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Ευρωπαϊκή Μελέτη EU.NET.ADB Α. Τσίτσικα, Ε. Ανδρή, Θ. Ψαλτοπούλου, Χ. Τζαβάρα, Θ. Σεργεντάνης, Φ. Μπακοπούλου, Μ. Πατσεάδου, C. Richardson, Γ. Χρούσος, Μ. Τσολιά
Paediatriki
Volume 78 • Number 1 • January - February - March 2015
Trimonthly publication of the Greek Paediatric Society
Contents
006
EDITORIAL
G.S. Varlamis
008
SHORT ABSTRACTS
012
REVIEW ARTICLES
Urolithiasis in childhood. Symptom or disease? Review of the literature
Maria Pavlou, Ekaterini Siomou, Nikolaos Chaliasos
028
The Safety of using melatonin in children: A review of current, international literature. Eugenia F. Laspa, Anna V. Papakonstantinou, Evangelos C. Kalogiannis, Maria Mironidou-Tzouveleki
038
Guidelines for evaluation and management of cryptorchidism
Eirini Dikaiakou, Elpis-Athina Vlachopapadopoulou, Alexandros Passalidis
048
ORIGINAL ARTICLES
Exercise Testing in monitoring lung disease among patients with cystic fibrosis Kampouras Asterios, Hatziagorou Elpis, Avramidou Vasiliki, Kontouli Kalliopi, Georgopoulou Vasiliki, Kirvassilis Fotios, Tsanakas Ioannis
058
Differential expression of extracellular matrix molecules in patients with neurofibromatosis type 1
Spyros P. Batzios, Eleni Papakonstantinou, Eleftherios Kontopoulos, Euthymia Vargiami, George Karakiulakis, Dimitrios I. Zafeiriou
President
A. Constantopoulos
Editorial board
Director
G. S. Varlamis
Members
S. Andronikou
E. Galanakis
A. Evangeliou
L. Thomaidou
M. Kanariou
A. Kapogiannis
S. Kitsiou-Tzeli
E. Mantadakis
P. Panagiotopoulou-Gartagani
A. Papadopoulou
V. Papaevagelou
A. Papathanassiou
A. Siamopoulou-Mavridou
A. Syrigou-Papavasiliou
Manuscript submission
e-mail: grammateia@e-child.gr
Instructions to authors: http://e-child.gr/publications/ instructions-to-authors
Owner Greek Paediatric Society 15, Mpakopoulou st. GR - 15451, Ν. Psychiko Tel.: +302107771140
e-mail: grammateia@e-child.gr
Annual subscription All foreign countries: US$50
070
How do children play today: Α timeless research
Dr. Panagiotis Kardaras, Niki Dedousi, Tatiana Vrettakou, Paraskevas Kilintzis, Evaggelia Farini, Maria-Eirini Vrettakou
100
Screening tests and record of metabolic syndrome in adolescents school population of western thessaloniki
Eleni P. Kotanidou, Aggeliki Kleisarchaki, Konstantina Mouzaki, Paraskevi Kokka, Ioannis Kyrgios, Iro Tsara, Efthimia Eustratiou, Anna-Bettina Haiditc, Vagia Papageorgiou, Maria Eboriadou-Petikopoulou, Assimina Galli-Tsinopoulou
110
Correlation of blood pressure and Body Mass Index (BMI) in Senior High School students
Papadopoulos Giorgos Ph.D., Tamattiri Kyriaki, Economou Alexandra, Akrita Christina, Engomiti Evdokia, Makri Antrea, Theophanous Zoe, Xatziantona Nicol, Charalambous Giorgos
122
Lung function in children with neuromuscular disorders. Experience from Thessaloniki Neuromuscular Disorders Unit
Maria Gogou, Maria Hatzistylianou, Maria Eboriadou, Evangelos Pavlou, Andreas Giannopoulos, Efterpi Pavlidou, Katerina Haidopoulou
136
Association between problematic internet use, socio-demographic variables and overweight/ obesity among European adolescents. Results from the EU NET ADB study
Artemis Tsitsika, Elisavet Andrie, Theodora Psaltopoulou, Chara Tzavara, Theodoros Sergentanis, Flora Bacopoulou, Magda Patseadou, Clive Richardson, George Chroussos, Marisa Tsolia
Παραπομπές:
1. Eliot L. What’s Going On in There? How the Brain and Mind Develop in the First Five Years of Life. New York, NY: Bantam Books; 1999. 2. UNICEF/World Health Organization. Integrating Early Childhood Development (ECD) Activities Into Nutrition Programmes in Emergencies. Why, What and How [guidance note]. 2014:1-16. 3. Hernandez-Reif M, Diego M, Field T. Preterm infants show reduced stress behaviors and activity after 5 days of massage therapy. Infant Behav Dev. 2007;30(4):557-561. 4. White-Traut RC, Schwertz D, McFarlin B, Kogan J. Salivary cortisol and behavioral state responses of healthy newborn infants to tactile-only and multisensory interventions. J Obstet Gynecol Neonatal Nurs. 2009;38:22-34. 5. Mindell JA, Telofski LS, Wiegand B, Kurtz ES. A nightly bedtime routine: impact on sleep in young children and maternal mood. Sleep. 2009;32(5):599-606. 6. White-Traut RC, Nelson MN, Silvestri JM, et al. Effect of auditory, tactile, visual, and vestibular intervention on length of stay, alertness, and feeding progression in preterm infants. Dev Med Child Neurol. 2002;44:91-97. 7. Field T, Cullen C, Largie S, Diego M, Schanberg S, Kuhn C. Lavender bath oil reduces stress and crying and enhances sleep in very young infants. Early Hum Dev. 2008;84(6):399-401. 8. Farroni T, Csibra G, Simion F, Johnson MH. Eye contact detection in humans from birth. Proc Natl Acad Sci U S A. 2002;99(14):9602-9605. 9. Herz RS. A naturalistic analysis of autobiographical memories triggered by olfactory visual and auditory stimuli. Chem Senses. 2004;29(3):217-224. 10. Sullivan RM, Toubas P. Clinical usefulness of maternal odor in newborns: soothing and feeding preparatory responses. Biol Neonate. 1998;74(6):402-408.
SHORT ABSTRACTS
Οι Τσίτσικα Α και συν. (ΚΠΑ) δημοσιεύουν
Correspondence
Maria Pavlou
Stavrou Niarhou Av. 45500, Ioannina, Greece e-mail: marpavlou@gmail.
com
Τ.
+302651099793
+302651099775
+306974075908
Urolithiasis in childhood. Symptom or disease? Review of the literature
Maria Pavlou, Ekaterini Siomou, Nikolaos Chaliasos
Abstract
Paediatric urolithiasis is rare but recently appears with increasing rates. Genetic predisposition, environmental and socioeconomic conditions influence the incidence, composition and location of the stone forming in the urinary tract. The causes are mainly metabolic about 40-50%, urinary tract infection 20-25% and anatomical abnormalities 10-25%. Hypercalciuria, hyperoxaluria, hypocitraturia, cystinuria, hyperuricosuria are the main metabolic disorders. The clinical presentation includes abdominal pain either as a typical renal colic or atypical, haematuria, nausea or vomiting, dysuria or urgency to urinate, urinary tract infection and occasionally irritability, bedwetting, penile edema and anorexia. Ultrasound of kidney-ureter-bladder is proposed as the initial imaging examination, showing every stone of any composition, structural abnormalities and grade of possible induced obstruction of the urinary system. The plain abdominal radiograph is widely used in clinical practice, showing only radiopaque stones and does not estimate obstruction. Investigation method of choice is computed tomography with high sensitivity and specificity, but is not recommended as a routine examination because of radiation. For every child with urolithiasis, metabolic investigation for lithogenic urine factors is required such as: measuring excretion of calcium, oxalate, cystine, uric acid or crystallization inhibitors (citrate, magnesium). Analysis of the passed stone is significant. Relapses are common in children, especially in the primary forms, with serious consequences for renal function. Therapeutic intervention of the acute episode but also longtime causative treatment is necessary. Conclusively, urolithiasis in children is the symptom rather than the disease, requires thorough metabolic examination, further causative treatment and follow up to prevent new stones formation.
