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.
The aim of the study is to assess the association of overweight/obesity and early menarcheal age.
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.
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).
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.
The Child Health Care System of Croatia Mestrovic, Julije, MD, PhD; Bralic, Irena, MD, PhD; Simetin, Ivana Pavic, MD, PhD ...
The Journal of pediatrics,
10/2016, Letnik:
177
Journal Article
Recenzirano
Odprti dostop
The Republic of Croatia is a Parliamentary Republic with a population of 4.2 million people that sits on the Adriatic coast within Central Europe. Gross domestic product is approximately 60% of the ...European Union average, which in turn, limits health service spending. The health system is funded through universal health insurance administered by the Croatian Health Insurance Fund based on the principles of social solidarity and reciprocity. The children of Croatia are guaranteed access to universal primary, hospital, and specialist care provided by a network of health institutions. Pediatricians and school medicine specialists provide comprehensive preventive health care for both preschool and school-aged children. Despite the Croatian War of Independence in the late 20th century, indicators of child health and measures of health service delivery to children and families are steadily improving. However, similar to many European countries, Croatia is experiencing a rise in the “new morbidities” and is responding to these new challenges through a whole society approach to promote healthy lifestyles and insure good quality of life for children.
Izvanbolničke upale pluća u djece Pavlov, Neven; Banac, Srđan; Bralić, Irena ...
Liječnički vjesnik,
10/2021, Letnik:
143, Številka:
9-10
Journal Article
Recenzirano
Odprti dostop
Izvanbolnička upala pluća jest potencijalno ozbiljna infekcija u djece. Dijagnostika izvanbolničkih upala pluća u djece temelji se na anamnestičkim podatcima i kliničkim simptomima i znacima, ...potpomognuto dodatnim dijagnostičkim pretragama: laboratorijskim, slikovnim i mikrobiološkim. Etiologija izvanbolničke upale pluća ovisi o brojnim čimbenicima, kao što su sezonstvo, geografski položaj, dob bolesnika i težina bolesti. Liječenje djeteta s izvanbolničkom upalom pluća uključuje primjenu simptomatskih mjera i u većine bolesnika antimikrobnu terapiju. U radu su prikazane kliničke preporuke Hrvatskog društva za pedijatrijsku pulmologiju radi ujednačenja postupaka i kriterija postavljanja dijagnoze, liječenja i prevencije izvanbolničkih upala pluća u djece.
Primary health care for children in Croatia are mostly provided by primary pediatricians (PP) in the urban and by family doctors in rural areas. During past decades, as apart of health care reforms, ...primary pediatric care experiences several changes. This study was undertaken in order to investigate the trends in organizational structure and functioning of the PPs, based on routinely collected data from Croatian Health Service Yearbooks, 1995 to 2012. The results have consistently shown a shortage of PPs in Croatia. The shortage obviously affects the average number of children per PP; number increased from 994 in 1995, to 1556 children in 2010, which was far above the standard. The shortage of PPs is also related to the high number of visits (30 to 40) per PP and per working day. The obtained results clearly show only the trends, therefore further research is needed for a full understanding of the PHC for pre-school children.
The aim of the study was to assess neonatal birth weight (BW) differences between inland and littoral Croatia, to identify BW groups with most pronounced differences, and possible variations in the ...rate of BW > or = 4000 g between Sibenik area and the rest of littoral (counties with access to the Adriatic Sea) and inland Croatia. The study included data on 99.42% of 200,740 live births recorded in 37 Croatian maternity hospitals during the 2001-2005 period. Distribution of 500-g BW groups was analyzed irrespective of neonatal sex and gestational age. Differences were found between the inland and littoral parts of Croatia according to distribution of the BW groups of < 2500 g (5.4% vs. 4.4%), 2500-3999 g (84% vs. 80.2%) and > or = 4000 g (10.6% vs. 15.4%) (chi2 = 882; p < 0.001).The highest rate of BW > or = 4000 g was recorded in Sibenik-Knin County (5-year mean 18.32%) and was greater throughout the littoral as compared with inland Croatia (5-year mean 14.99% vs. 9.58%). A shift towards higher BWgroups recorded throughout littoral as compared with inland Croatia supports the hypothesis on variation in anthropologic characteristics in the respective populations to be pronounced as early as at birth. Study results confirmed fetal macrosomia not to be exclusively characteristic of Sibenik-Knin County, since the rate of neonatal BW > or =4000 g was significantly higher in the entire littoral as compared with inland Croatia.
To assess secular trends in birth weights of liveborn infants in Croatia from 1983 to 2003.
Of a total of 959,591 liveborn infants in the study period, 384,367 were born in the prewar (1983-1989), ...226,226 during the war (1991-1995), and 348 998 in the postwar (1996-2003) period. The birth weight of liveborn infants was assessed by 500 g weight groups on the basis of data provided by the Croatian National Institute of Public Health.
The gradual and significant increase in the share of infants with birth weight > or =3500 g (<0.001) was paralleled by a reduction in the share of infants with birth weights 2500-3449 g (P<0.001) and <2500 g (P<0.05) in the study period. There was a positive trend in the proportion of 4000-4499 g, > or =4500 g (P<0.001 for both), and 500-999 g (P=0.002) birth weight groups and negative trend in 1000-1499 g, 2500-2999 g, and 3000-3499 g weight groups (P<0.001 for all). During the war period, the proportion of liveborn infants in the 2500-3499 g weight group decreased in comparison with prewar proportion; this trend continued in the postwar period (P<0.001 for both). In the war period, the proportion of liveborn infants with birth weights of 2000-2499 g was significantly larger (P<0.001) and that of > or =4500 g significantly smaller in comparison with the prewar and postwar proportions (P<0.001 for both).
Positive secular changes in infant birth weights observed in the prewar and postwar period contrasted negative changes during the war period in Croatia. This finding may suggest the association between war suffering and stress and changes in birth weights of newborns.
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