Background: Home artificial nutrition (HAN) is a developing method of treatment that reduces the need for hospitalizations. The epidemiology of pediatric HAN in Poland has not yet been covered in detail. This study is a longitudinal nationwide analysis of incidence, prevalence, and patients’ profile for HAN in Polish children. Methods: Assessment of National Health Fund (NFZ) data covering all pediatric patients treated with HAN in Poland between 2010 and 2018. Results: HAN was received by 4426 children, 65 patients were on home enteral nutrition (HEN) or home parenteral nutrition (HPN) at different times (HEN n = 3865, HPN n = 626). HAN was most frequently started before the child was 3 years old and long-term HAN programs (5–9 years) were reported. The most common principal diagnosis in HEN was food-related symptoms and signs. In HPN, it was postoperative gastrointestinal disorders. A regionally differentiated prevalence of HAN patients and centers was demonstrated. Mortality among patients was 24.9% for HEN, and 9.6% for HPN, and the main in-hospital cause of death was cardiac arrest. Conclusions: HAN’s use is increasing and evolving in Poland. Uneven distribution of patients and centers results in difficult access to the nutritional procedure which, together with the increasing number of patients, highlights the need for data analysis and development of nutrition centers.

Introduction: Abnormal body weight, including overweight and obesity, is a common health problem affecting children and adolescents. The present study aimed to analyse weight changes in children from preschool age to adolescence and to identify early predictors of excessive weight in adolescence, such as blood pressure and physical fitness observed in preschool children. Methodology: Data from 3075 children (1524 girls and 1594 boys), collected as part of the Gdańsk Centre for Health Promotion’s “Your Child’s Healthy Life” programme, were analysed, with each child assessed at ages 6, 10, and 14. Results: The results indicated that boys were more likely to be overweight, with a tendency for obesity to increase with age. Children who were overweight or obese at age 6 had a higher risk of remaining so for a longer period of time. In addition, low physical fitness (as measured by the KPRT test) and elevated blood pressure were significantly associated with excess body weight. Conclusions: The study underscores the importance of early intervention and consistent monitoring of childhood overweight and obesity to reduce their long-term impact on health.

Background: The massive resection of the small intestine leading to short bowel syndrome (SBS) deprives an organism of many immunocompetent cells concentrated in gut-associated lymphoid tissue, the largest immune organ in humans. We have aimed to access the influence of bowel resection on adaptive immunity in children, based on peripheral lymphocyte subsets and serum immunoglobulins. Methods: 15 children who underwent bowel resection in the first months of their life and required further home parenteral nutrition were enrolled into the study. Based on flow cytometry, the following subsets of lymphocytes were evaluated: T, B, NK, CD4+, C8+, and activated T cells. Results: Statistically significant differences were found for the rates of lymphocytes B, T, CD8+, and NK cells. The absolute count of NK cells was lower in the SBS group than in the control group. Absolute counts of lymphocytes, lymphocytes B, T, CD4+, and percentages of lymphocytes CD4+, and activated T cells inversely correlated with age in SBS group. Conclusions: Children with SBS do not present with clinical signs of immunodeficiency as well as deficits in peripheral lymphocyte subsets and serum immunoglobulins. The tendency of the lymphocyte subpopulations to decrease over time points out the necessity for longer follow- up.

Nutritional status disorders are a worldwide problem. Approximately 5.9 million children under the age of five die each year, and 45% of these deaths are related to malnutrition. The aim of the study was to analyse the prevalence of underweight children aged between 6 and 7 years old, living in the Gdańsk, Poland, in the years 1994–2020. The anthropometric parameters of 67,842 children were analysed. BMI (Body Mass Index) value <5 percentile (pc) was defined as underweight. The BMI value was compared to the WHO (World Health Organization) centile charts and the OLAF (research project PL0080) national reference charts. The prevalence of underweight children in relation to the WHO charts was 1.9%; underweight status was found to be more significant in the group of boys (2.1%) than the group of girls (1.7%) (p < 0.001). According to the OLAF centile charts, the underweight figure among all of the study population was 2.1% and no statistical significance between boys (2.1%) and girls (2.0%) was found (p = 0.670). The occurrence of underweight indviduals in the studied group slightly increased in the years 1994–2020. We found a statistically significant increasing linear trend in the analysis of underweight children in our group (p < 0.001), in group of boys (p < 0.001), but not girls (WHO p = 0.603; OLAF p = 0.787). This points to the need to conduct regular screening systems for children and adolescents.

Background: Massive resection of the small intestine leading to short bowel syndrome (SBS) deprives organism of many immunocompetent cells concentrated in gut associated lymphoid tissue- the largest immune organ in humans. We have aimed to access the influence of bowel resection on adaptive immunity in children, basing on peripheral lymphocyte subsets and serum immunoglobulins. Methods: 15 children, who underwent bowel resection in the first month of life and required further home parenteral nutrition were enrolled into the study.. Based on flow cytometry the following subsets of lymphocytes were evaluated: T, B, NK, CD4+, C8+and activated T cells. Results: Significantly statistical differences were found for the rates of lymphocytes B, T, CD8 + and NK cells. Absolute count of NK cells was lower in SBS group than in the control group. Absolute counts of lymphocytes, lymphocytes B, T, CD4+ and percentages of lymphocytes CD4+, and activated T cells inversely correlated with the time after resection. Conclusions: Children with SBS do not present with clinical signs of immunodeficiency as well as deficits in peripheral lymphocyte subsets and serum immunoglobulins. The tendency of the lymphocyte subpopulations to decrease over time after resection points out the necessity for longer follow- up.

Objectives: This study aimed to determine the prevalence of gastrostomy-related procedures and paediatric patients undergoing these procedures, alongside temporal trends, patient profiles, and regional disparities in procedure provision. Methods: We analysed anonymised National Health Fund data pertaining to patients who underwent procedures at regional centres in Poland from 2010 to 2019. To assess temporal patterns, procedure counts and patient prevalence were aggregated annually, and trends over time were evaluated using the Mann–Kendall trend test. Results: Percutaneous Endoscopic Gastrostomy (PEG) was performed in 2638 patients, while gastrostomy-other was performed in 2087 patients. The cumulative prevalence of patients during the 10-year follow-up period was as follows: PEG: 37.7 per 100,000 children; gastrostomy—other: 29.9 per 100,000 children. The procedure prevalence rates were PEG: 40.1 per 100,000 children; gastrostomy-other: 43.0 per 100,000 children. Gastrostomy-related procedures were performed most frequently in the first three years of life. Conclusions: Patient sex, age, and centre location influenced utilization, as shown by local variations. The increasing trend in gastrostomy procedures and the young patient age indicate the growing use of gastrostomy, with endoscopic placement being the most common. Given the rising numbers requiring gastrostomy, optimizing inter-centre collaboration could contribute to the identification and treatment of patients with special nutritional needs.