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ObjectiveTo evaluate the risk of childhood hospitalization associated with infant feeding patterns at 6-8 weeks of age in Scotland.Study designA retrospective population level study based on the linkage of birth, death, maternity, infant health, child health surveillance, and admission records for children born as single births in Scotland between 1997 and 2009 (n = 502 948) followed up to March 2012. Descriptive analyses, Kaplan Meier tests, and Cox regression were used to quantify the association between the mode of infant feeding and risk of childhood hospitalization for respiratory, gastrointestinal, and urinary tract infections, and other common childhood ailments during the study period.ResultsWithin the first 6 months of life, there was a greater hazard ratio (HR) of hospitalization for common childhood illnesses among formula-fed infants (HR 1.40; 95% CI 1.35-1.45) and mixed-fed infants (HR 1.18; 95% CI 1.11-1.25) compared with infants exclusively breastfed after adjustment for parental, maternal, and infant health characteristics. Within the first year of life and beyond, a greater relative risk of hospitalization was observed among formula-fed infants for a range of individual illnesses reported in childhood including gastrointestinal, respiratory, and urinary tract infections, otitis media, fever, asthma, diabetes, and dental caries.ConclusionsUsing linked administrative data, we found greater risks of hospitalization in early childhood for a range of common childhood illnesses among Scottish infants who were not exclusively breastfed at 6-8 weeks of age.

This is the first time that serial sections of axillary skin have been examined by histology and immunofluorescence. The markers reported to discriminate between apocrine and eccrine glands were found to be nonspecific. No evidence of apoeccrine glands was found either by histology or by immunofluorescence.

Study objective: To assess whether opportunistic and postal screening strategies for Chlamydia trachomatis can be compared with usual care in a randomised trial in general practice. Design: Feasibility study for a randomised controlled trial. Setting: Three West of Scotland general medical practices: one rural, one urban/deprived, and one urban/affluent. Participants: 600 women aged 16-30 years, 200 from each of three participating practices selected at random from a sample of West of Scotland practices that had expressed interest in the study. The women could opt out of the study. Those who did not were randomly assigned to one of three groups: postal screening, opportunistic screening, or usual care. Results: 38% (85 of 221) of the approached practices expressed interest in the study. Data were collected successfully from the three participating practices. There were considerable workload implications for staff. Altogether 124 of the 600 women opted out of the study. During the four month study period, 55% (81 of 146) of the control group attended their practice but none was offered screening. Some 59% (80 of 136) women in the opportunistic group attended their practice of whom 55% (44 of 80) were offered screening. Of those, 64% (28 of 44) accepted, representing 21% of the opportunistic group. Forty eight per cent (59 of 124) of the postal group returned samples. Conclusion: A randomised controlled trial comparing postal and opportunistic screening for chlamydial infection in general practice is feasible, although resource intensive. There may be problems with generalising from screening trials in which patients may opt out from the offer of screening.

