A single FENO measurement is probably of scarce prognostic and predictive value and it is not surprising to find discordance with BHR. We suggest that FENO measurement could represent a good marker of airway inflammation also in naïve atopic children with intermittent asthma. Repeated measurements over time are probably necessary to understand better the clinical implications of the data obtained in this study.

Asthma is related to atopy in pre-selected children only from the age of 7 years. House dust mite sensitization seems to be an important determinant of asthma in these "older" children.

According to our findings, most Italian general pediatricians do not seem to follow the recommendations of the 2009 NASPGHAN-ESPGHAN reflux guidelines and often prescribe PPIs despite a lack of efficacy for the symptoms being treated. We are well aware that the guidelines address the average situation and that the evaluation of individual patients may frequently reveal reasons for opening criteria for exceptions. Nevertheless, the over-diagnosis of gastroesophageal reflux disease (GERD) places undue burden on both families and national health system which has not been impacted by the publication of international guidelines.

Background: Allergic rhinitis is a known health problem worldwide. Objective: The aim of the study was to determine the association between breastfeeding and serum IgE level as well as its impact on quality of life in children with allergic rhinitis. Methodology: A cross sectional comparative study was done among pediatric patients aged 6-12 who have allergic rhinitis with evidence of positive skin prick test (SPT), for 30 specifically selected patients each for breastfed and non-breast-fed. For each patient, serum IgE was taken and interviewed using the modified allergy questionnaire by validated Sher Allergy Specialists questionnaire (Florida) and Rhinoconjuntivitis Quality of Life Questionnaires (RQLQ) by Juniper. Statistical analysis was performed using SPSS 13.0. The significant association was analyzed using Pearson's chi-square and Mann-Whitney U tests. Results: There was no significant difference (p = 0.688) with regards to serum IgE level between breastfed and non-breast-fed children. However, children who were breastfed have a better mean of quality of life (mean=1.1679) than non-breast-fed (mean=1.5274). Conclusion: Our study showed that there is no association between breastfeeding and serum IgE level. Nevertheless, the quality of life is better in breast-fed children. A larger sample and longer duration of study are required to substantiate these findings.