Pub Date : 2009-01-02DOI: 10.2174/1874309900802010039
J. Chan, K. Roth
Introduction: We aim to review the therapeutic options in ameliorating the progression of focal segmental glomerulosclerosis (FSGS). We shall comment on the long-term prognosis and the clinical implications of candidate genes in familial cases of FSGS. Materials and Method: Key references from the past concerning FSGS were analyzed, together with a PubMed search of the literature from 1998 to 2008. Results and Discussion: Treatment of FSGS consists of one or more of the following medications: vitamin E, prednisone, angiotensin-converting enzyme inhibitor, angiotensin receptor blocker; in the severe cases, methylprednisolone, cyclo- phosphamide, cyclosporine, calcineurin inhibitors, rituximab and mycophenolate. The prognoses with lengths of follow- up to 14 years were analyzed. The genetics of familial FSGS and the strategy of kidney transplants in such cases need special attention. Conclusion: We reviewed the available modalities of treatment and the long-term prognosis. The new findings on familial forms of FSGS and the clinical implications are succinctly presented.
{"title":"Primary Focal Segmental Glomerulosclerosis, an Important Component of Childhood Nephrotic Syndrome: Therapeutic Options and Genetic Basis","authors":"J. Chan, K. Roth","doi":"10.2174/1874309900802010039","DOIUrl":"https://doi.org/10.2174/1874309900802010039","url":null,"abstract":"Introduction: We aim to review the therapeutic options in ameliorating the progression of focal segmental glomerulosclerosis (FSGS). We shall comment on the long-term prognosis and the clinical implications of candidate genes in familial cases of FSGS. Materials and Method: Key references from the past concerning FSGS were analyzed, together with a PubMed search of the literature from 1998 to 2008. Results and Discussion: Treatment of FSGS consists of one or more of the following medications: vitamin E, prednisone, angiotensin-converting enzyme inhibitor, angiotensin receptor blocker; in the severe cases, methylprednisolone, cyclo- phosphamide, cyclosporine, calcineurin inhibitors, rituximab and mycophenolate. The prognoses with lengths of follow- up to 14 years were analyzed. The genetics of familial FSGS and the strategy of kidney transplants in such cases need special attention. Conclusion: We reviewed the available modalities of treatment and the long-term prognosis. The new findings on familial forms of FSGS and the clinical implications are succinctly presented.","PeriodicalId":89037,"journal":{"name":"The open pediatric medicine journal","volume":"72 1","pages":"39-44"},"PeriodicalIF":0.0,"publicationDate":"2009-01-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"86292473","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2008-10-15DOI: 10.2174/1874309900802010035
R. Rahhal, W. Bishop
Chronic nonspecific diarrhea in children, or toddler's diarrhea, is a frequently encountered entity in pediatric clinical practice. This disorder remains poorly understood. Suggested etiologies include malabsorption, dietary intake and motility abnormalities. We investigated the use of sacrosidase (a yeast sucrase supplement) in children with toddler's diar- rhea. The study outcome was clinical response to sacrosidase supplementation. Children, 1-6 years of age, with toddler's diarrhea were enrolled in an open prospective trial. Stooling patterns were obtained at baseline and while on supplementa- tion. Twelve patients were enrolled out of 40 patients who presented with chronic diarrhea. Eight patients did not respond to standard diet changes and were entered into the trial. With supplementation, 4 out of the 8 patients responded clinically with a decrease in mean daily stool frequency and an improvement in the mean daily stool consistency. Sacrosidase sup- plementation demonstrated a potential benefit in a subset of children with toddler's diarrhea. Response to sacrosidase may suggest excessive sucrose intake or unrecognized partial or complete sucrase deficiency in some children with toddler's diarrhea.
