An article is a brief summary of the principle of childnutrition in the first year of life, including the orderand manner of introduction of complementary foods.

The aim of allergy prophylaxis is to prevent childrenwith a genetically determined susceptibility to allergicdisease. Elimination diet in women during pregnancy orlactation does not reduce the frequency and severity ofallergic diseases in their children. Exclusive breastfeedingduring the first 4–6 months of life is the best wayof allergy prevention. When exclusive breastfeeding isimpossible in children with hereditary predisposition toallergy, EAACI and AAP recommend the use of formulaswith reduced allergenicity for at least first 4–6 months.EAACI recommends avoiding solid food for the first 4months. There is no reliable scientific evidence thatdelayed introduction of solid food may prevent foodallergy. Prebiotics and probiotics may play significantrole in allergy prevention.

Cholelithiasis (ChL) mostly affects adults. Increasedmorbidity is recently observed in children. In 30% itis determined by genetic factors. The predisposingfactors include: prematurity, total parenteral nutrition,use of drugs, chemotherapy, congenital hemolytic disease,biliary disorders, obesity, cystic fibrosis, Downsyndrome, congenital enteropathy, dehydration andurinary tract infections. The gallstones compositionin children is different than in adults and depends onmany factors including other disorders and geographicalfactors. Cholesterol stones are more common inadolescent girls and overweight people but calciumcarbonate stones are more common in boys. ChL isa poligenic disease. The following genes play importantrole in its pathogenesis: ABCG5, ABCG8, LDLR,CYP7A1, APOB, APOE, CETP, CCKAR/CCK-1R, SLC10A2,and ADRB3. APOB gene polymorphism is responsiblefor the different concentration of serum cholesterol,ischemic heart disease, diabetes type 2, and ChL.ADRB3 gene expression is responsible for the contractionof the gallbladder. Among patients with higherrisk of ChL Trp64Arg polymorphism is observed withADRB3 gene. The presence of ε4 allele of APOE geneis associated with various diseases such as ischemicheart disease, Alzheimer’s disease and ChL. ABCG5and ABCG8 are transporter genes. They play an importantrole in lipid homeostasis and pathogenesis of ChL.CCKAR gene encodes a receptor for cholecystokininA. It is as a factor for emptying gallbladder, and thepathogenesis of ChL. Challenge for better diagnosisand treatment of patients with a risk of gallstone disease is research for genes responsible for lithogenesis(LITH gene).

Crohn’s disease manifests during childhood and adolescencein up to 25% of patients, who specificallypresent the potential to linear growth impairment asa complication of chronic intestinal inflammation. Thestudies indicate that insuline-like growth factor (IGF-I),produced by the liver in response to growth hormone(GH) as the key mediator of suppression at the growthplate of bones is related to growth disorders. Novelevidence proves the association between malnutritionand proinflammatory cytokines in suppression of IGF-Iproduction. The potential role of noncytokine factors,such as lipopolysaccharides, to negatively influence thegrowth axis has recently been investigated. All abovementionedhypotheses are the optimistic perspectivefor developing further novel and targeted strategies,such as specific anticytokine biological therapy.

The study presents the stage of nurse’s educationaleffects to a child suffering from diabetes mellitus andhis family. The nurse’s diagnosis is the basis of teachingprocess and self – control teaching in diabetes.Educational programme for children and parents hasbeen introduced according to a self-care model asa nursing process (aim, task, educational range, formaleducational methods, education efficacy controlmethods). Correct education, together with nurse’sprofessionalism and creativity, can help the child andit’s family to solve the problems concerning the disease,as well as influence child’s behaviour and qualityof life.

The prevalence of at least one of the anxiety disordersin the population of children and adolescentsis estimated from 6 to 20%. The early identificationand the effective treatment may reduce the influencethese disorders have on the child’s functioning, aswell as diminish the persistence of these disorders ina long-term perspective. The clinicians must be ableto distinguish the adequate behavior for the developmentalstage like anxiety, fears and timidity from theanxiety disorders. According to the recommendationsof the American Academy of Child and AdolescentPsychiatry, while assessing the psychological conditionof the child it is necessary to conduct routinescreening to detect the presence of the anxiety. Incase of intensified anxiety symptoms, their character,other functioning disorders, as well as possible psychologicaldisorders and/or somatic diseases of shouldbe assessed. In the treatment strategy it is necessaryto consider adopting the multimodal therapeutic approach.

