Paediatric Clinic

Luxembourg, Luxembourg

Paediatric Clinic

Luxembourg, Luxembourg
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Patterson C.C.,Queen's University of Belfast | Gyurus E.,University of Pécs | Rosenbauer J.,Heinrich Heine University Düsseldorf | Cinek O.,University Hospital Motol | And 20 more authors.
Diabetologia | Year: 2012

Aims/hypothesis: The aim of the study was to describe 20-year incidence trends for childhood type 1 diabetes in 23 EURODIAB centres and compare rates of increase in the first (1989-1998) and second (1999-2008) halves of the period. Methods: All registers operate in geographically defined regions and are based on a clinical diagnosis. Completeness of registration is assessed by capture-recapture methodology. Twenty-three centres in 19 countries registered 49,969 new cases of type 1 diabetes in individuals diagnosed before their 15th birthday during the period studied. Results: Ascertainment exceeded 90% in most registers. During the 20-year period, all but one register showed statistically significant changes in incidence, with rates universally increasing. When estimated separately for the first and second halves of the period, the median rates of increase were similar: 3.4% per annum and 3.3% per annum, respectively. However, rates of increase differed significantly between the first half and the second half for nine of the 21 registers with adequate coverage of both periods; five registers showed significantly higher rates of increase in the first half, and four significantly higher rates in the second half. Conclusions/interpretation: The incidence rate of childhood type 1 diabetes continues to rise across Europe by an average of approximately 3-4% per annum, but the increase is not necessarily uniform, showing periods of less rapid and more rapid increase in incidence in some registers. This pattern of change suggests that important risk exposures differ over time in different European countries. Further time trend analysis and comparison of the patterns in defined regions is warranted. © Springer-Verlag 2012.


Kunesova M.,Institute of Endocrinology | Vignerova J.,National Institute of Public Health | Parizkova J.,Institute of Endocrinology | Prochazka B.,Paediatric Clinic | And 6 more authors.
Obesity Reviews | Year: 2011

The objective of this paper was an evaluation of change in prevalence of overweight and obesity in Czech children, and a comparison of cut-off points for body mass index references from the Czech Republic (CzR), International Obesity Task Force and WHO. The authors conducted a survey in 7-year-old children, and compared data from 1951, 1981, 1991, 2001 and 2008 (WHO cut-offs). 2008 data were evaluated according to different cut-offs. Results showed that since 1951 in boys, overweight prevalence increased from 13.0% in 1951 to 26.8% in 2001, in girls from 10.9% to 22.9%. Obesity increased in boys from 1.7% to 8.3%, in girls from 1.7% to 6.9%. From 2001 to 2008 obesity in boys increased; obesity in girls and overweight in both genders decreased. In 2008 cohort the following values were found: overweight and obesity: CzR criteria, percentage was lowest (14.8% boys and 11.1% girls); WHO criteria, highest prevalence (23.5% boys and 19.5% girls); obesity: lowest ratio International Obesity Task Force criteria (4.4% boys, 3.3% girls), highest ratio boys WHO criteria (10.0%), girls CzR criteria (5.0%). Overweight and obesity prevalence increased in 7-year-old Czech children since 1951; since 2001 prevalence is plateauing with exception of boys. Using different body mass index references resulted in marked differences in overweight and obesity prevalence. © 2011 The Authors. obesity reviews © 2011 International Association for the Study of Obesity.


Kone-Paut I.,University Paris - Sud | Darce-Bello M.,University Paris - Sud | Shahram F.,Shariati Hospital | Gattorno M.,G Gaslini Scientific Institute | And 15 more authors.
Rheumatology | Year: 2011

