S. Kolacek - Academia.edu (original) (raw)
Papers by S. Kolacek
Journal of Crohn's & colitis, Jan 11, 2017
; on behalf of the European Crohn's and Colitis Organisation [ECCO] and the European Society of C... more ; on behalf of the European Crohn's and Colitis Organisation [ECCO] and the European Society of Colo-Proctology [ESCP]
Journal of Crohn's and Colitis, 2014
by body weight (40kg, 160/80 mg; <40kg, 80/40 mg). At wk 4, patients were randomized to double-bl... more by body weight (40kg, 160/80 mg; <40kg, 80/40 mg). At wk 4, patients were randomized to double-blind higher-dose (HD) ADA (40kg, 40 mg every other week [EOW]; <40kg, 20 mg EOW) or lower-dose (LD) ADA (40kg, 20 mg EOW; <40kg, 10 mg EOW) to wk 52. Patients could escalate to blinded weekly therapy for flare or non-response, followed by OL HD ADA weekly for continued flare or non-response. Change from BL in height velocity z-score was measured at wk 26 and wk 52 in patients with and without growth delay at BL. Subgroup analyses by BL corticosteroid use, disease severity based on median BL PCDAI of study, and prior infliximab (IFX) use were performed. Results: Statistically significant improvement in growth was observed at wk 26 and wk 52 with ADA therapy in patients with growth delay (median height velocity z-score at BL 2.9; median change from BL: wk 26 = 2.4; wk 52 = 3.3, p < 0.001), but not in patients with normal growth. No significant differences between LD and HD ADA were observed. Growth improvement trended to be larger in patients with BL corticosteroid use, severe CD, and in IFX-naive patients. Conclusion: ADA treatment significantly improved growth in children with moderately to severely active CD and growth delay.
Journal of Pediatric Gastroenterology & Nutrition, 2014
New England Journal of Medicine, 2014
BACKGROUND A window of opportunity has been suggested for reducing the risk of celiac disease by ... more BACKGROUND A window of opportunity has been suggested for reducing the risk of celiac disease by introducing gluten to infants at 4 to 6 months of age. METHODS We performed a multicenter, randomized, double-blind, placebo-controlled dietaryintervention study involving 944 children who were positive for HLA-DQ2 or HLA-DQ8 and had at least one first-degree relative with celiac disease. From 16 to 24 weeks of age, 475 participants received 100 mg of immunologically active gluten daily, and 469 received placebo. Anti-transglutaminase type 2 and antigliadin antibodies were periodically measured. The primary outcome was the frequency of biopsy-confirmed celiac disease at 3 years of age. RESULTS Celiac disease was confirmed by means of biopsies in 77 children. To avoid underestimation of the frequency of celiac disease, 3 additional children who received a diagnosis of celiac disease according to the 2012 European Society for Pediatric Gastroenterology, Hepatology, and Nutrition diagnostic criteria (without having undergone biopsies) were included in the analyses (80 children; median age, 2.8 years; 59% were girls). The cumulative incidence of celiac disease among patients 3 years of age was 5.2% (95% confidence interval [CI], 3.6 to 6.8), with similar rates in the gluten group and the placebo group (5.9% [95% CI, 3.7 to 8.1] and 4.5% [95% CI, 2.5 to 6.5], respectively; hazard ratio in the gluten group, 1.23; 95% CI, 0.79 to 1.91). Rates of elevated levels of anti-transglutaminase type 2 and antigliadin antibodies were also similar in the two study groups (7.0% [95% CI, 4.7 to 9.4] in the gluten group and 5.7% [95% CI, 3.5 to 7.9] in the placebo group; hazard ratio, 1.14; 95% CI, 0.76 to 1.73). Breast-feeding, regardless of whether it was exclusive or whether it was ongoing during gluten introduction, did not significantly influence the development of celiac disease or the effect of the intervention. CONCLUSIONS As compared with placebo, the introduction of small quantities of gluten at 16 to 24 weeks of age did not reduce the risk of celiac disease by 3 years of age in this group of high-risk children.
