Papers by Ines von rosenstiel
Intensive Care Medicine, 1996
To understand the present status of pediatric intensive care in China, we conducted a survey betw... more To understand the present status of pediatric intensive care in China, we conducted a survey between October and December, 1993, involving 20 hospitals in 14 provinces and municipalities. The results showed that there were totally 41 ICUs for pediatric patients, including 19 pediatric ICUs (PICU), 18 neonatal ICUs (NICU) and 4 pediatric surgical ICUs (SICU), with total of 403 beds. The physicians to bed and nurses to bed ratios were 1:1.5 and 1:0.91 respectively. The average number of equipment per bed was 0.47 ventilator, 0.34 multi-function monitor and 0.47 infusion pump. Very few of the ICUs had portable X-ray machine, biochemical and blood gas analyzers, and hemodialysis machines. The most frequently treated diseases/conditions were pneumonia, intracranial infections, post-operation and sepsis in PICUs, and neonatal pneumonia, hypoxic ischemic encephalopathy and sclerema in NICUs. Pneumonia and respiratory failure accounted for 33.29% and 26.50% of all the diseases/conditions treated in the ICUs and the mean case fatality rate of respiratory failure was 24.50%. The results of the survey suggest that there is shortage of ICU beds and modern equipment, and treatment is often delayed due to excessively strict criteria for mechanical ventilation. A set of simple, and nationally acceptable criteria for evaluation of severity and cure of the diseases/conditions is urgently required.
Intensive Care Medicine, 1996
BMC Psychiatry, Jul 21, 2023
Background A lifestyle including poor diet, physical inactivity, excessive gaming and inadequate ... more Background A lifestyle including poor diet, physical inactivity, excessive gaming and inadequate sleep hygiene is frequently seen among Dutch children. These lifestyle behaviors can cause long-term health problems later in life. Unhealthy lifestyle and poor physical health are even more prevalent among children with mental illness (MI) such as autism, attention-deficit/hyperactivity disorder, depression, and anxiety. However, research on lifestyle interventions among children with MI is lacking. As a result, there are currently no guidelines, or treatment programs where children with MI and poor lifestyle can receive effective support. To address these issues and to provide insight into the effectiveness of lifestyle interventions in children with MI and their families, the Movementss study was designed. This paper describes the rationale, study design, and methods of an ongoing randomized controlled trial (RCT) comparing the short-term (12 weeks) and long-term (1 year) effects of a lifestyle intervention with care as usual (CAU) in children with MI and an unhealthy lifestyle. Methods A total of 80 children (6-12 years) with MI according to DSM-V and an unhealthy lifestyle are randomized to the lifestyle intervention group or CAU at a specialized child and adolescent mental hospital. The primary outcome measure is quality of life measured with the KIDSCREEN. Secondary outcomes include emotional and behavior symptoms, lifestyle parameters regarding diet, physical activity, sleep, and screen time, cognitive assessment (intelligence and executive functions), physical measurements (e.g., BMI), parenting styles, and family functioning, prior beliefs, adherence, satisfaction, and cost-effectiveness. Assessments will take place at the start of the study (T0), after 12 weeks (T1), six months (T2), and 12 months of baseline (T3) to measure long-term effects. Discussion This RCT will likely contribute to the currently lacking knowledge on lifestyle interventions in children with MI. Trial registration trialsearch.who.int/ NL9822. Registered at November 2 nd , 2021.
