The position statement was prepared by members of the Polish Cystic Fibrosis Society and is an update of previous recommendations. It is primarily intended for use by physicians and dieticians who care for children with cystic fibrosis. Nutritional recommendations are based on guidelines developed by international scientific societies and were adapted to Polish conditions. 

The article is a summary of European guidelines for the treatment of Kawasaki disease (2018). 

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Cervical cancer is the fourth most common cancer among all gynaecological cancers in the world. The HPV virus is the most frequent sexually transmitted infection. The connection between the HPV and the cervical cancer is at least 10 times stronger than the relation between smoking and lung cancer. The HPV16 and HPV18 are, amongst many genotypes, the most common oncogenic genotypes in cervical cancer. Vaccination against the HPV is the only form of primary prevention. Currently, there are three vaccinations available on the market: Silgard, Cervarix and Gardasil 9. According to the Polish Gynaecological Society experts, vaccination against the HPV is one of the components of the programme for prevention and early detection of cervical cancer. It is assumed that the potential long-term benefits arising from the use of the HPV vaccination will result in reduced mortality from cervical cancer by approximately 70% in 15 to 20 years’ time. Currently in Poland a preventive scheme: mother – pap-smear screening, daughter – the HPV vaccination should be preferred.

An eponym is a term which is named after person, place or thing, as well as a person, place, or thing after whom or after which something is named or believed to be named. There are medical eponyms for diseases, symptoms, physical signs, anatomical terms, laboratory tests and many others. A need for global uniformity in scientific publications evoked heated discussion about eponyms in medical language. There are supporters and opponents of medical eponyms’ application. It is the purpose of this paper to present current trends in the use of medical eponyms and to indicate some important rules of declension of foreign last names in Polish language.

Raynaud phenomenon (RP) is a common problem in internal medicine, but scientific reports and practice indicate that it is also not infrequent in pediatric 
 care. Children with RP are repeatedly referred to many specialists before they get the right advice. The basis for the diagnosis of RP are clinical symptoms: recurrent, reversible colour changes, most often to the fingers and toes, caused by exposure to physical or emotional factors. The aim of the article is to present current recommendations regarding the diagnosis and management of children and adolescents with RP. The basis for the diagnosis of RP are clinical symptoms: recurrent, reversible colour changes, most commonly affecting the fingers and toes, caused by exposure to physical or emotional factors. Raynaud’s symptom may be diagnosed by a pediatrician or family physician. Differentiation of the primary and secondary RP requires pediatric rheumatologist consultation and specialist tests. Because RP may be the first symptom of serious rheumatic disease and for many months or years ahead of other symptoms, patients always require long follow-up. 

The article presents selected issues regarding pediatric care for a child with a congenital heart defect. Methods of evaluating a child with a heart defect and the influence of cardiovascular pathology on management in various clinical situations such as infections, prevention of infectious diseases, nutrition, 
 caries are discussed. Some aspects of pharmacotherapy were also mentioned. 

In accordance of diagnosis criteria DSM-5 autism spectrum disorders have been placed in the category of neurodevelopmental disorders. Diagnosis, in case of suspicion of disorders form autism spectrum, should be done carefully and with usage of standardized diagnostic tools by an expert panel which is surely 
 ought to be consisted at least of a doctor and psychologist. ASD is rarely diagnosed as a singular medical condition. Coexistence of ASD with other mental disorders throughout whole duration of a life span concerns from 70 to 100% patients. The possibility to diagnose ASD with other and coexisting mental disorders is a extremely crucial change which was introduced in DSM-5. Aggressive, destructive behaviour and autoaggressive behaviour (SIB) are the additional problems not only for patients but also for their families. Those symptoms, also called problematic behaviours, often lead to hospitalization. They can also be the main manifestation of discomfort caused by somatic as well as psychological and environmental factors. The settlement of a patient with ASD on the ward is almost impossible. The strategy of conduct should consist on close collaboration between medical staff and the patient and their caretaker which include detailed interview about their abilities, ways of communication and habits (also eating habits) and observation. Basing on this we can come up with the medical strategy which will be implemented by the medical staff to minimize the amount of an emergencies − which in accordance with ASD patient feelings may be dangerous, aggravate discomfort and problematic behaviours. 

The benefits and safety of docosahexaenoic acid (DHA) supplementation were evaluated in numerous studies. Recommendations for DHA supplementation in infants, pregnant women and breastfeeding women were formulated. Current recommendations oblige manufacturers to introduce DHA fortification at the appropriate level in 2020. However, the benefits of DHA supplementation are still being studied and analyzed. 

According to epidemiological data, cow’s milk protein is the leading cause of allergy in infants and young children. A widespread opinion among the medical community exists that every third child in Europe is at risk of developing a food allergy. Thus the estimation of the risk of allergy in children, who are exposed to genetic and/or environmental factors or present symptoms that can be related to intake of cow’s milk, is very important. Because the sensitization and food allergy can occur in infancy, it appears that prevention strategies in form of early dietary interventions could prevent the development of allergic reaction and generate immunological tolerance for oral antigens. The paper outlines current recommendations for diet modification and the role of nutritional factors in prevention of food allergy. 

Intestinal microbiome is formed in the first 1000 days of a child’s life and during this period is particularly sensitive to various factors. Breastfeeding and 
 natural labor favorably affect the formation of infant intestinal microbiome and the development of the immune system, which translates into the health of the child. There are three groups of components in mother’s milk which modulate the composition of intestinal microbiome: prebiotic oligosaccharides, probiotic live bacteria and postbiotics − products of bacterial metabolism. The paper presents the basic concepts related to intestinal microbiota, the mechanisms of immunomodulatory activity of pre-, pro- and postbiotics and explains the importance of postbiotic origin. 

