The article is a summary of European guidelines for the treatment of IgA vasculitis (2019), formerly known as Henoch-Schönlein purpura.

Infants’ nutrition is crucial for their health and proper development. Breast-feeding is the best possible form of nutrition in this age group. However, if the infant must be fed using formula, it’s best if its composition should be similar to human milk. Recently milk fat globule membrane (MFGM) fraction has gained interest for its potential positive effects on neurodevelopment and immune system. The article presents the results of a randomized clinical trial conducted by Timby et al. in which oral microbiome of infants fed with MGFM supplemented formula was compared with that of children fed with standard formula. 

Opracowanie na podstawie: Timby N, Domellöf M, Holgerson PL i wsp. Oral Microbiota in Infants Fed a Formula Supplemented
with Bovine Milk Fat Globule Membranes − A Randomized Controlled Trial. PLoS ONE 2017;12:e0169831;
DOI:10.1371/journal.pone.0169831.

Post-infectious cough is a common reason for paediatric counselling, predominantly during autumn-winter season. Environmental exposition like cigarette smoke, smog significantly prolongs cough duration. Extensive epithelial damage due to infection is an important mechanism responsible for cough prolongation. Children who are generally healthy, without alarming symptoms and signs and cough persisting for less than 4 weeks do not need extended diagnostic procedures. The exception is pertussis suspicion. Non-specific post-infectious cough usually is self-limiting, most of drugs are not sufficiently effective, therefore are not routinely recommended for treatment of such type of cough. 

Disorders of mineral metabolism are a common finding in chronic kidney disease (CKD). These abnormalities result in significant bone and cardiovascular complications. It is known that some components of chronic kidney disease-mineral and bone disorder (CKD-MBD) may be observed already in grade 2 CKD, and at this stage may precede abnormalities found with routine laboratory tests. This review paper, based on recent evidence, publications and 
 recommendations, discusses the pathophysiology and management of CKD-MBD

Hypertrophic cardiomyopathy (HCM) is characterized by left ventricular hypertrophy, in which the thickness of the left ventricle wall exceeds the norm indexed to the child’s body surface by two standard deviations (z-score ≥ 2), excluding other causes of muscle hypertrophy such as congenital heart disease or hypertension. In the pediatric population, it is responsible for 42% of cardiomyopathies, making it the second most common form of cardiomyopathy in children. It is a genetically determined disease of the heart, inherited in the majority of cases in autosomal dominant manner. Hypertrophic cardiomyo- pathy is a disease with a very heterogeneous genetic basis. More than 80 genes related to the etiology of HCM have been described so far. Genetic tests in children with hypertrophic cardiomyopathy allow to identify the molecular etiology of the disease early in life, which has a significant impact on the diagnosis and further diagnostic and therapeutic procedures. Determining the cause and inheritance pattern of hypertrophic cardiomyopathy allows early carrier diagnostics and accurate estimation of the disease recurrence risk in the family. 

Praca została napisana w ramach realizacji grantu statutowego nr S176/2018 Instytutu „Pomnik − Centrum Zdrowia Dziecka”.
 

Nocturnal enuresis is a disorder that often occurs in children. It is affecting both, a child and the whole family. The pathophysiology of nocturnal enuresis is multifactorial, associated with the action of neurotransmitters and hormones, rhythm of sleep and awakeness and the action of the bladder. The two main causes of nocturnal enuresis are inadequate antidiuretic hormone (ADH) secretion and insufficient functional bladder capacity. Disorders associated 
 with nocturnal enuresis are mainly obesity, obstructive sleep apnea and constipation. All children with nocturnal enuresis should additionally be diagnosed towards kidney disease and other systemic diseases by performing abdominal ultrasound, urinalysis and basic blood tests. Further diagnostics is based primarily on the analysis of the voiding diary and the calendar. The first part of treatment for a patient with MNE is standard urotherapy defined as a treatment to improve the functioning of the lower urinary tract. The next stage, depending on the information based on the voiding diary, the physician decides whether to initiate treatment with desmopressin or with a bedwetting alarm. If the therapy fails, the child should be rediagnosed by a specialist. 

The microbiome of the digestive tract is formed from the first days of the newborn’s life, and its qualitative and quantitative composition plays a role in the maturation of the immune system and the formation of an immune response to foreign proteins, including food antigens. There are several factors causing microbiome disorders, including antibiotics. The current observations indicate the existing relationship between the occurrence of allergic diseases and antibiotic therapy, administered prenatally or postnatally in the early stages of infancy and childhood. Conducted researches have been aimed at explaining the pathomechanism of disorders in order to introduce effective preventive or therapeutic measures. In respect to food allergies, the absolute priority of mother milk over the milk formulas has been already proved. This article summarizes the effect of microorganisms on the human immune system, including immune-mediated diseases and their potential relationship with antibiotic therapy. Selected preventive and therapeutic methods against allergy in the early stages of the child’s development have also been presented. 

