Σύνδρομο εντεροκολίτιδας επαγόμενο σε πρωτείνη τροφής (FPIES) - Κλινική και ανοσολογική εικόνα παιδιατρικού πληθυσμού

Εισαγωγή: To Σύνδρομο Εντεροκολίτιδας Επαγόμενο από Τροφικές Πρωτεΐνες (FPIES), αφορά ένα σύνδρομο μη-IgE μεσολαβούμενης τροφικής αλλεργίας, που συνήθως παρουσιάζεται κατά τη βρεφική ηλικία και κυρίως σε βρέφη κάτω των 9 μηνών. Σκοπός: Σκοπός της παρούσας μελέτης ήταν να εμπλουτίσουμε τα δεδομένα σχετικά με το FPIES στην Ελλάδα και η διερεύνηση της συχνότητας εμφάνισης του συνδρόμου εντεροκολίτιδας σε σχέση με το είδος της τροφής σε παιδιατρικούς ασθενείς. Υλικό-Μέθοδος: Υλικό της μελέτης αποτέλεσαν 49 περιστατικά του συνδρόμου που καταγράφηκαν στο Γενικό Νοσοκομείο Παίδων Πεντέλης στην Παιδιατρική Κλινική, στην Μονάδα Αλλεργικών και Αναπνευστικών Παθήσεων κατά την χρονική περίοδο 2006-2016. Αποτελέσματα: Τα αποτελέσματα έδειξαν ότι η πλειοψηφία των περιστατικών οφείλεται σε κατανάλωση ψαριού (55.6%). Η μέση ηλικία εμφάνισης των συμπτωμάτων ήταν οι 12 μήνες (εύρος 0.5-120 μήνες). Σχεδόν το σύνολο του δείγματος παρουσίασε εμετό (93.5%), ενώ λήθαργο παρουσίασε το 39.1% των περιστατικών και διάρροια το 30.4%. Παρατηρήσαμε, ότι τα παιδιά με FPIES σε γάλα αγελάδος, σε σχέση με τα παιδιά με FPIES σε άλλα τρόφιμα, παρουσίαζαν λιγότερο συχνά εμετούς (72.7% vs. 100%, p=0.012) και περισσότερο συχνά διάρροια (72.7% vs. 14.7%), p=0.001). Παρατηρήθηκε δε, ότι τα παιδιά με FPIES στο ψάρι είχαν συχνότερα παρουσιάσει άσθμα κάποια στιγμή στο παρελθόν σε σχέση με τα παιδιά με FPIES σε άλλα τρόφιμα (36% vs. 5%, p=0.027). Επιπλέον, το 12.8% έχει εμφανίσει κάποιο επεισόδιο γαστροοισοφαγικής παλινδρόμησης. Συμπέρασμα: Υπάρχει η ανάγκη για διενέργεια προοπτικών μελετών κοόρτης σε εθνικό επίπεδο, ώστε να προσδιορισθεί καλύτερα η φυσική πορεία και ο επιπολασμός του FPIES. Επιπλέον, μελέτες για την παθοφυσιολογία του FPIES, τον εντοπισμό πιθανών βιοδεικτών και νέων θεραπειών είναι απαραίτητες για τη βελτίωση της φροντίδας των ασθενών με FPIES. Τέλος, είναι σημαντική η ενημέρωση και η επιμόρφωση των παιδιάτρων, ώστε να είναι ευαισθητοποιημένος ο θεράπων ιατρός για την αναγνώριση και αντιμετώπιση μιας οξείας νόσου, που μπορεί να έχει εξαιρετικά δυσμενή εξέλιξη για τον ασθενή.Introduction: Food Protein Induced Enterocolitis Syndrome (FPIES), refers to a non-IgE mediated food allergy syndrome, usually occurring in infancy and especially in infants under 9 months of age. Aim: The purpose of this study was to enrich the data on FPIES in Greece and to investigate the incidence of enterocolitis syndrome in relation to the type of food in pediatric patients. Material and methods: Study material consisted of 49 cases of the syndrome recorded at the Children's General Hospital of Penteli, in the Department of Allergy and Respiratory Diseases, during the period 2006-2016. Results: The results showed that the majority of cases were due to fish consumption (55.6%). The mean age of symptoms was 12 months (range 0.5-120 months). Almost the entire sample exhibited vomiting (93.5%), while lethargy showed 39.1% of the incidents and diarrhea was 30.4%. We observed that children with FPIES in cows' milk, compared to FPIES children in other foods, had less frequent vomiting (72.7% vs. 100%, p = 0.012) and more often diarrhea (72.7% vs. 14.7% , p = 0.001). It was observed that children with FPIES in fish had more often asthma at a time in the past than children with FPIES in other foods (36% vs. 5%, p = 0.027). In addition, 12.8% have experienced an episode of gastroesophageal reflux. Conclusion: There is a need to conduct prospective cohort studies at national level to better identify the physical course and prevalence of FPIES. In addition, studies on the pathophysiology of FPIES, the identification of potential biomarkers and new therapies are necessary to improve the care of patients with FPIES. Finally, it is important to inform and educate pediatricians in order to sensitize the physician to identify and treat the acute onset of FPIES, which can be extremely unfavorable for the patient

