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1. The lockdown effects on a pediatric obese population in the COVID-19 era

Author: Ugo Cucinotta, Malgorzata Wasniewska, C. Lugara, A. Zema, Mariella Valenzise, F D'Amico, Giuseppina Zirilli, and G B Pajno
Subjects: Male, Pediatric Obesity, Adolescent, Population, Comorbidity, Overweight, Pediatrics, RJ1-570, Body Mass Index, medicine, Humans, Exercise physiology, education, Child, Exercise, Life Style, Pandemics, Sedentary lifestyle, Retrospective Studies, education.field_of_study, business.industry, SARS-CoV-2, Research, Behavior change, COVID-19, Retrospective cohort study, medicine.disease, Italy, Child, Preschool, Communicable Disease Control, Quarantine, Female, medicine.symptom, business, Body mass index, Demography
Abstract: Background The social consequences of COVID-19 pandemic are universally known. In particular, the pediatric population is dealing with a radical lifestyle change. For some risk categories, such as overweight or obese children, the impact of home confinement has been greater than for others. The increased sedentary life, the wrong diet and social distancing have stopped the chance of losing weight. The aims of this study were to analyse the impact of COVID-19 lockdown on the behavior changes in a obese pediatric population and to explore the correlation between the new lifestyle and the level of parental instruction. Methods Data show features of 40 obese and overweight pediatric patients of our Clinic in Messina (Italy). We evaluated weight, height, BMI and other biochemical parameters: total cholesterol, HDL, LDL, triglyceride, transaminases, glycemia and insulinemia. After the lockdown, we contacted all patients in order to get some information about diet, physical activity and sedentary lifestyle changes in correlation to the level of their parents’ instruction. Additionally, we also evaluated 20 children twice from a clinical and laboratory perspective. Results The study showed an increase of daily meals during COVID-19 lockdown (3.2 ± 0.4 vs 5 ± 1, P < 0.001). In particular, children whose parents have primary school diploma ate a greater significant number of meals during the lockdown, compared to those who have parents with secondary school diploma (P = 0.0019). In addition, the 95% of patients did low physical activity during the lockdown and the 97.5% spent more time in sedentary activity. Even if BMI’s values don’t show significant differences, they have increased after the lockdown. We didn’t find any correlation between biochemical parameters before and after the lockdown. Conclusion The lockdown has had bad consequences on good style of life’s maintenance in overweight and obese children. The absence of a significant correlation between the worsening of biochemical parameters and the lockdown doesn’t allow to exclude any long-term consequences. It’s safe to assume that, if the hours spent in sedentary activity and the number of meals don’t diminish, there will probably repercussion on the biochemical parameters.
Published: 2021

2. Long term treatment with omalizumab in adolescent with refractory solar urticaria

Author: Stefano Passanisi, Stefania Arasi, Giuseppe Crisafulli, Giovanni Battista Pajno, Lucia Caminiti, Mauro Iannelli, and Giuseppina Zirilli
Subjects: Quality of life, Pediatrics, medicine.medical_specialty, Future studies, Long term treatment, Chronic inducible urticaria, Urticaria, Solar urticaria, Case Report, Omalizumab, RJ1-570, Young Adult, Refractory, immune system diseases, Concomitant Therapy, Anti-Allergic Agents, medicine, Humans, In patient, skin and connective tissue diseases, Anti-IgE, business.industry, General Medicine, medicine.disease, Management, Sunlight, Female, business, Quality of Life, medicine.drug
Abstract: BackgroundSolar urticaria represents an uncomfortable form of chronic inducible urticaria. First and second-line treatments are ineffective in some patients, leading to an impairment in their quality of life. Omalizumab represents a safe therapeutic option in case of refractory solar urticaria.Case presentationWe update a case of a 21-year-old Caucasian girl affected by solar urticaria from the age of 14. Poor disease control was achieved with standard or high-dose of H1-antihistamines. Several omalizumab courses, including a 1-year-long course, were practiced resulting in clinical remission and significant improvement in patient’s quality of life.ConclusionOur experience confirms the effectiveness and safety of omalizumab for the management of refractory solar urticaria. Future studies are awaited in order to monitor long term effects and chronic doses of this treatment, particularly in patients who need concomitant therapy with antihistamines.
Published: 2021

3. Association of Wheat Allergy and Coeliac Disease through Pediatric and Adult Age: A Review of Literature

Author: Giuseppe Acri, Giuseppe Crisafulli, Lucia Caminiti, Barbara Testagrossa, Stefano Costa, Salvatore Pellegrino, Ilenia Panasiti, and Giovanni Battista Pajno
Subjects: Pediatrics, medicine.medical_specialty, Nutrition and Dietetics, business.industry, Public Health, Environmental and Occupational Health, medicine, food and beverages, medicine.disease, business, Adult age, Wheat allergy, Coeliac disease, Food Science
Abstract: In recent years, the prevalence of large spectrum of gluten-related disorders (GRDs) has increased. Gluten is one of the most widely distributed components of food in both industrialized and developing countries. The main structural protein complex of wheat and its proteins are classified into albumins, salt-soluble globulins, and insoluble prolamins (gliadins and glutenins). Gluten is also included in other cereals, including rye and barley. GRDs can be classified, based on their pathogenic mechanism, into (i) Autoimmune disorders, (ii) Allergic disorders, (iii) No autoimmune, not allergic disorders. Coeliac disease (CD) is an autoimmune disorder that occurs in genetically predisposed individuals who develop an immune reaction to gluten. It affects about 1% of people in most populations. The disease primarily interests the small intestine, but it is characterized by a wide range of clinical presentations, with both intestinal and extra-intestinal symptoms. Wheat allergy (WA) is an adverse immunologic reaction to wheat proteins. In the large field of WA a further classification can be made, distinguishing IgE-dependent WA, triggered by ingestion, inhalation or cutaneous and/or mucosal contact of wheat, and IgE-non-dependent WA. Its prevalence varies depending on the age and region, from 0.4% to 4%. Urticaria and/or angioedema, and anaphylaxis with or without exercise as a trigger, appear typically during childhood, asthma and/or rhinitis (Baker’s asthma) are more common during adulthood. Non-coeliac gluten sensitivity (NCGS) is a condition in which gluten ingestion leads to one or more of a variety of immunological, morphological or symptomatic (both gastrointestinal or extra gastrointestinal) manifestations in people in whom CD has been excluded. It is supposed it’s due to an activated innate immune response.
Published: 2021

4. Inter-society consensus for the use of inhaled corticosteroids in infants, children and adolescents with airway diseases

Author: Vassilios Fanos, Fabio Cardinale, Salvatore Barberi, Alberto Villani, Carlo Caffarelli, Giovanni Simeone, Elena Chiappini, Roberto Bernardini, Monica Malventano, Luca De Franciscis, Annalisa Capuano, Stefano Luciani, Renato Turra, Stefania Zanconato, Domenico Minasi, Paolo Becherucci, Annamaria Bianchi, Marzia Duse, Paolo Biasci, Marcello Bergamini, Francesca Santamaria, Giuseppe Di Mauro, Serenella Castronuovo, Adima Lamborghini, Gian Luigi Marseglia, Francesco Paravati, Giovanni Battista Pajno, Alberto Martelli, Elio Novembre, Gabriella Di Mauro, Francesco Macrì, Giorgio Piacentini, Maria Carmen Verga, Giovanna Tezza, Iride Dello Iacono, Lucia Leonardi, Mattia Doria, Michele Miraglia Del Giudice, Giovanna De Castro, Raffaele Falsaperla, Luciana Indinnimeo, Riccardo Lubrano, Valentina Ferraro, Renato Cutrera, Lucia Diaferio, Vito Leonardo Miniello, Giampaolo Ricci, Melissa Borrelli, Gabriella Pozzobon, Agostino Nocerino, Germana Nardini, Francesco Di Mauro, Fabio Decimo, Anna Maria Zicari, Diego Peroni, Mariangela Tosca, Maria Di Cicco, Fabio Midulla, Luigi Masini, Amelia Licari, Carlo Alfaro, Valeria Caldarelli, Caterina Di Mauro, Elena Galli, Carlo Capristo, Cristina Piersantelli, Sergio Renzo Morandini, Massimo Landi, Giovanni Cerimoniale, Valter Spanevello, Daniele Giovanni Ghiglioni, Ahmad Kantar, Dora Di Mauro, Cristina Di Mauro, Giovanni Corsello, Attilio Varricchio, Duse, M., Santamaria, F., Verga, M. C., Bergamini, M., Simeone, G., Leonardi, L., Tezza, G., Bianchi, A., Capuano, A., Cardinale, F., Cerimoniale, G., Landi, M., Malventano, M., Tosca, M., Varricchio, A., Zicari, A. M., Alfaro, C., Barberi, S., Becherucci, P., Bernardini, R., Biasci, P., Caffarelli, C., Caldarelli, V., Capristo, C., Castronuovo, S., Chiappini, E., Cutrera, R., De Castro, G., De Franciscis, L., Decimo, F., Iacono, I. D., Diaferio, L., Di Cicco, M. E., Di Mauro, C., Di Mauro, D., Di Mauro, F., Di Mauro, G., Doria, M., Falsaperla, R., Ferraro, V., Fanos, V., Galli, E., Ghiglioni, D. G., Indinnimeo, L., Kantar, A., Lamborghini, A., Licari, A., Lubrano, R., Luciani, S., Macri, F., Marseglia, G., Martelli, A. G., Masini, L., Midulla, F., Minasi, D., Miniello, V. L., del Giudice, M. M., Morandini, S. R., Nardini, G., Nocerino, A., Novembre, E., Pajno, G. B., Paravati, F., Piacentini, G., Piersantelli, C., Pozzobon, G., Ricci, G., Spanevello, V., Turra, R., Zanconato, S., Borrelli, M., Villani, A., Corsello, G., Peroni, D., Duse, Marzia, Santamaria, Francesca, Verga, Maria Carmen, Bergamini, Marcello, Simeone, Giovanni, Leonardi, Lucia, Tezza, Giovanna, Bianchi, Annamaria, Capuano, Annalisa, Cardinale, Fabio, Cerimoniale, Giovanni, Landi, Massimo, Malventano, Monica, Tosca, Mariangela, Varricchio, Attilio, Zicari, Anna Maria, Alfaro, Carlo, Barberi, Salvatore, Becherucci, Paolo, Bernardini, Roberto, Biasci, Paolo, Caffarelli, Carlo, Caldarelli, Valeria, Capristo, Carlo, Castronuovo, Serenella, Chiappini, Elena, Cutrera, Renato, De Castro, Giovanna, De Franciscis, Luca, Decimo, Fabio, Iacono, Iride Dello, Diaferio, Lucia, Di Cicco, Maria Elisa, Di Mauro, Caterina, Di Mauro, Cristina, Di Mauro, Dora, Di Mauro, Francesco, Di Mauro, Gabriella, Doria, Mattia, Falsaperla, Raffaele, Ferraro, Valentina, Fanos, Vassilio, Galli, Elena, Ghiglioni, Daniele Giovanni, Indinnimeo, Luciana, Kantar, Ahmad, Lamborghini, Adima, Licari, Amelia, Lubrano, Riccardo, Luciani, Stefano, Macrì, Francesco, Marseglia, Gianluigi, Martelli, Alberto Giuseppe, Masini, Luigi, Midulla, Fabio, Minasi, Domenico, Miniello, Vito Leonardo, Del Giudice, Michele Miraglia, Morandini, Sergio Renzo, Nardini, Germana, Nocerino, Agostino, Novembre, Elio, Pajno, Giovanni Battista, Paravati, Francesco, Piacentini, Giorgio, Piersantelli, Cristina, Pozzobon, Gabriella, Ricci, Giampaolo, Spanevello, Valter, Turra, Renato, Zanconato, Stefania, Borrelli, Melissa, Villani, Alberto, Corsello, Giovanni, Di Mauro, Giuseppe, Peroni, Diego, and Marzia Duse, Francesca Santamaria, Maria Carmen Verga, Marcello Bergamini, Giovanni Simeone, Lucia Leonardi, Giovanna Tezza, Annamaria Bianchi, Annalisa Capuano, Fabio Cardinale, Giovanni Cerimoniale, Massimo Landi, Monica Malventano, Mariangela Tosca, Attilio Varricchio, Anna Maria Zicari, Carlo Alfaro, Salvatore Barberi, Paolo Becherucci, Roberto Bernardini, Paolo Biasci, Carlo Caffarelli, Valeria Caldarelli, Carlo Capristo, Serenella Castronuovo, Elena Chiappini, Renato Cutrera, Giovanna De Castro, Luca De Franciscis, Fabio Decimo, Iride Dello Iacono, Lucia Diaferio, Maria Elisa Di Cicco, Caterina Di Mauro, Cristina Di Mauro, Dora Di Mauro, Francesco Di Mauro, Gabriella Di Mauro, Mattia Doria, Raffaele Falsaperla, Valentina Ferraro, Vassilios Fanos, Elena Galli, Daniele Giovanni Ghiglioni, Luciana Indinnimeo, Ahmad Kantar, Adima Lamborghini, Amelia Licari, Riccardo Lubrano, Stefano Luciani, Francesco Macrì, Gianluigi Marseglia, Alberto Giuseppe Martelli, Luigi Masini, Fabio Midulla, Domenico Minasi, Vito Leonardo Miniello, Michele Miraglia Del Giudice, Sergio Renzo Morandini, Germana Nardini, Agostino Nocerino, Elio Novembre, Giovanni Battista Pajno, Francesco Paravati, Giorgio Piacentini, Cristina Piersantelli, Gabriella Pozzobon, Giampaolo Ricci, Valter Spanevello, Renato Turra , Stefania Zanconato, Melissa Borrelli, Alberto Villani, Giovanni Corsello, Giuseppe Di Mauro, Diego Peroni
Subjects: Male, Delphi Technique, Rhinosinusitis, Respiratory Tract Diseases, Delphi method, Rhinosinusiti, Laryngitis, Adrenal Cortex Hormone, Pediatrics, 0302 clinical medicine, Adrenal Cortex Hormones, Multidisciplinary approach, Inhaled corticosteroid, 030212 general & internal medicine, Child, Respiratory Tract Disease, Rhiniti, Societies, Medical, Rhinitis, education.field_of_study, Inhaled corticosteroids, Wheezing, General Medicine, Settore MED/38, Systematic review, Italy, Laryngotracheitis, Child, Preschool, Laryngotracheiti, Female, medicine.symptom, Human, medicine.medical_specialty, Consensus, Adolescent, Population, Consensu, RJ1-570, 03 medical and health sciences, Intervention (counseling), Administration, Inhalation, medicine, Laryngospasm, Humans, Adenoid hypertrophy, education, Intensive care medicine, Asthma, business.industry, Research, Infant, medicine.disease, 030228 respiratory system, business
Abstract: Background In 2019, a multidisciplinary panel of experts from eight Italian scientific paediatric societies developed a consensus document for the use of inhaled corticosteroids in the management and prevention of the most common paediatric airways disorders. The aim is to provide healthcare providers with a multidisciplinary document including indications useful in the clinical practice. The consensus document was intended to be addressed to paediatricians who work in the Paediatric Divisions, the Primary Care Services and the Emergency Departments, as well as to Residents or PhD students, paediatric nurses and specialists or consultants in paediatric pulmonology, allergy, infectious diseases, and ear, nose, and throat medicine. Methods Clinical questions identifying Population, Intervention(s), Comparison and Outcome(s) were addressed by methodologists and a general agreement on the topics and the strength of the recommendations (according to the GRADE system) was obtained following the Delphi method. The literature selection included secondary sources such as evidence-based guidelines and systematic reviews and was integrated with primary studies subsequently published. Results The expert panel provided a number of recommendations on the use of inhaled corticosteroids in preschool wheezing, bronchial asthma, allergic and non-allergic rhinitis, acute and chronic rhinosinusitis, adenoid hypertrophy, laryngitis and laryngospasm. Conclusions We provided a multidisciplinary update on the current recommendations for the management and prevention of the most common paediatric airways disorders requiring inhaled corticosteroids, in order to share useful indications, identify gaps in knowledge and drive future research.
Published: 2021

5. Biologics in food allergy: up-to-date

Author: Fortunato Lombardo, Giuseppe Crisafulli, Tommaso Aversa, Giovanni Battista Pajno, Stefano Passanisi, Lucia Caminiti, and Giuseppina Zirilli
Subjects: 0301 basic medicine, medicine.medical_specialty, medicine.medical_treatment, Clinical Biochemistry, Omalizumab, Alarmins, dupilumab, etokimab, ige-mediated food allergy, immunotherapy, mepolizumab, omalizumab, pathogenesis, reslizumab, law.invention, 03 medical and health sciences, 0302 clinical medicine, Randomized controlled trial, Food allergy, law, Drug Discovery, medicine, Humans, In patient, Clinical efficacy, Intensive care medicine, Pharmacology, Biological Products, business.industry, Antibodies, Monoclonal, Treatment options, Immunotherapy, medicine.disease, Dupilumab, 030104 developmental biology, 030220 oncology & carcinogenesis, business, Food Hypersensitivity, medicine.drug
Abstract: Introduction: In recent years, the advent of immunotherapy has remarkably improved the management of IgE-mediated food allergy. However, some barriers still exist. Therefore, the effort of researchers aims to investigate new perspectives in the field of non-allergen specific therapy, also based on the current knowledge of the pathogenesis of this disease.Areas covered: This review aims to focus on the role of biologics as a treatment option in patients with IgE-mediated food allergy. These agents are characterized by their ability to inactivate the Th2 pro-inflammatory pathways. Biologics can be used both alone and in association with immunotherapy. Monoclonal antibodies targeting IgE, the IL-4/IL-13 axis, IL-5, and alarmins have been proposed and investigated for treating food allergy.Expert opinion: The clinical efficacy and safety of biologics have been demonstrated in several preclinical studies and randomized controlled trials. Future studies are still required to address current unmet needs, including the identification of the optimal dose to be used by ensuring the effectiveness of therapy.
Published: 2021

6. Chronic cough in childhood: A systematic review for practical guidance by the Italian Society of Pediatric Allergy and Immunology

Author: Giovanni Battista Pajno, Fabio Cardinale, Maria Angela Tosca, Domenico Minasi, Mauro Calvani, Claudio Cravidi, Diego Peroni, Carlo Caffarelli, Sara Manti, Gian Luigi Marseglia, Ilaria Brambilla, Arabella Martelli, Elena Chiappini, Michele Miraglia Del Giudice, Giorgio Ciprandi, Amelia Licari, and Marzia Duse
Subjects: Pulmonary and Respiratory Medicine, medicine.medical_treatment, Immunology, Primary care, 03 medical and health sciences, 0302 clinical medicine, Allergy and Immunology, Humans, Immunology and Allergy, Medicine, Medical prescription, Child, Watchful Waiting, Societies, Medical, adolescents, algorithm, children, chronic cough, diagnosis, dry cough, wet cough, National health, business.industry, General Medicine, Combined Modality Therapy, Antitussive Agents, Chronic cough, Cough, Italy, 030228 respiratory system, Underlying disease, Chronic Disease, Practice Guidelines as Topic, Quality of Life, Etiology, Pediatric allergy, medicine.symptom, business, Watchful waiting, 030215 immunology
Abstract: The current systematic review presented and discussed the most recent studies on pediatric chronic cough. In addition, the Italian Society of Pediatric Allergy and Immunology elaborated a comprehensive algorithm to guide the primary care approach to a pediatric patient with chronic cough.Several algorithms on chronic cough management have been adopted and validated in clinical practice; however, unlike the latter, we developed an algorithm focused on pediatric age, from birth until adulthood. Based on our findings, children and adolescents with chronic cough without cough pointers can be safely managed, initially using the watchful waiting approach and, successively, starting empirical treatment based on cough characteristics. Unlike other algorithms that suggest laboratory and instrumental investigations as a first step, this review highlighted the importance of a “wait and see” approach, consisting of parental reassurance and close clinical observation, also due to interprofessional collaboration and communication between general practitioners and specialists that guarantee better patient management, appropriate prescription behavior, and improved patient outcome. Moreover, the neonatal screening program provided by the Italian National Health System, which intercepts several diseases precociously, allowing to treat them in a very early stage, helps and supports a “wait and see” approach.Conversely, in the presence of cough pointers or persistence of cough, the patient should be tested and treated by the specialist. Further investigations and treatments will be based on cough etiology, aiming to intercept the underlying disease, prevent potentially irreversible tissue damage, and improve the general health of patients affected by chronic cough, as well as the quality of life of patients and their family. Further high-quality randomized controlled trials are needed to validate this algorithm’s performance in real clinical practice.
Published: 2021

7. Health assessment for migrants and asylum seekers upon arrival and while hosted in reception centres: Italian guidelines

Author: Chiara Pajno, Maurella Della Seta, Luigina Ferrigno, Silvia Declich, Salvatore Geraci, Concetta Mirisola, Giulia De Ponte, Erica Eugeni, Rosalia Marrone, Franca D'Angelo, Maria Elena Tosti, Maurizio Marceca, Scilla Pizzarelli, Annalisa Rosso, and Giovanni Baglio
Subjects: Pregnancy test, medicine.medical_specialty, Referral, Refugee, Uterine Cervical Neoplasms, Scientific literature, 03 medical and health sciences, 0302 clinical medicine, Pregnancy, Humans, Mass Screening, Medicine, 030212 general & internal medicine, Early Detection of Cancer, Mass screening, Transients and Migrants, Refugees, business.industry, 030503 health policy & services, Health Policy, Public health, medicine.disease, Italy, Health assessment, Family medicine, Female, asylum seekers, guidelines, healthcare needs assessment, migrants, prevention and control, public health, 0305 other medical science, business, Malaria
Abstract: Background During 2016–17, national guidelines were developed in order to provide evidence-based recommendations on health assessments for migrants and asylum seekers upon their arrival in Italy. Methods Scientific literature published between 2005 and 2016 was searched in different databases. A free search was also performed on international organizations’ websites in order to identify additional relevant documents. A multidisciplinary panel discussed the resulting evidence and formulated recommendations. Results Evidence-based recommendations were formulated: signs and symptoms of specific diseases should to be actively searched for active TB, malaria, STI, intestinal parasites, diabetes, anaemia. In case of other health conditions (latent TB, HIV, HBV, HCV, STI, strongyloides, schistosoma, diabetes), testing should be offered to asymptomatic subjects coming from endemic areas or exposed to risk factors. Mass screening is recommended for anaemia and hypertension; a pregnancy test should be considered, while inclusion in cervical cancer screening and vaccination programs is recommended. A modulated, progressive approach was developed, covering an initial evaluation during rescue operations, a full medical examination at first line reception stage and the referral to national health services during second line reception. Conclusions It is important to produce and periodically update guidelines on these issues and local peculiarities should be taken into account in their design and implementation. Guidelines can not only support economic sustainability, but also counteract stigmatization dynamics.
Published: 2021

