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Objectives: To examine sex differences in disease profiles, management, and survival at 1 and 5 years after ischemic stroke (IS) among people with atrial fibrillation (AF). Methods: We performed a systematic literature search of reports of AF at IS onset according to sex. We undertook an individual participant data meta-analysis (IPDMA) of nine population-based stroke incidence studies conducted in Australasia, Europe, and South America (1993-2014). Poisson regression was used to estimate women:men mortality rate ratios (MRRs). Study-specific MRRs were combined using random effects meta-analysis. Results: In our meta-analysis based on aggregated data from 101 studies, the pooled AF prevalence was 23\% (95\% confidence interval [CI]: 22\%-25\%) in women and 17\% (15\%-18\%) in men. Our IPDMA is of 1,862 IS-AF cases, with women (79.2 ± 9.1, years) being older than men (76.5 ± 9.5, years). Crude pooled mortality rate was greater for women than for men (1-year MRR 1.24; 1.01-1.51; 5-year 1.12; 1.03-1.22). However, the sex difference was greatly attenuated after accounting for age, prestroke function, and stroke severity (1-year 1.09; 0.97-1.22; 5-year 0.98; 0.84-1.16). Women were less likely to have anticoagulant prescription at discharge (odds ratio [OR] 0.94; 95\% CI: 0.89-0.98) than men when pooling IPDMA and aggregated data. Conclusions: AF was more prevalent after IS among women than among men. Among IS-AF cases, women were less likely to receive anticoagulant agents at discharge; however, greater mortality rate in women was mostly attributable to prestroke factors. Further information needs to be collected in population-based studies to understand the reasons for lower treatment of AF in women.

Massi-Benedetti, F., Marini, A., Caccamo, M. L. and Falorni, A. (Paediatric Clinic of the University of Perugia and the Service of Neonatal Pathology of the University of -Milan, Italy). Blood glucose and plasma insulin and glucagon response during intravenous glucose tolerance test in newborn infants affected by erythroblastosis foetalis. Acta Paediatr Scand, 64:113, 1975.–Intravenous glucose injection (1 g/kg b.w.) was performed in eight newborn infants affected by erythroblastosis foetalis (IEF) and in seven controls during the first day of life in order to study insulin and glucagon response. The IEF infants were affected by mild or moderate hemolytic disease and their blood glucose values and plasma insulin concentrations before and throughout the test did not differ significantly from those of the controls. After the glucose injection the plasma glucagon concentrations showed great variations in both groups. The control infants did not show any significant changes; in the IEF infants, significant decreases were seen at 3 and 20 min of the test. These data seem to indicate that the alpha-cell sensitivity to glucose is greater in IEF than in normal infants and is not dependent on the development of the glucose-mediated insulin release mechanism.

The data from the present investigation differ from those of the previous study. The new version of hydrolysed protein formula did not induce changes in insulinaemia or in the insulinaemia/glycaemia ratio in pre- and postprandial samples when compared with the intact protein formula. The investigation also confirmed that branch chain aminoacids regulate insulin secretion and that the length of chain is insulinotropic for fatty acids, while the degree of unsaturation is not able to reduce insulin secretion in the newborn baby. This could be caused by stimulation of insulin output activated by the C20:5 n 3; the effects of fatty acids are probably related more to the variable composition of cell membrane than to the fatty acids circulating levels.

The incidence of allergic manifestations was evaluated from birth until 6 y of age in 83 very low-birthweight infants (VLBWIs). In the same period 98 full-term babies were followed from birth to 24 mo of life. All the subjects were examined by paediatricians to establish the presence of atopic dermatitis (AD), gastrointestinal disturbances (GD) and asthma (AS). The incidence of total allergic manifestations (31.3%) in VLBWIs was significantly lower than that (52%) in 24-mo-old infants, born at full term. The incidence of allergies in VLBWIs did not differ at all at the subsequent checks, up to 6 y of age. AD (33.7%) was the most common symptom, statistically higher in full-term infants than in VLBWIs (7.2%). GD had a similar distribution (8.2% in full-term infants vs 7.2% in VLBWIs). AS (16.8%) was significantly higher in VLBWIs than in those born full term (10.2%). In the various VLBWI subgroups analysed, AD was more prevalent in babies weighing >1000 g and in babies >30 wk of age; the incidence of GD was higher in infants weighing

