Authors present a schedule concerning either the diagnosis and management with a newborn delivered by a pregnant woman with suspected/confirmed SARS-CoV-2 virus or neonate with infection caused by SARS-CoV-2 virus.

Standardy Medyczne/Pediatria  2020, T. 17, 575-579, DOI:10.17443/SMP2020.17.09

The article presents the American Academy of Neurology (AAN) and American Headache Society (AHS) guidelines on acute treatment of migraine in children and adolescents, which were published in 2019 in Neurology.

Standardy Medyczne/Pediatria  2020, T. 17, 580-583

Opracowanie na podstawie: Oskoui M, Pringsheim T, Holler-Managan Y i wsp. Practice Guideline Update Summary: Acute Treatment of Migraine in Children and Adolescents: Report of the Guideline Development, Dissemination, and Implementation Subcommittee of the American Academy of Neurology and the American Headache Society. Neurology 2019;93:487-499.

The COVID-19 pandemics is a major, global health crisis majorly impacting many areas of social life. According to prognosis the employed preventive measures and the looming economic crisis may cause the biggest food crisis in 50 years. In a joint paper published in The Lancet in July 2020 UNICEF, FAO, WFP and WHO directors emphasize the worst consequences of the food crisis will be borne by children. They call for immediate actions to secure children’s right to proper nutrition.

Standardy Medyczne/Pediatria  2020  T. 17, 584-585

Opracowanie na podstawie: Fore HH, Dongyu Q, Beasley DM i wsp. Child malnutrition and COVID-19: the time to act is now. The Lancet 27/07/2020; DOI:10.1016/S0140-6736(20)31648-2.

Failure to thrive (FTT) is a descriptive diagnosis based on the results of anthropometric parameters compared to reference growth charts appropriate for age and gender. The article presents practical tips on FTT diagnosis and therapy, which will certainly be useful in everyday clinical practice.

Standardy Medyczne/Pediatria  2020, T. 17, 589-596

Biliary atresia is a rare disease but still is the main cause of neonatal cholestasis. Its complications are the main indications of liver transplantation in children. In the article authors present clinical aspects and actual opinion on etiology of biliary atresia.

Standardy Medyczne/Pediatria  2020, T. 17, 598-603

Praca powstała w ramach grantu wewnętrznego Instytutu „Pomnik – Centrum Zdrowia Dziecka” (nr grantu: s154/2017).

Introduction of a new drug – alprostadil – revolutionized the medical care of neonates with ductal-dependent congenital heart defects in the early 1980s. Maintaining the patency of the ductus arteriosus allowed them to survive in a stable condition until surgical or interventional treatment. This paper summarizes the principles of alprostadil use in newborns with congenital heart defects, including current data on drug dosing and observed adverse reactions.

Standardy Medyczne/Pediatria  2020, T. 17, 604-610

Hereditary pancreatitis (HP) is a genetic pancreatic disease. The classic type is caused by a cationic trypsinogen gene (PRSS1) mutation. Hereditary pancreatitis is diagnosed when a patient with unexplained pancreatitis has at least 2 first degree relatives with history of unexplained pancreatitis or at least 3 second degree relatives in 2 or more generations with history of unexplained pancreatitis. To date, an increasing number of gene mutations causing HP has been identified. Typically, symptoms begin in early childhood. Children with HP have more severe clinical presentation of the disease than non-HP patients. HP patients have a significantly higher risk of pancreatic cancer.

Standardy Medyczne/Pediatria  2020, T. 17, 612-617

In the recent years there has been an increase in the incidence of allergic diseases. One of the possible reasons behind this surge might be a disruption to the natural composition of the intestinal microbiota in the early stages of a child’s development. Previous studies have proved that caesarean section could potentially result in a disruption to the composition of the intestinal microbiota of a neonate. Notwithstanding, credible evidence that the delivery method itself might prompt the development of an allergy in the later life of a newborn is still lacking. However, a relation between the caesarean section and infantile eczema has been established and verified. Henceforth, there is a question rising whether it could be possible to modify the composition of the intestinal microbiota in newborns – either by specific procedures carried out during the perinatal period or by early supplementation of probiotic bacteria. So far it has been established that oral supplementation of probiotics has a positive effect upon the intestinal microbiome composition in neonates born by the caesarean section. Furthermore, the safety of the intervention has been demonstrated in premature neonates with very low birth weight. Moreover, the intervention has also been proved to decrease the incidence of a staphylococcal sepsis in this group.

