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Aim Methods Results Conclusion The purpose of this study was to evaluate irisin, myonectin and high‐sensitivity interleukin‐6 (hs IL‐6) levels in obese children and adolescents and to determine the association of these parameters with metabolic dysfunction–associated steatotic liver disease (MASLD) in children.Sixty‐one overweight/obese children with suspected liver disease and seventeen healthy controls were included in the study. MASLD was diagnosed according to the latest consensus. Circulating irisin, myonectin and hs IL‐6 were measured by enzyme‐linked immunosorbent assay (ELISA).The study group included 38 children meeting MASLD criteria and 23 children without diagnosed hepatic steatosis. The concentrations of the analysed myokines were comparable in the MASLD and non‐MASLD groups. Patients with MASLD were further divided according to the severity of hepatic steatosis. Significantly higher levels of alanine aminotransferase (ALT), aspartate aminotransferase (AST), gamma glutamyltransferase, uric acid and irisin were observed in patients with severe hepatic steatosis compared to mild hepatic steatosis. There were borderline statistically significant positive correlations of irisin with ALT and AST.We revealed that elevated irisin levels were associated with the degree of hepatic steatosis in MASLD. We also found a borderline significant positive association of irisin with liver enzymes. [ABSTRACT FROM AUTHOR]

Aim of the study: The new term "metabolic dysfunction associated steatotic liver disease" (MASLD) focuses on the bidirectional interplay between fatty liver and metabolic dysregulation. The aim of this study was to evaluate serum concentrations of uric acid (UA) in overweight/obese children and adolescents and to determine the association of this parameter with MASLD and metabolic dysregulation. Material and methods: One hundred and ninety-four overweight/obese children with suspected liver disease were included in the study. MASLD was diagnosed according to the latest consensus. Diagnosis of metabolic syndrome (MetS) was based on the International Diabetes Federation criteria in children aged ≥ 10 years (n = 182). Results: MASLD was diagnosed in 68.56% and MetS in 26.92% of patients. Children with MASLD had significantly higher values of alanine aminotransferase (ALT), aspartate aminotransferase (AST), γ-glutamyltransferase (GGT), total cholesterol, triglycerides (TG), UA and carotid intima-media thickness (IMT). Significantly higher levels of insulin, homeostasis model assessment of insulin resistance (HOMA-IR) and UA were observed in patients with MetS. Correlations were observed between UA and ALT, AST, GGT, TG, insulin, HOMA-IR, mean IMT, body mass index (BMI) and high-density lipoprotein cholesterol (HDL-C) in overweight and obese children. UA was helpful in differentiating between children with MetS and without MetS (p = 0.0003), while only borderline statistical significance was observed for MASLD (p = 0.05). Conclusions: Our results suggest that UA may be a potential additional and readily available marker of metabolic dysfunction in children with MASLD. Further studies on a larger group of patients are needed to confirm this association. [ABSTRACT FROM AUTHOR]

Chemical prestressing was developed during the 1960s; however, and due to technical difficulties at that time, the technology was not considered as an alternative to conventional prestressing; instead, it was only used as a shrinkage compensating method. Still, recent development in concrete technology encouraged several researchers to revisit this technology, where significant achievements were made. This paper aims to present a state‐of‐the‐art review about the recent development in the chemical prestressing technology. This includes reviewing existing field applications, existing types of expansive additives, influence of different expansive additives, influence of curing methods, mix proportioning, mechanical properties, and structural behavior. Furthermore, a thorough discussion was performed and suggestions were made for future researchers to help further contribute to the development of this prestressing technology. It was concluded that although the chemical prestressing technology seems very promising, more research is required before using it in practical applications. [ABSTRACT FROM AUTHOR]

