Ante Mazalin - Poliklinika Salvea

Have you already done a pediatric hip ultrasound examination?

Ante Mazalin — Tue, 26 Mar 2024 08:56:36 +0000

evelopmental dysplasia of the hip (DDH) is one of the most common congenital deformities of the human locomotor system. It occurs due to abnormal growth and improper anatomical relationships of the joint bodies – the acetabulum on the pelvic bone and the head of the femur.

When we talk about developmental hip dysplasia, we refer to various forms of the disorder – from transient instability of the newborn hip, to poorly developed acetabulum (acetabular dysplasia), to partial (subluxation) or complete ( da se ne ponavlja) dislocation of the joint.

Risk factors

The exact cause of developmental hip dysplasia is unknown, but there are certain risk factors:

Presence of developmental hip dysplasia in close family members
More common in female children
Breech position in the womb or breech birth
Prematurity
Low amniotic fluid
Twin pregnancy
High birth weight

A higher incidence of developmental hip dysplasia is also seen in newborns with other musculoskeletal disorders, such as torticollis (congenital wry neck) or foot deformities (pes equinovarus, pes metatarsus adductus, etc.).

Ultrasound of children's hips

Early detection of developmental hip dysplasia is extremely important because it allows timely and successful treatment, preventing late consequences such as chronic pain, reduced range of motion in the hip joint, shortening of the affected leg, and limping.

Therefore, in addition to regular clinical hip examinations in the maternity ward and during regular pediatric check-ups, it is recommended to routinely perform an ultrasound examination of the hips using the Graf method. This method provides a detailed insight into all anatomical structures of the joint and their relationships and is now an indispensable method in diagnosing developmental hip dysplasia.

The examination is recommended to be performed between the fourth and eighth week of life.

Preparation for the Hip Ultrasound Examination

The ultrasound examination is quick, painless, and completely harmless, with no exposure to radiation. The examination is performed by applying an ultrasound probe coated with contact gel to one hip and then the other. It is recommended to feed the child before the examination to ensure the baby is as calm as possible during the procedure. No additional preparation is required for the ultrasound examination.

This screening is conducted by trained pediatric orthopedists, pediatricians, or radiologists, and after a diagnosis is made, further treatment and monitoring are carried out by pediatric orthopedists.

The choice of treatment method and the success of the treatment depend on the degree of developmental hip dysplasia and the age at which it is detected. Therefore, the recommended screening ultrasound of the hips and regular systematic examinations are of utmost importance for every newborn.

Book an ultrasound examination of the hips at Polyclinic Salvea!

Contact us at +385 1 3300 505 or via email at info@poliklinika-salvea.com.

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Whooping cough or pertussis in children and why vaccinate a child against it

Ante Mazalin — Wed, 29 Nov 2023 15:14:05 +0000

Whooping cough, also known as pertussis, is a contagious respiratory disease caused by the bacterium Bordetella pertussis. It spreads rapidly through droplets from coughing or sneezing among people in close contact, making it highly transmissible among children in kindergartens and schools.

What are the symptoms of whooping cough in children?

The classic clinical presentation is most common in preschool and school-age children. It starts like a common cold lasting for a few days, followed by the characteristic stage of the illness: frequent bursts of coughing in a single exhalation, followed by a sudden, loud “whooping” inhalation. This is often accompanied by facial redness or blueness, tearing, and coughing up thick mucus. This intense phase of the illness gradually subsides over 2-4 weeks, with several more weeks needed for the child to fully recover and stop coughing.

A special concern is the infection in infants during the first few months of life. They often do not show the typical severe coughing stage – coughing may or may not be present. Complications are more frequent at this age and can include pneumonia, apnea (a pause in breathing which can be the only sign of the disease), and convulsions, which may require mechanical ventilation and pose a risk of permanent brain damage.

Why vaccinate your child against whooping cough?

The most severe forms of the disease occur in the first few months of life, which is why, according to the regular vaccination schedule, we start vaccinating children against whooping cough from the age of 2 months. This vaccine is part of the so-called “6-in-1” vaccine. Since the immunity provided by the vaccine lasts only 6 to 10 years, it is now recommended that pregnant women receive a booster shot in the third trimester. This is to primarily protect newborns through the transfer of antibodies via the placenta before their first vaccination, and also to protect the mother.

The Whooping Cough Vaccine Is Available at Salvea Polyclinic

Contact us to learn more about the vaccination recommendations against whooping cough and to schedule an appointment where our pediatrician will examine and vaccinate your child.

