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Sherman P, Hassall E, Fagundes-Neto U, Gold B, Kato S, Koletzko S, Orenstein S, Rudolph C, Vakil N, Vandenplas Y. Gastroösophageale Refluxkrankheit. Monatsschr Kinderheilkd 2010. [DOI: 10.1007/s00112-010-2165-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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52
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Berg AV, Krämer U, Link E, Bollrath C, Heinrich J, Brockow I, Koletzko S, Grübl A, Filipiak-Pittroff B, Wichmann HE, Bauer CP, Reinhardt D, Berdel D. Impact of early feeding on childhood eczema: development after nutritional intervention compared with the natural course - the GINIplus study up to the age of 6 years. Clin Exp Allergy 2010; 40:627-36. [DOI: 10.1111/j.1365-2222.2009.03444.x] [Citation(s) in RCA: 50] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Fischbach W, Malfertheiner P, Hoffmann JC, Bolten W, Bornschein J, Götze O, Höhne W, Kist M, Koletzko S, Labenz J, Layer P, Miehlke S, Morgner A, Peitz U, Preiss J, Prinz C, Rosien U, Schmidt W, Schwarzer A, Suerbaum S, Timmer A, Treiber G, Vieth M. S3-guideline "helicobacter pylori and gastroduodenal ulcer disease" of the German society for digestive and metabolic diseases (DGVS) in cooperation with the German society for hygiene and microbiology, society for pediatric gastroenterology and nutrition e. V., German society for rheumatology, AWMF-registration-no. 021 / 001. ZEITSCHRIFT FUR GASTROENTEROLOGIE 2009; 47:1230-63. [PMID: 19960402 DOI: 10.1055/s-0028-1109855] [Citation(s) in RCA: 37] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
This guideline updates a prior consensus recommendation of the German Society for Digestive and Metabolic Diseases (DGVS) from 1996. It was developed by an interdisciplinary cooperation with representatives of the German Society for Hygiene and Microbiology, the Society for Pediatric Gastroenterology and Nutrition (GPGE), and the German Society for Rheumatology. The guideline is methodologically based on recommendations of the Association of the Scientific Medical Societies in Germany (AWMF) for providing a systematic evidence-based S 3 level consensus guideline and has also implemented grading criteria according to the GRADE (Grading of Recommendations Assessment, Development, and Evaluation) process. Clinical applicability of study results as well as specifics for Germany in terms of epidemiology, antibiotic resistance status, diagnostics, and therapy were taken into account.
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Schreyer A, Ludwig D, Koletzko S, Hoffmann J, Preiß J, Zeitz M, Stange E, Herrlinger K. Aktualisierte S 3-Leitlinie zur Diagnostik des Morbus Crohn – radiologische Untersuchungstechniken. ROFO-FORTSCHR RONTG 2009; 182:116-21. [DOI: 10.1055/s-0028-1109837] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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55
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Müller-Ladner U, Alten R, Heiligenhaus A, Kekow J, Koletzko S, Mrowietz U, Ochsenkühn T, Radke M, Reich K, Rudwaleit M, Schreiber S. ["TRECID", TNFalpha related chronic inflammatory diseases - a new multiple diseases bridging concept]. Dtsch Med Wochenschr 2009; 134:2132-6. [PMID: 19809965 DOI: 10.1055/s-0029-1242011] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
The pro-inflammatory cytokine TNF alpha (TNF) has a key position in the pathogenesis of various infectious and inflammatory diseases. Clarification of its pivotal role in the pathogenesis of rheumatoid arthritis, spondyloarthritis, uveitis, psoriasis and inflammatory bowel disease has resulted in the successful development of TNF- blocking therapies, which have disease-modifying properties that exceed the effects of conventional therapeutic options. For this reason data on the concurrence of several chronic inflammatory diseases have led to the hypothesis of common pathogenetic processes of cytokine dysregulation. The acronym TRECID describes this concept of "TNF RElated Chronic Inflammatory Diseases". Physicians of different specialties have integrated new therapeutic options with TNF-blocking therapies into their strategies for the management of the affected patients. Thus the concept of TRECID can be regarded as a role model for a dynamic, interdisciplinary cooperation based on shared pathophysiological aspects.
