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  • 1
    ISSN: 1749-6632
    Quelle: Blackwell Publishing Journal Backfiles 1879-2005
    Thema: Allgemeine Naturwissenschaft
    Materialart: Digitale Medien
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  • 2
    Digitale Medien
    Digitale Medien
    Copenhagen : Munksgaard International Publishers
    Allergy 55 (2000), S. 0 
    ISSN: 1398-9995
    Quelle: Blackwell Publishing Journal Backfiles 1879-2005
    Thema: Medizin
    Notizen: Background: We aimed to investigate the influence of indoor factors on the prevalence of symptoms suggestive of atopic rhinitis in children aged 6–9 years in Upper Austria. Methods: We analyzed the results from an extended ISAAC (International Study of Asthma and Allergies in Childhood) questionnaire, answered by the parents, about indoor environment and symptoms strongly suggesting atopic rhinitis. This was defined as having reported a running, obstructed, or itchy nose apart from having a cold in the last year. The overall response rate was 93.4%. After excluding 6016 children (17.1%) with changed indoor environment (due to allergies in the family), we analyzed the remaining subsample of 18606 questionnaires. Results: The following factors were associated with an increased risk: mother's smoking during pregnancy and/or during time of breast-feeding (OR 1.28; CI 1.07–1.52), synthetic bedding (OR 1.21; CI 1.09–1.36), dampness/mold at home (OR 1.51; CI 1.31–1.74), central heating with gas (OR 1.75; CI 1.06–2.87), and space heating (OR 1.66; CI 1.01–2.98). Cooking with wood (OR 0.62; CI 0.46–0.84) was negatively associated with symptoms. Conclusions: The indoor environment plays a role in the symptoms of atopic rhinitis in children. However, the population-attributable risks were not particularly high; they were between −2.7% and 9% for the various exposures considered in this study.
    Materialart: Digitale Medien
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  • 3
    Digitale Medien
    Digitale Medien
    Oxford, UK : Blackwell Science Ltd
    Alimentary pharmacology & therapeutics 18 (2003), S. 0 
    ISSN: 1365-2036
    Quelle: Blackwell Publishing Journal Backfiles 1879-2005
    Thema: Medizin
    Notizen: Background : Antibiotics and thiopurines have been employed in the management of fistulizing Crohn's disease, although evidence of their efficacy is rare.Aim : To evaluate, in a prospective, open-label study, the influence of antibiotics and azathioprine on the clinical outcome of perianal fistulas in patients with Crohn's disease.Methods : Fifty-two patients entered the study, starting with an 8-week regimen of ciprofloxacin (500–1000 mg/day) and/or metronidazole (1000–1500 mg/day). Seventeen patients had already received daily azathioprine (2–2.5 mg/kg) at enrolment, whereas in 14 patients azathioprine was initiated after 8 weeks of antibiotic treatment. Outcome was evaluated by Fistula Drainage Assessment and the Perianal Disease Activity Index at weeks 8 and 20.Results : Overall, 26 patients (50%) responded to antibiotic treatment, with complete healing in 25% of patients at week 8. The Perianal Disease Activity Index decreased significantly from 8.4 ± 2.9 to 6.0 ± 4.0 (P 〈 0.0001). At week 20, the outcome was assessed in 49 patients (94%), 29 of whom (59%) had received azathioprine. Response was noted in 17 of the 49 patients (35%), with complete healing in nine patients (18%). Patients who received azathioprine were more likely to achieve a response (48%) than those without immunosuppression (15%) (P = 0.03). The Perianal Disease Activity Index was closely associated with treatment response and perianal disease activity.Conclusion : Antibiotics are useful to induce a short-term response in perianal Crohn's disease, and may provide a bridging strategy to azathioprine, which seems to be essential for the maintenance of fistula improvement.
