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Research paper thumbnail of Study Protocol Effect of the consumption of a fermented dairy product containing Bifidobacterium lactis DN173 010 on constipation in childhood: a multicentre randomised controlled trial (NTRTC: 1571

Hernia, 2009

ABSTRACT\BACKGROUND:Constipation is a frustrating symptom affecting 3% of children worldwide. Ran... more ABSTRACT\BACKGROUND:Constipation is a frustrating symptom affecting 3% of children worldwide. Randomised controlled trials show that both polyethylene glycol and lactulose are effective in increasing defecation frequency in children with constipation. However, in 30-50%, these children reported abdominal pain, bloating, flatulence, diarrhoea, nausea and bad taste of the medication. Two recent studies have shown that the fermented dairy product containing Bifidobacterium

Research paper thumbnail of Glucomannan is not effective for the treatment of functional constipation in children: A double-blind, placebo-controlled, randomized trial

Clinical Nutrition, 2011

Treatment measures for constipation in children are often not satisfactory. The aim was to assess... more Treatment measures for constipation in children are often not satisfactory. The aim was to assess the efficacy of glucomannan (GNN) as a sole treatment for functional constipation.Children aged 3–16 years with functional constipation according to Rome III criteria were randomly assigned to receive GNN (2.52 g/d) or placebo for 4 weeks.Of the 80 children, 72 (90%) completed the study. The primary outcome, treatment success (≥3 stools per week with no soiling), was similar in the GNN (n = 36) and placebo (n = 36) groups (relative risk 0.95, 95% CI 0.6 to 1.4). In the GNN group, the stool consistency score was higher at week 1 (P < 0.0001), lower at week 3 (P = 0.008), and similar at weeks 2 and 4. Stool frequency was higher only at week 3 (P = 0.007). Abdominal pain episodes were more frequent in the GNN group at week 1 (P = 0.04) and week 4 (P < 0.0001) but were similar between groups at weeks 2 and 3. No difference was observed in the frequency of any other secondary outcome or adverse event.In our setting, GNN, as dosed in this study, was not more effective than placebo in achieving therapeutic success in constipated children.The trial was registered at ClinicalTrials.gov (http://clinicaltrials.gov), number NCT01151878.

Research paper thumbnail of Systematic review: racecadotril in the treatment of acute diarrhoea in children: SYSTEMATIC REVIEW: RACECADOTRIL IN THE TREATMENT OF ACUTE DIARRHOEA

Alimentary Pharmacology & Therapeutics, 2007

SummaryBackgroundRacecadotril (acetorphan) is an antisecretory drug that exerts its antidiarrhoea... more SummaryBackgroundRacecadotril (acetorphan) is an antisecretory drug that exerts its antidiarrhoeal effects by inhibiting intestinal enkephalinase.Racecadotril (acetorphan) is an antisecretory drug that exerts its antidiarrhoeal effects by inhibiting intestinal enkephalinase.AimTo summarize studies testing the efficacy and safety of racecadotril for treating children with acute gastroenteritis.To summarize studies testing the efficacy and safety of racecadotril for treating children with acute gastroenteritis.MethodsReports were gathered by searching electronic databases MEDLINE, EMBASE, the Cochrane Library (all up to April 2007), relevant journals, and bibliographies of reviewed articles. Only randomized-controlled trials were included.Reports were gathered by searching electronic databases MEDLINE, EMBASE, the Cochrane Library (all up to April 2007), relevant journals, and bibliographies of reviewed articles. Only randomized-controlled trials were included.ResultsThree randomized-controlled trials (471 participants) met the inclusion criteria. Two trials reported stool output, and data suggested less stool output in the racecadotril group than in the control group. The duration of diarrhoea was significantly reduced in the three trials reporting this outcome. Achievement of a cure by day 5 was similar in both groups. Adverse effects were similar in both groups.Three randomized-controlled trials (471 participants) met the inclusion criteria. Two trials reported stool output, and data suggested less stool output in the racecadotril group than in the control group. The duration of diarrhoea was significantly reduced in the three trials reporting this outcome. Achievement of a cure by day 5 was similar in both groups. Adverse effects were similar in both groups.ConclusionsThe small number of included trials provided some evidence in favour of the use of racecadotril over placebo or no intervention, to reduce the stool output and duration of diarrhoea in children with acute gastroenteritis. However, more data in out-patients are needed. The safety as well as the cost-effectiveness of the therapy should be explored, before routine therapy with racecadotril is recommended.The small number of included trials provided some evidence in favour of the use of racecadotril over placebo or no intervention, to reduce the stool output and duration of diarrhoea in children with acute gastroenteritis. However, more data in out-patients are needed. The safety as well as the cost-effectiveness of the therapy should be explored, before routine therapy with racecadotril is recommended.

