Klinische Padiatrie最新文献

{"title":"Association Between Serum Vitamin D Levels, Clinical Disease Activity and Magnetic Resonance Imaging Lesion Burden in Pediatric Chronic Recurrent Multifocal Osteomyelitis.","authors":"Firat Gundogmus, Halil Kazanasmaz, Ender Can Eroglu, Mukaddes Kalyoncu","doi":"10.1055/a-2859-0223","DOIUrl":"https://doi.org/10.1055/a-2859-0223","url":null,"abstract":"<p><strong>Background: </strong>Chronic recurrent multifocal osteomyelitis is a rare autoinflammatory bone disorder in children. Vitamin D regulates immune and inflammatory pathways, but its impact on chronic recurrent multifocal osteomyelitis remains unclear. This study investigated the relationship between serum 25-hydroxyvitamin D levels and clinical, laboratory, and radiological characteristics of pediatric chronic recurrent multifocal osteomyelitis.</p><p><strong>Methods: </strong>Pediatric chronic recurrent multifocal osteomyelitis patients and age- and sex-matched healthy controls were retrospectively evaluated. Serum 25-hydroxyvitamin D, inflammatory markers, clinical disease activity score, and whole-body magnetic resonance imaging findings were analyzed.</p><p><strong>Results: </strong>Thirty-one chronic recurrent multifocal osteomyelitis patients and 31 controls were included. Chronic recurrent multifocal osteomyelitis patients had significantly lower 25-hydroxyvitamin D levels and a higher frequency of vitamin D deficiency (<i>p</i><0.001). Serum 25-hydroxyvitamin D levels showed no correlation with C-reactive protein, erythrocyte sedimentation rate, or the neutrophil-to-lymphocyte ratio, but were inversely correlated with the clinical disease activity score (<i>r</i>=- 0.429 and <i>p</i>=0.020) and the number of magnetic resonance imaging-detected skeletal lesions (<i>r</i>=- 0.376 and <i>p</i>=0.044). Logistic regression confirmed vitamin D deficiency as independently associated with chronic recurrent multifocal osteomyelitis (odds ratio=0.59, 95% confidence interva: 0.41-0.88, and <i>p</i>=0.007).</p><p><strong>Conclusions: </strong>Vitamin D deficiency is highly prevalent in pediatric chronic recurrent multifocal osteomyelitis and correlates with disease severity, reflected by clinical activity and lesion burden, independent of systemic inflammation. These findings suggest vitamin D as a potential biomarker in chronic recurrent multifocal osteomyelitis and highlight the need for prospective studies assessing its therapeutic role.</p>","PeriodicalId":17846,"journal":{"name":"Klinische Padiatrie","volume":" ","pages":""},"PeriodicalIF":0.9,"publicationDate":"2026-05-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147856384","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Devil's Advocate: Exclusive breastfeeding for six months - evidence-based gold standard or well-intentioned myth?]","authors":"Matthias V Kopp, Eckard Hamelmann","doi":"10.1055/a-2854-2379","DOIUrl":"https://doi.org/10.1055/a-2854-2379","url":null,"abstract":"<p><strong>Abstract: </strong>Breastfeeding is an important factor for the health of both mother and child. A new guideline on breastfeeding duration recommends, for the first time in Germany, six months of exclusive breastfeeding and a total breastfeeding duration of at least twelve months. However, these recommendations contradict other national guidelines and policy recommendations that suggest four to six months of exclusive breastfeeding. At the same time, the guideline rates the underlying evidence predominantly as low to very low. This article questions whether the strong recommendations are sufficiently evidence-based and discusses the methodological limitations of the new guideline on breastfeeding duration.</p>","PeriodicalId":17846,"journal":{"name":"Klinische Padiatrie","volume":" ","pages":""},"PeriodicalIF":0.9,"publicationDate":"2026-05-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147839766","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Influenza vaccination in healthy infants: Should healthy infants be included in the vaccination recommendations?]","authors":"Barbara Gärtner, Johannes Huebner, Jörg Schelling, Tilmann Schober","doi":"10.1055/a-2851-4526","DOIUrl":"10.1055/a-2851-4526","url":null,"abstract":"<p><strong>Abstract: </strong>Influenza is one of the most common vaccine-preventable infectious diseases in Germany, with sometimes severe, even fatal courses. Young children in particular, with or without a prevalent primary disease, have an increased risk of contracting influenza and play a crucial role in transmitting the virus to others. Vaccinations are the most effective medical measure to reduce the risk for influenza infections and complications. However, contrary to WHO recommendations, in Germany, healthy children are not included in the recommendations for influenza vaccinations. Data from various countries demonstrate that routine vaccination of children is well tolerated and reduces the number of influenza-related hospitalizations and deaths. Furthermore, a reduction in influenza infections in the general population and health economic benefits have been observed. The aim of this review is to advance the debate on the necessity of vaccinating healthy children in Germany, taking into account the current challenges.