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Background Acute diarrhoea (AD) plays an important role in paediatric patients because of its high incidence, severe clinical outcomes (dehydration) and epidemiological features (gastroenteritis spreads easily in children communities). Aims To evaluate the aetiology of AD and epidemiological characteristics for hospitalised children during January 2013–January 2014. Methods During mention period, there were performed stool cultures and Rotavirus/Adenovirus antigen testing from stool (immunochromatographic test) for patients admitted in paediatric hospital with AD diagnosis. The growth medium used for stool cultures: Hectoen-enteric and Selenite broth (for Salmonella, Shigella), Sorbitol MacConkey medium (for enteropathogen E. Coli -EPEC), CIN (for Yersinia) and CCDA (for Campylobacter, stool samples testing was initiated in July 2013). Exclusion criteria: positive stool culture for previously treated children. Results There were performed 2138 stool cultures and 1358 tests for Rotavirus/Adenovirus. The authors have identified 73 Salmonella spp. cases, 12 Shigella spp. cases, 4 EPEC cases, 31 children with Campylobacter spp., 222 Rotavirus cases and 22 patients with positive test for Adenovirus. Authors remarked high incidence Salmonella infection in July -September period (39 cases, 53.4%) and increased incidence of Rotavirus infection with 2 peaks totaling 52.7% of cases (January –December and May respectively). Conclusions Acute gastroenteritis major aetiology was the viral one; 2. Concerning bacterial aetiology of AD, Campylobacter spp. represented the second cause (Salmonella spp. was more frequent); 3. The aetiology awareness is useful in order to treat optimally patients with AD; 4. The antibiotics are recommended just for selected cases.

Background Sweat test (ST) remains gold standard in cystic fibrosis (CF) diagnosis. Alarm symptoms are age-related. Aims Retrospective review of cases subjected to ST. Methods Patients were selected by paediatricians, neonatologists, surgeons, based on suggestive symptoms, personal (PH) and familial history (FH). Inclusion criteria: for 0–1 month age group, patients with PH of atelectasis, meconium ileus, intussusception; 1–12 months, recurrent wheezing (RW), failure to thrive (FTT); 1–5 years, previous group symptoms, plus chronic cough/diarrhoea; >5 years, 1–5 years symptoms, plus recurrent pancreatitis/sinusitis. For all age, patients with PH of salty taste of sweat (STS), salt wasting syndrome, heat shock (HS), and FH of CF, azoospermia. ST was performed with Nanoduct system. Values 80 positive. Normal values patients were eventually retested, those with equivocal at least once, those with positive mandatory twice. Results Were performed 406 ST (344 patients): at 0–1 month 11 tests (45,4% peritonitis), at 1–12 months 175(65,5% RW), at 1–5 years 108(25,9% FTT), at >5 years 50(62,5% repeated pneumonia-RP). 4 tests equivocal, 5 false positive, 6 positive (5 infants: 1 RW, 1 HS, 2 atelectasis, 1 STS; 1 male 4 years old RP). Relating to age, only 1 positive from 141 RW infants (p 0,03) and 1 from 15 RP children; 2 positive from 6 atelectasis infants (p 0,0001), 1 from 2 HS and 1 from 2 STS infants (p 0,0002). Neither pancreatitis, FTT or positive FH. Conclusions Great attention on infants with other symptoms than classical ones: higher statistical significance for STS, HS, atelectasis.

Background and aims Sandifer syndrome is a dystonic movement disorder described in children with severe gastro-oesophageal reflux. The authors proposed to establish a causal relationship between abnormal neurobehavioral attacks and gastro-esophageal reflux disease. Methods Prospective observational study consisting of clinical evaluation for a period of six months and multidisciplinary investigations for 8 patients with postural dystonia. Results 8 patients aged between 6 months and 36 months presenting postural dystonia have been studied in relation to gastro-esophageal reflux. In the clinical assessment of the patients, abnormal neurobehavioral attacks: head and cervical dystonic posture, extensor spasm and reflux suggestive symptoms: regurgitation, irritability, crying have been observed mainly after feedings. Neurological examination and ENT proved normal. Ultrasound study and esophagoendoscopy showed gastro-esophagial reflux and esophagitis in the absence of hiatus hernia. The patients received medical treatment to control the gastroesophagial reflux with gradual improvement and complete remission of the symptoms in all cases. Conclusions Infants or children with dystonic posture and irritability should be evaluated for Sandifer Syndrome. Early diagnosis of the syndrome is essential, as effective treatment of the gastro-oesophageal reflux leads to resolution of the movement disorder.

