Background: Obesity is related to changes in adipokine secretion, activity of adipose tissue macrophages, helper T cells, and regulatory T cells. It has been confirmed that vitamin D has potent anti-inflammatory properties. It contributes to reduction in pro-inflammatory mediators and an increase in anti-inflammatory cytokines. There is also evidence that vitamin D could decrease C-reactive protein (CRP) and affect selected haematological indices.Aim of the Study: We aimed to evaluate the effect of vitamin D on interleukin (IL)-10, IL-17, CRP, blood leukocyte profile, and platelet (PLT) count in overweight and obese children before and after six months of vitamin D supplementation.Material and Methods: The study group consisted of 67 overweight and obese children aged 9.08-17.5 years. The control group included 31 normal weight peers age- and sex-matched. None of the studied children had received vitamin D supplementation before the study. Data were analyzed at baseline and after vitamin D supplementation.Results: The study group had lower baseline 25(OH)D (p<0.001) and higher white blood cell (WBC) (p=0.014), granulocyte (p=0.015), monocyte (p=0.009) and CRP (p=0.002) compared to the control group. In the study group, vitamin D levels were related negatively to nutritional status. Leukocyte profile parameters, PLT, CRP, IL-10 or IL-17 were not related to baseline 25(OH)D. Baseline IL-17 levels correlated with monocytes (R= 0.36, p=0.003) independently on 25(OH)D deficit. In children with vitamin D <15ng/ml, the baseline 25(OH)D was related to CRP (R=-0.42, p=0.017). After six months of vitamin D supplementation, we noticed a decrease in CRP levels (p=0.0003). Serum 25(OH)D correlated with IL-10 in that period (R=0.27, p=0.028). Moreover, we noticed that IL-10 correlated with monocyte (R=-0.28, p=0.023). We did not find any significant associations between 25(OH)D and leukocyte profile parameters, PLT, or IL-17. The multivariable stepwise regression analysis identified IL-10 as the parameter positively associated with 25(OH)D.Conclusions: Our study confirmed beneficial effects of vitamin D supplementation in overweight and obese paediatric populations. Vitamin D intake seems to exert its anti-inflammatory effect mainly via decreasing the CRP level and protecting stabile values of IL-10, rather than its impact on pro-inflammatory factors such as lL-17 and leukocyte profile parameters.

Background: The provision of care for dying cancer patients varies on a global basis. In order to improve care, we need to be able to evaluate the current level of care. One method of assessment is to use the views from the bereaved relatives. Aim: The aim of this study is to translate and pre-test the ‘Care Of the Dying Evaluation’ (CODE^TM) questionnaire across seven participating countries prior to conducting an evaluation of current quality of care. Design: The three stages were as follows: (1) translation of CODE in keeping with standardised international principles; (2) pre-testing using patient and public involvement and cognitive interviews with bereaved relatives; and (3) utilising a modified nominal group technique to establish a common, core international version of CODE. Setting/participants: Hospital settings: for each country, at least five patient and public involvement representatives, selected by purposive sampling, fed back on CODE^TM questionnaire; and at least five bereaved relatives to cancer patients undertook cognitive interviews. Feedback was collated and categorised into themes relating to clarity, recall, sensitivity and response options. Structured consensus meeting held to determine content of international CODE (i-CODE) questionnaire. Results: In total, 48 patient and public involvement representatives and 35 bereaved relatives contributed to the pre-testing stages. No specific question item was recommended for exclusion from CODE^TM. Revisions to the demographic section were needed to be culturally appropriate. Conclusion: Patient and public involvement and bereaved relatives’ perceptions helped enhance the face and content validity of i-CODE. A common, core international questionnaire is now developed with key questions relating to quality of care for the dying.

