Early vaccinations are not risk factors for celiac disease.

OBJECTIVES: To investigate if changes in the national Swedish vaccination program coincided with changes in the celiac disease (CD) incidence rate in infants (ie, the Swedish CD Epidemic), and to assess the potential association between these vaccinations and CD risk. METHODS: All studies were based on the National Swedish Childhood Celiac Disease Register. Using an ecological approach, we plotted changes over time in the national vaccination program in the graph displaying CD incidence rate. A population-based incident case-referent study of invited infants was performed. Exposure information was received through a questionnaire and child health clinic records. Vaccines explored were diphtheria/tetanus, pertussis (acellular), polio (inactivated), Haemophilus influenzae type b (conjugated), measles/mumps/rubella, and live attenuated bacillus Calmette-Guérin (BCG) in children with increased tuberculosis risk. Findings were subjected to a birth cohort analysis. RESULTS: Introduction of pertussis vaccine coincided in time with decreasing CD incidence rates. In the infant case-referent study, however, neither vaccination against pertussis (odds ratio 0.91; 95% confidence interval 0.60-1.4), nor against Haemophilus influenzae type b or measles/mumps/rubella was associated with CD. Coverage for the diphtheria/tetanus and polio vaccines was 99%. BCG was associated with reduced risk for CD (adjusted odds ratio 0.54; 95% confidence interval 0.31-0.94). Discontinuation of general BCG vaccination did not affect the cumulative incidence of CD at age 15 years. CONCLUSIONS: Early vaccinations within the national Swedish program were not associated with CD risk, nor could changes in the program explain the Swedish epidemic. A protective effect by BCG was suggested, which could be subject to further studies

Роль кафедры акушерства и гинекологии ФПК и ПК в подготовке врачей-интернов

ИНТЕРНАТУРА И РЕЗИДЕНТУРААКУШЕРСТВОГИНЕКОЛОГИЯМЕДИЦИНСКОЙ ПРАКТИКИ МЕНЕДЖМЕНТОБРАЗОВАНИЕ МЕДИЦИНСКО

Water purification capacity of natural mixed clays from Malawi

Lack of fresh and clean drinking water is a problematic issue for many people worldwide. The water quality in some streams in Malawi, situated in south east Africa, has recently been investigated. The study shows that the concentration of several heavy metals exceeds the guideline values in drinking water set by WHO. Even though some heavy metals are essential for human beings in low concentrations, they are hazardous to health in high concentrations. Problems with contaminated water exist all over the world but are striking and more difficult to solve in countries with low financial assets. It is therefore of great importance to find an effective technique to purify water that is both simple and cheap and where preferably domestic material is used. The aim of this study is to investigate whether three natural mixed clays from Malawi can be used to purify contaminated water from the heavy metals chromium(III), lead(II), cadmium(II), copper(II) and zinc(II) through adsorption. X-ray powder diffraction analyses proved that all samples contained quartz, and indicated presence of the iron oxide hematite. The chemical content of the samples was determined with a scanning electron microscope. Acid and base titrations were thereafter performed on raw material as well as on clay that had been purified from organic matter, carbonates and iron compounds, to obtain information regarding the chemical properties of the clay minerals. Finally, adsorption experiments were carried out by mixing the clays with heavy metal solutions and study the adsorption as function of pH. The pH values of the investigated clays are naturally high, which promotes hydrolyses of chromium(III) and lead(II) to precipitate and get sorbed on the surface. Cadmium(II), copper(II) and zinc(II) form on the contrary surface complexes, mainly inner-sphere ones. The adsorption of chromium(III), lead(II) and copper(II) was complete at pH = 7 for the purified clays, whereas cadmium(II) and zinc(II) were adsorbed to only 77 and 75 %, respectively, at pH ≈ 7.5. However, all metals are in principle completely removed from the aqueous phase in the raw material, which indicates that these nontreated natural clays are highly potential in heavy metal removal.Att inte ha tillgång till rent dricksvatten är verklighet för många människor runt om i världen. En undersökning av vattenkvaliteten i några floder i Malawi, i sydöstra Afrika, visar att koncentrationen av ett flertal tungmetaller kraftigt överstiger de gränsvärden som världshälsoorganisationen WHO har slagit fast. Trots att vissa tungmetaller är livsnödvändiga i låga koncentrationer så kan de i för höga halter ha mycket negativa hälsoeffekter. Problem av dessa slag förekommer på många håll, men slår kanske hårdast mot de länder som har små ekonomiska tillgångar. Det finns därför ett stort behov av att utveckla en effektiv reningsmetod som är både enkel och billig och där inhemskt material kan nyttjas. Denna studie syftar till att undersöka huruvida tre olika naturliga leror från Malawi kan användas för att rena kontaminerat vatten från tungmetallerna krom(III), bly(II), kadmium(II), koppar(II) och zink(II) genom adsorption. Med hjälp av pulverröntgendiffraktion kunde det konstateras att alla prover innehåller kiseloxiden kvarts. Det fanns även tecken på att järnoxiden hematit förekommer. Proverna studerades i ett svepelektronmikroskop utrustad med röntgenfluorescensdetektor, vilket möjliggjorde bestämning av grundämnessammansättningen. Genom syra- och bastitreringar på råmaterial samt lera som renats från organiskt material, karbonater och järnföreningar erhölls information om lerytornas kemiska egenskaper. Slutligen genomfördes studier där lera blandades med tungmetallösningar och adsorptionsgraden undersöktes vid olika pH-värden. Lerorna har naturligt ett högt pH-värde vilket främjar hydrolys av krom(III) och bly(II) som därmed faller ut och fastnar på ytorna. De andra studerade tungmetallerna, kadmium(II), koppar(II) och zink(II), adsorberades troligen till ytorna genom bildning av ytkomplex, främst av typen innersfärskomplex. Adsorptionen av krom(III), bly(II) och koppar(II) var fullständig vid pH = 7 i de renade jordarna, medan kadmium(II) och zink(II) endast adsorberades till 77 respektive 75 % i det undersökta pH-intervallet. I de orenade jordarna var däremot samtliga metaller i princip fullständigt avlägsnade från vattenfasen, vilket indikerar att dessa orenade naturliga leror har stor potential att kunna användas i vattenreningssyfte