Summary Purpose: To assess the advantages of the 2001 ILAE proposed diagnostic scheme for classification of newborns with epileptic seizures over the 1989 ILAE classification. Method: Clinical features, seizure semiology and duration, neurological evaluation, ictal and interictal EEG, brain imaging and outcome at the end of the neonatal period (44 weeks post-conceptional age) of 94 newborns with EEG confirmed seizures were analyzed. The 2001 ILAE classification was applied where possible. Results: Twenty patients died before the end of the neonatal period. In the remaining patients, applying axis 3, we classified 54 newborns as having epileptic seizures that do not require a diagnosis of epilepsy; 14 as symptomatic partial epilepsy; 5 within the neonatal epileptic syndromes and one as benign neonatal seizures (NS). Axis 4 in all newborns provided a valuable tool in order to better define the individual patient. Conclusions: Compared to the 1989 ILAE classification, which allowed a syndromic diagnosis in only 6/94 patients, the remaining being classified as Epilepsies and Syndromes undetermined whether focal or generalized, the 2001 ILAE diagnostic scheme, applied at the end of the neonatal period, offers a variety of approaches to classification, allowing an early distinction between epilepsy and single or isolated clusters of seizures, with therapeutic and prognostic implications.

Background: Coenzyme Q10 has been recognized as an important antioxidant factor besides its main role in bioenergetic metabolism. CoQ10 tissue levels depend both on exogenous dietetic intake and on endogenous biosynthesis, as this compound can be partly synthesized in human cells. Q10 plasma levels reflect the tissue content of the coenzyme and can be used to evaluate the presence of this compound in the human organism. Design/Methods: Aim of the study was to measure CoQ10 plasmatic levels in a newborn breast-fed population and to compare them to CoQ10 levels in a newborn formula-fed population in order to verify whether changes in CoQ10 plasmatic contents could be related to a different dietetic intakes. We measured CoQ10 plasmatic levels in 25 healthy term neonates with different dietetic intakes: 15 breast-fed and 10 bottle-fed with a common infant formula. These infants were evaluated prospectively during the first month of life. The analyses were performed on the mothers’ blood samples and cord blood samples at the time of delivery, then on infants at 4 and 28 days of age. Results: Our results showed markedly reduced Q10 levels in cord blood samples compared to maternal Q10 plasmatic levels at the time of delivery, suggesting placental impermeability towards this molecule or increased fetal utilization during labor and delivery. At 4 days of age Q10 levels had increased in both groups of neonates, but significantly more in breast-fed infants compared to formula-fed babies (p < 0.05). At 4 weeks of age no significant changes occurred in breast-fed infants, while values increased significantly in formula-fed infants (p < 0.05). The content of Q10 in breast milk samples was lower than in infant formula. Conclusions: The results of this study show that CoQ10 plasmatic levels are at least partly influenced by the exogenous dietetic supply.

Background: Oxygen (O2) plays a critical role in the O2-reduction reactions indispensable for life, but can produce free radicals that are involved in many diseases. Coenzyme Q10 (CoQ10), acting as a redox carrier in the respiratory chain, occupies a central position in the energy metabolism and oxidative defence. Neonates seem to be very subjected to oxidative stress because of their deficient antioxidant systems. Design/Methods: The aim of the study was to verify whether the mode of delivery may affect CoQ10 levels in the mother and neonate, and thus influence the risk of oxidative damage in the newborn. We measured CoQ10 levels in maternal plasma and cord blood at birth after three different modes of delivery (45 term healthy pregnancies): (1) vaginal in room air (VD) (n = 15); (2) elective caesarean section with general anaesthesia (50% O2 and 50% N2O) (CSg) (n = 15), and (3) elective caesarean section with spinal anaesthesia without O2 (CSs) (n = 15). Our results showed higher levels of Q10 in mothers and neonates with VD (1.29 ± 0.43 and 0.15 ± 0.06 µg/ml, respectively) or CSs (1.15 ± 0.28 and 0.24 ± 0.06 µg/ml, respectively) when compared to CSg (0.74 ± 0.28 and 0.07 ± 0.03 µg/ml, respectively) (p < 0.01). Conclusions: These data demonstrate that the mode of delivery may affect CoQ10 levels in mothers and neonates, and thus influence the risk of oxidative damage in the newborn.