Aim of the study: Metabolic-associated fatty liver disease (MAFLD) requires close monitoring due to its increased incidence and progression to fibrosis, cirrhosis and even hepatocellular carcinoma. The search for non-invasive markers to diagnose liver fibrosis is ongoing. The aim of our study was to evaluate the serum levels of growth differentiation factor-15 (GDF-15), thrombospondin-2 (TSP2), pentraxin 3 (PTX3) and angiopoietin-like protein 8 (ANGPTL8) in children with MAFLD. Material and methods: Fifty-six overweight/obese children with suspected liver disease were included in this prospective study. MAFLD was diagnosed according to the latest consensus. Vibration-controlled transient elastography (TE) was performed to detect clinically significant liver fibrosis. Serum concentrations of GDF-15, TSP2, PTX3 and ANGPTL8 were measured by enzyme-linked immunosorbent assay (ELISA). Results: Liver steatosis was diagnosed in abdominal ultrasound in 31 (55.36%) overweight/obese patients who were classified as the MAFLD group. Aspartate aminotransferase (AST)/platelet ratio (APRI) and liver stiffness measurement (LSM) values and TSP2 concentrations showed significantly higher values in patients in MAFLD than in the non-MAFLD group. TSP2 was significantly positively correlated with alanine transaminase (ALT), AST, g-glutamyltransferase (GGT) and APRI in the study group. The receiver operating characteristics (ROC) analysis showed that the area under the curve (AUC) of LSM, APRI and serum TSP2 was significant for predicting MAFLD in obese children. In the multivariable regression model, LSM was the only significant parameter associated with the diagnosis of MAFLD in children. Conclusions: TSP2 may be a potential biomarker of hepatocyte injury in pediatric patients with MAFLD. None of the examined biomarkers were found to be effective non-invasive markers of liver fibrosis in children. [ABSTRACT FROM AUTHOR]

Introduction: The incidence of eosinophilic esophagitis (EoE) is rapidly increasing in both children and adults. However, despite extensive research, data on disease pathogenesis and useful markers for predicting treatment response are still lacking. The aim of the study was to analyze matrix metalloproteinase-1 (MMP-1) and tissue inhibitor of metalloproteinase-1 (TIMP-1) expression in the esophagus of pediatric patients with EoE. Material and methods: This single-center study included newly diagnosed children with EoE based on endoscopic and histopathological results, children with esophageal eosinophilia (EE) not meeting the EoE criteria and healthy controls. Immunohistochemistry for MMP-1 and TIMP-1 was performed. Results: Among the 30 children whose biopsy specimens were evaluated, 10 patients were diagnosed with EoE, 10 patients with EE and 10 were healthy controls. Weak expression of MMP-1 in esophageal samples was observed in half or more cases in each group. However, strong MMP-1 expression was noted in half of EoE patients before treatment with a decrease in number of cases after treatment. Interestingly, lack of TIMP-1 expression was noted in all EoE patients, in contrast to EE samples, or control cases. Children with strong MMP-1 expression at the time of EoE diagnosis appeared to respond less well to proton pump inhibitors (PPIs) either alone or in combination with an elimination diet. There were no differences in MMP-1 expression with PPI monotherapy as opposed to combination therapy. Conclusions: Our data revealed that children with EoE did not express TIMP-1 in esophageal tissue, unlike EE and healthy controls. More intense expression of MMP-1 at diagnosis was associated with a poor response to treatment. [ABSTRACT FROM AUTHOR]

