Pediatria i Medycyna Rodzinna-Paediatrics and Family Medicine最新文献

{"title":"SARS-CoV-2 infection, hormonal contraception and pulmonary embolism in a 17-year-old female patient","authors":"A. Szydłowski, J. Kusa, Krzysztof Kocot, K. Gruszczyńska, A. Skierska, Z. Olczak, E. Moric-Janiszewska, A. Szydłowska","doi":"10.15557/pimr.2022.0028","DOIUrl":"https://doi.org/10.15557/pimr.2022.0028","url":null,"abstract":"The paper presents the history of a 17-year-old patient admitted to the paediatric cardiology department in a life-threatening condition with dyspnoea, blood desaturation up to 90% and chest pain. The patient contracted COVID-19 (she was not vaccinated), and additionally treated her acne with oestrogen hormonal drugs. Computed tomography of the chest revealed massive embolic changes in the pulmonary artery and its branches. After introduction of heparin under the control of activated partial thromboplastin time and then warfarin under the control of international normalised ratio (INR), regression of changes was achieved; however, the arterial vessel narrowed up to the upper lobe of the right lung. During cardiac catheterisation, the vessel was widened with a balloon and successfully opened. Follow-up echocardiography showed regression of changes, the dimensions of the right heart decreased, and the features of pulmonary hypertension disappeared. During the exercise test, she reached stage 4. After 2 months, to avoid patient exposure to radiation, follow-up magnetic resonance imaging of pulmonary vessels was performed instead of computed tomography, showing partial restoration of the artery. Currently, the patient is still taking warfarin (INR 2.5–3.5), is in good general condition and a lung scan is planned in the future.","PeriodicalId":42380,"journal":{"name":"Pediatria i Medycyna Rodzinna-Paediatrics and Family Medicine","volume":" ","pages":""},"PeriodicalIF":3.6,"publicationDate":"2022-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47534850","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Rational phytotherapy as an alternative treatment for acute respiratory tract infections","authors":"D. Zwolińska","doi":"10.15557/pimr.2022.0020","DOIUrl":"https://doi.org/10.15557/pimr.2022.0020","url":null,"abstract":"Acute respiratory tract infections in children are the most common reason for primary care appointments. Although the vast majority of cases are viral, antibiotic therapy, which involves more risks than benefits in these patients, is still overused, contributing to antibiotic resistance and adverse effects. Almost all recommendations indicate avoiding such approach and use symptomatic treatment supplemented with plant-based formulations instead. There is abundance of different medicinal plants that contain compounds with proven antiviral, antioxidant and immunomodulatory properties, which effectively support the combat against respiratory infections, especially if combined in one product (synergism). Contemporary rational phytotherapy assumes a scientific approach to plant-derived formulations, and it should be emphasised that the registration of herbal medicines is subject to the same restrictions as in the case of synthetic drugs. The paper discusses the composition and activity of compounds contained in medicinal plants and their role in the treatment of respiratory tract infections, with main focus on Pelargonium sidoides and elderberry, the properties of which have so far been the most thoroughly investigated and described. Their efficacy and safety in different forms of respiratory tract infections were discussed, showing that the use of products based on these plants significantly reduces disease duration and severity of clinical symptoms, as well as the need to use other agents, including antibiotics. The reasons for the use of Pelargonium sidoides preparations in the prevention and treatment of COVID-19 were also presented.","PeriodicalId":42380,"journal":{"name":"Pediatria i Medycyna Rodzinna-Paediatrics and Family Medicine","volume":" ","pages":""},"PeriodicalIF":3.6,"publicationDate":"2022-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44094495","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Difficulties in the surgical treatment of patients with cystinuria – a case report","authors":"B. Jurkiewicz, J. Samotyjek","doi":"10.15557/pimr.2022.0024","DOIUrl":"https://doi.org/10.15557/pimr.2022.0024","url":null,"abstract":"Cystinuria is an autosomal recessive disorder. Two genes responsible for cystinuria have been identified: SLC3A1 (chromosome 2p21) and SL7A9 (chromosome 19q12). Their mutations cause high clinical variability in the course of the disorder. Over the past 10 years, an increase in the prevalence of cystinuria has been observed, which is now approximately 1:7,000 newborns. Similarly to cystic fibrosis, it is one of the most common diseases with this pattern of inheritance. Its clinical picture usually includes active stone formation (at least twice a year) and short periods of remission. Cystinuria relatively quickly leads to chronic renal failure. Patients with this disorder require constant supervision as well as monitoring of treatment outcomes. This paper presents a case of a 17-year-old boy diagnosed with cystinuria at the age of 3 months, when first bilateral pelvicalyceal stones were found on ultrasound. Immediately after the diagnosis, fluid supply was increased, treatment