Search

The number of people suffering from diabetes, including type 1, is constantly increasing both in Poland and worldwide. Type 1 diabetes is a chronic disease characterized by uncertain prognosis and relapses, as well as permanent, irreversible, and progressive changes in health status. The ongoing disease results in dysfunction or disability, and the patient requires specialized supervision, care, and rehabilitation. However, the success of therapy does not depend solely on the perfection of treatment, but also on the patient's readiness to change their lifestyle and cooperate with the therapeutic team. The patient's constant alertness in making therapeutic decisions does not always lead to expected treatment results, and the risk of hypoglycemia associated with intensive insulin treatment depletes the patient's motivation for treatment, leading over time to the development of 'therapeutic burnout' and psychiatric disorders. This narrative review is an attempt to summarize the knowledge and possible future solutions in diabetes type 1 in Poland as well as highlight the importance of comprehensive care, including psychological care, which appears fundamental in a chronic disease such as type 1 diabetes. Therefore, the aim of the study was to present generational changes and psychosocial problems of patients with type 1 diabetes and to identify urgent challenges in diabetic care. Attention should be paid to the deteriorating mental condition of the young generations, who, in the course of diabetes, are exposed to additional psychological and psychiatric health problems. The next generation of patients will require more psychological care, which is why the challenge of the future is to create psychodiabetology centers. [ABSTRACT FROM AUTHOR]

This study reviewed the link between social media and the growing epidemic of childhood obesity in Europe. A task force from the European Academy of Paediatrics and the European Childhood Obesity Group searched published literature and developed a consensus statement. It found that there was evidence of a strong link between obesity levels across European countries and childhood media exposure and that parents and society needed a better understanding of the influence of social media on dietary habits.Conclusion: Health policies in Europe must take account of the range of social media influences that promote the development of childhood obesity. [ABSTRACT FROM AUTHOR]

Around one in ten adolescents suffer from chronic conditions and disabilities, and the transition from paediatric to adult care can be particularly challenging. Unplanned transfers can complicate education, work and health and result in patients being lost to follow-up, poor treatment adherence and more frequent hospitalisation. The Adolescent Health and Medicine Working Group of the European Academy of Paediatrics has developed a consensus statement for a successful transition.Conclusion: This statement will help paediatricians, adult care specialists, policymakers and other stakeholders to handle chronic care transitions so that they meet the expectations and needs of adolescents and their families. [ABSTRACT FROM AUTHOR]

The Bacillus Calmette–Guérin (BCG) vaccine has been in use for over 100 years. It protects against severe, blood-borne forms of tuberculosis. Observations indicate that it also increases immunity against other diseases. The mechanism responsible for this is trained immunity, an increased response of non-specific immune cells in repeated contact with a pathogen, not necessarily of the same species. In the following review, we present the current state of knowledge on the molecular mechanisms responsible for this process. We also seek to identify the challenges facing science in this area and consider the application of this phenomenon in managing the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic. [ABSTRACT FROM AUTHOR]

Background The aim of the study was to determine neurological and neuropsychiatric manifestations in a group of patients with previously undiagnosed or untreated phenylketonuria (PKU) in the south-eastern part of Poland. Methods The study was conducted among 400 adults with severe intellectual disability who were born prior to neonatal screening and who resided in Social Welfare Homes in south-eastern Poland. Participants were aged between 27 and 89 years (mean 51 years). The screening for PKU was performed by blood test using tandem mass spectrometry method (MS/MS) and analysis of organic acids in urine. Among all new identified untreated individuals, neurological symptoms were recorded and neuropsychiatric disturbances were assessed with The Neuropsychiatric Inventory-Nursing Home Version (NPI-NH). Results We found 10 previously undiagnosed and one previously diagnosed but untreated individuals with PKU (four women and seven men). The most commonly exhibited neurological manifestations included the following: profound speech disturbances, balance disturbances, muscular hypertonicity, muscular tremors and seizures. The most frequent behaviours included the following: aberrant/troublesome motor behaviour, agitation/aggression and euphoria/elation. Conclusion Data from the present study indicate that future treatment of these individuals should combine a dietary intervention with individual behavioural therapy and neurorehabilitation to improve general health and quality of life. [ABSTRACT FROM AUTHOR]

Abstract: Objective: The goal of the study was to assess the association between epicardial fat (EF) thickness and waist circumference, insulin resistance and other metabolic syndrome components in obese children. Methods: 52 obese children (23 males and 29 females) in the mean age 11.6±2.87 years were studied. Their mean BMI was 26.17±2.13. Control group included 54 normal weight children (22 males and 32 females) in the mean age 12.85±2.15 years (BMI −18.55±2.71). Obesity was defined according to IOTF criteria. EF thickness on the right ventricle was obtained in all children by two-dimensional M-mode echocardiogram. In obese children systolic (SBP) and diastolic (DBP) blood pressure was measured and fasting serum triglycerides, low- and high-density lipoproteins, cholesterol, and glucose and insulin levels were measured. Metabolic syndrome was determined according to IDF 2007 criteria. Results: We documented a statistically significant correlation between epicardial fat BMI z-score and waist circumference in both groups. No statistically significant correlation between EF thickness and HOMA Index was found. There was also no statistically significant difference in EF thickness between obese children with or without metabolic syndrome. Conclusion: Although EF in overweight children is a good indicator of visceral fat it does not seem to be the independent predictor of metabolic syndrome in this age group. The lack of relationship of EF thickness with insulin resistance and metabolic syndrome suggests that in children the prognostic value of this fat tissue may differ from that in adults. [ABSTRACT FROM AUTHOR]

Objective: To evaluate physical growth, development and nutritional status in adults with previously undiagnosed/ untreated phenylketonuria (PKU). Methods: Four hundred adults (201 females and 199 males) with severe intellectual disability who were born prior to compulsory neonatal screening (before 1976) and who resided in social welfare homes in southeastern Poland were screened for PKU. The screening was performed by blood test using a tandem mass spectrometry method (MS/MS) and was confirmed by analysis of organic acids in urine. Eleven were identified as previously undiagnosed and/or untreated PKU cases. They underwent an assessment of their somatic development/status. Results: Among the 11 PKU patients (4 females and 7 males) the following characteristics were observed: poor physical growth after somatic development (n = 8, 2 females aged 23 and 56 years and 6 males aged 28–59 years); decreased head circumference – microcephaly (n = 5, 1 female aged 56 years and 4 males aged 28–59 years); poor body height (n = 2, 1 female aged 23 years and 1 male aged 59 years); poor thoracic circumference (n = 9, 3 females aged 23–56 years and 6 males aged 28–59 years). Overall, body weight imbalance was noted in 9 (81.8%) patients and irregularity of body proportions in 6 (54.5%) patients. Conclusion: Our data showedthe importance of nutritional surveillance and impact of metabolic imbalance on physical growth and body stature in untreated PKU patients. We therefore recommend an adequate and individually planned introduction of dietary intervention among that group of patients in order to ameliorate its nutritional status, general fitness and health. Copyright © 2009 S. Karger AG, Basel [ABSTRACT FROM AUTHOR]