Research Square (Research Square), May 9, 2023
Background: A lifestyle including poor diet, physical inactivity, excessive gaming and inadequate... more Background: A lifestyle including poor diet, physical inactivity, excessive gaming and inadequate sleep hygiene is frequently seen among Dutch children. These lifestyle behaviors can cause long-term health problems later in life. Unhealthy lifestyle and poor physical health are even more prevalent among children with mental illness (MI) such as autism, attention-de cit/hyperactivity disorder, depression, and anxiety. However, research on lifestyle interventions among children with MI is lacking. As a result, there are currently no guidelines, or treatment programs where children with MI and poor lifestyle can receive effective support. To address these issues and to provide insight into the effectiveness of lifestyle interventions in children with MI and their families, the Movementss study was designed. This paper describes the rationale, study design, and methods of an ongoing randomized controlled trial (RCT) comparing the short-term (12 weeks) and long-term (1 year) effects of a lifestyle intervention with care as usual (CAU) in children with MI and an unhealthy lifestyle. Methods: A total of 80 children (6-12 years) with MI according to DSM-V and an unhealthy lifestyle are randomized to the lifestyle intervention group or CAU at a specialized child and adolescent mental hospital. The primary outcome measure is quality of life measured with the KIDSCREEN. Secondary outcomes include emotional and behavior symptoms, lifestyle parameters regarding diet, physical activity, sleep, and screen time, cognitive assessment (intelligence and executive functions), physical measurements (e.g., BMI), parenting styles, and family functioning, prior beliefs, adherence, satisfaction, and cost-effectiveness. Assessments will take place at the start of the study (T0), after 12 weeks (T1), six months (T2), and 12 months of baseline (T3) to measure long-term effects. Discussion: This RCT will likely contribute to the currently lacking knowledge on lifestyle interventions in children with MI. Trial registration: trialsearch.who.int/ NL9822. Registered at November 2 nd , 2021 BACKGROUND In recent years, increasing attention has been given to lifestyle and their effects on mental health. Various studies consistently show that adults with mental illness (MI) have higher rates of physical ill health and die earlier than those in the general population, largely due to treatable conditions associated with modi able risk factors such as smoking, obesity, substance misuse, and adverse effects of medication (1, 2). A recent meta-analysis shows promising effects of lifestyle interventions in adults with MI on their mental health (3). Unhealthy lifestyle and poor physical health are also frequently seen among children with MI, such as autism spectrum disorders (ASD), Attention De cit Hyperactivity Disorder (ADHD), depression, and anxiety disorders, compared to children without MI (4, 5). An unhealthy lifestyle among children consists, for example, of low physical activity (6), poor nutrition intake (7), disrupted sleep (8, 9), and elevated screen time (5, 10). An unhealthy lifestyle in the family may have a major impact on the mental, physical
The Journal of Pediatrics, Jun 1, 2010
To determine the prevalence of traditional cardiometabolic risk factors and to assess the effect ... more To determine the prevalence of traditional cardiometabolic risk factors and to assess the effect of overweight/obesity on the occurrence of these risk factors in a cohort of children with type 1 diabetes mellitus (T1DM). Two hundred eighty-three consecutive patients (3 to 18 years of age) attending an outpatient clinic for T1DM care were included. The prevalence of cardiometabolic risk factors, the metabolic syndrome, and high alanine aminotransferase, were assessed before and after stratification for weight status. Of all children (median age, 12.8 years; interquartile range, 9.9 to 16.0; median diabetes duration, 5.3 years; interquartile range, 2.9 to 8.6), 38.5% were overweight/obese (Z-body mass index > or =1.1). Overall, median HbA1c levels were 8.2% (interquartile range, 7.4 to 9.8), and HbA1c > or =7.5% was present in 73.9%. Microalbuminuria was found in 17.7%, high triglycerides (>1.7 mmol/L) in 17.3%, high LDL-cholesterol (>2.6 mmol/L) in 28.6%, low HDL-cholesterol (<1.1 mmol/L) in 21.2%, and hypertension in 13.1% of patients. In the overweight/obese children with T1DM, versus normal-weight children, a higher prevalence of hypertension (23.9% vs 5.7%), the metabolic syndrome (25.7% vs 6.3%), and alanine aminotransferase >30 IU/L (15.6% vs 4.5%) was found (all P < .05). Overweight/obesity and cardiometabolic risk factors were highly prevalent in a pediatric cohort with T1DM. Hypertension, the metabolic syndrome, and high alanine aminotransferase were significantly more prevalent in overweight/obese compared with normal-weight children with T1DM.
The Journal of Infectious Diseases, Dec 15, 2001
This prospective observational study investigated the relationship of the hypothalamicpituitary-a... more This prospective observational study investigated the relationship of the hypothalamicpituitary-adrenal axis to inflammatory markers and to disease severity in children with meningococcal disease. In total, 32 children were studied: 10 with distinct meningococcal meningitis (MM), 10 with MM and septic shock, and 12 with fulminant meningococcal septicemia (FMS). Levels of adrenocorticotropic hormone (ACTH) and interleukin (IL)-6, IL-8, and IL-10 were lowest in the MM group and dramatically elevated in the FMS group. Cortisol and C-reactive protein levels were highest in the MM group and relatively low in the FMS group. Levels of ACTH and inflammatory markers decreased within the first 24 h of admission, but cortisol levels did not fluctuate. Cortisol was significantly inversely correlated with IL-6, IL-8, and IL-10 (P < .04). These results suggest that the adrenal reserve in children is insufficient to handle the extreme conditions and stress associated with severe meningococcal disease.
