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Kellett S, Petrushkin H, Ashworth J, Connor A, McLoone E, Schmoll C, Sharma S, Agorogiannis E, Williams J, Choi J, Injarie A, Puvanachandra N, Watts P, Shafi A, Millar E, Long V, Kumar A, Hughes E, Ritchie A, Gonzalez-Martin J, Pradeep A, Anwar S, Warrior K, Muthusamy B, Pilling R, Benzimra J, Reddy A, Bush K, Pharoah D, Falzon K, O'Colmain U, Knowles R, Tadic V, Dick A, Rahi J, Solebo AL. 2 Pathways to detection of non-infectious childhood uveitis in the UK: findings from the UNICORN cohort study. BMJ Open Ophthalmol 2023; 8:A1. [PMID: 37797997 DOI: 10.1136/bmjophth-2023-biposa.2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/07/2023] Open
Abstract
INTRODUCTION Prompt detection of childhood uveitis is key to minimising negative impact. From an internationally unique inception cohort, we report pathways to disease detection.UNICORNS is a national childhood non-infectious uveitis study with longitudinal collection of a standardised clinical dataset and patient reported outcomes. Descriptive analysis of baseline characteristics are reported.Amongst 150 recruited children (51% female, 31% non-white ethnicity) age at detection ranged from 2-18yrs (median 10). In 69%, uveitis was diagnosed following onset of symptoms: time from first symptoms to uveitis detection ranged from 0-739days (median 7days), with longer time to detection for those presenting initially to their general practitioner. Non symptomatic children were detected through JIA/other disease surveillance (16%), routine optometry review (5%) or child visual health screening (1%). Commonest underlying diagnoses at uveitis detection were JIA (17%), TINU (9%, higher than pre-pandemic reported UK disease frequency) and sarcoid (1%). 60% had no known systemic disease at uveitis detection. At disease detection, in at least one eye: 34% had structural complications (associated with greater time to detection - 17 days versus 4 days for uncomplicated presentation).The larger relative proportions of children with non-JIA uveitis reported here increase the importance of improving awareness of childhood uveitis amongst the wider clinical communities. There is scope for improvement of pathways to detection. Forthcoming analysis on the full cohort (251 recruited to date across 33 hospitals and 4 nations) will provide nationally representative data on management and the determinants of visual and broader developmental/well-being outcomes.
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Affiliation(s)
- S Kellett
- University College London, Institute of Child Health, UK
| | - H Petrushkin
- University College London, Institute of Child Health, UK
| | - J Ashworth
- University College London, Institute of Child Health, UK
| | - A Connor
- University College London, Institute of Child Health, UK
| | - E McLoone
- University College London, Institute of Child Health, UK
| | - C Schmoll
- University College London, Institute of Child Health, UK
| | - S Sharma
- University College London, Institute of Child Health, UK
| | - E Agorogiannis
- University College London, Institute of Child Health, UK
| | - J Williams
- University College London, Institute of Child Health, UK
| | - J Choi
- University College London, Institute of Child Health, UK
| | - A Injarie
- University College London, Institute of Child Health, UK
| | | | - P Watts
- University College London, Institute of Child Health, UK
| | - A Shafi
- University College London, Institute of Child Health, UK
| | - E Millar
- University College London, Institute of Child Health, UK
| | - V Long
- University College London, Institute of Child Health, UK
| | - A Kumar
- University College London, Institute of Child Health, UK
| | - E Hughes
- University College London, Institute of Child Health, UK
| | - A Ritchie
- University College London, Institute of Child Health, UK
| | | | - A Pradeep
- University College London, Institute of Child Health, UK
| | - S Anwar
- University College London, Institute of Child Health, UK
| | - K Warrior
- University College London, Institute of Child Health, UK
| | - B Muthusamy
- University College London, Institute of Child Health, UK
| | - R Pilling
- University College London, Institute of Child Health, UK
| | - J Benzimra
- University College London, Institute of Child Health, UK
| | - A Reddy
- University College London, Institute of Child Health, UK
| | - K Bush
- University College London, Institute of Child Health, UK
| | - D Pharoah
- University College London, Institute of Child Health, UK
| | - K Falzon
- University College London, Institute of Child Health, UK
| | - U O'Colmain
- University College London, Institute of Child Health, UK
| | - R Knowles
- University College London, Institute of Child Health, UK
| | - V Tadic
- University College London, Institute of Child Health, UK