Objective: Description of the clinical, biochemical and genetic features of a Polish patient with familial glucocorticoid deficiency. Methods: Detailed clinical investigation, hormonal analysis and sequencing of the coding region of the melanocortin 2 receptor (MC2R) gene in this patient. Results: We report on a 3-month-old boy with familial glucocorticoid deficiency who presented at the age of 3 months with skin hyperpigmentation, muscle weakness, mild jaundice and constipation. Hormonal analyses revealed high ACTH and TSH serum concentrations, low serum cortisol concentration along with normal blood electrolytes. On hydrocortisone supplementation, the disease symptoms disappeared and the child recovered completely. His physical and mental development progresses normally. Genetic analysis disclosed a novel compound heterozygous MC2R mutation p.Leu46fs and p.Val49Met. Conclusion: The heterozygous p.Leu46fs mutation adds to the small number of MC2R nonsense mutations and is the first frameshift mutation within the first transmembrane domain of the receptor. According to molecular modeling the Val49Met mutation results in a structural change of the first transmembrane domain and in a potential novel interaction of the transmembrane domains I and VII. Copyright © 2008 S. Karger AG, Basel [ABSTRACT FROM AUTHOR]

The aim of this study was to assess the prevalence of hypertension and to investigate risk factors linked to hypertension in older adults. An observational study was conducted in a group of adults between 60 and 85 years of age, living in south-eastern Poland. In line with the specific inclusion criteria, 80 women and 29 men were enrolled for the study (109 adults). Participants' body weight, height, and body fat percentage (BFP) were assessed using a bioelectrical impedance analysis, blood pressure was measured using automated oscillometric sphygmomanometer, moderate-to-vigorous physical activity (MVPA) and sedentary time were assessed using a tri-axial accelerometer, whereas data related to socio-economic and lifestyle factors were collected using a self-report technique. Arterial hypertension was found at a rate of 16% in participants with normal body weight, 22% in those with overweight and 85% in those with obesity. Body mass index (BMI) and BFP correlated significantly with systolic blood pressure (SBP) and diastolic blood pressure (DBP). The highest median SBP and DBP values were found in the group of participants with obesity, and the lowest values were identified in those with normal body weight. Out of all the investigated socio-economic risk factors linked to hypertension, education level was the only one that showed significant associations. A logistic regression analysis was performed to check which factors were most strongly associated with hypertension in the study group. The stepwise method showed that hypertension was more common in participants with a higher BMI, and BFP and in those who did not meet MVPA recommendation. [ABSTRACT FROM AUTHOR]

The digital environment can pose health risks through exposure to unhealthy content. Yet, little is known about its relation to children's cognitive functioning. This study investigates the association between digital media (DM) exposure and children's cognitive functioning. This cross-sectional study is based on examinations of children aged 8–18 years (N = 8673) of the I.Family cohort (2013–2014). Exposure to television, computer, smartphone and internet was self-reported (hours/day). Media multitasking (MMT) was defined as simultaneous use of computers with other digital or non-screen-based activities. Standard instruments were used to assess cognitive inflexibility (score: 0–39), decision-making ability (− 100 to + 100) and impulsivity (12–48). Adjusted regression coefficients and 99.9%CIs were calculated by generalized linear mixed-effects models. In total, 3261 participants provided data for impulsivity, 3441 for cognitive inflexibility and 4046 for decision-making. Exposure to smartphones and media multitasking were positively associated with impulsivity (βsmartphone = 0.74; 99.9%CI = 0.42–1.07; βMMT = 0.73; 99.9%CI = 0.35–1.12) and cognitive inflexibility (βsmartphone = 0.32; 99.9%CI = -0.02–0.66; βMMT = 0.39; 99.9%CI = 0.01–0.77) while being inversely associated with decision-making ability. Extensive smartphone/internet exposure combined with low computer/medium TV exposure was associated with higher impulsivity and cognitive inflexibility scores, especially in girls. DM exposure is adversely associated with cognitive functioning in children and adolescents. Children require protection against the likely adverse impact of digital environment. [ABSTRACT FROM AUTHOR]

The objective of this article is to review how primary care providers – paediatricians, family practitioners, nurse practitioners - could address the use of substances by adolescents and respond to problematic behaviours and situations. Given the highly addictive properties of nicotine, adolescents should be supported in avoiding any consumption of tobacco or quitting if they already do so. Screening and investigation of substance use is usually not difficult, provided that it is processed in a neutral and empathetic atmosphere and securing confidentiality if the adolescent asks for it. Any type of substance use is potentially linked with adverse events such as injuries, violence, unplanned and unsafe sexual experience, alcoholic coma, 'bad trips' or unpleasant psychological experiences. As such, substance use should be identified and openly discussed with the adolescent. Moderate intermittent recreational use of legal and illegal substances (mainly alcohol and cannabis) should be carefully monitored over time, as it can lead to problematic use. Problematic use and substance use disorder require various interventions, including motivational interviewing, family counselling and psychotherapy, especially when substance use is linked with mental health disorders. Despite the importance of confidential care, parents or caregivers should be involved in problematic situations as much as possible. What is known: • While problematic use of substances is transient amongst many adolescents, it may be a threat to health and school/professional functioning • Primary care providers (PCPs) can address queries or offer preventive interventions to adolescents who use substances What is new: • Some interview tools can assist PCPs efficiently to identify problematic users of substances • There are effective approaches that PCPs can use to address problematic use by adolescent patients [ABSTRACT FROM AUTHOR]

The article discusses the impact of digital food and beverage marketing on the health and well-being of children.

The aim of the study was to assess the relationship between the health behaviours of diocesan priests in Poland and their level of life satisfaction. The specific goal was to determine the factors that most affect their quality of health (internal health control, the influence of others or coincidence) and life satisfaction (positive mental attitude, preventive behaviour, eating habits, health practices). The study involved 250 diocesan priests from the Podkarpackie region who took part in the research by completing an anonymous questionnaire. The questions were mainly based on tools for assessing health behaviours, namely the HBI—health behaviour inventory, MHLC—multidimensional scale of health locus of control and the SWLS—satisfaction with life scale. The general index of health behaviour of clergymen on the HBI scale was 77.12 ± 16.20 (Me = 78), showing a moderate level on the sten scale. On the MHLC health locus of control scale, the respondents believed that their health depended most on internal control: 25.27 ± 5.10 and the influence of others: 23.13 ± 5.57, are of utmost importance for their health. To a lesser extent they believed that health was dependent on chance: 17.60 ± 5.95. The SWLS satisfaction with life index was 22.51 ± 5.43 (Me = 23), also within the moderate range of the sten scale. The factors most closely related to the assessment of life satisfaction were positive mental attitudes and the overall HBI index. The health behaviours of priests measured by the HBI scale and the level of satisfaction with the life of SWLS clergymen are within a moderate range. On the MHLC scale, priests likewise believe that their health depends on themselves and then on others. They are clearly less likely to indicate accidental causes. [ABSTRACT FROM AUTHOR]

The dependency of CO2 reduction rate in acetonitrile-Bu4NClO4 solution on cathodes, which were modified by laser induction of a copper surface, was studied. The topography of laser-induced periodic surface structures (LIPSS) → grooves → spikes was successively formed by a certain number of pulses. It was proved that for a higher number of laser pulses, the surface area of the copper cathode increases and preferred platy orientation of the copper surface on [022] crystallografic direction and larger fluence values increase. At the same time, the content of copper (I) oxide on the surface of the copper cathode increases. Also, the tendency to larger fluency values is observed. It promotes the increase of cathodic current density for CO2 reduction, which reaches values of 14 mA cm-2 for samples with spikes surface structures at E = − 3.0 V upon a stable process. [ABSTRACT FROM AUTHOR]