    Materialart: Digitale Medien
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  • 4
    ISSN: 1365-2036
    Quelle: Blackwell Publishing Journal Backfiles 1879-2005
    Thema: Medizin
    Notizen: Background: Conventional non-steroidal anti-inflammatory drugs have been associated with an increased risk of exacerbation of inflammatory bowel disease.Aim: To evaluate, in a prospective, open-label study, the safety and efficacy of a 20-day regimen of the selective cyclo-oxygenase-2 inhibitor, rofecoxib, 12.5–25 mg/day, in inflammatory bowel disease patients with associated peripheral arthropathy and/or arthritis.Methods: Patients with clinically inactive to mild inflammatory bowel disease and a joint pain score of at least two points on a scale ranging from zero (none) to four (very poor) were eligible. Response was defined by a decrease of at least two points in the arthralgia score.Results: Of the 32 patients included, 26 (81%) were treated with rofecoxib, 25 mg/day, and six (19%) with rofecoxib, 12.5 mg/day. In three patients (9%), rofecoxib had to be withdrawn after a few days due to gastrointestinal complaints which ceased immediately after drug discontinuation. No flare of inflammatory bowel disease occurred. Thirteen of the 32 patients (41%) were responders and, overall, the arthralgia score decreased from two to one (P = 0.0001).Conclusions: This is the first prospective study on the use of a selective cyclo-oxygenase-2 inhibitor in inflammatory bowel disease patients with peripheral arthropathy and/or arthralgia. The promising safety and efficacy profile warrants further evaluation in controlled trials.
    Materialart: Digitale Medien
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  • 5
    ISSN: 1365-2036
    Quelle: Blackwell Publishing Journal Backfiles 1879-2005
    Thema: Medizin
    Notizen: Extracorporeal photochemotherapy has been proven effective in selected T-cell mediated diseases.〈section xml:id="abs1-2"〉〈title type="main"〉Aim:To evaluate the safety and efficacy of extracorporeal photochemotherapy in patients with steroid-dependent Crohn’s disease by an open, monocentric trial in three phases of 24 weeks each.〈section xml:id="abs1-3"〉〈title type="main"〉Methods:In phase 1 standardized steroid tapering was initiated in patients with a history of steroid-dependent Crohn’s disease. Those with a prospectively evaluated maintenance dose of at least 10 mg/day prednisolone continued steroid-withdrawal under the application of extracorporeal photochemotherapy in phase 2. The duration of remission or response was followed during phase 3. Colonic tissue bioptically obtained before and after extracorporeal photochemotherapy was studied by immunofluorescence microscopy for the presence of photoadduct positive cells.〈section xml:id="abs1-4"〉〈title type="main"〉Results:Out of 24 patients included in phase 1, 10 entered phase 2 for extracorporeal photochemotherapy. Four subjects achieved remission and four others response. Significant reductions in serum C-reactive protein levels and intestinal permeability were measured, as well as increases in quality of life and plasma adrenocorticotropic hormone levels. No major side-effects were observed. Remission remained stable in three out of four patients during phase 3. In three patients, positive nuclear stainings of photoadducts were detected in colonic mononuclear cells after extracorporeal photochemotherapy.〈section xml:id="abs1-5"〉〈title type="main"〉Conclusions:Extracorporeal photochemotherapy represents a safe steroid-sparing approach in patients with Crohn’s disease and is associated with intestinal homing of photopheresed cells.
    Materialart: Digitale Medien
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  • 6
    Digitale Medien
    Digitale Medien
    Springer
    Monatsschrift Kinderheilkunde 148 (2000), S. 343-347 
    ISSN: 1433-0474
    Schlagwort(e): Schlüsselwörter Stillen ; ISAAC ; Atopie ; Prädisposition ; Key words Breastfeeding ; ISAAC ; Atopy ; Predisposition
    Quelle: Springer Online Journal Archives 1860-2000
    Thema: Medizin
    Beschreibung / Inhaltsverzeichnis: Summary Background and methods: As part of the population – based ISAAC (International Study of Asthma and Allergy in Childhood) study conducted in Upper Austria we analyed breastfeeding and its effects on the development of atopic diseases in children up to the age of 6–9 years. Results: 74.6% of the parents reported breastfeeding their children; 25.9% of the children were breastfed for less than 2 months, 25.9% for 2 to 4 months, the recommended duration of exclusive breastfeeding for 5–6 months was followed by 13.2% of the mothers, and 10.4% of the children were exclusively breastfed for more than 6 months. Smoking during pregnancy and low educational level were inversly related to breastfeeding and the duration of exclusive breastfeeding. 23.8% of children were classified risk-children (one first grade relative with at least one atopic disease), 7.2% of children were classified high-risk children ( more than one first grade relative with an atopic disease). Discussion: In comparison to children without family predisposition, risk and high risk-children were breastfed both more often and also for a longer period of time. A protective effect of breastfeeding was only found for the prevalence of allergic rhinitis. We found no significant relation between asthma or atopic eczema and breastfeeding and dura-tion of exclusive breastfeeding respectively.