Partly Fermented Infant Formulae With Specific Oligosaccharides Support Adequate Infant Growth and Are Well-Tolerated.

Fermented formulae (FERM) and a specific mixture of 90% short-chain galacto-oligosaccharides and 10% long-chain fructo-oligosaccharides (scGOS/lcFOS; 9:1) have a potential beneficial effect on gastrointestinal function and microbiota development in infants. The present study assessed the safety and tolerance of the combination of partly fermented infant milk formulae and scGOS/lcFOS compared with either 1 feature, in healthy term infants. Four hundred thirty-two infants were enrolled before 28 days of age and followed up to 17 weeks of age and assigned to 1 of the 4 groups: (i) formula with scGOS/lcFOS, (ii) scGOS/lcFOS + 15% FERM, (iii) scGOS/lcFOS + 50% FERM, or (iv) 50% fermented formula (50% FERM). Primary outcome was daily weight gain during intervention (equivalence criterion: difference in daily weight gain ≤3 g/day). Infants' anthropometrics, formula intake, number, and type of (serious) AEs were monitored monthly. Stool samples were collected at baseline and after 17 weeks for analysis of physiological and microbiological parameters. Equivalence of weight gain per day was demonstrated in both the intention-to-treat and per-protocol population, with a mean weight gain (SD) of 29.7 (6.1), 28.2 (4.8), 28.5 (5.0), and 28.7 (5.9) g/day for the groups i to iv respectively. No differences were observed in other growth parameters, formula intake, and the number or severity of AEs. In all scGOS/lcFOS-containing formulae, a beneficial effect of scGOS/lcFOS was observed, indicated by the lower pH, lower Clostridium difficile levels, and higher secretory immunoglobulin A levels. The partly fermented infant milk formulae containing the specific mixture scGOS/lcFOS were well-tolerated and resulted in normal growth in healthy infants

Quality and Safety Aspects of Infant Nutrition

Quality and safety aspects of infant nutrition are of key importance for child health, but oftentimes they do not get much attention by health care professionals whose interest tends to focus on functional benefits of early nutrition. Unbalanced diets and harmful food components induce particularly high risks for untoward effects in infants because of their rapid growth, high nutrient needs, and their typical dependence on only one or few foods during the first months of life. The concepts, standards and practices that relate to infant food quality and safety were discussed at a scientific workshop organized by the Child Health Foundation and the Early Nutrition Academy jointly with the European Society for Paediatric Gastroenterology, Hepatology and Nutrition, and a summary is provided here. The participants reviewed past and current issues on quality and safety, the role of different stakeholders, and recommendations to avert future issues. It was concluded that a high level of quality and safety is currently achieved, but this is no reason for complacency. The food industry carries the primary responsibility for the safety and suitability of their products, including the quality of composition, raw materials and production processes. Introduction of new or modified products should be preceded by a thorough science based review of suitability and safety by an independent authority. Food safety events should be managed on an international basis. Global collaboration of food producers, food-safety authorities, paediatricians and scientists is needed to efficiently exchange information and to best protect public health. Copyright (C) 2012 S. Karger AG, Base

Innovative solutions to sticky situations: Antiadhesive strategies for treating bacterial infections

ABSTRACT Bacterial adherence to host tissue is an essential process in pathogenesis, necessary for invasion and colonization and often required for the efficient delivery of toxins and other bacterial effectors. As existing treatment options for common bacterial infections dwindle, we find ourselves rapidly approaching a tipping point in our confrontation with antibiotic-resistant strains and in desperate need of new treatment options. Bacterial strains defective in adherence are typically avirulent and unable to cause infection in animal models. The importance of this initial binding event in the pathogenic cascade highlights its potential as a novel therapeutic target. This article seeks to highlight a variety of strategies being employed to treat and prevent infection by targeting the mechanisms of bacterial adhesion. Advancements in this area include the development of novel antivirulence therapies using small molecules, vaccines, and peptides to target a variety of bacterial infections. These therapies target bacterial adhesion through a number of mechanisms, including inhibition of pathogen receptor biogenesis, competition-based strategies with receptor and adhesin analogs, and the inhibition of binding through neutralizing antibodies. While this article is not an exhaustive description of every advancement in the field, we hope it will highlight several promising examples of the therapeutic potential of antiadhesive strategies.</jats:p