Measurement or estimation of resting energy expenditure (REE) should be the first step in determining energy demand in physically active boys. The purpose of this study was to develop and validate new equations for resting energy expenditure in male children and adolescents practicing soccer. The cross-sectional studywas carried out among 184 boys in the derivation group and 148 boys in the validation group (mean age 13.20 ± 2.16 years and 13.24 ± 1.75 years, respectively). The calorimeter and device for assessing body composition by bioelectrical impedance analysis (BIA) were used. Model of multiple regression showed that REE can be predicted in this population with Eq. (1) (with height and weight data) or Eq. (2) (with age, height, and fat free mass data). Predictive Eq. (1) had an average error of 51 ± 199 kcal and predictive Eq. (2) − 39 ± 193 kcal. Cohen's d coefficient was 0.2, which confirms the small difference. The bias was 4.7% and 3.9%, respectively. The accuracy was 61.2% in the population for predictive Eq. (1) and 66.2% for predictive Eq. (2). Therefore, the new equations developed and validated in this study are recommended for the estimation of REE in physically active boys, when the use of IC is not feasible or available. [ABSTRACT FROM AUTHOR]

The European Academy of Paediatrics (EAP) is dedicated to promoting healthy lifestyles for children from birth into young adulthood. Physical exercise and leisure are essential to the development of healthy bodies, strong minds, and social skills. All children, without regard to their physical or mental capacities, should be provided with the time, the leadership, the facilities, and the equipment needed to exercise through sports while enjoying playing, even competing, in an environment appropriate to their capacities and aspirations. During exercise and sports, children should be assured of a safe and an appropriate environment that protects and promotes their human rights. Top sports that engage the best competitive athletes in an age group, in a region, in a country, or in the world should provide role models and even dreams for all children. These top sports, however, are also most usually surrounded by large political, economic, and/or business interests where only the best can compete while at times exacting a too high physical and/or psychological cost for those who have survived the cut, made the grade. Alongside this more and more children are being raised in environments with fewer open spaces as well as inside a media and digital culture making significantly less room for the enjoyment of physical exercise and leisure. Children's diets have also been changed dramatically by a significant intake of calorierich foods, which often have little nutritional value and which even a child's high metabolism rates not able to burn off efficiently. Conclusion With this Resolution, the EAP is calling for a renewed look at the role of sports and leisure in the lives of children and, by implication, at the way we structure, finance, and promote sports in Europe. The EAP is also asking that this Resolution be adopted by all organizers of sports involving children and young adults in Europe (and beyond), be that on the playground, in schools, in clubs, or in professional sporting organizations. The EAP would like that every child, throughout his or her childhood years and into young adulthood, can fully participate in sports in a safe environment where winning is playing and playing is winning. [ABSTRACT FROM AUTHOR]

Introduction. Granulosa cell tumor (GCT) is a kind of neoplasma which rise up from granulosa cells, a part of ovarian's stroma. Because of possibility of late relapse this tumor should be regarded as potential malignant. GCT is a hormonally active neoplasma. Tumor's cells secrete estradiol the most frequently, androgen, progesterone and prolactin rarely. Prognosis is very good, 5-years survival rates in stage I range 75-95%. Aim. We're presenting a case of 15 years old girl with juvenile granulosa cell tumor (JGCT) of a right ovary as an example of atypical medical history and difficulty in establishing optimal way of treatment. Leading symptoms was timbre changing which has been observed from 6 months. Ascertained high level of androgen in blood sample, in MRI revealed a tumor of a right ovary. Because of suspicion that a left ovary could be hypoplastic a surgeon decided to shell the tumor and left rest of the healthy right ovary. Because of attendance of neoplasma cells in the place of coagulation and a character of the tumor decided about a next operation (remove rest of the right ovary and a right fallopian tube) and chemotherapy. Conclusion. We need to determine an optimal treatment way of JGCT due to protect girl and women from unnecessary procedures and to assure the best quality of life. [ABSTRACT FROM AUTHOR]

Obesity is a chronic disease, in which treatment outcomes are highly dependent on patient and family adherence to behavioural recommendations. The role of healthy eating, physical activity, medication adherence as well as adherence to pre- and post-bariatric surgery protocols are of utmost importance for long-term treatment outcomes. Even the best interventions are not likely to reach their maximum benefit without significant levels of adherence on the part of the individual and family. Traditionally, the annual meeting of the European Childhood Obesity Group (ECOG) includes an expert workshop addressing one specific topic within the field of childhood obesity. During the 30th annual meeting, hosted by the University of Pécs, Hungary, as a virtual meeting, "adherence to treatment recommendations in obesity as a chronic disease" was addressed. The discussions that developed during the workshop are summarized in the following article. [ABSTRACT FROM AUTHOR]

Background: There are several observations that the onset of coronavirus 19 (COVID‐19) pandemic was associated with an increase in the incidence of diabetic ketoacidosis (DKA). However, due to heterogeneity in study designs and country‐specific healthcare policies, more national‐level evidence is needed to provide generalizable conclusions. Objective: To compare the rate of DKA in Polish children diagnosed with type 1 diabetes (T1D) between the first year of COVID‐19 pandemic (15 March 2020 to 15 March 2021) and the preceding year (15 March 2019 to 15 March 2020). Methods: Reference centers in 13 regions (covering ~88% of Polish children) retrospectively reported all new‐onset T1D cases in children from assessed periods, including DKA status at admission, administered procedures and outcomes. Secondly, we collected regions' demographic characteristics and the daily‐reported number of COVID‐19‐related deaths in each region. Results: We recorded 3062 cases of new‐onset T1D (53.3% boys, mean age 9.5 ± 4.3 years old) of which 1347 (44%) had DKA. Comparing pre‐ and post‐COVID‐19 period, we observed a significant increase in the rate of DKA (37.5%–49.4%, p <.0001). The fraction of moderate (+5.4%) and severe (+3.4%) DKA cases increased significantly (p =.0089), and more episodes required assisted ventilation (+2.1%, p =.0337). Two episodes of DKA during 2020/2021 period were fatal. By region, change in DKA frequency correlated with initial COVID‐19 death toll (March/April 2020) (R =.6, p =.0287) and change in T1D incidence (R =.7, p =.0080). Conclusions: The clinical picture of new‐onset children T1D in Poland deteriorated over a 2‐year period. The observed increase in the frequency of DKA and its severity were significantly associated with the overlapping timing of the COVID‐19 epidemic. [ABSTRACT FROM AUTHOR]

