[Preventative effect of a whey hydrolyzed formula (Nestle, NAN H.A.) on the development of allergic symptoms in infants]. Formula fortified with live probiotic culture reduces pulmonary and gastrointestinal bacterial colonization and translocation in a newborn animal model. Effect of feeding whey hydrolysate, soy and conventional cow milk formulas on incidence of atopic disease in high risk infants. Randomized controlled clinical trial on the efficacy of dentin desensitizing agents Hypoallergenicity of an extensively hydrolyzed whey formula. Comparison of a partially hydrolyzed infant formula with two extensively hydrolyzed formulas for allergy prevention: a prospective, randomized study. Corticosteroid Injection vs. Nonsteroidal Antiinflammatory Drug and Splinting in Carpal Tunnel Syndrome A hypertension control program in Yu-Chi, Taiwan: preliminary results. Preliminary study of the effect of low-intensity home-based physical therapy in chronic stroke patients. Severe early childhood caries and social determinants in three-year-old children from Northern Thailand: a birth cohort study Cumulative incidence of atopic disorders in high risk infants fed whey hydrolysate, soy, and conventional cow milk formulas. Relaxation training and attention placebo in the treatment of severe insomnia. Improving Adherence to Antiretroviral Therapy With Triggered Real-time Text Message Reminders: The China Adherence Through Technology Study Effects of a dietary and environmental prevention programme on the incidence of allergic symptoms in high atopic risk infants: three years follow‐up
We examined the prevent effect of a whey hydrolyzed formula ( NAN H.A. ) on the development of  allergic disease from new born infants . A hundred thirty three pregnant women were divided into the  NAN H.A.  group and the  control group . Mothers , who agreed to use the whey hydrolyzed formula to their infant , were classified into the NAN H.A. group . We examined laboratory date such as IgE levels of these infants as well as clinical symptoms for evaluating of the preventive effect of NAN H.A. The serum IgE levels from infants of the NAN H.A. group were lower than those of the control group . The incidance of the infants who showed allergic clinical symptoms was significant lower in the NAN H.A. group . The odds ratio to skin symptom at 3 years of age with multiple logistic regression was 5.32 between the control group and the NAN H.A. group ( p < 0.05 ) . It was 6.68 between mother 's history of allergy was positive and negative ( p < 0.02 ) . These results suggest that NAN H.A. can prevent the development of allergic symptoms in infants BACKGROUND / PURPOSE Acidified diets are protective against intestinal bacterial colonization and translocation .  Probiotic diets are design ed to modulate the intestinal flora to enhance mucosal immunity . This study was design ed to determine if formula acidified with live probiotic decreases bacterial gut colonization and translocation , and is equally tolerated as other acidified diets . METHODS One hundred twenty-eight rabbit pups delivered via cesarean section [ cesarean delivery , cesarean birth , abdominal delivery ] were r and omly assigned to 4 feeding groups :  NAN Nestle ( control , pH 7.0 ) ,  NAN acidified with citric acid ( pH 4.55 ) , biologically acidified Pelargon ( pH 4.55 ) , and  NAN with live Lactococcus lactis culture ( pH 4.2 ) . Pups were gavage fed every 12 hours with Enterobacter cloacae challenges of 10 colony-forming units/mL per feed and killed on day of life 3 . Lungs , liver , spleen , mesenteric lymph nodes ( MLNs ) , stomach , and cecum were cultured and quantitatively analyzed for target organism growth . Results were analyzed using chi(2 ) tests . RESULTS NAN with live probiotic culture , when compared with Pelargon , acidified NAN , and NAN , significantly reduced the incidence of Enterobacter pulmonary colonization ( P < .01 ) , bacterial translocation ( liver , P < .025 ; spleen and MLN , P < .05 ) , and gastric and intestinal colonization ( P < .001 for both ) . CONCLUSION Probiotic-fortified formula provides superior protection against pulmonary and gastrointestinal bacterial colonization and translocation compared with neutral and acidified formulas , and is equally tolerated The effect of feeding different infant formulas on incidence of atopic disease was assessed in a prospect i ve double-blind r and omized controlled trial among " high risk " infants with family history of atopy among first-degree relatives . The incidence of atopic eczema , wheezing , rhinitis , gastrointestinal symptoms , and colic was noted and serum IgE antibodies to milk were estimated . Seventy-two infants were recruited into each of the following groups : cow milk whey hydrolysate formula ( NAN/HA ) , conventional cow milk formula ( Similac ) , soy-based formula ( Isomil ) , and exclusive breast feeding for greater than or equal to 4 months .  