Mushroom poisoning continues to be a serious clinical problem in Poland. In this paper we present current recommendation concerning diagnosis and treatment in children poisoned with amanita phalloides.

Creation of standards is an important step in the development of nursing care. This is a starting point forfurther development of medical research and should be constantly improved both with the increased knowledge and practices presented in that field. The standards are intended to uncover deficiencies and anomalies in the medical care. The standard establishes the level of nursing care relevant for the applicable group of patients. Additionally it raises objectivity in the assessment ofthe current level of care and encourages further development of professional skills. Elaborated standard of nursing care of neonate with usage of Kangaroo method is suppose to improve nursing care on both Intensive Care and Neonatal Pathology wards.

Pneumococcal disease is the world’s leading cause of death in children and among adults 65-years-old and older. A seven-valent pneumococcal conjugate vaccine introduced in 2000 has been shown to reduce invasive pneumococcal disease in both vaccinated children andadults through induction of herd immunity, which was observed the first in USA and now in a few Europaen countries. Recently the impact of infant immunizationon pneumonia hospitalizations and mortality in all age groups has been documented in USA1. A seven-valent pneumococcal conjugate vaccine introduced in 2006 in Kielce is a reason of a significant reduction of pneumococcalpneumonia hospitalizations in children2. Since2009 seven-valent pneumococcal conjugate vaccination in infant has been shown to reduce pneumococcal pneumonia hospitalizations in adults 65 and older in 45% (not published data).

The main symptoms of inflammation process are pain and fever. Clinical studies have confirmed the beneficial effect of moderate fever in the course of viral orbacterial infections. However, it is also well known that high and prolonged fever has negative effects. The safe stand effective antipyretic drugs are acetaminophenand ibuprofen. Ibuprofen, except antipyretic and analgesic effect (typical also for paracetamol), has alsovery important, especially in infectious diseases, antiinflammatory activity. Pain is another frequent and significant problem for general practitioners, as well as clinicians. The World Health Organization (WHO) has developed standards for the pharmacological treatment of pain, called the analgesic ladder. Its three „degrees” form a comprehensive strategy of safe and effective use of analgesics. In pediatric primary care main analgetics are acetaminophen and nonsteroidalanti-inflammatory drugs, such as ibuprofen. The paper presents definitions, pathophysiology, types and measurement methods of fever and pain, as well asits management.

Prophilactic role of vitamine K supplementation forbleeding in infancy is presented. Controversies in theuse of vitamin K for bleeding prevention (especially in vitamin K deficiency-risk groups e.g. patients with cholestasis or chronic diarrhoea) and in dosing and administration regimens are discussed.

Summer apart from the rest, freedom and pleasant memories it is also a period of the increased risk of disorders associated with the effect of the heat stress, so as thermal cramps, overheating or also a heat stroke being a threat to life. Children are particularly susceptible to the complications associated with the effect ofthe heat stress, and there fore require the relevant protection. In the article manifestations of the exaggerated effect of the warm weather, ways of preventing and treatments were described. Also safe ways of practicing sport in the summer were discussed.

The article presents the classification and the characteristics of food hypersensitivity. It demonstrates the similarity between the clinical picture of food allergy and the more frequent non-allergic food hypersensitivity (NFH) which both can use the same mediators and effector cells. Both are induced by the same groups of food. It is difficult to diagnose the type of food hypersensitivity, especially in those patients who suffer from food allergy and among whom NFH is observed much more frequently. It results in a popular opinion about high incidence of food allergy at all life stages.

The term „chondrodysplasia punctata (CDP)” refers toa radiological symptom- punctate calcification (stippling), observed mostly in epiphyseal cartilage of longbones during first years of life. Such changes may occurin patients with many disorders, including inborn errors of metabolism related to e.g. peroxisomal function, cholesterol biosynthesis, as well as embryopathy and chromosomal aberrations. So far, several classification systems of CDP developed, depending on whether theetiology or clinical presentation. In this paper, congenitalmal formation syndromes, presenting with symptomsof CDP, based on one of the recently updated etiological classification are discussed.

Skeletal dysplasia is a group of congenital diseases of skeletal system. It is a heterogenic group of conditions causing often severe growth deficiency with body disproportion. The most common diseases are achondroplasia and hipochondroplasia. Trials of growth hormone treatment in children with different types of skeletal dysplasia have been reported for several years, although there are still no standards of such therapy present.

