The primary resistance rate of H. pylori strains isolated from Portuguese children to the commonly used anti-H. pylori antibiotics used is high. Additionally, the increasing trend of ciprofloxacin-resistant and double-resistant strains may compromise H. pylori eradication in a high-prevalence population.

Actinomycosis is a rare, indolent, and multisystemic infection caused by Actinomyces, commensal bacteria of the oral and intestinal flora. It usually occurs due to tissue disruption. It affects the abdominal region in 20% of cases, and the most common presentation is a perforated appendix. Symptoms are nonspecific, which makes differential diagnosis a challenge.We present the case of a healthy, nine-year-old boy of African ancestry with a five-month history of recurrent intermittent abdominal pain in the periumbilical and right lower quadrant areas. He recurred to the emergency department with symptoms suggestive of acute appendicitis and was submitted to an emergent laparotomy. The histologic examination revealed Actinomyces colonies compatible with the diagnosis of appendicular actinomycosis. He was treated with intravenous penicillin for a month and, subsequently, with oral amoxicillin for a year. He had complete remission of symptoms.Actinomycosis is a rare entity, particularly in children. Nevertheless, it should be considered in the differential diagnosis of an intrabdominal mass or unspecific recurrent, indolent, and abdominal pain. As symptoms are nonspecific, it can mimic other diseases. It is mostly diagnosed post-operatively, after histological examination. Early treatment is important to avoid recurrence, and, therefore, a high index of suspicion is required.

Celiac disease is an autoimmune disease that is expressed by chronic food sensitivity to gluten, having as typical symptoms diarrhea and weight loss. The present study has evaluated anthropometric marker progressions in 61 Portuguese children with celiac disease, at diagnosis time and at the study time, comparing these variations with the intake of gluten free products. Data from 61 children (59.0 % girls) with celiac disease were evaluated, following a gluten free diet for 5.0 ± 4.6 years. Statistical t-test analysis of pBMI at diagnosis and at study time, revealed a positive increase with statistical significance for both girls and boys (p = 0.008). The differences between ingested and recommended values were quantified and confirming the increase in total energy consumption and carbohydrates. Following a gluten free diet allows the recovery of the nutritional status in most children; however, nutritional counseling seems mandatory to avoid nutrient imbalances and further health issues.

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