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Background The World Health Organization recommends high-dose vitamin A supplementation (VAS) for children above six months of age in low-income countries. VAS has been associated with up-regulation of the Th2 response. We aimed to determine if VAS is associated with atopy in childhood. Methods Infants in Guinea-Bissau were randomly allocated VAS or placebo, either at six and nine months of age, or only at nine months of age. At six months of age, children were furthermore randomized to measles vaccine or inactivated polio vaccine. At nine months of age all children received measles vaccine. Children were revisited seven years later and skin prick testing was performed. Atopy was defined as a skin prick reaction ⩾3 mm. Results 40 of 263 children (15%) were atopic. Overall VAS had no significant effect on the risk of atopy (Prevalence Ratio 1.23; 95% CI 0.69-2.18). The Prevalence Ratio was 1.60 (0.66-3.90) for males and 1.00 (0.46-2.15) for females. Conclusions There was no significant effect of VAS in infancy on atopy later in childhood. The role of infant VAS in the development of atopy is still unclear. [ABSTRACT FROM AUTHOR]

The authors discuss issues regarding the prevalence of allergic disease in Australia. They explore several interventions to combat the epidemic of food allergy in the country, highlighting the potential use of vaccination with live attenuated Mycobacterium bovis, also known as bacille Calmette-Guerin (BCG). They present evidence suggesting that BCG vaccination can change T-helper cell polarisation in a similar manner to natural infection.

Background: Closed endotracheal suction interferes with mechanical ventilation received by infants, but the change to ventilation may be different when ventilator modes that target expired tidal volume (VT(e)) are used., Objective: To measure airway pressure and tidal volume distal to the endotracheal tube (ETT) during and after closed suction in a volume-targeted ventilation mode with the Dräger Babylog 8000+, and to determine the time until VT(e) returns to the baseline level., Methods: In this benchtop study, closed suction was performed on 2.5- to 4.0-mm ETTs connected to a test lung. 5-8 French suction catheters were used at suction pressures of 80-200 mm Hg during tidal-volume-targeted ventilation., Results: During catheter insertion and suction, circuit inflating pressure increased and tidal volume was maintained, except when a large catheter relative to the ETT was used, in which case tidal volume decreased. End-expiratory pressure distal to the ETT was reduced during suction by up to 75 cm H(2)O while circuit end-expiratory pressure was unchanged. Reduction in end-expiratory pressure distal to the ETT was greatest with large catheters and high suction pressures. Following suction, circuit and tracheal inflating pressures increased and tidal volume increased before returning to baseline in 8-12 s., Conclusions: Closed endotracheal suction interferes with ventilator function in volume-targeted mode, with substantially negative intratracheal pressure during suction, and the potential for high airway pressures and tidal volumes following the procedure. These effects should be considered and pressure limits set appropriately whenever using volume-targeted ventilation., (Copyright © 2010 S. Karger AG, Basel.)