| | - A Dick
- University College London, Institute of Child Health, UK
| | - J Rahi
- University College London, Institute of Child Health, UK
| | - A L Solebo
- University College London, Institute of Child Health, UK
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Seiler F, Trudzinski F, Hennemann K, Niermeyer T, Schmoll C, Kamp A, Bals R, Muellenbach R, Haake H, Lepper PM. Effektivität und Sicherheit der extrakorporalen CO2-Elimination unter Verwendung der Homburger Lunge – eine retrospektive Fallserie. Pneumologie 2017. [DOI: 10.1055/s-0037-1598428] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Affiliation(s)
- F Seiler
- Klinik für Innere Medizin V, Pneumologie, Allergologie, Beatmungs- und Umweltmedizin, Universitätsklinikum des Saarlandes
| | - F Trudzinski
- Klinik für Innere Medizin V, Pneumologie, Allergologie, Beatmungs- und Umweltmedizin, Universitätsklinikum des Saarlandes
| | - K Hennemann
- Klinik für Thorax- und Herz-Gefäßchirurgie, Abteilung für Kardiotechnik, Universitätsklinikum des Saarlandes
| | - T Niermeyer
- Klinik für Thorax- und Herz-Gefäßchirurgie, Abteilung für Kardiotechnik, Universitätsklinikum des Saarlandes
| | | | - A Kamp
- Klinik für Innere Medizin V, Pneumologie, Allergologie, Beatmungs- und Umweltmedizin, Universitätsklinikum des Saarlandes
| | - R Bals
- Klinik für Innere Medizin V, Pneumologie, Allergologie, Beatmungs- und Umweltmedizin, Universitätsklinikum des Saarlandes
| | - R Muellenbach
- Klinik für Anästhesiologie, Universitätsklinikum Würzburg
| | | | - PM Lepper
- Klinik für Innere Medizin V, Pneumologie, Allergologie, Beatmungs- und Umweltmedizin, Universitätsklinikum des Saarlandes
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Olewczynska N, Kaiser R, Böhmer P, Lensch C, Schäfers HJ, Rustler M, Joost T, Schmoll C, Kaestner F, Langer F, Wilkens H, Bals R, Lepper PM. Veno-veno-arterielle ECMO als Überbrückung bis zur Lungentransplantation bei einer wachen, nicht intubierten Patientin mit schwerer pulmonalarterieller Hypertonie. Pneumologie 2014. [DOI: 10.1055/s-0034-1367807] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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Kaestner F, Olewczynska N, Kaiser R, Böhmer P, Fähndrich S, Coulee L, Kamp A, Stehle I, Rentz K, Schmoll C, Henschke S, Schäfers HJ, Langer F, Wilkens H, Bals R, Lepper PM. Extrakorporale Membranoxygenierung bei Patienten mit Sepsis und septischem Schock als Überbrückung zur Lungentransplantation. Pneumologie 2014. [DOI: 10.1055/s-0034-1367769] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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Butler MG, Smith BK, Lee J, Gibson C, Schmoll C, Moore WV, Donnelly JE. Effects of growth hormone treatment in adults with Prader-Willi syndrome. Growth Horm IGF Res 2013; 23:81-87. [PMID: 23433655 PMCID: PMC4144013 DOI: 10.1016/j.ghir.2013.01.001] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/08/2012] [Revised: 12/13/2012] [Accepted: 01/03/2013] [Indexed: 10/27/2022]
Abstract
OBJECTIVE Since limited data exist on adults with Prader-Willi syndrome (PWS) and growth hormone (GH) treatment, we report our experience on the effects of treatment for one year on body composition, physical activity, strength and energy expenditure, diet, general chemistry and endocrine data with quality of life measures. DESIGN We studied 11 adults with PWS (6F:5M; average age=32 yrs) over a 2 year period with GH treatment during the first year only. Electrolytes, IGF-I, glucose, thyroid, insulin, lipids, body composition, physical activity and strength, diet, energy expenditure and quality of life data were collected and analyzed statistically using linear modeling at baseline, at 12 months following GH therapy and at 24 months after treatment cessation for 12 months. RESULTS Total lean muscle mass was significantly increased (p<0.05) during GH treatment along with moderate-vigorous physical activity and plasma IGF-I and HDL levels, but returned to near baseline after treatment. Percent body fat decreased during the 12 months of GH treatment but increased after treatment. CONCLUSIONS Previously reported beneficial effects of GH treatment in children with PWS were found in our adults regarding body composition, physical activity and plasma HDL and IGF-I levels. Several beneficial effects diminished to near baseline after cessation of GH treatment for 12 months supporting the continuation of treatment in PWS into adulthood and possibly adults not previously treated during childhood.
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Affiliation(s)
- M G Butler
- Department of Psychiatry & Behavioral Sciences, University of Kansas Medical Center, and Department of Pediatrics, Children's Mercy Hospital, Kansas City, United States.
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