Adolescent Idiopathic Scoliosis and Mental Health Disorders: A Narrative Review of the Literature

Adolescent idiopathic scoliosis (AIS) is the most common type of scoliosis. The condition begins in puberty, affects 1–4% of adolescents, and disproportionately affects young women. Our aim was to comprehensively examine the association between AIS and risk for depression, anxiety, eating disorders, psychotic disorders, and personality dysfunctional mechanisms. Methods: Literature review of related articles published in PubMed, Google Scholar, and Scopus up to 15 July 2021. Results: A total of 30 studies were deemed eligible, examining the effects of AIS upon mental health, and using appropriate psychometric inventories. Studies highlighted the association of brace treatment with elevated anxiety. In addition, mental health conditions and traits (e.g., anxiety and depressive symptoms, neuroticism) were detected more frequently amongst AIS patients compared to healthy controls. Conclusions: AIS represents a risk factor for mental health disorders. More longitudinal studies, utilizing accurate psychometric instruments, are warranted, to reveal the current impact of AIS on the mental health of youngsters, along with the tailoring of well-targeted interventions to reduce the burden of mental health issues in adulthood

Obesity in Children and Adolescents during COVID-19 Pandemic

Background: The COVID-19 pandemic has led to special circumstances and changes to everyday life due to the worldwide measures that were imposed such as lockdowns. This review aims to evaluate obesity in children, adolescents and young adults during the COVID-19 pandemic. Methods: A literature search was conducted to evaluate pertinent studies up to 10 November 2020. Results: A total of 15 articles were eligible; 9 identified 17,028,111 children, adolescents and young adults from 5–25 years old, 5 pertained to studies with an age admixture (n = 20,521) and one study included parents with children 5–18 years old (n = 584). During the COVID-19 era, children, adolescents and young adults gained weight. Changes in dietary behaviors, increased food intake and unhealthy food choices including potatoes, meat and sugary drinks were noted during the ongoing COVID-19 pandemic. Food insecurity associated with financial reasons represents another concern. Moreover, as the restrictions imposed reduced movements out of the house, physical activity was limited, representing another risk factor for weight gain. Conclusions: COVID-19 restrictions disrupted the everyday routine of children, adolescents and young adults and elicited changes in their eating behaviors and physical activity. To protect them, health care providers should highlight the risk of obesity and provide prevention strategies, ensuring also parental participation. Worldwide policies, guidelines and precautionary measures should ideally be established

Sexual Activity in Adolescents and Young Adults through COVID-19 Pandemic

During the COVID-19 pandemic, it has been postulated that the sexual life of adolescent and young adults has been impacted in various aspects, potentially affecting their well-being. Our aim is to investigate the potential changes in the sexual activity and relationships of adolescents and young adults during the COVID-19 pandemic. In general, a decrease in sexual desire was reported during the COVID-19 pandemic, in both genders. Fewer sexual intercourses and bonding behaviors between partners were associated with loneliness and depressive symptoms. On the contrary, an increase in sexual desire was expressed in a few people, with masturbation to be the most preferable means of satisfaction. The present paper highlights the multifaceted impact of COVID-19 upon the sexual life of adolescents and young adults during the ongoing pandemic. The changes observed in their sexual activity and relationships, could provide the basis of future preventive and educational programs