Vaccine coverage in children, adolescents and adults with type 1 diabetes and their close contacts in Crete.

Background: Individuals with type 1 diabetes (T1D) are at increased risk of infections from vaccine-preventable diseases. This study focuses on compliance of T1D patients to the recommended vaccination schedule, vaccination of their close contacts for influenza and on factors potentially contributing to vaccination program deviations.

Methods: The study population comprised children, adolescents and adults with T1D under follow-up at the Department of Pediatrics University Hospital and the Diabetic Center General Hospital, Heraklion, Crete-Greece.

Avoiding hypoglycemia: the use of insulin pump combined with continuous glucose monitor in type 1 diabetes crossing a Rocky Gorge.

Background: Continuous subcutaneous insulin infusion (CSII) and continuous glucose monitoring systems (CGMS) have been proven very effective in diabetes management.

Aim: This study evaluated the usefulness of these devices during prolonged, intense physical activity in an uncontrolled natural environment away from the clinical research center.

Design: Non-randomized, prospective and observational study.

Incidence of childhood Type 1 diabetes mellitus in Crete.

Aim: To investigate the epidemiology of childhood Type 1 diabetes mellitus in Crete over the last 25 years and to evaluate incidence trends over time.

Methods: The study included all children aged 0-14 years who live in Crete and were diagnosed during the 25-year period from 1 January 1992 to 31 December 2016.

Results: A total of 271 children were diagnosed with Type 1 diabetes during the 25-year period: 148 boys and 123 girls (boy:girl ratio 1.

Perifoveal capillary network quantification in young diabetic patients with subclinical or no retinopathy.

Objective: To assess the morphology of perifoveal capillary network with quantitative parameters in young patients with diabetes mellitus type I (DM I) using an algorithm.

Methods: Fifty-three images (33 eyes of 33 DM I patients and 20 eyes of 20 non-DM controls) were chosen retrospectively from the University Hospital of Heraklion digital fluorescein angiography database. An additional group consisting of patients with advanced DR abnormalities was included in our analysis to investigate whether our method detects alterations when they are present.

Comparison of digital color fundus imaging and fluorescein angiographic findings for the early detection of diabetic retinopathy in young type 1 diabetic patients.

Purpose: To compare the findings from digital 7-field color fundus (CF) photography and fundus fluorescein angiography (FFA) in young patients with diabetes mellitus (DM) type 1 without known diabetic retinopathy.

Methods: In this prospective, observational cohort study, 54 type 1 diabetic patients were recruited. Participants had been diagnosed with diabetes mellitus (DM) for at least 6 years, had Best Corrected Visual Acuity of 20/25 or better and did not have any known retinal pathology.

Carnitine status and lactate increase in patients with type I juvenile diabetes.

Aim: In 32 juvenile patients suffering from insulin dependent diabetes we observed a carnitine imbalance (increase in acylcarnitine and reduction of free carnitine), which was higher in patients with the highest levels of glycosylated hemoglobin. Parallel to that, in patients with the most prominent carnitine imbalance, there was the highest increase in the postprandial lactic acid level and the highest increase in the lactate/pyruvate ratio, without relating to ketosis. In addition, we observed a decrease in free carnitine related to the length of time after appearance of diabetes.

Health-related quality of life (HRQoL) of children with type 1 diabetes mellitus (T1DM): self and parental perceptions.

The aim of the study was to evaluate health-related quality of life (HRQoL) in children and adolescents with type 1 diabetes mellitus (T1DM) in Greece compared with healthy controls and to identify the effect of age, gender, age of onset of disease, and metabolic control on perceptions of HRQoL. A total of 117 children and adolescents with T1DM aged 5-18, their parents, and 128 matched healthy children and adolescents participated. Children and adolescents completed PedsQL™ 4.

Vitamin D receptor gene polymorphisms and susceptibility to type 1 diabetes in Crete, Greece.

Introduction: Association studies of vitamin D receptor (VDR) polymorphisms and risk of type 1 diabetes (T1D) have produced inconsistent results in different populations, pointing to contribution of additional genetic variants and environmental factors. In this study we investigated the association between four VDR polymorphisms and susceptibility to T1D in Crete, an island with homogenous population and considerably low incidence of T1D.

Results And Discussion: We genotyped 100 patients with T1D and 96 controls for the FokI (rs10735810), BsmI (rs1544410), ApaI (rs7975232), and TaqI (rs731236) single nucleotide polymorphisms by polymerase chain reaction and restriction fragment length polymorphism analysis.

Intron 4 polymorphism of the endothelial nitric oxide synthase eNOS gene and early microangiopathy in type 1 diabetes.

Nitric oxide (NO) is an endogenous vasodilator involved in inflammatory and autoimmune response, and in the pathophysiology of diabetic vascular disease. Endothelium-derived NO is formed from L-arginine by endothelial NO synthase (eNOS), and earlier studies have provided evidence for altered NO metabolism and impaired endothelial function in diabetes, probably due to polymorphisms in eNOS gene. In the present study we investigated the association of the eNOS gene intron 4 a/b VNTR polymorphism with diabetic microangiopathy in 61 young individuals with type 1 diabetes (T1D), 35 male and 26 female, aged 5.

Staphylococcus aureus nasal carriage might be associated with vitamin D receptor polymorphisms in type 1 diabetes.

Background: Polymorphisms in the vitamin D receptor (VDR) gene have been associated with susceptibility to several diseases, including type 1 diabetes (T1D) and infections. In this study we investigated whether VDR gene polymorphisms influence nasal carriage of Staphylococcus aureus in individuals with T1D.

