Frequency of common CYP3A5 gene variants in healthy Polish newborn infants

Cytochrome P450 monooxygenases catalyze the metabolism of approximately 40-60 % of widely used drugs with a A6986G CYP3A5 polymorphism determining expresser (A6986, *1) and reduced- expresser (*3) variants with modified drug metabolism activity. In this report, the allele frequency of CYP3A5 *1 and *3 (A6986 or G6986, respectively) was analyzed by the PCR-RFLP technique in a cohort of 200 Polish newborns from the West Pomeranian region. Of the studied group, 1 % (n = 2/200) proved homozygous for the CYP3A5*1 allele, 89 % (n = 178/200) for the *3 allele, and 10 % (n = 20/200) were heterozygous for *1/*3. Similar frequencies were found in other Caucasian European populations. This study provides basic genetic data related to the metabolism of drugs, with a narrow therapeutic window in a Polish population. Key words: CYP3A5 variants, pharmacogenetics, drug metabolis

Use of botulinum toxin in children with cerebral palsy

Cerebral palsy in children is a syndrome of disorders resulting from damage to the central nervous system in its early development [1]. Damage to the structure of the upper motor neuron during its early development leads to dysfunction of the central motor control system and, consequently, to impairment of the child’s functional development [2,3]. The consequences of damage to the central motor control system include the presence of muscular tension disorders, especially spasticity [4,5]. Botulinum toxin is one of the many pharmacological agents used to reduce spasticity. Botulinum toxin therapy is one of the most effective and currently safest methods for the treatment of spasticity in children [6]

Perinatal factors affecting the gut microbiota — are they preventable?

Intestinal microbiota affects many aspects of physiological processes. The type of microbiota in the early stages of life isa critical element conditioning the development of the immune response and food tolerance. Disturbed colonization ofthe digestive tract resulting from the amount or diversity of bacteria colonies stimulates an inflammatory response thatis associated in later life with inflammatory and autoimmune diseases. One of the elements disturbing normal colonizationin the perinatal period is the operative way of delivery by caesarean section and the administration of antibiotics,used as a prophylactic measure as well as for therapeutic reasons. Based on the current state of knowledge, there is a lotof evidence demonstrating the long-term adverse effects of these modifying agents for gut microbiota, which should bekept to a minimum as far as possible

Infant microbiome and factors determining colonization of the gastrointestinal tract and subsequent health consequences

Microbiome is a key element in maintaining health, forming all saprophytic, commensal and parasitic microorganisms that invade the human body. The development of microbiota begins already in the prenatal period, providing the way for further studies on the influence of the course and duration of pregnancy, delivery mode, feeding, exposure to environmental factors and gestational age. Colonization of the gastrointestinal tract of infants is an important aspect of later health. Probiotics and prebiotics can regulate the composition of bacterial flora of the gastrointestinal tract and thus influence the homeostasis of human body

Neonatal outcomes for women diagnosed with cancer during pregnancy — single-center study

Pregnancy complicated by cancer is one of the most serious challenges of modern perinatology. The increasing number of cancers diagnosed and treated during pregnancy requires a multidisciplinary approach to optimize the treatment of the person who is pregnant and deliver a healthy child. The aim of the study is to analyze the course of the neonatal period in children of mothers suffering from cancer during pregnancy, treated in a specialist hospital for women and children. Being diagnosed with cancer during pregnancy significantly increases the risk of premature delivery, prematurity and intrauterine growth restriction. Our own observations show no significant differences during the neonatal period in children of mothers suffering from a malignant tumor during pregnancy compared to children of healthy mothers. This applies to both full-term and premature babies. Modern treatment of malignant tumors during pregnancy seems to be safe for the fetus and newborn. It is optimal to conduct oncological, obstetric and neonatological treatment in one center. It seems advisable to conduct long-term follow-up observations in children of pregnant people with cancer. Since the described groups of patients and their newborns are small and heterogeneous, in order to develop appropriate standards, it is recommended to report these cases to central registers

The application of orthopedic equipment in the form of orthoses in children suffering from cerebral palsy

