The ingestion of foreign bodies is a worldwide pediatric pathology. We assessed the clinical, endoscopic, and therapeutic aspects of this condition in a pediatric gastroenterology unit. We reviewed 61 patients (median age of 3.25 ± 4.7 years). The most frequently ingested objects were coins (26.23%), unidentified metal objects (13.11%), bones (8.19%), batteries, and buttons (6.55%). The clinical features we encountered included abdominal pain (55.73%), vomiting (34.42%), and asymptomatic children (29.5%). Routine X-ray examination enabled finding the foreign body in 42 of the cases. An esophagogastroduodenoscopy was performed within 24–72 hours. 25 cases resulted in a negative endoscopy (40.98%), 19 objects (31.14%) were removed using a polypectomy snare, and extraction failure occurred in 17 patients (27.86%). 28 foreign bodies were passed without incidents; in 14 cases, the swallowed objects were never found. In one case, a battery was stuck in the esophageal folds and led to tracheal-esophageal fistula and bronchopneumonia and later to esophageal stenosis. We report a large proportion of foreign bodies that could not be identified or removed due to lack of early endoscopy and poor technical settings. Batteries and sharp objects lead to severe complications and preschool-age children are at high risk for such events.

We conducted an observational study over a 1-year period, including 234 children aged 4–18 years and their caregivers and a matching control group. 60.73% of the children from the study group were males. Average age for the onset of constipation was 26.39 months. The frequency of defecation was 1/4.59 days (1/1.13 days in the control group). 38.49% of the patients in the sample group had a positive family history of functional constipation. The majority of children with functional constipation come from single-parent families, are raised by relatives, or come from orphanages. Constipated subjects had their last meal of the day at later hours and consumed fast foods more frequently than the children in the control sample. We found a statistically significant difference between groups regarding obesity/overweight and constipation (χ 2 = 104.94, df = 2, p < 0.001) and regarding physical activity and constipation (χ 2 = 18.419; df = 3; p < 0.001). There was a positive correlation between the number of hours spent watching television/using the computer and the occurrence of the disease (F = 92.162, p < 0.001, and 95% Cl). Children from broken families, with positive family history, defective dietary habits, obesity and sedentary behavior, are at higher risk to develop chronic functional constipation.

Micronutrient deficiencies are common in inflammatory bowel disease and have clinical impact, being both a sign of complicated disease and a cause of morbidity. The involved systemic inflammatory response is responsible for altering the concentration of a wide range of trace elements in the serum, including zinc and selenium. This review summarizes recent advances and evidence-based knowledge regarding the impact of selenium and zinc on oxidative stress and microbiota changes in IBD patients. Getting new insight into the impact of malnutrition, particularly on the micronutrients' impact on the development, composition, and metabolism of microbiota, as well as the influence of oxidative stress and the mucosal immune response, could help in implementing new management strategies for IBD patients, with focus on a more integrated approach.

Background and objectives: Self-medication is a global phenomenon in both developed and emerging countries. At present, data regarding the practice, patterns, and factors associated with self-medication in Romanian patient groups of various ages and health are relatively scarce. A pilot study that uses a questionnaire was conducted to observe the attitudes as well as the behaviors of a group of Romanian parents related to self-medication, specifically their beliefs and perceived risks of the administration of medicine to their children without medical advice, frequency of self-medications, symptoms, and types of medications most commonly used without medical advice. Materials and Methods: The questionnaire was sent via e-mail or WhatsApp link on a mobile phone using the existing data at the general practitioner’s office together with the protection of data form and the informed consent form; some participants completed the questionnaire when they came for a regular visit at the general practitioner’s office. Of 246 applied questionnaires, we had a rate of responses of 98%. Results: We found a high percentage (70%) of parents who self-medicate their children. The data reveals a significant relation between parents’ beliefs on self-medication and their tendency to administrate drugs to their children without medical advice. A significant relation was also found between the likelihood of parental self-medication for their children and the number of illnesses experienced by their children over the six-month period prior to the survey. Even when parents have a correct understanding of self-medication risks, these are not aligned with actual behavior; therefore, parents continue to administer drugs to their children without medical advice. Conclusions: Our study helps to describe the patterns of parents’ decisions about self-medicating their children and to identify parents who are more predisposed to administering self-medication to their children.

Insulinomas are functional neuroendocrine pancreatic tumors rarely encountered in pediatric pathology.Insulinomas are usually solitary and sporadic, but may occur in association with multiple endocrine neoplasia type 1. Whipple's triad—hypoglycemia, simultaneous compatible adrenergic and/or neurological signs, and relief of symptoms upon the administration of glucose—remains the fundamental diagnostic tool.We report a case of insulinoma in an 11-year-old boy with malnutrition and mild psychic retardation.History revealed neuroglycopenic symptoms associated with hypoglycemia that returned to normal values after glucose intravenous infusion; before admission in our unit, the levels of circulating insulin, as well as the abdominal ultrasound and abdominal computed tomography scan, were reported within normal range. During hospitalization in our service, the glycemic curves showed recurring low values associated with low glycated hemoglobin, positive fasting test, and elevated C-peptide. The pancreatic ultrasound was inconclusive, but the magnetic resonance imaging revealed a high signal focal area with a diameter of 1 cm, located in the tail of pancreas. Conventional enucleation of the lesion prompted a spectacular normalization of glucose metabolism and the alleviation of the main clinical symptoms. The child had a favorable evolution in the clinical follow-up, presenting with weight gain and progressive remission to complete disappearance of most symptoms—except for the mental impairments.Although in our case Whipple's triad was apparent from the beginning, the diagnosis was delayed due to the failure of conventional imaging methods in locating the tumor. Weight loss and mental impairment contributed to the diagnosis pitfalls.Pediatricians should be aware of confusing and nonspecific symptoms, especially when children with insulinoma present mental or neurological retardation. Despite the existence of medical regimens, surgery remains the gold standard for the therapeutic approach to this condition.