No abstract

Transient lactose intolerance has been identified as a possible causative factor in infant colic. A double-blind randomised placebo-controlled crossover study to investigate this has been undertaken in 53 babies with symptoms of colic. Pre-incubation of the feed with lactase resulted in breath hydrogen levels and total crying time which were both at least 45% lower than figures with placebo treatment, in 26% of the full trial group (95% confidence interval 12.9% to 44.4%), and in 38% of compliers (95% confidence interval 18.8% to 59.4%). The remainder did not respond to the same extent. These findings suggest that infant colic may have a multiple aetiology, and that in a significant number of cases the immediate cause is transient lactose intolerance, in which cases pretreatment of feeds with lactase can result in considerable symptomatic benefits.

There was no association between the severity of periodontal disease and pregnancy outcome in this population.

Objective To investigate a putative relationship between preterm delivery and the carriage of polymorphic genes that code for the cytokines interleukin-1h (IL-1h) at codon þ3953 and tumour necrosis factor-a (TNF-a) at codon À308 in a group of postpartum women and to elucidate if the concurrent presence of periodontal disease increased the risk of preterm delivery in this group. Design Case -control study.Setting Postnatal wards at Guy's and St Thomas' Hospital Trust.Population Postpartum women from southeast London, UK.Methods Case subjects were defined as those who experienced a birth at less than 37 weeks of gestation.Control subjects gave birth at term. Demographic data were collected and a periodontal examination was performed. Blood samples were collected and analysed by restriction fragment length polymerase techniques for the presence of each of the allelic variants. Main outcome measures The level of periodontal disease and the carriage of allelic variants of IL-1h þ3953 and TNF-a À308 genes. Results Forty-eight case subjects and 82 control subjects were assessed. There was no statistically significant difference in the carriage of the IL-1h þ3953 allelic variant between cases and controls (29% versus 18%, P ¼ 0.112). However, 23 (48%) of the case subjects and 24 (29%) of controls were heterozygous or homozygous for the variant TNF-a À308 gene (odds ratio [OR] 2.2, 95% confidence interval [CI] 1.0-5.0, P ¼ 0.026).There was no association between the carriage of either the polymorphic IL-1h þ3953 or TNF-a À308 variant and the severity of periodontal disease. The combination of periodontal disease and the allelic variant did not increase the risk of preterm delivery. Conclusions In this study, a higher proportion of women who delivered preterm carried the polymorphic TNFa À308 gene. There did not appear to be any interaction between either of the genotypes and periodontal disease with preterm delivery as has been reported for bacterial vaginosis and the TNF-a À308 polymorphic gene.