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Background: Fermented foods have been proposed to prevent common infectious diseases (CIDs) in children attending day care or preschool. Objectives: To investigate the efficacy of dietary supplementation with cow’s skim milk fermented with the probiotic Lactobacillus paracasei CBA L74 in reducing CIDs in children attending day care or preschool. Methods: Multicenter, randomized, double-blind, placebo-controlled trial on healthy children (aged 12–48 months) consuming daily 7 grams of cow’s skim milk fermented with L. paracasei CBA L74 (group A), or placebo (maltodextrins group B) attending day care or preschool during the winter season. The main outcome was the proportion of children who experienced ≥1 episode of CID during a 3-month follow-up. Fecal biomarkers of innate (α- and β-defensins, cathelicidin) and acquired immunity (secretory IgA) were also monitored. Results: A total of 126 children (71 males, 56%) with a mean (SD) age of 33 (9) months completed the study, 66 in group A and 60 in group B. At intention to treat analysis, the proportion of children presenting ≥1 CID was 60% in group A vs. 83% in group B, corresponding to an absolute risk difference (ARD) of −23% (95% CI: −37% to −9%, p < 0.01). At per-protocol-analysis (PPA), the proportion of children presenting ≥1 CID was 18% in group A vs. 40% in group B, corresponding to an absolute risk difference (ARD) of −22% (95% CI: −37% to −6%, p < 0.01). PPA showed that the proportion of children presenting ≥1 acute gastroenteritis (AGE) was significantly lower in group A (18% vs. 40%, p < 0.05). The ARD for the occurrence of ≥1 AGE was −22% (95% CI: −37% to −6%, p < 0.01) in group A. Similar findings were obtained at PPA regarding the proportion of children presenting ≥1 upper respiratory tract infection (URTI), which was significantly lower in group A (51% vs. 74%, p < 0.05), corresponding to an ARD of −23% (95% CI: −40% to −7%, p < 0.01). Significant changes in innate and acquired immunity biomarkers were observed only in subjects in group A. Conclusions: Dietary supplementation with cow’s skim milk fermented with L. paracasei CBA L74 is an efficient strategy in preventing CIDs in children.

Objective: To evaluate longitudinal growth, pubertal development and ®nal height in patients with congenital hypothyroidism (CH) detected by a neonatal screening programme, and to identify factors potentially affecting growth outcome. Patients: Fifty-®ve patients (41 females) detected by neonatal screening and followed longitudinally from the time of diagnosis and treatment (25^5 days) up to the age of 17^0X5 years were evaluated retrospectively. Results: Pubertal development began and progressed normally in both males and females. In boys, a testicular volume of 4 ml was reached at 11X3^1X0 years. In girls breast enlargement (B2) occurred at a mean age of 10X3^1X2 years and the mean age of menarche was 12X5^1X2 years. The onset and the progression of puberty were independent of the aetiology, the severity of CH and the timing of the beginning of treatment. Girls treated with an initial amount of L-thyroxine (L-T 4 ) greater than 8 mg/kg per day showed an earlier onset of puberty (B2 9X4^0X9 years; menarche 11X5^0X8 years) compared with girls treated with a lower initial dose of L-T 4 (B2 10X5^1X2 years; menarche 12X6^1X2 years; P , 0X02). However, both groups attained a similar ®nal height (20X1^1X0 SDS and 0X4^1X0 SDS, respectively), which in both cases was above the target height P 0X03X All the patients in the study attained a mean ®nal height (0X1^1X1 SDS) within the normal range for the reference population and above the target height 20X9^0X9 SDS, P , 0X0001X No signi®cant relationship was found between ®nal height and severity of CH at diagnosis, initial L-T 4 dosage or aetiology of the defect. Patients with ectopic gland, thyroid aplasia or in situ gland attained a similar mean ®nal height (0X1^1X1 SDS, 0X5^1X0 SDS and 20X5^1X0 SDS, respectively), which was in all cases greater than target height 21X0^0X9Y 20X6^0X8Y 20X9^0X8 respectively; P , 0X05X Conclusions: Our results suggest that conventional management of children with CH detected by neonatal screening leads to normal sexual development and normal adult height, and that the major factor determining height in these children is familial genetic growth potential.

Under the umbrella of coeliac disease (CD), or gluten‐sensitive enteropathy, the concepts of silent, latent and potential CD have recently been introduced. While silent CD is marked by severe damage to the jejunal mucosa in the absence of clinical symptoms, both latent and potential CD are characterized by a jejunal mucosa that would be reported as normal by most clinical pathologists in an individual on a gluten‐containing diet. As opposed to potential coeliac patients, latent subjects sometime in their life have had a flat jejunal biopsy which recovered on a gluten‐free diet. Latent coeliac patients are often symptomatic; neither high titres of gliadin antibodies nor mucosal changes (including raised intraepithelial lymphocyte counts) are obligate features of latent CD, although the presence of elevated endomysial antibodies is probably the best predictor of progression towards villous atrophy. The term potential CD has been proposed for those subjects who do not have, and have never had, a jejunal biopsy consistent with overt CD, and yet have immunological abnormalities similar to those found in coeliac patients. Good markers of potential CD include the presence of serum endomysial antibodies, a high count of intraepithelial lymphocytes and subtle pathological alterations such as increased density of intraepithelial lymphocytes expressing γδ T cell receptor, signs of activated mucosal cell‐mediated immunity, coeliac‐like intestinal antibody pattern, and positive rectal gluten challenge.