Recycling of wastewater-derived phosphorus in Swedish agriculture--a proposal

In 2001 the Swedish Government commissioned the Swedish Environmental Protection Agency (Swedish EPA) (i) to examine the need for stricter human health and environmental regulations governing the agricultural use of sewage sludge and (ii) to propose national targets for the agricultural recycling of phosphorus (P) originating from wastewater. The Swedish EPA may propose: (i) stricter regulations on sludge treatment to limit the risk of spreading pathogens in the environment and transmission of infectious diseases; (ii) recycling of 20-30% of wastewater-P to agriculture by 2015 and recycling of 35-50% of wastewater-P to agriculture by 2025.

Allergic symptoms up to 4-6 years of age in children given cow milk neonatally. A prospective study

In a previously published prospective study, we followed the development of allergic symptoms in term infants with a slightly reduced birthweight (-1 SD to -2 SD). These children received, according to local routine, early feeding with cow milk formula in order to diminish such neonatal problems as hypoglycemia and hyperbilirubinemia. Of 216 infants 207 were observed for allergic symptoms up to 18 months of age. One group (F) received cow milk formula during the first days of life before the mother's breastmilk production started and was then breastfed; the other (B) was not given any formula before normal breastfeeding started. Unexpectedly, we found fewer allergic symptoms, in particular allergic skin problems, in the group fed cow milk, the difference being concentrated to children with a family history of allergic symptoms. At 5 years of age 183 of the 207 children have been reinvestigated. Mild symptoms of allergy (suspected and obvious) were found in 22% (F) and 27% (B) respectively (NS). Moderate and severe symptoms of allergy (obvious) were found in 4.2% (F) and 4.5% (B). In the subgroup with a double family history of allergic symptoms, 28% (7/25, F) and 59% (10/17, B) had symptoms of allergy (p less than 0.05). This difference was even more pronounced when laboratory tests in favour of atopic diagnosis were included, 14% (F) and 53% (B) respectively (p less than 0.05). Thus at 5 years we still find a significantly lower frequency of allergic symptoms in the subgroup fed cow milk formula early with a family history of allergic symptoms.(ABSTRACT TRUNCATED AT 250 WORDS)

3-Hydroxydicarboxylic aciduria--a fatty acid oxidation defect with severe prognosis

We describe five patients with a suspected defect in the beta-oxidation of fatty acids characterized by a massive excretion of 3-hydroxydicarboxylic acids in the urine and accumulation of 3-hydroxy fatty acids in serum during acute illness. Long-chain and medium-chain acyl-coenzyme A dehydrogenases in fibroblasts were normal in all patients. Four of them died of cardiomyopathy and liver insufficiency at 3 to 14 months of age. Two of the patients had elder siblings who had died unexpectedly in early infancy. These patients differ from previously described patients with beta-oxidation defects.

A longterm follow-up study of children born to women with contagious diseases at delivery

Data are presented from a long-term follow-up study of 308 live born children to women admitted post partum to the Department of Infectious Diseases (DID), Danderyd Hospital, Sweden, during a 10-year period (1975-1984) for avoiding nosocomial transmission of infections in the obstetrical wards. The rate of stillbirths (1/309 deliveries) was not higher than reported for all births in Stockholm. 20% of the live born children were transferred within 24 h after birth to the pediatric department for observation, but half of them could return to their mothers at the DID within 6 days (generally 3 days). Four newborns were treated at an intensive care unit. Only 3 fatalities occurred, all of them among newborns to mothers with an overt infection at delivery. The fatality rate (1.8%) was significantly higher among the newborns of these mothers than normally (0.3%) noted among all children born in Stockholm county during the period studied. Two of the 3 newborns, who all died within 3 days of life, had a low birth weight (600 and 1,000 g). The total number of newborns with low birth weights (less than 2,500 g) was, however, not higher in the above-mentioned group of newborns than for all children born in Stockholm county 1980. None of the 3 fatalities was caused by infection transmitted from the mother. No further deaths occurred. Infections in pregnancy at term, at birth or post partum were transmitted from the women to 41 (13%) of their newborns.(ABSTRACT TRUNCATED AT 250 WORDS)

Development of atopic disease after early administration of cow milk formula

We prospectively studied the incidence of atopic disease in healthy term infants with a birth weight between -1 and -2 SD who were fed a cow milk formula during the first few days of life. A total of 216 infants were randomized to receive either early feeding with formula before normal breastfeeding was started (n = 112) or "normal feeding" with breastmilk (n = 104). Symptoms of allergy developed in 18% of the infants before 18 months of age in the formula fed group, as compared to 33% in the breastfed group (P less than 0.05). The difference was confined to the group of infants with a history of allergy in two family members. Thus, 11% of the formula-fed infants developed allergy symptoms, as compared to 61% of the control infants (P less than 0.01). Our study implies that early feeding during the first days of life with a cow milk formula, before the introduction of breastmilk, may reduce the incidence of allergy symptoms before 18 months of age in infants with a family history of allergy.

Determination of cholesteryl sulphate by isotope dilution-mass spectrometry for diagnosis of steroid sulphatase deficiency

A specific and accurate method for determination of cholesteryl sulphate in serum based on isotope dilution-mass spectrometry has been developed. 2H-labelled cholesteryl sulphate was synthesized and used as internal standard. After addition of the internal standard to serum, the cholesteryl sulphate is extracted with butanol and purified by thin-layer chromatography. The material is then solvolysed, converted into trimethylsilyl ether, and analysed by combined gas chromatography-mass spectrometry. The ratio between unlabelled and labelled cholesterol is determined by selected ion monitoring of the ions at m/e 458 (corresponding to the molecular ion of derivative of unlabelled cholesterol) and m/e 465 (corresponding to the molecular ion of derivative of 2H7-labelled cholesterol). The concentration of cholesteryl sulphate is calculated with use of a standard curve. The coefficient of variation of the method was found to vary between 4% and 9% in different concentration ranges. Nine healthy male infants (age range, 1-3 yr) had concentrations of cholesteryl sulphate varying between 0.2 and 11 mumol/l (mean, 3.8 mumol/l). A boy with suspected steroid sulphatase deficiency had a concentration of cholesteryl sulphate of 69 and 64 mumol/l at the age of 12 and 18 months, respectively.

Comparative efficiency of chlorhexidine and ethanol in umbilical cord care

Recurrent epidemic spread of beta-hemolytic streptococci of Lancefield group A was seen in our maternity wards during a period when 70% ethanol was used for umbilical care. This prompted us to compare this regimen with one using 4% chlorhexidine in detergent for a period of 9 consecutive months. 2016 infants were studied. Umbilical colonization with group A, C and G streptococci was almost eliminated by use of 4% chlorhexidine in detergent and epidemic spread was not seen. Colonization rate of Staphylococcus aureus at the umbilical cord was reduced from 92% to 27%. The incidence of superficial infections during the first 4 postnatal weeks was reduced. Following the 9 months of comparative study 4% chlorhexidine in detergent has been routinely used in umbilical cord care at our hospital for more than 1 year without any epidemic spread of streptococci and with the same antibacterial efficiency.