From: John Kim [mailto:firstname.lastname@example.org]
Sent: Wednesday, September 22, 2010 9:37 PM
To: kiddoc blogger; Arlene Roman Kim; David Bertoncini; Drew Jun; Jimmy Ching; Karen Childs Colorado.Mountain View Pediatrics; Summer Scheid; Susan Lim; Yuri WU
Subject: Fwd: Probiotics and colic Lactobacillus reuteri DSM 17938 in Infantile Colic: A Randomized, Double-Blind, Placebo-Controlled Trial -- Savino et al. 126 (3): e526 -- Pediatrics
Lactobacillus reuteri DSM 17938 in Infantile Colic: A Randomized, Double-Blind, Placebo-Controlled Trial -- Savino et al. 126 (3): e526 -- PediatricsClipped from: http://pediatrics.aappublications.org/cgi/content/abstract/126/3/e526DOes anyone know where to get this stuff?Published online August 16, 2010
PEDIATRICS Vol. 126 No. 3 September 2010, pp. e526-e533 (doi:10.1542/peds.2010-0433)
Lactobacillus reuteri DSM 17938 in Infantile Colic: A Randomized, Double-Blind, Placebo-Controlled TrialFrancesco Savino, MD, PhDa, Lisa Cordisco, PhDb,Valentina Tarasco, MDa, Elisabetta Palumeri, MDa,Roberto Calabrese, BSca, Roberto Oggero, MDa,Stefan Roos, PhDc, Diego Matteuzzi, PhDb
a Department of Pediatrics, Regina Margherita Children Hospital, University of Turin, Turin, Italy;
b Department of Pharmaceutical Sciences, University of Bologna, Bologna, Italy; and
c Department of Microbiology, Swedish University of Agricultural Sciences, Uppsala, Sweden
OBJECTIVE To test the efficacy of Lactobacillus reuteri on infantile colic and to evaluate its relationship to the gut microbiota.
STUDY DESIGN Fifty exclusively breastfed colicky infants, diagnosed according to modified Wessel's criteria, were randomly assigned to receive either L reuteri DSM 17 938 (108 colony-forming units) or placebo daily for 21 days. Parental questionnaires monitored daily crying time and adverse effects. Stool samples were collected for microbiologic analysis.
RESULTS Forty-six infants (L reuteri group: 25; placebo group: 21) completed the trial. Daily crying times in minutes/day (median [interquartile range]) were 370 (120) vs 300 (150) (P = .127) on day 0 and 35.0 (85) vs 90.0 (148) (P = .022) on day 21, in the L reuteri and placebo groups, respectively. Responders (50% reduction in crying time from baseline) were significantly higher in the L reuteri group versus placebo group on days 7 (20 vs 8; P = .006), 14 (24 vs 13; P = .007), and 21 (24 vs 15; P = .036). During the study, there was a significant increase in fecal lactobacilli (P = .002) and a reduction in fecal Escherichia coli and ammonia in the L reuteri group only (P = .001). There were no differences in weight gain, stooling frequency, or incidence of constipation or regurgitation between groups, and no adverse events related to the supplementation were observed.
CONCLUSION L. reuteri DSM 17 938 at a dose of 108 colony-forming units per day in early breastfed infants improved symptoms of infantile colic and was well tolerated and safe. Gut microbiota changes induced by the probiotic could be involved in the observed clinical improvement.
Key Words: Lactobacillus reuteri • infantile colic • FISH • gut microflora • Escherichia coli
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Thursday, September 23, 2010
RE: Probiotics and colic Lactobacillus reuteri DSM 17938 in Infantile Colic: A Randomized, Double-Blind, Placebo-Controlled Trial -- Savino et al. 126 (3): e526 -- Pediatrics
Wednesday, September 22, 2010
Allergy Tips AAP
The following tips are from the American Academy of Pediatrics (AAP). Feel free to excerpt the tips or use them in their entirety for any print or broadcast story, with acknowledgment of source: The American Academy of Pediatrics Guide to Your Child's Allergies and Asthma.