with captopril and a mixture of citrates (Shohl’s solution) was initiated, which in later years was switched to potassium citrate/tiopronin. The implemented conservative treatment and constant nephrological care failed to prevent relapses in the patient. The boy underwent a total of 40 surgical interventions, including minimally invasive endoscopic procedures (extracorporeal lithotripsy, percutaneous nephrolithotripsy, ureteroscopic lithotripsy, retrograde intrarenal surgery) and three open surgeries to completely remove kidney stones.","PeriodicalId":42380,"journal":{"name":"Pediatria i Medycyna Rodzinna-Paediatrics and Family Medicine","volume":" ","pages":""},"PeriodicalIF":3.6,"publicationDate":"2022-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43147713","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Coenzyme Q10 – a literature review on supplementation in chronic disorders and the anti-aging process","authors":"Paulina Kostrzewska, Amanda Mandera, Krystian Nagi, A. Pawlikowska, Ewa Szuster","doi":"10.15557/pimr.2022.0019","DOIUrl":"https://doi.org/10.15557/pimr.2022.0019","url":null,"abstract":"Introduction: The continuous growth and aging of the population poses enormous challenges in maintaining the health of the entire world’s population, which is forecasted to exceed 9 billion by 2050. Diseases of the XXI century can be prevented by reducing risk factors and appropriate prophylaxis, which also includes supplementation. Aim: The aim of the study was to summarise data on the effects of coenzyme Q10 on the course of chronic diseases and the aging process. Materials and methods: PubMed and Google Scholar databases were searched. Most of the articles published after 2012 were reviewed. Brief description of the state of knowledge: Decreased levels of coenzyme Q10 and increased levels of oxidative stress have been found in the course of multiple chronic diseases. It seems logical that coenzyme Q10 supplementation improves mitochondrial function and provides antioxidant protection to organs and tissues affected by various pathophysiological conditions. In addition to significantly improving cardiovascular and neurological functions, coenzyme Q10 has also found a wide application in delaying skin aging processes. Conclusions: Coenzyme Q10 is the third most commonly used dietary supplement in the world. The efficacy of coenzyme Q10 in selected groups of patients has been confirmed in clinical trials. More research and clinical trials are needed with more participants undergoing longer-term supplementation to assess the benefits of coenzyme Q10.","PeriodicalId":42380,"journal":{"name":"Pediatria i Medycyna Rodzinna-Paediatrics and Family Medicine","volume":" ","pages":""},"PeriodicalIF":3.6,"publicationDate":"2022-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48343186","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Eosinophilic gastrointestinal disorders in childhood","authors":"Anna Chudoba","doi":"10.15557/pimr.2022.0016","DOIUrl":"https://doi.org/10.15557/pimr.2022.0016","url":null,"abstract":"Eosinophilic gastrointestinal disorders are a group of chronic inflammatory conditions characterised by the presence of eosinophilic infiltrates in the gastrointestinal wall. These disorders include eosinophilic esophagitis, eosinophilic gastritis, eosinophilic gastroenteritis, eosinophilic enteritis, and eosinophilic colitis. Their incidence is increasing, with eosinophilic esophagitis known to be the most common form. The etiopathogenesis of eosinophilic gastrointestinal disorders is not fully understood, and most likely associated with an abnormal immune response to food and/or inhalant allergen. They are often accompanied by allergies. Clinical symptoms, especially in the youngest children, are non-specific and depend on the gastrointestinal segment involved. These are most often feeding difficulties and regurgitation in infants, and heartburn, chest pain, dysphagia and food bite impaction in adolescents and adults. Except for eosinophilic esophagitis, there are no uniform diagnostic or therapeutic guidelines for eosinophilic gastrointestinal disorders. Diagnosis is challenging and it is based on the coexistence of clinical, endoscopic and histopathological symptoms and the exclusion of secondary causes of gastrointestinal eosinophilic infiltration. Treatment involves the use of proton pump inhibitors, an elimination diet, or glucocorticoid therapy. Endoscopic or surgical treatment may be necessary in some cases. Clinical remission does not correlate with histopathological remission, therefore monitoring of therapeutic effects requires multiple endoscopies with histopathological assessment of specimens. The aim of this paper was to present the current data on the incidence, diagnosis and treatment of eosinophilic gastrointestinal diseases in children.","PeriodicalId":42380,"journal":{"name":"Pediatria i Medycyna Rodzinna-Paediatrics and Family Medicine","volume":" ","pages":""},"PeriodicalIF":3.6,"publicationDate":"2022-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47977256","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Molar incisor hypomineralisation – aetiological factors and clinical manifestation","authors":"Danuta Ilczuk-Rypuła, Anna Dybek, Wojciech Terlecki, Sylwia Bulanda, D. Pietraszewska, L. Postek-Stefańska","doi":"10.15557/pimr.2022.0021","DOIUrl":"https://doi.org/10.15557/pimr.2022.0021","url":null,"abstract":"Molar