[CIGARETTE SMOKING AMONG SCHOOL ADOLESCENTS IN THE BRCKO DISTRICT OF BOSNIA AND HERZEGOVINA: A CROSS-SECTIONAL STUDY]. / PUSENJE CIGARETA MEDU ADOLESCENTIMA U DISTRIKTU BRCKO U BOSNI I HERCEGOVINI: PRESJECNA STUDIJA.

Objective: The objective of the study was to determine the prevalence of cigarette smoking in adolescents in public schools of the Brcko District of B&H in relation to their gender, age and place of residence. Participants and ­Methods: A cross-sectional study, based on the ESPAD (European School Survey Project on Alcohol and Other Drugs) questionnaire adapted to this research comprised 4,188 respondents who attended primary and secondary schools. Data were collected using a questionnaire prepared for each respondent. Results: Significantly fewer respondents smoke cigarettes compared to those who do not (p < 0.001), while in relation to gender male adolescents smoke more often than female adolescents (p = 0.012). In relation to their place of residence it is established that a significantly higher number of respondents from rural areas smoke cigarettes compared to those from the city (p < 0.001). More than half of the respondents, who smoke regardless of their gender, had their first cigarette before the age of 13. Male adolescents often begin smoking before the age of thirteen compared to female adolescents (p < 0.001), while female adolescents often begin smoking between the ages of 15 and 16 in relation to male adolescents (p <0.001). Every second respondent who smokes cigarettes irrespective of his/her place of residence did so at the age of 13. However, the respondents from rural areas smoke more often (p < 0.0001). Out of 895 respondents who smoked during the last month, 259 of or 30.3 % smoked only one cigarette a week, 162 or 18.1 % smoked 1-5 cigarettes a day, 168 or 18.8 % of the respondents smoked 6-10 cigarettes a day, 146 or 16.3 % smoked 11 to 20 cigarettes a day, and 160 or 17.9 % of the respondents smoked every day. Conclusion: Although 42.8 % of the respondents who had ever smoked cigarettes is significantly less compared to 57.2 % of the respondents who do not smoke, that number is disturbing since we talk about the vulnerable population group and the fact that every second adolescent started smoking at the age to 13.

[FOUNDATION OF THE MUSEUM FOR THE HISTORY OF HEALTH IN 1944 AND ROLE OF ITS FIRST CURATOR STANKO SIELSKI]. / OSNIVANJE MUZEJA ZA POVIJEST ZDRAVSTVA U HRVATSKOJ 1944. GODINE I ULOGA NJEGOVA PRVOG KUSTOSA STANKA SIELSKOG.

The Museum of the History of Health Care in Croatia, as the first such museum in the southeastern part of Europe, was established by the Croatian Medical Association in Zagreb in 1944. Beside Vladimir Cepulic (1891 - 1964) the head of the Croatian Medical Association, epidemiologist Stanko Sielski (1891 - 1958), was one of the most prominent personalities to be credited for realizing this project. He was born in Gracanica into a family of Polish origin. After his graduation in Vienna in 1919, he worked as an epidemiologist in Konjic, Prozor, Glamoc and other places in the area of Bosnia, mostly involved in typhoid fever and variola eradication. At the beginning of the Second World War he was in Banja Luka where he was given the duty of director of the Department of Endemic Syphilis Eradication. During 1942 and 1943 his correspondence took place with Vladimir Cepulic, which is today preserved in the Section of the History of Medicine of the Croatian Academy of Sciences and Arts in Zagreb. On the basis of this material it was possible to trace the circumstances of the foundation of the Museum of the History of Health Care, how items were collected for its first exhibition, and the role of Stanko Sielski in preserving the medical heritage and dissemination of knowledge of the history of medicine to a broader audience.

Newborn screening in southeastern Europe.

The aim of our study was to assess the current state of newborn screening (NBS) in the region of southeastern Europe, as an example of a developing region, focusing also on future plans. Responses were obtained from 11 countries. Phenylketonuria screening was not introduced in four of 11 countries, while congenital hypothyroidism screening was not introduced in three of them; extended NBS programs were non-existent. The primary challenges were identified. Implementation of NBS to developing countries worldwide should be considered as a priority.

Leopard syndrome: a report of five cases from one family in two generations.

