Department of Paediatrics
The Department of Paediatrics provides highly specialized medical care for children from infant age until the age of 19 years from the Bratislava and Western Slovakia region, and in selected sub-specialities like diabetology and hereditary disorders of metabolism for all regions of the Slovak republic.
PROFESSIONAL AND SCIENTIFIC ACTIVITIES
1. Diabetology. The Paediatric Diabetes Centre of the Slovak Republic, headed by Ľ. Barák, MD, PhD., is an integral part of the Department of Paediatrics. Its medical team aims to provide diagnosis, treatment and education (in its Educational centre) for children with all types of diabetes mellitus and their parents on a nationwide level. It manages the National Register of Children with Diabetes in co-operation with the National Centre for Health Information, and methodologically leads the research activities of the Slovak "Epidemiological Working Group of Paediatric Endocrinologists". The group is a leading authority in clinical research of monogenic forms of diabetes, including MODY, neonatal diabetes and diabetes mellitus syndrome, as well as congenital hyperinsulinism and other hypoglycaemic conditions. It runs several scientific projects in collaboration with the DIABGENE Biomedical Centre of Slovak Academy of Sciences, where the genetic identification of causal DNA mutations is carried out. In collaboration with other departments of the Faculty of Medicine of the Comenius University and the Slovak Medical University, the centre monitors the genetic background of newly-diagnosed patients with type 1 diabetes and their healthy siblings, as well as immunological events in their organism and potential triggers of autoimmune processes.
2. Inherited Metabolic Disorders. The Department of Paediatrics runs a specialized Centre for Inherited Metabolic Disorders. This provides, in close collaboration with the Department of Clinical Biochemistry of the Institute of Clinical Chemistry, clinical diagnosis, monitoring and treatment of children and adults with hereditary metabolic disorders. Particular attention is paid to comprehensive care for lysosomal storage diseases. Positive neonatal screening tests for metabolic diseases and/or patients with suspected metabolic disorders from the Bratislava and Western Slovakia region are referred from the National Neonatal Screening Centre for definite diagnosis a treatment. If required, advanced laboratory, genetic and other examinations can be carried out in close collaboration with foreign institutions and universities. Once the diagnosis of an inherited metabolic disorder is established, inpatient and outpatient care and monitoring is provided by specialized physicians and nurses.
3. Clinical and Molecular Genetics. The Laboratory of Clinical Genetics provides highly specialized molecular diagnosis of genetically-determined diseases, especially for paediatric patients hospitalized at the National Institute for Children’s Diseases. An important mission of the laboratory is the research and diagnosis of selected rare genetic diseases, mainly hereditary metabolic disorders, ciliopathies, RASopathies and rare malignant diseases. An additional focus of its work is the diagnosis of diseases of unknown aetiology using the latest molecular genetic technologies such as whole-genome and genomic sequencing. The interconnection of research activities and routine diagnostics creates a unique workplace that enables the implementation of diagnostics of rare diseases into clinical practice from bench to bedside and thus ensures the availability of highly sophisticated diagnostics in Slovakia.
4. Endocrinology. The paediatric endocrinology team is focused on the most common endocrine disorders in children, such as growth disorders, pituitary disorders, thyroid and adrenal gland diseases, insulin secretion and action disorders and disorders of puberty and sexual development. The team has a long tradition in the care for children with eating disorders, including childhood obesity and its complications (supported by a scientific VEGA grant) and especially anorexia nervosa. A working group for childhood osteology (OSTEOPED) has been established in close collaboration with the endocrinology team and has laid the foundations of the Children's Osteology Centre at NÚDCH. This working group functions as a platform for all experts who, based to their specialization, are involved with bone metabolism and bone diseases. The aim of the working group is to provide modern osteological diagnostics, monitoring and treatment of disorders of bone metabolism in children.
5. Immunology and Allergology. The Clinical Immunology Service provides diagnostics and treatment for children with congenital (primary) and acquired immune deficiencies, autoimmune diseases and allergic diseases in outpatient and hospital care. Our team is involved in the global network activities of the Jeffrey Modell Primary Immunodeficiency Foundation as a Diagnostic and Research Centre for Primary Immunodeficiencies. Our service is the documenting centre for the European Society for Immunodeficiency Registry in Slovakia. In close cooperation with the Bone Marrow Transplantation Unit of the Department of Haematology and Oncology, we provide immunology consultations for patients before and after haematopoietic stem cell transplantation. Pulmonology and allergy specialists provide highly specialized diagnostics and treatment of children with severe forms of bronchial asthma and food allergy. We provide consultancy services in clinical immunology and allergy for all clinics and departments within the National Institute for Children’s Diseases. Teaching activities involve theoretical and practical training for pre-graduate 4th -5th grade students of General Medicine in the field of Allergology at the Faculty of Medicine Comenius University. Our postgraduate teaching programme is part of the Postgraduate Paediatric training program.