Clinical nutrition (Edinburgh, Scotland), Jan 18, 2018
This medical position article by the European Society for Paediatric Gastroenterology, Hepatology... more This medical position article by the European Society for Paediatric Gastroenterology, Hepatology, and Nutrition summarises the current status of breast-feeding practice, the present knowledge on the composition of human milk, advisable duration of exclusive and partial breast-feeding, growth of the breast-fed infant, health benefits associated with breast-feeding, nutritional supplementation for breast-fed infants, and contraindications to breast-feeding. This article emphasises the important role of paediatricians in the implementation of health policies devised to promote breast-feeding.The European Society for Paediatric Gastroenterology, Hepatology, and Nutrition Committee on Nutrition recognises breast-feeding as the natural and advisable way of supporting the healthy growth and development of young children. This article delineates the health benefits of breast-feeding, reduced risk of infectious diarrhoea and acute otitis media being the best documented. Exclusive breast-fee...
Journal of Cystic Fibrosis, 2021
Georgian medical news, 2005
We study some normalisation properties of the deep-inference proof system NEL, which can be seen ... more We study some normalisation properties of the deep-inference proof system NEL, which can be seen both as 1) an extension of multiplicative exponential linear logic (MELL) by a certain non-commutative self-dual logical operator; and 2) an extension of system BV by the exponentials of linear logic. The interest of NEL resides in: 1) its being Turing complete, while the same for MELL is not known, and is widely conjectured not to be the case; 2) its inclusion of a self-dual, non-commutative logical operator that, despite its simplicity, cannot be axiomatised in any analytic sequent calculus system; 3) its ability to model the sequential composition of processes. We present several decomposition results for NEL and, as a consequence of those and via a splitting theorem, cut elimination. We use, for the first time, an induction measure based on flow graphs associated to the exponentials, which captures their rather complex behaviour in the normalisation process. The results are presented in the calculus of structures, which is the first, developed formalism in deep inference.
Journal of Pediatric Gastroenterology & Nutrition, 2021
The aim of this study was to assess the prevalence of functional gastrointestinal disorders (FGID... more The aim of this study was to assess the prevalence of functional gastrointestinal disorders (FGIDs) in children of Mediterranean area using Rome IV criteria and to compare the prevalence of FGIDs using Rome IV and Rome III criteria. This was a cross-sectional study enrolling children and adolescents living in Croatia, Greece, Israel, Italy, Macedonia, and Serbia. Subjects were examined in relation to the presence of FGIDs, using the Rome IV criteria. Data were compared with the results of a previous study using Rome III data. We analyzed 1972 children ages 4 to 9 years (group A), and 2450 adolescents 10 to 18 years old (group B). The overall prevalence of FGIDs was 16% in group A and 26% in group B, with statistical differences among countries in both groups (P < 0.001). In group A, the prevalence of FGIDs and of functional constipation (FC) was significantly lower than in the previous study (P < 0.001), whereas in group B no significant difference was found. In both groups of age, the prevalence of abdominal migraine and irritable bowel syndrome decreased significantly (P < 0.001 and P < 0.001, respectively) using Rome IV versus Rome III criteria, conversely functional dyspepsia increased (P < 0.001). FGIDs are common in children and adolescents, their frequency increases with age, and there is a significant variation in the prevalence of some FGIDs among different European countries. The application of the Rome IV criteria resulted in a significantly lower prevalence of FGIDs in children compared with Rome III criteria.
Journal of Crohn's and Colitis, 2020
Background According to current guidelines, most paediatric patients in Europe diagnosed with Cro... more Background According to current guidelines, most paediatric patients in Europe diagnosed with Crohn′s disease (CD) are prescribed long-term immunosuppressive therapy with azathioprine (AZA). This study aimed to develop a predictive model allowing to stratify patients who will not benefit from AZA maintenance treatment and who require a more intensive therapeutic approach early after diagnosis. Methods The study was designed to develop a clinical prediction rule using retrospective data analysis from patients included to prospective inception cohort, the EUROKIDS-IBD until 2017. In total, 1190 CD patients using AZA were selected from the registry in 13 European centres. Of these, 441 patients who responded to induction treatment, started AZA treatment within 6 weeks from the time of diagnosis and maintained remission at week 12 were entered into this multicentre study. The primary outcome was time to clinical relapse defined as a necessity of re-induction of remission. A sequence of ...
