Prevention and control of childhood asthma and allergy in the EU from the public health point of view: Polish Presidency of the European Union.

The leading priority for the Polish Presidency of the Council of the European Union was to reduce health inequalities across European societies, and, within its framework, prevention and control of respiratory diseases in children. This very important paper contain proposal of international cooperation on the prevention, early detection and monitoring of asthma and allergic diseases in childhood which will be undertaken by the EU member countries as a result of EU conclusion developed during the Polish Presidency of the Council of the European Union. This will result in collaboration in the field of chronic diseases, particularly respiratory diseases, together with the activity of the network of national institutions and NGOs in this area. Paper also contains extensive analysis of the socio-economic, political, epidemiological, technological and medical factors affecting the prevention and control of childhood asthma and allergy presented during Experts presidential conference organized in Warsaw-Ossa 21-22 September 2011.

Schizencephaly as a cause of spastic cerebral palsy.

PURPOSE: The objective was to investigate the clinical features of schizencephaly in children with spastic cerebral palsy. MATERIAL AND METHODS: The present study included 180 children with cerebral palsy, spastic tetraplegia, diplegia, and hemiplegia. All magnetic resonance (MR) scans were obtained using a 1.5 T MR scanner with the use of a standard circularly polarized head coil. RESULTS: Significant abnormalities relevant to cerebral palsy were evident on MRI in 95%. Periventicular leukomalacia was detected more frequently in children with spastic diplegia than in other patients. Cerebral atrophy was found more often in tetraplegic patients. Porencephalic cysts were detected more often in children with spastic hemiplegia. Congenital brain anomalies were evident in 20 (11.1%) children with spastic cerebral palsy. Twelve patients had schizencephaly with cerebral palsy. Children with spastic diplegia and tetraplegia had bilateral schizencephaly; patients with spastic hemiplegia only had unilateral schizencephaly. Most patients with schizencephaly had epilepsy. CONCLUSIONS: Schizencephaly occurred more often in patients with spastic hemiplegia. Early detection of brain abnormalities in children with cerebral palsy may help in the prognosis and in the introduction of appropriate therapy.

Risk factors for cerebral palsy in term birth infants.

PURPOSE: The aim of this study was to identify the antenatal, intrapartum and neonatal risk factors in term birth infants for cerebral palsy (CP) among babies in a hospital-based study. MATERIALS AND METHODS: The medical records of children with cerebral palsy referred to our Pediatric Rehabilitation Department in Bialystok were reviewed. Antenatal, intrapartum, and neonatal events were compared among 213 children with CP and 280 controls in a retrospective study. We studied live births >36 weeks gestation born between January 1, 1990, and December 31, 2005. RESULTS: Fifty-seven percent of the infants with CP were male. Spastic tetraplegia 78 (36.61%) and spastic hemiplegia 65 (30.51%) were the dominant types of CP. Factors associated with an increased risk of CP identified as antenatal and intrapartum risk factors were pre-eclampsia, abruptio placenta, and placenta previa. Birth asphyxia occurred significantly more often (p<0.001) in children with CP compared to controls. In the neonatal period, respiratory distress syndrome, meningitis and neonatal seizures were associated with an increased incidence of CP. CONCLUSION: Our findings confirm that several antenatal, intrapartum and neonatal risk factors for CP in term birth infants contribute to the etiology of CP.

Assessment of risk factors for osteoporosis and fractures in children with meningomyelocele.

PURPOSE: Our objective was to assess bone and muscular mass in children with meningomyelocele (MMC), and to analyze risk factors for osteoporosis and fractures based on densitometric examination. MATERIAL AND METHODS: The study group included 30 patients (15 girls and 15 boys) with MMC, aged 6-17 years, treated in the Department of Pediatric Rehabilitation, University Hospital. Physiotherapeutic assessment and laboratory tests (serum parathormone, alkaline phosphatase levels, calcium, and phosphate levels, and urine calcium levels) were performed. Densitometry was measured by dual energy X-ray absorptiometry using a Lunar DPX-L apparatus. Lean mass (fat-free tissue content) and fat mass (% fat content) was evaluated. RESULTS: Femur fractures were the most common 12/30 (40%); 5/30 (17%) of the children with MMC had multiple fractures. The incidence of fractures correlated significantly with BMI and body fat content (p = 0.03) Children with MMC and fractures had a tendency toward higher BMI, despite the same absolute value of body mass, compared to those without fractures. Body fat levels were higher in MMC patients with fractures than in those without fractures (BMI R = 0.393, p = 0.03). Children with MMC and fractures had significantly higher 24 h calcuria values, despite normal renal function indices (p = 0.03). CONCLUSIONS: Low-energetic fractures in MMC children may result from metabolic disturbances that are a consequence of excessive renal calcium loss or excessive fatty tissue content.

Clinical-electroencephalographic analysis of brain bioelectrical activity in children with myelomeningocele and internal hydrocephalus.

PURPOSE: The aim of the current study was the clinical and electroencephalographic (EEG) analysis of the brain bioelectrical activity in patients with myelomeningocele and internal hydrocephalus. MATERIAL AND METHODS: The present study included 86 children (44 boys and 42 girls) with myelomeningocele. The children were aged 1-17 years (mean 7 +/- 4.4 years). Thoracic myelomeningocele was identified in 24 children (28%), lumbar in 53 (62%) and sacral in 9 cases (10%). RESULTS: The standard EEG examination performed in the waking state revealed generalized changes in 53 patients (62%), including 19 (79%) with thoracic, 28 (53%) with lumbar and 6 (66%) with sacral myelomeningocele. Approximately 70% of the patients underwent ventriculoperitoneal shunting and epilepsy was found in 27 children (31.4%). The prevalence of changes detected in the left temporal region did not differ between the respective myelomeningocele types. No correlations were noted between the degree of spinal cord injury and the changes observed in the left temporal region in EEG recording. Likewise, changes found in the centroparietal region in EEG did not correlate with the site of myelomeningocele. Focal changes in the frontotemporal (p < 0.0067) and right temporal region (p < 0.0314) showed a positive correlation with the degree of spinal cord injury and were most frequent in patients with thoracic myelomeningocele. CONCLUSION: The analysis of EEG might facilitate evaluation and prognosis of epileptic seizures in children with myelomeningocele and internal hydrocephalus.