Guidelines in pediatric gastroenterology, hepatologyand nutrition
Childhood obesity: a comparison between Italian(SIP/SIEDP), American (Endocrine Society) and South-Korean (Korean Society of Pediatric GastroenterologyHepatology and Nutrition) guidelines
Giulio Ippolito, Sara Vizzuso, Matilde Amatruda,Giulia Vizzari, Elvira Verduci1
1U.O. di Pediatria Dipartimento di Scienze della Salute ASST Santi Paolo e Carlo – OspedaleSan Paolo – Università
Childhood obesity has become a truly global epidemicaffecting all populations, and Countries of all incomelevels. Do different Countries across the world manage thesame disease in the same way? In this commentary acomparison between most recent Italian, North-Americanand South-Korean guidelines will be made, pointing outsimilarities and differences.
Pediatric Nutrition and Health and Food Science
News in Pediatric Intestinal Pseudo-obstruction
Antonella Diamanti, Fabio Fusaro1Tamara Caldaro Teresa Capriati Manila Candusso Valerio Nobili 2Osvaldo Borrelli
1Unità Operativa di Chirurgia ed Endoscopia Digestiva, Ospedale pediatrico Bambino Gesù, Roma Unità Operativa Epatologia e Gastroenterologia,Ospedale pediatrico Bambino Gesù, Roma Divisione di Neurogastroenterologia e Motilità, Dipartimento di gastroenterologia pediatrica,2Institute of Child Health and Great Ormond Street Hospital, London, UK
Pediatric intestinal pseudo-obstruction (PIPO)is the mostsevere disorders of gut motility with high levels ofmorbidity and mortality. We reviewed all children fulfillingnew PIPO criteria over a 30-year period in PediatricHospital Bambino Gesù, aiming at evaluating long-termnutritional outcomes (overall survival, prevalence ofenteral autonomy and parenteral nutrition dependency andrate of major complications) and clinical characteristics(onset and growth course).
Surgical treatment of portal hypertension in children
Fabrizio di Francesco, Jean de Ville de Goyet1
1Epatologia e Trapianto di Fegato Pediatrico IRCCS ISMETT, Palermo
The management of children with portal hypertension hasdramatically changed during the past decade, with animprovement in outcome. This has been achieved mostlyby an increasingly more efficient control of varices byendoscopy and the success of liver transplantation.Although the indications for surgical portosystemic shuntshave reduced in recent decades, they are still indicated fornon-cirrhotic portal hypertension – mostly patients withpre-hepatic portal hypertension and some rare conditionswhere the primary disease can be cured before the liverparenchyma is damaged by chronic secondary changes(Budd-Chiari syndrome). In children with pre-hepaticportal hypertension, the meso-Rex bypass is now a goldstandard and can even be proposed preemptively, but islimited to those patients with a favorable anatomy. Incirrhotic patients, elective portosystemic shunt surgery isreserved for failure to respond to conservativemanagement in the absence of alternative therapies andin selected cases with well-preserved hepatic function.
News in Pediatric Gastroenterology Pharmacology
New direct acting antivirals
Daniele Serranti1Giuseppe Indolfi12
1Epatologia Pediatrica, Azienda Ospedaliero-Universitaria Meyer 2Dipartimento NEUROFARBA, Università degli Studi di Firenze
Direct acting antivirals active against hepatitis C virus actby inhibiting the crucial steps of the viral lifecycle. Theefficacy of these drugs has been demonstrated to be high(>90%) in adults, adolescents and children with chronichepatitis C. Three different combinations of direct actingantivirals have been approved for use in adolescents (≥12years old): sofosbuvir/ledipasvir, sofosbuvir plus ribavirinand glecaprevir/pibrentasvir. The aim of the present articleis to provide a comprehensive description of the currentknowledge on the use of direct acting antivirals in childrenand adolescents.
Intestinal angiodysplasia, an uncommon cause of severeanemia in children
Giulia Spina, Marco Roversi1Maria Rosaria Marchili, Alberto Villani2
1University of Rome Tor Vergata,Academic Department, Rome Italy2Pediatric and Infectious Diseases Unit, Academic Department, Rome, Italy
We admitted an eleven-years-old girl with a severe irondeficiency anaemia. She had chronic abdominal pain anda positive faecal occult blood test. Gastrointestinalendoscopy revealed an infection by Helicobacter Pylori,which was treated accordingly. After 2 weeks the girl stillhad pain. Capsule endoscopy revealed an angiodysplasiaof the ileum, whose resection lead to remission ofsymptoms.
Autoinflammatory diseases and related gastrointestinalmanifestations in the pediatric age
Maria Greca Magnolia1Elisabetta Cortis2
1Ospedale S. Maria della Stella Orvieto 2Ospedale S Eugenio Roma
Autoinflammatory diseases, Periodic Fever Syndrome, FamilialMediterranean Fever, Mevalonate Kinase Deficiency, TumourNecrosis Factor Receptor Associated Periodic Fever Syndrome,Autoinflammatory diseases are characterized by innate immunityabnormalities. The first 4 described AID were familialMediterranean fever, cryopyrin-associated periodic fever syndrome(CAPS), mevalonate kinase deficiency (MKD) and TNFRSF1A-receptor associated periodic fever syndrome (TRAPS). with theprogresses of genetic analysis, many new diseases have beendiscovered; some with recurrent fever, others with predominantimmune deficiency. Macrophage Activation Syndrome Scarica l’articolo
Recent Advance in Basic Science
Intestinal tuberculosis: clinical features, diagnosis and treatment
L. Lancella, L. Cursi, A. Orlandi, E. Masiello, S. Chiurchiù, P. Pansa, A. Villani
UOC Pediatria Generale e Malattie Infettive Ospedale Pediatrico Bambino Gesù – IRCCS – Roma
Intestinal tuberculosis is an uncommon disease which affectsmainly people who come from developing countries. Clinicalfeatures are fever, abdominal pain, ascites, weight loss and nightsweats. Diagnosis is established by the demonstration of M.Tuberculosis in a biopsy specimen of an involved site or inascitic fluid by culture test. Radiological examinations andendoscopy are essential in the diagnostic process. Thedifferential diagnosis mainly includes Crohn’s disease.