Incidence rate ratios of admission rates, season 2009–2010 versus other seasons.

<p>Incidence rate ratios of admission rates, season 2009–2010 versus other seasons.</p

Monthly admission rates 2005–2011 by year.

<p><b>Season 2009–2010 highlighted.</b> A: Gastroenteritis. B: Influenza. C: Lower airway infections. D: Upper airway infections.</p

Number of hospitalizations in 394,170 children during 2,330,174 person-years by age.

<p>Number of hospitalizations in 394,170 children during 2,330,174 person-years by age.</p

Alcohol Intake in Pregnancy Increases the Child's Risk of Atopic Dermatitis. The COPSAC Prospective Birth Cohort Study of a High Risk Population

<div><h3>Background</h3><p>Atopic dermatitis has increased four-fold over the recent decades in developed countries, indicating that changes in environmental factors associated with lifestyle may play an important role in this epidemic. It has been proposed that alcohol consumption may be one contributing risk factor in this development.</p> <h3>Objective</h3><p>To analyze the impact of alcohol intake during pregnancy on the development of atopic dermatitis during the first 7 years of life.</p> <h3>Method</h3><p>The COPSAC cohort is a prospective, longitudinal, birth cohort study of 411 children born to mothers with a history of asthma, followed up for 7 years with scheduled visits every 6 months as well as visits for acute exacerbations of atopic dermatitis. Risk of atopic dermatitis from any alcohol consumption during pregnancy was analyzed as time-to-diagnosis and adjusted for known risk factors.</p> <h3>Results</h3><p>177 of 411 children developed atopic dermatitis before age 7 years. We found a significant effect of alcohol intake during pregnancy on atopic dermatitis development (HR 1.44, 95% CI 1.05–1.99 p = 0.024). This conclusion was unaffected after adjustment for smoking, mother's education and mother's atopic dermatitis.</p> <h3>Limitations</h3><p>The selection of a high-risk cohort, with all mothers suffering from asthma, and all children having a gestational age above 35 weeks with no congenital abnormality, systemic illness, or history of mechanical ventilation or lower airway infection.</p> <h3>Conclusion</h3><p>Alcohol intake by pregnant women with a history of asthma, is significantly associated with an increased risk for the child for developing atopic dermatitis during the first 7 years of life.</p> </div

Kaplan-Meier plots for the effect of alcohol intake during pregnancy on subsequent atopic dermatitis development in the offspring during the first 7 years of life.

<p>Kaplan-Meier plots for the effect of alcohol intake during pregnancy on subsequent atopic dermatitis development in the offspring during the first 7 years of life.</p

Clinical Presentation of Atopic Dermatitis by Filaggrin Gene Mutation Status during the First 7 Years of Life in a Prospective Cohort Study

<div><h3>Background</h3><p>Filaggrin null mutations result in impaired skin barrier functions, increase the risk of early onset atopic dermatitis and lead to a more severe and chronic disease. We aimed to characterize the clinical presentation and course of atopic dermatitis associated with filaggrin mutations within the first 7 years of life.</p> <h3>Method</h3><p>The COPSAC cohort is a prospective, clinical birth cohort study of 411 children born to mothers with a history of asthma followed during their first 7 years of life with scheduled visits every 6 months, as well as visits for acute exacerbations of dermatitis. Atopic dermatitis was defined in accordance with international guidelines and described at every visit using 35 predefined localizations and 10 different characteristics.</p> <h3>Results</h3><p>A total of 170 (43%) of 397 Caucasian children developed atopic dermatitis. The R501X and/or 2282del4 filaggrin null mutations were present in 26 (15%) of children with atopic dermatitis and were primarily associated with predilection to exposed skin areas (especially the cheeks and back of the hands) and an up-regulation of both acute and chronic dermatitis. Furthermore, we found the filaggrin mutations to be associated with a higher number of unscheduled visits (3.6 vs. 2.7; p = 0.04) and more severe (moderate-severe SCORAD 44% vs. 31%; p = 0.14), and widespread dermatitis (10% vs. 6% of the body area, p<0.001) with an earlier age at onset (246 vs. 473 days, p<0.0001) compared to wild-type.</p> <h3>Conclusion</h3><p>In children, filaggrin mutations seem to define a specific endotype of atopic dermatitis primarily characterized by predilection to exposed areas of the body, in particular hands and cheeks, and an up-regulation in both acute and chronic morphological markers. Secondary, this endotype is characterized by an early onset of dermatitis and a more severe course, with more generalized dermatitis resulting in more frequent medical consultations.</p> </div

Frequency of skin localizations in respect to filaggrin status.

<p>Frequency of localizations in relation to the number of visits at the clinical research unit, 0–7 years, grouped and stratified by <i>FLG</i> status. Numbers above the bars indicate the p values.</p

Incidence and Determinants of Ventilation Tubes in Denmark

<div><p>Background and objectives</p><p>Many children are treated for recurrent acute otitis media and middle ear effusion with ventilation tubes (VT). The objectives are to describe the incidence of VT in Denmark during 1997–2011 from national register data, furthermore, to analyze the determinants for VT in the Copenhagen Prospective Studies on Asthma in Childhood₂₀₁₀ (COPSAC₂₀₁₀) birth cohort.</p><p>Methods</p><p>The incidence of VT in all children under 16 years from 1997–2011 were calculated in the Danish national registries. Determinants of VT were studied in the COPSAC₂₀₁₀ birth cohort of 700 children.</p><p>Results</p><p>Nationwide the prevalence of VT was 24% in children aged 0 to 3 three years, with a significant increase over the study period. For all children 0–15 years, the incidence of VT was 35/1,000. In the VT population, 57% was male and 43% females. In the COPSAC₂₀₁₀ birth cohort, the prevalence of VT during the first 3 years of life was 29%. Determinants of VT were: maternal history of middle ear disease; aHR 2.07, 95% CI [1.45–2.96] and siblings history of middle ear disease; aHR 3.02, [2.11–4.32]. Paternal history of middle ear disease, presence of older siblings in the home and diagnosis of persistent wheeze were significant in the univariate analysis but the association did not persist after adjustment.</p><p>Conclusion</p><p>The incidence of VT is still increasing in the youngest age group in Denmark, demonstrating the highest incidence recorded in the world. Family history of middle ear disease and older siblings are the main determinants for VT.</p></div

Summary of skin localizations in respect to filaggrin status.

<p>The figure summarizes the localizations more often affected in children with <i>FLG</i> null mutations compared to wild type children (red and blue areas), with red areas illustrating the localizations specifically selected by PLSDA as driving sites.</p

Age distribution of children 0–15 years who received ventilation tubes between 1997–2011 in Denmark.

<p>Age distribution of children 0–15 years who received ventilation tubes between 1997–2011 in Denmark.</p