The coexistence of inflammatory bowel disease (IBD) with pancreatic pathology is rare in children. A retrospective analysis of data from 1538 children diagnosed with IBD in 2014–2021 was conducted to determine the frequency and causes of pancreatitis and asymptomatic hyperlipasemia (HL) or hyperamylasemia (HA) in this group of patients. Among the 176 children (11.4%) with pancreatic involvement (PI), acute pancreatitis (AP) was diagnosed in 77 children (43.8%), and HA or HL was observed in 88 children (50.0%). Only a few patients were diagnosed with autoimmune or chronic pancreatitis (6.2%). PI was observed at the time of the IBD diagnosis in 26.1% of the cases. A total of 54.5% of the patients had moderate to severe IBD, and 96% had colonic involvement at the time of diagnosis of PI. Idiopathic PI was the most common (57%), followed by drug-induced PI (37%) and azathioprine (AZA). In patients with AZA-induced AP, the successful introduction of 6-mercaptopurine (6-MP) to therapy was noted in 62.5% of the children. Our results suggest that routine monitoring of pancreatic enzymes in patients with IBD should be performed, especially after the initiation of the AZA treatment. The presence of transient HA/HL in IBD does not necessarily indicate pancreatic pathology. [ABSTRACT FROM AUTHOR]

The article describes measurements of strains of concrete, steel and textile reinforcement with distributed fiber optic sensors (DFOS). The technology of distributed strain measurements gains currently increasing attention within the civil engineering field and indeed the DFOS can be applied in various measurement scenarios providing results and insights which were not possible before. Within this article, the fibers and adhesives that are most commonly used are compared and several measurement scenarios and their results are described, including precise strain measurements with high resolution as well as measurements on large‐scale specimens. Concrete strains were measured in a multiaxial compression stress state and also during setting and hardening and in flexural tests. Strains of the steel and textile reinforcement were monitored along the bond zone and also in flexural tests. Finally, cracking patterns were observed and compared with digital image correlation methods. Validated examples of applications of DFOS in laboratory work are described. [ABSTRACT FROM AUTHOR]

The incidence of gallstone disease has increased in recent years. The pathogenesis of cholelithiasis is not fully understood. The occurrence of the disease is influenced by both genetic and environmental factors. This article reviews the literature on cholelithiasis in children, with the exception of articles on hematological causes of cholelithiasis and cholelithiasis surgery. The aim of this review is to present the latest research on the pathogenesis of gallstone disease in children. The paper discusses the influence of all factors known so far, such as genetic predisposition, age, infections, medications used, parenteral nutrition, and comorbidities, on the development of gallstone disease. The course of cholelithiasis in the pediatric population is complex, ranging from asymptomatic to life-threatening. Understanding the course of the disease and predisposing factors can result in a faster diagnosis of the disease and administration of appropriate treatment. [ABSTRACT FROM AUTHOR]

(1) Background: Disturbances in the sphingolipid profile are observed in many diseases. There are currently no data available on the evaluation of sphingolipids and ceramides in cholelithiasis in children. The aim of this study was to evaluate the concentrations of sphingolipids in the sera of pediatric patients with gallstones. We determined their relationship with anthropometric and biochemical parameters. (2) Methods: The concentrations of sphingolipids in serum samples were evaluated using a quantitative method, ultra-high-performance liquid chromatography–tandem mass spectrometry. (3) Results: The prospective study included 48 children and adolescents diagnosed with gallstones and 38 controls. Serum concentrations of total cholesterol (TC); sphinganine (SPA); ceramides—C14:0-Cer, C16:0-Cer, C18:1-Cer, C18:0-Cer, C20:0-Cer and C24:1-Cer; and lactosylceramides—C16:0-LacCer, C18:0-LacCer, C18:1-LacCer, C24:0-LacCer and C24:1-LacCer differed significantly between patients with cholelithiasis and without cholelithiasis. After adjusting for age, gender, obesity and TC and TG levels, we found the best differentiating sphingolipids for cholelithiasis in the form of decreased SPA, C14:0-Cer, C16:0-Cer, C24:1-LacCer and C24:0-LacCer concentration and increased C20:0-Cer, C24:1-Cer, C16:0-LacCer and C18:1-LacCer. The highest area under the curve (AUC), specificity and sensitivity were determined for C16:0-Cer with cholelithiasis diagnosis. (4) Conclusions: Our results suggest that serum sphingolipids may be potential biomarkers in pediatric patients with cholelithiasis. [ABSTRACT FROM AUTHOR]

