Irritable bowel syndrome in twins: genes and environment.

BACKGROUND AND AIMS: Both environmental and genetic factors may contribute to irritable bowel syndrome (IBS). Nutrition in fetal life, an early environmental factor, seems to influence the development of chronic diseases later in life, such as coronary heart disease, hypertension, and non-insulin diabetes. This population based twin study evaluated the association between intrauterine growth, measured by weight and gestational age, and IBS. Structural equation analyses were conducted to analyse genetic and environmental sources of variation in liability to IBS. METHODS: A postal questionnaire was sent to 12 700 Norwegian twins born between 1967 and 1979. The questionnaire included a checklist of 31 illnesses and symptoms, including IBS. The influence of birth weight on developing IBS was tested in four weight groups. Disease discordant monozygotic (MZ) pairs were analysed to test the association between intrauterine growth and IBS. RESULTS: Concordance for IBS was significantly greater (p = 0.011) in monozygotic (22.4%) than in dizygotic (9.1%) twins. The heritability of IBS was estimated to be 48.4% among females. Birth weight below 1500 g (adjusted odds ratio 2.4 (95% confidence interval 1.1, 5.3)) contributed significantly to the development of IBS, which appeared 7.7 years earlier than in higher weight groups. In the MZ group with birth weights lower than 2500 g, twins with IBS were significantly lighter than twins without disease (190.6 g; p = 0.02). CONCLUSION: The present study demonstrates that restricted fetal growth has a significant influence on the development of IBS later in life. Weight below 1500 g influences age at onset. Genetic contribution appears to be important for IBS among females.

Preparing teams for low-frequency emergencies in Norwegian hospitals.

BACKGROUND: Medical emergencies and major trauma require optimal team function. Leadership, co-operation and communication are the most essential issues. Due to low caseloads such emergencies occur rarely in most Norwegian hospitals. Team training of personnel between real emergencies is expected to improve performance in comparable settings. Most hospitals have cardiac arrest teams, but it is known that the training of such multiprofessional teams varies widely. We wanted to know if this also was the case for trauma teams and resuscitation teams for newborns. METHODS: A telephone survey of training practices in all the Norwegian hospitals with acute cover was conducted in 2002. Information was obtained on whether trauma teams and neonatal resuscitation teams had participated in practical multiprofessional training during the previous 6 or 12 months. RESULTS: Information was obtained from all 50 hospitals. Of the acute care hospitals, 30% had trained their trauma teams during the previous 6 months, and an additional 18% when considering the previous year, while 38% of neonatal wards had multiprofessional training during the previous 6 months, and additionally 13% had had training during the previous year. Additionally four neonatal wards had had regular training of nurses only. More than 80% of all respondents judged regular team training to be achievable, and none considered this training impossible. CONCLUSION: Only half the Norwegian acute care hospitals reported at least yearly training of trauma and neonatal resuscitation teams. Regular team training represents an underused potential to improve handling of low-frequency emergencies.

[Does supplementation of essential fatty acids influence the visual acuity and cognitive function of term infants?]. / Har tilskudd av essensielle fettsyrer effekt på synsfunksjon og kognitiv utvikling hos fullbårne spedbarn?

BACKGROUND: Norwegian health authorities recommend supplementation of essential fatty acids such as cod liver oil to term infants from four weeks of age. The essential fatty acids are seen as contributing to optimal development of the visual acuity and cognitive functions. This study reviews recent research on this issue. MATERIAL AND METHODS: We assessed six randomized controlled trials, published in 1998 and 1999, of which two evaluated visual function and four cognitive development. Outcome were measured by a number of standardized tests. We compared the results from our review with results from a Cochrane review which evaluated six studies published from 1995 to 1997. RESULTS: Only one of the tests used in the visual acuity studies showed significant effect at three out of the four age-related points in time at which the test was administered. Only one of the tests used in the cognitive development studies showed significant effect. INTERPRETATION: The studies reviewed here are in accordance with previous research and do not provide evidence for the claim that supplementation with essential fatty acids as such is significant in order to achieve optimal visual function and cognitive development in healthy term infants.