On March 1, 2023, a new submission system has been launched. The manuscripts with all their attachments should be submitted via publishing platform Journals System.

We would like to inform you that from June 28, 2023, a publication fee of PLN 2000 / 450 EUR will be introduced by the publisher of “Pediatria i Medycyna Rodzinna – „Paediatrics and Family Medicine” for papers submitted to the Editorial team.

The article aims to formulate criteria determining the right moment to discontinue life support to a terminally ill child at the end of life. The argument refers to two standards guiding critical decision-making: medical futility and the patient’s best interests. When a child demonstrates discernment, account must also be taken of their reasoning. The deterioration of a child’s health, which precedes the decision to stop further therapeutic efforts, is a clinical condition that immediately precedes torment that can only lead to death, or a situation of complete and definitive exclusion of positive perception and feeling.

Melatonin plays a pivotal role in the regulation of biological rhythms, beginning during prenatal development through maternal signalling and continuing postnatally via breast milk. In neonates, whose circadian systems are functionally immature, maternal melatonin serves as a critical entraining agent, facilitating the synchronisation of the sleep–wake cycle, supporting neurodevelopmental processes, and enhancing immune system maturation. Breast milk demonstrates distinct diurnal variations in melatonin concentration, alongside other bioactive components, establishing it as a vital chrononutritional medium.

Ectodermal dysplasia comprises a group of hereditary disorders affecting the development of the skin and its appendages. Among the more than 150 characterised forms of ectodermal dysplasia, hypohidrotic ectodermal dysplasia is the most prevalent in children. Hypohidrotic ectodermal dysplasia is marked by reduced sweating, sparse hair, a limited number of conical-shaped teeth, and brittle nails. The condition results from mutations in genes involved in the EDA-EDAREDARADD-NF-κB signalling pathway, which is crucial for early epithelial-mesenchymal communication during the formation of skin appendages.

Idiopathic nephrotic syndrome is a rare kidney disease characterised by nephrotic proteinuria, hypoalbuminemia, hyperlipidaemia and oedema. The incidence of idiopathic nephrotic syndrome ranges from 2 to 7 cases per 100,000 children per year. Children between 1 and 10 years of age are mainly affected. The pathogenesis is associated with damage to the microstructure of glomerular filtration barrier, which may be caused by a variety of immune-mediated factors.

Since the synthesis of histamine in 1907, new reports about its properties and role in the human body have periodically appeared. Its blood levels remain constantly low, almost undetectable, under normal physiological conditions. Increasing histamine levels lead to serious clinical symptoms, including cardiac arrest. Histamine is involved in many processes and allergic reactions. It exerts its effects by acting on receptors, of which four types have been described so far.

Myocarditis, due to its diverse clinical presentation, is a big challenge for clinicians. Aim of the paper was to assess the left ventricular myocardial performance index by echocardiography and the relationship between left ventricular myocardial performance index and the oedema in T2-weighted cardiac magnetic resonance imaging in children with myocarditis.

Autoimmune hepatitis is a chronic inflammatory process of unknown ethology, characterised by high levels of transaminases and IgG antibodies, the presence of tissue autoantibodies, and a typical histological picture. In the population of children, the paediatric form of autoimmune hepatitis and autoimmune sclerosing cholangitis are collectively classified as juvenile autoimmune liver disease. The condition often coexists with other autoimmune disorders.

The high prevalence of autism spectrum disorder (ASD), the specificity of paediatric patients and the determination of their parents give rise to the growing interest of scientists in potential therapeutic approaches. There are multiple aetiological factors involved, and more will probably be discovered. Currently, the involvement of genetic and environmental factors in the aetiology is widely accepted. Growing evidence has been presented for the link between gut dysbiosis and autism.

Obesity is a chronic disease and a significant public health problem. It is estimated that more than 650 million adults, 340 million adolescents, and 39 million children are obese. Obesity leads to organ complications including type 2 diabetes, hypertension and heart diseases. The management of obesity is based on nutritional therapy combined with lifestyle changes and increased physical activity. Pharmacotherapy is also crucial, and incretin analogues are a relatively new group of drugs. 