Keywords: urolithiasis, nephrolithiasis, hypercalciuria, hyperoxaluria, hypocitraturia, cystinuria, hyperuricosuria
Maria Pavlou
Ekaterini Siomou
Nikolaos Chaliasos
Pediatric Department, University Hospital of Ioannina
Παθοφυσιολογία
Zn και καισίου, γλυκοζαμινογλυκάνες (ηπαρίνη, υαλουρονικό
(24).
(Proteus, Klebsiella, Pseudomonas, Enterobacter, Providencia, Staphylococcus, Ureaplasma urealyticum, Enterococci, Corynebacterium urealyticum)
phosphate-apatite-carbonate).
Phenytoin, triamterene, sulfonamides, felbamate, ceftriaxone, indinavir, ciprofloxacin, guaifenesin/ ephedrine 1.
Topiramate, zonisamide, acetazolamide
2.
Uric acid
CaOx 45-65 %, (Ca2)3(PO4)2 14-30 %,
4% (15,16,40).
Μεταβολικά
Calcium. (Avner ED, Harmon WE, Niaudet P, Yoshikawa N. Textbook of Pediatric Nephrology. 6th Edition. SpringerVerlag. Berlin Heidelberg. 2009;(58).1409.)
<75mg/g cr
>0.18-0.40 mg/mg cr <0.53 mg uric acid/ dL
[=Urine uric acid (mg/ dL)x Plasma cr(mg/ dL)/Urine cr (mg/dL)]
<4mg/Kg/24h >2
<45 mg/1.73m2/24h
<0.5mmol/1.73m2/24h <60 mg/1.73m2/24h
<0.12mg/mg >1
<815mg/1.73m2/24h <88 mg/1.73m2/24h
Dent’s disease (CLCN5 mutations)
Lowe syndrome (OCRL1 mutations)
Glycogen storage disease type 1a (G6PC/glucose-6-Phosphatase)
Wilson’s disease (ATP7B)
Renal Tubular Axidosis Type I (ATP6B1, AE1 mutations, carbonic anhydrase deficiency)
Tyrosinemia type 1 (FAH/fumarylacetoacetase)
Familial hypomagnesemia-hypercalciuria ( PCLN-1/paracellin-1 or Claudin 16 mutations)
Bartter syndrome Type I →V (SLC12A1/NKCC2, KCNJ1/ROMK , CLCNKB, BSND , CaSR)
Gordon’s syndrome (WNK1, WNK4 )
Liddle’s syndrome (SCNN1B and SCNN1G )
Autosomal dominant hypocalcemia (CaSR/calcium-sensing receptor)
Familial isolated hypoparathyroidism (CaSR/calcium-sensing receptor)
MEN1 with hyperparathyroidism (Menin)
Parathyroid tumors with ossifying fibromas of the jaw (HPT-JT) (Parafibromin)
Infantile hypophosphatasia (ALPL/alkaline Phosphatase)
Metaphyseal chondrodysplasia Jansen type (PTHR)
Πολυγονιδιακές
(sAC, CaSR, VDR)
Osteogenesis imperfecta type 1 (COL1A1 και COL1A2)
McCune-Albright syndrome (GNAS1)
Hereditary hypophosphatemia with rickets and hypercalciuria (PHEX mutations/NPT2a)
Hereditary hypophosphatemia with rickets and hypercalciuria (no NPT2a mutation)
Congenital lactase deficiency (locus linked to 2q21), sucrose-isomaltase (SI)
Glucose/galactose malabsorption ( SLC5A1)
Blue diaper syndrome (possibly SLC16A10/T-)
Williams–Beuren syndrome (ELN, LIMK1, RFC2)
Cystic fibrosis ( CFTR)
β-Thalassemia ( HBB/-globin)
Beckwith-Wiedemann syndrome (p57(KIP2)- NSD1- H19 gene
Phenylketonuria (PKU1/phenylalanine hydroxylase)
Orlistat, ↑ VitC
Ethylene glycol
Πρωτοπαθής υπεροξαλουρία I AGXT alanine-glyoxylate-aminotransferase Πρωτοπαθής
II GRHPR glyoxylate-reductase/hydroxypyruvatereductase
Πρωτοπαθής
III HOGA1
DHDPSL 4-hydroxy-2-oxoglutarate-aldolase
Cre, Ca, Na, P, Ox,
Oxalobacter
Βιβλιογραφία
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Correspondence
Eugenia Laspa
37, Konstantinou Karpou str, 50500, Servia, Kozani, Greece
e-mail: eugenialaspa@ gmail.com
T. +306978307900
The Safety of using melatonin in children: A review of current, international literature
Eugenia F. Laspa, Anna V. Papakonstantinou, Evangelos C. Kalogiannis, Maria Mironidou-Tzouveleki
Abstract
With the present review we seek to clarify the use of melatonin during childhood and the risks associated with its administration. Melatonin is a hormone secreted by the pineal gland. It is a primary circadian pacemaker, and it may induce sleep during the day. Its secretion is suppressed by light. It is currently used for the treatment of sleep disorders in both healthy children and in those with neurodevelopmental disorders as well. Its administration is quite frequent among the pediatric population as it seems to have a low toxicity index and a large therapeutic “window”. However, there are no clear clinical guidelines on its safety and in particular on its long-term effects. Throughout a search in medical databases, it was found that melatonin can cause morning drowsiness, dizziness, diarrhea, tachycardia, hypothermia, headache and increased enuresis. Its effect on the reproductive system is still under investigation. Nonetheless, according to studies in laboratory animals, it is shown to induce changes in pubertal development and seasonal reproduction. In addition, taking into account the anti-inflammatory, antioxidant and neuroprotective effects, the need to investigate its impact on every system of the human body is immediate. In conclusion, the existing data are still inadequate concerning the indications of administration of melatonin in children, the dose and the duration of treatment, the age of administration and the long-term side effects. Future studies should focus on the optimal regimen and the possible side effects due to long-term use.
Keywords: melatonin, children, safety issues, DLMO
Eugenia F. Laspa
Evangelos C. Kalogiannis Medical Doctor, Aristotle University of Thessaloniki
Anna V. Papakonstantinou Medical Doctor, Postgraduate Student, Aristotle University of Thessaloniki
Maria Mironidou-Tzouveleki
Anesthesiologist, Professor of Pharmacology, A’ Laboratory of Pharmacology, Medical School, Aristotle University of Thessaloniki, Greece
DLMO:
Oliviero Bruni, Daniel Alonso-Alconada, Frank Besag, Valerie Biran, Wiebe Braam, Samuele Cortese et al. Current role of melatonin in pediatric neurology: Clinical recommendations. Eur J Paediatr Neurol. 2015 Mar;19(2):122-133
Βιβλιογραφία
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2. Lerner AB, Case JD, Takshashi Y. Isolation of melatonin, the pineal gland factor that lightens melanocytes. J Am Chem Soc 1958;80:2587.