UNLABELLED: This is the first reported family with Leopard syndrome (LS) from Bosnia and Herzegovina. We report five cases of LS from two generations of the same family. In the present series of patients from one family, all patients carry the same recurrent mutation Y279C in the PTPN11 gene, exhibiting different phenotypes and a variable expression of multiple lentigines. The diagnosis may be on clinical basis as the diagnostic clues of LS are: multiple lentigines and cafè-au-lait-spots, short stature, distinctive face, congenital heart disease, conduction abnormalities, abnormal genitalia, and sensorineural deafness. CONCLUSION: the clinical diagnosis of LS should be molecularly confirmed in the patient.

The impact of delayed cardiac surgery on the postnatal growth of children with congenital heart disease in Bosnia and Herzegovina.

The aim of this study was to evaluate preoperative and postoperative growth in children with congenital heart disease (CHD) when cardio-surgical treatment is delayed. Growth data were analysed on 116 children with various types of CHD (cyanotic lesions (Group 1), left to right shunt (Group 2) and obstructive lesions (Group 3)), who underwent cardiac surgery after a certain period of waiting. Preoperatively, during the time (median 1.13 (0.55-2.39)) years of waiting for surgery, their mean weight z-score decreased from -1.38 (+/- 1.19) to -1.41 (+/- 1.28), and their mean height z-score from -0.65 (+/- 1.41) to -0.81 (+/- 1.36). Children in Group 1 developed a significant linear growth deficit, in Group 2 weight was more affected than height, while in Group 3 both growth parameters were gradually slowly, but not significantly reduced. Postoperatively weight and height z scores, although they showed a linear trend of improvement for all three groups, remained significantly reduced for two years after surgery. At the time of the last examination at the age 9.11 (5.66-13.10) years, the mean height z score -0.16 (+/- 1.28), was significantly reduced p < 0.0001, than predicted height 0.23 (+/- 0.82). Growth catch-up was related to age at surgery and preoperative growth deficit. Delayed cardiac surgery in children with CHD aggravated growth deficit and caused slow and incomplete postoperative growth catch-up.

Association of early menarche age and overweight/obesity.

AIM: The aim of the study is to assess the association of overweight/obesity and early menarcheal age. PATIENTS AND METHODS: The study comprised 2127 healthy girls aged 9 to 16 years. Menarcheal age was estimated by status quo method. The girls' body weight and height were measured and their body mass index (BMI) calculated. The diagnostic criteria of the WHO were used to define overweight and obesity. Girls with a BMI in the range of 1-2 for age and sex were considered overweight. Girls with a BMI >2 standard deviation (SD) for age and sex were considered obese. Girls with a BMI >1 SD for age and sex were considered overweight/obese. Social and economic status was analyzed according to years of education completed, parents' occupations, and the number of children in the family. RESULTS: Median menarcheal age was 12.83 years; 25% girls had menarche before 11.98 years and 75% by 13.69 years. By 11.21 years, 10% of girls had had menarche, and 95% by 14.91 years. Girls who had menarche before 11.98 years had higher body weight values (48.5 vs. 40.2 kg) (p<0.001), height (159.3 vs. 149.2 cm) (p<0.001), and BMI (18.9 vs. 17.8 kg/m2) (p=0.003) than their peers without menarche. Girls with menarche before 11.98 years had significantly higher BMI values than girls with menarche after 13.69 years (18.94 vs. 17.84 kg/m2) (p=0.008). Girls with menarche before 11.98 years and those after 13.69 years differ significantly in distribution of thinness (3.4% vs. 2.54%), normal weight (85.3% vs. 91.8%), and overweight/obesity (11.2% vs. 5.7%) (p=0.002). CONCLUSIONS: Girls who experienced early menarche are significantly more often overweight/obese. Overweight/obesity may be considered as one of the predictors for the early occurrence of menarche.

Health-related quality of life and metabolic control in children with type 1 diabetes mellitus in Bosnia and Herzegovina.