Introduction: With the increasing prevalence of liver steatosis, non-invasive methods are sought to detect it and to assess the degree of lipid accumulation in the liver. The aim of this preliminary study was to assess the serum concentrations of stanniocalcin-2 (STC-2), pregnancy-associated plasma protein A (PAPP-A) and insulin-like growth factor binding protein (IGFBP-4) among children with obesity, check if they detect liver steatosis and determine whether they differentiate mild and advanced steatosis. Material and methods: This prospective study involved 62 obese children (39 boys and 23 girls, median age 13.75 years). Infectious, autoimmune, metabolic and toxic liver conditions were excluded. All subjects underwent body composition analysis, anthropometric measurements, abdominal ultrasound and routine blood chemistry analyses. STC-2, PAPPA and IGFBP-4 were measured using ELISA kits. The control group consisted of 19 non-obese, healthy children with correct body mass index and without organic pathologies. Results: The concentration of examined biomarkers in obese children with liver steatosis was significantly higher than in the control group and STC-2 was also significantly higher in children with advanced steatosis in comparison to children with mild steatosis. In the group of obese children with liver steatosis STC-2 positively correlated with: gamma-glutamyltransferase, cholesterol, triglycerides, low-density lipoprotein cholesterol, homeostatic model assessment-insulin resistance and waist-hip ratio. The ability of serum STC-2 to detect advanced liver steatosis was significant (AUC = 0.746, p = 0.0022, cut-off 135.27 pg/ml). Conclusions: This preliminary study demonstrated that STC-2 can be regarded as a potential non-invasive marker of advanced liver steatosis in obese children. The other analyzed parameters (PAPP-A and IGFBP-4) seem not to be useful in diagnosis of liver steatosis in obese children. [ABSTRACT FROM AUTHOR]

Distributed strain measurements of prestressed concrete elements with fibre optic sensors The article presents the application of the technology of distributed strain measurements to prestressed concrete members. Distributed fibre optic sensing technology is based on light backscattering and enables strain measurements with high spatial resolution over the entire length of the optical fibre. Such an approach allows the replacement of thousands of conventional spot strain gauges, arranged in series, with a single optical fibre. The article presents composite fibre optic sensors and their application for strain measurements and crack development investigations. Three practical examples of prestressed concrete elements were described, namely truck scale platforms, prestressed concrete girders with a length of 24 meters, and one of the largest bridges in Poland. The structural members were analysed at different stages of construction, during fabrication and hardening, tendon activation, installation, proof loading, and also as a post‐installed measurement system. The aim of this article was to demonstrate the possibilities of measurements with composite distributed fibre optic sensors. [ABSTRACT FROM AUTHOR]

Introduction: An increase in the incidence of eosinophilic oesophagitis (EoE) in children is being observed worldwide. The diagnosis is confirmed by the morphological examination of the mucosa biopsies. The aim of our study was to evaluate the clinical course of EoE in the first year of diagnosis, and the effectiveness of the first-line treatment of EoE in children. Material and methods: This single-centre retrospective study included children with EoE newly diagnosed between January 2015 and December 2020. Patients were monitored after initial treatment and 12 months after diagnosis. The study assessed clinical, endoscopic, and histological responses to various therapeutic strategies. Results: Of the 27 children diagnosed with EoE, 19 were enrolled in the study. The median age of children with EoE was 9 years (range 2-17 years) and the majority were male (84.2%). The most frequent initial treatments were proton pump inhibitors (PPIs) (47.4%), also in combination with an elimination diet (36.8%). Clinical improvement was noted in 73.7% of cases after initial therapy and in 84.2% of patients after 12-month follow-up. However, endoscopic and histological improvement was observed less frequently, in 52.6% and 47.4% of patients, respectively. Forty-two per cent of children with EoE obtained clinical, endoscopic, and histological improvement, and the majority of them received PPIs in mono- or combination therapy with an elimination diet. Conclusions: Choosing an effective treatment that provides clinical, endoscopic, and histological improvement in patients with EoE is a challenge for clinicians. According to our observations, clinical improvement should not be a single indicator of treatment success; therefore, it is necessary to repeat upper endoscopy and oesophageal biopsy. [ABSTRACT FROM AUTHOR]