incisor hypomineralisation is described as enamel hypomineralisation of systemic origin involving the first permanent molars. It is also often associated with damage to permanent incisors, which undoubtedly have an important function during developmental age. It is estimated that permanent incisors are involved in approximately 30% of patients with molar incisor hypomineralisation. Early diagnosis of molar incisor hypomineralisation, implementation of appropriate treatment and knowledge of the factors that may contribute to this disorder can reduce the risk of loss of the affected teeth. The aetiology of the disorder has not been fully established. Many studies have shown correlations between molar incisor hypomineralisation and a particular aetiological factor. Research is underway to narrow down this area of consideration, as the aetiology identified to date is very extensive and multifactorial. Both genetic, epigenetic and environmental factors influence the onset of molar incisor hypomineralisation. In the large latter group, a particular role in the aetiology of the disorder is attributed to maternal viral infections during pregnancy, as well as chronic maternal diseases such as hypertension or diabetes, maternal use of certain medications during pregnancy, perinatal complications and diseases of early childhood. Many studies indicate that genetic factors and endocrine disturbances are the most important predisposing factors for molar incisor hypomineralisation. This paper discusses the diagnostic challenges and the most likely aetiological factors of molar incisor hypomineralisation investigated to date.","PeriodicalId":42380,"journal":{"name":"Pediatria i Medycyna Rodzinna-Paediatrics and Family Medicine","volume":" ","pages":""},"PeriodicalIF":3.6,"publicationDate":"2022-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45610844","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Peculiarities of changes in the cardiovascular system in the course of sepsis in newborns","authors":"N. Kretsu, O. Koloskova, T. Bilous","doi":"10.15557/pimr.2022.0023","DOIUrl":"https://doi.org/10.15557/pimr.2022.0023","url":null,"abstract":"The issues of early diagnostics of cardiovascular disorders in neonates with sepsis using up-to-date methods of examination are relevant today and will remain so in the future. They can be used as screening methods with the purpose to verify the possible development of cardiovascular dysfunction. Aim of the study: The study aimed to investigate the peculiarities of possible changes in the cardiovascular system and physiological electrical heart activity in neonates with signs of generalised infectious-inflammatory process, and to assess possible diagnostic methods and use of electrocardiography to verify cardiovascular disorders in newborns with neonatal sepsis. Materials and methods: To achieve the study objective, we followed up a total of 69 neonates with signs of generalised infectious-inflammatory process. Group I (32 patients – 46.4%) included neonates with a term of gestation of 37–42 weeks, and group II included 37 preterm neonates (53.6%) with a term of gestation under 36 weeks inclusive. Results: Generalised infectious-inflammatory process during the neonatal period of term infants is accompanied by electrocardiographic signs of left ventricular overload associated with the female sex (r = 0.30), delivery by cesarean section (r = 0.27), and assessment of neonatal condition by a 5-minute Apgar score (r = −0.33). The study demonstrates that increased values of lactate dehydrogenase activity in the blood plasma both in the term and preterm neonates are associated with left ventricular overload among the former, and the right ventricular overload among the latter, that is, preterm neonates. Conclusions: Increased values of lactate dehydrogenase activity in the blood serum of both term and preterm neonates are associated with left ventricular overload in term neonates, while right ventricular overload in preterm infants thus can be considered as a marker of cardiovascular dysfunction caused by neonatal sepsis, especially in the subpopulation of term patients considering its diagnostic value. Changes found in electrophysiological heart activity promote the necessity of routine use of electrocardiography in neonates with signs of the septic process.","PeriodicalId":42380,"journal":{"name":"Pediatria i Medycyna Rodzinna-Paediatrics and Family Medicine","volume":" ","pages":""},"PeriodicalIF":3.6,"publicationDate":"2022-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41672536","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Chronic anaemia in children as a manifestation of gastrointestinal disorders","authors":"Milena Wronecka, E. Pac-Kożuchowska, A. Mroczkowska-Juchkiewicz, Jakub Wronecki","doi":"10.15557/pimr.2022.0015","DOIUrl":"https://doi.org/10.15557/pimr.2022.0015","url":null,"abstract":"Anaemia is a common problem encountered by paediatricians and general practitioners in the paediatric population. If left untreated, it can lead to serious health consequences, slower development and cognitive impairment. Therefore, it is extremely important to identify its cause and implement appropriate treatment. Since iron deficiency is the most common cause of anaemia, oral iron supplementation at appropriate doses should be used as a first step. However, anaemia may be