Methemoglobinemia induced by vegetable intake in infants in northern Spain.

BACKGROUND AND OBJECTIVE: Acquired methemoglobinemia (MHb) induced in infants by intake of vegetables is a condition uncommonly reported in the literature. The purpose of the present study was to study new vegetables involved and other epidemiological risk factors. METHODS: Seventy-eight cases of diet-induced MHb seen in Pamplona from 1987 to 2010 are reported. Infant characteristics were collected, and a case-control study was conducted using as controls 78 age- and sex-matched infants selected at the same geographic area. Bivariate logistic regression analyses were performed to detect factors involved in MHb occurrence. Nitrate levels were tested in natural vegetables used to prepare purées. RESULTS: A clear relation was found between MHb and use of borage (Borago officinalis) (OR 5.2; 95% CI 1.1-24.6) and maybe chard (Beta vulgaris var cicla) (OR 2.0; 95% CI 0.4-8.7), time from preparation to use (OR 17.4, 95% CI 3.5-86.3 if the purée had been prepared 24-48 hours before and OR 24.9, 95% CI 3.3-187.6 if prepared >48 hours before), and breast-feeding (OR 10.4; 95% CI 1.9-57.2). Tests confirmed that vegetables with the highest nitrate levels were borage (n = 15), with mean nitrate levels of 3968 mg/kg, and chard (n = 17), with mean levels of 2811 mg/kg. CONCLUSIONS: The main associated factors were shown to be time from purée preparation to use (>24 hours), use of certain vegetables (borage and chard), and breast-feeding. Nitrate levels in both vegetables implicated as etiological factors in acquired MHb are high.

The impact of caesarean delivery and type of feeding on cow's milk allergy in infants and subsequent development of allergic march in childhood.

BACKGROUND: The incidence of IgE-mediated cow's milk allergy (CMA) has increased over the last few years. There are several genetic and environmental risk factors that may be related to this allergy and the subsequent allergic march (AM). METHODS: A prospective, cohort study was conducted in patients recruited into the study between 1998 and 2002. Information on clinical variables and complementary tests, perinatal and obstetric factors and the type of hydrolysed formula used was recorded. A cross sectional study on the prevalence of allergic diseases in this cohort was performed in 2004. RESULTS: We compared IgE-mediated CMA patients with non-IgE-mediated CMA patients and found that IgE-mediated CMA is associated with caesarean delivery (OR = 2.14 95% CI: 1.02-4.49), duration of breast feeding (>2 months, OR = 4.14; 95% CI: 2.17-7.89) and the use of supplementary artificial formula whilst breast feeding (OR = 2.86; 95% CI: 1.33-6.13). The factors associated with AM in IgE-mediated CMA patients were caesarean delivery (OR = 0.42; 95% CI: 0.19-0.92) and the use of more extensively hydrolysed high grade hydrolysates (+EH/HGH) (OR = 0.44; 95% CI: 0.20-0.98), both as protective factors. CONCLUSIONS: Caesarean delivery is demonstrated as being a risk factor for IgE-mediated CMA, but it does not increase the risk of AM in these infants. The use of +EH/HGH appears to protect IgE-mediated CMA patients from eventually developing AM.

¿Influye la población inmigrante en el Índice de Natalidad en Navarra? Datos preliminares del Hospital Virgen del Camino. Periodo agosto-diciembre 2000 / Does the immigrant population influence the birth rate in Navarra? Preliminary data of the "Virgen del Camino" Hospital. Period from August to December 2000

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