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To assess the nutritional status and incidence of feeding difficulties in Polish children up to 2 years of age with cow's milk allergy (CMA) on cow's milk proteins‐free diet. A cross‐sectional, multi‐center study included children aged 6 months to 2 years with confirmed or suspected (without oral food challenge) diagnosis of CMA on the elimination diet for at least 1 month. The primary outcomes were an assessment of proportion of children with impaired nutritional status (with the weight for length and body mass index (BMI) z‐score > 1 and <−1), and feeding difficulties according to the Montreal Children's Hospital Feeding Scale. Children with confirmed and suspected CMA were assessed separately. A 144 children with confirmed CMA and 88 with suspected CMA were included (57 and 78% with multiple food allergies, respectively). Among children with confirmed CMA, one‐third (35.5%) of participants had any nutritional status impairment regardless of definition. Among those, most of children had mild malnutrition (10.4 vs. 9%) and possible risk of overweight (11.1 vs. 9.7%; following respectively BMI for age and weight for length z‐scores). Only 16.0% of children had feeding difficulties. Feeding difficulties was identified to be a risk factor for moderate malnutrition compared to children without feeding difficulties (odds ratio 10, 95% confidence interval: 4−27). Mild malnutrition and possible risk of overweight are concern in children up to 2 years of age on cow's milk proteins‐free diet. Feeding difficulties are less common, however, may affect the nutritional status. Poor growth in children with food allergy was found in several studies.Early elimination diet may lead to development of feeding difficulties.Data on prevalence of impaired nutritional status and feeding difficulties in children with cow's milk allergy (CMA) are limited. Poor growth in children with food allergy was found in several studies. Early elimination diet may lead to development of feeding difficulties. Data on prevalence of impaired nutritional status and feeding difficulties in children with cow's milk allergy (CMA) are limited. Both malnutrition and possible risk of overweight are concern in Polish children up to 2 years of age on cow's milk‐free diet.Feeding difficulties are not so common, however, there was found an association between impaired nutritional status and feeding difficulties.Nutritional status should be addressed in monitoring of children with CMA. Both malnutrition and possible risk of overweight are concern in Polish children up to 2 years of age on cow's milk‐free diet. Feeding difficulties are not so common, however, there was found an association between impaired nutritional status and feeding difficulties. Nutritional status should be addressed in monitoring of children with CMA.

The virulence patterns observed in viruses transmitted by Varroa destructorimplied a potential association of these honey bee pests in Poland with the Korean haplotype. Nevertheless, it is noteworthy that this hypothesis lacked direct verification. Therefore, the aim of the study was to determine the haplotype affiliation of V. destructormites infesting bees in Poland and Ukraine. Adult females were collected from drone brood from honey bee colonies maintained in the apiary at the University of Life Sciences in Lublin, Poland, and the apiary in Synevyr National Park in Ukraine. The haplotype affiliation was determined through the sequencing of the cytochrome oxidase subunit I gene (CO I; 929 bp) fragment. Based on the phylogenetic comparison with 84% bootstrap support, the V. destructorfemales from both locations were confirmed to represent three haplotypes: Korean 1 (AmK1-1), Korean 2 (AmK1-2), and Chinese 4 (AmK1-4). They are the most virulent types of this parasite worldwide and in Poland. Concurrently, the present study confirms that the Synevyr National Park in Ukraine is isolated from alien bee subspecies, but is not free from alien parasites.

The aim of the study was to analyse the intestinal microbiota of honey bees (Apis mellifera) treated with amitraz. In the present study, the microbiological profile of the honey bee intestines showed minor changes in the microbiota following the application of amitraz. A comparison of the numbers of bacteria and fungi revealed a positive downward trend in the number of fungi. The number of decreased bacteria, included E. coliand especially Clostridiumspp., which were not isolated from the intestines of bees treated with amitraz. The number of lactic acid bacteria before and after treatment was at a similar level of 8.3 log cfu/g of intestinal contents.

Nowadays, cell cultures are a standard tool in animal biotechnology, but the problem with honeybees is the constant lack of appropriate cell lines to be used in in vitro research. Until the imperfections of bee tissue cultures are resolved, researchers have to conduct experiments on bees in laboratory cage tests (LCTs).

For more than forty years, laboratory cage tests (LCTs) have been used in honeybee research. These tests facilitate the control of elements of the environment present in the laboratory, which allows the minimization of the impact of the changing environmental conditions and conditions in the bee colony nest on the studied features. Therefore, it is possible to estimate the content of the genetic component of a particular trait and to assess the impact of a specific substance or tested agent on the traits of bees.

