Acute urticaria (AU) is a common condition that often presents in childhood. Although there is a general perception of cyclic annual trends in AU, no one has tried to identify any seasonal variation on its prevalence and incidence, associate environmental influences and impute geographic, ethnic, or even genetic features that may contribute to its onset. We aimed to analyze the influence of climate and geographic parameters on annual fluctuation of AU cases referred to the Emergency Departments (EDs) of Norwich (UK) and Heraklion (Crete, Greece), compare all identifiable potential triggers and severity, and calculate the prevalence and incidence of AU. Record-based data of all children up to 14 yr of age referred to both EDs between June 2005 and May 2007 were examined retrospectively. Demographic characteristics and any potential identifiable triggers of AU were recorded and compared. Poisson's regression was utilized to examine any influence of meteorological parameters on AU incidence. Edwards' test for seasonality was applied to identify any significant seasonal trend of the AU incidence within each city. Seven hundred and twenty-nine AU cases were identified (324 in Norwich and 405 in Heraklion), among 56,624 total referrals (28,931 and 27,693 cases, respectively). Respiratory infections were found to be the most commonly associated potential triggers of AU and food allergens the least. AU cases and incidence rates in both cities were equally distributed during the study period. A non-significant seasonal trend in AU incidence (October, April-May) was observed in Norwich, in contrast to a significant seasonal pattern (December, February-May) of AU in Heraklion. Temperature was inversely associated with AU incidence, while the statistically significant effect of relative humidity varied. Acute childhood urticaria shows a similar epidemiological pattern in northern and southern Europe regardless of the expected differences in genetic, geographic, and environmental background. Temperature and humidity are correlated with AU incidence. Seasonality of several acute respiratory viral infections, the most prominent associated trigger of AU, coincides with the observed AU seasonality, suggesting a potential linkage. However, this needs to be elucidated from larger epidemiological studies.
In July 1998, a telemedicine link was established between the Venizelio General Hospital in Crete and the Paediatric Cardiology Department of the Aghia Sophia Children's Hospital in Athens. The telemedicine link used ISDN at 384 kbit/s for diagnosis, management and education in congenital heart disease. Over 18 months, a total of 39 teleconsultations were carried out, concerning 93 children with haemodynamically significant cardiac abnormalities. Forty-four children (47%) were managed locally after teleconsultation, while three children with transposition of the great arteries (3%) were transported as emergency cases to Athens in the first days of life. The other 46 children (50%) had a scheduled appointment at a tertiary centre for cardiac catheterization, angiocardiography, operative treatment or surgical repair. The telemedicine link brought a number of benefits, such as better access to the tertiary centre and the avoidance of patient transportation.
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As the life span of patients with cystic fibrosis (CF) has gradually increased, a variety of problems, like osteoporosis, have been recognized. Hypovitaminosis D, hypogonadism, lack of physical activity and chronic inflammation are some of the factors that contribute to the pathogenesis of bone disease in CF patients. Decreased absorption of vitamin K because of pancreatic insufficiency could be another risk factor for osteoporosis. The aim of the study was to determine the implication of vitamin K in the pathogenesis of osteoporosis in CF children and adolescent. We studied 20 patients with CF (ten boys) aged 6 to 7 years old and 25 healthy subjects of similar age and sex. All patients were evaluated before and 1 year after vitamin K supplementation. In all patients and controls serum carboxy-terminal propeptide of procolagen type I (PICP), amino-terminal propeptide of procolagen type I (PINP), bone alkaline phosphatase (sALP), osteocalcin (OC), cross-linked carboxy terminal telopeptide of type 1 collagen (ICTP), vitamin D, parathormone (PTH) and undercarboxylated osteocalcin (GLU-OC) were determined. Urine deoxypyridinoline/creatinine was also determined. Bone density was measured only in the patients using dual-energy x-ray absorptiometry (DEXA). Our results indicated that 55% of CF patients had osteoporosis. The supplemented patients showed: a)increase of bone density (0.789Ϯ0.149 than 0.737 Ϯ 0.151, pϽ0.0001), b) increase of PINP (579.35Ϯ275.11microg/l than 341.65Ϯ270.77microg/l, pϽ0.0001) c) increase of PICP (341.30Ϯ140.53 microg/l than 290.06Ϯ117.64microg/l, pϽ0.011) d)increase of sALP (51.75Ϯ14.94microg/l than 45.28Ϯ20.48 microg/l, pϽ0.024) e)increase of oc (26.22Ϯ14.25ng/ml than 15.45Ϯ11.62ng/ml, pϽ0.004) f)decrease of GLU-OC (2.28Ϯ3.93ng/ml than 6.60Ϯ6.24, pϽ0.004). According to our results, vitamin K supplementation in CF children and adolescent improves BMD by enhancing osteoblast activity. ESTROGEN ATTENUATES OLIGODENDROCYTE APOPTOSIS CAUSED BY HYPEROXIA DEPARTMENT OF NEONATOLOGY, BASEL UNIVERSITY CHILDREN'S HOSPITAL (SWITZERLAND)Background: In the developing human brain, periventricular leukomalacia (PVL) is the predominant white matter injury underlying the development of cerebral palsy. Our group recently showed that a rise of oxygen tissue tension is a powerful trigger to initiate apoptosis in premature and immature, but not in mature oligodendrocytes (OL). Estrogen plays an important role in the development and function of the cerebral nervous system, and estrogen receptors show a specific distribution with high density arround the third ventricle, the region where OL progenitors are generated. We therefore examined the effects of estrogen on hyperoxia-induced cell death in cultured rat immature oligodendroglia cells.Methods: OLN-93 cells, derived from spontaneously transformed cells of 5-to 10-day-old primary rat brain oligodendrocytes were subjected to 24 -72 h of hyperoxia (80% O2) in the presence or absence of estrogen (17beta-estradiol) at various concentrations. These immature oligodendr...
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