The study was designed as a 6-weeks, doubleblind, placebo-controlled clinical trial and conducted in 48 adult patients with a moderate to severe SAR. The treatment efficacy was evaluated by the mean change in the symptom score (TSS), quality of life (QoL), specific serum IgE and IgG, nasal eosinophils, and physicians' and patients' global evaluation. Compared to placebo, HMC significantly decreased the intensity of rhinorrhea while for other primary efficacy variables the treatment groups did not differ. In contrast, investigators and patients equally judged the treatment with HMC as more efficacious. In addition, the analysis of changes from baseline inside the groups for TSS, QoL, and 4 main symptoms of SAR were strikingly in favor of the active treatment. In patients with SAR due to weed pollen allergy HMC significantly improved primary variables, reflective TSS and QoL. The study revealed a significant number of positive signals indicating the therapeutic effectiveness of the HMC in patients with SAR which should be further tested in larger, multicentre trials with more patients. Copyright © 2009 John Wiley & Sons, Ltd.


Lamot L.,University of Zagreb | Lamot L.,Childrens Hospital Srebrnjak | Bukovac L.T.,Childrens Hospital Srebrnjak | Vidovic M.,University of Zagreb | And 2 more authors.
Clinical and Experimental Rheumatology | Year: 2011

Introduction: Our aim was to assess long-term efficacy and tolerability of etanercept and infliximab in patients with JIA. Materials and methods: This was an observational, retrospective study of 41 patients treated with anti-TNF therapy. We assessed clinical remission, flare, ACR improvement, improvement of DAS-28, and JADAS. Some patients with polyarticular JIA were scored according to the modified SHARP criteria. Results: Twenty-four weeks after beginning of therapy 35 patients (92.1%) achieved ACR 20, 33 patients (86.8%) ACR 30, 31 patients (81.6%) ACR 50, 28 patients (73.7%) ACR 70 and 20 patients (52.6%) ACR 90. In the same period 19 patients (50%) had good DAS-28 response, 12 patients (31.6%) had moderate response, and 5 patients (13.2%) did not respond to therapy. Statistically significant difference was shown in the average value of JADAS-71 before the beginning and 24 weeks after introduction of anti-TNF therapy. Eleven patients had a flare in the study period (28.9%); five on etanercept (13.1%), three on infliximab (7.9%), and three flared on both of the medications (7.9%). After 12 months, fifteen patients fulfilled criteria for clinical remission on medications. Seven of them were on infliximab and eight on etanercept. Eleven patients have fulfilled criteria for clinical remission off of medications: three were taking etanercept, seven infliximab, and one was switched from etanercept to infliximab. Conclusion: In our patient cohort, both etanercept and infliximab performed well, since we found no significant difference in the duration, response, flare, resistance or adverse effects between both drugs, however long term remissions are rare. © Clinical and Experimental Rheumatology 2011.


Soric M.,University of Zagreb | Turkalj M.,Childrens Hospital Srebrnjak | Kucic D.,Childrens Hospital Srebrnjak | Marusic I.,Childrens Hospital Srebrnjak | And 2 more authors.
Sleep Medicine | Year: 2013

Objective: To assess the validity of a multi-sensor activity monitor in estimating sleep and wake compared to polysomnography in children and adolescents. Methods: A total of 43 children and adolescents (29 boys, 14 girls), aged 7-17years (mean age [SD] = 11.0 [2.4] years) participated in the study. Participants wore the SenseWear Pro3 Armband™ (SWA) body monitor (BodyMedia Inc) during an overnight polysomnographic assessment in a paediatric sleep laboratory. Sleep measures included sleep onset latency (SOL), wake after sleep onset (WASO), total sleep time (TST) and sleep efficiency (SE). Results: No systematic bias of the SWA was noted for any of the sleep measures assessed, but limits of agreement were wide and amounted to -76 to +58. min for SOL, -75 to 102. min for WASO, -109 to +99. min for TST and -22 to +20% for SE. In addition, no effect of gender, age group (children versus adolescents) or overweight on the accuracy of the SWA was found. Conclusions: The SenseWear Armband™ showed good agreement with polysomnography at the group level, while at the individual level rather, poor agreement between the two methods was observed. Consequently, at this point the use of the SWA in the clinical evaluation of sleep cannot be advocated. © 2012 Elsevier B.V.