{"title":"Sacrosidase Trial in Chronic Nonspecific Diarrhea in Children","authors":"R. Rahhal, W. Bishop","doi":"10.2174/1874309900802010035","DOIUrl":"https://doi.org/10.2174/1874309900802010035","url":null,"abstract":"Chronic nonspecific diarrhea in children, or toddler's diarrhea, is a frequently encountered entity in pediatric clinical practice. This disorder remains poorly understood. Suggested etiologies include malabsorption, dietary intake and motility abnormalities. We investigated the use of sacrosidase (a yeast sucrase supplement) in children with toddler's diar- rhea. The study outcome was clinical response to sacrosidase supplementation. Children, 1-6 years of age, with toddler's diarrhea were enrolled in an open prospective trial. Stooling patterns were obtained at baseline and while on supplementa- tion. Twelve patients were enrolled out of 40 patients who presented with chronic diarrhea. Eight patients did not respond to standard diet changes and were entered into the trial. With supplementation, 4 out of the 8 patients responded clinically with a decrease in mean daily stool frequency and an improvement in the mean daily stool consistency. Sacrosidase sup- plementation demonstrated a potential benefit in a subset of children with toddler's diarrhea. Response to sacrosidase may suggest excessive sucrose intake or unrecognized partial or complete sucrase deficiency in some children with toddler's diarrhea.","PeriodicalId":89037,"journal":{"name":"The open pediatric medicine journal","volume":"85 1","pages":"35-38"},"PeriodicalIF":0.0,"publicationDate":"2008-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"83479659","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2008-06-23DOI: 10.2174/1874309900802010030
L. Korsch, A. Hombach, C. Schnegg, Michael Weiss, E. Korsch
Rationale: Exhaled nitric oxide (eNO) is reported to be increased in the airways of patients with asthma bron- chiale. Objectives: To investigate eNO concentration and lung function in non-, mono- and polysensitised children with mild asthma bronchiale before and after exercise challenge. Findings: Investigation of a total of 59 children (49 mono- or polysensitised, 10 nonsensitised). No significant differences regarding age, gender, height and asthma medication. Significant difference between the groups regarding weight and subsequently BMI. ENO levels were only elevated in allergic asthmatic children (mean 37.0 ppb) compared to the non al- lergic children (mean 10.0 ppb, p < 0.0001). A correlation between eNO concentrations and the residual volume was es- tablished. ENO levels after exercise challenge were only slightly lower than before exercise. Conclusion: Elevated levels of eNO were only found in the group of asthmatic children with an allergic background. Therefore eNO can be used as a marker to differentiate between allergic and non allergic asthma. Asthmatic severity or therapy did not have a significant influence on the eNO levels. In patients with allergic asthma bronchiale eNO may be used as a helpful indicator in the adapting anti-inflammatory treatment. Although statistically significant in allergic chil- dren, the influence of exercise challenge on eNO levels is minimal.
理由:据报道，哮喘患者呼吸道呼出的一氧化氮(eNO)增加。目的:探讨非、单、多致敏儿童轻度支气管哮喘运动刺激前后一氧化氮(eNO)浓度与肺功能的关系。结果:共调查59例儿童(49例单一或多致敏，10例非致敏)。在年龄、性别、身高和哮喘药物方面没有显著差异。两组之间在体重和随后的BMI方面有显著差异。ENO水平仅在过敏性哮喘儿童(平均37.0 ppb)中高于非过敏性儿童(平均10.0 ppb, p < 0.0001)。建立了一氧化氮浓度与残留体积之间的相关性。运动挑战后的ENO水平仅略低于运动前。结论:仅在有过敏背景的哮喘患儿中发现eNO水平升高。因此，eNO可作为区分过敏性哮喘和非过敏性哮喘的标志物。哮喘严重程度和治疗对eNO水平没有显著影响。在变应性支气管哮喘患者中，eNO可作为适应抗炎治疗的有用指标。虽然在过敏儿童中有统计学意义，但运动挑战对eNO水平的影响很小。
{"title":"Differences in Exhaled Nitric Oxide in Non- and Mono- or Polysensitised Allergic Children with Asthma Bronchiale","authors":"L. Korsch, A. Hombach, C. Schnegg, Michael Weiss, E. Korsch","doi":"10.2174/1874309900802010030","DOIUrl":"https://doi.org/10.2174/1874309900802010030","url":null,"abstract":"Rationale: Exhaled nitric oxide (eNO) is reported to be increased in the airways of patients with asthma bron- chiale. Objectives: To investigate eNO concentration and lung function in non-, mono- and polysensitised children with mild asthma bronchiale before and after exercise challenge. Findings: Investigation of a total of 59 children (49 mono- or polysensitised, 10 nonsensitised). No significant differences regarding age, gender, height and asthma medication. Significant difference between the groups regarding weight and subsequently BMI. ENO levels were only elevated in allergic asthmatic children (mean 37.0 ppb) compared to the non al- lergic children (mean 10.0 ppb, p < 0.0001). A correlation between eNO concentrations and the residual volume was es- tablished. ENO levels after exercise