[Vasculitis in children].

Vasculitis is a group of rare diseases of unknown etiology, characterised by inflammation and necrosis of blood vessels, contributing to various clinical consequences. The variety of clinical symptoms and presence of symptoms from various syndromes often make the diagnosis difficult. Until now no causal treatment has been established.

[Therapy of chronic viral hepatitis type B in children after previous ineffective interferon-alpha treatment].

Unlabelled: THE AIM of this study was to estimate the efficacy of nucleoside analogue (lamivudine) in the therapy of chronic viral hepatitis type B in children, after previous, ineffective treatment with interferon-alpha.

Patients And Methods: we analyzed 53 children with chronic viral hepatitis type B, who had not responded to Interferon-alpha treatment conducted 1-7,5 years before this study (mean 4,0 +/- 7,5; median 4 years). Inclusive criteria to re-therapy with lamivudine were as follows: increased serum alanine aminotransferase activity, detected at least three times during 6 months before treatment, HBsAg and HBeAg present in the blood, viral HBV DNA detected for at least 6 months before the beginning of lamivudine therapy (above 200 genome copies per mL) and inflammation activity observed in liver biopsy specimen (biopsy performed within previous 24 months).

[Chronic hepatitis B in children--is it still a real problem?].

Over one million people all over the world die every year due to the complications of HBV infections. This problem is particularly important in Asia, Africa and in the West Pacific region where HBV infection is widely spread (from 5-20% up to 80% of all infected people in the world). In these regions HBV infections are transmitted mostly perinatally or during early childhood.

Acute acalculous cholecystitis of viral etiology--a rare condition in children?

Acute acalculous cholecystitis (AAC) comprises 5% to 10% of all cases of acute cholecystitis in adults and appears to be even less frequently diagnosed in children. The diagnosis of AAC is established upon some clinical, laboratory, and ultrasonographic findings, which may sometimes be ambiguous and confusing especially in children. Diagnostic difficulties may result in either delayed diagnosis or unnecessary surgical intervention.

[Short bowel syndrome in children - own experience].

The Aim: of this study was to analyze the clinical status of children with short bowel syndrome (SBS) shortly after the resection and during following years.

Material And Methods: we reviewed retrospectively 5 children with SBS aged from 2 years and 7 months till 14 years and 5 months, who were on total parenteral nutrition due to intestinal resection. The resection was performed, when they were either newborns or infants.

[Immune components of human milk].

Many benefits of breast-feeding have been generally accepted. In the article the constituents of human milk supporting the immune system of breast fed babies are reviewed. The effect of maternal undernutrition on immunological properties of breast milk is also presented.

[Giardiasis in children - clinical diversity and diagnostic problems based on own experience].

Unlabelled: Parasitosis still remains a significant pediatric health problem, despite improving hygienic conditions and social awareness.

The Aim Of This Study: was to analyze clinical manifestations of Giardia lamblia infection in children hospitalized in the Department of Pediatrics, Pediatric Gastroenterology and Oncology of Medical University of Gdansk.

Material And Methods: studied children included 49 patients aged 2.

[Etiology of community - acquired acute diarrhea in children].

The Aim: of the study was to analyse the etiology of home acute diarrhea in children.

Material And Methods: 2636 children with community-acquired acute diarrhea were included in the study. Stool samples were analysed for the presence of Salmonella spp, Shigella spp, rotaviruses and adenoviruses.

[Mesenteric lymphadenopathy - a valid health problem in children].

The Aim: of the study is to evaluate the reasons of mesenteric lymphadenopathy and its clinical picture in hospitalized children.

Material And Methods: the study was performed on 127 children (49 girls and 78 boys age of 8 months to 18 years; mean age 9 years and 3 months) hospitalized in the Department of Paediatrics, and Paediatric Gastroenterology and Oncology, Medical University of Gdansk. Ultrasonography showed enlarged abdominal lymph nodes in all children.

[Congenital extrahepatic biliary atresia as a cause of cholestasis in newborns and infants].

Unlabelled: Congenital extrahepatic biliary atresia (CEBA) is one of the most common causes of cholestasis in newborns and infants.

The Aim Of The Study: was the analysis of clinical presentation, results of laboratory and imaging investigations as well as clinical outcome of children with extrahepatic cholestasis caused by CEBA.

Materials And Methods: the analyzed group included 15 children aged from 2 weeks to 4 months.

