Cow's Milk Research Articles

Effect of pasteurization on the physicochemical and nutritional quality of milk from the Korhogo dairy

Stabilization of the nutritional value of milk is essential for its conservation. It is in this context that the aim of this study was to evaluate the nutritional quality of raw and pasteurized cow's milk produced in Korhogo with a view to its valorization. Raw and pasteurized milk were sampled from June 24 to July 13, 2024, at the Korhogo dairy. The physicochemical and nutritional parameters of the two types of milk were determined according to AOAC methods. The results of the physicochemical parameters revealed that the values ​​of pH, acidity, dry matter and degree brix are respectively 6.64 ± 0 .01 and 6.90 ± 0.00; 18.00 ± 0.10; 16.20 ± 0.04 °D; 121.93 ± 0.64; 126.23 ± 2.19 g/L and 10.10 ± 0.10; 11.20 ± 0.10 °Brix for raw and pasteurized milk. The nutritional parameters of raw and pasteurized milk show significant contents of ash (7.00 ± 0.01 and 7.47 ± 0.01 g/L), lipids (40.80 ± 0.02 and 36.30 ± 0.46 g/L), proteins (40.71 ± 0.01 and 37.02 ± 0.01 g/L) and carbohydrates (33.42 ± 0.03 and 45.44 ± 0.04 g/L). Pasteurization could be used to stabilize the nutritional value of milk.

Factors Associated with Weaning in Infants with Cow's Milk Allergy: A Cohort Study.

Objective: To analyze the factors associated with weaning in infants with cow's milk allergy (CMA) treated at a food allergy reference center in a state in the northeast of Brazil. Method: A prospective cohort study, with a case group (children with CMA) and two control groups (symptomatic nonallergic children [SC] and asymptomatic [AC]). At the beginning of the study, 30 children comprised the CMA group, 84 the SC group, and 52 the AC group. Survival analysis was performed to compare breastfeeding time between the three groups and an adjusted linear regression model to verify the factors associated with breastfeeding time. Results: At the beginning of the study, 33.3% of children in the CMA group, 17.1% in the SC group, and 69.6% in the AC group were exclusively breastfeeding (p = 0.005). The most common factors for weaning in children with CMA were the cow's milk elimination diet (30%), allergic symptoms in the child (20%), and breast engorgement (20%). Children who used a cup as a means of offering infant formula spent 281 more days breastfeeding compared with those who used a baby bottle (Bstd = 1.39; p = 0.031). Conclusion: Children with CMA and nonallergic gastrointestinal complaints weaned earlier compared with asymptomatic children. The main causes of weaning in CMA children were maternal difficulty adhering to the elimination diet, breast engorgement, and allergic symptoms in the child. Using a cup was the main factor associated with longer breastfeeding duration, regardless of gastrointestinal symptoms and socioeconomic factors.

Regional differences in diagnosis and management of cow's milk allergy.

: Various guidelines for the diagnosis and management of cow's milk allergy (CMA) have been pu- blished. : This study aimed to compare voting outcomes of experts from Mexico, the Middle East, and the European Society of Pediatric Gastroenterology Hepatology and Nutrition (ESPGHAN) on statements regarding CMA. : The 3 expert groups voted on the same 10 state- ments. Each participant voted anonymously using a score of 0-9 (≥6 meant agreement; <5 reflected disagreement). If <75% of the participants agreed with the statement, it was rejected. None of the groups was aware of the voting outcomes of another group. : There was broad consensus amongst the 3 groups. Agreement was reached that infant colic as a sin- gle manifestation is not suggestive of CMA. All groups confirmed that an extensively hydrolysed formula is the preferred elimination diet in mild/moderate CMA cases; however, hydrolysed rice formula is an alternative. Amino acid-based formulas should be reserved for infants with severe symptoms. The discrepancy in voting outcomes re- garding soy formulas highlights the differences in opinions. Two of 13 ESPGHAN experts (15%), 1 of 14 Middle East experts (7%), and 6 of 26 Mexican experts (23%) disagreed with the statement that soy formula should not be the first choice for the diagnostic elimination diet but can be considered in some cases for economic, cultural, and pala- tability reasons. All of the ESPGHAN and Mexican ex- perts agreed that there was no added value of probiotics, prebiotics, or synbiotics to the efficacy of elimination diets on CMA, whereas 3 of 14 Middle East experts (21%) deter- mined that there was sufficient evidence. : Although all statements were accepted by the 3 groups, there were relevant differences illustrating va- riations according to geography, culture, cost, and formula availability. These findings emphasize the need for region-specific guidelines.

