Refine
Year of publication
Document Type
- Doctoral Thesis (67)
- Article (27)
Has Fulltext
- yes (94)
Is part of the Bibliography
- no (94)
Keywords
- - (12)
- Immuntherapie (7)
- Neuroblastom (7)
- Schwangerschaft (7)
- neuroblastoma (7)
- Frühgeborene (6)
- Muttermilch (6)
- immunotherapy (6)
- Fettsucht (5)
- Frühgeborenes (5)
- Kind (5)
- Neugeborene (5)
- Neugeborenes (5)
- SNiP (4)
- children (4)
- dinutuximab beta (4)
- Adipositas (3)
- Impfung (3)
- Screening (3)
- ch14.18/CHO (3)
- pregnancy (3)
- preterm infants (3)
- Apoptosis (2)
- Body-Mass-Index (2)
- Cytokine (2)
- Ernährung (2)
- Fortifier (2)
- Frühgeburt (2)
- GD2 (2)
- Geburtsgewicht (2)
- Gehirn (2)
- Jugend (2)
- Kinder (2)
- Masern (2)
- Metabolische Azidose (2)
- Morbidität (2)
- Neugeborenenscreening (2)
- Polymorphismus (2)
- Prävention (2)
- SNP (2)
- Schwangerschaftsvorsorge (2)
- Sepsis (2)
- Sterblichkeit (2)
- Survey of Neonates in Pomerania (2)
- TRAIL (2)
- Ultraschall (2)
- Vorsorge (2)
- Wachstum (2)
- asthma (2)
- exacerbation (2)
- fortifier (2)
- growth (2)
- outcome (2)
- preterm infant (2)
- 5-FU (1)
- A549 (1)
- AEBSF (1)
- Acylcarnitine (1)
- Anthropometrie (1)
- Anti-Idiotyp (1)
- Anti-idiotypic vaccines (1)
- Anti-idiotypischer Antikörper (1)
- Antikörperbildung (1)
- Antisense oligonucleotides (1)
- Antoxidant capacity (1)
- Asthma bronchiale (1)
- Asthmatiker (1)
- Asthmatod (1)
- B cell class switch (1)
- BRD <Begriff> (1)
- Bayesian (1)
- Bcl-2 (1)
- Bcl-xL (1)
- Beatmung (1)
- Behandlungserfolg (1)
- Besiedlung (1)
- Bilirubinmessung (1)
- Blutgasanalyse (1)
- Bluttransfusion, Frühgeburt, Neonatologie (1)
- Body composition (1)
- Brain maturation (1)
- Breast milk (1)
- C-reactive protein (1)
- CD11b (1)
- Chemotherapie (1)
- Chlamydophila pneumoniae (1)
- Cholesterin (1)
- Cholesterol (1)
- Colaizzi (1)
- Congenital Malformations (1)
- DAOY (1)
- DEXA (1)
- DEXA-Messung (1)
- DNA-Vakzinierung (1)
- Dehydroepiandrosteron (1)
- Deutschland <Östliche Länder> (1)
- Diabetes (1)
- Diagnose (1)
- Dinutuximab beta (1)
- Diphosphonate (1)
- Disialogangliosid (1)
- Dual Energy X- Ray Absorbtiometrie DEXA (1)
- Durchimpfungsrate (1)
- Einflussfaktoren (1)
- Elektroencephalogramm (1)
- Embryopathie (1)
- Encephalitis (1)
- Entropie (1)
- Entropy (1)
- Entwicklungsdiagnostik (1)
- Epilepsie (1)
- Ergebnis (1)
- Ernährung von Frühgeborenen (1)
- Essen (1)
- Estradiol (1)
- Ewing-Sarkom (1)
- FAP-IL-2v (1)
- FCGR polymorphism (1)
- FLIP (1)
- Fc gamma receptor (1)
- Fehlbildung (1)
- Fetal zone steroids (1)
- Fetopathia diabetica (1)
- Fetopathie (1)
- Fett (1)
- Fettleibigkeit (1)
- Fettmasse (1)
- Fischöl (1)
- Fish oil (1)
- Flavanols (1)
- Fortifizierung (1)
- Fortifizierungsstrategien (1)
- Frauenmilch (1)
- Funktionelle Kernspintomografie (1)
- Funktionelle NMR-Tomographie (1)
- Ganglidiomab (1)
- Geburt (1)
- Gefühl (1)
- Gehirnentwicklung (1)
- Gestationsdiabetes (1)
- Gesundheit (1)
- Gesundheitsrisiko (1)
- Gesundheitsverhalten (1)
- Gewichtsentwicklung (1)
- Gewichtsverlust (1)