8. Heterogeneity of pollen food allergy syndrome in seven Southern European countries: The @IT.2020 multicenter study

Author: Blerina Bregu, Alfred Priftanji, Ozlem Goksel, Fusun Kalpaklioglu, Elisabetta Pellegrini, Münevver Pinar, Lucia Caminiti, Dah Tay Jang, Blerta Lame, Dolores Hernandez, Paolo Maria Matricardi, Simone Pelosi, Aykut Güvensen, Fotis Psarros, Valeria Villella, Maria Dimou, Stefania Arasi, Tara Maria Hoffmann, Andrea Di Rienzo Businco, Andrea Barbalace, Antonio Nieto, Mariana Couto, Paraskevi Xepapadaki, Duygu Yazici, Javier de Andrés Suárez, Michael Makris, Ruth Llusar, Xenophon Aggelidis, Ekaterina Potapova, Eris Mesonjesi, Cansin Sackesen, Salvatore Tripodi, Nikolaos G. Papadopoulos, Mariana Pereira, Theresa Lipp, Sule Caglayan Sozmen, Aydan Acar Şahin, Alessandro Travaglini, Claire Dimier, Ifigenia Sfika, E. Caeiro, Ayşe Bilge Öztürk, Giovanni Battista Pajno, Ana Pereira, Maria Antonia Brighetti, Denis Charpin, Laurie Pahus, Valentine Verdier, Luís Delgado, Anne Bourgoin, João Fonseca, Ilenia Panasiti, Angel Mazon, Michel Thibaudon, Stephanie Dramburg, Centre recherche en CardioVasculaire et Nutrition = Center for CardioVascular and Nutrition research (C2VN), Aix Marseille Université (AMU)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement (INRAE), Öztürk, Ayşe Bilge (ORCID 0000-0003-0166-424X & YÖK ID 147629), Saçkesen, Cansın (ORCID 0000-0002-1115-9805 & YÖK ID 182537), Yazıcı, Dilek, Lipp, T., Acar Şahin, A., Aggelidis, X., Arasi, S., Barbalace, A., Bourgoin, A., Bregu, B., Brighetti, M. A., Caeiro, E, Çağlayan Sözmen, S., Caminiti, L., Charpin, D., Couto, M., Delgado, L., Di Rienzo Businco, A., Dimier, C., Dimou, M. V., Fonseca, J. A., Göksel, O., Güvensen, A., Hernandez, D., Hoffmann, T. M., Jang, D. T., Kalpaklıoğlu, F., Lame, B., Llusar, R., Makris, M., Mazon, A., Mesonjesi, E., Nieto, A., Pahus, L., Pajno, G., Panasiti, I., Papadopoulos, N. G., Pellegrini, E., Pelosi, S., Pereira, A. M., Pereira, M., Pınar, N. M., Potapova, E., Priftanji, A., Psarros, F., Sfika, I., Suarez, J., Thibaudon, M., Travaglini, A., Tripodi, S., Verdier, V., Villella, V., Xepapadaki, P., Matricardi, P. M., Dramburg, S., Koç University Research Center for Translational Medicine (KUTTAM) / Koç Üniversitesi Translasyonel Tıp Araştırma Merkezi (KUTTAM), and School of Medicine
Subjects: 0301 basic medicine, Allergy, Southern Europe, Clinical immunology, [SDV]Life Sciences [q-bio], seasonal allergic rhinitis, Oral Allergy Syndrome, Panallergen, Pollen Food Allergy Syndrome, Seasonal Allergic Rhinitis, 0302 clinical medicine, Prevalence, Immunology and Allergy, Children, Profiles, ComputingMilieux_MISCELLANEOUS, food and beverages, Oral Allergy Syndrome, Panallergen, Pollen Food Allergy Syndrome, Seasonal Allergic Rhinitis, Southern Europe, Settore MED/01, panallergen, pollen food allergy syndrome, Pollen, oral allergy syndrome, 600 Technik, Medizin, angewandte Wissenschaften::610 Medizin und Gesundheit::610 Medizin und Gesundheit, Food Hypersensitivity, Risk, medicine.medical_specialty, Oral allergy syndrome, Pollen food allergy syndrome, Seasonal allergic rhinitis, Population, Immunology, Settore BIO/02, Settore BIO/03, Cross Reactions, Sensitization, Pollen-food allergy, 03 medical and health sciences, otorhinolaryngologic diseases, medicine, Humans, Ige, Skin Tests, business.industry, Rhinitis, Allergic, Seasonal, Cross-Reactivity, Allergens, Peach, medicine.disease, Medicine, Cypress Pollen, 030104 developmental biology, 030228 respiratory system, Multicenter study, Family medicine, Informatics, business
Abstract: Background Pollen food allergy syndrome (PFAS) is a frequently underdiagnosed disease due to diverse triggers, clinical presentations, and test results. This is especially relevant in geographic areas with a broad spectrum of pollen sensitization, such as Southern Europe. Objectives To elucidate similarities and differences of PFAS in nine Southern European centers and identify associated characteristics and unique markers of PFAS. Methods As part of the @IT.2020 Multicenter Study, 815 patients with seasonal allergic rhinitis (SAR), aged 10-60 years, were recruited in seven countries. They completed questionnaires regarding SAR, comorbidities, family history, and PFAS, and underwent skin prick testing (SPT) and serum IgE testing. Results Of the 815 patients, 167 (20.5%) reported PFAS reactions. Most commonly, eliciting foods were kiwi (58, 34.7%), peach (43, 25.7%), and melon (26, 15.6%). Reported reactions were mostly local (216/319, 67.7%), occurring within 5 min of contact with elicitors (209/319, 65.5%). Associated characteristics included positive IgE to at least one panallergen (profilin, PR-10, or nsLTP) (p = 0.007), maternal PFAS (OR: 3.716, p = 0.026), and asthma (OR: 1.752, p = 0.073). Between centers, heterogeneity in prevalence (Marseille: 7.5% vs. Rome: 41.4%, p < 0.001) and of clinical characteristics was apparent. Cypress played a limited role, with only 1/22 SPT mono-sensitized patients reporting a food reaction (p < 0.073). Conclusions PFAS is a frequent comorbidity in Southern European SAR patients. Significant heterogeneity of clinical characteristics in PFAS patients among the centers was observed and may be related to the different pollen sensitization patterns in each geographic area. IgE to panallergen(s), maternal PFAS, and asthma could be PFAS-associated characteristics., EAACI Fellowship Award of the European Academy of Allergology and Clinical Immunology; Euroimmun [118583], SA was supported by the EAACI Fellowship Award of the European Academy of Allergology and Clinical Immunology. The study has been supported by an unrestricted grant from Euroimmun (grant number 118583). The ESEP assay has been provided by Euroimmun. The Informatics Platform AllergyCARD (TM) and the app AllergyMonitor (R) have been provided by TPS Production.
Published: 2021

9. Consensus statement of the Italian society of pediatric allergy and immunology for the pragmatic management of children and adolescents with allergic or immunological diseases during the COVID-19 pandemic

Author: Fabio Cardinale, Giorgio Ciprandi, Salvatore Barberi, Roberto Bernardini, Carlo Caffarelli, Mauro Calvani, Giovanni Cavagni, Elena Galli, Domenico Minasi, Michele Miraglia Del Giudice, Viviana Moschese, Elio Novembre, Francesco Paravati, Diego G Peroni, Maria Angela Tosca, Giovanni Traina, Salvatore Tripodi, Gian Luigi Marseglia, Doriana Amato, Caterina Anania, Elisa Anastasio, Rachele Antignani, Stefania Arasi, Martire Baldassarre, Ermanno Baldo, Andrea Barbalace, Simona Barni, Federica Betti, Annamaria Bianchi, Ezio Bolzacchini, Maira Bonini, Paolo Bottau, Sara Bozzetto, Maria Antonia Brighetti, Davide Caimmi, Silvia Caimmi, Luigi Calzone, Caterina Cancrini, Lucia Caminiti, Giulia Capata, Lucetta Capra, Carlo Capristo, Elena Carboni, Francesco Carella, Riccardo Castagnoli, Elena Chiappini, Fernanda Chiera, Iolanda Chinellato, Loredana Chini, Francesca Cipriani, Flavio Civitelli, Pasquale Comberiati, Daniele Contini, Stefania Corrente, Claudio Cravidi, Giuseppe Crisafulli, Barbara Cuomo, Enza D'Auria, Sofia D'Elios, Fabio Decimo, Auro Della Giustina, Rosa Maria Delle Piane, Maria De Filippo, Valentina De Vittori, Lucia Diaferio, Maria Elisa Di Cicco, Dora Di Mauro, Marzia Duse, Silvia Federici, Giuseppe Felice, Maria Grazia Fenu, Giuliana Ferrante, Tiziana Foti, Fabrizio Franceschini, Daniele Ghiglioni, Giuliana Giardino, Mattia Giovannini, Giovanni Cosimo Indirli, Cristiana Indolfi, Massimo Landi, Francesco La Torre, Lucia Maddalena Leone, Amelia Licari, Lucia Liotti, Vassilios Lougaris, Nunzia Maiello, Paride Mantecca, Sara Manti, Marco Maria Mariani, Alberto Martelli, Carla Mastrorilli, Violetta Mastrorilli, Davide Montin, Francesca Mori, Roberta Olcese, Giorgio Ottaviano, Claudia Paglialunga, Giovanni Pajno, Giuseppe Parisi, Stefano Pattini, Luca Pecoraro, Umberto Pelosi, Claudio Pignata, Giampaolo Ricci, Silvia Ricci, Stefano Rizzi, Caterina Rizzo, Sara Rosati, Paolo Rosso, Maria Sangerardi, Angelica Santoro, Francesca Saretta, Lucrezia Sarti, Marco Sartorio, Majla Sgruletti, Annarosa Soresina, Ifigenia Sfika, Mayla Sgrulletti, Nuccia Tesse, Valentina Tranchino, Alessandro Travaglini, Malizia Velia, Elvira Verduci, Mario Vernich, Elisabetta Veronelli, Stefano Volpi, Martina Votto, Anna Maria Zicari, Cardinale, F., Ciprandi, G., Barberi, S., Bernardini, R., Caffarelli, C., Calvani, M., Cavagni, G., Galli, E., Minasi, D., Del Giudice, M. M., Moschese, V., Novembre, E., Paravati, F., Peroni, D. G., Tosca, M. A., Traina, G., Tripodi, S., Marseglia, G. L., Amato, D., Anania, C., Anastasio, E., Antignani, R., Arasi, S., Baldassarre, M., Baldo, E., Barbalace, A., Barni, S., Betti, F., Bianchi, A., Bolzacchini, E., Bonini, M., Bottau, P., Bozzetto, S., Brighetti, M. A., Caimmi, D., Caimmi, S., Calzone, L., Cancrini, C., Caminiti, L., Capata, G., Capra, L., Capristo, C., Carboni, E., Carella, F., Castagnoli, R., Chiappini, E., Chiera, F., Chinellato, I., Chini, L., Cipriani, F., Civitelli, F., Comberiati, P., Contini, D., Corrente, S., Cravidi, C., Crisafulli, G., Cuomo, B., D'Auria, E., D'Elios, S., Decimo, F., Giustina, A. D., Piane, R. M. D., De Filippo, M., De Vittori, V., Diaferio, L., Di Mauro, M. E., Duse, M., Federici, S., Felice, G., Fenu, G., Ferrante, G., Foti, T., Franceschini, F., Ghiglioni, D., Giardino, G., Giovannini, M., Indirli, G. C., Indolfi, C., Landi, M., La Torre, F., Leone, L. M., Licari, A., Liotti, L., Lougaris, V., Maiello, N., Mantecca, P., Manti, S., Mariani, M. M., Martelli, A., Mastrorilli, C., Mastrorilli, V., Montin, D., Mori, F., Olcese, R., Ottaviano, G., Paglialunga, C., Pajno, G., Parisi, G., Pattini, S., Pecoraro, L., Pelosi, U., Pignata, C., Ricci, G., Ricci, S., Rizzi, S., Rizzo, C., Rosati, S., Rosso, P., Sangerardi, M., Santoro, A., Saretta, F., Sarti, L., Sartorio, M., Sgruletti, M., Soresina, A., Sfika, I., Sgrulletti, M., Tesse, N., Tranchino, V., Travaglini, A., Velia, M., Verduci, E., Vernich, M., Veronelli, E., Volpi, S., Votto, M., Zicari, A. M., Cardinale, Fabio, Ciprandi, Giorgio, Barberi, Salvatore, Bernardini, Roberto, Caffarelli, Carlo, Calvani, Mauro, Cavagni, Giovanni, Galli, Elena, Minasi, Domenico, Del Giudice, Michele Miraglia, Moschese, Viviana, Novembre, Elio, Paravati, Francesco, Peroni, Diego G, Tosca, Maria Angela, Traina, Giovanni, Tripodi, Salvatore, Marseglia, Gian Luigi, SIAIP task force Pignata, Claudio, Cardinale, F, Ciprandi, G, Barberi, S, Bernardini, R, Caffarelli, C, Calvani, M, Cavagni, G, Galli, E, Minasi, D, Del Giudice, M, Moschese, V, Novembre, E, Paravati, F, Peroni, D, Tosca, M, Traina, G, Tripodi, S, Marseglia, G, Amato, D, Anania, C, Anastasio, E, Antignani, R, Arasi, S, Baldassarre, M, Baldo, E, Barbalace, A, Barni, S, Betti, F, Bianchi, A, Bolzacchini, E, Bonini, M, Bottau, P, Bozzetto, S, Brighetti, M, Caimmi, D, Caimmi, S, Calzone, L, Cancrini, C, Caminiti, L, Capata, G, Capra, L, Capristo, C, Carboni, E, Carella, F, Castagnoli, R, Chiappini, E, Chiera, F, Chinellato, I, Chini, L, Cipriani, F, Civitelli, F, Comberiati, P, Contini, D, Corrente, S, Cravidi, C, Crisafulli, G, Cuomo, B, D'Auria, E, D'Elios, S, Decimo, F, Giustina, A, Piane, R, De Filippo, M, De Vittori, V, Diaferio, L, Di Mauro, M, Duse, M, Federici, S, Felice, G, Fenu, G, Ferrante, G, Foti, T, Franceschini, F, Ghiglioni, D, Giardino, G, Giovannini, M, Indirli, G, Indolfi, C, Landi, M, La Torre, F, Leone, L, Licari, A, Liotti, L, Lougaris, V, Maiello, N, Mantecca, P, Manti, S, Mariani, M, Martelli, A, Mastrorilli, C, Mastrorilli, V, Montin, D, Mori, F, Olcese, R, Ottaviano, G, Paglialunga, C, Pajno, G, Parisi, G, Pattini, S, Pecoraro, L, Pelosi, U, Pignata, C, Ricci, G, Ricci, S, Rizzi, S, Rizzo, C, Rosati, S, Rosso, P, Sangerardi, M, Santoro, A, Saretta, F, Sarti, L, Sartorio, M, Sgruletti, M, Soresina, A, Sfika, I, Sgrulletti, M, Tesse, N, Tranchino, V, Travaglini, A, Velia, M, Verduci, E, Vernich, M, Veronelli, E, Volpi, S, Votto, M, Zicari, A, and Fabio Cardinale, Giorgio Ciprandi, Salvatore Barberi, Roberto Bernardini, Carlo Caffarelli, Mauro Calvani, Giovanni Cavagni, Elena Galli, Domenico Minasi, Michele Miraglia Del Giudice, Viviana Moschese, Elio Novembre, Francesco Paravati, Diego G Peroni, Maria Angela Tosca, Giovanni Traina, Salvatore Tripodi, Gian Luigi Marseglia, Doriana Amato, Caterina Anania, Elisa Anastasio, Rachele Antignani, Stefania Arasi, Martire Baldassarre, Ermanno Baldo, Andrea Barbalace, Simona Barni, Federica Betti, Annamaria Bianchi, Ezio Bolzacchini, Maira Bonini, Paolo Bottau, Sara Bozzetto, Maria Antonia Brighetti, Davide Caimmi, Silvia Caimmi, Luigi Calzone, Caterina Cancrini, Lucia Caminiti, Giulia Capata, Lucetta Capra, Carlo Capristo, Elena Carboni, Francesco Carella, Riccardo Castagnoli, Elena Chiappini, Fernanda Chiera, Iolanda Chinellato, Loredana Chini, Francesca Cipriani, Flavio Civitelli, Pasquale Comberiati, Daniele Contini, Stefania Corrente, Claudio Cravidi, Giuseppe Crisafulli, Barbara Cuomo, Enza D'Auria, Sofia D'Elios, Fabio Decimo, Auro Della Giustina, Rosa Maria Delle Piane, Maria De Filippo, Valentina De Vittori, Lucia Diaferio, Maria Elisa Di Cicco, Dora Di Mauro, Marzia Duse, Silvia Federici, Giuseppe Felice, Maria Grazia Fenu, Giuliana Ferrante, Tiziana Foti, Fabrizio Franceschini, Daniele Ghiglioni, Giuliana Giardino, Mattia Giovannini, Giovanni Cosimo Indirli, Cristiana Indolfi, Massimo Landi, Francesco La Torre, Lucia Maddalena Leone, Amelia Licari, Lucia Liotti, Vassilios Lougaris, Nunzia Maiello, Paride Mantecca, Sara Manti, Marco Maria Mariani, Alberto Martelli, Carla Mastrorilli, Violetta Mastrorilli, Davide Montin, Francesca Mori, Roberta Olcese, Giorgio Ottaviano, Claudia Paglialunga, Giovanni Pajno, Giuseppe Parisi, Stefano Pattini, Luca Pecoraro, Umberto Pelosi, Claudio Pignata, Giampaolo Ricci, Silvia Ricci, Stefano Rizzi, Caterina Rizzo, Sara Rosati, Paolo Rosso, Maria Sangerardi, Angelica Santoro, Francesca Saretta, Lucrezia Sarti, Marco Sartorio, Majla Sgruletti, Annarosa Soresina, Ifigenia Sfika, Mayla Sgrulletti, Nuccia Tesse, Valentina Tranchino, Alessandro Travaglini, Malizia Velia, Elvira Verduci, Mario Vernich, Elisabetta Veronelli, Stefano Volpi, Martina Votto, Anna Maria Zicari
Subjects: Allergy, Review, 030207 dermatology & venereal diseases, Settore MED/38 - Pediatria Generale E Specialistica, 0302 clinical medicine, COVID-19, Child, Pandemic, Immunologic disease, Asthma, Adolescent, Viral, 030212 general & internal medicine, Disease management (health), Societies, Medical, pandemic, child, adolescent, allergy, asthma, immunologic disease, Incidence (epidemiology), lcsh:RJ1-570, Disease Management, General Medicine, Atopic dermatitis, Settore MED/38, Coronavirus Infections, Decision Making, Humans, Italy, Pneumonia, Viral, Pragmatic Clinical Trials as Topic, SARS-CoV-2, Allergy and Immunology, Betacoronavirus, Consensus, Pandemics, Latex allergy, Human, Telemedicine, Consensu, 03 medical and health sciences, Medical, medicine, Risk factor, Betacoronaviru, business.industry, Coronavirus Infection, lcsh:Pediatrics, Pneumonia, medicine.disease, Immunology, Societies, business, Rare disease
Abstract: The COVID-19 pandemic has surprised the entire population. The world has had to face an unprecedented pandemic. Only, Spanish flu had similar disastrous consequences. As a result, drastic measures (lockdown) have been adopted worldwide. Healthcare service has been overwhelmed by the extraordinary influx of patients, often requiring high intensity of care. Mortality has been associated with severe comorbidities, including chronic diseases. Patients with frailty were, therefore, the victim of the SARS-COV-2 infection. Allergy and asthma are the most prevalent chronic disorders in children and adolescents, so they need careful attention and, if necessary, an adaptation of their regular treatment plans. Fortunately, at present, young people are less suffering from COVID-19, both as incidence and severity. However, any age, including infancy, could be affected by the pandemic.Based on this background, the Italian Society of Pediatric Allergy and Immunology has felt it necessary to provide a Consensus Statement. This expert panel consensus document offers a rationale to help guide decision-making in the management of children and adolescents with allergic or immunologic diseases.
Published: 2020

10. Vulvar contact dermatitis caused by sensitization to colophonium in a patient with type 1 diabetes

Author: Lucia Caminiti, Giuseppina Salzano, Paolina Lonia, Francesca Galletta, Giovanni Battista Pajno, Vittoria Donia, Fortunato Lombardo, and Stefano Passanisi
Subjects: sanitary pads, medicine.medical_specialty, Sanitary pads, Dermatology, Adhesives, medicine, Humans, case report, Immunology and Allergy, Child, Menstrual Hygiene Products, Sensitization, glucose sensor, Menarche, Type 1 diabetes, Contact Points, business.industry, Blood Glucose Self-Monitoring, Patch test, medicine.disease, diapers, Diabetes Mellitus, Type 1, medicine.anatomical_structure, Dermatitis, Allergic Contact, case report, diapers, glucose sensor, patch test, resin, sanitary pads, resin, Female, Vulvar Diseases, business, Contact dermatitis, Resins, Plant, patch test
Published: 2021

11. Pregnant women’s knowledge and behaviour to prevent cytomegalovirus infection: an observational study

Author: Chiara Boccherini, Pierluigi Benedetti Panici, Valentina D'Ambrosio, Ludovico Muzii, Maria Giovanna Salerno, Antonio Pizzuti, Daniele Di Mascio, Sara Corno, Roberto Brunelli, Cristina Pajno, Maria Grazia Piccioni, Francesco Bisogni, Antonella Giancotti, and Flaminia Vena
Subjects: Adult, Health Knowledge, Attitudes, Practice, medicine.medical_specialty, Perinatal care, Congenital cytomegalovirus infection, Cytomegalovirus, 03 medical and health sciences, 0302 clinical medicine, prevention, Patient Education as Topic, Pregnancy, medicine, Humans, cytomegalovirus infection, Potential source, 030212 general & internal medicine, Pregnancy Complications, Infectious, 030304 developmental biology, 0303 health sciences, Risk behaviour, Transmission (medicine), business.industry, Obstetrics, Obstetrics and Gynecology, medicine.disease, Infectious Disease Transmission, Vertical, congenital infection, Cytomegalovirus infection, Cross-Sectional Studies, Italy, Cytomegalovirus Infections, Pediatrics, Perinatology and Child Health, pregnant women, Female, Observational study, Pregnant Women, business, Risk Reduction Behavior, Needs Assessment
Abstract: Objectives Congenital cytomegalovirus (cCMV) infection can negatively affect pregnancy outcomes, but may be prevented by simple precautions. Literature suggests that gynaecologists do not always adequately inform about preventive behaviour and most pregnant women have a low-level knowledge regarding cCMV infection. The aim of this study is to evaluate knowledge and risk behaviours related to cCMV infection in an unselected group of pregnant women. Methods An institutional based cross-sectional study was conducted in three Maternal and Fetal Divisions in Rome between November and February 2019 on 296 pregnant women, their knowledge on cCMV was measured using six cytomegalovirus (CMV) related questions. Results Out of the 296 respondents, 59.1% had heard, read or seen information about cCMV infection. Regarding the way of transmission, 96/296 (32.4%) correctly recognize children as a potential source of the infection but only 25/296 (8.44%) knew all prevention practices, 28/296 (9.5%) of women reported that they have never performed cCMV test during pregnancy. Conclusions The results of this survey show that knowledge on cCMV infection among pregnant women is poor. This highlights the need to improve counselling on all preventive practices for cCMV infection during perinatal care consultation.
Published: 2020

12. An observational study to assess Italian obstetrics providers’ knowledge about preventive practices and diagnosis of congenital cytomegalovirus

Author: Valentina D'Ambrosio, Maria Grazia Piccioni, Antonio Pizzuti, Rech F, Chiara Boccherini, Sara Corno, Paola Ciolli, Cristina Pajno, Ludovico Muzii, Roberto Brunelli, Flaminia Vena, Pierluigi Benedetti Panici, and Antonella Giancotti
Subjects: neurodevelopmental disability, Adult, Male, medicine.medical_specialty, Population, Congenital cytomegalovirus infection, congenital cytomegalovirus infection, Young Adult, 03 medical and health sciences, 0302 clinical medicine, Obstetrics and gynaecology, medicine, antenatal counseling, preventive practices, Humans, 030212 general & internal medicine, Seroconversion, education, education.field_of_study, 030219 obstetrics & reproductive medicine, medicine.diagnostic_test, Obstetrics, business.industry, Obstetrics and Gynecology, medicine.disease, Cross-Sectional Studies, Italy, Cytomegalovirus Infections, Pediatrics, Perinatology and Child Health, Amniocentesis, Female, Observational study, Clinical Competence, Serum screening, business
Abstract: Objectives Congenital cytomegalovirus (cCMV) infection can be easily prevented by hygienic measures. Up to date the majority of the studies in literature highlighted a reduction in cCMV antenatal counseling and its prevention. Our purpose was to evaluate obstetrics providers’ knowledge about cCMV infection, management and the behavioral practices to avoid it. Methods This is a cross-sectional survey carried out in Umberto I Hospital, “Sapienza” University of Rome between November 2019 and January 2020. We recruited 148 specialists and residents in Obstetrics and Gynecology through online anonymous multiple-choice 13-questions, 10 min-survey comparing responses between the two groups. Results A total of 94.6% of all participants said they always prescribe cytomegalovirus (CMV) serum screening: 73.6% of them regularly counsel about preventive practices, with specialists recording higher percentages (85.4 vs. 65.1%, p Conclusions Prevention of maternal seroconversion is crucial: even if our data show an acceptable knowledge about antenatal counseling, we encourage clinicians to firmly inform and educate women about behavioral measures.
Published: 2020

