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Hypoallergenicity of a thickened hydrolyzed formula in children with cow’s milk allergy

World Journal of Clinical Cases 2019年第16期7卷 2256-2268页

作者： Danilo Rossetti salvatore Cucchiara AlessANDra Morace Beatrice Leter salvatore oliva Department of Pediatrics Sapienza University of Rome

BACKGROUND Allergy to cow’s milk is the most frequent allergy occurring in infants and young children.The dietary management of these patients consists of the elimination of any cow’s milk proteins from the diet,and for formula-fed infants,the substitution of the usual infant formula with an adapted formula that is generally based on extensively hydrolyzed cow’s milk proteins.The American Academy of Pediatrics has established specific criteria to confirm the hypoallergenicity of a formula intended for these children.AIM To assess the hypoallergenicity of a new thickened extensively hydrolyzed casein-based formula (TeHCF) in children with cow’s milk allergy (CMA).METHODS Children diagnosed with CMA through a double-blind placebo-controlled food challenge (DBPCFC) were randomly administered increased doses of a placebo formula or the TeHCF [Allernova,new thickener including fibres (Novalac)] under double-blind conditions and medical surveillance on two separate days.Otherwise,both of these formulas and a cow’s milk-based formula were randomly introduced to children who were highly suspected of having CMA on three separate days.Immediate and late reactions occurring after the introduction of any of these formulas were thoroughly recorded by the physician at the hospital and reported by parents to the physician after hospital discharge,respectively.If the children tolerated the TeHCF during the DBPCFC,they were exclusively fed this formula during a 3-mo period where potential allergic symptoms,anthropometric parameters,as secondary outcomes,and adverse events were registered.The Cow’s Milk-related Symptoms Score (CoMiSSTM) was assessed and anthropometric parameters were compared to World Health Organization (WHO) reference data.RESULTS Of the 30 children included in the study,the CMA diagnosis of 29 (mean age: 8.03 ± 7.43 mo) patients was confirmed by a DBPCFC.The children all tolerated the TeHCF during both the challenge and the subsequent 3-mo feeding period,which they all completed.During the latter period,the CoM

关键词： Cow's milk allergy Hypoallergenicity Tolerance Thickened extensively hydrolyzed formula Digestive comfort Dietary management

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A pediatric non-protein losing Menetrier's disease successfully treated with octreotide long acting release

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World Journal of Gastroenterology 2012年第21期18卷 2727-2729页

作者： Giovanni Di Nardo salvatore oliva Marina Aloi Federica Ferrari Simone Frediani Adriana Marcheggiano salvatore Cucchiara Department of Pediatrics Pediatric Gastroenterology and Liver Unit Sapienza University of Rome00161 Rome Italy Department of Medical Science Sapienza University of Rome00161 Rome Italy

Pediatric Menetrier's disease (MD) is an uncommon, acute, self-limited hypertrophic gastropathy characterized by enlarged gastric folds associated with epithelial hyperplasia and usually accompanied by protein losing gastropathy. Gastric cytomegalovirus infection is found in one third of MD children and its treatment is often associated with remission. Diagnosis often requires fullthickness biopsy due to inability to detect typical histological findings with conventional endoscopic biopsy. We report an uncommon case of non self-limited pediatric MD needing endoscopic mucosal resection for diagnosis which was then successfully treated with octreotide long-acting release (LAR). To the best of our knowledge, this is the first pediatric MD case successfully treated with octreotide LAR. Our experience suggests octreotide LAR as treatment for refractory MD before gastrectomy.

关键词：治疗蛋白儿童肽发行代理细胞增生病毒感染

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Pediatric gastrointestinal bleeding: Perspectives from the Italian Society of Pediatric Gastroenterology

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World Journal of Gastroenterology 2017年第8期23卷 1328-1337页

作者： Claudio Romano salvatore oliva Stefano Martellossi Erasmo Miele Serena Arrigo Maria Giovanna Graziani Sabrina Cardile Federica Gaiani Gian Luigi de'Angelis Filippo Torroni Unit of Pediatrics Department of Human Pathology in Adulthood and Childhood“G.Barresi”University of Messina Department of Pediatrics and Infantile Neuropsychiatry Pediatric Gastroenterology and Liver UnitSapienza University of Rome Institute for Maternal and Child Health IRCCS‘Burlo Garofalo’ Department of Translational Medical Science Section of PediatricsUniversity of Naples“Federico II” Gastroenterology and Endoscopy Unit G.Gaslini Children’s Hospital-IRCCS Gastroenterology and Endoscopy Unit “San Giovanni Addolorata”Hospital Hepatology Gastroenterology and Nutrition UnitBambino GesùChildren’s Hospital Gastroenterology and Endoscopy Unit University of Parma Department of Surgery and Transplantation Digestive Surgery and Endoscopy UnitBambino GesùChildren’s Hospital

There are many causes of gastrointestinal bleeding(GIB) in children, and this condition is not rare, having a reported incidence of 6.4%. Causes vary with age, but show considerable overlap; moreover, while many of the causes in the pediatric population are similar to those in adults, some lesions are unique to children. The diagnostic approach for pediatric GIB includes definition of the etiology, localization of the bleeding site and determination of the severity of bleeding; timely and accurate diagnosis is necessary to reduce morbidity and mortality. To assist medical care providers in the evaluation and management of children with GIB, the "Gastro-Ped Bleed Team" of the Italian Society of Pediatric Gastroenterology, Hepatology and Nutrition(SIGENP) carried out a systematic search on MEDLINE via Pub Med(http://www.***.nlm.***.gov/pubmed/) to identify all articles published in English from January 1990 to 2016; the following key words were used to conduct the electronic search: "upper GIB" and "pediatric" [all fields]; "lower GIB" and "pediatric" [all fields]; "obscure GIB" and "pediatric" [all fields]; "GIB" and "endoscopy" [all fields]; "GIB" and "therapy" [all fields]. The identified publications included articles describing randomized controlled trials, reviews, case reports, cohort studies, casecontrol studies and observational studies. References from the pertinent articles were also reviewed. This paper expresses a position statement of SIGENP that can have an immediate impact on clinical practice and for which sufficient evidence is not available in literature. The experts participating in this effort were selected according to their expertise and professional qualifications.

