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Pavic I.,University of Zagreb | Raos M.,Srebrnjak Childrens Hospital | Aberle N.,General Hospital dr. Josip Bencevic
Pediatric Infectious Disease Journal | Year: 2011

BACKGROUND: There are limited data available on interferon-γ release assay (IGRA) performance in children up to 5 years of age, with documented exposure to active tuberculosis (TB). The aim of this study was to evaluate (1) the influence of infectivity of adult source cases on test results, (2) the impact of age, and (3) the level of agreement, between IGRA and tuberculin skin test (TST) results. METHODS: A total of 142 Bacille Calmette-Guerin-vaccinated children up to 5 years of age were investigated because of a history of exposure to active TB. QuantiFERON-TB Gold In-Tube IGRA (QFT) and TST assays were performed. RESULTS: Test results were significantly influenced by positive finding of cavitary lesions (QFT, odds ratio [OR] = 6.15; TST, OR = 7.48) and positive acid-fast bacilli (QFT, OR = 4.01; TST, OR = 4.47) in active TB contacts. QFT resulted in 1 indeterminate response (0.7%), attributable to low mitogen. There was no evidence for age having any effect on QFT performance. The 2 tests showed a moderate overall concordance (89%; κ = 0.591) at a TST cutoff value of ≥10 mm. CONCLUSIONS: Association of positive QFT and TST results with risk factors for infection in child contacts (presence of cavitary lesions and acid-fast bacilli smear positivity in index cases) suggests that both the tests have good diagnostic accuracy. However, there was significant discord between results of the 2 tests that could not be definitively resolved. Thus, in a high-risk population of children up to 5 years of age, both tests (QFT and TST) should be performed and the child should be considered infected if either or both tests are positive. Copyright © 2011 by Lippincott Williams & Wilkins.

Vlasic V.,Womens and Childrens Hospital | Trifunovic J.,Clinical Hospital Center Osijek | Cepelak I.,University of Zagreb | Nimac P.,Srebrnjak Childrens Hospital
Biochemia Medica | Year: 2011

Background: Urate levels may be a marker of oxidative stress. The aim ofthe present study was to find out are there any differences in urate concentrations in exhaled breath condensate (EBC) between children with obstructive sleep apnea (OSA) and healthy children. Materials and methods: EBC was collected in children with obstructive sleep apnea (OSA) and clinically healthy children. Urate measurements in EBC and serum were performed by enzymatic color test. Results: The higher concentration ofurates in EBC ofchildren with OSA than clinically healthy children indicatethe oxidative stress in their airways. Since there was no significant difference in serum concentration of urates between children with OSA and healthy children, it could be considered that urates are sintetized in the airways of children with OSA. Conclusions: The present study indicated that urates in EBC (but not in serum) may be used as a marker of local synthesis ofantioxidant compounds, but definitive conclusion must be supported by investigations involving larger number of participants.

Pavic I.,Clinical Hospital Sestre Milosrdnice | Pavic P.,Elementary School Trilj | Palcic I.,Clinical Hospital Sestre Milosrdnice | Nenadic N.,Srebrnjak Childrens Hospital
International Journal of Environmental Health Research | Year: 2012

Passive smoking has been found to be associated with a large number of disorders of passive smokers. It seems that the children are the most susceptible population for harmful effects of passive smoke exposure. The aim of this study was to evaluate the effect of passive smoking on children's functional abilities. The target population was 199 children who were 13-15 years old at the time of the study. For the assessment of motor skills 6-min run test was used. Children exposed to passive smoking by their mothers had statistically significant lower functional abilities (r =0.7029; 95% CI 0.7707 to 0.6194; p < 0.0001). We also found statistically significant difference if the both parents are smokers (r =0.3343; 95% CI 0.4595 to 0.1961; p < 0.0001). The results of our study did not show statistically significant difference if the children are exposed to cigarette smoke by their fathers (r = 0.03139; 95% CI 0.1171 to 0.1785; p = 0.6792). Public health preventive actions should go toward minimizing the exposure of children to passive smoking by counseling the smoking parents that quitting smoking provides enormous health benefits not only to them but also to their children. © 2012 Copyright Taylor and Francis Group, LLC.

Cepelak I.,University of Zagreb | Vlasic Z.,Srebrnjak Childrens Hospital
Laboratory Medicine | Year: 2010

Background: To determine whether urates as a marker of oxidative stress could be determined in exhaled breath condensate (EBC), and if there are any differences in urate concentrations between asthmatic and healthy children. Methods: Exhaled breath condensate was collected using an EcoScreen condenser (Erich Jaeger GmbH, Hoechberg, Germany). Urate measurements were performed by enzymatic color test. Asthmatic children were divided into 2 groups: children with controlled asthma and children with acute exacerbation of asthma. Results: Exhaled breath condensate urate concentration was statistically significantly higher in children with controlled asthma compared with control group and acute exacerbation group. Seven children with acute exacerbation of asthma had unmeasurable urate concentrations. Conclusion: Study results showed EBC to contain a measurable urate concentration, which was significantly higher in children with controlled asthma compared with clinically healthy children and children with acute exacerbation of asthma.

Fucic A.,Institute for Medical Research and Occupational Health | Gamulin M.,University of Zagreb | Ferencic Z.,Srebrnjak Childrens Hospital | Stancic Rokotov D.,Jordanovac Clinic for Thoracic Surgery | And 4 more authors.
Toxicologic Pathology | Year: 2010

Lung cancer is a dominant cause of cancer mortality. The etiology of lung cancer is mainly related to cigarette smoking, airborne genotoxic carcinogens, and arsenic, but its sex-specific incidence suggests that other mechanisms, such as hormones, may also be involved in the process of carcinogenesis. A number of agents commonly present in the living environment can have dual biological effects: not only are they genotoxic / carcinogenic, but they are also hormonally active as xenoestrogens. This dualism may explain sex-specific differences reported in both types and incidence of lung cancer. In a novel approach to investigate the complexity of lung cancer, etiology, including systems biology, will be used as a tool for a simultaneous interpretation of measurable environmental and biological parameters. Using this approach, the etiology of human lung cancer can be more thoroughly investigated using the available data from oncology and environmental health. The information gained could be applied in the introduction of preventive measures, in personalized medicine, and in more relevant legislation, which should be adjusted to reflect the current knowledge on the complex environmental interactions underlying this life-threatening disease. © 2010 by The Author(s).

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