Synbiotics in children with cow's milk allergy: a randomized controlled trial

Cow's milk protein allergy usually occurs in infants within the first months of life. It can affect several organs, but gastrointestinal symptoms are the most clinical symptoms observed. The most effective treatment is restricting the cow 's milk protein in mother and infant's diet. Lactobacillus GG supplementation in infant could be effective through modulation of the immune system and the gut microflora. Thirty two breastfed infants with Cow's milk protein allergy were enrolled in a double-blinded randomized controlled trial in which they received Synbiotic [n=16] or placebo [n=16] once a day for one month, simultaneously with Cow's milk protein restriction in mother and infant's diet. Clinical gastrointestinal symptoms [vomiting, colic, rectal bleeding and diarrhea], head circumference, body length and weight were recorded at the beginning, the end of the first and third month of study. Percentage of increment in head circumference and weight were statistically more in synbiotic group compared with placebo group at the end of the first and third month of study. There was no significant difference in resolution of clinical gastrointestinal symptoms [vomiting, colic, rectal bleeding or diarrhea] and percentage of increment in body length. Synbiotic supplementation in infants may improve increment of head circumference and weight gain, but has no effect on resolution of clinical symptoms

Congenital aortocaval fistula from right subclavian artery to superior vena cava in an adult with tetralogy of fallot

Congenital aortocaval fistula in association with complex congenital heart disease has never been described before. We represent an adult with tetralogy of fallot and an undiagnosed subclavian artery to superior vena cava fistula in previous catheterisms. He underwent surgical correction, successfully. After 8 months post operation he was doing well with improved functional capacity and no cyanosis

Effect of a new synbiotic mixture on atopic dermatitis in children: a randomized-controlled trial

Atopic dermatitis [AD] is the most common chronic relapsing skin disease seen in infancy and childhood. The intestinal microbiota play an important role in immune development and may play a role in the development of allergic disorders. Manipulation of the intestinal microbiota by synbiotics may therefore offer an approach to the prevention or treatment of AD and allergic diseases. We studied the clinical and immunologic effects of a new symbiotic [a mixture of seven probiotic strains of bacteria and Fructooligosaccharide] in infants and children with AD. In a randomized, double-blind, placebo-controlled study, 40 infants and children aged 3 months to 6 years with AD received either a synbiotic or placebo for 8 weeks. The Severity Scoring of Atopic Dermatitis [SCORAD] index was recorded at baseline and also at 4 and 8 weeks of treatment. There was no significant difference between the probiotic and placebo group in baseline characteristics including sex, age, family history, corticosteroid usage and prick testing. Mean age was 23 months. The synbiotic group showed a significantly greater reduction in SCORAD than did the placebo group [P=0.001]. No specific effect was demonstrated of the probiotics employed on cytokine profile [P=0.4, P=0.6]. Egg white was the most common [45%] allergen followed by peanut and cow's milk. This study provides evidence that a mixture of seven strains of probiotics and Fructooligosaccharide can clinically improve the severity of AD in young children. Further studies are needed to investigate the effects on underlying immune responses and the potential long term benefits for patients with AD