关键词：胃肠的流血内视镜检查法降低胃肠的流血上面的胃肠的流血小儿科

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Capsule endoscopy in pediatrics: A 10-years journey

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World Journal of Gastroenterology 2014年第44期20卷 16603-16608页

作者： salvatore oliva Stanley A Cohen Giovanni Di Nardo Gianfranco Gualdi salvatore Cucchiara Emanuele Casciani Department of Pediatrics Pediatric Gastroenterology Unit Sapienza University of Rome Children’s Center for Digestive Health Care Radiology DEA Sapienza University of Rome University Hospital Umberto I

Video capsule endoscopy(CE) for evaluation the esophagus(ECE), small bowel(SBCE) and the colon(CCE) is particularly useful in pediatrics, because this imaging modality does not require ionizing radiation, deep sedation or general anesthesia. The risk of capsule retention appears to be dependent on indication rather than age and parallels the adult experience by indication, making SBCE a relatively safe procedure with a significant diagnostic yield. The newest indication, assessment of mucosal change, greatly enhances and expands its potential benefit. The diagnostic role of CE extends beyond the SB. The use of ECE also may enhance our knowledge of esophageal disease and assist patient care. Colon CCE is a novel minimally invasive and painless endoscopic technique allowing exploration of the colon without need for sedation, rectal intubation and gas insufflation. The limited data on ECE and CCE in pediatrics does not yet allow the same conclusions regarding efficacy; however, both appear to provide safe methods to assess and monitor mucosal change in their respective areas with little discomfort. Moreover, although experience has been limited, the patency capsule may help lessen the potential of capsule retention; and newly researched protocols for bowel cleaning may further enhance CE's diagnostic yield. However, further research is needed to optimize the use of the various CE procedures in pediatric populations.

关键词： Capsule endoscopy Children Small bowel Pediatric e

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Italian survey on non-steroidal anti-inflammatory drugsand gastrointestinal bleeding in children

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World Journal of Gastroenterology 2016年第5期22卷 1877-1883页

作者： Sabrina Cardile Massimo Martinelli Arrigo Barabino Paolo Gandullia salvatore oliva Giovanni Di Nardo Luigi Dall'Oglio Francesca Rea Gian Luigi de'Angelis Barbara Bizzarri Graziella Guariso Enzo Masci Annamaria Staiano Erasmo Miele Claudio Romano Gastroenterology and Endoscopic Unit Department of PediatricsUniversity of Messina98100 MessinaItaly Department of Translational Medical Science Section of PediatricsUniversity of Naples“Federico II”80131 NaplesItaly Department of Pediatric Gastroenterology Gaslini Institute16148 GenoaItaly Department of Pediatrics and Infantile Neuropsychiatry Pediatric Gastroenterology and Liver UnitSapienza University of Rome00185 RomeItaly Digestive Surgery and Endoscopy Unit Bambino GesùChildren’s Hospital00165 RomeItaly Gastroenterology and Endoscopy Service University of Parma43126 ParmaItaly Unit of Paediatric Gastroenterology Digestive EndoscopyHepatologyand Care of Children with Liver TransplantationDepartment of Women’s and Children’s HealthUniversity Hospital of Padova35128 PadovaItaly Gastrointestinal Endoscopy Azienda Ospedaliera San Paolo University HospitalUniversity of Milan20142 MilanItaly

AIM: To investigate gastrointestinal complications associated with non-steroidal anti-inflammatory drug(NSAIDs) use in children.METHODS: A retrospective, multicenter study was conducted between January 2005 and January 2013, with the participation of 8 Italian pediatric gastroenterology centers. We collected all the cases of patients who refer to emergency room for suspected gastrointestinal bleeding following NSAIDs consumption, and underwent endoscopic evaluation. Previous medical history, associated risk factors, symptoms and signs at presentation, diagnostic procedures, severity of bleeding and management of gastrointestinal bleeding were collected. In addition, data regarding type of drug used, indication, dose, duration of treatment and prescriber(physician or selfmedication) were examined. RESULTS: Fifty-one patients, including 34 males, were enrolled(median age: 7.8 years). Ibuprofen was the most used NSAID [35/51 patients(68.6%)]. Pain was the most frequent indication for NSAIDs use [29/51 patients(56.9%)]. Seven patients had positive family history of Helicobacter pylori(H. pylori) infection or peptic ulcer, and 12 had associated comorbidities. Twenty-four(47%) out of 51 patients used medication inappropriately. Hematemesis was the most frequent symptom(33.3%). Upper gastrointestinal endoscopy revealed gastric lesions in 32/51(62%) patients, duodenal lesions in 17(33%) and esophageal lesions in 8(15%). In 10/51(19.6%) patients, a diagnosis of H. pylori gastritis was made. Forty-eight(94%) patients underwent medical therapy, with spontaneous bleeding resolution, while in 3/51(6%) patients, an endoscopic hemostasis was needed.CONCLUSION: The data collected in this study confirms that adverse events with the involvement of the gastrointestinal tract secondary to NSAID use are also common in

关键词： Hematemesis Gastrointestinal bleeding non-steroidal anti-inflammatory drug Melena Pediatrics

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