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Flu (influenza) in children: symptoms, duration and treatment of flu

Ante Mazalin — Wed, 29 Nov 2023 14:59:35 +0000

What is influenza?

Influenza, commonly known as the flu, is an acute infectious disease caused by the influenza virus. It causes epidemics worldwide, typically during the colder months. It spreads rapidly through droplets, putting children, especially preschoolers, at high risk due to their not yet fully developed hygiene habits (frequent runny noses, coughing, and sneezing without covering their mouths, close contact with other children in group settings).

What is the incubation period and what are the symptoms of influenza?

The period from contact with an infected person to the development of symptoms is short, ranging from 1 to 4 days. In children, the illness often does not follow a typical course. The most common symptom is a high fever accompanied by respiratory symptoms (runny nose, coughing, sore throat, hoarseness), while some children may predominantly experience gastrointestinal issues, such as diarrhea and vomiting.

How to treat influenza in children?

If the child feels better, behaves normally, eats, drinks fluids, and the fever reduces with medication, the illness generally follows a non-threatening course. Symptomatic treatment at home is recommended, which includes reducing the fever and ensuring the child drinks plenty of fluids.

What are the complications of influenza in children?

The younger the child, the higher the risk of complications. Complications can be due to the virus itself or secondary bacterial infections (most commonly bacterial ear infections or sinusitis, less frequently bronchitis and pneumonia). Rare and severe complications include febrile seizures, myocarditis (inflammation of the heart muscle), meningitis and encephalitis (inflammation of the brain), and bacteremia or sepsis (penetration of bacteria in the bloodstream).

Signs of complications in children

Signs that may indicate complications and a more severe course of illness include:

High fever that does not respond well to medication or is accompanied by chills
Severe headache or ear pain
Pronounced drowsiness, lethargy, or difficulty waking up
Frequent and severe coughing
Rapid and labored breathing
Repeated vomiting
Appearance of a rash

These signs require an immediate medical examination.

Should children be vaccinated against influenza?

Vaccination against influenza is highly recommended, particularly for children under 5 years of age (noting that vaccines are registered for infants older than 6 months), individuals with chronic illnesses, healthcare workers, and those working with children in kindergartens and schools. Currently available quadrivalent vaccines contain four strains of the virus that circulated in the previous season, providing 70-80% protection.

Pregnant women are also at high risk for severe influenza, and vaccination during the second or third trimester is advised to protect both the mother and the unborn child, as well as the newborn in the first few months of life.

Influenza vaccination for children at Salvea Polyclinic

Contact us today to learn more about influenza vaccination available for your children at the Salvea Polyclinic.

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Vaccination of children against Rotavirus: why, when and are there side effects

Ante Mazalin — Wed, 29 Nov 2023 14:46:44 +0000

Why vaccinate your child against Rotavirus?

Rotavirus is the leading cause of diarrhea and vomiting in preschool-aged children. It is highly contagious and spreads quickly and easily among household members, often leading to severe clinical symptoms such as significant dehydration that may require hospitalization. Vaccination is the best method to prevent the spread of Rotavirus and avoid severe illness.

What are the symptoms of Rotavirus?

The incubation period for Rotavirus is very short, only 1 to 2 days, and a child can be contagious for 1 to 3 weeks after symptoms appear. Symptoms include:

Elevated temperature
Vomiting
Diarrhea and abdominal pain

Due to the nature of these symptoms, it is important to ensure adequate fluid intake during the illness to prevent dehydration.

When should your child be vaccinated?

It is recommended that all children receive the Rotavirus vaccine. Vaccination should begin in the first month of life and be completed by six months of age because younger children are at greater risk of severe illness.

In Europe, more than 3.6 million children under the age of 5 get sick from Rotavirus each year, and many of these cases could be prevented with early vaccination. Rotavirus-induced gastroenteritis is a childhood illness that is most effectively prevented with vaccination.

What is the Rotavirus vaccination process like?

The rotavirus vaccine is administered in two or three doses, depending on the type of vaccine. The vaccine is a liquid in an ampoule that is given orally – children usually consume it without any issues.

What are the side effects of the vaccine?

Common side effects include transient irritability and mild diarrhea. Serious side effects such as apnea, intussusception, or allergic reactions to the vaccine are extremely rare.

Book your appointment for Rotavirus vaccination!

At the Salvea Polyclinic, you can get more information about the vaccine and schedule a vaccination appointment for your child. Contact us today!

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Bronchitis in children: causes, symptoms and treatment

Ante Mazalin — Wed, 29 Nov 2023 14:30:10 +0000

What is bronchitis?

