Spożywanie wspólnych posiłków,wsparcie i komunikacja w rodzinie jako predyktory zdrowia subiektywnego i zadowolenia z życia nastolatków

Objective

To analyze relationships between the frequency of family meals, clear communication, support within the family and subjective health and life satisfaction of 11–15-year-olds.

Material and Methods

The study was conducted in 2012 among 319 primary and lower secondary school pupils. Young people filled the anonymous questionnaire about family meals, family relations, health and life satisfaction. Statistical analysis included partial correlations, linear regression analysis and structural modelling.

Results

The vast majority of the young people at least once a week, ate each of the main meals with their parents, 31% daily ate breakfast with their parents, and 46% – lunch and dinner. Frequency of family meals was significantly correlated with clarity of communication and support within the family. Family meals and family relationships positively correlated with subjective health and life satisfaction of young people. Frequency of eating family meals was a predictor of subjective adolescents’ health (direct and indirect relationship) and life satisfaction (indirect relationship). In both cases, support and communication within the family were the mediators.

Conclusion

Promoting family meals should be an important method of improving the quality of life of young people.     

Napiętnowanie społeczne w chorobach przewlekłych

Regardless of diagnosis, chronic disease usually stigmatizes any patient. Social stigmatizing is one of the major risk factors for the quality of an individual's psychosocial functioning. Because of label of disease, patient is often ostracized. Social rejection equals a decline in mood and self-esteem. It also threatens emotional, social and intellectual growth of patients, particularly in developmental age. Limitation of peer contacts and lack of self-esteem may contribute to a loss of motivation. Such a condition often leads to discontinuation of medical recommendations. The stigma of the disease exerts a strong influence on the whole family system. Both patient's parents and siblings struggle with burden, whose negative consequences are reflected in family's and social's relationships as well as daily functioning. This paper discusses the definition, mechanism of the phenomenon, and consequences of social stigma, as well as presents literature review relating to stigmatization in the context of selected chronic diseases and family burden.     

Ograniczenie lub pozbawienie władzy rodzicielskiej a uczestnictwo rodziców w procesie diagnostyczno-terapeutycznym podejmowanym wobec małoletniego pacjenta

This paper addresses the issues of parents’ participation in the diagnostic and therapeutic procedures, whose parental authority has been restricted or suspended or deprived of parental authority. The problems of participation in the diagnosis and therapy are discussed taking into account the right to give consent to the provision of health and the right to be informed about the health of the child.     

Autoimmunizacyjne zespoły gruczołowe u dzieci – przebieg kliniczny i klasyfikacja na podstawie analizy wybranych przypadków

Autoimmune polyglandular syndrome, APS, is characterised by the presence of two or more chronic autoimmune organ-specific diseases in one individual. There are four types of APS; however, variable clinical course often makes the proper APS-type diagnosis difficult.In this paper, we would like to present 3 patients with APS, whose diagnosis has changed over time. The first patient was a girl with alopecia and normocytic anaemia, both of which occurred when she was 9 years old. At the age of 12, an autoimmune thyroiditis was diagnosed, and antibodies against adrenal cortex were found when she turned 17. The second patient was a 10-year-old boy admitted to the hospital because of vomiting, stomach ache and stomatitis/candidiasis. He also suffered from polydypsia and decreased appetite for several days. Type 1 diabetes and Addison's disease had been diagnosed. The third patient was a 16-year-old female with acute thrombocytopenia and anaemia accompanied by Graves’ disease. Additionally, during the course of the disease, she developed symptoms of lupus-like syndrome and central facial nerve palsy.The described cases indicate that the course of the disease as well as the diagnosis of the patient with APS may change over time. Atypical development of an autoimmune disease or atypical response for standard treatment should lead to extensive diagnosis towards new elements of the syndrome. Every organ-specific autoimmune disease might be the first prodrome of APS.     