challenge were only slightly lower than before exercise. Conclusion: Elevated levels of eNO were only found in the group of asthmatic children with an allergic background. Therefore eNO can be used as a marker to differentiate between allergic and non allergic asthma. Asthmatic severity or therapy did not have a significant influence on the eNO levels. In patients with allergic asthma bronchiale eNO may be used as a helpful indicator in the adapting anti-inflammatory treatment. Although statistically significant in allergic chil- dren, the influence of exercise challenge on eNO levels is minimal.","PeriodicalId":89037,"journal":{"name":"The open pediatric medicine journal","volume":"29 1","pages":"30-34"},"PeriodicalIF":0.0,"publicationDate":"2008-06-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"89495664","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2008-04-23DOI: 10.2174/1874309900802010021
G. Veereman-Wauters, S. Cucchiara
Paediatric Crohn's disease (CD) affects 5 in 100,000 children in the US and Europe and can result in growth re- tardation and delayed sexual development. Therefore, early diagnosis and treatment is critical, with the goal being main- tenance of symptomatic remission and a change in disease course. Conventional treatment relies on aminosalicylate main- tenance therapy with corticosteroids to control acute exacerbations and immunomodulators for steroid-resistant or fre- quently relapsing disease. Infliximab has demonstrated efficacy in moderately to severely active paediatric CD, with 88.4% patients in clinical response and 58.9% in clinical remission at week 10. Significant improvements in quality of life, height, reduction in corticosteroid use and mucosal healing were observed with infliximab. Traditional 'step-up' treatment strategy may be suboptimal because relapse and steroid dependency/resistance rates remain high. A 'top down' approach using biologic therapy earlier may suppress intestinal inflammation and promote prolonged and stable remis- sion, but safety issues need to be considered.
{"title":"The Management of Paediatric Crohn’s Disease: Addressing Unmet Needs","authors":"G. Veereman-Wauters, S. Cucchiara","doi":"10.2174/1874309900802010021","DOIUrl":"https://doi.org/10.2174/1874309900802010021","url":null,"abstract":"Paediatric Crohn's disease (CD) affects 5 in 100,000 children in the US and Europe and can result in growth re- tardation and delayed sexual development. Therefore, early diagnosis and treatment is critical, with the goal being main- tenance of symptomatic remission and a change in disease course. Conventional treatment relies on aminosalicylate main- tenance therapy with corticosteroids to control acute exacerbations and immunomodulators for steroid-resistant or fre- quently relapsing disease. Infliximab has demonstrated efficacy in moderately to severely active paediatric CD, with 88.4% patients in clinical response and 58.9% in clinical remission at week 10. Significant improvements in quality of life, height, reduction in corticosteroid use and mucosal healing were observed with infliximab. Traditional 'step-up' treatment strategy may be suboptimal because relapse and steroid dependency/resistance rates remain high. A 'top down' approach using biologic therapy earlier may suppress intestinal inflammation and promote prolonged and stable remis- sion, but safety issues need to be considered.","PeriodicalId":89037,"journal":{"name":"The open pediatric medicine journal","volume":"11 1","pages":"21-29"},"PeriodicalIF":0.0,"publicationDate":"2008-04-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"84901296","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2008-03-27DOI: 10.2174/1874309900802010016
V. Loening-Baucke, A. Swidsinski
The aims of the study were to identify the frequency and causes of chronic abdominal pain in a large academic primary care population at the University of Iowa Children's Hospital. We evaluated retrospectively the complete charts of children >4 years old, seen for at least one health maintenance visit in the primary paediatric clinic during a 6-month period, for complaints and causes of chronic abdominal pain. Of 493 boys and 469 girls with a mean age of 9.1 years, 12.7% had been evaluated for chronic abdominal pain. Constipation as cause of abdominal pain occurred in 83%, child- hood functional abdominal pain in 8%, colic in 5%, gastroesophageal reflux in 2% and infection in 2%. The life-time prevalence rate for chronic abdominal pain was 13.3%; was due to functional causes in 13.1% and due to organic diseases in 0.2%. Functional constipation was the most frequent cause of chronic abdominal pain in a large primary care paediatric population.