WHEN TO SUSPECT AN ALLERGY
Here are some common clues that could lead you to suspect your child may have an allergy:
- Repeated or chronic cold-like symptoms that last more than a week or two, or develop at about the same time every year. These could include a runny nose, nasal stuffiness, sneezing, throat clearing, and itchy, watery eyes.
- Recurrent coughing, wheezing, chest tightness, difficulty breathing, and other respiratory symptoms may be a sign of asthma. Coughing may be an isolated symptom; symptoms that increase at night or with exercise are suspicious for asthma.
- Recurrent red, itchy, dry, sometime scaly rashes in the creases of the elbows and/or knees, or on the back of the neck, buttocks, wrists, or ankles.
- Symptoms that occur repeatedly after eating a particular food that may include hives, swelling, gagging, coughing or wheezing, vomiting or significant abdominal pain.
- Itching or tingling sensations in the mouth, throat and/or ears during certain times of year or after eating certain foods.
COMMON ALLERGENS ON THE HOME FRONT
- Dust mites (dust mites are microscopic and are found in bedding, upholstered furniture and carpet as well as other places)
- Furred animal allergens (dogs, cats, guinea pigs, gerbils, rabbits, etc.)
- Pest allergens (cockroaches, mice, rats)
- Pollen (trees, grasses, weeds)
- Molds and fungi (including molds too small to be seen with the naked eye)
- Foods (cow's milk, eggs, peanuts, tree nuts, soy, wheat, fish and shellfish)
HOW TO MANAGE ALLERGIC NASAL SYMPTOMS
- Nasal allergy symptoms can be caused by a variety of environmental allergens including indoor allergens such as dust mites, pets, and pests as well as outdoor allergens such as pollens. Molds, which can be found indoors and outdoors, can also trigger nasal allergy symptoms.
- Allergy testing should be performed to determine what, if any, of these environmental allergens your child is allergic to.
- An important step in managing allergy symptoms is avoidance of the allergens that trigger the symptoms.
- If your child is allergic to pets, the addition of pets to your family would not be recommended. If your child has allergy symptoms and is allergic to a pet that lives with your family, the only way to have a significant impact on your child's exposure to pet allergens is to find the pet a new home.
- If your child is allergic to pests, professional extermination, sealing holes and cracks that serve as entry points for pests, storing foods in plastic containers with lids and meticulous clean up of food remains can help to eliminate the pests and reduce allergen levels.
- Dust mites congregate where moisture is retained and food for them (human skin scales) is plentiful. They are especially numerous in bedding, upholstered furniture, and rugs. Padded furnishings such as mattresses, box springs, and pillows should be encased in allergen-proof, zip-up covers, which are available through catalogs and specialized retailers. Wash linens weekly and other bedding, such as blankets, every 1 to 2 weeks in hot water. (The minimum temperature to kill mites is 130 degrees. If you set your water heater higher than 120 degrees, the recommended temperature to avoid accidental scald burns, take care if young children are present in the home.)
- If your child is allergic to outdoor allergens, it can be helpful to use air conditioners when possible. Showering or bathing at the end of the day to remove allergens from body surfaces and hair can also be helpful. For patients with grass pollen allergy, remaining indoors when grass is mowed and avoiding playing in fields of tall grass may be helpful. Children with allergies to molds should avoid playing in piles of dead leaves in the fall.
MEDICATIONS TO CONTROL SYMPTOMS
Your child's allergy treatment should start with your pediatrician, who may refer you to a pediatric allergy specialist for additional evaluations and treatments.
- Antihistamines – Ones taken by mouth can help with itchy watery eyes, runny nose and sneezing, as well as itchy skin and hives. Some types may cause drowsiness.
- Nasal Corticosteroids - Highly effective for allergy symptom control and are widely used to stop chronic symptoms. Safe to use in children over long periods of time. Must be used daily.
- Allergy Immunotherapy - Immunotherapy, or allergy shots, may be recommended to reduce
your child's allergy symptoms. Allergy shots are only prescribed in patients with confirmed allergy. If allergen avoidance and medications are not successful, allergy shots for treatment of respiratory allergies to pollen, dust mites, cat and dog dander, and outdoor molds can help decrease the need for daily medication.
- Ask your doctor about additional therapies.