Recombinant human growth hormone therapy (rhGH) has been widely accepted as the safe treatment for short stature in children with such genetic syndromes as Prader–Willi syndrome and Turner or Noonan syndrome. Some patients with short stature and rare genetic syndromes are treated with rhGH as growth hormone-deficient individuals or as children born small for their gestational age. After years of experience with this therapy in syndromic short stature, it has been proved that there are some aspects of long-term rhGH treatment beyond growth promotion, which can justify rhGH use in these individuals. This paper summarizes the data of a literature review of the effects of rhGH treatment beyond growth promotion in selected genetic syndromes. We chose three of the most common syndromes, Prader–Willi, Turner, and Noonan, in which rhGH treatment is indicated, and three rarer syndromes, Silver–Russel, Kabuki, and Duchenne muscular dystrophy, in which rhGH treatment is not widely indicated. Many studies have shown a significant impact of rhGH therapy on body composition, resting energy expenditure, insulin sensitivity, muscle tonus, motor function, and mental and behavioral development. Growth promotion is undoubtedly the primary benefit of rhGH therapy; nevertheless, especially with genetic syndromes, the additional effects should also be considered as important indications for this treatment.

Cardiovascular diseases remain the leading cause of mortality worldwide, with multiple risk factors contributing to their development. Among these, obesity and hyperhomocysteinemia have been recognized as significant contributors to endothelial dysfunction, a key early event in the pathogenesis of atherosclerosis. Our study aimed to evaluate the relationship between total homocysteine (tHcy) levels and traditional cardiovascular risk factors in overweight and obese adolescents. We enrolled 42 obese, 14 overweight, and 25 non-obese children. No significant differences in tHcy levels were observed between overweight, obese, and non-obese adolescents. Homocysteine positively correlated with age (r = 0.433, p < 0.011) and creatinine concentrations (r = 0.363, p = 0.001) in the overall group of overweight, obese, and non-obese children, as well as in the combined group of overweight and obese children (for age: r = 0.275, p = 0.025; for creatinine: r = 0.278, p = 0.025). We did not find any association between homocysteine and atherogenic lipid profile, insulin-resistance status, blood pressure, and inflammatory parameters in overweight and obese patients. Age emerged as the strongest independent predictor of homocysteine levels. The observed association with creatine suggests a potential renal contribution to homocysteine metabolism.

Obesity-related low-grade inflammation is a significant factor responsible for the development of metabolic syndrome and chronic diseases, which can begin even in early childhood. Recently, there has been growing interest in the impact of vitamin D3 supplementation on inflammatory markers in overweight and obese individuals; however, findings remain inconsistent. Therefore, we aimed to conduct a systematic review to assess the effects of vitamin D3 supplementation on inflammatory markers in overweight and obese children and adolescents, focused exclusively on the analysis of randomized controlled trials (RCTs) identified by searching PubMed, EMBASE, and Cochrane Library. The results of this study were synthesized and reported following the PRISMA statement. A total of 294 citations were identified through electronic literature searches, of which two RCTs were finally included in our systematic review. We found that vitamin D3 supplementation did not affect the changes in C-reactive protein (CRP), interleukin-6 (IL-6), and tumor necrosis factor-α (TNF-α), but led to a decrease in leptin levels. The small number of studies meeting the inclusion criteria for our systematic review limits the value of the presented results, but also indicates the need for in-depth research on this topic.

Pseudohypoparathyroidism type 1b (PHP-1b) is a rare genetic disorder caused by mutations or epigenetic alterations of the maternal GNAS gene, resulting in isolated renal resistance to parathyroid hormone (PTH) and, in some cases, partial resistance to thyroid-stimulating hormone. Clinical manifestations typically result from hypocalcemia and resemble those seen in hypoparathyroidism, while laboratory tests show elevated serum PTH levels along with hypocalcemia and hyperphosphatemia. We present a case of a girl with an unusual course of PHP: from non-autoimmune hypothyroidism coexisting with hypercalcemia at the age of 1 year to the diagnosis of PHP-1b at the age of 3.5 years, before the onset of symptomatic hypoparathyroidism. In the absence of a clear cause for hypothyroidism, assessment of calcium and phosphate metabolism should be considered. Initial hypercalcemia does not exclude the diagnosis of PHP-1b. Long-term monitoring of calcium and phosphate metabolism parameters may be necessary for a final clinical diagnosis.