The number of infants who exited for reasons other than atopy and were excluded from analysis were 4 , 5 , 4 , and 12 in the four groups , respectively . The incidence of one or more symptoms of possible allergic etiology was five of 68 infants fed NAN/HA , 24 of 67 infants fed Similac , 25 of 68 infants fed Isomil , and 12 of 60 breast-fed infants . Among symptomatic infants , skin prick test to milk proteins was positive in four out of five infants fed NAN/HA , 16 of 24 fed Similac , 2 of 25 fed Isomil , and 7 of 12 breast-fed . IgE antibodies to milk were found in 2 of 68 , 9 of 67 , 0 of 68 , and 6 of 60 infants in the four groups , respectively . It is concluded that exclusive breast feeding for more than 4 months is partially protective against the development of atopic disease among high risk infants . ( ABSTRACT TRUNCATED AT 250 WORDS Abstract Objective . To investigate the effects of four dentin desensitizers on pain reduction in hypersensitive cervical dentin lesions . Material s and methods . The trial was design ed as a r and omized , controlled , four-arm , single-masked study . Fifty subjects with at least one hypersensitive lesion in each of the four quadrants were allocated . The requested pre-operative pain , determined as a response to 2-s air-blast ( AB ) and probe scratching ( PS ) , was ≥5 on a VAS scale , 0 = no through to 10 = worst pain . R and omly each subject received each of the four treatments : MS Coat One F ( MSC , Sun Medical , Japan ) , Nanoseal ( NAN , Nishin , Japan ) , Teethmate Desensitizer ( TMD , Kuraray Noritake , Japan ) and Gluma Desensitizer PowerGel ( GLU , HeraeusKulzer , Germany ) . The investigator assessed blindly the pain response using the two stimuli and recorded the patients ’ VAS scores before and immediately after application , after 1 week and after 1 , 3 and 6 months . Statistical data treatment . ANOVA and post-hoc testing ( p ≤ 0.05 ) . Results . Forty-nine subjects completed the trial . Pre-operative dentin hypersensitivity ( DH ) for the groups was not significantly different . All desensitizers reduced DH significantly throughout the 6-months observation . ANOVA revealed significant differences among VAS scores , obtained with the desensitizing agents ( p < 0.001 ) . Ranking by post-hoc testing was : MSC > NAN > TMD > GLU ( p < 0.05 ) . Upon PS NAN and TMD showed slight but significant regain of sensitivity after 6 months . For GLU PS scores immediately after application and after 6 months were not significantly different , whereas recalls after 1 week , 1 month and 3 months revealed significantly lower scores . Conclusion . The calcium phosphate-based TMD and GLU proved highly effective in reducing sensitivity Several different protein hydrolysate-based infant formulas have been promoted as hypoallergenic and considered suitable for the dietary management of cow 's milk allergy ( CMA ) . Accepting that none of the hydrolysate-based products is completely safe , the American Academy of Pediatrics ( AAP ) recommends that these formulas should be tested in a double-blind placebo-controlled setting and tolerated by at least 90 % of children with proven CMA . In principle , this recommendation is also endorsed by the European Society of Paediatric Gastroenterology and Nutrition ( ESPGAN ) and the European Society of Paediatric Allergy and Clinical Immunology ( ESPACI ) . In this two-center study , 32 children with proven CMA were tested with the extensive hydrolysate whey formula Nutrilon Pepti , for comparison with Profylac ( extensive ) and Nan HA ( partial ) whey hydrolysate products .  Skin-prick tests ( SPTs ) were , respectively , positive to the three hydrolysate formulas in 19 % , 15 % , and 32 % of children . After oral challenge it was concluded that 97 % ( 95 % CI : 85 - 100 % ) of the children tolerated  Nutrilon Pepti , 94 % ( 95 % CI : 75 - 100 % ) tolerated Profylac , and 64 % ( 95 % CI : 37 - 81 % ) tolerated Nan HA . This study demonstrates that the extensive hydrolysates Nutrilon Pepti and Profylac are well tolerated in a population of children with proven CMA and that both products can be considered safe for their intended use . This study confirms that a very small number of children react even to extensively hydrolyzed formulas . SPT prior to oral exposure to the hydrolysate-based formulas can indicate whether a child is at risk of showing reactions to the product . Introduction of new products to these children should be carried out under a doctor 's supervision . However , the majority of the SPT-positive children did tolerate the two extensively hydrolyzed whey-based formulas tested The aim of this study was to compare the allergy-preventive effect of a partially hydrolyzed formula with two extensively hydrolyzed formulas , in infants with a high risk for development of allergic disease . High-risk infants from four Danish centres were included in the period from June 1994 to July 1995 . Five-hundred and ninety-five high-risk infants were identified . High-risk infants were defined as having biparental atopy , or a single atopic first-degree relative combined with cord blood immunoglobulin E ( IgE ) > or = 0.3 kU/l . At birth all infants were r and omized to one of three different blinded formulas .  