Use of Soy-Based Formulas and Cow's Milk Allergy: Lights and Shadows.

oybean (Glycine max) is a species of legume native to East Asia and used in childhood diet for over 2,000 years in the East. Soy protein formulas have been available for almost a century. Nowadays, the increase in cow's milk allergy and vegetarian dietary preferences are driving consumers toward cow's milk alternatives. In this paper, we reviewed the nutritional composition of soy-based infant formula and discussed their possible use in pediatric age, mainly focusing on prevention and treatment of cow's milk allergy. Protein quality is determined by digestibility and amino acid content. Purified or concentrated vegetable proteins (e.g., soy protein and gluten) have high digestibility (>95%), similar to those of animal ones. For some intact vegetable products (e.g., whole cereals and pulses), protein digestibility is lower (80-90%). Food processing and heat treatment also influence protein digestibility. Considering these data, we tried to evaluate the possible use of soybean and derivatives in pediatric age, including the nutritional composition of soy formulas and the clinical indications for their use. Moreover, since plant-based beverages are being perceived as healthy by consumers and their use is growing on the market, we recommend that soy drink should not be used as a substitute for infant formulas or cow's milk in children younger than 24 months

[Prevalence and duration of breastfeeding during the first six months of life: factors affecting an early cessation].

OBJECTIVES: to assess the mean duration, prevalence and reasons that lead to an early cessation of breastfeeding in a group of healthy term infants in the first six months of life. METHODS: prospective, observational study. One-hundred Caucasian, non smoking mothers, that intended to breastfeed for at least 12 weeks, were enrolled. Information on anthropometric parameters, type of delivery, socio-demographic characteristics, mode of feeding and reasons for stopping breastfeeding have been obtained through three different questionnaires (submitted at enrollment, on the 7th day, at 1, 2, 3 and 6 months). RESULTS: exclusive breastfeeding gradually decreased from the 7th day to the 6th month of life. Most of the mothers stopped breastfeeding during the first month and a half or after 3 months and a half. Two percent of the mothers stopped on the 7th day whereas at 6 months the percentage of cessation was 14%. The cumulative percentage of interruption at 6th month was 45%. Maternal factors, like sore nipples or delayed onset of lactation, were the most frequent reasons that led to an early cessation, while during the following months inadequate breast milk and latch-on problems were predominant. On the other hand, attending a pre-natal course or having a previous successful breastfeeding experience were significantly associated with a long-lasting breastfeeding. CONCLUSIONS: promotion of breastfeeding during the prenatal course and a better support for lactation management during the first months seem to be the areas where more efforts are needed to implement breastfeeding rates

Clinical outcomes of fully and partially threaded zygomatic implants in a cohort of patients with minimum 7.5-year follow-up

OBJECTIVE: The aim of this retrospective case series report was to evaluate the results of oral rehabilitation with extra-sinus zygomatic implant surgery with a minimum follow-up of 7.5 years. PATIENTS AND METHODS: A total of 35 patients with 87 zygomatic implants were included. The mean follow-up period of the patients was 93 months. The zygomatic implant survival and complications were evaluated as criteria for success. RESULTS: There were no implant failures. Overall success rate without complications for zygomatic implant was 88.5%. Complications developed in 4 patients (1 cutaneous fistula and 3 mucositis). According to the results on an implant basis, patients with previously failed conventional implants had greater probability of complications. Patients with quad zygomatic implants had higher incidence of complications than those with two zygomatic implants. Fully threaded implant design was associated with higher incidence of mucositis than partially threaded design. No relation was found between implant success and smoking, prosthesis type, and antagonist dentition. When conducting the analysis using the patient as unit, only the antagonist dentition showed significant difference, the worst outcome being associated with the Toronto resin prosthesis. CONCLUSIONS: Zygomatic implants can be considered as a safe alternative to conventional implant insertions and bone grafting procedures in oral rehabilitation of patients with severely atrophic maxillary bone

Current knowledge on the effects of environmental contaminants in early life nutrition

Breast milk represents the optimal source of feeding for newborns, in terms of nutritional compounds and as it provides immunological, metabolic, organic, and neurological well-being. As a complex biological fluid, it consists not only of nutritional compounds but also contains environmental contaminants. Formulas through production, contact with bottles and cups, and complementary feeding can also be contaminated. The current review focuses on endocrine-disrupting chemicals, and made-man xenoestrogens present in the environment and both commonly present in food sources, agricultural practices, packaging, consumer products, industry, and medical care. These contaminants are transferred by passive diffusion to breast milk and are delivered during breastfeeding. They mainly act by activating or antagonizing hormonal receptors. We summarize the effects on the immune system, gut microbiota, and metabolism. Exposure to endocrine-disrupting chemicals and indirect food additives may induce tissue inflammation and polarize lymphocytes, increase proinflammatory cytokines, promote allergic sensitization, and microbial dysbiosis, activate nuclear receptors and increase the incidence of allergic, autoimmune, and metabolic diseases. Breast milk is the most important optimal source in early life. This mini-review summarizes current knowledge on environmental contaminants and paves the way for strategies to prevent milk contamination and limit maternal and infant exposure during pregnancy and the first months of life

The importance of a differential diagnosis between true hemifacial microsomia and pseudo-hemifacial microsomia in the post-surgical long-term prognosis.

Long-term results after surgical treatment of the mandibular asymmetry in growing children with hemifacial microsomia (HFM), whether with osteotomies or distraction osteogenesis, have mostly shown a tendency towards the recurrence of the asymmetry. In contrast, in the literature we find sporadic case reports where the long-term post-surgical follow-up of patients diagnosed as HFM, are surprisingly stable. All these reports refer to patients who have substantially no soft tissue involvement, but only severe mandibular ramus and condyle deformities. The phenotypes of these cases are unexpectedly similar. The authors suggest, that it is possible that all of these cases might be isolated hemimandibular hypoplasias, misdiagnosed as HFM, which present a normal functional matrix and, therefore, tend to grow towards the original symmetry. Differential diagnosis between true HFM and this HFM-like isolated hemimandibular hypoplasia (pseudo-HFM) is of great importance given the very different prognosis and it is possible through the collaboration between not only surgeons and orthodontists, but also of geneticists and dysmorphologists