The determination of hormonal biomarkers is of increasing interest in many diseases, including cystic fibrosis (CF). Hormones that have not been estimated and described so far in CF include kisspeptin (KISS) and proopiomelanocortin (POMC), which are involved in the regulation of many processes, including appetite and fertility. Therefore, the aim of our study was to estimate the level of KISS and POMC in sera from CF patients and to determine the correlation between these hormones and clinical parameters. For this purpose, we estimated the levels of KISS and POMC in 38 CF patients and 16 healthy participants with enzyme-linked immunosorbent assay. We found significantly reduced levels of KISS and POMC in people with CF compared to healthy subjects (1.76 ± 0.46 vs. 2.27 ± 0.56 ng/mL, p < 0.05 and 6.25 ± 4.36 vs. 14.74 ± 6.24 ng/mL, p < 0.001, respectively). Furthermore, the level of both hormones was negatively correlated with age. The hormones studied did not correlate with the results of spirometry and each other. Thus, decreased KISS and POMC levels may be associated with lower body weight and delayed puberty in patients with CF. [ABSTRACT FROM AUTHOR]

The determination of hormonal biomarkers is of increasing interest in many diseases, including cystic fibrosis (CF). Hormones that have not been estimated and described so far in CF include kisspeptin (KISS) and proopiomelanocortin (POMC), which are involved in the regulation of many processes, including appetite and fertility. Therefore, the aim of our study was to estimate the level of KISS and POMC in sera from CF patients and to determine the correlation between these hormones and clinical parameters. For this purpose, we estimated the levels of KISS and POMC in 38 CF patients and 16 healthy participants with enzyme-linked immunosorbent assay. We found significantly reduced levels of KISS and POMC in people with CF compared to healthy subjects (1.76 ± 0.46 vs. 2.27 ± 0.56 ng/mL, p < 0.05 and 6.25 ± 4.36 vs. 14.74 ± 6.24 ng/mL, p < 0.001, respectively). Furthermore, the level of both hormones was negatively correlated with age. The hormones studied did not correlate with the results of spirometry and each other. Thus, decreased KISS and POMC levels may be associated with lower body weight and delayed puberty in patients with CF. [ABSTRACT FROM AUTHOR]

Introduction: While international prevention guidelines recently advocated, in addition to moderate and vigorous physical activity (MVPA) guidelines, for a minimization of sedentary (SED) time, recommendations remain to be developed for youths with obesity. Methods: A literature search was conducted in PubMed, the Cochrane Library, plus the reference lists of selected articles for relevant publications in English, including original papers, systematic reviews, and meta-analyses, with search terms "sedentary behaviors" or "sedentary time" or "screen time" AND "children" or "adolescents" AND "obesity" or "adiposity" or "cardiometabolic risk" or "cardiometabolic disease." The results were summarized as a narrative review and presented to the scientific board of the European Childhood Obesity Group (ECOG), who then discussed their implication in clinical practice and proposed the position outlined in this paper. Results: SED and screen times are associated with adiposity and cardiometabolic risks, independently of youths' physical activity (PA) level. Besides considering MVPA and SED times as separate variables, comprehensive studies have questioned the impact of different patterns of MVPA and SED levels. Although lower body adiposity and better cardiometabolic health are achieved among those with desirable movement behavior patterns (i.e., more MVPA/less SED or active/not SED), youths with intermediate patterns (i.e., high MVPA/high SED and low MVPA/low SED, or active/SED and inactive/not SED) have been found to be associated with intermediate risks. Conclusion: There is a need to decrease SED behaviors irrespective of MVPA and to consider PA-SED patterns in youth with obesity. The ECOG encourages anti-obesity strategies targeting both PA and SED behaviors to support the shift from long periods of SED time, especially screen time, to daily routines incorporating bouts of PA. Stepwise or sequential approaches to movement behavior counseling might start with targeting SED at first to decrease cardiometabolic risks when implementing MVPA is not yet possible. [ABSTRACT FROM AUTHOR]

Introduction. Obesity is the result of long-term imbalance between the amount of energy supplied and spending. It is contributes to an increased risk of metabolic complications, cardiovascular disease. Aim. The aim of the study was to assess the prevalence of overweight and obesity in preschool from Rzeszów region in 2008 and 2012. Methods. Based on the results of studies conducted between 2008 and 2012 the trend has been characteristic of obesity and overweight occurring in a population of preschool children in Rzeszow region. Weight and height were measured in 976 preschool children (485 girls and 491 boys). Children between the ages of 3-6 were examined. On the basis of measurements their body mass index (BMI) was calculated. Overweight and obesity were diagnosed according to the International Obesity Task Force criteria. Results. The prevalence of overweight among preschool girls was 9.1% and boys 9.9% in 2008 and 12.4% girls and 11.3% boys in 2012. The obesity level was 8.4% among boys and 7.2% girls in 2008 and 11.1% and 10.8% in 2012. Conclusion. The study results indicate that particular attention should be put to prevent obesity among the preschool children from Rzeszow region [ABSTRACT FROM AUTHOR]

Severe obesity defined as BMI value corresponding to an adult > 40 kg/m2 affects 1–5% of children and adolescents in Europe. The purpose of this study was to assess the occurrence of cardiovascular risk factors in children and adolescents with severe obesity. The analysis included 140 patients (75 female) at the mean age of 14 ± 2.1 SD (range 10–18) years (all recruited in 4 regional reference centers in Poland). Severe obesity was defined as BMI > 35 kg/m2 (children 6–14 years), and BMI > 40 kg/m2 (> 14 years). Fasting plasma samples have been obtained in all patients, and OGTT was performed in all patients. The metabolic risk factors were defined as high blood pressure (BP > 90 percentile for height, age, and sex), HDL cholesterol < 1.03 mmol/L, TG ≥ 1.7 mmol/L, and hyperglycemic state (fasting blood glucose > 5.6 mmol/L, or blood glucose 120′ after oral glucose load > 7.8 mmol/L). Additionally, the MetS z-score was calculated using Metabolic Syndrome Severity Calculator. One hundred twenty-four (89%) participants presented with high BP, 117 (84%) with abnormal lipid profile, and 26 with the hyperglycemic. Only 12 (9%) were free of metabolic complications. More than 60% of patients had more than one cardiovascular risk factor. The high BP was significantly associated with the severity of obesity (F = 9.9, p = 0.002). Patients with at least one metabolic complication presented with significantly younger age of the onset of obesity (the mean age of the patients with no overt obesity complications was 10 years, while the mean age of those who presented at least one was 4.7 ± 3.5 SD years (p = 0.002)). A significant positive association between in the value of the Mets BMI z-score with age was observed (R = 0.2, p < 0.05). There were no differences between girls and boys regarding Mets BMI z-score (1.7 ± 0.8 vs 1.7 ± 0.7, p = 0.8).Conclusions: The most common metabolic risk factor in children and adolescents with severe obesity was high BP. The most important factor determining presence of obesity complications, and thus the total metabolic risk, seems to be younger (< 5 years) age of onset of obesity.What is Known?• It is estimated that 1-5% of children and adolescents in Europe suffer from severe obesity corresponding to an adult BMI > 40 kg/m2, and it is the fastest growing subcategory of childhood obesity.• Children with severe obesity face substantial health risk that may persist into adulthood, encompassing chronic conditions, psychological disorders and premature mortality.What is new:• The most common complication is high BP that is significantly associated with the severity of obesity (BMI z-score), contrary to dyslipidemia and hyperglycemic state, which do not depend on BMI z-score value.• The most important factor determining presence of obesity complications, and thus the total metabolic risk, seems to be younger (< 5 years) age of onset of obesity.What is Known?• It is estimated that 1-5% of children and adolescents in Europe suffer from severe obesity corresponding to an adult BMI > 40 kg/m2, and it is the fastest growing subcategory of childhood obesity.• Children with severe obesity face substantial health risk that may persist into adulthood, encompassing chronic conditions, psychological disorders and premature mortality.What is new:• The most common complication is high BP that is significantly associated with the severity of obesity (BMI z-score), contrary to dyslipidemia and hyperglycemic state, which do not depend on BMI z-score value.• The most important factor determining presence of obesity complications, and thus the total metabolic risk, seems to be younger (< 5 years) age of onset of obesity. [ABSTRACT FROM AUTHOR]

