The article present new recommendations of the Polish Hemangioma and Vascular Malformation Group (PaNaMa) of the Polish Association of Pediatric Surgeons for treatment of infantile hemangioma with propranolol. Group PaNaMa consists of pediatric surgeons from major clinical pediatric surgical centres in Poland involved actively in care of children with hemangiomas. New recommendations have been based of their clinical experience and they reflect a rapid progress in an active treatment of infantile hemangiomas. The recommendations present practical tips for physicians and various specialists dealing in their clinical practice with children affected by hemangiomas. 

Neisseria meningitidis of serogroup B is currently responsible for the vast majority, over 70% of cases of the invasive meningococcal disease in Poland and throughout Europe. Due to the similarity of serogroup B polysaccharide capsule to the adhesion molecules of human neural cells, a polysaccharide vaccine against these dangerous microorganisms could not be developed. The breakthrough brought about the sequencing of bacterial genome and obtaining recombinant surface proteins using genetic engineering. The technique described as “reverse vaccinology” has led to development of two protein vaccines: 2-component (Trumenba) and 4-component (Bexsero). The article discusses the results of a study evaluating the theoretical coverage of meningococcal strains belonging to serogroup B occurring in Poland by the 4-component Bexsero vaccine (4CMenB), published in Vaccine in 2016. 

Vaccinations are among the most common sources of iatrogenic pain in children. In order to minimize anxiety among parents and children and to decrease the risk of noncompliance it is beneficial to use any available methods to alleviate vaccinations related pain. The article summarize a publication from the World Journal of Pediatrics, in which the results of a study conducted to compare the efficacy of using EMLA creams and vapocoolant sprays were presented. 

Café au lait macules (CALMs) are common congenital or acquired pigmented skin lesions. The prevalence of one CALM was noted in 25% of children 
 older than 1 month of age. Three or more CALMs were reported to occur in 1,1-3,3% of general population. This symptom should be regarded as an indication to refer the patient to the Neurocutaneous Syndromes Center. Neurocutaneous disorders are congenital disorders manifesting with central nervous system and cutaneous abnormalities. Currently more than 30 entities belong to this group, with neurofibromatosis type 1 (NF1) being the most frequent disease. Less frequent neurocutaneous diseases are: NF type 2, Legius syndrome, McCune’a-Albright syndrome, LEOPARD syndrome and other rare diseases. Due to the variety of syndromes, CALMs may be difficult to distinguish from other pigmentary lesions. The aim of this paper is the evaluation of the frequency of CALMs occurrence with the analysis of pathogenesis of diseases associated with this skin lesions. We also present the strategy of management with the patient presenting CALMs. 

The article constitutes an analysis of indications for ursodeoxycholic acid treatment in children based on the characteristics of commercial preparations and literature review. 

The article presents currently available methods of hypertensive target organ damage assessment in children and adolescents with hypertension. It includes both examinations recognized by Polish and European societies (Polish Society of Arterial Hypertension, European Society of Hypertension), such as echocardiography, eye fundus assessment and albuminuria assessment, as well as tests considered as optional (carotid intima-media thickness and pulse wave velocity measurements). The paper also presents evidence of the usefulness of measuring central systolic blood pressure during the diagnosis of hypertension, especially in adolescents. The problem of spurious hypertension was also discussed and the results of the few studies published so far on this subject were analyzed.

Pollen-food syndrome (PFS) is an IgE-dependent allergic reaction, that occurs after consumption of fresh fruits and vegetables in patients sensitized to pollen and homologous food allergens. It manifests usually with oral and nasopharyngeal symptoms as mouth itching or tongue and throat swelling (oral allergy syndrome; OAS). Some patients may experience systemic reactions at the same time such as nausea, diarrhea, vomiting, generalized urticaria, shortness of breath or even anaphylactic shock. PFS is common in adults with pollen allergy and rarely seen in the pediatric population, so there is still a limited information regarding the onset and sensitization patterns in this group of age. 

Microbiota means all microorganisms inhabiting the human body. They help in nutrients’ digestion and energy retrieval in the gastrointestinal tract. Microbiota affects the development and functioning of the immune system, protects against pathogens and inflammation. Live microorganisms, that have a beneficial health effect, are referred to as “probiotics”. However, the viability of bacteria is not necessary to achieve a health-promoting effect. Bioactive components, produced by bacteria or released by bacterial cell lysis, also offer benefits to an organism and are called postbiotics. Most of available studies on their potential health-promoting effects in infants concern fermented milk based infant formula, which meets all criteria of the postbiotic definition. Current reports confirm, that they are well tolerated and have some potential beneficial effects on stabilization of the microbiota, immune response, protection against pathogens. The exact mechanisms involved in the effects require further research. 