Background: Alcohol consumption by adolescents is responsible for a number of adverse health and social outcomes. Despite the well-established effect of alcohol use on the development of alcoholic liver disease, the relationship between the pattern of alcohol consumption and liver fibrosis is still unclear. This study is a follow-up to work on liver damage from alcohol intoxication. The aim of our study was to explore the early effects of alcohol intoxication on liver fibrosis in adolescents. Methods: The prospective study included 57 adolescents aged 14–17 years admitted to the emergency department (ED) from February 2017 to June 2018 due to acute alcohol intoxication. Serum levels of amino terminal propeptide of type III procollagen (PIIINP), type IV collagen, matrix metallopeptidase 9 (MMP-9) and tissue inhibitor of metalloproteinase 1 (TIMP-1) were determined by enzyme-linked immunosorbent assays. Results: There were significant differences in MMP-9 (p = 0.02) and TIMP-1 (p = 0.007) levels between the study and control groups. Liver parameters and selected markers of fibrosis were similar in groups in terms of blood alcohol concentrations (BAC). MMP-9 was positively correlated with alanine aminotransferase (ALT) (r = 0.38; p = 0.004) and total bilirubin (r = 0.39; p = 0.004). Positive significant correlations were also found between TIMP-1 and ALT (r = 0.47; p < 0.001), AST (r = 0.29; p = 0.03) and total bilirubin (r = 0.32; p = 0.02). In receiver operating characteristic (ROC) analysis, MMP-9 (AUC = 0.67, p = 0.02) and TIMP-1 (AUC = 0.69, p = 0.003) allowed for the differentiation of patients with and without alcohol intoxication. Conclusion: Our results show that even a single episode of alcohol intoxication in adolescents can lead to imbalance in markers of fibrosis. [ABSTRACT FROM AUTHOR]

The spectrum of liver involvement during coronavirus disease 2019 (COVID-19) is broad and mainly includes elevated liver enzymes and cholestasis. severe acute respiratory syndrome corona-virus-2 (SARS-CoV-2) infection most often leads to a transient moderate increase in liver enzymes that is not accompanied by disturbances in the synthetic function of the liver. However, there is increasing evidence that SARS-CoV-2 infection is associated with the development of autoimmune disorders. the pathogenesis of autoimmune hepatobiliary diseases is not fully understood, taking into account genetic and environmental factors such as viral infections. we present a pediatric case of autoimmune sclerosing cholangitis (ASC), which was diagnosed 2 months after SARS-CoV-2 infection. To the best of our knowledge, ASC potentially triggered by CoVid-19 has not been reported in pediatric patients. Further studies are needed to describe the clinical impact of the development of autoimmune liver diseases potentially associated with SARS-CoV-2 infection in pediatric patients. Our observations indicate that children with liver injury potentially caused by COVID-19 require long-term monitoring of liver function parameters. [ABSTRACT FROM AUTHOR]

Extraintestinal manifestations (EIMs) are observed in 15–20% of patients with inflammatory bowel disease (IBD). One of the rare EIMs is myocarditis, the incidence of which is estimated at around 1%. The main cause of myocarditis is a viral infection. Other causes include autoimmune diseases and drug complications (sulfasalazine, mesalazine). We present the case of an 11-year-old girl with Crohn's disease (CD) with EIMs, manifested as hip joint inflammation and erythema nodosum. At the same time, the symptoms of myopericarditis appeared with changes in electrocardiogram (ECG), echocardiography and high troponin I concentration. Therapy with corticosteroids resulted in the resolution of skin lesions and cardiological symptoms. Systemic connective tissue diseases, viral and bacterial infections were excluded in the differential diagnosis. The suspicion of mesalazine-induced EIMs was also ruled out as the symptoms resolved despite continued therapy with mesalazine. No further recurrences of myopericarditis were observed. [ABSTRACT FROM AUTHOR]

