Search

Childhood obstructive sleep apnoea syndrome (OSAS) acts as a check on growth and nutritional status. An increase in sleeping energy expenditure has been proposed as a possible mechanism, but to date, no studies have determined whether energy requirements (total energy expenditure; TEE) are raised in OSAS. The aim of this study was to test the hypothesis that OSAS is associated with increased TEE.Eleven children (mean±sd 5.8±2.2 yrs of age) with OSAS confirmed by nocturnal polysomnography were each matched with a pair of healthy controls (n=22) of the same age and sex. TEE was measured using the doubly-labelled water method in all subjects. In 10/11 patients TEE was also measured after adenotonsillectomy and changes in TEE assessed.There was no significant difference in TEE between patients (mean±sd 325±44 kJ·kg−1·day−1) and controls (339±48 kJ·kg−1·day−1), nor between patients and age- and sex-specific literature data on TEE, using the doubly-labelled water method. Differences in TEE within patients, beforeversusafter surgery, were minor and not statistically significant.This study does not support the hypothesis that obstructive sleep apnoea syndrome in childhood is associated with increased energy requirements, and suggests that alternative explanations for the effect of this syndrome on growth and energy balance should be sought.

By providing free access for European medical specialists to the European job market via two relevant directives (issued in 1975 and 2005), the European Union (EU) has effected an automatic recognition of the diplomas and certificates of qualification in medicine in all member countries. This is only acceptable on the basis of harmonised training standards across the entire EU. Thus, it is mandatory to work towards such harmonised standards in all medical specialties. As a result of the first directive and more than 10 years ago, the Long Range Planning Committee of the Paediatric Assembly of the European Respiratory Society (ERS), led by M. Zach, developed the first European syllabus for Training in Paediatric Respiratory Medicine as a tertiary care subspecialty. This pioneering syllabus not only served as a model for other tertiary care subspecialties in paediatrics but also helped establish and strengthen paediatric respiratory medicine (PRM) as a subspecialty within Europe. With the syllabus as a guide, the ERS Paediatric Assembly and the ERS School have continuously promoted state-of-the-art training in PRM. In contrast to adult respiratory medicine, which has long been established as a specialty in most European countries, PRM is still developing as a subspecialty in Europe 1. Widely different approaches to training are still the reality in EU states. Formal training in a recognised training centre is the norm in countries such as the UK, the Netherlands, Germany, Austria and Switzerland; in other countries there is no formal recognition of PRM, and junior doctors have to train abroad or in adult respiratory depts. Training in particular areas sometimes occurs in other subspecialties, such as …