METHODS: In a randomised double-blind controlled, parallel, multicountry intervention study, 767 healthy children, ages 11 to 29 months, received GUM with scGOS/lcFOS/LCPUFAs (the active group, n = 388), GUM without scGOS/lcFOS/LCPUFAs (the control group, n = 379), or cow's milk (n = 37) for 52 weeks. The primary outcome measure was the number of episodes of upper respiratory tract infections or gastrointestinal infections based on a combination of subject's illness symptoms reported by the parents during the intervention period.
RESULTS: Children in the active group compared with the control group had a decreased risk of developing at least 1 infection (299/388 [77%] vs 313/379 [83%], respectively, relative risk 0.93, 95% confidence interval [CI] 0.87-1.00; logistic regression P = 0.03). There was a trend toward a reduction (P = 0.07) in the total number of infections in the active group, which was significant when confirmed by one of the investigators (268/388 [69%] vs 293/379 [77%], respectively, relative risk 0.89, 95% CI 0.82-0.97; P = 0.004, post hoc). More infectious episodes were observed in the cow's milk group, when compared with both GUM groups (34/37 [92%] vs 612/767 [80%], respectively, relative risk 1.15, 95% CI 1.04-1.28).
CONCLUSIONS: This is the first study in children to show a reduced risk of infection following consumption of GUM supplemented with scGOS/lcFOS/n-3 LCPUFAs. The borderline statistical significance justifies a new study to confirm this finding.
METHODS: A retrospective analysis of prospectively collected data was conducted. Skeletal maturity was determined using Risser, SSMS, TOCI and CVM for each patient. Crosstabulations of axial vs. appendicular markers were formed to analyze their concordance and discordance. Logistic and logarithmic regression models were run to assess longitudinal growth (postoperative height gain and leg-length growth) and curve modulation (follow-up instrumented Cobb correction after index operation), respectively. Models were compared using Akaike information criterion (AIC).
RESULTS: 34 patients (32 F/2 M, mean age: 12.8 ± 1.5 years, mean follow-up: 47.7 (24-80) months) were included. The median preoperative maturity stages were: Risser: 1 (-1-4), SSMS: 4 (1-7), TOCI: 6 (1-8) and CVM: 4 (1-6). At latest follow-up, all patients reached skeletal maturity. Concordance and discordance were observed between axial vs. appendicular systems that demonstrated a range of possible distributions of CVM, where trunk peak height velocity occurred before, simultaneously with or after the standing height peak height velocity. R-squared values for Risser, SSMS, TOCI and CVM were 0.701, 0.783, 0.810 and 0.811, respectively, for prediction of final height; 0.759, 0.821, 0.831 and 0.775 for final leg-length, and 0.507, 0.588, 0.668 and 0.673 for curve modulation. Delta AIC values demonstrated that different skeletal maturity assessment methods provided distinctive information regarding follow-up height gain, leg-length growth and curve behavior.
CONCLUSIONS: Risser score provided considerably less information for all three outcome variables. TOCI and SSMS provided substantial information regarding remaining leg-length assessments, while in terms of assessment of total height gain and curve modulation after surgery, CVM and TOCI offered substantial information and SSMS offered strong information. Mutual use of axial and appendicular markers may provide valuable insight concerning timing of surgery and magnitude of surgical correction.