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BACKGROUND Iodine is an essential micronutrient for intellectual development in children. Information on iodine intakes based on 24-h urinary iodine excretion (UIE) is scant, because iodine status is only assessed by the measurement of urinary iodine concentration (UIC) in spot urine samples. OBJECTIVES The aim of our study was to evaluate the iodine intake of school-age children and adolescents, using UIE measurement in 24-h urine collections. METHODS The study population included 1270 healthy subjects (677 boys, 593 girls) aged 6-18 y (mean age ± SD: 10.3 ± 2.9) from 10 Italian regions. Daily iodine intake was estimated as UIE/0.92, based on the notion that $\sim$92% of the dietary iodine intake is absorbed. The adequacy of intakes was assessed according to the Dietary Reference Values for iodine of the European Food Safety Authority (EFSA). Body mass index (BMI) and UIC were also measured for each subject. RESULTS Based on the scientific opinion of EFSA, 600 of 1270 subjects (47.2%) had a lower than adequate iodine intake, with a higher prevalence among girls (54.6%) compared with boys (40.2%) (P

s / Digestive and Liver Disease 46 (2014) e85–e127 e95 4.5±0.6pg/ml, mean FT4 1.2± .4 ng/dl. TSH levels were above cutoff laboratory range in 10% of our population and the 2 patients (0.2%) of the whole population presented TSH≥10 UI/ml. We found a significant positive correlation between TSH levels and BMI z-score (rho=0.121, p=0.001), even after adjustment for age and sex (r=0.117, p=0.001); a positive correlation was also observed between FT3 and BMI z-score (rho=0.161, p

s / Digestive and Liver Disease 46 (2014) e85–e127 e115 ance of symptoms (constipation, abdominal pain, aphtae) whereas the restatement caused the reappearance. Diagnosis was therefore an adverse reaction to gluten (NCGS). Results: Gluten-free diet has resulted in a stable condition of well-being. An year after the diagnosis, the boy does not denounce any symptoms. Being it not celiac disease, no strict recommendations have bee provided in relation to food contamination. At present transglutaminase antibodies remain negative. Conclusions: NCGS is rare in childhood. Diagnosis requires a high index of trace, the exclusion of other forms of gluten intolerance (celiac disease, wheat allergy), intestinal biopsy and gluten challenge. Up to now the follow-up and the prognosis are difficult to be scheduled as clinical records and knowledge on the matter are insufficient. http://dx.doi.org/10.1016/j.dld.2014.07.131 CELIAC DISEASE: OUR RESULTS ACCORDING TO THE NEW ESPGHAN DIAGNOSTIC CRITERIA

ileostomy because of an episode of marked abdominal overdistentionwith constipation and respiratorydifficulties.Manynutritional treatments were performed, with limited success, in order to gain a correct fluid balance and improve his growth: he was fed either orally or by percutaneous endoscopic gastrostomy. Themain limiting factor was the high fecal: 60g/kg/day. Finally treatment with loperamide (0.18mg/kg/die) and intermittent stool recycling (through the distal stoma) was successful with a consistent reductionof stooloutput, normalfluidandelectrolytebalanceandweight gain. He was discharged after 12 months with the recommendation to make: 2 milk meals and 2 baby food a day, cardiological treatment (propanolol andASA), intestinal decontamination, loperamide and stool recycling (2 times a day). Conclusions: Management of CIPO is often complex requiring pharmacological and nutritional support, and often surgical approaches. The combination of stool re-infusion and loperamide can be considered in patients with high stoma output and electrolytes imbalance, in order to limit the fluid loss and allow to gain weight.

