Manejo nutricional de las intolerancias digestivas más comunes del lactante / Nutritional management of the most common digestive intolerance in infants

Las intolerancias digestivas más comunes del lactante i n c l u y e n e s t r e ñ imi e n t o , r e g u r g i t a c i ó n , llanto/irritabilidad, cólico, gas excesivo y diarrea, que en muchos casos, pueden ser normales, sin embargo, es frecuente ante estas intolerancias, cambiar las fórmulas infantiles. En el presente artículo, un grupo de profesionales de la salud relacionados con la gastroenterología y alergología pediátrica, describen los antecedentes, las definiciones, y el manejo nutricional de cada una de estas intolerancias digestivas.

The most common symptoms of digestive intolerances in infants include constipation, regurgitation,crying/irritability, cramps, excessive gas and diarrhea. Some of these symptoms may be completely normaland are explained in part as a result of the maturation process of the GI tract of young infants. However, it isvery common that parents and doctors due to any of these symptoms switch formulas. A group of experts'pediatric gastroenterologists and pediatric allergists from different countries decided to review this topicand provide practical recommendations.

Prevalence of asthma and comorbid allergy symptoms in Singaporean preschoolers.

The cross-sectional prevalence of wheeze, rhinitis and eczema in 7,549 randomly selected Singaporean preschoolers aged 4 to 6 years old is reported in this study. Cumulative and past 12 months ('current') prevalence of wheeze was 27.5% and 16.0%, respectively. 'Asthma' was reported by 11.7%. Current rhinitis prevalence was 25.3% and rhinoconjunctivitis, 7.6%. Current chronic rash affected 13.5% of subjects while 9.9% reported chronic rash with flexural distribution. After multivariate analysis, the main risk factors for 'current wheeze' and self-reported asthma, respectively, were family history of allergy (adjusted odds ratio [aOR] 3.22 [2.79-3.71], aOR 3.93 [3.34-4.63]); concurrent rhinoconjunctivitis (aOR 4.04 [3.31-4.92], aOR 3.02 [2.43-3.76]); concurrent chronic flexural rash (aOR 2.56 [2.13-3.08], aOR 2.95 [2.41-3.62]) and previous respiratory infection (aOR 4.80 [4.17-5.53], aOR 3.28 [2.80-3.85]). Thus, these allergy-associated symptoms already affect a considerable portion of children by the preschool years, supporting the need for allergy education and intervention program in this age group.

Comparative study of the reactogenicity of a three-component acellular pertussis vaccine and whole-cell pertussis vaccine administered to healthy Singaporean infants.

The objective of this study was to assess and compare the reactogenicity of GlaxoSmithKline (GSK) Biologicals' diphtheria-tetanus-tricomponent acellular pertussis vaccine (DTPa) and the locally used combined diphtheria-tetanus-whole-cell pertussis vaccine (DTPw) as a primary vaccination course in healthy infants at the age of 3, 4 and 5 months. A phase IV, single-blinded, randomized comparative clinical study involved one hundred and eighty healthy infants with two study groups in a 2:1 ratio to receive either DTPa or DTPw vaccine which were administered intramuscularly at the right anterior-lateral aspect of the thigh. The incidence and intensity of local solicited symptoms such as pain, redness and swelling at injection site and general solicited symptoms such as fever and fussiness were evaluated. Serious adverse events were followed for one month after each vaccination. The overall incidence of local and general symptoms was significantly higher in the group receiving locally used DTPw vaccine as compared to the group receiving GSK DTPa vaccine. Solicited local symptoms, pain (47.4% vs 15.1%), redness (95.9% vs 84.9%) and swelling (46.2% vs 18.5%), were reported more frequently in the group receiving DTPw vaccine than in the group receiving DTPa vaccine. Fever (> or = 37.5 degrees C) (52% vs 14.6%) and fussiness (60.8% vs 33.6%) were also more commonly reported in the DTPw group. There were six serious adverse events reported (4 with DTPw and 2 with DTPa). None of them related to the study vaccines, as considered by the investigators. Thus it was found that GSK Biologicals' DTPa vaccine was significantly less reactogenic as compared to the locally used DTPw vaccine manufactured by Commonwealth Serum Laboratories when administered as a 3-dose primary vaccination course to healthy infants at the age of 3, 4 and 5 months in Singapore.

An evaluation of asthma morbidity in Singaporean schoolchildren--a teachers' survey.

Asthma is the most common chronic illness in childhood. This study evaluated the asthma morbidity among Singaporean schoolchildren. The survey involved 1,744 schoolteachers using a structured written questionnaire. 73.4% of class teachers reported at least 1 asthmatic student in their class. 37.1% of teachers had students absent from school for up to 3 days per month and 5.1% missed school for 4 to 14 days in a month. 87.4% of the physical education (PE) teachers reported at least 1 asthmatic student in their class. 65.2% reported an average of 1-3 students sitting out at each PE lesson and 15.1% reported students who were exempted from PE for more than 3 months in a year due to asthma. The morbidity of asthma in Singaporean schoolchildren in terms of school absenteeism and exemption from PE classes is substantial. The data supports a need to improve asthma control amongst our schoolchildren.