</p>","PeriodicalId":17846,"journal":{"name":"Klinische Padiatrie","volume":" ","pages":""},"PeriodicalIF":0.9,"publicationDate":"2026-05-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147654445","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Fecal Calprotectin as a Potential Biomarker of Gastrointestinal Inflammation in Children With Cerebral Palsy: A Prospective Pilot Study.","authors":"Ece Gültekin, Abdullah Sert, Meryem K Başaran","doi":"10.1055/a-2842-7680","DOIUrl":"https://doi.org/10.1055/a-2842-7680","url":null,"abstract":"<p><p>The presence of calprotectin in feces may be a consequence of neutrophil migration into the gastrointestinal tissue thanks to an inflammatory process. Fecal calprotectin is a non-invasive, cost-effective, specific, and sensitive test used to compare fecal calprotectin concentrations between cerebral palsy children and healthy children and to investigate the relationship between fecal calprotectin levels and cerebral palsy.A total of 25 patients with cerebral palsy and 27 healthy children were included in the study. We conducted a 3-month cohort study following two groups of children. One stool sample was collected from each participant. Subjects provided a single fecal sample for calprotectin measurements. Fecal samples were frozen on receipt at -80°C for further analysis.Median fecal calprotectin levels were found to be statistically significantly higher in the cerebral palsy group than in the control group (<i>p</i>=0.01). Albumin levels in the cerebral palsy group were found to be statistically significantly higher than in the control group (<i>p</i>=0.04). Total protein levels were statistically significantly higher in the cerebral palsy group than in the control group (<i>p</i>=0.01). This study confirms the possible association between increased calprotectin and cerebral palsy disease. The cut-off point, determined as 23.5 μg/g based on fecal calprotectin levels, yielded a sensitivity value of 0.92 and a specificity value of 0.96.Children with cerebral palsy exhibit elevated fecal calprotectin levels compared to healthy peers, suggesting altered intestinal inflammatory activity. Although fecal calprotectin is not proposed as a diagnostic marker for cerebral palsy, it may serve as an adjunctive indicator of subclinical intestinal inflammation in this population.</p>","PeriodicalId":17846,"journal":{"name":"Klinische Padiatrie","volume":" ","pages":""},"PeriodicalIF":0.9,"publicationDate":"2026-04-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147690934","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Do Paediatric Patients with a Trichobezoar Benefit from a Modified Laparoscopic Approach? A Systematic Review.","authors":"Frauke Alexandra Blaum, Ahmad Alsweed, Wolfgang Eberl, Esther Lau, Johannes Leonhardt","doi":"10.1055/a-2833-9457","DOIUrl":"https://doi.org/10.1055/a-2833-9457","url":null,"abstract":"<p><p>Trichobezoars represent a rare condition in paediatric patients, and evidence-based treatment recommendations are lacking. Most reported cases describe surgical removal, predominantly by laparotomy.We present a minimally invasive surgical strategy based on two paediatric cases of gastric trichobezoars and review the current literature. A PubMed search was performed including research articles and case reports published between 2016 and 2020. Inclusion criteria were isolated trichobezoars in patients aged ≤18 years, while reports describing combined bezoars were excluded. Extracted data included age, sex distribution, clinical presentation, medical history, imaging, treatment modality, and follow-up management.Thirty-four publications comprising 41 paediatric cases of trichobezoars were identified (age range: 2-17 y; female-to-male ratio: approximately 7:1). Endoscopic removal was attempted in 10 cases, requiring conversion to laparotomy in nine cases and to a modified laparoscopic technique in one case. Overall, 36 bezoars were removed by laparotomy, 5 by a modified laparoscopic technique, and only 1 by purely laparoscopic extraction without auxiliary incision.Our modified minimally invasive approach resulted in an uncomplicated postoperative course and a favourable cosmetic outcome. The technique enables safe removal of trichobezoars while minimising the risk of intra-abdominal contamination.</p>","PeriodicalId":17846,"journal":{"name":"Klinische Padiatrie","volume":" ","pages":""},"PeriodicalIF":0.9,"publicationDate":"2026-04-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147690984","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Rare Presentation of Duchenne Muscular Dystrophy: Acute Rhabdomyolysis.","authors":"Esra Sayar, Mustafa Kılıç, Suzan İcil, Abdülkerim Kolkıran, Abdullah Sezer","doi":"10.1055/a-2842-7622","DOIUrl":"https://doi.org/10.1055/a-2842-7622","url":null,"abstract":"","PeriodicalId":17846,"journal":{"name":"Klinische Padiatrie","volume":" ","pages":""},"PeriodicalIF":0.9,"publicationDate":"2026-04-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147690911","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Co-occurrence of Gluten-free Diet Adherence on Bone Mineral Density and Growth in Children with Celiac Disease.","authors":"Serhat Duman, Sadık Sami Hatipoglu, Hasret Ayyildiz Civan","doi":"10.1055/a-2833-0306","DOIUrl":"10.1055/a-2833-0306","url":null,"abstract":"<p><p>To