RESUMO
Weaning (or introduction of complementary feeding) is a special and important moment in the growth of a child, both for the family and the infant itself, and it can play a major role in the child's future health. Throughout the years, various weaning modes have come in succession, the latest being baby-led weaning; the timing for introducing foods and the requirements of which sort of nutrient for weaning have also changed over time. Furthermore, the role played by nutrition, especially in the early stages of life, for the onset of later non-communicable disorders, such as diabetes, obesity or coeliac disease has also been increasingly highlighted.Members of Italian Society of Gastroenterology, Hepathology and Pediatric Nutrition (SIGENP) and the Italian Society of Allergology and Pediatric Immunology (SIAIP) Emilia Romagna here propose a practical approach for pediatricians to deal with daily practice. The four main areas for discussion were weaning in relation with the onset of allergic diseases, coeliac disease, diabetes and metabolic syndrome, the nutrition requirements to take into account for assessing the diet of infants under one year of age and about the practice of baby-led weaning focusing on limits and benefits, respectively.
Assuntos
Fenômenos Fisiológicos da Nutrição do Lactente/normas , Estado Nutricional , Guias de Prática Clínica como Assunto , Comportamento Alimentar , Humanos , Lactente , Alimentos Infantis/normas , Valores de ReferênciaAssuntos
Adolescente/fisiologia , Asma/diagnóstico , 2-Piridinilmetilsulfinilbenzimidazóis , Albuterol/uso terapêutico , Amoxicilina/uso terapêutico , Androstadienos/uso terapêutico , Antibacterianos/uso terapêutico , Anti-Infecciosos/uso terapêutico , Antiulcerosos/uso terapêutico , Asma/tratamento farmacológico , Asma/fisiopatologia , Benzimidazóis/uso terapêutico , Brônquios/patologia , Brônquios/cirurgia , Broncodilatadores/uso terapêutico , Broncoscopia , Tumor Carcinoide/diagnóstico , Tumor Carcinoide/fisiopatologia , Tumor Carcinoide/cirurgia , Diagnóstico Diferencial , Quimioterapia Combinada , Fluticasona , Fluxo Expiratório Forçado/fisiologia , Volume Expiratório Forçado/fisiologia , Refluxo Gastroesofágico/diagnóstico , Refluxo Gastroesofágico/tratamento farmacológico , Refluxo Gastroesofágico/fisiopatologia , Humanos , Imunoglobulina E/sangue , Neoplasias Pulmonares/diagnóstico , Neoplasias Pulmonares/fisiopatologia , Neoplasias Pulmonares/cirurgia , Masculino , Metronidazol/uso terapêutico , Omeprazol/análogos & derivados , Pantoprazol , Teste de Radioalergoadsorção , Sons Respiratórios/diagnóstico , Sons Respiratórios/fisiopatologia , Sulfóxidos/uso terapêutico , Síndrome , Tomografia Computadorizada por Raios X , Teste Tuberculínico , Capacidade Vital/fisiologiaRESUMO
BACKGROUND: Fractional exhaled nitric oxide (FE(NO)) and exhaled carbon monoxide (ECO) have been proposed as markers of airway inflammation and oxidative stress. OBJECTIVE: The aim of this study was to assess the effect of oral prednisone treatment on FE(NO) and ECO levels in a group of 30 asthmatic children with asthma exacerbation. METHODS: Thirty asthmatic children with asthma exacerbation were treated with oral prednisone for 5 days (1 mg/kg/day). Before and after prednisone therapy, ECO was measured by means of a chemical analyzer and FE(NO) was measured by means of a chemiluminescence analyzer. ECO and FE(NO) were also measured in a group of healthy nonatopic children. RESULTS: Before therapy, both ECO values and FE(NO) values were higher in asthmatic children (ECO, 3.2 +/- 0.2 ppm; FE(NO) online, 74.9 +/- 6.2 ppb; FE(NO) offline, 20.2 +/- 1.4 ppb) than in healthy controls (ECO, 2.0 +/- 0.2 ppm [P <.01]; FE(NO) online, 10.1 +/- 0.8 [P <.0001]; FE(NO) offline, 5.9 +/- 0.4 ppb [P <.0001]). An overlap in ECO values was found between healthy controls and asthmatic children. After prednisone therapy, there was a significant reduction in FE(NO) values (FE(NO) online, 40.6 +/- 4.6 ppb [P <.0001]; FE(NO) offline, 11.1 +/- 0.8 ppb [P < 0.0001]) and a slight but nonsignificant decrease in ECO values (2.7 +/- 0.2 ppm [P = not significant]) in the asthmatic group. No significant correlation between ECO values and FE(NO) values was found in either the asthmatic children or the controls. CONCLUSIONS: After a course of prednisone therapy, in children with asthma exacerbation there is a significant decrease in FE(NO) but no significant change in ECO levels. This possibly suggests that ECO is less sensitive than FE(NO) to inhibition by corticosteroids.