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Objective - The study was undertaken in order to assess on the basis of the opinions of high school teachers if the conditions exist in their schools to provide adequate assistance to pupils suffering from type 1 diabetes mellitus in a state of hypoglycaemia. Subjects and Methods - 74 teachers from 35 different schools were surveyed by means of a cross-sectional study. According to whether the school was attended by a pupil suffering from T1DM, the teachers were divided into two groups: group 1 (schools with a pupil suffering from T1DN; n=7) and group 2 (schools without any pupils suffering from T1DM; n=47). Results - Most of the teachers knew what hypoglycaemia is, and there was no statistically significant difference between the two groups in this regard (p=0.718). There were more negative answers in both groups (p=00.001 and p<0.001) to the question: "Does the school have written instructions on how to treat hypoglycaemia?" In the first group the question: "Can a pupil measure his/her blood sugar levels during lesson time?" received more positive replies (p=0.013), whilst in the second group the difference between the replies was not statistically significant (p=0.144). In response to the question "Does the school have drinks or food available to treat hypoglycaemia?" there were more negative answers in both groups (p<0.001 and p<0.001). To the question: "Can a child suffering from diabetes eat food or have a drink during lesson time?" there were more positive answers in both groups (p<0.001, and p<0.001). In response to the question: "Does the school have people who know how to give an injection of glucagon?" there were more negative answers in both groups (p=0.003, and p<0.001). There were no statistically significant differences between the groups in terms of the answers given. The main reasons for insufficient care for pupils suffering from T1DM whilst in school were seen by 40.5% of teachers as a lack of attention given to the problems of these pupils and the lack of education of teaching staff about T1DM. Conclusion - The results obtained indicate that the conditions are not met in our schools to provide appropriate assistance to children suffering from T1DM in a state of hypoglycaemia. [ABSTRACT FROM AUTHOR]

Objective The purpose of this study was to determine median age at menarche in the Federation of Bosnia and Herzegovina (FB&H) and to estimate the distribution of age at menarche for FB&H girls. Subjects and methods A cross-sectional study was conducted from September 2002 to May 2003 in all Cantons of the FB&H. The random stratified sample included 19,803 girls aged 9.0 to 17.5 years. Data were collected using the status quo method. Probit analysis was used to estimate median age at menarche and 95% confidence intervals. Results The median age at menarche for all FBiH girls is 13.02 years (12.99-13.05, 95% CI). Three percent of all girls start to menstruate before 11.04 years of age (10.98-11.09, 95% CI), and 97% of all girls are menstruating by 15.37 years of age (15.29-15.44, 95% CI). This distribution of ages indicated that ~95% of FB&H girls start to menstruate between 11.04 and 15.37 years of age. The median age at menarche throughout FB&H varied in a range of only six months, from 12.85 in Canton Sarajevo to 13.34 in Canton West Herzegovina. Girls from three Cantons -- Canton Sarajevo, Posavina and Una Sana reached menarche significantly earlier than those from other Cantons. Conclusion This study enabled the FB&H and each Canton to have standards of age at menarche expressed in percentiles. As no previous information was available about the age at menarche in FB&H, the present results will afford a basis for future studies which should aim at analysing the trend and tempo of secular changes in age at menarche. [ABSTRACT FROM AUTHOR]

The article presents a study which evaluated the effect of topical iodine-containing antiseptics on neonatal thyroid-stimulating hormone (TSH) of Caesarean-delivered infants born in an area where iodine is deficient. The conclusion was that data gathered from the study suggested that full term Caesarean delivered babies' TSH were not affected when iodine antiseptics were used during the operation.

Monitoring the growth and development of children is the main task of preventive programs of pediatric health care. This is the best and simplest way of establishing the state of health of the child population, and at the same time, in the case of growth disorders, to make possible the timely application of possible preventive measures. For each child with short or tall stature in primary health care a detailed medical history should be taken, a physical examination undertaken using anthropological standards, assessment of bone maturation, calculation of genetic potential and basic laboratory tests. If there is a suspicion of normal variants of either short or tall stature, in order to establish a definite diagnosis the patient should be referred to a pediatric endocrinologist. Insofar as this suspicion is confirmed, the patient and his/ her parents should be acquainted with the nature of the disorder and given information on attaining the definitive height of the child. The growth of these children should be monitored up to the end of growth at least once a year. In patients whose body height is below the 3rd percentile, or above the 95th percentile, after excluding normal forms of short or tall stature, attention should be turned to discovering the pathological causes of short or tall stature. The examination of these children may be long, complex and expensive, but its needs to be done in stages, mainly in a specialized institution. [ABSTRACT FROM AUTHOR]

Introduction An enlarged lymph node is the most common neck mass in children. The usual causes of enlargement are infections such as bacterial and viral adenitis, pharyngitis, an infectious diseases and Hodgkin disease. However, sometimes enlarged lymph nodes can be found in thyroid carcinoma as the first manifestation of the disease. Case report Here we report on 11- year old girl with painful cervical lymphadenopathy. An ultrasound and cytological examination followed by fine-needle aspiration cytology from the thyroid gland revealed a papillary carcinoma. A total thyroidectomy with lymph nodes dissection was performed. The postoperative diagnosis confirmed thyroid carcinoma metastaticum in the lymph nodes. With a view to implementing the further diagnostic and therapeutic protocol a whole body scintigraphy was performed and it revealed a radioiodine collection in the area of the remaining thyroid tissue. As a result radioiodine therapy i.e. 100 mCi (370 MBq) was administered. Substitution therapy was administered. A year later the whole body scan showed a focus of increased uptake in the neck indicating that there was a need to repeat radioiodine therapy. This time a dose of 100 mCi was administered (total dose of radioiodine ablation amounts to 200 mCi). Since the surgery was performed five years ago there have not been any signs of local recurrence or metastasis. Conclusion Enlarged lymph nodes are a serious clinical problem. Therefore, lymphadenopathy regardless of its occurrence demands detailed clinical testing. Priority should be given in this pathology diagnostics to ultrasound examination in combination with fine-needle aspiration cytology, which can reveal the cause of the disease in good time and reliably. [ABSTRACT FROM AUTHOR]

