Ziarnica złośliwa u nastolatka – późne rozpoznanie. Opis przypadku

The reported case presents a 15-year-old boy diagnosed with Hodgkin’s disease (Hodgkin’s disease, HL) after about 2 months of outpatient care in primary health care (POZ). The patient was diagnosed with Hodgkin’s disease in 3rd stage, which significantly reduces the chances of complete recovery from the initial stage of diagnosis. Symptoms reported by the boy, such as cough, subfebrile states, decreased well-being, itchy rash, if present alone, are not pathognomonic for any disease, however, occurring simultaneously with characteristic abnormalities in the scope of physical examination, may help in faster diagnosis and initiation of proper treatment. This is especially important in times of pandemic, when most medical advice is provided by phone. A medical and environmental interview should be carried out with particular care and attention, and a physical examination should be made faster, so as not to overlook a disease that is dangerous and may endanger the patient’s health and life.

Wpływ masy szkolnego plecaka transportowanego skośnie na prawym lub lewym barku i przy różnoimiennym biodrze na cechy postawy w płaszczyźnie strzałkowej i poprzecznej 7-letnich uczniów obojga płci

Introduction. The continuing percentage of postural statics disorders may have its roots in the method of carrying the loads of school supplies. Aim. The aim of the study was to show the effects of the load of the container with school supplies carried obliquely on the left shoulder and right hip or on the right shoulder and left hip in the sagittal and transverse planes on the posture. Material and methods. Body posture tests were carried out on a group of 65 pupils aged 7 years, using the projection moire method in four positions: 1-the habitual posture, 2 – the posture after a 10-minute asymmetric loading, 3 – the posture assumed one minute after removing the load, 4 - two minutes after taking the load off. Physical fitness was measured with the Sekita test. The analysis included the values of posture features to determine the significance of their differences and correlation with physical fitness to determine its relationship with the size of these differences. Conclusions. (1) The mode of carrying school items obliquely on the right or left shoulder and on different hips may cause significant adaptation changes in the skeletal and muscular system. It should be assumed that the bigger these changes are, the longer the carriage time is, the greater the mass of the container and the intensity of physical effort are. The changes are not gender specific. The analyzed carriage method should not be practiced among 7-year-old children of both sexes. (2) The overall fitness level shows a diversified relationship with changes in the values of postural traits as a result of the assumed carriage of school supplies. This relationship is bigger among boys. In case of girls, correlations are observed between endurance and the size of the inclination angle of the thoracic-lumbar spine. Among boys, all the features of physical fitness correlate most often with asymmetry of convexity of the lower angles of shoulder blades and the pelvic torsion in the transverse plane. The impact is gender dependent.

Hospitalizacja dzieci i młodzieży w województwie śląskim

Introduction. Health condition is one of the basic factors determining the quality of life of children and adolescents. Childhood ill health is especially dangerous as it can interfere with developmental processes and lead to long-term and permanent health problems. Health problems that cause hospitalization are mainly childhood diseases, which, due to the course or accompanying complications, require hospital treatment. The most common reasons for hospitalizing children and adolescents in children are respiratory infections, cardiovascular diseases, cancer, and mental diseases. Aim. The aim of the article is to present the most frequent hospitalizations of children and adolescents from various cities of the Silesian Voivodeship in 2010-2018. Material and methods. The research material is data from the Silesian Voivodeship Office in Katowice – Department of Health. Results. The hospitalization rate for bronchial asthma is increasing in Bielsko-Biała and Sosnowiec. In Bielsko-Biała, Katowice, Sosnowiec and Zabrze, the number of children hospitalized due to mental disorders is increasing. Conclusions. Hospitalization due to neoplastic diseases is variable in all the discussed cities of the Silesian Voivodeship. One of the basic elements of health policy is having knowledge about the health condition of the population of children and adolescents and its wider health needs. Analyzes of the frequency and causes of hospitalization of children and adolescents can be a source of information on factors influencing the health of children and adolescents.

