Recommendations of the American of the United States Preventive Services Task Force (USPSTF) suggest that, the current evidence on the effectiveness of methods of screening for hypertension in the prevention of cardiovascular disease in childhood or in adulthood are insufficient to assess the balance of benefits and harms. These results were published in Pediatrics journal and raise a lot of controversy, especially among clinicians. We discuss the results of the study and present critical opinion of hypertension committees.

Oseltamivir (Tamiflu) is the antiviral drugs recommended by international health organizations (WHO, CDC) in the treatment and prevention of influenza. In recent years, studies indicating no significant benefits from the use of neuraminid ase inhibitors appeared, and the final report was published in the British Journal of Medicine. Simultaneously, there are other papers indicating the positive effects of treatment with oseltamivir. The results provokeda discussion among doctors, epidemiologists and representatives of pharmaceutical companies, government organizations, public health.

Haematuria and proteinuria are the most common abnormalities present in urine analysis, which are the reason to visit the paediatrician or specialist (nephrologist or urologist). These abnormalities may be of transient or persistent character. May be isolated or the sign of various systemic disorders. Basic first-step diagnostics is mandatory and in selected cases the second-step diagnostic procedures, including renal biopsy may be necessary.

The paper discussed the basic methods of vision examination for children. The most frequent causes of disorders of vision in children were described, including congenital and acquired diseases. These are: optic nerve atrophy, retinopathy of prematurity and its complications, cataracts, glaucoma, uveitis, refractive errors, tumors and eye injuries. In the majority of cases concerning the aquired disorders of vision casual treatment is possible.

There are inherited and acquired coagulation disorders. Acquired coagulation disorders are usually the result of primary disease. Von Willebrand disease is the most common among inherited coagulation disorders. Haemophilia A is less common but 5-7 times more often than haemophilia B. The other coagulation defects, as a results of factor VII, V, X, XI or XIII deficiency are detected very rarely. The diagnosis of bleeding disorder is based on characteristic clinical anamnesis, signs of clinical examination and the laboratory results of coagulation tests. The coagulation factor concentrates, properfor supplementation of deficient factor and supportive drugs are used in the treatment. The inherited coagulation disorders are incurable at presentand treatment is needed during life of the patient. The prophylaxis is the treatment of choice in children with severe type of haemophilia. Prophylaxisprevents of joint bleeds and protects against haemophilic arthropathy. In the publication the rules of diagnosis and treatment of children with inheritedcoagulation defects were presented based on randomized multicentre studies, guidelines presented by the group of scientists and valuable retrospective multicentre studies.

Allergic diseases are the most common chronic diseases in children (especially persistent allergic rhinitis). Urticaria although rarely occurring (5.58% ofPolish children) can cause a significant decrease of quality of life. Typical wheals are characterized by elevation in the center surrounded by erythema, are well defined, quite hard, occur within minutes and quickly disappear (up to 24h). They are accompanied by itching and sometimes burning. Urticariacan be divided into 4 groups: spontaneous acute, spontaneous chronic, physical and other types (e.g. cholinergic, contact). Acute urticaria lasts up to 6weeks (> 90% of cases in children). The most common triggers are infections, drugs and food allergens. In acute urticaria, it is not indicated for detailedanalysis. Treatment includes: identification and elimination of triggers and the use of second-generation antihistamines. Currently, we have a new drug- Rupatadine, which combines two synergistic mechanisms of action (anti-H1 and anti-PAF). It is the only drug to have proven high efficacy and safety inchildren with urticaria and PAR from 2 years of age.

The acute otitis media is a common disease, especially in small children. That is why it is clinical and socioeconomic problem. Recurring acute otitis mediais especially difficult problem because of its negative influence on individuals development as well as on the quality of family life. The possibility of serious complications increases in recurring acute otitis media. The paper outlines the etiology and pathophysiology recurring acute otitis media emphasizes the role of bacterial biofilm formation. The methods of prevention are described of recurring otitis media with presentation results of clinical trials with Streptococus salivarius K12.