The intensive treatment of leukemias has improved the prognosis within the past recent years, nevertheless,the adverse effects resulting from nonspecific actions and narrow therapeutic index of anti-cancer drugs arestill observed. Several months of the remission-maintaining therapy, based on oral chemotherapeutics, requires careful haematological monitoring. Treatment with mercaptopurine or thioguanine must be discontinued during acute infection. Since the leukopenia, neutropenia and hepatotoxity are being observed during the whole treatment in patients with acute leukemia, the thiopurines dosage should be also dependent on the results of blood tests (e.g. blood cell count, serum activity of liver enzymes). However, the future treatment will be based on the individualized therapy which will be designed by determining the patient’s pharmacogenetic profile.

The authors present their own experience in long-lasting, multidisciplinary treatment of facial clefts, takingin to account the management in other centers as well. Frequently observed in these children problems concerning breathing, feeding, upper airway and ear infections, especially in the preoperative period, then speech abnormality and psychological problems require specific care of numerous specialists. The surgical treatment is multistage and the surgical techniques used inour clinic provide good long-term results. At present day a great weight is attached to the etiological factors causing the deformity, including genetics, especially in cases, where cleft lip or palate is a part of a congenitald efect.

Prophylaxis is one of the main challenges for the medical health systems nowadays. Prevention of diseases and early diagnosis, before the symptomatic phase, seems to be more beneficial than expensive therapy. Malnutrition as the symptom of chronic diseases isa major concern in childhood and should be prevented. We present changes in approach to prophylaxis in the field of pediatric gastroenterology.

Immunosuppressants are commonly used after organ transplantation to prevent acute rejection. Becauseof a narrow therapeutic index and pharmacokineticinter-individual variability, therapeutic drug monitoringis essential. Kinetic variability is greater in children and it’s caused by age-related changes in enzyme activity. The most common methods used in clinical laboratoryare: high performance liquid chromatography with UV detection (HPLC/UV) and liquid chromatography tandem with mass spectrometry (LC/MS). Immunoenzymatic methods are also used, for instance CMIA – Chemiluminescent Microparticle Immunoassay. The article describes following immunosuppressants: tacrolimus and mycophenolate mofetil (MMF) and antiviraldrug – ganciclovir.

Introduction.
Skin nodules are visible lesions, raised above skin surface. They do not fade and often grow up gradually, which usually causes parents’ anxiety.They usually derive from epithelium, descend from skin appendages, like pilomatricoma, epidermal cyst andatheroma. The pigmented naevi and vascular anomaliesconstitute the main group among nonepithelialnodules.

Objectives.
The objective of the study is analysis of type and detailed localization of skin head and neck nodules in children up to 3rd year of age.

Material and methods.
The material constituted case histories, surgical protocoles and results of histopathological examination of patients up to 3rd year of age, who in years 2000–2009 were treated in The Department of Paediatric Surgery and Oncology Medical Universityof Lodz.

Results.
In years 2000–2009 in The Department of Paediatric Surgery and Oncology Medical University of Lodz 60 patients up to 3 rd year of age were operated because of skin head and neck nodules. The average age of children in the moment of operation was 17 month sand the youngest operated patient was 3 months old. The most common nodules are dermoid cyst – 27 (45%) and atheroma – 20 (33,33%).

Conclusions.
Most nodules are benign lesions, but ifnot cured could grow up, compress surrounding structuresand undergo inflammation. All were removed surgically. In order to qualify to surgical procedure decidedlesion’s location, ability of development of inflammation and after-effects connected with that.

HCMV (human cytomegalovirus) infection is the most frequent congenital viral infection. HCMV, as a neurotropicvirus, causes sequelas in nervous system including often drug resistant epileptic seizures starting already in the first months of life. Information about congenital symptomatic and subclinical cytomegalovirus infection and actual knowledge concerning epileptic seizures in infants infected with cytomegalovirus is presented. Congenital malformations of nervous systemin HCMV infection are described. Diagnosis and therapy in symptomatic epileptic seizures in infants with cytomegalovirus infection is presented. Basedon long itudinal, prospective studies of 138 patient streated in IP CZD, diagnostic and therapeutic algorithm for epileptic seizures caused by cytomegalovirus is presented. Usage of molecular biology methods was taken into account, as well as treatment of symptomatic epileptic seizures with ganciclovir and tetracosactide (Synacthendepot). In patients with drug resistant epilepsy, retrospective diagnosis of cytomegalovirus infection is possible using Guthrie cards or store umbilical blood.

