Browsing by Person "Wilson, D. C."

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25-hydroxyvitamin D concentration in paediatric cancer patients from Scotland: A prospective cohort study
(Cambridge University Press, 2016-12-15) Revuelta-Iniesta, Raquel; Paciarotti, Ilenia; Davidson, Isobel; McKenzie, Jane; Brand, Celia; Chin, Richard; Brougham, Mark FH; Wilson, D. C.
Children with cancer are potentially at high risk of plasma 25-hydroxyvitamin D [25(OH)D] inadequacy and despite UK vitamin D supplementation guidelines their implementation remains inconsistent. Thus, we aimed to investigate 25(OH)D concentration and factors contributing to 25(OH)D inadequacy in paediatric cancer patients. A prospective cohort study of Scottish children aged <18 years, diagnosed with and treated for cancer (patients) between Aug 2010-Jan 2014 was performed, with control data from Scottish healthy children (controls). Clinical and nutritional data were collected at defined periods up to 24 months. 25(OH)D status was defined by the Royal College of Paediatrics and Child Health (2013); inadequacy [<50 nmol/L: deficiency (<25 nmol/L), insufficiency (25-50 nmol/L)], sufficiency (51-75 nmol/L), optimal (>75 nmol/L). Eighty-two patients [median(IQR) age 3.9(1.9-8.8); 56% males)] and 35 controls [median(IQR) age (6.2(4.8-9.1); 49% males] were recruited. 25(OH)D inadequacy was highly prevalent in the controls (63%; 22/35), and in the patients (64%; 42/65) at both baseline and during treatment (33-50%). Non-supplemented children had the highest prevalence of 25(OH)D inadequacy at every stage with 25(OH)D median(IQR) ranging from 32.0 (21.0-46.5) nmol/L to 45.0(28.0-64.5) nmol/L. Older age at baseline [R=-0.46; p<0.001], overnutrition (BMI ≥85th centile) at 3 months [p=0.005; RR=3.1] and not being supplemented at 6 months (p=0.04; RR=4.3) may have contributed to lower plasma 25(OH)D. Paediatric cancer patients are not at higher risk of 25(OH)D inadequacy than healthy children at diagnosis; however prevalence of 25(OH)D inadequacy is still high and non-supplemented children have a higher risk. Appropriate monitoring and therapeutic supplementation should be implemented.
Complementary and alternative medicine usage in Scottish children and adolescents during cancer treatment
(Churchill Livingstone, 2014-11) Revuelta-Iniesta, Raquel; Wilson, M.; White, K.; Stewart, L.; McKenzie, Jane; Wilson, D. C.
Aim: To determine the prevalence of the use of CAM and spiritual practices in the paediatric oncology population of SE Scotland and to establish both the reasons for their use and the perceived benefits. Methods: A retrospective survey was performed using previously piloted questionnaires. These were distributed to families whose children were <18 years and diagnosed with cancer. Demographic and clinical data were collected, descriptive statistics were used to establish frequencies and univariate associations were established by 2 test. Results: Of 169 families approached, 74 (44%) returned completed questionnaires. 41 (55%) families used CAM and 42 (57%) sought spiritual remedies whilst receiving conventional treatment. Higher socioeconomic status was the only factor associated with CAM usage and the most popular therapies were vitamins and minerals ( n=22; 53%), followed by massage ( n=12; 29%) and fish oils ( n=12; 29%). Most families used CAM to reduce stress and, overall, CAM was perceived to be beneficial. Conclusion: The high prevalence of CAM usage in this population highlights the need for physicians to enquire routinely about CAM use and warrants high-quality interventional studies to assess safety and efficacy. Summary: The use of Complementary and Alternative Medicine (CAM) among paediatric patients during cancer treatment is popular worldwide, yet data from the UK are scarce. This study showed that more than half of this Scottish cohort used CAM and that there was an overall positive perception of the effect that these therapies had on the patients. Also, socio-economically advantaged families might be more likely to use CAM in Scotland. 2014 Elsevier Ltd.
Effects of pediatric cancer and its treatment on nutritional status: A systematic review
(2015-03-28) Revuelta-Iniesta, Raquel; Paciarotti, Ilenia; Brougham, F. H. M.; McKenzie, Jane; Wilson, D. C.
Context: Malnutrition in pediatric cancer is common worldwide, yet its prevalence and effects on clinical outcomes remain unclear. Objective: The aim of this review was to evaluate primary research reporting the prevalence of malnutrition in pediatric cancer patients and to assess the effects of pediatric cancer and its treatment on nutritional status. Data Sources: Electronic databases of MEDLINE, CINHAL, and PubMed were searched (January 1990-February 2013). Study Selection: Studies of patients aged <18 years who were diagnosed with and treated for cancer and for whom measurements of anthropometry were reported were included. The primary outcome was the prevalence of malnutrition (undernutrition and overnutrition), expressed as body mass index (BMI), in children diagnosed with and treated for cancer. Data Extraction: Evidence was appraised critically by employing the Critical Appraisal Skills Program tool, and data was extracted from original articles. Data Synthesis: A total of 46 studies were included, most of which were considered to be of low quality on the basis of heterogeneity in both the criteria and the measurements used to define malnutrition. Undernutrition was identified by measuring BMI, weight loss, mid-upper arm circumference, and triceps skinfold thickness, while overnutrition was assessed using BMI. Overall, the prevalence of undernutrition ranged from 0% to 65% and overnutrition from 8% to 78%. Finally, undernutrition in pediatric cancer at diagnosis was associated with poor clinical outcomes in 6 of 9 studies. Conclusion: The possibility of a high prevalence of malnutrition in childhood cancer, indicated by the studies reviewed, highlights the need for high-quality, populationbased, longitudinal studies using standard criteria to identify malnutrition.