Mutations in FGFR1 have recently been associated with Hartsfield syndrome, a clinically distinct syndromic form of holoprosencephaly (HPE) with ectrodactly, which frequently includes combinations of craniofacial, limb and brain abnormalities not typical for classical HPE. Unrelated clinical conditions generally without craniofacial or multi-system malformations include Kallmann syndrome and idiopathic hypogonadotropic hypogonadism. FGFR1 is a principal cause for these less severe diseases as well. Here we demonstrate that of the nine FGFR1 mutations recently detected in our screen of over 200 HPE probands by next generation sequencing, only five distinct mutations in the kinase domain behave as dominant-negative mutations in zebrafish over-expression assays. Three FGFR1 mutations seen in HPE probands behave identical to wild-type FGFR1 in rescue assays, including one apparent de novo variation. Interestingly, in one HPE family, a deleterious FGFR1 allele was transmitted from one parent and a loss-of-function allele in FGF8 from the other parent to both affected daughters. This family is one of the clearest examples to date of gene:gene synergistic interactions causing HPE in humans., (Published by Oxford University Press 2016. This work is written by (a) US Government employee(s) and is in the public domain in the US.)

The aim was to describe the clinical and laboratory characteristics of diabetes mellitus type 1 at its onset. The hospital records at Tuzla pediatric hospital were analysed of 109 children aged 0-14 who presented with diabetes between 1990 and 2005. The data base was divided into three age groups: 0-4.9, 5-9.9 and 10-14 years - referred to hereafter as the younger, middle and older age groups. We found the duration of symptoms prior to diagnosis to be significantly shortest in the younger age group. Polyuria, polydipsia and weight loss were the main presenting symptoms in all age groups. The median blood glucose value was 26.0 mmol/L and the pH value was 7.30. The incidence of diabetic ketoacidosis of 48.0% and the median HbA 1c value of 10.7% at diagnosis indicate that disease was not recognised long before diagnosis. Since our desire is to avoid the development of ketoacidosis, it is necessary to educate people who are in permanent contact with children about the symptoms of diabetes type 1. This could to a certain degree prevent the presentation of the life-threatening condition of diabetic ketoacidosis, if the occurrence of diabetes cannot be prevented.

Purpose: The aim of the study was to estimate, according to parents and their children with diabetes, how far school personnel have an understanding of diabetes and is trained to provide appropriate treatment of diabetes emergencies., Work Method: The study included 37 children and adolescents with diabetes type 1 (17 girls and 20 boys) from 31 schools in the Canton of Tuzla, aged 7-18 years. A descriptive research method was used in the study and for data gathering a closed type survey was used., Results: Only 13 or 35.3 % of the 37 surveyed parents were satisfied with the care of their child with diabetes at school, while 24 or 64.7 % parents expressed dissatisfaction with it. According to the parents' statements, class teachers are 100 % informed about the existence of students with diabetes type 1 at their schools, while PE teachers (97.9 %) and the headmasters of the schools (81.1 %) are less well-informed. Regarding the question about whether the school personnel is trained for diabetes-related tasks, the parents answered YES in 25.7 % cases; 54.3 % of them answered NO, and 20 % of them answered DON'T KNOW. However, only 35.2 % of parents found that some of the employees at the school are trained to recognize the symptoms of hypoglycemia while the number of positive answers concerning treatment of hypoglycemia (18.9 %) or glucagon administration (13.5 %) was much lower. The answer to the question: "Is blood glucose testing allowed in the classroom?" in 91.5 % cases was YES, 5.7 % NO and in 2.8 % of cases was DON'T KNOW., Conclusion: The results of our survey show that children with diabetes do not have appropriate diabetes care in school.

In the paper it was identified firstly the short stature, then importance of anamnesis, physical examination, anthropometric measurements and calculated parameters of growth. Then followed the classification of causes for short stature with a specific review on differentiation of normal from pathologic variants. Further in the text it was pointed out the importance of observing normal variants of short stature since between 84% and 87% children are with height under the 3rd percentile. Then followed tables showing pathologic causes of the short stature, and then diagnostic and therapeutic approach to the child with proportionately short stature and short stature associated with dysmorphic features.

Goiter frequency and urinary iodine excretion levels were assessed in schoolchildren, aged 7-15 years, living in Tuzla Canton. Goiter frequency was evaluated by clinical examination and ultrasound of the thyroid gland. Goiter by inspection and palpation was found in 19.1% of all subjects, in 19.8% of girls and 18.4% of boys. With regard to updated reference values for thyroid volume reported by WHO and ICCIDD, goiter by ultrasonography was found in 12.9% (n = 62) of all subjects (n = 480). Median urinary iodine was 71.0 micrograms/L. Mild iodine deficiency is observed in Tuzla Canton, based on goiter frequency and urinary iodine excretion. Neonatal TSH results, obtained in the programme of the neonatal thyroid screening, were also analyzed. The frequency of neonatal TSH above 5 mU/L was 12.0% indicating, as two other indicators, mild degree of iodine deficiency in this region. The results underline the inefficacy of iodine prophylaxis with 10 mg K1 per kg of salt in correcting iodine deficiency. On the basis of the study, carried out in the rest of the Federation of Bosnia and Herzegovina, the new regulation was proclaimed in 2001 requiring 20-30 mg of iodine per kg of salt.