Leczenie biologiczne we wtórnych zespołach hemofagocytarnych. Przegląd piśmiennictwa i opis przypadku zespołu aktywacji makrofagów w przebiegu leczenia etanerceptem układowej postaci młodzieńczego idiopatycznego zapalenia stawów

Macrophage activation syndrome (MAS), a secondary hemophagocytic lymphohistiocytosis (HLH), may be diagnosed in the course of the systemic inflammatory connective tissue diseases, especially systemic onset juvenile idiopathic arthritis (so-JIA). The pathological hyperactivation of the immune system results from a defective cytotoxicity of T lymphocytes and NK cells, leading to organ infiltration by these cells, hypercytokinemia and multiorgan failure. The classic clinical symptoms of this syndrome include fever, hepatosplenomegaly, bleeding. The most typical laboratory findings are hyperferritinemia, hypofibrinogenemia, a decrease of erythrocyte sedimentation rate, cytopenias or sudden drop in blood cells count and hemophagocytosis in the bone marrow or in tissues. The clinical course may be rapid and fatal. In the last decade, the biological agents against inflammatory cytokines – particularly inhibitors of tumor necrosis factor (TNF) and interleukin 1 and 6 (IL-1, IL-6) – are more widely used in the treatment of JIA. In Poland, etanercept and adalimumab are registered for use in children with polyarthritis JIA and tocilizumab (anti-IL-6) in so-JIA. Some casuistic reports on biological therapy, both as a risk factor of MAS and about its high efficiency in the treatment of this disease, have been found in medical literature recently.     

Pseudouchyłek powikłaniem długotrwałego zalegania ciała obcego w przełyku u 5,5-rocznego chłopca

We present a case of a 5.5-year-old boy with complications after long-term retention of a foreign body in the esophagus. The patient presented certain symptoms such as dysphagia, odynophagia, cough and vomiting. The case mentioned above proves that in children with chronic respiratory symptoms (such as cough, stridor) or gastrointestinal ones (dysphagia, odynophagia) the possibility of foreign body ingestion should always be considered as the cause of these complaints.     

Wpływ wczesnych zakażeń na stężenie adiponektyny i leptyny w surowicy noworodków donoszonych

Objective

Adiponectin and leptin play an important role in the children development, but the effect of early-onset neonatal infections on their values is not well known.

Zmiany stężeń waspiny i leptyny w surowicy u noworodków donoszonych z wrodzonym zapaleniem płuc

Objective

Vaspin and leptin play an important role in the foetal and postnatal development of children, which may be disturbed by infections. The effect of congenital infection on serum vaspin and leptin values is not well known.

Objawy hipolaktazji występujące wśród dzieci,młodzieży i studentów szkół szczecińskich

Introduction

Adult-type hypolactasia is a physiological and genetically conditioned process, which is manifested by a regular decrease of the intestinal lactase activity from childhood to adulthood. It results in an incomplete digestion process in the small intestine, which can lead to intestinal disorders, and is diagnosed as lactose intolerance (LI).

Choroby wątroby i nerek w przebiegu ciliopatii

Ciliopathies constitute a group of disorders characterized by cilia abnormalities and an extremely heterogeneous clinical presentation. The liver and kidneys are the most commonly affected organs and the term hepatorenal fibrocystic disorders is used to describe ciliopathies with combined liver and kidney involvement. Liver disorders in ciliopathies can be grouped into three categories: congenital hepatic fibrosis, Caroli's disease and polycystic liver disease. Kidney disorders related to primary cilia abnormalities include autosomal dominant and recessive polycystic kidney diseases and nephronophthisis.     

Sposoby oceny przez rodziców ciepłoty ciała dzieci

Introduction

There are various methods of measuring the temperature, various types of thermometers and places where the temperature can be measured. Currently electronic thermometers are the most widely used, mercury thermometers gradually becoming obsolete. A common point of measurement is the armpit, but in pediatric practice the measurement in the external auditory canal is considered to be the golden standard. Many people also assess temperature by touch, regardless of whether they have a home thermometer or not.The aim of the study was to analyze parental ways to measure body temperature, taking into account the thermometer measurements and approximate measurement.

Materials and methods

The survey was conducted on 206 people (194 mothers, 11 fathers, and 1 grandmother). The mean age of children was 24.2 months (min 2 weeks, max. 17 years, SD 37.7). The questionnaire included questions open and closed, single- and multiple-choice, and were concerning the assessment of the child's body temperature when fever was suspected. They were asked for a measurement method and the interpretation of the other symptoms of the child's fever. The results were statistically analyzed using Statistica version 6.0.

