Effect of pacifier use on exclusive and any breastfeeding: a meta-analysis.

The objective of this meta-analysis was to determine with cross-sectional and cohort trails whether the use of pacifier increases the risk of early weaning from exclusive breastfeeding before six months of age or cessation of breastfeeding from any breastfeeding before 24 months of age. Additionally, the effect of the age for starting pacifier use on breastfeeding duration was analyzed in the cohort trails. The Medline database was searched (1980 to 2006) with "breastfeed, breastfeeding, or breast feed" and "pacifier, dummy, or soother" as individual keywords. Only human studies published in English were included. Unpublished data were not sought. Twelve trials with weaning from exclusive breastfeeding and 19 trials with cessation of any breastfeeding were included in the meta-analysis. The meta-analysis was performed with Stata 6.0 statistical package. Summary risk ratio for early weaning before six months of age in exclusive breastfeeding trails was 2.016 (95% CI: 1.619-2.511) for pacifier users compared with nonusers in studies with univariate analysis and 1.792 (95% CI: 1.452-2.212) in studies with multivariate analysis. Similarly, pacifier usage compared with nonusers reduced the duration of any breastfeeding in both univariate (2.760, 95% CI: 2.083-3.657) and multivariate trials (1.952, 95% CI: 1.662-2.293). The use of pacifiers was associated with shortened duration of exclusive and of any breastfeeding. Given the increase in the benefits with duration of breastfeeding, parents should be informed of the link between pacifier use and shortened breastfeeding duration in order to help them make informed decisions about their children's care.

Effect of erythropoietin on brain tissue after experimental head trauma in rats.

BACKGROUND: The purpose of this study was to investigate the effect of EPO on LPO, on ultrastructural findings, and on antiapoptotic bcl-2 and survivin gene expressions after TBI. The authors also compared the activity of EPO with that of MPSS. METHODS: Wistar rats were divided into 6 groups: sham-operated, control, moderate TBI-alone (300 g/cm), TBI + EPO-treated (1000 IU/kg), TBI + MPSS-treated (30 mg/kg), and TBI + vehicle-treated (0.4 mL albumin solution) groups. RESULTS: Compared with the levels in control and sham-operated animals, LPO was significantly elevated in rats in the trauma-alone group. The administration of EPO and MPSS significantly decreased the LPO levels (P < .05). Trauma also increases the antiapoptotic bcl-2 gene expression significantly at 24 hours postinjury (P < .05), but it has no effect on survivin expression. The EPO and MPSS treatments caused significant elevation in both gene expressions (P < .05). It is also showed that MPSS has more protective effect than EPO on brain ultrastructure, especially on the structure of small- (P < .05) and medium-sized myelinated axons, after TBI. CONCLUSIONS: EPO has protective effects after moderate TBI, and this effect seems better than MPSS on antiapoptotic gene expression and LPO. The protection of cerebral subcellular organelles after traumatic injury is more prominent in MPSS-treated animals than EPO-treated animals quantitatively. This experimental study indicates that the benefits of EPO in the management of TBI have promising results and prompts further studies on the difference between EPO and MPSS in histopathological findings at the subcellular level.

Tracing immature myelin in acute disseminated encephalomyelitis.

Inherent abnormalities of myelin have been suggested in the pathogenesis of multiple sclerosis (MS). We investigated myelin in acute disseminated encephalomyelitis (ADEM) patients by magnetic resonance spectroscopy (MRS) and cerebrospinal fluid (CSF) analysis for citrulline, a marker of immature myelin. A citrulline peak was observed in the normal appearing white matter of 7/15 patients and of 1/10 age-matched neurological controls (p=0.08). CSF citrulline was elevated in 4/6 patients. Alterations in the composition of myelin might predispose to or follow acute inflammatory disorders of the central nervous system.