13. GCK-MODY in a child with cystic fibrosis: the doubt of the treatment plan

Author: Stefano Costa, Stefano Passanisi, Maria Cristina Lucanto, Giovanni Battista Pajno, Giuseppina Salzano, and Fortunato Lombardo
Subjects: Pediatrics, medicine.medical_specialty, Endocrinology, Diabetes and Metabolism, medicine.medical_treatment, Cystic fibrosis-related diabetes, 030209 endocrinology & metabolism, Enteral administration, Cystic fibrosis, cystic fibrosis, 03 medical and health sciences, 0302 clinical medicine, Endocrinology, Diabetes mellitus, medicine, Glucose homeostasis, Respiratory function, 030212 general & internal medicine, Glycemic, treatment, business.industry, Insulin, medicine.disease, hyperglycaemia, monogenic diabetes, Pediatrics, Perinatology and Child Health, business
Abstract: Objectives The diagnosis of cystic fibrosis related diabetes (CFRD) is not often easy as glucose homeostasis may be influenced by various disease-related conditions such as enteral continuous drip feeding, frequent acute illness, use of systemic corticosteroids and other concomitant medications. Other forms of diabetes should be considered in the diagnostic work-up, particularly in the first decade of life. Case presentation We hereby present the case of a cystic fibrosis 6-year-old female child diagnosed with glucokinase-maturity onset of diabetes of the young (GCK-MODY). The choice of treatment plan was doubtful since GCK-MODY does not usually require insulin treatment, but hyperglycemia could pose a threat to the respiratory tract. After intensive glucose monitoring, we decided to defer pharmacological treatment based on acceptable daily glycemic control. To date, no worsening in her respiratory function has been revealed. Conclusions Recognition of non-CFRD forms of diabetes is fundamental to plan the most suitable treatment and follow-up.
Published: 2020

14. Advances in Management of Food Allergy in Children

Author: Lucia Caminiti, Giovanni Battista Pajno, Giuseppe Crisafulli, and Fernanda Chiera
Subjects: DNA vaccine, medicine.medical_specialty, Allergen immunotherapy, medicine.medical_treatment, desensitization, medicine.disease_cause, Biological Factors, Allergen, Food allergy, Vaccines, DNA, medicine, Humans, Immunologic Factors, Ingestion, biologics, Child, Intensive care medicine, Desensitization (medicine), food allergy, modified proteins, business.industry, Probiotics, Public health, medicine.disease, Discontinuation, Clinical trial, Desensitization, Immunologic, Pediatrics, Perinatology and Child Health, immunotherapy, business, Food Hypersensitivity, Diet Therapy, Drugs, Chinese Herbal
Abstract: Food allergy is a potentially life-threatening medical condition and a significant public health concern worldwide. The current management consists of strict avoidance of the culprit food and treating any adverse reactions from unintended food ingestion. The increasing prevalence of food allergy encouraged research and clinical trials in the field of specific allergen immunotherapy (AIT) which represents an appealing approach, especially in pediatric age. AIT consists of the gradual administration of growing amounts of the offending allergen in order to induce food desensitization, which is an increase in the threshold for reactivity while continuing on regular exposure to the allergen. AIT can be administered through oral, sublingual, epicutaneous, and subcutaneous routes. Reports on oral immunotherapy (OIT) thus far have been more extensive. The desirable goal is to achieve "post desensitization effectiveness", that is the ability to introduce food without reaction even after a period of discontinuation of the offending food. Other therapeutic approaches are being studied alongside immunotherapy such as modified proteins, probiotics, Chinese herbal supplements, biologic therapies, and DNA vaccines.
Published: 2020

15. EAACI guidelines on allergen immunotherapy:Hymenoptera venom allergy

Author: Franziska Ruëff, Antonella Muraro, V. Pravettoni, Asiyah Sheikh, Holger Mosbech, Dimitris I. Mitsias, E. M. Varga, R. G. Van Wijk, Markus Ollert, Oliver Pfaar, Hadar Zaman, R. Gawlik, R. van Ree, Susanne Halken, Dermot Ryan, Graham Roberts, M. Fernandez-Rivas, Joanna Lange, Gunter J. Sturm, Ioana Agache, Elizabeth Angier, Mitja Košnik, O. Spranger, S. Dhami, Steffen Lau, Darío Antolín-Amérigo, Constantinos Pitsios, Moises A. Calderon, Marek Jutel, M. B. Bilò, G. B. Pajno, Stefania Arasi, Betül Ayşe Sin, Thilo Jakob, J. N. G. Oude Elberink, Ewa Cichocka-Jarosz, Ervin Ç. Mingomataj, Cezmi A. Akdis, Ear, Nose and Throat, Experimental Immunology, AII - Inflammatory diseases, APH - Global Health, and APH - Personalized Medicine
Subjects: Allergen immunotherapy, medicine.medical_specialty, Allergy, Effectiveness, complex mixtures, 03 medical and health sciences, 0302 clinical medicine, Autoinjector, medicine, Immunology and Allergy, Adverse effect, Anaphylaxis, 030201 allergy, business.industry, Venom immunotherapy, Hymenoptera venom allergy, Guideline, medicine.disease, Dermatology, eye diseases, 3. Good health, Sting, Safety, business
Abstract: Hymenoptera venom allergy is a potentially life-threatening allergic reaction following a honeybee, vespid, or ant sting. Systemic-allergic sting reactions have been reported in up to 7.5% of adults and up to 3.4% of children. They can be mild and restricted to the skin or moderate to severe with a risk of life-threatening anaphylaxis. Patients should carry an emergency kit containing an adrenaline autoinjector, H1-antihistamines, and corticosteroids depending on the severity of their previous sting reaction(s). The only treatment to prevent further systemic sting reactions is venom immunotherapy. This guideline has been prepared by the European Academy of Allergy and Clinical Immunology’s (EAACI) Taskforce on Venom Immunotherapy as part of the EAACI Guidelines on Allergen Immunotherapy initiative. The guideline aims to provide evidence-based recommendations for the use of venom immunotherapy, has been informed by a formal systematic review and meta-analysis and produced using the Appraisal of Guidelines for Research and Evaluation (AGREE II) approach. The process included representation from a range of stakeholders. Venom immunotherapy is indicated in venom-allergic children and adults to prevent further moderate-to-severe systemic sting reactions. Venom immunotherapy is also recommended in adults with only generalized skin reactions as it results in significant improvements in quality of life compared to carrying an adrenaline autoinjector. This guideline aims to give practical advice on performing venom immunotherapy. Key sections cover general considerations before initiating venom immunotherapy, evidence-based clinical recommendations, risk factors for adverse events and for relapse of systemic sting reaction, and a summary of gaps in the evidence.
Published: 2020

16. Pediatric use of omalizumab for allergic asthma

Author: Riccardo Castagnoli, Gian Luigi Marseglia, Amelia Licari, Giovanni Battista Pajno, Stefania Arasi, and Lucia Caminiti
Subjects: severe asthma, 0301 basic medicine, Pediatrics, medicine.medical_specialty, precision medicine, Clinical Biochemistry, Pain, Omalizumab, macromolecular substances, Disease, Immunoglobulin E, Severity of Illness Index, Anti-asthmatic Agent, Efficacy, 03 medical and health sciences, 0302 clinical medicine, children, Drug Discovery, Severity of illness, medicine, Humans, biologics, Anti-Asthmatic Agents, Child, Asthma, Pharmacology, biology, business.industry, medicine.disease, Treatment Outcome, 030104 developmental biology, difficult-to-treat asthma, omalizumab, Half-Life, 030220 oncology & carcinogenesis, biology.protein, business, Anaphylaxis, medicine.drug
Abstract: Severe pediatric asthma is associated with significant morbidity as well as with a high economic burden. It represents a heterogeneous disease with multiple clinical phenotypes. Currently, physicians are facing the challenge to provide a 'personalized medicine approach', which is tailored to the diverse pathomechanisms underlying clinical presentations. Three main endotypes of airway inflammation have been described in children with severe asthma. While neutrophilic and paucigranulocytic inflammatory patterns are quite uncommon in childhood, type Th2 inflammation asthma with elevated IgE is the most prevalent in pediatric asthma. Considering the pivotal role of IgE in type Th2 inflammation asthma, the blockade of IgE using anti-IgE therapy represents a potent therapeutic option for severe pediatric asthma in children.This review aims to focus on the role of omalizumab as a treatment option in pediatric patients (aged six years and above) with severe allergic asthma.The clinical efficacy and safety of omalizumab for the treatment of pediatric asthma is well documented in clinical trials and observational studies. Further studies are still required to characterize the potential benefit of anti-IgE therapy in airway remodeling, identify additional biomarkers of clinical response and address current unmet needs, including the limit on omalizumab use in children younger than six years.
Published: 2020

17. Hypoplasia of the Corpus Callosum: A Single Center Experience and a Concise Literature Review

Author: Antonella Giancotti, Chiara Boccherini, Sara Corno, Cristina Pajno, Pierluigi Benedetti Panici, Valentina D'Ambrosio, Raffaella Cellitti, Lucia Manganaro, Flaminia Vena, and Roberto Brunelli
Subjects: 0301 basic medicine, endocrine system, congenital, hereditary, and neonatal diseases and abnormalities, Corpus callosum hypoplasia, 030105 genetics & heredity, Single Center, Corpus callosum, Ultrasonography, Prenatal, Corpus Callosum, Pathology and Forensic Medicine, 03 medical and health sciences, Prenatal ultrasound, 0302 clinical medicine, Pregnancy, Prenatal Diagnosis, mental disorders, medicine, Humans, Ultrasonography, 030219 obstetrics & reproductive medicine, business.industry, General Medicine, Anatomy, medicine.disease, Magnetic Resonance Imaging, Hypoplasia, nervous system diseases, nervous system, Pediatrics, Perinatology and Child Health, Female, Agenesis of Corpus Callosum, business
Abstract: Aim: Corpus callosum hypoplasia is described as a fully formed corpus callosum with reduced thickness. Our purpose is to evaluate the current knowledge about this anomaly including it’s effect on t...
Published: 2020

18. Agreements and controversies of national guidelines for bronchiolitis: Results from an Italian survey

Author: Maria Angela Tosca, Marzia Duse, Fabio Cardinale, Arabella Martelli, Carlo Caffarelli, G B Pajno, Giorgio Ciprandi, Ilaria Brambilla, Elena Chiappini, Gian Luigi Marseglia, Domenico Minasi, Claudio Cravidi, Mauro Calvani, Michele Miraglia Del Giudice, Eugenio Baraldi, Sara Manti, Amelia Licari, Manti, Sara, Licari, Amelia, Brambilla, Ilaria, Caffarelli, Carlo, Calvani, Mauro, Cardinale, Fabio, Ciprandi, Giorgio, Cravidi, Claudio, Duse, Marzia, Martelli, Alberto, Minasi, Domenico, Miraglia Del Giudice, Michele, Pajno, Giovan B, Tosca, Maria A, Chiappini, Elena, Baraldi, Eugenio, and Marseglia, Gianluigi
Subjects: medicine.medical_specialty, Immunology, children, Surveys and Questionnaires, medicine, Surveys and Questionnaire, Immunology and Allergy, Humans, survey, guidelines, Quality of care, Child, Therapeutic regimen, treatment, business.industry, Infant, Newborn, Infant, Survey research, Original Articles, RC581-607, medicine.disease, Newborn, Hospitalization, Italy, Acute Bronchiolitis, Bronchiolitis, Family medicine, Radiological weapon, bronchioliti, Hospital admission, Original Article, Immunologic diseases. Allergy, business, guideline, Human, bronchiolitis
Abstract: Introduction Significant variations in the management of bronchiolitis are often recorded, and, in parallel, to recommend a univocal clinical approach is challenging and still questioned. This study is aimed to evaluate the diagnostic and therapeutic management of bronchiolitis in children adopted by Italian pediatricians following the national guidelines. Material and Methods A survey study was designed and carried out by sending an email an open‐ended questionnaire developed by an expert panel of the Scientific Board of the Italian Society of Pediatric Allergology and Immunology (SIAIP). Questions were designed according to the national intersociety consensus document on treatment and prevention of bronchiolitis in newborns and infants. Results Overall, 234 pediatricians were taking part in the study. When diagnosing bronchiolitis, only 44.01% (103/234) of participants correctly followed the national guidelines. All participants (100%) would perform laboratory tests and/or radiological exams. 44.01% administered oxygen (O2) when O2 saturation was minor than 92%. About the therapeutic regimen, marked discrepancies between national guidelines and recorded answers were reported. Indications for hospital admission and discharge criteria were in line with the national guidelines. Conclusions There is a significant practice variation in the management of acute bronchiolitis among Italian physicians. Some wrong attitudes need to be further discouraged, such use of diagnostic procedures and therapeutic approaches. Further research is urgently required to define the best management of patients with bronchiolitis and implement strategies to standardize care and improve the quality of care.
Published: 2021

19. Proposal of 0.5 mg of protein/100 g of processed food as threshold for voluntary declaration of food allergen traces in processed food: A first step in an initiative to better inform patients and avoid fatal allergic reactions, A GA²LEN position paper

Author: Giovanni Battista Pajno, Stefan Wöhrl, Sasho Stoleski, Caroline Nilsson, Mary Jane Marchisotto, Ronald van Ree, Carina Venter, Anna Nowak-Wegrzyn, Montserrat Fernandez-Rivas, Akio Tanaka, Barbara Rogala, Benjamin Kendziora, Michihiro Hide, Stefano Del Giacco, Katarina Stevanovic, Dragan Mijakoski, Enrico Heffler, Nikolaos G. Papadopoulos, Werner Aberer, Antoine Deschildre, Lisa A. Beck, Kate Grimshaw, M. Gotua, Torsten Zuberbier, Hugh A. Sampson, Marek Jutel, Mikela Odemyr, Carlo Lombardi, Erkka Valovirta, Antonella Cianferoni, Nicolette W. de Jong, Jovanka Karadzinska Bislimovska, Michael J. Cork, Christer Janson, Karin Hoffmann-Sommergruber, Gianenrico Senna, Jean Bousquet, Michael Makris, Carsten Bindslev-Jensen, Tamara Dörr, Joan Bartra, Ana Todo-Bom, Mika J. Mäkelä, Ulf Darsow, Margitta Worm, Richard Loh, Rosan Meyer, Giampaolo Ricci, Roy Gerth van Wijk, Audrey Dunn Galvin, Joaquim Mullol, M Alvaro, Alessandro Fiocchi, Zuotao Zhao, Stefania Arasi, Marta Ferrer, Norito Katoh, Philippe Bégin, Brigita Sitkauskiene, Sushil Paudel, Knut Brockow, Johannes Ring, Edward F. Knol, Susanne Lau, Gary W.K. Wong, Jordan Minov, Cristoforo Incorvaia, Marcus Maurer, Hasan Arshad, Fatih A Topal, Bright I Nwaru, Hania Szajewska, Andrew Bush, Tamar Kinaciyan, Adnan Custovic, Elizabeth Angier, O M Kurbacheva, Diana Deleanu, Harald Renz, Peter Smith, Motohiro Ebisawa, J. Grünhagen, Swen Malte John, Carla P. Jones, Barbara Ballmer-Weber, Ear, Nose and Throat, Experimental Immunology, AII - Inflammatory diseases, APH - Global Health, and APH - Personalized Medicine
Subjects: Food industry, Eggs, Immunology, Provocation test, Declaration, medicine.disease_cause, 03 medical and health sciences, 0302 clinical medicine, Allergen, Food allergy, Food Labeling, Environmental health, anaphylaxis, Immunology and Allergy, Medicine, Ingestion, Animals, Humans, SDG 2 - Zero Hunger, 030304 developmental biology, 2. Zero hunger, 0303 health sciences, Meal, food allergy, business.industry, digestive, oral, and skin physiology, Allergens, medicine.disease, 3. Good health, nutrition, 030228 respiratory system, Food processing, business, 600 Technik, Medizin, angewandte Wissenschaften::610 Medizin und Gesundheit::610 Medizin und Gesundheit, Food Hypersensitivity
Abstract: Background\ud \ud Food anaphylaxis is commonly elicited by unintentional ingestion of foods containing the allergen above the tolerance threshold level of the individual. While labeling the 14 main allergens used as ingredients in food products is mandatory in the EU, there is no legal definition of declaring potential contaminants. Precautionary allergen labeling such as “may contain traces of” is often used. However, this is unsatisfactory for consumers as they get no information if the contamination is below their personal threshold. In discussions with the food industry and technologists, it was suggested to use a voluntary declaration indicating that all declared contaminants are below a threshold of 0.5 mg protein per 100 g of food. This concentration is known to be below the threshold of most patients, and it can be technically guaranteed in most food production. However, it was also important to assess that in case of accidental ingestion of contaminants below this threshold by highly allergic patients, no fatal anaphylactic reaction could occur. Therefore, we performed a systematic review to assess whether a fatal reaction to 5mg of protein or less has been reported, assuming that a maximum portion size of 1kg of a processed food exceeds any meal and thus gives a sufficient safety margin.\ud \ud \ud \ud Methods\ud \ud MEDLINE and EMBASE were searched until 24 January 2021 for provocation studies and case reports in which one of the 14 major food allergens was reported to elicit fatal or life-threatening anaphylactic reactions and assessed if these occurred below the ingestion of 5mg of protein. A Delphi process was performed to obtain an expert consensus on the results.\ud \ud \ud \ud Results\ud \ud In the 210 studies included, in our search, no reports of fatal anaphylactic reactions reported below 5 mg protein ingested were identified. However, in provocation studies and case reports, severe reactions below 5 mg were reported for the following allergens: eggs, fish, lupin, milk, nuts, peanuts, soy, and sesame seeds.\ud \ud \ud \ud Conclusion\ud \ud Based on the literature studied for this review, it can be stated that cross-contamination of the 14 major food allergens below 0.5 mg/100 g is likely not to endanger most food allergic patients when a standard portion of food is consumed. We propose to use the statement “this product contains the named allergens in the list of ingredients, it may contain traces of other contaminations (to be named, e.g. nut) at concentrations less than 0.5 mg per 100 g of this product” for a voluntary declaration on processed food packages. This level of avoidance of cross-contaminations can be achieved technically for most processed foods, and the statement would be a clear and helpful message to the consumers. However, it is clearly acknowledged that a voluntary declaration is only a first step to a legally binding solution. For this, further research on threshold levels is encouraged.
Published: 2021

