In daily medical practice there are many controversies related to the use of medicinal products in breach of registration. The law allows the use of drugs and other products beyond the precise registration, if required conditions are met. At the same time, the possibility of prescribing medicinal products beyond the registration, should not be identified as the right to prescribe“off-label” drugs for reimbursement. The issues of refunds are strictly determined in the announcement of the Minister of Health, which is issued every two months under the Act “reimbursement”. This article clarifies when doctors can use a drug beyond the registration laws when the product deployed outside there gistered indications can be prescribed for the reimbursement.

Breastfeeding is the optimal way of infants’ feeding. American Academy of Pediatrics recommends expanding this way of feeding for infants born premature lyor sick. However, low birth weight is still regarded asa major risk factor for artificial feeding. The paper presents our experience on the stimulation and maintenance of lactation in mothers who delivered prematurely. The principles of guidelines were applicable in the post-natal period in Department of Perinatology and Gynaecology in Zabrze, which made it possible to initiate and maintain breastfeeding in infantswith low birth weight. Rules of procedure have been presented, as early stimulation of lactation, kangaroo method care, store and transport of the breast milk. The rules are based on the WHO and UNICEF recommendation swhich were popularized in other countries. Implemented standard allowed to obtain high rates of breast feeding among infants with low birth weight in that Department. Knowledge of medical staff about the physiology of lactation and compliance to the postpartum rules of conduct created the conditions for the proper initiation and maintenance of lactation afterpremature delivery.

In the past two decades, research on the cytokines involved in the pathogenesis of Inflammatory Bowel Disease(IBD) have been very successful, both in providing major insights into the mechanism of these diseases and in pointing the direction of new therapies. Numerous studies proved that cytokines responding in IBD are dominated by the T-cells. In Crohn’s disease (CD), dominate action of lymphocyte Th1, Th17, interleukins derived from CD4 cells (mainly IL-17 and 22) and INF-γ. In contrast, in ulcerative colitis (UC), a Th 2-like differentiation process is paramount, which results in expansion of natural killer T cells producing IL-13 and IL-5. In this review, we will focus on the main pro-inflammatory cytokines response in CD and UC, excluding the role of inflammatory cells.

Surveillance of invasive infections, especially vaccine preventable, should be a priority of public health inall countries. In Poland this role has been assigned to the National Reference Centre for Bacterial Meningitis (NRCBM) which was established in 1997. To further enhance the surveillance in this area, the NRCBM established in 2008 a voluntary network called BINet for monitoring community-acquired invasive bacterial infections. At present, more than 180 Polish hospitals and microbiological laboratories are involved. During four years of activities on-going education of clinician sand microbiologists has been a major priority and this has led to greater awareness of the pathogens causing invasive infections and the importance of performing appropriate bacteriological testing. We hope that further initiatives will lead us to a better knowledge and understanding of the true burden and epidemiology of invasive infections in Poland and to better implementation of diagnostic, therapeutic and prophylactic standards, comparable to other European countries.

In this paper we present analgesia algorithms in the most common painful conditions seen in patients of the Department of Gastroenterology, Hepatology and Feeding Disorders and the Departmentof Immunology – Children’s Memorial Health Institute in Warsaw. Proposed algorithms are based onexpected/actualpain intensity-adjusted multimodal analgesia. We also discuss basic principles of pediatricpa in management and procedural sedation/analgesiain painful diagnostic procedures.

The article presents the guide lines of central catheters nursing in children, with particular emphasis on the long-term catheters. It also presents the most common complications resulting from the presence of a central access, methods of their prevention and treatment.

Autoimmune polyglandular syndrome type 1 (APS 1) is a rare genetic disease caused by mutations in the autoimmune regulator (AIRE) gene located on chromosome 21. APS 1 usually manifests in childhood or during puberty. To diagnose the syndrome the presence of two of the three following conditions: mucocutaneous candidiasis, hypoparathyroidism, adrenocortical failure (Addison’s disease) is required. In the course of APS 1 other autoimmune conditions can also appear.

Supportive care is one of the most important part of the cancer therapy. The goals of the cancer supportive care is to reduce the morbidity and toxicity of the disease and cancer therapy, improve the general physical and mental health and the quality of life for newly diagnosed cancer patients on therapy, as well as promotelong-term survivorship.

Benign recurrent intrahepatic cholestasis, first described in 1959, is characterized by recurrent cholestatic episodes and pruritus. For years it was though to be a benign disease without signs of chronic liver involvement. Recently, there are more reports of a more aggressive course.

Probiotics and prebiotics, for many years, are an object of scientific interest. It is claimed that they have anomni directional, positive influence on various diseases. Probiotic and/or prebiotic supplementation in the diet of formula-fed infants affect the modification of intestinal microflora and thus has an impact on their health. This paper presents a review of available studies on the role of probiotics and prebiotics in the prevention and treatment of diseases in infants.

Diarrhea is a very common problem in infants and children and in most cases, it is not associated to any serious consequences. However, repeated episodes or chronic diarrhea can lead to malnutrition and havea negative impact on growth. In this article we will discuss the highlights of diagnosis and treatment of acute, chronic, chronic nonspecific and traveler’s diarrhea.

Recent updates of the European, American and Polish nutritional recommendations requires updates of the nutritional norm for children. We present the Polish Expert Group statement (2012) on the intake of selected nutrients (proteins, lipids, carbohydrates, vitamin D and E) essential for nutrition in children aged 1–3 years. For this purpose the Expert Group reviewed available scientific data consisting of there cent guidelines, nutritional norms and recommendations, systematic reviews and expert opinions as well as original publications, in relation to the specific requirements for the Polish population.