BackgroundAlthough Lactobacillus rhamnosus GG ATCC 53103 (LGG) has been consumed by 2 to 5 million people daily since the mid 1990s, there are few clinical trials describing potential harms of LGG, particularly in the elderly.ObjectivesThe primary objective of this open label clinical trial is to assess the safety and tolerability of 1×1010 colony forming units (CFU) of LGG administered orally twice daily to elderly volunteers for 28 days. The secondary objectives were to evaluate the effects of LGG on the gastrointestinal microbiome, host immune response and plasma cytokines.MethodsFifteen elderly volunteers, aged 66–80 years received LGG capsules containing 1×1010 CFU, twice daily for 28 days and were followed through day 56. Volunteers completed a daily diary, a telephone call on study days 3, 7 and 14 and study visits in the Clinical Research Center at baseline, day 28 and day 56 to determine whether adverse events had occurred. Assessments included prompted and open-ended questions.ResultsThere were no serious adverse events. The 15 volunteers had a total of 47 events (range 1–7 per volunteer), 39 (83%) of which were rated as mild and 40% of which were considered related to consuming LGG. Thirty-one (70%) of the events were expected, prompted symptoms while 16 were unexpected events. The most common adverse events were gastrointestinal (bloating, gas, and nausea), 27 rated as mild and 3 rated as moderate. In the exploratory analysis, the pro-inflammatory cytokine interleukin 8 decreased during LGG consumption, returning towards baseline one month after discontinuing LGG (p = 0.038) while there was no difference in other pro- or anti-inflammatory plasma cytokines.Conclusions Lactobacillus rhamnosus GG ATCC 53103 is safe and well tolerated in healthy adults aged 65 years and older.Trial RegistrationClinicalTrials.gov NCT 01274598

Background: Over one-third of the world's population is exposed to household air pollution (HAP) but the separate effects of cooking with solid fuel and kerosene on childhood mortality are unclear. Objectives: To evaluate the effects of both solid fuels and kerosene on neonatal (0-28 days) and child (29 days-59 months) mortality. Methods: We used Demographic and Health Surveys from 47 countries and calculated adjusted relative risks (aRR) using Poisson regression models. Results: The aRR of neonatal and child mortality in households exposed to solid fuels were 1.24 (95% CI: 1.14, 1.34) and 1.21 (95% CI: 1.12, 1.30), respectively, and the aRR for neonatal and child mortality in households exposed to kerosene were 1.34 (95% CI: 1.18, 1.52) and 1.12 (95% CI: 0.99, 1.27), controlling for individual, household, and country-level predictors of mortality. Conclusions: Kerosene should not be classified as a clean fuel. Neonates are at risk for mortality from exposure to solid fuels and kerosene.

obtaining an appropriate interpreter. Many of the adult participants preferred an internet-based video interpreting service over in-person interpreters because of increased dialect options, as well as shorter wait times. Although traditional medicines and healing techniques were used in refugee camps and occasionally in Indianapolis, most Burmese place trust with western medicine and report valuing and complying with physician recommendations. Many have a basic understanding of good health practices and the causes of illness. This is seen most consistently in the adolescent groups. Interpretation: Overall, Burmese Chin have adapted to their new home. Although they experience common frustrations with the healthcare system, these frustrations were exacerbated by long waits for an interpreter. Resources, such as a phone or video-based interpreter, are available in most health care facilities and preferred by the Burmese. More research is needed to better understand the challenges of the Burmese population residing in the United States.Background: Anemia affects 45% of preschool children worldwide, with an even higher prevalence in low and middle-income countries, despite nutritional interventions and iron supplementation. The contribution of household factors to anemia is less well described. To further evaluate the effect of household and individual risk factors for anemia, we analyzed data from the four East African countries that performed hemoglobin testing during the most recent administration of the Demographic and Health Surveys (DHS 2010-2011). Methods: We analyzed data from 14,718 children age 6 to 59 months in Tanzania, Rwanda, Uganda, and Burundi. A household survey was administered to an adult respondent, and anthropometry and hemoglobin testing were conducted on children after parental consent. We performed univariate analyses and multivariate logistic regression using survey procedures in SAS 9.4. We grouped risk factors as follows: demographic (age, sex), socioeconomic (wealth index, maternal education level, number of household members), water/sanitation (use of shared toilet facilities, unimproved toilets, lack of clean drinking water, unsafe stool disposal), nutritional (height-for-age [HAZ], weight-for-age [WAZ], a low iron-diet, premature intake of cows' milk), recent illnesses (diarrhea, bloody diarrhea, or fever in the past 2 weeks), and prophylactic measures (iron supplementation in the last week, deworming in the last 6 months, bednet usage). We constructed multivariate models within each risk factor category to identify factors that were most predictive of anemia, and then included these factors in our final model. Findings: The mean hemoglobin among tested children was 11.2 (SD 1.8); 60% of children had at least mild anemia (Hb < 11) and 19% at least moderate anemia (Hb < 10). Significant protective factors in the final multivariate model included older age (OR 0.97 per month [95% CI 0.96, 0.97]), female sex (OR 0.82 [0.75, 0.91]), and deworming treatment (OR 0.82 [0.73, 0.90]).