Objective: To set-up an international cohort of patients suspected with Behçet's disease (BD). The cohort is aimed at defining an algorithm for definition of the disease in children. Methods: International experts have defined the inclusion criteria as follows: recurrent oral aphthosis (ROA) plus one of following-genital ulceration, erythema nodosum, folliculitis, pustulous/acneiform lesions, positive pathergy test, uveitis, venous/arterial thrombosis and family history of BD. Onset of disease is <16 years, disease duration is 43 years, future follow-up duration is 54 years and informed consent is obtained. The expert committee has classified the included patients into: definite paediatric BD (PED-BD), probable PED-BD and no PED-BD. Statistical analysis is performed to compare the three groups of patients. Centres document their patients into a single database. Results: At January 2010, 110 patients (56 males/54 females) have been included. Mean age at first symptom: 8.1 years (median 8.2 years). At inclusion, 38% had only one symptom associated with ROA, 31% had two and 31% had three or more symptoms. A total of 106 first evaluations have been done. Seventeen patients underwent the first-year evaluation, and 36 had no new symptoms, 12 had one and 9 had two. Experts have examined 48 files and classified 30 as definite and 18 as probable. Twenty-six patients classified as definite fulfilled the International Study Group criteria. Seventeen patients classified as probable did not meet the international criteria. Conclusion: The expert committee has classified the majority of patients in the BD group although they presented with few symptoms independently of BD classification criteria. © The Author 2010. Published by Oxford University Press on behalf of the British Society for Rheumatology. All rights reserved.


Muckelbauer R.,Charité - Medical University of Berlin | Kalhoff H.,Paediatric Clinic | Muller-Nordhorn J.,Charité - Medical University of Berlin | Kersting M.,University of Bonn
Current Nutrition and Food Science | Year: 2011

Childhood overweight and obesity is a global epidemic with rising trends in both developed and developing countries. Overweight and obesity are major causes of morbidity during childhood and are important early risk factors for several adult morbidities and mortality. Although the mechanism of overweight development is not fully understood, it is confirmed that overweight occurs as a consequence of imbalance between individual energy intake and energy expenditure. Besides genetic factors, modifiable factors such as family behavior, cultural environment, personal lifestyle choices such as a sedentary lifestyle and unhealthy dietary habits influence the development of obesity resulting in an increased 'obesogenic' risk in specific groups of children. So far, previous intervention programs have had limited success in tackling the rising prevalence of obesity. Thus, in addition to treatment and individual approaches, prevention programs targeting the obesogenic environment could be the key strategy for controlling the epidemic of obesity. This article is aimed to present definitions as well as the epidemiology of overweight and obesity. Furthermore, it describes the current knowledge on the multifactorial etiology involving interactions among genetic background and different social and environmental factors. The article critically reviews the current body of evidence regarding the effectiveness of previous interventions to prevent the development of overweight and obesity during childhood. Finally, recommendations for future research are provided which is needed to improve and enable the prevention of obesity in children and adolescents. © 2011 Bentham Science Publishers.


Porksen S.,Copenhagen University | Laborie L.B.,University of Bergen | Nielsen L.,Copenhagen University | Louise Max Andersen M.,Copenhagen University | And 15 more authors.
BMC Endocrine Disorders | Year: 2010

Background: To investigate disease progression the first 12 months after diagnosis in children with type 1 diabetes negative (AAB negative) for pancreatic autoantibodies [islet cell autoantibodies(ICA), glutamic acid decarboxylase antibodies (GADA) and insulinoma-associated antigen-2 antibodies (IA-2A)]. Furthermore the study aimed at determining whether mutations in KCNJ11, ABCC8, HNF1A, HNF4A or INS are common in AAB negative diabetes.Materials and methods: In 261 newly diagnosed children with type 1 diabetes, we measured residual β-cell function, ICA, GADA, and IA-2A at 1, 6 and 12 months after diagnosis. The genes KCNJ11, ABCC8, HNF1A, HNF4A and INS were sequenced in subjects AAB negative at diagnosis. We expressed recombinant K-ATP channels in Xenopus oocytes to analyse the functional effects of an ABCC8 mutation.Results: Twenty-four patients (9.1%) tested AAB negative after one month. Patients, who were AAB-negative throughout the 12-month period, had higher residual β-cell function (P = 0.002), lower blood glucose (P = 0.004), received less insulin (P = 0.05) and had lower HbA1c(P = 0.02) 12 months after diagnosis. One patient had a heterozygous mutation leading to the substitution of arginine at residue 1530 of SUR1 (ABCC8) by cysteine. Functional analyses of recombinant K-ATP channels showed that R1530C markedly reduced the sensitivity of the K-ATP channel to inhibition by MgATP. Morover, the channel was highly sensitive to sulphonylureas. However, there was no effect of sulfonylurea treatment after four weeks on 1.0-1.2 mg/kg/24 h glibenclamide.Conclusion: GAD, IA-2A, and ICA negative children with new onset type 1 diabetes have slower disease progression as assessed by residual beta-cell function and improved glycemic control 12 months after diagnosis. One out of 24 had a mutation in ABCC8, suggesting that screening of ABCC8 should be considered in patients with AAB negative type 1 diabetes. © 2010 Pörksen et al; licensee BioMed Central Ltd.