Hydrolysates of mare's milk proteins. Immunochemical and physico-chemical characteristics

In recent years, the attention of specialists has been attracted by a significant increase in allergic diseases, especially among children. Enzymatic hydrolysis with the participation of peptidases is considered the most effective measure to reduce the allergenicity of milk proteins. The study of the features of protein proteolysis by various enzymes, aimed at establishing optimal process parameters, is the subject of research in the production of hydrolysates with specified properties: a certain peptide and amino acid profile, reduced antigenic properties. At the same time, for a correct preclinical assessment of the safety and potential effectiveness of specialized food products, it is not enough only to determine the molecular weight distribution of peptide fractions in the composition. A necessary additional and informative indicator of reducing the potential allergenicity of the hydrolysate is the degree of preservation of the antigenic properties of the initial protein (residual antigenicity), determined by immunochemical methods. The preparation and subsequent comprehensive assessment of enzymatic hydrolysates of mare's milk proteins is of considerable interest, since, according to the results of clinical studies, it was suggested that upon allergy to cow's milk proteins mare's milk can be considered hypoallergenic. The purpose of this work was to obtain enzymatic hydrolysates of mare's milk proteins using domestic enzymes and their further physico-chemical and immunochemical characteristics. The object of the study was mare's milk protein obtained from skimmed mare's milk powder as a protein substrate. Two samples of enzymes from various manufacturers of the Russian Federation were used in the work. The results of the conducted studies show that the peptide profiles of hydrolysates vary greatly depending on the enzyme used, however, the multiplicity of antigenicity reduction practically does not depend on the nature of the enzyme, and does not depend on an increase in the enzyme/substrate ratio. The peptide profile and the multiplicity of reducing the antigenicity of hydrolysates of mare's milk proteins are influenced by ultrafiltration treatment of the obtained hydrolysates, which allows reducing the content of antigenic structures in the final product by several orders of magnitude.

The influence of zootechnical factors on the composition of proteins in raw cow's milk

The scientific review is devoted to the current problem of the quality of raw materials in the production of dairy products. The purpose of the research is to update scientific data on the influence of zootechnical factors on the protein composition of raw cow›s milk. In the context of the development of the specialized nutrition market, an in-depth study of milk proteins is necessary as the most important source of essential amino acids. The authors reviewed the scientific works of domestic and foreign specialists, covering the influence of various factors on the protein composition of raw cattle milk. During the formation of the scientific review, the factors studied were divided into the following groups: selection-genetic, feed, temporal, zoohygienic and technological. This made it possible to determine the degree of influence of factors on milk quality indicators, especially proteins, and to trace their dependence on each other.

Infant formula with added Lacticaseibacillus rhamnosus GG supported adequate growth and was well tolerated in healthy term infants: a randomized controlled trial

IntroductionLacticaseibacillus rhamnosus GG (LGG) is a well-studied probiotic with a history of safe use.MethodsIn this double-blind, prospective study, growth and tolerance were evaluated in healthy term infants randomized to: marketed, routine intact cow's milk protein-based formula (Control, n = 172) or a similar investigational formula with added LGG (INV-LGG, n = 179; 106 CFU LGG®/g powder) from 14 to 120 days of age. Anthropometrics, stool characteristics, fussiness, and gassiness were evaluated through Day 120. Medically confirmed adverse events were recorded throughout the study period. The primary outcome was rate of weight gain from Day 14–120.ResultsOf 351 infants enrolled, 275 completed (Control, n = 131; INV-LGG, n = 144). No significant group differences in rate of weight gain from Day 14–120 were detected. Study formula acceptance and tolerance was good with no significant differences in study discontinuation due to study formula or parent-reported gassiness, stool frequency, or stool consistency; however mean fussiness relative to normal was significantly lower for INV-LGG vs Control at Days 60 and 90.DiscussionIn healthy term infants, a routine intact cow's milk protein-based formula with added LGG supported adequate growth and was well tolerated. Further studies are needed to evaluate potential benefits for fussiness and efficacy outcomes. Clinical Trial RegistrationClinicaltrials.gov, identifier (NCT01897922).