Advances in Experimental Medicine and Biology
Ten Central and Eastern [NLG4]European countries have recently joined the European Union. This hi... more Ten Central and Eastern [NLG4]European countries have recently joined the European Union. This historical enlargement provided a good opportunity to discuss the challenges and opportunities in Pan-European Research Collaboration for researchers from Central/Eastern Europe. This paper summarises examples of productive research collaboration between East and West, current challenges[NLG5], and ideas on how to facilitate better collaboration. A short overview of training, mobility and career development opportunities, covered by the Marie Curie actions, is also presented.
Alimentary pharmacology & therapeutics, Jan 26, 2015
New evidence emerged on early feeding practices and the risk of coeliac disease. To systematicall... more New evidence emerged on early feeding practices and the risk of coeliac disease. To systematically update evidence on these practices to find out whether there is a need to revise current recommendations. MEDLINE, EMBASE and the Cochrane Library were searched from July 2012 (end of last search) to February 2015 for studies of any design that assessed the effect of gluten consumption and breastfeeding on the development of coeliac disease and/or coeliac disease-related autoimmunity. We identified 21 publications, including two, new, large, randomised controlled trials performed in high-risk infants. Exclusive or any breastfeeding, as well as breastfeeding at the time of gluten introduction, did not reduce the risk of developing coeliac disease during childhood. For infants at high risk of developing coeliac disease, gluten introduction at 4 months of age in very small amounts, or at 6 or 12 months of age, resulted in similar rates of coeliac disease diagnosis in early childhood. Late...
Journal of Crohn's & colitis, 2014
Children and adolescents with Crohn's disease (CD) present often with a more complicated dise... more Children and adolescents with Crohn's disease (CD) present often with a more complicated disease course compared to adult patients. In addition, the potential impact of CD on growth, pubertal and emotional development of patients underlines the need for a specific management strategy of pediatric-onset CD. To develop the first evidenced based and consensus driven guidelines for pediatric-onset CD an expert panel of 33 IBD specialists was formed after an open call within the European Crohn's and Colitis Organisation and the European Society of Pediatric Gastroenterolog, Hepatology and Nutrition. The aim was to base on a thorough review of existing evidence a state of the art guidance on the medical treatment and long term management of children and adolescents with CD, with individualized treatment algorithms based on a benefit-risk analysis according to different clinical scenarios. In children and adolescents who did not have finished their growth, exclusive enteral nutriti...
Georgian medical news, 2005
Lijec̆nic̆ki vjesnik, 2000
Wilson's disease (WD) is an inherited disease of copper accumulation, caused by a failure of ... more Wilson's disease (WD) is an inherited disease of copper accumulation, caused by a failure of biliary excretion of excess copper. Accumulated copper causes tissue damage. The chelating drugs penicillamine and trientine have been the mainstay of therapy and most patients with WD were treated with the potentially toxic cupriuretic agents. A more recent approach has used zinc, which blocks the absorption of copper and increases copper excretion in the stool, and long term administration induces a negative copper balance. Until recently, most patients have been treated initially with cupriuretic agents to remove excess of copper, and then maintained with oral zinc. Recently, zinc has been used for initial treatment as well and for treatment of the presymptomatic patients. So far, zinc therapy has demonstrated exceptional efficacy and lack of toxicity. In this article we present our data on the long-term follow-up of three children with WD, whose initial as well as consecutive treatme...
Collegium antropologicum, 1999
Coeliac disease is a permanent intolerance to gluten, producing small-intestinal lesions. Its inc... more Coeliac disease is a permanent intolerance to gluten, producing small-intestinal lesions. Its incidence in European countries varies from 1:400 to 1:2000, while there are no such epidemiological data for Croatia. Therefore, we investigated the incidence of coeliac disease for ten-year period in one well-defined region. Also, data concerning age at diagnosis and symptoms at the disease onset were collected. The cumulative incidence was 1.9:1000 life-births. The disease presented typically in more than 60% of cases. In 65% of patients, symptoms appeared during the first 2 years of life, while, when diagnosed, 45% were below 2 years. Also, it was shown that coeliac disease presented significantly later in children diagnosed during the last five years (p < 0.05). In conclusion, coeliac disease in Croatia is more frequent than previously suspected. It presents early, mostly with classical symptoms, although a tendency towards later ages of diagnosis was observed during the last few ye...
