Rudolf Schmitzberger

Das Fetale Tabaksyndrom – Ein Statement der Österreichischen Gesellschaften für Allgemein- und Familienmedizin (ÖGAM), Gynäkologie und Geburtshilfe (ÖGGG), Hygiene, Mikrobiologie und Präventivmedizin (ÖGHMP), Kinder- und Jugendheilkunde (ÖGKJ) sowie Pneumologie (ÖGP)

Over more than 50 years, the nocuous effects of smoking in pregnancy on the fetus are well known. In the first years of science the focus was primarily on restricted fetal growth while in more recent years over 10.000 studies investigated the incomparably big sum of detrimental effects for the unborns health. In this statement we want to present the recent scientific findings on this topic. The statement is aimed to show all doctors who treat pregnant women the present situation and evidence. In the beginning we give a short overview about the epidemiological situation in Europe. Then we present step by step the health effects with regards to pathophysiology and clinics. Furthermore the reader will learn about possibilities for smoking cessation in pregnancy. The problem of passive-smoking in pregnancy will be dealt with in a separate chapter. At present there is strong evidence that pregnant smoking has a detrimental effect on birth-weight, placenta-associated disease, stillbirth, sudden infant death syndrome (SIDS), childhood overweight, clefts, lung function, asthma, cardiovascular diseases and mental developmental disorders. These factors can be summarized by the term Fetal Tobacco Syndrome. There is supply for more studies for less investigated health effects. Pregnancy is a chance to stop smoking as most women show a high motivation in this period. Hence doctors of all disciplines should inform pregnant women about the detrimental effects of smoking on their unborn child and show them possibilities for smoking cessation.

[The Fetal Tobacco Syndrome - A statement of the Austrian Societies for General- and Family Medicine (ÖGAM), Gynecology and Obstetrics (ÖGGG), Hygiene, Microbiology and Preventive Medicine (ÖGHMP), Pediatrics and Adolescence Medicine (ÖGKJ) as well as Pneumology (ÖGP)].

Over more than 50 years, the nocuous effects of smoking in pregnancy on the fetus are well known. In the first years of science the focus was primarily on restricted fetal growth while in more recent years over 10.000 studies investigated the incomparably big sum of detrimental effects for the unborns health. In this statement we want to present the recent scientific findings on this topic. The statement is aimed to show all doctors who treat pregnant women the present situation and evidence. In the beginning we give a short overview about the epidemiological situation in Europe. Then we present step by step the health effects with regards to pathophysiology and clinics. Furthermore the reader will learn about possibilities for smoking cessation in pregnancy. The problem of passive-smoking in pregnancy will be dealt with in a separate chapter. At present there is strong evidence that pregnant smoking has a detrimental effect on birth-weight, placenta-associated disease, stillbirth, sudden infant death syndrome (SIDS), childhood overweight, clefts, lung function, asthma, cardiovascular diseases and mental developmental disorders. These factors can be summarized by the term Fetal Tobacco Syndrome. There is supply for more studies for less investigated health effects. Pregnancy is a chance to stop smoking as most women show a high motivation in this period. Hence doctors of all disciplines should inform pregnant women about the detrimental effects of smoking on their unborn child and show them possibilities for smoking cessation.

Rezidivierende obstruktive Bronchitis und Asthma bronchiale im Vorschulalter@@@Recurrent obstructive bronchitis and bronchial asthma in preschool children: Konsensuspapier der Österreichischen Gesellschaft für Kinder- und Jugendheilkunde (ÖGKJ) und der Österreichischen Gesellschaft für Pneumologie (ÖGP)@@@Consensus paper issued by the Austrian Society for Paediatric and Adolescent Medicine (ÖGKJ) and the Austrian Society for Pneumology (ÖGP)

D. Reinhardt, München Monatsschr Kinderheilkd 2006 · 154:679–684 DOI 10.1007/s00112-006-1364-x Online publiziert: 4. Juli 2006

Langwirksame Beta-2-Sympathomimetika in der pädiatrischen Asthmatherapie – Freund oder Feind?