Excessive hair growth in girls is one of the most common reasons for referrals to endocrine clinics. Most of them are diagnosed with mild hirsutism or hypertrichosis with no accompanied endocrine disorder. The gold standard for assessing the severity of hirsutism is the Ferriman-Gallwey scale. However, it’s subjective and difficult in the case of applied depilation. Each patient with hirsutism estimated at more than 8 points requires endocrinological consultation, mesurement of androgens level in the blood serum, and if needed − exclusion of PCOS, Cushing’s syndrome, hyperprolactinemia and LO-CAH. If indicated parameters of lipid and carbohydrate metabolism should be evaluated. In the case of rapid progression of hirsutism severity or sudden emergence of it – androgenic tumors (ovaries and adrenal glands) should be excluded. Cosmetic methods and pharmacotherapy can be used in hirsutism treatment (contraceptive pills, antiandrogens). Nevertheless in adolescent girls with PCOS body weight reduction in the case of overweight and obesity, as well as a healthy lifestyle is indicated. Metformin is often offered to patients with insulin resistance. The effects of treatment can be assessed no earlier than after 6-12 months. 

Molluscum contagiosum is a mild, self-limiting skin infection caused by poxvirus. It is common in children, but can also occur in adolescents. The virus is transmitted through direct skin-to-skin contact or fomites (bath sponges, towels). Molluscum contagiosum presents as asymptomatic single or multiple small (2-5 mm) flesh-colored dome-shaped papules or nodules with central umbilication. Lesions may be more widespread, larger or atypical in immunocompromised individuals. The diagnosis of molluscum contagiosum is usually clinical, based on the characteristic appearance of skin lesions. Usually, 
 laboratory studies are not indicated in children with molluscum contagiosum. As the infection has usually a self-limiting character, treatment is optional for immunocompetent children. 

Objectives: The aim of the study was to assess the epidemiology and course of rotavirus infection detected in children hospitalized at the Department of Pediatric in Provincial Specialized Hospital in Lublin throughout in 2015-2017.

Materials and methods: Retrospective analysis of medical records of 564 patients diagnozed with rotavirus gastroenterocolitis.

Results: Over the study period, 2008 children with acute gastroenterocolitis were hospitalized. Rotavirus-related diarrhoea was diagnozed in 563 (28%) cases. The mean age of admitted patients was 2,67 years. In the analyzed group, 46% were children aged 1-3 years. The mean length of hospitalization was 5,2 days. The mean time of symptoms was: fever-1,9 days, vomiting-2 days and diarrhoea-4,5 days.

Conclusions: Rotavirus infections are important cause of children’s diarrhoea, concerning mainly patients under 3 years of age. Rotavirus infection can lead to many serious complications. 

Objectives: Obtaining collective information on the state of health and development of pupils population in Katowice in order to adequately correct preventive programs carried out in subsequent years.

Materials and methods: The study group consisted of 1627 children, including 795 (48.86%) girls and 832 (51.14%) boys from Katowice, aged 9 years. Analysis was based on: the interview concerning the child’s health problems and physical activity obtained from parents or legal guardians, basic physical examination, body posture and selected anthropometric parameters: height, body mass, BMI (body mass index), perimeter waist. Probands were grouped by gender.

Results: The most frequent health problems in the study population are: posture defects, skin pathologies, especially the presence of pigmented nevus and dry skin, overweight and obesity, malocclusion, abnormalities in the male genitourinary system. The most frequent diseases reported by caregivers were allergic diseases, especially bronchial asthma. On the basis of the study and found irregularities, the relevant recommendations were given to 42.66% respondents. 42.59% children were referred to specialist doctors. Referrals to the hospital were not issued.

Conclusions: Based on the conducted study, it was assessed that in the field of primary care over early school-aged patients, particular attention should had been paid to: prevention, diagnosis and treatment of postural defects, observation of pigmented moles as potential cancerous changes, prevention and treatment of overweight and obesity, prophylaxis, diagnostics and treatment of malocclusion, diagnosis and treatment of abnormalities of male 
 genitourinary system

Źródło finansowania: Urząd Miasta Katowice

Rotaviruses are the most important etiologic agents of acute gastroenteritis in children in Poland. Infection is typically less severe in adults. Household transmission may disrupt daily routine in the family. The article presents and discusses a case of a family rotavirus infection.