Collegium antropologicum, 1998
Multi-Indicator Survey (MICS) on children in Croatia was supported by UNICEF's Zagreb Office.... more Multi-Indicator Survey (MICS) on children in Croatia was supported by UNICEF's Zagreb Office. The purpose of this research was to establish the present situation in terms of breastfeeding, nutrition and prevention of the most significant health problems in primary health care i.e. acute respiratory and diarrhoeal diseases in children (ARI/CDD), and the level of knowledge. The survey for MICS in Croatia included altogether 370 segments, and from each 40 households were selected. This resulted in 14,800 households being selected for the final sample. 1563 (or 10.6%) of households selected had children under 5 years of age. In the whole sample there were altogether 1937 children under 5 years of age. Having summarized all relevant data, several general conclusions and assumptions may be drawn. The breast-feeding rate is very low, and therefore unsatisfactory. At the age of 4 months, more than 50% of all mothers have already stopped breast-feeding their infants, and only 20% of infa...
Lijec̆nic̆ki vjesnik
Results of different studies performed in the last ten years stress the possibility that infant n... more Results of different studies performed in the last ten years stress the possibility that infant nutrition is the important determinant of later development, and that many adult chronic diseases may have the origins in the very first few years of life. According to the hypothesis of "long-term programming", if the lack of nutrients was present in the critical phase of human development it will have a long-lasting or permanent effect on the final outcome. This paper is the review of the latest findings and the present state of knowledge about the possible permanent influences of general undernourishment, lack of some nutrients and the type of infant nutrition on a) psychomotor development, b) development of chronic diseases in children, and c) development of chronic diseases in late adulthood.
Journal of Crohn's and Colitis Supplements, 2009
presence of extraintestinal symptoms and the need of intestinal surgery and immunosuppressive the... more presence of extraintestinal symptoms and the need of intestinal surgery and immunosuppressive therapy. Results: 9% of the cases didn't achieve the target height, without significant differences for the year at diagnosis. However no patient diagnosed in the last decade reached a final height below the 3ºcent. No significant difference was observed between Crohn and UC patients. Only the height at diagnosis and the score of disease severity during the follow up predicted a final height below the genetic target. Conclusion: Most of the IBD patients diagnosed before 16 years of age in the last thirty years reached the genetic target for final height irrespective of the year at diagnosis and the therapeutic strategy. The only significant negative predictive factors for a final height below the genetic target are height at diagnosis and severity of the disease during the follow up.
Journal of Crohn's and Colitis Supplements, 2007
Introduction: Geographical studies of Inflammatory Bowel Disease (IBD) may lead to etiologic clue... more Introduction: Geographical studies of Inflammatory Bowel Disease (IBD) may lead to etiologic clues. One study has shown a north south gradient for Crohn' s Disease (CD) but not for Ulcerative Colitis (UC) in France. Metropolitan France is divided in 341 job areas, in which most of the active people reside and work. There are economic, sociodemographic and health data available for all job areas. The aim of this study was to refine the geographical distribution of IBD in France using this smaller scale. Methods: This study was conducted in metropolitan France and included patients to whom IBD reimbursement was newly attributed between January 1, 2000 and December 31, 2002. Data provided relate to age, sex, postcode area of residence and IBD type. The mapping of geographical distribution of smoothed relative risks (RR) of CD and UC was carried out using a Bayesian approach, taking into account autocorrelation and population size in each job area. Results: From January 1, 2000 to December 31, 2002, 14,213 patients with CD (57% of women) and 12,452 patients with UC (48% of women) were registered by the five health insurance funds, among the overall population of 59,368,981. In the population as a whole, the standardized incidence rate was 8.1 for 100,000 inhabitants (95% CI: 8.0-8.3) for CD and 7.1 [7.0-7.3] for UC. The width of SIR variation was in the same order of magnitude in CD and UC (0.16 to 2.43 and 0.00 to 2.16 respectively). At the scale of job area, there was a clear north south gradient for CD; Smoothed RR decreased from 1.43 (95% Bayesian confidence interval (BCI): 0.95-2.05) in northern France to a minimum of 0.80 (95% BCI: 0.68-0.93) in south-central France, but it then increased to 1.00 (95% BCI: 0.72-1.39) in southern France. There was no such gradient for UC. Conclusion: This study refines the geographical distribution of CD and UC in France at the scale of job area. It confirms a north south gradient for CD but not for UC. P141 EPIDEMIOLOGY OF IBD IN CROATIAN CHILDREN