Cardiovascular Diabetology, 2009
Background: Differences in prevalence of cardiometabolic risk factors between different ethnic gr... more Background: Differences in prevalence of cardiometabolic risk factors between different ethnic groups are largely unknown. We determined the variation in cardiometabolic risk profile according to ethnicity in a cohort overweight/obese Dutch children. Methods: An oral glucose tolerance test was performed in 516 overweight/obese Dutch children of multi-ethnic origin, attending an obesity outpatient clinic of an urban general hospital (mean age 10.6 ± 3.2; 55.2% boys). Anthropometric parameters and blood samples were collected, and the prevalence of (components of) the metabolic syndrome (MetS) and insulin resistance were determined in each ethnic group. Results: Major ethnic groups were Dutch native (18.4%), Turkish (28.1%), and Moroccan (25.8%). The remaining group (27.7%) consisted of children with other ethnicities. Turkish children had the highest mean standardized BMI compared to Dutch native children (P < 0.05). As compared to Moroccan children, they had a higher prevalence of MetS (22.8% vs. 12.8%), low HDL-cholesterol (37.9% vs. 25.8%), hypertension (29.7% vs. 18.0%) and insulin resistance (54.9% vs. 37.4%, all P < 0.05). Although Turkish children also had higher prevalences of forementioned risk factors than Dutch native children, these differences were not statistically significant. Insulin resistance was associated with MetS in the Turkish and Moroccan subgroup (OR 6.6; 95%CI, 2.4-18.3 and OR 7.0; 95%CI, 2.1-23.1, respectively). Conclusion: In a Dutch cohort of overweight/obese children, Turkish children showed significantly higher prevalences of cardiometabolic risk factors relative to their peers of Moroccan descent. The prospective value of these findings needs to be established as this may warrant the need for differential ethnic-specific preventive measures.
Clinical Infectious Diseases, Apr 1, 1999
In summary, empyema due to C. glabrata has not been reported previously. Early diagnosis and appr... more In summary, empyema due to C. glabrata has not been reported previously. Early diagnosis and appropriate treat-1. Srivastava S, Kleiman G, Manthous CA. Torulopsis pneumonia. A case ment of infections due to Torulopsis species with prompt, adereport and review of the literature. Chest 1996; 110:858-61. 2. Stone H, Kolb L, Currie C, Geheber C, Cuzzell J. Candida sepsis: pathogen-quate drainage of an empyema will reduce morbidity and moresis and principles of treatment.
European Journal of Pediatrics, Aug 12, 2008
We studied the association between alanine aminotransferase (ALT) and features of the metabolic s... more We studied the association between alanine aminotransferase (ALT) and features of the metabolic syndrome in a cohort of overweight and obese children aged 3-18 years. An oral glucose tolerance test was performed in 443 consecutive children from an obesity outpatient clinic (median age 11.2, range 3.1-18.0 years; n=240 boys) of multi-ethnic origin. The prevalence of the metabolic syndrome, insulin resistance, elevated ALT (>30 IU/L), and the association of ALT with (components of) the metabolic syndrome was assessed. The metabolic syndrome was present in 26.9%. Elevated ALT levels were found in 20.3%, with a higher prevalence in boys than in girls (25.8% versus 13.8%, P<0.001). ALT was associated with the prevalence of the metabolic syndrome, insulin resistance, high triglycerides, and low HDLcholesterol after adjustment for gender, age, and BMI. In conclusion, elevated ALT levels were highly prevalent and associated with the metabolic syndrome, insulin resistance, high triglycerides, and low HDL-cholesterol in an obese multiethnic pediatric population.
PubMed, Feb 24, 1996
A 4-year-old boy who each night was placed in an orthopaedic corset because of congenital multipl... more A 4-year-old boy who each night was placed in an orthopaedic corset because of congenital multiple arthrogryposis developed heat stroke with hyperpyrexia and multiorganic failure in a hot summer. Treatment consisted of administration of fluids, antibiotics and anticonvulsive agents; the child recovered completely. In children who are sick and have fever, the use of such corsets should temporarily be suspended.