Background: The type of feeding can differently influence bile acid ontogeny during the period of physiologic cholestasis that characterizes early human development. Aim: To investigate the effects of feeding from birth, conventional or partially protein hydrolyzed cow’s milk formulas were compared with breast milk regarding bile acid concentration and the composition of gallbladder bile in newborn guinea pigs. Methods: Forty newborn guinea pigs were allocated to one of three different feeding regimens: breast milk (n = 14), intact protein formula (n = 13) and partially protein hydrolyzed formula (n = 13). After 8 days, one third of the pups from each group was sacrificed; another third was sacrificed on the 14th day and the remainder on the 20th day of life. Bile acids in gallbladder bile were analyzed by gas chromatography/mass spectrometry and HPLC. Results: During the first 2 weeks of life, weight gain was significantly higher in breast-fed than in artificially fed pups. An age-related increase in total biliary bile acid concentrations was evident for breast-fed and hydrolyzed formula-fed animals, but not for those fed intact protein formula. Breast-fed animals had the highest total biliary bile acid concentrations on day 20 of life, with significant increases in chenodeoxycholic and 7-oxo-lithocholic acid concentrations, which were absent in the other two groups. Concentrations of 7-oxo-lithocholic acid on day 8 were significantly higher in animals fed intact protein formula compared with breast-fed and partially protein hydrolyzed formula-fed animals. Conclusions: In newborn guinea pigs, breast feeding is associated with a marked increase in biliary bile acid concentrations, which was not observed in artificially fed animals. The higher biliary bile acid concentrations and better weight gain in our breast-fed animals may reflect a greater feed efficiency associated with natural feeding. Biliary bile acid composition on day 8 suggests more rapid intestinal bacterial bile acid biotransformation in animals fed intact protein formula compared to other feeding regimens.

This study was designed to collect data on the prevalence of respiratory syncytial virus (RSV) infection in Italy in infants hospitalized for lower respiratory tract infections, and to evaluate which of the recognized risk factors might be associated with disease severity. Thirty-two centers throughout Italy participated in the study. Over a 6-month period (November 1,1999 to April 30, 2000), we evaluated all children2 years of age hospitalized for lower respiratory tract infections. All subjects were tested for RSV within 24 hr of hospitalization by using an immuno-enzymatic diagnostic test (Abbott Testpack, RSV). Logistic regression was used to identify the factors that might be associated with more severe disease or could increase the likelihood of RSV positivity in hospitalized infants. Out of a total of 1,232 children enrolled, 40.6% were found to be RSV-positive (RSV+). The peak of the RSV epidemic occurred in February, while the lowest prevalence of RSV positivity was seen in November (P0.05). A high proportion of study subjects had low birth weight and low gestational age. The clinical diagnosis at hospitalization was bronchiolitis in 66.7%, pneumonia in 15.3%, and wheezy bronchitis in 18.1%. In the bronchiolitis group, a higher prevalence of RSV+ was found in patients with gestational ageor= 33 weeks or 34-35 weeks, as compared to those with a gestational ageor= 36 weeks (P0.04). No differences were found in the proportion of RSV+ patients in the three gestational age subgroups with pneumonia and wheezy bronchitis (P0.05, each comparison). Independent of the clinical diagnosis at admission, RSV infection was associated with more severe respiratory impairment. Environmental smoke exposure was higher in subjects with bronchiolitis than in those with wheezy bronchitis (P0.04), and RSV+ was positively related with the birth order (P0.05). The presence of older siblings and birth order plays an important role in RSV infection. The collected data show that, in Italy, RSV is an important cause of lower respiratory tract infection in infants. Gestational age, birth order, birth weight, and exposure to tobacco smoke affected the prevalence and severity of RSV-related lower respiratory tract disease.

