Background: Changes in adipokine secretion may be involved in the anti-epileptic effect of a ketogenic diet (KD) in drug-resistant epilepsy (DRE). Objectives: The assessment of the influence of KD on serum adiponectin, omentin-1, and vaspin in children with DRE. Methods: Anthropometric measurements (weight, height, BMI, and waist-to-hip circumference ratio) were performed in 72 children aged 3–9 years, divided into 3 groups: 24 children with DRE treated with KD, 26—treated with valproic acid (VPA), and a control group of 22 children. Biochemical tests included fasting glucose, insulin, beta-hydroxybutyric acid, lipid profile, aminotransferases activities, and blood gasometry. Serum levels of adiponectin, omentin-1 and vaspin were assayed using commercially available ELISA tests. Results: Serum levels of adiponectin and omentin-1 in the KD group were significantly higher and vaspin—lower in comparison to patients receiving VPA and the control group. In all examined children, serum adiponectin and omentin-1 correlated negatively with WHR and serum triglycerides, insulin, fasting glucose, and HOMA-IR. Vaspin levels correlated negatively with serum triglycerides and positively with body weight, BMI, fasting glucose, insulin, and HOMA-IR. Conclusion: One of the potential mechanisms of KD in children with drug-resistant epilepsy may be a modulation of metabolically beneficial and anti-inflammatory adipokine levels.

Emerging evidence highlights extracellular vesicles (EVs), especially exosomes, as critical molecular messengers linking pediatric obesity to multi-organ complications. This scoping review synthesizes current knowledge on EVs-mediated intercellular communication that exacerbates inflammation, insulin resistance, endothelial dysfunction and organ-specific damage. Data demonstrate that adipose- and endothelial-derived EVs carry bioactive cargo, microRNAs, proteins, and lipids, that modulate key pathways driving metabolic derangements and vascular injury, often preceding detectable clinical biomarkers. Notably, maternal obesity influences EVs composition in breast milk, shaping early-life metabolic programming and offspring risk of obesity. Recent studies underscore the diagnostic and therapeutic potential of EVs in obesity-related conditions such as metabolic-associated fatty liver disease (MAFLD), early renal injury, and cardiovascular dysfunction in children. Furthermore, EVs released in response to exercise or bariatric surgery may mediate systemic metabolic improvements, offering a novel window into personalized interventions. Despite promising findings, standardization of EV isolation and profiling in pediatric research is lacking, and large-scale longitudinal studies are urgently needed. By deepening our understanding of EVs biology, clinicians may advance early detection, risk stratification, and targeted therapies to interrupt the progression from childhood obesity to lifelong metabolic and cardiovascular disease.

Childhood obesity has emerged as one of the most pressing public health challenges of the 21st century. Early-onset obesity is associated with an increased risk of developing numerous comorbidities later in life. Despite extensive research into its multifactorial etiology—including genetic, behavioral, environmental, and socioeconomic factors—the precise molecular mechanisms underlying the development and persistence of obesity in the pediatric population remain incompletely understood. Proteomics offers promising insights into these mechanisms. The application of proteomics in pediatric obesity research has grown, enabling the identification of proteins that reflect dynamic changes in metabolic and inflammatory pathways. This advancement allows clinicians to move beyond traditional anthropometric measurements toward personalized approaches with notification of early complications of obesity. A systematic search was conducted across PubMed, Scopus, and Web of Science for studies published between 2010 and 2025. Inclusion criteria: human studies, participants aged 0–18, proteomic analysis of obesity, and biomarkers. Data extraction and quality assessment followed standardized protocols. From 239 articles, 20 were included. Key dysregulated proteins include APOA1, CLU, and HP. LC-MS/MS was the predominant technique used. Some biomarkers were predictive for obesity complications in children. Proteomics holds clinical potential for early detection and personalized treatment of pediatric obesity. Standardized methodologies and longitudinal studies are needed for translation into clinical practice.

Zastosowanie FDG PET/CT w kwalifikacji dzieci z padaczk? lekooporn? do leczenia neurochirurgicznego - Marcin Chyra, Marek Mandera, Magdalena Dudzi?ska, Ma?gorzata Mikanik-Klemens

Porażenie wiotkie kończyn górnych u 6-latka jako manifestacja wyściółczaka anaplastycznego rdzenia kręgowego - Marcin Chyra, Magdalena Dudzińska, Marek Mandera, Katarzyna Lipka, Marek Boba