Case Reports, Apr 20, 2017
The Journal of pediatrics, 2018
To assess the accuracy of pulse oximetry screening for critical congenital heart defects (CCHDs) ... more To assess the accuracy of pulse oximetry screening for critical congenital heart defects (CCHDs) in a setting with home births and early discharge after hospital deliveries, by using an adapted protocol fitting the work patterns of community midwives. Pre- and postductal oxygen saturations (SpO) were measured ≥1 hour after birth and on day 2 or 3. Screenings were positive if the SpO measurement was <90% or if 2 independent measures of pre- and postductal SpO were <95% and/or the pre-/postductal difference was >3%. Positive screenings were referred for pediatric assessment. Primary outcomes were sensitivity, specificity, and false-positive rate of pulse oximetry screening for CCHD. Secondary outcome was detection of noncardiac illnesses. The prenatal detection rate of CCHDs was 73%. After we excluded these cases and symptomatic CCHDs presenting immediately after birth, 23 959 newborns were screened. Pulse oximetry screening sensitivity in the remaining cohort was 50.0% (95% ...
Intensive Care Medicine, 1996
P036 PROGNOSTIC FACTORS IN MENINGOCOCCAL INFECTION: PREDICTORS OF MORTALITY. Inge Van Herreweghe ... more P036 PROGNOSTIC FACTORS IN MENINGOCOCCAL INFECTION: PREDICTORS OF MORTALITY. Inge Van Herreweghe MD , Avram Benatar MD, Dirk Danschutter RN, Jose Ramet MD,PhD. Pediatric Intensive Care Unit, AZ Vrije Universiteit, 1090 Brussels, Belgium. The ...
Obesity Facts
Introduction: School closures due to the COVID-19 pandemic affect children’s daily structure, mea... more Introduction: School closures due to the COVID-19 pandemic affect children’s daily structure, mealtimes, physical activity, and sleeping habits, possibly exacerbating weight gain, particularly in vulnerable children with overweight and obesity. This study aimed to evaluate both perceived and objectively measured weight gain in children in the Netherlands during the COVID-19 pandemic and the effect of prior lifestyle intervention. Methods: A total of 150 children of the Children, Obesity and Lifestyle during COVID-19 (COLC) study (cohort A) reported perceptions of weight change during the COVID-19 pandemic. Anthropometric data of 65 children with overweight and obesity were collected at the expertise Centre for Overweight Adolescent and Children’s Healthcare in the same period (COACH; cohort B). Results: In cohort A, 43% of children with overweight and obesity perceived weight gain during the pandemic, compared to 15% of lean children. In cohort B, the BMI z-score increased significa...
Journal of Adolescent and Young Adult Oncology
Purpose: Participatory design (PD) is a collective creative design process involving designers an... more Purpose: Participatory design (PD) is a collective creative design process involving designers and nondesigners. There is limited reporting on the experience of using PD for adolescent and young adult (AYA) care. This study summarizes lessons from employing PD to develop care for AYAs with cancer. Methods: A qualitative multiple-case study method was conducted of three PD processes addressing food (FfC), intimacy and sexuality (I&S), and integrative medicine (IM) in caring for AYAs with cancer. Results: Local key stakeholders, who were exposed to a problem and had not been successful at solving it individually, were recruited to ''dream'' together. Through this synergy, a shared understanding of the problem and a joint mission emerged to find a solution. PD tools were used to develop a problem definition. An open mind and explorative research helped to understand the problems, and stakeholders were managed such that idea-sharing and learning were enabled. Designers translated ideas into prototypes. The PD process was prolonged due to the hierarchical hospital environment, business considerations, and additionally required evidence. The FfC program produced an effective new food service for the whole hospital. The I&S initiative developed a podcast, two articles, and a prototype website. The IM project developed a pilot study. Conclusions: For a PD process to successfully develop care for AYAs, one needs to use designers and skilled people, PD tools, and an open-ended approach to visualize and materialize new forms of care. Furthermore, recruitment and facilitation techniques help leverage knowledge and create a synergy in a democratic environment between stakeholders.
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Papers by Ines von rosenstiel