MMR vaccination of children with egg allergy is safe.

INTRODUCTION: Measles, mumps and rubella (MMR) vaccination is part of the Danish Childhood Vaccination Programme. It is known that children may react with anaphylaxis to MMR vaccines containing traces of egg protein. In Denmark, national clinical guidelines recommend that children with egg allergy be referred to vaccination at a paediatric ward despite changed recommendations in other countries. The purpose of this study was to determine whether children with egg allergy presented with anaphylactic/allergic reactions to MMR vaccination and to discuss whether Danish recommendations should be upheld. MATERIAL AND METHODS: Data collected through evaluation of the histories of children referred to the Paediatric Ward at Hillerød Hospital from 01.01.2008 to 28.02.2011 and coded according to action diagnosis and/or supplementary diagnosis in International Classification of Diseases 10 (ICD-10) for food allergy, oedema angioneurotica and tentative diagnosis as well as the procedure code for oral food challenge. A total of 32 patients were included, all were both sensitized to egg and had been MMR vaccinated. RESULTS: The 32 patients had received a total of 41 doses of MMR vaccine. None of them had shown anaphylactic/allergic reactions to the MMR vaccines. 23% of the vaccines were given with considerable delay. CONCLUSION: Based on our study, we conclude that the Priorix MMR vaccine may be administered just as safely to children diagnosed with egg allergy as to other children. We found no evidence in support of the current Danish recommendations. We therefore recommend that the Statens Serum Institut, the Danish Paediatric Society and/or the Danish Health and Medicines Authority reconsider these recommendations. FUNDING: not relevant TRIAL REGISTRATION: not relevant.

[Malignant ovarian tumour as cause of virilisation in a 12 year-old girl]. / Malign ovarietumor som årsag til virilisering af en 12-årig pige.

Virilisation in girls includes androgen dependent growth of terminal hair, acne, deepening of the voice and increased muscle mass. Sudden onset of symptoms, rapid progression, short duration and hyperandrogenaemia are ominous signs and the patient must be referred to a specialist as soon as possible to rule out cancer and avoid worsening of the irreversible virilisation. We describe a girl with severe virilisation as the sole symptom of an androgen producing Sertoli-Leydig cell tumour. Ovarian tumours are rare in children and malignant ovarian tumours account for less than 1% of childhood cancer.

[Culture-negative bacterial meningitis diagnosed with polymerase chain reaction]. / Bakteriel meningitis uden dyrkningsfund diagnosticeret med polymerasekædereaktion.

Aetiological diagnosis of patients with bacterial meningitis and possible secondary complications is crucial for the implementation of optimal treatment. Molecular biological methods such as polymerase chain reaction (PCR) can be used. We here present a clinical case in which the diagnosis of pneumococcal meningitis with a subsequent complication in the form of a secondary cerebral abscess was primarily made by real-time PCR after treatment had been initiated.

Acupuncture on the day of embryo transfer: a randomized controlled trial of 635 patients.

This prospective, randomized, controlled and double-blinded trial studied whether acupuncture in relation to embryo transfer could increase the ongoing pregnancy rates and live birth rates in women undergoing assisted reproductive therapy. A total of 635 patients undergoing IVF or intracytoplasmic sperm injection (ICSI) were included. In 314 patients, embryo transfer was accompanied by acupuncture according to the principles of traditional Chinese medicine. In the control group, 321 patients received placebo acupuncture using a validated placebo needle. In the acupuncture group and the placebo group, the ongoing pregnancy rates were 27% (95% CI 22-32) and 32% (95% CI 27-37), respectively. Live birth rates were 25% (95% CI 20-30) in the acupuncture group and 30% (95% CI 25-30) in the placebo group. The differences were not statistically significant. These results suggest that acupuncture administered in relation to embryo transfer has no effect on the outcome of IVF and ICSI.

Estrogenic effect of propylparaben (propylhydroxybenzoate) in rainbow trout Oncorhynchus mykiss after exposure via food and water.

The estrogenic effect of propylparaben was investigated in a rainbow trout Oncorhynchus mykiss test system. Propylparaben was administered orally to sexually immature rainbow trout every second day for up to 10 days in doses between 7 and 1830 mg kg(-1) 2 d(-1) and in the water at 50 and 225 microg l(-1) for 12 days. Plasma vitellogenin was measured before and during the exposures and the concentrations of propylparaben in liver and muscle were determined at the end of experiments. Increases in average plasma vitellogenin levels were seen at oral exposure to 33 mg propylparabenkg(-1) 2 d(-1); the most sensitive fish responded to 7 mg kg(-1). The ED(50) values for increase in vitellogenin synthesis were 35, 31 and 22 mg kg(-1) 2 d(-1) at day 3, 6 and 11, respectively. Exposure to 225 microg propylparabenl(-1) increased vitellogenin synthesis, but exposure to 50 microg l(-1) did not. Propylparaben showed little tendency to bioaccumulation in rainbow trout; less than 1 per thousand of the total amount of propylparaben administered orally at 1830 mg kg(-1) 2 d(-1) over the 10-d experimental period was retained in muscle and liver 24 h after the end of the experiment. Exposure to 225 microg propylparabenl(-1) for 12 d led to concentrations of 6700 and 870 microg propylparabenkg(-1) liver and muscle, respectively. Half lives for propylparaben were 8.6 h in liver and 1.5 h in muscle.