According European Position Paper on Rhinosinusitis and Nasal Polyps 2007 and 2012 rhinosinusitis is initially viral infection (”viral rhinosinusitis“) with nasal obturation, discomfort or pain in nasal sinus projection and nasal discharge for less than 10 days. “Post-viral rhinosinusitis” is noninfectious inflammatory process with characteristic more or less profuse mucosy or mucopurulent discharge lasting not longer than 12 weeks. Bacterial rhinosinusitisis an active bacterial inflammatory process. Viral and post-viral rhinosinusitis require intensive symptomatic treatment: antipyretic, analgesic and antiinflammatory, nasal steroids nebulisation with 0.9% or 2-3% NaCl or with ambroxol, neb-decongestants, antisecretory and nasal steroids. For dry cough resulting from postnasal drip cough suppression with the first generation antihistaminics in combination with pseudoephedrine are recommended. “Bacterial rhinosinusitis” which is demonstrated with unilateral pain in sinus projection and high fever and profuse purulent discharge should be treated with antibiotics for presumed pneumococcal or non-typable Haemophilus influenzae infections with analgetic antipyretic treatment.

The article discusses development of the intestinal microbiota of children in early age of life, factors affecting colonization of gastrointestinal tract of newborns and the functions of microbiota. It was found in newborns that development of intestinal microbiota after birth has a significant impact on healthand a balanced intestinal microbial composition in childhood determines health preservation. Factors influencing the succession of the gastrointestinal tractin newborns include: duration of pregnancy, method of delivery, hospital environment, type of food and supplement of mother and child with prebiotics. Thearticle describes substances with prebiotic characteristics and shows the importance and impact of prebiotics on children’s health.

Coarctation of the aorta is a congenital heart disease, where the isthmus of the aorta is narrowed. This defect is characterized by variable clinical presentation and can manifest at different ages. In the newborn, severe undetected coarctation of the aorta may, after a few weeks result in sudden deterioration of health, rapidly developing heart failure, kidney disease, and even death. It is also one of the main causes of hypertension in children. Untreated, it leads to multiorgan failure or even premature death, but correct diagnosis and appropriate treatment, increases the chances of a patient living a „normal” life. Properly performed pediatric examination provides sufficient information for one to suspect the presence of the defect and refer the patient for cardiac consultation.

Sjögren’s syndrome (SS) is a chronic autoimmune disease characterized by dysfunction of exocrine glands, mainly salivary and lachrymal, but alsovarying degrees of systemic involvement. SS is one of the most common connective tissue diseases in adults; it is rarely diagnosed in children. Clinical manifestation is often different in pediatric patients compared to adults. The most common feature observed in children is recurrent parotid swelling. Sicca syndrome, although the most characteristic for SS in adults, is rarely observed in children. The most common laboratory abnormalities include hipergammaglobulinemia, elevated erythrocyte sedimentation rate (ESR) and the presence of autoantibodies such as anti-SSA/Ro, anti-SSB/La, antinuclearantibodies (ANA) and rheumatoid factor (RF). Lymphocytic infiltration of the exocrine glands revealed in minor salivary gland biopsy is characteristic forSS. Apart from different clinical manifestations, another problem in diagnosing this syndrome in children is lack of diagnostic criteria created for pediatric population. Since SS syndrome is a systemic disease and there is a possibility of involvement of many organs, our patients require multidisciplinary care.

Prader-Willi syndrome (PWS) is one of the dysmorphic syndromes with variable genetic basis and clinical features. Most of PWS cases originate de novo asa non-inherited deletion in paternally 15 chromosome (75% of cases) or materal uniparental disomy (20% of cases). The clinical symptoms of Prader-Willisyndrome involve face dysmorphic features, small hands and feet, short stature, hypotonia, hypogonadism, hyperphagia and obesity, mental retardation, developmental delay and behavioral problems. We report behavioral phenotypes, characteristic for this syndrome, that became one of the main reasons for seeking medical help for patients and their families. Improving dietary behaviors, comprehensive physiotherapeutic care and emphasizing the role of physical activity of children with the syndrome described, caused moving out to the forefront of the psychiatric symptoms which represent a major challenge for both children and youth psychiatrists, pediatricians and other physicians.

During the last decades of progress in solid organ transplantation, the knowledge of posttransplant lymphoproliferative disease dramatically improved. Due to the modern diagnostic methods, especially enabling monitoring of EBV infection and new therapy including anti-CD20 antibody there isa reduction of severe, live threatening cases. Authors present review summarizing current approaches to PTLD patients with special concern to livertransplant recipient according to the literature and own experiences.

