OBJECTIVES: The objective of this review paper was to stimulate collaborative discussions toward the development of a general concept of an open source protocol for a feasible and efficient longitudinal birth cohort study exploring non-communicable diseases (NCDs), their multifactorial etiology and relations between various risk factors. STUDY DESIGN: The present paper systematically reviews the design of existing birth cohorts in Europe containing environmental exposure data, and assesses a quantity and quality of their research outcomes as their potential to be an effective tool for studying non-communicable diseases and their risk factors. METHODS: European birth cohorts with more than 3000 participants have been included in the study. A total number of scientific papers published in the internationally recognized journals and their impact factors and citation records were evaluated for all cohorts as surrogates for their efficiency to contribute to NCDs understanding and thus their prevention. RESULTS: The birth cohorts contributing most significantly to the NCD understanding shared common features: (i) study size between 10,000 and 15,000 mother-child pairs; (ii) repeated assessment of children from prenatal into adulthood; and (iii) availability of biological samples. Smaller cohorts and cohorts with a specific focus generated a lower number of publications; however, these often received considerably a higher number of citations. CONCLUSIONS: General cohort studies with 10,000-15,000 mother-child pairs allow a broader context interpretation, publish a higher number of articles, and often lead to the formation of infrastructures for 'spin-off (nested) studies'.
- Klíčová slova
- European birth cohorts, Non-communicable diseases, Research outcomes, Study design,
- MeSH
- běloši * MeSH
- databáze faktografické MeSH
- dítě MeSH
- kohortové studie * MeSH
- lidé MeSH
- longitudinální studie MeSH
- novorozenec MeSH
- rizikové faktory MeSH
- vystavení vlivu životního prostředí * MeSH
- Check Tag
- dítě MeSH
- lidé MeSH
- novorozenec MeSH
- Publikační typ
- časopisecké články MeSH
- přehledy MeSH
- Geografické názvy
- Evropa MeSH
The diagnosis and treatment of the injured spleen in children changed markedly during the last 20 years. However even when contemporary diagnostic algorithms and therapeutic procedures are used, there are still problems for which we lack an unequivocal answer. Based on their own experience and data in the literature the authors try to contribute to the solution of this important traumatological problem.
Laparoscopic operations (LO) of adults are performed as a routine in many departments, while LO in children are only at their onset. During September 1994 to May 1995 at the Clinic of Paediatric Surgery and Traumatology in Brno the first 100 LO and two thoracoscopic operations were performed. The group is formed by children aged 3 to 17 years. Their mean age was 10.6 years. The number comprised 14 acute operations, the remainder were planned operations. There was no perioperative fatality. Complications included one abscess of the Douglas bag, once the necessity of minilaparotomy on account of minor haemorrhage after resection of Meckel's diverticulum by means of endoGIA and once because the size of the tumour. Early conversion was necessary in two patients.
The authors present a case dealing with the treatment of a congenital diaphragmatic hernia. The procedure comprises surgery, extracorporeal membrane oxygenation--ECMO, classical and non-conventional pulmonary ventilation and pharmacological treatment. By using these methods it is possible to treat successfully a certain group of neonates with a congenital diaphragmatic hernia.
- MeSH
- brániční hernie chirurgie MeSH
- lidé MeSH
- mimotělní membránová oxygenace * MeSH
- novorozenec MeSH
- pooperační péče MeSH
- předoperační péče MeSH
- vrozená brániční kýla * MeSH
- Check Tag
- lidé MeSH
- mužské pohlaví MeSH
- novorozenec MeSH
- Publikační typ
- anglický abstrakt MeSH
- časopisecké články MeSH
- kazuistiky MeSH
The authors describe their initial experience, organization, and problems associated with the development of an EMCO centre. Its main activities are those of a neonatal ECMO centre (to a smaller extent paediatric ECMO and ECCO2R-LF PPV of adults) during the first 4 months of its existence. During the period the ECMO centre was contacted in 10 instances. The referring department indicated the ECMO centre correctly in six instances. However, at least in two instances too late and the patients died (during priming of the ECMO circuit or transport could not be implemented because of the critical condition). In two instances, however, the ECMO staff failed as it was unable to ensure a minimum of seven days of safe operation of ECMO and therefore ECMO was not provided. Based on this experience the authors present an organizational model of the ECMO unit which is formed ad hoc when needed and comprises specialists of various professions from the sphere of emergency medicine. The main purpose of the present paper is to inform referring departments on the indications, selection criteria, contraindications of ECMO in neonates and children and to ensure thus not only smooth communication between the ECMO centre and the referring department but in the first place early referral to the ECMO centre at a time when transport is not yet a problem.
- MeSH
- dítě MeSH
- dospělí MeSH
- kojenec MeSH
- lidé MeSH
- mimotělní membránová oxygenace * MeSH
- novorozenec MeSH
- projektování a výstavba zařízení MeSH
- řízení zdravotnických zařízení MeSH
- Check Tag
- dítě MeSH
- dospělí MeSH
- kojenec MeSH
- lidé MeSH
- novorozenec MeSH
- Publikační typ
- anglický abstrakt MeSH
- časopisecké články MeSH