20. Nrf2-interacting nutrients and COVID-19: time for research to develop adaptation strategies

Author: Bousquet, Jean, Cristol, Jean-Paul, Czarlewski, Wienczyslawa, Anto, Josep M, Martineau, Adrian, Haahtela, Tari, Fonseca, Susana C, Iaccarino, Guido, Blain, Hubert, Fiocchi, Alessandro, Canonica, G Walter, Fonseca, Joao A, Vidal, Alain, Choi, Hak-Jong, Kim, Hyun Ju, Le Moing, Vincent, Reynes, Jacques, Sheikh, Aziz, Akdis, Cezmi A, Zuberbier, Torsten, Amir Hamzah Abdul Latiff, Baharudin, Abdullah, Werner, Aberer, Nancy, Abusada, Ian, Adcock, Alejandro, Afani, Ioana, Agache, Xenofon, Aggelidis, Jenifer, Agustin, Cezmi, A Akdis, Mübeccel, Akdis, Mona, Al-Ahmad, Abou Al-Zahab Bassam, Hussam, Alburdan, Oscar, Aldrey-Palacios, Emilio Alvarez Cuesta, Hiba Alwan Salman, Ashraf, Alzaabi, Salma, Amade, Gene, Ambrocio, Rosana, Angles, Isabella, Annesi-Maesano, Ignacio, J Ansotegui, Josep, M Anto, Paula Ara Bardajo, Stefania, Arasi, Margarete, Arrais, Hasan, Arshad, Maria-Cristina, Artesani, Estrella, Asayag, Francesca, Avolio, Khuzama, Azhari, Claus, Bachert, Diego, Bagnasco, Ilaria, Baiardini, Nissera, Bajrović, Petros, Bakakos, Sergio Bakeyala Mongono, Christine, Balotro-Torres, Sergio, Barba, Cristina, Barbara, Elsa, Barbosa, Bruno, Barreto, Joan, Bartra, Xavier, Basagana, Eric, D Bateman, Lkhagvaa, Battur, Anna, Bedbrook, Martín Bedolla Barajas, Bianca, Beghé, Antra, Bekere, Elizabeth, Bel, Ali Ben Kheder, Mikael, Benson, Elena-Camelia, Berghea, Karl-Christian, Bergmann, Roberto, Bernardini, David, Bernstein, Mike, Bewick, Slawomir, Bialek, Artur, Białoszewski, Thomas, Bieber, Nils, E Billo, Maria-Beatrice, Bilo, Carsten, Bindslev-Jensen, Leif, Bjermer, Hubert, Blain, Irina, Bobolea, Malgorzata Bochenska Marciniak, Christine, Bond, Attilio, Boner, Matteo, Bonini, Sergio, Bonini, Sinthia, Bosnic-Anticevich, Isabelle, Bosse, Sofia, Botskariova, Jacques, Bouchard, Louis-Philippe, Boulet, Rodolphe, Bourret, Philippe, Bousquet, Fulvio, Braido, Andrew, Briggs, Christopher, E Brightling, Jan, Brozek, Luisa, Brussino, Roland, Buhl, Roxana, Bumbacea, Rosalva, Buquicchio, María-Teresa Burguete Cabañas, Andrew, Bush, William, W Busse, Jeroen, Buters, Fernan, Caballero-Fonseca, Moïses, A Calderon, Mario, Calvo, Paulo, Camargos, Thierry, Camuzat, R Canevari, F, Antonio, Cano, G Walter Canonica, Arnaldo, Capriles-Hulett, Luis, Caraballo, Vicky, Cardona, Kai-Hakon, Carlsen, Jonas Carmona Pirez, Jorge, Caro, Warner, Carr, Pedro, Carreiro-Martins, Fredelita, Carreon-Asuncion, Ana-Maria, Carriazo, Carme Carrion, Y Ribas, Thomas, Casale, Mary-Ann, Castor, Elizabeth, Castro, G Caviglia, A, Lorenzo, Cecchi, Alfonso Cepeda Sarabia, Maciej, Chalubinski, Ramanathan, Chandrasekharan, Yoon-Seok, Chang, Victoria, Chato-Andeza, Lida, Chatzi, Christina, Chatzidaki, Niels, H Chavannes, Claudia Chaves Loureiro, Aurora-Alejandra Chavez Garcia, Marta, Chelninska, Yuzhi, Chen, Lei, Cheng, Sharon, Chinthrajah, Tomas, Chivato, Ekaterine, Chkhartishvili, George, Christoff, Henry, Chrystyn, Derek, K Chu, Antonio, Chua, Alexander, Chuchalin, Kian Fan Chung, Alberto, Cicerán, Cemal, Cingi, Giorgio, Ciprandi, Ieva, Cirule, Ana-Carla, Coelho, Enrico, Compalati, Jannis, Constantinidis, Jaime Correia de Sousa, Elisio Manuel Costa, David, Costa, María Del Carmen Costa Domínguez, André, Coste, Cottini, M, Linda, Cox, Carlos, Crisci, Maria Angiola Crivellaro, Alvaro, A Cruz, John, Cullen, Adnan, Custovic, Biljana, Cvetkovski, Wienczyslawa, Czarlewski, Gennaro, D'Amato, Jane da Silva, Ronald, Dahl, Sven-Erik, Dahlen, Vasilis, Daniilidis, Louei Darjazini Nahhas, Ulf, Darsow, Janet, Davies, Frédéric de Blay, Giulia De Feo, Eloisa De Guia, José-Ricardo De la Torre Navarrete, Chato De Los Santos, Esteban De Manuel Keenoy, Govert De Vries, Diana, Deleanu, Pascal, Demoly, Judah, Denburg, Philippe, Devillier, Alain, Didier, Sanja Dimic Janjic, Maria, Dimou, Anh Tuan Dinh-Xuan, Ratko, Djukanovic, Maria Do Ceu Texeira, Dejan, Dokic, Margarita Gabriela Domínguez Silva, Habib, Douagui, Nikolaos, Douladiris, Maria, Doulaptsi, Gérard, Dray, Ruta, Dubakiene, Eve, Dupas, Stephen, Durham, Marzia, Duse, Mark, Dykewicz, Didier, Ebo, Natalija, Edelbaher, Thomas, Eiwegger, Patrik, Eklund, Yehia, El-Gamal, Zeinab, A El-Sayed, Shereen, S El-Sayed, Magda, El-Seify, Regina, Emuzyte, Lourdes, Enecilla, Marina, Erhola, Heidilita, Espinoza, Jesús Guillermo Espinoza Contreras, John, Farrell, Lenora, Fernandez, Paola Fimbres Jimenez, Antje Fink Wagner, Alessandro, Fiocchi, Wytske, J Fokkens, Lenia, Folletti, Joao, A Fonseca, Jean-François, Fontaine, Francesco, Forastiere, Jose Miguel Fuentes Pèrez, Emily, Gaerlan-Resureccion, Mina, Gaga, José Luis Gálvez Romero, Amiran, Gamkrelidze, Alexis, Garcia, Cecilia Yvonne García Cobas, María de la Luz Hortensia García Cruz, Valeria Garcia Ortiz, Jacques, Gayraud, Matteo, Gelardi, Bilun, Gemicioglu, Dimitra, Gennimata, Sonya, Genova, José, Gereda, Roy Gerth van Wijk, Antonio, Giuliano, René-Maximiliano, Gomez, Miguel-Ange Gonzalez Ballester, Sandra González Diaz, Maia, Gotua, Christos, Grigoreas, Ineta, Grisle, Marta, Guidacci, Nick, Guldemond, Zdenek, Gutter, Antonieta, Guzmán, Tari, Haahtela, Ramsa, Halloum, David, Halpin, Eckard, Hamelmann, Suleiman, Hammadi, Richard, Harvey, Enrico, Heffler, Joachim, Heinrich, Adnan, Hejjaoui, Birthe, Hellquist-Dahl, Luiana Hernández Velázquez, Mark, Hew, Elham, Hossny, Peter, Howarth, Martin, Hrubiško, Yunuen Rocío Huerta Villalobos, Marc, Humbert, Salina, Husain, Michael, Hyland, Guido, Iaccarino, Moustafa, Ibrahim, Nataliya, Ilina, Maddalena, Illario, Cristoforo, Incorvaia, Antonio, Infantino, Carla, Irani, Zhanat, Ispayeva, Juan Carlos Ivancevich, Edgardo Ej Jares, Deborah, Jarvis, Ewa, Jassem, Klemen, Jenko, Rubén Darío Jiméneracruz Uscanga, Sebastian, L Johnston, Guy, Joos, Maja, Jošt, Kaja, Julge, Ki-Suck, Jung, Jocelyne, Just, Marek, Jutel, Igor, Kaidashev, Omer, Kalayci, Fuat, Kalyoncu, Jeni, Kapsali, Przemyslaw, Kardas, Jussi, Karjalainen, Carmela, A Kasala, Michael, Katotomichelakis, Loreta, Kavaliukaite, Kazi, S Bennoor, Thomas, Keil, Paul, Keith, Musa, Khaitov, Nikolai, Khaltaev, You-Young, Kim, Bruce, Kirenga, Jorg, Kleine-Tebbe, Ludger, Klimek, Fanny, W Ko, Bernard Koffi N'Goran, Evangelia, Kompoti, Peter, Kopač, Gerard, Koppelman, Anja Koren Jeverica, Seppo, Koskinen, Mitja, Košnik, Tomasz, Kostka, Kosta, V Kostov, Marek, L Kowalski, Tanya, Kralimarkova, Karmen Kramer Vrščaj, Helga, Kraxner, Samo, Kreft, Vicky, Kritikos, Dmitry, Kudlay, Mikael, Kuitunen, Inger, Kull, Piotr, Kuna, Maciej, Kupczyk, Violeta, Kvedariene, Marialena, Kyriakakou, Nika, Lalek, Massimo, Landi, Stephen, Lane, Désiree, E Larenas-Linnemann, Susanne, Lau, Daniel, Laune, Jorge, Lavrut, Lan, Le, Martina, Lenzenhuber, Gualtiero, Leo, Marcus, Lessa, Michael, Levin, Jing, Li, Philip, Lieberman, Giuseppe, Liotta, Brian, Lipworth, Xuandao, Liu, Rommel, Lobo, Karin, C Lodrup Carlsen, Carlo, Lombardi, Renaud, Louis, Stelios, Loukidis, Olga, Lourenço, Jorge, A Luna Pech, Bojan, Madjar, Enrico, Maggi, Antoine, Magnan, Bassam, Mahboub, Alpana, Mair, Anke-Hilse Maitland van der Zee, Mika, Makela, Michael, Makris, Hans-Jorgen, Malling, Mariana, Mandajieva, Patrick, Manning, Manolis, Manousakis, Pavlos, Maragoudakis, Gianluigi, Marseglia, Gailen, Marshall, Mohammad Reza Masjedi, Jorge, F Máspero, Juan José Matta Campos, Marcus, Maurer, Sandra, Mavale-Manuel, Cem, Meço, Erik, Melén, Giovanni, Melioli, Elisabete, Melo-Gomes, Eli, O Meltzer, Enrica, Menditto, Andrew, Menzies-Gow, Hans, Merk, Jean-Pierre, Michel, Yann, Micheli, Neven, Miculinic, Luís, Midão, Florin, Mihaltan, Nikolaos, Mikos, Manlio, Milanese, Branislava, Milenkovic, Dimitrios, Mitsias, Bassem, Moalla, Giuliana, Moda, María Dolores Mogica Martínez, Yousser, Mohammad, Frances-Montserrat, Moharra, Mostafa, Moin, Mathieu, Molimard, Isabelle, Momas, Monique, Mommers, Alessandro, Monaco, Stephen, Montefort, Lucia-Elvira, Montenegro, Riccardo, Monti, Dory, Mora, Mario, Morais-Almeida, Ralph, Mösges, Badr Eldin Mostafa, Joaquim, Mullol, Lars, Münter, Antonella, Muraro, Ruth, Murray, Antonio, Musarra, Tihomir, Mustakov, Robert, Naclerio, Kari, C Nadeau, Rachel, Nadif, Alla, Nakonechna, Leyla, Namazova-Baranova, Gretchen, Navarro-Locsin, Hugo, Neffen, Kristof, Nekam, Angelos, Neou, Eustachio, Nettis, Daniel, Neuberger, Laurent, Nicod, Stefania, Nicola, Verena, Niederberger-Leppin, Marek, Niedoszytko, Antonio, Nieto, Ettore, Novellino, Elizabete, Nunes, Dieudonné, Nyembue, Robyn, E O'Hehir, Cvetanka, Odjakova, Ken, Ohta, Yoshitaka, Okamoto, Kimi, Okubo, Brian, Oliver, Gabrielle, L Onorato, Maria Pia Orru, Solange, Ouédraogo, Kampadilemba, Ouoba, Francisco-Javier, Padilla, Pier Luigi Paggiaro, Aris, Pagkalos, Pajno, Giovanni Battista, Gianni, Pala, P Palaniappan, S, Isabella, Pali-Schöll, Susanna, Palkonen, Stephen, Palmer, Carmen Panaitescu Bunu, Petr, Panzner, Nikos, G Papadopoulos, Vasilis, Papanikolaou, Alberto, Papi, Bojidar, Paralchev, Giannis, Paraskevopoulos, Hae-Sim, Park, Giovanni, Passalacqua, Vincenzo, Patella, Ian, Pavord, Ruby, Pawankar, Soren, Pedersen, Susete, Peleve, Simona, Pellegino, Ana, Pereira, Mariana, Pereira, Tamara, Pérez, Andrea, Perna, Diego, Peroni, Oliver, Pfaar, Nhân, Pham-Thi, Bernard, Pigearias, Isabelle, Pin, Konstantina, Piskou, Constantinos, Pitsios, Davor, Plavec, Dagmar, Poethig, Wolfgang, Pohl, Antonija Poplas Susic, Todor, A Popov, Fabienne, Portejoie, Paul, Potter, Lars, Poulsen, Alexandra, Prados-Torres, Fotis, Prarros, David, Price, Emmanuel, Prokopakis, Francesca, Puggioni, Elisa, Puig-Domenech, Robert, Puy, Klaus, Rabe, Silvia, Rabotti, Filip, Raciborski, Josephine, Ramos, Cristina, Recalcati, Marysia, T Recto, Shereen, M Reda, Frederico, S Regateiro, Norbert, Reider, Sietze, Reitsma, Susana, Repka-Ramirez, Erminia, Ridolo, Janet, Rimmer, Daniela Rivero Yeverino, José Angelo Rizzo, Carlos, Robalo-Cordeiro, Graham, Roberts, Karen, Robles, Nicolas, Roche, Mónica Rodríguez González, Eréndira Rodríguez Zagal, Giovanni, Rolla, Christine, Rolland, Regina, Roller-Wirnsberger, Miguel Roman Rodriguez, Antonino, Romano, Jan, Romantowski, Philippe, Rombaux, Joel, Romualdez, Jose, Rosado-Pinto, Nelson, Rosario, Lanny, Rosenwasser, Oliviero, Rossi, Menachem, Rottem, Philip, W Rouadi, Nikoleta, Rovina, Irma Rozman Sinur, Mauricio, Ruiz, Lucy Tania Ruiz Segura, Dermot, Ryan, Hironori, Sagara, Daiki, Sakai, Daiju, Sakurai, Wafaa, Saleh, Johanna, Salimaki, Konstantinos, Samitas, Boleslaw, Samolinski, María Guadalupe Sánchez Coronel, Mario, Sanchez-Borges, Jaime, Sanchez-Lopez, Melissa, Sansonna, Codrut, Sarafoleanu, Faradiba Sarquis Serpa, Joaquin, Sastre, Eleonora, Savi, Agne, Savonyte, Bisher, Sawaf, Glenis, K Scadding, Sophie, Scheire, Peter, Schmid-Grendelmeier, Juan Francisco Schuhl, Holger, Schunemann, Maria, Schvalbová, Jorgen, Schwarze, Nicola, Scichilone, Gianenrico, Senna, Cecilia, Sepúlveda, Elie, Serrano, Sara, Shamai, Aziz, Sheikh, Mike, Shields, Vasil, Shishkov, Nikos, Siafakas, Alexander, Simeonov, Estelle Fer Simons, Juan Carlos Sisul, Brigita, Sitkauskiene, Ingelbjorg, Skrindo, Tanja Soklič Košak, Dirceu, Solé, Martin, Sondermann, Talant, Sooronbaev, Manuel, Soto-Martinez, Manuel, Soto-Quiros, Barnaro Sousa Pinto, Milan, Sova, Michael, Soyka, Krzysztof, Specjalski, Annette, Sperl, Otto, Spranger, Sofia, Stamataki, Lina, Stefanaki, Cristiana, Stellato, Rafael, Stelmach, Timo, Strandberg, Petra, Stute, Abirami, Subramaniam, Charlotte Suppli Ulrik, Michael, Sutherland, Silvia, Sylvestre, Aikaterini, Syrigou, Luis Taborda Barata, Nadejda, Takovska, Rachel, Tan, Frances, Tan, Vincent, Tan, Ing Ping Tang, Masami, Taniguchi, Line, Tannert, Pongsakorn, Tantilipikorn, Jessica, Tattersall, Filippo, Tesi, Uta, Thieme, Carel, Thijs, Mike, Thomas, Teresa, To, Ana Maria Todo-Bom, Alkis, Togias, Peter-Valentin, Tomazic, Vesna, Tomic-Spiric, Sanna, Toppila-Salmi, Maria-José Torres Jaen, Elina, Toskala, Massimo, Triggiani, Nadja, Triller, Katja, Triller, Ioanna, Tsiligianni, Uberti, M, Ruxandra, Ulmeanu, Jure, Urbancic, Marilyn Urrutia Pereira, Martina, Vachova, Felipe, Valdés, Rudolf, Valenta, Marylin Valentin Rostan, Antonio, Valero, Arunas, Valiulis, Mina, Vallianatou, Erkka, Valovirta, Michiel Van Eerd, Eric Van Ganse, Marianne van Hage, Olivier, Vandenplas, Tuula, Vasankari, Dafina, Vassileva, Cesar Velasco Munoz, Maria Teresa Ventura, Cécilia, Vera-Munoz, Frédéric, Viart, Dilyana, Vicheva, Pakit, Vichyanond, Petra, Vidgren, Giovanni, Viegi, Claus, Vogelmeier, Leena Von Hertzen, Theodoros, Vontetsianos, Dimitris, Vourdas, Vu Tran Thien Quan, Martin, Wagenmann, Samantha, Walker, Dana, Wallace, Yun De Wang, Susan, Waserman, Katrin, Wehner, Magnus, Wickman, Sian, Williams, Dennis, Williams, Nicola, Wilson, Gary, Wong, Kent, Woo, Lucyna, Wozniak, John, Wright, Piotr, Wroczynski, Paraskevi, Xepapadaki, Plamen, Yakovliev, Masao, Yamaguchi, Kwok, Yan, Yoke Yeow Yap, Mais, Yassin, Barbara, Yawn, Panayiotis, Yiallouros, Arzu, Yorgancioglu, Shigemi, Yoshihara, Ian, Young, Osman, B Yusuf, Asghar, Zaidi, Fares, Zaitoun, Petra, Zalud, Heather, Zar, T Zedda, M, Mario, E Zernotti, Luo, Zhang, Nanshan, Zhong, Mihaela, Zidarn, Torsten, Zuberbier, Celia, Zubrinich, Charité - UniversitätsMedizin = Charité - University Hospital [Berlin], Humboldt University Of Berlin, Berlin Institute of Health (BIH), Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier), Contre les MAladies Chroniques pour un VIeillissement Actif en Languedoc-Roussillon (MACVIA-LR), Université Montpellier 1 (UM1)-Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre Hospitalier Universitaire de Nîmes (CHU Nîmes)-Université de Montpellier (UM)-Centre National de la Recherche Scientifique (CNRS)-European Innovation Partnership on Active and Healthy Ageing Reference Site (EIP on AHA), Commission Européenne-Commission Européenne-Organisation Mondiale de la Santé / World Health Organization Office (OMS / WHO), Physiologie & médecine expérimentale du Cœur et des Muscles [U 1046] (PhyMedExp), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Montpellier (UM)-Centre National de la Recherche Scientifique (CNRS), IMIM-Hospital del Mar, Generalitat de Catalunya, Universitat Pompeu Fabra [Barcelona] (UPF), CIBER de Epidemiología y Salud Pública (CIBERESP), Instituto de Salud Global - Institute For Global Health [Barcelona] (ISGlobal), Center for Research in Environmental Epidemiology (CREAL), Universitat Pompeu Fabra [Barcelona] (UPF)-Catalunya ministerio de salud, Barts & The London School of Medicine and Dentistry, Queen Mary University of London (QMUL), Helsingin yliopisto = Helsingfors universitet = University of Helsinki, Helsinki University Central Hospital [Finland] (HUCH), Departamento de Geociencias, Ambiente e Ordenamento do Territorio (DGAOT), Universidade do Porto = University of Porto, University of Naples Federico II = Università degli studi di Napoli Federico II, Euromov (EuroMov), Université de Montpellier (UM), IRCCS Ospedale Pediatrico Bambino Gesù [Roma], Istituto Clinico Humanitas [Milan] (IRCCS Milan), Humanitas University [Milan] (Hunimed), Center of Research in Health Technologies and Information Systems (CINTESIS), AgroParisTech, World Institute of Kimchi [Gwangju], Département Maladies Infectieuses et Tropicales, Hôpital Universitaire, Montpellier, France, Recherches Translationnelles sur le VIH et les maladies infectieuses endémiques et émergentes (TransVIHMI), Institut de Recherche pour le Développement (IRD)-Université de Yaoundé I-Université Cheikh Anta Diop [Dakar, Sénégal] (UCAD)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Montpellier (UM), University of Edinburgh, Universität Zürich [Zürich] = University of Zurich (UZH), Humboldt-Universität zu Berlin, Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier)-Université Montpellier 1 (UM1)-Centre Hospitalier Universitaire de Nîmes (CHU Nîmes)-European Innovation Partnership on Active and Healthy Ageing Reference Site (EIP on AHA), Commission Européenne-Commission Européenne-Organisation Mondiale de la Santé / World Health Organization Office (OMS / WHO)-Centre National de la Recherche Scientifique (CNRS)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Montpellier (UM), Université de Montpellier (UM)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS), University of Helsinki, Universidade do Porto, University of Naples Federico II, Recherches Translationnelles sur le VIH et les maladies infectieuses endémiques er émergentes (TransVIHMI), Université Cheikh Anta Diop [Dakar, Sénégal] (UCAD)-Institut de Recherche pour le Développement (IRD)-Université de Yaoundé I-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Montpellier (UM)-Université Montpellier 1 (UM1), MORNET, Dominique, UCL - SSS/IREC/PNEU - Pôle de Pneumologie, ORL et Dermatologie, UCL - (MGD) Service de pneumologie, Bousquet J., Cristol J.-P., Czarlewski W., Anto J.M., Martineau A., Haahtela T., Fonseca S.C., Iaccarino G., Blain H., Fiocchi A., Canonica G.W., Fonseca J.A., Vidal A., Choi H.-J., Kim H.J., Le Moing V., Reynes J., Sheikh A., Akdis C.A., Zuberbier T., Abdul Latiff A.H., Abdullah B., Aberer W., Abusada N., Adcock I., Afani A., Agache I., Aggelidis X., Agustin J., Akdis M., Al-Ahmad M., Al-Zahab Bassam A., Alburdan H., Aldrey-Palacios O., Alvarez Cuesta E., Alwan Salman H., Alzaabi A., Amade S., Ambrocio G., Angles R., Annesi-Maesano I., Ansotegui I.J., Ara Bardajo P., Arasi S., Arrais M., Arshad H., Artesani M.-C., Asayag E., Avolio F., Azhari K., Bachert C., Bagnasco D., Baiardini I., Bajrovic N., Bakakos P., Bakeyala Mongono S., Balotro-Torres C., Barba S., Barbara C., Barbosa E., Barreto B., Bartra J., Basagana X., Bateman E.D., Battur L., Bedbrook A., Bedolla Barajas M., Beghe B., Bekere A., Bel E., Ben Kheder A., Benson M., Berghea E.-C., Bergmann K.-C., Bernardini R., Bernstein D., Bewick M., Bialek S., Bialoszewski A., Bieber T., Billo N.E., Bilo M.-B., Bindslev-Jensen C., Bjermer L., Bobolea I., Bochenska Marciniak M., Bond C., Boner A., Bonini M., Bonini S., Bosnic-Anticevich S., Bosse I., Botskariova S., Bouchard J., Boulet L.-P., Bourret R., Bousquet P., Braido F., Briggs A., Brightling C.E., Brozek J., Brussino L., Buhl R., Bumbacea R., Buquicchio R., Burguete Cabanas M.-T., Bush A., Busse W.W., Buters J., Caballero-Fonseca F., Calderon M.A., Calvo M., Camargos P., Camuzat T., Canevari F., Cano A., Canonican G.W., Capriles-Hulett A., Caraballo L., Cardona V., Carlsen K.-H., Carmona Pirez J., Caro J., Carr W., Carreiro-Martins P., Carreon-Asuncion F., Carriazo A.-M., CarrionyRibas C., Casale T., Castor M.-A., Castro E., Caviglia A.G., Cecchi L., Cepeda Sarabia A., Chalubinski M., Chandrasekharan R., Chang Y.-S., Chato-Andeza V., Chatzi L., Chatzidaki C., Chavannes N.H., Chaves Loureiro C., Chavez Garcia A.-A., Chelninska M., Chen Y., Cheng L., Chinthrajah S., Chivato T., Chkhartishvili E., Christoff G., Chrystyn H., Chu D.K., Chua A., Chuchalin A., Chung K.F., Ciceran A., Cingi C., Ciprandi G., Cirule I., Coelho A.-C., Compalati E., Constantinidis J., Correia de Sousa J., Costa E.M., Costa D., del Carmen Costa Dominguez M., Coste A., Cottini M., Cox L., Crisci C., Crivellaro M.A., Cruz A.A., Cullen J., Custovic A., Cvetkovski B., D'Amato G., da Silva J., Dahl R., Dahlen S.-E., Daniilidis V., Darjazini Nahhas L., Darsow U., Davies J., de Blay F., De Feo G., De Guia E., De la Torre Navarrete J.-R., De los Santos C., De Manuel Keenoy E., De Vries G., Deleanu D., Demoly P., Denburg J., Devillier P., Didier A., Dimic Janjic S., Dimou M., Dinh-Xuan A.T., Djukanovic R., Do Ceu Texeira M., Dokic D., Dominguez Silva M.G., Douagui H., Douladiris N., Doulaptsi M., Dray G., Dubakiene R., Dupas E., Durham S., Duse M., Dykewicz M., Ebo D., Edelbaher N., Eiwegger T., Eklund P., El-Gamal Y., El-Sayed Z.A., El-Sayed S.S., El-Seify M., Emuzyte R., Enecilla L., Erhola M., Espinoza H., Espinoza Contreras J.G., Farrell J., Fernandez L., Fimbres Jimenez P., Fink Wagner A., Fokkens W.J., Folletti L., Fontaine J.-F., Forastiere F., Fuentes Perez J.M., Gaerlan-Resureccion E., Gaga M., Galvez Romero J.L., Gamkrelidze A., Garcia A., Garcia Cobas C.Y., de la Luz Hortensia Garcia Cruz M., Ortiz V.G., Gayraud J., Gelardi M., Gemicioglu B., Gennimata D., Genova S., Gereda J., Gerth van Wijk R., Giuliano A., Gomez R.-M., Gonzalez Ballester M.-A., Gonzalez Diaz S., Gotua M., Grigoreas C., Grisle I., Guidacci M., Guldemond N., Gutter Z., Guzman A., Halloum R., Halpin D., Hamelmann E., Hammadi S., Harvey R., Heffler E., Heinrich J., Hejjaoui A., Hellquist-Dahl B., Hernandez Velazquez L., Hew M., Hossny E., Howarth P., Hrubisko M., Huerta Villalobos Y.R., Humbert M., Husain S., Hyland M., Ibrahim M., Ilina N., Illario M., Incorvaia C., Infantino A., Irani C., Ispayeva Z., Ivancevich J.C., Jares E.E., Jarvis D., Jassem E., Jenko K., Jimeneracruz Uscanga R.D., Johnston S.L., Joos G., Jost M., Julge K., Jung K.-S., Just J., Jutel M., Kaidashev I., Kalayci O., Kalyoncu F., Kapsali J., Kardas P., Karjalainen J., Kasala C.A., Katotomichelakis M., Kavaliukaite L., Bennoor K.S., Keil T., Keith P., Khaitov M., Khaltaev N., Kim Y.-Y., Kirenga B., Kleine-Tebbe J., Klimek L., Ko F.W., Koffi N'Goran B., Kompoti E., Kopac P., Koppelman G., Koren Jeverica A., Koskinen S., Kosnik M., Kostka T., Kostov K.V., Kowalski M.L., Kralimarkova T., Kramer Vrscaj K., Kraxner H., Kreft S., Kritikos V., Kudlay D., Kuitunen M., Kull I., Kuna P., Kupczyk M., Kvedariene V., Kyriakakou M., Lalek N., Landi M., Lane S., Larenas-Linnemann D.E., Lau S., Laune D., Lavrut J., Le L., Lenzenhuber M., Leo G., Lessa M., Levin M., Li J., Lieberman P., Liotta G., Lipworth B., Liu X., Lobo R., Lodrup Carlsen K.C., Lombardi C., Louis R., Loukidis S., Lourenco O., Luna Pech J.A., Madjar B., Maggi E., Magnan A., Mahboub B., Mair A., Maitland van der Zee A.-H., Makela M., Makris M., Malling H.-J., Mandajieva M., Manning P., Manousakis M., Maragoudakis P., Marseglia G., Marshall G., Masjedi M.R., Maspero J.F., Matta Campos J.J., Maurer M., Mavale-Manuel S., Meco C., Melen E., Melioli G., Melo-Gomes E., Meltzer E.O., Menditto E., Menzies-Gow A., Merk H., Michel J.-P., Micheli Y., Miculinic N., Midao L., Mihaltan F., Mikos N., Milanese M., Milenkovic B., Mitsias D., Moalla B., Moda G., Mogica Martinez M.D., Mohammad Y., Moharra F.-M., Moin M., Molimard M., Momas I., Mommers M., Monaco A., Montefort S., Montenegro L.-E., Monti R., Mora D., Morais-Almeida M., Mosges R., Mostafa B.E., Mullol J., Munter L., Muraro A., Murray R., Musarra A., Mustakov T., Naclerio R., Nadeau K.C., Nadif R., Nakonechna A., Namazova-Baranova L., Navarro-Locsin G., Neffen H., Nekam K., Neou A., Nettis E., Neuberger D., Nicod L., Nicola S., Niederberger-Leppin V., Niedoszytko M., Nieto A., Novellino E., Nunes E., Nyembue D., O'Hehir R.E., Odjakova C., Ohta K., Okamoto Y., Okubo K., Oliver B., Onorato G.L., Orru M.P., Ouedraogo S., Ouoba K., Padilla F.-J., Paggiaro P.L., Pagkalos A., Pajno G., Pala G., Palaniappan S., Pali-Scholl I., Palkonen S., Palmer S., Panaitescu Bunu C., Panzner P., Papadopoulos N.G., Papanikolaou V., Papi A., Paralchev B., Paraskevopoulos G., Park H.-S., Passalacqua G., Patella V., Pavord I., Pawankar R., Pedersen S., Peleve S., Pellegino S., Pereira A., Pereira M., Perez T., Perna A., Peroni D., Pfaar O., Pham-Thi N., Pigearias B., Pin I., Piskou K., Pitsios C., Plavec D., Poethig D., Pohl W., Poplas Susic A., Popov T.A., Portejoie F., Potter P., Poulsen L., Prados-Torres A., Prarros F., Price D., Prokopakis E., Puggioni F., Puig-Domenech E., Puy R., Rabe K., Rabotti S., Raciborski F., Ramos J., Recalcati C., Recto M.T., Reda S.M., Regateiro F.S., Reider N., Reitsma S., Repka-Ramirez S., Ridolo E., Rimmer J., Rivero Yeverino D., Rizzo J.A., Robalo-Cordeiro C., Roberts G., Robles K., Roche N., Rodriguez Gonzalez M., Rodriguez Zagal E., Rolla G., Rolland C., Roller-Wirnsberger R., Roman Rodriguez M., Romano A., Romantowski J., Rombaux P., Romualdez J., Rosado-Pinto J., Rosario N., Rosenwasser L., Rossi O., Rottem M., Rouadi P.W., Rovina N., Rozman Sinur I., Ruiz M., Ruiz Segura L.T., Ryan D., Sagara H., Sakai D., Sakurai D., Saleh W., Salimaki J., Samitas K., Samolinski B., Sanchez Coronel M.G., Sanchez-Borges M., Sanchez-Lopez J., Sansonna M., Sarafoleanu C., Sarquis Serpa F., Sastre J., Savi E., Savonyte A., Sawaf B., Scadding G.K., Scheire S., Schmid-Grendelmeier P., Schuhl J.F., Schunemann H., Schvalbova M., Schwarze J., Scichilone N., Senna G., Sepulveda C., Serrano E., Shamai S., Shields M., Shishkov V., Siafakas N., Simeonov A., Simons E.F., Sisul J.C., Sitkauskiene B., Skrindo I., Soklic Kosak T., Sole D., Sondermann M., Sooronbaev T., Soto-Martinez M., Soto-Quiros M., Pinto B.S., Sova M., Soyka M., Specjalski K., Sperl A., Spranger O., Stamataki S., Stefanaki L., Stellato C., Stelmach R., Strandberg T., Stute P., Subramaniam A., Suppli Ulrik C., Sutherland M., Sylvestre S., Syrigou A., Taborda Barata L., Takovska N., Tan R., Tan F., Tan V., Tang I.P., Taniguchi M., Tannert L., Tantilipikorn P., Tattersall J., Tesi F., Thieme U., Thijs C., Thomas M., To T., Todo-Bom A.M., Togias A., Tomazic P.-V., Tomic-Spiric V., Toppila-Salmi S., Torres Jaen M.-J., Toskala E., Triggiani M., Triller N., Triller K., Tsiligianni I., Uberti M., Ulmeanu R., Urbancic J., Urrutia Pereira M., Vachova M., Valdes F., Valenta R., Valentin Rostan M., Valero A., Valiulis A., Vallianatou M., Valovirta E., Van Eerd M., Van Ganse E., van Hage M., Vandenplas O., Vasankari T., Vassileva D., Velasco Munoz C., Ventura M.T., Vera-Munoz C., Viart F., Vicheva D., Vichyanond P., Vidgren P., Viegi G., Vogelmeier C., Von Hertzen L., Vontetsianos T., Vourdas D., Tran Thien Quan V., Wagenmann M., Walker S., Wallace D., De Wang Y., Waserman S., Wehner K., Wickman M., Williams S., Williams D., Wilson N., Wong G., Woo K., Wozniak L., Wright J., Wroczynski P., Xepapadaki P., Yakovliev P., Yamaguchi M., Yan K., Yap Y.Y., Yassin M., Yawn B., Yiallouros P., Yorgancioglu A., Yoshihara S., Young I., Yusuf O.B., Zaidi A., Zaitoun F., Zalud P., Zar H., Zedda M.T., Zernotti M.E., Zhang L., Zhong N., and Zidarn M.
Subjects: MAPK/ERK pathway, ARIA group, Allergy, [SDV]Life Sciences [q-bio], NF-KAPPA-B, debelost, Review, Pharmacology, Resveratrol, PROTECTS, chemistry.chemical_compound, 0302 clinical medicine, RESPIRATORY SYNDROME CORONAVIRUS, ENDOPLASMIC-RETICULUM STRESS, Medicine and Health Sciences, Immunology and Allergy, Medicine, OXIDATIVE STRESS, COVID-19, Foods, Insulin resistance, Nrf2, Nutrients, Obesity, TRPA1, 2. Zero hunger, 0303 health sciences, RESPIRATORY, INSULIN-RESISTANCE, Muscle cell proliferation, SULFORAPHANE, 3. Good health, [SDV] Life Sciences [q-bio], 030220 oncology & carcinogenesis, SIGNALING PATHWAY, Signal transduction, Life Sciences & Biomedicine, Pulmonary and Respiratory Medicine, NRF2 ACTIVATORS, MUSCLE-CELL PROLIFERATION, Immunology, 610 Medicine & health, Lung injury, Settore MED/10 - Malattie Dell'Apparato Respiratorio, ACUTE LUNG INJURY, 03 medical and health sciences, COVID-19, Foods, Insulin resistance, Nrf2, Nutrients, Obesity, TRPA1, udc:616.9, odpornost proti inzulinu, SULFORAPHANE PROTECTS, Transcription factor, PI3K/AKT/mTOR pathway, 030304 developmental biology, Science & Technology, business.industry, SARS-CoV-2, food, medicine.disease, chemistry, hranila, SYNDROME CORONAVIRUS, business, hrana, GREEN TEA
Abstract: There are large between- and within-country variations in COVID-19 death rates. Some very low death rate settings such as Eastern Asia, Central Europe, the Balkans and Africa have a common feature of eating large quantities of fermented foods whose intake is associated with the activation of the Nrf2 (Nuclear factor (erythroid-derived 2)-like 2) anti-oxidant transcription factor. There are many Nrf2-interacting nutrients (berberine, curcumin, epigallocatechin gallate, genistein, quercetin, resveratrol, sulforaphane) that all act similarly to reduce insulin resistance, endothelial damage, lung injury and cytokine storm. They also act on the same mechanisms (mTOR: Mammalian target of rapamycin, PPARγ:Peroxisome proliferator-activated receptor, NFκB: Nuclear factor kappa B, ERK: Extracellular signal-regulated kinases and eIF2α:Elongation initiation factor 2α). They may as a result be important in mitigating the severity of COVID-19, acting through the endoplasmic reticulum stress or ACE-Angiotensin-II-AT1R axis (AT1R) pathway. Many Nrf2-interacting nutrients are also interacting with TRPA1 and/or TRPV1. Interestingly, geographical areas with very low COVID-19 mortality are those with the lowest prevalence of obesity (Sub-Saharan Africa and Asia). It is tempting to propose that Nrf2-interacting foods and nutrients can re-balance insulin resistance and have a significant effect on COVID-19 severity. It is therefore possible that the intake of these foods may restore an optimal natural balance for the Nrf2 pathway and may be of interest in the mitigation of COVID-19 severity.
Published: 2020

