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Altered gut microbiota composition and/or activity (dysbiosis) plays a role in the pathogenesis of allergic diseases. Targeting the gut microbiome with probiotics, prebiotics, or synbiotics may contribute to the prevention and/or treatment of allergic diseases. This article summarizes data from randomized controlled trials or their meta-analyses that assessed the clinical effectiveness of probiotics, prebiotics, and synbiotics in the prevention and treatment of select allergic diseases. The MEDLINE database was searched (up to July 2020) to identify relevant studies. The purpose of this technical review is to provide support for an expert position paper on the role of microbiota modification in the prevention and treatment of allergic diseases.

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WYKAZ TABEL

I. Probiotyki. Wpływ na mikrobiotę – podsumowanie badań z randomizacją

II. Probiotyki w profilaktyce alergii

III. Probiotyki w leczeniu egzemy, alergicznego nieżytu nosa (ANN), astmy, alergii na pokarm

IV. Prebiotyki. Wpływ na parametry immunologiczne

V. Prebiotyki. Wpływ suplementacji na kliniczne punkty końcowe

VI. Prebiotyki. Profilaktyka i leczenie alergii

VII. Synbiotyki. Wpływ na mikrobiotę – podsumowanie badań z randomizacją

VIII. Synbiotyki. Profilaktyka alergii

IX. Synbiotyki. Leczenie alergii

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.

The article discusses the role of the nutritional team in the therapeutic process of patients with failure to thrive (FTT).

Dandy-Walker syndrome (DWS) is a rare congenital posterior fossa anomaly characterized by hypoplasia or agenesis of the cerebellar vermis, cystic enlargement of the fourth ventricle and upward displacement of tentorium cerebelli. The symptoms usually become apparent in the first year of life due to hydrocephalus development, which concerns approximately 90% of patients and structural abnormalities of the cerebellum. Prenatal diagnosis by ultrasound is possible after the 18th-20th week of gestation, however the magnetic resonance imaging (MRI) is a gold standard of DWS and it is should be used to confirm the diagnosis. MRI allows to exact assessment of the structures of the posterior fossa. Early diagnosis and neurosurgical treatment of developed hydrocephalus significantly improves patient prognosis.

Utilising cord blood for admission tests in newborns on their first day of life is a painless procedure, that is infection risk free, does not affect cardiovascular adaptation and does not contribute to iatrogenic blood loss. Although time restricted, this procedure is an unique opportunity that has many advantages and as such should routinely be used in modern neonatal practice, especially in the care of very low birthweight infants. This article elaborates on diagnostic tests which can be done using cord blood, discusses their limitations and clinical importance. We also present our proposal for the procedure of obtaining cord blood for admission tests. Putting this procedure into everyday clinical practice might serve as a quality improvement initiative.

The autumn-winter period is associated with an increased incidence of respiratory tract infections in children. This raises high parents’ expectations regarding effective methods of strengthening children’s immunity. The role of doctors is to advise the most effective lifestyle changes and help in choosing the most effective preparations. Many of them are not proven to be effective. In this review we critically evaluate the scientific evidence for the effectiveness of the most popular substances used for preventing common respiratory infections in children, including vitamins, drugs, dietary supplements, herbal preparations, probiotics and bacterial lysates.

Isolated congenital esophageal stenosis (CES) is a rare esophageal wall abnormality, caused by abnormal separation of the respiratory tract from esophagus. It can be associated with other congenital malformations. Clinical manifestation is typically associated with introduction of solid food, but it can occur even in neonatal period or in late childhood. Typical symptoms include dysphagia, regurgitation, vomiting and lack of appetite. The most important in diagnostic imaging are esophagography and endoscopy. Further evaluation consists of endoscopic ultrasonography, manometry and 24-hour pH-metry. Treatment depends on CES type. In most cases definitive treatment can be made by endoscopic dilatation, in some surgical intervention is mandatory. The outcomes for both endoscopic and surgical treatment are good.

Klippel-Feil syndrome (KFS) is a congenital anomaly of the cervical vertebrae, resulting in a fused appearance. Pathogenesis remains unknown – it may occur as an isolated abnormality or as a part of others congenital defects syndromes. Symptoms are demonstrated with different frequency. The clinical triad consisting of short neck, low posterior hairline, and limited neck movement is most often observed. The physical examination and radiography of the cervical spine are essential for the diagnosis. The treatment is conservative. Surgical treatment is considered for patients with persistent pain, neuropathy, myelopathy and documented spinal instability.

The COVID-19 pandemic poses a number of problems and challenges for the public health sector. One of the most important, is sustaining the vaccine coverage at protective level. In order to implement the Preventive Vaccination Program, hexavalent vaccines (the so-called 6 in 1) can be used. They are effective and safe, and there is a wide possibility of their co-administration with other vaccinations, including vaccines against Streptococcus pneumoniae, or recommended vaccinations. A significant limitation of hexavalent vaccines is their price - they are not refunded preparations. The use of hexavalent vaccines makes it possible to simplify the implementation of the Protective Vaccination Program as much as possible and reduce the number of vaccination visits. This is particularly important during a pandemic. Firstly – because of the need to maintain vaccine coverage at appropriate level and to avoid outbreaks of infectious diseases that can be prevented by vaccination. Secondly – due to the necessity to limit the doctor-patient contacts in accordance with the principles of social distancing.

Progressive familial intrahepatic cholestasis belongs to the family of familial intrahepatic cholestais disorders inherited in an autosomal recessive pattern. The aim of this manuscript was to describe the pathogenesis, clinical presentation, diagnostic process and treatment of inborn errors of bile acids synthesis, based on the literature review and center experiences.