Short-term reduction in feed intake by dairy cows in the postpartum period leads to subclinical ketosis development

Subclinical ketosis is widespread in highly productive dairy cows after calving and often remains undiagnosed, leading to reduced productivity. Physiologically controlled feeding in the first weeks after calving and during the intensive lactation period can reduce the incidence of ketosis. The study aimed to determine how a short-term reduction of feed after calving affects the formation of ketone bodies in blood, urine and milk of dairy cows. The group of ten Ukrainian black-spotted dairy breed cows after calving aged from 4 to 6 years was involved in the experiment lasted for 72 h. In 24 h the amount of compound feed, haylage, and silage received by cows was gradually reduced until complete exclusion in the diet. Blood, urine, and milk samples were collected three times a day. The content of ketone bodies, β-hydroxybutyrate and glucose was estimated with the corresponding sets of indicator strips. The content of total bilirubin, cholesterol, albumin and enzymes activity in the blood serum were determined on biochemical analyzer. It was found that in 24 h after the beginning of feed reduction the level of blood glucose decreased, persistent hypoglycemia within 48 and 72 h was developed, the concentration of β-hydroxybutyrate in blood and milk and of ketone bodies in urine was elevated. The increase in total bilirubin concentration and liver enzymes activity in the blood serum with a simultaneous decrease in albumin level and delayed sodium propionate conversion into glucose were observed. Thus, short-term reduction in feed intake by dairy cows after calving causes ketosis development and violation of liver functions. Keywords: dairy сows, feeding level, glucose, ketosis, liver damage, β-hydroxybutyrate

Qualitative indicators of milk and fermented milk products when activated zeolite and probiotics are included in the diet of cows

Relevance. The quality of milk depends on the season of the year, the breed of animals, the state of metabolism, and the characteristics of feeding and maintenance technology. The quality of milk determines its technological properties and the quality of its processed products.Methods. The content of somatic cells in milk, the acidity of milk, cottage cheese, yogurt, and syneresis of yogurt were determined. In milk processing products, the content of the mass fraction of nitrogen and crude protein, crude ash, calcium, and phosphorus was determined.Results. When feeding cows with the yeast probiotic activated zeolite and the phytoprobiotic “Provitol”, a significant decrease in the content of somatic cells in freshly milked milk of cows was established by 13.02% (p &lt; 0.05). Significantly lower milk acidity values were established (by 6.00% (p &lt; 0.001) and 12.79% (p &lt; 0.001), respectively), significantly higher yogurt acidity values (by 6.00% (p &lt; 0.001) and 12.79% (p &lt; 0.001), respectively, significantly lower yogurt syneresis (by 4.70% (p &lt; 0.001) and 3.10% (p &lt; 0.01), respectively). The use of activated zeolite and yeast probiotic “Kluver Pro” in the diets leads to a significantly higher content (compared with the control) of the mass fraction of fat in cottage cheese and yogurt — by 10.47 abs. % (p &lt; 0.001) and 4.58 abs. % (p &lt; 0.001).

Sensory Evaluation of Chhana Burfi Process with Jackfruit (Artocarpus hetrophyllus L.) Pulp

