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Cow's milk protein allergy (CMPA) is the most frequent cause of food allergy in the first months of life. Despite the fact that there are different guidelines and recommendations on the management of children with CMPA, there continues to be great variability in diagnostic and therapeutic criteria in Latin America. The Food Allergy Working Group of the Latin American Society for Pediatric Gastroenterology, Hepatology and Nutrition summoned a group of Latin American experts to reach a consensus and formulate a document to unify diagnostic and therapeutic criteria for CMPA. Three teams were formed, each with a coordinator, and the members of each team developed a series of statements for their corresponding module: a) clinical manifestations and diagnosis; b) diagnostic tools, and c) treatment. A search of the medical literature was carried out to support the information presented in each module and 28 statements were then selected. The statements were discussed, after which they were evaluated by all the experts, utilizing the Delphi method. Their opinions on statement agreement or disagreement were anonymously issued. The final statements selected were those with above 75% agreement and their corresponding recommendations were formulated, resulting in the document presented herein. Resumen: La alergia a las proteínas de leche de vaca (APLV) constituye la causa más frecuente de alergia alimentaria en los primeros meses de vida. A pesar de la existencia de diferentes guías y recomendaciones sobre el manejo de niños con APLV, en Latinoamérica sigue observándose una gran variabilidad de criterios diagnósticos y terapéuticos. El grupo de trabajo de Alergia Alimentaria de la Sociedad Latinoamericana de Gastroenterología, Hepatología y Nutrición Pediátrica se dio a la tarea de convocar a un grupo de expertos de la región, realizar un consenso y elaborar un documento con el objetivo de unificar criterios diagnósticos y terapéuticos para APLV. Se dividió el grupo en tres equipos bajo un coordinador para cada equipo, y los miembros de cada grupo formularon una serie de enunciados correspondientes a uno de tres módulos diferentes: a) manifestaciones clínicas; b) herramientas diagnósticas, y c) tratamiento. Se buscó la información en la literatura médica para sustentar la información de cada uno de ellos, y posteriormente se seleccionaron 28 enunciados, los cuales fueron discutidos y posteriormente evaluados por todos los expertos, a través de método Delphi, quienes emitieron su opinión sobre acuerdo o desacuerdo sobre las mismas de forma anónima. Todos los enunciados obtuvieron porcentajes de acuerdo mayores al 75%, por lo que permanecieron, y con base en ellos se elaboraron las recomendaciones y se presentan.

Resumen: La alergia a las proteínas de leche de vaca (APLV) constituye la causa más frecuente de alergia alimentaria en los primeros meses de vida. A pesar de la existencia de diferentes guías y recomendaciones sobre el manejo de niños con APLV, en Latinoamérica sigue observándose una gran variabilidad de criterios diagnósticos y terapéuticos. El grupo de trabajo de Alergia Alimentaria de la Sociedad Latinoamericana de Gastroenterología, Hepatología y Nutrición Pediátrica se dio a la tarea de convocar a un grupo de expertos de la región, realizar un consenso y elaborar un documento con el objetivo de unificar criterios diagnósticos y terapéuticos para APLV. Se dividió el grupo en tres equipos bajo un coordinador para cada equipo, y los miembros de cada grupo formularon una serie de enunciados correspondientes a uno de tres módulos diferentes: a) manifestaciones clínicas; b) herramientas diagnósticas, y c) tratamiento. Se buscó la información en la literatura médica para sustentar la información de cada uno de ellos, y posteriormente se seleccionaron 28 enunciados, los cuales fueron discutidos y posteriormente evaluados por todos los expertos, a través de método Delphi, quienes emitieron su opinión sobre acuerdo o desacuerdo sobre las mismas de forma anónima. Todos los enunciados obtuvieron porcentajes de acuerdo mayores al 75%, por lo que permanecieron, y con base en ellos se elaboraron las recomendaciones y se presentan. Abstract: Cow's milk protein allergy (CMPA) is the most frequent cause of food allergy in the first months of life. Despite the fact that there are different guidelines and recommendations on the management of children with CMPA, there continues to be great variability in diagnostic and therapeutic criteria in Latin America. The Food Allergy Working Group of the Latin American Society for Pediatric Gastroenterology, Hepatology and Nutrition summoned a group of Latin American experts to reach a consensus and formulate a document to unify diagnostic and therapeutic criteria for CMPA. Three teams were formed, each with a coordinator, and the members of each team developed a series of statements for their corresponding module: a) clinical manifestations and diagnosis; b) diagnostic tools, and c) treatment. A search of the medical literature was carried out to support the information presented in each module and 28 statements were then selected. The statements were discussed, after which they were evaluated by all the experts, utilizing the Delphi method. Their opinions on statement agreement or disagreement were anonymously issued. The final statements selected were those with above 75% agreement and their corresponding recommendations were formulated, resulting in the document presented herein.