Journal of Crohn's & colitis, Jan 11, 2017
; on behalf of the European Crohn's and Colitis Organisation [ECCO] and the European Society of C... more ; on behalf of the European Crohn's and Colitis Organisation [ECCO] and the European Society of Colo-Proctology [ESCP]
Journal of Crohn's and Colitis, 2014
by body weight (40kg, 160/80 mg; <40kg, 80/40 mg). At wk 4, patients were randomized to double-bl... more by body weight (40kg, 160/80 mg; <40kg, 80/40 mg). At wk 4, patients were randomized to double-blind higher-dose (HD) ADA (40kg, 40 mg every other week [EOW]; <40kg, 20 mg EOW) or lower-dose (LD) ADA (40kg, 20 mg EOW; <40kg, 10 mg EOW) to wk 52. Patients could escalate to blinded weekly therapy for flare or non-response, followed by OL HD ADA weekly for continued flare or non-response. Change from BL in height velocity z-score was measured at wk 26 and wk 52 in patients with and without growth delay at BL. Subgroup analyses by BL corticosteroid use, disease severity based on median BL PCDAI of study, and prior infliximab (IFX) use were performed. Results: Statistically significant improvement in growth was observed at wk 26 and wk 52 with ADA therapy in patients with growth delay (median height velocity z-score at BL 2.9; median change from BL: wk 26 = 2.4; wk 52 = 3.3, p < 0.001), but not in patients with normal growth. No significant differences between LD and HD ADA were observed. Growth improvement trended to be larger in patients with BL corticosteroid use, severe CD, and in IFX-naive patients. Conclusion: ADA treatment significantly improved growth in children with moderately to severely active CD and growth delay.
Journal of Pediatric Gastroenterology & Nutrition, 2014
New England Journal of Medicine, 2014
BACKGROUND A window of opportunity has been suggested for reducing the risk of celiac disease by ... more BACKGROUND A window of opportunity has been suggested for reducing the risk of celiac disease by introducing gluten to infants at 4 to 6 months of age. METHODS We performed a multicenter, randomized, double-blind, placebo-controlled dietaryintervention study involving 944 children who were positive for HLA-DQ2 or HLA-DQ8 and had at least one first-degree relative with celiac disease. From 16 to 24 weeks of age, 475 participants received 100 mg of immunologically active gluten daily, and 469 received placebo. Anti-transglutaminase type 2 and antigliadin antibodies were periodically measured. The primary outcome was the frequency of biopsy-confirmed celiac disease at 3 years of age. RESULTS Celiac disease was confirmed by means of biopsies in 77 children. To avoid underestimation of the frequency of celiac disease, 3 additional children who received a diagnosis of celiac disease according to the 2012 European Society for Pediatric Gastroenterology, Hepatology, and Nutrition diagnostic criteria (without having undergone biopsies) were included in the analyses (80 children; median age, 2.8 years; 59% were girls). The cumulative incidence of celiac disease among patients 3 years of age was 5.2% (95% confidence interval [CI], 3.6 to 6.8), with similar rates in the gluten group and the placebo group (5.9% [95% CI, 3.7 to 8.1] and 4.5% [95% CI, 2.5 to 6.5], respectively; hazard ratio in the gluten group, 1.23; 95% CI, 0.79 to 1.91). Rates of elevated levels of anti-transglutaminase type 2 and antigliadin antibodies were also similar in the two study groups (7.0% [95% CI, 4.7 to 9.4] in the gluten group and 5.7% [95% CI, 3.5 to 7.9] in the placebo group; hazard ratio, 1.14; 95% CI, 0.76 to 1.73). Breast-feeding, regardless of whether it was exclusive or whether it was ongoing during gluten introduction, did not significantly influence the development of celiac disease or the effect of the intervention. CONCLUSIONS As compared with placebo, the introduction of small quantities of gluten at 16 to 24 weeks of age did not reduce the risk of celiac disease by 3 years of age in this group of high-risk children.