The primary objective of the study was to examine the relationship between generic and disease-specific HRQOL scores and metabolic control in children with Type 1 Diabetes Mellitus (T1DM). This cross-sectional study included 65 consecutive children between ages 5 and 18 years with T1DM. According to their values of glycosylated hemoglobin (HbA(1C)), the children were assigned to one of two groups. In Group 1 (N = 21) were the children with HbA(1C) values < 8% (good to moderate metabolic control) and Group 2 (N = 44) were children with > 8% (poor metabolic control). To evaluate generic and disease-specific HRQOL scores in children with T1DM in relation to metabolic control, we used the PedsQL 4.0 Generic Core Scales and the PedsQL 3.0 Diabetes Module. The patients in Group 1, by pediatric patient self-report and parent proxy-report, had statistically better disease-specific HRQOL scores on the diabetes symptoms, treatment barriers, treatment adherence and worry domains in comparison with Group 2. We also found significant correlations between the total generic HRQOL scores and HbA(1C) for both parent proxy-reports' Spearman's coefficient of rank correlation rho = -0.257; p = 0.0412 and pediatric patients' Spearman's coefficient of rank correlation rho = -0.269; p = 0.0313. The current findings suggest that poor glycemic control in children with T1DM is associated with lower generic and disease-specific HRQOL scores in developing and transitional countries.

Medical Biography of Isak Samokovlija: The Famous Bosnian-Herzegovinian Writer.

The purpose of this paper is to shed light on the biographical, professional, and health-educational works of Dr. Isak Samakovlija, who was better known as a writer than a doctor in the country where he was born. He was born in 1889 in Gorazde, the easternmost province in the Austrian-Hungarian monarchy, into a modest Jewish merchant family. He attended high school in Sarajevo and completed his studies in medicine in Vienna in 1917. During the First World War, he served twice in the Austro- Hungarian army. After the end of the First World War in 1918, he completed a medical internship at the National Hospital in Sarajevo. He began his service as a doctor, first in Gorazde and then in Fojnica and Sarajevo. After the establishment of the Independent State of Croatia in May 1941, he was dismissed from his duties in the service without the right to pension or support, and without the right to appeal. In the Independent State of Croatia, he was twice mobilized into the Home Guard and was manager of the clinic in the Alipasin Most refugee camp. After World War II, he was the head of the Health Education Department of the Ministry of Public Health of the People's Republic of Bosnia and Herzegovina in Sarajevo. Together with a group of enthusiastic doctors, he founded and edited the first Bosnian medical journal Zivot i Zdravlje (Life and Health). In that journal, Dr. Samokovlija published 29 articles of health and educational content. In 1949, Dr. Samokovlija left the Ministry of Public Health and continued to edit the literature and art journal Brazda, but he still had a private practice until the end of his life. He died in Sarajevo on January 15, 1955. He was buried with the highest state honors at the Jewish cemetery in Sarajevo. CONCLUSION: Isak Samakovlija (1889-1955) was one of the first medical doctors born in Bosnia and Herzegovina. He made a significant contribution to the improvement of people's health after the First and Second World Wars in the places where he worked. His special contribution are his articles on health education.

Dr. Masa Zivanovic: A Pioneer in Health Care for Women and Children in Bosnia and Herzegovina.

The aim of the article is to present, primarily to the medical world and also the general public, the personality and work of Masa Zivanovic (1890-1960), a pioneer in the health care of children and mothers in Bosnia and Herzegovina (BH), a health educator and one of the leaders of the Yugoslav Women's Rights Movement in the period between the two world wars. She was born in Croatia (then part of the Austro-Hungarian Empire) as Maria Skopszynski, in a family of Polish-Czech origin. After studying at the Temporary Women's Lyceum in Zagreb and passing the matriculation exam at the boy's High School (1909), she obtained the title of Doctor of Medicine in Vienna (1916). Her activity in the Women's Rights Movement has so far generally attracted more attention from researchers than her medical work. However, this work was very important because the general and health education of women, expectant mothers and mothers, after the two World Wars was very poor in BH, and the rates of child morbidity and mortality were high. Masa Zivanovic spent almost her entire working life in Sarajevo. For 30 years, she was the head of the Dispensary for Mothers and the Children, later the Institute for Maternal and Child Health Care, into which the previous institution grew in 1931. She was among the first followers of the new concept of "comprehensive paediatrics", which included social care for children, disease prevention and treatment of the sick. She successfully connected the medical mission with the mission of a women's rights activist, also trying to act as a health educator through articles published in the Women's Movement magazine (Zenski pokret). For a time, she was the president of the Society for the Education of Woman and Protection of her Rights, i.e. the Women's Movement, and a delegate at conferences of international feminist organizations. CONCLUSION: Masa Zivanovic was a physician, a pioneer in the health care of children and mothers in BH, a long-time director of the Institute for Health Care of Mothers and Children in Sarajevo, and one of the leaders of the Yugoslav Women's Rights Movement.

