Rapid spread of severe acute respiratory syndrome coranovirus-2 virus (SARS-CoV-2) caused pandemic of Coronavirus Disease 19 (COVID-19). Clinical course of the disease presents symptoms mainly from the respiratory system such as: cough, dyspnea and fever, and among some patients can deteriorate even further to acute respiratory distress syndrome (ARDS) leading to death. This outbreak, as well as previous ones (SARS, MERS) pose significant challenge for health care managers, epidemiologists and physicians. Below we are presenting clinical course of the COVID-19 among special group of patients; pregnant women and newborns, who require special clinical management during hospitalization. Apart from presenting published clinical reports and case presentations there is also information regarding risks of acquiring infection by newborn. In the summary of this manuscript we present practical guidelines for managing labor as well as neonatal care. It is important to stress out, that this manuscript is based on the information available for March 13, 2020. 

Increasing prevalence of asthma and allergic diseases has been linked to the changes in the composition of gut microbiota, possibly caused by increased use of antybiotics. A study conducted by Ni et al., which results were presented in a paper published in BMC Pediatrics, indicates that antibiotic therapy in the first year of life and in the subsequent years is associated with asthma and allergic rhinitis development. 

Opracowanie na podstawie: Ni J, Friedman H, Boyd BC i wsp. Early antibiotic exposure and development of asthma and allergic rhinitis in childhood. BMC Pediatr 2019;19:225.

Available data suggests positive impact of fermented and partially fermented infant formulas, potentially caused by postbiotics produced by bacteria during the fermentation process. Simultaneously nonfermented infant formulas supplemented with short and long chained oligosaccharides also seem to have beneficial effects. The article presents the main results of a study conducted by Rodriguez-Herrera et al, which assessed the use of partially fermented infant formula containing short chained galactooligosaccharides (scGOS) and long chained fructooligosaccharides (lcFOS) in healthy infants. 

Opracowanie na podstawie: Rodriguez-Herrera A, Mulder K, Bouritius H i wsp. Gastrointestinal Tolerance, Growth and Safety of a Partly Fermented Formula with Specific Prebiotics in Healthy Infants: A Double-Blind, Randomized, Controlled Trial. Nutrients 2019;11:1530.
 

The paper presents the current state of knowledge on the course of COVID-19 in children, a disease caused by a novel coronavirus SARS-CoV-2. The data on the disease in children is limited, but it seems that its symptoms in pediatric patients are significantly milder than in adults. However, even a small percentage of sequelae caused by the infection in children during the expanding epidemics may cause a significant increase in a number of pediatric patients needing hospitalization. 

The article presents some selected issues in the area of “rheumatic” childhood diseases and what a pediatrician should know about them. The clinical picture and principles of diagnosis of rheumatic diseases in children are discussed, starting from growth pains and some inflammatory arthropathies, most often found in everyday practice of a pediatrician. Another issue presented is widely diagnosis and treatment of juvenile idiopathic arthritis (JIA), the most common childhood arthritis, the leading cause of acquired disability in childhood. It presents the rules of cooperation pediatric rheumatologist with a pediatrician. 

Cow’s milk proteins are considered to be the most common cause of food allergy in the youngest children, with approximately 70-80% of them believed to achieve lasting immune tolerance by the age of 3. Recent reports indicate that the percentage of patients with persistent allergy to cow’s milk proteins may be higher than previously thought. The paper presents issues in the field of epidemiology and natural history of allergy to cow’s milk proteins, as well as current possibilities of predicting its persistent form. 

Allergy to cow’s milk protein is recognized as a global health and social problem, with steadily increasing incidence. Invariably, the basis of therapy for years has been the temporary use of the elimination diet, with periodic verification of the legitimacy of its use by means of oral food challenge. Any dietary intervention may carry the risk of nutritional deficiencies and have a negative impact on the patient’s quality of life. The paper presents management, primarily dietary, in persistent allergy to cow’s milk proteins. Possible health consequences of unjustified or prolonged dietary treatment were also discussed. 

Due to the ever-increasing incidence of persistent food allergies and severe forms of the disease, the search for methods to modify its natural course has become the focus of interest of scientists around the world in the last two decades. Cow’s milk is one of the most allergenic foods. Oral immunotherapy and the supply of baked goods containing high temperature cows ‘milk proteins now seem to be promising alternatives to the traditional treatment model 
 for persistent allergy to cows’ milk proteins. The paper discusses both methods, taking into account the current state of knowledge, their advantages and limitations. 

Differential diagnosis of non-infectious pustular skin diseases in children is extensive and often causes a lot of difficulty. This group of dermatological 
 diseases in children differs in clinical appearance from changes in adults, which results from the specificity of the structure and function of children’s skin. Pustular diseases show a great similarity of the clinical picture despite different pathogenesis. Distribution of changes, patient’s age, clinical picture are features that can provide important diagnostic and etiological indications for these diseases. It is especially important to make a correct diagnosis in newborns because the pustules can also be a manifestation of sepsis or other serious infectious diseases. Below mainly non- infectious pustular dermatoses in children have been demonstrated with tips on how to diagnose these diseases. We also provide current information on their treatment. 

Scars are a result of natural healing processes which consist of overlapping phases. In case of healing disorders, two main conditions should be mentioned: excessive or insufficient healing. The management of abnormally healed wounds and scars is dependent on the underlying condition, the place and the extent of the pathology. Difficult scarred wounds require specialised dressings, vacuum-assisted closure therapy or secondary suturing. The treatment of wide, hypertrophic scars or keloids is not always successful – the risk-benefit ratio should be considered. Among the most frequently employed methods are glucocorticosteroid injections, laser treatment, excision of the scar and secondary suturing. After the completion of the healing process, proper maintenance of scars is of vital importance.

