COnsensus on Pediatric Pain in the Emergency Room: the COPPER project, issued by 17 Italian scientific societies.

In the pediatric setting, management of pain in the emergency department - and even in common care - is a challenging exercise, due to the complexity of the pediatric patient, poor specific training of many physicians, and scant resources.A joint effort of several Italian societies involved in pediatrics or in pain management has led to the definition of the PIPER group and the COPPER project. By applying a modified Delphi method, the COPPER project resulted in the definition of 10 fundamental statements. These may represent the basis for improving the correct management of children pain in the emergency department.

Use of a probiotic mixture containing Bifidobacterium animalis subsp. lactis BB12 and Enterococcus faecium L3 in atopic children.

BACKGROUND: Imbalance of the human gut microbiota in childhood, mainly due to low gut biodiversity and a low bifidobacterial load, has been suggested as a risk factor for atopy. Administration of Enterococcus faecium L3 in infants has been shown to increase the gut bifidobacterial count. The aim was to verify if a mixture of Bifidobacterium animalis subsp. lactis BB12 and E. faecium L3 could reduce the signs, symptoms and need for drugs in atopic children. METHODS: We retrospectively analyzed, and compared with controls, clinical outcomes following use of BB12 and L3 strains when administered 3 months before or during the development of signs and symptoms of atopy. RESULTS: When administered in the 3 months before the development of atopy, the BB12 and L3 strains significantly reduced (P<0.001) rhinitis, watery eyes and cough/bronchospasm. However, reduced efficacy was observed when the mixture was given during the 3 months of atopy. The mixture of strains also significantly reduced the use of oral antihistamines, inhaled corticosteroids (in the same children in two different years) and oral corticosteroids (in different children in the same year). CONCLUSIONS: When administered as a prophylactic, the mixture of BB12 and L3 (iNatal Ped®) statistically decreases the signs and symptoms of atopy and reduces the use of drugs. Administration of the same probiotics as treatment after the appearance of atopy is less effective.