The article focuses on antimicrobial therapy of selected gastrointestinal infections in children. It summarizes epidemiology, clinical manifestations and recommendations for specific antimicrobial treatment in pediatric patients.

Authors present chosen topics presented during 5 thIPTA (International Paediatric Transplant Association) Congress, that took place in Istambul, in April 2009.

The relationship between food hypersensitivity and motility disorders of gastrointestinal tract is controversial. Experimental data and clinical observations give evidences that mucosal allergic response may disrupt motility of particular organs of this tract. Moreover, in particular subjects, food allergy may potentially change nociceptive pathways and lead to chronic visceral hyperalgesia. In this paper authors are discussing this topic with regard to potential role of allergic response (Th2, mast cells, eosinophils and their mediators) and dysmotility, based on animal models and clinical observations in children.

This paper aims to evaluate the effectiveness and safety of probiotics for the prevention and treatment of gastrointestinal and respiratory tract infections. The MEDLINE and The Cochrane Library (both up to August2009) were searched for randomized controlled trials (RCT) or their meta-analyses. Selected strains of probiotic shave been tested and demonstrated health benefitsin gastrointestinal and respiratory tract infections.The best documented is the use of selected probiotics for the treatment of acute gastroenteritis.

Two antipyretic and analgetic drugs- paracetamol and ibuprofen are available without prescription as havingover the counter status (OTC). They are widely used by patients in selftreatment and are often suggested by pharmacist. Paracetamol is not antiinflammatory drug. It’s action is purely central. Blocking prostaglandin and NO synthesisit decrease brain perception and spinal transmission of pain signals. Blocking prostaglandin synthesis in brain it acts also on hypothalamic thermostat decreasing setpoint and resulting in temperature reduction. Ibuprofen is a nonsteroidal antiinflammatory drug andits analgetic and antipyretic activity is a result of antiinflammatory peripheral activity and central “paracetamol-like” action on brain and spine.In vitro investigation on tissue model, in epidemiological study of gastrotoxicity and in wide spectrum clinical investigation in adults and in children, and incomparison of ibuprofen with paracetamol ibuprofen was labeled as a safest drug amongs classical NSAID. For his antiinflammatory activity and stronger analgesic and antipyretic effectivity in comparison with paracetamolin respiratory tract infection, in migraine andin menstrual pain ibuprofen should be applied as the first in regular 6hours intervals for the 3–5 days, and ifit appears necessary it may be supported or substituted with paracetamol.

In recent years bronchial asthma has been the most frequent chronic disease in childhood. It is considered that in Poland due to the common smoking habit and allergy epidemic broncho-obstructive disorders will play even more important role in the next few years. The basic diagnostic tool in these conditions is spirometry.Pediatricians should know how to use and interpretlung function tests as they do ECG or blood pressure measurements. In this article the indications, use and clinical advantages of lung function tests in children have been presented. There are various lung function tests as spirometry test with its modifications, unspecific bronchial challenges and bronchodilating tests and more advanced testsas plethysmography, lung mechanics and lung diffusing capacity measurements.

Endothelin-1 is involved in the physiology and pathophysiology of many organs including alimentary tract. The peptide modulates blood flow in the gastrointestinalvasculature and microvasculature and regulates contractility of smooth muscle cells. An excess of endothelin-1 may be an important factor contributing to pathogenesis of various forms of mucosal injury ingastric and duo denal ulceration, inflammatory bowel diseases, necrotizing enterocolitis, cirrhosis and other. Elevated levels of circulating and tissue endothelin-1 inpatients with various gastrointestinal diseases may bedue to impaired enzymatic degradation of the peptide. In contrast to kidneys, lungs, heart and liver, the mechanismsthat regulate endothelin-1 concentration inthe gastrointestinal tissues are completely unknown. However, three apparently novel, high affinity endothelin-1 degrading peptidases have been found veryrecently in rat duodenal and small intestine mucosa. Whether the same or similar peptidases are presentin humans, and whether impairment of their activity, resulting in the increase of tissue endothelin-1 concentration occur in gastrointestinal diseases will require further research.

Pneumonias are common infectious diseases in children. The empirical treatment is based on etiology indifferent age groups. In the treatment of aspiration pneumonia antibiotics against anaerobic bacteria should be introduced. The presence of parapneumonic effusionis an indication for pleural tap and in most cases local treatment is necessary.

