Welcome to issue 18 dEar FriEndS and collEagUES, there was very encouraging feedback from ESPE members regarding the new design of the last newsletter. your comments and suggestions are very important to us, so now we are asking for your feedback in a more structured way. Please let us know your burning questions and what you expect of the newsletter - to make it even better! We are launching several new initiatives in this issue. one is to reflect on practices in different centres in Europe and share this information with our ESPE members. Please contact us about your special expertise; this could include items such as research projects or diagnostic tests in your lab (especially the diagnosis of rare diseases). We hope by sharing this information in the newsletter we will improve the awareness and availability of high quality research and clinical facilities in Europe. We would like the newsletter to be an instrument that supports comprehensive and widespread collaboration between colleagues and centres. Please send your comments/information to firstname.lastname@example.org. in this issue, you will find preliminary notes about the 51st ESPE Meeting to be held in leipzig, germany in September. it’s just the right time to register! the scientific programme is excellent as usual, and we thank Wieland Kiess, the president of ESPE 2012 and of the programme organising committee for his hard work. another important message in our newsletter relates to the the accreditation and Syllabus Subcommittee which has been redesigned under the umbrella of the Education and training
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dEar ESPE MEMBErS, FrİEndS and collEagUES, as most of you are aware, one of my first
actions as new ESPE Secretary general was to organise a membership survey allowing us to
further develop our Society. the response rate was very high, demonstrating how much ESPE
members care about their Society. Most of the current ESPE activities were greatly appreciated,
including the annual ESPE meetings - which confirms that we are on the right track.
nevertheless, there is still room for improvement. Based on constructive feedback from the
membership, the ESPE council is currently forming the future strategy for ESPE. all activities
will be carefully reviewed to ensure the optimal outcome. this is important as the economic
crisis in Europe is likely to affect ESPE’s economy as well. to prepare for this, council has taken
action to attract new sponsors, and a special task force has been formed, with the aim of making
ESPE less dependent on industry support. hopefully, this will allow new initiatives to be
a record number of abstracts have been submitted to the 51st annual ESPE Meeting in
leipzig on 20-23 September 2012. Please make sure to reserve these dates in your calendar.
President Wieland Kiess, the local organising committee and the programme organising
committee have made a tremendous effort to make this meeting a great success. Please don’t
forget to register and make travel arrangements.
For more information on all of our activities, please visit the ESPE website at
www.eurospe.org or contact me directly at email@example.com or via the ESPE Secretariat at
ESPE Secretary General
dEar collEagUES, We previously reported the formation of an accreditation and Syllabus
Subcommittee under the umbrella of the Education and training committee (Etc).
this group’s first aim is to update the paediatric endocrine training syllabus which was last
updated in 2001 (as per the website). this update is to revise, restructure and amend the current
guidelines in the light of present practice and new developments, as well as evaluating the
feasibility of the current tutorial system approach in view of national differences in pediatric
training, and focusing on minimum but obligatory requirements. you may recall we asked for
your assistance and collaboration in updating the syllabus.
in the light of further discussions, we have decided to divide the paediatric endocrine training
programme into different chapters, and to allocate each chapter to an expert from a different
country. the group that is involved in these studies comprises lars Sävendahl (Sweden), chris
Kelnar (UK), Jeremy allgrove (UK), Peter hindmarsh (UK), Sten drop (the netherlands), anita
hokken-Koelega (the netherlands), Stefan riedel (austria), Jesús argente (Spain), christa Flück
(Switzerland), Maithe tauber (France), Stefano cianfarani (italy) and Wieland Kiess (germany).
the plan is to work on a draft that we can present to you for your comments. there will be a
poster presentation during the next ESPE meeting in leipzig covering the initial draft and the
issues to be discussed.
thanks to all who collaborated.