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Chen CM, Weidinger S, Klopp N, Sausenthaler S, Bischof W, Herbarth O, Bauer M, Borte M, Schaaf B, Lehmann I, Behrendt H, Krämer U, Berdel D, von Berg A, Bauer CP, Koletzko S, Illig T, Wichmann HE, Heinrich J. Common variants in FCER1A influence total serum IgE levels from cord blood up to six years of life. Allergy 2009; 64:1327-32. [PMID: 19245427 DOI: 10.1111/j.1398-9995.2009.02005.x] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND In a recent genome wide scan, a functional promoter variant (rs2251746) in the gene encoding the alpha chain of the high affinity receptor for immunoglobulin E (IgE) (FCER1A) was identified as major determinant of serum IgE levels. OBJECTIVE The aim of this study was to investigate the role of rs2251746 on total IgE levels measured at different stages of life from birth (cord blood) up to the age of 6 and to evaluate its interaction with the environmental influences in two German birth cohorts. METHOD Data from two German birth cohorts were analysed (n = 1043 for the LISA cohort and n = 1842 for the GINI cohort). In the studies, total serum IgE was measured from cord blood, and blood samples taken at the age of 2/3 and 6 years. In a subgroup of the LISA study, house dust samples were collected at age of 3 months and the amount of endotoxin was determined. Random effect models were used to analyse the longitudinal health outcomes. RESULTS In the two cohorts, the heterozygote and the rare homozygote of rs2251746 was consistently associated with lower total IgE levels from birth up to the age of 6 years with an allele-dose effect (P < 0.02 for blood samples taken at each time point in both cohorts). No interaction between the two FCER1A encoding gene and environmental exposures including endotoxin, worm infestation and day care centre attendance during early childhood were observed. CONCLUSION Common variants in FCER1A strongly influence basal IgE production independently from environmental stimuli. These effects can be observed already in cord blood pointing to altered gene expression in foetus.
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Osterrieder S, Prell C, Schwarzer A, Lottspeich C, Rüssmann H, Ossiander G, Koletzko S. Verbesserter einstufiger monoklonaler chromatographischer Immunoassay zum Nachweis von Helicobacter pylori Antigen im Stuhl bei Kindern. KLINISCHE PADIATRIE 2009. [DOI: 10.1055/s-0029-1214348] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Fischbach W, Malfertheiner P, Hoffmann JC, Bolten W, Bornschein J, Götze O, Höhne W, Kist M, Koletzko S, Labenz J, Layer P, Miehlke S, Morgner A, Peitz U, Preiss JC, Prinz C, Rosien U, Schmidt WE, Schwarzer A, Suerbaum S, Timmer A, Treiber G, Vieth M. [S3-guideline "Helicobacter pylori and gastroduodenal ulcer disease"]. ZEITSCHRIFT FUR GASTROENTEROLOGIE 2009; 47:68-102. [PMID: 19156594 DOI: 10.1055/s-0028-1109062] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
This guideline updates a prior concensus recommendation of the German Society for Digestive and Metabolic Diseases (DGVS) from 1996. It was developed by an interdisciplinary cooperation with representatives of the German Society for Microbiology, the Society for Pediatric Gastroenterology and Nutrition (GPGE) and the German Society for Rheumatology. The guideline is methodologically based on recommendations of the Association of the Scientific Medical Societies in Germany (AWMF) for providing a systematic evidence-based consensus guideline of S 3 level and has also implemented grading criteria according to GRADE (Grading of Recommendations Assessment, Development and Evaluation). Clinical applicability of study results as well as specifics for Germany in terms of epidemiology, antibiotic resistance status, diagnostics and therapy were taken into account.
