Skin in newborns and infants differs from skin in adults and is more susceptible to damage. The main goal of skin care in newborns and infants is
to maintain skin’s integrity by protecting its epidermal barrier. Skin care includes bathing using liquid cleaning agents and caring for the umbilical
cord stump. Special skin care is required for prematurely born infants and in children with elevated risk of atopic dermatitis.

In this paper we present the results of the randomized double-blind clinical trial performed by Berende et al., who aimed to evaluate the effect of a prolonged
antibiotic therapy on the quality of life in patients with persistent symptoms attributed to borreliosis.

The author discussed reports on feeding and swallowing disorders in children discussed at the 50th Annual Meeting of European Society for Paediatric
Gastroenterology, Hepatology and Nutrition, 10-13 May 2017 in Athens.

Suspected central nervous system infection, which is diagnosed based on cerebrospinal fluid testing, is the major indication for lumbar puncture.
The etiology of CNS infection is of key importance for appropriate treatment and justifies all efforts made to collect the cerebrospinal fluid. The most
important contraindications for lumbar puncture include shock, respiratory failure and bleeding disorders. Increased intracranial pressure is inaccurately
considered as a contraindication. If increased pressure is accompanied by differences in the pressure between the cranial cavity and the vertebral
canal, it can give rise to the most dangerous complication, i.e. displacement of the brain into the spinal canal, with additional compression of brain
structures. With maintained communication, the pressure is equalised immediately at a time of puncture. Lumbar puncture can almost always be performed
safely without prior imaging. The aim of imaging is to exclude conditions that could impair pressure equalisation, such as cerebral oedema, cranio-
vertebral defects or tumour. Conditions that require imaging include impaired consciousness, focal symptoms, optic disk oedema, recent convulsions
and impaired immunity.

Fever is defined as a raised body temperature above the upper limit of the normal temperature because of a switch set point temperature control to
a higher level. Factors affecting the physiological body temperature include age, time of day, physical activity, the activity of the endocrine glands.
The range of valid values of the body temperature of children depends on the place of measurement. In young children (< 3 years old) rectal thermometry
has been considered the gold standard for temperature measurement. In clinical practice, the fever is defined as a condition in which the
body temperature is 38 deg. C or greater. Diagnosis of fever should take into account the patient’s age, individual risk factors, general condition,
local epidemiological situation, medical history, clinical examination and additional tests. The fever could be the only symptom of a serious infection
in infants and young children. The article presents the algorithms in febrile children, we discuss the differential diagnosis of systemic inflammatory
response syndromes.

The most commonly used antipyretics and analgesics in children are paracetamol (acetaminophen) and ibuprofen due to their favorable safety profile.
We compared the efficacy and safety of both medications in common pediatric conditions: fever, pain, otitis media, varicella and arthritis; moreover we
overviewed indications for paracetamol/ibuprofen combination therapy. Both drugs alike have an analgesic effect in otitis media. Ibuprofen is more effective
in fever. The most important side effects of both medications are discussed: paracetamol is safer in terms of gastrointestinal and renal complications,
however should be avoided in liver diseases. Ibuprofen should be avoided in children treated with glucocorticosteroids, children with vomiting or
diarrhea due to possible nephrotoxic effects, and in children with aspirin asthma. Concomitant use of drugs does not bring any benefits, but combination
therapy with alternating dosage allows for reducing of the single dose of each drug.

The cause of ophthalmic diseases in children may be: infections, trauma or congenital abnormalities. The most common symptoms are pain and redness
of the eyes and the most common pathology is bacterial conjunctivitis. The differentiation of the „red eye” should also include uveitis, which can
be accompanied by symptoms of general connective tissue disease. In addition, there is often a tearing usually associated with obstruction of lacrimal
duct. Another symptom is a loss of transparency of cornea or lens that can be associated with impaired vision and may indicate a serious pathologies.
The occurrence of white pupil symptom should always suspect retinoblastoma, the most common malignant intraocular tumour in children. A rare
disease which may cause irreversible blindness is congenital glaucoma, while enlargement or asymmetry of the eyeball can be observed. Another problem
is strabismus, not treated can lead to amblyopia. Furthermore, optic nerve diseases require serious assessment which are usually associated with
bacterial or viral infections in children. Swelling of the optic nerve disc requires extremely careful diagnostics to exclude the intracranial pathology.