Cerebral palsy is a broad term, including various, changing with age movement and postural disorders of cerebral origin [1]. Gait of children suffering from cerebral palsy is characterized by changeability. Observed gait abnormalities are caused by incorrect steering of movements of a child and they are the effects of brain damage and compensation mechanisms. The orthoses should be applied in children suffering from cerebral palsy to protect against deformations of lower limbs. An orthosis prevents the occurrence of articular contractures, probably as a result of inhibition of biomechanical changes in periarticular collagen caused by immobilization [9,10]. Selecting an appropriate orthosis is a key element of the process of treatment of diseases of musculoskeletal system. Orthosis should always be selected individually, depending on the needs and capabilities of a patient. The following orthoses can be distinguished: ankle joint orthoses, dynamic foot orthosis and complex orthoses stabilizing ankle joint, knee joint and hip joint. Selecting an appropriate orthopedic equipment is a very important aspect in complex rehabilitation of children suffering from cerebral palsy

Mode of delivery and other risk factors for Escherichia coli infections in very low birth weight infants

BACKGROUND: Infections in newborns remain one of the most significant problems in modern medicine. Escherichia coli is an important cause of neonatal bloodstream and respiratory tract infections and is associated with high mortality. The aim of our study was to investigate the epidemiology of E. coli infection in Polish neonatal intensive care units (NICUs) and resistance to antibiotics, with particular reference to the safety of very low birth weight infants. METHODS: Continuous prospective infection surveillance was conducted in 2009–2012 in five NICUs, including 1,768 newborns whose birth weight was <1.5 kg. Escherichia coli isolates from different diagnostic specimens including blood, tracheal/bronchial secretions and others were collected. All isolates were tested using disk diffusion antimicrobial susceptibility methods. Pulsed-field gel electrophoresis was used to determine the possible horizontal transfer of E. coli among patients. RESULTS: The incidence of E. coli infections was 5.4% and 2.0/1,000 patient-days. The occurrence of E. coli infections depended significantly on the NICU and varied between 3.9% and 17.9%. Multivariate analysis that took into account the combined effect of demographic data (gender, gestational age and birth weight) and place of birth showed that only the place of hospitalisation had a significant effect on the E. coli infection risk. The highest levels of resistance among all E. coli isolates were observed against ampicillin (88.8%) and amoxicillin/clavulanic acid (62.2%). Among E. coli isolates, 17.7% were classified as multidrug resistant. Escherichia coli isolates showed different pulsotypes and dominant epidemic clones were not detected. CONCLUSIONS: Our data indicate that antibiotic prophylaxis in the presence of symptoms such as chorioamnionitis and premature rupture of membranes did not help reduce the risk of E. coli infection. Multivariate analysis demonstrated only one significant risk factor for E. coli infection among infants with a birth weight <1.5 kg, that is, the impact of the NICU, it means that both neonatal care and care during pregnancy and labour were found to be significant

The most common spinal defects among children and adolescents

Correct posture is a harmonized system of individual parts of the body in relation to each other and in relation to the mechanical axis of the body, maintained at minimum tension of the muscular and nervous systems [1,2,3]. Any postural defect is commonly referred to as a bad posture. According to Wilczyński, these are changes in an upright, free position of the body, which differ significantly from the typical posture of a given gender, age, constitutional structure and race, which are the result of pathological changes and may occur at all body levels [4,5,6]. The most common postural defects associated with the spine include concave, round, round-concave, flat and scoliosis back. Problems that occur in relation to each disease are not only a part of bad posture and do not concern only the spine itself. This is a complex problem and it is necessary to approach the subject holistically and in many directions

The methods of therapy of children suffering from cerebral palsy

Cerebral palsy and methods of therapy that can be applied in the process of rehabilitation of children were described in this article. Cerebral palsy is a motor syndrome caused by permanent damage to the structures of central nervous system in the prenatal, perinatal or postnatal period [1]. Cerebral palsy is a complex therapeutic problem. It is not possible to cure it completely, therefore, the main goal is alleviation of pain to make the child as independent in everyday life as possible [2]. Nowadays, rehabilitation of children suffering from cerebral palsy is based on the methods of neurodevelopmental rehabilitation, which are the most effective and more child-friendly. These methods include, among others, Vojta and NDT-Bobath method. Additional methods that can be applied while supporting the development of children suffering from cerebral palsy are sensory integration method and MEDEK method. If appropriate and comprehensive rehabilitation shall be initiated at early stage in children suffering from cerebral palsy, the chance for achievement of proper mobility in the future will be bigger [3]. The effects of therapy depend on the type of damage, regularity of therapy. Therapeutic program must be selected individually to every child after thorough diagnosis and observation [2,4]