secondary and often the only symptom of pathological processes in the body. It very often accompanies gastrointestinal diseases, which cause impaired absorption of hematopoietic elements, blood loss through the gastrointestinal tract and dysregulation of iron metabolism accompanying chronic diseases. Therefore, anaemia unresponsive to oral iron treatment should prompt diagnosis for gastrointestinal diseases most common in the paediatric population. Specialised investigations should target the suspected clinical entity, enabling its diagnosis. A correct diagnosis allows for optimal treatment of the underlying disease and, as a result, resolution of the pathology triggering anaemia. However, it takes a long time to regain normal intestinal mucosal function, therefore it is often necessary to additionally include intravenous iron infusions and, in selected cases, packed red blood cell transfusions to rapidly normalise red cell system parameters.","PeriodicalId":42380,"journal":{"name":"Pediatria i Medycyna Rodzinna-Paediatrics and Family Medicine","volume":" ","pages":""},"PeriodicalIF":3.6,"publicationDate":"2022-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48899850","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Non-standard therapeutic methods for severe bronchopulmonary dysplasia in a premature newborn – case report","authors":"Dominika Paw, M. Sokołowska, Ewa Głuszczak-Idziakowska, Marta Walentowska-Janowicz, J. Schreiber-Zamora, B. Kociszewska-Najman","doi":"10.15557/pimr.2022.0026","DOIUrl":"https://doi.org/10.15557/pimr.2022.0026","url":null,"abstract":"Bronchopulmonary dysplasia is a lung disease that is the most common complication of prematurity and the most common chronic lung disease in neonates treated with mechanical ventilation and/or oxygen therapy. Children with bronchopulmonary dysplasia are at risk of cardiovascular complications, such as pulmonary arterial hypertension and left ventricular hypertrophy. The presented case concerns a premature infant born at 24 weeks gestation with severe bronchopulmonary dysplasia complicated by pulmonary arterial hypertension, interstitial emphysema and emphysema. The patient was subject to non-standard therapeutic procedures including L-citrulline, which may have a beneficial effect on the treatment of complications of severe bronchopulmonary dysplasia. Despite proper treatment, it is not always possible to avoid severe complications of bronchopulmonary dysplasia. Currently, available therapies are not always fully effective and it is necessary to continue searching and implementing new treatments to lower the risk of infant death and minimise long-term complications.","PeriodicalId":42380,"journal":{"name":"Pediatria i Medycyna Rodzinna-Paediatrics and Family Medicine","volume":" ","pages":""},"PeriodicalIF":3.6,"publicationDate":"2022-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43025605","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A rare case of complex ventricular arrhythmia and heart failure in a 15.5-year-old athlete","authors":"A. Szydłowska, K. Gruszczyńska, Z. Olczak, E. Moric-Janiszewska, A. Szydłowski","doi":"10.15557/pimr.2022.0027","DOIUrl":"https://doi.org/10.15557/pimr.2022.0027","url":null,"abstract":"A 15.5-year-old boy, an athlete, reported to his general practitioner due to episodes of chest pain during exercise, weakness and a feeling of irregular heartbeat that had been occurring for a month. He reported episodes of fainting in the past. Physical examination revealed arrhythmia and the patient was referred for a cardiological consultation, and then admitted to a reference cardiology department for extended cardiac diagnosis. Approximately 66,000/day (49.8%) of premature ventricular beats were recorded in 24-hour Holter electrocardiogram, including episodes of non-sustained ventricular tachycardia. Echocardiography revealed left ventricular systolic dysfunction with a decrease in its ejection fraction to 51.5%. Magnetic resonance imaging of the heart was performed, which showed foci of late post-contrast enhancement, located subepicardialy in the side wall of the left ventricle, corresponding to post-inflammatory changes in the myocardium. Left and right ventricular ejection fraction on magnetic resonance imaging were 48% and 46%, respectively. Pharmacological treatment included a beta-blocker (metoprolol), propafenone and an angiotensin converting enzyme inhibitor (enalapril). During the treatment, ventricular arrhythmia subsided almost completely, a gradual improvement in left ventricular systolic function was observed, and the patient was relieved of pain. The boy was discharged home with a recommendation to continue pharmacological treatment, lead a sparing lifestyle, and postpone practicing sports. At present, the boy’s general condition is good, he does not report any complaints, takes medications regularly, and does sports only for recreation. A follow-up Holter showed only single premature ventricular beats, while echocardiography showed an improved left ventricular systolic function (ejection fraction 63%), which is a good prognostic indicator.","PeriodicalId":42380,"journal":{"name":"Pediatria i Medycyna Rodzinna-Paediatrics and Family Medicine","volume":" ","pages":""},"PeriodicalIF":3.6,"publicationDate":"2022-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48755006","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}