The future of primary paediatric care in Europe: reflections and Report of the EPA/UNEPSA Committee.

Background: Changes in the scope of the field of paediatrics and the variability in primary paediatric care (PPC) and practice throughout Europe motivated the European Paediatric Association and Union of National European Paediatric Societies and Associations (EPA/UNEPSA) to establish a working group to discuss definitions of paediatric coverage in terms of age limits, find common denominators in the provision of PPC and examine the challenges and goals of 21st century paediatrics relevant to the continent. These issues were presented at the 2008 Europaediatrics in Istanbul, where a consensus declaration was drawn up and accepted by the EPA/UNEPSA Executive Committee.

Aim: To present an outline of the essential elements of the 2008 EPA/UNEPSA Executive Committee consensus declaration.

Assessment of left ventricular structure and function in rats subjected to pressure-overload hypertrophy in time.

Background: Left ventricular hypertrophy (LVH) is an adaptive response to increased haemodynamic load and an independent risk factor for the development of heart failure. Although the pathophysiological features during the development of cardiac hypertrophy have been extensively studied, the time course of LVH is less clearly defined.

Aim: To define the time-dependency of the LVH process in vivo and compare the data by necropsy.

Time course and progression of pressure overload-induced cardiac hypertrophy in rats.

Aim: To study the time course and progression of pressure overload-induced left ventricular hypertrophy

Methods: Left ventricular hypertrophy was induced in rats by abdominal aorta constriction and assessed at different time points (10, 15, 20, 25, 35, and 45 days) after operation.

Results: The cardiac index (the ratio of heart weight to body weight) in aortic-banded animals was characterised by phasic changes when compared with the sham operated and the control animals. In aortic-banded rats the cardiac index rose sharply at days 10 and 15 after operation.

A reproducible model of cardiac hypertrophy in rats. Problems and obstacles we faced.

Aim: To develop a reproducible model of significant left ventricular hypertrophy in order to study the role played by the tumor suppressor protein 53 (P53) in the mechanisms of cardiac hypertrophy, the cross-talk with the other factors and the connection between expression and activity of P53, cardiac myocyte apoptosis and heart hypertrophy; to discuss the problems and obstacles we faced.

Methods: Male Wistar rats were used in the experiments. Left ventricular hypertrophy was induced by banding the abdominal aorta.

Centromeric instability of chromosomes 1, 9 and 16 with variable immune deficiency. Support of a new syndrome.

A four-month-old girl with facial dysmorphism, moderate mental retardation, immune deficiency (decreased IgG and IgA and absence of IgM), centromeric instability of chromosomes 1, 9, 16 and very rarely of chromosome 2, and disposition to formation of multibranched chromosomal figures, is described. The case is the fifth described with such chromosomal and immune abnormalities, which prove the existence of a new syndrome. The authors suggest an autosomal recessive inheritance.