All mothers had unrestricted diets during pregnancy and lactation and were encouraged to breast-feed exclusively . If breast-feeding was insufficient , one of the three formulas , according to r and omization , was given during the first 4 months . It was recommended not to introduce cow 's milk , cow 's milk products . and solid foods until the age of 4 months . After the age of 4 months a normal unrestricted diet and conventional cow 's milk-based formula were given when needed . All infants were followed-up prospect ively with interview and physical examination at the age of 6 , 12 , and 18 months , and if any possible atopic symptoms were reported . If food allergy was suspected , controlled elimination/challenge procedures were performed in a hospital setting . Of 550 infants included in the study , 514 were seen at all visits and 36 were excluded owing to noncompliance . Of 478 infants who completed the study , 232 were exclusively breast-fed , 79 received an extensively hydrolyzed casein formula ( Nutramigen ) , 82 an extensively hydrolyzed whey formula ( Profylac ) , and 85 a partially hydrolyzed whey formula ( Nan HA ) , during the first 4 months of life . These four groups were identical in regard to atopic predisposition , cord blood IgE , birthplace , and gender . Exclusively breast-fed children were exposed less to tobacco smoke and pets at home and belonged to higher social classes , whereas the three formula groups were identical concerning environmental factors . The frequency of breast-feeding was high ; only eight ( 2 % ) children were not breast-fed at all . The three formula groups were identical in regard to duration of breast-feeding and age at introduction of formula and solid foods . No significant differences were found in the three groups of infants receiving formula milk regarding the cumulative incidence of atopic dermatitis or respiratory symptoms . The cumulative incidence of parental-reported cow 's milk allergy was significantly higher in children fed partially hydrolyzed formula ( Nan HA ) compared with extensively hydrolyzed formula ( Nutramigen or Profylac ) at 12 and 18 months ( NanHA , 7.1 % ; Nutramigen , 2.5 % ; Profylac , 0 % ; p=0.033 ) . The cumulative incidence of confirmed cow 's milk allergy was 1.3 % ( three of 232 ) in exclusively breast-fed infants , 0.6 % ( one of 161 ) in infants fed extensively hydrolyzed formula ( Nutramigen or Profylac ) , and 4.7%(four of 85 ) in infants fed partially hydrolyzed formula ( Nan HA ) . Partially hydrolyzed formula was found to be less effective than extensively hydrolyzed formula in preventing cow 's milk allergy , 0.6 % vs. 4.7 % ( p=0.05 ) , but because of the small number of cases the results should be interpreted with caution . Compared with other similar studies the frequency ofatopic symptoms was low , even though the dietetic intervention did not include either maternal diet during lactation or dietary restrictions to the children after the age of 4 months Çeliker R , Arslan Ş , İnanıcı F : Corticosteroid injection vs. nonsteroidal antiinflammatory drug and splinting in carpal tunnel syndrome . Am J Phys Med Rehabil 2002;81:182–186 . Objective To compare the efficacy of local corticosteroid injection to a nonsteroidal antiinflammatory drug and splinting for the treatment of carpal tunnel syndrome . Design This study was a prospect i ve , unblinded , r and omized clinical trial with an 8-wk follow-up . Thirty-three h and s of 23 patients were r and omly treated with acemetacine and splinting ( group A ) or with corticosteroid injection ( group B ) . Clinical ( symptom severity scale , visual analog scale , Tinel and Phalen tests ) and electromyographic evaluations were performed on initial visit and after 8 wk . Results Clinical and electromyographic parameters , which were similar at baseline , were improved in both groups after treatment . Improvement was also similar when both groups were compared at 8 wk . Conclusion Both splinting combined with the use of a nonsteroidal antiinflammatory drug and steroid injection into the carpal tunnel result ed in significant improvement in carpal tunnel syndrome The purpose of this study was to evaluate the feasibility and effectiveness of a community approach to  hypertension control  in both high risk and general population s in an agricultural district with limited medical and community re sources . It was conducted in Yu-Chi district of Nan-Tou county in central Taiwan from 1993 to 1994 . The study included blood pressure screening , follow-up , health education , village-based campaigns , and program evaluation after 6 months of intervention . Two villages each were r and omly assigned to intervention and control groups . Intervention comprised visits by trained volunteers to measure blood pressure and body weight , and education related to hypertension .  