Background: The establishment of a balanced intestinal microflora which may protect against infection is desirable for the preterm infant. Objective: To investigate the effect of a preterm formula milk supplement consisting of oligosaccharides in similar proportions to human milk on the faecal flora and stool characteristics of preterm infants. Study design: To resemble the effect of human milk, an oligosaccharide mixture consisting of 90% galacto-oligosaccharides and 10% fructo-oligosaccharides was used to supplement a standard preterm formula at a concentration of 10 g/l. This supplemented formula was studied in 15 preterm infants, and the results were compared with those found in 15 infants fed a formula supplemented with maltodextrin as placebo. A group fed fortified mother's milk was investigated as a reference group (n = 12). On four days during a 28 day feeding period (1, 7, 14, and 28), the faecal flora was investigated, and stool characteristics, growth, and possible side effects were recorded. Results: During the study period, the number of bifidobacteria in the group fed the oligosaccharide supplemented formula increased to the upper range of bifidobacteria counts in the reference group. The difference between the supplemented and non-supplemented groups was highly significant (p = 0.0008). The stool characteristics were also influenced by the supplement: the stool frequency after 28 days was significantly lower in the control group than in the oligosaccharide supplemented group (p = 0.0079) and the reference group (p < 0.0001). Over the study period, the stool consistency in the control group became harder, but remained fairly stable in the other two groups. There was no effect of the different diets on the incidence of side effects (crying, regurgitation, vomiting) or on weight gain or length gain. Conclusion: Supplementing preterm formula with a mixture of galacto- and fructo-oligosaccharides at a concentration of 10 g/l stimulates the growth of bifidobacteria in the intestine and results in stool characteristics similar to those found in preterm infants fed human milk. Therefore prebiotic mixtures such as the one studied may help to improve intestinal tolerance to enteral feeding in preterm infants.

Freezing is a commonly used preservation method in the meat industry. The understanding of the product behavior during the freezing process can assist in a better process management and quality control. This work reports the study of freezing and thawing of three types of processed meat in order to determine process parameters in an industrial forced‑air freezing tunnel at ‑30oC. Chicken sausages (frankfurter type), mortadela (bologna type) and mechanically deboned chicken meat (MDCM) were studied. Products were placed in several layers in corrugated cardboard boxes (CCB) for sausages and mortadela. MDCM was placed in a nylon box. Temperature sensors were inserted in the products and the freezing and thawing curves were obtained. Freezing curves were used to determine the freezing time (tf), initial freezing point (Tf) and final freezing point (T’m). Products placed in different layers in the CCB had significantly different freezing times, being the higher rates for products placed in more external layers than internal ones. The external layers of product were subjected to heat transfer by convection showing its importance to decrease freezing time. The results strongly suggest that products placed in different layers could have distinct quality properties and also play a key role in the freezing process efficiency.

Neste trabalho relata-se o caso de uma paciente de 46 anos de idade com queixa de aumento de volume periumbilical e dor leve antes da menstruação. O quadro evoluiu com aumento gradativo da dor. Foram realizados ultra-som, tomografia computadorizada e ressonância magnética. Após laparotomia exploradora, foi retirado material para biópsia que confirmou o diagnóstico de leiomiomatose peritoneal disseminada.The present study reports the case of a 46-year-old female patient complaining of mild premenstrual pain and increase in the volume of the periumbilical region. The condition progressed with a gradual increase of the pain intensity. Ultrasonography, computed tomography and magnetic resonance imaging were performed. Biopsy of tissue collected during exploratory laparotomy confirmed the diagnosis of leiomyomatosis peritonealis disseminata.

The present study reports the case of a 46-year-old female patient complaining of mild premenstrual pain and increase in the volume of the periumbilical region. The condition progressed with a gradual increase of the pain intensity. Ultrasonography, computed tomography and magnetic resonance imaging were performed. Biopsy of tissue collected during exploratory laparotomy confirmed the diagnosis of leiomyomatosis peritonealis disseminata.

