The author presents basic information concerning clinical picture, diagnosis process, acute and chronic medical complications and medical care in anorexia nervosa patients.

This article presents the controversies related to the recent regulations of the Ministry of Health regarding advertising of the medicinal products. They concern the range of pharmaceutical companies’ representatives activity within the healthcare institutions.

One of the problems in contemporary science is an increasing number of fraudulent articles. In Poland there are no scientific articles describing the cases that violate a good publication practice. The author of this article reminds the case from the Silesian Medical School (year1998) regarding 50 fraudulent papers and describes anew case of plagiarism in Polish scientific journal. Healso refers to the incident of serious academic fraud and scientific misconduct revealed recently at the Zheijang University in China which resulted from the lack of supervision by the leader of the research group.

Background:
There are no large cross-sectional studieson pediatric HBV and HCV epidemiology in Poland. The data obtained from official governmental register and the data published by opinion leaders group arein conflict.

Aim of the study:
The aim of the study was to collect the snap shot data on epidemiological situation for HBV or HCV infection in selected pediatric centers. We wanted to determine the number of patients with HBV or HCV infection, the number of children with liver cirrhosis or HCC in the course of chronic viral liver disease. We described the availability of therapeutic options for HBV or HCV infections in different medical centers.

Material and methods:
The questionnaire survey was sent to 20 hospitals involved in liver disease therapy in children in 2008. 13 centers responded to the questionnaire.

Results:
Six responding centers are infectious diseasehospitals. 6 centers defined them selves as pediatrichospitals and one site is a gastroenterology, hepatologyand liver transplant center. All centers provide medical care on inpatient and outpatient basis for children aged 0-18 years. The number of patients treated at everysite varies from 900 to 7000 per year (total around36000). HBV infection was reported in 1033 children, HCV infection in 356 and combined HBV-HCV infectionin 60. 80% of these cases were reported from infectious diseases sites. HBV related liver cirrhosis was diagnosed in 9 and HBV related HCC in 2 children. HCV related liver cirrhosis was found in 9 subjects. Anycase of HCC in children with HCV infection was noted. Majority of sites stated that their data under estimatethe real frequency of the HBV and HCV infections. The therapy for HBV infection is provided by 6 centers. 28 patients got interferon and 56 got lmiwudine treatment in 2007. HCV infection is treated in 6 centers and42 children got interferon+rybavirine and 17 got peginetrferon+rybavirine treatment.

Conclusions:
Our data shows that the number of patients with HBV infection and combined HBV-HCV infection is lower than it was in the middle of nineties of XX century. The number of patients with HCV infection is growing up. The number of children with HBV or HCV related liver cirrhosis or HCC is very small. Patients with HBV/HCV infection are grouped in infections diseases hospitals. Most centers stated that there were no major limitations in the access to antiviral therapy in 2007.

The permeability tests are a simple, non-invasive diagnostic tools allowing examination of functional bowel diseases. They are used to asses the conditions, relapse and the effectiveness of the therapy, moreover to investigate possible genetic influences on intestinal barrier in Crohn disease (CD). They are also helpful in differentiation between the inflammatory bowel diseases (IBD) and the other constitutive epithelial disorders. The methods are consist in the measurements of urineor stool samples. The most popular parameters are: the calprotectin and not degradated in vivo sacharides(Lactulose,L-rhamnose, Mannitol), often compared withblood parameters such as CRP, ESR or serum albumins. To sum up, the permeability tests are highly useful inthe diagnosis of children because thy are non-invasive, universal (the result does not depend neither on theage, nor gender and past surgeries), rapid and make the possibility of multiple repetition (in contrary to endoscopy).

Nebulisations remain important tool for the delivery of aerolised medications in many respiratory disorders, most commonly airway obstruction. Nebulisations are used in hospital setting as well as in home. The clinical practice of nebulisation should be supported by scientific evidence. This article presents answers to frequently asked questions about proper use of nebulisers.

Clinical symptoms, as well as treatment of anaphylactic reaction in children differ from adult’s anaphylaxis in many ways. On the basis of current literature, epidemiology, etiology, risk factors, principles of diagnosis, clinical symptoms, differential diagnosis, treatment, prophylaxis and education specific for children anaphylaxis are presented.

The article gives the general practitioners and pediatrician spractical advice how to instruct parents before the vacation trip with children. There were presented basic rules how to react in life-threatening conditions (the loss of consciousness, circulatory and breathing depression, the anaphylactic shock, strangling) as well asin usually less dangerous events like e.g. injuries of the face, eyes, nose, fractures, bleeding, bites by insects, vipers, bruises, chafes, solar burns or cuts. Prevention of solar burns, bites and stinging by insects, travel sickness and food poisonings were also introduced as well as the principles of dressing children and safe usage of the air-conditioning. Author reminds when the vaccination before the trip is necessary and what a travelling medicine cabinet should contain.

