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Health-related quality of life (HRQOL) assesses how disease and therapeutic management affect health, psychological status, social interaction and coping with symptoms in respect to the patient's own perceptions and expectations. The significant increase in the prevalence of inflammatory bowel disease (IBD), relapse-remitting course, debilitating symptoms, and frequent complications make this group of inflammatory diseases very important in respect of the patient's quality of life, particularly in children. The only IBD-specific HRQOL instrument, developed for paediatric patients, IMPACT III, has already been validated in different countries worldwide. However, in Croatia there are no clinical studies on the quality of life in children with IBD. Moreover, specific HRQOF instruments have not been validated. In order to address this problem, cross-cultural adaptation of IMPACT-III is necessary in order to use it in children suffering from IBD in Croatia.


Vitamins and minerals play an important role in the growth and development of children. World Health Organization (WHO) estimates that about 2 billion people worldwide are nutrient deficient, mostly in developing countries. Groups that are particularly prone to the deficiency are pregnant women, nursing mothers and children. There are several strategies which aim to supplement vitamins and minerals including education, changes in eating habits, supplementation and enrichment of foods and drinks. The aim of this review article is to present the latest scientific evidence on vitamins (vitamins A and D) and minerals (iron and zinc) substitution and to point to the European Society for Pediatric Gastroenterology, Hepatology and Nutrition (ESPGHAN) Committee on Nutrition position papers regarding iron and vitamin D in the European children.


Niseteo T.,Referentni Centar za Djecju Gastroenterologiju i Prehranu | Vukadin M.,Centar za Zastitu Mentalnog Zdravlja Djece I Adolescenata
Paediatria Croatica, Supplement | Year: 2014

Feeding is a natural and biologically conditioned process which is regulated by the psychophysiological changes of hunger and satiety state, nevertheless, the prevalence of some form of feeding problems in children without developmental difficulties is 25-45% and 80% in children with developmental disabilities. Although diagnostic systems are still not standardized, six different types of feeding disorders are defined: (1) Feeding Disorder of State Regulation, (2) Feeding Disorder of Reciprocity, (3) Infantile Anorexia, (4) Sensory Food Aversions, (5) Post-traumatic Feeding Disorder and (6) Feeding Disorder Associated with Concurrent Medical Condition. Though there is still no standard method for assessment and diagnosis of this complex and extremely important area of child and family issues, assessment, diagnosis and treatment of the child's condition requires a multidisciplinary approach with team that includes a pediatrician, psychologist, dietitian, speech and language therapist and occupational therapist, as well as other specialists if needed.


Vulin K.,Klinika Za Pedijatriju | Hojsak I.,Referentni Centar za Djecju Gastroenterologiju i Prehranu
Lijecnicki Vjesnik | Year: 2015

Infantile colic have been known for the long time and are one of the most common reasons for pediatrician's appointment in early infancy. However, their etiology and pathogenesis are yet to be determined. Diagnosis is based on thorough medical history and physical examination. Special attention should be given to red flags or warning signs which could indicate a presence of serious illness. If no other abnormality is present, except inconsolable crying, there is no need for further diagnostic procedures. There is an extensive range of proposed therapeutic measures; however scientific evidence for all of them is scarce. Therefore, the aim of this review article is to present currently available evidence for the management of infantile colic and to provide a possible therapeutic algorithm.


Kolacek S.,Referentni Centar za Djecju Gastroenterologiju i Prehranu
Acta Medica Croatica | Year: 2011

Food hypersensitivity affects children and adults with an increasing prevalence, and is therefore an important public health problem in the majority of developed countries. Moreover, self-reported reactions to food are of several times higher prevalence, compared to hypersensitivity diagnosed following well established evidence-based diagnostic guidelines. In children, allergic food reactions are more common compared to non-allergic food hypersensitivity reactions, and 90% of them are caused with only 8 food allergens: cow's milk, soya, egg, fish, shellfish, peanut, tree-nuts and gluten. Diagnosis should be based on challenge tests with the potentially offending food allergens. Concerning other, more conservative diagnostic procedures, negative serology and negative skin-prick tests can exclude IgE-mediated food allergy, but positive tests, due to high rate of false positive reactions are not sufficient for diagnosis. Strict dietary avoidance of incriminated allergens is the only well established management strategy. However, this should be applied only if food allergy is well documented - following the exposition tests. Introducing elimination diet in a paediatric population, particularly with the elimination of multiple foods, could cause inappropriate growth and disturb organ maturation. Concerning allergy prevention, avoidance of allergens is not efficacious either during pregnancy and lactation or weaning period, and is therefore, not recommended neither as a population preventive measure, nor in children at risk.

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