Cilj rada je podsjetiti na predanalitičke, analitičke i poslijeanalitičke osobitosti i ograničenja određivanja D-dimera radi racionalneprimjene laboratorijske pretrage te ispravnog tumačenja nalaza i literaturnih navoda. U cirkulaciji zdravih osoba nalazi se vrlo malakoličina D-dimera, a patološko povećanje njegove vrijednosti prisutno je u kliničkim stanjima s pojačanom koagulacijskom i fi brinolitičkom aktivnošću, odnosno njegovim promijenjenim metabolizmom. Rutinsko određivanje D-dimera primjenjuje se za postavljanje dijagnoze i praćenje tijeka diseminirane intravaskularne koagulacije te u diferencijalnoj dijagnostici tromboembolijskih stanja.Zbog velike negativne prediktivne vrijednosti koncentracija D-dimera manja od defi nirane granične vrijednosti isključuje dijagnozutromboembolijske bolesti i pomaže u probiru pacijenata kojima je potrebna daljnja obrada skupim slikovnim metodama. Imunokemijske metode za kvantitativno određivanje koncentracije D-dimera nisu standardizirane, primjenjuju monoklonska anti-D-dimerantitijela različite specifi čnosti te različite detekcijske reakcije, zbog čega je prisutna heterogenost u izvještavanju rezultata, što otežava usporedbu nalaza i rezultata istraživanja dobivenih različitim metodama. Kako bi nalaz i tumačenje nalaza D-dimera biliispravni i pouzdani, potrebno je zadovoljiti predanalitičke zahtjeve: najpogodnije vrijeme uzorkovanja, poznavanje osobitosti metode kojom je određena koncentracija D-dimera te poznavanje ograničenja određivanja D-dimera vezana za pojedina patološkastanja.

Prikazujemo žensko dojenče s fenotipskim karakteristikama sindroma Cornelia de Lange kod kojeg je dokazana i uspješno kirurškiliječena pridružena malrotacija crijeva. Svrha je rada upozoriti na činjenicu da malrotacija crijeva, iako ne pripada skupini učestalihsimptoma sindroma Cornelia de Lange, ne smije biti izostavljena u diferencijalnoj dijagnostici gastrointestinalnih tegoba u navedenih bolesnika.

The already published reference values for cardiopulmonary exercise test (CPET) might not be representative for our population. Our aim is to create reference values for CPET in children and adolescents in northwest Croatia. Exercise testing according to modifi ed Bruce treadmill protocol was performed in 164 healthy children aged 11-17 years. Results are presented as mean and standard deviation. Mann-Whitney test was used for continuous variables without normal distribution. Boys reached signifi cantly higher peak oxygen consumption (VO2) at anaerobic threshold (AT) with mean 37.13±8.9 mL/kg/min compared with 31.95±6.6 mL/kg/ min in girls. The same fi nding was recorded for VO2 at peak exercise (peak VO2) where boys reached signifi cantly higher peak VO2 of 51.3±8.9 as compared with 41.49±6.51 mL/kg/min in girls. During incremental work, systolic pressure increased from mean 109.86±14.2 mm Hg to 145.43±11.9 mm Hg, with no signifi cant diff erence between girls and boys. During incremental work, together with linear increase in heart rate and systolic pressure, oxygen pulse that represents cardiac output, showed linear increase with signifi cantly higher values in boys. Compared with girls, boys had signifi cantly higher tidal volume at rest and reached signifi - cantly higher peak minute ventilation. This study has comprehensively provided a reference set of data for the most important cardiopulmonary variables in a population of healthy children and adolescents in northwest Croatia. Our fi ndings showed strong correlation with previous reports and gave a basis for further research.

Aim: to investigate seasonal diff erences in concentrations of total IgE (tIgE), specific IgE to birch allergen Bet v, and index of specific IgE (I-sIgE) in children with hypersensitivity to birch allergen Bet v. Methods: Children with asthma and/or rhinitis (N=19) sensitive to birch allergen Bet v. Concentrations of tIgE and sIgE to Bet v were determined by the use of standardized UniCAP-fl uoroimmunoassay method. Also, I-sIgE was calculated. Selected biomarkers were determined during the birch pollen season (from March to June) and out of season (during October). Results: During the birch pollen season, concentration of sIgE to Bet v was [M(IQR) = 33.9(7.2-130.3) kIUA/L], and out of season [M(IQR) = 5 (2.3-32.7) kIUA/L], p = 0.005. At the same time neither tIgE nor I-sIgE were statistically diff erent. During the pollen season, the largest concentrations of tIgE (1378 kIU/L) and sIgE (942 kIUA/L) was found in the child with asthma and rhinitis, also sensitive to grass, ragweed and hazel allergens. I-sIgE was 0.68. Out of season uIgE was 146 kIU/L, sIgE to Bet v 46 kIUA/L, and I-sIgE 0.31. Conclusions: For precise interpretation of tIgE, sIgE to Bet v and I-sIgE blood samples should be taken during the pollen season.