Evidence indicates that the GBV-C or hepatitis G virus can cause persistent infection in humans, but little is known on the importance of vertical transmission. To assess the risk of mother-to-infant transmission and the clinical outcome of infected babies, we investigated 175 anti-HCV positive mothers and followed-up their children for 3-33 months. GBV-C RNA was detected by RT-PCR and anti-E2 antibody was assayed by EIA. Thirty-four (19.4%) women were GBV-C RNA positive and transmission occurred to 21 (61.8%) babies; 20 (95.2%) acquired GBV-C alone, and one (4.8%) GBV-C and HCV. Maternal factors such as intravenous drug use, HIV coinfection, HCV-RNA positivity, and type of feeding were not correlated with GBV-C transmission. GBV-C RNA remained persistently positive in all infected babies but one baby who seroconverted to anti-E2. Seven (35%) babies with GBV-C alone developed marginally elevated ALT; the baby with HCV and GBV-C co-infection had the highest ALT peak value (664 IU/l). Seven of the 141 (5%) babies born to the GBV-C RNA negative mothers acquired HCV and six (85.7%) had abnormal ALT. The mean ALT peak value was significantly higher (P < 0.05) for babies with HCV than for those with GBV-C. None of the children with GBV-C or with HCV became icteric. GBV-C is frequently present in anti-HCV positive women. The infection is transmitted efficiently from mother to baby and rate of transmission is much higher than that for HCV. GBV-C can cause persistent infection in babies but usually without clear evidence of liver disease.

Platelet function was investigated in full-term infants on the first, the fourth and the tenth days of life and compared to normal adult controls. Platelet function was analyzed through a new cytofluorimetric technique with two murine monoclonal antibodies, PAC-1 and anti-GMP-140, directed against two membrane proteins expressed on the activated platelets’ surface. The percentage of activated platelets detected with PAC-1 and anti-GMP-140 was evaluated at basal condition and after in vitro stimulation with a weak agonist (ADP) and a strong Txa2 analogue inducer (U 46619). At day 1 platelet activation at basal condition was negligible and similar to adult controls both with PAC-1 (1.2 vs. 1.1%) and anti-GMP-140 (2.6 vs. 3.3%). On the contrary, after ADP stimulation the percentage of PAC-1-positive activated platelets was significantly reduced in neonates compared to adults (22 vs. 66%; p < 0.001) and even more after U 46619 (11 vs. 72%; p < 0.001). The percentage of anti-GMP-140-positive activated platelets behaved similarly after adding both ADP (26 vs. 46%; p < 0.01) and U 46619 (37 vs. 67%; p < 0.001). The reduced platelet activation after ADP and U 46619 persisted at day 4 both with PAC-1 and with anti-GMP-140. On the contrary, at day 10 newborn platelets analyzed with anti-GMP-140 behaved similarly to the adult ones both at basal condition and after stimulation with ADP or U 46619 (6 vs. 3% at basal state, 42 vs. 46% after ADP addition, and 55 vs. 67% after U 46619). These data demonstrate that the reduced platelet activation present in newborns is restored by the tenth day after birth.

The fibrinolytic system controls fibrin deposition and its clearance. The efficacy of this system can be evaluated by plasminogen concentration determinations and by the behavior of factors such as histidine-rich glycoprotein (HRG) which controls plasminogen activation and α2-antiplasmin which controls plasmin activity. Circulating plasminogen levels are decreased in the neonatal period. We studied factors affecting fibrinolysis in neonates and observed that an important reduction in HRG accompanied the reduced circulating plasminogen levels, with the result that 85% of circulating plasminogen was not bound to HRG and was thus free for binding to fibrin and for activation to plasmin. This condition is consistent with the increased fibrinolytic activity secondary to the ‘clotting activation’ observed in the neonatal period particularly on the 1st day of life.

In this work, computational simulations were performed in order to characterize the way electromagnetic radiation interacts with the human head. Average of realistic parameters of bio-materials, such as bones and head liquids, as well as near field radiation parameters of a half-wave dipole are beeing considered in order to achieve results. This way, a software was developed in which Maxwell's equations are numerically solved by using a Beowulf cluster. The solver is based on the finite-difference time-domain method, associated to domain truncation by the uniaxial perfectly mactched layers technique and full-wave solutions have been obtained from the simulation. All averaged SAR values and electric field distributions inside modeled analysed structures have been compared to experimental results obtained in a full setup laboratory with all equipments necessary to perform dosimetric validations of telecomunication devices as shown in IEEE 1528.