3. Cornal S, Ochoa-Sanchez R, Gobbi G. Sleep-wake characterization of double MT1/MT2 receptor knockout mice and comparison with MT1 and MT2 receptor knockout mice. Behav Brain Res 2013;243:231-8.
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Correspondence
Elpis-Athina Vlachopapadopoulou
e-mail: elpis.vl@gmail. com
Τ.: +302132009851
Κ.: +306932247228
Guidelines for evaluation and management of cryptorchidism
Eirini Dikaiakou, Elpis-Athina Vlachopapadopoulou, Alexandros Passalidis
Summary
Cryptorchidism or undescended testis is the most common congenital abnormality of the genitourinary tract in newborn boys. Recent studies describe rates up to 3% approximately among full term boys. Men with a history of undescended testis have an increased risk of developing testicular cancer and subfertility compared with men in the general population. This article presents an overview of recent published literature, in order to inform physicians who treat these children about physical exam and evaluation of the boy with cryptorchidism as well as the treatment options. According to the American Urological Association (ΑUA) recent guidelines, providers should not perform ultrasound in the evaluation of boys with cryptorchidism prior to referral. Boys who do not have spontaneous testicular descent by six month should be referred to a surgical specialist for evaluation, while all phenotypic male newborns with bilateral, nonpalpable testes should immediately consult an appropriate specialist. Surgical treatment (orchiopexy) for undescended testes is recommended as the gold standard therapy to place undescended testes in a normal scrotal position or to remove nonviable testicular remnants. Hormonal therapy has been tried before surgery, but has not proven to be efficacious in inducing testicular descent and is no longer recommended. If performed sufficiently early, surgical correction appears to reduce the risk of subfertility and testicular cancer but does not completely eliminate it. Therefore, appropriate follow up for the patient is very significant. In addition, boys who have undergone treatment for undescended testes should be taught how to perform monthly testicular self-examination during adolescence.
Keywords: Cryptorchidism; orchiopexy; hormones; subfertility; malignancy; testis
Eirini Dikaiakou
Elpis-Athina Vlachopapadopoulou
Endocrinology - Growth and Development, Aglaia Kyriakou Children’s Hospital
Alexandros Passalidis 2nd Pediatric Surgery Clinic, Aglaia Kyriakou Children’s Hospital
Testicular Determining Factor (TDF)
Sex Determining Region of the Y chromosome (SRY)
Prader-Willi,
Laurence-Moon, 6)
Beckwith-Wiedemann, Smith-Lemli-Opitz, Cornelia de Lange syndrome,
Συντομογραφίες:
AUA: American Urological Association
MIF: Mullerian inhibiting factor
TDF: Testicular Determinind Factor
SRY : Sex Determininig Region of the Y chromosome
INSL-3 : Insulin like 3
AMH: AntimullerianHormone
SGA : Small for Gestational Age
hCG: Human horionic gonadotropin
LH : Luteinizing hormone
FSH: Follicle stimulating hormone
ACTH: Adrenocorticotropic hormone
LHRH : Luteinizing hormone-releasing hormone
Βιβλιογραφία
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Resolution Chest Tomography, HRCT)
Correspondence
Elpida Hatziagorou
6 Ploutarchou str, 55236 e-mail: elpcon@otenet.gr T. +306972851721
Exercise testing in monitoring lung disease among patients with cystic fibrosis
Kampouras Asterios, Hatziagorou Elpis, Avramidou Vasiliki, Kontouli Kalliopi, Georgopoulou Vasiliki, Kirvassilis Fotios, Tsanakas Ioannis
Abstract
Introduction: Early detection of structural abnormalities of the lungs is a primary objective in monitoring and treating patients with Cystic Fibrosis (CF); High-Resolution-Computed-Tomography (HRCT) is the reference method. Spirometry and cardiopulmonary exercise testing are also used for monitoring CF patients.
Aim: To evaluate the deterioration of exercise testing parameters over a two-year period compared to the change of spirometry and HRCT parameters.
Methods: Seventeen CF patients were evaluated with HRCT, spirometry and exercise testing twice, over a two-year period. The change of each parameter and their correlation, over the twoyear period was evaluated.
Results: 17 CF patients (mean age 16.7 years, mean FEV1 78.9%) were evaluated. FEV1 was not found to change significantly in the two-year period (p=0.723). Mean Bhalla score was increased significantly (p=0.004), while mean VO2max% deteriorated significantly, as well (p=0.032). VE / VO2 during maximal exercise could predict the extent of bronchiectasis, mucus plugging and the total Bhalla score (p<0.05). VE/VCO2 at peak exercise could predict the severity of bronchiectasis and airway wall thickening (p<0.05).
Conclusions: Exercise testing is more sensitive than spirometry in monitoring patients with mild and moderated CF; exercise testing may predict early structural abnormalities in patients with CF.
Keywords: cardiopulmonary exercise testing, cystic fibrosis, HRCT, exercise intolerance, spirometry, children
Kampouras Asterios
Hatziagorou Elpis
Avramidou Vasiliki
Kontouli Kalliopi
Kirvassilis Fotios
Tsanakas Ioannis
Paediatric Pulmonology Unit, 3rd Paediatric Dept, Aristotle University of Thessaloniki, Hippokration Hospital of Thessaloniki
Georgopoulou Vasiliki
Radiology Dept, Hippokration Hospital of Thessaloniki
(13-14).
(Ergoline, Vmax Series V.20-1, Sensor medics)
(cardiograph model Corina, S.N. 101164361, Cardiosoft software V5.15)
Bhalla
Bhalla
Ύψος (cm)
Βάρος (kg)
BMI (kg/m2)
ΔF508 homozygous
ΔF508 heterozygous
Pseudomonas aeruginosa
Bhalla score 17 (5
(52.9%)
(53%)
(0;13)
(R2=0,55, p=0,002),
(R2=0,80, p<0,05)
=0,67, p=0,001),
p=0,003).
=0,46, p=0,005),
Bhalla score
Δοκιμασία
VOpeak(L/min)
VOpeak%
VO2max(mL/kg/min)
VO2max%
AT%
VE (L/min)
BR%
VD/VT (maximum exercise)
VE/VO2 (Peak Ex)
VE/VCO2 (Peak Ex)
Σπιρομέτρηση
FEV1(L)
% predicted
FVC(L)
% predicted
1.41 (0; 3) 0.65 (0; 2) 2.35 (0; 3)
(0; 2)
(0; 1) 1.71 (0; 2)
(0; 0) 0.71 (0;2) 0.53 (0;1)
8.06 (0; 13)
1.76 (0.93; 2.61) 71.06 (38; 101)
38.44 (21.50; 59.90)
83.65 (53; 116)
47.35 (21; 74)
62.18 (44.70; 81.00) 38.19 (11; 100)
0.13 (0.07; 0.19) 32.87 (25; 41) 33.53 (28; 44)
2.43 (1.36; 3.31) 78.88 (42; 94)
2.97 (1.63; 3.96) 87.35 (58; 106)
0.06 (0.24) 0.41(0.71)
0.00 (0.50)
0.06 (0.56) 0.24 (0.44)
0.24 (0.56) 0.12 (0.33)
0.24 (0.66) 0.06 (0.56) 1.41 (1.73)
-0.10 (0.37) -4.53 (14.29) -5.66 (8.93) -11.0 (19.35) -5.81 (14.70) -4.97 (15.47) -5.375 (33.80)
0.00 (0.04 0.60 (3.23) 0.59 (2.74)
0.17 (0.48) 1.06 (12.12) 0.19 (0.54) 0.35 (12.53)
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23. Aurora P, Bush A, Gustafsson P, Oliver C, Wallis C, Price J, et al. Multiple-Breath Washout as a Marker of Lung Disease in Preschool Children with Cystic Fibrosis. American Journal of Respiratory and Critical Care Medicine. 2005;171(3):249-56.