Serum transferrin consists of the mixture of isoformswith a different number of sialic acid residues linkedto N-glycans. Isoforms are quantified by isofocusingusing %CDT (Carbohydrate Deficient Transferrin) value.An abnormal profile of isoforms with the cathodal shiftindicates hypoglycosylation and serves as CDG marker.Transferrin hypoglycosylation due to deficiency of theentire glycans occurs also in patients with fructosemia.Glycosylation deficit in fructosemia is transient andpass on treatment with fructose free diet. Fructosemiais caused by a deficiency of aldolase B the enzyme ofliver, kidney and intestine. The typical symptoms arepoor feeding, vomiting, failure to thrive, hepatomegaly,edema, coagulation disorder, hypoglycemia and appearafter waning on normal diet containing fructose anddisappear on fructose free diet. In the part of patientsthe atypical clinical picture include neurological symptomsor can mimic other inborn errors of metabolismsuch as disorders of b-oxidation and CDG. Normalizationof the transferrin glycosylation during treatmentenables apply transferrin isoforms to fructosemia diagnosis.%CDT decreases after 2–4 weeks of treatmentpoints to fructosemia.

C-type natriuretic peptide (CNP), acting through its receptor– natriuretic peptide receptor-B (NPR-B), playsa critical role in linear growth. CNP has a direct regulatoryeffect on chondrocytes and growth plate activityand indirect impact through its interaction with theGH-IGF-I axis. The observations are documented by invitro studies on osteoclast, osteoblast, and chondrocytecultures and genetic studies on animals and humans.Knockout mice for CNP and NPR-B are dwarfed, andtransgenic mice overexpressing CNP are overgrown.In humans, homozygous NPR-B mutation is regardedthe cause of acromesomelic dysplasia, Maroteauxtype (AMDM). NT-proCNP is a stable product of CNPsynthesis which is secreted into circulation, so plasmaconcentration of NT-proCNP reflects CNP production.Recent studies have shown that plasma NT-proCNPlevels are associated not only with the physiologicallinear growth (neonates and pubescent children), butalso with altered growth in pathology (short stature ofa different origin), or with growth-affecting treatments(growth hormone and testosterone therapy, glucocorticoids).In summary, NT-proCNP levels in blood mayserve as a useful marker of growth plate activity in bothphysiology and disease, and may gain a clinical utilityin monitoring growth-promoting therapy.

Introduction: Clinical trials vary depending on the stageand character of the studies, Sponsor`s requirements,tested drugs, and age of the patients. Despite the differences,tools for professional data analysis are similar.Objective: The aim of this work is to discuss the toolsneeded to properly design, assembly and analysis ofvariables in clinical trails.Description: The test can be divided into several periods:the preparation of guidelines, and documentation,collection of patient data, „cleaning the dataset” (ie, medical terms coding, verification of logicaland substantive information), the statistical analysisof the data and preparing the final report. Each stephas a different nature, and involves a different groupof people, but ultimately each stage is to gather reliabledata analysis.Lengthy process of data analysis begins with the preparationof protocol and data analysis plan, which definesall the variables that determine their nature, limitvalues and relationships between the variables anddefines the system to be created lists of data, tablesand figures as well as statistical analysis. These documentsform the basis for the preparation of paper orelectronic case report form (CRF), which is a tool forrecording data. The patient’s physician completed CRFby the investigator based on medical history, and thecompleteness and correctness of the data are checked by monitor, who in unclear situations asks the investigatorquestions to rule out errors or concerns. Datachecked according above rules are transmitted to thedatabase, where again are reviewed for logical andsubstantive compliance. When all possible to gatherinformation are confirmed by, the database is closedlist of tables with data and statistical results are generated.Based on those tables and statistical results, thefinal report is prepared.Errors committed at any stage may result in the lackof data for analysis, which in many cases can makeimpossible the completion of the objective specifiedin the protocol.Conclusions: The presented methodology is time andlabor intensive, but provides reliable results. Practiceshows that the more work will be devoted to the designstage of the plan, data analysis and CRF, the better willbe the final report.

