Background: Pneumothorax (PTX) is a potential complication of respiratory support in preterm newborns. Less invasive approach to respiratory care likely decreases PTX incidence.
Methods: This retrospective study aimed to investigate the association between non-invasive respiratory support and
PTX incidence. We also aimed for evaluating mortality rate and main morbidities linked to PTX, including
bronchopulmonary dysplasia (BPD), severe intraventricular hemorrhage (IVH), severe retinopathy (ROP). We included
459 premature infants delivered before 30 weeks gestation over the period of January 1, 2012 to December 31, 2017
and admitted to the Neonatal Intensive Care Unit of Clinical Centre, University of Debrecen.
Results: 27 infants were identified with diagnosis of symptomatic pneumothorax over the study period. Between
2015–2017, more preterm infants were stabilized on non-invasive respiratory support compared to the period of
2012–2014 (63.6% versus 20.6%, p<0.001). PTX became less frequent (2.6% versus 9.2%, p=0.0027) with more
extensive use of non-invasive respiratory support (2015–2017) as a primary approach to respiratory care. Mortality rate
was higher (37% verus 10,2%, p<0,001) and severe IVH (32% versus 14,0%, p=0,037), severe ROP (29% versus 10,1%,
P=0,028) were also more common among premature infants with PTX.
Conclusion: Primary use of non-invasive respiratory support in combination with early rescue surfactant administration
in preterm infants with good respiratory effort reduces PTX rate and associated adverse outcome.

The case riport of an idiopathic orbital myositis in a paediatric patient, where the picture suggested an acute, severe local bacterial infection – ethmoiditis or cellulitis of the orbit, but was resistent to systemic antibiotics. The symptoms:
orbital pain, diplopia with normal vision, restriction of the extraocular muscle movement, proptosis, swollen eyelids, conjunctival hyperemia as in our case, are characteristical. The orbital MR shows enlargement of one or more
extraocular muscle(s), with high T2 signal intensity. Differential diagnostic challenges are thyroid associated orbitopathy, myositis with associated auto-immune mediated systemic disease, also local neoplasm (orbital lymphome) must be excluded (painless). In mild cases NSAID, in moderate cases steroids are recommended, in severe, steroid resitant cases consider radiotherapy, periorbital steroids, other immuntherapy.

Ecthyma gangraenosum is a morphologically typical dermal manifestation of an invasive bakterial infection mostly as a consequence of neutropenia and needs one-two febrile days to evolve. The etiologic agent in the majority of patients is
P. aeruginosa, but occasionally other Gram-negative bacilli and S. aureus can play causative role. The empirical antibacterial treatment is the use of a broad spectrum molecule with antipseudomonal activity. The bacteriologist can encounter a phenomenon in which seemingly isogenic bacterial subpopulations show heterogeneity of response to antibiotics. This is called heteroresistance. Its interpretation is the competency of the clinical microbiologist.

Measurement of body composition can be useful in many areas of medicine, and it can provide guidance on the care of chronic patients, nutrition, risk assessment of complications and predicting expected outcomes. Air- displacement plethysmography (ADP) is a practical, reliable and valid method of body composition measurement, and the newborn-infant type of this method (PeaPod) is being used more and more in both clinical trials and everyday patient care. The purpose of the article is to discuss the methodology and the advantages and disadvantages of the method, and the potential areas of application.

Preterm newborns form a particularly vulnerable population with relatively high mortality rate and healthcare associated infections are more common among them, compared to that in their full term counterparts. In the literature it
has been proven, that properly maintained surveillance and evidence based infection control measures (check list, local protocols, audit) are applicable, sustainable and successful measures in the battle against these infections. Thus, strict hygienic protocols play an important role, by which half of the occurred nosocomial infection can be prevented.

Children’s poisoning cases present in general practioners’ office are rather frequent, but actions to be taken are not well known by doctors not working in this field. It is important to evaluate the medical history of each case as closely as possible. The right approach is facilitated by proper questions: How old is the child? What is her/his weight? What did she/he eat? How much of that did she/he eat? When did she/he eat it? Does she/he have sympthoms? Bring sample!!! Be aware that actually asymptomatic child can develop symptoms later. Kids under the age of 3 are in greatest danger and the most common poisoning is corrosive injuries; self-intent adolescents usually need hospitalization because of medicine exposure. The most important thing to do is to decide whether we should send the patient to the hospital or not. In Hungary, the National Toxicology Information Service or the Department of Toxicology and Metabolic Diseases of Heim Pál National Pediatric Institute can help you with your decisions.

Incontinentia pigmenti or Bloch-Sulzberger syndrome is a rare X-linked, dominant genodermatosis. This disease can be seen in female newborns because in males this illness is usually lethal. In this disease, 4 different stages can be distinguished, which onset in the first days, and it causes real difficulty to differentiate from other sickness. It is especially complicated to differentiate the incontinentia pigmenti from infection. In order to cure the patient properly,
it is important that every field of medicine took part of the healing process: such as dentists, neurologists, ophthalmologists, pediatricians, dermatologists, and of course geneticists.

Botulism is a rare, but potencially life threatening neuroparalytic syndrome, which is occured by the neurotoxin of Clostridium Botulism. The 13 year old boy was admitted to our ward with fatigue, vomiting, diplopia, mydriasis - his
eyes were dilateted and, there was no reaction to light (nor direct, neither indirect). His neurological symptoms were progressing over the days: uni- then bilateral paresis of n. abducens, bilateral ptosis with the left side predominance,
and the lability of the vegetative nerve system emerged. Mouse bioassay proved botulinum toxin in our patient’s serum.
We transferred him to the Heim Pál Children’s Hospital, where the heptavalent antitoxin was given to him. Shortly after the admission of the antitoxin, his symptoms ceased.

Appendicitis is the most common acute abdominal disease managed operatively by the pediatric surgeon. Many different illnesses may cause right iliac fossa pain, we would like to report a rare case. An adolescent patient was
operated because of acute abdominal signs, with a suspected diagnosis of appendicitis. During laparoscopic exploration we found a macroscopically intact appendix vermiformis, and a total different illness was detected surpisingly…