Temperatures of worker- and drone-brood rearing in various hive locations were compared in both colonies kept on small-cell combs (4.90 mm) (SMC) and standard-cell combs (5.50 mm) (STC) in two seasons. Temperatures close to the worker-brood comb placed near the rightmost storage-comb were lower than those near the worker brood in the nest centre but equal to those near the outskirt drone-brood comb (34.37-35.24°C) regardless of the month and the comb-cell size. Temperatures of the brood rearing in the SMC did not differ from those in the STC, independently on the location (center-periphery) and the brood type (drone-worker). Occasionally, they were even higher in the STC near the peripheral drone-brood comb and in the nest centre. We concluded that the drones which are involved in colony reproduction could affect its thermoregulation. The peripheral drone brood can be heated just as well as the worker brood, if the colony is strong enough and has the proper drone-worker ratio. Therefore, it is doubtful whether a higher temperature near the worker brood in the SMC limit the development of the V. destructorpopulation. A lower temperature may not be a factor in encouraging V. destructorfemales to prefer trap-drone-combs for reproduction in the SMC. Strong field colonies may be especially prone to such behaviour. Therefore, temperature cannot be considered a mechanism of effective Varroacontrol in SMC.

ObjectiveTo systematically assess the diagnostic accuracy of the Clinical Dehydration Scale (CDS), the WHO Scale and the Gorelick Scale in identifying dehydration in children with acute gastroenteritis (AGE).DesignThree databases, two registers of clinical trials and the reference lists from identified articles were searched for diagnostic accuracy studies in children with AGE. The index tests were the CDS, WHO Scale and Gorelick Scale, and reference standard was the percentage loss of body weight. The main analysed outcomes were the sensitivity, specificity, positive likelihood ratio (LR) and negative LR.ResultsTen studies were included. In high-income countries, the CDS provided a moderate-to-large increase in the post-test probability of predicting moderate to severe (≥6%) dehydration (positive LR 3.9–11.79), but it was of limited value for ruling it out (negative LR 0.55–0.71). In low-income countries, the CDS showed limited value both for ruling in and ruling out moderate-to-severe dehydration. In both settings, the CDS showed poor diagnostic accuracy for ruling in or out no dehydration (<3%) or some dehydration (3%–6%). The WHO Scale showed no or limited value in assessing dehydration in children with diarrhoea. With one exception, the included studies did not confirm the diagnostic accuracy of the Gorelick Scale.ConclusionLimited evidence suggests that the CDS can help in ruling in moderate-to-severe dehydration (≥6%) in high-income settings only. The WHO and Gorelick Scales are not helpful for assessing dehydration in children with AGE.

The aim of the study was to evaluate the effectiveness and safety of 2 different polyethylene glycol (PEG) doses for the maintenance treatment of functional constipation in children.

The aim of the study was to evaluate the effectiveness and safety of 2 different polyethylene glycol (PEG) doses for the maintenance treatment of functional constipation in children. Children with functional constipation according to the Rome III criteria were randomly assigned to receive PEG 4000 at a dose of either 0.7 g/kg (high-dose group; n = 45) or 0.3 g/kg (low-dose group; n = 47) for 6 weeks. Adjustment of the therapy was recommended in the event of <3 bowel movements (BM) per week or =3 BM per day. The primary outcome measure was treatment success, defined as =3 BM per week with no fecal soiling during the last week of the intervention. A total of 90 of 92 randomized children, with a mean age of 3.7 ± 2.1 years, completed the study. In the analysis based on allocated treatment, treatment success was similar in both groups (relative risk 0.9, 95% confidence interval 0.78–1.03). Compared with the high-dose PEG group, the low-dose PEG group had an increased need for therapy adjustment of borderline significance (relative risk 2.0, 95% confidence interval 1.0–4.2), an increased risk of painful defecation, a lower number of stools per week, and lower parental satisfaction. Adverse events were similar in both groups. To achieve treatment success, both tested doses of PEG were equally safe and effective in the treatment of children with functional constipation.

Many protocols of bowel preparation are available for use in children; however, none of them is commonly accepted. The aim of the study was to evaluate the efficacy and acceptability of high-volume polyethylene glycol (PEG) versus low-volume PEG combined with bisacodyl (BPEG) versus sennosides for colonoscopy preparation in children.

