Instytut Matki i Dziecka w Warszawie

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Instytut Matki i Dziecka w Warszawie

Poland
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Czyewska K.,University Medyczny znaniu | Cudzilo D.,Instytut Matki i Dziecka W Warszawie | Wysocka M.,Instytut Matki i Dziecka W Warszawie | Matthews-Kozanecka M.,University Medyczny znaniu
Pediatria Polska | Year: 2011

One of the important factors in life, especially for children and youth is appropriate diet. However, attention is paid very rarely to difficulties in consuming food by people with fixed appliances during orthodontic treatment. A patient during phase of orthodontic therapy needs special diet, due to increased risk of culminating the dental plaque. Orthodontists focusing on this problem trust their instincts in giving food recommendations for patients, because there is no sufficient scientific proves concerning this problem. © 2011 by Polskie Towarzystwo Pediatryczne Otrzymano.


SNODeBSKA-KILJANSKA M.,University of Warsaw | SNODeBSKA-KILJANSKA M.,Medical University of Warsaw | Kondracka A.,University of Warsaw | Kondracka A.,Medical University of Warsaw | And 14 more authors.
Polski Merkuriusz Lekarski | Year: 2013

Iodine deficiency and thyroid gland disorders are especially harmful for pregnant women and normal fetal development. After initiation in 1997of obligatory iodine prophylaxis, Poland has been found since 2003 a country with sufficient delivery of this microelement. However, in the population of pregnant women, slight deficiency of this element still exists. Insufficient iodine supply results in abnormalities of thyroid hormones' biosynthesis. Simultaneously, adaptive changes, occurring in pregnancy, make the proper interpretation of hormone's assays difficult. Lack of normative data for the thyroid hormones concentration in the each pregnancy trimester for Polish population cause additional difficulties in the interpretation of these results. The aim of the study was prospective observation of iodine intake and thyroid function in healthy pregnant women supplemented with 150 μg of iodine daily Materials and methods. 62 healthy pregnant women living in Warsaw in the early weeks of pregnancy, confirmed by ultrasonographic examination, were included to this study. Pregnancies were singleton resulting in birth of healthy neonates. Urinary iodine concentrations (UIC), serum TSH, fT4, fT3, antyTPO, thyroid volume and morphology by the ultrasonography examination were assessed in consecutive trimesters of pregnancy. TSH level was measured in the each newborn. Results. Low urinary iodine concentrations (UIC)-median 96 μg/l was found at the beginning of pregnancy. Only in 14% of pregnant women UIC exceeded 150 μg/l. In spite of intended supplementation of at least 150 μg of extra iodine per day, medians of UIC in the next trimesters were 122 μg/l and 129 μg/l, respectively. TSH levels kept reference values for the 1st trimester of pregnancy in 86% of participants and in the next trimesters in 85% and 95%, respectively. Levels of fT4 were within reference range for the women in the 1st trimester. In 2 nd trimester 12% and in 3rd trimester 33% of pregnant women had fT4 level below the reference value. Concentrations of fT3 were within reference values during whole pregnancy. Median thyroid volume was respectively 11.12 ml; 13.0 ml and 15.75 ml (range: 6.8-26.8 ml) in subsequent trimesters.Median neonatal' TSH level on the 3rd day of life, as a screening of thyroid insufficiency, was 1.34 mIU/l (range: 0.01-6.6 mIU/l) and in 4. 41 % of newborns TSH concentrations were higher than 5 mIU/l. Conclusion. Despite the sufficient supply of iodine in the whole population, iodine consumption among the pregnant women is still not satisfactory. The increase of TSH values above the upper reference level for pregnant women in 15% of patients may be related to iodine deficiency.It is important to educate pregnancy planning women about this problem. Our observations confirm the importance of the recommendations that during the pregnancy every woman should receive supplementation of iodine at the minimal amount of 150 μg daily.