Professor Feyza Darendeliler
Chair, Accreditation and Syllabus Subcommittee
Professor Jan Lebl
Chair, Education and Training Committee
WE MUSt Bid FarEWEll to our esteemed friend and teacher, Professor dr med. dietrich Knorr, doyen and founding father of paediatric endocrinology in germany. our speciality, now over 50 years old, owes an immense debt to the work and example of dieter Knorr. as our london colleague, Martin Savage, recently wrote in an email: ‘dieter was an outstanding person and a key pioneer and leader in paediatric endocrinology and a role model to many people.’ in 1962 dieter Knorr was one of the select number of founding members of ESPE, which was launched by his friend, andrea Prader, in Zurich, and which, together with the german Society for Endocrinology and the german Paediatric Society, was to become the scientific home for him and his ever-increasing number of disciples. dieter completed his doctorate in paediatrics in 1963. in 1969, he spent a research sabbatical at the department of Endocrinology at the national institutes of health in Bethesda, Maryland, USa, and, after his return, was appointed as a professor. From 1974 until his retirement in 1988 he was head of the department for Paediatric Endocrinology at the University children’s hospital, Munich. the greater part of his scientific publications date from this period. they emphasised the importance of child-oriented, methodically exact, sensitive and specific hormone analysis in the early diagnosis and treatment of the various adrenal and gonadal biosynthesis defects and related disorders. dieter was an inspiring teacher of paediatric endocrinology, who worked tirelessly in the hospital and outpatients’ clinic as well as in the endocrinology lab. he was convinced that thorough experience in both these areas was vital for coping with the diagnostic and therapeutic challenges in the best interests of the sick child. With his refreshing modesty and reliability he was not only a dedicated and compassionate doctor for his patients and their parents, he was also an exemplary role model for his scientific colleagues. his extraordinary legacy has been carried down in the following generations of outstanding and dedicated paediatricians and scientists. he was appointed an honorary member of several scientific societies. the german Society for Endocrinology, whose Meeting President he was in 1986, conferred on him their highest award, the Berthold Medal, and established the prestigious dietrich Knorr Prize in his honour, which has been awarded at the Society’s annual meeting since 2003 for the best scientific publication in the field of the adrenal glands and the gonads. ESPE honoured dieter Knorr, as the only german to date, with its rarely awarded honorary Membership in 1998. With dieter Knorr we have lost a truly great representative of our field - and a very dear friend as well. We remember him with respect and affection and honour his memory. Wolfgang Sippell
onE oF thE MarvElloUS, but still underutilised, opportunities that ESPE offers is the
Sabbatical leave Programme, sponsored by Eli lilly. this programme (established in 1993)
enables ESPE members to undertake ‘sabbatical’ leave to perform research in another institution.
this provides a unique opportunity for scientific renewal, development of new research and
establishment of collaborative links. We believe that such sabbatical leave can substantially
contribute to your scientific career, and thereby improve the quality of paediatric endocrine
research, education and patient care in Europe.
the ESPE Sabbatical leave committee will grant two or three positions per year (up to €25 000
per recipient), and the leave will typically extend over 3-12 months. the grant is a contribution
towards the cost of travel, housing, and academic and other items related to the sabbatical leave.
consideration will also be given to support requests for contributory payments to other persons
covering clinical, teaching and other duties during the leave of absence.
Who can apply?
the candidate must be an ESPE member with an active research commitment in paediatric
endocrinology. So, contrary to associations between the word ‘sabbatical’ and ‘established’
professors, this programme is primarily targeted towards paediatric endocrinologists in the
middle of their scientific careers, who wish to make a substantial step forward.
What is required of the host institution?
the sabbatical leave should be spent in a place other than the applicant’s own institution. the
host institution should be of known excellence in the field of research selected by the candidate.
it should deliver a statement indicating acceptance of the candidate and that appropriate
facilities will be made available to undertake the research. it is expected that collaborative work
will continue after the sabbatical leave is completed.
ESPE Sabbatical Leave Programme
Are there other demands after
a short report should be submitted to the
Sabbatical leave committee within 3 months
of completing the programme. there will be
an opportunity, rather than an obligation, to
present your scientific results in a minireview
in Hormone Research in Paediatrics.