Adipose tissue is the main source of adipokines and therefore serves not only as a storage organ, but also has an endocrine effect. Chemerin, produced mainly in adipocytes and liver, is a natural ligand for chemokine-like receptor 1 (CMKLR1), G-protein-coupled receptor 1 (GPR1) and C-C motif chemokine receptor-like 2 (CCRL2), which have been identified in many tissues and organs. The role of this protein is an active area of research, and recent analyses suggest that chemerin contributes to angiogenesis, adipogenesis, glucose homeostasis and energy metabolism. Many studies confirm that this molecule is associated with obesity in both children and adults. We conducted a systematic review of data from published studies evaluating chemerin in children with various disease entities. We searched PubMed to identify eligible studies published prior to February 2022. A total of 36 studies were selected for analysis after a detailed investigation, which was intended to leave only the research studies. Moreover, chemerin seems to play an important role in the development of cardiovascular and digestive diseases. The purpose of this review was to describe the latest advances in knowledge of the role of chemerin in the pathogenesis of various diseases from studies in pediatric patients. The mechanisms underlying the function of chemerin in various diseases in children are still being investigated, and growing evidence suggests that this adipokine may be a potential prognostic biomarker for a wide range of diseases. [ABSTRACT FROM AUTHOR]

Background and Aim: Adipokines and hepatokines are proteins secreted by adipose tissue and the liver. To date, the levels of adipokines and hepatokines in cholelithiasis have only been evaluated in studies in adult patients. The purpose of our research was to assess the levels of circulating adipokines: chemerin, vaspin, progranulin, retinol-binding protein 4 (RBP-4) and hepatokine: fibroblast growth factor 21 (FGF-21) and to compare their concentrations in paediatric patients with and without cholelithiasis.Methods: The prospective study included 54 children and adolescents diagnosed with gallstones and 26 controls. Fasting serum levels of adipokines and hepatokine were determined by enzyme-linked immunosorbent assays.Results: The serum levels of chemerin, FGF-21 and RBP-4 were significantly higher in children and adolescents with gallstones compared to the control group. Elevated levels of triglycerides, RBP-4, and a homeostatic model for assessing insulin resistance (HOMA-IR) were observed in overweight or obese patients compared to patients with normal weight and cholelithiasis. Chemerin concentrations were increased in the normal-weight children and adolescents with cholelithiasis compared to the control group. Children and adolescents with gallstones and abnormal weight had significantly higher levels of chemerin, FGF-21 and RBP-4 than healthy controls.Conclusion: Elevated serum chemerin levels were significantly higher in non-obese patients with cholelithiasis than in non-obese controls, suggesting a potential role of chemerin in the development of cholelithiasis in children and adolescents. [ABSTRACT FROM AUTHOR]

Flexural and bond behaviour of chemically prestressed concrete elements with textile reinforcement Chemical prestressing is a method of introducing stresses into concrete with the use of expansive admixtures instead of mechanical devices. The paper presents an approach to chemical prestressing of thin textile reinforced concrete elements. Measurements of free and restraint expansion are described, as well as experimental investigations regarding flexural and bond behaviour of thin specimens with carbon textile grids. Results of four‐point bending tests on slab members and of bond tests are presented. It was confirmed that the use of expansive concrete influences the behaviour of textile reinforced concrete specimens. The cracking load can be increased with increasing amount of expansive admixture, as well as the deflection at first cracking. Similarly, higher maximal bond stresses are achieved for specimens made of expansive concrete that of control mixture. The results are evaluated and an overview is provided. [ABSTRACT FROM AUTHOR]