- Gewichtszunahme (1)
- Glia (1)
- Glucocorticosteroide (1)
- Greifswald / Zentrum für Kinder- und Jugendmedizin Greifswald (1)
- Grenzwerte (1)
- HACA (1)
- HCMV (1)
- HLA-System (1)
- Hausärzte (1)
- Hepatitis B (1)
- Heteroduplexanalyse (1)
- Hirnentwicklung (1)
- Hirnhautentzündung (1)
- Histon-Deacetylase (1)
- Histondeacetylase-Inhibitoren (1)
- Histondeacetylaseinhibitoren (1)
- Histone (1)
- Histonedeacetylaseinhibitor (1)
- Hydronephrose (1)
- Hyperglykämie (1)
- Hyperoxie (1)
- Hütgelenksdysplasie (1)
- IGF-II (1)
- IL-6 (1)
- IUGR (1)
- Immunsystem (1)
- Impfstoff (1)
- Impftermine (1)
- Impfverhalten (1)
- Infektion (1)
- Infektionskrankheit (1)
- Inhibition (1)
- Intensivstation (1)
- Interleukin 2 (1)
- Interleukin 6 (1)
- Interreg (1)
- Iod (1)
- Iodausscheidung (1)
- Isoflavones (1)
- JIA (1)
- Juvenile Idiopathische Arthritis (1)
- KIR mismatch (1)
- KIR/HLA mismatch (1)
- Kernspintomografie (1)
- Keuchhusten (1)
- Kinderlähmung (1)
- Klassifikation nach Schwangerschaftsdauer und Geburtsgewicht (1)
- Klonogenes Überleben (1)
- Knochendichte (1)
- Knochenmarktransplantation (1)
- Knochenmineralgehalt (1)
- Kohorte (1)
- Koordinationsstörung (1)
- Krankheitsverlauf (1)
- Kurzfristige Prognose (1)
- Körperfettgehalt (1)
- Körperzusammensetzung (1)
- Langfristige Prognose (1)
- Late-onset-sepsis (1)
- Lipid emulsions (1)
- Lipidemulsionen (1)
- Lungenkrebs (1)
- MDSCs (1)
- MIF (1)
- MRI (1)
- Macrophage Migration Inhibitory Factor (1)
- Makronährstoffgehalt (1)
- Maternal pre-pregnancy overweight and obesity (1)
- Maternal pre-pregnancy underweight (1)
- Mecklenburg-Vorpommern (1)
- Medulloblastom (1)
- Meningitis (1)
- Mikrowellen (1)
- Mimotop (1)
- Missbildung (1)
- Mortalität (1)
- Motorik (1)
- Mukoviszidose (1)
- Muttermilchsupplement (1)
- Mutterschaftsrichtlinien (1)
- NEC, Nekrotisierende Enterokolitis, Transfusion, VLBW, Frühgeburt, Very-Low-Birth-Weight-Frühgeborene, Neonatologie (1)
- NK cells (1)
- NMR-Tomographie (1)
- NPC 15437 (1)
- Nabelschnurblut (1)
- Neonaten (1)
- Neonatologie (1)
- Neugeborenengelbsucht (1)
- Neugeborenensepsis (1)
- Neuroblastoma (1)
- Neuroprotektion (1)
- Neutrophil Extracellular Traps (1)
- Nierenfunktionsstörung (1)
- Nierenkrankheit (1)
- Obesity (1)
- Offspring’s development (1)
- Offspring’s health (1)
- Offspring’s social behavior (1)
- Optimierung von Muttermilch (1)
- PD-L1 (1)
- PKC(eta) (1)
- Parenteral nutrition (1)
- Parenterale Ernährung (1)
- Pasteurisierung (1)
- Pediatrics (1)
- Peptidom (1)
- Permutation (1)
- Perzentil (1)
- Phorbolester (1)
- Pneumokokken (1)
- Preterm infants (1)
- Promotorpolymorphismus (1)
- Prostatakrebs (1)
- Proteinkinase C (1)
- Präfrontaler Cortex (1)
- Pädiatrische Onkologie (1)
- Rцntgenabsorptionsspektroskopie (1)
- RFLP (1)
- RV (1)
- Resistenzfaktor (1)
- Rezeptor (1)
- Risikofaktoren für Frühgeburtlichkeit (1)
- SGA (1)
- SNiP study (1)
- SNiP-Studie (1)
- SSCP (1)
- Schwangere (1)
- Schwangerschaftsdiabetes (1)
- Schädelsonographie (1)
- Score (1)
- Serinprotease (1)
- Severe asthma (1)