How to apply?
details of the procedure can be found on the
ESPE website (www.eurospe.org/awards/
awards_sabbatical.html). the 2012 deadline
for applications is 30 May. applications can
be sent to the chair of the Sabbatical leave
a period in another institution can stimulate
your scientific development enormously, and
may have a big impact on the rest of your
working life! Use the opportunity!
on behalf of the committee,
Chair, Sabbatical Leave Committee
ESPE Working Group Updates
Maternal serum levels of 25-hydroxy-vitamin D during pregnancy
and risk of type 1 diabetes in the offspring
Sørensen iM, Joner g, Jenum Pa, Eskild a, torjesen Pa & Stene lc
department of Pediatrics, oslo University hospital, Ullevål, oslo,
Diabetes 2012 61 175-178
BacKgroUnd: risk of type 1 diabetes (t1d) has been reported to
be reduced after intake of vitamin d supplements during pregnancy
or early childhood. the aim of this study was to assess whether
lower maternal serum concentrations of 25-hydroxy-vitamin d
(25-oh d) during pregnancy were associated with an increased risk
of t1d in the offspring.
MEthodS: 25-oh d levels were measured using a
radioimmunoassay on samples from late pregnancy in 109 women
delivering a child who developed t1d before 15 years of age (case
subjects) and from 219 control women.
rESUltS: there was a trend towards a higher risk of t1d with lower
levels of 25-oh d during pregnancy: the odds of t1d being 2.38
(1.12-5.07) for the offspring of women with the lowest levels of
25-oh d (first quartile) compared to the offspring of women with
levels above the upper quartile.
conclUSion: reduced maternal 25-oh d levels increase the risk of
developing t1d in the offspring. if these results are confirmed, they
could provide support for the initiation of a randomised intervention
trial to prevent t1d in children by enhancing maternal 25-oh d
levels during pregnancy.
COMMENTARY by M Loredana Marcovecchio and Francesco Chiarelli
over the last few years there has been a growing interest in the
immunomodulatory effect of vitamin d and in its association with the
pathogenesis of autoimmune diseases, such as t1d (1). reduced levels of
vitamin d have been reported in children and adults with t1d
compared with healthy controls. in addition, there have also been
studies assessing the potential role of polymorphisms in genes
implicated in vitamin d metabolism in the pathogenesis of t1d (2).
this recent study reports an interesting association between reduced
maternal serum vitamin d levels and risk of developing t1d in the
offspring before the age of 15 years. levels of vitamin d were reduced
in mothers of offspring who developed t1d compared with controls
(65.8 vs 73.1 nmol/l). of particular note was the finding that children
born to women with a 25-oh d level in the lowest quartile had a risk
of developing t1d which was more than twofold higher than those
born to women with a 25-oh d level in the highest quartile. these
findings suggest that vitamin d could influence t1d risk during
prenatal life, by influencing the immune system. in fact, although the
exact mechanisms linking reduced vitamin d levels to t1d are not yet
completely understood, there is evidence suggesting that vitamin d can
enhance immunologic tolerance (3).
these results are of interest given that they provide further support
for the potential role of vitamin d in the pathogenesis of t1d and, in
the meantime, they confirm the role of environmental factors acting
early in life in the pathogenesis of this autoimmune disease. if these
results are confirmed in future studies, they could represent the driving
force for trials with vitamin d supplementation during pregnancy as a
preventive strategy for t1d.
(1) danescu lg, levy S, levy J 2009 vitamin d and diabetes mellitus. Endocrine 35 11-17.
(2) cooper Jd, Smyth dJ, Walker nM et al. 2011 inherited variation in vitamin d genes is
associated with predisposition to autoimmune disease type 1 diabetes. Diabetes 60 1624-1631.
(3) hewison M 2010 vitamin d and the immune system: new perspectives on an old theme.
Endocrinology and Metabolism Clinics of North America 39 365-379, table of contents.
Yearbook of Pediatric Endocrinology: Editors’ preview
Editors Ze’ev Hochberg and Ken Ong pick out some of the outstanding papers published in the last few months from the yearbook of Pediatric Endocrinology.