investigate the impact of gluten-free diet adherence on bone mineral density and growth in children with celiac disease.This retrospective cross-sectional study reviewed the medical records of 75 pediatric patients diagnosed with celiac disease. Data on adherence to a gluten-free diet, bone mineral density assessed by dual-energy X-ray absorptiometry, anthropometric measurements, and laboratory parameters were collected. Bone mineral density was evaluated using <i>Z</i>-scores, and low bone mass for age was defined as a bone mineral density <i>Z</i>-score of<-2 according to International Society for Clinical Densitometry pediatric guidelines.Of the 75 patients, 26 (34.7%) patients were men and 49 (65.3%) patients were women; 48 (64%) patients adhered to the diet and 27 (36%) patients did not. Most patients (96%) had normal bone mineral density <i>Z</i>-scores, while 3 (4%) patients had low bone mass for age. The mean height was 141.09±19.34 cm and the mean weight was 37.50±14.95 kg. Growth failure was observed in 10.6% for height, 21.3% for weight, and 5.3% for both. No significant association was observed between diet adherence and sex, bone mineral density findings, growth failure, or most laboratory parameters. Ferritin levels were significantly higher in adherent patients, and positive correlations were observed between diet adherence and hemoglobin and ferritin levels.Adherence to a gluten-free diet showed a trend toward higher bone mineral density <i>Z</i>-scores but without statistically significant differences. The low prevalence of low bone mass for age may limit the detection of differences between groups. Prospective longitudinal studies are needed to clarify the long-term impact of dietary adherence on bone health in pediatric celiac disease.</p>","PeriodicalId":17846,"journal":{"name":"Klinische Padiatrie","volume":" ","pages":""},"PeriodicalIF":0.9,"publicationDate":"2026-04-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147458272","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Treatment of RSV in pediatric inpatients (Leave 5) and early effects of nirsevimab passive immunization in a regional German pediatric network].","authors":"Katharina Remke, Anna Hoffmann, Michael Zemlin, Marie-Claire Detemple, M Ghiath Shamdeen, Fabian Drautz, Wolfgang Thomas, Nicole Schröder, Sven Thorsten Nipken, Tania de la Rosa-Ramos, Fabian Berger, Daniel Picard, Arne Simon","doi":"10.1055/a-2826-9348","DOIUrl":"https://doi.org/10.1055/a-2826-9348","url":null,"abstract":"<p><p>Inpatient treatment of RSV infection involves non-evidence based measures, including excessive antibiotic therapy. The introduction of nirsevimab as a passive immunization is intended to reduce the number of infants requiring inpatient treatment.Can inpatient treatment of RSV infection be improved in a regional pediatric infectious diseases network? Does the introduction of nirsevimab have an impact on inpatient epidemiology?Prospective study (2024/2025) in six pediatric hospitals in one region. Agreement on a treatment standard including five interventions that should be avoided (Leave 5). Analysis of epidemiology (≤24 months and 25-36 months) 2022-2025.121 Clinical Review Forms (CRF) were collected, 101 (83.5%) patients were≤24 months old. The length of stay was 4±3 days vs. 3.5±2 days (≤24 months vs. 25-36 months). At least one risk factor was documented in 24% (≤24 months) and 25% (25-36 months; p=0.8). In 56% of cases, all 5 Leave 5 measures were avoided (≤24 months 58%, 25-36 months 45%). In patients≤24 months, only 9% received antibiotics. After the introduction of nirsevimab, there was a decrease in the number of RSV treatment cases≤24 months (over 60%; p<0.0001).Evidence-based, predominantly supportive therapy for RSV infection in hospitalized children≤24 months can be promoted through a coordinated approach in a pediatric infectious disease network. Shortly after the introduction of nirsevimab, a clear effect on inpatient epidemiology is already evident.</p>","PeriodicalId":17846,"journal":{"name":"Klinische Padiatrie","volume":" ","pages":""},"PeriodicalIF":0.9,"publicationDate":"2026-04-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147633806","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Wolcott-Rallison Syndrome: A Case Report with Novel Homozygous EIF2AK3 Gene Mutation.","authors":"Qiaomian Zhu, Xiaolin Wang, Huiping Zhang","doi":"10.1055/a-2800-2131","DOIUrl":"https://doi.org/10.1055/a-2800-2131","url":null,"abstract":"","PeriodicalId":17846,"journal":{"name":"Klinische Padiatrie","volume":" ","pages":""},"PeriodicalIF":0.9,"publicationDate":"2026-03-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147521404","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical Course of Hyperostosis Due to SP7 (Osterix) Gain-of Function Mutation.","authors":"Uwe Wintergerst, Rainer Biedermann, Bernd Wegener, Adalbert Raimann, Gabriele Hartmann","doi":"10.1055/a-2808-3688","DOIUrl":"https://doi.org/10.1055/a-2808-3688","url":null,"abstract":"","PeriodicalId":17846,"journal":{"name":"Klinische Padiatrie","volume":" ","pages":""},"PeriodicalIF":0.9,"publicationDate":"2026-03-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147486505","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}