- Shiny application (1)
- Soy (1)
- Sport (1)
- Statine (1)
- Studiendesign (1)
- Symptom (1)
- Säugling (1)
- Säure-Base-Gleichgewicht (1)
- T cell maturation (1)
- TIGIT (1)
- Tea (1)
- Therapie (1)
- Toxoplasmose (1)
- Transplantat-Wirt-Reaktion (1)
- Triglyceride (1)
- Tumor-Nekrose-Faktor (1)
- Untergewicht (1)
- Very low birthweight infants (1)
- Vorinostat (1)
- Vorsorgeverhalten (1)
- Wundstarrkrampf (1)
- Zelllinie (1)
- Zwillingskollektiv mit Fehlbildungen (1)
- acylcarnitine (1)
- airways (1)
- allergy (1)
- antenatal care (1)
- anti-GD2 antibody (1)
- anti-GD<sub>2</sub> immunotherapy (1)
- anti-idiotype (1)
- apoptosis (1)
- apoptosis-associated speck-like protein (ASC) (1)
- asthmadeath (1)
- autoinflammation (1)
- bilirubin measurement (1)
- binational medicine (1)
- biomarker (1)
- blood gas analysis (1)
- body composition (1)
- body mass index (1)
- bone mineral content (1)
- bone mineralization (1)
- breast milk (1)
- breast milk supplementation (1)
- calprotectin (1)
- carbohydrates (1)
- case report (1)
- ch14.18 (1)
- child health (1)
- childhood (1)
- clonogenic survival (1)
- complement dependent cytotoxicity (1)
- complication (1)
- cross border education (1)
- cytokine (1)
- data mining (1)
- diabetes (1)
- diagnostic support (1)
- diagnostics (1)
- dinutuximab (1)
- disease behavior (1)
- dopaminerges System (1)
- dual energy x-ray absorbtiometry DXA (1)
- dual energy x-ray absorptiometry (1)
- ductal closure (1)
- endocarditis (1)
- endoscopy (1)
- epigenome (1)
- extracellular traps (1)
- fat (1)
- fat mass (1)
- fibroblast activation protein α (1)
- flow cytometry – methods (1)
- funding (1)
- fusarium (1)
- gestational diabetes (1)
- gut–lung axis (1)
- healtcare (1)
- health behavior (1)
- hematopoietic stem cell transplantation (1)
- hexavalent vaccine (1)
- hexavalenter Impfstoff (1)
- high risk asthmatics (1)
- high-risk neuroblastoma (1)
- histone (1)
- histone deacetylase inhibitor (1)
- hospitalization (1)
- human milk (1)
- humanized mice (1)
- ibuprofen (1)
- immunity (1)
- indomethacin (1)
- infant (1)
- inflammasome (1)
- inflammation (1)
- inflammatory bowel disease (1)
- inhibition (1)
- intervention (1)
- invasive mold infection (1)
- juvenile idiopathic arthritis (1)
- linear discriminant analyses (1)
- lipids (1)
- long-term infusion (1)
- management (1)
- maternal deseases (1)
- maternale Erkrankungen (1)
- medical accessoires (1)
- medizinische Accessoires (1)
- metabolic acidosis (1)
- metabolic risk factors (1)
- microarray (1)
- milk analysis (1)
- mimotope (1)
- mitochondria (1)
- molecular (1)
- monitoring (1)
- monocytes (1)
- morbidity (1)
- mortality (1)
- mycoses (1)
- myeloid regulatory cells (1)
- myeloid-derived suppressor cells (1)
- myr-PKCε V1-2 (1)
- neonate (1)
- neonates (1)
- neurological outcome (1)
- neurologisches Outcome (1)
- neurotoxicity (1)
- neutrophils (1)
- niedergelassene Ärzte (1)
- nosokomial (1)
- nutritional status (1)
- obesity (1)
- oligodendrocyte precursor cells (1)
- optical imaging analyses (1)
