A proposed intervention for newborn infants in countries with suspected vitamin A (VA) deficiency is to administer 50,000 IU retinyl palmitate at birth to reduce mortality risk. However, no studies have investigated birth weight effects. In this study, low birth weight (LBW; <1 kg, n ¼ 18) and healthy birth weight (HBW) piglets (>1.5 kg, n ¼ 18) from VA-depleted sows were dosed with 25,000 or 50,000 IU retinyl palmitate (26.2 or 52.4 mmol retinol equivalents) at birth to compare VA reserves. Blood was collected at varying times (n ¼ 3-5/time/dose), and piglets were killed at 12 or 24 h for blood, liver, kidneys, spleen, lungs, adrenal gland, and intestinal contents. HBW piglets had significantly higher birth, death, and organ weights than LBW (P < 0.0001 for all). HBW and LBW piglets, which received VA, had higher liver and kidney VA concentrations (0.18 AE 0.09, 0.24 AE 0.10 mmol/g liver and 13.4 AE 4.1, 14.2 AE 4.5 nmol/g kidney, respectively) than controls (n ¼ 10) (0.051 AE 0.01 mmol/g liver and 1.01 AE 0.43 nmol/g kidney) (P ¼ 0.0061 and < 0.0001, respectively). Total liver (9.75 AE 5.16 mmol) and kidney retinol (204 AE 79.1 nmol) were higher in HBW than LBW piglets (P < 0.0001). Extrahepatic tissues, except lung, had higher VA concentration than controls (P < 0.0001). Serum retinol and ester concentrations were higher in treated than control piglets (P ¼ 0.0028, P < 0.0001, respectively), and significantly changed during the times sampled (P ¼ 0.022, P ¼ 0.011, respectively). Peak serum retinyl ester concentrations, which occurred at 3 h, were higher in piglets that received 50,000 IU (4.2 AE 4.4 mmol/L) than 25,000 IU (2.7 AE 2.3 mmol/L) (P ¼ 0.031). Regardless of dose amount, HBW piglets stored more supplemental VA than LBW piglets when administered at birth.
Pertussis, or whooping cough, is a highly contagious respiratory illness caused most frequently by Bordetella pertussis. Clinical presentation ranges in severity, but lifethreatening illness disproportionately affects children and immunocompromised individuals. Acellular vaccines for pertussis have been available for decades, and they are recommended throughout the lifespan. A patient who had received a kidney transplant presented with respiratory distress and dry cough as manifestations of coinfection with B pertussis and Bordetella parapertussis/bronchiseptica. The goal of this case report was to highlight the importance of immunization programs at transplant centers, which are in the unique position to care for patients both with end-stage organ disease and in the post-transplant setting. K E Y W O R D S Bordetella, immunization, kidney transplant, pneumonia, transplant | 5 of 5 HOVEL Et aL. Derrick J. Chen
Current vitamin A supplementation methods for infants in vitamin A‐deficient populations have no specific dosing recommendations regarding birth weight. A proposed intervention is to administer 50,000 IU retinyl palmitate to newborn infants to reduce mortality risk. To investigate birth weight effects, low birth weight (LBW) piglets (1.5 kg) from vitamin A‐depleted sows were dosed with either 25,000 or 50,000 IU retinyl palmitate at birth to compare liver vitamin A reserves and overall vitamin A status. Blood collection occurred at varying time points after dose and piglets were killed at 12 and 24 h for organ and serum collection. Serum, liver, kidneys, spleen, lungs, adrenals, and intestinal contents were collected and analyzed for vitamin A using HPLC methods. Both healthy weight and LBW piglets had significantly higher liver and kidney vitamin A concentrations than control piglets that received no dose (P = 0.0061 and <0.0001, respectively), but no significant differences between dose, weight, or time groups existed. However, total liver and kidney retinol was higher in healthy weight piglets (P < 0.0001). Vitamin A concentration in lung, spleen, and adrenal glands did not differ between any treated and control piglets. Serum retinol significantly increased with time for all treated piglets, regardless of birth weight (P = 0.005), but dose and weight had no effect on serum retinol concentration. In conclusion, healthy weight piglets stored more of the supplemental doses than LBW piglets. Grant Funding Source: Supported by the Nutrition Unit at the World Health Organization.
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