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.     

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.     

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.     

Niedokrwistość z niedoboru żelaza w przebiegu niedoboru IgA i celiakii – opis przypadku

The paper shows the case of a 4-year-old boy treated ineffectively with anaemia caused by iron deficiency. After 6 months of treatment with oral iron medical preparation a sustainable anaemia and significant iron decrease was found out. Thorough differential diagnosis lead to the recognition of coeliac disease as a main cause of the chronic anaemia and the failure in iron supplementation. Following the applied gluten-free diet with simultaneous further therapy with iron preparations, a progressive recovery of the child's health was achieved, normalisation of laboratory test results and further normal physical and psychomotor development of the boy.     

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.

Przepuklina pępowinowa i wytrzewienie wrodzone – różnice i podobieństwa w etiologii,diagnostyce oraz postępowaniu z noworodkiem

Omphalocele and gastroschisis are the most common congenital abdominal wall defects. This article presents etiology and strategies in diagnostics and in prenatal and postnatal management in these disorders. There are similarities and differences between gastroschisis and omphalocele which are essential for correct patient management. Most abdominal wall defects are detected antenatally. Prenatal diagnosis may influence timing, route and location of delivery and it facilitates postnatal multidisciplinary approach.     

Skala Depresji i Lęku (HADS) – zastosowanie w grupie zdrowych i chorych na mukowiscydozę nastolatków w Polsce

Introduction

Chronic disease carries the risk of emotional disorders among adolescents. It is important to observe early signs to implement treatment. One commonly used screening tool is Hospital Anxiety and Depression Scale (HADS), which has Polish adaptation for adults. Although there are publications presenting the validation of a scale for use in adolescents, in Poland this study has not yet been conducted. The aim of the present study was to evaluate the use of Anxiety and Depression Scale among Polish healthy and CF adolescents.

Methods

Anxiety and Depression Scale was examined in 142 adolescents, including 65 patients with CF in Cystic Fibrosis Centre at the Institute of Mother and Child, as well as in 77 healthy students. Scale accuracy has been verified by comparing the State-Trait Anxiety Inventory STAI and the Center for Epidemiological Study for Depression CES-D.

Results

The relatively high HADS scale reliability (Cronbach's α = 0.83) and good stability in test-retest analysis (ρ = 0.75 for the depression subscale and ρ = 0.67 for the anxiety subscale) was reported. Correlations item–scale were statistically significant and ranged from r = 0.32 to r = 0.74. χ² test showed a link between anxiety subscale HADS-A and the two subscales STAI (anxiety as a state and as a trait) and between subscale HADS-D and CES-D.

Conclusions

Our study achieved satisfactory indicators of reliability, stability and validity of the test. The test could be useful in adolescents with cystic fibrosis, due to the limited number of questions concerning the somatic symptoms that may result from the underlying disease.     

Udział epigenetycznych i genetycznych defektów regionu 11p15 w etiologii zespołu Beckwitha i Wiedemanna

Epigenetic processes, including genomic imprinting, are important for normal human growth and development. Beckwith-Wiedemann syndrome (BWS) is a disorder characterized by pre- and postnatal overgrowth in children, abdominal wall defects, macroglossia and a high risk of tumors. BWS is caused by different molecular defects of the 11p15 region containing several imprinted genes. The genes are localized into two domains: the first one is controlled by the imprinting control region ICR1 and the second one is controlled by ICR2. Epigenetic and genetic disturbances observed in BWS include ICR1 hypermethylation, ICR2 hypomethylation, paternal uniparental disomy, deletions, duplications, translocations, inversions in the 11p15 region, and point mutations in the CDKN1C gene. In this work new findings about Beckwith-Wiedemann syndrome etiology and molecular diagnostics are presented.     

Czynniki ryzyka,etiologia i wyniki leczenia zakażeń Candida sp. u noworodków hospitalizowanych w oddziale intensywnej terapii

BackgroundCandida infection develop in 6–18% of neonates with mortality rate between 22–32%.AimA 6-years retrospective analysis of mobility rate, risk factors and results of the treatment of Candida infections in newborns hospitalized in NICU.MaterialThe study comprised 80 (46 boys, 34 girls) newborns, among them 27 with ELBW, 20 with BW between 1001–1500 g, 16 with BW 1501–2500 g i 17 weighing >2500 g. Fluconazole prophylaxis was applied from third day of life in all newborns.Results113 Candida infections were noted in 80 newborns, among them 10 in first week of life, 28 between 8^th and 15^th day, 33 between 16–30^th and 42 > 30^th day of life. Eighteen types of Candida sp. were isolated, most often C. albicans (275), C. sake (25%) and C. lusitaniae (18%). Died 14 (17,5%) infants. Significant relationship between death of newborns and their fetal maturity and number of Candida infections was stated. Any significant relationship between birth weight, gender, clinical state after birth, time of hospitalization of newborns and results of the treatment was noted.Conclusions1. In newborns treated in the NICU, despite fluconazole prophylaxis, late-onset Candida infections are noted. 2. C. albicans, C. sake and C. lusitaniae dominate in etiology of neonatal invasive Candida infection. 3. Fetal maturity and number of Candida infections have significant prognostic values in newborns with Candida infection.     