Rutkowski P.,Klinika Nowotworow Tkanek Miekkich | Mazurkiewicz T.,Medical University of Lublin | Krzakowski M.,Klinika Nowotworow Tkanek Miekkich | Ptaszynski K.,Klinika Nowotworow Tkanek Miekkich | And 24 more authors.
Nowotwory | Year: 2011

Bone sarcomas comprise a heterogenous group of rare mesenchymal tumors (less than 0.5% of malignant neoplasms in adults). From the clinical point of view they can be divided into two main groups: spindle-cell sarcomas (osteosarcomas, majority of chondrosarcomas and less common subtypes) and small-cell sarcomas (mainly the Ewing family of tumors). Correct diagnosis and effective therapy is performed in direct cooperation of radiologists, oncologic and orthpedic surgeons, clinical oncologists, radiotherapists, rehabilitants, pathologists, nuclear medicine specialists and molecular biologists. The most important principle in diagnostics and therapy of primary malignant bone tumors is a multidisciplinary approach in experienced centers. Improvement of diagnostics, implementation of combined therapy and technological developments have increased the indications for limb-sparing surgery and improved long-term results of treatment.


Korycinska-Chaaban D.,Instytut Matki i Dziecka W Warszawie | Ciecielag E.,Instytut Matki i Dziecka W Warszawie | Szponar E.,Oddzial Patologii Noworodkow | Kosciesza A.,Oddzial Patologii Noworodkow | And 2 more authors.
Pediatria Polska | Year: 2014

Phenylketonuria (PKU) is an autosomal recessive metabolic disease caused by an error of phenylalanine metabolism. Delayed treatment or treatment performed unsystematically might lead to neurological disorders and progressive intellectual disability. In the Prader-Willi syndrome (PWS) clinical manifestations change with age. Feeding difficulties resulting from the poor suck and hypotonia are typical in the neonatal period and early infancy. As patients grow their activities increase, muscle tone improves, the extreme hyperphagia appears - the main cause of obesity. Mental development of patients is usually mildly retarded. We report the case of a patient affected by two genetic diseases: PKU and PWS. Variety of clinical symptoms and abnormal results of laboratory analyses make the correct diagnosis difficult. Elevated phenylalanine level in screening newborn test, disorders of muscle tone, poor suck, and low urine biopterin concentration did not allow to clearly rule out the hyperphenylalaninemia caused by a tetrahydrobiopterin deficiency (BH 4). Data from obstetric anamnesis and the early postnatal clinical findings suggested the PWS. Hyperphagia and the increased risk of carbohydrates tolerance disorders in patients with PWS make it very difficult to balance properly the low-phenylanine diet necessary in PKU treatment. The patient presented by us needs well-coordinated multidisciplinary medical care which aims to provide proper physical development and to support the boy's mental potential as well as appropriate functioning in the society. © 2014 Polish Pediatric Society. Published by Elsevier Urban & Partner Sp. z o.o. All.


Socha J.,Klinika Gastroenterologii | Socha P.,Klinika Gastroenterologii | Weker H.,Instytut Matki i Dziecka w Warszawie | Neuhoff-Murawska J.,Klinika Gastroenterologii
Pediatria Wspolczesna | Year: 2010

We present the influence of nutrition on health in concern of changing knowledge during last centuries and with future perspectives. © 2010 Almamedia Press.


Dudek A.,Instytut Matki i Dziecka W Warszawie | Gryglicka H.,Instytut Matki i Dziecka W Warszawie | Hozyasz K.K.,Instytut Matki i Dziecka W Warszawie
Pediatria Polska | Year: 2014

This paper discusses the issues related to the hen's egg. It describes the process of laying eggs and bio-physicochemical changes which occur over time. The study cites data on production and consumption of eggs in Poland and discusses the principles of classification of eggs intended for retail trade. The study contains an analysis of the composition of eggs as well as the impact of diet and bird species on the content of the individual components. It presents Polish recommendations for introducing eggs into a child's diet and the benefits that this involves. The paper brings closer diverse opinions of many scientific societies on the impact of egg consumption on cardiovascular diseases. It describes the problem of eggs as frequent allergen and the risks associated with the use of vaccines produced on the basis of egg white. © 2014 Polish Pediatric Society. Published by Elsevier Urban & Partner Sp. z o.o. All rights reserved.