Growth and obesity in 7-year-old Croatian children: secular changes from 1991 to 2008.

The study analyses secular changes in body weight, height and body mass index (BMI) in children in the Splitsko-dalmatinska County, Croatia, in the period from 1991 to 2008. The overweight/obesity trends from 1991 to 1999 and from 2000 to 2008 are assessed. The study included three cohorts of healthy 7-year-old children, measured during their regular medical examination before enrolment at school: 1991 (n = 514), 1999 (n = 428) and 2008 (n = 452), in a total of 1,394 children, 686 (49.21%) of whom were girls. Overweight/obesity was defined according to the International Obesity Task Force criteria. From 1991 to 2008, there was a statistically significant rise in body weight and BMI in boys and girls (1.47 vs 1.50 kg; 0.55 vs 0.75 kg) and height in boys (1.4 cm). In 2008, the girls were 0.14 kg heavier and 0.39 cm taller than the girls of the same age measured in 1999, but their BMI was lower by 0.02 units. The frequency of obesity rose from 1991 to 2008 by 1.4 times in boys and 1.7 times in girls. The prevalence of obesity in girls rose from 1991 to 1999 (from 4.3% to 8.6%), but in 2008, it fell (7.1%). The prevalence of obesity in boys fell in 1999 (from 4.3% to 3.9%) but rose in 2008 (6.2%). The values of body weight, height and BMI in the observed population moved from 1991 to 2008 towards higher WHO standard values, which is descriptive of the problem of obesity and supports the need to consider the choice of cut-off points for obesity/overweight in local and national studies. In conclusion, the slowdown noticed in secular changes in body weight and BMI is encouraging and shows the importance of continuous paediatric health care for children, combined with an altered attitude in society towards obesity in children.

Incidence of asthma in children in Tuzla Canton--Bosnia and Herzegovina.

Asthma is one of the most common chronic diseases whose incidence shows constant growth in childhood. The objective of this work was to look into asthma incidence in children in relation to their age group and sex in a retrospective study, at Tuzla Canton area. The study comprised children of both sexes, age 0-14 who fell sick with asthma within the period from January 1st 2003 to December 31st 2007. The overall incidence and the incidence in relation to age group and sex was calculated as the number of children suffering from asthma, within the age group 0-14 years per 1000 children of the same age group in the Tuzla Canton. Asthma was diagnosed in 277 children (66.1% male and 33.9% female). The difference between asthma frequency in boys and girls was significant (chi2 = 56.16; df = 1; p < 0.0001). The average difference in proportion between the boys and girls was 32.2% (95% CI = 24.32-40.08). From this sample group the boys had a 3.8 times greater risk (OR = 3.79; %95 CI = 2.67-5.39) of contracting asthma. The average rate of incidence of asthma for both sexes in the observed period was 0.67/1000 (95% CI; 0.6-0.7; for boys 0.86/1000; for girls 0.47/1000). There was a statistically significantly higher incidence of asthma in boys in relation to girls (t = 6.3836, df = 32; p < 0.0001). The epidemiological data obtained could be useful for early detection and adequate treatment of children with asthma in the mentioned area.

Quality of life in children after cardiac surgery for congenital heart disease.

The aim of this study was to assess the quality of life children after cardiac surgery for congenital heart disease (CHD) and to compare these results with healthy children. To assess the quality of life children after surgery for CHD we performed a cross-sectional study of 114 patients who were patients at the Department of Paediatrics in Tuzla, between the ages of 2 and 18 years, of both sexes, and with one of their parents. We used the "PedsQL 4.0 Generic Core Scales", with both child self-report and parent proxy-reports. By self assessment, the PedsQL total scores for quality of life were statistically significantly different between children after cardiac surgery for ages 13 to 18 years and healthy children, while by parent report PedsQL total scores were statistically significantly different between children after cardiac surgery for ages 5 to 7 years and healthy children. By self assessment, children after cardiac surgery for ages from 5 to 7 and 13 to 18 years reported that they have a statistically significantly lower quality of life in the segment school functioning compared to the healthy children. By parental assessment, children after cardiac surgery for ages 2 to 4, 5 to 7 and 8 to 12 years have a statistically significantly lower quality of life in the segments of physical and psychosocial health, emotional, social and school functioning. The results of our study indicate that children after cardiac surgery for CHD by self and parent assessment have a lower quality of life than healthy children.

