Analiza rodzinnych czynników ryzyka występowania prób samobójczych w grupie dziewcząt w wieku 12-16 lat : badania pilotażowe

Objective: The analysis of family risk factors associated with the occurrence of suicidal attempts and self-mutilation in girls aged 12–16 years old. Material and method: The participants of this study consisted of 34 girls aged 12–16 years old, hospitalized in the Department of Paediatrics of the Medical University (Klinika Pediatrii UM) in Lublin due to suicidal attempts. Fifty-five percent of the participants came from complete families, 20% were brought up by mothers only, 20% declared their parents to be divorced. The majority of the girls (76%) were hospitalized due to medication overdose, 8% due to medication overdose and vein cutting, and 5% due to medication and alcohol overdose. The participants were presented with a complementary metric survey, and guided interviews were carried out with them. Results: A positive relationship between the number of self-mutilation acts and the number of suicidal attempts has been shown. The greatest number of suicidal attempts has been observed in the group of girls whose parents were divorced. Such a relationship has not been observed in the case of self-mutilation acts. A positive correlation has been observed between the feeling of isolation and the number of self-mutilation acts and suicidal attempts. The increase in the number of family rows was indicative of the increase in the number of self-mutilation acts. The feeling of being rejected by the family was positively related to the number of suicidal attempts. Conclusions: Adolescent girls with a tendency towards suicidal behaviours are simultaneously prone to self-destructive behaviours. Parental relationships affect the girls’ functioning, with the risk of suicidal attempts being higher in the group of girls whose parents are divorced. The risk of suicidal attempts and self-mutilation acts increases with the feeling of isolation in teenage girls

The interplay of oxidative stress and immune dysfunction in Hashimoto’s thyroiditis and polycystic ovary syndrome: a comprehensive review

In recent years, there has been a significant increase in the concomitant incidence of Hashimoto’s thyroiditis (HT) and polycystic ovary syndrome (PCOS), both in terms of incidence, etiology, and clinical consequences. PCOS patients suffering from autoimmune thyroid diseases show insulin resistance, impaired glucose tolerance, weight gain, and metabolic and reproductive complications. Studies have shown that chronic stress and its consequence, i.e. oxidative stress, play an important role in the pathomechanism of both disorders. It has also been shown that long-term exposure to stress triggers biological mechanisms, in particular related to the regulation of the inflammatory cascade, which plays a key role in autoimmune diseases. The paper is a review of the literature on the role of chronic stress, oxidative stress, and immune processes in the pathogenesis of HT and PCOS. In addition, the review is a source of knowledge about the treatment of these diseases, and in particular the use of antioxidants in therapeutic management

Intentional poisonings in urban and rural children – a 6-year retrospective single centre study

Introduction Intentional poisonings among children and adolescents are a problem not only for paediatricians, but also constitute a big issue for public health. In many countries worldwide, including Poland, an increase has been observed in suicidal behaviours at developmental age. Objective The aim of the study was a retrospective evaluation of patients hospitalized due to intentional poisoning in the Department of Paediatrics, Children’s University Hospital in Lublin, Poland, in 2007–2012. Material and Methods In the study period, 149 patients were hospitalized in the Paediatric Department of the Children’s University Hospital in Lublin, due to intentional poisoning with medicines or other chemical substances. The study group comprised 135 girls and 14 boys; The majority of patients (n=105) were urban inhabitants, and only 44 lived in the rural areas. Medical records were analyzed, with consideration of medical, psychological and psychiatric examinations. Results Girls constituted as much as 90.6% of the study group. The majority of patients lived in urban areas – 70.46%. A total of 16.77 % of patients came from incomplete families. Alcohol problem occurred in 19 families. The most frequent cause of a suicide attempt was conflict in the family, followed by school problems. During the 6-year-study period, an upward tendency in the incidence of intentional poisoning was observed, particularly in the first 4 years. Discussion and conclusion Suicide attempts in adolescents were mostly undertaken by girls from the urban environment. The majority of those attempts were caused by family problems, including alcoholism