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.     

Stężenie leptyny i omentyny-1 w surowicy eutroficznych,zdrowych noworodków donoszonych

Objective

The study of leptin and omentin-1 in adults and older children indicates on the relationship these hormones have with state of nutrition, diabetes, insulin-sensitivity and arterial hypertention. The effect of leptin and omentin on fetal growth in healthy neonates is not well known.

Aim

The evaluation of serum leptin and omentin concentrations in healthy, eutrophic full-term neonates according to their gender, anthropometric parameters and mode of mother's delivery.

Materials and methods

The study involved 79 (49 girls, 27 boys) neonates, among them 63 were vaginal born and 19 by cesarean section. Serum leptin and omentin-1 concentrations were measured between 3rd and 7th day of life by ELISA method.

Results

It was found that mean serum leptin is significantly higher in girls than in boys and serum omentin-1 concentration significantly lower in female than in male neonates. Statistically significant (p < 0.05) negative correlations between serum leptin level and body length, and between serum omentin-1 concentration and head circumference were observed. Mode of delivery had no influence on lepton and omentin-1 concentrations.

Conclusions

1) These data demonstrate that serum leptin and omentin-1 concentrations in healthy eutrophic full-term neonates are associated with their gender, leptin level with body length and omentin-1 with head circumference. 2) Birth weight and mode of mother's delivery do not have a significant influence on serum leptin and omentin-1 concentrations in full-term, eutrophic neonates.     

Ortoreksja – patologiczna kontrola nad odżywianiem. Zagrożenie dla dzieci i młodzieży

Eating disorders are serious threat to children and adolescents living in western countries. Parental influence as well as sociocultural standards, shapes specific attitudes towards selection, preparing and consuming food among juveniles. Orthorexia is a form of eating disorder, which is based on concentration over quality of consumed food. The paper provides symptomatology of orthorerxia along with various risk factors that may cause children and adolescents to develop disturbed eating behaviours.     

Zakażenia narządów płciowych u dziewcząt – profilaktyka i leczenie

Genital infections are a frequent diagnosis in pediatric and adolescent gynecology out-patient clinics, 2/5 of which relate to girls aged 0–14 years. The course of disease ranging from symptoms and ending on the treatment depends on many factors, foremost of the infection pathogen, but also on the child's age, coexisting diseases and sexual activity. Genital infections in girls can be caused by bacteria, viruses, fungi, parasites or factors of non-communicable. The most common symptoms of vulvovaginitis in girls are vaginal discharges with different color, texture and smell, occurring in 60–90% of the cases. Diagnosis of genital infections should begin with an anamnesis. During gynecological examination of external sexual organs, the vestibule of the vagina, urethra and area around the anus should be revealed for the presence of skin lesions and absences of the defects of interior genital. In sexually active girls cervix and vaginal walls should be also revealed. Personal hygiene and supportive treatment (sitz baths, vaginal irrigation, topical soothing agents, corticosteroids, antihistamines, loose cotton underwear, preparations of lactic acid) play a huge role in the prevention of vulvovaginitis in girls. Treatment of infections should be based on the result of bacteriological testing and antibiogram, in dose adjusted to age and body weight of girl.     

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).

Uwarunkowania środowiskowe a stan odżywienia dzieci i młodzieży województwa podlaskiego

IntroductionChildren nutritional status results from both inherited genetic predispositions and environmental factors, such as biogeographic and social and economic ones.AimThe aim of the study was to evaluate the influence of environmental factors on children and adolescents nutritional status in the Podlasie Province.Material and methodsThe study was carried out on 592 children, aged 1–14, living in the urban and rural regions of the Podlasie Province. Questionnaires and anthropometric measurements with BMI were performed.ResultsBody mass deficit was observed in 24.2% of the examined children while overweight and obesity – in 12.5%. The highest percentage of body mass deficit (32.2%) was in the youngest children (1–3 years of age) and it decreased with the age. Body mass deifcit was also stated in families with lack of money for the rent (30.7%) and for food (32.5%). The percentage of children with overweight and obesity was comparable in all age groups and was approximately 12%. The lowest, 7.0%, was in large families.ConclusionsNutritional status of the examined children was conditioned by the family status, the number of children in the family and financial deficit. The highest percentage of under nutritional children was observed in families with lack of money for the rent and food.