Epidemiologia chorób przewlekłych wśród dzieci i młodzieży w województwie śląskim

Introduction. Health condition is one of the basic factors determining the quality of life of children and adolescents. In early childhood, its poor condition is particularly dangerous as it can interfere with developmental processes and lead to long-term and permanent health problems. Chronic diseases are distinguished among the most common health diseases of children and adolescents. They constitute one of the most serious phenomena and problems of the modern world, resulting from the prevalence in the population, and above all from the consequences it causes in an individual and social sense. The catalog of chronic diseases includes: asthma, allergies, heart diseases, arterial hypertension, stroke, cancer, kidney diseases, multiple sclerosis, degenerative joint diseases and mental diseases. In Poland, the prevalence of chronic diseases in children aged 0-14 is found in 27%, and among adolescents aged 15-19 it is found in 23%. According to the age category of children, chronic disease was diagnosed in 23% of children aged 0-4; 30% – 5-9 years; 29% – 10-14 years. No systematic epidemiological studies are conducted in Poland on the occurrence of chronic diseases in the population of children and adolescents. Aim. The aim of the article is to present the epidemiology of selected chronic diseases among children and adolescents living in several cities of the Silesian Voivodeship. Material and methods. The research material is data from the Silesian Voivodship Office in Katowice – Department of Health. Tables were then drawn up that illustrate the epidemiology of the diseases discussed. Results. The lowest incidence rate of bronchial asthma was recorded in Sosnowiec in 2010 (18.2/10,000) and the highest in Bielsko-Biała in 2014 (91.1/10,000). In Bielsko-Biała and Katowice, the cancer incidence rate is increasing. Conclusions. The general health condition of Polish children (0-14 years) is moderately satisfactory, and children and adolescents from industrial areas, which include the Śląskie Voivodeship, are particularly exposed to more frequent incidence of respiratory diseases and various types of allergies. Currently, every fourth child has long-term health problems (26.1%), and they are more common in older children, among 10-14 year-olds (31.2%).

Kiedy pacjent jest oporny na leczenie – historia dziewczynki z aplazją szpiku

Acquired aplastic anemia (AAA) is a rare disease of the haematopoietic system in children. In the absence of a compatible family donor of bone marrow, immunosuppressive therapy is used in combination with anti-thymocytic globulin and cyclosporine. We present a 6-year-old girl diagnosed with severe aplastic anemia (SAA), initially treated only with cyclosporine (CSA) due to lack of a drug in Ukraine. In 2 months of therapy, the child was admitted to a Polish clinic. Due to the persistence of aplasia, she received standard treatment with CSA and anti-lymphocyte globulin, to which she did not respond. In view of disease progression and the lack of a completely compatible unrelated donor. It was decided to transplant from a 9/10 compatible donor, which was successful. Now the child is in remission of the disease and has 100% donor chimerism. Despite the difficulties in therapy, the girl has been healthy for over 2 years.

PIMS-TS – co o nim wiemy

Peadiatric inflammatory multisystem syndrome associated with COVID-19 is a new term that describes the COVID-19-associated multi-system inflammatory syndrome in children, which appeared in medical terminology with the spread of the SARS-CoV-2 pandemic. The connection with a past SARS-CoV-2 infection can usually be demonstrated by means of laboratory and molecular tests. The course of the disease is associated with dysfunction of the immune system, hence the clinical picture may be very similar to Kawasaki disease (initially this syndrome was called 'Kawasaki disease-like'). Cardiac complications, including heart failure, were also observed in PIMS. Therefore, cardiological diagnostics is necessary in every child diagnosed with PIMS. Moreover, it should be noted that a patient diagnosed with PIMS should be under the supervision of a multidisciplinary team of doctors. Both the treatment od PIMS and the clinical picture are similar to the treatment of Kawasaki disease. It is mainly based on the use of intravenous immunoglobulin, anticoagulants, and sometimes also glucocorticosteroids. After treatment, cardiological control is necessary due to possible complications in the cardiovascular system.