Pneumococci (Streptococcus pneumoniae) are an important etiological factor of invasive diseases (sepsis, meningitis), pneumonia and otitis media. In 2001, the first pneumococcal vaccine (7-valent) was registered in Europe. Since 2009, two vaccines with broader serotype coverage (10-valent and 13-valent) are available. The article presents current data on the national epidemiology of pneumococcal infections, the history of introducing pneumococcal vaccination in Poland, including the development of local government health programs and the private market, as well as a description of the current picture of mandatory vaccination. The availability of pneumococcal vaccination in European countries will be characterized. 

Źródło finansowania: Opracowanie zostało sfinansowane i przeprowadzone na zlecenie Pfizer Polska Sp. z o.o.
 

The article is a summary and review of a randomized, controlled trial conducted in 2014-2015, focused on the effects of MFGM and lactoferrin supplementation of infant formula on neurodevelopment.

Opracowanie na podstawie: Li F, Wu SS, Berseth CL i wsp. Improved Neurodevelopmental Outcomes Associated with Bovine Milk Fat Globule Membrane and Lactoferrin in Infant Formula: A Randomized, Controlled Trial. Journal of Pediatrics 2019;215:24-31.e8.
 

Alpha-1-antitrypsin is the most prevalent protease inhibitor in serum. Alpha-1-antitrypsin deficiency is a frequent genetic disorder that may predispose to liver damage and chronic obstructive pulmonary disease (COPD). The risk of developing liver disease was estimated to be about 10% in PiZZ phenotype. The liver transplantation improved prognosis and is the only method of definitive treatment. Promising treatments include gene therapy, transplantation of hepatocytes, which are still experimental methods. 

During treatment of children, difficult situations associated with severe brain damage may occur. Sometimes clinical symptoms and the results of additional tests indicate severe brain dysfunction and in extreme cases its death. Distinguishing between these two states is very important. In the case of severe brain damage, the patient may be in a vegetative state and the escalation of treatment, and even its maintenance in the current range is unjustified from an ethical point of view. Such patients should be provided with palliative care. Diagnosis of brain death entitles to formal recognition of patient as deceased and termination of all therapies. The supportive management of the organism of brain dead person can only be justified by the intention to procure organs for transplantation. Amendments to the criteria for brain death diagnosis are carried out every few years. In January 2020 the Ministry of Health published a announcement containing updated criteria for determining brain death developed by a team of specialists created for this purpose. This paper presents the most important elements of these criteria, with particular emphasis on the specificity of brain death recognition in children. 

Introduction: Orbital tumors are uncommon in children, representing around 3-9% of all pathological masses in orbital area. Vascular tumors, inflammatory lesions and dermoids are the most common benign orbital lesions in the pediatric population.

Case report: A 5-year-old girl (Patient 1) presented with double vision, convergent strabismus, right eye amblyopia and hypopiae. Her imaging revealed a pathological mass (15 x 9 x 16 mm) in the right eye, suggesting lymphangioma. The change was partially sugicaly removed and complementary sclerotherapy was performed. A 6-year-old boy (Patient 2) presented with similar symptoms. His MRI revealed a tumor (2.5 x 1.5 cm) in the right eye, suggesting cavernous hemangioma. Pathology resection was complete. Histopathological examination in both cases revealed benign dermoid cysts.

Conclusions: The correct diagnosis of orbital dermoids is difficult, as the standard diagnostic methods might be misleading. Surgical removal is a gold standard treatment. A complete resection usually leads to full recovery. No reccurence is observed. 

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6-7 marca bieżącego roku w hotelu Sheraton Grand Warsaw odbyła się VIII edycja konferencji „Standardy medyczne w praktyce neonatologicznej i pediatrycznej”. Tegoroczne spotkanie dydaktyczno-naukowe z udziałem ekspertów z różnych dziedzin medycznych zostało przygotowane ze szczególnym uwzględnieniem zagadnień wskazanych jako istotne przez uczestników poprzednich edycji wydarzenia. Konferencję rozpoczął wykład prof. Wojciecha Hankego, który w niezwykle ciekawy sposób przedstawił zagadnienie wpływu zanieczyszczenia powietrza na stan zdrowia dzieci i młodzieży. Kolejne wykłady poprowadzili wybitni neonatolodzy i pediatrzy, a każdy z omawianych problemów został dodatkowo zobrazowany opisami konkretnych przypadków. Ważnym wydarzeniem w trakcie konferencji była premiera książki „Choroby rzadkie” pod redakcją prof. Anny Dobrzańskiej, dra Łukasza Obryckiego i prof. Piotra Sochy, przedstawiającej ponad 180 jednostek 
chorobowych. Ta opracowana przez grupę wybitnych specjalistów pozycja zasługuje na szczególną uwagę choćby dlatego, że konkretna choroba występuje rzadko, jednak w sumie ogromna ich liczba dotyka ok. 6-8% populacji. Nawiązując do książki, bardzo ciekawy wykład „I Ty możesz rozpoznać chorobę rzadką” wygłosił jeden z jej współredaktorów – dr Łukasz Obrycki. Tegoroczna konferencja zgromadziła ponad 500 lekarzy. Prezentowane wykłady poświęcone diagnostyce oraz leczeniu noworodków, niemowląt i dzieci starszych spotkały się z ogromnym zainteresowaniem. Wszystkim Uczestnikom dziękujemy za udział w wydarzeniu, a Sponsorom za wsparcie w czasie organizacji. Mamy nadzieję, że doświadczenia zdobyte podczas kolejnej edycji konferencji pozwolą przygotować następne spotkanie jeszcze lepiej. Do zobaczenia w marcu 2021 r. na IX edycji naszego wydarzenia! Redakcja