Neonates with history of prematurity have higher risk of infection than term infants. This is caused by the immaturity of the immune system and the lack 
 of maternal antibodies. Polish immunization program recommends that premature babies be vaccinated according to their chronological age. The use of combination vaccines is strongly recommended. The use of these allows more efficient implementation of the routine immunization program and minimizing 
 the number of injections. Two hexavalent vaccines are available in Poland: Hexacima® and Infanrix hexa®. Both protect against diphtheria, tetanus, 
 pertussis, poliovirus, hepatitis B and Haemophilus influenzae type B (DTaP-IPV-Hib-HBV). Infanrix hexa® has been studied in a population of premature babies 
 − safety, tolerability and short-term and long-term immune response were satisfactory. Data on occurrence severe adverse events following immunization (bradycardia, apneas) are not conclusive. The episodes usually resolved spontaneously or required minor medical intervention. 

Introduction: Propionic aciduria is caused by the deficiency of an enzyme (propionyl-CoA carboxylase) that catalyzes a biotin-dependent, reversible reaction of propionyl-CoA conversion into methylmalonyl-CoA on the catabolic pathway of valine and isoleucine. In the majority of patients, the symptoms appear during infancy and take the form of an intoxication syndrome. A chronic form is also possible, and various symptoms can appear from early childhood to adulthood. Both forms of the disease may show episodes of rapid deterioration of the general condition, caused by states of increased catabolism that are a life-threatening condition.

Aim of the study: Evaluation of patients’ clinical status and response to treatment

Material and methods: A retrospective analysis of the clinical picture and treatment effects of patients with propionic aciduria, under the care of the Department of Paediatrics, Nutrition and Metabolic Diseases of Children’s Memorial Health Institute in Warsaw.

Results: In the study 7 patients with recognized propionic aciduria were presented. In 5 of them, the first symptoms of the disease occurred in the neonatal period and early infanthood, in the form of an intoxication syndrome. In 2 of them the symptoms have occured after 12 months of age. The median of diagnosis age was 4.7 months. All patients from the moment they are diagnosed remain on a low-protein diet, receive carnitine supplementation and metronidazole. Two patients due to hyperammonemia require chronic treatment with sodium benzoate, and one patient receives chronic antibiotic therapy. Most patients have delayed cognitive development, three have epilepsy, and two have LQTS. In five patients, typical decompensation occurred in the course of the disease − in three of them numerous (> 10), one of the patients underwent severe decompensation with multi-organ failure and encephalopathy.

Conclusions: Propionic aciduria is a disease with an uncertain prognosis. It involves the occurrence of numerous metabolic decompensations that require intensive treatment. Despite treatment in the course of the disease there are many complications - mainly neurological and cardiac. 

Thyroid gland pathology requiring surgical treatment are rare in children, but they are endangered by same complications, including recurrent laryngeal nerve palsy. The risk can be reduced by use of Intraoperative neurophysiological monitoring (IONM) – intermittent (I-IONM) or continuous (C-IONM), that gives the surgeon information about nerve integrity and signal conduction.

The aim of the study was to compare both monitoring methods and establish the standard for thyroid gland resection in children.

Material and methods: 152 medical histories of thyroid surgery were analyzed for recurrent laryngeal nerve palsy, the number of EMG curves obtained on surgery, the number of signal cut-off and the length of neuromonitoring according to monitoring method: I-IONM vs C-IONM and the type of surgery were performed.

Results: The groups analyzed were statistically equal for age and sex. In both groups there were no permanent paralysis of recurrent laryngeal nerve after surgery, there was statistically significant bigger number of EMG curves noted on surgery and longer monitoring time in the I-IONM group. Regarding surgery type there was significant difference in EMG curves number, but the time of the surgery was shorter in C-IONM group only in total thyroidectomy cases.

Conclusion: Continuous intraoperative neurophysiological monitoring should be the standard in thyroid gland surgery in children. 

In children, vertical transmission is the most common way of HIV infection. As (a part of) prevention, it is recommended to conduct two HIV tests during pregnancy. In case of maternal infection just prior to the onset of labor, there is a high risk of mother-to-child transmission of HIV. Early diagnosis of HIV in children provides effective treatment and prevents progression of HIV infection to AIDS. In vertically infected infants, AIDS may develop even in the first year of life. HIV diagnosis in children is often associated with a long diagnostic process due to many nonspecific symptoms that may suggest(mimic) an alternative diagnosis. This paper presents a case of a 11-month-old vertically HIV infected boy (diagnosed at the AIDS stage), whose mother had undergone HIV test twice during pregnancy and both tests were negative. General practitioners and paediatricians should consider HIV infection in children with recurrent infections, as well as severe or unusual course of the disease, even in those born by mothers with negative results of HIV screening tests. 

Long QT syndrome is a rare genetic disorder that leads to the malfunction of ion channels in cardiomyocytes. The range of clinical manifestation includes palpitations, syncope and sudden cardiac arrest. Careful evaluation of clinical and family history and assessment of repolarization period on ECG are critical to make a correct diagnosis. We present a boy with drug resistant epilepsy and moderate mental retardation whose father died at young age. The patient was diagnosed with LQTS at age of 11 years. Due to adequate pharmacological and interventional treatment the subject remains stable without 
 seizures since 4.5 years. 

The article presents a case of a girl diagnosed with hypoplastic left heart syndrome, who couldn’t be treated with first stage single-ventricle palliation in the neonatal period. Five months long alprostadil infusion used to maintain ductal patency was the only condition for survival until the next stage surgery. The presented case underlines the issue of adverse effects that may occur during prolonged alprostadil treatment.