Clinical nutrition (Edinburgh, Scotland), Jan 18, 2018
This medical position article by the European Society for Paediatric Gastroenterology, Hepatology... more This medical position article by the European Society for Paediatric Gastroenterology, Hepatology, and Nutrition summarises the current status of breast-feeding practice, the present knowledge on the composition of human milk, advisable duration of exclusive and partial breast-feeding, growth of the breast-fed infant, health benefits associated with breast-feeding, nutritional supplementation for breast-fed infants, and contraindications to breast-feeding. This article emphasises the important role of paediatricians in the implementation of health policies devised to promote breast-feeding.The European Society for Paediatric Gastroenterology, Hepatology, and Nutrition Committee on Nutrition recognises breast-feeding as the natural and advisable way of supporting the healthy growth and development of young children. This article delineates the health benefits of breast-feeding, reduced risk of infectious diarrhoea and acute otitis media being the best documented. Exclusive breast-fee...
Journal of Cystic Fibrosis, 2021
Georgian medical news, 2005
We study some normalisation properties of the deep-inference proof system NEL, which can be seen ... more We study some normalisation properties of the deep-inference proof system NEL, which can be seen both as 1) an extension of multiplicative exponential linear logic (MELL) by a certain non-commutative self-dual logical operator; and 2) an extension of system BV by the exponentials of linear logic. The interest of NEL resides in: 1) its being Turing complete, while the same for MELL is not known, and is widely conjectured not to be the case; 2) its inclusion of a self-dual, non-commutative logical operator that, despite its simplicity, cannot be axiomatised in any analytic sequent calculus system; 3) its ability to model the sequential composition of processes. We present several decomposition results for NEL and, as a consequence of those and via a splitting theorem, cut elimination. We use, for the first time, an induction measure based on flow graphs associated to the exponentials, which captures their rather complex behaviour in the normalisation process. The results are presented in the calculus of structures, which is the first, developed formalism in deep inference.
Journal of Pediatric Gastroenterology & Nutrition, 2021
The aim of this study was to assess the prevalence of functional gastrointestinal disorders (FGID... more The aim of this study was to assess the prevalence of functional gastrointestinal disorders (FGIDs) in children of Mediterranean area using Rome IV criteria and to compare the prevalence of FGIDs using Rome IV and Rome III criteria. This was a cross-sectional study enrolling children and adolescents living in Croatia, Greece, Israel, Italy, Macedonia, and Serbia. Subjects were examined in relation to the presence of FGIDs, using the Rome IV criteria. Data were compared with the results of a previous study using Rome III data. We analyzed 1972 children ages 4 to 9 years (group A), and 2450 adolescents 10 to 18 years old (group B). The overall prevalence of FGIDs was 16% in group A and 26% in group B, with statistical differences among countries in both groups (P < 0.001). In group A, the prevalence of FGIDs and of functional constipation (FC) was significantly lower than in the previous study (P < 0.001), whereas in group B no significant difference was found. In both groups of age, the prevalence of abdominal migraine and irritable bowel syndrome decreased significantly (P < 0.001 and P < 0.001, respectively) using Rome IV versus Rome III criteria, conversely functional dyspepsia increased (P < 0.001). FGIDs are common in children and adolescents, their frequency increases with age, and there is a significant variation in the prevalence of some FGIDs among different European countries. The application of the Rome IV criteria resulted in a significantly lower prevalence of FGIDs in children compared with Rome III criteria.
Journal of Crohn's and Colitis, 2020
Background According to current guidelines, most paediatric patients in Europe diagnosed with Cro... more Background According to current guidelines, most paediatric patients in Europe diagnosed with Crohn′s disease (CD) are prescribed long-term immunosuppressive therapy with azathioprine (AZA). This study aimed to develop a predictive model allowing to stratify patients who will not benefit from AZA maintenance treatment and who require a more intensive therapeutic approach early after diagnosis. Methods The study was designed to develop a clinical prediction rule using retrospective data analysis from patients included to prospective inception cohort, the EUROKIDS-IBD until 2017. In total, 1190 CD patients using AZA were selected from the registry in 13 European centres. Of these, 441 patients who responded to induction treatment, started AZA treatment within 6 weeks from the time of diagnosis and maintained remission at week 12 were entered into this multicentre study. The primary outcome was time to clinical relapse defined as a necessity of re-induction of remission. A sequence of ...
