In the newborn period, pathological and physiological skin changes are often mixed and difficult to verify. The spectrum of neonatal skin symptoms is very wide, ranging from benign transient lesions to serious diseases. In addition to the harmless, rapidly regressing skin phenomena, the author presents the vascular and developmental disorders, congenital naevus and skin infections that has observed and monitored during his decades of professional work in paediatrics and pediatric dermatology. In connection with the analysis of individual disease groups, it draws attention to the pathological processes affecting other organ systems that appear together with skin lesions. The clarification and care of such patients in many cases requires the cooperation of allied professions. The skin lesions included in the review study are illustrated with numerous images.

Q-fever is a rare zoonosis, most often spread by domestic animals. The acute form of disease causes a flu-like febrile illness, which can be associated with pneumonia or hepatitis, more than half of the cases are asymptomatic. Q-fever pneumonia cannot be distinguished from other form of CAP on the basis of clinical, radiological and laboratory characteristics, the medical history may draw attention to it. Often the anamnesis is not informative, in the two cases presented we performed the serological tests based on the epidemiological situation, that confirms the disease. Chronic Q fever most often presents as endocarditis.

Adolescence and inflammatory bowel diseases independently pose a challenge to nutrition therapy professionals. The increased nutritional requirements of physical development during puberty and the psychosocial changes during adolescence make it difficult to effectively treat chronic inflammatory disease, especially with medical nutritional therapy. It often develops with complete or partial malnutrition with a deficiency or excessive intake of certain
nutrients. Adolescent nutritional characteristics may increase the risk of developing inflammatory bowel disease or exacerbate its nutritional consequences. During the treatment of IBD, it is important to assess the nutritional status of patients, assess the severity of deficiencies and start effective nutritional therapy in time, in order to avoid and prevent
nutrition-related side effects and complications.

The mainstays of nutrition therapy are oral nutritional supplements, of which a wide range is available. Oral medical foods can be useful for supplementing energy and nutrient intake and for exclusive nutrition. To choose optimally it is necessary to know the composition and other aspects – osmolality, fiber content. The following review provides an overview of these.

In case of inadequate oral feeding, introduction of artificial enteral feeding is necessary. As a short-term solution, nasogastric tube placement is often appropriate, but when the tube feeding is required for more than 3-6 weeks, artificial stoma formation is necessary. Based on the risk-benefit assessment, the methodology of the stoma formation is determined by the patient’s age, body size, associated diseases, as well as the needs of parents and caregivers and local expertise. The possibility for complications is also reduced by multidisciplinary approach. With properly chosen equipment, feeding formula and caregiver education, the patient’s nutritional status and growth can be assured, and the quality of life can be improved for a prolonged time.

The paper summarises our knowledge of the possibilities, opportunities and risks of the children’s home parenteral nutrition. The HPN is nowadays in Hungary a rarely, but increasingly necessary and more widely used therapeutic method in cases of patients with small bowell insufficience. This treatment can help cure these patients or provide them with a good quality of life for years in home conditions.

The nutritional management of an infant or child with liver disease depends on whether the disease is acute, chronic or metabolic. Potential problems warranting nutritional attention occur when there is a disturbance in the usual metabolic functions of the liver. These include glucose homeostasis, protein synthesis, bile salt production, lipid metabolism and vitamin storage. Dietary therapy is primarily aimed at managing the consequences of these disturbances, to meet the increased needs and to prevent malnutrition, as it affects the outcome.

Chronic, serious disease,like pediatric cancer, can cause negative changes in nutritional status of patients.
Malnutrition, intended as both overnutrition or undernutrition, is a common problem in children with cancer, impacting quality of life as well as survival. In addition, nutritional imbalances during childhood can significantly affect proper growth. It became evident that proper nutritional support is essential not only at the diagnosis but during the treatment, and even beyond for a long term period. The most important supportive therapy is nutritional therapy for treated oncology patients to moderate complications, improve the chance of survival, and enhance quality of life. We summarize the main elements of nutritional therapy from screening, and assessment of nutritional status to applying the appropriate method of nutritional therapy without complications. We aimed to collect the relevant and important recommendations in the field of clinical nutrition, and emphasize the significance of the supportive nutrition therapy in pediatric oncological patients.

Nutrition plays a central role in the management of pancreatic diseases. In mild or moderately severe acute pancreatitis early (<48 hours) oral nutrition should be attempted with the return to regular-fat diet as tolerated. Jejunal tube feeding should be reserved for those unable to tolerate oral or nasogastric tube feeding. Early enteral nutrition can safely be started in severe forms of disease. Children should receive regular-fat diet in between episodes of acute recurrent pancreatitis and pancreatic enzyme replacement therapy should not be routinely used. Children with chronic pancreatitis should be screened for signs of impaired growth, malnutrition and pancreatic exocrine insufficiency, they should receive regular-fat diet.

Children with psychomotor developmental problems and those who lost their abilities due to different diseases might need rehabilitation. The ptimary goal of rehabiltiation rehabilitation is to provide appropriate therapeutic interventions and tools to ensure the highest possible level of independence and quality of life for the affected child and their families.
Nutritional therapy is an integral part and a fundamental pillar of the rehabilitation process, as optimal body composition enables children’s physical and intellectual development. Furthermore, assessing and addressing eating behaviors, social interactions related to meals, and social relationships are also part of the rehabilitation care. A multidisciplinary team centered around the affected child and his/ her their family assists in resolving nutritional challenges and promoting the social integration of the patient and their family. To achieve this, a therapeutic program must be developed that takes into account general knowledge about nutrition and specific knowledge related to the particular disease, the child’s individual capabilities, needs, and the material and personnel conditions of the institution where the rehabilitation work takes place.

In today’s world, the acronym SMA is not only meaningful to those affected and professionals, but it has also become widely known to the general public. This widespread awareness can be attributed to the development of three different disease-modifying gene therapies that revolutionized the treatment of spinal muscular atrophy, opening up new perspectives for both patients, their families, and caregivers. Since 2018, these various treatment options have
gradually become available in Hungary, funded by the state insurance system based on individual equity assessments, where the therapeutic effect is often perceived as a miracle. Children, who were mostly helpless and vulnerable before, can move again, their need for respiratory support decreases, their development, life expectancy, and of course, their quality of life improve significantly. Children, who were mostly helpless and vulnerable before, can move again, while their need for respiratory support decreases, their development, life expectancy, and of course, their quality of life improve significantly. The natural course of the disease has fundamentally changed, especially if we apply gene therapy as early as possible, even in symptom-free newborns. However, it is important to emphasize that even the latest treatments do not provide a cure for the patients, especially in terms of gastroenterological problems and nutritional challenges. We still have a lot of work to do, and in fact, it has become even more complex with the emergence of different phenotypes of the disease. In our article, we present the current guidelines for nutritional therapy and the latest exciting issues concerning science from the perspectives of a gastroenterologist and a dietitian.