    Notizen: Zusammenfassung Hintergrund und Methode: Im Rahmen einer ISAAC(International Study of Asthma and Allergy in Childhood)-Vollerhebung in Oberösterreich wurden die Stillgewohnheiten von Müttern und die Auswirkung des Stillverhaltens auf das Auftreten atopischer Erkrankungen der Kinder bis zum Alter von 6–9 Jahren analysiert. Ergebnisse: Insgesamt gaben 74,6% der Eltern (retrospektiv mittels Fragebogen) Stillen als Ernährungsform ihrer Kinder an; jeweils 25,9% der Kinder wurden weniger als 2 Monate bzw. 2–4 Monate ausschließlich mit Muttermilch ernährt, an die empfohlene Stilldauer von 5–6 Monaten hielten sich 13,2% der Mütter und 10,4% der Kinder wurden mehr als 6 Monate gestillt. Rauchen der Mutter und niedrige Bildung der Eltern zeigten eine signifikant inverse Beziehung zu Stillprävalenz und Stilldauer. 23,8% der Kinder wurden als Risikokinder (1 Verwandter 1. Grads mit zumindest einer atopischen Erkrankung) eingestuft, 7,2% der Kinder wurden als Hochrisikokinder (mehr als 1 Verwandter 1. Grads mit atopischer Erkrankung) bezeichnet. Diskussion: Im Vergleich zu Kindern ohne familiäre Belastung wurden Risikokinder und Hochrisikokinder signifikant häufiger und länger gestillt. Eine protektive Wirkung des Stillens konnte allerdings nur für das Auftreten einer allergischen Rhinitis festgestellt werden. Zwischen Stillverhalten bzw. Stilldauer und dem Auftreten von Asthma bronchiale und atopischem Ekzem bis zum Alter von 6–9 Jahren konnte kein signifikanter Zusammenhang gefunden werden.
    Materialart: Digitale Medien
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  • 7
    ISSN: 1432-1076
    Schlagwort(e): Key words Growth hormone therapy ; Normal variant short stature ; Height prediction ; Target height
    Quelle: Springer Online Journal Archives 1860-2000
    Thema: Medizin
    Notizen: Abstract Seventeen children with normal variant short stature and a predicted height below −2 SDS were treated with growth hormone (GH) six times a week for a period of 5 years. Patients were randomly selected to receive three different doses of GH, group 1 (n=6) 3␣IU/m2 per day, group 2 (n=6) 4.5 IU/m2 per day and group 3 (n=5) 3 IU/m2 per day in the 1st year and 4.5␣IU/m2 per day thereafter. There was a significant increase in height after 1 and 2 years for all patients and for all subgroups. However, this increase was not dependent on GH dose. The decrease in height velocity during the 2nd year was not prevented by the increase of GH dose in group 3. The change of predicted height after 2 years was +0.75 SDS (according to Tanner Whitehouse). Fourteen children have been treated for 4␣years and 8 children for 5 years without a further change in height prediction. Nine patients have reached final height which was 2.4 cm (+0.41 SDS) above pretreatment height prediction. Final height was nearly identical to predicted height after 1 year of therapy. Conclusion An increment in height prediction was observed during the first 2 years of GH treatment and maintained thereafter. However, there was only a minor increase in final height over predicted height which does not justify the general use of GH in children with normal variant short stature.
    Materialart: Digitale Medien
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  • 8
    ISSN: 1432-1076
    Schlagwort(e): Key words Turner syndrome ; Growth hormone ; Anabolic steroids ; IGF-I ; IGFBP-3
    Quelle: Springer Online Journal Archives 1860-2000
    Thema: Medizin
    Notizen: Abstract Thirty-nine girls with Ullrich-Turner syndrome (UTS) (median age 9.5 years) were treated with growth hormone (GH) with either 12 or 18 IU/m2 per week for 12 months followed by combination therapy with either oxandrolone (Ox) (0.0625 mg/kg/day po) or low-dose testosterone (T) (5 mg im every 2 weeks). Growth velocity improved significantly after 12 IU/m2 per week (6.4 ± 1.7 cm/year vs 4.0 ± 1.3 cm/year, x ± SD, P 〈 0.001) and 18 IU/m2 per week of GH (6.5 ± 1.3 cm/year vs 4.5 ± 1.4 cm/year, P 〈 0.001). Ox, but not T was effective in maintaining growth velocity during the 2nd year of therapy (6.9 ± 1.3 vs 5.3 ± 1.5 cm/year). Basal insulin-like growth factor-I (IGF-I) concentrations were in the lower normal range and increased significantly in patients treated with 18 IU/m2 per week (357 ± 180 ng/ml vs 160 ± 84 ng/ml) and 12 IU/m2 per week (273 ± 121 ng/ml vs 140 ± 77 ng/ml). IGF-I concentrations increased further after addition of Ox (533 ± 124 ng/ml, P 〈 0.001) or T (458 ± 158, P 〈 0.05). IGFBP-3 concentrations were in the upper normal range before therapy and increased only moderately in both GH dosage groups. However, IGF binding protein-3 (IGFBP-3) concentrations were not affected by additional Ox or T treatment. Conclusions 1. Conventional GH doses are effective in increasing growth velocity in UTS, especially, when combined with Ox. This additive effect is not evident when GH is combined with low dose T. 2. Changes in growth velocity are accompanied by an increase of the IGF-I/IGFBP-3 ratio. 3. Ox obviously acts by increasing IGF-I levels independent of the GH status.