The study was conducted at Dept. of Animal Husbandry and Dairy Science, Dr. BSKKV, Dapoli, Ratnagiri, Maharashtra, India during August 2021 to May 2022 to evaluate the suitability of Jackfruit pulp as flavouring agent in developing flavoured Chhana Burfi and its production cost. Basically, Cow milk required for preparation of Chhana, Citric acid used for Coagulation of milk, Sugar and Jackfruit pulp etc. was required to conduct this research. The curd mass obtained when milk is coagulated with the organic acids such as citric acid at higher temperature and after subsequent drainage of whey, mass of curd obtained is called chhana. Chhana was used as base material for preparation of chhana burfi. The Chhana Burfi was prepared from cow milk by incorporating jackfruit pulp @ 10% (F1), 15% (F2), and 20% (F3) and two sugar level i.e. 15% (S1) and 18% (S2) On the basis of weight of Chhana. All treatment is analyzed for sensory characteristic i.e. colour and appearance, body and texture, flavour and overall acceptability by using 9-point Hedonic scale. Present study investigated that jackfruit pulp could be successfully utilized for preparation of flavoured chhana burfi. The most acceptable quality flavour Chhana Burfi could be prepared by using 15% jackfruit pulp and 18% sugar. Prepared delicious milk product i.e. Jackfruit flavour Chhana Burfi rich taste and flavour along with nutritional value. The production cost of Jackfruit flavour Chhana Burfi (most acceptable level i.e.S2F2) was Rs. 355.8/- per kg.

Whole genome sequence analysis of multi-drug resistant and biofilm-forming Staphylococcus haemolyticus isolated from bovine milk

BackgroundMilk is an excellent growth medium for microorganisms due to its nutritive composition. Microorganisms have been implicated in bovine mastitis (BM) in dairy cows as well as causing infections in animals and humans. Despite extensive endeavours to manage BM, this condition continues to persist as the most prevalent and economically burdensome problem affecting dairy cattle on a global scale. Non-aureus staphylococci (NAS) species such as Staphylococcus haemolyticus, S. epidermidis, and S. xylosus are currently the predominant microbiological agents identified as the main cause of subclinical udder infections and are also considered opportunistic pathogens in cases of clinical mastitis in dairy cows. Therefore, it is crucial to elucidate the genetic profile of these species. The primary objective of this study was to characterise three phenotypically determined multidrug-resistant NAS environmental strains (NWU MKU1, NWU MKU2, and NWU MKS3) obtained from dairy cows milk via whole-genome sequencing.ResultsThe results confirmed that the three isolates were S. haemolyticus with genome sizes of 2.44, 2.56, and 2.56 Mb and a G + C content of 32.8%. The genomes contained an array of antibiotic resistance genes that may potentially confer resistance to a range of antibiotic classes, such as macrolides, fluoroquinolones, aminoglycosides, cephalosporins, tetracyclines, peptides, and phenicol. Furthermore, all the genomes carried virulence genes, which are responsible for several functions, such as adhesion, enzyme and toxin production. The genomes of these organisms contained signatures encoding mobile genetic elements such as prophages and insertion sequences.ConclusionThese findings indicate there is a need for diligent monitoring with improved management practices and quality control strategies on farms to safeguard milk production systems and human health.

Co-cultivation of selected Lactiplantibacillus plantarum strains with starter cultures under osmotic stress increases folate content and enhances product quality in fermented dairy

This study aimed to identify lactic acid bacteria (LAB) strains with high folate production potential to enhance the folate content in fermented dairy products. From 284 LAB strains sourced from fermented vegetables and dairy, six were selected for their outstanding folate production. Among these, Lactiplantibacillus plantarum TXZ2-26 and L. plantarum FJ2-3 demonstrated strong synergistic interactions with the starter culture, resulting in an increased total LAB cell count after co-cultivation. The effects of five different stress conditions on the growth, folate production, and expression of key folate-synthesis genes (folE, folP, folQ, folB, folK) in the two strains were further examined, revealing that the two strains demonstrated increased folate production under 3% NaCl stress. Finally, both unstressed and NaCl-stressed strains were used in the fermentation of goat and cow milk alongside the starter culture. The results revealed that the addition of L. plantarum TXZ2-26 and FJ2-3 significantly boosted the folate content of the fermented dairy products and improved their physicochemical properties, with the stressed strains exhibiting a more pronounced effect. These findings underscore the potential of L. plantarum TXZ2-26 and FJ2-3 as effective probiotics for producing folate-enriched fermented foods.