Personalised medicine is critical in managing allergic diseases, with the variety of second-generation antihistamines necessitating tailored approaches to individual patient needs. This encompasses considerations of age, pregnancy, breastfeeding, hepatic and renal failure, drug interactions, and aging. This paper synthesises current research and guidelines on the use of antihistamines across diverse clinical scenarios, paying special attention to paediatric allergy treatment, including safety profiles of first- and second-generation antihistamines, their use during pregnancy, breastfeeding, and interactions with other drugs, as well as considerations for elderly patients.

Vaccines are an extremely effective primary prevention tool recommended for routine use in children worldwide. Vaccination is crucial for patients with underlying diseases, including children living with HIV, because of their increased risk of morbidity and mortality from various vaccine-preventable diseases. Complex care for patients living with HIV includes antiretroviral therapy (which has dramatically improved survival), prophylaxis and treatment of common infections, prophylaxis and treatment of opportunistic infections, and vaccination.

Urinary tract infections can recur in children, and due to their potential long-term consequences, they require appropriate diagnosis and prompt treatment. Although Escherichia coli is the most common aetiology, an increase in infections with drug-resistant strains has been observed. The aim of this study was to develop current diagnostic and treatment recommendations in the era of increasing microbial resistance.

Five years after publishing the first Polish recommendations on the management of influenza, especially after the COVID-19 pandemic, there was a need to update the recommendations. Influenza is an acute infectious disease of the respiratory tract that occurs in all age groups. The course of the disease may vary in severity and clinical picture, from asymptomatic to severe with symptoms of respiratory failure. The possibility of pandemic infections and serious complications distinguish influenza from other viral respiratory diseases.

Treatment of obesity is one of the challenges of the 21^st century. It is a risk factor for the development of other diseases such as hypertension, coronary heart disease or cancer. Diagnosis of obesity should be based on body mass measurements, taking into account height and sex. It is also recommended to measure waist and hip circumference. In the article the authors reviewed guidelines regarding pharmacological treatment of obesity. The authors focus on summarising indications for pharmacotherapy, descriptions of individual drugs, their doses, as well as therapy goals and pointing out differences between individual recommendations.

As a result of genetic changes and mutations of SARS-CoV-2, new variants emerge that have different properties compared to the original strains of the virus, which is a challenge for public health. XBB.1.5, also known as Kraken, is a subvariant of Omicron, and it is the most infectious and transmissible strain of SARS-CoV-2 to date. XBB.1.5 is the dominant strain in the United States of America, spreading worldwide, including in Europe and Asia. XBB.1.5 has properties to evade the immune system and reinfect individuals who have had COVID-19 before due to its strong binding to angiotensin-converting enzyme 2, and antibody evasion.

The influenza virus is an important cause of morbidity, complications and mortality worldwide. Anyone can be infected, regardless of latitude or age. The paper describes the history of obtaining a modern influenza vaccine that does not deviate from current World Health Organization standards in Poland. Dozens of studies assessing the post-vaccination humoral response for different types of influenza vaccine, measuring levels of anti-haemagglutinin and anti-neuraminidase antibodies (although not in all of the studies) have been presented.

Allergic diseases and chronic inflammatory diseases of the respiratory system, such as asthma or chronic rhinosinusitis, continue to pose a real challenge to modern medicine. The causes of the growing problem generated by these diseases is thought to be in the interaction of genes and the environment. In the light of current knowledge, it seems that the environmentally dependent interaction between the airway microbiota ecosystem and the epithelium is able to shape the functions of the local immune system, producing a number of molecular and clinical consequences. In this paper, an attempt was made to describe the role of microbiota composition disorders (dysbiosis) of the upper respiratory tract and allergies in the development of chronic rhinosinusitis in children.

The skin microbiota is a complex ecosystem consisting of bacteria, fungi and viruses. The role of the human skin microbiota is to maintain homeostasis in the body. Disruption of the balance of the natural composition of the human microbiome can lead to the development of inflammation and infection. Atopic dermatitis is a chronic and recurrent non-infectious, inflammatory dermatosis characterised by erythematous and exfoliative skin lesions, accompanied by pruritus and a tendency to superinfection.