The article is a summary of a review from 2019, regarding a state-of-the-art summary about the efficacy of combined or alternating therapy of ibuprofen and paracetamol in febrile children.

Opracowanie na podstawie: Trippella G, Ciarcià M, de Martino M i wsp. Prescribing Controversies: An Updated Review and Meta-Analysis on Combined/Alternating Use of Ibuprofen and Paracetamol in Febrile Children. Front Pediatr 2019;7:217; DOI:10.3389/fped.2019.00217.
 

The authors presented selected reports on liver disorders in children discussed at the 52st Annual Meeting of European Society for Paediatric Gastroenterology, Hepatology and Nutrition, 5-8 June 2019 in Glasgow. 

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Opracowanie na podstawie: Socha P, Jańczyk W, Dhawan A i wsp. Wilson’s Disease in Children: A Position Paper by the Hepatology Committee of the European Society for Paediatric Gastroenterology, Hepatology and Nutrition. J Pediatr Gastroenterol Nutr 2018;66:334-344.
 

The healthy nutrition and lifestyle pyramid for children and adolescents is a schematic illustration of nutritional recommendations. It presents the possibili- ties of menu diversification, as well as indicates the healthy proportions between individual products. Recommendations regarding lifestyle and physical activity allow to regulate the diet, introduce active rest and counteract the risk of developing overweightness and obesity and many civilization diseases. 

Sepsis is a clinical syndrome, in which an abnormal inflammatory response triggered by an infectious agent damages the vital organs leading to their ischemia and secondary insufficiency. Sepsis is a life-threatening condition and only the soon-to-be-started proper therapy can save the patient. The article presents the current state of the art knowledge about sepsis in children, focusing on the recommended procedure, based on the recommendations of the British National Institute for Health and Care Excellence (NICE) and the international Surviving Sepsis Campaign (SSC). 

Congenital cytomegalovirus infection (cCMV), is the most common intrauterine TORCH infection and the leading nongenetic cause of sensorineural hearing loss (SNHL). Approximately 85-90% of infected newborns are asymptomatic at birth, however, up to 25% of them will develop late-onset sequelae such as SNHL and neurodevelopmental retardation. A complexity of virus-host interaction during CMV infection is due to overlapping of viral and human factors. It seems, there is a connection between human genetic predisposition (Single-nucleotide polymorphism, SNP) and susceptibility to cCMV and course of the disease. We hope, in the future, it will be possible to identify newborns, and even fetuses in prenatal testing, who are in a greater risk of severe course of the disease. Our goal is to diminish the probability of omission of the symptoms of the disease in the future, as there is no general screening of cCMV in Poland. 

Acute abdominal emergencies in neonates and infants are some of the most frequently occurring reasons for performing diagnostic imaging studies in this age group. The correct choice of imaging modality, based on the suspected disease, allows for prompt diagnosis and treatment. The article presents current information regarding the optimal imaging modalities depending on the patient’s clinical history. 

Cereal products are an important component of the diet of both children and adolescents, as well as adults. Although they are no longer the basis of the nutrition pyramid, they are still the main source of energy and carbohydrates. Cereals are one of the first food products introduced to the children’s menu during the extension of the diet, after the recommended period of exclusive breastfeeding. However, not all cereal products have the same nutritional value. 
 Research indicates a beneficial effect on health resulting from the consumption of whole-grain products and a negative one, from excessive consumption of refined cereal products with a high content of added sugars. The range of cereal products available on the market has changed significantly in recent years. Breakfast cereals, which are one of the most-advertised food groups around the world, are a special cereal product in the children’s diet. It is therefore necessary to educate children, adolescents and all those involved in the nutrition of these vulnerable population groups about the nutritional value of cereal products, in particular about the content of added sugars in children cereals. 

The microbiome is vital for human development and growth. Pre-, pro- and postbiotics are recognized to convey health benefits by improving gut homeostasis, however they also may indirectly exert desirable systematic effects through regulation of intestinal immune system or via soluble particles absorbed by the gut. Postbiotics are defined as any substance synthesized as a result of metabolic activity of microbes or released after bacterial lysis, which confers beneficial effects to the host directly or indirectly. Although exact mechanisms of postbiotic action have not been entirely elucidated, it has been revealed that they demonstrate immunomodulatory, anti-inflammatory, anti-atherogenic or anti-bacterial properties. Postbiotics are getting more attention due to their safety, long shelf life and stability allowing their wide clinical applications. 