{"title":"Constipation is the Most Frequent Cause of Chronic Abdominal Pain in Children","authors":"V. Loening-Baucke, A. Swidsinski","doi":"10.2174/1874309900802010016","DOIUrl":"https://doi.org/10.2174/1874309900802010016","url":null,"abstract":"The aims of the study were to identify the frequency and causes of chronic abdominal pain in a large academic primary care population at the University of Iowa Children's Hospital. We evaluated retrospectively the complete charts of children >4 years old, seen for at least one health maintenance visit in the primary paediatric clinic during a 6-month period, for complaints and causes of chronic abdominal pain. Of 493 boys and 469 girls with a mean age of 9.1 years, 12.7% had been evaluated for chronic abdominal pain. Constipation as cause of abdominal pain occurred in 83%, child- hood functional abdominal pain in 8%, colic in 5%, gastroesophageal reflux in 2% and infection in 2%. The life-time prevalence rate for chronic abdominal pain was 13.3%; was due to functional causes in 13.1% and due to organic diseases in 0.2%. Functional constipation was the most frequent cause of chronic abdominal pain in a large primary care paediatric population.","PeriodicalId":89037,"journal":{"name":"The open pediatric medicine journal","volume":"45 1","pages":"16-20"},"PeriodicalIF":0.0,"publicationDate":"2008-03-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"88165159","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2008-03-14DOI: 10.2174/1874309900802010011
I. Ahmad, K. Davis, S. Emi, C. Uy, J. Sills
Objective: Spontaneous intestinal perforations (SIP) in extremely low birth weight infants are distinctly different from necrotizing enterocolitis. The etiology of SIP is not well understood. Our objective was to identify perinatal therapeutic interventions that may increase the risk of spontaneous intestinal perforations. Methods: Medical records of extremely low birth weight infants (BW<1000g) admitted to a neonatal intensive care unit during 42-month period were studied. Infants with radiologic or histologic diagnosis of necrotizing enterocolitis were excluded. Information collected included maternal and infant demographics, perinatal risk factors, clinical findings and interventions, and exposure to medications before and after delivery. Chi square and paired t-tests were used to compare SIP patients to those with no perforation (NP). Mean values are given with standard error of the mean. Results: There were 13 SIP and 165 NP. There were more male infants (84.6% vs 49.1%, p<0.025) and more out born infants (61.5% vs 39.9%, p<0.05) in the SIP group. The use of maternal tertbutaline was higher in the SIP group (30.8% vs 9.1%, p<0.015). Early treatment with indomethacin (0-3days) was significantly higher in the SIP group (69.2% vs 27.9%, p=0.002). Hypotension requiring dopamine was significantly higher in the SIP group (69.2% vs 34.6%, p=0.017). Combined exposure to antenatal steroids and postnatal indomethacin was significantly higher in the SIP group (69.2% vs 36.4%, p=0.019), as was the combined early treatment with hydrocortisone and indomethacin (7.7% vs 0.6%, p=0.02). Conclusions: Early use of indomethacin, and co-exposure to antenatal or postnatal steroids is related to development of spontaneous intestinal perforation in extremely low birth weight infants. Prenatal exposure to maternal terbutaline and postnatal use of dopamine for hypotension increases the risk for SIP in these infants.
目的:极低出生体重儿自发性肠穿孔(SIP)与坏死性小肠结肠炎明显不同。SIP的病因尚不清楚。我们的目的是确定围产期治疗干预可能增加自发性肠穿孔的风险。方法:对新生儿重症监护病房收治的极低出生体重儿(BW<1000g) 42个月的医疗记录进行分析。排除影像学或组织学诊断为坏死性小肠结肠炎的婴儿。收集的信息包括孕产妇和婴儿人口统计、围产期危险因素、临床表现和干预措施，以及分娩前后的药物暴露情况。使用卡方检验和配对t检验比较SIP患者与无穿孔(NP)患者。给出的平均值带有平均值的标准误差。结果:SIP 13例，NP 165例。SIP组男婴较多(84.6% vs 49.1%， p<0.025)，外生儿较多(61.5% vs 39.9%， p<0.05)。SIP组产妇特布他林使用率较高(30.8% vs 9.1%， p<0.015)。SIP组患者早期应用吲哚美辛治疗(0 ~ 3天)的比例明显高于对照组(69.2% vs 27.9%， p=0.002)。在SIP组中，需要多巴胺的低血压明显更高(69.2% vs 34.6%， p=0.017)。SIP组产前类固醇和产后吲哚美辛联合暴露率显著高于对照组(69.2% vs 36.4%， p=0.019)，早期氢化可的松和吲哚美辛联合治疗率也显著高于对照组(7.7% vs 0.6%， p=0.02)。结论:极低出生体重儿早期使用吲哚美辛，并在产前或产后同时暴露于类固醇与自发性肠穿孔的发生有关。产前暴露于母体特布他林和产后使用多巴胺治疗低血压会增加这些婴儿发生SIP的风险。
{"title":"Risk Factors for Spontaneous Intestinal Perforation in Extremely Low Birth Weight Infants","authors":"I. Ahmad, K. Davis, S. Emi, C. Uy, J. Sills","doi":"10.2174/1874309900802010011","DOIUrl":"https://doi.org/10.2174/1874309900802010011","url":null,"abstract":"Objective: Spontaneous intestinal perforations (SIP) in extremely low birth weight infants are distinctly different from necrotizing enterocolitis. The etiology of SIP is not well understood. Our objective was to identify perinatal therapeutic interventions that may increase the risk of spontaneous intestinal perforations. Methods: Medical records of extremely low birth weight infants (BW<1000g) admitted to a neonatal intensive care unit during 42-month period were studied. Infants with radiologic or histologic diagnosis of necrotizing