All residents 40 years of age and older were enrolled . A total of 471 residents from the intervention villages and 426 residents from the control villages completed the study . Overall , for the intervention and control groups , the knowledge and behavior related to hypertension improved significantly 6 months after the baseline survey . The improvement was greater in the subgroup of hypertensives in the intervention group than in the controls . The educational intervention also significantly improved the status of awareness , treatment , and the control of hypertension , and reduced blood pressure in the hypertensive subjects . We conclude that a hypertension control program that relies solely on limited community re sources is feasible and effective This study was a preliminary examination of the effect of low-intensity home-based physical therapy on the performance of activities of daily living ( ADL ) and motor function in patients more than 1 year after stroke . Twenty patients were recruited from a community stroke register in Nan-Tou County , Taiwan , to a r and omized , crossover trial comparing intervention by a physical therapist immediately after entry into the trial ( Group I ) or after a delay of 10 weeks ( Group II ) . The intervention consisted of home-based physical therapy once a week for 10 weeks . The Barthel Index ( BI ) and Stroke Rehabilitation Assessment of Movement ( STREAM ) were used as st and ard measures for ADL and motor function . At the first follow-up assessment at 11 weeks , Group I showed greater improvement in lower limb motor function than Group II . At the second follow-up assessment at 22 weeks , Group II showed improvement while Group I had declined . At 22 weeks , the motor function of upper limbs , mobility , and ADL performance in Group II had improved slightly more than in Group I , but the between-group differences were not significant . It appears that low-intensity home-based physical therapy can improve lower limb motor function in chronic stroke survivors . Further studies will be needed to confirm these findings Background The purpose of this study was to investigate the prevalence and social risk factors of severe early childhood caries in three-year-old children in Northern Thail and , using a birth-cohort study Methods The data utilized in this study were from the prospect i ve cohort study of Thai children ( PCTC ) from the 28 to 38 weeks gestational age until the children reached the age of 36 months ( N = 597 ) in Mueang Nan district , Northern Thail and .  Question naires were administered at different time points and dental examination was conducted at the age of 3 years of the child . Results 44.1 % of the 3 year old children had S-ECC . In multivariate logistic regression analysis , environmental factors ( the use of rain or well water as drinking water , no schooling of mother of child , being male ) , and risk behaviour ( sleeping with a bottle at 30 months ) were associated with S-ECC . Further , in bivariate analysis , psychological distress in the mother , lack of spousal relationship support , suckle to sleep when going to bed , introduction of soft drinks at 12 months , having had more frequently sweet food , and less than daily tooth brushing before 30 months were associated with S-ECC . Conclusions A very high rate of S-ECC was observed , and oral health may be influenced by social factors A recent increase in the prevalence of atopic disorders and the enormous costs of management of atopic patients have prompted attempts at prevention . We have examined the effect of exclusive breast feeding and of feeding different infant formulas on incidence of atopic disease in a prospect i ve r and omized controlled study . Seventy-two infants were recruited into each of the following groups : cow milk whey hydrolysate formula ( NAN/HA ) conventional cow milk formula ( Similac ) , soy-based formula ( Isomil ) , and exclusive breast feeding for greater than 4 months .  The cumulative incidence of atopic eczema , recurrent wheezing , rhinitis , gastrointestinal symptoms , and colic were noted . Skin prick tests and radioallergosorbent tests for IgE antibodies to milk and soy were performed . At 12 and 18 months of age , the incidence of atopic eczema as also that of all atopic symptoms was significantly lower and similar in the breast-fed and whey hydrolysate groups , compared with the cow milk and soy formula groups . IgE antibodies were detected more often in the cow milk and soy formula groups , especially the former . Among symptomatic infants , fewer skin positive prick tests were seen in the soy group compared with the cow milk group . Our observations show that among infants at high risk of developing atopic disease because of positive family history , exclusive breast feeding or whey hydrolysate formula is associated