Kalhoff H.,Paediatric Clinic | Breidenbach R.,Public Health Service Dortmund | Smith H.-J.,CareFusion | Marek W.,Institute for Occupational Physiology
Respirology | Year: 2011

Background and objective: The use of the impulse oscillometry system (IOS) allows differentiated lung function testing with a minimum of cooperation at normal tidal breathing. The aim of this cross-sectional study was to assess the association of body mass (overweight and obese) with oscillometric parameters in preschool children. Methods: A preschool medical check of 518 children (age 6.01 ± 0.25 years) included IOS recordings of airway resistance and lung reactance (MasterScreen IOS, CareFusion, Höchberg, Germany). Measured values of respiratory resistance (R5) and reactance (X5) at 5 Hzwere correlated with BMI. In addition,datawere compared with recently published reference equations. Results: In this young age group of 241 boys and 277 girls therewas no significant association between oscillometric parameters and BMI. When compared with current IOS reference values of healthy subjects the relationship of R5 (109 ± 25%) and X5 (105.5 ± 35%) suggested mildly elevated peripheral resistance in this unselected group of preschool children. Conclusions: IOS is ideally suited to obtain measurements of respiratory function in preschool children. At the age of 6 years, standard oscillometric values do not indicate impaired respiratory function associated with increased BMI. © 2010 The Authors Respirology © 2010 Asian Pacific Society of Respirology.


Polenakovic M.,Macedonian Academy of science and Arts | Gucev Z.,Paediatric Clinic
Prilozi (Makedonska akademija na naukite i umetnostite. Oddelenie za medicinski nauki) | Year: 2014

The Macedonian Academy of Sciences and Arts (MASA), held a scientific workshop for journal editors in biomedicine: "Publishing integrity and good practices in editing in biomedicine" on April 25, 2014 in MASA, Skopje. The meeting looked into old problems and new situations in editing and publishing, with emphasis on the situation in developing countries. This global knowledge-based society is founded on the results obtained from scientific research. The data from basic research in developed countries contribute in a quite substantial manner to the newly added economic value. One of the main reasons for underdevelopment in South Eastern Europe (SEE) is certainly a low or non-existent contribution of scientific research in the newly added economic value. This has largely to do with the perception of the political elites which simply lack the insight on the crucial importance of science in development. In the long term this leads to societies in which there are distortions in the understanding of the most basic values. Academic publishing has experienced tremendous growth: so far there are at least 50 million scientific articles. Interestingly, publishing in developing countries has experienced a rate of growth higher than in developed countries. However, this is not the case with the Balkan countries. The meeting looked at some old and some newly emerging problems in editing and publishing. First, the high cost for universities and researchers to purchase journals adversely affects both publishing and editing. In developing countries the high cost of purchasing scientific literature is an almost insurmountable problem in spite of the fact that some publishing companies offer discounted fees. Open access journals in South Eastern European (SEE) countries are hardly achievable as this also incurs costs that have to be covered in some way or other. The peer review process has the fundamental difficulty that reviewers are in the situation of a Procrustean bed, tending to accept reports which support the reviewer's concepts of thinking and, like Procrustes, cutting everything else out. Authorship is often a contentious issue, as undeserved authors appear on the list of authors. Some principles are now a norm in academic publishing. This applies to the declaration of a conflict of interest, the consent of the patient and the approval of the Ethical Board of the institution. This global informational technological revolution has, unfortunately, led to largely widespread and increasingly sophisticated deviations: plagiarism, data fabrication and data falsification as forms of scientific misconduct. Those events are now more widespread than in the past. Luckily new tools to track them are much better than previously. The race for perfect publishing integrity and for the best good practices in editing in biomedicine is on. New and old challenges will be met. The benevolent and caring society, educated professionals and an enlightened public remain essential preconditions. The wealth of nations depends on R&D and consequently on academic publishing.