enterocolitis were excluded. Information collected included maternal and infant demographics, perinatal risk factors, clinical findings and interventions, and exposure to medications before and after delivery. Chi square and paired t-tests were used to compare SIP patients to those with no perforation (NP). Mean values are given with standard error of the mean. Results: There were 13 SIP and 165 NP. There were more male infants (84.6% vs 49.1%, p<0.025) and more out born infants (61.5% vs 39.9%, p<0.05) in the SIP group. The use of maternal tertbutaline was higher in the SIP group (30.8% vs 9.1%, p<0.015). Early treatment with indomethacin (0-3days) was significantly higher in the SIP group (69.2% vs 27.9%, p=0.002). Hypotension requiring dopamine was significantly higher in the SIP group (69.2% vs 34.6%, p=0.017). Combined exposure to antenatal steroids and postnatal indomethacin was significantly higher in the SIP group (69.2% vs 36.4%, p=0.019), as was the combined early treatment with hydrocortisone and indomethacin (7.7% vs 0.6%, p=0.02). Conclusions: Early use of indomethacin, and co-exposure to antenatal or postnatal steroids is related to development of spontaneous intestinal perforation in extremely low birth weight infants. Prenatal exposure to maternal terbutaline and postnatal use of dopamine for hypotension increases the risk for SIP in these infants.","PeriodicalId":89037,"journal":{"name":"The open pediatric medicine journal","volume":"42 1","pages":"11-15"},"PeriodicalIF":0.0,"publicationDate":"2008-03-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"87778754","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2008-02-13DOI: 10.2174/1874309900802010007
J. Classen
Cohort data from Denmark in all children born from January 1, 1990 to December 31, 2000 was analyzed to assess the association between immunization and type 1 diabetes in all Danish children and in a subgroup where children had a sibling with type 1 diabetes. Pediatric vaccines were associated with a statistically significant increased risk of type 1 diabetes in 12 of 21 endpoints in the general population. The rate ratios in children who received at least one dose of a specific vaccine were also elevated in the subgroup and were statistically the same as in the general population. Three doses of the hemophilus vaccine were associated with a rate ratio of 1.23 (1.02<
{"title":"Risk of Vaccine Induced Diabetes in Children with a Family History of Type 1 Diabetes","authors":"J. Classen","doi":"10.2174/1874309900802010007","DOIUrl":"https://doi.org/10.2174/1874309900802010007","url":null,"abstract":"Cohort data from Denmark in all children born from January 1, 1990 to December 31, 2000 was analyzed to assess the association between immunization and type 1 diabetes in all Danish children and in a subgroup where children had a sibling with type 1 diabetes. Pediatric vaccines were associated with a statistically significant increased risk of type 1 diabetes in 12 of 21 endpoints in the general population. The rate ratios in children who received at least one dose of a specific vaccine were also elevated in the subgroup and were statistically the same as in the general population. Three doses of the hemophilus vaccine were associated with a rate ratio of 1.23 (1.02<<RR<<1.48) and an absolute risk in the general population of three cases/100,000 per year compared to 1.58 (0.60<<RR<<4.15) and an absolute risk of 2885 cases/100,000 per year in the subgroup with a sibling with type 1 diabetes. The hemophilus immunization is associated with a cumulative attributable risk of 2.3/100 (2.3%) in the subgroup.","PeriodicalId":89037,"journal":{"name":"The open pediatric medicine journal","volume":"1 1","pages":"7-10"},"PeriodicalIF":0.0,"publicationDate":"2008-02-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"86550904","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2008-02-11DOI: 10.2174/1874309900802010001
J. Classen
Background: Previous studies demonstrated clusters of cases of IDDM occurring 24 to 48 months after immu- nization with the hemophilus, pertussis and combined measles mumps rubella vaccines. Data was analyzed to determine if similar clustering of cases of IDDM occurred after immunization with the hepatitis B vaccine. Methods: Data on the inci- dence of IDDM from hepatitis B immunized and unimmunized cohorts of children was analyzed for the presence of clus- ters occurring after hepatitis B immunization. Results: Data from Italy, France, and New Zealand indicated rises in the in- cidence of IDDM occurred between 24 to 48 months after the introduction of the hepatitis B immunization in young chil- dren. Conclusion: Several different vaccines as well as infections with natural mumps virus are followed by clusters of cases of IDDM that occur about 24 to 48 months after immunization. This suggests a similar mechanism of action, possi- bly the triggering of a progressive autoimmune phenomenon.
