Maternal multivitamin intake and orofacial clefts in offspring: Japan Environment and Children's Study (JECS) cohort study

Objectives: Orofacial clefts are common birth defects with a lack of strong evidence regarding their association with maternal nutrition. We aimed to determine whether a relationship exists between maternal nutrient or multivitamin intake and orofacial clefts. Design: This is a prospective, population-based nationwide cohort study. Setting: The study was conducted in 15 regional centres, consisting of local administrative units and study areas. Participants: A total of 98 787 eligible mother–child pairs of the Japan Environment and Children’s Study were included. Intervention: Exposures were maternal nutrition and the use of supplemental multivitamins in mothers. Primary and secondary outcome measures: Outcomes were the occurrence of any orofacial cleft at birth. Multinomial logistic regression analyses were used to evaluate the association between maternal multivitamin intake and the incidence of orofacial clefts. Results: Of the 98 787 children, 69 (0.07%) were diagnosed with cleft lip alone, 113 (0.11%) were diagnosed with cleft lip and palate, and 52 (0.05%) were diagnosed with cleft palate within 1 month after birth. Regarding the total orofacial cleft outcome, statistically significant point estimates of relative risk ratios (RR) were determined for multivitamin intake before pregnancy (RR=1.71; 95% CI 1.06 to 2.77) and during the first trimester (RR=2.00; 95% CI 1.18 to 3.37), but the association was not significant for multivitamin intake after the first trimester (RR=1.34; 95% CI 0.59 to 3.01). Maternal micronutrient intake via food was not associated with the incidence of orofacial clefts in offspring. Conclusions: Intake of multivitamin supplements shortly before conception or during the first trimester of pregnancy was found to be associated with an increased incidence of orofacial clefts at birth. Pregnant women and those intending to become pregnant should be advised of the potential risks of multivitamin supplementation

Intravenous immunoglobulin for the treatment of Kawasaki disease

This is a protocol for a Cochrane Review (intervention). The objectives are as follows: To evaluate the efficacy and safety of IVIG in treating and preventing cardiac consequences of Kawasaki disease

Groove Pancreatitis with Several Cystic Lesions around the Pancreatic Head Treated Conservatively: Report of a Case

A 61-year-old man was admitted to our hospital with epigastric pain and vomiting. Enhanced abdominal computed tomography revealed inflammatory change of the pancreatic groove and focal wall thickening of the second portion of the duodenum with several cystic lesions around the head of the pancreas. We diagnosed atypical type of groove pancreatitis. The patient made a satisfactory recovery by conservative medication treatment for acute on chronic pancreatitis and cystic lesions disappeared in parallel with pancreatitis. Groove pancreatitis is a rare form of chronic pancreatitis, and to the best of our knowledge, our patient is the first case in the English literature of groove pancreatitis with cystic lesions around the head of the pancreas, which disappeared after conservative treatment for pancreatitis

Photoluminescence and photoluminescence excitation spectra from AlN doped with Gd3+

The photoluminescence (PL) spectra from Al0.98Gd0.02N andAl0.87Gd0.13N consisting of Gd3+ related 3.95 eV sharp emis-sion lines and other bands, and the PL excitation (PLE) spec-tra from 3 to 7 eV have been investigated by using a highly linear polarized synchrotron radiation light source. The Gd related 3.95 eV sharp lines in the PL spectra are similar to those in other cathodoluminescence (CL) and PL research. However, the broad emission bands around 3.95 eV lineswhich are normally found in other CL works are not ob- served. Other broad emission bands are clearly observed in the energy region of 1.5 ~ 3.5 eV. PLE spectra monitored at both the 3.95 eV sharp line and the broad emission band ofAl0.98Gd0.02N clearly indicate that these emission processes are host excitations which are reflected by an AlN-like band structure and crystalline anisotropy. On the other hand, the PLE and optical reflectance spectra of Al0.87Gd0.13N reveal an unclear band structure with a long band tail in the lower en-ergy side