GGT (72U/l) with normal bilirubin levels. The subsequent abdominal US-confirmed the previous result of gallbladderwall thickening (1 cm) which was more irregular and predominantly localized at the fundus. A mild hepatomegaly was also noticed. There was no evidenceof gallstones. A cholangio-MRI studywasperformedand it revealedmarkedand segmentarywall thickeningof the gallbladder fundus andmid-distal portion. Therefore antibiotic treatmentwith I.V. meropenem (60mg/kg/day)was started. After 5 days therewas no substantial clinical improvement, hence steroid therapy with I.V. methylprednisolone (1.1mg/kg/day) was started. Clinical conditionquickly improved and abdominal pain promptly disappeared after the first dose of steroids, with a complete resolution of the symptoms at discharge. The patient received a total of five days of I.V. steroids, subsequently switched to oral steroids (deflazacort 1.7mg/kg/day). An abdominal US performed at day 10th of steroid therapyshowedmarked reductionof gallbladderwall thickening. No further episodes of abdominal pain were reported at the subsequent follow-up. Conclusions: Hepato-biliary involvement in children with HSP has been rarely described. It can include isolated biochemical alterations (increase in serum ALT and GGT) and US abnormalities (hepatomegaly, gallbladder hydrops and, more rarely, gallbladder wall thickening). The pathogenesis of gallbladderwall involvement is thought to be related to the inflammatory process affecting blood vessels. Therefore it is typically a patchy phenomenon (such as in our patient) and can require steroid treatment. It is particularly important to have anhigh indexof suspicion of gallbladder involvement in HSP in order to prevent more serious complications, such as gallbladder perforation.

Short bowel syndrome (SBS) is responsible of chronic intestinal malabsortion of nutrients, due to a loss of at least 50% of the small bowel absorption surface. The main causes are necrotizing enterocolitis (NEC), intestinal atresia, volvulus and gastroschisis. The incidence of SBS is about 24.5/100,000 newborns. These patients need a central venous access to allow a long-term parenteral nutrition. Complications such as infections, mechanical problems due to catheter insertion (as pleural effusion or cardiac tamponade), thromboembolism and vascular fibrin-lipid or calcium phosphate occlusion may occur. Central venous catheter (CVC) sepsis is one of the main causes of morbidity and mortality in patients with SBS and central venous access. Rates of infection in pediatric patients with SBS range from 1 to 6:1000 days of parenteral nutrition (PN). Intestinal decontamination may prove useful to counteract the over-bacterial growth: antimicrobials are typically administered cyclically, alternating different drugs in order to reduce bacterial resistance. However, decontamination treatment remains largely empirical due to lack of available scientific data. We describe the case of one of our patient affected by SBS who presented several episodes of CVC-mediated-sepsis. A 34weeks female (born after twin pregnancy) underwent ileocolonic resection (including the ileo-cecal valve) at 4th day of life forNEC,with 65 cmof small bowel residual anddistal colon. PNwas started immediately after surgery, following central line insertion. Shewas fully PNdependent until 6months of age and subsequently enteral feeding through gastrostomy was progressively increased. Currently (18months of age) her nutritional requirements are covered by 50% PN and 50% hydrolyzed formula. The clinical course has been characterized by 4 CVC related sepsis, initially treated with lock therapy (urokinase) and systemic antibiotics. In 4 of those episodes (1 case of Candida sepsis and 3 cases of medical treatment’s failure) line replacement has been required, despite antimicrobial prophylaxis. Three further central line replacements were needed because of accidental dislocation of the catheter. Overall she had 7 different lines inserted: 5 catheters surgically placed (3 Broviac and 2 Groshong lines) and 2 more central vascular accesses percutaneously placed. The average length of each catheter was found to be 45 days. It was not possible to identify any immunological underlyingdisease or predisposing familiar risk factors, possibly responsible for those episodes. Recently, a more intensive antibiotic intermittent prophylaxis regimen (including Metronidazole or Ciprofloxacin associated with Miconazole) has been started. No further infectious episodes have been recorded in the last 3 months. The patient is currently in good clinical condition with adequate neurocognitive development and satisfactory growth (currently auxological parameters lie between the 3rd and the 10th centile). PO4