- ordinal regression model (1)
- pain (1)
- patent ductus arteriosus (1)
- pediatric oncology and hematology (1)
- perianal disease (1)
- peripartale Pathologien (1)
- physician vaccination attitude (1)
- platelets (1)
- population‐based birth cohort (1)
- prediction (1)
- premature (1)
- prematurity (1)
- primary immunodeficiency disease (1)
- principal component analyses (1)
- protein (1)
- public health (1)
- pulmonary function tests (1)
- questionnaire (1)
- randomised (1)
- reactivation (1)
- rhinovirus (1)
- rhinovirus A (1)
- rhinovirus B (1)
- rhinovirus C (1)
- risk factors for preterm birth (1)
- schweres Asthma (1)
- sepsis (1)
- serine protease (1)
- single-chain variable fragments (1)
- splenic rupture (1)
- standard fortification (1)
- study design (1)
- surgery (1)
- survey of neonates in pomerania (1)
- telemedicine (1)
- termingerechte Umsetzung (1)
- transplantation (1)
- tumor necrosis factor-related apoptosis-inducing ligand (TRAIL) (1)
- urine (1)
- vaccination coverage (1)
- ventilation (1)
- virus infection (1)
- weight gain (1)
- wheeze (1)
- zeitgerecht (1)
- Übergewicht (1)
- ärztliche Impfeinstellung (1)
Institute
- Klinik und Poliklinik für Kinder- und Jugendmedizin (94) (remove)
Publisher
- MDPI (10)
- Frontiers Media S.A. (9)
- BioMed Central (BMC) (2)
- Wiley (2)
- Hindawi (1)
- Nature Publishing Group (1)
- S. Karger AG (1)
- Springer Nature (1)
Ziel. Das Ziel dieser Arbeit bestand darin, mit Hilfe des Survey of Neonates in Pomerania
(SNiP) einen umfassenden Überblick über die Schwangerenvorsorge in Mecklenburg-
Vorpommern zu geben.
Methode. Analysiert wurden die Daten von 4092 Schwangeren aus den Jahren 2004 bis 2008
des populationsbasierten Survey of Neonates in Pomerania.
Ergebnisse. Die Teilnahmequote an serologischen und sonographischen Screenings lag
zwischen 91 % bis 99 %. Die erste Vorsorgeuntersuchung erfolgte durchschnittlich in der
10. Schwangerschaftswoche (SD = 3.8 Schwangerschaftswochen). 3382 (86.1 %) Frauen
nahmen an mindestens zehn der nach den Mutterschaftsrichtlinien vorgesehenen
Vorsorgeuntersuchungen teil (Standardvorsorge). Bei 547 (13.9 %) Schwangeren erfolgte eine
Vorsorge unter Standard. Signifikante Prädiktoren für eine Unterversorgung waren eine
niedrige mütterliche Schulbildung (relatives Risikoratio [RRR] = 2.5, 95 % CI 1.6 – 3.8), das
mütterliche Alter und die Parität (χ2(6) = 24.923, p < .001). Die Gesundheitsprävention,
gemessen an Supplementeinnahme (Jod: χ2(3) = 125.934, p < .001; Folsäure: χ2(3) = 222.798,
p < .001) und Wahrnehmung schwangerschaftsbegleitender Angebote
(Geburtsvorbereitungskurse, Vorstellung in der Geburtsklinik, χ2(3) = 385.279, p < .001) hing
ebenfalls von der mütterlichen Bildung ab. Negative Einflüsse auf die Schwangerschaft standen
im Zusammenhang zum Einkommen. Das Risiko zu rauchen (OR 0.19, 95 % CI 0.15 – 0.24)
sank ebenso wie der BMI (Coef. = -.83, p < .000) mit der Höhe des Einkommens. Der
Alkoholkonsum dagegen stieg bei höherem Einkommen (OR 1.30, 95 % CI 1.15 – 1.48) an.
