Principles of diagnostic evaluation of lymphadenopathy in children are presented. Key elements of evaluationare: medical history and physical examination, specific laboratory testing, imaging examination and, in somecases – biopsy of lymph node with histopathology. The critical challenge for the primary care physician is to identify which cases are secondary to malignancies orother serious conditions.

Influenza is an acute respiratory illness caused by an RNA orthomyxovirus. It occurs mainly during the winterseason in outbreaks and epidemics. Despite of all medical advances, nothing has been introduced during the past 100 years to affect the recurrent pattern of influenza epidemics and pandemics. Fever, headache, myalgia, and weakness are typical of the illness. In most cases influenza is a self-limited disease in the general population, however, it is a reason for school and work absenthism and it is associated with increased morbidity and mortality in high risk populations. Treatment for people not in high risk groups is just palliative measures to keep hydration and symptoms under control.Specific antivirals are recommended for those at riskof complications. For those not at risk treatment with standardised black elderberry extract was used with good results. Black elderberry has been proven to haveantiviral activity in clinical trials.

Vaccines and their undisputable ability to prevent mortality and morbidity due to infectious diseasesmay cause side effects. A vaccine controversy is as old as vaccines themselves. Over the last years there is evidence of increase of anti-vaccine movements in Poland. The opinions of physicians, promoting this type of prophylaxis are criticized. This paper presents currentanti-vaccine movement and provides examples from numerous web sites on dangerous effects of immunization, which are not scientifically documented. As counterargumentto vaccine opponents, the standardized medical and scientific analyses are cited, and “facts on myths” are presented.

Infections caused by herpesviruses (Herpes simplex) are very common among children and adults. Primary and secondary infections may occur, most of them being asymptomatic. Symptoms are present only in 10% of cases. Skin changes caused by herpesvirus type 1(HSV-1) are usually present on a face or upper part of the chest, type 2 (HSV-2) affects genital region and causes herpes neonatorum. Both HSV-1 and HSV-2 can involve central nervous system. Clinical manifestations of primary infection include gingivostomatitis herpetica, eczema herpeticum, herpetic whitlow, conjunctivitis, meningo-encephalitis, vulvovaginitis and herpesneonatorum. Reactivation results in recurrent infection, rarely may cause encephalitis. The infection is usually self-limited and mild. In immunocom promised patients, neonates and in patients with encephalitis prognosis is uncertain, because of the risk of severe, disseminated disease and/or late complications. Acyclovir is used for treatment.

Anorexia nervosa is a psychiatric disorder classified asone of the eating disorders, characterized by a weight loss of at least 15% of predicted body weight, which is accompanied by fear of weight gain, distorted perception of own body image and by performing actions that lead to weight loss. In addition to mental and physical changes, hormonal disorders of hypothalamic-pituitary-axis and the gonads are also observed.This disease affects about 1% of girls at puberty. It is 9 times less frequent in boys. In the paper the etiological factors and mechanisms leading to disease are detailed. The diagnostic difficulties, differential diagnosis and therapeutic options are also presented.

Microbial theory of allergy development assumes that the modified microflora (microbiota) colonizing the intestinal tract in infants can activate the immune system towards proallergic processes. Probiotics modulating the composition of the microflora affect the development of the intestinal ecosystem, and there fore found application in the primary prevention of allergy and inthe treatment of allergic diseases. Clinical effects of probiotics may depend both on genetic and environmental factors influencing population variation of the gut microflora. The paper presents a population-based differences in the composition of gut microflora, which may affect the development of allergies and a review of clinical trials evaluating the effectiveness of probiotics in the prevention and treatment of allergies, especially those using the same probiotic strain in different populations. Research performed in Polish population has also been presented.

The most dangerous complication of antibiotic therapy is pseudomembranous colitis caused by toxins A and/or B synthesized by Clostridium difficile. In the last years increasing frequency of such infections, especially a new clone producing binary toxin similar to one synthesized by Clostridium perfringens. Frequency of antibiotic‑associated diarrhea is estimated at 1–3 caseson 100 000 of cycles in the ambulatory settings and 1–10 cases to 1000 cycles of antibiotic treatment in hospital conditions. In Poland antibiotics most often triggering diarrhea are: amoxycilin (35%), parenteral givencefuroxime (31.6%) and amoxycilin with clavulanate (29.4%). The risk factors of the Clostridium difficile infectionare: hospitalization, age, non-specific enteritides, glucocorticosteroids, acquired or inborn immunological deficiencies and applying proton pump inhibitors. Infection is confirmed by ELISA tests in faeces, best detecting both toxins simultaneously (A and B). Theirsensitivity is very good (94–100%), however specificityis only satisfactory (88–93%). Methods of the molecularbiology are marked by higher specificity and sensitivity, however they aren’t universally available. An endoscopicexamination is playing a support role in diagnosis. In prevention reducing of the unnecessary supply of antibiotics, general hygiene, washing hands, applying glovesplay a fundamental role, as well the cohortationand isolation of patients. The proven role in the preventionplay probiotics such as Sacharomyces boulardiiand Lactobacillus GG (decrease of the infectionrisk about 60–70%).In the treatment apart from putting the antibiotic away in mild forms of infection metronidazole is applied, and in heavier vancomycin (both orally or intrarectally). In recurrent infections, vancomycin (with everyday, pulsatingmethod or in reducing doses), Saccharomyces boulardii and rifaximin are administrated. There are new therapeutic methods such as nitazoxanide and fidaxomycin.