24. Kozlowska WJ BA, Wade A, et al. Lung function from infancy to the preschool years after clinical diagnosis of cystic fibrosis. Am J Respir Crit Care Med. 2008;178:42-9.
25. Gustafsson PM, De Jong PA, Tiddens HAWM, Lindblad A. Multiple-breath inert gas washout and spirometry versus structural lung disease in cystic fibrosis. Thorax. 2008;63(2):129-34.
26. Demirkazık FB, Arıyürek OM, Özçelik U, Göçmen A, Hassanabad HK, Kiper N. High resolution CT in children with cystic fibrosis: correlation with pulmonary functions and radiographic scores. European journal of radiology. 2001;37(1):54-9.
27. Loeve M, Krestin GP, Rosenfeld M, de Bruijne M, Stick SM, Tiddens HA. Chest computed tomography; a validated surrogate endpoint of cystic fibrosis lung disease? European Respiratory Journal. 2012; 42(3):844-857. Martínez TM, Llapur CJ, Williams TH, Coates C, Gunderman R, Cohen MD, et al. High-Resolution Computed Tomography Imaging of Airway Disease in Infants with Cystic Fibrosis. American Journal of Respiratory and Critical Care Medicine. 2005;172(9):1133-8.
29. Sanders DB, Li Z, Brody AS, Farrell PM. Chest Computed Tomography Scores of Severity Are Associated with Future Lung Disease Progression in Children with Cystic Fibrosis. American Journal of Respiratory and Critical Care Medicine. 2011;184(7):816-21.
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31. Pike SE, Prasad SA, Balfour-Lynn IM. Effect of intravenous antibiotics on exercise tolerance (3-min step test)) in cystic fibrosis*. Pediatric Pulmonology. 2001;32(1):38-43.
32. Moorcroft AJ DM, Webb AK. Exercise testing and prognosis in adult cystic fibrosis. Thorax. 1997;52(3):291-3.
33. Nguyen S LS, Cracowski C, Perez T, Valette M, Neviere R, Aguilaniu B, Wallaert B. Prognostic value of clinical exercise testing in adult patients with cystic fibrosis Rev Mal Respir. 2010;27(3):219-25.
34. Pianosi P, LeBlanc J, Almudevar A. Peak oxygen uptake and mortality in children with cystic fibrosis. Thorax. 2005;60(1):50-4.
35. Barker M, Franke E, Böhle M, Pfannenstiel C, Heimann G. Effect of DNase on exercise capacity in cystic fibrosis. Pediatric Pulmonology. 2004;38(1):70-4.
36. Werkman MS, Hulzebos EHJ, Helders PJM, Arets BGM, Takken T. Estimating peak oxygen uptake in adolescents with cystic fibrosis. Archives of Disease in Childhood. 2014;99(1):215.
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Correspondence
Spyros P. Batzios
93 Konstantinoupoleos str, 54642, Thessaloniki e-mail: spyros.batzios@ gmail.com T. +302311251088
Differential expression of extracellular matrix molecules in patients with neurofibromatosis type 1
Spyros P. Batzios, Eleni Papakonstantinou, Eleftherios Kontopoulos, Euthymia Vargiami, George Karakiulakis, Dimitrios I. Zafeiriou
Abstract
The aim of the present study was the assessment of the expression of various molecules of the Extracellular Matrix, in patients with Neurofibromatosis type I (NF1), with the goal to use those molecules as potential biomarkers for patients’ diagnosis and disease follow-up.
Patients & Methods: The sample included 45 patients with NF1, as well as an equal number of healthy subjects. Gelatinase activity (MMP-2 and MMP-9) was measured with the use of gelatin zymography. The concentration of circulating ECM molecules was measured by ELISA, while their expression at the genetic level was assessed with the use of Real-Time RT-PCR. The enzyme activity of hyaluronidases was measured with the use of hyaluronidase zymography.
Results: NF1 patients had a statistically significant increase in the circulating levels of MMP-2, TIMP-1, TIMP-2 and MMP-9/TIMP-1. MMP-2 levels correlated with the age only in the patient group. No significant differences were found concerning the expression of hyaluronic acid (HA) and the enzymes/receptors which are involved in its metabolism. Syndecan-2, decorin and versican were increased in the serum of NF1 patients as well. Logistic regression analysis was performed to estimate the odds ratios of variables in the prediction of the presence of clinical/ laboratory features of the disease. The increase of HA in the serum of patients increased significantly the risk of having UBOs in brain MRI.
Conclusions: The index study revealed the potential use of ECM molecules as biomarkers for NF1. According to our results many of the studied molecules can be potentially used for the diagnosis and follow-up of patients suffering from the above mentioned disorder.
Keywords: neurofibromatosis type 1, extracellular matrix, matrix metalloproteinases, hyaluronic acid, proteoglycans
Spyros P. Batzios
Eleftherios Kontopoulos
Euthymia Vargiami
Dimitrios I. Zafeiriou
1st Paediatric Department, Aristotle University of Thessaloniki, Hippokration General Hospital, Thessaloniki, Greece
Eleni Papakonstantinou
George Karakiulakis
Department of Pharmacology, Medical School, Aristotle University of Thessaloniki, Thessaloniki, Greece
ιστικοί
(Hyaluronic acid, HA)
(Tissue inhibitors of Metalloproteinases, TIMPs),
(Hyaluronan Synthases, HASs; Hyaluronidases, HYALs; CD44; RHAMM)
(Neurofibromatosis
Η
MMPs, TIMPs, HA, HASs, HYALs,
Συντομογραφίες:
NF1: νευροϊνωμάτωση
1 (Neurofibromatosis type 1)
MMPs:
μεταλλοπρωτεάσες
συνδετικού
(Matrix metalloproteinases)
TIMPs:
(Tissue inhibitors of matrix metalloproteinases)
HA:
(Hyaluronic acid)
HAS:
HA (Hyaluronic acid synthases)
HYAL:
(Hyaluronidases)
PG:
(Proteoglycan)
MMP-9/TIMP-1
MMP-2/TIMP-2
MMP-1
MMP-2
MMP-3
MMP-9
TIMP-1
TIMP-2
r=-0.055, p=0.737
r=0.301, p=0.043
r=-0.388, p=0.023
r=-0.225, p=0.201
r=-0.163, p=0.356
r=-0.143, p=0.419
r=-0.103, p=0.723
r=0.245, p=0.639
r=-0.809, p=0.040
r=-0.086, p=0.871
r=0.088, p=0.889
r=-0.150, p=0.809
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20. Wight TN, Kinsella MG, Evanko SP, Potter-Perigo S, Merrilees MJ. Versican and the regu-
lation of cell phenotype in disease. Biochim Biophys Acta. 2014;1840(8):2441-51.