To assess the prevalence of cardiovascular risk factors (CVRFs) in children and adolescents with type 1 diabetes (T1D) in the International SWEET registry and the possible role of clinical variables in modifying the risk of having single or multiple CVRFs. The study is a cross-sectional study. Cut-off points for CVRFs were fixed according to International Society for Pediatric and Adolescent Diabetes (ISPAD) guidelines and WHO parameters: LDL cholesterol (LDL-C) > 100 mg/dL; Systolic Blood Pressure (BP-SDS) > 90th percentile for sex, age, and height; BMI-SDS > 2SD for sex and age. Logistic regression models were applied to evaluate variables associated with at least 1 or 2 CVRFs among registry children and adolescents. 29,649 individuals with T1D (6–18 years, T1D ≥ 2 years) participating in the SWEET prospective multicenter diabetes registry were included. In the cohort, 41 % had one or more CVRFs, and 10 % had two or more CVRFs. Thirty-five percent of enrolled individuals had LDL-C > 100 mg/dL, 26 % had BMI-SDS > 2SD, and 17 % had Systolic BP-SDS > 90th percentile. Females had higher frequency than males of having 1 or 2 CVRFs (45.1 % vs 37.4 %, 11.8 % vs 7.8 %; p < 0.001). Multivariable logistic regression models showed that sex (female), HbA1c category (>7.0 %), and age (>10 years) were associated with a higher chance of having at least 1 or 2 CVRFs (p < 0.001). In children and adolescents with T1D, female sex, in addition to HbA1c above 7 %, and older age (>10 years) was associated with a higher risk of having at least a CVRF (LDL-C, BMI-SDS, BP) according to internationally defined cut-offs. [ABSTRACT FROM AUTHOR]

Summary: World Health Organization defines obesity as abnormal or excess adipose tissue accumulation. Nowadays, this condition is a serious threat to the public health in most countries around the world. Obesity adversely affects physical, mental, and in most cultures, social well‐being. However, throughout the ages—from ancient times to the 21st century—this condition has been subject to various interpretations. As a matter of fact, obesity has not always been regarded as a disease. For many decades, excessive body weight has been considered rather a symbol of health. It was a marker of wealth and prosperity, as well as a sign of high social status. The centuries that passed on the development of science and medicine have gradually changed its face, but significant progress in understanding the causes and consequences of obesity has been made in the last 30 years. This paper presents the historical outline of obesity and its treatment from ancient times to the present—from its affirmation to the epidemic in the late 20th and 21st century. [ABSTRACT FROM AUTHOR]

Tissue engineering is an interdisciplinary field of science that has developed very intensively in recent years. The first part of this review describes materials with medical and dental applications from the following groups: metals, polymers, ceramics, and composites. Both positive and negative sides of their application are presented from the point of view of medical application and mechanical properties. A variety of techniques for the manufacture of biomedical components are presented in this review. The main focus of this work is on additive manufacturing and 3D printing, as these modern techniques have been evaluated to be the best methods for the manufacture of medical and dental devices. The second part presents devices for skull bone reconstruction. The materials from which they are made and the possibilities offered by 3D printing in this field are also described. The last part concerns dental transitional implants (scaffolds) for guided bone regeneration, focusing on polylactide–hydroxyapatite nanocomposite due to its unique properties. This section summarises the current knowledge of scaffolds, focusing on the material, mechanical and biological requirements, the effects of these devices on the human body, and their great potential for applications. [ABSTRACT FROM AUTHOR]

Soon after the discovery of the first active component of Cannabis sativa - -A9-THC, it has been shown that its action is mediated mainly through the activation of specific membrane protein - cannabinoid receptor (CB). So far two types of this protein were isolated: CB1 and CB2. It is already known that they constitute the intracellular signaling system, called Endocannabinoid System (ECS), which also includes their ligands and enzymes involved in the synthesis and degradation of this compounds. ECS is abundant in the brain regions associated with feeding control and also in peripheral organs regulating food intake and glucose and lipids metabolism, suggesting the crucial role of this system in pathogenesis of obesity. Much evidence has proven potent orexigenic action of endocannabinoids induced via the CB1 receptors activation in CNS. They also stimulate lipogenesis, leading to the fat accumulation in such organs like the liver. Moreover, the CB1 receptor agonist-based treatment induced insulin resistance and development of hyperglycaemia - characteristic metabolic parameters of obesity. These results has led to the development of CBl-blocking drugs with potential efficacy in obesity treatment. Preclinical and clinical studies with the use of antagonist/inverse agonist - rimonabant have shown significant decrease in body weight and improve in cardiometabolic risk factors. However, serious psychiatric effects of this substance contributed to its withdrawal from the market. The main goal is to design a drug which might prevent obesity without these side effects. Therapies based on the CB1 receptor's neutral antagonists or selective, inverse agonists might be a promising strategy in obesity treatment. [ABSTRACT FROM AUTHOR]

Individuals with autism spectrum disorder (ASD) struggle to access high-quality health care due to the shortage of trained providers. ECHO (Extension for Community Healthcare Outcomes) Autism is a unique educational program that allows ASD experts to provide knowledge and skills to professionals in local communities to deliver evidence-based care to children with ASD and their families. The model teaches clinicians how to screen and diagnose ASD, as well as manage common co-occurring medical and mental health issues. ECHO Autism is particularly useful for addressing the complex needs of children with ASD and reducing disparities often present in rural and underserved communities. The model can be disseminated globally due to its flexibility in accommodating local and regional differences in social norms and constructs. This article provides an overview of the format of the ECHO Autism model, data supporting the model's efficacy, and discusses future research directions. [ABSTRACT FROM AUTHOR]

Lower levels of physical activity are associated with an increased overall cardiometabolic risk, as well as the risk or being overweight. It is difficult to determine the optimal level of physical activity that protects the needs of children and young people. Studies on the required number of steps, as well as approximating the daily volume of physical activity, are gaining increasing credibility in research and practice. Researchers propose a "rule" of ≥ 11,500 steps per day, for children and teenagers of both sexes. The aim of the study was to assess whether 11,500 steps a day is sufficient to maintain normal blood pressure among children and adolescents. 1002 children and adolescents aged 4–15 were included in the study. To assess physical activity, measured in the number of steps per day, the Actigraph accelerometer wGT3X-BT was used. The normal number of steps was defined as greater than or equal to 11,500 steps per day for children and teenagers, for both girls and boys. In the entire study group, a significantly lower risk of hypertension was observed when the number of steps was normal (OR is 0.45 and the upper confidence limit for OR is 0.71). The study confirmed the beneficial protective role of physical activity against hypertension in older children and adolescents. However, it should be emphasized that no such relationship has been demonstrated in the case of preschool children. The presented norms of the number of steps should be promoted to the wider community to make prevention of cardiovascular diseases even more effective. [ABSTRACT FROM AUTHOR]

