Management strategies in the treatment of neonatal and pediatric gastroenteritis.

Acute gastroenteritis, characterized by the onset of diarrhea with or without vomiting, continues to be a major cause of morbidity and mortality in children in mostly resource-constrained nations. Although generally a mild and self-limiting disease, gastroenteritis is one of the most common causes of hospitalization and is associated with a substantial disease burden. Worldwide, up to 40% of children aged less than 5 years with diarrhea are hospitalized with rotavirus. Also, some microorganisms have been found predominantly in resource-constrained nations, including Shigella spp, Vibrio cholerae, and the protozoan infections. Prevention remains essential, and the rotavirus vaccines have demonstrated good safety and efficacy profiles in large clinical trials. Because dehydration is the major complication associated with gastroenteritis, appropriate fluid management (oral or intravenous) is an effective and safe strategy for rehydration. Continuation of breastfeeding is strongly recommended. New treatments such as antiemetics (ondansetron), some antidiarrheal agents (racecadotril), and chemotherapeutic agents are often proposed, but not yet universally recommended. Probiotics, also known as "food supplement," seem to improve intestinal microbial balance, reducing the duration and the severity of acute infectious diarrhea. The European Society for Paediatric Gastroenterology, Hepatology and Nutrition and the European Society of Paediatric Infectious Diseases guidelines make a stronger recommendation for the use of probiotics for the management of acute gastroenteritis, particularly those with documented efficacy such as Lactobacillus rhamnosus GG, Lactobacillus reuteri, and Saccharomyces boulardii. To date, the management of acute gastroenteritis has been based on the option of "doing the least": oral rehydration-solution administration, early refeeding, no testing, no unnecessary drugs.

Extra virgin olive oil and oleic acid

For many decades, researchers have investigated the relationships between health status and consumption of extra virgin olive oil. Extra virgin olive oil (and oleic acid) is considered important for the prevention of coronary heart disease. While the biomolecular aspects involving G protein need further research, oleic acid levels in platelets may be a discriminating factor, together with linoleic and arachidonic acid, for coronary heart disease. There is still ample debate regarding the effects of oleic acid alone or in combination with antioxidants (AU)

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Probiotics and the skin.

A review of the relationships between probiotics and the skin is presented. After a brief historical introduction, the main pathophysiological data on intestinal microflora, the immune system and the skin are presented. Clinical studies with probiotics in atopic children are discussed in detail. Many experimental studies have found that probiotics exert specific effects in the luminal lumen and on epithelial cells and immune cells with antiallergic potential. Not all probiotics have the same immunological properties. Moreover, although rarely, complications of probiotic use can occur and must be known and taken into account. This review underlines the potential interest in probiotics for the management of skin pathology.

[Hyperhomocysteinemia in pediatric age and nutritional aspects of folates: an early cardiovascular risk factor]. / Iperomocisteinemia in età evolutiva e aspetti nutrizionali dei folati: un fattore di rischio cardiovascolare precoce.

During the last decade, scientific evidence is mounting that elevated plasma levels of homocysteine are associated with an increased risk of atherosclerosis and cardiovascular ischemic events. Despite this evidence, however, there are still concerns about the mechanisms(s) by which homocysteine exerts its pro-atherogenic effect, and it is unclear whether the decreased plasma levels of homocysteine through diet or drugs may be paralleled by a reduction in cardiovascular risk. Experimental studies have shown that many possible mechanisms are implicated in the pro-atherogenic effect of homocysteine. Endothelial function is altered in subjects with hyperhomocysteinemia, and endothelial dysfunction is correlated with plasma levels of homocysteine. Exercise training reduces plasma levels of homocysteine and improves endothelial function, however without evidence of a better outcome. Larger studies are needed in order to demonstrate that the reduction of plasma levels of homocysteine by oral supplementation with folates and vitamins B6 and B12 translates into a decreased incidence of ischemic events, in particular in patients with documented coronary artery disease and ischemic encephalopathy.