@article {7739, title = {Food protein-induced enterocolitis syndrome caused by fish and/or shellfish in Italy.}, journal = {Pediatr Allergy Immunol}, year = {2015}, month = {2015 Aug 19}, abstract = {

BACKGROUND: The study describes the demographic features, culprit foods, clinical features and outcomes for children presenting with acute fish and/or shellfish food protein-induced enterocolitis syndrome (FPIES) in four Italian paediatric allergy centres.

METHODS: A retrospective/prospective study was undertaken. All children diagnosed with fish or shellfish FPIES were enrolled. The diagnosis of FPIES was based on Sicherer{\textquoteright}s or Miceli Sopo clinical criteria. Skin prick tests (SPT) were performed in all patients, at the time of diagnosis and prior to OFC.

RESULTS: Seventy children were enrolled. Mean age at first episode was 14 months (range 6-46 months); mean age at diagnosis was 34 months (range 6-164 months). Sole and cod were the fish most commonly implicated. Fifty-seven of 70 (81\%) children had FPIES exclusively to fish, 37 of 57 (65\%) children had single-fish FPIES, 20 of 57 (35\%) multiple-fish FPIES, nine of 70 (13\%) presented adverse reactions exclusively to shellfish, and four of 70 (6\%) presented adverse reactions to both fish and shellfish. Only four (5.7\%) children presented episodes of acute FPIES with different foods (2 to cow{\textquoteright}s milk, 1 to egg, 1 to beef); in all cases, onset was prior to that of fish or shellfish FPIES. Fifteen of 70 (21\%) children tolerated fish other than the offending fish. Twenty-four of 70 (34\%) children achieved tolerance (age range 24-102 months).

CONCLUSIONS: The chief peculiarities of acute fish and shellfish FPIES, compared to more frequent cow{\textquoteright}s milk or soy FPIES, are (i) later age of onset, (ii) longer persistence and (iii) possibility of tolerating fish other than the offending fish. Adverse reactions with shellfish are possible.

}, issn = {1399-3038}, doi = {10.1111/pai.12461}, author = {Miceli Sopo, Stefano and Monaco, Serena and Badina, Laura and Barni, Simona and Longo, Giorgio and Novembre, Elio and Viola, Serena and Monti, Giovanna} } @article {3572, title = {A comparison of three scales for measuring pain in children with cognitive impairment.}, journal = {Acta Paediatr}, volume = {103}, year = {2014}, month = {2014 Nov}, pages = {e495-500}, abstract = {

AIM: Pain is a neglected problem in children with cognitive impairments, and few studies compare the clinical use of specific pain scales. We compared the Non-Communicating Children{\textquoteright}s Pain Checklist Postoperative Version (NCCPC-PV), the Echelle Douleur Enfant San Salvador (DESS) and the Children{\textquoteright}s Hospital of Eastern Ontario Pain Scale (CHEOPS). The first two were developed for children with cognitive impairment, and the third is a more general pain scale.

METHODS: Two external observers and the child{\textquoteright}s caregiver assessed 40 children with cognitive impairment for pain levels. We assessed inter-rater agreement, correlation, dependence on knowledge of the child{\textquoteright}s behaviour, simplicity and adequacy in pain rating according to the caregiver for all three scales.

RESULTS: The correlation between the NCCPC-PV and the DESS was strong (Spearman correlation coefficient = 0.76) and better than between each scale and the CHEOPS. Although the DESS showed better inter-rater agreement, it was more dependent on familiarity with the child and was judged more difficult to use by all observers. The NCCPC-PV was the easiest use and the most appropriate for rating the child{\textquoteright}s pain.

CONCLUSION: The NCCPC-PV was the easiest to use for pain assessment in cognitively impaired children and should be adopted in clinical settings.

}, issn = {1651-2227}, doi = {10.1111/apa.12748}, author = {Massaro, Marta and Ronfani, Luca and Ferrara, Giovanna and Badina, Laura and Giorgi, Rita and D{\textquoteright}Osualdo, Flavio and Taddio, Andrea and Barbi, Egidio} } @article {3493, title = {Cow{\textquoteright}s milk allergy in children, from avoidance to tolerance.}, journal = {Endocr Metab Immune Disord Drug Targets}, volume = {14}, year = {2014}, month = {2014 Mar}, pages = {47-53}, abstract = {

