Cow’s milk protein allergy (CMPA) is the most common food allergy found in children under 3 years of age. In most cases, it occurs in infancy. Early diagnosis and appropriate treatment can decrease the risk of impaired growth. In our study, we evaluated 40 children, with ages between 1 month and 3 years, diagnosed with IgE-mediated or non-IgE-mediated CMPA, from january to december 2017, in the Department of Pediatrics of the Clinical Emergency County Hospital of Constanta. The inclusion criteria consisted of: age, natural or artificial feeding, specific IgE levels, CoMiSS score, and clinical manifestations. The Cow’s Milk-related-Symptom-Score (CoMiSS) was developed as a screening and diagnostic tool for CMPA prediction, and can guide pediatricians and primary care physicians to make an early diagnostic, as it can be easily missed. We observed a higher number of cases of CMPA registered among children who were artificially fed (57,5%), followed by those with mixed nutrition (25%), the remaining (17,5%) being represented by exclusively breastfed infants. The most frequent clinical manifestations were rashes (87,5%), failure to thrive (82,5%), regurgitation (50%) and diarrhea (35%). Further data should be collected to prove if the association between a CoMiSS score higher than 12 and specific IgE-mediated CMPA is clinically relevant, and can predict, based on clinical examination and anamnesis, high serum levels of specific immunoglobulin E. The prognosis can depend on the titre of specific IgE at the time of diagnosis, as they are more likely to develop several crossed allergies and less prone to become tolerant to cow milk proteins than those with non-IgE-mediated CMPA.

Inflammatory bowel disease (IBD) is a chronic condition of the gastrointestinal tract comprising of two entities: Crohn disease (CD) and Ulcerative colitis (UC). Considered rare in children in the past, inflammatory bowel disease is nowadays more frequently found, raising diagnostic and treatment challenges. In our study, we have taken into consideration all children diagnosed with inflammatory bowel disease, in the Department of Pediatrics of the Clinical Emergency County Hospital of Constanta, from 2016 to 2019. 14 children were diagnosed with inflammatory bowel disease during this timeframe, 8 with Crohn disease (57,14%) and 6 with Ulcerative colitis (42,86%). The mean age at onset was 8.2 years for Crohn disease patients, varying between 20 months to 15 years, and 12.8 years for Ulcerative colitis patients, varying between 8 to 14 years. After a positive diagnosis, different types of induction therapy was implemented, depending on the activity and severity of the disease, as well as on the type of inflammatory bowel disease. 12 patients received iv corticosteroids for an average of five days, followed by oral corticosteroids for 4-8 weeks. Aminosalicylates (Mesalazine) was used as a sole induction treatment in children with UC, or in association with corticosteroids in severe cases (4 cases). Immunomodulatory treatment (Azathioprine) was used for maintaining remission in 5 children with Crohn disease for an average period of 6 months. In 3 cases of CD, antibiotics, such as Metronidazole, were used in the initial treatment. Biological therapy, such as Adalimumab (ADA), was administered as an induction therapy in patients with refractory to conventional treatment forms, in 5 cases, with a favourable outcome.

Common femoral arteries diameters (left and right) were studied, on a number of 60 cases (26 women and 34 men) with a General Electric – Voluson 730 Expert ultrasonograph. The diameters of the common femoral arteries, left and right, were measured in three points: proximal, middle and inferior, in 60 cases as it follows: 26 cases on women (43,33%) and 34 cases on men (56,70%). Regarding the proximal third of the right common femoral artery, the diameter range was found between 6,1 and 8,9mm, in women being between 6,2-7,9mm, and in men between 6,1-8,9mm. The diameter of the middle third had values between 5,8-9,7mm, in women ranging from 6,1 to 7,8mm, and in men from 5,8 to 9,7mm. At the level of the inferior third, the femoral artery had a diameter between 6,8-12,7mm, in women ranging from 6,5 to 9,8mm, and in men from 6,3 to 12,7mm. The common left femoral artery, in its proximal third had a diameter with values between 5,7 – 9,9mm, in women from 6,2 to 8,0mm, and in men being between 5,7-9,9mm. In the middle third the values were found between 6,1-9,8mm, in women being from 6,6 to 7,9mm, and in men from 6,1 to 9,8mm. Regarding the inferior third, the diameters had values between 7,0-12,5mm, in women ranging from 7,1 to 10,5mm, and in men, from 6,8 to 12,5mm.