21. A European survey of management approaches in chronic urticaria in children: EAACI Paediatric Urticaria Taskforce

Author: Martin K. Church, S. Lefevre, Montserrat Alvaro-Lozano, Burcin Beken, Sophia Tsabouri, Giovanni Battista Pajno, Stefania Arasi, Petra Staubach, Tabi A. Leslie, George N. Konstantinou, Torsten Zuberbier, Sherief R. Janmohamed, Charlotte G. Mortz, Helena Pité, Susanne Lau, Carlo Caffarelli, Lauri Ann van der Poel, Carsten Flohr, Krzysztof Rutkowski, Surgical clinical sciences, Medicine and Pharmacy academic/administration, Dermatology, and Skin function and permeability
Subjects: Adult, medicine.medical_specialty, Urticaria, Immunology, Dermatology, Omalizumab, urticaria diagnosis, chronic urticaria, Second line, Surveys and Questionnaires, Humans, Immunology and Allergy, Medicine, Chronic Urticaria, Child, Chronic urticaria, child, urticaria treatment, business.industry, Task force, Guideline, Third line, Family medicine, Chronic Disease, Pediatrics, Perinatology and Child Health, Histamine H1 Antagonists, omalizumab, Allergists, Approaches of management, business, medicine.drug
Abstract: Background: Although well described in adults, there are scarce and heterogeneous data on the diagnosis and management of chronic urticaria (CU) in children (0-18 years) throughout Europe. Our aim was to explore country differences and identify the extent to which the EAACI/GA²LEN/EDF/WAO guideline recommendations for paediatric urticaria are implemented. Methods: The EAACI Taskforce for paediatric CU disseminated an online clinical survey among EAACI paediatric section members. Members were asked to answer 35 multiple choice questions on current practices in their respective centres. Results: The survey was sent to 2,773 physicians of whom 358 (13.8%) responded, mainly paediatric allergists (80%) and paediatricians (49.7%), working in 69 countries. For diagnosis, Southern European countries used significantly more routine tests (e.g., autoimmune testing, allergological tests, and parasitic investigation) than Northern European countries. Most respondents (60.3%) used a 2nd generation antihistamine as first- line treatment of whom 64.8% up dosed as a second- line. Omalizumab, was used as a second line treatment by 1.7% and third-line by 20.7% of respondents. Most clinicians (65%) follow EAACI/WAO/GA2LEN/EDF guidelines when diagnosing CU, and only 7.3% follow no specific guidelines. Some clinicians prefer to follow national guidelines (18.4%, mainly Northern European) or the AAAAI practice parameter (1.7%). Conclusions: Even though most members of the Paediatric Section of EAACI are familiar with the EAACI/WAO/GA2LEN/EDF guidelines, a significant number do not follow them. Also, the large variation in diagnosis and treatment strengthens the need to re-evaluate, update and standardize guidelines on the diagnosis and management of CU in children.
Published: 2021

22. Cow's milk allergy guidelines promote over‐diagnosis of cow's milk disease

Author: Hania Szajewska and Giovanni Battista Pajno
Subjects: allergy diagnosis, food allergy, pediatrics, Pediatrics, medicine.medical_specialty, business.industry, Cow's milk allergy, Food allergy, Immunology, Immunology and Allergy, Medicine, Disease, business, medicine.disease, Over diagnosis
Published: 2021

23. The role of mobile health technologies in allergy care: An EAACI position paper

Author: Jean Bousquet, Jean-Christoph Roger J-P Caubet, James Gardner, Ralph Mösges, Simon Blank, Dermot Ryan, Alla Nakonechna, Daniel Perez-Formigo, Markus Ollert, Ignacio Esteban-Gorgojo, Ileana Ghiordanescu, Darío Antolín-Amérigo, Giovanni Battista Pajno, Jörn Wittmann, Jeroen Buters, Elisa Boni, Constantinos Pitsios, Karin Hoffmann-Sommergruber, Knut Brockow, Philippe Gevaert, Uwe Berger, Harmieke van Os-Medendorp, Matteo Bonini, Tania Elliott, Peter Hellings, Jennifer Shih, Marina Atanaskovic-Markovic, Salvatore Tripodi, Michael S. Blaiss, Stephanie Dramburg, A. Fusun Kalpaklioglu, Ioana Agache, Oliver Pfaar, Lauri-Ann Van der Poel, João Fonseca, Christian Apfelbacher, Ozlem Cavkaytar, Gilda Varricchi, Jose Oteros, S. Sanchez-Garcia, Farid Marmouz, Alberto Alvarez-Perea, Victoria Cardona, Ángela Meijide Calderón, Paolo Maria Matricardi, Michael Rudenko, Catalina Panaitescu, Margitta Worm, KKÜ, Ear, Nose and Throat, Kırıkkale Üniversitesi, Tıp Fakültesi, Dahili Tıp Bilimleri Bölümü, Kalpaklıoğlu, A. Fusun, Charité - UniversitätsMedizin = Charité - University Hospital [Berlin], Hospital General Universitario 'Gregorio Marañón' [Madrid], Hospital Universitario Ramón y Cajal [Madrid], Universidad de Alcalá - University of Alcalá (UAH), University of Regensburg, University of Belgrade [Belgrade], Medizinische Universität Wien = Medical University of Vienna, Augusta University - Medical College of Georgia, University System of Georgia (USG), Center of Allergy & Environment (CK-CARE, ZAUM), Helmholtz-Zentrum München (HZM), German Research Center for Environmental Health - Helmholtz Center München (GmbH), Royal Brompton Hospital, Fondazione 'Policlinico Universitario A. Gemelli' [Rome], Università cattolica del Sacro Cuore [Roma] (Unicatt), Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier), Contre les MAladies Chroniques pour un VIeillissement Actif en Languedoc-Roussillon (MACVIA-LR), Université Montpellier 1 (UM1)-Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre Hospitalier Universitaire de Nîmes (CHU Nîmes)-Université de Montpellier (UM)-Centre National de la Recherche Scientifique (CNRS)-European Innovation Partnership on Active and Healthy Ageing Reference Site (EIP on AHA), Commission Européenne-Commission Européenne-Organisation Mondiale de la Santé / World Health Organization Office (OMS / WHO), Technical University of Munich (TUM), Vall d'Hebron University Hospital [Barcelona], Geneva University Hospital (HUG), Istanbul Medeniyet University [Istanbul, Turquie] (IMU), New York University Langone Medical Center (NYU Langone Medical Center), NYU System (NYU), General Hospital of Villalba [Madrid], Center of Research in Health Technologies and Information Systems (CINTESIS), Universidade do Porto, Department of Hygiene and Epidemiology, University of Porto Medical School, Porto, Great North Children's Hospital, Partenaires INRAE, Newcastle University [Newcastle], Ghent University Hospital, Emergency University Hospital Elias, European Forum for Research and Education in Allergy and Airway Diseases (EUFOREA), Catholic University of Leuven - Katholieke Universiteit Leuven (KU Leuven), University of Kirikkale, Hopital Réné Dubos, University of Vigo [ Pontevedra], University Hospital of Cologne [Cologne], Clinical Research International Ltd., Royal Liverpool and Broadgreen University Hospital NHS Trust, Liverpool Hope University, Luxembourg Institute of Health (LIH), University of Southern Denmark (SDU), University of Messina, Romanian Primary Care Respiratory Group (RespiRo), Hospital Universitario de Torrejón, Univ Politecn Madrid, Ctr Tecnol Biomed, Pozuelo De Alarcon 28223, Madrid, Spain, Philipps Universität Marburg, University of Cyprus (UCY), Centre Harley Street Allergy Clinic, Centre of Medical Informatics [Edinburgh, UK] (Usher Institute of Population Health Sciences and Informatics), University of Edinburgh, Hospital Infantil Universitario Niño Jesús [Madrid, Spain] (HIUNJ), Institute of Health Carlos III, Emory University School of Medicine, Emory University [Atlanta, GA], Policlinico Casilino (Ospedale Policlinico Casilino), Medical Physics Department,Guy's and St Thomas'NHS Foundation Trust, London, UK, Medical Physics Department, London, UK, Medical Physics Department, Guy's and St Thomas'NHS Foundation Trust-Medical Physics Department, Guy's and St Thomas'NHS Foundation Trust, University Medical Center [Utrecht], 'Federico II' University of Naples Medical School, Transilvania University of Brasov, Helmholtz Zentrum München = German Research Center for Environmental Health, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Università cattolica del Sacro Cuore = Catholic University of the Sacred Heart [Roma] (Unicatt), Technische Universität Munchen - Université Technique de Munich [Munich, Allemagne] (TUM), Universidade do Porto = University of Porto, Philipps Universität Marburg = Philipps University of Marburg, University of Cyprus [Nicosia] (UCY), Hospital Infantil Universitario Niño Jesús (HIUNJ), Salvy-Córdoba, Nathalie, Matricardi, Paolo Maria, Dramburg, Stephanie, Alvarez-Perea, Alberto, Antolín-Amérigo, Darío, Apfelbacher, Christian, Atanaskovic-Markovic, Marina, Berger, Uwe, Blaiss, Michael S, Blank, Simon, Boni, Elisa, Bonini, Matteo, Bousquet, Jean, Brockow, Knut, Buters, Jeroen, Cardona, Victoria, Caubet, Jean-Christoph, Cavkaytar, Özlem, Elliott, Tania, Esteban-Gorgojo, Ignacio, Fonseca, Joao A, Gardner, Jame, Gevaert, Philippe, Ghiordanescu, Ileana, Hellings, Peter, Hoffmann-Sommergruber, Karin, Kalpaklioglu, A Fusun, Marmouz, Farid, Meijide Calderón, Ángela, Mösges, Ralph, Nakonechna, Alla, Ollert, Marku, Oteros, José, Pajno, Giovanni, Panaitescu, Catalina, Perez-Formigo, Daniel, Pfaar, Oliver, Pitsios, Constantino, Rudenko, Michael, Ryan, Dermot, Sánchez-García, Silvia, Shih, Jennifer, Tripodi, Salvatore, Van der Poel, Lauri-Ann, van Os-Medendorp, Harmieke, Varricchi, Gilda, Wittmann, Jörn, Worm, Margitta, Agache, Ioana, Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier)-Université Montpellier 1 (UM1)-Centre Hospitalier Universitaire de Nîmes (CHU Nîmes)-European Innovation Partnership on Active and Healthy Ageing Reference Site (EIP on AHA), and Commission Européenne-Commission Européenne-Organisation Mondiale de la Santé / World Health Organization Office (OMS / WHO)-Centre National de la Recherche Scientifique (CNRS)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Montpellier (UM)
Subjects: 0301 basic medicine, MESH: Drug Hypersensitivity, MESH: Asthma, Allergy, MESH: Chronic Urticaria, [SDV.MHEP.PSR]Life Sciences [q-bio]/Human health and pathology/Pulmonology and respiratory tract, immunoglobulin E, 0302 clinical medicine, Immunology and Allergy, Chronic Urticaria, Position paper, Disease management (health), MESH: Desensitization, Immunologic, [SDV.IMM.ALL]Life Sciences [q-bio]/Immunology/Allergology, mHealth, Self-management, ddc:618, Health technology, Disease Management, allergen-immunotherapy, Mobile Applications, Telemedicine, EAACI, allergy, digital health, mobile health technology, position paper, 3. Good health, Dermatitis, Allergic Contact, biomarker, MESH: Mobile Applications, Psychology, allergic rhiniti, Digital health, Food Hypersensitivity, [SDV.IMM.ALL] Life Sciences [q-bio]/Immunology/Allergology, allergen, molecular allergology, Immunology, Internet privacy, component-resolved-diagnosi, Context (language use), Mobile health technology, MESH: Disease Management, Dermatitis, Atopic, Drug Hypersensitivity, 03 medical and health sciences, [SDV.MHEP.PED] Life Sciences [q-bio]/Human health and pathology/Pediatrics, MESH: Dermatitis, Allergic Contact, IgE test, MESH: Dermatitis, Atopic, Humans, Mobile technology, Anaphylaxis, Physician-Patient Relations, [SDV.MHEP.PED]Life Sciences [q-bio]/Human health and pathology/Pediatrics, MESH: Humans, business.industry, Rhinitis, Allergic, Seasonal, MESH: Rhinitis, Allergic, Seasonal, asthma, molecular spreading, [SDV.MHEP.DERM] Life Sciences [q-bio]/Human health and pathology/Dermatology, diagnostic algorithm, MESH: Anaphylaxis, 030104 developmental biology, 030228 respiratory system, Desensitization, Immunologic, Digital Health, Eaaci, Mobile Health Technology, Position Paper, MESH: Telemedicine, MESH: Food Hypersensitivity, [SDV.MHEP.PSR] Life Sciences [q-bio]/Human health and pathology/Pulmonology and respiratory tract, MESH: Physician-Patient Relations, business, [SDV.MHEP.DERM]Life Sciences [q-bio]/Human health and pathology/Dermatology
Abstract: Oteros, Jose/0000-0002-9369-8633; Fonseca, Joao Almeida/0000-0002-0887-8796; Alvarez-Perea, Alberto/0000-0001-7417-7309; Oteros, Jose/0000-0002-9369-8633; Gevaert, Philippe/0000-0002-1629-8468; Antolin, Dario/0000-0001-5699-4022; Apfelbacher, Christian/0000-0003-3805-8219; Buters, Jeroen/0000-0003-3581-5472; Berger, Uwe E./0000-0002-9265-2131; Blank, Simon/0000-0002-5649-1078; Cardona, Victoria/0000-0003-2197-9767; Dramburg, Stephanie/0000-0002-9303-3260 WOS: 000486665800001 PubMed: 31230373 Mobile health (mHealth) uses mobile communication devices such as smartphones and tablet computers to support and improve health-related services, data and information flow, patient self-management, surveillance, and disease management from the moment of first diagnosis to an optimized treatment. The European Academy of Allergy and Clinical Immunology created a task force to assess the state of the art and future potential of mHealth in allergology. The task force endorsed the "Be He@lthy, Be Mobile" WHO initiative and debated the quality, usability, efficiency, advantages, limitations, and risks of mobile solutions for allergic diseases. The results are summarized in this position paper, analyzing also the regulatory background with regard to the "General Data Protection Regulation" and Medical Directives of the European Community. The task force assessed the design, user engagement, content, potential of inducing behavioral change, credibility/accountability, and privacy policies of mHealth products. The perspectives of healthcare professionals and allergic patients are discussed, underlining the need of thorough investigation for an effective design of mHealth technologies as auxiliary tools to improve quality of care. Within the context of precision medicine, these could facilitate the change in perspective from clinician- to patient-centered care. The current and future potential of mHealth is then examined for specific areas of allergology, including allergic rhinitis, aerobiology, allergen immunotherapy, asthma, dermatological diseases, food allergies, anaphylaxis, insect venom, and drug allergy. The impact of mobile technologies and associated big data sets are outlined. Facts and recommendations for future mHealth initiatives within EAACI are listed.
Published: 2020