Research paper thumbnail of Systematic review of randomised controlled trials: Probiotics for functional constipation

A systematic review and subset meta-analysis of published randomised controlled trials of psychol... more A systematic review and subset meta-analysis of published randomised controlled trials of psychological therapies for children and adolescents with chronic pain is reported. A search of four computerised abstracting services recovered 123 papers from which 28 potential trials were identified. Eighteen met the criteria for inclusion in the review. The majority of these papers reported brief behavioural and cognitive behavioural interventions for children with headache and many were conducted in community (i.e. school) settings. Meta-analysis was applicable for 12 headache trials and one trial of recurrent abdominal pain using the Pain Index. The odds-ratio for a 50% reduction in pain was 9.62 and the number needed to treat was 2.32, indicating that the psychological treatments examined are effective in reducing the pain of headache. The quality of the 18 trials retrieved is narratively reviewed and suggestions for the development of trials in this field are made.

Research paper thumbnail of Effects of iron supplementation in nonanemic pregnant women, infants, and young children on the mental performance and psychomotor development of children: a systematic review of randomized controlled trials

American Journal of Clinical Nutrition, 2010

Background: Uncertainty exists regarding the effects of iron supplementation on neurodevelopmenta... more Background: Uncertainty exists regarding the effects of iron supplementation on neurodevelopmental outcomes in the absence of anemia. Objective: Our objective was to evaluate the effects of iron supplementation in nonanemic pregnant women and in nonanemic healthy children aged ,3 y on the mental performance and psychomotor development of children. Design: In this systematic review, MEDLINE, EMBASE, and The Cochrane Library were searched through December 2009 for randomized controlled trials (RCTs). Results: None of 5 RCTs individually showed a beneficial effect of iron supplementation during early life on the Mental Developmental Index of the Bayley Scales of Infant Development at different ages throughout the first 18 mo. Meta-analysis of 3 RCTs (n = 561) showed that, compared with placebo, supplementation with iron had no significant effect on children's Mental Developmental Index at '12 mo of age (weighted mean difference: 1.66; 95% CI: 20.14, 3.47). Three of 5 RCTs showed a beneficial effect of iron supplementation on the Psychomotor Development Index at some time points, whereas 2 did not. Meta-analysis of 3 RCTs (n = 561) showed significant improvement on the Psychomotor Development Index at '12 mo of age in the iron-supplemented group compared with the control group (weighted mean difference: 4.21; 95% CI: 2.31, 6.12). Two RCTs showed no effect of iron supplementation on behavior. Neither of the 2 RCTs that addressed the influence of prenatal iron supplementation showed an effect of iron on either the intelligence quotient or behavioral status of the children. Conclusion: Limited available evidence suggests that iron supplementation in infants may positively influence children's psychomotor development, whereas it does not seem to alter their mental development or behavior.

Research paper thumbnail of Study Protocol Effect of the consumption of a fermented dairy product containing Bifidobacterium lactis DN173 010 on constipation in childhood: a multicentre randomised controlled trial (NTRTC: 1571

Hernia, 2009

ABSTRACT\BACKGROUND:Constipation is a frustrating symptom affecting 3% of children worldwide. Ran... more ABSTRACT\BACKGROUND:Constipation is a frustrating symptom affecting 3% of children worldwide. Randomised controlled trials show that both polyethylene glycol and lactulose are effective in increasing defecation frequency in children with constipation. However, in 30-50%, these children reported abdominal pain, bloating, flatulence, diarrhoea, nausea and bad taste of the medication. Two recent studies have shown that the fermented dairy product containing Bifidobacterium

Research paper thumbnail of Glucomannan is not effective for the treatment of functional constipation in children: A double-blind, placebo-controlled, randomized trial

Clinical Nutrition, 2011

Treatment measures for constipation in children are often not satisfactory. The aim was to assess... more Treatment measures for constipation in children are often not satisfactory. The aim was to assess the efficacy of glucomannan (GNN) as a sole treatment for functional constipation.Children aged 3–16 years with functional constipation according to Rome III criteria were randomly assigned to receive GNN (2.52 g/d) or placebo for 4 weeks.Of the 80 children, 72 (90%) completed the study. The primary outcome, treatment success (≥3 stools per week with no soiling), was similar in the GNN (n = 36) and placebo (n = 36) groups (relative risk 0.95, 95% CI 0.6 to 1.4). In the GNN group, the stool consistency score was higher at week 1 (P < 0.0001), lower at week 3 (P = 0.008), and similar at weeks 2 and 4. Stool frequency was higher only at week 3 (P = 0.007). Abdominal pain episodes were more frequent in the GNN group at week 1 (P = 0.04) and week 4 (P < 0.0001) but were similar between groups at weeks 2 and 3. No difference was observed in the frequency of any other secondary outcome or adverse event.In our setting, GNN, as dosed in this study, was not more effective than placebo in achieving therapeutic success in constipated children.The trial was registered at ClinicalTrials.gov (http://clinicaltrials.gov), number NCT01151878.