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Brockow I, Zutavern A, Hoffmann U, Grübl A, von Berg A, Koletzko S, Filipiak B, Bauer CP, Wichmann HE, Reinhardt D, Berdel D, Krämer U, Heinrich J. Early allergic sensitizations and their relevance to atopic diseases in children aged 6 years: results of the GINI study. J Investig Allergol Clin Immunol 2009; 19:180-187. [PMID: 19610260] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/28/2023] Open
Abstract
BACKGROUND Only a few studies have analyzed the value of early sensitization in predicting the development of atopic disease. The relevance of low immunoglobulin (Ig) E antibody levels in this respect also remains unclear. OBJECTIVE To investigate the relevance of sensitization in 12-month-old children in the development of atopic disease by the age of 6 years. METHODS We analyzed data for 1290 children with a positive family history of atopy from the prospective, multicenter German Infant Nutritional Intervention (GINIplus) study and investigated the relationship between the presence of detectable specific IgE antibodies at the age of 12 months and the development of atopic disease by the age of 6 years. RESULTS In all, 10.9% of children analyzed developed sensitization. At the age of 6 years, 20.6% of children with early sensitization had eczema compared to 9.4% of those without (odds ratio [OR], 2.31; 95% confidence interval [CI], 1.42-3.74). The corresponding figures were 15.4% vs 7.3% for allergic rhinitis (OR, 2.22; CI, 1.31-3.78) and 10.2% vs 2.6% (OR, 3.93; 95% CI, 1.98-7.76) for asthma. Children with early sensitization to aeroallergens had the greatest risk of subsequent atopic disease. Early sensitization did not increase risk in children without eczema within the first year of life. Very low specific IgE levels (0.18-0.34 kU/L) were not significantly associated with any of the outcomes analyzed. CONCLUSION Sensitization to common food allergens and to aeroallergens in particular during the first year of life was found to be a strong predictor for the development of atopic disease by the age of 6 years in children with a positive family history of atopy.
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Hoffmann JC, Preiss JC, Autschbach F, Buhr HJ, Häuser W, Herrlinger K, Höhne W, Koletzko S, Krieglstein CF, Kruis W, Matthes H, Moser G, Reinshagen M, Rogler G, Schreiber S, Schreyer AG, Sido B, Siegmund B, Stallmach A, Bokemeyer B, Stange EF, Zeitz M. [Clinical practice guideline on diagnosis and treatment of Crohn's disease]. ZEITSCHRIFT FUR GASTROENTEROLOGIE 2008; 46:1094-146. [PMID: 18810679 DOI: 10.1055/s-2008-1027796] [Citation(s) in RCA: 55] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Kalach N, Bontems P, Koletzko S, Mourad-Baars P, Shcherbakov P, Celinska-Cedro D, Iwanczak B, Gottrand F, Martinez-Gómez M, Pehlivanoglu E, Oderda G, Urruzuno P, Casswall T, Lamireau T, Sykora J, Roma E, Veres G, Wewer V, Charkaluk M, Mégraud F, Cadranel S. SFP-11 – Hépatologie, gastro-entérologie et nutrition – Etude prospective multicentrique européenne pilote sur l’ulcère peptique ou les érosions gastroduodénales chez l’enfant. Arch Pediatr 2008. [DOI: 10.1016/s0929-693x(08)72079-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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63
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Chen CM, Morgenstern V, Bischof W, Herbarth O, Borte M, Behrendt H, Kramer U, von Berg A, Berdel D, Bauer CP, Koletzko S, Wichmann HE, Heinrich J. Dog ownership and contact during childhood and later allergy development. Eur Respir J 2008; 31:963-73. [DOI: 10.1183/09031936.00092807] [Citation(s) in RCA: 38] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
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Götzberger M, Bufler P, Häberle B, Tympner C, Schweinitz DV, Koletzko S, Eigler A. Raumforderung des Pankreaskopfes bei einem 15-jährigen Mädchen. ZEITSCHRIFT FUR GASTROENTEROLOGIE 2007. [DOI: 10.1055/s-2007-992705] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Schwarzer A, Lottspeich C, Rüssmann H, Ossiander G, Koletzko S. Evaluation of a novel rapid one-step monoclonal chromatographic immunoassay for detection of Helicobacter pylori in stool from children. Eur J Clin Microbiol Infect Dis 2007; 26:475-80. [PMID: 17554570 DOI: 10.1007/s10096-007-0322-4] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/24/2023]
Abstract
A new rapid office-based one-step monoclonal immunoassay (RAPID Hp StAR, DakoCytomation, Cambridge, UK) for detection of Helicobacter pylori antigen in stool was evaluated in children against invasive diagnostic methods and compared to the results of a monoclonal EIA targeting the same antigen (Amplified IDEIA Hp StAR, DakoCytomation, Cambridge, UK). Coded stool samples from 118 symptomatic children (0.3-18.8 years) were investigated prior to any anti-H. pylori therapy. Fifty-four children were H. pylori infected defined by positive culture and/or two other positive tests ((13)C-urea breath test, histology, rapid urea test), the remaining 64 children showed concordant negative results. Thirty-four infected children (4.8-17.8 years) were monitored with (13)C-urea breath test (five remained positive) and stool test 6-8 weeks after anti-H. pylori therapy. The immunoassays were independently read by two investigators. The monoclonal EIA showed excellent sensitivity and specificity before (98% and 100%, respectively) and after therapy (100%; 96.2%). The rapid immunoassay was invalid for technical reasons in nine samples (5.9%). The two observers agreed in 31 positive and 93 negative results, but had discordant results in 17 samples (11.2%). Overall, the rapid test showed a poor sensitivity (63.8%-71.1%), but a good specificity (91.1%-96.2%) before treatment. We conclude that the new office based monoclonal enzyme immunoassay for diagnosis of H. pylori should be modified to improve sensitivity, inter-observer-variability and some technical problems. In contrast, the monoclonal EIA stool test is highly reliable, both pre- and post therapy, and equivalent to the (13)C-urea breath test.