Spatial distribution and risk assessment of perchlorate in raw cow milk from China

Perchlorate is a ubiquitous environmental contaminant worldwide, recognized as an emerging thyroid toxicant. This study focused on the pollution status, spatial distribution, possible sources of perchlorate in raw cow milk collected from 155 dairy farms in China, as well as the health risk of exposure to perchlorate through dairy products. The results showed that the detection rate of perchlorate in raw milk was 100% with the mean of 15.9 μg/kg, indicating the ubiquitous contamination of perchlorate in raw milk from China. The simulation of spatial distributions indicated that the levels of perchlorate in raw milk were spatially correlated, and relatively high levels of perchlorate exist in certain parts of Beijing-Tianjin-Hebei, Shanxi, Henan, and Zhejiang, suggesting potential environmental perchlorate contamination in these regions. A positive correlation was found between the perchlorate level in milk and the perchlorate level in feed, indicating the transfer process of perchlorate from feed to milk. The hazard quotient (HQ) values of exposure to perchlorate by dairy products ranged between 0 and 2.14, with the mean of 0.0188 and P95 of 0.101, indicating relatively low health risk to perchlorate through dairy products. To our knowledge, this is the first nationwide study on the spatial distribution and risk assessment of perchlorate in raw cow milk from China.

Feeding Cows with Olive Cake Enriched in Polyphenols Improves the Sustainability and Enhances the Nutritional and Organoleptic Features of Fresh Caciocavallo Cheese.

In this study, Caciocavallo, a typical cheese produced in Sicily Island (Italy), was obtained from the milk of dairy cows fed with and without enriched olive cake (ECO and CTR, respectively) in order to evaluate nutritional, microbiological, volatile, and sensory differences in cheeses. ECO cheese showed greater (p < 0.05) MUFA and PUFA and polyphenols content and lower SFA content than CTR cheese. Microbiological analyses revealed the absence of Salmonella, Listeria monocytogenes, Escherichia coli, and E. coli O157, and no significant differences in the viable counts of the remaining microbial groups analyzed, between samples. Thermophilic lactococci were more prevalent in ECO cheese. The implementation of a culture-independent method, such as PCR-DGGE analyses, revealed the presence of a more diverse microbial population in both cheeses. Regarding the volatile compounds profile, long-chain free fatty acids were more abundant in the ECO cheese, resulting in a healthier free fatty acid profile. This study also showed that, especially for their appearance and taste, consumers mostly appreciated the ECO cheese. The results show that using enriched olive cake could enhance the sustainability and the quality of Ragusano cheese, improving not only the health of its consumers but also positively influencing tastes and acceptability.

The Efficacy and Safety of Stepwise Oral Food Challenge in Children with Cow’s Milk Allergy

Plain Language SummaryStepwise oral food challenge (OFC) tests begin with low doses of allergens, progressing to full doses. This is one of the strategies used to avoid anaphylactic reactions to the reintroduction of allergens. We previously reported the safety and efficacy of hen egg OFC. In this study, we discuss it for cow’s milk (CM) allergy. We included 927 children (median age, 3.2 years) who underwent CM-OFC between 2017 and 2021. The target challenge dose was classified as low (<10 mL), middle (≥10 mL but <100 mL), or full. When the participants reacted to low doses, they underwent very low-dose OFC using baked milk or <1 mL of CM. Positive reactions developed in 210 cases (22.7%), including 69 anaphylactic reactions (7.4%). A lower target dose resulted in more positive OFC results and anaphylaxis. Multivariate analysis indicated that only in low-dose OFCs, higher CM-specific IgE (CM-sIgE) levels, younger age, and complete CM elimination were associated with positive OFC results. Food ladders, an approach to reintroduce allergens, are becoming increasingly popular. Although we believe that OFC is a safer strategy to reintroduce CM to children with CM allergy, our CM-OFCs appeared to develop more anaphylactic reactions than milk ladders. The stepwise OFC reintroduced small amounts of CM, even in cases with high CM-sIgE levels or a history of anaphylaxis. Performing CM-OFC at a younger age, preferably from infancy, with very low doses, similar to milk ladders, may facilitate the safe reintroduction of CM.

Lactobacillus rhamnosus Helps to Reduce the Duration of Bleeding in Breastfed Infants with Allergic Proctocolitis.