[Epidemiological characteristics of acute lymphoblastic leukemia in children from Tuzla Canton]. / Epidemioloske znacajke akutne limfoblastne leukemije u djece Tuzlanske zupanije.

This study was undertaken to determine epidemiological characteristics of acute lymphoblastic leukemia (ALL) in children aged 0-14 years from Tuzla Canton, during a 13-year period (1995-2007). This retrospective study analyzed patient medical records from University Department of Pediatrics, Tuzla University Clinical Center, as well as documentation of other medical facilities providing additional diagnostic and therapeutic treatment to these patients. Records on the population of children during the study period were obtained from Federal Department of Statistics. ALL was diagnosed in 41 children, 27 (66.0%) male and 14 (34.1%) female. The mean incidence rate for both sexes was 3.3/100,000 (2.3-4.4). It was higher in boys (4.2/100,000) than in girls (2.3/100,000). The highest incidence rate was recorded in 2002 (7.6/100,000). Study results provided reliable insight into the epidemiological characteristics of ALL in children from Tuzla Canton and proved useful for planning a pediatric health care program in the area.

Kornelija Rakic: A Woman Doctor for Women and Children in Serbia and Bosnia and Herzegovina.

This short biography focuses on the life and medical activities of Kornelija Rakic (1879-1952), a Serbian female pioneer of medicine from the then Hungarian province of Vojvodina, who acquired an MD from the University of Budapest in 1905. Rakic came from a humble background, and a Vojvodina Serbian women's organization enabled her to become a physician and pursue her social medicine mission. After a futile attempt to open a private practice as a "woman doctor for women" in Novi Sad in 1906, she successfully applied to the Austro-Hungarian provincial government in Sarajevo for the position of an official female physician in occupied Bosnia. Rakic began her career as an Austro-Hungarian (AH) official female physician in Bihac (1908-1912) and was transferred to Banja Luka in 1912 and to Mostar in 1917=1918. Kornelija Rakic stayed in Mostar after the monarchy collapsed in 1918 and continued to work as a public health officer in the service of the Kingdom of Serbs, Croats and Slovenes, founded in 1918. Subsequently, she served as the head of the "dispensary for mothers and children" at the Public Health Centre in Mostar, founded in 1929, where she practiced until her retirement in 1949. After World War II, Rakic served as Vice President of the Red Cross Society in Mostar. She received numerous awards and medals from the Austro-Hungarian Empire, the Kingdom of Yugoslavia and the Federal People's Republic of Yugoslavia. Kornelija Rakic died in Mostar in 1952 and was buried at the local Orthodox cemetery of Bjelusine. CONCLUSION: Kornelija Rakic (1879-1952) was the first Serbian female physician in Novi Sad, Vojvodina, and she was employed as an AH official female physician in Bihac (1908-1912), Banja Luka (1912-1917) and Mostar (1917-1918). After World War I, she participated in the establishment and expansion of public health institutions in Mostar and Herzegovina from 1918-1949 against the backdrop of the devastation of the two World Wars.

Rosalie Sattler-Feuerstein: An Austro-Hungarian Official Female Physician in Bosnia and Herzegovina, 1914-1919.

This short biography traces the life and medical activities of Rosalie Sattler, née Feuerstein (1883-19??), who was employed as an official female physician at the Austro-Hungarian (AH) provincial public health department in Sarajevo from 1914-1919. Born in 1883 into a Jewish middle-class family in Chernivtsi (then Czernowitz), Ukraine, in Bukovina, the easternmost province in Austria, Feuerstein moved to Vienna in 1904 to study medicine. After earning her MD from Vienna University in 1909, she started her career as an assistant physician at the Kaiser Franz Josef Hospital in Vienna. In spring 1912, Feuerstein moved to Sarajevo to work as an intern at the local provincial hospital (Landeskrankenhaus). In the same year, she married AH district physician Moritz Sattler (1873-1927) in Vienna. In 1914, Sattler-Feuerstein successfully applied to be an AH official female physician in Bosnia. She was an employee of the provincial public health department in Sarajevo and never functioned as an official female physician in the sense of the relevant AH service ordinance. After the collapse of the monarchy, Sattler-Feuerstein continued to be employed as an official female physician of the Kingdom of Serbs, Croats, and Slovenes. She resigned from service in 1919 and established herself as a private general practitioner in Sarajevo with her husband, who had also resigned as an official physician and started to practice privately at that point. Widowed in 1927, she left Sarajevo for an unknown destination, likely in 1938-1939, and vanished from historical records. CONCLUSION: Rosalie Sattler-Feuerstein (1883-19??) came to Bosnia as the eighth AH official female physician and worked as an employee of the AH provincial public health department in Sarajevo from 1914-1919, after which she practiced as a private physician in Sarajevo for more than 25 years.