Excessive mucus secretion is a common feature ofboth acute and chronic respiratory diseases, such as chronic bronchitis, chronic obstructive pulmonary disease(COPD), cystic fibrosis (CF), bronchiectases and bronchial asthma. Ambroxol, an active metabolite of bromhexine, is a mucoactive agent with mucokinetic properties, stimulating activity of the cillia and production of surfactant. It possesses also anti-inflammatory, anti-oxidative, and local anaesthetic activity. Studies concerning its properties have confirmed that ambroxolis a highly safe medicine. Its features allow for its widespread and safe clinical application.

Tooth decay (dental caries) is a disease concerning the majority of the population in the world. It arises through the interaction: susceptibility of hard tissue of teeth, the impact of bacterial plaque, the presence of substrates necessary for bacterial life, and the time the action of acids produced by bacteria. It is possible to modify the impact on tooth surfacesand metabolic processes between dental plaque and dental hard tissues. Thus it is possible to control the development and progression of caries lesion. In the prevention of dental caries following factors play an important role: nn mechanical removal of bacterial plaque (oral hygiene), nn chemical (antibacterial) modification of the plate, nn the use of fluorine compounds, nn the composition of the diet. The health promotion aimed at increasing awareness ofthe pro-health of both children and parents is extremely important, as well as periodic visits to the dentist’s office, giving the possibility to implement appropriate prevention methods.

Adenoid hypertrophy is one of the most common clinical problems in children encountered by general practitioners, paediatricians and otolaryngologists intheir everyday practice. Despite the fact, that the issue seems to be fully understood and diagnostics simpleand available, the management of adenoid hypertrophyis still controversial and may cause some difficulties. In every single case multiple factors must be take nunder consideration, however the effects of treatment may not always meet the doctor’s or parents’ expectations. Moreover, to avoid serious complications ofthe disease, early detection and treatment are necessary, sometimes requiring cooperation of different specialists. Based on the literature review we introduce characteristics of adenoid hypertrophy with its consequences inthe context of treatment dilemmas.

Iodine is an essential nutrient. The natural sources of iodine are fish, milk and some grains. As in take of iodinefrom natural sources in Poland is low, salt and infant formulas are fortified with iodine. The requirement foriodine increases in some life periods like in puberty, pregnancy and lactation. Monitoring of iodine status was described. In Poland there are several parameters used for monitoring like TSH concentration (valuable in neonatal period) and thyroglobulin concentration (in children and teenagers). Triiodothyronine and thyroxine concentration deficiency are not primarily used for assessment of iodine status– still they have additional value in evaluation of thyroid function. Methods of prophylaxis and treatment of iodine deficiency are presented.

The paper is a review of medical literature from the period of 1993–2011 concerning Smith-Lemli-Opitz syndrome. Part I provides information on the etiology, clinical picture and diagnosis of the disease. Part II contains information on how to deal with patients.

Point of care testing (POCT) is defined as a medical testing either at the site of the patient care or closely to that site but not in a medical laboratory. Because of the low number of pre-, intra- and post-analytic phases in the POCT procedure, results of testing are available ina shorter time and it is the most essential advantage of POCT. Although the tests run in POCT are usually more expensive than measured in laboratories, a faster diagnosing, lower level of complications and shorter hospitalization reduce the overall treatment and social costs. However, POCT operators, frequently without sufficient laboratory education, may make the results of the tests less reliable. The results from POCT which do not fit theclinical status of the patient and the clinical laboratory tests generate extra costs for additional analysis and patient examination. In spite of this disadvantages, the number of tests involving the POCT procedures systematically increases and, in the nearest future, it may reach 50% all in vitro measurements.

In the article, etiology, genetic background, clinical symptoms dependently on age, diagnostic criteria and possibilities of therapy in children with Prader-Willisyndrome (PWS) are presented. Currently it seems, that growth hormone is the only effective therapy in this disorder. In the paper beneficial effects (first ofall positive metabolic changes) of such therapy are presented. Since 2006 in Poland children with Prader-Willi syndrome have been treated with recombinant human growth hormone under the Therapeutic Health Program funded by National Health Fund. The recommended diagnostic schedule, indications for therapy according to National Health Fund requirements, criteria for the start and end of the treatment are discussed. Data indicating potential benefits of continuing growth hormone therapy in adults are also presented.

Every development concerns the use of a given potential. In the case of newborns and infants with low muscle tone (including the premature children borne with a physiologically low muscle tone), making use ofthe given potential it is not easy and that is why these patients sometimes need support from a therapist.The tasks for the speech therapist include organization of relevant experience exposure from the surrounding environment and monitoring the development of functions responsible for the development of speech and food intake. It is impossible to perform this without understanding the specific needs of a child with low muscle tone. It doesn’t always concern a pathologically low tone, sometimes we talk about low tone within the limits or about a temporary decreased tone.This article tackles the dangers in the development of speech and food in take in children with low muscletone and emphasize key points in the speech therapy.

The article presents a case of a two-year old boy with a complicated pneumonia who was diagnosed with Pelger-Huët anomaly (PHA) in the course of hospitalization. PHA is an abnormality of neutrophils’ structure that may be either in born failure (primary PHA) or a resultof infections or neoplastic conditions (secondary PHA). The presented case underlines the issue of differential diagnosis of primary and secondary PHA ina patient with a severe course of infectious disease.

The paper reviews essential legal notions related to the copyright law. Good practices are emphasized based on discussion of duties and privileges of authors whoare employees of the scientific institutions. The scope of author’s responsibilities for the work and examples of violation of the copyright laws in Poland are presented. Focusing on the plagiarism it shows the scale of the phenomenon of the scientific misconduct and its consequences.