Research paper thumbnail of Systematic review: racecadotril in the treatment of acute diarrhoea in children: SYSTEMATIC REVIEW: RACECADOTRIL IN THE TREATMENT OF ACUTE DIARRHOEA

Alimentary Pharmacology & Therapeutics, 2007

SummaryBackgroundRacecadotril (acetorphan) is an antisecretory drug that exerts its antidiarrhoea... more SummaryBackgroundRacecadotril (acetorphan) is an antisecretory drug that exerts its antidiarrhoeal effects by inhibiting intestinal enkephalinase.Racecadotril (acetorphan) is an antisecretory drug that exerts its antidiarrhoeal effects by inhibiting intestinal enkephalinase.AimTo summarize studies testing the efficacy and safety of racecadotril for treating children with acute gastroenteritis.To summarize studies testing the efficacy and safety of racecadotril for treating children with acute gastroenteritis.MethodsReports were gathered by searching electronic databases MEDLINE, EMBASE, the Cochrane Library (all up to April 2007), relevant journals, and bibliographies of reviewed articles. Only randomized-controlled trials were included.Reports were gathered by searching electronic databases MEDLINE, EMBASE, the Cochrane Library (all up to April 2007), relevant journals, and bibliographies of reviewed articles. Only randomized-controlled trials were included.ResultsThree randomized-controlled trials (471 participants) met the inclusion criteria. Two trials reported stool output, and data suggested less stool output in the racecadotril group than in the control group. The duration of diarrhoea was significantly reduced in the three trials reporting this outcome. Achievement of a cure by day 5 was similar in both groups. Adverse effects were similar in both groups.Three randomized-controlled trials (471 participants) met the inclusion criteria. Two trials reported stool output, and data suggested less stool output in the racecadotril group than in the control group. The duration of diarrhoea was significantly reduced in the three trials reporting this outcome. Achievement of a cure by day 5 was similar in both groups. Adverse effects were similar in both groups.ConclusionsThe small number of included trials provided some evidence in favour of the use of racecadotril over placebo or no intervention, to reduce the stool output and duration of diarrhoea in children with acute gastroenteritis. However, more data in out-patients are needed. The safety as well as the cost-effectiveness of the therapy should be explored, before routine therapy with racecadotril is recommended.The small number of included trials provided some evidence in favour of the use of racecadotril over placebo or no intervention, to reduce the stool output and duration of diarrhoea in children with acute gastroenteritis. However, more data in out-patients are needed. The safety as well as the cost-effectiveness of the therapy should be explored, before routine therapy with racecadotril is recommended.

Research paper thumbnail of Systematic review of randomised controlled trials: Probiotics for functional constipation

A systematic review and subset meta-analysis of published randomised controlled trials of psychol... more A systematic review and subset meta-analysis of published randomised controlled trials of psychological therapies for children and adolescents with chronic pain is reported. A search of four computerised abstracting services recovered 123 papers from which 28 potential trials were identified. Eighteen met the criteria for inclusion in the review. The majority of these papers reported brief behavioural and cognitive behavioural interventions for children with headache and many were conducted in community (i.e. school) settings. Meta-analysis was applicable for 12 headache trials and one trial of recurrent abdominal pain using the Pain Index. The odds-ratio for a 50% reduction in pain was 9.62 and the number needed to treat was 2.32, indicating that the psychological treatments examined are effective in reducing the pain of headache. The quality of the 18 trials retrieved is narratively reviewed and suggestions for the development of trials in this field are made.

Research paper thumbnail of Effects of iron supplementation in nonanemic pregnant women, infants, and young children on the mental performance and psychomotor development of children: a systematic review of randomized controlled trials

American Journal of Clinical Nutrition, 2010

Background: Uncertainty exists regarding the effects of iron supplementation on neurodevelopmenta... more Background: Uncertainty exists regarding the effects of iron supplementation on neurodevelopmental outcomes in the absence of anemia. Objective: Our objective was to evaluate the effects of iron supplementation in nonanemic pregnant women and in nonanemic healthy children aged ,3 y on the mental performance and psychomotor development of children. Design: In this systematic review, MEDLINE, EMBASE, and The Cochrane Library were searched through December 2009 for randomized controlled trials (RCTs). Results: None of 5 RCTs individually showed a beneficial effect of iron supplementation during early life on the Mental Developmental Index of the Bayley Scales of Infant Development at different ages throughout the first 18 mo. Meta-analysis of 3 RCTs (n = 561) showed that, compared with placebo, supplementation with iron had no significant effect on children's Mental Developmental Index at '12 mo of age (weighted mean difference: 1.66; 95% CI: 20.14, 3.47). Three of 5 RCTs showed a beneficial effect of iron supplementation on the Psychomotor Development Index at some time points, whereas 2 did not. Meta-analysis of 3 RCTs (n = 561) showed significant improvement on the Psychomotor Development Index at '12 mo of age in the iron-supplemented group compared with the control group (weighted mean difference: 4.21; 95% CI: 2.31, 6.12). Two RCTs showed no effect of iron supplementation on behavior. Neither of the 2 RCTs that addressed the influence of prenatal iron supplementation showed an effect of iron on either the intelligence quotient or behavioral status of the children. Conclusion: Limited available evidence suggests that iron supplementation in infants may positively influence children's psychomotor development, whereas it does not seem to alter their mental development or behavior.