This paper presents summary of new recommendation of American Academy of Pediatrics on fruit juice consumption in children.

The authors discussed reports on liver disorders in children discussed at the 50th Annual Meeting of European Society for Paediatric Gastroenterology,
Hepatology and Nutrition (ESPGHAN), 10-13 May 2017 in Prague.

Urticaria is a common skin condition. The lifetime prevalence is about 20%. Although often self-limited and benign, it can cause significant discomfort, continue
for months to years, and uncommonly represent a serious systemic disease or life-threatening allergic reaction. Diagnosis is made clinically. Different
viruses are the main cause of acute urticaria, while chronic urticaria is idiopathic in 80% to 90% of cases. Chronic urticaria is classified into spontaneous versus
inducible types. Any routine diagnostic measures in acute urticaria is recommended unless elements of the history or physical examination suggest
specific underlying conditions. The mainstay of treatment is avoidance of triggers, if identified. Non-sedating H1-antihistamine is the first-line treatment for
2-4 weeks; if urticaria was not controlled, increasing the dose up to 4 times is recommended. More than one-half of patients with chronic urticaria will have
resolution or improvement of symptoms within a year.

The guidance for parents and caregivers usually discuss ways in which early child’s experiences influence food preferences and eating behavior. Individual
patterns of food preferences and eating behaviors emerge and differ depending on the foods offered, developmental readiness and on the oral motor
skills. It is necessary to understand how infants and toddlers develop the food preferences and self-regulatory processes for developing feeding skills appropriate
for age. Therefore, the aim of this paper is to present the development of the oral motor skills related to the spoon feeding, drinking from the cup,
biting and eating with hand.

Sugar and his various forms, among others the glucose-fructose syrup, is a common ingredient of food products. Consumption of sugar is so high that it
causes health concerns. Children, already in pre-school age are eating twice amount of sugar then they should. In contrast with natural sugars contained in
raw food sugar added by food industry and also by the consumer is questioned the most. One of primary source of sugar are sugar sweetened beverages.
Although their role in the obesity is not fully explained they in fact are increasing the energy value of the diet. Children can easily avoid the excessive intake
of these calories by replacing sweetened drink with water. From 2016 nutritional value of food, including content of sugars is placed on the label of almost
all products. Therefore it is possible and necessary to make a good choice during purchase of the food.

Acute viral rhinosinusitis is self-limiting element of upper respiratory tract viral infection which usually resolves within 10 days. Non-viral rhinosinusitis
is noninfectious inflammatory process of moderate intensity, which can up to 3 months persist should be treated with topical glikocorticosteroids. Only
acute bacterial rhinosinusitis should be treated with antibiotics for presumed pneumococcal or nontypable Haemophilus influenzae infection. Septic
complications are rare, in most cases occur during early stage of the bacterial rhinosinusitis. The article focuses on the treatment according to updated
Recommendation for treatment in community-acquired respiratory tract infections developed by National Antibiotic Protection Program 2016 and current
EPOS guidelines.

This article deals with general rules of preparation for elective paediatric anaesthesia. It covers all aspects of necessary preparations such as: preoperative
anaesthetic consultation, specialist consultations, laboratory tests and fasting guidelines. It concerns also assessment of anaesthetic risk and factors
increasing the risk of complications. The most common contraindications for elective anaesthesia are presented including recommendations concerning
timing of vaccines, infective diseases as well as respiratory tract infections in relation to anaesthesia. This article also touches the problem of anesthetic
neurotoxicity for the developing brain, the hot-topic of the last decade.

Drug interactions in the pediatric population are increasingly a problem in practice both for the pediatrician and for the family doctor. Differences in pharmacokinetic
parameters in infants and children increase the risk of adverse drug interactions in pediatrics, particularly pharmacokinetic interactions. The
current knowledge about the most common drug interactions in pediatrics has been collected.

The problem of malnutrition affects 8-32% all of the patients with a neoplastic disease, and in case of progression it is noted in 40% of the patients. It may
impact growth and maturation disorders, as well as the development of cognitive and emotional functions. In oncology faulty nutrition not only derives
from the presence of the primary disease but also from abnormal metabolism, concentration change of different cytokines and appetite neuroregulators,
disorders of the alimentary tract functions (absorption and excretion) and the treatment itself. Malnutrition may negatively impact the efficiency of the applied
antineoplastic treatment for example by affecting the cytostatics absorption. The frequency of neutropenic fever occurrence and risk of bacteremia
increase in cases of the described disorder and in the opinion of some authors, the percentage of relapses and complications deriving from the antineoplastic
therapy also increase. Limited possibilities of conventional medicine, caring for a seriously sick child, fear of the disease and its long-term, burdensome
treatment, often tarnished trust of the health system and the social pressure favor the use of all kinds of alternative therapies, including dietary supplements
or special diets, despite the lack of sufficient proof of their effectiveness.