PubMed | Instytut Matki i Dziecka w Warszawie.
Type: Journal Article | Journal: Pediatric endocrinology, diabetes, and metabolism | Year: 2012

Insulin resistance is characterized by decreased tissue sensitivity to insulin. The hallmark of insulin resistance is decreased tissue glucose uptake despite normal or elevated insulin concentration. There has been an upward trend in the incidence of insulin resistance in developed countries, although in pediatric population it is difficult to assess. Both genetic and environmental factors play an important role in the etiology of insulin resistance, namely increased diet caloricity and decreased physical activity. Gradually, this leads to adipose tissue build-up. The role of visceral adipose tissue is of particular importance, mainly due to its significant endocrine activity, leading to adverse metabolic effects. The most important consequences of insulin resistance in children include increased incidence of type 2 diabetes, atherogenic dyslipidemia and arterial hypertension, which lead to increased cardiovascular risk. Children with insulin resistance can develop nonalcoholic steatohepatitis and sleep apnea syndrome. In case of female pediatric patients a higher incidence of polycystic ovary syndrome (PCOS) is observed. Furthermore, the authors reviewed opinions on risk factors for insulin resistance, as well as direct and indirect insulin resistance assessment methods. The article presents the principles of primary and secondary prevention of insulin resistance in children, with particular allowance for dietary recommendations and recommendations to increase physical activity, and, in selected cases, current guidelines on pharmacological treatment.


PubMed | Instytut Matki i Dziecka w Warszawie
Type: Comparative Study | Journal: Polski merkuriusz lekarski : organ Polskiego Towarzystwa Lekarskiego | Year: 2010

Osteosarcoma is a primary malignant bone tumor, whose peak incidence occurs in the second decade of life during the adolescent growth spurt. Complex oncological treatment consisted of chemotherapy combined with surgery which substantially increased the cure rate of patients with osteosarcoma, but it is very important to identify patients with poor prognosis and to treat them with more aggressive therapy.To assess serum biochemical bone turnover markers as prognostic indicators in patients with osteosarcoma.We studied 55 patients from age 5 to 20 years with diagnosed osteosarcoma treated at the Institute of Mother and Child in Warsaw. The studied group was divided into 2 subgroups consisted of 27 patients with favorable (disease remission) and 28 patients with unfavorable (disease progression) prognosis. Venous blood was collected from patients in the morning hours at time of diagnosis, during anticancer treatment and after completion of treatment. Serum osteocalcin (OC), bone alkaline phosphatase (BALP) and C-terminal cross-linking telopeptide of type I collagen (CTX) were analyzed by immunoenzymatic methods.At time of diagnosis, in patients with unfavorable prognosis concentration of bone formation markers were higher (OC by 30% and BALP by 60%) than in those with good prognosis, however, CTX level was similar in both groups of patients. During chemotherapy in patients with poor prognosis we observed higher levels of bone turnover markers in comparison to subjects with favorable prognosis. After the completion of therapy, in patients with progression median values of bone formation markers were over twofold and bone resorption marker about 50% higher as compared to patients with remission of disease. These differences were statistically significant at p < 0.05 for OC, p < 0.001 for BALP and p < 0.01 for CTX.Our results suggest that bone turnover markers, especially bone alkaline phosphatise may be useful in the monitoring and in the assessment of the efficacy of therapy in children with osteosarcoma. Higher rates of bone formation and resorption during treatment and after its completion are associated with unfavorable prognosis and may indicate progression of disease.

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