Schlussfolgerungen. Die Schwangerschaftsvorsorge ist in Mecklenburg-Vorpommern gut
etabliert. Dennoch sollten vermehrt präventive Ansätze gerade für jüngere Schwangere und für
diejenigen mit geringerer Schulbildung und niedrigerem Einkommen in den Vordergrund
gerückt werden, um auch hier optimale Bedingungen in der Schwangerschaft, bei der Geburt
und für das künftige Leben des Kindes zu schaffen.
Frauenmilch ist die beste Nahrung in den ersten sechs Lebensmonaten. Bioaktive Peptide in der Muttermilch scheinen eine große Rolle bezüglich deren präventiver Wirkung zu spielen. In den letzten Jahren hat sich die Methode der Massenspektrometrie zur Erforschung des Peptidoms rasant entwickelt. Aber es fehlt noch an Grundlagenforschung und einheitlichen Protokollen zur präanalytischen Verarbeitung der Muttermilchproben. Studien sind daher nur bedingt vergleichbar. Nicht nur für die Wissenschaft, sondern auch im klinischen Kontext ist es für den Einsatz von Spenderfrauenmilch erforderlich, den Einfluss verschiedener Lagerungsbedingungen auf das Muttermilchpeptidom zu kennen.
Im Rahmen der vorliegenden Studie wurden anhand der Muttermilchproben von vier Spenderinnen vier verschiedene Lagerungsbedingungen mit anschließender Lagerung bei –80 °C, die im klinischen Alltag (Lagerung bei –20 °C für 120 h), beim Transport von Muttermilchproben (Lagerung bei 4 °C für 6 h) oder in der häuslichen Umgebung der Frauen (Lagerung bei Raumtemperatur für 24 h bzw. 4 h) vorkommen, untersucht. Die Pro-ben wurden mit direkt bei –80 °C gelagerten Proben verglichen.
Die Ergebnisse zeigen eine sinkende Anzahl an identifizierbaren Proteinen mit steigender Temperatur. Vor allem nach der Lagerung bei Raumtemperatur über 24 h nahm die Signalintensität vieler Peptide entweder ab oder die Peptide verschwanden komplett. Eine Erklärung könnte sein, dass die in der Muttermilch enthaltenen Proteasen bei Raumtemperatur weiterhin aktiv sind und zur proteolytischen Spaltung der Proteine führen.
Aufgrund der vorliegenden Ergebnisse ist zu empfehlen, Frauenmilch für Peptidomstudien direkt bei mindestens –20 °C zu lagern und im Anschluss bei –80 °C einzufrieren. Im klinischen Umgang mit Muttermilch müssen zusätzlich die negativen Einflüsse der Lagerung bei niedrigen Temperaturen berücksichtigt werden. Von einer bis zu 24-stündigen Lagerung bei Raumtemperatur, ist dringend abzuraten.
Research has already shown that the maternal anthropometry affects birth weight. The impact on birth weight, body length and head circumference percentiles was not yet investigated. The aim of our observational studies was to develop individualized percentile charts (birth weight, body length and head circumference) for neonates based on maternal weight and height. To achieve this, we analyzed data of 2.2 million newborns stratified by maternal height and weight from the German Perinatal Survey.
The percentiles based on 18 groups stratified by maternal anthropometry for both sexes showed significant differences between identical original percentiles. The differences were up to almost 800 g between identical percentiles for petite and grande mothers. Birth length differed by several centimeters for the same percentiles between groups of short and tall stature mothers, whereas birth head circumference differed up to 1.2 cm.