Background: Cow's milk protein allergy (CMPA) is the most common food allergy in infants. The current standard of care (SOC) involves eliminating the allergen from both the infant's and mother's diet for 2-4 weeks. The purpose of this study is to assess the effectiveness of Lactobacillus rhamnosus (Ramnoflor) in reducing the duration of bleeding in these infants. Methods: This randomized clinical trial was conducted at Bahrami Children's Hospital on breastfed infants who were diagnosed with CMPA and had a positive occult blood (OB) test. Patients were randomly assigned to either the control or case groups. All patients received SOC therapy, with the case group receiving Ramnoflor and the control group receiving a placebo. Data were recorded on the checklist, and the children were followed and visited three times during the study, with an OB assessment at each visit. Results: The study enrolled 48 infants. Among the infants in the case group, the OB test was positive in four cases (8.3%) on the fifth day. However, there were no positive cases on the 14th and 30th days. The prevalence of this test was significantly lower in patients who received probiotics compared to the control group on the fifth day (p < 0.001). There were no positive OB tests on the 14th and 30th days in any of the groups, and no significant difference was observed between the groups. Conclusion: The addition of L. rhamnosus to SOC therapy led to a decrease in the duration of rectal bleeding in infants with CMPA compared to the control group.

Colchicine can keep the viability of bacteria in mastitic milk by preventing leukocyte phagocytosis in dairy cow and goat

Despite the occurrence of mastitis, no bacteria were detected in any of the milk samples after culture. This is partially because the neutrophils present in milk phagocytose bacteria during milk preservation. In this study, we investigated whether colchicine inhibited the decrease in viable bacteria in milk by suppressing phagocytosis during preservation. The number of viable bacteria decreased when cow milk was preserved for 5 h. However, the addition of 0.1 and 1% colchicine significantly increased the number of viable bacteria (p &amp;lt; 0.05). The percentage of culture-negative cow’s milk increased more than two-fold after 5 h compared to that at 0 h of preservation, however this percentage was significantly reduced by the addition of colchicine (p &amp;lt; 0.05). When goat milk with mastitis was incubated with bacteria (Escherichia coli, Klebsiella pneumoniae, and Staphylococcus aureus), the percentage of phagocytosed neutrophils decreased significantly with the addition of colchicine (p &amp;lt; 0.05). These results indicate that colchicine suppressed the decrease in the number of viable bacteria by preventing neutrophil phagocytosis during milk preservation. These findings may help in the identification of mastitis-causing bacteria and the selection of antibiotics for the treatment of mastitis.

Preparation of Value Added Cow Milk Lassi Blended with Custard Apple (Annona squamosa L.) Pulp

Lassi was prepared from different proportions of cow milk and custard apple pulp, i.e., 100:0 (T1), 90:10 (T2), 85:15 (T3), and 80:20 (T4). The mean score for the flavour was 8.17, 8.21, 8.32, and 8.27 for lassi prepared under treatments T1, T2, T3, and T4, respectively. The highest score was obtained by treatment T3, while the lowest score was recorded by treatment T1. The result indicated that the lassi prepared with 15 per cent custard apple pulp was superior over 0, 10, and 20, per cent levels. The colour and appearance score of lassi was significantly affected due to the addition of different levels of custard apple pulp. The mean scores for colour and appearance of lassi were T1 (8.43), T2 (8.45), T3 (8.48), and T4 (8.46). The highest score (8.48 out of 9) was obtained from lassi prepared with 15 per cent custard apple pulp as compared to other treatments. The highest score was obtained by treatment T3, while the lowest score was obtained by treatment T1. The body and texture score of lassi was significantly affected due to the addition of different levels of pulp. The significantly highest score (8.40 out of 9) was obtained by lassi prepared with 15 per cent (T3) custard apple pulp, while the lowest score (8.35) was obtained by plain lassi (T1). The sensory scores for overall acceptability of custard apple lassi treatments T1, T2, T3, and T4 were 8.33, 8.35, 8.39, and 8.36, respectively. It was observed that the custard apple lassi prepared from 85 parts cow milk and 15 parts custard apple pulp was most acceptable and ranked between like very much to like extremely. The addition of a higher proportion of pulp in the lassi was scored towards the lower side by a panel of judges.

