Grass pollen‐related seasonal allergic rhinoconjunctivitis (SARg) is clinically heterogeneous in severity, comorbidities, and response to treatment. The component‐resolved diagnostics disclosed also a high heterogeneity at molecular level. Our study aimed at analyzing the characteristics of the IgE sensitization to Phleum pratense molecules and investigating the diagnostic relevance of such molecules in childhood.

Background and aims: Enteral nutrition (EN) is an important aid for children with severe neurological impairment. This study aims to evaluate the effect of EN by gastrostomy tube on anthropometric parameters and quality of life (QoL). Moreover we evaluated, during EN, the efficacy of vitamin D3 supplementation on bone mineral density (BMD).

Chronic intestinal pseudo-obstruction (CIPO) is a severe form of gastrointestinal dysmotility (often due to derangement of the innervation/smooth muscle/interstitial cells of Cajal) with recurrent episodes of intestinal subocclusion mimicking a mechanical obstruction. Because of its complexity and heterogeneity, CIPO is often misdiagnosed or remains unrecognized until advanced stages. Management is a critical aspect in CIPO patient care. So far, most prokinetic drugs have not proven efficacy in restoring intestinal propulsion, thus nutritional support, fluid/electrolyte replacement, and antibiotics are the mainstay of treatment. In this issue of the journal, Ohkubo etal showed promising data indicating that percutaneous endoscopic gastro-jejunostomy (PEG-J) can be proposed as a measure for intestinal decompression, thereby improving CIPO-associated abdominal symptoms, including pain. In addition to a concise update of clinical and diagnostic features, the present minireview tackles management options, with a major emphasis on PEG-J, for CIPO patients.

Pollen‐food syndrome (PFS) is heterogeneous with regard to triggers, severity, natural history, comorbidities, and response to treatment. Our study aimed to classify different endotypes of PFS based on IgE sensitization to panallergens.

Background: children with cerebral palsy have in 90% of cases impairment in feeding and high risk of early death because of aspiration of food into the lungs. Aim: the aim of the research was to assess, by questionnaires, the quality of life and the nutritional assessment in 30 children with severe neurological impairment fed via gastrostomy (Group A) and in 30 controls oral feeding with the same severe disabilities. Material and Methods: at baseline we evaluated the symptoms, the therapy and the mean weight for age to Z score (SDS). The quality of life has been studied by a questionnaire based on “Cerebral Palsy Quality of Life Questionnaire for Children (CP-QOL-Child)” validated by the international literature. Results: after 6 months of follow-up the mean values of the questionnaire on the quality of life of patients in group A were significantly higher than those in group B (p < 0.002). The mean weight for age Z-score (95% CI) in patients of group A was at the baseline-2.5 (−3.2 and −2.2 extremes) and after 6 months −1.9 (−2.5 and −1.4 extremes) (p < 0.002). There was no change from baseline in patients of group B −2.6 (−3.4 and −2.3 extremes). Conclusion: our results do suggest several benefits associated with the intervention. Weight for age increased to a clinically significant degree over the study period. Parents felt that the intervention had a positive impact on their child's health and in particular on feeding and ease of administration of medications.

Background: Oral Viscous Budesonide (OVB) is a recent therapeutic option for Eosinophilic Esophagitis (EoE) versus dietary restriction and inhaled steroids.

Background: Second generation colon capsule endoscopy (CCE-2) was proven to be accurate for the diagnosis of neoplastic lesions in adults. Although appealing, as it potentially may overcome invasiveness of colonoscopy, to date, CCE-2 in pediatric patients was never described. Primary aim of this study was to determine the accuracy of CCE-2 in evaluating disease activity in pediatric patients suffering from ulcerative colitis (UC). Disease extension, tolerability, inter-observer agreement, and safety were also evaluated. Methods: Pediatric patients with a known UC and candidates for endoscopy were prospectively enrolled. Patients underwent CCE-2 (Given Imaging, Israel) at day 0, followed by colonoscopy in the late afternoon or at day 1. Colonoscopy was the gold standard. Investigators who performed colonoscopy were blinded to CCE-2 results and vice versa. For the evaluation of disease activity the Matt's score was adopted. Patients were classified as either normal (Matt's score < 6) or with active inflammation (Matt's score > 6). Disease extension and interobserver agreement were assessed according to k statistic. Results: Thirty consecutive UC pediatric patients (mean age 14.1 ± 3.2 years) were enrolled. One patient was excluded from the analysis due to the inability to swallow the capsule, therefore 29 patients were included in the final analysis. CCE-2 was able to properly classify the disease activity with a sensitivity and specificity of 96% [95% CI 79–99] and 100% [95% CI 60–100], respectively; and positive and negative predictive values of 100% [CI 95%: 85–100] and 85% [CI 95%: 49–97], respectively. There was a high concordance between the two procedures in evaluating disease extension (k = 0.87). CCE-2 was better tolerated compared with colonoscopy (p < 0.05). Interobserver agreement was excellent in all cases (k > 0.89). No serious adverse events were reported. Discussion: When combining the good accuracy in the definition of disease activity and extension and the high tolerability, CCE-2 may play a role in the follow-up and monitoring of children with UC. Funding: Given imaging has supported this study providing 30 CCE-2.

Introduction: Chronic urticaria (CU) is a condition characterized by pomfoid lesions and intense itching, which persist for more than 6 weeks. Several etiologic factors have been proposed for CU, but the etiology of this condition is unknown in more than 80% of cases. In recent years it has increasingly been suggested that infection with Helicobacter pylori induces a variety of systemic effects that may lead to extragastrointestinal and chronic skin disorders such as CU. Therefore, eradication of Helicobacter pylori has been suggested as a treatment for CU in cases wherever infection is documented. This has been the basis for several small trials with conflicting results and multiple review articles with differing conclusions. Objective: We aimed to verify a possible relationship between Helicobacter pylori and chronic idiopathic urticaria, evaluating the Helicobacter pylori eradication as a treatment for the CU in childhood. Materials and methods: 100 children with CU and 135 healthy children as controls were subjected to medical history questionnaire, routine laboratory tests and C-urea breath test (UBT). The patients positive to UBT underwent esophagogastroduodenoscopy with biopsy, urease test and culture test for Helicobacter pylori. All cases with Helicobacter pylori infection and gastrointestinal symptoms underwent, for 10 days, sequential therapy with omeprazole, amoxicillin, clarithromycin and tinidazol. After six weeks we verified by UBT the eradication of Helicobacter pylori and the remission of CU. The statistical analysis of results was performed with the Chi-2 test, significance for p < 0.05. Results: The Helicobacter pylori infection was present in 50% (50/100) of patients with CU and 40% (54/135) of healthy controls (difference was not statistically different in two study groups). The resolution of the CU was in 18.5% (5/27) of children Helicobacter pylori-positive after eradication treatment, in 8% (2/23) of children Helicobacter pylori-positive not undergone any therapy and in 14% (7/50) of children without Helicobacter pylori infection (difference was not statistically different in tree study groups). Conclusions: There was no difference between patients with Helicobacter pylori infection after eradication therapy and patients with Helicobacter pylori infection not undergone any treatment on CU resolution. Large, randomized, double-blinded, controlled trials that are methodologically sound are needed to establish the therapeutic utility of Helicobacter pylori eradication in patients with CU. The evidence that routine Helicobacter pylori eradication in patients with CU improves outcomes is of low quality. In view of this, and the uncertainty of the balance between harms/burdens and benefits, this therapeutic intervention is associated with a weak recommendation