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Are children who were delivered by forceps more likely to get acute otitis media? The question was asked by a mother at a clinic in Mallorca. A subsequent retrospective analysis of clinic data (

) showed an increase in incidence of acute otitis media among toddlers who had had a forceps delivery. Non-operative vaginal delivery, vacuum extraction, and caesarean section were each followed by a 30% incidence of acute otitis media in the second year of life whereas the incidence after forceps delivery was 40%. The mother’s suggestion is supported by not proved.

Heat-shock proteins promote immune responses and children with juvenile idiopathic arthritis (JIA) whose T cells react to autologous heat-shock protein 60 (HSP60) tend to do better. It might be possible to develop immunotherapy to promote this T cell reactivity, particularly for children with oligoarticular JIA. Before this can happen, however, it will be necessary to identify specific HSP60 epitopes involved in JIA. Researchers in Holland, Italy, and the USA (

) used computer algorithms to identify eight potentially relevant epitopes. They assessed the T cell responses induced by each of these epitopes in peripheral blood mononuclear cells of 33 patients with polyarticular JIA, 24 with oligoarticular JIA, 27 healthy controls, and 20 disease controls (with type I diabetes). Five of the eight HSP60 epitopes induced T cell proliferation and interleukin 10 …

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