Our analysis showed that maternal anthropometry has a significant effect on the classification of newborns as LGA (large for gestational age), AGA (appropriate for gestational age) and SGA (small for gestational age). Individualized charts show higher specificity than percentile charts that do not include those data and provide more individual prediction of perinatal risks.
Das Neuroblastom (NB) stellt als Tumor des sympathischen Nervenstranges den häufigsten extrakraniellen soliden Tumor des Kindesalters dar. Ein Bedarf innovativer Therapien, welche eine effektive Anti-Tumorantwort induzieren, ergibt sich aus dessen heterogener Charakteristik, höchst aggressivem Wachstum und trotz Therapien hohen Rezidivraten der high-risk-Patient*innen. In den letzten Jahren konnten durch zunehmende Erkenntnisse im Bereich der Tumor- immunologie verschiedene immuntherapeutische Verfahren etabliert werden. So stellt die Anti-GD2-Therapie (ch14.18/CHO) einen zentralen klinischen Pfeiler der multimodalen Therapie des high-risk-NB dar. Hierbei werden Anti-GD2-AK verab- reicht, die das NB-spezifische Antigen GD2 erkennen, was zur gezielten Aktivierung des körpereigenen Immunsystems hauptsächlich durch NK-Zellen mit anschlie- ßender Tumorzelllyse führt. Herausforderungen ergeben sich aus der Überwindung der immuninhibitorischen Tumorumgebung sowie der Reduzierung natürlicher Regulationsmechanismen.
Vorherige Arbeiten der Arbeitsgruppe haben eine Anti-GD2-Immuntherapie abhängige Induktion des Immuncheckpoints PD-1/PD-L1 sowie der regulatorischen myeloiden CD11b+-Zellen (MRC) gezeigt. Für die vorliegende Arbeit war nun die Rolle der CD11b+ MRC von besonderem Interesse. Hierfür wurden CD11b+ Zellen in einem syngenen NB-Mausmodell mittels Anti-CD11b-AK blockiert oder durch 5-FU selektiv depletiert, was zu einem deutlich reduzierten Tumorwachstum und verbessertem Überleben führte. Zusätzlich wurde mittels RT-PCR die relative Gen- expression MRC-modulierender Gene (Arg1, CCL2, GM-CSF, IDO, IFNγ, IL-1β, IL-4, IL-6, IL-6R, IL-8, IL-10, M-CSF, M-CSFR, iNOS, TGF-β1 und VEGF-A) in der Tumormikroumgebung sowie der Milz evaluiert. Hier wurde eine Reduktion der modulierenden Gene nicht nur in der Tumormikroumgebung, sondern sogar peri- pher durch die Depletion von MRC nachgewiesen. Somit konnte eine negative Rolle der MRC beim NB bestätigt werden.
Diese Ergebnisse stellten eine Grundlage für die kombinierte Immuntherapie aus Anti-GD2-AK und MRC-Depletion dar. Eine Steigerung der antitumoralen Wirksam- keit im Vergleich zu den entsprechenden Monotherapien wurde gezeigt. Dabei wurden eine verbesserte Überlebenswahrscheinlichkeit und ein reduziertes Tumor- wachstum festgestellt. Die vorliegenden Ergebnisse liefern daher die Grundlage für einen neuartigen kombinierten Therapieansatz, um die immer noch schlechten Überlebenschancen der high-risk-Patient*innen zu verbessern.