24. Prospective evaluation of autoimmune and non-autoimmune subclinical hypothyroidism in down syndrome children

Author: Giorgia Pepe, Domenico Corica, Luisa De Sanctis, Mariacarolina Salerno, Maria Felicia Faienza, Daniele Tessaris, Gerdi Tuli, Iris Scala, Laura Penta, Angela Alibrandi, Giovanni Battista Pajno, Tommaso Aversa, Malgorzata Wasniewska, Pepe, G., Corica, D., de Sanctis, L., Salerno, M., Faienza, M. F., Tessaris, D., Tuli, G., Scala, I., Penta, L., Alibrandi, A., Pajno, G. B., Aversa, T., and Wasniewska, M.
Subjects: Male, medicine.medical_specialty, Down syndrome, Thyroiditis, Adolescent, Endocrinology, Diabetes and Metabolism, autoimmune subclinical hypothyroidism, non-autoimmune subclinical hypothyroidism, 030209 endocrinology & metabolism, Hashimoto Disease, autoimmune subclinical hypothyroidism, non-autoimmune subclinical hypothyroidism, Down Syndrome, Gastroenterology, Group B, 03 medical and health sciences, 0302 clinical medicine, Endocrinology, Internal medicine, Medicine, Humans, Euthyroid, Prospective Studies, Prospective cohort study, Child, Preschool, Subclinical infection, business.industry, Thyroid disease, Autoantibody, Thyroiditis, Autoimmune, General Medicine, medicine.disease, Child, Disease Progression, Down Syndrome, Hashimoto Disease, Prospective Studies, Thyroiditis, Autoimmune, 030220 oncology & carcinogenesis, Child, Preschool, Disease Progression, Down Syndrome, Female, Thyroid function, business, Autoimmune
Abstract: Objective To evaluate the prevalence and natural course of autoimmune and non-autoimmune subclinical hypothyroidism (SH) in Down syndrome (DS) children and adolescents. Design Prospective multicenter study. Methods For the study, 101 DS patients with SH (TSH 5–10 mIU/L; FT4 12–22 pmol/L), aged 2–17 years at SH diagnosis were enrolled. Annual monitoring of TSH, FT4, BMI, height, and L-thyroxine dose was recorded for 5 years. Thyroid autoimmunity was tested at diagnosis and at the end of follow-up. Results Thirty-seven out of 101 patients displayed autoantibody positivity (group A); the remaining 64 were classified as non-autoimmune SH (group B). Group A was characterized by higher median age at SH diagnosis and by more frequent family history of thyroid disease (6.6 vs 4.7 years, P = 0.001; 32.4% vs 7.8%, P = 0.001 respectively), whereas congenital heart defects were more common in group B (65.6% vs 43.2%, P = 0.028). Gender, median BMI (SDS), height (SDS), FT4, and TSH were similar in both groups. At the end of follow-up: 35.1% of group A patients developed overt hypothyroidism (OH) vs 17.2% of group B (P = 0.041); 31.25% of group B vs 10.8% of group A became biochemically euthyroid (P = 0.02); and 37.8% of group A vs 51.5% of group B still had SH condition (P = 0.183). Logistic regression suggested autoimmunity (OR = 3.2) and baseline TSH values (OR = 1.13) as predictive factors of the evolution from SH to OH. Conclusions In DS children, non-autoimmune SH showed higher prevalence and earlier onset. The risk of thyroid function deterioration over time seems to be influenced by thyroid autoimmunity and higher baseline TSH values.
Published: 2020

25. Urogenital Abnormalities in Adenosine Deaminase Deficiency

Author: Andrea Finocchi, Gianni Russo, Caterina Cancrini, Claire Booth, Antonio Marzollo, Massimo Alfano, Chiara Azzari, Gigliola Di Matteo, Silvia Ricci, Stuart Adams, Federica Barzaghi, Francesca Ferrua, Lucia Pacillo, Roberta Pajno, Maria Pia Cicalese, Silvia Pecorelli, Andrea Salonia, Alessandro Aiuti, Salvatore Recupero, Arianna Lesma, Pajno, R., Pacillo, L., Recupero, S., Cicalese, M. P., Ferrua, F., Barzaghi, F., Ricci, S., Marzollo, A., Pecorelli, S., Azzari, C., Finocchi, A., Cancrini, C., Di Matteo, G., Russo, G., Alfano, M., Lesma, A., Salonia, A., Adams, S., Booth, C., and Aiuti, A.
Subjects: Delayed puberty, Male, Pediatrics, medicine.medical_specialty, puberty, Adolescent, Adenosine Deaminase, Immunology, urogenital abnormalities, ADA-SCID, cryptorchidism, pubertal development, undescended testis, Urogenital System, Medical microbiology, Quality of life, Agammaglobulinemia, medicine, Immunology and Allergy, Humans, Sex organ, Child, Retrospective Studies, business.industry, Genitourinary system, Sexual Development, Infant, Newborn, Urogenital Abnormality, Infant, medicine.disease, Settore MED/38, Adenosine deaminase deficiency, Child, Preschool, Cohort, Female, Severe Combined Immunodeficiency, Original Article, medicine.symptom, business
Abstract: Background Improved survival in ADA-SCID patients is revealing new aspects of the systemic disorder. Although increasing numbers of reports describe the systemic manifestations of adenosine deaminase deficiency, currently there are no studies in the literature evaluating genital development and pubertal progress in these patients. Methods We collected retrospective data on urogenital system and pubertal development of 86 ADA-SCID patients followed in the period 2000–2017 at the Great Ormond Street Hospital (UK) and 5 centers in Italy. In particular, we recorded clinical history and visits, and routine blood tests and ultrasound scans were performed as part of patients’ follow-up. Results and Discussion We found a higher frequency of congenital and acquired undescended testes compared with healthy children (congenital, 22% in our sample, 0.5–4% described in healthy children; acquired, 16% in our sample, 1–3% in healthy children), mostly requiring orchidopexy. No urogenital abnormalities were noted in females. Spontaneous pubertal development occurred in the majority of female and male patients with a few cases of precocious or delayed puberty; no patient presented high FSH values. Neither ADA-SCID nor treatment performed (PEG-ADA, BMT, or GT) affected pubertal development or gonadic function. Conclusion In summary, this report describes a high prevalence of cryptorchidism in a cohort of male ADA-SCID patients which could represent an additional systemic manifestation of ADA-SCID. Considering the impact urogenital and pubertal abnormalities can have on patients’ quality of life, we feel it is essential to include urogenital evaluation in ADA-SCID patients to detect any abnormalities, initiate early treatment, and prevent long-term complications.
Published: 2019

26. Hexavalent vaccines in preterm infants: an update by Italian Society of Pediatric Allergy and Immunology jointly with the Italian Society of Neonatology

Author: Fabio Mosca, Mauro Calvani, Domenico Minasi, Chiara Petrolini, Carlo Caffarelli, Carlo Pietrasanta, Elena Chiappini, Arabella Martelli, Lorenza Pugni, Marzia Duse, G B Pajno, Mariangela Tosca, Sara Manti, Gian Luigi Marseglia, Fabio Cardinale, M. Miraglia Del Giudice, Amelia Licari, Chiappini, E., Petrolini, C., Caffarelli, C., Calvani, M., Cardinale, F., Duse, M., Licari, A., Manti, S., Martelli, A., Minasi, D., Miraglia Del Giudice, M., Pajno, G. B., Pietrasanta, C., Pugni, L., Tosca, M. A., Mosca, F., and Marseglia, G. L.
Subjects: Pediatrics, medicine.medical_specialty, Vaccination schedule, Hexavalent vaccines, Preterm infants, Vaccines, Review, 03 medical and health sciences, 0302 clinical medicine, 030225 pediatrics, Humans, Medicine, Age Factor, Hexavalent vaccine, Vaccines, Combined, 030212 general & internal medicine, Neonatology, Adverse effect, Immunization Schedule, Age Factors, Infant, Infant, Newborn, Infant, Premature, Italy, Practice Guidelines as Topic, business.industry, Tetanus, Diphtheria, lcsh:RJ1-570, lcsh:Pediatrics, medicine.disease, Vaccination, Immunization, Preterm infant, Vaccine-preventable diseases, business, Vaccine, Human
Abstract: Hexavalent vaccines, protecting against six diseases (diphtheria, tetanus, pertussis [DTaP], poliovirus, hepatitis B virus [HBV], and Haemophilus influenzae type b [Hib], are routinely the standard of care in Europe. The use of combined vaccines allows the reduction of number of injections and side effects, the reduction of costs, and the increase in adherence of the family to the vaccination schedule both in terms of the number of doses and timing. The safety profile, efficacy and effectiveness of hexavalent vaccines have been extensively documented in infants and children born at term, and data are accumulating in preterm infants. Hexavalent vaccines are particularly important for preterm infants, who are at increased risk for severe forms of vaccine preventable diseases. However, immunization delay has been commonly reported in this age group. All the three hexavalent vaccines currently marketed in Italy can be used in preterm infants, and recent data confirm that hexavalent vaccines have a similar or lower incidence of adverse events in preterm compared to full-term infants; this is likely due to a weaker immune system response and reduced ability to induce an inflammatory response in preterm infants. Apnoea episodes are the adverse events that can occur in the most severe preterm infants and / or with history of respiratory distress. The risk of apnoea after vaccination seems to be related to a lower gestational age and a lower birth weight, supporting the hypothesis that it represents an unspecific response of the preterm infant to different procedures. High seroprotection rates have been reported in preterm infants vaccinated with hexavalent vaccine. However, a lower gestational age seems to be associated with lower antibody titres against some vaccine antigens (e.g. HBV, Hib, poliovirus serotype 1, and pertussis), regardless of the type of hexavalent vaccine used. Waiting for large effectiveness studies, hexavalent vaccines should be administered in preterm infants according to the same schedule recommended for infants born at term, considering their chronological age and providing an adequate monitoring for cardio-respiratory events in the 48–72 h after vaccination, especially for infants at risk of recurrence of apnoea.
Published: 2019

27. Options of immunotherapeutic treatments for children with asthma

Author: Giovanni Battista Pajno, Federica Porcaro, and Renato Cutrera
Subjects: Pulmonary and Respiratory Medicine, Allergen immunotherapy, medicine.medical_specialty, Neutrophils, Omalizumab, Antibodies, Monoclonal, Humanized, Immunoglobulin E, medicine.disease_cause, 03 medical and health sciences, 0302 clinical medicine, Allergen, immune system diseases, Eosinophilic, medicine, Humans, Immunology and Allergy, Anti-Asthmatic Agents, 030212 general & internal medicine, Child, Intensive care medicine, Asthma, biology, allergen specific immunotherapy, asthma endotypes, asthma phenotypes, biologic treatment, children, business.industry, Interleukins, Inhaler, Public Health, Environmental and Occupational Health, medicine.disease, respiratory tract diseases, 030228 respiratory system, Desensitization, Immunologic, biology.protein, business, Mepolizumab, Biomarkers, medicine.drug
Abstract: Introduction: Asthma is the most common chronic disease in children. Avoiding triggers, and pharmacologic treatment with short acting beta-agonist, inhaler corticosteroids and anti-leukotriene are often enough to obtain symptoms control. Nevertheless, there is a subset of children with severe asthma and poor symptom control despite maximal therapy. In these patients, anti-IgE and anti-IL5 monoclonal antibodies are suggested as the fifth step of Global Initiative for Asthma guidelines. Area covered: Immunotherapeutic treatments are now suggested for asthma management. This article will discuss the available evidence on allergen immunotherapy and biologic drugs in pediatric asthma treatment. Expert opinion: Previously published studies demonstrated a good efficacy and safety profile of Allergen Immunotherapy in patients with mild-moderate asthma and sensitization to one main allergen. New understanding of mechanisms underlying severe asthma inflammation has allowed the identifications of specific biomarkers guiding the clinician in the choice of patient specific drug. Among the suggested immunotherapeutic options, omalizumab (blocking IgE) remains the first choice for atopic 'early onset' asthma in patients aged over 6 years. Instead, mepolizumab (blocking the IL5 ligand) should be considered for 'eosinophilic' asthma. Other biologic drugs are under consideration but data on the pediatric population are still lacking.
Published: 2019

28. Congenital jugular vein phlebectasia or aneurysma: A rare entity in prenatal diagnosis

Author: Sara Corno, Cristina Pajno, Lucia Manganaro, Valentina D'Ambrosio, Pierluigi Benedetti Panici, Antonella Giancotti, Flavia Ventriglia, Roberto Brunelli, and Flaminia Vena
Subjects: Congenital vascular malformation, jugular vein, prenatal diagnosis, Fetus, medicine.medical_specialty, 030219 obstetrics & reproductive medicine, business.industry, Ultrasound, Vascular malformation, Rare entity, Obstetrics and Gynecology, Prenatal diagnosis, medicine.disease, 03 medical and health sciences, 0302 clinical medicine, 030220 oncology & carcinogenesis, Jugular vein, cardiovascular system, Medicine, Radiology, business, External jugular vein, Pediatric population
Abstract: Vascular malformations arising from the wall of the external jugular vein are rare and appeared most commonly in pediatric population. Here, we present a case of vascular malformation in the left external jugular vein diagnosed in a fetus during third trimester ultrasound. This is the first described case in prenatal diagnosis.
Published: 2019

29. Thyrotropin serum levels and coexistence with Hashimoto’s thyroiditis as predictors of malignancy in children with thyroid nodules

Author: Giovanni Battista Pajno, Giuseppe Crisafulli, Cristina Mignosa, Domenico Corica, Giorgia Pepe, Giuseppina Zirilli, Giuseppina Salzano, and Filippo De Luca
Subjects: Thyroid nodules, medicine.medical_specialty, endocrine system, endocrine system diseases, Levothyroxine, Nodular lymphocytic thyroiditis, Pre-cancerous factors, Thyrotropin, Hashimoto Disease, Malignancy, Gastroenterology, Thyroiditis, 03 medical and health sciences, 0302 clinical medicine, Subclinical hypothyroidism, 030225 pediatrics, Internal medicine, Biomarkers, Tumor, Humans, Medicine, Thyroid Neoplasms, Thyroid Nodule, 030212 general & internal medicine, Child, Thyroid cancer, Subclinical infection, TSH serum levels, business.industry, Thyroid, lcsh:RJ1-570, lcsh:Pediatrics, medicine.disease, Childhood, medicine.anatomical_structure, Relative risk, Commentary, business, medicine.drug
Abstract: Thyroid cancer (TC) in childhood is a rare disease characterized by an excellent prognosis. Thyroid nodules in children, although less common than in adults, have a greater risk of malignancies, particularly in those cases associated with anamnestic, clinical and ultrasonographic risk factors. Among the factors, which have been found to be linked with an increased relative risk of TC in children, an important role seems to be possibly played by an underlying nodular Hashimoto’s thyroiditis (HT) and by the serum levels of TSH. Aim of this Commentary was to specifically address this last point. According to the available pediatric literature on the relationships between these risk factors and phenotypical expression of TC in children, it is possible to conclude that: 1) It is not completely clarified if HT per se predisposes to malignancy or if it represents an incidental histologic finding in cases with TC or if it may be the result of an immune response against tumoral cells. 2) It is unclear whether phenotypic expression of TC is more severe in the cases with associated HT but normal TSH serum levels. 3) Persistently elevated TSH levels play an independent role as predictors of the likelihood of TC, especially in children but also in adults. 4) Patients with nodular HT and subclinical hypothyroidism need to be treated with Levothyroxine in order to prevent the development of both TC and severe thyroid dysfunctions.
Published: 2019

30. EAACI Guidelines on Allergen Immunotherapy: House dust mite-driven allergic asthma

Author: Elisabeth Angier, Pawe Gajdanowicz, Ozlem Cavkaytar, Milena Sokolowska, Ralph Mösges, Cezmi A. Akdis, Marek Jutel, Oscar Palomares, Dermot Ryan, Matteo Bonini, Ioana Agache, Juan José Yepes-Nuñez, Graham Roberts, Oliver Pfaar, Nikolaos G. Papadopoulos, Omer Kalayci, Breda Flood, Giovanni Battista Pajno, Ronald van Ree, Gunter J. Sturm, Kenji Izuhara, Roy Gerth van Wijk, Eva M. Varga, Montserrat Fernandez-Rivas, Susanne Lau, Sylwia Smolinska, Erasmus MC other, Internal Medicine, Ear, Nose and Throat, Experimental Immunology, AII - Inflammatory diseases, APH - Global Health, and APH - Personalized Medicine
Subjects: 0301 basic medicine, Pediatrics, medicine.medical_specialty, Allergen immunotherapy, Allergy, Lydia Becker Institute, medicine.medical_treatment, Immunology, Settore MED/10 - MALATTIE DELL'APPARATO RESPIRATORIO, medicine.disease_cause, 03 medical and health sciences, 0302 clinical medicine, Allergen, Pharmacotherapy, ResearchInstitutes_Networks_Beacons/lydia_becker_institute_of_immunology_and_inflammation, allergen immunotherapy, allergy, asthma, asthma control, asthma exacerbations, GRADE, house dust mites, lung function, medicine, Animals, Humans, Immunology and Allergy, Antigens, Dermatophagoides, Asthma, Desensitization (medicine), House dust mite, biology, business.industry, Pyroglyphidae, lung function, Guideline, Allergens, asthma, allergy, medicine.disease, biology.organism_classification, asthma control, respiratory tract diseases, GRADE, 030104 developmental biology, 030228 respiratory system, Desensitization, Immunologic, asthma exacerbations, allergen immunotherapy, business, house dust mites
Abstract: Allergen immunotherapy (AIT) has been in use for the treatment of allergic disease for more than 100 years. Asthma treatment relies mainly on corticosteroids and other controllers recommended to achieve and maintain asthma control, prevent exacerbations, and improve quality of life. AIT is underused in asthma, both in children and in adults. Notably, patients with allergic asthma not adequately controlled on pharmacotherapy (including biologics) represent an unmet health need. The European Academy of Allergy and Clinical Immunology has developed a clinical practice guideline providing evidence-based recommendations for the use of house dust mites (HDM) AIT as add-on treatment for HDM-driven allergic asthma. This guideline was developed by a multi-disciplinary working group using the Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach. HDM AIT was separately evaluated by route of administration and children and adults: subcutaneous (SCIT) and sublingual AIT (SLIT), drops, and tablets. Recommendations were formulated for each. The important prerequisites for successful treatment with HDM AIT are (a) selection of patients most likely to respond to AIT and (b) use of allergen extracts and desensitization protocols of proven efficacy. To date, only AIT with HDM SLIT-tablet has demonstrated a robust effect in adults for critical end points (exacerbations, asthma control, and safety). Thus, it is recommended as an add-on to regular asthma therapy for adults with controlled or partially controlled HDM-driven allergic asthma (conditional recommendation, moderate-quality evidence). HDM SCIT is recommended for adults and children, and SLIT drops are recommended for children with controlled HDM-driven allergic asthma as the add-on to regular asthma therapy to decrease symptoms and medication needs (conditional recommendation, low-quality evidence).
Published: 2019

31. Novel diagnostic techniques and therapeutic strategies for IgE-mediated food allergy

Author: Fortunato Lombardo, Giuseppe Crisafulli, Giuseppina Salzano, Giovanni Battista Pajno, Tommaso Aversa, and Stefano Passanisi
Subjects: Pulmonary and Respiratory Medicine, medicine.medical_specialty, Allergy, Clinical Decision-Making, Omalizumab, Disease, Immunologic Tests, 03 medical and health sciences, 0302 clinical medicine, Reslizumab, Food allergy, Predictive Value of Tests, medicine, Immune Tolerance, Immunology and Allergy, Humans, Intensive care medicine, 030304 developmental biology, 0303 health sciences, business.industry, General Medicine, Articles, Immunoglobulin E, medicine.disease, Dupilumab, Treatment Outcome, 030228 respiratory system, Immunotherapy, business, Mepolizumab, Anaphylaxis, Biomarkers, Food Hypersensitivity, medicine.drug
Abstract: Background: Immunoglobulin E (IgE) mediated food allergy is a potentially life-threatening condition and represents a heavy burden for patients and their families. Identification of the most suitable way for management of each patient has currently become the primary goal for physicians. Methods: This study reviewed the current literature related to IgE-mediated food allergy. Results: The use of innovative diagnostic tools, such as allergen-specific IgG4 determination, basophil activation test, and component-resolved diagnostics, is currently available to facilitate a proper diagnosis of food allergy. After several decades of “passive clinical management” of the disease, which was based only on avoidance of the allergenic food and the use of epinephrine in the event of anaphylaxis, there has been a switch to active treatment. The most recent evidence-practice guidelines strongly recommend the use of immunotherapy as an effective therapeutic option, particularly in cases of allergy to cow's milk, egg, or peanut. The use of omalizumab, in association with immunotherapy or alone, has been tested in several studies, and results on its effectiveness seemed to be encouraging. Other biologics, such as dupilumab, reslizumab, mepolizumab, and other anticytokines therapies, are being investigated. Another interesting future treatment strategy could be the use of DNA vaccines. Conclusion: In recent years, the management of IgE-mediated food allergy has greatly improved. Knowledge of pathogenetic mechanisms, understanding of the disease course, and the introduction of novel biomarkers led to more accurate diagnoses along with the active treatment of patients.
Published: 2021

32. Pubertal induction in girls with Turner Syndrome

Author: Malgorzata Wasniewska, Giovanni Battista Pajno, Mariella Valenzise, Domenico Corica, Giorgia Pepe, Maria Francesca Messina, and Tommaso Aversa
Subjects: Adult, Pediatrics, medicine.medical_specialty, medicine.drug_class, Hormone Replacement Therapy, Endocrinology, Diabetes and Metabolism, Gonadal dysgenesis, Turner Syndrome, law.invention, Hypergonadotropic hypogonadism, Endocrinology, Randomized controlled trial, law, Breakthrough bleeding, Turner syndrome, Internal Medicine, Medicine, Humans, Prospective Studies, Estradiol, business.industry, Estrogens, medicine.disease, Regimen, Estrogen, Female, medicine.symptom, business, Progestin
Abstract: Turner syndrome (TS) is the most common female sex chromosome aneuploidy in females, and patients may present with hypergonadotropic hypogonadism due to gonadal dysgenesis. Timing and modalities of pubertal induction in these patients is still a matter of debate. Aim of this review is to focus on the latest update on pubertal induction in TS. Based on literature data, the following practical approach to this issue is recommended. Pubertal induction should begin between 11 and 12 years of age, starting with low doses of estradiol to preserve height potential. Transdermal 17β-Estradiol (17β-E2) could represent the first-choice induction regimen as it is more physiologic compared to an oral regimen and avoids the first-pass mechanism in the liver. In the case of poor compliance, administration of oral 17β-E2 or ethinyl estradiol could be offered. Incremental dose increases, approximately every 6 months, can contribute to mimic normal pubertal progression until adult dosing is reached over a 2- to 3- year period. Progestin should be added once breakthrough bleeding occurs or after 2 to 3 years of estrogen therapy or if ultrasound shows a mature uterus with thick endometrium. Treatment needs to be individualized and monitored by clinical assessment in relation to patient compliance and satisfaction. Well-designed prospective randomized clinical trials aimed to identify the best estrogen regimen for pubertal induction in TS girls are needed.
Published: 2021