    Materialart: Digitale Medien
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  • 9
    Digitale Medien
    Digitale Medien
    Springer
    European journal of pediatrics 158 (1999), S. 362-366 
    ISSN: 1432-1076
    Schlagwort(e): Key words Type 1 diabetes ; Children ; Risk factors ; Case control ; Environmental
    Quelle: Springer Online Journal Archives 1860-2000
    Thema: Medizin
    Notizen: Abstract The aim of this study was to investigate environmental risk factors in the development of type 1 diabetes mellitus in a population-based case-control study. Parents of all patients with manifestation of type 1 diabetes between 1989 and 1994 in Vienna were asked to complete a questionnaire (n = 114). Control children (n = 495), matched for age and sex, were randomly recruited from all schools in Vienna. Fathers of diabetic children were significantly older at the time their children were born than fathers of control children (P = 0.015). Children with diabetes were more likely to be second- or third-born children (P 〈 0.05) and fewer went to kindergarten than the control group children (P = 0.007). No significant difference in duration of gestation, percentage of delivery by caesarean section, birth weight or length was found. Neonatal jaundice was more often observed in the patient group (P = 0.038). Breast feeding was reported by 82.7% of mothers of diabetic children and by 81% of mothers of control children, and the duration of breast feeding was longer in patients than in controls (n.s.). Conclusion In our study, the development of type 1 diabetes mellitus was associated with higher paternal age and neonatal jaundice. No correlation could be found with dietary intake of cow's milk products in early infancy, vaccination and other environmental factors.
    Materialart: Digitale Medien
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  • 10
    ISSN: 1432-1076
    Schlagwort(e): Key words Ullrich-Turner syndrome  ;  Growth hormone therapy  ;  Thyroid hormone regulation  ;  Insulin-like growth factor I
    Quelle: Springer Online Journal Archives 1860-2000
    Thema: Medizin
    Notizen: Abstract  Administration of human growth hormone (GH) has yielded conflicting results concerning its role on thyroid function in patients with Ullrich-Turner syndrome. Therefore, we investigated the course of thyroid hormone parameters and thyroxin binding globulin in relation to GH therapy, IGF-I and additional oxandrolone-(Ox) or testosterone (T) treatment in 20 patients with Ullrich-Turner syndrome. During the 1st year the patients received only GH. There was no change in T4, fT4, and TSH levels, T3 increased significantly (P 〈  0.01) after 6 and 12 months, resulting in a higher T3/T4 ratio. TBG (P 〈 0.05) and IGF-I (P 〈 0.01) increased after 6 months and remained elevated at 12 months. A significant positive correlation was found between the change of T4 and TBG after 6 months (r = 0.47, P 〈 0.05) and after 12 months (r = 0.69, P 〈 0.005). Thirteen patients were further investigated after addition of an anabolic compound; 7 received Ox (0.0625 mg/kg/day po) and 6 low dose T (5 mg i.m. every 14 days). Chronological age was comparable in these groups (10.7 ±  2.7 vs 10.7  ± 3.6 years). After 6 months of combination therapy with Ox, T4, T3 and TSH decreased. As T4 and T3 showed a parallel decrease the T3/T4 ratio remained elevated. TBG declined after 6 and 12 months (P 〈 0.05), while IGF-I showed a further increment (P 〈 0.05). There was no correlation between the changes in T4 and IGF-I, TSH and TBG, respectively. In the T-treated group only IGF-I increased (P 〈 0.05) to the same extent as in the Ox-treated patients, whereas the thyroid parameters did not change. Conclusion The observed changes in thyroid hormone and TBG levels in the Ox group were not mediated by GH or IGF-I. The Ox-induced TBG decrease might be linked to altered pancreatic functions regulating carbo-hydrate metabolism.
    Materialart: Digitale Medien
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