Many protocols of bowel preparation are available for use in children; however, none of them is commonly accepted. The aim of the study was to evaluate the efficacy and acceptability of high-volume polyethylene glycol (PEG) versus low-volume PEG combined with bisacodyl (BPEG) versus sennosides for colonoscopy preparation in children. Participants ages 10 to 18 years were randomly assigned to receive either PEG 60 or PEG 30 mL kg-1day-1plus oral bisacodyl 10 to 15 mg/day or sennosides 2 mg kg-1day-1for 2 days. A blinded assessment of bowel cleansing was made by the endoscopist according to the Aronchick and Ottawa scales. Patient acceptability was evaluated with the visual-analog scale. Analysis was done on an available case analysis basis. Of 240 patients enrolled in the study 234 patients were available for analysis of the efficacy of colon cleansing. There were no significant differences found among the 3 groups for the proportions of participants with excellent/good (PEG: 35/79, BPEG: 26/79, sennosides 25/76) and poor/inadequate (PEG: 20/79, BPEG: 28/79, sennosides 28/76) bowel preparation evaluated with the Aronchick scale and for the mean Ottawa total score (PEG: 5.47 ± 3.63, BPEG: 6.22 ± 3.3, sennosides: 6.18 ± 3.53). Acceptability of bowel cleansing protocol was similar in all of the groups (P= 0.8). All 3 cleansing methods showed similar efficacy and tolerability; however, none of them was satisfactory.

Objective: To systematically evaluate the effects of n-3 long-chain polyunsaturated fatty acids (n-3 LCPUFA) supplementation of pregnant and/or lactating women on the neurodevelopment and visual function of their children.Methods: Systematic review. Randomized controlled trials (RCTs) comparing n-3 LCPUFA maternal supplementation were identified through electronic databases (MEDLINE, EMBASE, the Cochrane Library) and the references of reviewed articles.Results: Overall, 13 publications, some with important methodological limitations, were included. With regard to supplementation during pregnancy, among 3 RCTs that evaluated this intervention, 1 RCT (n  =  72) showed significantly better eye and hand coordination assessed with the Griffiths Mental Development Scales at 30 months of age. Another RCT (n  =  29) demonstrated an effect of n-3 LCPUFA supplementation on the cloth step of intentional solutions of the 2-step problem-solving test. No other effects were demonstrated. There was no consistent effect of n-3 LCPUFA supplementation during pregnancy on the children's visual acuity. With regard to supplementation during lactation, among 3 RCTs that assessed this intervention, 1 RCT (n  =  133) showed significant improvement on the Bayley Psychomotor Development Index in 30-month-old children; however, there was no influence of such supplementation on the results of different tests performed in the same group of children or in others. There was no consistent effect of n-3 LCPUFA supplementation during lactation on the children's visual function. Supplementation during pregnancy and lactation (3 RCTs) did not affect child neurodevelopment assessed up to 7 years of age.Conclusion: Evidence from RCTs does not demonstrate a clear and consistent benefit of n-3 LCPUFA supplementation during pregnancy and/or lactation on child neurodevelopment and visual acuity. These results should be interpreted with caution due to methodological limitations of the included studies.

Porównanie skuteczności środków miejscowo znieczulających skórę w redukcji bólu podczas planowanego pobierania krwi u dzieci.

Uncertainty exists regarding the treatment of patients with nonalcoholic fatty liver disease (NAFLD) who are unable to lose weight and/or change lifestyle. The present study assesses the effectiveness and safety of pharmacological and dietary supplement interventions for NAFLD.

Uncertainty exists regarding the treatment of patients with nonalcoholic fatty liver disease (NAFLD) who are unable to lose weight and/or change lifestyle. The present study assesses the effectiveness and safety of pharmacological and dietary supplement interventions for NAFLD. MEDLINE, EMBASE, and the Cochrane Library were searched for randomized controlled trials (RCTs) both in adults and in children. Fifteen (2 pediatric patients and 13 adults) RCTs met the inclusion criteria. A significant effect on normalization of alanine transaminase was found in patients treated with metformin compared with vitamin E, and in those treated with high-dose (3 g) carnitine vs diet. In contrast, there was no difference in patients treated with pioglitazone combined with vitamin E versus vitamin E alone, ursodeoxycholic acid (UDCA) combined with vitamin E or alone versus placebo, or UDCA versus combination of vitamin E and vitamin C, and in patients treated with vitamin E, probucol, N-acetylcysteine, low doses of carnitine, or Yo Jyo Shi Ko compared with placebo. Aspartate aminotransferase normalization was significantly higher in those treated with UDCA combined with vitamin E versus UDCA alone or placebo, and in those treated with metformin. Small number of subjects, high drop-out rates, and numerous interventions in 1 study limit the value of many studies. Only 7 RCTs analyzed biopsy specimens, but most of them have significant methodological limitations. Pioglitazone had reduced liver necrosis and inflammation in 1 large study. Limited data do not allow one to draw firm conclusions on the efficacy of various treatments for NAFLD.