Eosinophilic esophagitis (EoE) is a chronic, local immune-mediated esophageal disease with eosinophil-dominated inflammation. The incidence of the disease is rapidly increasing in both children and adults. The pathogenesis of the disease is still not well understood. We present a review of the literature devoted to the EoE immunopathology, in particular the markers of inflammation and epithelial integrity, and their usefulness in disease monitoring and therapy. We performed a systematic search of the MEDLINE/PubMed databases for studies to examine the use of immunohistochemistry as a diagnostic tool for EoE. The gold standard of EoE diagnosis requires multiple endoscopies with biopsies for histological assessment. The minimum number of eosinophils evaluated in hematoxylin-eosin staining to diagnose EoE is 15 per high-power field in at least one esophageal mucosa biopsy. However, in some cases, the count of eosinophils is not specific and insufficient as the only indicator. Recent works confirm the usefulness of assessment of some biomarkers in establishing the diagnosis and monitoring the treatment effects. Immunohistochemistry seems to be a promising option not only in clinical recognition, but also in the selection and monitoring of treatment effects. However, these methods have not yet recommended for routine clinical use. [ABSTRACT FROM AUTHOR]

Inflammatory bowel disease (IBD) diagnosis and therapy is challenging for every pediatrician, especially when complicated with extraintestinal manifestations. The article reviews current literature on the hepatobiliary manifestations associated with inflammatory bowel disease in the pediatric population. [ABSTRACT FROM AUTHOR]

The technology of prestressing concrete structures has been a well‐established field in structural engineering since the last century. Nowadays, new materials developed for reinforcing concrete structures, such as fibre‐reinforced polymers (FRPs), open further possibilities for engineers. FRP tendons are more and more often investigated as an efficient and suitable material for prestressing, and there are already some field applications of this technology. This paper aims to describe the current state of knowledge in the field of prestressing with FRP tendons, with regard to available materials, developed anchorages and undertaken investigations. Researches conducted in areas such as bond strength, ductility, durability, long‐term behavior, and high‐temperature resistance are described and summarized. Our goal was to provide a summary of what has been achieved so far in the research field of prestressing concrete structures with FRP tendons; however, field applications and standardization issues are not part of this review. [ABSTRACT FROM AUTHOR]

Neutropenia, congenital or acquired, is related to impaired granulocyte production in the bone marrow or increased destruction by antibodies. Autoimmune neutropenia of infancy (AIN) is associated with the occurrence of antineutrophil antibodies. AIN is the most common cause of neutropenia in infants and young children. However, its incidence is low. Detection of anti-neutrophil antibodies is an important step in confirming the diagnosis of AIN, although their detection is difficult due to low titer and poor avidity. In differential diagnosis, another cause of neutropenia should be considered, such as a drug-induced mechanism, viral infection, autoimmune and metabolic disease, hematological conditions or immune deficiency syndromes. Despite the benign course of AIN, serious infectious complications can occur. Spontaneous remission of neutropenia was observed in 95% of patients during 24 months of follow-up. We present a case of a 10-month-old boy with deafness, heart defect and Morgagni-Larrey hernia diagnosed in our department because of formation of a skin abscess due to autoimmune neutropenia. [ABSTRACT FROM AUTHOR]