Literally translated, it means inflammation of the bronchi, the lower airways that branch off from the trachea (trachea), which consequently become narrowed due to various causes with increased secretion of bronchial secretions.

What causes bronchitis in children?

In children, it is most often the result of infection with various viruses that also cause inflammation of the upper respiratory system, less often it is bacterial, and it can also be triggered by other influences such as cigarette smoke or environmental allergens.

What are the symptoms and signs of bronchitis?

Along with common cold symptoms such as sniffles, sneezing and sore throat, cough is the most pronounced symptom, and it can be dry or productive with expectoration, sometimes accompanied by audible “whistling” and “scraping” in the chest. It is extremely important to spot the symptoms and signs of a compromised respiratory system in time, such as rapid breathing, use of auxiliary respiratory musculature (seen as pulling in the intercostal muscles or jugulum – the area above the sternum), blue coloration of the mucous membrane of the tongue and lips, and in infants, moaning and nodding their head when breathing – then you need to see a doctor immediately.

How is bronchitis treated in children?

Parents can independently start to carry out symptomatic therapy – nasal lavage with physiological saline solution or commercially available preparations of hypertonic seawater solution, inhalation with physiological saline solution, maintenance of good hydration of the child. In the event that the above measures do not help or signs of a respiratory system threat appear, further assessment of the condition and therapy should be left to the pediatrician. Given that bronchitis is most often caused by viruses, antibiotics have no effect in this case.

What if bronchitis recurs?

In the case of repeated “attacks” of bronchitis, the doctor will consider the need for further treatment in accordance with the medical history of the child and his family and the clinical picture, given that various other chronic diseases of the respiratory and other systems can manifest themselves with the above symptoms.

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Chickenpox in children: symptoms, duration and treatment

Ante Mazalin — Sun, 26 Nov 2023 14:14:33 +0000

What are chicken pox?

Chicken pox, also known as varicella, is a viral infectious disease that is extremely easily transmitted by secretions of the respiratory tract or the fluid of blistered skin changes, so it most often affects several children in the same group (kindergarten groups or school classes). The first signs of the disease appear 10 to 20 days, and most often around 14, after contact with a sick person.

What does chicken pox look like?

Typical skin changes in chicken pox are small pinkish-red papules that turn into blisters within 24 hours, after which they dry up and become scabs in a few days and eventually fall off on their own.

Such a rash breaks out in waves over 4 to 5 days, in each wave new papules appear that later go through all the previously mentioned stages and may or may not be accompanied by an elevated body temperature, which, if it occurs, usually returns to normal when the rash stops breaking out. Skin changes first appear on the trunk, where they are usually the densest, and then spread to the neck, face, scalp, arms and legs. It should also be noted that the mucous membranes of the eye, ear, mouth and genitals can also be affected.

When all the blisters become scabs, usually around the 10th day after the onset of the disease, the child is no longer contagious and can usually return to the collective after 2 weeks. No scars remain on the skin, except for more heavily infected scabs or those that the child persistently peeled mechanically.

What are the complications of chicken pox?

Complications of chicken pox are not common and the disease usually goes through the previously described clinical course. If they occur, the most common complication is purulent, bacterial inflammation of the skin, the entry point of which is “scratched” blisters. Serious complications of the disease – viral pneumonia or inflammation of the brain and meninges (children with weakened immunity or those suffering from malignant diseases are at greater risk) are much less common.

Signs of the disease that may indicate complications and should be reported to the doctor immediately:

scabs or blisters that, along with the underlying skin, look pus-filled, extremely red, or the rash appears bloody
a rash that occurs in the eye area
fever, especially of 40°C body temperature and above, which drops after the use of medicine
severe cough, heavy breathing and wheezing
drowsiness, weakness and lethargy, frequent vomiting, severe headache in an older child (especially if it does not respond to the use of analgesics), dizziness or dizziness when walking

How to treat chicken pox in children?

Symptomatic therapy is primarily carried out. We lower the elevated body temperature with paracetamol and ibuprofen in the recommended doses. Itching can be alleviated by coating or spraying the skin changes with preparations available in pharmacies, showering with water or possibly rinsing with a mild solution of hypermanganese while drying the skin with a soft towel by gently patting without rubbing. An antihistamine prescribed by the doctor can also help. To prevent further infection of the rash, it is important to trim the child’s nails, regularly wash his hands with antibacterial soap, and in case of pronounced itching of a small child, cotton gloves can be put on him.