Many mothers choose breastfeeding as the healthiestway of feeding an infant. Breastfeeding is a naturalprocess, based on ‘cooperation’ between the motherand the infant as a dyad: the mother produces themilk – the infant suckles the milk. The process notdisturbed by improper practices may last as long asthe mother and the infant wish. Thus the care overthe breastfeeding dyad doesn’t involve any specialmedical interventions, but is rather based on the primumnon nocere strategy, on supporting the mother inher choice and on the professional asessment of thebreastfeeding. Some mothers, suffering from severeproblems during breastfeeding, may need help fromspecialists who have knowledge and experience inlactation counseling, such as lactation consultants andcounselors.The paper discusses the main aspects of successfulbreastfeeding, such as the right technique, effectivesuckling and feeding on demand. It also presents certaincommon mistakes made by mothers or medicalstaff, that can disturb proper, physiologic course ofbreastfeeding. The clinical cases presented in the paperillustrate typical problems. The aim of the paper is toshow doctors practical methods that support breastfeeding.

The group of 36 children aged from 1 to 18 years withunexplained fever lasting longer than 10 days wasstudied. The most frequent cause were infectious diseases(52,7%) and systemic connective tissue disorders(41,6%). Infection of tuberculosis was found in almosthalf of the children (46,6%). The most frequent systemicconnective tissue disorder was juvenile idiopathicarthritis (60%). A severe complication of infectiousdiseases and connective tissue disorders was reactivehemophagocytic syndrome/macrophage activationsyndrome (25% of cases) with multiorgan failure.

Authors present selected liver topics presented during43rd Annual Meeting of the ESPGHAN (European Societyfor Paediatric Gastroenterology, Hepatology and Nutrition)Istambul, June 2010.

During the last few years intensive experimental andclinical research in the introducing the cancer vaccinesis ongoing. Data from different laboratories suggestthe possibility of turning leukemic cells into antigenpresenting cells, but the function of leukemia-deriveddendritic cells is not fully understood. It is known thatCD40L stimulation enhances the antigen presentingcapabilities of not only normal but also neoplasmaticB cells. For the purpose of this project children withacute lymphoblastic leukemia (pre-B phenotype) andadults with chronic lymphocytic leukemia were enrolled.Leukemic cells were turned into dendritic cellswith the CD40L/IL-4 stimulation and put into the mixedlymphocyte culture with allogeneic T lymphocytes. Beforeand after the culture leukemic cells were assessedfor dendritic cell phonotype, allogeneic T lymphocyteswere assessed in the context of activation. Results of our experiments showed that it is possible to turnleukemic cells into dendritic cells. Leukemia-deriveddendritic cells show: the upregulation of costimulatoryand adhesion molecules, higher expression of chemokinesinvolved in T-cell migration, maintenance and/or upregulation of tumor associated antigens expression,activation of some elements involved in antigenprocessing machinery, induction of allogeneic T-cellsresponse.

Objectives. Update of the reference ranges of height,weight and BMI in the form of centile charts and z-scorefor school-aged children and adolescents.Materials and methods. Anthropometric data from17 281 participants of current health survey ‘Elaborationof the reference range of arterial blood pressurefor the population of children and adolescents in Poland– PL0080 OLAF’ were used. Data were analyzedwith SAS 9.2 software. Centile charts and z-score ofanthropometric indicators were constructed using theLMS method with LMS Chart Maker Pro 2.42 package.Results. Current and representative for population ofchildren and adolescents centile charts and z-score ofheight, weight and BMI.Conclusions. Presented centile charts and z-score byage and gender for children and adolescents enableearly diagnosis of growth and nutritional status disturbances.