Soon after the discovery of the first active component of Cannabis sativa -- -Δ9-THC, it has been shown that its action is mediated mainly through the activation of specific membrane protein -- cannabinoid receptor (CB). So far two types of this protein were isolated: CB1 and CB2. It is already known that they constitute the intracellular signaling system, called Endocannabinoid System (ECS), which also includes their ligands and enzymes involved in the synthesis and endegradation of this compounds. ECS is abundant in the brain regions associated with feeding control and also in peripheral organs regulating food intake and glucose and lipids metabolism, suggesting the crucial role of this system in pathogenesis of obesity. Much evidence has proven potent orexigenic action of endocannabinoids induced via the CB1 receptors activation in CNS. They also stimulate lipogenesis, leading to the fat accumulation in such organs like the liver. Moreover, the CB1 receptor agonist-based treatment induced insulin resistance and development of hyperglycaemia -- characteristic metabolic parameters of obesity. These results has led to the development of CB1-blocking drugs with potential efficacy in obesity treatment. Preclinical and clinical studies with the use of antagonist/inverse agonist -- rimonabant have shown significant decrease in body weight and improve in cardiometabolic risk factors. However, serious psychiatric effects of this substance contributed to its withdrawal from the market. The main goal is to design a drug which might prevent obesity without these side effects. Therapies based on the CB1 receptor's neutral antagonists or selective, inverse agonists might be a promising strategy in obesity treatment. [ABSTRACT FROM AUTHOR]

The authors of the published version of this article inadvertently omitted the table note of the Table 2 under the Appendix section. The complete Table 2 is shown in this article]. [ABSTRACT FROM AUTHOR]

Background: Youth with type 1 diabetes (T1D) (16–18 y.o.) present worst disease control of all age groups and need structured interventions. Those should be based on unbiased, national‐scale outcomes, which have not yet been successfully assessed in Poland. Objective: To evaluate the glycemic control in young patients with T1D in Poland. Method: All pediatric diabetes care centers and the nine largest centers for adults with T1D were invited to this cross‐sectional study, conducted in March 2018. Eligibility was defined as age ≤ 30 years and diabetes duration ≥1 year. Blinded samples of capillary blood and clinical questionnaires were sent to coordinating center, where HbA1c was measured by high‐pressure liquid chromatography. Results: Nine adult and 25/28 pediatric centers participated, providing data for 1255 patients (50.8% males), mean age 12.3 years (95%CI:12.1–12.6) for children and 23.2 years (22.9–23.6) for adults; mean diabetes duration 7.1 years (6.8–7.3). This covered ~8% of pediatric population and 2% of 18–30‐years‐olds with T1D. Mean HbA1c was comparable between children and adults (57 mmol/mol [7.4%], 95%CI:56‐57 mmol/mol [7.3–7.4%] vs. 57 mmol/mol [7.4%], 95%CI:56–60 mmol/mol [7.3–7.6%], p = 0.1870). Overall, 45.2% of patients achieved ISPAD target (<53 mmol/mol [<7.0%]). During the month preceding the study, 0.9% of patients experienced severe hypoglycemia and 0.4% suffered ketoacidosis. HbA1c was related to the method of insulin therapy, continuous glucose monitoring use and body weight (p < 0.0001). Conclusions: In Polish children and young adults with T1D glycemic control expressed as HbA1c is promising in the light of ISPAD guidelines. Our results confirm the known associations between better glycemic control and the use of new technologies and maintaining optimal body weight. [ABSTRACT FROM AUTHOR]

The great demand for functional, particularly biologically active, metal nanoparticles has led to the search for technologically effective, green, and controlled methods of synthesizing these metal nanoparticles. Plasma glow discharge is one of the most promising techniques in this direction. The results of studies based on the synthesis of colloidal solutions of stabilized silver nanoparticles (AgNPs) by the microplasma method in solutions of a nontoxic surfactant sodium polyacrylate (NaPA) are presented. It is shown that AgNPs with a size of 2–20 nm are formed in solutions of 0.05–0.2 mmol⋅L−1 AgNO3 + 5 g⋅L−1 NaPA at U = 250 V by tungsten cathode plasma glow discharge. At 20°C, the yellow solutions are formed with λmax ≈ 410 nm, which are stable during long-term storage. It was found that the process of AgNPs formation corresponds to a first-order reaction on the AgNO3 concentration. Its value has little effect on the geometry of nanoparticles, so the Ag(I) concentration in solution is one of the main factors influencing the rate of microplasma synthesis of AgNPs. The antimicrobial activity of synthesized AgNPs solutions against strains of Escherichia coli, Staphylococcus aureus, and Candida albicans was established. [ABSTRACT FROM AUTHOR]

Background: Ultrasonographic assessment of stool retention in children with chronic constipation requires the diagnosis of megarectum.Objective: The aim of the study was to evaluate an atypical method of US assessment of megarectum, fecal impaction and enlarged colon in order to decide whether it can be used as an assessment method for children with functional chronic constipation.Materials and Methods: A total of 120 children with a positive diagnosis of chronic constipation were included in the study. All patients fulfilled the ROME II diagnostic criteria for defecation disorders. The control group comprised 105 patients with a normal defecation pattern. Children with a US diagnosis of megarectum, fecal impaction and enlarged colon were referred for proctoscopy and measurement of colonic transit time.Results: The transverse diameter of the rectal ampulla increases with age and thus influenced the US measurements in both the patient and control groups. The numerical values of this parameter differed significantly between patients and controls in all age groups. The rectopelvic ratio is the ratio of the width of the rectal ampulla (as seen by US) to the distance between the anterior superior iliac spines (measured externally using a measuring tape). This allows the definition of megarectum. In the diagnosis of fecal impaction, US showed a sensitivity of 88.3% relative to proctoscopy. In children with fecal impaction the colonic transit time, average segmental transit time for the rectum and sigmoid colon, and average segmental transit time for the left colon were significantly longer. There was no statistically significant difference for the right side of the colon.Conclusion: US assessment of stool retention and overfilling of the colon in children with functional chronic constipation has a high correlation with proctoscopy findings and colonic transit time. The rectopelvic ratio can be used to diagnose megarectum in children with functional chronic constipation with a cut-off value of 0.189. [ABSTRACT FROM AUTHOR]

Background: The outbreak of the Covid-19 pandemic has created a number of obstacles to daily functioning, which have led to a need for major changes in lifestyles. The aim of the study was to assess whether and to what extent the outbreak of the Covid-19 pandemic has affected the health behaviours of young adults.Methods: 506 people aged 18 to 34 ([Formula: see text] =24.67 years ±4.23 years) who filled in an online survey were qualified for the study. Assessment was made of eating habits (a modified Food Frequency Questionnaire, FFQ), physical activity and sedentary behaviours (International Physical Activity Questionnaire, short form IPAQ-SF), sleep quality (The Pittsburgh Sleep Quality Index, PSQI), and generalized anxiety (Generalized anxiety Disorder, 7-item, GAD-7 scale).Results: During the pandemic, young adults changed their dietary preferences toward sweets and cereal products, increased alcohol (p < 0.001) and fat (p = 0.005) intake, significantly reduced their physical activity (from 8752.5 metabolic equivalents (MET) min/week vs. 6174.6 MET min/week, p < 0.001), increased the time spent sedentarily (Me = 240 min vs. Me = 360 min, p < 0.001) and had decreased sleep quality (PSQI score Me = 7.00 vs. Me = 9.00).Conclusions: The Covid-19 pandemic worsened health behaviours and intensified the feeling of generalized anxiety in young adults. Generalized anxiety during obligatory lockdown had the greatest negative impact on sedentary behaviours and sleep quality. [ABSTRACT FROM AUTHOR]

