Cough is one of the most common symptoms that makes parents search medical aid. For this reason knowledge of the rules of cough management is crucial for both, paediatricians and general practitioners. In this article we present a step-by-step procedure of diagnosis and treatment that should be applied in chronically coughing children. Depending on the source, chronic cough is defined by the presence of cough for over 4 or 8 weeks (American College of Chest Physicians or British Thoracic Society guidelines respectively). Defining the type of chronic cough - specific cough or non-specificisolated cough - remains the backbone of the diagnostic process. Specific cough is characterised by the presence of pointers suggestive of specific disorders in history, clinical examination and/or spirometry or chest radiography. In the case of non-specific isolated cough the above-mentioned pointers are absent. This article contains a description of subsequent stages in the process of reaching a diagnosis in a chronically coughing child. .

Constipation is a common problem in children worldwide. In this article we present a practical guide to the diagnostics and management of paediatric constipation. The efficacy of various therapeutic methods including diet, laxatives and probiotics are discussed.

Coeliac disease is an immune-mediated enteropathy triggered by the exposure to dietary gluten. The disease affects 1 in 160 of the general population. The majority of cases remain undiagnosed. The paper presents a proposition of the new classification of gluten-related disorders and the revised nomenclature of different forms of coeliac disease (‘the Oslo definitions’). The author focuses on current knowledge of non-classical signs and conditions associated with the disease.

The colonization of the infant gastrointestinal tract influences the development and function of multiple organs and systems, including immunity and nervous system. Child’s intestinal microbiota is not as stable as in adults and depends on several environmental factors, like pregnancy, delivery, nutritionor antimicrobial therapy. Specific aberrations in intestinal microbiota composition in early life may contribute to necrotizing colitis, inflammatory bowel disease, celiac disease or obesity. The use of probiotics plays a role in prevention of these diseases and may have beneficial impact for the development and overall health of the child. This article presents selected aspects of development of gut microbiota, its impact on immunity and neurodevelopment, and use of probiotics.

This paper contains the most important information concerning the activation of the immune system of the neonate and disturbances of this process inthe case of delivery by caesarean section.

Glucocorticosteroids are the medications that have been used for more than 50 years in various diseases, with their antiinflammatory and immunosuppresive effect. Apart from their positive influence, the usage of glucocorticosteroids can cause many adverse effects. In the paper we analysesome of them: secondary adrenal insufficiency, growth retardation, osteopenia, osteoporosis and increased tendency to infections. During the long-term glucocorticosteroid treatment we should monitor the adrenal function, eye function, bone density and growth velocity in children. The dose of the medication should be the lowest effective dose, a period of the therapy should be the shortest and the way of supplying medication should be correct. If there is a possibility we should recommend glucocorticosteroids in inhalation rather than per os and not exceed the highest doses. The doses given once daily in the morning or every other day decrease less the function of hypothalamic-pituitary-adrenal axis and growth velocity in children. Only then we are sure that our therapy is effective with minimal possible adverse effects.

Although effective analgesia is obviously beneficial to the patient, it also carries the risk of minor and major, possibly life- threatening complications. In thelast, third part of publication principles of safe and effective analgesia use in children are discussed. Analgesics commonly used in pediatric pain as well assome controversies regarding analgesics use in children are also explained.

Benign Acute Childhood Myositis (BACM) is relatively rare, acute and self-limiting muscle disease with a good prognosis. BACM occurs mainly in schoolage dchildren and its pathogenesis is associated with various usually viral infections. Clinically it manifests by sudden pain and weakness of muscles accompanied by gait abnormalities. Laboratory investigations show characteristic hematologic changes, hypertransaminasemia and elevated creatine phosphokinase levels. BACM is treated symptomatically. Prompt diagnosis is essential to prevent unnecessary investigations and therapeutic interventions.

Liver tumors are very rare in infants, but any focal lesion in the liver requires rapid diagnosis because of the potential for the occurrence of malignant tumors. Most of liver lesions in the liver in the neonatal period are benign, usually detected incidentally during physical examination or screening abdominal ultrasound examination performed for other reasons. According to the references, the most common lesions are benign haemangiomas and hamartomas. The most common liver cancer in children is hepatoblastoma.

Objectives:
Presentation of the characteristic of lesions in the liver occurring in newborns.

Material and method:
Authors present 14 patients hospitalized in the Department of Neonatology, Pathology and Neonatal Intensive Care, admittedfor the diagnosis of liver lesions.

Results:
In most patients, the diagnosis was based on CT scans of the abdomen. Malignant disease was diagnosed in two cases (multiple metastases of neuroblastoma), three cases of liver cysts, four cases of vascular lesions, three patients after haemorrhagia and two patients after extravasation ofTPN administered by the umbilical vein to the liver parenchyma. In one patient in spite of histologically benign nature of the lesion (haemangioma) death occurred as a result of vascular insufficiency.

Conclusions:
Analysis of hospitalized infants found that lesions in the liver may be very different in nature and very different degrees of severity of clinical signs. Imaging examinations have significant role in diagnosis of liver lesions in newborn.