Ascites is defined as an abnormal fluid accululation within the peritoneal cavity. Etiological factors and diagnostic methods were presented. Liver cirrhosis
with portal hypertension is the most common cause of ascites in children. Treatment of mild and moderate ascites includes: sodium restriction
and diuretics. In case of refractory ascites paracentesis with albumin infusion, peritoneovenous shunt or transjugular intrahepatic portal-systemic stent-
-shunt should be considered. Liver transplantation is the treatment of choice in children with refractory ascites associated with the end stage liver disease.

In the paper authors chase news and studies on pharmacotherapy and monitoring diabetes in pediatric population. The new therapeutic approaches
to type 2 diabetes, researches and trends in studies on new insulins and insulin pumps, which are going to close loop (pump which act based
on algorithms depends on continues glycemic monitoring system). For practitioners indications and contraindications to therapy by continues
subcutaneous insulin infusion by pumps were added.

Allergic diseases are common health disorders, affecting 20-30% of infants with a family history of allergy and about 10% of children regardless from
the family history to allergic disease. The risk to develop allergic diseases may be related to intestinal microbial composition. Prebiotics, by affecting
the composition and activity of intestinal microbial activity, can have a beneficial effect on the functioning of the human body.
The article presents recommendations of the World Allergy Organization (WAO), published in March 2016, concerning the use of prebiotics in the prevention
of allergic diseases.

Calcium preparations are widely used in many countries in Central and Eastern Europe as a popular remedy for allergy and common cold. Their administration
is not recommended by any polish nor international guidelines. As the number of publications related to this topic is limited, and their results
are inconsistent and ambiguous, calcium intake remains controversial. Considering the possible interactions of calcium preparations with other
medicines, especially used in the treatment of allergies, their intake may seem dangerous. The article presents the current view on the treatment of allergies
and common colds using calcium supplements.

Guillain-Barré syndrom (GBS) is acute, infectious polyneuropathy with autoimmune origin and different clinical forms. It is the most common reason of
acute, generalized, flaccid paralysis in children. Monophasic, unfebrile, classic form presents as acute, flaccid paralysis of legs with areflexion. Disorder
can be predated by infection, vaccination or surgical intervention. Besides, GBS can be the first symptom in neoplasms (lymphomas) and other autoimmune
processes, like lupus erytematosus. GBS diagnosis should be based on the proteincellular dissociation in cerebrospinal fluid examination and
demyelinating or axonal neuropathy demonstrated in electromyography. Heterogenous, clinical course makes the diagnosis harder, especially in GBS
mixed forms. The aim of study is to present different forms of GBS taking into consideration the differential diagnosis.

Cerebral cysts are a group of various brain pathologies in newborns. They can develop as a cause of pathological influence of inflammatory factors,
developmental disorders, hypoxia or toxins. They vary in location, volume and prognosis. Cerebral cysts may present no symptoms, mild symptoms,
or due to their slow growth − severe neurological symptoms, which require further imaging diagnostics and immediate neurosurgical intervention.
This review will present most frequent types of cerebral cysts in newborns observed in Department of Neonatology in University Hospital in Wrocław.

The article reviews literature on the difficult subject of diagnostic imaging in case of suspected non-accidental injuries (NAI) in children. Radiological
features of NAI as well as diagnostic protocols developed and recommended by international pediatric and radiological societies are presented in the
publication. The article also highlights the lack of guidelines for the diagnosis and management of NAI in Poland and the need for their development.

