Objective – The objective of this study was to assess the health-related quality of life (HRQoL) in children with cerebral palsy (CP) in relation to socioeconomc status (SES) of family. Methods – The cross-sectional study included 75 children with CP between ages 5 and 18 years and their parents. The control group was formed by random selection by matching each patient with one or two healthy control participants. To evaluate the generic HRQoL in children with CP we used the PedsQL™ 4.0 Generic Core Scales which include both a parent proxy-report and a child self-report with age-appropriate versions. SES was determined using a classification system based on the parents’ job and educational level. Results – Lower-SES children with CP showed significant lower medians of total scores, physical health, psychosocial health, and social functioning HRQoL than lower SES control participants and, middle SES children with CP showed significant lower medians of total scores, physical health, psychosocial health, than middle SES control participants. Parental reports revealed significantly poorer HRQoL in lower SES children with CP in total scores, physical health, psychosocial health, social functioning, and school functioning than lower SES control participants. Also, the parental proxy reports for middle SES children with CP were significantly lower in total scores, physical health, psychosocial health, and social functioning than middle SES control participants. Conclusions – This study showed that low and middle SES children with CP have lower HRQoL than low and middle SES healthy children. Our results call for the creation of socialeconomic and psychological programs which might have beneficial effects for children and adolescents with CP and their families.

Objective – Outbreaks of sepsis caused by multidrug-resistant Acinetobacter baumannii in neonatal intensive care units have been reported, but rarely from our country. We describe such an outbreak in the Department of Paediatrics of the University Clinical Centre Tuzla in 2012 to investigate risk factors, the mode of transmission and to assess control measures. Setting – An 18 bed, level 3 neonatal intensive care unit in a university affiliated teaching hospital. Patients and methods – Seventeen neonates who developed multidrug-resistant Acinetobacter baumannii nosocomial infection were matched to 17 neonates who were admitted to the same unit without infections, during the outbreak period. Cases and controls were compared for possible risk factors (birth weight, gender, intubation, antibiotic use, etc.). Surveillance cultures were collected from health care personnel and the environment. Results – Six out of the 17 neonates (35.3%) died. Surveillance cultures were negative. Seventeen isolates from newborns had the same patterns of resistance. Multidrug-resistant Acinetobacter baumannii was brought into the unit by an infected infant who was transferred from the neurosurgery hospital. Risk factors significantly associated with the infection were: incubator care (OR 6.66; p =0.034), exposure to a central venous catheter (OR 13.75; p=0.004), mechanical ventilation (OR 5.25;p =0.031) and exposure to a patient with Acinetobacter baumannii infection (OR 38.40; p =0.02). Conclusion – Surveillance cultures for all newborns transferred from other hospitals and isolation measures are important to prevent nosocomial infections and outbreak. Negative environmental and health care worker cultures have to be meticulously analyzed. Cohorting of affected newborns and nursing staff, contact isolation, and environmental cleaning are crucial to control the outbreak.

Objective – Teratomas with sacrococcygeal, mediastinal and gonadal locations are the most frequently occurring pediatric germ cell tumors. Cervicofacial and intracranial locations are rare. Approximately 20% of giant cervical teratoma causes airway compression. We report a congenital cervical teratoma with partial airway compression diagnosed post-natally in a preterm infant. Case report – A 27 year old mother delivered a male infant at 35 weeks gestation after her first uneventful pregnancy. The newborn had a notable anterior neck mass measuring 4x5 cm. The alpha fetoprotein level was elevated at 317.5 ng/ml and I²-HCG was less than 1.2 mI U/ml. An MRI scan showed a 24x53x27 mm prelaryngeal and paratracheal solid-cystic mass compressing and shifting the larynx and trachea to the right. The tumor was approached via a wide collar incision. It did not communicate with the oesophagus, trachea or thyroid gland and did not infiltrate the surrounding tissues. It was completely excised. Pathological examination revealed an immature teratoma. The recovery was uneventful. Conclusion – Teratoma in infancy may present in an unusual cervical location. Not only giant tumors may compress the airway.