Increased at risk screening and recognition of a typical presentation does not fully explain the 6.5-fold increase in Paediatric Coeliac Disease (CD) incidence in the last 20 years in S E Scotland
(2012-07) Merrick, V.; White, Lois; Bannerman, Elaine; Russell, R. K.; Basude, D.; Henderson, P.; Wilson, D. C.; Gillett, P. M.; Coeliac UK; Gloag Family Foundation
Introduction - Current diagnostic practice for paediatric CD in the UK includes increased screening of family members and at- risk groups for example, diabetes mellitus.
Systematic review and meta-analysis: Prevalence and possible causes of vitamin D deficiency and insufficiency in pediatric cancer patients
(Elsevier, 2015-01-16) Revuelta-Iniesta, Raquel; Rush, Robert; Paciarotti, Ilenia; Rhatigan, E. B.; Brougham, F. H. M.; McKenzie, Jane; Wilson, D. C.
Background and aims: Vitamin D inadequacy is now an internationally recognized health problem and pediatric cancer patients may be at even higher risk than healthy children. We aimed to evaluate primary research to establish the prevalence of vitamin D inadequacy and to explore its possible causes in pediatric cancer patients. Methods: Electronic databases were searched (no restriction-Aug 2013) with no language restrictions and keywords related to cancer and vitamin D. We included studies of patients aged <18 years, diagnosed with and treated for cancer and reporting plasma vitamin D status. Evidence was critically appraised employing the CASP tool. Meta-analysis was performed when appropriate. Results: We included 19 studies, which were mainly of moderate-quality and heterogeneous in the definitions of vitamin D deficiency and insufficiency. The median (range) prevalence of vitamin D deficiency was 14% (0-61.5%) and insufficiency 23% (0-83%). Finally, a significant effect of younger age with vitamin D inadequacy was shown (effect size:-0.132; 95%CI-0.203,-0.060). Conclusion: There is a possibility of a high prevalence of vitamin D inadequacy in pediatric cancer patients, especially older children, urging the need for high-quality population-based longitudinal studies using standard definitions.
The incidence of childhood coeliac disease in Scotland: first year of the SPSU coeliac project.
(2011-06) White, Lois; Gillett, P. M.; Bannerman, Elaine; Wilson, D. C.; Livingston, J.; Coeliac UK; Gloag Family Charity
Objectives and Study: To establish the incidence of coeliac disease (CD) (<16 years) in Scotland using the Scottish Paediatric Surveillance Unit (SPSU) e-reporting system and through strategic contacts within the 3 Tertiary GI Regions - West (W), East (E) and North (N) of Scotland.
The rising incidence of celiac disease in Scotland
(2013-10) White, Lois; Merrick, V. M.; Bannerman, Elaine; Russell, R. K.; Basude, D.; Henderson, P.; Wilson, D. C.; Gillett, P. M.
Background and objectives: Although the incidence of pediatric celiac disease (CD) is increasing globally, it is uncertain whether this is attributed to improved case ascertainment or signifies a true rise. We aimed to identify all incident cases of childhood CD in southeast Scotland over the period 1990 to 2009 to assess trends in totalincidence and cases diagnosed as a result of (1) a classic presentation, (2) a nonclassic presentation, or (3) targeted screening. Methods: Twenty-year retrospective cohortstudy of case notes, pathology databases, endoscopy, and patient records for all children (<16 years of age) diagnosed with CD on biopsy in southeast Scotland (at-riskpopulation of 225 000-233 000). Data were age-gender standardized and Poisson regression models used to calculate changes in incidence over time. Results: A total of 266 children were diagnosed from 1990 to 2009 with an increase in incidence from 1.8/100 000(95% confidence interval [CI] 1.1-2.7) to 11.7/100 000 (95% CI 9.8-13.9) between the epochs 1990 to 1994 and 2005 to 2009, respectively (P < .0001). The incidence of nonclassic presentation (children with a monosymptomatic presentation and those with extraintestinal symptoms) and actively screened cases increased by 1566% (P < .05) and 1170% (P < .001) from 1990 to 1999 to 2000 to 2009, respectively. However, a rise in the incidence of Oslo classic cases from 1.51/100 000 (95% CI 0.91-2.38) in 1990 to 1994 to 5.22/100 000 (95% CI 3.98-6.75) in 2005 to 2009 (P < .01) remained evident. Conclusions: The incidence of pediatric CD increased 6.4-fold over the 20 years. This study demonstrates that this rise is significant for classic CD, indicating a true rise in the incidence of pediatric CD. 2013 by the American Academy of Pediatrics.
Trends in Paeditric Coeliac Disease 1990-2009: A UK Regional Retrospective Audit of Cases
(BMJ, 2012-05) White, Lois; Merrick, V.; Bannerman, Elaine; Wilson, D. C.; Russell, R. K.; Basude, D.; Henderson, P.; Gillett, P. M.; Coeliac UK; Gloag Family Foundation
Aim - To review all incident cases of paediatric coeliac disease (CD) in a UK region over the 20 year period from 1990-2009; to observe trends in incidence, symptom presentation, age at diagnosis and the impact of active screening of at-risk groups; and to audit laboratory results at diagnosis for 01/2005-12/2009.