Tibial stress fracture simulate osteomyelitic foci in the course of chronic recurrent multifocal osteomyelitis.

Chronic recurrent multifocal osteomyelitis (CRMO) is an extremely rare and most severe form of chronic nonbacterial osteomyelitis of unknown etiology. Here we present the first case of a six-year-old girl in which was observed that the stress fracture mimic osteomyelitic foci in the course of CRMO.

Complete transcatheter closure of a patent arterial duct with subsequent haemolysis.

We report a development of severe haemolysis after complete transcatheter closure of patent arterial duct. Aortography and echocardiography revealed no signs of residual shunt. Haemolysis occurred a day after the implantation. Aortography was performed and the extrusion of coil in aorta was evident. The extruded part of the coil was surgically removed. No signs of haemolysis remained.

Dental status as a quality control health care parameter for children with disabilities.

The aim of this study was to determine the level of dental health condition in children with disabilities and to find out weather dental health status might be used as a quality control parameter regarding overall health care for disabled children. Disabled and healthy children from 3 to 17 years old were examined. There were 86 boys and 34 girls in each group. Dental health status was evaluated using the World Health Organization diagnostic criteria for decayed, missing and filled teeth. The relations between mean decayed, missing and filled teeth index for primary, mixed and permanent dentition showed no statistically significant differences among groups. Our results showed that disabled children have evenly level of dental caries as their healthy peers. One can conclude that organized health care for disabled children have positive influence on dental care, too. Furthermore, dental status as an indicator of dental care level might be used as a parameter for quality control regarding overall health care for disabled children.

Hearing loss assessed by universal newborn hearing screening--the new approach.

OBJECTIVE: Universal hearing screening at the delivery centers enable early detection of hearing impairment. Since the 2002, hearing screening in neonates is performed in all Croatian delivery centers. The aim of this study was to propose the retest after 3 weeks period to those neonates with presumably hearing impairment demonstrated by evoked otoacoustic emission (E-OAE) method. Second aim was to asses the prevalence of hearing impairment in the Northern Adriatic region of Croatia. PATIENTS AND METHODS: Investigation has been conducted at the Department of Gynecology and Obstetrics, University Hospital in Rijeka, Croatia, in the period from 16 October 2002 to 31 December 2006. The hearing screening was performed in all newborns immediately before their discharge from the hospital, using the E-OAE method. Newborns with a possibility of hearing impairment were invited for retesting after 3 weeks, using the same method. Those newborns, whose repeated screening suggested a possible hearing impairment, were sent to an audiologist. RESULTS: The hearing screening was performed by E-OAE method in 11.746 (98.9%) out of 11.869 newborns. The positive result indicating hearing impairment had 5.7% (676) children. These children where retested 3 weeks later using same method and only 128 (1.1%) of them still had positive results. Definite bilateral hearing impairment was confirmed by audiologists in seven children, which accounts for the total incidence of hearing impairment of 0.6 per thousand. CONCLUSIONS: Universal newborn hearing screening provides early detection of hearing loss. Retesting after 3 weeks with the same-E-OAE method we raised the specificity of E-OAE method, eliminating false-positive results (4.2%), decreased the attendance of healthy children to the audiologist center and most likely lowering the total costs and eventual parental and/or children stress.