Pregled bolesti u djece turista za vrijeme posjeta Splitsko-dalmatinskoj županiji

The aim was to determine morbidity of foreign children during their tourist visit to Split-Dalmatia County, Croatia. The study included medical documentation of 233 foreign children tourists aged under 18 years, hospitalized at Clinical Department of Pediatrics, Split University Hospital Center in the period from January 2007 to December 2013. Demographic data were statistically analyzed. Of 233 children tourists hospitalized at our department, 134 (57.5%) were boys. Most of the children tourists (51.1%) were aged 0-5 years. According to nationality, they were from 30 countries from all over the world, but mostly from Europe (97.9%). The highest number of children tourists were from Germany (14.2%). The highest percentage of children tourists (92.7%) were hospitalized during summer months. The mean length of hospital stay was 4.4±3.3 days. According to the reason for hospitalization, children tourists were mostly admitted to our hospital for nervous system symptoms (32.6%); 43.4% of these had febrile seizures and 39.5% epilepsy. The nervous system symptoms were followed by injury and poisoning (14.6%), respiratory symptoms (14.1%), submersion and heat injuries (9.9%), and digestive symptoms (9.4%). In conclusion, we describe foreign pediatric population hospitalized in the Split University Hospital Center during their vacation in the Split-Dalmatia County, Croatia. The largest number of children tourists were from Germany and the nervous system symptoms were the most common reason for hospitalization. Therefore, we suggest cooperation between the Croatian health care system and Croatian National Tourist Board for developing prevention strategies regarding morbidity in pediatric tourist population. In particular, prevention and fi rst line therapy for cerebral seizures should be broadly available, such as in hotels, apartments, and even on beaches.Cilj je odrediti morbiditet u strane djece za vrijeme turističkog posjeta Splitsko-dalmatinskoj županiji, Hrvatska. U istraživanje je uključena medicinska dokumentacija 233-je strane djece turista u dobi do 18 godina, hospitalizirane na Klinici za dječje bolesti KBC Split u razdoblju od siječnja 2007. do prosinca 2013. godine. Demografski podatci su statistički analizirani. Od ukupno 233-je djece turista hospitalizirane na našem odjelu njih 134 (57,5%) bili su dječaci. Većina djece turista (51,1%) bila je u dobnoj skupini od 0-5 godina. Prema nacionalnosti bila su iz ukupno 30 zemalja diljem svijeta, ali većinom iz Europe (97,9%). Najveći broj djece turista bio je iz Njemačke (14,2%). Najviši postotak djece turista (92,7%) bio je hospitaliziran ljeti. Hospitalizacija je prosječno trajala 4,4±3,3 dana. Najčešći razlozi hospitalizacije djece turista bili su neurološki simptomi (32,6%), od toga je 43,4% imalo febrilne konvulzije i 39,5% epilepsiju. Zatim su slijedile ozljede i trovanja (14,6%), od toga su ozljede bile prisutne u 61,8% slučajeva, a trovanja u 38,2%. Blesti dišnog sustava (14,2%) treće su po učestalosti, većina bolesnika imala je upalu donjih (42,4%) ili gornjih (36,4%) dišnih puteva. Potom slijede utapanja i ozljede toplinom (9,9%) te bolesti probavnog sustava (9,4%). Zaključno, opisali smo stranu pedijatrijsku populaciju hospitaliziranu u KBC-u Split za vrijeme turističkog posjeta Splitsko-dalmatinskoj županiji. Najveći broj djece turista bio je iz Njemačke i najčešći razlog hospitalizacije bili su neurološki simptomi. Stoga predlažemo suradnju između Ministarstva zdravlja i Hrvatske turističke zajednice radi razvoja strategije za prevenciju bolesti, uzimajući u obzir morbiditet u djece turista. Posebice treba naglasiti prevenciju cerebralnih napadaja te činjenicu da bi prvolinijska terapija trebala biti široko dostupna, primjerice u hotelima i apartmanima, pa i na plažama

Analysis of leptin, adiponectin and adiponectin gene polymorphism and leptin receptor in obese children and adolescents

Background: The aim of this study was to determine serum levels of leptin and adiponectin of obese children to identify the influence of leptin receptor gene polymorphisms on leptin resistance and leptin levels, as well as the association between the polymorphisms of adiponectin gene and adiponectin levels.Materials and methods: A case-control study comparing a study group of 74 obese children (age 13.34±2.60 years) to a normal weight-age matched (age 13.39±2.64 years) control group of 69 children. In both groups, body mass index (BMI) and waist/hip circumference, systolic and diastolic blood pressure were measured. Also, the leptin and adiponectin levels, as well as glucose and lipid metabolism parameters, and highly sensitive C-reactive protein (hs-CRP) were measured. Insulin sensitivity was evaluated using fasting insulinemia and Homeostatic Model Assessment for Insulin Resistance (HOMA-IR). All subjects were tested for gene-tic polymorphisms in LEPRQ223R (rs1137101), ADIPOQ G276T (rs1501299) and ADIPOT45G (rs2241766).Results: The phenotypes of the obese children study group were significantly higher than in the control group in weight, BMI, waist/hip circumferences and systolic blood pressure (SBP) (P<0.001). We confirmed that in obese children the levels of leptin in the blood are increased and levels of adiponectin are decreased (P<0.001). The differences of the genotype distributions of leptin receptor (LEPRQ223R) and adiponectin (ADIPOG276T and ADIPOT45G) gene polymorphisms in the study group of obese chil-dren and a control group was not observed.Conclusion: In this study, we demonstrated increased leptin level and significantly decreased level of adiponectin in the obese children group compared with the control group. The results of the analysis of glucose metabolism and lipidogram between the two groups showed that insulin, HOMA-IR, and triglycerides, as well as hsCRP were increased and significantly different in the group of obese children compared to the control group, as expected. However, by including a significantly larger number of tested and control samples of both sexes and age-specific groups, with a larger number of tested SNPs, the genes investigated in this study would probably give better insight into a multicomplex disease such as obesity