This work presents a multi-platform three-dimensional computational electromagnetic environment called SSAR-BR. It was developed using free software and applied to design devices and analyze non-ionizing radiation effects in humans. The SSAR-BR integrates a CAD interface and pos-processing module developed in Java and the processing is performed by numerical methods in C++ (FDTD 3D) and Fortran (FEM 3D). This entire solution provides a sophisticated computational environment based on Software Engineering principles, which contributes with computational performance and components reuse. The evaluations tests were focused in the numerical accuracy and the human-machine interactions, providing successful results in both cases.

Neste trabalho relata-se o caso de uma paciente de 46 anos de idade com queixa de aumento de volume periumbilical e dor leve antes da menstruação. O quadro evoluiu com aumento gradativo da dor. Foram realizados ultra-som, tomografia computadorizada e ressonância magnética. Após laparotomia exploradora, foi retirado material para biópsia que confirmou o diagnóstico de leiomiomatose peritoneal disseminada. The present study reports the case of a 46-year-old female patient complaining of mild premenstrual pain and increase in the volume of the periumbilical region. The condition progressed with a gradual increase of the pain intensity. Ultrasonography, computed tomography and magnetic resonance imaging were performed. Biopsy of tissue collected during exploratory laparotomy confirmed the diagnosis of leiomyomatosis peritonealis disseminata.

In a previous study on formula-fed preterm infants, we were able to demonstrate that dietary oligosaccharides (a mixture of 90% galacto-oligosaccharides and 10% fructo-oligosaccharides in a concentration of 1 g/dl) stimulate the growth of faecal bifidobacteria. In the present explorative analysis of this study, we focus on the effect of the dominance of bifidobacteria on the presence of clinically relevant pathogens (Staphylococcus aureus, Staphylococcus epidermidis, Staphylococcus haemolyticus, Pseudomonas aeruginosa, Enterobacter, Klebsiella, Proteus, Streptococcus group B, Clostridium difficile, Bacillus subtilis and Acinetobacter).The data demonstrate that stimulation of bifidobacteria by prebiotic oligosaccharides reduces the presence of clinically relevant pathogens in the faecal flora, indicating that prebiotic substances might have the capacity to protect against enteral infections.

To the Editor .— Three articles on probiotics administration that appeared in Pediatrics 1–3 prompt us to present our data, which recently were briefly summarized.4 We examined in low birth weight infants the effects of 3 different kinds of probiotics ( Saccharomyces boulardii , Bacillus subtilis , and Lactobacillus GG) versus placebo on intestinal colonization, changes in the fecal flora, and production of specific IgA and IgM. We found …

Aim: To evaluate pancreatic development in newborn guinea pigs fed since birth intact or low-hydrolyzed protein formulas compared with breast milk. Methods: Forty-five newborn guinea pigs were allocated to three feeding regimens: breast milk (n = 15) and two isocaloric isonitrogen milk formulas containing intact (n = 15) or low-hydrolyzed proteins (n = 15). Body weight and food consumption were recorded every day. After 8 days, one third of pups from each group was killed, and the remaining animals were weaned. Another third was killed on day 14, and the remainders were killed on day 20. Zymogen storage was evaluated on pancreatic sections, whereas DNA and RNA concentrations were measured by a fluorometric method. Results: Compared with breast fed pups, both groups of artificially fed animals showed lower weight gain during the first 2 weeks of life but not after weaning. Both formulas fed groups had significantly lower amount of zymogen granules in pancreatic acinar cells at 8 and 14 days of life. This reduction was still present at day 20 in intact protein formula but not in low-hydrolyzed protein formula fed animals in which higher RNA/DNA ratio was also observed compared with breast fed pups. Conclusion: In newborn guinea pigs, artificial feeding is associated with reduced zymogen storage at days 8 and 14 of life. After weaning, cellular content of zymogen granules is comparable with breast fed pups only in low-hydrolyzed protein formula fed animals, even in the presence of some evidence of pancreatic hypoplasia.