Standardy Medyczne/Pediatria  2020, T. 17, 619-623,  DOI:10.17443/SMP2020.17.08

Congenital disorders of protein glycosylation (CDG) form a large and heterogeneous group of diseases, in which an abnormal co- and posttranslational protein glycosylation of different proteins occur. The symptoms of CDG are often multi-system, although some CDGs present as organ or system specific disease and may mimic other known and more common diseases. The main diagnostic tools of CDG are transferrin isofocusing and molecular genetics. Specific treatment is available only for a few CDGs, whereas in the majority of them the treatment is only symptomatic.

Standardy Medyczne/Pediatria  2020, T. 17, 624-628

Currently, hyperbaric oxygen therapy (HBOT) is extremely popular. It is widely used in many branches of medicine, starting from cosmetology and aesthetic medicine, through neurology, dermatology, otolaryngology, ending with treatment of extensive, severe wounds and skin burns. Due to the need for specific hyperbaric center adaptations for use in pediatric patients and differences in therapy protocols, data on HBOT in children is limited. The aim of this article is summarized and present current indications of hyperbaric medicine in children.

Standardy Medyczne/Pediatria  2020, T. 17, 629-635

Head injuries are common in all age groups, however as much as 25-30% of admissions to hospital are due to head injuries in children under 15 years of age. In the pediatric population, head injuries are a major cause of disability and death. Isolated head injuries have the highest mortality rates. The best clinical criterion for assessing a child after a head injury at all stages of medical management is the Glasgow coma scale based on three parameters: eye opening reaction, motor and verbal response, and for the youngest children – a child’s coma scale developed by Hahn. Computed tomography is the only recommended imaging modality to assess the acute effects of head trauma. The paper presents pediatric head trauma management strategies developed in the Emergency Department at the prof. dr. med. Jan Bogdanowicz Children’s Hospital in Warsaw and the indications for hospitalization.

Standardy Medyczne/Pediatria  2020, T. 17, 637-643

Tourette syndrome is neuropsychiatric disorder beginning before 18 years of age. The main symptoms are motor and vocal tics lasting more than 12 months. Additionally, attention deficit hyperactivity disorder (ADHD) and obsessive-compulsive disorder (OCD) may occur. In 50% Tourette syndrome cases family history is positive. Psychological factors can be a trigger for the first symptoms of the disease. The pathomechanism of the disease is still unclear. There are no characteristic changes in patients neuroimaging studies results. Diagnosis of the disease is established on the basis of current clinical criteria. There is no cure for the disease. Only symptomatic methods are available. Behavioral interventions and pharmacotherapy are mostly used in the treatment. The most commonly used drugs are classic and atypical neuroleptics and adrenergic receptor agonists. Many patients do not require treatment, because of mild symptoms.

Standardy Medyczne/Pediatria  2020, T. 17, 644-646

In children with autism spectrum disorders (ASD), introduction of dietary manipulations to decrease autistic behavioral traits as well as improve social functioning and intellectual abilities is very common. Gluten free and/or casein free diet (GFCFD/GFD), for example, is the most common dietary intervention among complementary and alternative therapeutical methods. Efficacy and safety of these elimination diets in patients with ASD remain disputable. To date, the high-quality evidence concerning impact of all elimination diets on long–term functioning of children with ASD is limited, mainly due to methodological difficulties and short-time-observation period. 

Standardy Medyczne/Pediatria  2020, T. 17, 647-652

Neuroblastoma (NBL) is one of the most common (7-10%) neoplastic diseases in children. It derives from the cells of sympathetic nervous system. In NBL many of non-specific symptoms occur, such as: somnolence, decreased appetite, nutritional status disorders, vomiting, abdominal pain, constipation or diarrhea, as well as pallor, weakness, leg pain, limping, chronic cough and irritability. About 50% of patients are diagnosed in stage 4. The prognosis depends on age of a child at diagnosis, stage of disease and also on genetical aberrations in NBL cells. At presence, about 70% of children in all stages may be cured. However, in children over 1 year of age with 4 stage in spite of therapy intensification, treatment results are still poor (30-50% of curability). The diagnosis of disease in less advanced stages may have effect on improvement of treatment results. It is very important that the child is thoroughly examined by physician at every opportunity, including the abdomen, as the tumor in initial stage may not show any signs.