Effect of T injection and EGCG on T and DHT concentrations in serum and hairAnalysis using LC-MS ⁄ MS on serum and hair samples was performed to determine the difference in the T and DHT concentrations in each group. We found no difference in the T and DHT concentrations between the T-injected and T + EGCG groups (unpublished data). ConclusionWe report the first in vivo experiment showing the influence of T injection and EGCG on hair follicles. Our results suggest that T injection in a B6CBAF1 ⁄ j mouse model induces hair loss by apoptosis of hair follicles rather than through the androgen metabolic pathway. Furthermore, it was shown that EGCG can prevent hair loss by reducing T-induced apoptosis of follicular epithelial cells and provoke hair re-growth after epilation.The best animal model of androgen-induced alopecia is the stump-tailed macaque, but because of its large size and high cost, researchers favour a more easily handled murine model (19). The B6CBAF1 ⁄ j mice used in this study were first introduced by Matias et al. (17) as a T-induced androgenic alopecia mice model. The B6CBAF1 ⁄ j mouse is not a perfect androgen-induced alopecia model in that androgen is needed to be given continuously, and once androgen supplementation ceases, the mouse regains its hair within 3 months. Because B6CBAF1 ⁄ j mice are convenient, costeffective and suitable with respect to the time course of results, B6CBAF1 ⁄ j mice were used in this study.Even though there was no difference in the expression of 17b-and 3b-HSD between the T-injected and T + EGCG groups, we cannot exclude the possibility of the effect of EGCG on androgen metabolism of hair follicles because EGCG application down-regulated T-induced AR expression of hair follicles. To resolve this question, further functional in vitro studies using hair follicle culture will be needed.From our study, we propose topical EGCG as a promising therapeutic tool in the management of androgen-related hair loss. Acknowledgements Conflict of interestThe authors declare no conflict of interests. Supporting InformationAdditional Supporting Information may be found in the online version of this article: Figure S1. Immunohistochemical histology of the upper dorsal skin stained with androgen receptor (a-f). Table S1. Number of hair follicles counted by Folliscope Ò on day16 after epilation. Table S2. Comparison of the intensity of the apoptosis by TUNEL staining and immunohistochemical staining of androgen receptor of the treated groups. Topical application of 10% EGCG (a), testosterone (T)'s vehicle injection (b), T injection (c), T injection + topical application of EGCG vehicle (ethanol)) (d), T injection + topical application of 10% cyproterone acetate (e), and T injection + topical application of EGCG (f) (·400).Appendix S1. Materials and methods. Please note: Wiley-Blackwell are not responsible for the content or functionality of any supporting materials supplied by the authors. Any queries (other than missing material) should be directed to the corresponding author for the ...

Malnutrition states are relatively uncommon in the UK but we have seen two recent cases which have heightened our awareness of both dermatological manifestations of malnutrition and of nutritional sequelae of a dermatological problem. Case 1 is a patient with anorexia nervosa presenting with features of pellagra. This condition is due to deficiency of niacin and responds rapidly to replacement therapy. Classical presentation is an erythematous rash on photoexposed sites, often related to heat or friction. There are three reported cases of pellagra occurring in patients with anorexia nervosa. Case 2 is an adult atopic with sensitizations to multiple foodstuffs. A self-imposed restriction diet caused multiple nutritional deficiencies. Restriction diets in adult atopics are not particularly common in the UK, but there is some evidence to suggest that they may cause significant nutritional deficiency. A nutrition screen may be indicated more frequently than is currently recognized.

OBJECTIVE. The objective of this study was to optimize CT protocols for whole-body PET/CT by reducing radiation dose while minimizing effects on image quality. MATERIALS AND METHODS. Before protocol optimization, a survey of 140 consecutive patients was conducted to establish the baseline dose from a whole-body PET/CT examination. Another sample of 100 patients was surveyed to evaluate the reduction of radiation dose after implementation of the new protocol. Effective dose from the CT component of the examination was estimated using dose-length product (DLP) values from reports generated by the scanner and anatomy-specific conversion factors. Twenty-six patients who underwent studies before and after the optimization were included in an analysis of image quality. All 26 patients had maintained the same weight between the examinations and were scanned in the same position using a similar technique except for the changes made for CT dose optimization. The studies were randomized and blinded for an experienced PET and CT reader who graded the imaging quality of anatomic structures. RESULTS. CT protocol optimization resulted in a 32% reduction of the mean CT radiation dose: The mean effective dose was reduced from 8.1 to 5.5 mSv. The blinded analysis of image quality showed no clinically significant degradation of the lower-dose studies. The only structures visualized statistically better on the higher-dose CT scans were the carotid arteries and the region of the posterior triangle. CONCLUSION. The results of this study showed that optimization of CT acquisition can effectively reduce radiation dose in a whole-body PET/CT examination without significantly sacrificing image quality.

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