Circulatory failure, present

Enzalutamide mostly in children with PE, mainly with mitochondrial encephalomyopathies, lysosomal diseases and congenital disorders of glycosylation, was probably due to cardiomyopathy seen in those patients (Tab. V). Lower respiratory tract infections required an intense treatment based on antibiotics, systemic corticosteroids, mucolytics, cardiovascular drugs and aerosol therapy. Corticosteroids were most often used in the groups of children with PE and DD (Tab. VI). Antireflux management was most frequently introduced in the group with DD and PE. Albumin infusions were necessary mainly in children with PE and CAODS. Respiratory tract infections belong to the most common diseases in children. In younger patients morbidity is much higher than in older ones [18]. In developing Erismodegib cell line countries, respiratory tract infections belong to main death causes of children under the age of 5. Pneumonia is a reason for hospitalization in 40% infants, still remains a serious health problem, especially in the youngest children and in so called ‘high risk groups’ including children with neurological diseases [2, 4, 9, 19]. Diagnostic and therapeutic difficulties concerning pneumonia in the youngest children, are potentiated

by the course and complications of the underlying neurological disease [6, 7, 10., 11., 12., 13., 14., 15., 16. and 17.. Epidemiological data suggest that viruses, mainly rhinoviruses, are principal pathogens causing respiratory tract infections in children [1, 3]. Bacterial superinfections usually follow a primary viral disease.

others This type of infection is caused mainly by Streptococcus pneumoniae, Haemophilus influenzae, Staphylococcus aureus and Moraxella catarrhalis. Mycoplasma pneumoniae and Chlamydia pneumoniae should also be considered as pathogenic factors [18]. In patients with neurological disorders, pneumonia often develops on the base of chronic inflammation caused by neonatal respiratory disorders, airway colonization by pathogens, cardiovascular and respiratory congenital defects, muscular hypotonia, spine and chest deformity and increasing mucous retention in the airways [2, 6, 20]. Physical examination in contrast to symptoms and radiographic findings, usually reveals minimal abnormalities for these pneumoniae. The evaluation of respiratory murmur during physical examination is hindered by common in most children auscultatory changes connected with bronchopulmonary dysplasia, airway flaccidity or obturation accompanying GER. It is also necessary to differentiate between crepitation and fine rales – these sounds occur not only during inflammation, but also in circulatory insufficiency and transudates due to hypoalbuminemia [1, 10, 11, 13, 21].