Exclusive enteral nutritional (EEN) is recommended as first-line therapy in children and adolescents with an active Crohn disease, as a safe and highly effective
method to induce remission, achieve intestinal mucosal healing with a beneficial effect on nutritional status, growth and quality of life. EEN involves
the use of nutritionally complete liquid diet given exclusively, instead of usual food and fluids for a defined period of time (usually 6-8 weeks). Oral feeding
is recommended, while an artificial access (tube-feeding, stoma) can be used in situations when the natural route is unacceptable or insufficient to cover
protein and energy requirements. The mode of delivery (continuous, bolus) does not affect the effectiveness of therapy. Polymeric diets, that are better tolerated
and accepted, are recommended. Modified formulas are indicated only in specific clinical situations (cow’s milk protein allergy, digestive /absorption
disorders).

Nutritional treatment brings a lot of benefits, but involves a risk of complications, which could disturb therapeutic effects. Prevention and treatment
of parenteral and enteral nutrition complications have been discussed.

Bronchopulmonary dysplasia (BPD) remains the most common complication of prematurity. The rate of BPD is stable, despite advances in the medical
care. Commonly used preventive measures: antenatal cortisteroids, surfactant therapy and gentler ventilation strategies changed the pathophysiology of
chronic lung disease. New BPD has milder clinical course and is defined by disruption of distal lung growth. The lung function impairment is reflected in
oxygen dependency. The most important risk factors for BPD are gestational age, fetal growth restriction, genetic susceptibility, mechanical ventilation, inflammation
and oxygen toxicity. Long-term outcomes of BPD like recurrent infection, limited exercise tolerance and neurodevelopmental impairment have
impact on quality of life of patients and their families. Steroids are proven to reduce death rate or BPD rate at 36 weeks postmenstrual age and can facilitate
extubation. Unfortunately administration of steroids in neonatal period was previously reported to be associated with a higher risk of cerebral palsy.
The timing, doses and indications for steroids are very important to facilitate extubation and the same time limiting side-effects. The use of caffeine and vitamin
A were also suggested in prevention of BPD.

Lung function testing in obstructive airway diseases not only helps us to make a proper diagnosis but also is used in monitoring the disease and predicting
loss of its control. The gold standard nowadays is spirometry, however it often cannot be used in children aged < 5 years. Impulse oscillometry
(IOS) is a simple, noninvasive tool that permits passive measurement of lung mechanics. It requires minimal cooperation. IOS parameters may be even
more sensitive in detecting small airways abnormalities than spirometry

Objectives: 3-methylglutaconic (3-MGA) aciduria is a specific marker of metabolic defects associated with mutations in the: AUH, SERAC1, TAZ, CLPB, OPA3,
DNAJC19, TMEM70 genes. The aim of the study was to develop recommendations for 3-MGA-urii differentiation, including indication for molecular testing. Material and methods: 356 cases of 3-MGA-uria revealed among more than 70,000 GC-MS organic acid profiles in urine were included in
the study. Age of screening (onset), specific clinical symptoms, and 3-MGA-urii excretion amounts were analyzed. Presence of specific clinical
symptoms (and DNA availability) were the basis of qualification for molecular study. All available molecular and metabolic data were included
in the analysis.
Results: Positive results of molecular diagnostics were received in phenotypes dominated by involvement of liver (43,9%), central nervous
system with neutropenia (53%) and deafness (80%), and in heart (25%). Definite diagnosis was established in 48 out of 94 studied patients
(51,1%). In 18 of these, the defects of genes specifically associated with 3-MGA-uria (SERAC1, TMEM70, CLPB, TAZ) were detected. In 75% of
neonates, mutations in genes specifically associated with 3-MGA-uria or other defects (hyperammonemia type I, SLO syndrome) were identified.
In older age group (>1.5 years), the positive DNA results were not connected with 3-MGA specificity and were found occasionally (glycogen
storage disease, mitochondrial disorders).
Conclusions: Results of the study indicate that the diagnosis of 3-MGA-uria should be based on the severity of the disease, patient’s age
and the nature of the dominant clinical symptoms.