Insufficient sleep duration and physical activity (PA) are known risk factors for overweight and obesity in children; however, there are no studies on comprehensive associations of objectively-measured sleep parameters and PA with excess weight and excess adiposity in kindergarteners. Therefore, the aim of this study was to determine the associations between objectively measured sleep parameters and PA with excess weight and excess adiposity, defined as BMI ≥ 85th percentile and body fat percentage (BFP) ≥ 85th percentile, respectively. Sleep parameters and PA were measured in 676 subjects aged 5–6 years using accelerometers for 7 days, worn at the participant's hip. Bioelectrical impedance analysis was used to estimate BFP. In the total sample, lower sleep duration, sleep efficiency, vigorous PA and the number of steps per day were associated with excess weight. However, excess adiposity was associated with lower sleep duration, total PA, vigorous PA, moderate-to-vigorous physical activity (MVPA) and the number of steps per day. Logistic regression by the stepwise progressive method showed that the strongest predictor of excess adiposity in boys and girls was vigorous PA, while the strongest predictor of excess weight in boys was sleep efficiency. A holistic approach to health targeting all of these factors synergistically is needed to optimize the effectiveness of obesity prevention and treatment interventions. [ABSTRACT FROM AUTHOR]

Background: Due to the growing risk of obesity and related diseases in the population of children, effective preventive measures are of great importance. Front-of-pack (FOP) nutrition labelling may contribute to health promotion by increasing consumer awareness on the nutritional qualities of packaged foods and purchasing decisions, and it may stimulate food providers to improve the composition of products. Summary: Appropriate labelling should enable customers to make healthy choices quickly and intuitively. Key Messages: The European Academy of Paediatrics and the European Childhood Obesity Group makes an appeal to European Union legislators to immediately introduce a mandatory, uniform, and interpretative FOP nutrition labelling system. [ABSTRACT FROM AUTHOR]

• Steroids are potent regulators of glucose, fat, and protein metabolism. • Children with obesity display several changes in the action of steroid enzymes. • Changes in the activity of 11βHSD1, 20αHSD, 5β-reductase + 3αHSD complex and 11βOH-lase were found. • Some changes in the activity of steroid enzymes might represent a compensatory mechanism to reduce steroids exposure of the target tissues. Rising prevalence of obesity has become an important impulse to investigate basic mechanisms involved in regulating the energy balance. It is widely accepted that steroids are potent factors affecting glucose, fat, and protein metabolism. Our study was aimed to analyze differences in the total amount of selected enzymes implicated in steroid metabolism in a group of children suffering from obesity and those with normal weight, further subdivided according to sex and pubertal stage. Data were obtained from 187 Caucasian children and adolescents, including 113 patients (63 girls, 50 boys) with obesity and 74 (34 girls, 40 boys) normal weight volunteers. Standard clinical examinations were performed in both groups. To evaluate the impact of puberty, preadolescent children and those with advanced puberty were assessed separately. Urine steroid excretion profiles were analyzed using gas chromatography/mass spectrometry method. Children with obesity revealed several changes in in the total amount of steroid enzymes as assessed by the relevant metabolite proportions, compared to their norm weight peers. Girls showed a significant increase in the activity of 11βHSD1, while boys demonstrated a relevant elevation in 20αHSD action. Regardless of sex, children with obesity showed an increase in the activity of 5β-reductase + 3αHSD complex and a decrease in the involvement of 11βOH-lase. The effect is attenuated when consider pre- and pubertal subgroups. We hypothesize that changes in the activity levels of selected enzymes may be a compensatory mechanism to limit the glucocorticoid exposure of key target tissues as well as to improve metabolic control and reduce long-term complications of obesity. [ABSTRACT FROM AUTHOR]

Childhood obesity is one of the most serious public health problems. The prevalence of obesity among children is increasing and may negatively affect their immediate health, but it can also lead to obesity in adulthood. The aim of the study was to compare BMI cut-off points by examining three main international references: the World Health Organization (WHO), the International Task Force Obesity (IOTF) and the US Center for Disease Control and Prevention (CDC). Ultimately, the study group consisted of 18,144 children and adolescents aged 6.5–17.5 years. Body mass was measured on medical scales with an accuracy of ± 100 g and height measurement was taken using a height meter with an accuracy of ± 0.1 cm three times. Underweight, overweight and obesity were calculated according to WHO, IOTF and CDC BMI international references. There were differences in the incidence of underweight between the classifications: 16.8% according to IATF, 5.3% according to WHO and 9.9% according to CDC. There were also differences in the incidence of overweight and obesity between the classifications: 13% according to IOTF, 19.7% according to WHO and 14.1% according to CDC. In the CDC and WHO studies, a significantly higher prevalence of childhood obesity (4.0% and 4.7%, respectively) was observed compared with IOTF (2.1%). The prevalence of overweight and obesity in this study was higher among boys compared to girls. However, estimates of prevalence of overweight and obesity differ in methods and reference cut-off points. Higher prevalence was obtained in IOTF classification, followed by the WHO and CDC classification. [ABSTRACT FROM AUTHOR]

Background: Adiposity is closely related to hypertension (HTN) in paediatric population. However, which adiposity indicator is most associated with HTN among children and adolescents with intellectual disability remains unknown. The aim of this study was to evaluate the associations between HTN prevalence and different adiposity indicators: body mass index (BMI) percentile, body fat percentage (BFP), waist circumference (WC), hip circumference (HC), waist‐hip ratio (WHR) and waist‐to‐height ratio (WHtR) in students with intellectual disability. Methods: Cross‐sectional study included a sample of 568 schoolchildren with intellectual disability, aged 7–18 years. Blood pressure, BMI, body composition, WC and HC were determined using standardized equipment. Results: Multivariate logistic regression showed that male gender, adolescence, high HC and excessive BFP were significant independent factors that increased risk of HTN occurrence in population with intellectual disability. Conclusions: Findings indicated that HC and BFP, in particular, may be helpful tools to detect HTN in population with intellectual disability. [ABSTRACT FROM AUTHOR]

Summary: While most of the time unconsidered, child and adolescent obesity has been also associated with impaired brain health and function that can definitely affect their social interaction and integration, and then well‐being and mental health. The European Childhood Obesity Group recently gathered experts in the field who discussed the main available and reliable evidence regarding the role of physical activity on brain health and cognitive functioning in children and adolescents with obesity and who propose here their main conclusions and recommendations. [ABSTRACT FROM AUTHOR]

The authors of the published version of this article inadvertently omitted the table note of the Table 2 under the Appendix section. The complete Table 2 is shown in this article] [ABSTRACT FROM AUTHOR]

