Airways flat angioma misdiagnosed as difficult asthma in an adolescent

A 15 years-old boy came to our attention with a diagnosis of poorly controlled asthma. This case required thorough investigations: CT scan imaging revealed a flat angioma extending from the carina to the left main bronchus. Rigid bronchoscopy confirmed the presence of an angioma showing widespread mucosal diffusion involving most of the posterior tracheal wall and main bronchi, on the left side. We present this case report and these images to readers seeking for other experiences in the diagnosis of wide superficial bronchial angioma in pediatric age

Appropriate and inappropriate vitamin supplementation in children

The vitamin status of a child depends on many factors and most of the clinical studies do not take into account the different access to adequate nutrition of children coming from different countries and the consequent major differences in micronutrients or vitamin deficits between low-income and high-income countries. Vitamin supplements are included in the general field of dietary supplements. There is a large amount of not always factual material concerning vitamin supplements, and this may sometimes create confusion in clinicians and patients. Inadequate information may lead to the risk of attributing beneficial properties leading to their over-use or misuse in the paediatric field. Vitamin supplementation is indicated in all those conditions in which a vitamin deficiency is found, either because of a reduced intake due to reduced availability of certain foods, restrictive diets or inadequate absorption. The lack of guidelines in these fields may lead paediatricians to an improper use of vitamins, both in terms of excessive use or inadequate use. This is due to the fact that vitamin supplementation is often intended as a therapy of support rather than an essential therapeutic tool able to modify disease prognosis. In fact, various vitamins and their derivatives have therapeutic potential in the prevention and treatment of many diseases, especially in emerging conditions of paediatric age such as type 2 diabetes and the metabolic syndrome. The aim of the present article is to analyse the state of the art and consider new perspectives on the role of vitamin supplements in children

Gastroesophageal reflux in the breastfed infant less than 4 months old: is this really an issue?

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Parental Perceptions and Concerns Related to the Consequences of Pediatric Obesity: Feeling or Real Problem?

Lifestyle modifications (i.e., nutrition and physical activity) remain the main tools in the context of childhood obesity's treatment and prevention of short and long-term consequences. At the same time, parental perception of child weight represents an even more important tool. It is known that more than half of parents of overweight/obese children underestimate their child's weight status or are not worried about the risks associated with childhood overweight/obesity. Consequently, parental perception of childhood obesity can often be erroneous, and, even when accurate, subsequent parental behaviors can inadvertently contribute to the onset or persistence of childhood and adult obesity. Starting from the evidence that targeting a parent to induce a behavioral change is more effective than targeting the child only without parental participation, parental perceptions of childhood obesity can therefore represent a very important tool to take into consideration to achieve improvements in the context of childhood obesity. Therefore, knowledge of parental perception of children's weight status is needed to help pediatricians to organize and adapt activities and programs that promote healthy weight management among children. Specifically, early assessments of parents' perceptions of a child's weight, followed by regular follow-up visits, appropriate feedback, continuing education efforts, and efforts to follow the child's weight status over time, can be potentially very helpful

Allergy and Sexual Behaviours: an Update

The exact prevalence of hypersensitivity reactions related to sexual behaviours is not known; however, they heavily impact on the quality of life and of sex life of affected patients. In fact, not only common respiratory and skin allergies, such as asthma, rhinitis, urticaria and atopic dermatitis, but also food and drug allergy have been found to negatively affect the quality of sex life. Allergic diseases impact on the sexual function in both physical and psychological ways, representing one of the main complaints of a considerable proportion of patients. Sexual behaviours may act as the triggers of allergic reactions or as the carriers of allergens. Food and drug allergens can be carried through human organic fluids, like saliva and semen. Latex in condoms and numerous substances in lubricants, spermicides, topical medications and cosmetics can cause allergic reactions or contact dermatitis. Sexual activity itself is also a potential trigger of symptoms in patients affected by respiratory allergies, like honeymoon asthma and rhinitis. In seminal plasma hypersensitivity, seminal fluid proteins are the culprit allergens. The present review aims at summarizing the state of the art about allergy and sexual behaviours. In clinical practice, the influence of common allergic diseases on the sexual quality of life should be taken carefully into account. Sexual behaviours need to be accounted in the differential diagnosis of hypersensitivity reactions, and awareness on those exposure routes should be raised between different specialists and general practitioners

The potential role of zinc, magnesium and selenium against COVID-19: a pragmatic review

INTRODUCTION: Several studies have analyzed the role of antioxidant minerals as positive modulators of the immune system in facing viral infections. We discuss their possible protective role in Sars-Cov 2 infection selecting minerals for which literature provides most evidences, such as zinc (Zn), magnesium (Mg), and selenium (Se). DISCUSSION: All these minerals have a role in modulating antiviral and antibacterial immunity and to regulate the inflammatory response. Their deficiency is associated with a higher prevalence of respiratory tract infections andendothelial dysfunction. These features are related to COVID-19 pathophysiology. CONCLUSIONS: It seems that an optimal micronutrient status in terms of Zn, Mg and Se, is able to effectively strengthen the immune system during the COVID-19 infection. Anyway, further studies are necessary

21-Hydroxylase-Deficient congenital adrenal hyperplasia classic form therapy knowledge and management: targeted educational intervention for paediatricians

21-Hydroxylase-Deficiency (21 OHD) is the most common form of congenital adrenal hyperplasia (CAH), a group of rare inherited autosomal recessive disorders caused by mutations in genes coding for enzymes involved in the synthesis of cortisol in the adrenal cortex. The enzyme 21-\u3b2 hydroxylase is coded by CYP21A2 gene (Cytochrome P450 Family 21 Subfamily A Member 2) and mutations in this gene are present in almost 90-95% of cases of CAH with a frequency of 1 to 15000 1. The disease is commonly distinguished in two forms according to the severity of the enzyme deficiency: a classic form with early clinical onset, and a non-classic form with milder clinical picture and late onse