Glycemic control in diabetic children: role of mother's knowledge and socioeconomic status.

The aim of this study is to investigate the role of mother's knowledge and socioeconomic status (SES) of the family on glycemic control in diabetic children. Our sample was taken from successive admissions to the outpatient's diabetes clinics in Tuzla, Bosnia and Herzegovina. Diabetes knowledge was assessed using the Michigan Diabetes Research and Training Center Diabetes Knowledge Test. Glycemic control was assessed by glycosylated hemoglobin (HbA(1C)). The mother's demographics were obtained by self-report. To categorize families' SES, parents' level of education, and current employment were recorded and analyzed using the Hollingshed two-factor index of social position. As expected, higher mother's knowledge was significantly associated with lower HbA(1C) (r = -0.2861705, p = 0.0442). Also, a significant correlation was found between the families' SES and HbA(1C) levels (r = 0.4401921; p = 0.0015). Mothers with more knowledge have children with better metabolic control, and low SES is significantly associated with higher levels of HbA1c. Improvement of mothers' knowledge and family SES may improve glycemic control and ultimately decrease acute and chronic complications of diabetes in children.

Does the severity of congenital heart defects affect disease-specific health-related quality of life in children in Bosnia and Herzegovina?

UNLABELLED: The aim of this study was to assess whether the severity of congenital heart defects (CHD) affects disease-specific health-related quality of life (HRQOL) in children after open heart surgery. One hundred and fourteen children with CHD and one of their parents participated in the study. HRQOL was evaluated by the PedsQL 3.0 Cardiac Module. The children were assigned to one of three groups according to severity of CHD. Children with cyanotic CHD (Group 3) reported that their HRQOL on several domains was lower than that of children with anomalies with the left-right shunt and children with obstructive anomalies. Also, by parent proxy-report, patients with anomalies with the left-right shunt had statistically significant, better HRQOL scores for the heart problems and treatment scales, perceived physical appearance, treatment anxiety, cognitive problems, and communication scales in comparison to the children with cyanotic CHD. By self-report, children of Group 1 reported that they had statistically significant, better HRQOL in the heart problems and treatment scales compared with Group 2. CONCLUSIONS: The results of the assessment by the PedsQL 3.0 Cardiac Module, a cardiac disease-specific instrument for children with CHD, indicate that HRQOL is poorest in children with complex CHD. Therefore, it is necessary to take the appropriate preventive measures for these patients, which include early (timely) cardiosurgical intervention and active psychological support to limit the negative impact of serious forms of CHD on the quality of life of these children.

[Impact of the family socioeconomic status on health related quality of life in children operated on for congenital heart defects]. / Povezanost socijalnoekonomskog stanja obitelji i kvaliteta zivota djece nakon operacije urodene anomalije srca.

