Aim: The aim of this study was to analyze risk factors and outcome of neonatal pneumothorax in Tuzla Canton. Methods: Neonates with chest X-ray confirmed pneumothorax in University Clinical Center of Tuzla, within a three-year period, from January 2015 to December 2017, were retrospectively studied. Participants were evaluated for baseline characteristics, predisposing factors of neonatal pneumothorax, accompanying disorders and mortality. Results: During the observed three-year period 11425 neonates were born in Tuzla Canton, with 7.33 % of preterm births, and 604 neonates were treated in NICU, with 265 neonates who required mechanical ventilation. Neonatal pneumothorax (NP) was diagnosed in 22 patients (9 term, 13 preterm), 12 (54.5%) were male. The incidence was 0.20% of total births, respectively 3.64% of those treated in NICU. The mean gestational age were 35.1 ± 3.0 weeks and birth weight 2 506.8 ± 727.7 grams. NP was mostly unilateral (72.7%) and right-sided. The most commonly associated diseases were: respiratory distress syndrome, intracranial haemorrhage, pneumonia, transient tachypnea and sepsis. In 8 (36.4%) neonates, the underlying cause of NP could be mechanical ventilation (secondary), whereas in 14 (63.6%) NP was spontaneous, without previous mechanical ventilation, although 11 of them required mechanical ventilation after pneumothorax. Conclusion: All perinatal risk factors were investigate, and significant differences in two observed groups related to mechanical ventilation were found for birth weight, gestational age, Caesarean section, length of mechanical ventilation, surfactant replacement therapy and outcome. Three (13.64%) neonates with NP died, and among risk factors with poor outcome, significant was only Apgar score in the first minute ≤ 5.

Coeliac, in ordinary people known as “flour allergy” and in medicine world known as gluten enteropathy which means enteric damage caused by gluten. Data about incidence of gluten enteropathy is different in different countries around the World and depend on is it or is it not the right diagnosis for enteric disorder. Sometimes, this disease is unrecognized because of unspecific clinical signs. This disease is happening in every moment of a lifetime, most common during the childhood when the children try to eat any food which contains gluten. Anyway, if children had no symptoms it doesn’t¢t mean that disease not exists, and that¢is because we have to do diagnostic tests to confirm gluten enteropathy. Gluten intolerance is chronic disease and demand use of the specific non gluten food during the lifetime. Early diagnosis is right way to prevent unregularly growth. Aim of this study was to show the influence of early diagnostic about growth. For each patient we had a permission of parents and we showed our original results for three month we investigated.

Introduction: Reasons for acute renal failure in hospitalized infants were sepsis, hypovolemia, asphyxia, respiratory distress syndrome, surgical interventions and congenital heart defects.The aim of this study was to determine the frequency and and main etiologies, and early outcome of neonatal acute renal failure.Materials and Methods: At Intensive Care Unit, Clinical Center Tuzla, from 15. 01. 2013 to 15. 01. 2015 in 21 newborn was diagnosed renal failure, based on the amount of excreted urine and serum creatinine.Results: The prevalence of renal failure was 6.84%, with a higher incidence of female. 33.3% of infants were term neonates. Oliguria was diagnosed in 71.4% of newborns. Sepsis was the most common predisposing factor for the development of renal failure, associated with high mortality. Other causes of renal failure were perinatal hypoxia, RDS, surgical interventions and congenital heart defects. There was a positive correlation between the gestational age of the newborn and serum creatinine.Discussion: Early prevention of risk factors with rapid diagnosis and effective treatment, can affect further outcome of acute renal failure in infants.

Introduction: Acute respiratory failure (ARF) is the most common problem seen in the preterm and term infants admitted to neonatal intensive care units. Etiology is not uniform, and mostly depend on gestational age. For adequate treatment is certainly important to recognize and treat underlying disease, but at the same time, we have to supply adequate respiratory support, tissue perfusion and oxygen deliveries. For a good outcome we need reliable estimation method for functional state of respiratory system, as well as monitoring the effects of treatment. Current assessment ARF is with blood gas, chest X-ray and Oxygenation index (OI). OI is quite aggressive assessment method for neonates, because it involves arterial blood sampling. Promoted in recent studies, Oxygen saturation index (OSI) measured by pulse oximetry, attempts to objectively score respiratory disease with parameters available non-invasively. The aim of our research is to evaluate correlation between OSI and OI in neonates with ARF requiring mechanical ventilation. Material and methods: In a retrospective cohort study 101 neonates were selected, treated at the Department of intensive therapy and care, Pediatric clinic of Tuzla, due to ARF requiring mechanical ventilation.We reviewed data such as gestational age, birth weight, gender, Apgar scores, values of Score for Neonatal Acute Physiology-Perinatal Extension, all the parameters from the arterial blood gas analysis, pulse oximetry values, Oxygenation Index and Oxygenation Saturation Index, that were calculated by the formulas. OSI and OI were calculated and correlated. Mean values of OSI and OI correlated with Pearson's coefficient of 0.76; p < 0.0001 (95% CI = 0.66-0.83). OSI correlated with SNAP-PE with Pearson's coefficient of 0.52; p < 0.0001 (95% CI = 0.36-0.65). Comparing the values of OSI between patients who died and those who survived, we fo-und that OSI correlated with the outcome with Spearman's coefficient of -0.47; p < 0.0001 (95% CI = -0.16 --0.31). Bland-Altman plot confirmed correlation between OSI and OI in mean values, identifying discrepancy between two indices for extreme values. In conclusion, OSI correlates significantly with OI in infants with respiratory failure. This noninvasive method of oxygenation assessment, utilizing pulse oximetry, can be used to assess the severity of ARF and mortality risk in neonates.

Gastric mucosal lesion caused H. pylori infection is a reversible process and the eradication of this infection not only stops the activity of the inflammatory process, but also restores the mucous membranes. Eradication leads to a significant drop in the incidence of recurrence of gastritis and peptic ulcer disease, and can lead to prevention of malignant disease in 70-80% of cases, even, and perhaps more.