The article summarizes the main points of the position paper by the European Society for Paediatric Gastroenterology, Hepatology, and Nutrition (ESPGHAN) Committee on Nutrition on the use of palm oil in infant formula, which was published in May 2019 in the Journal of Pediatric Gastroenterology and Nutrition. 

Opracowanie na podstawie: Bronsky J, Campoy C, Embleton N i wsp. ESPGHAN Committee on Nutrition. Palm Oil and Beta-palmitate in Infant Formula: A Position Paper by the European Society for Paediatric Gastroenterology, Hepatology, and Nutrition (ESPGHAN) Committee on Nutrition. J Pediatr Gastroenterol Nutr 2019;68:742-760.
 

Human milk oligosaccharides (HMOs) are the third most abundant component of human milk. The presence of HMOs is one of the largest differences in the composition of breast milk and infant formula. Currently, biotechnology allows producing large amounts of HMOs such as 2-fucosyllactose (2’FL) and lacto-N-neotetraose (LNnT). This review provides answers to frequently asked questions related to HMOs in breast milk. It also discusses the results of the first randomized controlled trials evaluating the safety and efficacy of 2’FL and LNnT added to infant formulas. 

Background: Biliary atresia (BA) is a progressive disease of extra and intrahepatic bile ducts developing in the first weeks of life. It is the main cause of neonatal cholestasis and the most frequent indication for liver transplantation in children. The first line treatment is Kasai hepatoportoenterostomy (HPE) which is a resection of fibrous remnants of biliary ducts followed by anastomosing a conventional Roux-en-Y loop of jejunum to the fibrous edges of the transected fibrous tissue in the porta hepatis. The restoration of intestinal bile flow can delay or even stop the progression of BA, however most of the children eventually are liver transplantation candidates even after successful HPE. Those who survive without transplantation require long-life follow-up due to chronic liver disease. The aim of the study was to assess the psychosocial functioning and the quality of life (QoL) in pediatric transplant-free survivors.

Methods: We performed psychological assessment in transplant-free children with BA. Twenty-two children (15 girls and 7 boys aged from 6 to 18 yrs (11.5 ± 3.6 yrs) participated in the study. The level of emotional and social functioning was diagnosed by using The Child Behavior Checklist (CBCL) and Youth Self Report (YSR). The KINDL was used for HRQOL assessment. Additionally strategies for coping with stress were being investigated by “How Do You Cope?” Questionnaire.

Results: We did not observe problems in emotional and social functioning in the study group. However the greater the intensity of the emotional difficulties in the group the lower level of the subjective sense of quality of life. Active coping strategies and seeking social support were most effective models for adaptation to the chronic disease. No significant gender and age differences were found.

Conclusion: In transplant-free patients with BA HRQoL is related to psychosocial functioning. The anti-stress strategies in this group are based on the model of active coping and seeking social support. 

The article describes the case of a boy with refractory rash, suggestive of seborrheic dermatitis complicated by bacterial infection. Based on characteristic medical history and additional studies the patient wasfinally diagnosed with Langerhans cell histiocytosis (LCH). The heterogeneous clinical manifestation of the disease was discussed, the need to include histiocytosis in the differential diagnosis of the most common skin changes in children was emphasized. 

The aim of this paper is to present the current knowledge concerning TRPS (trichorhinophalangeal syndrome) and its clinical picture based on two cases. Moreover, the genetic knowledge bases and the recommended clinical management is featured. TRPS is a very rare genetically determined disease and its types have the same main symptoms and etiology. The additional symptoms, their various severity and various pathogenetic molecular mechanisms divide TRPS into three types (type I, II and III). The exact incidence of TRPS is not yet established. Up to now a little over 100 TRPS I and TRPS II cases and ca. 100 TRPS III were described. Arguably many patients remain undiagnosed due to diversity of symptoms and often their weak expression. 

Focal liver nodular hyperplasia (FNH – focal nodular hyperplasia), due to its asymptomatic course, is usually a randomly detected lesion. Once the diagnosis is made, periodic radiological check-ups are usually recommended for further management. When deciding on surgical treatment, the benefits and risks of complications associated with the localization of the lesion should always be considered.