Advances in Experimental Medicine and Biology
Ten Central and Eastern [NLG4]European countries have recently joined the European Union. This hi... more Ten Central and Eastern [NLG4]European countries have recently joined the European Union. This historical enlargement provided a good opportunity to discuss the challenges and opportunities in Pan-European Research Collaboration for researchers from Central/Eastern Europe. This paper summarises examples of productive research collaboration between East and West, current challenges[NLG5], and ideas on how to facilitate better collaboration. A short overview of training, mobility and career development opportunities, covered by the Marie Curie actions, is also presented.
Alimentary pharmacology & therapeutics, Jan 26, 2015
New evidence emerged on early feeding practices and the risk of coeliac disease. To systematicall... more New evidence emerged on early feeding practices and the risk of coeliac disease. To systematically update evidence on these practices to find out whether there is a need to revise current recommendations. MEDLINE, EMBASE and the Cochrane Library were searched from July 2012 (end of last search) to February 2015 for studies of any design that assessed the effect of gluten consumption and breastfeeding on the development of coeliac disease and/or coeliac disease-related autoimmunity. We identified 21 publications, including two, new, large, randomised controlled trials performed in high-risk infants. Exclusive or any breastfeeding, as well as breastfeeding at the time of gluten introduction, did not reduce the risk of developing coeliac disease during childhood. For infants at high risk of developing coeliac disease, gluten introduction at 4 months of age in very small amounts, or at 6 or 12 months of age, resulted in similar rates of coeliac disease diagnosis in early childhood. Late...
Journal of Crohn's & colitis, 2014
Children and adolescents with Crohn's disease (CD) present often with a more complicated dise... more Children and adolescents with Crohn's disease (CD) present often with a more complicated disease course compared to adult patients. In addition, the potential impact of CD on growth, pubertal and emotional development of patients underlines the need for a specific management strategy of pediatric-onset CD. To develop the first evidenced based and consensus driven guidelines for pediatric-onset CD an expert panel of 33 IBD specialists was formed after an open call within the European Crohn's and Colitis Organisation and the European Society of Pediatric Gastroenterolog, Hepatology and Nutrition. The aim was to base on a thorough review of existing evidence a state of the art guidance on the medical treatment and long term management of children and adolescents with CD, with individualized treatment algorithms based on a benefit-risk analysis according to different clinical scenarios. In children and adolescents who did not have finished their growth, exclusive enteral nutriti...
Georgian medical news, 2005
Lijec̆nic̆ki vjesnik, 2000
Wilson's disease (WD) is an inherited disease of copper accumulation, caused by a failure of ... more Wilson's disease (WD) is an inherited disease of copper accumulation, caused by a failure of biliary excretion of excess copper. Accumulated copper causes tissue damage. The chelating drugs penicillamine and trientine have been the mainstay of therapy and most patients with WD were treated with the potentially toxic cupriuretic agents. A more recent approach has used zinc, which blocks the absorption of copper and increases copper excretion in the stool, and long term administration induces a negative copper balance. Until recently, most patients have been treated initially with cupriuretic agents to remove excess of copper, and then maintained with oral zinc. Recently, zinc has been used for initial treatment as well and for treatment of the presymptomatic patients. So far, zinc therapy has demonstrated exceptional efficacy and lack of toxicity. In this article we present our data on the long-term follow-up of three children with WD, whose initial as well as consecutive treatme...
Collegium antropologicum, 1999
Coeliac disease is a permanent intolerance to gluten, producing small-intestinal lesions. Its inc... more Coeliac disease is a permanent intolerance to gluten, producing small-intestinal lesions. Its incidence in European countries varies from 1:400 to 1:2000, while there are no such epidemiological data for Croatia. Therefore, we investigated the incidence of coeliac disease for ten-year period in one well-defined region. Also, data concerning age at diagnosis and symptoms at the disease onset were collected. The cumulative incidence was 1.9:1000 life-births. The disease presented typically in more than 60% of cases. In 65% of patients, symptoms appeared during the first 2 years of life, while, when diagnosed, 45% were below 2 years. Also, it was shown that coeliac disease presented significantly later in children diagnosed during the last five years (p < 0.05). In conclusion, coeliac disease in Croatia is more frequent than previously suspected. It presents early, mostly with classical symptoms, although a tendency towards later ages of diagnosis was observed during the last few ye...
