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.

[A role of hemodialysis in the treatment of acute renal failure in children less than 5 years of age]. / Rola hemodializy w leczeniu ostrej niewydolnosci nerek u dzieci ponizej 5 roku zycia.

Mortality in acute renal failure (ARF) still exceeds 50%. However, while the outcome data for ARF in adults are readily available, similar data for pediatric population are scarce. Children survival rate varies between centres, particularly in regard to age and size of a child, and cause of ARF. Dialysis continues to be a major supportive intervention in severe acute renal failure. There are few data available that address treatment modality impact on ARF outcome. The youngest patients are usually treated with peritoneal dialysis, though sometimes hemodialysis is used even in children with very low birth body weight. We reviewed a 9-year experience with hemodialysis in children under 5 years of age. 33 children (13 boys, 10 girls) were treated with hemodialysis in the analysed period. Their mean age was 26.8 +/- 23.0 years, mean body weight 10.6 +/- 4.6 kg. Cardiac surgery and haemolytic-uremic syndrome were the major causes of ARF in the studied group. Dialysis duration, ultrafiltration rate, maximum blood flow, mortality and its risk factors were analysed. 232 dialyses were conducted in the studied group, mean 6 dialyses per patient. Mean dialysis time was 85 +/- 42 min for the first and 135 +/- 38 min for consecutive procedures. Urea reduction rates in the first and following dialyses were 50% and 58% respectively. Maximum blood flow was 7.4 ml/kg/min, i.e. higher than recommended. However, no adverse events were caused by that. Mortality rate was 38%. Hemodialysis may be used in small children, when indicated, with no higher death rate than standard peritoneal dialysis.

[An incidence and etiology of Tenckhoff catheter in patients treated with CAPD]. / Czestosc wystepowania i etiologia zapalen ujscia zewnetrznego cewnika Tenckhoffa u chorych leczonych metoda dializy otrzewnowej.

Continuous ambulatory peritoneal dialysis (CAPD) is a renal replacement therapy of choice in small children, the elderly, diabetics, subjects with cardiovascular disease and with difficulties in vascular access. Frequent complication of this method is the infection of the Tenckhoff catheter exit site, definition of which has not been firmly established yet. The aim of this study was to assess the frequency of catheter exit infections, its bacterial etiology and the efficacy of antibiotic treatment. The study material consisted of 21 subjects (11 female, 10 male) treated with CAPD in 1992-99 at our department, mean age 19.8 +/- 11.8 yrs, with mean CAPD treatment time 33 +/- 27 months. They were divided into two groups: group I--patients aged > or = 5 yrs, and group II--patients aged 15 yrs. Mean catheter usage time was 15.8 +/- 14.9 months. 43 cases of catheter exit site infection was diagnosed (0.7 case of infection per patient per year). Infection frequency was found to be 1 case in 9.4 months and 1 in 26.5 months, in group I and II, respectively (p < 0.001). Catheter usage in two groups was 10.4 +/- 8.2 and 21.4 +/- 15.4 months, respectively (p < 0.01). The most frequent pathogen was S. aureus (31 cases), with 5 cases of MRSA strains found. Antibiotic treatment was applied according to Keane's recommendations and it lasted 13.2% of CAPD treatment duration. In conclusion, catheter exit site infection occurred more often in children under the age of 5 yrs, and the catheter usage time was significantly shorter in this group of patients.