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Correspondence
Panagiotis Kardaras
Konstantinoupoleos 49, 54642, Thessaloniki e-mail.: pk@med.auth.gr Τ. +302310892483
How do children play today: Α timeless research
Dr. Panagiotis Kardaras, Niki Dedousi, Tatiana Vrettakou, Paraskevas Kilintzis, Evaggelia Farini, Maria-Eirini Vrettakou
Background: Playing is connected to the cognitive, social and emotional development of children, which is commonly accepted in numerous scientific fields. The current study builds on a two decade long research regarding the changes that have occurred to playing habits, the effect of consumerism and introduction of new technologies. The sport of preference and amount of free time were also investigated.
Methods: The survey was conducted using a random sample of schools, in children between 1015 years old in the Thessaloniki area using a specially adapted questionnaire. Out of 1958 valid answered questionnaires, 1058 were conducted in semi-urban areas and the other 899 in central areas of Thessaloniki. Statistical analysis of the data was performed.
Results: Electronic games played at home, through the Internet and mobile phone are particularly popular, with children choosing them between a few times a week to every day. Most popular team sport is football (20,9%, p<0,05). Traditional games are not the most popular in the everyday life of children, whereas games with advertised heroes reach 65,1%. Even though the majority of children prefer cooperative playing, 12,7% of boys and 9,1% of girls prefer individual playing. Also, free time has been limited from 2-3 hours a day to 1-2 hours a day.
In conclusion, growth of new technologies has significantly affected the way children play, the influence of consumerism has been increased and free time of children has been reduced.
Keywords: playing, electronic games, sports, internet, free time
Dr. Panagiotis Kardaras
Niki Dedousi
Tatiana Vrettakou
Paraskevas Kilintzis
Evaggelia Farini
Maria-Eirini Vrettakou
στη έρευνα ήταν: 19ο, 26ο, 30ο, 72ο, 80ο, 92ο Δημοτικό
Πυλαίας, 5ο Γυμνάσιο Σταυρούπολης, 4ο, 7ο Γυμνάσιο Καλαμαριάς, 1ο, 2ο, 3ο Δημοτικό
1ο
1ο Γυμνάσιο
4η
Συντομογραφίες:
NF1: νευροϊνωμάτωση τύπου 1 (Neurofibromatosis type 1)
MMPs:
μεταλλοπρωτεάσες του συνδετικού ιστού (Matrix metalloproteinases)
TIMPs: ιστικοί
(Tissue inhibitors of matrix metalloproteinases)
HA:
οξύ (Hyaluronic acid)
HAS: συνθετάσες του HA (Hyaluronic acid synthases)
HYAL:
(Hyaluronidases)
PG: πρωτεογλυκάνη (Proteoglycan)
5.
4.1.
4.1.1
4.1.2.
4.1.3
4.2.
4.2.1.
4.2.2.
4.2.3
4.3
4.3.1.
4.3.2.
4.3.3.
4.4.1.
Bayblade, Ben Ten, Barbie, Winx, Monster High, Pokemon, Spiderman, κ.α.
4.5.1. Έρευνα 1994
13%
4.5.2. Έρευνα 2003
27,8%
4.5.3. Έρευνα 2014
65,1%
4.6. Προτιμάς να
4.6.1. Έρευνα 1994
4,4%
4.6.2. Έρευνα 2003
4.6.3. Έρευνα 2014
10,9%
4.7.1. Έρευνα
87%
,2%
95,4%
89,0%
4.7.3.
Bayblade, Ben ten, Barbie, Winx, Monster High,
Bayblade, Ben Ten, Barbie, Winx, Monster High, Pokemon
0,038 0,204 0,116 0,000 0,000 0,000 0,000
1ου, 2ου, 3ου Δημοτικού Σχολείου Περαίας, 1ου Γυμνασίου Περαίας, 1ου Γυμνασίου Νέων Επιβατών, 1ου
1. Wood E. Play, Learning and the early childhood curriculum. UK: Sage; 2013. p.6-10
2.
2001
4. Fromme J. Computer games as a part of children’s cultures. Game Studies 2003; 3(1)
6.
7. Cole M, Cole S.
2003: 52
11. Berger A, Video games: a popular cultural phenomenon. New Jersey: Transaction Publishers; 2002. P. 108-109
12. Τάσση Μ.
2008 από http://www.newinka.gr/ (2006),
13. Kasteleijn-Nolst DG, Martins da Silva A, Ricci S, et al. Video games are exciting: a European study of vídeo game- induced seizures and epilepsy. Epileptic Disord 2002; 4: 121-128
14. Prensky, M. Digital game-based learning. New York: McGraw-Hill; 2001
15. Squillaci T. Η
2006
16. Mizen P, Hutchby I, Pole CJ, Moran-Ellis J, Bolton A. Children, Technology and Culture: The Impacts of Technologies in Children’s, 1st ed. London: Ian Hutchby & Jo Moran-Ellis; 2001
17. Nelson M D., Gordon- Larsen P. Physical activity and sedentary behavior patterns are associated with selected adolescent health risk behavior. Pediatrics, 117: 1281-1290; 2006
(≥200mg/dl)
(≥130mmHg)
Correspondence
Assimina Galli-Tsinopoulou
Ring Road Nea Efkarpia, 56403, Thessaloniki, Greece
e-mail: gallitsin@gmail. com
agalli@auth.gr
T.-F.: +302310991537
Eleni P. Kotanidou
Aggeliki Kleisarchaki
Konstantina Mouzaki
Paraskevi Kokka
Ioannis Kyrgios
Iro Tsara¹
Efthimia Eustratiou
Maria Eboriadou-Petikopoulou
Assimina Galli-Tsinopoulou
4th Department of Pediatrics, Faculty of Medicine, Aristotle University of Thessaloniki, Papageorgiou General Hospital, Thessaloniki
Anna-Bettina Haiditc
Department of Hygiene, Faculty of Medicine, Aristotle University of Thessaloniki, Thessaloniki
Vagia Papageorgiou
Former Assistant Professor of Child Psychiatry
Screening tests and record of metabolic syndrome in adolescents school population of Western Thessaloniki
Eleni
P. Kotanidou, Aggeliki Kleisarchaki, Konstantina Mouzaki, Paraskevi Kokka, Ioannis Kyrgios, Iro Tsara, Efthimia Eustratiou, Anna-Bettina Haiditc, Vagia Papageorgiou, Maria Eboriadou-Petikopoulou, Assimina Galli-Tsinopoulou
Abstract
Background: Adolescent obesity constitutes a phenomenon with epidemic characteristics. Increased rates of metabolic syndrome represent a consequence of this epidemic, leading to high risk for chronic diseases in adolescence. The study herein, presents the primary outcomes of a school-based intervention trial regarding the control of the metabolic syndrome among adolescents of Western Thessaloniki.
Methods: The aim of the study was to identify the metabolic syndrome in the school adolescent population and to record it according to the current established criteria of the International Diabetes Federation (IDF). A total of 424 adolescents, aged 14.10 ± 1.78 years were recruited. Anthropometric values were recorded. All participants underwent a school-based laboratory investigation including glucose cholesterol and triglyceride levels and body composition determination, via telematics health care devices.
