[Comparing the effectiveness of a "short-term double-dose" hepatitis B vaccination schedule with the "standard 3-dose" schedule: a randomized clinical trial]

With respect to the importance of hepatitis B vaccination of high-risk groups such as prisoners, this study was performed to assess the comparability of a short-course double-dose vaccination schedule with the standard 3-dose schedule. Within a randomized clinical trial, a short-course vaccination [at months 0 and 1] with 20 microgram [double-dose] doses of the vaccine was compared to the standard method of hepatitis B vaccination [at months 0, 1 and 6, with 10-microgram doses] in 100 prisoners in Zahedan city in Iran in 2009. We made sure the sera from all the individuals were negative for markers of previous hepatitis B infection. Subsequently serum from all the participants was tested for anti-HBs antibody 1, 2 and 7 months after the first dose of vaccination. Seroconversion rates [HBsAb>10 mIU/ml] 1, 2 and 7 months after the first dose of vaccination were similar in the routine [11%, 79% and 94%, respectively] relative to the double-dose group [26%, 95% and 93%, respectively]. The mean values of anti-HBs antibody titers were similar in the 1st and 2nd months for the two groups but it was significantly higher [P=0.002] in the routine dose [514 mIU/ml] versus the double-dose group [130 mIU/mL], in the 7th month. Demonstrating comparable results with the standard 3-dose schedule, it seems that short-term double-dose vaccination for hepatitis B is a safe and acceptable method for use in high-risk groups such as prisoners

Cow's Milk Allergy among Children with Gastroesophageal Reflux Disease

BACKGROUND/AIMS: Gastroesophageal reflux disease (GERD) and cow's milk allergy (CMA) are two common conditions that occur in infancy. This study was performed to investigate the frequency of CMA in a group of patients with GERD. METHODS: Eighty-one children with signs and symptoms of GERD were enrolled in this study. All subjects received omeprazole for 4 weeks after the initial evaluation. Empirical elimination of cow's milk from the diet was started for the patients who did not respond to the omeprazole treatment. RESULTS: Seventy-two cases presented with gastrointestinal signs and symptoms, whereas the remaining nine cases presented with respiratory complaints. After the initial treatment with omeprazole, two thirds of the cases (54 patients, 66.7%) responded well, and all of their symptoms were resolved. Cow's milk was eliminated from the diets of the remaining 27 patients. All signs and symptoms of GERD were resolved in this group after a 4 week elimination of cow's milk from the diet. CONCLUSIONS: A diagnosis of CMA was considered in one third of the pediatric cases with signs and symptoms of GERD. This finding shows that CMA can mimic or aggravate all signs and symptoms of severe GERD during infancy.