Introduction: Hematopoietic stem cell transplantation (HSCT) has become a standard treatment for various malignant and non-malignantdiseases in children. Despitethis, HSCT mayfrequently induce multiplecomplications. Wefocused on thyroid dysfunction following HSCT in the pediatric population. Material and methods: The total of HSCT patients hospitalized between 2010-2020 in the Department of Pediatric Hematology, Oncology and Transplantology, Children's University Hospital in Lublin was 189. Our retrospective observational study included 76 children, based on thyroid parameters available in at least 2 of 3 testings: before HSCT, 1-year follow-up, and 5-year follow-up. The study group consisted of 37 children below and 39 equal to or over the median age of 7 years (p = 0.14). Patients were compared in groups based on age, gender, HSCT indication, irradiation in conditioning, and stem cell source, allowing us to determine their impact on thyroid function. The correlation between thyroid dysfunction and HSCT-related factors was analyzed after data collection. Results: Out of 76 children, 36 required thyroxine substitution approximately 5 years after HSCT. We observed lower levels offT4 in groups who underwent total body irradiation (TBI) and busulfan ortreosulfan conditioning (p = 0.015 and p = 0.0005, respectively). Conclusiuons: Due to the likelihood of hypothyroidism following HSCT conditioning, thyroid function tests should remain the standard of care.
Introduction: The primary treatment method for T2 immune response-related airway inflammations, such as eosinophilic inflammation, is topical glucocorticosteroid therapy. However, its effectiveness is limited by the challenge of drug penetration into the perinasal cavity. The introduction of a new generation of pulsating nebulizers has partially addressed this issue. Pulsating nebulizers (vibrating aerosol) enhance the penetration of nebulized medication into the paranasal sinuses, thereby opening a new therapeutic option for the treatment of chronic sinusitis. Consequently, a new regulatory indication has been approved for the use of budesonide in chronic rhinosinusitis with nasal polyps. Aim: The aim of the study was to compare the aerodynamic particle size distribution (APSD) of the dispersed suspensions of the test drug (TD) and the reference drug (RD) administered using the PARI SINUS2 nebulizer system, consisting of the PARI LC SPRINT SINUS nebulizer and the PARI SINUS2 compressor Material and methods: Comparison of the APSD of the dispersed suspensions of the TD and the RD administered using the PARI SINUS2 nebulizer system. Twelve nebulizations of each formulation were tested using six PARI SINUS2 nebulizer systems, with two repetitions per system. The methods were review of studies and own research. The APSD study was conducted using a next-generation impactor (NGI) and a laser diffraction spectrometer after nebulization of 2 mL suspensions of TD and RD via the PARI SINUS2 nebulizer system. Statistical analyses included descriptive statistics as well as 90% and 95% confidence intervals for the difference in means and the ratio of means of the examined parameters. Results: The TD was well-suited to the nebulization procedure. Both formulations (TD and RD) exhibited significant variability in the aerosol droplet distribution at different levels of the NGI cascade impactor. In the case of TD, larger droplets were more easily generated, which promoted deposition of the drug at the upper levels of the impactor. The equivalence of the two forms of budesonide, RD and TD, in the treatment of chronic rhinosinusitis with nasal polyps using a pulsating nebulizer was demonstrated. These indications were acknowledged by the Office for Registration of Medicinal Products, Medical Devices and Biocidal Products (URPLWMiPB) and added to the Product Information of TD. Conclusions: Both budesonide formulations were effective. Budesonide administered via vibrational nebulization is effective in the treatment of chronic rhinosinusitis with nasal polyps.
Alzheimer's disease (AD) remains one of the greatest challenges in modern medicine, serving as the leading cause of dementia in the elderly. Despite decades of research, effective causal treatment is still not available, and current therapies mainly focus on alleviating symptoms. However, in recent years, there has been significant progress in therapies targeting pathological proteins – amyloid β (Aβ) and tau – offering hope for modifying the course of the disease. In this review, we discuss the latest achievements in AD treatment, including clinical trial results involving monoclonal antibodies (lecanemab, donanemab), the role of biomarkers in early diagnosis, and the impact of non- pharmacological interventions such as diet and physical activity. Additionally, we analyze the challenges associated with anti-amyloid therapy, including side effects and limitations of current methods. We also emphasize the importance of personalized medicine and future research directions that may lead to breakthroughs in Alzheimer's disease therapy. Materials and methods: This review was conducted systematically to identify and analyze relevant scientific literature regarding advancements in the treatment and diagnosis of Alzheimer's disease. The PubMed database was searched. Articles were searched using the following words: "Anti-amyloid therapies"; "Alzheimer's disease"; "Lekanemab"; "Donanemab"; "Alzheimer's biomarkers"; "Cerebrospinal fluid"; "CSF"; "Tau protein"; "Non- pharmacological interventions"; "Mediterranean diet"; "Dementia prevention"; "Amyloid- related imaging abnormalities"; "Disease-modifying therapies”; „traumatic brain injury”.
Background: Attention Deficit Hyperactivity Disorder (ADHD) is characterised by three main symptoms: excessive impulsivity, hyperactivity, and difficulty concentrating and maintaining attention. Early diagnosis of ADHD is crucial to ensure timely and appropriate medical intervention.Aim of the study: The aim of this study is to provide an in-depth analysis of recent research on ADHD in children.Material and methods: A broad set of MeSH keywords and terms, including ADHD, Attention Deficit Hyperactivity Disorder, diagnosis, and treatment, was used. The search was conducted using the PubMed, Scopus, and Wiley Library databases.Results: A review of the literature highlights the complexity of ADHD, which requires a multifaceted therapeutic approach. Effective treatment includes pharmacotherapy, such as stimulant and non-stimulant medications, as well as non-pharmacological interventions, including behavioural therapy, iron and probiotic supplementation, and alternative approaches such as yoga and music therapy. The study also emphasised the importance of emerging diagnostic technologies, such as EEG analysis and machine learning frameworks, in improving diagnosis and enabling more personalised treatment.Conclusions: ADHD requires a comprehensive therapeutic approach that includes early diagnosis, appropriate pharmacotherapy, and behavioural and environmental support. New diagnostic and therapeutic technologies may significantly enhance treatment effectiveness. Further research into pathophysiological mechanisms and the development of personalised therapeutic strategies is needed.
Complex regional pain syndrome (CRPS) is chronic pain affecting the peripheral parts of the limbs. The diagnosis is based on the 2004 “Budapest Criteria”. There are many differences in clinical symptoms in children compared to adult patients. Both diagnostics, diagnosis and treatment require a multidisciplinary team, including: an orthopedist, a pediatrician, a rheumatologist, a neurologist, a rehabilitator, a psychologist, a psychiatrist, an anesthesiologist, and a pain management specialist.At the University Children's Hospital in Krakow, from May 2023 to April 2024, 4 patients with CRPS were treated. The symptoms of the disease, as well as the course of the disease, are characterized by considerable diversity. All patients received multidrug therapy, rehabilitation and psychological care. When the therapy was ineffective, interventional methods of treating chronic pain were implemented. CRPS is a challenge to diagnose and treatment can be long-lasting and partially effective only, as the cases described show.