Background. The German maternity guidelines require regular medical checkup (MC) during pregnancy as a measure of prevention. Socioeconomic factors such as education, profession, income and origin, but also age and parity may influence the preventive and health behavior of pregnant women. The aim was to investigate the influence of these factors on the participation rate in MC of pregnant women. Method. The current analysis is based on the prospective population-based birth cohort study Survey of Neonates in Pomerania, which was conducted in Western Pomerania, Germany. The data of 4092 pregnant women from 2004 to 2008 were analyzed regarding the antenatal care and health behavior. Up to 12 MC were regularly offered; participation in 10 MC is defined as standard screening according to maternity guidelines. Results. Women participated in the first preventive MC on average in the 10th (±3.8 SD) week of pregnancy. 1343 (34.2%) women participated in standard screening and 2039 (51.9%) took a screening above standard. 547 (13.92%) women participated in less than the 10 standard MCs. In addition, about one-third of the pregnancies investigated in this study were unplanned. Bivariate analyses showed an association between better antenatal care behavior and higher maternal age, stabile partnerships and mother born in Germany, p < 0.05. On the contrary antenatal care below standard were more often found by women with unplanned pregnancies, less educational women and women with lower equivalent income, p < 0.001. Health behaviors also influenced antenatal care. Whereas the risk of antenatal care below standard increased by smoking during pregnancy (RRR 1.64; 95% CI 1.25, 2.14) and alcohol consumption (RRR 1.31; 95% CI 1.01, 1.69), supplementation intake was associated with decreased risk (iodine—RRR 0.66; 95% CI 0.53, 0.81; folic acid—RRR 0.56; 95% CI 0.44, 0.72). The health behavior of pregnant women also differs according to their social status. Higher maternal income was negatively correlated with smoking during pregnancy (OR 0.2; 95% CI 0.15, 0.24), but positively associated with alcohol consumption during pregnancy (OR 1.3; 95% CI 1.15, 1.48) and lower pre-pregnancy BMI (Coef. = 0.083, p < 0.001). Lower maternal education was positively correlated with smoking during pregnancy (OR 59.0; 95% CI 28.68, 121.23). Conclusions. Prenatal care according to maternity guidelines is well established with a high participation rate in MC during pregnancy of more than 85%. However, targeted preventive measures may address younger age, socioeconomic status and health-damaging behaviors (smoking, drinking) of the pregnant women because these factors were associated with antenatal care below standard.
Inflammasome activation and formation of ASC specks in patients with juvenile idiopathic arthritis
(2023)
Objective
The formation of large intracellular protein aggregates of the inflammasome adaptor ASC is a hallmark of inflammasome activation and characteristic of autoinflammation. Inflammasome activated cells release the highly proinflammatory cytokine IL-1β in addition to ASC specks into the extracellular space. Autoinflammatory activity has been demonstrated in systemic JIA, however minimal data exist on the role of inflammasomes in other JIA subtypes. We therefore investigated, if pyroptotic cells are present in the circulation of oligo- and poly-articular JIA.
Methods
Peripheral blood of JIA patients (n = 46) was investigated for ASC speck formation, a key step in inflammasome activation, by flow cytometry and immunofluorescence. Free ASC and proinflammatory cytokine levels were determined by ELISA and multiplex assay.
Results
Oligo-articular JIA patients showed a significantly increased proportion of ASC speck+ monocytes compared to poly-articular JIA patients. In serum free ASC alone is not sufficient to assess inflammasome activity and does not correlate with ASC speck+ monocytes. Compared to control several cytokines were significantly elevated in samples of JIA patients. JIA serum containing antinuclear antibodies, incubated with ASC specks boosts a secondary inflammation by IL-1β production in macrophages.
Conclusion
For the first time, we detect ex vivo inflammasome activation by ASC speck formation in oligo- and poly-articular JIA patients. Most notably, inflammasome activation was significantly higher in oligo- compared to poly-articular JIA patients. This data suggests that inflammasome derived autoinflammation may have a greater influence in the previously thought autoimmune oligo-articular JIA patients.
Predicting complications in pediatric Crohn's disease patients followed in CEDATA-GPGE registry
(2023)
Background
Complications of Crohn's disease (CD) often impair patients' quality of life. It is necessary to predict and prevent these complications (surgery, stricturing [B2]/penetrating [B3] disease behavior, perianal disease, growth retardation and hospitalization). Our study investigated previously suggested and additional predictors by analyzing data of the CEDATA-GPGE registry.
Methods
Pediatric patients (< 18 years) diagnosed with CD with follow up data in the registry were included in the study. Potential risk factors for the selected complications were evaluated by performing Kaplan-Meier survival curves and cox regression models.
