Killed Mycobacterium vaccae suspension in children with moderate-to-severe atopic dermatitis: a randomized, double-blind, placebo-controlled trial.

BACKGROUND: The hygiene hypothesis is often proposed to explain the high prevalence of atopy in the western world. Dysregulation of the immune system may result from inadequate exposure to micro-organisms such as mycobacteria. A small trial suggested that a killed extract of Mycobacterium vaccae ameliorates atopic dermatitis (AD). OBJECTIVES: To confirm in a large clinical trial whether killed M. vaccae ameliorates AD in 5-16-year-old children. METHODS: This was a randomized, placebo-controlled, double-blind, multi-centre study of the effect of intradermal injection of killed M. vaccae (0.1 or 1 mg) on patients, aged 5-16, with moderate-to-severe AD. Patients were followed up for 24 weeks. The primary end point was the change in severity of AD at 12 weeks, assessed using the six area, six-sign, atopic dermatitis (SASSAD) score. Secondary end points included changes in disease extent, patient's global assessment and children's dermatology life quality index. RESULTS: There were 166 patients randomized. The mean SASSAD score fell to a similar degree at week 12 in all treatment arms: from 33 to 24, (26%) in the high-dose group, from 30 to 23 (25%) in the low-dose group and from 36 to 27 (24%) in the placebo group (P>0.05). Secondary end points followed the same trend. Adverse events were generally those expected to occur in this population. Injection site reactions occurred in 32 patients at week 4. CONCLUSIONS: M. vaccae was no more effective than the placebo in ameliorating the severity of AD.

A case of syphilitic interstitial pulmonary fibrosis.

Diagnosis of late pulmonary syphilis was made in a 72-year old woman on the basis of her medical history of untreated genital syphilis, serological and radiological findings, and the response to therapy. The diagnosis was confirmed two years later by autopsy findings. There was a good correlation between chest x-ray radiography, computed tomography scans, and autopsy findings. In the diagnosis of sarcoidosis and other diseases with similar radiological interstitial lung pattern, syphilitic interstitial pulmonary fibrosis should be carefully excluded.

Allele frequencies of six highly polymorphic DNA loci in the Croatian population.

The allele frequency distributions in a series of Croats were analyzed for six unlinked polymorphic DNA loci: THO1, FESFPS, VWA01, APOB, D1S80, and D17S5. The allele frequencies were determined for 100 unrelated genomic DNA samples. The observed heterozygote frequencies of the loci ranged from 0.63 to 0.76; however, the the expected heterozygosity ranged from 0.68 to 0.82, with only D17S5 having a significant excess of homozygous phenotypes (p < 0.001). The excess homozygosity seen in the D17S5 system may be due to allelic drop-out and warrants further technical analysis of that system, given the uniform lack of significant deviation in the other five systems. The forensic usefulness of these systems can be measured using two different statistics: the power of discrimination and the likelihood of a coincidental match. The power of discrimination ranged from 0.85 to 0.94 for the 6 systems with the combined likelihood of a coincidental match based on these 6 systems of 1 in 3.6 million, or slightly less than the population of Croatia. A second, more conservative estimator of the likelihood of a match is based on the most common phenotype for each system. If someone had the most common phenotype for each of the 6 systems, the chance of a coincidental match would be approximately 1 in 64,000. For paternity testing the usefulness of a system is measured by the average power of exclusion or (1-power of exclusion), the random man not excluded. The average power of exclusion, based on observed heterozygosity, ranged from 0.33 to 0.53, and the average power of exclusion based on the expected heterozygosity ranged from 0.39 to 0.64. The combined average power of exclusion was 99.2% for these 6 systems, using the expected heterozygosity. Based on the results of testing these six systems, there is no significant substructuring within the southern Croatian populations, and these systems provide a useful tool for forensic, paternity, and anthropological applications.