We wanted to evaluate nutrient in take and nutrition status of children with intestinal failure receivinglong‑term parenteral nutrition (PN). We know that weight and height correlate with bone mineral status and patients on long‑term PN are at increased risk of growth retardation and development of metabolic bon edisease

Objectives:
The aim of the study was to assess growth and its influence on the bone mineral status of children receiving home parenteral nutrition (HPN).

Materials and methods:
We examined 48 (forty eight) children with intestinal failure receiving long‑term parenteral nutrition. Mean age was 8,3 years (range: 36– 293 months). Parenteral and enteral energy in takes were calculated and on that basis two groups of patients were studied: A (n = 26) with >50% energy from PN and B (n = 22) with ≤50% energy from PN. Meanduration of PN was 90 months (group A: 100 months, group B: 80 months). In all patients anthropometric measurements (weight for age and height for age), bone age and the bone mineral density (BMD) by dual‑energyX‑ray absorptiometry (DXA) were assessed.

Results:
Mean total (enteral and parenteral) energy intakewas 109 kcal/kg/day: in group A: 89 and in group B:128 kcal/kg/day. Majority children were malnourished, 21 children with body weight below 10 centile – group (group A: 13, group B: 8; no significant differences; ns), with 12 <3 centile and 25 children with height <10 centile (group A: 19, group B: 6, p < 0,05) and 19 children <3centile. Eighteen children had delayed bone age above 12 months (mean 17,4 months, in group A: 20 months, in group B: 14,8 months). Twelve patients had DXA-Totaldecreased bone mineral density (Z‑score <-1): group A:7 patients, group B: 5 patients; ns) and 26 patients had DXA-Spine decreased bone mineral density (group A:13, group B: 13, ns).

Conclusions:
Children on long‑term parenteral nutrition are at significantly increased risk of growth retardation and development of metabolic bone disease. Height deficiency is frequent in patients on predominant PN.

Objective.
The aim of this study was an evaluation of eating habits and nutritional status in selected group of young men with low and high physical activity.

Materials and methods.
The study was carried out among 55 men aged 23 ± 2 years, including 24 men with sedentary lifestyle and 31 men who exercised sport. Based on the body mass and body height measurements results, the Body Mass Index (BMI) was calculated.The results pertaining to the nutritional habits were analyzed based on the questionnaire.

Results.
Too low body weight was found in 8% of men with sedentary lifestyle (BMI: 23.8 ± 4.1), and in 29% and 13% men with over weight and obesity, respectively. In 45% of men with high physical activity (BMI:25.5 ± 2.0) overweight was observed, which probably is associated with greater muscular mass. It wasalso shown that the frequency of food consumptionwas higher in men with high physical activitythan in men with low activity. Men who were involvedin regular sport more frequently ate cereals and dairy products and consumed less sweetness than inactive subjects.

Conclusions.
Men with low physical activity show irregular ityin eating habits, while men with high physical activity eat more healthy. In high percentage of menin both groups excess body weight occurred. In thecase of people who are physically active probably muscle mass decreases the reliability of BMI.

Aim:
The study aimed at the analysis of the oral hygienic state, the evaluation of parodontium condition and the description of periodontic treatment needs inthe group of children and youth with epilepsy from Lublin region.

Methods:
Clinical and questionnaire study encompassed 107 individuals in total, aged 6 to 18 yrs. For the investigated population OHI-S, DI-S and CI-S indexes were calculated. The periodontal treatment needs with CPITN index were described. The study results were subjects to the statistical analysis.

Results:
The OHI-S index achieved the medium value of 2.22 ± 1.00. The DI-S and CI-S were 1.79 ± 0.70 and 0.43 ± 0.52, respectively. The CPITN index reached the mean value of 1.52 ± 0.62.

Conclusion:
The oral hygienic state and parodontium condition of the studied population of children and youth with epilepsy of the macroregion of Lublin is unsatisfactory.

The aim of the study was to present contemporary approachon infective endocarditis prophylaxis. The new guidelines of European Cardiology Society(2009) and American Heart Association recommendations for antibiotic prophylaxis in infective endocarditis published in 2007 are described. The comparison of previous and the new recommendations was done and the scientific evidence which caused the revision of the statement on prophylaxis was discussed.