Централна дебелина: oбем на половина, однос обем на половина и колкови, однос обем на половина и висина кај 13-годишни деца

Obesity in children is a growing worldwide health problem, with a tenfold increase over just four decades. The aim of this study was to determine the prevalence of obesity and to identify central obesity in children aged 13 years from southwestern part of North Macedonia. Materials and methods: This cross-sectional study included a total of 178 healthy children of both sexes (boys 98, girls 80) aged 13 years living in Tetovo, North Macedonia. Results: The prevalence of categorized BMI according to CDC in all 13-year old children (n=178) was 4.5% underweight, 20.2% overweight and 16.3% obese. Among boys, the total prevalence of underweight, overweight and obese was consistently 4.1% vs. 19.4 %vs. 15.3%, while girls had statistically insignificant higher prevalence of underweight, overweight and obese 5% vs. 21.2% vs. 17.5%. At a comparison of the central obesity parameters like WC,WHR, WHtR showed statistically significant differences between sexes (p<0.003, p<0.0001, p<0.011).In the entire sample, the prevalence of high risk for waist-to-hip ratio (WHR) was 34.3% and the prevalence of high risk for waist-to-height ratio (WHtR) was 31.5%. In boys, the prevalence of high risk for WHR was 51% and for WHtR was 35.7% while in girls for WHR was 13.8 % and for WHtR 26.2%. A significant association of male gender with high risk for WHR (X2=27.161; df=1; p=0.0001) was found while for WHtR (X2 =1.830; p=0.176) there was no statistically significant sssociation. It is important to underline that in boys the risk of central obesity was 6.53 times higher compared to girls of the same age [OR=6.53 (3.08–13.83) 95% CI. Conclusions: In our study girls had a higher BMI prevalence of general overweight and obesity vs. boys, and a significant association of male gender with high risk for WHR was detected. Additionally, healthcare professionals should always consider assessing the measurements and risk of central obesity in obese or overweight children, and seek for the unique risk factors associated with each type of obesity and tailor interventions accordingly.Дебелината во детска возраст е сè поголем јавноздравствен проблем глобално, со десеткратно зголемување во текот на последниве четири децении. Целта на оваа студија беше да се процени преваленцијата на дебелината и да се идентификува централната дебелина кај децата на возраст од 13 години во северозападниот дел на Р.С. Македонија. Материјали и методи: Во оваа студија на пресек беа вклучени вкупно 178 здрави деца од двата пола (момчиња 98, девојчиња 80) на 13-годишна возрастод Тетово, Северна Македонија. Резултати: Преваленцијата на катагоризираниот БМИ според CDC кај сите 13-годишни деца (n=178) беше 4,5% потхранети, 20,2% натхранети и 16,3% дебели. Кај момчињата вкупната преваленција на потхранети, натхранети и дебели беше 4,1%; 19,4%; 15,3%,  додека кај девојчињата имаше статистички незначителна поголема преваленција на потхранети, натхранети, и дебели 5%; 21,2%; 17,5%. При споредбата на параметрите за централна дебелина како WC, WHR, WHtR истите покажаа статистички значајни разлики помеѓу половите (p<0,003, p<0,0001, p<0,011). Кај целиот примерок, преваленцијата на висок ризик за WHR беше 34,3%, додека преваленцијата на висок ризик за WHtR беше 31,5%. Кај момчињата, преваленцијата на висок ризик за WHR беше 51%, а заWHtR беше 35,7% додека кај девојчињата за WHR беше 13,8%,а за WHtR 26,2%. Утврдивме статистички сигнификантна поврзаност на машкиот пол со висок ризик за WHR (X2=27.161; df=1; p=0,0001), додека за WHtR (X2 =1.830; p=0.176) не постои статистички значајна поврзаност. Важно е да се нагласи дека кај момчињата ризикот од централна дебелина беше 6,53 пати поголем во споредба со оној кај девојчињата на истата возраст [OR=6,53 (3,08-13,83) 95% CI]. Заклучок: Оваа студија покажа дека девојчињата во споредба со момчињата имаа повисока преваленција на БМИ, потхранетост и дебелина, а беше регистрирана значајна поврзаност на машкиот пол со висок ризик за WHR. Здравствените работници треба секогаш да размислуваат за проценка и на ризикот од централна дебелина кај дебели и натхранети деца, како и идентификување  на факторите на ризик поврзани со секој тип на дебелина и соодветно приспособување на понатамошните интервенции

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Intensification of systemic chemotherapy with incinclusionof high doses methotrexate (MTX) has contributed to the improvement of event-free survival in children with acute lymphoblastic leukemia (ALL). Despite this benefit, this agent might cause serious toxicity, even life-treating events during treatment. Therefore, prediction, early detection and management of toxic effects during therapy with high doses of MTX is still a great challenge for every pediatric oncologist.The aim of our study was to evaluate the incidence of toxic effects of chemotherapy with high doses of MTX (5 g/m^2) and to compare them with toxicity during application of lower doses of MTX (2 g/m^2).Retrospective record review of 77 children with medium risk ALL was done. Patients were treated in the Department of hematology and oncology at the University children's hospital in Skopje. Forty-five of them were treated with 5 g/m^2 and 32 of them were treated with 2 g/m^2 (historic group). Toxicity was registered according to the protocol for acute toxicity, part of the ALL BFM 95 protocol.Toxic effects were predominant in the group treated with higher doses of MTX. The  most significant toxic  effects were hepatotoxicity, oral mucositis and myelosuppression.  More  severe grade of hepatotoxicity and oral mucositis were present in the study group. In our study toxic  effects were more common in the study group due to application of higher doses of MTX.Variations in toxicity between the patients of the study group are probably due  to the genetic differences in the drug absorption, their excretion and cellular transport. Current studies are dedicated on discovering genetic markers which will  be able  to predict the risk  of appearance of MTX toxicity.Intensification of systemic chemotherapy with in- clusion of high doses methotrexate (MTX) has contributed to the improvement of event-free survival in children with acute lymphoblastic leukemia (ALL). Despite this benefit, this agent might cause serious toxicity, even life-treating events during treatment. Therefore, prediction, early detection and management of toxic effects during therapy with high doses of MTX is still a great challenge for every pediatric oncologist.The aim of our study was to evaluate the incidence of toxic effects of chemotherapy with high doses of MTX (5 g/m2) and to compare them with toxicity during application of lower doses of MTX (2 g/m2).Retrospective record review of 77 children with medium risk ALL was done. Patients were treated in the Department of hematology and oncology at the University children's hospital in Skopje. Forty-five of them were treated with 5 g/m2 and 32 of them were treated with 2 g/m2 (historic group). Toxicity was registered according to the protocol for acute toxicity, part of the ALL BFM 95 protocol. Toxic effects were predominant in the group treated with higher doses of MTX. The  most significant toxic  effects were hepatotoxicity, oral mucositis and myelosuppression.  More  severe grade of hepatotoxicity and oral mucositis were present in the study group. In our study toxic  effects were more common in the study group due to application of higher doses of MTX. Variations in toxicity between the patients of the study group are probably due  to the genetic differences in the drug absorption, their excretion and cellular transport. Current studies are dedicated on discovering genetic markers which will  be able  to predict the risk  of appearance of MTX toxicity