Results

The parents most often measure the temperature only using the electronic thermometer – 143 people (often in urban areas); 42 people measured fever using the mercury thermometer (more often in older children as well as in rural areas); in some cases – with several types of thermometers. Frequently temperature is measured in the armpit (in this way 90/186 people measure the temperature; more often in older children), less frequently – on the forehead (46/186 people, often younger children), rectum (40/186 people; often younger children), in the ear (31/186 people), and occasionally in other places. 115/125 people also measure children's temperature in an “orientation” way, by hand, usually on the head/forehead. For parents, other methods of assessing a child's fever are: the evaluation of the child's behavior, the change of the face expression, eyes, mouth, and a change in breathing.

Conclusions

In our study all parents use thermometers. The most commonly used are electronic thermometers, rarely – mercury thermometers. Frequently temperature is measured in the children's armpit, alternatively on the forehead, in the rectum, and the outer ear. A large number of parents additionally assess the child's body temperature by touch, and sometimes parents pay attention to other symptoms of fever.     

Powikłania ospy wietrznej u dzieci w województwie łódzkim w latach 2001–2012

Varicella may cause serious, even life-threatening complications.     

Rozsiane aspiracyjne zapalenie oskrzelików w przebiegu achalazji przełyku u 9-letniego chłopca – opis przypadku

Achalasia is a rare disease in children. Diagnostic difficulties arise from nonspecific symptoms, especially in young children, and similarity to other more common clinical entities such as gastroesophageal reflux disease.     

Udział mleka kobiecego w żywieniu noworodków urodzonych przedwcześnie

Aim

The objective of this study was to assess methods of feeding preterm neonates during hospitalization and at NICU discharge.

Material and methods

It was a questionnaire-based observational study on the use of human breast milk in nutrition of preterm infants. The questionnaires were distributed among mothers of preterm neonates on the last day of hospitalization.The material was divided into two groups: children born before 33 weeks of gestation (group 1) and children born between 33 and 37 weeks of gestation (group 2).

Results

During hospitalization, 85% received maternal breast milk – 24% were given breast milk only and 61% were additionally fed with neonatal formula for preterm babies, whereas 15% infants received only the formula. At the day of discharge data on feeding ways were: 59% children received exclusive breast-feeding, 12% mixed-feeding (maternal breast milk combined with formula in a 50:50 ratio), 9% mixed-feeding with formula constituting over 50% of the total supply, and 20% were not breastfed at all. In group 2, during hospitalization, 84% were breastfed and the remaining 16% received formula. At the day of discharge the ratio was in favor of maternal breast milk: 95% of the infants received it. Additional analysis of ways of administering breast milk and formula were made. The results revealed that 19 mothers were breastfeeding, 4 used expressed breast milk, and 28 combined both methods. Additionally 29% children received formula: in 8 of them, i.e. a half of the studied cases, it constituted less than half of daily milk supply, while the remaining subjects received maternal breast milk and formula in a 1:1 ratio.     

Nowe techniki kariotypowania molekularnego przydatne w rozpoznawaniu mikroaberracji chromosomów u dzieci z zespołami wad,opóźnieniem psychoruchowym i niepełnosprawnością intelektualną

Precise cytogenetic diagnostics (e.g. FISH) in patients harboring chromosomal microaberrations is difficult, mostly due to a manifestation of similar clinical symptoms. Possible cost of the diagnosis could be increased to an unacceptable extent which results in resignation from further analyses. However these patients might account for the large number of people in genetic counselors’ offices; therefore they demand precisely anomaly-oriented further diagnostics. These problems could be usually solved by introduction of molecular karyotyping techniques (e.g. Real-time PCR, multiplex ligation-dependent probe amplification, BACs-on-Beads™), which allow detection of different chromosomal microaberrations in a single DNA sample required for final diagnosis of genetic syndrome, and thus seem to be very useful in patients suspected of harboring such an aberration.     

Dwuletnia ocena rozwoju noworodków urodzonych przedwcześnie i hospitalizowanych w ośrodku III stopnia referencji z rozpoznanym krwawieniem około- i dokomorowym II–IV stopnia

Introduction

Periventricular and intraventricular hemorrhage (IVH) in preterm infants may influence their future development. Although the latest foreign publications indicate changing prognosis at different grades of hemorrhage, Polish literature on this topic is scarce.