Scurvy-Anow forgotten previously widespread disease

From the sea voyages of the fifteenth century often lasting for years with provisions only of fish, salted meat and biscuits reports came of fatal health alterations of the seamen which were characterized by prostration, loss of teeth and bad breath.Reports on comparable endemic illnesses soon came from the Netherlands, North Germany, the Baltic area, France, Lorraine, Geneva, Bohemia, Moravia, Silesia, Swabia and Russia: the so-called land scurvy. The first medical specification was found in aletter from 1541 by Johann Echt to colleges in the area of Lower Germany, which was published four times. One of the first comprehensive considerations was prepared by the English physician James Lind. Scurvy was also mostly published under many local names, such as Skorbut, Scharbock or Scheurbuik.The pathology of scurvy is dominated by gingival necrosis with loss of teeth, hemorrhages with destruction of the cartilage-bone border especially of the ribs and by subperiosteal hemorrhages of the ribs and long bones.For treatment and prevention of scurvy eating green plants as originally Ficaria verna (lesser celandine, pilewort), Chelidonium majus (great celandine, nipplewort, tetterwort) and Cochlearia officinalis (scurvy grass) proved to be effective. Where green plants were missing decoctions of conifer needles and fresh animal innards were used. When the infantile disease originally named "acute rachitis" in England was diagnosed as scurvy (later Möller-Barlow disease) the treatment of cow's milk for baby food became of great interest.Finally, hexuronic acid, later called ascorbic acid or vitaminC, was found to be adrug that could easily dosed for curing and prevention of scurvy.

Are pediatricians aware of the mysterious FPIES? Current diagnostic and treatment options. Case report

The prevalence of food allergies continues to grow steadily, and due to certain difficulties in diagnosing allergies not associated with immunoglobulin E, some conditions are little known. Such diagnosis-challenging diseases include food protein-induced enterocolitis syndrome (FPIES), a relatively low-prevalence disease most commonly occurring in early childhood but, in some cases, affecting adults as well. The pathogenesis of FPIES has not been reliably studied. FPIES is associated with elevated serum tryptase and release of pro-inflammatory cytokines, including interleukin-17. A characteristic symptom of FPIES is uncontrollable vomiting, which is probably triggered by the serotonin secreted by enterochromaffin cells, which activates the vagus nerve and the vomiting reflex, determining a good response of vomiting relief with ondansetron, a serotonin receptor antagonist. Changes in gut microbiota composition were also reported in FPIES. FPIES can lead to severe complications such as hypovolemic shock due to the rapid progression of symptoms and rapid dehydration, which often requires hospitalization of patients with acute FPIES. The provoking factors usually include products from the "big nine" allergens: cow's milk, eggs, gluten, soy, nuts, peanuts, fish, seafood, and sesame. FPIES can be acute or chronic; the manifestations slightly differ depending on the disease form. Laboratory diagnosis is difficult due to the lack of reliable biomarkers, and the diagnosis is established clinically and confirmed with an oral provocation test. The key treatment for FPIES is to eliminate the trigger protein from the diet, and depending on the severity of the disease, some patients may be allowed to consume a heat-treated allergen. The prognosis of FPIES is favorable: tolerance to the trigger product in most cases is developed within two years. Further studies are required to clarify the pathogenesis, prevalence, and treatment methods, with prospective follow-up of patients with a history of FPIES and the analysis of concurrent and subsequent diseases, including allergic conditions. The article presents two clinical cases of children diagnosed with FPIES.

Unforeseen severity in a case of neonatal cow milk protein allergy: a case report

Cow milk protein allergy (CMPA) is one of the most common childhood allergies that manifests with a range of digestive symptoms and skin reactions, which usually resolve with age. In this report, we present the case of a one-month-old male who presented with a rare and severe manifestation of neonatal CMPA. The neonate underwent numerous hospital admissions due to a presentation that closely mimicked symptoms of a metabolic disorder and sepsis. Our primary objective is to highlight the significance of systematically considering or excluding a CMPA diagnosis, irrespective of the severity of presentation. This proactive approach may potentially reduce future complications among the affected paediatric population, thereby preventing prolonged hospitalisation and the associated disease burden, as seen in this case. Keywords: Cow milk protein allergy, Metabolic acidosis, Amino-acid based infant formula, Neonatal food allergy, CMPA.