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Koletzko S, Richy F, Bontems P, Crone J, Kalach N, Monteiro ML, Gottrand F, Celinska-Cedro D, Roma-Giannikou E, Orderda G, Kolacek S, Urruzuno P, Martínez-Gómez MJ, Casswall T, Ashorn M, Bodanszky H, Mégraud F. Prospective multicentre study on antibiotic resistance of Helicobacter pylori strains obtained from children living in Europe. Gut 2006; 55:1711-6. [PMID: 16603633 PMCID: PMC1856474 DOI: 10.1136/gut.2006.091272] [Citation(s) in RCA: 159] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
AIM To prospectively assess the antibacterial resistance rate in Helicobacter pylori strains obtained from symptomatic children in Europe. METHODS During a 4-year period, 17 paediatric centres from 14 European countries reported prospectively on patients infected with H pylori, for whom antibiotic susceptibility was tested. RESULTS A total of 1233 patients were reported from Northern (3%), Western (70%), Eastern (9%) and Southern Europe (18%); 41% originated from outside Europe as indicated by mother's birth-country; 13% were <6 years of age, 43% 6-11 years of age and 44% >11 years of age. Testing was carried out before the first treatment (group A, n = 1037), and after treatment failure (group B, n = 196). Overall resistance to clarithromycin was detected in 24% (mean, A: 20%, B: 42%). The primary clarithromycin resistance rate was higher in boys (odds ratio (OR) 1.58; 1.12 to 2.24, p = 0.01), in children <6 years compared with >12 years (OR 1.82, 1.10 to 3.03, p = 0.020) and in patients living in Southern Europe compared with those living in Northern Europe (OR 2.25; 1.52 to 3.30, p<0.001). Overall resistance rate to metronidazole was 25% (A: 23%, B: 35%) and higher in children born outside Europe (A: adjusted. OR 2.42, 95% CI: 1.61 to 3.66, p<0.001). Resistance to both antibiotics occurred in 6.9% (A: 5.3%, B: 15.3%). Resistance to amoxicillin was exceptional (0.6%). Children with peptic ulcer disease (80/1180, 6.8%) were older than patients without ulcer (p = 0.001). CONCLUSION The primary resistance rate of H pylori strains obtained from unselected children in Europe is high. The use of antibiotics for other indications seems to be the major risk factor for development of primary resistance.
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Anzinger M, Gospos J, Pitzl H, Koletzko S, Heldwein W, Schmitt W. Blue-Rubber-bleb-Naevus-Syndrom und therapeutische Doppel-Ballon-Enteroskopie. ZEITSCHRIFT FUR GASTROENTEROLOGIE 2006; 44:1141-4. [PMID: 17115355 DOI: 10.1055/s-2006-927296] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
This is the first report about the endoscopic removal of hemangiomas in the gastrointestinal tract using the double-balloon enteroscopic technique. We report on a 16-year-old female patient with a 10-year history of chronic anemia due to recurrent gastrointestinal bleeding. Besides permanent iron substitution, up to 3 blood transfusions per week are necessary. At birth a blue rubber-bleb nevus syndrome was diagnosed, with blue angiomatous lesions preferring her skin and digestive tract. In the 8 years before admittance numerous conventional endoscopic procedures and one intraoperative endoscopy with laser coagulation of many cavernous hemangiomas were performed. In our department the successful treatment of 150 hemangiomas with argon plasma coagulation or polypectomy in combination with double-balloon enteroscopy and conventional endoscopy was achieved without complications.