The article reviews the current knowledge on bacterial lysates (LB) used in respiratory tract infections and presents their composition and mechanisms of action. The most important effects of LB in the prevention of recurrent respiratory tract infections in adults and children and in the management of chronic obstructive pulmonary disease (COPD) are discussed. The authors also highlight the new possibilities of using LB in allergic diseases and some economic aspects of LB therapy

Introduction: Studies on the relationship between children’s injuries and alcohol intoxication confirm a positive correlation. Socio-medical studies on the size and directions of alcohol consumption indicate many negative accompanying phenomena. Alcohol consumption by adolescent is associated with an increased risk of injury and death, as well as their engaging in ‘risky’ behavior. According to the questionnaire surveys, alcohol ‘drinking’ by children is similar to that observed in adults.

Aim of the study: The aim of the study was to characterize the group of adolescents who suffered from injuries in association with alcohol consumption and to define the profile of a “drinking teenager”.

Material and methods: The study included patients aged 9–18 years who had sustained a craniocerebral injury related to alcohol consumption, admitted to the Children’s University Hospital in Kraków during the trauma duty. The research was conducted over a period of 3 years. The patients were matched to both groups in terms of age and nature of the injury. Ultimately 111 patients were included in the study (study group – 49, control group – 62). In order to make the assessment, a questionnaire was developed for patients who suffered an alcohol-related injury and for the control group

Results: The highest average concentration of alcohol in the blood – 1.68 ± 0.75 ‰ was recorded in the group of people consuming spirits. The surveyed teenagers mostly did not consume alcohol at the time of the injury for the first time, and usually had drunk alcohol many times before. They were most often motivated by the will to gain new experiences – such an answer was given by as many as 55.8% of respondents. In the analyzed group children the most often drank beer (45%), and the least frequently sparkling wine (1.8%) and wine (3.6%). Children from the study group drank vodka more often than the control group. The average age of the first contact with alcohol (alcohol initiation) in the study group was 11.74 ± 1.42, while in the control group – 12.74 ± 1.52. In both groups it was usually 12 years old. Children from the test group more often consumed larger amounts of alcohol at a time, therefore they were more often intoxicated (83.7%) than children from the control group (14.3%). Children from the study group consumed alcohol even every month (23.3%). 32.6% of patients declared the presence of conflicts with the law as a result of alcohol consumption. Children abusing alcohol more often came from single-parent families, large families with problems in adapting or accepted social rules and norms, although assessed as moderately wealthy.

Conclusions: Polish teenagers consume alcohol frequently, and the nature and circumstances of alcohol consumption are similar to those observed in adult patients. The consequences of alcohol intoxication in adolescents also do not differ significantly from those experienced by adults. Actions aimed at limiting the phenomenon of alcoholism should be undertaken primarily by government institutions and public benefit organizations.

Objectives: Aim of the study was to assess impact of COVID-19 including anti-epidemic measures as well as restricted access to health care providers on incidence of infectious diseases of childhood.

Materials and methods: The number of cases and the incidence of infectious diseases of childhood reported in Poland during period 1.03.2020-31.05.2020 were compared to a corresponding period in 2019. Differences in the number of cases between 2020 and 2019 were tested with the Chi-square test and the 95% confidence intervals of the incidence were compared.

Results: In the period from March 1st, 2020 to May 31rd, 2020, the number of cases of influenza and influenza-like diseases in children aged 0-14 years, diarrhoea and gastrointestinal infections (bacterial, viral and unspecified) in children under 3 years of age, and childhood infectious diseases was significantly lower compared to the corresponding period of 2019. The incidence of analysed diseases and health problems was significantly lower in 2020 compared to 2019.

Conclusions: Significant reduction in number of cases and incidence of childhood infectious diseases was reported during first three months of COVID-19 pandemic in Poland.

Informacja o źródle zewnętrznego finansowania badania – w wykonaniu pracy nie korzystano z zewnętrznego źródła finansowania.

Introduction: The global COVID-19 pandemic has forced changes in the functioning of health care system, both in outpatient and inpatient care.

Aim: The aim of the study was the analysis of hospitalizations of patients during a pandemic in 2020, and to compare the data obtained with the corresponding months of 2019 year.

Material and methods: A total of 2,375 medical histories of children reporting to the Emergency Room were analyzed during February 1, 2019 – May 31, 2019 and February 1, 2020 – May 31, 2020, of which 691 children were hospitalized in Pediatric Ward.

Results: In 2020 in the studied period, the number of consultations in the Emergency Room and hospitalizations in Pediatric Ward was significantly lower than the previous year. In all analyzed months, fever was the most common symptom that occurred in hospitalized patients. In 2020, viral gastrointestinal infections were significantly less frequent. Length of hospitalization was slightly reduced in 2020. By May 31, 2020, a positive SARS-CoV-2 RT-PCR test was obtained in 3 patients and their caregivers.

Conclusions: Although COVID-19 pandemic affects children less, it does have an impact on hospitalizations in the Pediatric Ward. The number and duration of hospitalization has decreased, the profile of patients has changed.

We present a case of a 19-year-old cyclist with a history of recurrent upper respiratory tract infections, who underwent symptomatic treatment for acute rhinitis. After about two weeks, the patient deteriorated, the amount of purulent secretion increased, fever started, and one-sided facial pain, which was intensifying when bending the head. The disease excluded the athlete from training and significantly hindered his daily routine. Based on the medical history and examination, we diagnosed acute bacterial rhinosinusitis, and instituted therapy with high doses of amoxicillin. Due to a lack of improvement after 48 hours, a corrected therapy with amoxicillin with clavulanic acid for a total of 10 days was successfully applied. Conclusions: failure of first-line treatment is an indication for the correction of the treatment. Following the current recommendations provides the best chances for effective treatment of the patient while protecting antibiotics