PubMed | Macedonian Academy of science and Arts and Paediatric Clinic
Type: Journal Article | Journal: Prilozi (Makedonska akademija na naukite i umetnostite. Oddelenie za medicinski nauki) | Year: 2015

The Macedonian Academy of Sciences and Arts (MASA), held a scientific workshop for journal editors in biomedicine: Publishing integrity and good practices in editing in biomedicine on April 25, 2014 in MASA, Skopje. The meeting looked into old problems and new situations in editing and publishing, with emphasis on the situation in developing countries. This global knowledge-based society is founded on the results obtained from scientific research. The data from basic research in developed countries contribute in a quite substantial manner to the newly added economic value. One of the main reasons for underdevelopment in South Eastern Europe (SEE) is certainly a low or non-existent contribution of scientific research in the newly added economic value. This has largely to do with the perception of the political elites which simply lack the insight on the crucial importance of science in development. In the long term this leads to societies in which there are distortions in the understanding of the most basic values. Academic publishing has experienced tremendous growth: so far there are at least 50 million scientific articles. Interestingly, publishing in developing countries has experienced a rate of growth higher than in developed countries. However, this is not the case with the Balkan countries. The meeting looked at some old and some newly emerging problems in editing and publishing. First, the high cost for universities and researchers to purchase journals adversely affects both publishing and editing. In developing countries the high cost of purchasing scientific literature is an almost insurmountable problem in spite of the fact that some publishing companies offer discounted fees. Open access journals in South Eastern European (SEE) countries are hardly achievable as this also incurs costs that have to be covered in some way or other. The peer review process has the fundamental difficulty that reviewers are in the situation of a Procrustean bed, tending to accept reports which support the reviewers concepts of thinking and, like Procrustes, cutting everything else out. Authorship is often a contentious issue, as undeserved authors appear on the list of authors. Some principles are now a norm in academic publishing. This applies to the declaration of a conflict of interest, the consent of the patient and the approval of the Ethical Board of the institution. This global informational technological revolution has, unfortunately, led to largely widespread and increasingly sophisticated deviations: plagiarism, data fabrication and data falsification as forms of scientific misconduct. Those events are now more widespread than in the past. Luckily new tools to track them are much better than previously. The race for perfect publishing integrity and for the best good practices in editing in biomedicine is on. New and old challenges will be met. The benevolent and caring society, educated professionals and an enlightened public remain essential preconditions. The wealth of nations depends on R&D and consequently on academic publishing.


PubMed | Paediatric Clinic
Type: Journal Article | Journal: Appetite | Year: 2010

Successful breastfeeding is predicated on its initial success. Salt appetite during lactation may be relevant to breastfeeding success because sodium is essential for development of foetus and neonate. Here we examined whether maternal salt preference might facilitate breastfeeding. Nursing mothers (n=327) were categorized as high, medium or low salt preferring, and the relationship to persistence of exclusive breastfeeding during the first 25 days postnatal was evaluated. Contrary to expectation, we find that mothers with low salt preference persisted in breastfeeding beyond day 7 postnatal in comparison to mothers with high salt preference, and mothers with high salt preference had the shortest exclusive breastfeeding duration up to postnatal day 25. Awareness of this among health workers and nursing mothers could contribute to successful breastfeeding.


PubMed | Paediatric Clinic
Type: Journal Article | Journal: Scandinavian cardiovascular journal : SCJ | Year: 2011

In a retrospective study we assessed surgical results following right ventricular to pulmonary artery connection repair or replacement at a medium of 2.4 years (0-8) follow-up. Data were retrieved from hospital charts.Three hundred and sixty five operations were performed in 286 patients in eight years starting in 2000 using different surgical methods. Homografts and Monocusps had a more than 50% significantly lower risk for reoperation than Contegra or bicuspid valves (p < 0.01). Data for infants and older children and grown ups were analysed separately. In the infant group no significant difference between the different methods (homograft, Contegra and Monocusp) was detected. In older patients, the Perimount valves performed extremely well with no need for reoperation after 2.5 years of follow-up. Perimount valves and homografts performed better than other solutions (p = 0.01).Although the follow-up for the Perimount valves was short, they are promising and need to be followed long-term. The homograft and the Monocusp remain valuable choices.

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