Aim

To present relationship between severity of II–IV grade IVH in preterm infants hospitalized in the 3rd level unit and diagnosed with USG, and neurological outcomes at 2 years corrected age.

Material and methods

Ninety eight infants who had been admitted to the NICU at the Institute of Mother and Child in Warsaw and diagnosed with II–IV grade IVH were observed. Motor, language, cognitive, visual and hearing developments were assessed at 2 years corrected age.

Results

Intensity of neurological impairments increased with grade of hemorrhage and presence of accompanying cystic periventricular leukomalacia (PVL). In children with III grade IVH without PVL, cerebral palsy did not occur. Cerebral palsy, including tetraplegia, was diagnosed mostly in children with IV grade IVH.

Conclusions

Short-term evaluation of preterm infants indicates the possibility of occurrence of cerebral palsy in children with II grade IVH. Neurodevelopment of children with III grade IVH is only slightly worse, as long as it is not accompanied by PVL. Prognosis for infants with IV grade IVH is poor in most of the cases and these children should be handled differently from infants with III grade IVH. Brain MRI in selected cases may improve prediction of neurological impairments in this population.     

Stanowisko dotyczące postępowania w rodzinnej hipercholesterolemii u dzieci i młodzieży. Stanowisko Forum Ekspertów Lipidowych

Familial hypercholesterolemia (FH) is a genetic disease that causes accelerated atherosclerosis and a high risk of occurrence of cardiovascular events. Atherosclerosis in the course of FH develops insidiously and reaches an advanced stage before the onset of clinical symptoms. Homozygous form of FH occurs in the Caucasian population with a frequency of one per million, while the heterozygous form of FH in European countries applies on average in 1 person per 500. FH diagnosis is an indication to take the whole family under medical care, education, and to introduce dietary and pharmacological treatment. The aim of treatment in children with FH is to achieve more than 50% reduction in LDL level or to achieve LDL-cholesterol concentrations below 130 mg/dl and below 100 mg/dl in diabetic children. The effectiveness of low fat diet in the treatment of FH is limited. The medicaments of first choice in the treatment of FH are statins. After initiation of therapy in children, cholesterol levels and the side effects of therapy and its impact on children's development, nutritional status, degree of sexual maturity should be routinely evaluated. Familial hypercholesterolemia is a relatively common metabolic disorder, but still quite rarely recognized and not properly treated. Early diagnosis and appropriate treatment of FH in children and adolescents can significantly reduce the risk of cardiovascular disease and sudden death in adults. The purpose of these recommendations is to describe the current epidemiological situation in Poland, to establish the guidelines for identifying FH in children and adolescents and to enable the introduction of effective treatment.     

Ocena żywności oferowanej w sklepikach szkolnych i kupowanej przez dzieci z krakowskich szkół podstawowych

Aim

The aim of the present study was to determine the impact of food advertising in primary schools on the food purchasing habits of children from primary schools in Krakow.

Methods

50 randomly selected primary schools in Krakow, Poland were included to the investigation in 2011/2012; 12 400 children are in primary and secondary schools in this city. Schools were visited by one of the members of the research team, who filled in a questionnaire regarding the type of food products displayed or advertised in the school shop window and recorded the presence of direct corporate advertising in the proximity of the school shop. Shop owners were asked to fill in a form describing food purchases by students within the week preceding the visit. The school principal (or one of teachers) completed a form describing the school's policy regarding food advertising and the sponsorship of school activities by food companies.

Results

Studies have shown that less than half of the shops selling children healthy foods such as sandwiches, yogurt, fruit. The largest number of offered products in the surveyed shops accounted for mineral water, carbonated soft drinks and pastries. Taking into account all the shops regardless of the type of school, the most exposed commodity are non-carbonated beverages (33.33%); snacks, candy bars and wafers, juice and chocolate bars take second place. Students often buy bagels (26.19%), less snacks (19.05%), followed by sweet carbonated beverages (11.9%), juices and jellies (7.14%) and sandwiches, sweets and pastries (4,75%).

Conclusions

Educational programmes should be introduced in schools with the aim of improving the understanding of nutritional principles among pupils, teachers and parents.