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Haisch M, Hering P, Schadewaldt P, Brösicke H, Braden B, Koletzko S, Steffen C. Biomedical Application of an Isotope Selective Nondispersive Infrared Spectrometer for 13CO2 and 12CO2 Concentration Measurements in Breath Samples. ACTA ACUST UNITED AC 2006. [DOI: 10.1080/00211919408046741] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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69
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Morgenstern V, Zutavern A, Cyrys J, Brockow I, Gehring U, Koletzko S, Bauer CP, Reinhardt D, Wichmann HE, Heinrich J. Respiratory health and individual estimated exposure to traffic-related air pollutants in a cohort of young children. Occup Environ Med 2006; 64:8-16. [PMID: 16912084 PMCID: PMC2092590 DOI: 10.1136/oem.2006.028241] [Citation(s) in RCA: 201] [Impact Index Per Article: 11.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
OBJECTIVES To estimate long-term exposure to traffic-related air pollutants on an individual basis and to assess adverse health effects using a combination of air pollution measurement data, data from geographical information systems (GIS) and questionnaire data. METHODS 40 measurement sites in the city of Munich, Germany were selected at which to collect particulate matter with a 50% cut-off aerodynamic diameter of 2.5 microm (PM2.5) and to measure PM2.5 absorbance and nitrogen dioxide (NO2). A pool of GIS variables (information about street length, household and population density and land use) was collected for the Munich metropolitan area and was used in multiple linear regression models to predict traffic-related air pollutants. These models were also applied to the birth addresses of two birth cohorts (German Infant Nutritional Intervention Study (GINI) and Influence of Life-style factors on the development of the Immune System and Allergies in East and West Germany (LISA)) in the Munich metropolitan area. Associations between air pollution concentrations at birth address and 1-year and 2-year incidences of respiratory symptoms were analysed. RESULTS The following means for the estimated exposures to PM2.5, PM2.5 absorbance and NO2 were obtained: 12.8 microg/m3, 1.7x10(-5) m(-1) and 35.3 mug/m3, respectively. Adjusted odds ratios (ORs) for wheezing, cough without infection, dry cough at night, bronchial asthma, bronchitis and respiratory infections indicated positive associations with traffic-related air pollutants. After controlling for individual confounders, significant associations were found between the pollutant PM2.5 and sneezing, runny/stuffed nose during the first year of life (OR 1.16, 95% confidence interval 1.01 to 1.34) Similar effects were observed for the second year of life. These findings are similar to those from our previous analysis that were restricted to a subcohort in Munich city. The extended study also showed significant effects for sneezing, running/stuffed nose. Additionally, significant associations were found between NO2 and dry cough at night (or bronchitis) during the first year of life. The variable "living close to major roads" (<50 m), which was not analysed for the previous inner city cohort with birth addresses in the city of Munich, turned out to increase the risk of wheezing and asthmatic/spastic/obstructive bronchitis. CONCLUSIONS Effects on asthma and hay fever are subject to confirmation at older ages, when these outcomes can be more validly assessed.
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Elitsur Y, Lawrence Z, Rüssmann H, Koletzko S. Primary clarithromycin resistance to Helicobacter pylori and therapy failure in children: the experience in West Virginia. J Pediatr Gastroenterol Nutr 2006; 42:327-8. [PMID: 16540805 DOI: 10.1097/01.mpg.0000214157.52822.40] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
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Dilger K, Alberer M, Busch A, Enninger A, Behrens R, Koletzko S, Stern M, Beckmann C, Gleiter CH. Pharmacokinetics and pharmacodynamic action of budesonide in children with Crohn's disease. Aliment Pharmacol Ther 2006; 23:387-96. [PMID: 16422998 DOI: 10.1111/j.1365-2036.2006.02771.x] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
BACKGROUND Budesonide is effective as initial therapy of mild to moderate Crohn's disease in adults. Superior tolerability to conventional corticosteroids might be attributed to extensive first-pass metabolism of budesonide by cytochrome P450 3A. AIM To evaluate biotransformation and pharmacodynamic action of budesonide in children. METHODS Drug disposition and effects on endogenous cortisol were evaluated in 12 children with Crohn's disease (5-15 years) after first intake of 3 mg budesonide (single dose), and again after 1 week of thrice daily dosing (steady-state). The parent drug and cytochrome P450 3A-dependent metabolites were analysed in blood and urine. RESULTS Pharmacokinetic parameters of budesonide following single-dose administration (e.g. AUC(0-infinity) 7.7+/-5.1 h ng/mL, C(max) 1.8+/-1.2 ng/mL) did not change upon multiple dosing. Overall systemic elimination of budesonide reflected by clearance and half-life was not different between children and adults. After 1 week of treatment reversible adrenal suppression was observed - most pronounced in children aged below 12 years. CONCLUSIONS Disposition of oral budesonide appears to be similar between children and adults, but the doctor has to be aware of an increased risk for adrenal suppression in paediatric patients.