ZusammenfassungAus kürzlich erschienenen Publikationen ergibt sich der Verdacht, dass langwirksame Beta-2-Mimetika (long acting beta-2 agonist = LABA) das Risiko der Asthmamortalität steigern könnten. Eine dementsprechende Warnung wurde im Jahre 2005 durch die amerikanische Food and Drug Administration (FDA) veröffentlicht. Entsprechend den aktuellen österreichischen Konsensus-Empfehlungen zur medikamentösen Behandlung des Asthma bronchiale im Kindes- und Jugendalter sollen LABAs erst als Zusatzmedikation bei jenen Patienten zum Einsatz kommen, deren Symptome mit einem niedrig dosierten inhalativen Steroid (inhaled corticosteroid = ICS) alleine nicht ausreichend kontrolliert sind. Für den Einsatz von LABAs in der ersten Stufe des therapeutischen Algorithmus, d.h. die Verschreibung von ICS-LABA-Kombinationen in der Ersteinstellung, ergibt sich aus diesen Konsensus-Therapieempfehlungen keine Indikation.SummaryRecent publications suggest that long-acting beta-2 agonists (LABAs) increase the risk for death in asthma. The American Food and Drug Administration (FDA) published a relevant alert in 2005. In the currently valid Austrian consensus guidelines for drug therapy of bronchial asthma in children and adolescents, LABAs are only recommended as add-on therapy in those patients whose asthma is not sufficiently controlled by inhaled corticosteroids (ICS) alone. LABAs have no established role in earlier steps of the therapeutic algorithm; consequently, the prescription of ICS-LABA combinations for initial treatment of paediatric asthma is not supported by these consensus treatment guidelines.

Das Fetale Tabaksyndrom – Ein Statement der Österreichischen Gesellschaften für Allgemein- und Familienmedizin (ÖGAM), Gynäkologie und Geburtshilfe (ÖGGG), Hygiene, Mikrobiologie und Präventivmedizin (ÖGHMP), Kinder- und Jugendheilkunde (ÖGKJ) sowie Pneumologie (ÖGP)@@@The Fetal Tobacco Syndrome – A statement of the Austrian Societies for General- and Family Medicine (ÖGAM), Gynecology and Obstetrics (ÖGGG), Hygiene, Microbiology and Preventive Medicine (ÖGHMP), Pediatrics and Adolescence Medicine (ÖGKJ) as well as Pneumology (ÖGP)

Over more than 50 years, the nocuous effects of smoking in pregnancy on the fetus are well known. In the first years of science the focus was primarily on restricted fetal growth while in more recent years over 10.000 studies investigated the incomparably big sum of detrimental effects for the unborns health. In this statement we want to present the recent scientific findings on this topic. The statement is aimed to show all doctors who treat pregnant women the present situation and evidence. In the beginning we give a short overview about the epidemiological situation in Europe. Then we present step by step the health effects with regards to pathophysiology and clinics. Furthermore the reader will learn about possibilities for smoking cessation in pregnancy. The problem of passive-smoking in pregnancy will be dealt with in a separate chapter. At present there is strong evidence that pregnant smoking has a detrimental effect on birth-weight, placenta-associated disease, stillbirth, sudden infant death syndrome (SIDS), childhood overweight, clefts, lung function, asthma, cardiovascular diseases and mental developmental disorders. These factors can be summarized by the term Fetal Tobacco Syndrome. There is supply for more studies for less investigated health effects. Pregnancy is a chance to stop smoking as most women show a high motivation in this period. Hence doctors of all disciplines should inform pregnant women about the detrimental effects of smoking on their unborn child and show them possibilities for smoking cessation.