The "sugar" clear cell tumor of the lung-clinical presentation and diagnostic difficulties of an unusual lung tumor in youth.

A case of the "sugar" clear cell tumor of the lung in a 16-year-old boy is presented. The course of the disease with general symptoms, never reported before, highlights diagnostic difficulties of an extremely rare lung tumor in youth. The boy presented with daily spikes of unexplained high fever of 6 weeks' duration with features of hypochromic microcytic anemia, elevated erythrocyte sedimentation rate, C-reactive protein, alpha(2)- and beta-globulins, and elevated platelet count.

[Fimbriae as virulence factors of uropathogenic strains of Escherichia coli].

In this paper uropathogenic Escherichia coli strains are characterized. In particular, fimbrie as virulence factors are presented and their role in the clinical course of urinary tract infection is assessed.

Lamivudine therapy for children with chronic hepatitis B.

Aim: To assess the effectiveness and side-effects of lamivudine therapy for children with chronic hepatitis B (CHB) who fail to respond to or have contraindications to interferon-alpha (IFN-alpha) therapy.

Methods: Fifty-nine children with CHB were treated with 100 mg lamivudine tablets given orally once daily for 12 mo. Alanine aminotransferase (ALT) activity was evaluated monthly during the therapy and every 3 mo after its discontinuation.

[Autoimmunity in children with chronic hepatitis C treated with interferon alpha and ribavirin].

The role of interferon alpha or the virus itself in the pathogenesis and the risk of autoimmunological disorders in patients infected with HCV, still remain unknown, especially in children. The aim of the study was to evaluate the incidence of autoantibodies and the risk of autoimmunological disorders in children with chronic hepatitis C, treated with interferon alpha and ribavirin in the Department of Paediatrics, Paediatric Gastroenterology and Oncology in Gdansk. In the studied group of 12 patients, in 4 cases autoantibodies were present in low titers prior to the treatment and they had no prognostic value for the response to the therapy or the risk of autoimmunological disorders.

[Therapeutic difficulties in a patient with ulcerative colitis and concomitant HBV and HCV infection].

The aim of the paper was to describe therapeutic difficulties in a patient with ulcerative colitis. In the long-term clinical course of the disease a concomitant infection with hepatotropic viruses (HBV, HCV) was diagnosed. Due to the different treatment of autoimmunological diseases and chronic viral hepatitis the necessity of further search of therapeutic schedules for this group of patients is still needed.

[Gastroesophageal reflux disease presenting as severe bronchial asthma in an 18 months old child].

It is known that gastro-esophageal reflux can trigger bronchospasm among children with asthma and cystic fibrosis as well as in children without chronic respiratory tract disorders. In our practice we have met only once with the case of a child misdiagnosed as having severe asthma in whom surgical treatment of gastro-esophageal reflux disease ended with full withdrawal of respiratory symptoms. On the basis of this case we conclude that the diagnostic procedures should be performed in cases of asthma resistant to typical treatment.

Serum interleukin 6 and interleukin 12 levels in children with chronic hepatitis HBV treated with interferon alpha.

Introduction: The course of HBV infection and the outcome of interferon alpha (IFNalpha) therapy of patients with chronic hepatitis B, is determined by the antiviral immune response of the host. The aim of the study was to investigate 1) the correlation between IL-6 and IL-12 serum levels and biochemical and histopathological changes in children with chronic hepatitis B, 2) predictive value of pre-treatment serum levels of these cytokines in patients treated with interferon alpha and 3) changes in serum levels of these cytokines after interferon alpha treatment.

Methods: Serum levels of IL-6, IL-12 (heterodimer p70) and IL-12 (heterodimer p70 & p40 subunit) were determined by specific ELISA in 39 children with chronic hepatitis B on the first and the last day of IFNalpha therapy.

Cytomegalovirus disease in neonates and infants--clinical presentation, diagnostic and therapeutic problems--own experience.

Background: The aim of the study was to present diagnostic problems, different clinical presentations and results of treatment of cytomegalovirus infections in neonates and infants.

Material/methods: The study was carried out in a group of 31 children from 10 days to 12 months of age (17 boys, 14 girls). The diagnosis was based on serological investigations (presence of specific IgM antibodies and/or increasing titer of IgG antibodies), presence of intermediate or early CMV antigen in peripheral blood leukocytes or positive blood or urine PCR results.