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Laubereau B, Filipiak-Pittroff B, von Berg A, Grübl A, Reinhardt D, Wichmann HE, Koletzko S. Caesarean section and gastrointestinal symptoms, atopic dermatitis, and sensitisation during the first year of life. Arch Dis Child 2004; 89:993-7. [PMID: 15499049 PMCID: PMC1719727 DOI: 10.1136/adc.2003.043265] [Citation(s) in RCA: 89] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
AIMS To investigate the effect of caesarean section on gastrointestinal symptoms, atopic dermatitis, and sensitisation to nutritional allergens in infants. METHODS A total of 865 healthy full term neonates with parental history of allergy participating in the prospective German Infant Nutritional Intervention Program (GINI) were exclusively breast fed during the first four months of life and had a one year follow up. Data were obtained by follow up visits at age 1, 4, 8, and 12 months, weekly diaries for the first six months, and measurement of total and specific IgE at birth and 12 months. RESULTS Infants born by caesarean section (147/865, 17%) had a greater risk of diarrhoea (OR(adj) 1.46, 95% CI 1.022 to 2.10) and sensitisation to food allergens, both in adjusted (OR(adj) 2.06, 95% CI 1.123 to 3.80) and stratified analyses (by cord blood IgE). Caesarean delivery was not associated with colicky pain and atopic dermatitis. CONCLUSION Caesarean delivery might be a risk factor for diarrhoea and sensitisation in infants with family history of allergy. Further research in this area seems warranted as choosing caesarean section becomes increasingly popular.
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Koletzko S, Buderus S. Medikamentöse Therapie der gastroösophagealen Refluxkrankheit. Monatsschr Kinderheilkd 2004. [DOI: 10.1007/s00112-004-1012-2] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Laubereau B, Brockow I, Zirngibl A, Koletzko S, Gruebl A, von Berg A, Filipiak-Pittroff B, Berdel D, Bauer CP, Reinhardt D, Heinrich J, Wichmann HE. S39.3: Effect of breastfeeding on the development of atopic dermatitis during the first 3 years of life– results from the GINI - birth cohort study. Biom J 2004. [DOI: 10.1002/bimj.200490291] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
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Koletzko S, Konstantopoulos N, Bosman D, Feydt-Schmidt A, van der Ende A, Kalach N, Raymond J, Rüssmann H. Evaluation of a novel monoclonal enzyme immunoassay for detection of Helicobacter pylori antigen in stool from children. Gut 2003; 52:804-6. [PMID: 12740334 PMCID: PMC1773690 DOI: 10.1136/gut.52.6.804] [Citation(s) in RCA: 98] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
Abstract
BACKGROUND Reliable non-invasive methods for detection of Helicobacter pylori infection are required to investigate the incidence, transmission, and clearance of infection in childhood. AIM To evaluate a new monoclonal enzyme immunoassay (EIA) (FemtoLab H pylori Cnx) for detection of H pylori antigen in stool in a large cohort of children compared with invasive diagnostic methods and the (13)C urea breath test. PATIENTS AND METHODS A total of 302 symptomatic previously untreated children (aged 0.5-18.7 years; 148 girls) were recruited at three centres. H pylori status was defined by results of culture, histology, the rapid urease test, and the (13)C urea breath test. Stool samples were investigated locally by the EIA using two different production lots. According to the manufacturer's recommendations, an optical density (OD) of 0.150 was used as a cut off value. RESULTS OD values clearly differentiated between the 92 H pylori infected and the 210 non-infected children (median (5th-95th percentiles) 2.729 (0.232->4.000) v 0.021 (0.009-0.075)). Only two false positive and two false negative results occurred, giving a sensitivity, specificity, positive predictive value, and negative predictive value of 98%, 99%, 98%, and 99%, respectively. No significant relation was found between age and OD values in infected or non-infected children. CONCLUSIONS The monoclonal stool antigen EIA was excellent in diagnosing H pylori infection in symptomatic children. Accuracy was independent of the laboratory, production lot used, or the child's age. Because only 18/116 children <6 years of age were infected with H pylori, further validation of the test is needed in young infected children.
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