Among other components of human milk, oligosaccharides might contribute to the high efficiency of calcium absorption of breastfed infants. In adults, it can be shown that dietary oligosaccharides can improve calcium absorption. The present analysis was performed to evaluate a possible influence of dietary oligosaccharides on parameters of calcium metabolism in preterm infants. The concentrations of calcium and phosphorus in plasma and in spot urine samples as well as the plasma activity of the alkaline phosphatase were measured in preterm infants fed either a standard formula (n = 15) or a formula supplemented with dietary oligosaccharides (n = 15) at the end of a 4-wk feeding period. Conclusions: There was no influence of the different diets on the plasma concentration of calcium and phosphorus or on the plasma activity of alkaline phosphatase. In urine, there was a tendency towards higher calcium concentrations in the group fed the supplemented formula compared concentrations in the group fed the standard formula. The concentrations of phosphate were not significantly different and, as a consequence, there was a tendency towards a higher Ca/P molar ratio in the group fed the supplemented formula. The data indicate that the calcium absorption might be influenced by the dietary oligosaccharides. Thus, the possible effect of dietary oligosaccharides on calcium homeostasis should be included in the discussion concerning the consequences of the use of dietary oligosaccharides in preterm infant nutrition.

The influence of appropriate post-discharge nutrition on somatic growth and cognitive development of very low-birthweight infants in the first year of life is currently a major topic in infant nutrition. Appropriate intakes of proteins, iodine and the addition of LC-PUFAs (arachidonic acid (AA), docosahexaenoic acid (DHA)) in the "right" quantities improve cognitive development and are conducive to a good correlation between somatic growth and neurodevelopment. Conclusion: When mother' milk is not available post-discharge, in addition to more proteins and minerals, formula for low-birthweight infants should contain AA and DHA, since the endogenous production of these important compounds from the precursors can be reduced in the first months of life, chiefly in the very low-birthweight infants.

The effect of interleukin-3 (IL-3) on histamine release from cord and adult blood basophils were evaluated. Leukocyte suspensions, obtained from adult patients with respiratory allergy (n = 15), normal adult subjects (n = 15), and neonates with (n = 15) and without (n = 19) atopic disposition, were stimulated with anti-IgE, fMLP, and IL-3. IgE-mediated histamine release was significantly higher in adult patients, either allergic or normal, than in neonates with or without atopic disposition. A trend toward higher fMLP-induced histamine release was found in allergic adult subjects. IL-3 had a weak direct histamine-releasing activity in allergic adult subjects and in neonates, but not in normal adult donors. A significant enhancing effect of IL-3 on histamine release induced by anti-IgE was observed in neonates with and without atopic disposition and in normal adult subjects, but not in atopic adult patients. IL-3 exerted a priming effect also when basophils were stimulated with fMLP, without any significant difference between neonates and adult subjects. Passive sensitization with IgE-rich serum resulted in a significant increase in anti-IgE-induced, but not in IL-3-induced, histamine release from cord-blood basophils. In conclusion, IL-3 primes cord-blood as well as adult blood basophils for a consecutive anti-IgE- or fMLP-induced histamine release and its activity is not limited by the low density of membrane IgE in cord-blood basophils.