Making A Difference
Bone and Growth Plate Working Group thE BonE and groWth PlatE WorKing groUP brings together experts in growth, calcium/phosphate metabolism and bone strength. We have recently founded a European Bone and growth Plate network to encourage discussion on supra-regional public health issues, collaborative research and audit, distribution of information on meetings and updates, and ad-hoc discussions. interested ESPE members should contact me (Wolfgang.firstname.lastname@example.org). in glasgow last year, our session attracted so much interest that many people had to be turned away! We have put together another exciting programme for leipzig. Please come along to our session as well as to our committee’s business meeting, and help plan activities for the coming year, both scientifically and for public health-related topics. you may also be interested in the forthcoming 3rd European Workshop in growth Plate research, vienna, austria, 5-6 July, which is organised by our member dr gabriele haeusler (http://gp2012.univie.ac.at). Wolfgang Högler Chair, Bone and Growth Plate Working Group Paediatric and Adolescent Gynaecology Working Group thE Pag WorKing groUP includes paediatric endocrinologists interested in improving the reproductive health of young girls and adolescents worldwide. they strive to do this by: promoting active research in reproductive-related disorders with special attention to cross collaboration between basic and clinical aspects; interacting with physicians involved in related disciplines, particularly in the development of joint projects among the ESPE membership and related societies. Each year, we organise the Pag Symposium just before the start of the ESPE annual meeting. the topic of the 2011 event in glasgow was ‘amenorrhea in adolescence’. it was coordinated by Professors lourdes ibáñez and charles Sultan, and had over 250 attendees. the forthcoming Pag Symposium in leipzig on 20 September 2012 is entitled ‘Sexual precocity in girls: a growing problem’. the Pag Working group has drafted a programme highlighting the practical aspects of the topic, and covering both the abnormalities associated with sexual precocity during childhood and the potential gynaecological alterations in adolescence and young adulthood derived from these. last year, Professor charles Sultan and dr laura gaspari finalised the details of a collaborative clinical project entitled ‘Prevalence of hyperandrogenism in adolescent girls previously treated for central precocious puberty and followed up for at least 2 years after menarche’. dr gaspari will officially present this project to the audience at the Pag Symposium in leipzig. i would like to encourage all paediatric endocrinologists interested in this field to contact us for potential collaborations and to suggest topics that they would like to see covered in future Pag Symposia. Lourdes Ibáñez email@example.com For further details about these and other ESPE Working Groups see www.eurospe.org/about/workinggroups.html. Stefan Aronson Halmstad Hospital, Halland, Sweden i aM 74 yEarS old, still working part-time as a paediatrician, now as a mentor for younger doctors entering paediatrics. i have been engaged in paediatric endocrinology since 1966, and after my thesis in 1976 i planned to join ESPE. however, i was put off seeking membership, particularly because Swedish paediatric endocrinology was considered an exclusive subspecialty then, which discouraged too many being active in the field. today Swedish paediatric endocrinology has lost its exclusiveness and is represented at all county hospitals in Sweden. For me personally it became imperative to join ESPE after having been engaged as an ESPE tutor in ESPE’s nairobi training centre for african paediatric endocrinologists. over the past 40 years i have attended many ESPE meetings. they have been a great source of knowledge through both the presentations and the many informal personal contacts. Working in a county hospital since 1979, i was alone in my interest for many years. ESPE influx helped me in my ambitions to increase the local platform for paediatric endocrinology. it has also been possible for me to present some poster data at ESPE, the most thrilling being at the last meeting in glasgow as mentor and co-author of dr Elizabeth oyenusi from lagos, nigeria, fellow of the Pan-african ESPE Fellowship at the nairobi training centre. i would encourage prospective members to join and enjoy all that ESPE can offer a paediatric endocrinologist (established or in the making)! devote yourself to paediatric endocrinology: it is a very broad subspecialty, involved in the basic process of growth and development, fundamental to paediatrics. Subspecialising in paediatric endocrinology is rewarding at all levels of paediatric work. ESPE welcomes you early in your personal career or at any stage up to an advanced university level. at this level, membership is more or less mandatory, as a part of one’s career, and ESPE will offer you advanced education, international contacts for further development, and the standards for clinical work and research