Results: In the total sample (59% girls), body mass index was 21.82±3.25kg/m2 while waist circumference was 78.78±9.29 cm. Systolic (SBP) and diastolic (DBP) blood pressure were 121.21±11.89mmHg and 73.88±10.54mmHg, respectively. Mean cholesterol levels were 172.42±27.48mg/dl, triglycerides levels 88.07±40.15mg/dl and glucose levels 100.89±15.11mg/ dl. After examining the components of the metabolic syndrome in adolescents, 24.4% of the sample presented abdominal obesity (waist circumference: girls>80cm, boys>94cm). Hyperglycemia (≥100mg/dl) was found in 52.2% of the sample, hypercholesterolemia (≥200mg/dl) in 15% and elevated triglycerides (≥150mg/dl) in 6.3% of adolescents. Increased SBP (≥130mmHg) presented the 22% of participants, while increased DBP (≥85mmHg) was apparent in 11.7% of them. Finally, almost one out of six adolescents (15.9%) presented metabolic syndrome. Conclusions: A significant percentage of the adolescent school population of Western Thessaloniki fulfills the criteria of the metabolic syndrome. In order to avoid the development of chronic diseases, implementation of prevention and intervention strategies are considered in adolescence as priority actions.
Keywords: metabolic syndrome, adolescents, obesity
Suisse)
W100b (Foracare Suisse).
FORA d40b (Foracare Suisse).
Med-Care (Biochemical Systems International Srl).
p-value
(15.9%)
14.61±1.91
14.00±1.76
(mmΗg) ΧΟΛΗΣΤΕΡΟΛΗ (mg/dl)
(mg/dl)
ΓΛΥΚΟΖΗ (mg/dl)
(20),
“Muscatine”
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23. Magnussen CG, Raitakari OT, Thomson R, Juonala M, Patel DA, Viikari JS et al. Utility of currently recommended pediatric dyslipidemia classifications in predicting dyslipidemia in adulthood: evidence from the Childhood Determinants of Adult Health (CDAH) study, Cardiovascular Risk in Young Finns Study, and Bogalusa Heart Study. Circulation 2008;117:32-42.
24. Katzmarzyk PT, Pérusse L, Malina RM, Bergeron J, Després JP, Bouchard C. Stability of indicators of the metabolic syndrome from childhood and adolescence to young adulthood: the Québec Family Study. J Clin Epidemiol 2001;54:190-195.
25. De Ferranti SD, Gauvreau K, Ludwig DS, Neufeld EJ, Newburger JW, Rifai N. Prevalence of the metabolic syndrome in American adolescents: findings from the Third National Health and Nutrition Examination Survey. Circulation 2004;110: 2494-2497.
26. Setayeshgar S, Whiting SJ, Vatanparast H. Metabolic syndrome in canadian adults and adolescents: prevalence and associated dietary intake. ISRN Obes 2012;2012:816846.
27. Fadzlina AA, Harun F, Nurul Haniza MY, Al Sadat N, Murray L, Cantwell MM et al. Metabolic syndrome among 13 year old adolescents: prevalence and risk factors. BMC Public Health 2014;14:S7.
28. Li P, Jiang R, Li L, Liu C, Yang F, Qiu Y. Prevalence and risk factors of metabolic syndrome in school adolescents of northeast China. J Pediatr Endocrinol Metab 2014;27:525-532.
29. Kim HM, Park J, Kim HS, Kim DH. Prevalence of the metabolic syndrome in Korean adolescents aged 12-19 years from the Korean National Health and Nutrition Examination Survey 1998 and 2001. Diabetes Res Clin Pract 2007;75:111-114.
30. Mehairi AE, Khouri AA, Naqbi MM, Muhairi SJ, Maskari FA, Nagelkerke N et al. Metabolic syndrome among Emirati adolescents: a school-based study. PLoS One. 2013;8:e56159.
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36. Hatzis CM, Papandreou C, Sifaki-Pistolla D, Jildeh C, Kafatos AG. The metabolic syndrome among preschool and school age children and adolescents in Crete in the first decade of the 21st century. Hormones (Athens). 2014;13:588-590.
37. Christodoulos AD, Douda HT, Tokmakidis SP. Cardiorespiratory fitness, metabolic risk, and inflammation in children. Int J Pediatr 2012;2012:270515.
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Correspondence
Papadopoulos Giorgos
St. Catherine, 3100, Limassol, Cyprus
e-mail: cytogenivf@ yahoo.co.uk
Τ.: +35799619890
Correlation of blood pressure and Body Mass Index (BMI) in Senior High School students
Papadopoulos Giorgos Ph.D., Tamattiri Kyriaki, Economou Alexandra, Akrita Christina, Engomiti Evdokia, Makri Antrea, Theophanous Zoe, Xatziantona Nicol, Charalambous Giorgos
Introduction: Several studies in adolescents have shown association of body mass index (BMI) with blood pressure, where individuals with a BMI >= 25, and classified as overweight or obese, have comparatively higher blood pressure than people with normal BMI levels (BMI < 25). We did not find in the literature any such study on Cyprus concerning adolescents of the upper secondary cycle (15-18 years), so we decided to research this in our school.
Methods: We studied boys and girls of all ages and measured BMI and blood pressure. Statistical analysis was performed for correlation of blood pressure with BMI, age, smoking and sex.
Results: We found direct correlation between the overall BMI and the systolic and diastolic pressure. The correlation was more significant with systolic pressure. When we compared separately normal weight, overweight and obese individuals, we found a positive correlation in the first case, very slightly negative correlation in the second and slightly negative correlation in the third case. There was no statistical difference in systolic and diastolic pressure levels related to smoking or age. There was a significant difference in the systolic pressure between boys and girls, but not in the diastolic pressure.
Conclusions: For the first time, data is presented for adolescents of ages 15 to 18 years in Cyprus that shows a direct correlation of increasing BMI with increasing systolic and diastolic pressure, findings that are consistent with those of other international studies.
Papadopoulos Giorgos
Ph.D.
Tamattiri Kyriaki
Economou Alexandra
Akrita Christina
Engomiti Evdokia
Makri Antrea
Theophanous Zoe
Xatziantona Nicol
Charalambous Giorgos
Lyceum of St. Nicholas, St. Catherine, Limassol, Cyprus
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15. Re R.N. Obesity-Related Hypertension. The Ochsner Journal 2009; 9:133–136.
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17. Hanevold C., Waller J., Daniels S., Portman R., Sorof J. The effects of obesity, gender and ethnic group on left ventricular hypertrophy and geometry in hypertensive children: a collaborative study of the International Pediatric Hypertension Association. Pediatrics. 2004;113:328–333.
18. Sorof J.M., Cardwell G., Franco K., Portman R.J. Ambulatory blood pressure and left ventricular mass index in hypertensive children.Hypertension. 2002;39:903–908.
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20. Urbina E.M., Khoury P.R., McCoy C., Daniels S.R., Kimball T.R., Dolan L.M. Cardiac and vascular consequences of pre-hypertension in youth. J ClinHypertens(Greenwi ch).2011;13:332–342.
21. Sorof J., Daniels S. Obesity hypertension in children: a problem of epidemic proportions. Hypertension 2002; 40:441–447.
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30. Chi Le-Ha, Beilin L. J., Burrows S., Huang Rae-Chi, Oddy W. H., Hands B. et al. Oral contraceptive use in girls and alcohol consumption in boys are associated with increased blood pressure in late adolescence. European Journal of Preventive Cardiology December 2013; 20:947955
31. Rabbia F., Veglio F., Pinna G., Oliva S., Surgo V., Rolando B., et al. Cardiovascular risk factors in adolescents: prevalence and familial aggregation. Prev Med. 1994; 23(6):809-15.