Despite the fact that vaccines save 2–3 million lives worldwide every year, a percentage of children are not getting appropriately vaccinated, thus leading to disease outbreaks. One of the major reasons of low vaccine uptake in Europe is vaccine hesitancy, contributing to the recent measles outbreaks. Monitoring of vaccine hesitancy is valuable in early identification of vaccine concerns. We performed an eighteen country European survey on parents' attitudes and behaviors regarding their children's immunization. Parents having at least one child 1–4 years old were mostly recruited by primary care paediatricians to reply to a web-based questionnaire. The questionnaire was developed by the European Academy of Paediatrics Research in Ambulatory Setting Network steering committee, based on similar surveys. An individual level hesitancy score was constructed using the answers to 21 questions, and correlations of the score with socio-demographic characteristics and types of providers were explored. To assess inter country differences, a country level self -reported confidence was defined. Fifty six percent and 24% of 5736 respondents defined themselves as "not at all hesitant", and "somewhat hesitant", respectively. Parents who consulted general practitioners were more hesitant than parents who consulted pediatricians (p < 0.05). Consultation with homeopathists was associated with the highest reported hesitancy (p < 0.05). Vaccine confidence was highest in Portugal and Cyprus, and lowest in Bulgaria and Poland. The majority of parents in Europe believe in the importance of childhood vaccination. However, significant lack of confidence was found in certain European countries, highlighting the need for continuous monitoring, awareness and response plans. The possible influence of different types of healthcare providers on parental decisions demonstrated for the first time in our survey, calls for further research. Monitoring and continuous medical education efforts aimed mostly at those professionals who might not be likely to recommend vaccination are suggested. [ABSTRACT FROM AUTHOR]

The authors discuss the consistent global trend in the intake of ultra-processed food (UPF) among children despite all that is known about its negative consequences, with topics mentioned such as the European Childhood Obesity Group, UPF consumption, and digital food marketing.

Background: The prevalence of abdominal obesity (AO) is high in individuals with intellectual disability (ID). The aim of this study was to assess the prevalence of hypertension (HPT) in students with ID with different distributions of adipose tissue. Method: Study involved 568 participants with ID. AO was assessed on the basis of waist circumference (WC) measurements. Results: The risk of HPT was more than threefold higher in individuals with AO (OR = 3.38) than in the subjects with normal WC. Correlation between the prevalence of AO and HPT was observed in girls and individuals with mild levels of ID (OR = 6.07 and 7.67 respectively). The prevalence of HPT increases sharply in girls whose WC is greater than or equal to the 90 percentile, and in boys when it exceeds the 75th percentile. Conclusion: An association between WC and HPT was observed in abdominally obese students with ID. [ABSTRACT FROM AUTHOR]

Aim The seasonal variation of incidence of type 1 diabetes (T1D) theory supports the hypothesis that environmental factors play a role in the onset of the disease. The aim of this study is to assess seasonality of month of diagnosis in children with T1D in Poland. Material and methods the study group consisted of 2174 children from eastern and central Poland diagnosed with T1D between 2010 and 2014. Analysis was performed in different age groups, based on place of residence (rural/urban area) and depending on sex. Results We noted significant seasonality in the incidence of T1D with a peak in diagnosis of diabetes in January and the minimum rate in June. A total of 423 (19%) children were diagnosed in the warmest months (June to August with a mean temperature of 16.8°C) compared to 636 (29%) recognised in the coldest months (December to February with a mean temperature of −1.6°C), OR 0.57 95%CI [0.51-0.67], p<0.0001. We noted a more flat seasonal pattern in children 0-4 years of age compared with subjects 5–17 years old with a week correlation of trend comparison between both groups, r=0.69, p=0.001. Similar seasonal variation in the incidence of T1D was noted in children from urban and rural setting. For girls, seasonal pattern peaks were observed one month earlier as compared to boys. Conclusions Seasonal variation in incidence of T1D diagnosis of Polish children supports the role of different environmental factors in diabetes onset. The majority of children were diagnosed with diabetes in autumn and winter. [ABSTRACT FROM AUTHOR]

Background: Health risks associated with the high consumption of sugar-sweetened beverages (SSBs) include overweight or obesity and their complications such as diabetes, as well as oral and dental decay, among others. Aim: The aim of the present statement is to inform health care professionals, parents, care-givers, teachers and school head teachers, stakeholders and governing bodies about the risks associated with drinking SSBs in infants, children and adolescents. Methods: We searched PubMed and the Cochrane databases for English language studies published from 2010 through October 1, 2018, for randomized clinical trials, meta-analyses, systematic reviews and observational studies (search terms are reported in eAppendix in the Supplement). We also manually searched the references of selected articles, reviews, meta-analyses and practice guidelines. Recommendations: Consumption of SSB by children and adolescents should be limited, and the consumption of water and other non-sweetened beverages should be promoted. Educational institutions such as nurseries, pre-schools and schools should offer unlimited access to drinking water, whereas the sale of SSBs should be banned. [ABSTRACT FROM AUTHOR]

The incidence of treatment related mortality in children with acute lymphoblastic leukemia (ALL) is reported to be between 2% and 4% with infections being the leading cause. Aim: To establish a relationship between body mass index at diagnosis (BMI 0), after protocol I therapy completion (BMI I) and the incidence rate ratio (IRR) of infectious/febrile episodes in children with ALL intermediate risk. Methods: Thirty one consecutive patients (2–18 years old, with a male to female ratio of 19/12) with newly diagnosed ALL that were treated uniformly according to ALL IC 2009 protocol were included in this analysis. Results: A BMI decrease of at least 5% during protocol I therapy and BMI 1 under 15th percentile score corresponds significantly with higher IRR (with P-values 0.04 and 0.006 respectively) during the whole intensive therapy. Conclusion: Some relationships between BMI reduction and higher IRR in ALL patients were found, but their significance is limited by the size of the group analyzed. [ABSTRACT FROM AUTHOR]

Diabetes mellitus type 2 (T2DM) and its vascular complications are a serious world health problem. For this reason it is important to look for new diabetes complication risk factors. The aim of this study was to determine whether 18-bp insertion/deletion (I/D) polymorphism at −2549 position of the vascular endothelial growth factor (VEGF) gene is associated with diabetic vascular complications (DVC). Caucasian subjects (n = 100) with T2DM were recruited for this study. Genotyping of the VEGF gene I/D polymorphism was done by the polymerase chain reaction (PCR) method. The results were correlated with laboratory and clinical data. In our population heterozygous of the VEGF gene polymorphism was observed most frequently (57%). DVC were observed in 53 patients. Heterozygous T2DM patients significantly more often suffered from heart failure (HF) and stroke (p = 0.05). Amongst all the DVC, D allele of the VEGF polymorphism had a significantly increased risk of diabetic retinopathy (DR) (OR = 1.31; p = 0.033) irrespective of the duration of diabetes, BMI, the glycemia control expressed by HbA1c, renal function, lipid values or applied treatment. The studied polymorphism did not correlate with coronary heart disease, peripheral vascular disease, cardiovascular death, diabetic kidney disease or applied treatment. The multivariate logistic regression analysis showed that the D allele in the promoter region of the VEGF gene is an independent risk factor of DR irrespective of other laboratory and clinical variables in T2DM patients. Our study suggests that I/D allele in the studied gene is associated with HF and strokes. [ABSTRACT FROM AUTHOR]