The paper describes history and principles of elaboration and interpretation of blood pressure (BP) percentile charts. Most important studies done in Poland has been also described. First reports on BP in healthy children come from the beginning of 20th century. Inthe twenties and thirties of 20th century reports in childhood indicating relationship of BP with age, bodymass and height were published. In the early fifties of20th century Pickering’s group, basing on population BP data, published hypothesis on developmental origin ofarterial hypertension and predisposition of the part of population to develop arterial hypertension with age.Contemporary, most widely used BP percentile chartsin childhood are based on measurements obtained with sphygmomanometer in North American population. However, replacement of sphygmomanometers by oscillometric devices, worldwide obesity epidemics in children, ethnic and methodological differences cause emerging need for the new normative data obtained by oscillometry, regarding not only age, height and gender differences but also ethnicity and body mass. Because BP is related to body mass, elaboration of normative data based on measurements done in population within creasing prevalence of overweight and obesity would lead to increase of absolute values of given percentile.Thus, some authors, basing on increasing amount of data from prospective population studies concerning cardiovascular morbidity in adulthood in relation to exposure to risk factors in childhood, suggest using age and gender adjusted, absolute cut-off BP valuesin children which define cardio vascular risk. The other proposal is elaboration of BP percentile charts based on measurements obtained from children with normal weight.

Status asthmaticus (acute asthma, near-fatal asthma) is a life-threatening condition which should be treated immediately. Early intervention with short-acting β2-agonists, systemic corticosteroids can prevent hospitalization. In article GINA, NAEPP and BTS guidelines for treatment of status asthmaticus are discussed.

Bronchial hyperreactivity (BHR) is the cardinal feature of asthma. This is also one of the main parts of its definition. In the present paper the epidemiology, pathomechanisms of bronchial hyperreactivity and the possibility of its occurrence in other diseases than asthma has been discussed.

The child who has recurrent infections poses one ofthe most difficult diagnostic challenges in pediatrics.The clinician faces a double challenge in determining first whether the child is healthy or it has a serious disease, and then, in the latter case, how to confirm orexclude the diagnosis with the minimum number of the least invasive tests. In this report the authors proposea multi-stage own experience-based approach that is designed to help in management of patients with recurrent respiratory tract infections. The multi-stage design allows the cost-effective screening for correct and early diagnosis and prevents unjustifiable treatment. It may also prove a useful guide to the clinician.

Oral allergy syndrome is an IgE – mediated allergy caused by cross-reacting proteins of some foods and plants. Pollen allergic patients may develop symptoms following the ingestion of raw apples, pears, carrots, celery, hazelnuts and kiwi. This cross- reactivity between tree, grasses, weeds pollen and some fruits and vegetables is due to homology among various pathogenesis proteins. Symptoms include oral (lips, tongue, palate, and oral mucosa membranes) itching, swelling, sometimes oedema of these organs, occasionally pruritis and angioedema can affect throat. Systemic reactions are generally rare.

Allergic rhinitis is a global health problem, as 600 million subjects suffer from it. It is the most frequent allergic disease. Allergic rhinitis is a symptomatic disorder of the nose induced by allergen exposure with anIgE-mediated inflammatory process. The risk factors for allergic rhinitis include indoor and outdoor allergens as well as occupational exposure. The diagnosis of allergic rhinitis is often quite easy, but in young children may cause problems and many children are stillunder-diagnosed. The management of allergic rhinitis requires patient education, pharmacotherapy and allergen-specific immunotherapy. Allergic rhinitis should beconsidered as a strong risk factor for bronchial asthma development. Its severity correlates with the course of asthma. Patients with persistent allergic rhinitis should be screened for asthma while patients with asthma should be evaluated for rhinitis.

In the article the definition of the anaphylaxis, epidemiology, pathogenesis, symptoms, prophylaxis and treatment was described. Anaphylactic reactions arenot classified in any European documents; therefore the epidemiological data is not very reliable. There isalso a problem to plan a controlled research on drugefficacy in anaphylaxis. The current guidelines are more like an expert’s recommendations than official guidelines. In this article the problem of the treatment was pointed out, as it is a life threatening condition most often caused due to the medical procedures.

The food allergy is the frequent cause of many clinical symptoms in developmental age. The pathology refers to these individuals in which digested food has changed differently body organism’s reaction than in healthy individuals. This paper contains unupdate knowledge related to this issue.