Collegium antropologicum, 1998
Multi-Indicator Survey (MICS) on children in Croatia was supported by UNICEF's Zagreb Office.... more Multi-Indicator Survey (MICS) on children in Croatia was supported by UNICEF's Zagreb Office. The purpose of this research was to establish the present situation in terms of breastfeeding, nutrition and prevention of the most significant health problems in primary health care i.e. acute respiratory and diarrhoeal diseases in children (ARI/CDD), and the level of knowledge. The survey for MICS in Croatia included altogether 370 segments, and from each 40 households were selected. This resulted in 14,800 households being selected for the final sample. 1563 (or 10.6%) of households selected had children under 5 years of age. In the whole sample there were altogether 1937 children under 5 years of age. Having summarized all relevant data, several general conclusions and assumptions may be drawn. The breast-feeding rate is very low, and therefore unsatisfactory. At the age of 4 months, more than 50% of all mothers have already stopped breast-feeding their infants, and only 20% of infa...
Lijec̆nic̆ki vjesnik
Results of different studies performed in the last ten years stress the possibility that infant n... more Results of different studies performed in the last ten years stress the possibility that infant nutrition is the important determinant of later development, and that many adult chronic diseases may have the origins in the very first few years of life. According to the hypothesis of "long-term programming", if the lack of nutrients was present in the critical phase of human development it will have a long-lasting or permanent effect on the final outcome. This paper is the review of the latest findings and the present state of knowledge about the possible permanent influences of general undernourishment, lack of some nutrients and the type of infant nutrition on a) psychomotor development, b) development of chronic diseases in children, and c) development of chronic diseases in late adulthood.
Journal of Crohn's and Colitis Supplements, 2009
presence of extraintestinal symptoms and the need of intestinal surgery and immunosuppressive the... more presence of extraintestinal symptoms and the need of intestinal surgery and immunosuppressive therapy. Results: 9% of the cases didn't achieve the target height, without significant differences for the year at diagnosis. However no patient diagnosed in the last decade reached a final height below the 3ºcent. No significant difference was observed between Crohn and UC patients. Only the height at diagnosis and the score of disease severity during the follow up predicted a final height below the genetic target. Conclusion: Most of the IBD patients diagnosed before 16 years of age in the last thirty years reached the genetic target for final height irrespective of the year at diagnosis and the therapeutic strategy. The only significant negative predictive factors for a final height below the genetic target are height at diagnosis and severity of the disease during the follow up.
Journal of Crohn's and Colitis Supplements, 2007
Introduction: Geographical studies of Inflammatory Bowel Disease (IBD) may lead to etiologic clue... more Introduction: Geographical studies of Inflammatory Bowel Disease (IBD) may lead to etiologic clues. One study has shown a north south gradient for Crohn' s Disease (CD) but not for Ulcerative Colitis (UC) in France. Metropolitan France is divided in 341 job areas, in which most of the active people reside and work. There are economic, sociodemographic and health data available for all job areas. The aim of this study was to refine the geographical distribution of IBD in France using this smaller scale. Methods: This study was conducted in metropolitan France and included patients to whom IBD reimbursement was newly attributed between January 1, 2000 and December 31, 2002. Data provided relate to age, sex, postcode area of residence and IBD type. The mapping of geographical distribution of smoothed relative risks (RR) of CD and UC was carried out using a Bayesian approach, taking into account autocorrelation and population size in each job area. Results: From January 1, 2000 to December 31, 2002, 14,213 patients with CD (57% of women) and 12,452 patients with UC (48% of women) were registered by the five health insurance funds, among the overall population of 59,368,981. In the population as a whole, the standardized incidence rate was 8.1 for 100,000 inhabitants (95% CI: 8.0-8.3) for CD and 7.1 [7.0-7.3] for UC. The width of SIR variation was in the same order of magnitude in CD and UC (0.16 to 2.43 and 0.00 to 2.16 respectively). At the scale of job area, there was a clear north south gradient for CD; Smoothed RR decreased from 1.43 (95% Bayesian confidence interval (BCI): 0.95-2.05) in northern France to a minimum of 0.80 (95% BCI: 0.68-0.93) in south-central France, but it then increased to 1.00 (95% BCI: 0.72-1.39) in southern France. There was no such gradient for UC. Conclusion: This study refines the geographical distribution of CD and UC in France at the scale of job area. It confirms a north south gradient for CD but not for UC. P141 EPIDEMIOLOGY OF IBD IN CROATIAN CHILDREN