Spezifische Immuntherapie bei IgE-vermittelten allergischen Erkrankungen im Kindes- und Jugendalter - eine Übersicht über in Österreich zugelassene/ registrierte Allergenpräparate

A pediatric consensus report on allergen-specific immunotherapy for children and adolescents is presented for Austria. Products on the market in Austria are presented and categorised according to studies performed on the target population of children and adolescents, their effectiveness and indication. In general, more clinical studies on children and adolescents are mandatory for most of the available allergen-specific immunotherapeutics. In addition, the use of allergen-specific immunotherapy in general should be promoted as the exclusive treatment with long-lasting effects in type I allergies in particular in children.SummaryA pediatric consensus report on allergen-specific immunotherapy for children and adolescents is presented for Austria. Products on the market in Austria are presented and categorised according to studies performed on the target population of children and adolescents, their effectiveness and indication. In general, more clinical studies on children and adolescents are mandatory for most of the available allergen-specific immunotherapeutics. In addition, the use of allergen-specific immunotherapy in general should be promoted as the exclusive treatment with long-lasting effects in type I allergies in particular in children.ZusammenfassungDer Consensus Report zur Spezifischen Immuntherapie bei IgE-vermittelten allergischen Erkrankungen im Kindes- und Jugendalter ist einerseits aufgrund des zunehmend größeren Angebotes an Allergenpräparaten entstanden. Andererseits besteht die ethische Verpflichtung Kinder und Jugendliche mit Allergenpräparaten zu behandeln, die auch in Studien an Kindern und Jugendlichen getestet worden sind (EU Regulative). Neben einer Auflistung aller in Österreich für den Gebrauch an Kindern zugelassener Allergenpräparate folgt eine differenzierte und kritische Betrachtung der Studienlandschaft. Neue Studien an Kindern sind zu fordern, gleichzeitig ist auch ein deutlicher Nachholbedarf in der Anwendung dieser sehr effektiven Behandlungsform IgE-vermittelter Allergien festzuhalten.

Spezifische Immuntherapie bei IgE-vermittelten allergischen Erkrankungen im Kindes- und Jugendalter – eine Übersicht über in Österreich zugelassene/registrierte Allergenpräparate@@@Allergen-specific Immunotherapy for children and adolescents – a review on available products in Austria: Konsensus Report 2009 der AG Pneumologie und Allergologie der Österreichischen Gesellschaft für Kinder und Jugendheilkunde

A pediatric consensus report on allergen-specific immunotherapy for children and adolescents is presented for Austria. Products on the market in Austria are presented and categorised according to studies performed on the target population of children and adolescents, their effectiveness and indication. In general, more clinical studies on children and adolescents are mandatory for most of the available allergen-specific immunotherapeutics. In addition, the use of allergen-specific immunotherapy in general should be promoted as the exclusive treatment with long-lasting effects in type I allergies in particular in children.SummaryA pediatric consensus report on allergen-specific immunotherapy for children and adolescents is presented for Austria. Products on the market in Austria are presented and categorised according to studies performed on the target population of children and adolescents, their effectiveness and indication. In general, more clinical studies on children and adolescents are mandatory for most of the available allergen-specific immunotherapeutics. In addition, the use of allergen-specific immunotherapy in general should be promoted as the exclusive treatment with long-lasting effects in type I allergies in particular in children.ZusammenfassungDer Consensus Report zur Spezifischen Immuntherapie bei IgE-vermittelten allergischen Erkrankungen im Kindes- und Jugendalter ist einerseits aufgrund des zunehmend größeren Angebotes an Allergenpräparaten entstanden. Andererseits besteht die ethische Verpflichtung Kinder und Jugendliche mit Allergenpräparaten zu behandeln, die auch in Studien an Kindern und Jugendlichen getestet worden sind (EU Regulative). Neben einer Auflistung aller in Österreich für den Gebrauch an Kindern zugelassener Allergenpräparate folgt eine differenzierte und kritische Betrachtung der Studienlandschaft. Neue Studien an Kindern sind zu fordern, gleichzeitig ist auch ein deutlicher Nachholbedarf in der Anwendung dieser sehr effektiven Behandlungsform IgE-vermittelter Allergien festzuhalten.