6. Nephrology. The Department of Paediatrics has many years of experience in the comprehensive diagnosis and treatment of the most common congenital and acquired kidney diseases, including prenatal and postnatal ultrasonography, percutaneous renal biopsy, dialysis and kidney transplantation. The main scientific and professional interests are treatment-resistant nephrotic syndrome and chronic progressive glomerulonephritis as well as rare kidney disorders including atypical haemolytic-uremic syndrome, nephropathic cystinosis, hereditary tubulopathies etc. The Department of Paediatrics provides comprehensive care for children with chronic renal failure, including kidney transplantation. The team leader, Prof. Ľ. Podracká, MD, PhD, is running the National Register of Dialysis and Transplanted Children (PETS) and is actively involved in the European Society for Paediatric Nephrology (ESPN). Research projects are focused mainly on the study of cardiovascular risk and disorders of bone metabolism in children with progressive nephropathies.
7. Gastroenterology and Hepatology. The activities of the gastroenterology and hepatology team are focused on the diagnostics and treatment of the most common diseases of the digestive tract and acute and chronic disorders of nutrition. The team provides medical care for Slovakia’s largest cohorts of paediatric inflammatory bowel disease (IBD) patients (Crohn's disease, ulcerative colitis), hepatopathies (Wilson's disease, autoimmune liver disease) and short-bowel syndrome. The unit serves as a reference centre for the biological treatment of children with IBD in Slovakia. Endoscopic procedures (gastrofibroscopy and colonoscopy) and liver biopsies are performed in the inpatient clinic. We are the only paediatric centre in Slovakia coordinating specialized care for children in the liver transplantation program with close cooperation with the paediatric transplantation centre in Essen, Germany. Post-transplantation care and follow-up is provided in the outpatient gastroenterology clinic. The department is the post-gradual teaching centre for paediatric gastroenterology.
8. Rheumatology. In the field of paediatric rheumatology, the Department of Paediatrics provides diagnosis, treatment and follow-up for patients with rare rheumatic diseases of childhood such as inflammatory disorders of joints (arthritis), bones, vessels (vasculitis), systemic diseases as well as genetically determined autoinflammatory periodic fever syndromes. In order to be able to provide the most complex and advanced care, we closely cooperate with the Department of Paediatric Orthopaedics, the National Institute for rheumatic diseases in Piešťany, rehabilitation facilities and internationally recognized institutions abroad.
9. Intensive care. The Intensive Care Unit of the Department of Paediatrics provides medical care for children with serious medical conditions of diverse aetiology that require paediatric intensive care, bed-side monitoring of vital functions (including NIRS and CVP monitoring) or specific supportive measures, especially children with complicated respiratory infections, primary immune deficiencies, metabolic diseases and disturbances of the internal environment, patients after complex intestinal surgery, liver and renal transplantation. The ICU can offer modern complex medical equipment and trained medical personnel.
The Department of Paediatrics is responsible for the teaching undergraduate students of the Faculty of Medicine, Comenius University in Bratislava, Slovakia in the following study programmes: 1) General Medicine, Paediatrics for students of the 5th and 6th year of study, in Slovak and English language; 2) Dentistry, Paediatrics for students of the 5th year, in Slovak and English language.
The Department of Paediatrics is an accredited institution for post-graduate studies (specialty training) in Paediatrics; Paediatric Endocrinology and Diabetology and Metabolic and Nutritional disorders; Paediatric Gastroenterology, Hepatology and Nutrition. Within the postgraduate (doctoral) studies scheme, the Department of Paediatrics is an accredited institution for doctoral (3rd level) education in Paediatrics.
The teaching of students takes place in the specialty wards of the Department of Paediatrics and lectures are given in the lecture halls of the National Institute for Children's Diseases on Limbova street (Kramáre). The Department of Paediatrics provides the students with lectures, seminars, simulation lectures and practical teaching that are a compulsory part of the curriculum. Students' knowledge of the studied matter is assessed during examinations. In specific cases, practical lectures can be substituted provided that both lectures are on the same topic and after an agreement with the lecturer. The schedule of lectures and practical lectures is listed in the students' section. Practical lectures begin at 8.30 a.m. Paediatric propedeutics (Winter term) and Paediatrics (1, 2, 3) are evaluated in a form of a written exam (test).