Cow's milk protein allergy (CMPA) is the most frequent cause of food allergy in the first months of life. Despite the fact that there are different guidelines and recommendations on the management of children with CMPA, there continues to be great variability in diagnostic and therapeutic criteria in Latin America. The Food Allergy Working Group of the Latin American Society for Pediatric Gastroenterology, Hepatology and Nutrition summoned a group of Latin American experts to reach a consensus and formulate a document to unify diagnostic and therapeutic criteria for CMPA. Three teams were formed, each with a coordinator, and the members of each team developed a series of statements for their corresponding module: a) clinical manifestations and diagnosis; b) diagnostic tools, and c) treatment. A search of the medical literature was carried out to support the information presented in each module and 28 statements were then selected. The statements were discussed, after which they were evaluated by all the experts, utilizing the Delphi method. Their opinions on statement agreement or disagreement were anonymously issued. The final statements selected were those with above 75% agreement and their corresponding recommendations were formulated, resulting in the document presented herein., (Copyright © 2022 Asociación Mexicana de Gastroenterología. Published by Masson Doyma México S.A. All rights reserved.)

Obesity is an epidemic with important health repercussions in addition to high treatment-related costs. Between 2006 and 2007 the WHO developed new assessment tools, which aren't being globally used. In fact, there is no unified problem management across the hemisphere., Objectives: To update obesity epidemiology, to promote application of WHO’s standards, to review new findings on physiopathology (i.e., fatty tissue as endocrine organ, intestinal microbiota), to update epidemiological information, and to provide management guidelines that can be integrated in clinical care., Methods: LAPSGHAN called up its members to collaborate in preparing this review article under the direction of an editor/coordinator, who selected the contents and literature with the best evidencetogether with the members. Each member prepared a separate document for each content. The chosen contents were later collated, unified, and edited. Results. This documents highlights the following: 1) Although extreme obesity is increasing in the US, overweight and obesity prevalence has stabilized, while in other countries it is alarmingly increasing; 2) New information regarding role of fatty tissue as endocrine organ and self-regulator of obesity; 3) The promising role of microbiota; and 4) Guidelines for children handling during consultation and follow-up., Conclusions: There is no widespread implementation of standards and guidelines from the World Health Organization (WHO). There is no agreement as to whether z-scores or percentiles should be used, especially regarding children under 2 due to their changing body complexion. The most accepted tool to assess overweight, obesity and severe obesity is the Body Mass Index (BMI). This document provides recommendations on how to approach clinical care with affected children.

Objective: altered motility or anatomy of the rectum, anus and perineal floor may lead to symptoms which are unresponsive to routine therapeutic approaches. These disturbances usually lead to constipation, fecal incontinence, or both. Different tests and techniques for evaluating anorectal and perineal disorders, developed in the last two decades, make a better understanding of these disorders possible. This study was designed to evaluate the diagnostic benefits of combining manometry, defecography and anal endosonography in the assessment of patients with anorectal disorders., Methods: twenty-five children with constipation (with or without soiling), incontinence and/or prolapse underwent anal manometry, defecography and anal endosonography. Group A consisted of 9 children with fecal incontinence, group B consisted of 10 children with constipation with soiling, and group C comprised 6 children with constipation without soiling., Results: in group A resting incontinence was associated with a hypotonic external sphincter in 4 out of 9 patients, 2 of whom had internal anal sphincter thinning. In group B resting incontinence was associated with a hypotonic external sphincter in 8 out of 10 patients, 6 of whom had internal anal sphincter thinning. In group C these associations were not seen in any of the patients., Conclusions: barium enema is not sufficient for an accurate diagnosis of anorectal disorders. No single test is capable of revealing the type of disease. Anal manometry, defecography and endosonography are complementary procedures in the assessment of this group of disorders. This new approach will improve our knowledge of the pathogenesis of these disorders in children. However, further studies are needed to obtain conclusive evidence.