Methods: In 93 T1D patients, VDR polymorphisms on FokI F>f, BsmI B>b, ApaI A>a, and TaqI T>t were determined in DNA extracted from peripheral blood leukocytes, and a nasal swab was obtained to detect colonization by S.

STAT4: a risk factor for type 1 diabetes?

Genes and mechanisms involved in autoimmune diseases, affecting approximately 5% of human population, remain still obscure but there is accumulating evidence that common genetic factors might predispose to multiple autoimmune disorders. STAT4, a transcription factor transmitting signals induced by several key cytokines, has recently been identified as a genetic risk factor for rheumatoid arthritis (RA), systemic lupus erythematosus (SLE), and Sjögren's disease (SD), thus indicating that multiple autoimmune diseases may share common biochemical pathways that lead to immune deregulation. Here we demonstrate for the first time, in a genetically homogeneous population, the association of the STAT4 rs7574865 G/T polymorphism, which has been shown to be associated with these autoimmune diseases, with susceptibility to type 1 diabetes (T1D).

Intron 4 a/b polymorphism of the endothelial nitric oxide synthase gene is associated with both type 1 and type 2 diabetes in a genetically homogeneous population.

Current classifications of diabetes distinguish between type 1 diabetes (T1D) and type 2 diabetes (T2D), however recent evidence highlights overlap between T1D and T2D. Earlier studies have suggested altered nitric oxide (NO) metabolism in both T1D and T2D. In the present case-control study, we investigated whether the endothelial NO synthase gene intron 4 a/b polymorphism is associated with T1D and T2D in the island of Crete, a well-defined area with genetically homogeneous population.

Insulin-induced oedema in children and adolescents.

Oedema is an uncommon complication of insulin therapy, which has only rarely been reported in childhood. We describe a case of a 12-year-old girl with newly diagnosed type 1 diabetes, who presented with oedema of the lower extremities and periorbitally, one day after the initiation of insulin treatment. Other causes of oedema were excluded.

Carnitine deficiency in children and adolescents with type 1 diabetes.

Carnitine is essential for the lipid and carbohydrate metabolism, and proper metabolic control in type 1 diabetes has potential impact on long-term complications. The plasma total, free, and acylcarnitine levels in 47 children and adolescents with type 1 diabetes were determined by a radioisotopic assay and compared to the values of a series of anthropometric measurements and metabolic parameters, including blood glycosylated hemoglobin Alc, serum cholesterol and triglycerides, and urine microalbumin levels. Plasma values for total, free, and acylcarnitine were 30.

Quantitative ultrasound measurements in children and adolescents with: type 1 diabetes.

The aim of the current study was to evaluate bone status at the radius and phalanx in children and adolescents with type 1 diabetes by using quantitative ultrasound (QUS) measurements. Thirty pediatric patients, 16 male and 14 female, with type 1 diabetes of duration of 5 to 177 months and mean (+/- SD) age 11.3 +/- 4.

Epidemiology of childhood type I diabetes in Crete, 1990-2001.

Aim: To study the epidemiological patterns of childhood-onset type I diabetes in Crete, Greece.

Methods: The incidence (new cases per 100,000 per year) from 1990 to 2001 was determined in the population of Crete < or = 14 y of age.

Results: A total of 89 cases was ascertained.

Comparative randomized study: administration of natural and synthetic surfactant to premature newborns with respiratory distress syndrome.

Background: The respiratory distress syndrome (RDS) in premature newborns has been etiologically correlated to immature lungs and specifically with surfactant deficiency. Exogenous administration of surfactant is nowadays considered to be the treatment of choice. In this paper we attempt a comparison of clinical results from the administration of natural Alveofact and synthetic Exosurf surfactants in premature newborns with respiratory distress syndrome.

Breast feeding--when nature fails to satisfy.

Human milk is the ideal source of nutrition for the healthy neonate. Milk from the mother whose diet is sufficient will supply the necessary nutrients. It is a considerable problem to discern if the milk supply is the adequate quantity for the infant.

Transverse myelitis associated with herpes simplex virus infection.

The case of an otherwise healthy 6-year-old boy with symptoms and signs of acute transverse myelitis is presented. The diagnosis was confirmed by magnetic resonance imaging. An episode of gingivostomatitis had preceded, and serology indicated herpes simplex virus type 1 infection.

Association between duration of neonatal hospital stay and morbidity in the first month of life.

The morbidity of 506 healthy full-term newborns was studied in the first month of life in relation to the time they stayed in the hospital. The average time for the newborns who were born by vaginal delivery was 73.3+/-11.

Bronchoscopy for foreign body removal in children. A review and analysis of 210 cases.

Objective: A foreign body aspiration in the tracheobronchial tree is a dangerous and common medical emergency in childhood, with serious and potentially lethal consequences. It must be suspected in children with a suggestive history, even though the clinical symptoms or radiographic findings are not pathognomonic for foreign body aspiration.

Methods: In this study 210 pediatric cases, with a suggestive history of foreign body aspiration undergoing bronchoscopy in the last 8 years in the department, were reviewed.

MR imaging of pituitary hyperplasia in a child with growth arrest and primary hypothyroidism.

Magnetic resonance imaging of pituitary hyperplasia has been rarely described in children with primary hypothyroidism. We report a case of pituitary hyperplasia in a child presented with significant growth arrest and laboratory evidence of hypothyroidism. Magnetic resonance imaging revealed symmetrical pituitary enlargement simulating macroadenoma.