33. Acute cough in children and adolescents: A systematic review and a practical algorithm by the Italian Society of Pediatric Allergy and Immunology

Author: Michele Miraglia Del Giudice, Arabella Martelli, Claudio Cravidi, Marzia Duse, Sara Manti, Gian Luigi Marseglia, Diego Peroni, Giorgio Ciprandi, Domenico Minasi, Ilaria Brambilla, Maria Angela Tosca, Amelia Licari, Fabio Cardinale, Carlo Caffarelli, Elena Chiappini, Giovanni Battista Pajno, and Mauro Calvani
Subjects: Glycerol, Pulmonary and Respiratory Medicine, Adolescent, Apitherapy, Acute cough, Immunology, Primary care, Allergy and Immunology, Practical algorithm, Humans, Immunology and Allergy, Medicine, Child, Watchful Waiting, Levodropropizine, Societies, Medical, National health, Respiratory tract infections, Plant Extracts, business.industry, Infant, Honey, General Medicine, acute cough, acute cough relievers, adolescents, algorithm, children, Clinical Practice, Antitussive Agents, Cough, Italy, Propylene Glycols, Child, Preschool, Acute Disease, Practice Guidelines as Topic, Quality of Life, Pediatric allergy, business, medicine.drug
Abstract: The current systematic review presented and discussed the most recent studies on acute cough in pediatric age. After that, the Italian Society of Pediatric Allergy and Immunology elaborated a comprehensive algorithm to guide the primary care approach to pediatric patients, such as infants, children, and adolescents, with acute cough. An acute cough is usually consequent to upper respiratory tract infections and is self-resolving within a few weeks. However, an acute cough may be bothersome, and therefore remedies are requested, mainly by the parents. An acute cough may significantly affect the quality of life of patients and their family.Several algorithms for the management of acute cough have been adopted and validated in clinical practice; however, unlike the latter, we developed an algorithm focused on pediatric age, and, also, in accordance to the Italian National Health System, which regularly follows the child from birth to all lifelong. Based on our findings, infants from 6 months, children, and adolescents with acute cough without cough pointers can be safely managed using well-known medications, preferably non-sedative agents, such as levodropropizine and/or natural compounds, including honey, glycerol, and herb-derived components.
Published: 2021

34. Fetoscopic laser ablation in twin-to-twin transfusion syndrome: tips for counselling

Author: Antonella Giancotti, Rossella D’Alisa, Francesca Manicone, Flaminia Vena, Roberto Brunelli, Alessandro Martinino, Valentina D'Ambrosio, Lorenzo Spiniello, Daniele Di Mascio, Ludovico Muzii, Sara Corno, and Cristina Pajno
Subjects: Counseling, medicine.medical_specialty, Polyhydramnios, fetofetal transfusion, fetoscopy, pregnancy, twin, Oligohydramnios, Anastomosis, Twin-to-twin transfusion syndrome, medicine, Humans, Laser procedure, Pregnancy, business.industry, Infant, Newborn, Obstetrics and Gynecology, Gestational age, medicine.disease, Surgery, Premature Birth, Female, twin, Laser Therapy, pregnancy, business, Complication
Abstract: Twin-to-twin transfusion syndrome (TTTS) is a serious complication that affects approximately 10-15% of monochorionic twin pregnancies. The most important role for the development of this condition is the presence of an unbalanced flow through the inter-twin vascular anastomoses. Depending on the number, type and direction of the connecting vessels, blood can be transfused disproportionately from one twin (the donor) to the other twin (the recipient). The diagnosis is defined prenatally by ultrasound and involves of two main criteria: the presence of a monochorionic diamniotic (MCDA) pregnancy; and the presence of oligohydramnios in the donor's sac- deep vertical pocket (DVP) 2 cm - and polyhydramnios in the recipient's sac- DVP>8 cm. Once diagnosed, TTTS is usually graded by using the Quintero staging system, that is composed by five stages, from oligohydramnios in the donor and polyhydramnios in the recipient twin to fetal demise in one or both twins. Photocoagulation of the anastomotic vessels, usually followed by equatorial dichorionization, it has currently become the most common fetoscopic operation today and is considered as the gold standard for stage II-IV TTTS. pPROM, chorioamniotic separation and iatrogenic preterm birth are among the most common complications of fetoscopic laser ablation, and the mean gestational age at delivery after laser procedure is about 31 weeks.
Published: 2021

35. Effects of domotics on cognitive, social and personal functioning in patients with Parkinson's disease: A pilot study

Author: Rocco Salvatore Calabrò, Maria Grazia Maggio, Valentina Pajno, Giuseppa Maresca, Desiree Latella, Rosaria De Luca, Giuseppe Di Lorenzo, Smeralda Anchesi, Adriana Andaloro, and Alfredo Manuli
Subjects: Gerontology, Parkinson's disease, business.industry, Rehabilitation, technology, industry, and agriculture, Physical Therapy, Sports Therapy and Rehabilitation, Cognition, Parkinson Disease, Pilot Projects, Disease, medicine.disease, Quality of life (healthcare), Home automation, Activities of Daily Living, Quality of Life, Medicine, Humans, In patient, business, Neurorehabilitation
Abstract: Home automation (HA) is either a "smart" house or a supportive environment, which enables the patients to regain an active role in daily life. HA could allow people affected by Parkinson Disease (PD) to better manage their daily lives. This study aims to evaluate the effects of domotics on quality of life, and personal/social autonomy in PD patients. We enrolled 40 with PD undergoing neurorehabilitation, who were randomized into either the control (CG) or the experimental group (EG). Two different rehabilitative approaches were used: the CG was submitted to a traditional training, whilst the EG underwent HA training, in which the activities were carried out through the use of assistive technologies. In both the training, the exercises were performed in small samples of 3-5 patients. Results showed that both CG and EG had a significant improvement in global cognitive functioning, executive functions, and instrumental autonomy. However, only in the EG, we observed a significant increase in social adaptation, activities of daily living and quality of life. This pilot study suggests that HA training could be a useful tool for the rehabilitation of patients with PD, improving social and cognitive functioning, personal autonomy and quality of life.
Published: 2020

36. Kawasaki disease epidemic: pitfalls

Author: Romina Gallizzi, Giovanni Battista Pajno, Giovanni Corsello, and Romina Gallizzi, Giovanni Corsello, Giovanni Battista Pajno
Subjects: 2019-20 coronavirus outbreak, Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), Inflammatory response, viruses, Pneumonia, Viral, Hyperinflammatory response, Kawasaki disease, Pediatric population, SARS-CoV-2, COVID-19, Coronavirus Infections, Humans, Mucocutaneous Lymph Node Syndrome, Pandemics, Betacoronavirus, Virus, Settore MED/38 - Pediatria Generale E Specialistica, Medicine, Viral, skin and connective tissue diseases, Viral etiology, business.industry, lcsh:RJ1-570, lcsh:Pediatrics, Pneumonia, medicine.disease, Immunology, Etiology, Commentary, business
Abstract: Recent reports have described in the pediatric population a new type of hyperinflammatory response manifested following contact with SARS-CoV-2, with some of the clinical features attributable to Kawasaki disease (KD). The purpose of this commentary is to remark on a possible recent association between SARS-CoV-2 and KD. Although today little is known about the etiology of KD, the most accepted hypothesis is that of a probable viral etiology, therefore, even the SARS-CoV-2 virus could trigger, in genetically predisposed subjects, an exaggerated inflammatory response that is clinically evident like the one described in KD.
Published: 2020

37. Uniparental disomy and pretreatment IGF-1 may predict elevated IGF-1 levels in Prader-Willi patients on GH treatment

Author: Malgorzata Wasniewska, Maria Chiara Pellegrin, Rita Fischetto, Francesca Macchi, Antonella Lonero, Sara Osimani, A. Crinò, Adriana Franzese, Sarah Bocchini, Gilda Cassano, Luana Nosetti, Annamaria Perri, Giuseppa Patti, Maria Rosaria Licenziati, Michele Sacco, Stefano Stagi, Alessandro Salvatoni, G. Trifirò, Rosanna Lia, Simona Filomena Madeo, Irene Rutigliano, Lorenzo Iughetti, Paola Giordano, Danilo Fintini, Gianluca Tornese, Alessio Convertino, Patrizia Matarazzo, Graziano Grugni, S. Ferraris, Emanuela Scarano, Domenico Corica, Valentina Fattorusso, Viviana Valeria Palmieri, Roberta Pajno, L. Ragusa, Maurizio Delvecchio, Palmieri, V. V., Lonero, A., Bocchini, S., Cassano, G., Convertino, A., Corica, D., Crino, A., Fattorusso, V., Ferraris, S., Fintini, D., Franzese, A., Grugni, G., Iughetti, L., Lia, R., Macchi, F., Madeo, S. F., Matarazzo, P., Nosetti, L., Osimani, S., Pajno, R., Patti, G., Pellegrin, M. C., Perri, A., Ragusa, L., Rutigliano, I., Sacco, M., Salvatoni, A., Scarano, E., Stagi, S., Tornese, G., Trifiro, G., Wasniewska, M., Fischetto, R., Giordano, P., Licenziati, M. R., and Delvecchio, M.
Subjects: Male, 0301 basic medicine, medicine.medical_specialty, Adolescent, Endocrinology, Diabetes and Metabolism, Growth hormone therapy, 030209 endocrinology & metabolism, Adverse effect, Gastroenterology, Growth velocity, 03 medical and health sciences, Adverse effects, IGF-1, Prader-Willi syndrome, Uniparental disomy, Child, Child, Preschool, Female, Human Growth Hormone, Humans, Infant, Insulin-Like Growth Factor I, Prader-Willi Syndrome, Prognosis, Uniparental Disomy, 0302 clinical medicine, Endocrinology, Internal medicine, medicine, Preschool, Normal range, business.industry, Human growth hormone, medicine.disease, Highly sensitive, 030104 developmental biology, Gh treatment, business
Abstract: Pediatric patients with Prader-Willi syndrome (PWS) can be treated with recombinant human GH (rhGH). These patients are highly sensitive to rhGH and the standard doses suggested by the international guidelines often result in IGF-1 above the normal range. We aimed to evaluate 1 the proper rhGH dose to optimize auxological outcomes and to avoid potential overtreatment, and 2 which patients are more sensitive to rhGH. In this multicenter real-life study, we recruited 215 patients with PWS older than 1 year, on rhGH at least for 6 months, from Italian Centers for PWS care. We collected auxological parameters, rhGH dose, IGF-1 at recruitment and (when available) at start of treatment. The rhGH dose was 4.3 (0.7/8.4) mg/m2/week. At recruitment, IGF-1 was normal in 72.1% and elevated in 27.9% of the patients. In the group of 115 patients with IGF-1 available at start of rhGH, normal pretreatment IGF-1 and uniparental disomy were associated with elevated IGF-1 during the therapy. No difference in height and growth velocity was found between patients treated with the highest and the lowest range dose. The rhGH dose prescribed in Italy seems lower than the recommended one. Normal pretreatment IGF-1 and uniparental disomy are risk factors for elevated IGF-1. The latter seems to be associated with higher sensitivity to GH. In case of these risk factors, we recommend a more accurate titration of the dose to avoid overtreatment and its potential side effects.
Published: 2019

38. Anthropometric characteristics of newborns with Prader–Willi syndrome

Author: Luana Nosetti, Sara Azzolini, Simona Filomena Madeo, Valentina Bonaita, S. Ferraris, Paola Cianci, Alessandro Salvatoni, Silvia Salvatore, Irene Rutigliano, Antonino Crinò, Graziano Grugni, G. Trifirò, Maurizio Delvecchio, Michele Sacco, Roberta Pajno, Lorenzo Iughetti, Alex Moretti, Nella Augusta Greggio, Domenico Corica, Malgorzata Wasniewska, Maria Rosaria Licenziati, Emanuela Scarano, Massimo Agosti, Salvatoni, A, Moretti, A, Grugni, G, Agosti, M, Azzolini, S, Bonaita, V, Cianci, P, Corica, D, Crinò, A, Delvecchio, M, Ferraris, S, Greggio, N, Iughetti, L, Licenziati, M, Madeo, S, Nosetti, L, Pajno, R, Rutigliano, I, Sacco, M, Salvatore, S, Scarano, E, Trifirò, G, and Wasniewska, M
Subjects: Male, congenital, hereditary, and neonatal diseases and abnormalities, Percentile, medicine.medical_specialty, Birth weight, growth, percentiles, Gestational Age, percentile, Health problems, newborn, Prader–Willi, Genetics, medicine, Birth Weight, Humans, Genetics (clinical), Prader-Willi, Anthropometric data, Anthropometry, Body Height, Female, Infant, Newborn, Linear Models, Prader-Willi Syndrome, Obstetrics, Singleton, business.industry, Infant, nutritional and metabolic diseases, Gestational age, Newborn, Small gestational age, business
Abstract: This is a retrospective multicenter nationwide Italian study collecting neonatal anthropometric data of Caucasian subjects with Prader–Willi syndrome (PWS) born from 1988 to 2018. The aim of the study is to provide percentile charts for weight and length of singletons with PWS born between 36 and 42 gestational weeks. We collected the birth weight and birth length of 252 male and 244 female singleton live born infants with both parents of Italian origin and PWS genetically confirmed. Percentile smoothed curves of birth weight and length for gestational age were built through Cole's lambda, mu, sigma method. The data were compared to normal Italian standards. Newborns with PWS showed a lower mean birth weight, by 1/2 kg, and a shorter mean birth length, by 1 cm, than healthy neonates. Females with a 15q11-13 deletion were shorter than those with maternal uniparental maternal disomy of chromosome 15 (p
Published: 2019

39. 2019 ARIA Care pathways for allergen immunotherapy

Author: Dana Wallace, Karin C. Lødrup Carlsen, M. T. Ventura, Igor Kaidashev, Stephen R. Durham, Motohiro Ebisawa, Oliver Pfaar, Hae-Sim Park, Daniel Laune, Wytske Fokkens, Antonella Muraro, Moises A. Calderon, Torsten Zuberbier, Mohamed H. Shamji, Mark S. Dykewicz, Roy Gerth van Wijk, Josep M. Antó, Samantha Walker, Petr Panzner, Giorgio Walter Canonica, Nelson Rosario, Juan Carlos Ivancevich, Holger J. Schünemann, Susanne Halken, Lorenzo Cecchi, Sinthia Bosnic-Anticevich, Violeta Kvedariene, Stefania La Grutta, João Fonseca, Marek L Kowalski, Tari Haahtela, Aziz Sheikh, Montserrat Fernandez-Rivas, Nhan Pham-Thi, Isabelle Bosse, Jean Bousquet, Lan Le, Despo Ierodiakonou, Tomohisa Iinuma, Lars Jacobsen, Christine Rolland, Gert Marien, Wienczyslawa Czarlewski, Glenis Scadding, Ioana Agache, Bolesław Samoliński, Olga Lourenço, Ludger Klimek, Yoshitaka Okamoto, Ulrich Wahn, Joaquim Mullol, Erkka Valovirta, Luigi Caraballo, Sanna Toppila-Salmi, Ioanna Tsiligianni, Derek K. Chu, Ruby Pawankar, Jean Luc Fauquert, Musa Khaitov, Jorg Kleine Tebbe, Jean-François Fontaine, Victoria Cardona, Désirée Larenas-Linemann, Thomas B. Casale, Omer Kalayci, Alvaro A. Cruz, Arunas Valiulis, Anna Bedbrook, Susanne Lau, Alkis Togias, H.-J. Malling, Claus Bachert, Dermot Ryan, Elísio Costa, Giovanni Passalacqua, Ignacio J. Ansotegui, Ana Todo Bom, Marek Jutel, Enrica Menditto, Piotr Kuna, Nikolaos G. Papadopoulos, Gregoire Mercier, Mario Sánchez-Borges, Karl-Christian Bergmann, Susan Waserman, Gunter J. Sturm, Maryline Valentin-Rostan, Arzu Yorgancioglu, Giovanni Battista Pajno, Jan Brozek, George Du Toit, Robyn E O'Hehir, Peter Hellings, Graham Roberts, uBibliorum, Contre les MAladies Chroniques pour un VIeillissement Actif en Languedoc-Roussillon (MACVIA-LR), Université Montpellier 1 (UM1)-Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre Hospitalier Universitaire de Nîmes (CHU Nîmes)-Université de Montpellier (UM)-Centre National de la Recherche Scientifique (CNRS)-European Innovation Partnership on Active and Healthy Ageing Reference Site (EIP on AHA), Commission Européenne-Commission Européenne-Organisation Mondiale de la Santé / World Health Organization Office (OMS / WHO), Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier), Center for Rhinology and Allergology, National Institute of Allergy and Infectious Diseases [Bethesda] (NIAID-NIH), National Institutes of Health [Bethesda] (NIH), Department of Clinical Epidemiology and Biostatistics and Medicine, McMaster University [Hamilton, Ontario], Department of Allergy and Immunology, Hospital Quiròn Bizkaia Erandio, UPC Research Laboratories, Allergy Department, University of Crete [Heraklion] (UOC), Department of Allergy and Clinical Immunology, Transylvania University of Brasov, Universitat Pompeu Fabra [Barcelona] (UPF), Ghent University Hospital, Charité - UniversitätsMedizin = Charité - University Hospital [Berlin], Department of Dermatology and Allergy [Berlin, Allemagne], Comprehensive Allergy Center [Berlin, Allemagne], Berlin Institute of Health (BIH)-Berlin Institute of Health (BIH), The University of Sydney, Woolcock Institute of Medical Research [Sydney], CHU Montpellier, Departments of Clinical Epidemiology and Biostatistics and Medicine [Ontario], Section of Allergy and Clinical Immunology [London, UK], Imperial College London-Royal Brompton Hospital-National Heart and Lung Institute, Humanitas Clinical and Research Center [Rozzano, Milan, Italy], Institute for Immunological Research (University of Cartagena), University of Cartagena, Allergy Section, Department of Internal Medicine, Vall d'Hebron University Hospital [Barcelona], Division of Allergy and Immunology, Department of Medicine, Creighton University, Department of Health Research Methods, Evidence and Impact, McMaster University, Hamilton, ON, Canada, Universidade do Porto, Instituto de Biologia Molecular e Celular (IBMC), Universidade Federal da Bahia (UFBA), UCB Pharma, Colombes, Section of Allergy and Clinical Immunology, Imperial College London-Royal Brompton Hospital-National Heart and Lung Institute [UK], King‘s College London, Saint Louis University School of Medicine [St Louis], Sagamihara National Hospital, CHU Estaing [Clermont-Ferrand], CHU Clermont-Ferrand, Instituto de Investigación Sanitaria del Hospital Clínico San Carlos [Madrid, Spain] (IdISSC), European Forum for Research and Education in Allergy and Airway Diseases (EUFOREA), Center of Research in Health Technologies and Information Systems (CINTESIS), Department of Allergology, Erasmus University Medical Center [Rotterdam] (Erasmus MC), Helsinki University Hospital, Odense University Hospital, University Hospitals Leuven [Leuven], Chiba University Hospital, Servicio de Alergia e ImmunologiaBuenos Aires (Clinica Santa Isabel), Research Centre for Prevention and Health (RCPH), Department of Public Health [Copenhagen], Faculty of Health and Medical Sciences, University of Copenhagen = Københavns Universitet (KU)-University of Copenhagen = Københavns Universitet (KU)-Faculty of Health and Medical Sciences, University of Copenhagen = Københavns Universitet (KU)-University of Copenhagen = Københavns Universitet (KU)-Capital Region of Denmark, Department of Clinical Immunology, Wroclaw Medical University, Ukrainina Medical Stomatological Academy [Poltava, Ukraine], Laboratory of Molecular Immunology [Moscow, Russian Federation] (National Research Center), Institute of Immunology [Moscow, Russian Federation]-Federal Medicobiological Agency [Moscow, Russian Federation], Hacettepe University = Hacettepe Üniversitesi, Allergy & Asthma Center Westend, Outpatient Clinic Hanf, Department of Immunology, Rheumatology and Allergy, Division of Internal Medicine, Asthma and Allergy, Medical University of Łódź (MUL)-Barlicki University Hospital, Vilnius University [Vilnius], CNR-IBIM : National Research Council-Institute of Biomedicine and Molecular Immunology, Department of Pediatric Pneumology and Immunology, Ho Chi Minh City University of Technology (HCMUT), University of Oslo (UiO), Faculty of Health Sciences and CICS-UB (Health Sciences Research Centre), 'Federico II' University of Naples Medical School, Centro de Investigación Biomédica en Red Enfermedades Respiratorias (CIBERES), Food Allergy Referral Centre Veneto Region [Padua, Italy], Universita degli Studi di Padova, Monash University [Melbourne], Department of Otorhinolaryngology, Department of Pediatrics, Allergy Unit, University of Messina, Ajou University School of Medicine, Department of Allergology and Clinical Immunology, Medical Faculty in Pilsen-Charles University in Prague - the First Faculty of Medicine, Allergy and Respiratory Diseases, University of Genoa (UNIGE), Saint Mary's Hospital [London], St Mary's Hospital [London], Department of Pediatrics, Nippon Medical School, Pediatrics, Universidade Federal do Paraná (UFPR), Medical Centre, Woodbrook Medical Centre, Medical University of Warsaw - Poland, Department of Prevention of Environmental Hazards and Allergology, Medical University of Warsaw - Poland-Faculté de Pharmacie de Paris, Department of Allergy and Clinical Immunology [Caracas, Venezuela], Centro Medico-Docente La Trinidad, The Royal National Throat, Nose and Ear Hospital, Imperial College London, Centre for Population Health Sciences, University of Edinburgh, Medical University Graz, University of Coimbra [Portugal] (UC), Vilnius University Clinic of Children's Diseases, Suomen Terveystalo Allergy Clinic, Università degli studi di Bari Aldo Moro (UNIBA), Department for Pediatric Pneumology and Immunology, Asthma UK Centre in Allergic Mechanisms of Asthma, King's College London, (MRC), Guy's Hospital [London], Nova Southeastern University (NSU), Department of Pulmonology, Manisa Celal Bayar University, Department of Dermatology, Medical School-Charité - UniversitätsMedizin = Charité - University Hospital [Berlin], Association Asthme et Allergie, Internal Medicine, Bousquet, J., Pfaar, O., Togias, A., Schunemann, H. J., Ansotegui, I., Papadopoulos, N. G., Tsiligianni, I., Agache, I., Anto, J. M., Bachert, C., Bedbrook, A., Bergmann, K. -C., Bosnic-Anticevich, S., Bosse, I., Brozek, J., Calderon, M. A., Canonica, G. W., Caraballo, L., Cardona, V., Casale, T., Cecchi, L., Chu, D., Costa, E., Cruz, A. A., Czarlewski, W., Durham, S. R., Du Toit, G., Dykewicz, M., Ebisawa, M., Fauquert, J. L., Fernandez-Rivas, M., Fokkens, W. J., Fonseca, J., Fontaine, J. -F., Gerth van Wijk, R., Haahtela, T., Halken, S., Hellings, P. W., Ierodiakonou, D., Iinuma, T., Ivancevich, J. C., Jacobsen, L., Jutel, M., Kaidashev, I., Khaitov, M., Kalayci, O., Kleine Tebbe, J., Klimek, L., Kowalski, M. L., Kuna, P., Kvedariene, V., La Grutta, S., Larenas-Linemann, D., Lau, S., Laune, D., Le, L., Lodrup Carlsen, K., Lourenco, O., Malling, H. -J., Marien, G., Menditto, E., Mercier, G., Mullol, J., Muraro, A., O'Hehir, R., Okamoto, Y., Pajno, G. B., Park, H. -S., Panzner, P., Passalacqua, G., Pham-Thi, N., Roberts, G., Pawankar, R., Rolland, C., Rosario, N., Ryan, D., Samolinski, B., Sanchez-Borges, M., Scadding, G., Shamji, M. H., Sheikh, A., Sturm, G. J., Todo Bom, A., Toppila-Salmi, S., Valentin-Rostan, M., Valiulis, A., Valovirta, E., Ventura, M. -T., Wahn, U., Walker, S., CORBO UGULINO, Wallace, Waserman, S., Yorgancioglu, A., Zuberbier, T., Hospital Quirónsalud Bizkaia [Bilbao], Sagamihara National Hospital [Kanagawa, Japan], Universidade do Porto = University of Porto, University of Copenhagen = Københavns Universitet (UCPH)-University of Copenhagen = Københavns Universitet (UCPH)-Faculty of Health and Medical Sciences, University of Copenhagen = Københavns Universitet (UCPH)-University of Copenhagen = Københavns Universitet (UCPH)-Capital Region of Denmark, Wrocław Medical University, Università degli Studi di Padova = University of Padua (Unipd), Charles University [Prague] (CU)-Medical Faculty in Pilsen, Università degli studi di Genova = University of Genoa (UniGe), Centro Médico Docente La Trinidad, Università degli studi di Bari Aldo Moro = University of Bari Aldo Moro (UNIBA), and Hibade, Monique
Subjects: Cost effectiveness, [SDV]Life Sciences [q-bio], Cost-Benefit Analysis, Comorbidity, medicine.disease_cause, 0302 clinical medicine, Allergen, Cost of Illness, Immunology and Allergy, Medicine, 030212 general & internal medicine, [SDV.IMM.ALL]Life Sciences [q-bio]/Immunology/Allergology, Precision Medicine, mHealth, Children, media_common, Allergen immunotherapy, Rhinitis, Disease Management, 3. Good health, [SDV] Life Sciences [q-bio], rhiniti, Treatment Outcome, Practice Guidelines as Topic, Critical Pathways, [SDV.IMM]Life Sciences [q-bio]/Immunology, Disease Susceptibility, [SDV.IMM.ALL] Life Sciences [q-bio]/Immunology/Allergology, medicine.medical_specialty, [SDV.IMM] Life Sciences [q-bio]/Immunology, Attitude of Health Personnel, Immunology, Clinical Decision-Making, 03 medical and health sciences, Pharmacotherapy, rhinitis, stratification, children, media_common.cataloged_instance, Animals, Humans, European union, Intensive care medicine, allergen immunotherapy, asthma, children, mHealth, rhinitis, stratification, Asthma, business.industry, Allergens, asthma, medicine.disease, Rhinitis, Allergic, Review article, 030228 respiratory system, Desensitization, Immunologic, allergen immunotherapy, Stratification, business, Biomarkers
Abstract: Allergen immunotherapy (AIT) is a proven therapeutic option for the treatment of allergic rhinitis and/or asthma. Many guidelines or national practice guidelines have been produced but the evidence-based method varies, many are complex and none propose care pathways. This paper reviews care pathways for AIT using strict criteria and provides simple recommendations that can be used by all stakeholders including health professionals. The decision to prescribe AIT for the patient should be individualized and based on the relevance of the allergens, the persistence of symptoms despite appropriate medications according to guidelines as well as on the availability of good-quality and efficacious extracts. Allergen extracts cannot be regarded as generics. Immunotherapy is selected by specialists for stratified patients. There are no currently available validated biomarkers that can predict AIT success. In adolescents and adults, AIT should be reserved for patients with moderate/severe rhinitis or for those with moderate asthma who, despite appropriate pharmacotherapy and adherence, continue to exhibit exacerbations that appear to be related to allergen exposure, except in some specific cases. Immunotherapy may be even more advantageous in patients with multimorbidity. In children, AIT may prevent asthma onset in patients with rhinitis. mHealth tools are promising for the stratification and follow up of patients. This article is protected by copyright. All rights reserved.
Published: 2019

