Pneumocystis Pneumonia: Still a serious disease in children.

Pneumocystis carinii pneumonia is a common opportunistic respiratory infection among children with human immunodeficiency virus and a weakened immune system. The primary infection in immunocompetent patients may be asymptomatic, whereas fever, shortness of breath, night sweats, nonproductive (dry) cough, pneumonia, progressive respiratory distress and apnea are cardinal symptoms of full-blown pneumocystis pneumonia. The diagnosis can be confirmed by histochemical staining of biological specimens or, recently, by polymerase chain reaction. International recommendations indicate that the drug of choice is the intravenously administered trimethoprim-sulfamethoxazole combination. Early diagnosis and appropriate treatment reduce the mortality of the disease. This article briefly highlights the epidemiology of Pneumocystis pneumonia, its diagnosis and therapeutic options in the pediatric population.

Pneumocystis pneumonia: still a serious disease in children.

Pneumocystis carinii pneumonia is a common opportunistic respiratory infection among children with human immunodeficiency virus and a weakened immune system. The primary infection in immunocompetent patients may be asymptomatic, whereas fever, shortness of breath, night sweats, nonproductive (dry) cough, pneumonia, progressive respiratory distress and apnea are cardinal symptoms of full-blown pneumocystis pneumonia. The diagnosis can be confirmed by histochemical staining of biological specimens or, recently, by polymerase chain reaction. International recommendations indicate that the drug of choice is the intravenously administered trimethoprim-sulfamethoxazole combination. Early diagnosis and appropriate treatment reduce the mortality of the disease. This article briefly highlights the epidemiology of Pneumocystis pneumonia, its diagnosis and therapeutic options in the pediatric population.

Is urine intercellular adhesion molecule-1 a marker of renal disorder in children with ureteropelvic junction obstruction?

AIM: We aimed to investigate whether urine intercellular adhesion molecule-1 (ICAM-1) might serve as a marker of renal disorder in children with ureteropelvic junction obstruction. MATERIAL AND METHODS: Twenty-nine children with severe hydronephrosis (HN) were compared with 23 participants with mild HN and with 19 healthy peers. RESULTS: Urine ICAM-1/uCre levels were significantly higher in HN children than healthy controls (P<0.01), and in severe HN when compared with mild HN (p<0.05). CONCLUSIONS: It seemed to us that uICAM-1 is a biomarker of renal disorder, and might have the potential to predict which patients will require surgery.

The effects of breastfeeding on serum asymmetric dimethylarginine levels and body composition in children.

INTRODUCTION: The purpose of this work was to investigate the association of serum asymmetric dimethylarginine (ADMA) and high-sensitivity C-reactive protein (hs-CRP) levels with duration of breastfeeding and body composition in children. PATIENTS AND METHODS: The study group consisted of 88 patients with a median age of 12 months (42 boys, 46 girls), classified as never breastfed or fully breastfed. ADMA and hs-CRP were measured by immunoenzymatic enzyme-linked immunosorbent assay commercial kits. Body composition analysis was performed by bioelectrical impedance. RESULTS: We found significantly higher serum ADMA levels but not serum hs-CRP levels in never breastfed compared with the fully breastfed group (p<0.05). Serum ADMA was inversely associated with high-density lipoprotein-cholesterol levels and breastfeeding duration (p<0.05). Positive correlation was found between ADMA and body fat mass (p<0.05). CONCLUSIONS: In never breastfed children, increased ADMA is observed; however, further studies are needed to assess whether breastfeeding duration affects body fat and body composition at older ages.

Increased circulating inflammatory markers may indicate that formula-fed children are at risk of atherosclerosis.

AIM: The aim of this study was to determine whether formula-fed children have higher serum monocyte chemoattractant protein-1 (MCP-1) and uric acid levels than breast-fed children and to evaluate the association between these inflammatory markers and breastfeeding duration. METHODS: The study group consisted of 87 patients aged between five and 32 months. Participants were divided into breast-fed and formula-fed groups and into age groups of ≤12 months and >12 months. MCP-1 was measured by the commercial immunoenzymatic ELISA kit, and uric acid was assessed using the colorimetric method. RESULTS: Children in the formula-fed group had statistically significant higher serum MCP-1 and uric acid levels than breast-fed children (p < 0.01 and p < 0.05, respectively). Anthropometric parameters were comparable in both groups. Serum MCP-1 and uric acid levels were negatively correlated with duration of breastfeeding (p < 0.01 and p < 0.05). There was a positive relationship between serum MCP-1 and uric acid concentrations (r = 0.27, p < 0.05). CONCLUSION: Increased circulating inflammatory markers may indicate that formula-fed children are at risk of atherosclerosis. However, further studies are needed.

[The role of early-life metabolic programming in the pathogenesis of lifestyle diseases]. / Rola wczesnego programowania metabolicznego w patogenezie chorób cywilizacyjnych.

In recent years, a blooming period of genomics brings a window of opportunity to assess predispositions to some diseases in individuals, even before the first symptoms appear. However, a risk of becoming ill is more complex, as the gene expression is modified by epigenetic and environmental factors. Fetal development and first months of life are periods of dynamic growth and significant sensitivity to external factors. According to the theory of early-life metabolic programming, adaptive changes in these stages have lasting health effects. Among many environmental factors, the youngest children's diet plays an important role. Breastfeeding of newborns and infants is an essential part of lifestyle diseases prevention. Constantly increasing number of reports link natural nutrition of the youngest children with less risk of obesity, hypertension, dyslipidemia and insulin resistance in future life. However, further long-term studies taking into account number of bias factors, explaining protective mechanisms of human milk, are needed.