in paediatric endocrinology. Khadija Humayun Aga Khan University, Karachi, Pakistan WhilE BEing trainEd at the royal hospital for Sick children in yorkhill, glasgow, UK, i saw the support ESPE was providing for paediatric endocrinology training not only in Europe but for developing countries in africa. i always thought ESPE would be the perfect platform to seek support for developing the subspecialty in my country, Pakistan, through the networking that this forum offers. i hope to have an active role in ESPE as non-EU member, and to get ESPE to organise a support programme for Pakistan. i would also encourage any prospective member to join ESPE, to attend the meetings and apply for the various training opportunities. ESPE Working Groups Meet new ESPE members ESPE Activities 7 17th ESPE Winter School 24 February-1 March 2012, Kiev, Ukraine thE 17th ESPE WintEr School - the first to be held in Ukraine - took place in the grand admiral resort, set in a forest of tall snowy pine trees near the small town of irpin, about 20km from Ukraine’s capital Kiev. the venue was ideal, and the main conference room was beautifully decorated and just the right size for the 8 teachers and 26 students. this year our host co-ordinator was Professor nataliya Zelinskaya from Kiev, ably assisted by Professor Marina Mamenko from luhansk in southeastern Ukraine. the other members of the Winter School faculty were Professor angela hübner (dresden, germany), dr Malcolm donaldson (co-ordinator; glasgow, UK), Professor John gregory (cardiff, UK), Professor christa Flück (Berne, Switzerland) and Professor Margaret Zacharin (Melbourne, australia). We were joined by dr artur Mazur, host co-ordinator for next year’s event in rzeszow, Poland. of 54 applicants, we were able to invite 26 doctors from Ukraine, surrounding countries and beyond. the breakdown of students was: Ukraine (7), russia (5), Belarus (3), Bulgaria (2), croatia (1), czech republic (1), Estonia (1), lithuania (2), Macedonia (1), Poland (1), romania (1) and Sudan (1). as usual, the teaching was divided into plenary sessions and small group work. the faculty members tried to cover all aspects of paediatric endocrinology during the 5 days, with interactive lectures. normal growth and puberty, basic endocrinology and molecular endocrinology came early in the programme, and were followed by lectures on growth disorders, growth hormone treatment, delayed puberty and sexual precocity, adrenal insufficiency and excess, congenital adrenal hyperplasia and disorders of sexual development, thyroid disease, diabetes, obesity, calcium and bone disorders, salt and glucose balance and late endocrine effects of childhood cancer. Each student had to present a case to the plenum, which was very helpful in reinforcing the points made in the lectures. christa Flück’s evening sessions on how to do research and audit, and how to critically evaluate a publication, were very well received, and selected students presented their projects to the plenum during the last two evenings. the small group sessions included an hour and a half of teachers’ cases each day (always the most popular part of the programme!) as well as rehearsal of student cases and research projects. our much needed half day excursion on the third day was to Kiev, where our guide yuri took us round the cathedral of St Sophia, St Michael’s cathedral and the amazing Kievo-Pecherska lavra monastery complex with its museum and catacombs, the latter containing the mummies of orthodox saints! We then had a splendid evening meal in Shinok, a traditional Ukrainian restaurant. as usual there was singing (and occasionally dancing) in the evenings at grand admiral hotel. in previous Winter Schools this has tended to be either unaccompanied or with the guitar. on this occasion, however, our host nataliya Zelinskaya was able to regale us with wonderful (but often sad!) Ukrainian songs at the piano, aided by the Ukrainian and russian doctors. Feedback from the students was exceptionally good this year and we came away feeling that it had equalled the best of our Winter Schools. as always, we are deeply grateful to Ferring Pharmaceuticals and especially to their global Brand Manager Phil Boothroyd in Switzerland, for sponsoring our meetings, as they have done since the inception of Winter School in 1995. Malcolm Donaldson ESPE Winter School Co-ordinator (2008-date) Glasgow, UK ESPE Winter School 2013 RZESZOW, POLAND, 15-21 FEBRUARY the 18th ESPE Winter School sees a return to Poland, and will be held near the southeastern town of rzeszow. dr artur Mazur, our host co-ordinator, has already identified five venues, one of which will be chosen in June. We are encouraging applicants from both west and east Ukraine (most of this year’s applicants being from the east) and also from russia, the Baltic States, romania, Slovakia, hungary and Bulgaria. Future Winter Schools We are committed to holding the 2015 Winter School in tblisi, georgia, but thereafter no final decisions have been taken, although several countries have expressed interest
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