Bowel inflammation is a general term which includes mainly inflammatory bowel disease (IBD) comprised of Crohn’s disease and ulcerative colitis. However, there are also other inflammatory bowel conditions, mostly systemic diseases, which are far more rare than IBD. The term undetermined colitisrefers to these cases of inflammatory bowel disease which cannot be classified neither as Crohn’s disease (CD) nor ulcerative colitis (UC) on the base ofhistologic examination of specimen taken during colonoscopy or colectomy. The differential diagnosis of IBD includes also microscopic colitis (MC) and infectious colitis.

Objectives:
Analysis of the influence of the acute malnutrition in the course of anorexia nervosa (AN) on the hepatic metabolism of 13C-methacetin. Evaluation of the usefulness of 13C-methacetin breath test (MBT) in children with AN.

Materials and Methods:
In total 25 children aged 14.8 ± 1.6 years (13-18 years) were studied. Among them were 12 girls with AN in the acute phase of the disease (BMI mean 15,3 ±2,1 kg/m2). As a control group we studied 13 children without diagnosis of any liver disease, and with normal body mass index aswell normal ALT, INR and GGT results.

Results:
In the control group all results of MBT were within normal range. Also in children with AN no one result of MBT revealed decrease in the total 13CO2 recovery during the 120 minutes of the test. However, patients with AN presented the peculiar feature of hepatic metabolism of 13C-methacetin. Statistically significant increase in the mean values of 13CO2 recovery after standard dosis of 13C-methacetin was found in this patients. Mean 13CO2 recovery after 120 minutes (%CD120) was respectively 38.8±4.39% in patients with AN and 27.9±3.85% in the control group (p<0.0001). The acceleration of hepatic metabolism of 13C-methacetin (%CD120 >37,3%) was found in 7 out of 12 girls with AN (58.3 %).

Conclusion:
In children with malnutrition due to AN the breath test with 13C-methacetin may be not fully reliable in diagnosing impaired liver function.

Objectives:
The aim of the study was to estimate the treatment of the children with oral cavity mucocele and its predilection to age, sex, localization and possible recurrences.

Methods:
Mucocele was diagnosed in 34 pediatric patients of the Pediatric Otolaryngology Clinic in Lublin in age from 1 to 17 years old, treated in years2007-2013. All the cases were qualified to surgical treatment.

Results:
Of the 34 patients, 18 (53%) were females and 16 (47%) were males. According to the literature the most common location of the mucocele was the lower lip. Literature date states that the lesion is most common among men. In case of our group the lesion was located in the lower lip in 23 cases (67,6%). Mucocele located in lower lip was diagnosed in 14 cases (61%) in girls and 9 cases (39%) in boys. In other cases the lesion was found on the tongue and in the oral cavity vestibule. Tongue located lesion was observed in 5 cases, among them 3 cases were boys (60%) other 2 were girls (40 %). Mucocele was found inthe oral cavity vestibule in 6 cases, 4 cases were observed in girls (67%) and the other 2 in boys (33%). There were totally 4 recurrent cases (9%).Conclusions: Mucocele is more common among girls. The most common localization of lesion is lower lip, which is conclusive with literature. Other rare localizations are tongue and oral cavity vestibule. Recurrence is rare and surgical excision seems to be the final treatment of the mucocele.

Caffey disease (infantile cortical hyperostosis) is a rare infancy disease. It is characterised by bone changes and systemic symptoms (fever, soft tissue swelling, decreased movement of affected bones). In this article, the authors report presently 4-years-old girl in whom symptoms of disease occurred during in neonetal period. The uncertainty of treatment’s efficiency has been pointed out (indomethacin, ibuprofen) because of self-limiting nature of the disease.

Type 1 neurofibromatosis (NF1, von Recklinghausen’s disease) belongs to the group of phacomatoses and causes the formation of neurofibromas in the course of the nerves. In some cases it may also lead to skeletal symptoms. Its diagnosis requires at least two of the diagnostic criteria introduced by the National Institutes of Health, among which are mentioned characteristic skeletal complications. This work presents two cases of paediatric patients in whom symptoms and complications of the skeletal system are severe and cause motor dysfunction.