Early introduction of very small amounts of multiple foods to infants: A randomized trial.

BACKGROUND: We investigated whether multiple food allergies could be safely prevented by simultaneously administering very small amounts of multiple foods. METHODS: Infants 3-4 months old with atopic dermatitis from 14 primary care pediatric clinics in Japan were enrolled in this randomized, placebo-controlled trial. The infants were administered either mixed allergenic food powder (MP) containing egg, milk, wheat, soybean, buckwheat, and peanuts, or placebo powder (PP). The amount of powder was increased in a stepwise manner on weeks 2 and 4, and continued until week 12. The occurrence of food allergy episodes after powder intervention was assessed at 18 months old. This trial was registered with the University Hospital Medical Information Network Clinical Trials Registry (number UMIN000027837). RESULTS: A total of 163 participants were randomly allocated to either the MP group (n = 83) or the PP group (n = 80). The incidence of food allergy episodes by 18 months was significantly different between the MP and PP groups (7/83 vs. 19/80, respectively; risk ratio 0.301 [95% CI 0.116-0.784]; P = 0.0066). Egg allergies were reduced in the MP group. In addition, food allergy episodes from any of the other five foods were significantly reduced, although the reductions in those due to individual foods were not significant. CONCLUSIONS: Gradually increasing the intake of very small amounts of multiple foods in early infancy can safely reduce the incidence of egg allergies. Other foods may also suppress food allergies, but no definitive conclusions could be reached.

[A case of rhabdomyolysis associated with Salmonella encephalopathy].

We report a case of severe rhabdomyolysis associated with Salmonella encephalopathy. A 3-year-old girl was admitted to our hospital because of status convulsives and unconsciousness. She was diagnosed as having Salmonella encephalopathy with rhabdmyolysis, and was treated by mild hypothermia and mechanical ventilation. Five days later she developed anuria with increased serum levels of myoglobin, CK and creatinine. And the diagnosis of acute renal failure was made. Peritoneal dialysis was begun from 6 days after admission. Hyperinfusion, the usual therapy of rhabdomyolysis, was not performed. She survived showing gradual improvement of renal function and consciousness. In a case of rhabdomyolysis complicating a neurologic disorder, a well-known poor prognostic factor, priority should be given to brain protection rather than to symptomatic treatment of rhabdomyolysis.

Brain evoked potentials of 3-D auditory stimuli.

BACKGROUND: For evaluation of spatial cognitive function, we studied the brain evoked potentials (EP) of 3-D auditory stimuli in regard to the change of latencies in normal subjects aged 1-21 years and compared them with patients who have mental retardation (MR). METHODS: A total of 144 normal subjects and 67 patients with MR were tested. The EP were elicited by 1000 Hz fixed and enlarged tones with Doppler effect randomly presented. No specific task was imposed in relation to the auditory stimuli. Electroencephalograms were recorded at the Fpz, Fz, Cz, Pz and Oz scalp locations (10-20 system), referenced to linked earlobes. The 64 responses of EP were averaged. The EP were measured from the difference in waveform by subtracting the EP of the fixed tone stimuli from that of the enlarged tone stimuli. RESULTS: The waveforms of EP consisted of the components P0, N1, P1, N2 and P2. These components (P0, N1, P1, N2 and P2) in the EP gradually shortened with increasing age in children. About 30% of patients with MR showed more prolonged latencies than normal subjects. CONCLUSION: These results suggest that these components indicated auditory kinetic evoked potentials. This developmental change could be related to maturational phenomena regarding spatial cognitive function. The EP of 3-D auditory stimuli may be used in children to evaluate the development of spatial cognitive function.