{"title":"Clustering of Cases of IDDM 2 to 4 Years after Hepatitis B Immunization is Consistent with Clustering after Infections and Progression to IDDM in Autoantibody Positive Individuals","authors":"J. Classen","doi":"10.2174/1874309900802010001","DOIUrl":"https://doi.org/10.2174/1874309900802010001","url":null,"abstract":"Background: Previous studies demonstrated clusters of cases of IDDM occurring 24 to 48 months after immu- nization with the hemophilus, pertussis and combined measles mumps rubella vaccines. Data was analyzed to determine if similar clustering of cases of IDDM occurred after immunization with the hepatitis B vaccine. Methods: Data on the inci- dence of IDDM from hepatitis B immunized and unimmunized cohorts of children was analyzed for the presence of clus- ters occurring after hepatitis B immunization. Results: Data from Italy, France, and New Zealand indicated rises in the in- cidence of IDDM occurred between 24 to 48 months after the introduction of the hepatitis B immunization in young chil- dren. Conclusion: Several different vaccines as well as infections with natural mumps virus are followed by clusters of cases of IDDM that occur about 24 to 48 months after immunization. This suggests a similar mechanism of action, possi- bly the triggering of a progressive autoimmune phenomenon.","PeriodicalId":89037,"journal":{"name":"The open pediatric medicine journal","volume":"13 1","pages":"1-6"},"PeriodicalIF":0.0,"publicationDate":"2008-02-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"89267676","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2007-09-18DOI: 10.2174/1874309900701010001
L. Matturri, A. Lavezzi
The aim of this study was to identify in stillbirth a possible involvement of morphological and/or physiological alterations of structures of the central autonomic nervous system in the mechanism of death. The study, including the in- depth histological examination of brainstem and cerebellum, was performed on 42 stillbirths, aged from 22 to 40 gesta- tional weeks, 12 of which were explained and 30 were unexplained deaths. In the sudden unexplained stillbirths a variety of morphological and/or biological abnormalities of different structures and nuclei was found, above all the hypoplasia of the parafacial complex, frequently associated with hypoplasia of the arcuate and pre-Botzinger nuclei, and with thyrosine-hydroxylase immunonegativity in the locus coeruleus. A significant correla- tion was also observed between the neuropathologic findings and mother's smoking habit.
{"title":"Pathology of the Central Autonomic Nervous System in Stillbirth","authors":"L. Matturri, A. Lavezzi","doi":"10.2174/1874309900701010001","DOIUrl":"https://doi.org/10.2174/1874309900701010001","url":null,"abstract":"The aim of this study was to identify in stillbirth a possible involvement of morphological and/or physiological alterations of structures of the central autonomic nervous system in the mechanism of death. The study, including the in- depth histological examination of brainstem and cerebellum, was performed on 42 stillbirths, aged from 22 to 40 gesta- tional weeks, 12 of which were explained and 30 were unexplained deaths. In the sudden unexplained stillbirths a variety of morphological and/or biological abnormalities of different structures and nuclei was found, above all the hypoplasia of the parafacial complex, frequently associated with hypoplasia of the arcuate and pre-Botzinger nuclei, and with thyrosine-hydroxylase immunonegativity in the locus coeruleus. A significant correla- tion was also observed between the neuropathologic findings and mother's smoking habit.","PeriodicalId":89037,"journal":{"name":"The open pediatric medicine journal","volume":"17 1","pages":"1-8"},"PeriodicalIF":0.0,"publicationDate":"2007-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"73201569","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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