Pediatric Office

Detmold, Germany

Pediatric Office

Detmold, Germany
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Simundza R.,Family Medicine Office | Kaliterna V.,Teaching Institute of Public Health of Split Dalmatia County | Vulic D.M.,Pediatric Office | Pejkovic S.,University of Split
Gynaecologia et Perinatologia | Year: 2015

Ureaplasma (U.) urealyticum is one of the most common mycoplasmas of the urogenital system. The aim of our study was to investigate the prevalence of U. urealyticum during the 2008-2012 period. Patients and methods. Our study included 5000 samples of endocervical swabs suspected for U. urealyticum. The patient sample was non-randomized. We used a standardized test procedure for laboratory testing with Mycoplasma Duo and S.I.R. Mycoplasma Test (Biorad, France). Results. In 2008, 302 (30.2%) samples were U. urealyticum positive, 315 (31.5%) samples were positive in 2009, 355 (35.5%) in 2010, 339 (33.9%) in 2011 and 307 (30.7%) in 2012. Conclusion. There was no difference in the prevalence of U. urealyticum over the 5-year period, ranging from 30% to 35% in women from the Split-Dalmatia County. © 2015, Hrvatsko Drustvo Ginekologa i Opstetricara. All rights reserved.

Molnar T.,University of Szeged | Farkas K.,University of Szeged | Nagy F.,University of Szeged | Lakatos P.L.,Semmelweis University | And 5 more authors.
Scandinavian Journal of Gastroenterology | Year: 2010

Objective. There is limited data on pregnancy outcome in inflammatory bowel diseases (IBD) (Crohn's disease [CD] and ulcerative colitis [UC]) from Eastern Europe. The aim of our multicenter study was to compare the pregnancy outcomes and the data of infants in pregnancies before and after the diagnosis of IBD. Patients and methods. 97 pregnancies in women with IBD (36 CD and 61 UC) and 70 pregnancies in the same women before the diagnosis of IBD (24 CD and 46 UC) were compared. The influence of disease activity and medical treatment during pregnancy on gestational age at birth, birth weight, health status of the newborns and the frequency of childhood diseases were analyzed. Results. Preterm birth and low birth weight were more common in IBD compared to those pregnancies delivered before the diagnosis of the disease (p 0.008, p 0.048). The occurrence of congenital abnormalities was not influenced by IBD, whereas childhood diseases occurred more frequently in the offspring of mothers with active UC. Disease activity in CD and UC during pregnancy did not predispose to abnormal birth outcome, compared to inactive disease. The type of medical treatment did not affect the pregnancy outcome in IBD. Conclusion. Preterm birth and low birth weight were more common in IBD. The medical treatment of the active disease during pregnancy did not increase the frequency of abnormal birth outcomes. Medical maintenance treatment should be continued during pregnancy to avoid relapses, although IBD seems to be an independent risk factor for low birth weight and preterm birth. © 2010 Informa Healthcare.

Scherdel P.,National Health Research Institute | Scherdel P.,University Paris - Sud | Salaun J.-F.,Pediatric office | Robberecht-Riquet M.-N.,Association Francaise de Pediatrie Ambulatoire | And 28 more authors.
PLoS ONE | Year: 2013

Objective: We aimed to study current practices in growth monitoring by European primary care paediatricians and to explore their perceived needs in this field. Methods: We developed a cross-sectional, anonymous on-line survey and contacted primary care paediatricians listed in national directories in the 18 European countries with a confederation of primary care paediatricians. Paediatricians participated in the survey between April and September 2011. Results: Of the 1,198 paediatricians from 11 European countries (response rate 13%) who participated, 29% used the 2006 World Health Organization Multicentre Growth Reference Study growth charts, 69% used national growth charts; 61% used software to draw growth charts and 79% did not use a formal algorithm to detect abnormal growth on growth charts. Among the 21% of paediatricians who used algorithms, many used non-algorithmic simple thresholds for height and weight and none used the algorithms published in the international literature. In all, 69% of paediatricians declared that a validated algorithm to monitor growth would be useful in daily practice. We found important between-country variations. Conclusion: The varied growth-monitoring practices declared by primary care paediatricians reveals the need for standardization and evidence-based algorithms to define abnormal growth and the development of software that would use such algorithms. © 2013 Scherdel et al.

Knuf M.,Johannes Gutenberg University Mainz | Knuf M.,Childrens Hospital | Pankow-Culot H.,Pediatric Office | Grunert D.,Praxis Inc. | And 8 more authors.
Pediatric Infectious Disease Journal | Year: 2012

