Silvija Pušeljić

Histopathological placental inflammation provides objective evidence of intrauterine inflammatory exposure in preterm birth, but placental histopathology i

Aim: In the last decade, an increase in the incidence of autoimmune thyroid disease in children has been observed. The aim of the study was to determine the incidence of thyroid disease in the pediatric population treated at the Pediatric Clinic in Osijek; to determine if there was a rise in thyroid disease incidence in pediatric population in the observed period; and to determine whether there was any association of certain factors with an increased incidence of thyroid disease.Methods: This study was a two-year retrospective study in two separately observed one-year periods (2010 and 2017). All patients with thyroid endocrinological disorders treated at the Pediatric Clinic of the University Hospital Centre Osijek were included in the study. Their medical records were used to obtain data. Differences between variables were tested by the χ2 test, Fisher's exact test and Mann-Whitney U test. The level of statistical significance was accepted for p <0.05.Results: There was a 2.4-fold increase in the approximate incidence of thyroid disease, 9.7-fold higher approximate incidence of autoimmune thyroiditis, 9.75-fold higher approximate incidence of unspecified hypothyroidism and a triple increase in the approximate incidence of non-toxic goiter. Other unspecified thyroid diseases are also statistically significantly on the rise. An analysis of factors such as anamnestic features, age, gender, comorbidities and other relevant data could not explain the increased incidence of thyroid disease.Conclusion: The incidence of thyroid disease has increased considerably in the observed years, following world trends. Efforts should be taken to clarify the mechanisms and factors involved in causing thyroid diseases in the pediatric population.

Aim: The objectives of this study are to evaluate the incidence of headache considering the type of headache, to define the types of headaches, to determine the difference in the status of diagnostic scanning in children with headaches, to establish a correlation between the psychological profile of the child and the incidence of headache, and to establish a correlation between socio-demographic characteristics and the type of headache.Patients and Methods: The study included 139 patients with headache symptoms up to the age of 18, hospitalized at the Pediatric Clinic of the University Hospital Center Osijek from 1/1/2017 to 31/12/2018. The data included demographic data, diagnosis, environmental factors, EEG findings, neuroimaging data processing and other indicated medical tests.Results: A headache usually occurs between the ages of 12 and 18 (69.8%). It is more common in girls (70.5%). The common localizations are frontal and occipital. Altered standard EEG findings were reported in 26.7% of patients. Additional neuroradiological processing (brain MRI) was indicated in 98 patients (70.5%), with changes found in 56 patients (57.1%). Psychological assessment indicated that patients with functional headaches predominantly suffer from anxiety, emotional instability and somatization, while patients with organic headaches reported high stress levels (82%).Conclusion: Headaches occur more frequently in pubescent girls. The most common concomitant symptoms include nausea and vomiting, while the most common localization is frontal. Patients also report emotional instability, cognitive deficits and somatization, as well as high stress levels. Headache as a result of psychological tension is the most common diagnosis in the observed group of patients.

Aim: In this case-control study we wanted to compare the perinatal outcome of naturally conceived newborns to those born after in vitro fertilization (IVF).Methods: At the University Hospital Centre Osijek, in the period from January 2014 to December 2016, we analysed 120 in vitro fertilization pregnancies and compared to 120 natural conception pregnancies. Characteristics of mothers, birth method, perinatal outcome, and vital characteristics of newborns were analysed.Results: IVF-ET pregnancies included 70.0% singleton pregnancies, 28.3% twin and 1.7% triplet pregnancies, while all naturally conceived pregnancies were singletons. When pregnancies were compared between IVF-ET and naturally conceived groups, the following characteristics of mothers were established: age 34.83 (5.8):30.39 (3.9); previous pregnancy 13.3%:56.7%; complications in pregnancy 50.0%:25.0%; Caesarean section (CS) 69.2%:35.8%. All of these were statistically significant (p < 0.001). Comparison of newborns between those two groups established the following: prematurity 39.5% vs. 12.7%; lowest BW 2,114 vs. 3,000 grams; lowest GA 22.29 vs. 28.71 weeks. In the IVF-ET group, 5.7% of newborns had a gestational age of 22-25 weeks, but there were no newborns of that gestational age among the naturally conceived newborns. These were also statistically significant differences (p < 0.001). Apgar score was 10 for both groups, but the difference was in the interquartile range, the values of which were lower in the IVF-ET group.Conclusion: In vitro fertilization pregnancies are high risk due to the characteristics of both the mother and the infant and, as such, require special attention and care.

Introduction: Numerical and structural chromosomal aberrations are some of the most common causes of intellectual disability/mental retardation (ID/MR), especially syndromic, and they represent about 10% of ID/MR that can be detected using cytogenetic methods. Aim: The aim of this study is to show the results of cytogenetic findings in 340 patients with ID/MR and dysmorphia and/or multiple malformations in Eastern Croatia, examined at the Paediatric Clinic of the Clinical Hospital Centre Osijek and the Medical Genetics Laboratory at the Faculty of Medicine Osijek. Methods: Cytogenetic analysis of 340 samples from patients with ID/MR and/or dysmorphia was conducted using G-banding with Trypsin/Giemsa (GTG) and fluorescent in situ hybridization (FISH). Results: A total of 340 patients with ID/MR with dysmorphia and/or multiple malformations were referred for cytogenetic evaluation. The age range of patients was 0-18 years. The analysis included 221 boys (65%) and 119 girls (35%). A chromosomal aberration was found in 24.5% of patients. Numerical aberrations (aneuploidy) were seen in 64 patients (18.8%). The most common type of autosomal aneuploidy was trisomy 21, found in 14.7% of patients. Sex chromosome aneuploidy was detected in 2.6% of patients. Structural abnormalities were found in 6.5% of patients. Conclusion: The results of our study show that cytogenetic analysis in patients with ID/MR should nowadays be applied when aneuploidies are suspected, since the first-line genetic test for patients with ID/MR, especially non-syndromic, is the Array Comparative Genomic Hybridization (aCGH).