A prospective case-control study is presented to assess an allergy prevention programme in children up to 36 months of age. Infants born at three maternity hospitals were followed from birth: 279 infants with high atopic risk (intervention group) were compared with 80 infants with similar atopic risk but no intervention (non-intervention group). The intervention programme included dietary measures (exclusive and prolonged milk feeding diet followed by a hypoantigenic weaning diet) and environmental measures (avoidance of parental smoking in the presence of the babies, day care > 2 years of life). Mothers in this group who had insufficient breast milk were randomly assigned to one of two coded formulas: either a hydrolysed milk formula (Nidina HA, Nestle) or a conventional adapted formula (Nan, Nestle). Other environmental measures remained the same as for the breastfeeding mothers. The non-intervention group were either breastfed or received the usual Italian milk feeding and weaning diet, without environmental advice. The main outcome measures were anthropometric measurements and allergic disease manifestations. Normal anthropometric data were observed both in the intervention group and in the non-intervention group. The incidence of allergic manifestations was much lower in the intervention group than in the non-intervention group at 1 year (11.5 versus 54.4%, respectively) and at 2 years (14.9 versus 65.6%) and 3 years (20.6 versus 74.1%). Atopic dermatitis and recurrent wheezing were found in both the intervention group and the non-intervention group from birth up to the second year of life, while urticaria and gastrointestinal disorders were only present in the non-intervention group in the first year of life. Conjunctivitis and rhinitis were present after the second year in both the intervention group and the non-intervention group. Relapse of the same allergic symptom was less in the intervention group (13.0%) than in the non-intervention group (36.9%). In comparison to the non-intervention group, there were fewer intervention group cases with two or more different allergic symptoms (8.7 versus 32.6%), and they were more likely to avoid steroid treatment (0 versus 10.8%) and hospital admission (0 versus 6.5%). Babies in the non-intervention group fed with adapted formula were more likely to develop allergies than breastfed babies in the same group. In the intervention group the breastfed infants had the lowest incidence of allergic symptoms, followed by the infants fed the hydrolysed formula (ns). Infants in the intervention group fed the adapted formula had significantly more allergies than the breastfed and hydrolysed milk fed infants, although less than their counterparts in the non-intervention group. Of the affected subjects in the intervention group, 80.4% were RAST and/or Prick positive to food or inhalant allergens. Total serum IgE values detected at birth in the intervention group were not predictive, but at 1 and 2 years of age, IgE values more than 2 SD above the mean in asymptomatic babies were found to predictive for later allergy. In breastfed babies the total IgE level at 1 and 2 years of age was lower than in the other two feeding groups. Of the various factors tested in the non-intervention group, the following were the most important in the pathogenesis of allergic symptoms: (i) formula implementation begun in the first week of life; (ii) early weaning (< 4 months); (iii) feeding beef (< 6 months); (iv) early introduction of cow's milk (< 6 months); and (v) parental smoking in the presence of the babies and early day care admission (< 2 years of life). All the preventive measures used in this study (exclusive breastfeeding and/or hydrolysed milk feeding, delayed and selective introduction of solid foods, and environmental advice) were effective at the third year of follow-up, greatly reducing allergic manifestations in high atopic risk babies in comparison with those not receiving these interventions

To the Editor .— After reading the article by Owen et al1 on a possible reduction of low-density lipoproteins in adolescents fed mother’s milk (MM) and that of Martin et al2 on a positive influence on adulthood height, the answer is yes. However, recently it has been shown that the prolonged feeding of MM has a negative influence on arterial stiffness3 and increases over the long-term the risk of atopy and asthma.4 Furthermore, higher levels of immunoglobulin E (IgE) were seen in children fed MM compared with those that were formula-fed.5 In these cases, the answer is no. A possible explanation of these contrasting findings would be derived if we consider the targets of nature and the changes of life …

96 Usefulness of An Early Breastfeeding Assessment Score to Predict Exclusive Breastfeeding Failure

Cerebral Vasoreactivity to Arterial Carbon Dioxide Tension in Premature Infants: Effect of Ibuprofen

Maternal Preeclampsia As a Risk Factor for Respiratory Distress Syndrome in "Small for Gestational Age" Infants

Oxygen Administration to Mothers during Caesarean Section with Spinal Anaesthesia Decreases Vitamine E but Not Q10 Levels in Mothers and Neonates

Comparison between the Effects on Cerebral Perfusion of Blood Withdrawal (W) and Infusion (I) through the Umbelical Venous Catheter (UVC) in Preterm Infants before and after Ibuprofen (IBU)

Early Hypocalcemia and Indices of Bone Turnover In Very Low And Extremely Low Birth Weight Infants 1511

Introduction Mithocondrial Q10 (ubiquinone) plays a role in the regulation of the velocity of respiratory chain but data on its effect as antioxidant agent during the stress of delivery are still lacking.

Q10 is considered an important factor for the mythocondrial respiratory activity1 as well as an antioxidant agent2 Q10 plasma levels reflect tissue (myocardium) content of the substance3. We have analyzed plasma Q10 levels (HPLC method) (mcg/ml) in mothers (natural delivery) (M), cord blood(CB) and in their infants (I) at 4 days and at 4 weeks of age.