Correspondence
Gogou Maria
Dimitriou Nika 44, 60100, Katerini, Greece e-mail: mariaangogou@ gmail.com T.: +302351036093
Lung function in children with neuromuscular disorders. Experience from Thessaloniki Neuromuscular Disorders Unit
Maria Gogou, Maria Hatzistylianou, Maria Eboriadou, Evangelos Pavlou, Andreas Giannopoulos, Efterpi Pavlidou, Katerina Haidopoulou
Abstract
Objectives: The aim of this study is to evaluate lung function in children and adolescents with neuromuscular disorders.
Methods: The population of the study included children and adolescents attending the Respiratory Department of Neuromuscular Disorders Unit of Thessaloniki during the years 2011-2014. Epidemiologic data were collected, as well as data about their respiratory status, such as subcutaneous hemoglobin saturation with oxygen, end-tidal CO2, spirometric parameters and peak cough flow. All results were statistically analyzed.
Maria Gogou
Maria Hatzistylianou
Evangelos Pavlou
Andreas Giannopoulos
Efterpi Pavlidou
2nd Pediatric Department, Aristotelian
University of Thessaloniki, University General Hospital AHEPA, Thessaloniki, Greece
Maria Gogou
Maria Hatzistylianou
Maria Eboriadou
Evangelos Pavlou
Andreas Giannopoulos
Efterpi Pavlidou
Katerina Haidopoulou
Neuromuscular Disorders Unit, University General Hospital AHEPA, Thessaloniki, Greece
Results: Data from 67 patients were collected. The most frequent diagnosis was muscular dystrophy Duchenne (33%). Totally 44 of 67 patients performed spirometry and 26 of them were proved to have reduced lung function (mainly of restrictive type). Peak cough flow was significantly lower in children with abnormal spirometry. Subcutaneous hemoglobin saturation with oxygen remained normal, even in patients with abnormal spirometry, but CO2 seemed to be earlier affected. Moreover, peak cough flow was found to be positively associated with values of spirometry and this correlation was stronger for forced vital capacity and weaker for peak expiratory flow. Besides, loss of free-walking ability was proved to be a significant risk factor for disturbed respiratory function. As regards compliance with medical instructions, 70% of patients attended systematically a respiratory physiotherapy program, whereas ~2/3 of children were not vaccinated against influenza virus.
Conclusions: Respiratory problems have a high prevalence among children with neuromuscular disorders. Peak cough flow seems to be an earlier indicator of reduced pulmonary function and its values are closely correlated with values of forced vital capacity. The long-term follow-up of these children should include frequent evaluation of their respiratory function, especially after loss of their free-walking ability.
Keywords: children, neuromuscular disorders, lung function, spirometry, peak cough flow
(Forced Vital Capacity-FVC),
(Forced Expiratory Volume 1-FEV1)
(Peak Cough Flow-PCF).
(Peak Expiratory Flow-PEF).
Αντίθετα, όταν το z-score της FEV1<-1,96 με φυσιολογικό z-score για την FVCκαι
(3).
Συντομογραφίες:
FVC: forced vital capacity,
FEV1: forced expiratory volume in the 1st second,
PEF: peak expiratory flow,
PCF:
SpO2 (97,77±0,61% VS 97,7±0,82%, p>0,05).
(34,04±1,56mm Hg VS 32,8±2,56mm Hg, p=0,058). (Πίνακας 1)
1. Allen J. Pulmonary complications of neuromuscular disease: A Respiratory mechanics perspective. Pediatr Res Rev 2010; 11: 18-23
2. Roberto R, Fritz A, Hagar Y, Boice B, Skalsky A, Hwang H, et al. The natural history of cardiac and pulmonary function decline in patients with duchenne muscular dystrophy. Spine 2011; 36:1009-17
3.
Θεσσαλονίκη: University Studio Press 2006: 35-44
4. Backman H, Lindberg A, Sovijärvi A, Larsson K, Lundbäck B, Rönmark E. Evaluation of the global lung function initiative 2012 reference values for spirometry in a Swedish population sample. BMC Pulm Med 2015; 25, 15:26
5. Sharma GD. Pulmonary function testing in neuromuscular disorders. Pediatrics 2009; 123: 219-21
6. Panitch HB. The pathophysiology of respiratory impairment in pediatric neuromuscular diseases. Pediatrics 2009; 123: 215-8
7. Suárez AA, Pessolano FA, Monteiro SG, Ferreyra G, Capria ME, Mesa L, et al. Peak flow and peak cough flow in the evaluation of expiratory muscle weakness and bulbar impairment in patients with neuromuscular disease. Am J Phys Med Rehabil 2002; 81: 506-11
8. Gauld LM, Boynton A. Relationship between peak cough flow and spirometry in Duchenne Muscular Dystrophy. Pediatr Pulmonol 2005; 39:457-60
9. Bersanini C, Khirani S, Ramirez A, Lofaso F, Aubertin G, Beydon N, et al. Nocturnal hypoxemia and hypercapnia in children with neuromuscular disorders. Eur Respir J 2012; 39: 1206-1212
10. Toussaint M, Steens M, Soudon P. Lung function accurately predicts hypercapnia in patients with Duchenne muscular dystrophy. Chest 2007; 13: 368-75
11. Bothwell JE, Gordon KE, Dooley JM, Mac Sween J, Cummings EA, Salisbury S. Vertebral fractures in boys with Duchenne muscular dystrophy. Clin Pediatr 2003; 42: 353–6
12. Smith AD, Koreska J, Moseley CF. Progression of scoliosis in Duchenne muscular dystrophy. J Bone Joint Surg Am 1989; 71: 1066–7
13. Arens R, Muzumdar H. Sleep, sleep disordered breathing, and nocturnal hypoventilation in children with neuromuscular diseases. Pediatr Respir Rev 2010; 11: 24-30
14. Danov Z, Schroth MK. Respiratory Management of Pediatric Patients with Neuromuscular Disease. Pediatric Annals 2010; 39: 769-75
15. Finder JD, Birnkrant D, Carl J, Farber HJ, Gozal D, Iannaccone ST, et al. Respiratory care of the patient with Duchenne muscular dystrophy: ATS consensus statement. Am J Respir Crit
Care Med. 2004; 170: 456-65
16. Parkeri ΑΕ, Robb SA, Chambers J, Davidson AC, Evans K, Dowd JO, et al. Analysis of an adult Duchenne muscular dystrophy population. Q J Med 2005; 98:729–736
17. Bushby K, Finkel R, Birnkrant DJ, Case LE, Clemens PR, Cripe L, et al. Diagnosis and management of Duchenne muscular dystrophy, part 2: implementation of multidisciplinary care. Lancet Neurol 2010; 9:77-93
18. Simonds AK. Recent advances in respiratory care for neuromuscular disease. Chest 2006; 130: 1879-86
19. Fauroux B, Quijano-Roy S, Desguerre I, Khirani S. The value of respiratory muscle testing in children with neuromuscular disease. Chest 2015; 147:552-9
20. 46. Wang CH, Finkel RS, Bertini ES, Schroth M, Simonds A, Wong B, et al. Consensus statement for standard of care in spinal muscular atrophy. J Child Neurol 2007; 22:1027-49
21. Warren R, Stefans V, Horan S. Breathe easy: Respiratory care in neuromuscular diseases, 2nd ed. Tucson: MDA Publications Department, 2009:17-22
22. Strehle EM. Long-term management of children with neuromuscular disorders. J Pediatr (Rio J) 2009; 85: 379-84
NET.ADB
EU.NET.ADB (www.eunetadb.eu). Μέθοδοι:
ποσοστό παχύσαρκων/υπέρβαρων εφήβων (19.8%), ενώ
(6.8%).
