Do early-life exposures explain why more advantaged children get eczema? Findings from the U.K. Millennium Cohort Study

Background: Atopic dermatitis (eczema) in childhood is socially patterned, with higher incidence in more advantaged populations. However, it is unclear what factors explain the social differences. Objectives: To identify early-life risk factors for eczema, and to explore how early-life risk factors explain any differences in eczema. Methods: We estimated odds ratios (ORs) for ever having had eczema by age 5 years in 14 499 children from the U.K. Millennium Cohort Study (MCS), with a focus on maternal, antenatal and early-life risk factors and socioeconomic circumstances (SECs). Risk factors were explored to assess whether they attenuated associations between SECs and eczema. Results: Overall 35·1% of children had ever had eczema by age 5 years. Children of mothers with degree-level qualifications vs. no educational qualifications were more likely to have eczema (OR 1·52, 95% confidence interval 1·31–1·76), and there was a gradient across the socioeconomic spectrum. Maternal atopy, breastfeeding (1–6 weeks and ≥ 6 months), introduction of solids under 4 months or cow's milk under 9 months, antibiotic exposure in the first year of life and grime exposure were associated with an increased odds of having eczema. Female sex, Pakistani and Bangladeshi ethnicity, smoking during pregnancy, exposure to environmental tobacco smoke and having more siblings were associated with reduced odds for eczema. Controlling for maternal, antenatal and early-life characteristics (particularly maternal smoking during pregnancy, breastfeeding and number of siblings) reduced the OR for eczema to 1·26 (95% confidence interval 1·03–1·50) in the group with the highest educational qualifications compared with the least. Conclusions: In a representative U.K. child cohort, eczema was more common in more advantaged children. This was explained partially by early-life factors including not smoking during pregnancy, breastfeeding and having fewer siblings

Ventricular Tachycardia in a Pediatric Patient with High-Risk Thrombotic Thrombocytopenia Purpura

An 8-year-old previously healthy male was diagnosed with thrombotic thrombocytopenic purpura (TTP) and increased serum cardiac troponin I. Telemetry recorded non-sustained ventricular tachycardia, without ST-segment changes or other abnormalities on serial electrocardiogram. This case illustrates that cardiac monitoring by telemetry should be considered in high-risk TTP with elevated cardiac troponin

Community-based trial of screening for Chlamydia trachomatis to prevent pelvic inflammatory disease: the POPI (prevention of pelvic infection) trial.

BACKGROUND: Pelvic inflammatory disease (PID) is common and can lead to tubal factor infertility, ectopic pregnancy or chronic pelvic pain. Despite major UK government investment in the National Chlamydia Screening Programme, evidence of benefit remains controversial. The main aim of this trial was to investigate whether screening and treatment of chlamydial infection reduced the incidence of PID over 12 months. Secondary aims were to conduct exploratory studies of the role of bacterial vaginosis (BV) in the development of PID and of the natural history of chlamydial infection. DESIGN: Randomised controlled trial with follow up after 12 months. SETTING NON-HEALTHCARE: Common rooms and lecture theatres at 20 universities and further education colleges in Greater London. PARTICIPANTS: 2500 sexually active female students were asked to complete a questionnaire on sexual health and provide self-administered vaginal swabs and smears. INTERVENTION: Vaginal swabs from intervention women were tested for chlamydia by polymerase chain reaction (PCR) and those infected referred for treatment. Vaginal swabs from control women were stored and analysed after a year. Vaginal smears were Gram stained and analysed for BV. MAIN OUTCOME MEASURE: Incidence of clinical PID over 12 months in intervention and control groups. Possible cases of PID will be identified from questionnaires and record searches. Confirmation of the diagnosis will be done by detailed review of medical records by three independent researchers blind to whether the woman is in intervention or control group. TRIAL REGISTRATION: Clinical Trials NCT 00115388