Background: Underage drinking is associated with health risk behaviors. Serum keratin-18 (CK18) levels are increased in liver diseases and may be biomarkers of outcome. The purpose of this study was to determine if the total CK18 (M65) or caspase-cleaved CK18 (M30) levels were different in adolescents admitted to hospital because of alcohol intoxication and controls with excluded liver diseases. Methods: A prospective study included 57 adolescents after alcohol use and 23 control subjects. The concentrations of M30 and M65 in the serum samples were evaluated using an enzyme-linked immunosorbent assay. Results: The median age was 15 (14–17) years and 49% were male. There were significant differences in M65 levels between the study and control groups (p = 0.03). The concentrations of M30 and M65 were insignificant in adolescents divided into subgroups according to blood alcohol concentrations (BAC). Significant positive correlations were found between BAC and M65 levels (p = 0.038; r = 0.3). In receiver operating characteristic (ROC) analysis M65 (cut-off = 125.966 IU/l, Se = 70.2%, Sp = 43.5%) allowed to differentiate between patients with and without alcohol intoxication (AUC = 0.66, p = 0.03). Conclusion: M65 appears to be a promising non-invasive biomarker of hepatocyte injury during alcohol intoxication in adolescents. Moreover, a higher concentration of M65 may indicate early organ injury before the increase in the activity of liver enzymes, alanine aminotransferase (ALT) and aspartate aminotransferase (AST). [ABSTRACT FROM AUTHOR]

Background: An increase in the incidence of eosinophilic esophagitis worldwide is being observed in children. The aim of the study was to analyze the incidence, clinical manifestations, biochemical markers and endoscopic features of children with eosinophilic esophagitis in comparison to patients with non-eosinophilic esophagitis. Methods: This single-center retrospective study included newly diagnosed children with eosinophilic (EoE) and non-eosinophilic (non-EoE) esophagitis based on endoscopic and histopathological results between January 2013 and December 2018. Result: Among 433 of enrolled children with esophagitis, 36 (8.31%) were diagnosed with EoE (median age of 10 years). Male predominance and an increased percentage of allergy cases in the EoE group were noticed. Dysphagia was the only symptom that significantly differentiated both groups (p = 0.006). Endoscopic findings with relevant relationships with EoE included linear fissuring, decreased vascular pattern, trachealization and whitish exudates. No significant difference in the prevalence of other reported diseases between groups was observed. Conclusion: The results of EoE analysis in children from North-Eastern Poland did not differ from reports from other countries. The reported symptoms were not specific for EoE, and only dysphagia and some endoscopic lesions were helpful to differentiate children with EoE from non-EoE. [ABSTRACT FROM AUTHOR]

Background and Objectives: Inflammatory bowel disease (IBD) is a chronic condition and mainly affects the intestines, however, the involvement of the other organs of the gastrointestinal tract (upper part, pancreas, and liver) have been observed. The coexistence of IBD with pancreatic pathology is rare, however, it has been diagnosed more frequently during recent years in the pediatric population. This article reviews the current literature on the most common pancreatic diseases associated with IBD in the pediatric population and their relationship with IBD activity and treatment. Materials and Methods: We performed a systematic review of data from published studies on pancreatic disorders, also reported as extraintestinal manifestations (EIMs), among children with IBD. We searched PubMed and Web of Science to identify eligible studies published prior to 25 April 2020. Results: Forty-four papers were chosen for analysis after a detailed inspection, which aimed to keep only the research studies (case control studies and cohort studies) or case reports on children and only those which were written in English. The manifestations of IBD-associated pancreatic disorders range from asymptomatic increase in pancreatic enzymes activity to severe disease such as acute pancreatitis. Acute pancreatitis (AP) induced by drugs, mainly thiopurine, seems to be the most- often-reported pancreatic disease associated with IBD in children. AP associated with other than drug etiologies, and chronic pancreatitis (CP), are rarely observed in the course of pediatric IBD. The pancreatic involvement can be strictly related to the activity of IBD and can also precede the diagnosis of IBD in some pediatric patients. The course of AP is mild in most cases and may occasionally lead to the development of CP, mainly in cases with a genetic predisposition. Conclusions: The involvement of the pancreas in the course of IBD may be considered as an EIM or a separate co-morbid disease, but it can also be a side effect of IBD therapy, therefore a differential diagnosis should always be performed. As the number of IBD incidences with concomitant pancreatic diseases is constantly increasing in the pediatric population, it is important to include pancreatic enzymes level measurement in the workup of IBD.