αγόρια (ΣΚ=2.89, 95%ΟΑ: 2.46-3.38), η υπερβολική χρήση κοινωνικών δικτύων (ΣΚ=1.26, 95%ΟΑ: 1.01-1.31), η διαμονή στην Ελλάδα (ΣΚ=2.32,,95%ΟΑ: 1.79-2.99) σχετίστηκαν θετικά με παχυσαρκία. Ο αριθμός των αδελφών (ΣΚ=0.79, 95%ΟΑ: 0.64-0.97), οι καλές
σχολικές επιδόσεις (ΣΚ=0.74, 95%ΟΑ: 0.63-0.88), το εκπαιδευτικό επίπεδο των γονέων (ΣΚ=0.89, 95%ΟΑ: 0.82-0.97) και η διαμονή στην Ολλανδία (ΣΚ=0.49, 95%ΟΑ: 0.31-0.77)
σχετίστηκαν
Correspondence
Artemis Tsitsika
24 Mesogeion Av, 11527, Athens, Greece
e-mail: info@youthhealth.gr
T./F.: +302107710824
Association between problematic internet use, socio-demographic variables and overweight/obesity among European adolescents. Results from the
EU.NET.ADB study
Artemis Tsitsika, Elisavet Andrie, Theodora Psaltopoulou, Chara Tzavara, Theodoros Sergentanis, Flora Bacopoulou, Magda Patseadou, Clive Richardson, George Chroussos, Marisa Tsolia
Abstract
Artemis Tsitsika
Elisavet Andrie
Chara Tzavara
Magda Patseadou
Marisa Tsolia
Adolescent Health Unit, 2nd Department of Paediatrics, University of Athens, “P.&A. Kyriakou” Children’s Hospital, Athens
Theodora Psaltopoulou
Theodoros Sergentanis
Department of Hygiene and Epidemiology, Medical School, University of Athens
Flora Bacopoulou
George Chroussos
1st Department of Paediatrics, University of Athens, “Aghia Sophia” Children’s Hospital, Athens
Clive Richardson
Panteion University of Social and Political Sciences
Background: Obesity in childhood and adolescence remains a global public health issue. Loss of control of daily internet use can lead adolescents to neglect their health care and can increase their body weight. This study aims to examine the relationship between problematic internet use and overweight/obesity among adolescents from seven European countries (Iceland, The Netherlands, Germany, Poland, Romania, Spain and Greece) participating in the EU.NET. ADB survey (www.eunetadb.eu).
Methods: A sample of 11.298 adolescents aged 14-17 years (representative samples from each country) took part in the study. Collection of data was performed from October 2011 until May 2012. The questionnaire included socio-demographic data, information about internet use, family, school achievement and parental control. Body weight and height were self-reported. Internet addiction tool (IAT) (Young 1998) was used for assessing excessive internet use. Logistic regression analysis was used for data processing.
Results: A percentage of 12.4% of the whole sample were overweight/obese and 14.1% were detected with problematic internet use. Greece had the highest adolescent overweight/obesity prevalence (19.8%), while the Netherlands the lowest one (6.8%). Males (OR=2.89, 95% CI: 2.46-3.38), excessive use of social networking (OR=1.26, 95% CI: 1.01-1.31) and Greek ethnicity (OR=2.32, 95% CI: 1.79-2.99) were significantly associated with overweight/obesity. Having a sibling (OR=0.79, 95% CI: 0.64-0.97), high school performance (OR=0.74, 95% CI: 0.63-0.88), high parental educational level (OR=0.89, 95% CI: 0.82-0.97) and Dutch ethnicity (OR=0.49, 95% CI: 0.31-0.77) were inversely related to obesity.
Conclusions: The association between overweight/obesity and problematic internet use, as well as specific socio-demographic variables, can set the basis for the development of public health policies.
Keywords: adolescents, overweight, demographic, socioeconomic factors, problematic internet use
22.0 (IBM Corp., Armonk, NY, USA).
ήταν άρρενες (n=5.140) και οι 8.972 (87,8%) είχαν
αδερφιών=1,9,
9.012 (87,6%) είχαν
απόκλιση (Standard Deviation, SD=1.3, διάμεσος τιμή, Median=1). Οι 1.275 συμμετέχοντες (12,4%) ήταν υπέρβαροι/παχύσαρκοι, ενώ
(SD=3.1).
(p<0.001, Pearson chi-square test).
(OR=3.20, 95% CI: 2.79-3.67),
ΚΔ (OR=1.15, 95% CI: 1.01-1.31), την ΕΔΒ χρήση
διαδικτύου (OR=1.14, 95% CI: 1.01-1.29) και τη ΣΕΔ (OR=1.70, 95% CI: 1.08-2.67). Αντιθέτως, το υπέρβαρο/παχύσαρκο σχετίστηκε
ηλικία (OR=0.84, 95% CI: 0.73-0.95), την ύπαρξη αδερφών στην οικογένεια (OR=0.80, 95% CI: 0.67-0.95), την καλή σχολική επίδοση (OR=0.79, 95% CI: 0.69-0.90), και το υψηλό μορφωτικό επίπεδο των γονέων (OR=0.87, 95% CI: 0.82-0.93). Σχετικά με τη διαφορά που
καταγράφηκε μεταξύ των επτά ευρωπαϊκών χωρών, η Ελλάδα (OR=2.08, 95% CI: 1.64-2.64)
(OR=1.44, 95% CI: 1.11-1.85)
(OR=0.61, 95% CI: 0.41-0.91).
Ο πίνακας 4 δείχνει τα αποτελέσματα της
φύλο (OR=2.89, 95% CI: 2.46-3.38), η ΕΔΒ χρήση ΚΔ (OR=1.26, 95% CI: 1.091.46) και η ελληνική (OR=2.32, 95% CI: 1.79-2.99) ή
(OR=1.48, 95% CI: 1.121.96)
(OR=0.74, 95% CI: 0.63-0.88),
(OR=0.79, 95% CI: 0.64-0.97),
(OR=0.89, 95%CI: 0.820.97)
95%CI: 0.31-0.77)
1629 (15.8)
1492 (14.5) 1646 (16.0) 1437 (14.0)
1845 (17.9) 844 (8.2) 1394 (13.6) 5147 (50.0) 5140 (50.0) 5544 (53.9) 4743 (46.1) 9012 (87.6) 1092 (10.6) 183 (1.8) 1576 (16.4) 3525 (36.7)
3041 (31.7) 1261 (13.1) 192 (2.0) 1245 (12.2) 8972 (87.8)
65 (0.7) 622 (7.0)
2609 (29.4) 2276 (25.6)
3303 (37.2)
Ελλάδα
Φυσιολογικό
Υπέρβαρο/Παχύσαρκο
Γερμανία
Φυσιολογικό
Υπέρβαρο/Παχύσαρκο
Ισλανδία
Φυσιολογικό
(2.79-3.67)
(0.73-0.95)
(0.67-0.95)
(2.46-3.38)
(0.64-0.97)
(0.82-0.97)
(0.63-0.88) 1.26 (1.09-1.46) 2.32 (1.79-2.99) 1.48 (1.12-1.96) 1.16 (0.85-1.60) 0.96 (0.72-1.29)
(0.59-1.09)
(0.31-0.77)
Βιβλιογραφία
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