Drug therapy, such as acyclovir, is reserved for the treatment of the disease in children with a weakened immune system or who suffer from other chronic diseases, as well as in more severe forms of chickenpox and complications.

Should the child be vaccinated against chicken pox?

There is an effective vaccine against chicken pox that is not included in the mandatory vaccination schedule, and it can be used in children older than 12 months. Once vaccinated, the child usually does not get chickenpox, and if it does, it usually has a very mild form with an extremely low risk of developing complications. The same effect can be achieved by administering the vaccine to unvaccinated children even up to 5 days after contact with a sick person. It is also recommended to vaccinate adults who have not recovered from chicken pox, since their risk of developing a more severe form of the disease is higher, especially women of reproductive age who are planning to become pregnant, as the virus can cause more severe damage to the fetus.

When not to vaccinate a child?

Children who previously had an allergic reaction to gelatine or neomycin (traces of which can be found in the vaccine) or to a previous dose of chickenpox vaccine. Also, given that the vaccine contains a live, inactivated virus, it should not be used during pregnancy or 3 months before pregnancy and in children with a weakened immune system.

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Elevated body temperature in children: what to do when a child has a fever?

Ante Mazalin — Wed, 22 Nov 2023 13:16:56 +0000

We consider an elevated body temperature in a child above 37.2°C measured under the armpit (axillary temperature), or 37.8°C measured in the hindgut (rectal temperature) or in the ear (tympanic temperature). It warns us about the existence of a certain disease, in children most often of infectious origin.

When to measure a child's temperature?

Always when the child seems warmer than usual, when he or she is calmer, irritable and tearful, has a poor appetite and with the presence of signs of illness (e.g. severe sniffling, coughing, diarrhea or vomiting, rash, headache or the like).

How to measure a child's temperature correctly?

In the first year of a child’s life, it is recommended to measure the rectal temperature – the narrower part of the thermometer is placed about 2 cm into the opening of the hindgut and kept there as long as the temperature on the thermometer rises (usually it takes 2 to 3 minutes).

In older children, we usually measure axillary, by placing the narrow part of the thermometer in the centre of the previously dried armpit and placing the hand next to the body. The required measurement time is about 10 minutes.

Measurement with an ear thermometer is not recommended in infants, especially in children younger than 6 months, due to the possible imprecise measurement resulting in a narrower ear canal, while in older children it may be unreliable in the case of a cerumen plug in the ear canal.

When to lower children's temperature?

In principle, it is recommended to start lowering the temperature in children when it is above 38°C measured under the armpit or 38.5°C rectally. However, given that elevated body temperature is one of the ways in which the body deals with infectious disease agents, primarily by improving the function of the immune system, the need to lower the temperature is best assessed individually. Children who are lively, have no pain, behave properly and tolerate a high temperature well should not be given an antipyretic immediately.

On the other hand, for the youngest children (up to 12 months of age) and the older ones who have severe accompanying symptoms such as muscle pain, headache, lethargy, poor appetite and malaise, we can start lowering the body temperature even before reaching the specified values.

Why do we lower the temperature in children?

In addition to alleviating the previously mentioned accompanying symptoms of fever, by lowering high temperature values in children, we reduce the possibility of other unwanted consequences, primarily dehydration (increased fluid loss) or febrile convulsions (a seizure during which the child loses consciousness and turns blue), usually lasting several seconds to minutes, especially in the youngest children.

How to lower a child's fever?

Primarily with medicines. The most suitable are paracetamol and ibuprofen, if possible as a single drug or a combination of both in case of ineffectiveness of one drug, while following the instructions on quantities and time interval between administration of individual doses (the interval between two doses of paracetamol should not be shorter than 5 hours). We can also help by bathing the child – about twenty minutes after giving the medicine (onset of action for the specific medicine) while preventing shivering, put the child in a water tub at a temperature of about 37°C for about twenty minutes for slow cooling.

We must also not forget about the risk of dehydration, so it is necessary to regularly offer the child liquid – tea, juice or water at room temperature.

When to contact the doctor?

In the case of elevated body temperature in newborns and infants younger than 6 months, because then there is a higher probability of serious bacterial infections than at a later age, and the signs and symptoms of the disease are often more difficult to notice.

In older children, it is necessary to contact us immediately in case of an extremely high temperature (40°C and above), especially if it is less responsive to medication or is accompanied by shivering, and in the event of other signs of the disease – severe headache, profuse vomiting, impaired consciousness, difficulty breathing, skin rash or refusal to take liquids.

If you recognize some of these signs, do not hesitate to contact us – the medical team of the Salvea Polyclinic is at your disposal.

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