Elimination diet (ED) in children with food allergy (FA) could be responsible of inadequate caloric and essential fatty acids (EFA) intake. We investigated the plasmatic profile of EFA in children with FA on ED. Methods. Prospective multicenter study including children with FA (6-36 m) on ED for at least 30 days compared to healthy children. EFA were measured by capillary gas-chromatography at the enrolment (T0) and after 6 m (T1) of elimination diet established after specific dietary counseling. Results. We enrolled 86 children with FA, and 66 healthy controls. The length of ED diet was 10.8 m (95%CI 8-14 m). Table reports EFA profiles in study groups (*p<.05 controls vs FA at T0; °p< 0.5 FA at T0 vs FA at T1). Conclusions. ED in children with FA determine an EFA deficiency, in particular for polyunsaturated fatty acids, despite a specific nutritional intervention decided after nutritional counseling. Table

Results: The diagnosis was obtained with barium enema in 4 patients. The remaining child, operated for intestinal occlusion, at surgery presented a dolicosigma with tight mesenteric root. All patients underwent colic resection with intestinal anastomosis. The resection was performed as emergency procedure in three cases. In two cases, an attempt to resolve the volvulus after barium enema was successful, and the patients were operated electively after having performed anorectal manometry (normal findings in both). Surgical specimens were investigated for aganglionosis, resulting normal in all cases. No post-operative complications were reported. During the follow up (range 20 months – 31 years) one patient presented an episode of intestinal subocclusion, treated conservatively. Discussion: Sigmoid volvulus has to be considered in the differential diagnosis of intense recurrent abdominal pain associated to vomiting and distension. A high index of suspicion is essential in order to perform the diagnostic barium enema or CT scan. Colonic resection (with laparotomic or laparoscopic approach) represents the optimal therapeutic solution, possibly as elective surgery. Considering the risk of intestinal necrosis and peritonitis, a nonoperative approach (decompressive rectal probe, rigid or flexible colonoscopy) is not warranted as a routine. The variable clinical presentation and the possible spontaneous resolution of pain can determine diagnostic delay and errors, responsible for the high mortality reported in adulthood (up to 16% in surgical series and 36% in patients treated conservatively).

L. Cosenzaa , G. Terrin a, M. Di Costanzoa, R. Nocerino a , A. Coruzzoa , A. Celardoa, M. Velardoa, A. Passariello a , B. Malamisurab , V. Brunoa, R. Auricchio a,c , R. Tronconea,c , R. Berni Canani a,c aDepartment of Pediatrics, University of Naples “Federico II”; bPediatric Unit S. Maria dell’Olmo Hospital Cava dei Tirreni, Salerno; cEuropean Laboratory for the Investigation on Food Induced Diseases (ELFID), University of Naples “Federico II”

Background: Cystic Fibrosis (CF) is a chronic disease characterized by an increased energy demand.Despite an improvement in nutritional status during the last decades, malnutrition remains a problem for many CF patients.Aim: To compare growth charts of Italian CF patients and normal subjects.Patients and Methods: We studied 892 CF patients aged 0-18 years (M 50.7%, mean age 9.2±6.4yrs) followed-up in 10 Italian Reference Centres.Height-for-Age percentile (HAP), Weight-for-Age percentile (WAP) and BMI were calculated in all patients and used to draw the correspondent growth charts in two sexes.We compared the course of 50th percentile (pc) in CF patients and normal subjects (CDC 2000).Results: HAP, WAP and BMI 50th pcs in CF patients were lower than normal subjects, in both sexes and at all ages considered.Conclusions: Our results show that Italian CF children have subnormal growth at all ages.Nutritional management is difficult for several clinical and psychosocial reasons but an early detection of malnutrition is essential for a better prognosis.

S19cells over-expressing NHERF1.These data suggest that NHERF1 participates in the organization of the actin cytoskeleton through activation of RhoA and ezrin.

Background. We have previously demonstrated that an unbalanced diet with deficient caloric intake is a frequent feature of food allergy (FA) affected children, determining a significant impact on body growth.