Acute bronchit is is one of the most common infectious diseases in childhood of mainly viral etiology. Despiteits benign character and good prognosis, pharmacological treatment is overused in acute bronchitis. In the article etiology, symptoms and course of acute bronchitis are discussed and therapeutic management is indicated.

Juvenile polyposis of infancy is one of the three forms of juvenile polyposis syndrom. It is the most severe form of juvenile polyposis syndrom with poor prognosis, affecting infants and children below 2 years of age. Onlya few cases of juvenile polyposis of infancy were reportedup to now. Clinical symptoms occur in first months of life, including gastrointestinal symptoms, failure tothrive and symptoms from other organs. Clinical presentation of the disease reflects the involvement of the gastrointestinal tract by polyps. The ethiopathogenesis, clinical presentation, diagnosis, treatment and prognosisin juvenile polyposis syndrom, especially in juvenile polyposis of infancy were reviewed in this article.

Congenital chloride diarrhea (CLD) is a rare disorder characterized by persistent chloride (Cl) rich diarrhea from birth. It leads to dehydratation and hypochloremic metabolic alkalosis. CLD is treated with sodium and potassium chloride. Hereby we present a case report of a 16-months old boy with atypical course of disease diagnosed because of failure to thrive. The molecularanalysis revealed the Polish founder mutation for CLD.After correct ion supplementation nutritional state and growth improved.

Objectives.
Children and adolescents mortality assessment in years 1999–2006.

Materials and methods.
Mortality rates (total andby cause) assessment according to individual records from Polish mortality register and population estimates. Trends in mortality rates were estimated by linearregression.

Results.
Total mortality and mortality due to external causes have declined in each analysed age group.Transportation accidents were main cause of death. In age 1–4 years mortality due to cancer, neurological disorders and congenital malformations, and in age 15–19 years mortality due to other internal diseases have declined.

Conclusions.
Differences from Western Europe countries indicate need for solutions increasing children’s and adolescents’ safety with regard to home, education and leisure environment.

Objective:
The aim of the study was to analyze foreign bodies ingestion in children, clinical symptoms, the kind of foreign bodies (FB), location in gastrointestinal tractin different age groups.

Patients and methods:
Retrospective analysis included151 children (77 boys and 74 girls) aged from 1 month to 13 years (mean age: 3 years), hospitalized in the period of 1999–2006 in whom endoscopy was performed after confirmed or suspected ingestion of FB.

Results:
The most frequent were blunt FB (coins – 94,batteries – 8, buttons – 6), localized in the esophagus (79) and in stomach (72). In 116 cases the FB were radiopaque. The most frequent clinical manifestations were: choking, pain at swallowing, nausea and swallowing impairment, more rarely: anxiety and dyspnea. To observe the age influence on studied parameters two groups of children were distinguished: A – children ≤ 2years of age (n = 60, 39.7%) and B – children > 2 years (n = 91, 60.3%).

Following parameters were comparedbetween groups A vs B respectively:
- time from ingestion to endoscopy (A – 19 vs B – 7hours, p = 0.24)
- location in esophagus or stomach: (A – 32/28 vsB – 47/44; p = 0.83)
- appearance of symptoms (A – 37% vs B – 47%;p = 0.19)
- radiopaque foreign body in x-ray (A – 87% vsB – 88%; p = 0.85)
- kind of foreign body (coins dominated in bothgroups: A – 67% vs B – 61%; p = 0.5)

Conclusion:
There was no difference between infants and children >2 years in clinical course of FB ingestion. The results allowed us to proposed guidelines for the management of children who ingested FB.

The main aim of the article is the comparison of the legaland ethical standards of pharmaceutical marketing between Poland and other regulations being in force worldwide. The most important documents – international, American and European were compared with polish ones. It turned out that polish norms concerning drug advertising are stricter than those in United States, and those which are required due to the presence in the European Union. Unfortunately Poland is lagging behind the other countries if we consider voluntary jurisdiction of organizations that associate: pharmaceutical companies, physicians or medical students to control drug advertisements. If such organizations have the ethical codes they are not as fast updating as polish law and they do not establish really stricter rules. There is no polish association that would act against giving any small gifts, even a pen, from industry to physicians whereas in U.S., Great Brittan and Italy they function very well.