Zabiegi kardiologii interwencyjnej u noworodków

In the last 30 years, a great progress has been made in the treatment of congenital heart defects by interventional cardiology procedures. Cardiac catheter interventions are implemented in fetuses with critical aortic stenosis and pulmonary atresia with intact ventricular septum to promote the growth and improve function of the left or right ventricle. In a case of aortic stenosis it could prevent the evolution to hypoplastic left heart syndrome. Balloon atrial septostomy or stent placement is a lifesaving procedure in fetuses with hypoplastic left heart syndrome and highly restrictive or intact atrial septum. The majority of cardiac catheter interventional procedures in neonates are palliative and lifesaving. They include: balloon atrial septostomy or static balloon dilation or cutting balloon septostomy or stenting of the atrial septum in congenital heart defects with duct-dependent blood mixing, balloon valvuloplasty in neonates with critical aortic valve stenosis, stent implantation into the right ventricular outflow tract or arterial duct in cyanotic neonates with duct-dependent pulmonary circulations, angioplasty for stenotic vessels. The therapeutic cardiac interventions in neonatal period are: pulmonary valvuloplasty in patients with critical pulmonary stenosis and challenging transcatheter ductus arteriosus closure in preterm and extremely low birth weight infants.

Skuteczność profilaktycznych szczepień przeciwko ospie wietrznej

Chickenpox is one of the most common and most contagious childhood diseases in Poland. Despite the introduction of chickenpox vaccination, approximately 200,000 cases are reported in Poland every year. The incubation period is 10-21 days. Varicella is manifested by a fever and a characteristic rash. Despite widespread public opinion about the safe course of the disease, severe complications such as meningitis and encephalitis are observed. In the US, since the introduction of universal vaccination, the incidence and hospitalization because of chickenpox has dropped dramatically. In Poland, despite the introduction of recommended vaccinations, the number of cases has recently increased.

Ciężkie zwężenie zastawki aortalnej u noworodka

Aortic stenosis is a congenital heart disease which may present with different symptomatology and may lead to heart failure in newborn. A case of a 9-days old newborn with a severe aortic stenosis is presented. Due to impaired systolic function of the left ventricle and rapidly increasing symptoms of heart failure (tachypnea, dyspnoea, tachycardia) the neonate required pharmacological treatment (prostaglandin E1 infusion and phosphodiesterase inhibitor c-AMP) and balloon valvuloplasty as a matter of urgency. In chest X-ray the heart silhouette was enlarged, the electrocardiogram showed signs of overload of both ventricles. In echocardiography thickened aortic valves with a pin-hole opening, normal left ventricle size with signs of its hypertrophy and reduced contractility (ejection fraction 45%) and a moderate mitral regurgitation were found. Angiography and balloon valvuloplasty of the aortic valve was performed through puncture of the right femoral artery. After expansion of the balloon at the stenotic valve a very good result of the treatment was achieved – low invasive gradient (22 mm Hg) between the left ventricle and the aorta and a trivial aortic valve regurgitation. The good outcome of the procedure was confirmed and monitored in the next days. The general state of the child improved significantly, systolic function of the left ventricle returned to normal values. Because of a complication after the procedure – a thrombosis in the external iliac artery, a 3-month anti-clotting therapy was performed. No improvement in the patency of the vessel was observed; however, abundant collateral vessels provided the extremity with proper circulation.

Tonsillektomia w populacji pediatrycznej – główne wskazania, aktualne wytyczne Amerykańskiej Akademii Otolaryngologów Chirurgów Głowy i Szyi

In February 2019 American Academy of Otolaryngology-Head and Neck Surgery published clinical practice guidelines which provides evidence-based recommendations that applies to children under consideration for tonsillectomy. This update to the 2011 publication includes large amount of new, practical information about pre-, intra- and postoperative care and management, that can be useful for surgeons as well as GPs and pediatricians