Different clinical picture of coeliac disease in children

Wprowadzenie: Na przestrzeni ostatnich lat obserwuje się wzrost zachorowalności na chorobę trzewną. Coraz częściej pierwsze objawy choroby są niespecyficzne i mogą powodować trudności diagnostyczne. Wczesne rozpoznanie choroby i wprowadzenie diety bezglutenowej poprawia jakość życia pacjentów i zapobiega rozwojowi potencjalnych powikłań. Cel pracy: Celem pracy była analiza manifestacji klinicznych celiakii w wieku rozwojowym oraz określenie specyficznych objawów choroby dla poszczególnych grup wiekowych. Materiał i metody: Materiał stanowiła dokumentacja medyczna pacjentów hospitalizowanych w Klinice Pediatrii Uniwersytetu Medycznego w Lublinie latach 2005–2010, u których po raz pierwszy postawiono rozpoznanie celiakii. Pacjentów podzielono na dwie grupy. Grupę I stanowiły dzieci poniżej 6. roku życia, a grupę II pacjenci powyżej 6. roku życia. W pracy uwzględniono częstość objawów klinicznych w stosunku do wieku i płci pacjentów, choroby współwystępujące oraz wywiad rodzinny w kierunku celiakii. Do obliczeń statystycznych wykorzystano oprogramowanie Statistica 5.0. Wyniki: W latach objętych analizą w Klinice Pediatrii celiakię rozpoznano po raz pierwszy u 13 dzieci w wieku od 2 do 15 lat. Wśród pacjentów z Grupy I najczęstszymi objawami był niedobór masy ciała (83,33%) oraz niedobór wzrostu i wzdęcie brzucha (po 50,00%). W Grupie II najczęstszymi objawami celiakii były anemia mikrocytarna (57,14%), niedobór masy ciała i niedobór wzrostu (po 42,86%), bóle brzucha (28,57%). Różnice w obrazie klinicznym celiakii w zależności od wieku i płci nie były istotne statystycznie (odpowiednio p = 0,55; p = 0,77). Wnioski: Celiakia manifestuje się wieloma objawami, ujawnia się często w sposób nietypowy lub asymptomatyczny. Wykazano różnice w obrazie klinicznym celiakii w poszczególnych grupach wiekowych.Introduction: It has been observed that the coeliac disease (CD) incidence rate has increased in recent years. CD’s first symptoms are uncharacteristic and may hinder an accurate diagnosis. Making an early diagnosis and going on a glutenfree diet improve patients’ quality of life and prevent the development of potential complications. Objective: The aim of this study was to analyse clinical manifestations of coeliac disease during development and to identify specific symptoms of the disease for individual age groups. Materials and methods: The study was based on the medical documentation of inpatients of the Clinic of Paediatrics, Medical University of Lublin, who stayed in the clinic between 2005 and 2010 and who were first diagnosed with coeliac disease. The patients were divided into two groups. Children under six were in group 1 and children over six were in group 2. The study accounted for the incidence rate of clinical symptoms considering the patients’ age and sex, accompanying diseases and a family history aimed at coeliac disease. Statistica 5.0. software was used for statistical analysis. Results: 13 children aged two to 15 were diagnosed with coeliac disease at the Clinic of Paediatrics at the time when the study was conducted. The most common symptoms among patients from group 1 were weight deficiency (83,33 percent), height deficiency and aerenterectasia (50,00 percent each). The most common symptoms among patients from group 2 were microcytic anaemia (57,14 percent), weight deficiency and height deficiency (42,86 percent each), abdominal pain (28,57 percent). Differences in the clinical picture of the disease considering the patients’ age and sex were not statistically significant (p=0, 55; p=0, 77 respectively). Conclusions: Coeliac disease manifests itself with many symptoms, appears in an uncharacteristic or asymptomatic way. It has been proved that there are differences in the clinical picture of the disease among individual age groups

Clinical Significance of Serum Elafin in Children with Inflammatory Bowel Disease

Background: The role of elafin in the pathophysiology of inflammatory bowel disease (IBD) has not been not elucidated. We aimed to evaluate serum elafin in children with IBD and assess its relationship with disease activity. Methods: We enrolled children with IBD in the study group and children with functional abdominal pain in the control group. We evaluated serum elafin using enzyme-linked immunosorbent assay kits. Results: In children with IBD, serum elafin (mean ± SD: 4.192 ± 1.424 ng/mL) was significantly elevated compared with controls (mean ± SD: 3.029 ± 1.366 ng/mL) (p = 0.0005). Elafin was significantly increased in children in the active phase of IBD (mean ± SD: 4.424 ± 1.449 ng/mL) compared with the control group (p = 0.0003). In IBD remission, only children with ulcerative colitis (mean ± SD: 4.054 ± 1.536 ng/mL) had elevated elafin compared with controls (p = 0.004). ROC analysis revealed that the area under the curve (AUC) of serum elafin was 0.809 while discriminating patients with ulcerative colitis from the control group, and the AUC was 0.664 while differentiating patients with Crohn’s disease from the control group. Conclusions: Serum elafin was found to be elevated in our cohort of children with IBD, depending on disease activity. Serum elafin was increased in the active phases of both ulcerative colitis and Crohn’s disease, but only in the remission of ulcerative colitis. Elafin appears to be a potential candidate for a biomarker of ulcerative colitis

Hepatitis associated with parvovirus B19 infection in a 12-year-old-boy. Case report

Parvovirus B19 infection is one of the most common viral diseases manifested with a rash in school children. The vast majority of rare clinical forms of parvovirus B19 infection are associated with hepatitis.We present the case of a 12-year-old boy with parvovirus B19-associated hepatitis.</p

Is It Inflammatory Bowel Disease Flare or Pediatric Inflammatory Multisystem Syndrome Temporally Associated with COVID-19?