OBJECTIVE: The aim of the study was to assess the impact of the family socioeconomic status (SES) on health related quality of life (HRQoL) in children operated on for congenital heart defects. PATIENTS AND METHODS: The study included 114 children aged 1.6-18 (mean = 10.2 +/- 4.2) years (46.5% male and 53.5% female), followed up at University Department of Pediatrics in Tuzla after cardiac surgery, and one of their parents or caretakers. Of 114 children with congenital heart defects, 54.4% had anomalies with left-right shunt, 18.4% obstructive type anomalies and 27.2% complex anomalies. Control group consisted of 127 healthy age-matched subjects (age range 1.5-18, mean = 11.2 +/- 4.2 years; 49.6% male and 50.4% female). In this prospective study, we used PedsQL 4.0 Generic Core Scale to assess HRQoL of children operated on for congenital heart defects. This measurement includes both the parent proxy and child reports. The family SES was assessed by use of Hollingshead two factor index of social position. Statistical significance of differences between respondents and control group was determined by use of t-test and ANOVA with Bonferroni test. RESULTS: The reports of children operated on for congenital heart defects yielded no statistically significant difference in their HRQoL according to family SES. Parental proxy reports showed medium scores for physical health and activity to be significantly lower in children from low SES families as compared with those from medium SES families. Scores on school activities also differed significantly between patients with low and higher family SES. Parental reports revealed statistically significantly poorer HRQoL in children from low SES families in terms of physical health and activity, psychosocial and emotional health and social activities scores, as compared with the control group with low SES. Children operated on for congenital heart defects from medium and high SES families also had statistically lower school activities in comparison to control group of children from medium or high SES families. CONCLUSION: The results of HRQoL according to parental proxy report indicated low SES to influence various aspects of HRQoL in children operated on for congenital heart defects. This could be explained by the fact that the risk factors associated with low SES may directly or indirectly affect not only family HRQoL but also HRQoL of children operated on for congenital heart defects. Therefore, it appears necessary for the low SES families with a child suffering from chronic disease to receive help from wider community to solve the above mentioned problem.

[Quality-of-life of adolescents with acne vulgaris]. / Kvaliteta zivota adolescenata s akne vulgaris.

OBJECTIVE: To determine the quality of life in adolescents with acne vulgaris in relation to the severity of clinical picture and sex using the Skindex-29 general questionnaire. PATIENTS AND METHODS: Using a sectional study, the quality of life was analyzed in 90 adolescents of both sexes, aged 16 to 21 years, who were suffering from acne vulgaris. The study was conducted between January 1, 2008 and January 31, 2009, at Department of Dermatovenereology, Dr. Irfan Ljubijankic Cantonal Hospital in Biha6. According to the type of efflorescence, its localization and severity of clinical features, respondents were classified in three groups: group 1 consisted of adolescents with acne comedonica, group 2 with acne papulopustulosa, and group 3 with acne conglobata. The quality of life in these adolescents suffering from acne vulgaris was evaluated by using the general Skindex-29 questionnaire consisting of 30 questions grouped into three scales (scale of emotions, symptom scale, and scale of social and physical functioning) about the psychological impact of acne on the quality of life. RESULTS: In the study group, there were 54 (60%) female and 36 (40%) male respondents, mean age 17.5 (range 15.6-20.6) years. Of the total number of patients with acne vulgaris, nine (4 female and 5 male; 10%) had acne comedonica (group 1), 72 (46 female and 26 male; 80%) acne papulopustulosa (group 2) and nine (4 female and 5 male; 10%) acne conglobata (group 3) (p > 0.95). Skindex-29 values expressed as mean +/- SD or median (range) in groups 1,2 and 3 were as follows: on the scale of emotions 43.1 +/- 22.2, 60.4 +/- 20.1 and 52.5 +/- 28.7 (p = 0.084); on the scale of symptoms 26.5 +/- 15.4, 49.0 +/- 20.5 and 42.95 +/- 26.1 (p = 0.039); and on the scale of functioning 23.4 +/- 24.6, 36.0 +/- 23.2 and 34.8 +/- 30.9 (p = 0.341), with cumulative score of 31.0 +/- 10.5, 47.5 +/- 12.0 and 43.44 +/- 8.8 (p = 0.069), respectively. Skindex-29 values were expressed as median (range) in women and men in all three groups, as follows: women, scale of emotions 44.0 (27.5-60), 64.0 (10-90) and 62.5 (5-83) (p = 0.25); scale of symptoms 32.7 (21.5-42.4), 54.2 (17.6-90) and 63.5 (17.8-92) (p = 0.17); scale of functioning 22.2 (2-46.5), 39.2 (0-90) and 51.6 (0-83) (p = 0.31); and men, scale of emotions 30.0 (22.5-90), 55.5 (7.5-100) and 40.2 (30-97.5) (p = 0.26); scale of symptoms 11.9 (4-50), 54.0 (0-75) and 28.5 (17.8-42.8) (p = 0.003); and scale of functioning 13.0 (5-77), 31.7 (0-84) and 14.6 (4.5-72.9) (p = 0.58). CONCLUSION: Acne vulgaris affects the quality of life in adolescents involved regardless of the severity of the clinical picture, with a pronounced impact in women.