COMMON TRIGGERS OF ASTHMA:
- ALLERGIES (molds, pollen, dust mites, cockroaches, animals--especially cats, dogs, and mice)
- TOBACCO SMOKE
- INFECTIONS (viral respiratory infections, colds, sinus infections)
- OUTDOOR AIR POLLUTION
- INDOOR AIR POLLUTION (aerosol sprays, cooking fumes, odors, smoke: cigarettes/tobacco, wood fires, wood-burning stoves)
MANAGING ECZEMA (ATOPIC DERMATITIS):
- Steroid creams are very effective. When used sparingly and at the lowest strength that does the job, they are very safe.
- Non-steroidal anti-inflammatory creams or ointments can be used for itching and redness and decrease the need for steroid creams.
- Antihistamine medication may be prescribed to relieve the itching, and help break the itch-scratch cycle.
- Long-sleeved sleepwear may also help prevent nighttime scratching.
- Soaps containing perfumes and deodorants may be too harsh for children's sensitive skin.
- Use laundry products that are free of dyes and perfumes and double-rinse clothes, towels and bedding.
- Lukewarm soaking baths are good ways to treat the dry skin of eczema. Gently pat your child dry after the bath to avoid irritating the skin with rubbing. Then, liberally apply moisturizing cream right away.
- Eczema, particularly when severe, may be associated with food allergies (e.g., milk, egg, peanut).
- Launder new clothes thoroughly before your child wears them. Avoid fabric softener.
© 2010 - American Academy of Pediatrics
Abstracted from the American Academy of Pediatrics Guide to Your Child's Allergies and Asthma.
For more information on allergies and asthma, visit the AAP Section on Allergy and Immunology web site
Prevalence of Colonization not causing disease in young well children is 12% Prevalence of Streptococcal Pharyngitis and Streptococcal Carriage in Children: A Meta-analysis -- Shaikh et al. 126 (3): e557 -- Pediatrics
Prevalence of Colonization not causing disease in young well children is 12% Prevalence of Streptococcal Pharyngitis and Streptococcal Carriage in Children: A Meta-analysis -- Shaikh et al. 126 (3): e557 -- PediatricsClipped from: http://pediatrics.aappublications.org/cgi/content/abstract/126/3/e557
PEDIATRICS Vol. 126 No. 3 September 2010, pp. e557-e564 (doi:10.1542/peds.2009-2648)
Prevalence of Streptococcal Pharyngitis and Streptococcal Carriage in Children: A Meta-analysisNader Shaikh, MD, MPHa, Erica Leonard, MDb,Judith M. Martin, MDc
Divisions of a General Academic Pediatrics and
c Pediatric Infectious Diseases, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania; and
b Swedish Family Medicine Residency Program, Seattle, Washington
OBJECTIVES Prevalence estimates can help clinicians make informed decisions regarding diagnostic testing of children who present with symptoms of pharyngitis. We conducted a meta-analysis to determine the (1) prevalence of streptococcal infection among children who presented with sore throat and (2) prevalence of streptococcal carriage among asymptomatic children.
METHODS We searched Medline for articles on pediatric streptococcal pharyngitis. We included articles in our review when they contained data on the prevalence of group A Streptococcus (GAS) from pharyngeal specimens in children who were younger than 18 years. Two evaluators independently reviewed, rated, and abstracted data from each article. Prevalence estimates were pooled in a meta-analysisand stratified according to age group.
RESULTS Of the 266 articles retrieved, 29 met all inclusion criteria. Among children of all ages who present with sore throat, the pooled prevalence of GAS was 37% (95% confidence interval [CI]: 32%–43%). Children who were younger than 5 years had a lower prevalence of GAS (24% [95% CI: 21%–26%]). The prevalence of GAS carriage among well children with no signs or symptoms of pharyngitis was 12% (95% CI: 9%–14%).
CONCLUSIONS Prevalence rates of GAS disease and carriage varied by age; children who were younger than 5 years had lower rates of throat cultures that were positive for GAS.
Key Words: Streptococcus • carriage • pediatrics • prevalence • meta-analysis
Abbreviations: GAS = group A Streptococcus • CI = confidence interval
Accepted May 20, 2010.