Petkovic G.,Childrens Hospital Srebrnjak | Barisic I.,University of Zagreb
International Journal of Environmental Research and Public Health | Year: 2013

Fetal alcohol syndrome (FAS) is a congenital syndrome caused by maternal alcohol consumption during pregnancy and is entirely preventable by abstinence from alcohol drinking during this time. Little is known about the prevalence of FAS and maternal alcohol consumption during pregnancy in Western countries. We present the results of FAS/partial fetal alcohol syndrome (PFAS) prevalence study and maternal characteristics in a sample of schoolchildren from a rural province of Croatia. This study involved seven elementary schools with 1,110 enrolled children attending 1st to 4th grade and their mothers. We used an active case ascertainment method with passive parental consent and Clarified IOM criteria. The investigation protocol involved maternal data collection and clinical examination of children. Out of 1,110 mothers, 917 (82.6%) answered the questionnaire. Alcohol exposure during pregnancy was admitted by 11.5%, regular drinking by 4.0% and binge drinking by 1.4% of questioned mothers. Clinical examination involved 824 (74.2%) schoolchildren and disclosed 14 (1.7%) with clinical signs of FAS and 41 (5.0%) of PFAS. The observed FAS prevalence, based on 74.2% participation rate, was 16.9, PFAS 49.7 and combined prevalence was 66.7/1,000 examined schoolchildren. This is the first FAS prevalence study based on active ascertainment among schoolchildren and pregnancy alcohol drinking analysis performed in a rural community of Croatia and Europe. High prevalence of FAS/PFAS and pregnancy alcohol consumption observed in this study revealed that FAS is serious health problem in rural regions as well as a need to develop future studies and preventive measures for pregnancy alcohol drinking and FASD.


Erceg D.,Childrens Hospital Srebrnjak | Nenadic N.,Childrens Hospital Srebrnjak | Plavec D.,Childrens Hospital Srebrnjak | Nogalo B.,Childrens Hospital Srebrnjak | Turkalj M.,Childrens Hospital Srebrnjak
Medical Science Monitor | Year: 2012

Background: Recent guidelines recommend inhaled corticosteroids as the first-line treatment for persistent asthma. However, long-term corticosteroid treatment in children has raised concerns about potential growth rate deceleration. We aimed to assess the association of growth velocity with the use of inhaled corticosteroids in prepubertal children with asthma in a "real-life" setting. Material/Methods: This study included 844 children aged 4-9.5 years coming to the hospital for regular check-ups between October 2006 and February 2009 for asthma with/without allergic rhinitis and no other known constraints of growth. Out of the 844 children, 790 had all data needed for analysis - 245 children were not treated with ICS, 545 children received ICS (fluticasone, budesonide) with/without INCS (fluticasone, mometasone or budesonide). During the study period, 48 children with/without ICS received short SCS courses. Results: Mean (SE) height at the first check-up was 123.1 (0.31) cm; range (100.0-147.8 cm). Mean (SE) linear growth velocity (LGV) of the included children was 0.185 (0.0035) mm/day between 2 checkups. No significant difference was found in LGV between the group not treated with ICS (0.180 mm/day±0.0055) and the group treated with ICS (0.187±0.0044 mm/day). Also, there was no statistical difference between subgroups according to additional therapy with INCS and SCS. No significant correlation was found for LGV and daily dose of ICS (r=0.086, p>0.05). Conclusions: In our retrospective study using electronic hospital database, ICS and combined use of corticosteroids did not show any association with LGV in prepubertal asthmatic children in a "real-life" setting.


Knezevic Z.,Ruder Boskovic Institute | Beck N.,Clinical Hospital sveti Duh | Milkovic D.,Childrens Hospital Srebrnjak | Miljanic S.,Ruder Boskovic Institute | Ranogajec-Komor M.,Ruder Boskovic Institute
Radiation Measurements | Year: 2011

Radiophotoluminescence (RPL) dosimetry systems are under permanent development. The following dosimetric characteristics of the GD-352M RPL glass dosimeter with FGD-1000 reader (Dose Ace system) developed for medical applications were investigated: uniformity/batch homogeneity, reproducibility, linearity, detection threshold, energy dependence in air and on phantom. Some characteristics were compared to two kinds of LiF; Cu,Mg,P TLDs: GR-200A (China) and TLD-100H (Harshaw). The characteristics investigated fulfil the requirements of the IEC 62387-1:2007 Standard for personal and environmental dosimetry (IEC, 2007). These dosimetry systems were applied in paediatric chest X-ray diagnostics on 60 patients. The dosimetry results with both dosimetry systems showed a good correlation of dose measured on the back of the patient with the body mass index (BMI) on examination by two technicians (average dose 0.12-0.19 mSv). Higher doses (0.33-0.39 mSv) were found on the patients examined by the third technician. Measurements on further 40 patients following additional consulting and education of the techniciams showed dose reduction (0.13-0.18 mSv for all 3 technicians). © 2011 Elsevier Ltd. All rights reserved.

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