Objective To identify which laboratory tests that change over time are most valuable for the timely diagnosis of macrophage activation syndrome (MAS) complicating systemic juvenile idiopathic arthritis (sJIA). Methods A multistep process, based on a combination of expert consensus and analysis of real patient data, was conducted. A panel of experts was first asked to evaluate 115 profiles of patients with MAS, which included the values of laboratory tests at the pre-MAS visit and at MAS onset, and the change in values between the two time points. The experts were asked to choose the 5 laboratory tests in which change was most important for the diagnosis of MAS and to rank the 5 selected tests in order of importance. The relevance of change in laboratory parameters was further discussed and ranked by the same experts at a consensus conference. Results Platelet count was the most frequently selected test, followed by ferritin level, aspartate aminotransferase (AST), white cell count, neutrophil count, and fibrinogen and erythrocyte sedimentation rate. Ferritin was most frequently assigned the highest score. At the end of the process, platelet count, ferritin level and AST were the laboratory tests in which the experts found change over time to be most important. Conclusions We identified the laboratory tests in which change over time is most valuable for the early diagnosis of MAS in sJIA. The dynamics of laboratory values during the course of MAS should be further scrutinised in a prospective study in order to establish the optimal cut-off values for their variation.

Communication is a great value of the whole humankind. People who communicate well are able to convey their knowledge and ideas to other people. Good and quality communication is necessary for functioning in all spheres of the social life, and at the same time for the functioning of the pedagogical-educational process. The research has been conducted for determining which types, i.e. what sort of communication is dominant in the relation principal - students. The sample included 590 students of primary and secondary school and 14 principals from the region of Herzegovina (Bosnia and Herzegovina). Licker's scale was used for gathering data. Results of the research showed that communication between principal and students, there was democratic, direct and non-violent communication between principals and students. Communication between a principal and students is still the area, which is not given great significance. Most often, the accent is on communication between students and teachers, avoiding the analysis of communication between students and principals. Although in the pedagogical-educational work, communication between students and teachers is dominant; our opinion is that it is necessary to develop this communicational area as well. Quality communication at school should be a strategic point of principals, and it should be planned and applied consciously and continuously.