40. Review for 'Update on Food Allergy'

Author: Giovanni B Pajno
Subjects: business.industry, Food allergy, Environmental health, Medicine, business, medicine.disease
Published: 2020

41. Agreements and controversies of national Guidelines for bronchiolitis: results from an Italian Survey among paediatricians

Author: Elena Chiappini, Gian Luigi Marseglia, Ilaria Brambilla, Fabio Cardinale, Sara Manti, Michele Miraglia Del Giudice, Alberto Martelli, Carlo Caffarelli, Claudio Cravidi, Marzia Duse, Amelia Licari, Giorgio Ciprandi, Maria Angela Tosca, Mauro Calvani, Domenico Minasi, and G B Pajno
Subjects: medicine.medical_specialty, Therapeutic regimen, business.industry, Acute Bronchiolitis, Bronchiolitis, Family medicine, Radiological weapon, Hospital admission, Medicine, Survey research, Quality of care, business, medicine.disease
Abstract: Introduction. Significant variations in the management of bronchiolitis are often recorded, and, in parallel, to recommend a univocal clinical approach it is not easy and is still questioned. This study is aimed to evaluate the diagnostic and therapeutic management of bronchiolitis in children adopted by Italian paediatricians following the national guidelines. Material and methods. A survey study was designed and carried out by sending an email an open-ended questionnaire developed by an expert panel of the Scientific Board of the Italian Society of Pediatric Allergology and Immunology (SIAIP). Questions were designed according to the national inter-society consensus document on treatment and prevention of bronchiolitis in newborns and infants. Results. Overall, 234 paediatricians were taking part in the study. When diagnosing bronchiolitis, only 44.01% (103/234) of participants were correctly following the national guidelines. All participants (100%) would perform laboratory tests and/or radiological exams. 44.01% administered oxygen (O2) when O2 saturation was major than 92%. About the therapeutic regimen, marked discrepancies between national guidelines and recorded answers were reported. Indications for hospital admission and discharge criteria were in line with the national guidelines. Conclusions. There is a significant practise variation in the management of acute bronchiolitis among Italians physicians. Some wrong attitudes need to be further discouraged, such use of diagnostic procedures and therapeutic approaches. Further research is urgently required to define the best management of patients with bronchiolitis as well as implement strategies to standardize care and improve the quality of care.
Published: 2020

42. Nutrition and Avoidance Diets in Children With Food Allergy

Author: Domenico Corica, Tommaso Aversa, Giovanni Battista Pajno, Malgorzata Wasniewska, Lucia Caminiti, and Fortunato Lombardo
Subjects: early-introduction, Allergen immunotherapy, non-IgE-mediated food allergy, medicine.medical_treatment, 030204 cardiovascular system & hematology, medicine.disease_cause, law.invention, 03 medical and health sciences, 0302 clinical medicine, Allergen, Randomized controlled trial, law, Food allergy, 030225 pediatrics, Environmental health, Elimination diet, Intervention (counseling), medicine, Desensitization (medicine), tolerance, business.industry, lcsh:RJ1-570, lcsh:Pediatrics, early-introduction, elimination diet, food allergen, immunotherapy, non-IgE-mediated food allergy, tolerance, medicine.disease, Pediatrics, Perinatology and Child Health, Observational study, elimination diet, immunotherapy, business, food allergen
Abstract: Food allergy (FA) is a significant health issue which considerably influences the quality of life of both children and their family. The increasing prevalence of FA, documented in the last 3 decades, has led to the reassessment of FA prevention strategies and particularly to giving up the approach based on delaying the introduction of potential food allergens. Several observational and interventional studies demonstrated a potential effectiveness of the early food introduction strategy in FA prevention, although strong evidence from randomized controlled trials are lacking and, sometimes, contrasting. The current approach to FA is mainly based on avoidance diet and the use of rescue medications in case of allergic reaction, although active allergen immunotherapy has recently become an increasingly important therapeutic strategy to approach IgE-mediated FA, potentially able to induce improvement through desensitization to a specific food. This review provides an overview on the historical evolution of recommendations about FA and on evidence published in the last 15 years on nutritional intervention strategy, i.e., early introduction of allergen or avoidance diet, in the prevention and management of IgE-mediated and non-IgE-mediated FA in children.
Published: 2020

43. Management of pernio-like cutaneous manifestations in children during the outbreak of COVID-19

Author: Claudio Guarneri, Anna Maria Bagnato, Diana Sutera, Giuseppe Nunnari, Francesca Mazza, Romina Gallizzi, Alessandra Spagnolo, Serafinella P. Cannavò, Giovanni Battista Pajno, and Loredana Grasso
Subjects: Male, medicine.medical_specialty, Isolation (health care), Adolescent, skin lesions, Dermatology, Disease, Nasal congestion, Serology, Disease Outbreaks, 030207 dermatology & venereal diseases, 03 medical and health sciences, 0302 clinical medicine, COVID-19 Testing, pernio‐like, children, COVID‐19, medicine, Humans, pernio-like, Respiratory system, Preschool, Child, business.industry, SARS-CoV-2, Outbreak, COVID-19, General Medicine, Original Articles, medicine.disease, Connective tissue disease, Chilblains, Immunoglobulin M, 030220 oncology & carcinogenesis, Child, Preschool, Chills, Female, Original Article, medicine.symptom, business, chilblain, children, COVID-19, management, pernio-like, skin lesions, Adolescent, COVID-19, Chilblains, Child, Child, Preschool, Disease Outbreaks, Female, Humans, Immunoglobulin M, Male, SARS-CoV-2, COVID-19 Testing, chilblain, management
Abstract: Background During the outbreak of COVID‐19 many pernio‐like lesions have been increasingly reported. The aim of the study is to describe our management of these skin manifestations and to evaluate a possible correlation to SARS‐CoV‐2 infection. Methods All patients underwent clinical and laboratory tests to detect a possible underlying connective disease and also to specific SARS‐CoV‐2 investigations such as oropharyngeal swab and IgG‐IgM serology. Results Nine patients aged between five and fifteen years old were evaluated. Skin lesions observed were purplish, erythematous and oedematous, in some cases painful and itchy. Six out of nine had respiratory and systemic symptoms (cough, nasal congestion, chills, fever, asthenia) that preceded cutaneous findings of approximately two weeks. Concerning blood exams, three out of nine had D‐dimer weakly increased, four had ANA positivity: two with a title 1:160, one with 1:320 and one with 1:5120 and a speckled pattern. The latter patient had also ENA SS‐A positive and RF positivity, confirmed at a second check, so as to allow us to make a diagnosis of connective tissue disease. Four out of nine had aPL positivity (IgM). Reactants acute phase were all negative. Oropharyngeal swabs and serology tests for SARS‐CoV‐2 was negative (borderline in one patient for IgM). No treatment was needed. Conclusions Even if we do not have enough data to prove it, we hypothesize a correlation between pernio‐like lesions and SARS‐CoV‐2 infection for an increased number of these lesions described during the pandemic and also because such manifestations appeared when temperatures were mild and patients were at home in isolation for the lockdown. Many questions remain open about interaction host‐virus. This article is protected by copyright. All rights reserved.
Published: 2020

44. Allergen Immunotherapy in children with respiratory allergic diseases

Author: Montserrat Alvaro-Lozano, Mónica Sandoval, Ilenia Panasiti, Stefania Arasi, and Giovanni Battista Pajno
Subjects: Allergen immunotherapy, medicine.medical_specialty, Time Factors, Immunologic desensitization, Injections, Subcutaneous, MEDLINE, Administration, Sublingual, Context (language use), History, 21st Century, Allergic rhinitis, Immunologic Desensitization, 03 medical and health sciences, 0302 clinical medicine, Immune system, Adjuvants, Immunologic, 030225 pediatrics, Medicine, Humans, Intensive care medicine, Child, Asthma, Conjunctivitis, Allergic, Immunity, Cellular, business.industry, Mechanism (biology), Age Factors, History, 20th Century, Immunoglobulin E, medicine.disease, Rhinitis, Allergic, Natural history, 030228 respiratory system, Desensitization, Immunologic, Child, Preschool, Pediatrics, Perinatology and Child Health, Patient Compliance, business
Abstract: Allergen immunotherapy (AIT) is a well-established treatment for allergic respiratory diseases. It represents a cornerstone in the clinical management of allergic children since it is the only curative option to date able to modify the natural history of Ig-E mediated allergic diseases. Through a well-defined immunologic mechanism, AIT promotes regulatory T cells and cuts down the immune response induced by allergens. According to current guidelines based on up-to-date evidence, AIT should be offered to children with moderate-severe allergic rhinitis and/or controlled asthma starting from 5 years of age, further to an adequate risk-benefit assessment which includes patient's adherence to the treatment and a proper selection of the right product. Younger age and mild disease could be considered based on an individual evaluation. Both subcutaneous (SCIT) and sublingual (SLIT) routes of administration have a good efficacy and safety profile with safer outcomes for SLIT compared to SCIT. Only standardized products with documented evidence of clinical efficacy should be used. Although AIT is used worldwide, there are still gaps and limitations, including the lack of reliable biomarkers predictive of the clinical outcome. Novel adjuvants are currently under investigations to boost the strength and efficiency of the immune response, as well as new formulations with better efficacy and better patient's adherence to the treatment. Herein, we aim to provide an overview of current key evidence with major regard to clinical practice as well as knowledge gaps and future research needs in the context of AIT in children with respiratory allergic diseases.
Published: 2020

45. Quarantine Due to the COVID-19 Pandemic From the Perspective of Pediatric Patients With Type 1 Diabetes: A Web-Based Survey

Author: Maria Pecoraro, Stefano Passanisi, Giuseppina Salzano, Angela Alibrandi, Francesco Pira, Vittoria Donia, Giovanni Battista Pajno, Paola Lonia, and Fortunato Lombardo
Subjects: medicine.medical_specialty, media_common.quotation_subject, Population, coronavirus, Disease, 030204 cardiovascular system & hematology, Pediatrics, law.invention, lockdown, 03 medical and health sciences, 0302 clinical medicine, children, law, 030225 pediatrics, Diabetes mellitus, Quarantine, Pandemic, medicine, education, resilience, media_common, education.field_of_study, Type 1 diabetes, outbreak, business.industry, lcsh:RJ1-570, lcsh:Pediatrics, Brief Research Report, medicine.disease, management, technology, Family medicine, Pediatrics, Perinatology and Child Health, Cohort, Psychological resilience, business
Abstract: Background: A crucial aspect of the 2019 coronavirus disease (COVID-19) pandemic was the psychological impact on the population. Most countries issued restrictive laws to reduce community-based viral spread. Children and adolescents were forced to experience physical and social distancing. Subjects with chronic diseases, such as type 1 diabetes, were more vulnerable and at higher risk of developing psychological disorders. Methods: We conducted a web-based survey to investigate the behavioral responses during quarantine due to the COVID-19 outbreak in a cohort of pediatric patients with type 1 diabetes. Data were collected on demographic and clinical characteristics, lifestyle changes, and the impact of COVID-19 on the management of diabetes. Results: Two hundred four pediatric patients (aged 5–18 years) with type 1 diabetes completed the questionnaire. Interestingly, patients ≤12 years were significantly more influenced by the quarantine period in their approach to the disease than older patients. Conclusion: Although quarantine was a stressful psychological condition, our results showed that most children and adolescents with type 1 diabetes developed high levels of resilience and excellent coping skills by using technology in a proper way.
Published: 2020

46. The evolution of allergen-specific immunotherapy: The near and far future

Author: Fortunato Lombardo, Maria Francesca Messina, Stefano Passanisi, Giovanni Battista Pajno, and Mariella Valenzise
Subjects: Allergen immunotherapy, medicine.medical_specialty, Telemedicine, Oral immunotherapy, precision medicine, Immunology, wild-type allergens, 03 medical and health sciences, 0302 clinical medicine, Adjuvants, Immunologic, Food allergy, medicine, Immunology and Allergy, Humans, biologics, 030212 general & internal medicine, Intensive care medicine, mobile health, business.industry, Specific immunotherapy, oral immunotherapy, Allergens, Precision medicine, medicine.disease, Clinical trial, 030228 respiratory system, adjuvants, Desensitization, Immunologic, Pediatrics, Perinatology and Child Health, Active treatment, adjuvants, biologics, mobile health, oral immunotherapy, precision medicine, wild-type allergens, business, Biomarkers, Food Hypersensitivity
Abstract: In the era of precision medicine, allergen immunotherapy (AIT) represents a landmark for the management of IgE-mediated allergic diseases. AIT is recognized as a potentially curative therapy and is currently accepted and routinely prescribed worldwide. However, there are still unmet needs. The efforts of researchers are aimed at implementing current immunotherapeutic strategies to improve the standard care of patients suffering from IgE-mediated respiratory allergic diseases. In addition, over the horizon, the most realistic option is the active treatment of IgE-mediated food allergy with oral immunotherapy. Preclinical studies and clinical trials are increasingly conducted to identify innovative forms of AIT administration, potential biomarkers, alternative immunotherapeutic allergen candidates, and new adjuvants. Telemedicine could represent a further emerging field capable of supporting health service delivery and improving clinical outcomes of AIT.
Published: 2020

47. Influence of Age on Partial Clinical Remission among Children with Newly Diagnosed Type 1 Diabetes

Author: Giovanni Battista Pajno, Valentina Urzì Brancati, Giuseppina Salzano, Fortunato Lombardo, Angela Alibrandi, Matilde Mondio, Albino Gasbarro, and Stefano Passanisi
Subjects: Male, medicine.medical_specialty, Adolescent, Health, Toxicology and Mutagenesis, medicine.medical_treatment, lcsh:Medicine, 030209 endocrinology & metabolism, Newly diagnosed, length, 030204 cardiovascular system & hematology, Logistic regression, Article, Cohort Studies, 03 medical and health sciences, chemistry.chemical_compound, 0302 clinical medicine, GADA, Internal medicine, honeymoon, Remission phase, medicine, Humans, Hypoglycemic Agents, Insulin, Child, Aged, Glycated Hemoglobin, Type 1 diabetes, C-peptide, business.industry, Remission Induction, lcsh:R, Public Health, Environmental and Occupational Health, Age Factors, medicine.disease, Diabetes Mellitus, Type 1, chemistry, Female, business, C-peptide, Early diagnosis, GADA, Honeymoon, Length, Body mass index, Cohort study, early diagnosis
Abstract: Partial clinical remission (PCR) is a transitory period characterized by the residual endogenous insulin secretion following type 1 diabetes (T1D) diagnosis and introducing the insulin therapy. Scientific interest in PCR has been recently increasing, as this phase could be crucial to preserve functional beta cells after T1D onset, also taking advantage of new therapeutic opportunities. The aim of this study was to assess the frequency, duration and associated factors of PCR in children newly diagnosed with T1D. Our cohort study included 167 pediatric patients aged 13.8 &plusmn, 4.1 years. The association of clinical and laboratory factors with the occurrence and duration of PCR was evaluated via logistic regression and multivariable generalized linear model, respectively. PCR occurred in 63.5% of the examined patients. Patients who achieved the remission phase were significantly older, and they had lower daily insulin requirement compared with non-remitters. PCR was positively associated to body mass index (OR = 1.11, p = 0.032), pH value (OR 49.02, p = 0.003) and c-peptide levels (OR 12.8, p = 0.002). The average duration of PCR was 13.4 months, and older age at diagnosis was the only predictor factor. Two years after diagnosis remitter patients had lower HbA1c and daily insulin requirement.
Published: 2020
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48. MANAGEMENT OF PEDIATRIC RHEUMATOLOGICAL DISEASES DURING THE OUTBREAK OF COVID-19: OUR EXPERIENCE

Author: Alessandra Spagnolo, Romina Gallizzi, Giovanni Battista Pajno, Diana Sutera, and Francesca Mazza
Subjects: medicine.medical_specialty, 2019-20 coronavirus outbreak, Coronavirus disease 2019 (COVID-19), business.industry, lcsh:RC633-647.5, Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), MEDLINE, COVID-19, Rheumatological Diseases, Outbreak, COVID-19, Hematology, lcsh:Diseases of the blood and blood-forming organs, Infectious Diseases, Emergency medicine, medicine, business, Letter to the Editor, Rheumatological Diseases
Abstract: Since the COVID-19 epidemic has evolved rapidly also in Italy, specialists in pediatric rheumatology have found themselves addressing the problems of their patients and in particular how to manage the risk of infection and immunosuppressive treatment. This work aims to make known the experience of our center.
Published: 2020

49. Prolonged asymptomatic SARS-CoV-2 infection in a child receiving immunosuppressive therapy

Author: Marianna Di Frenna, Roberta Pajno, Daniele Canarutto, Federica Del Tedesco, Graziano Barera, Paolo Del Barba, and Maria Pia Guarneri
Subjects: Pulmonary and Respiratory Medicine, 2019-20 coronavirus outbreak, Coronavirus disease 2019 (COVID-19), Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), viruses, Pneumonia, Viral, Case Report, Case Reports, heart, Asymptomatic, SARS‐CoV‐2, coronavirus disease 2019, Risk Factors, Pandemic, medicine, Humans, Pediatrics, Perinatology, and Child Health, Child, Pandemics, business.industry, Viral Epidemiology, SARS-CoV-2, virus diseases, COVID-19, Infant, medicine.disease, Virology, Pneumonia, inflammation, Pediatrics, Perinatology and Child Health, medicine.symptom, business, severe acute respiratory syndrome coronavirus 2
Abstract: The spectrum of clinical manifestations of coronavirus disease 2019 in children is yet to be fully elucidated. We report the case of an infant who tested positive for severe acute respiratory syndrome coronavirus 2 (SARS‐CoV‐2) and developed mild cardiovascular inflammation, a novelty for patients of very young age, that contributes to defining the puzzling nature of this disease in pediatric patients. The potential cardiovascular involvement of SARS‐CoV‐2 in children should always be taken into account.
Published: 2020

50. Omalizumab in children and adolescents with chronic spontaneous urticaria: Case series and review of the literature

Author: Stefania Arasi, Giovanni Battista Pajno, Lucia Caminiti, Giuseppe Crisafulli, Stefano Passanisi, and Giuseppina Salzano
Subjects: Male, Pediatrics, medicine.medical_specialty, Adolescent, Urticaria, Histamine Antagonists, Dermatology, Omalizumab, Adolescent age, Efficacy, 030207 dermatology & venereal diseases, 03 medical and health sciences, 0302 clinical medicine, children, Prednisone, Anti-Allergic Agents, Medicine, Humans, Chronic Urticaria, Child, Male gender, Chronic urticaria, Aged, Series (stratigraphy), treatment, business.industry, biologicals, children, chronic urticaria, omalizumab, treatment, General Medicine, biologicals, Methylprednisolone, 030220 oncology & carcinogenesis, Chronic Disease, business, medicine.drug
Abstract: The recent EAACI/GA2 LEN/EDF/WAO guidelines recommend omalizumab (anti-IgE) for the management of patients aged ≥12 years with chronic urticaria unresponsive to high-doses second-generation H1 -antihistamines (antiH1 ). However, there is little published information on the success of omalizumab for such a treatment in children. We reported our experience of six patients with chronic spontaneous urticaria (CSU) treated with omalizumab. Mean age of our case series was 14.7 years (range 11-16 years) with a prevalence of male gender (66.7%). All six patients were treated with at least one 6-months course of omalizumab. The average follow-up period was 13 ± 6 months. Only one patient was no responder to omalizumab therapy. Thus far, two patients have experienced a complete CSU regression over 12 months after the final omalizumab administration. The remaining three patients needed a second course of treatment. Our experience demonstrates that omalizumab is effective and safe as treatment option for CSU unresponsive to antiH1 , even in adolescent age.
Published: 2020

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