Optical/Near-Infrared Imaging of Infrared-Excess Palomar-Green QSOs

Ground-based high spatial-resolution (FWHM < 0.3-0.8") optical and near-infrared imaging (0.4-2.2um) is presented for a complete sample of optically selected Palomar-Green QSOs with far-infrared excesses at least as great as those of "warm" AGN-like ultraluminous infrared galaxies (L_ir/L_big-blue-bump > 0.46). In all cases, the host galaxies of the QSOs were detected and most have discernable two-dimensional structure. The QSO host galaxies and the QSO nuclei are similar in magnitude at H-band. H-band luminosities of the hosts range from 0.5-7.5 L* with a mean of 2.3 L*, and are consistent with those found in ULIGs. Both the QSO nuclei and the host galaxies have near-infrared excesses, which may be the result of dust associated with the nucleus and of recent dusty star formation in the host. These results suggest that some, but not all, optically-selected QSOs may have evolved from an infrared-active state triggered by the merger of two similarly-sized L* galaxies, in a manner similar to that of the ultraluminous infrared galaxies.Comment: Aastex format, 38 pages, 4 tables, 10 figures. Higher quality figures are available in JPG forma

Kaluza-Klein Holography

We construct a holographic map between asymptotically AdS_5 x S^5 solutions of 10d supergravity and vacuum expectation values of gauge invariant operators of the dual QFT. The ingredients that enter in the construction are (i) gauge invariant variables so that the KK reduction is independent of any choice of gauge fixing; (ii) the non-linear KK reduction map from 10 to 5 dimensions (constructed perturbatively in the number of fields); (iii) application of holographic renormalization. A non-trivial role in the last step is played by extremal couplings. This map allows one to reliably compute vevs of operators dual to any KK fields. As an application we consider a Coulomb branch solution and compute the first two non-trivial vevs, involving operators of dimension 2 and 4, and reproduce the field theory result, in agreement with non-renormalization theorems. This constitutes the first quantitative test of the gravity/gauge theory duality away from the conformal point involving a vev of an operator dual to a KK field (which is not one of the gauged supergravity fields).Comment: 47 pages, v2: minor improvements, version to appear in JHE

Large-scale structure in a new deep IRAS galaxy redshift survey

We present here the first results from two recently completed, fully sampled redshift surveys comprising 3703 IRAS Faint Source Survey (FSS) galaxies. An unbiased counts-in-cells analysis finds a clustering strength in broad agreement with other recent redshift surveys and at odds with the standard cold dark matter model. We combine our data with those from the QDOT and 1.2 Jy surveys, producing a single estimate of the IRAS galaxy clustering strength. We compare the data with the power spectrum derived from a mixed dark matter universe. Direct comparison of the clustering strength seen in the IRAS samples with that seen in the APM-Stromlo survey suggests b_O/b_I=1.20+/-0.05 assuming a linear, scale independent biasing. We also perform a cell by cell comparison of our FSS-z sample with galaxies from the first CfA slice, testing the viability of a linear-biasing scheme linking the two. We are able to rule out models in which the FSS-z galaxies identically trace the CfA galaxies on scales 5-20h^{-1}Mpc. On scales of 5 and 10h^{-1}Mpc no linear-biasing model can be found relating the two samples. We argue that this result is expected since the CfA sample includes more elliptical galaxies which have different clustering properties from spirals. On scales of 20h^{-1}Mpc no linear-biasing model with b_O/b_I &lt; 1.70 is acceptable. When comparing the FSS-z galaxies to the CfA spirals, however, the two populations trace the same structures within our uncertaintie

Non-alcoholic fatty liver disease: relationship with cardiovascular risk markers and clinical endpoints

Non-alcoholic fatty liver disease (NAFLD) is a common diagnosis and is increasing in prevalence worldwide. NAFLD is usually asymptomatic at presentation; progression of the disease is unpredictable, leading to the development of a variety of techniques for screening, diagnosis and risk stratification. Clinical methods in current use include serum biomarker panels, hepatic ultrasound, magnetic resonance imaging, and liver biopsy. NAFLD is strongly associated with the metabolic syndrome, and the most common cause of death for people with the condition is cardiovascular disease. Whether NAFLD is an independent cardiovascular risk factor needs exploration. NAFLD has been associated with surrogate markers of cardiovascular disease such as carotid intima-media thickness, the presence of carotid plaque, brachial artery vasodilatory responsiveness and CT coronary artery calcification score. There is no effective medical treatment for NAFLD and evidence is lacking regarding the efficacy of interventions in mitigating cardiovascular risk. Health care professionals managing patients with NAFLD should tackle the issue with early identification of risk factors and aggressive modification. Current management strategies therefore comprise lifestyle change,with close attention to known cardiovascular risk factors