Food allergy is the primary cause of anaphylaxis in paediatric age affecting roughly 4\% of children and their families worldwide, and requiring changes in dietary habits. The prognosis for food allergy in children has traditionally been regarded as good for the most frequent allergens, however the prognosis for cow{\textquoteright}s milk allergy in the pediatric age is currently considered to be worse than previously believed. There is now enough evidence that measures of avoidance for children at risk did not have any preventive effect whatsoever, but they still came to be counterproductive by avoiding the physiological interaction between food allergens and gastrointestinal mucosal immune system. Programs of specific oral tolerance induction (SOTI) have obtained interesting results in the treatment of food allergy supporting the idea that antigen exposure through gastrointestinal section is important to allow the development of tolerance. Nevertheless this approach is not yet considered "ready" for community recommendations. In this paper we describe our experience in the field of SOTI in children with cow{\textquoteright}s milk allergy.

}, keywords = {Animals, Cattle, Child, Child, Preschool, Desensitization, Immunologic, Humans, Immune Tolerance, Milk Hypersensitivity, Milk Substitutes, Retrospective Studies}, issn = {2212-3873}, author = {Calligaris, Lorenzo and Longo, Giorgio and Badina, Laura and Berti, Irene and Barbi, Egidio} } @article {3514, title = {A precordial rub in a boy with a severe attack of ulcerative colitis.}, journal = {Pediatr Emerg Care}, volume = {30}, year = {2014}, month = {2014 Apr}, pages = {268}, abstract = {

A case of a pneumomediastinum mimicking a pericarditis in a boy with an occult perforation due to ulcerative colitis is reported. Pneumomediastinum is a rare complication of severe attacks of ulcerative colitis, with or without the previous development of a toxic megacolon, that should be considered in the differential diagnosis.

}, keywords = {Adolescent, Colitis, Ulcerative, Diagnosis, Differential, Humans, Intestinal Perforation, Male, Mediastinal Emphysema, Pericarditis, Radiography, Thoracic}, issn = {1535-1815}, doi = {10.1097/PEC.0000000000000111}, author = {Badina, Laura and Ferrara, Giovanna and Guastalla, Pierpaolo and Barbi, Egidio} } @article {1935, title = {The dietary paradox in food allergy: yesterday{\textquoteright}s mistakes, today{\textquoteright}s evidence and lessons for tomorrow.}, journal = {Curr Pharm Des}, volume = {18}, year = {2012}, month = {2012}, pages = {5782-7}, abstract = {

During the last decades the prevalence of food allergy has significantly increased among children and antigen avoidance still remains the standard care for the management of this condition. Most reactions are IgE-mediated with a high risk of anaphylaxis requiring emergency medications in case of inadvertent ingestion. Recent studies showed that continuous administration of the offending food, rather than an elimination diet, could promote the development and maintenance of oral tolerance. Indeed, intestinal transit of food proteins and their interaction with gut-associated lymphoid tissue (GALT) is the essential prerequisite for oral tolerance. On the contrary, low-dose cutaneous exposure to environmental foods in children with atopic dermatitis and altered skin barrier facilitates allergic sensitization. The timing and the amount of cutaneous and oral exposure determine whether a child will have allergy or tolerance. Furthermore, previous preventive strategies such as the elimination diet during pregnancy and breastfeeding, prolonged exclusive breastfeeding and delayed weaning to solid foods did not succeed in preventing the development of food allergy. On the other hand, there could be an early narrow window of immunological opportunity to expose children to allergenic foods and induce natural tolerance. Finally, the gradual exposure to the offending food through special protocols of specific oral tolerance induction (SOTI) may be a promising approach to a proactive treatment of food allergy.

}, keywords = {Anaphylaxis, Antigens, Breast Feeding, Child, Dermatitis, Atopic, Female, Food Hypersensitivity, Humans, Immunoglobulin E, Pregnancy, Time Factors}, issn = {1873-4286}, author = {Badina, Laura and Barbi, Egidio and Berti, Irene and Radillo, Oriano and Matarazzo, Lorenza and Ventura, Alessandro and Longo, Giorgio} } @article {1810, title = {Exhaled nitric oxide as a guide to management of asthma in pregnancy.}, journal = {Lancet}, volume = {379}, year = {2012}, month = {2012 Feb 25}, pages = {708; author reply 708-9}, keywords = {Asthma, Breath Tests, Female, Glucocorticoids, Humans, Nitric Oxide, Pregnancy, Pregnancy Complications}, issn = {1474-547X}, doi = {10.1016/S0140-6736(12)60300-6}, author = {Bibalo, Chiara and Badina, Laura and Longo, Giorgio and Ventura, Alessandro} }