Nephroblastoma (Wilms Tumor) is the most common malignant neoplasm of the kidney in the childhood. Clear cell sarcoma, rhabdoid tumour and renal cell carcinoma are significantly less frequent histological types of malignant renal tumors in paediatric population. Abdominal ultrasonography, computed tomography and magnetic resonance are used for clinical imaging in these patients. In this paper we discuss radiological images of childhood renal malignant tumors, including their differential diagnosis as well as accuracy of different 
 imaging techniques. Practical rules for the choice of radiological techniques in these patients are also provided. The text is illustrated with radiological images. 

Oral inflammation includes gingivitis, periodontitis as well as inflammation of cheeks, lips, tongue, palate, throat and floor of mouth. This article discusses the most common oral inflammation. One of the most common oral inflammation is gingivitis. Gingivitis usually begins in early childhood and their frequency increase with age. The main reason of gingivitis is the accumulation of dental plaque on the connection of the gum and neck of the tooth. Infants and small children often suffer from herpetic stomatitis. It’a a disease caused by Herpes Simplex virus (HSV-1). The etiology of inflammation of lips and tongue, throat and the floor of the mouth are varied and each type determines the treatment procedure and prognosis. Aphthae is also a common clinical problem in the paediatric population. Oral inflammation in children is also a frequent side effect of oncological treatment. 

Institutional care of abandoned children, especially those physically or mentally disabled, has changed many times across the ages. Mental diseases have been an important problem since the ancient times. Together with physical disability it was the major reason of leaving children by their parents. The first attempts to organize care for abandoned children were medieval hospitals-almshouses. The analysis of particular steps in formation of institutional care over unwanted or disabled children shows how much has changed in a positive way. Mentally and physically disabled children are nowadays treated as fully-fledged citizens. Current forms of treatment are characterized by being child-focused, restricted by law institutions and operated by well qualified staff. New perspective of care over diseased children appears: leaving of institutional care to support activities focused on supporting the family and its reintegration. Aim of article is to describe the problem of leaving children by their parents across the ages. 

Objectives: The aim of the study was to analyze human milk composition of samples from women who gave birth prematurely, verification of proposed procedures and assessment of human milk analysis suitability for diagnostic purposes.

Material and methods: The material was 70 human breast milk samples 24 hour collected from 36 from women who gave birth prematurely (< 37 weeks of pregnancy) during the first 8 weeks of lactation. he study was performed using the Human Milk Analyzer by MIRIS (HMA MIRIS, Uppsala, Sweden). The content of nutrients in each sample was determined three times. Statistical analysis was based on averaged results from three measurements, correlations between three replications of each parameter were calculated (Pearson correlation).

Results: The average nutritional value and the range of results in the tested samples, expressed in g/100 ml, was: fat 3.99 (2.30-6.60); total protein 1.48 
 (1.03-2.40); crude protein 1.18 (0.80-1.90); carbohydrates 6.86 (6.20-7.53). The average energy value was 70.88 kcal (54.67-92.33 kcal). The correlations between the three measurements performed for total protein, crude protein, fat, total solids and energy ranged from 0.876 to 0.987, correlations between carbohydrate measurements ranged from 0.620 to 0.726.

Conclusions: The daily milk collection procedure and the measurement of three samples allows to obtain reliability results with accuracy. Target fortification on the basis of human milk analysis, carried out in accordance with the principles of good laboratory practice, can be successfully implemented in neonatal units in Poland. 

Pracę wykonano w ramach projektu badawczego realizowanego w latach 2016-2017, finansowanego ze środków dotacji statutowej uzyskanej przez Wydział Nauki o Zdrowiu.

The authors present four cases of newborns (three girls, one boy) diagnosed with a teratoma tumour, treated in 2017 and 2018. Three patients were diagnosed with mature and one with immature teratoma. The tumours were located in the sacrococcygeal region, in the stomach and mediastinal area. In all children the tumour was detected prenatally by ultrasound or magnetic resonance imaging examination. Thanks to prenatal diagnosis the disease was quickly identified and patients could be referred for further treatment to the reference centre. Early and comprehensive diagnostics and multispecialist treatment allowed to obtain a very good therapeutic effect.