Intestinal failure-associated liver disease is the most prevalent complication affecting children with intestinal failure receiving the long-term parenteral nutrition.
The paper comprises up-to-day lecture on its pathogenesis, clinical presentation, risk factors, treatment and prevention.

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One of the first acoustic stimuli we are exposed to before birth is the voice of the mother and the sounds of her heartbeat. Intrauterine environment
enables fetuses to develop the organ of hearing. Preterm infants are born during a critical period for auditory brain development.
There is an acoustic gap between the Neonatal Intensive Care Unit (NICU) and womb. Premature infants often are exposed to continuous loud noise. This
excess auditory stimulation creates negative physiological responses, may lead to hearing impairment and dysfunction of central nervous system. Medical
care is a major source of noise in intensive care units.
Modifying the neonatal intensive-care unit to reduce noise levels provides an environment more conducive to maturation and recovery from illness. It is
necessary to introduce practice interventions for decreasing noise levels in the neonatal intensive-care unit. In order to improve the conditions it is necessary
first of all to change the habits of the staff.
Positive auditory experiences, known in the life of intrauterine sounds, are important for the proper development of the nervous system of prematurely
born babies. Stimulation with sounds similar to those experienced during fetal life protects against the adverse effects of noise present in the hospital
environment.

Objectives: The aim of the study was to evaluate steatosis and fibrosis of the liver in obese children using Transient Elastography (FibroScan®) in whom fatty
liver was primarily excluded based on normal ultrasound (US) and ALT measures.
Materials and methods: 44 children with obesity (BMI > 95 c) and 27 children with normal body weight (BMI < 85 c) aged 8-18y were investigated by
FibroScan®, weight and height measurements. Statistical analysis used the Mann-Whitney U test. For correlation evaluation - Spearman›s test.
Results: The median age in control group was 13,9 yrs and in the obese group 14,1 yrs. The median z-score BMI value of the control group was 0,12 (range
-2,26 to 0,96) and for the obese group 2,02 (range 0,76 to 2,79). The median value for CAP (Controlled Attenuation Parameter) in controls was 200 dB/m
(range 100-261) and for the obese group was significantly higher - 274 dB m (range 119-400) (p < 0,0001). The cut-off point for CAP was accepted in range
249 dB/m, and fatty liver was found in 64% of obese patients and 7.5% of lean controls. Median of Liver Stiffness Measurement (LSM) obtained with
FibroScan® were 4.3 kPa (range 2.9 - 6.8) in the control group and 4.6 kPa (range 1.9-12) in the group with obesity (P = 0,3504). Correlation analysis in obese
patients showed a positive correlation between z-score BMI and CAP (r = 0.34, P = 0,0121) and between z-score BMI and E (r = 0.41, P = 0,0033).
Conclusions: FibroScan® can detect and quantify liver steatosis in obese children in whom fatty liver was primarily excluded based on normal ultrasound
and ALT measures. Liver steatosis seems to be commonly associated with obesity in children. FibroScan® with the CAP option is a useful tool for non-invasive
assessment of liver steatosis with higher sensitivity than US.

Respiratory tract infections in children are one of the most common reasons for medical consultations and hospitalizations. Uncomplicated community acquired
pneumonia can be diagnosed on the basis of a comprehensive patient interview and results of physical and other auxiliary examinations. Contrary
to popular opinions, making a right decision about further treatment is not easy and can require special attention in some cases. For example infants can
show no classical symptoms of pneumonia. Taking into consideration cases when neither medical history nor physical examination give definite results,
radiological diagnosis is a decisive factor for final diagnosis. This type of examination can be cumbersome because of the need for specific preparation.
Additionally, X-ray examination can pose additional risk related to the side effects of ionizing radiation. As an alternative to X-ray, lung ultrasound technique
is becoming an increasingly popular diagnostic method which can be applied for pneumonia diagnosis. This article presents selected clinical cases of pneumonia
in which lung ultrasound examination was chosen as a primary diagnostic method.

Constipation in childhood is a rather serious clinical problem. It is very important to find out the cause of the constipation and treat it. It is very important
to determine whether the cause of constipation is not congenital dysganglionosis (for ex. Hirschsprung’s disease). This paper article should clarify dysganglionosis
disease and gastrointestinal dysmotility disorders in children.
This article was based on the chapter from “Children’s Gastroenterology − Handbook for Specialization” edited by P. Socha, D. Lebensztejn, D. Kaminska
(Media-Press 2016).