Results
For the complication surgery, the potential risk factors older age, B3 disease, severe perianal disease and initial therapy with corticosteroids at the time of diagnosis were identified. Older age, initial therapy with corticosteroids, low weight-for-age, anemia and emesis predict B2 disease. Low weight-for-age and severe perianal disease were risk factors for B3 disease. Low weight-for-age, growth retardation, older age, nutritional therapy, and extraintestinal manifestations (EIM) of the skin were identified as risk factors for growth retardation during the disease course. High disease activity and treatment with biologicals were predictors for hospitalization. As risk factors for perianal disease, the factors male sex, corticosteroids, B3 disease, a positive family history and EIM of liver and skin were identified.
Conclusion
We confirmed previously suggested predictors of CD course and identified new ones in one of the largest registries of pediatric CD patients. This may help to better stratify patients’ according to their individual risk profile and choose appropriate treatment strategies.
This article reports on the development, implementation and management of a German–Polish telemedicine network in the field of pediatric oncology and hematology in the Euroregion Pomerania. The achievements and challenges of joint medical case reviews involving patients and their care givers, as well as cross-border education activities for physicians, students and nursing staff, are presented. In addition to a progress report, the results of an evaluation of the participants and teachers, likewise the measurement of knowledge growth, are given.
Objectives: Several clinical disease activity indices (DAIs) have been developed to noninvasively assess mucosal healing in pediatric Crohn’s disease (CD). However, their clinical application can be complex. Therefore, we present a new way to identify the most informative biomarkers for mucosal inflammation from current markers in use and, based on this, how to obtain an easy-to-use DAI for clinical practice. A further aim of our proof-of-concept study is to demonstrate how the performance of such a new DAI can be compared to that of existing DAIs.
Methods: The data of two independent study cohorts, with 167 visits from 109 children and adolescents with CD, were evaluated retrospectively. A variable selection based on a Bayesian ordinal regression model was applied to select clinical or standard laboratory parameters as predictors, using an endoscopic outcome. The predictive performance of the resulting model was compared to that of existing pediatric DAIs.
Results: With our proof-of-concept dataset, the resulting model included C-reactive protein (CRP) and fecal calprotectin (FC) as predictors. In general, our model performed better than the existing DAIs. To show how our Bayesian approach can be applied in practice, we developed a web application for predicting disease activity for a new CD patient or visit.
Conclusions: Our work serves as a proof-of-concept, showing that the statistical methods used here can identify biomarkers relevant for the prediction of a clinical outcome. In our case, a small number of biomarkers is sufficient, which, together with the web interface, facilitates the clinical application. However, the retrospective nature of our study, the rather small amount of data, and the lack of an external validation cohort do not allow us to consider our results as the establishment of a novel DAI for pediatric CD. This needs to be done with the help of a prospective study with more data and an external validation cohort in the future.
Background
Short-term infusions of dinutuximab beta plus isotretinoin and cytokines administered in previous immunotherapy studies in neuroblastoma were associated with severe pain. Here, long-term, continuous infusion of single-agent dinutuximab beta was evaluated in patients with relapsed/refractory neuroblastoma.
Methods
In this open-label, single-arm, Phase 2 study, patients with either refractory or relapsed high-risk neuroblastoma received dinutuximab beta by continuous infusion over 10 days of each cycle, for up to five cycles. The primary endpoint was objective response rate 24 weeks after the end of cycle 5. Secondary endpoints included adverse events, intravenous morphine use, best response, duration of response, and three-year progression-free and overall survival.
Results
Of the 40 patients included, 38 had evaluable response. Objective response rate was 26% and best response rate 37%. Median duration of response was 238 days (IQR 108–290). Three-year progression-free and overall survival rates were 31% (95% CI 17–47) and 66% (95% CI 47–79), respectively. Prophylactic intravenous morphine use and duration of use decreased with increasing cycles. The most common grade 3 treatment-related adverse events were pain, diarrhea, and hypokalemia.
Conclusion
Long-term continuous infusion of single-agent dinutuximab beta is tolerable and associated with clinically meaningful responses in patients with relapsed/refractory high-risk neuroblastoma.
Clinical trial registration
The study is registered with ClinicalTrials.gov (NCT02743429) and EudraCT (2014-000588-42).