Background Selective IgA deficiency (SIgAD) is the most frequent primary antibody deficiency. Aims Authors emphasise the phenotype diversity among SIgAD patients included in our clinic casuistry. Methods Authors analysed clinical and biochemical features of patients that fulfilled SIgAD diagnosis criteria. They’ve been evaluated concerning previous respiratory and gastro-intestinal diseases severity (necessity for intravenous antibiotics and/or intensive care measures). Serology investigations performed: complete blood count and evaluations for immunoglobulin isotype, IgG subclass, total IgE, specific IgE for cow’s milk precipitins. Autoimmune status estimation included antibodies against: red blood cells, basement membrane, smooth muscle, thyroglobulin, thyroid microsomal antigens, transglutaminase IgG/endomysium and nuclear proteins. Authors accomplished microbiological tests for patients with sinopulmonary infections and analysed stools in order to exclude Giardia/ Cryptococcus infections. Susceptibility for brochiectasis justified chest X-ray. Results Among 8 SIgAD patients followed in our clinic, 3 patients were considered as asymptomatic. The others were diagnosed with: recurrent knee arthritis in context of Epstein-Barr virus reactivation confirmed by quantitative PCR for DNA-EBV in serum (1 patient), celiac disease (2 patients), giardiasis (2 patients), asthma and allergic rhinitis (1 patient), cow milk allergy (1 patient). Sinopulmonary infections/ purulent otitis were identified for all symptomatic cases. One patient was diagnosed with tonsil phlegmon. No immunological thrombocytopenic purpura or autoimmune hemolytic anaemia were confirmed. Conclusions 1. In spite of small number of SIgAD patients, authors revealed a quite large range of clinical manifestations: from asymptomatic status to recurrent arthritis due to EBV reactivations; 2. Three patients presented more than 1 clinical feature.

Background Still exist controversies about sodium bicarbonate (SB) effectiveness in metabolic acidosis (MA). The SB dose finally remain at discretion of physician. Aims Proving SB efficiency in severe acute dehydration (SAD) with MA secondary to acute diarrhoea (AD) in children. Methods Retrospective study conducted between May–September 2013, in 0–5 years old patients hospitalised for AD with SAD and MA. We chose the propitious age group and season for acute gastrointestinal pathology. We considered SAD loss >10% of body weight and severe MA pH Results In A Group, at admission, 57,14% presented pH 15; at 4 H, all presented alkalosis. In B Group, at admission, 50% presented severe MA; at 1 H, 25% presented alkalemia, 50% bicarbonate 86,04% presented respiratory compensation (RC), pCO 2 around 20 mmHg. Percentage of patients which developed alkalosis was significantly greater in A than B Group (p 0,004); no significance between C and B Group (p 0,57). Conclusions In choosing the bicarbonate dose in metabolic acidosis, the physician should consider also the RC, especially at 2 meq/kg dose.

Background Growth assessment is an integral part of infants health. An understanding of anemia risk factors is essential to identify the groups that are more vulnerable. The Aim of the study was to identify the risk factors for malnutrition in the vulnerable age group of 6 to 12 months and to evaluate possible related risk factors with anemia. Methods The cross-sectional study which evaluated 206 infants aged between 6–12 months who attended the Pediatric Clinic during the years 2010–2011 for inadequate growth. Mothers were interviewed to collect informations regarding socioeconomic status and nutrition practices. Nutritional status was evaluated by anthropometric measurements using growth charts. Anemia was diagnosed if hemoglobin was ≤11 g/dL. Results Mild and moderate anemia was characterised by hemoglobin levels below 11.0 and 9.5 g/dL. Rates for mild and moderate anemia were 38.6% and 11.9%. The highest anemia prevalence was found at 6 to 8 months of age. The risk factors for anemia were: urban residence (p=0 . 004), fever in the past 5–7 days (p . 001) and age at 6–8 months (p=0 . 024), socioeconomic level and nutrition practices. Infants who were exclusively breastfed for 6 months showed lower prevalence of anemia compared to their mixed feeding. According to weight and length for-age, 49% of the infants were at 25 th , 32% at 10 th , 9.2% at 5 th and there was a significant correlation between the duration of breastfeeding and nutritional status. Conclusions Strategies to control infant anemia should include health promotion and nutritional education for families from all socioeconomic levels.

Background Cow’s milk allergy is considered to be the first and most common type of allergy during early infancy. Gastro-esophageal reflux disease and cow’s milk allergy are two different diseases with common clinical features. The aim of the study was to evaluate the clinical data in relation with gastroesophageal reflux and cow’s milk allergy in infants. Material and Methods The prospective study includes 36 infants aged between 2–6 months who attended at Pediatric Clinic during the year 2011 for the clinical evocative manifestations of gastroesophageal reflux. Study protocol includes: clinical criteria, familial/personal atopic features, mother diet, duration of breastfeeding, infant formula, esophageal ultrasonographic study, serum specific IgE cow’s milk. Results The clinical presentations of the infants were associated or isolated agitation/irritability, feeding refusal (p Conclusions Clinical assessment and allergy tests in infants with the suspicion of gastroesophageal reflux revealed the association of these diseases. The concomitant therapy was followed by clinical resolution of symptoms.