with a lower incidence and thus a delay in the occurrence of allergic disorders compared with groups fed conventional cow milk or soy formulas This study compared the effectiveness of progressive relaxation training with and without a supplementary relaxation recording , which the subjects played at home , and an attention placebo manipulation in the modification of severe insomnia in adult volunteers . The results indicated that the relaxation training procedures were significantly more effective than placebo and no-treatment controls in modifying several parameters of sleeping behavior , in reducing consumption of sleep-inducing medication , and in influencing a self-report anxiety measure . The supplementary relaxation tape did not increase the effectiveness of relaxation training  conducted in the clinic , and there was no difference in the efficacy of the placebo and no-treatment conditions . Physiological data gathered during the last treatment session indicated few significant correlations between reductions in arousal associated with relaxation training and treatment outcome . Recent years have witnessed increasing interest in the treatment of insomnia from a behavioral framework . Case studies and uncontrolled group investigations suggesting the effectiveness of relaxation training techniques and stimulus control procedures ( Bootzin , 1972 ; Geer & Katkin , 1966 ; Jacobson , 1964 ; Kahn , Baker , & Weiss , 1968 ) have given rise to controlled studies . Thus far this research has indicated that relaxation training procedures are effective in modifying several parameters of sleeping behavior in volunteer insomniacs . However , the mechanism(s ) by which this training operates have not been clearly identified . One possibility is that this technique works because of its placebo value . Relaxation training would seem to have high face validity for the treatment of insomnia , and the impressive proprioceptive muscle feedback often associated with the technique may add to its credibility , Although a number of studies have attempted to investigate this issue ( Borkovec & Fowles , 1973 ; Borkovec , Kaloupek , & Slama , 197S ; Borkovec , Steinmark , & Nan , 1973 ; Haynes , Woodward , Moron , & Background : Real-time adherence monitoring is now possible through medication storage devices equipped with cellular technology . We assessed the effect of triggered cell phone reminders and counseling using objective adherence data on antiretroviral therapy ( ART ) adherence among Chinese HIV-infected patients . Methods : We provided ART patients in Nanning , China , with a medication device ( Wisepill ) to monitor their ART adherence electronically . After 3 months , we r and omized subjects within optimal ( ≥95 % ) and suboptimal ( < 95 % ) adherence strata to intervention vs. control arms . In months 4–9 , intervention subjects received individualized reminders triggered by late dose taking ( no device opening by 30 minutes past dose time ) and counseling using device-generated data . Controls received no reminders or data -informed counseling . We compared postintervention proportions achieving optimal adherence , mean adherence , and clinical outcomes . Results : Of 120 subjects enrolled , 116 ( 96.7 % ) completed the trial . Preintervention optimal adherence was similar in intervention vs. control arms ( 63.5 % vs. 58.9 % , respectively ; P = 0.60 ) . In the last intervention month , 87.3 % vs. 51.8 % achieved optimal adherence [ risk ratio ( RR ) : 1.7 , 95 % confidence interval ( CI ) : 1.3 to 2.2 ] and mean adherence was 96.2 % vs. 89.1 % ( P = 0.003 ) . Among preintervention suboptimal adherers , 78.3 % vs. 33.3 % ( RR : 2.4 , CI : 1.2 to 4.5 ) achieved optimal adherence and mean adherence was 93.3 % vs. 84.7 % ( P = 0.039 ) . Proportions were 92.5 % and 62.9 % among optimal adherers , respectively ( RR : 1.5 , CI : 1.1 to 1.9 ) and mean adherence was 97.8 % vs. 91.7 % ( P = 0.028 ) . Postintervention clinical outcomes were not significant . Conclusions : Real-time reminders significantly improved ART adherence in this population . This approach seems promising for managing HIV and other chronic diseases and warrants further investigation and adaptation in other setting ABSTRACT A prospect i ve 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 r and omly assigned to one of two coded formulas : either a hydrolysed milk formula ( Nidina HA , Nestlé ) or a conventional adapted formula ( Nan , Nestlé ) . 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 nonintervention group . The incidence of allergic manifestations was much lower in the intervention group than in the nonintervention 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
A subgroup analysis reported significant differences in the promotion of physical activity based on baseline physical activity levels and the type of instrument used to assess levels of physical activity .
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