Standardy Medyczne/Pediatria  2020, T. 17, 653-659

Anxiety disorders include conditions with symptoms of intense fear and anxiety and related changes in function. Their prevalence in the developmental population is high and affects 10-20% of minors. The course of disorders may be chronic and their impact on current and subsequent functioning may be significant. Anxiety disorders often co-occur with other psychopathological symptoms and are associated with an increased risk of suicide attempts and self-harm. Often, the first specialists in contact with the patient are family doctors and pediatricians. Psychotherapy, especially CBT, and/or pharmacotherapy is recommended in the treatment of anxiety disorders in children and adolescents. It is important to include parents in the treatment process, and often also other systems in which the child functions.

Standardy Medyczne/Pediatria 2020, T. 17, 661-669

The fall and winter season contribute to frequent respiratory infections, mainly of viral etiology, in young children. While they are usually mild, and their number decreases with age, there is an interest in effective measures for reducing their burden. Due to the COVID-19 pandemic, the interest is even greater. As microbiota plays a role in immunity, there is interest in interventions targeting the gut microbiota with modifiers such as probiotics. This article aims to help physicians make rational decisions by providing evidence-based, up-to-date information on the role of probiotics in the prevention and/or treatment of respiratory infections in children. The Cochrane Library and MEDLINE (both up to July 2020) were searched for randomized controlled trials or their meta-analyses on probiotics and respiratory tract infections.

Standardy Medyczne/Pediatria  2020, T. 17, 671-679

Lactose intolerance is a condition characterized by symptoms such as stomach pain, diarrhea, bloating and gas after lactose intake which can occur in people with hypolactasia. Hypolactasia may be caused by primary (genetic factors) or secondary factors including acute gastrointestinal infections or chronic diseases of the gastrointestinal tract such as celiac disease, short bowel syndrome or Crohn disease. This review is aimed at providing an overview of the pathogenesis, epidemiology, with particular emphasis on diagnostic options as well as dietary and therapeutic interventions for lactose intolerance in children.

Standardy Medyczne/Pediatria  2020, T. 17,  681-690

Autoimmune polyglandular syndromes (APS) are a group of autoimmune disorders characterized by impairment of the function of several endocrine glands. There are 4 types of APS, among them the most common is APS2. APS1 is caused by a mutation in the autoimmune regulator gene (AIRE). Genetic testing for the AIRE gene confirms the diagnosis and serves to determine the risk of developing other components of APS1 in patients with isolated autoimmune hypoparathyroidism or Addison’s disease.

Standardy Medyczne/Pediatria  2020, T. 17, 691-693

Introduction: Appropriate way of nutrition during pregnancy, lactation as well as the diet of young child may affect the risk of developing diseases in the future life of the child.

Objectives: Assess the knowledge of pregnant and breast-feeding women about the role of diet in child development.

Material and methods: The study included 320 women during pregnancy or lactation. A questionnaire was used which consisted of 30 single-choice questions about nutrition and a socioeconomic characteristics of study population.

Results: The study showed that the level of women’s knowledge of nutrition and supplements used is low. Inadequate level of knowledge was observed especially in the areas of diet during breastfeeding, weight control during pregnancy, importance of way of child delivery, as well as complementary feeding.

Conclusions: The study results justify the need of increasing education on nutrition during pregnancy, lactation, and diet of young child, which can be appropriate prevention of civilization diseases.

Standardy Medyczne/Pediatria  2020, T. 17, 695-702

Difficulties with feeding, especially during diet extension, are a common cause of concern for parents that they report to a pediatrician. If feeding disorders lead to nutritional status deterioration, except for the implementation of proper feeding rules and diet modification introduction of an appropriate high-calorie nutritional supplement should be considered. The paper presents a case of an infant with feeding disorders, abnormal weight gain and periodic diarrhea in whom a high-calorie supplement with partial whey hydrolysate was used in therapy.

Standardy Medyczne/Pediatria  2020, T. 17, 705-707

Patients with anatomic or functional aspalenia are at a significantly risk of overwhelming infection particularly involving the encapsulated bacteria Streptococcus pneumoniae, Haemophilus influenzae type b and meningococci A,C,Y, W135 and exposed to group B mennigococi. Preventive strategies includes immunization, and antibiotic prophylaxis in children under 1 years old, in older one antibiotic prophylaxis considered individually.

Standardy Medyczne/Pediatria  2020, T. 17, 709-717

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