Pre- and postnatal exposure of children to tobacco smoke during the first four years of life--observations of the authors.

INTRODUCTION: Environmental exposure to tobacco smoke is a significant threat for human health, where the higher is its degree, the more immature the human organism is. Therefore, the exposure to Tobacco smoke in foetal life exerts unfavourable effects on developing foetus and may cause early and distant results in children. MATERIAL AND METHODS: The study comprised 318 children in their first four years of life, treated for various medical conditions. The examined children were divided into two groups, Group 1--children exposed to Tobacco smoke--and Group 2--a control group with children from non-smoking families. History data were obtained on the basis of a specially designed questionnaire, used by the doctor in an individual conversation with parent. In each third child from the group 1 cotinine concentration in urine was assayed by the method of high performance liquid chromatography-UV-VIS and the cotinine/creatinine ratio was calculated. RESULTS OF STUDY: Results demonstrated environmental exposure to tobacco smoke in 173 children (Group 1). Out of them 31.2% were the children whose mothers had smoked also during pregnancy (Subgroup A). The other 119 children from Group 1 were accounted to Subgroup B, i.e., children, where other household members had been smoking cigarettes. A comparative group comprised 143 children from non-smoking families. The results demonstrated then that 17% of all the examined children were those, exposed to tobacco smoke effects already in their foetal life, predisposing them to prematurity and low birth weight. Moreover, it was observed that the young age and lower education level of their parents, together with worse housing conditions, may suggest a predisposing character and role of the mentioned factors.

Prevalence of atopic dermatitis in infants during the first six months of life: authors' observations.

INTRODUCTION: Atopic dermatitis (AD) is a frequent chronic skin disease in infants. It creates great difficulties, both diagnostic and therapeutic. AIM: To assess the prevalence of atopic dermatitis in infants during the first 6 months of life. MATERIAL AND METHODS: The analysis comprised 2256 children at the age of not more than 6 months, treated at the 2(nd) Department of Paediatrics and Allergology of the Polish Mother's Memorial Hospital in Lodz, Poland, during seven years. Out of all the patients, children with cutaneous changes were isolated, and the location, type and aetiology of changes were assessed. RESULTS: Dermal changes were diagnosed in 471 children, including 391 (17.3% of all the patients) with atopic dermatitis. Out of the children with AD, IgE-dependent allergy was identified in 39.9%. Cow's milk protein was the most frequent sensitising allergen. In 71.6% of the infants, cutaneous changes were disseminated and involved at least two areas of the body. All of them were strongly itching. An applied elimination diet, together with anti-allergic medications in some of the children, provided a clear clinical improvement. CONCLUSIONS: Performed studies demonstrated the prevalence of atopic dermatitis in 17.3% of examined children. The changes in children with AD were disseminated, what was confirmed already at the infantile age. The obtained clinical improvement after the applied therapy indicates a relationship between the observed symptoms and allergic disease.

The usefulness of soluble transferrin receptor (sTfR) in differentiating anemia occurring in young children.

We evaluated the usefulness of soluble transferrin receptor (sTfR) and of the sTfR/log ferritin index(sTfR/logF) in the differentiation of anemia in young children. 96 children, aged 6-36 months, were examined.From these, four groups were distinguished: 1 - (IDA): 33 children with anemia due to iron deficiency; 2 -(IA): 19 children with infectious anemia without iron deficiency; 3 - (IA + ID): 16 children with infectious anemia and iron deficiency; and 4 - a comparator group (CG): 28 healthy children without iron deficiency. The soluble transferrin receptor, hematological indices and iron balance were evaluated and the sTfR/logF was calculated for each examined child. It was proved that the mean values of sTfR and sTfR/logF were substantially higher in children with anemia due to iron deficiency, and in those with infectious anemia and iron deficiency,vs. those with infectious anemia or in healthy children. This suggests that both sTfR and the sTfR/logF are good indicators of iron deficiency and could be useful in the differential diagnostics of anemia, especially in young children.

Role of selenium and zinc in the pathogenesis of food allergy in infants and young children.

INTRODUCTION: Selenium and zinc are indispensable microelements for normal functioning and development of the human body. They are cofactors of many enzymes of the antioxidative barrier (selenium - glutathione peroxidase; zinc - superoxide dismutase). The aim of the study was to evaluate the importance of selenium and zinc in the pathogenesis of food allergy in small children. MATERIAL AND METHODS: The study was performed in 134 children with food allergy, aged 1 to 36 months. The control group was composed of 36 children at the same age, without clinical symptoms of food intolerance. Each child had estimated serum levels of zinc and selenium. Furthermore, the authors evaluated activity of glutathione peroxidase (GSH-Px) in erythrocyte lysates and serum. Tests were performed twice, before and after 6-month administration of elimination diet. RESULTS: The obtained results showed that children with food allergy had significantly lower concentrations of selenium, zinc and examined enzymes in comparison to children from the control group. Concentration of selenium and zinc as well as activity of examined enzymes increased after application of eliminative diet. CONCLUSIONS: In children with allergy decreased concentrations of selenium and zinc, and lower values of glutathione peroxidase and superoxide dismutase which increased after elimination diet were affirmed. These observations suggest their role in pathogenesis of food allergy. Conducted observations indicate the need to monitor trace elements content in the diet in children with food allergy. The results showed that children with food allergy had a weakened antioxidative barrier.