Background: Induction of immunologic memory was assessed following primary vaccination with 10-valent pneumococcal nontypeable Haemophilus influenzae protein D conjugate vaccine (PHiD-CV). Methods: Infants were randomized (1:1) to receive 3 doses of PHiD-CV or 7vCRM (7-valent CRM197-conjugated pneumococcal conjugate vaccine [PCV]) at 2, 3, and 4 months of age followed by 23-valent pneumococcal polysaccharide vaccine (23vPS) booster dose at 11 to 14 months of age. Pneumococcal geometric mean antibody concentrations (GMCs) and opsonophagocytic activity (OPA) geometric mean titers were measured. Results: Postprimary immune responses were consistent with those in previous PHiD-CV and 7vCRM studies. Following 23vPS boosting, vaccine serotype-specific antibody GMCs increased 6.5-to 33.3-fold and 4.8-to 32.2-fold versus prebooster in the PHiD-CV and 7vCRM groups, respectively. Postbooster OPA titers increased 2.8-to 38.8-fold and 2.6-to 58.9-fold, respectively. Postbooster antibody GMCs exceeded postprimary levels but, for some serotypes, postbooster OPA geometric mean titers were lower than postprimary in both groups. An additional dose of the same PCV received for priming was administered to 52 children aged 46 to 50 months, resulting in higher responses versus postprimary vaccination for all serotypes, but not always higher than post-23vPS booster. Conclusions: Induction of immunologic memory following PHiD-CV priming was confirmed. Additional PCV boosting in 4-year-olds did not provide strong evidence of hyporesponsiveness induced by previous 23vPS boosting. However, our results did not rule out depletion of the memory B cell pool following 23vPS vaccination, resulting in subsequent attenuated immune responses, and therefore support the use of PCV rather than 23vPS for booster vaccination in the second year of life. © 2012 Lippincott Williams & Wilkins.

Knuf M.,Childrens Hospital | Knuf M.,Johannes Gutenberg University Mainz | Zepp F.,Johannes Gutenberg University Mainz | Meyer C.U.,Johannes Gutenberg University Mainz | And 9 more authors.
European Journal of Pediatrics | Year: 2010

This study compared intramuscular and subcutaneous administration of two doses of measles-mumps-rubella-varicella (MMRV) combination vaccine (Priorix-Tetra™, GlaxoSmithKline Biologicals) in children. Healthy children (N=328) were randomised to receive MMRV either intramuscularly or subcutaneously. Reactogenicity was similar between treatment groups for immediate vaccination pain, vaccination site pain, redness and incidence of fever and rashes. Slightly less vaccination site swelling occurred during days 0-3 of the post-vaccination period after intramuscular administration. Seroconversion rates for all components, 42-56 days post-dose 2, ranged from 99.3% to 100% in the intramuscular group and from 98.6% to 100% in the subcutaneous. Cell-mediated immunity data supported the humoral immunogenicity findings. In summary, the MMRV vaccine is well tolerated and highly immunogenic when administered either subcutaneously or intramuscularly to children in the second year of life. © 2010 Springer-Verlag.

Thollot F.,Association Francaise de Pediatrie Ambulatoire | Scheifele D.,British Columbia Childrens Hospital | Pankow-Culot H.,Pediatric Office | Cheuvart B.,Glaxo SmithKline Vaccines | And 3 more authors.
Pediatric Infectious Disease Journal | Year: 2014

Background: The immunogenicity and safety of the investigational diphtheria, tetanus, acellular pertussis, hepatitis B, poliomyelitis, Haemophilus influenzae type b (Hib) and meningococcal serogroup C (MenC) heptavalent combination vaccine were compared with those of licensed control vaccines. Methods: In this open, phase II, randomized study (NCT01090453), 480 infants from Germany, France and Canada received the heptavalent vaccine (Hepta group) or hexavalent and monovalent MenC control vaccines (HexaMenC group) co-administered with a 13-valent pneumococcal conjugate vaccine at 2, 4 and 12 months of age. Immunogenicity was measured 1 month after the second primary dose, and before and 1 month after the booster dose. Safety and reactogenicity were also evaluated. Results: Non-inferiority of immune responses to MenC and Hib induced by 2-dose primary vaccination with the heptavalent vaccine versus control vaccines was demonstrated. In exploratory analyses, postprimary and postbooster functional antibody geometric mean titers against MenC tended to be lower (1119.5 vs. 3200.5; 2653.8 vs. 6028.4) and antibody geometric mean concentrations against Hib higher (1.594 vs. 0.671 μg/mL; 17.678 vs. 13.737 μg/mL) in the Hepta versus the HexaMenC group. The heptavalent and control vaccines were immunogenic to all other antigens, although immune responses to poliovirus were lower than expected in both groups. No differences in safety and reactogenicity profiles were detected between groups. Conclusions: The heptavalent vaccine induced non-inferior MenC and Hib responses compared with control vaccines. Both vaccination regimens, when administered at 2, 4 and 12 months of age, had comparable safety profiles and were immunogenic to all antigens, with lower-than-expected responses to poliomyelitis. Copyright © 2014 by Lippincott Williams and Wilkins.