Background: Pediatric inflammatory multisystem syndrome temporally associated with COVID-19/multi-system inflammatory syndrome in children (PIMS-TS/MIS-C) is a potentially life-threatening complication of SARS-CoV-2 infection in children. Gastrointestinal manifestations are prominent in children with PIMS-TS/MIS-C. Thus, it is challenging to differentiate this condition from an exacerbation of inflammatory bowel disease (IBD). We aimed to present the clinical characteristics, and diagnostic and therapeutic difficulties in patients with overlapping IBD and PIMS-TS/MIS-C; Methods: We reviewed medical records of children hospitalized due to overlapping IBD and PIMS-TS/MIS-C in a single pediatric hospital from December 2020 to December 2021; Results: There were four children with overlapping IBD flare and PIMS-TS/MIS-C. In three cases, IBD recognition preceded PIMS-TS/MIS-C onset and PIMS-TS/MIS-C occurred during anti-inflammatory therapy of IBD. All children presented with gastrointestinal symptoms at PIMS-TS/MIS-C onset. All patients received IVIG and ASA treatment. In three children there was a need to use steroids to resolve PIMS-TS/MIS-C symptoms. One child was vaccinated against COVID-19; Conclusions: SARS-CoV-2 infection may affect patients with underlying inflammatory conditions such as IBD, inducing systemic symptoms of PIMS-TS/MIS-C, and probably triggering IBD after PIMS-TS/MIS-C. The resemblance of clinical presentations is the main source of diagnostic and therapeutic challenges in PIMS-TS/MIS-C in patients with underlying IBD

Acute Pancreatitis as a Complication of Antiepileptic Treatment: Case Series and Review of the Literature

Acute pancreatitis (AP) appears to be rare disease in childhood. In children, it has a different aetiology and course, and requires different management than in adult patients. The diagnosis of AP is based on at least two of the three criteria, which include typical clinical symptoms, abnormalities in laboratory tests and/or imaging studies of the pancreas. There are many known causes leading to AP in children including infections, blunt abdominal trauma, genetic factors, gallstone disease, metabolic disorders, anatomical defects of the pancreas, systemic diseases, as well as drugs, including antiepileptic drugs, and especially preparations of valproic acid. In our study, we present four cases of young patients diagnosed with acute pancreatitis as a complication of valproic acid therapy and we present a review of the literature. We believe that the activity of pancreatic enzymes should be monitored in children treated with valproate preparations in the case of clinical symptoms suggesting AP

The Impact of Digital Screen Time on Dietary Habits and Physical Activity in Children and Adolescents

Background: Over the last few decades, the time children spend using electronic devices has increased significantly. The aim of the study was to evaluate the impact of screen time on dietary behaviors and physical activity in children and adolescents. Methods: An online survey was conducted among parents of preschool and school-aged children during the COVID-19 lockdown in Poland. There were 3127 surveys used in the analysis. Results: Survey responses referred to 1662 (53%) boys and 1465 (47%) girls, with a mean age of 12.1 ± 3.4 years. During a routine weekday, most children (71%) spent >4 h on educational activities using electronic devices, and 43% of children spent 1–2 h using devices for recreational purposes. The majority of children (89%) were exposed to screens during meals, and ate snacks between main meals (77%). There was an association between screen time and the exposure to screens during meals, and between screen time and time spent performing physical activity. Conclusions: This study revealed that the majority of children were exposed to screens during meals, which is a risk factor of obesity. The promotion of the judicious use of digital devices and healthy dietary habits associated with the use of screens may be an important component of obesity prevention strategies

Exceptional manifestation of polyautoimmunity in a very young girl – a case report

Polyautoimmunity is defined as the presence of more than one autoimmune disease in a single patient. The exact pathogenic mechanisms responsible for the coexistence of distinct autoimmune diseases within an individual have not been clearly explained. We report a case of a very young girl with the extremely rare co-existence of four distinct autoimmune diseases i.e. juvenile idiopathic arthritis, type 1 diabetes mellitus, coeliac disease and autoimmune hepatitis, recognized based on validated international classification criteria. The best to our knowledge there has been no case reporting coexistence of these particular four disorders in an individual. Moreover, all these diseases occurred during first three years of life, which also cause that case unique. Molecular studies of human leukocyte antigen (HLA) class II in our patient showed the presence of the HLA DRB1*01, HLA DRB1*03, HLA DQB1*02, HLA DQB1*05 molecules, which may suggest immunogenetic links between those autoimmune diseases. The presented case highlights the importance of active screening for other autoimmune diseases, if a patient with one autoimmune disease manifests with new or nonspecific symptoms