Domachowske J.B.,Syracuse University | Pankow-Culot H.,Pediatric Office | Bautista M.,University of the East Ramon Magsaysay | Feng Y.,Glaxosmithkline | And 4 more authors.
Journal of Infectious Diseases | Year: 2013

Background. Two antigenically distinct influenza B lineages have cocirculated since 2001, yet trivalent influenza vaccines (TIVs) contain 1 influenza B antigen, meaning lineage mismatch with the vaccine is frequent. We assessed a candidate inactivated quadrivalent influenza vaccine (QIV) containing both B lineages vs TIV in healthy children aged 3-17 years.Methods. Children were randomized 1:1:1 to receive QIV or 1 of 2 TIVs (either B/Victoria or B/Yamagata lineage; N = 2738). Hemagglutination-inhibition assays were performed 28 days after 1 or 2 doses in primed and unprimed children, respectively. Immunological noninferiority of QIV vs TIV against shared strains, and superiority against alternate-lineage B strains was based on geometric mean titers (GMTs) and seroconversion rates. Reactogenicity and safety were also assessed ( NCT01196988).Results. Noninferiority against shared strains and superiority against alternate-lineage B strains was demonstrated for QIV vs TIV. QIV was highly immunogenic; seroconversion rates were 91.4%, 72.3%, 70.0%, and 72.5% against A/H1N1, A/H3N2, B/Victoria, and B/Yamagata, respectively. Reactogenicity and safety of QIV was consistent with TIV.Conclusions. QIV vs TIV showed superior immunogenicity for the additional B strain without interfering with immune responses to shared strains. QIV may offer improved protection against influenza B in children compared with current trivalent vaccines. © 2013 The Author. Published by Oxford University Press on behalf of the Infectious Diseases Society of America.

Rumke H.C.,Rotterdam University | Loch H.P.,Medical Practice Wolfenbuttel | Hoppenbrouwers K.,Catholic University of Leuven | Vandermeulen C.,Catholic University of Leuven | And 4 more authors.
Vaccine | Year: 2011

Background: The MMRV combination vaccine, Priorix-Tetra™, is currently licensed in several European countries using a two-dose schedule in infants aged ≥9 months, with a preferred 6-week to 3-month interval between doses. This study was undertaken to generate safety and immunogenicity data for two doses of MMRV vaccine administered according to dose schedules using the shortest permitted interval of 4 weeks versus a longer interval of 12 months, which would allow flexible adaptation to local immunization calendars. Methods: Healthy children aged 11-13 months were randomized (1:1:1) to receive 2 doses of either: MMRV vaccine with a 4-week interval between doses (MMRV-4W group, N= 188), MMRV vaccine with a 12-month interval between doses (MMRV-12M group, N= 184), or MMR vaccine with a 4-week interval between doses (MMR group, N= 187). Blood samples were taken prior to, and 4-6 weeks after each vaccination. Results: Post-Dose 2, both MMRV groups exhibited an adequate immunogenic response for all components; however the MMRV-12M group showed significantly greater geometric mean titers for mumps, rubella and varicella. Two varicella breakthrough cases occurred within the 12-month interval between doses in theMMRV-12Mgroup. Local and general reactogenicity results were similar for all groups except for the MMRV-4W group, which had a greater incidence of fever during Days 0-14 post-Dose 1. Conclusions: Two doses of MMRV vaccine administered in the second year of life elicited adequate immunogenicity and were well-tolerated whether administered with a dose interval of 4 weeks or 12 months. © 2011.

Knuf M.,Johannes Gutenberg University Mainz | Zepp F.,Johannes Gutenberg University Mainz | Helm K.,Pediatric Office | Maurer H.,Pediatric Office | And 4 more authors.
European Journal of Pediatrics | Year: 2012

Two doses of a varicella-containing vaccine in healthy children <12 years are suggested to induce better protection than a single dose. Persistence of immunity against measles, mumps, rubella, and varicella as well as varicella breakthrough cases were assessed 3 years after two-dose measles, mumps, rubella, and varicella (MMRV) vaccination or concomitant MMR (Priorix™) and varicella (Varilrix™) vaccination. Four hundred ninety-four healthy children, 12- 18 months old at the time of the first dose, received either two doses of MMRV vaccine (GlaxoSmithKline Biologicals) 42- 56 days apart (MMRV, N=371) or one dose of MMR and varicella vaccines administered simultaneously at separate sites, followed by another MMR vaccination 42-56 days later (MMR + V, N=123). Three hundred-four subjects participated in 3-year follow-up for persistence of immunity and occurrence of breakthrough varicella (MMRV, N=225; MMR + V, N=79). Antibodies were measured by ELISA (measles, mumps, rubella) and immunofluorescence (varicella). Contacts with individuals with varicella or zoster and cases of breakthrough varicella disease were recorded. Three years post-vaccination seropositivity rates in subjects seronegative before vaccination were: MMRV-measles, 98.5% (geometric mean titer [GMT]=3,599.6); mumps, 97.4% (GMT=1,754.5); rubella, 100% (GMT=51.9); varicella, 99.4% (GMT=225.5); MMR + V-measles, 97.0% (GMT= 1,818.8); mumps, 93.8% (GMT=1,454.6); rubella, 100% (GMT=53.8); and varicella, 96.8% (GMT=105.8). Of the subjects, 15-20% reported contact with individuals with varicella/zoster each year. After 3 years, the cumulative varicella breakthrough disease rate was 0.7% (two cases) in the MMRV group and 5.4% (five cases) in the MMR + V group. Conclusion: Immunogenicity of the combined MMRV vaccine was sustained 3 years post-vaccination. (208136/041/NCT00406211). © Springer-Verlag 2011.

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