Klinische Padiatrie最新文献

{"title":"[Neonatal Hyperbilirubinemia - Bridging the Care Gap in the Early Neonatal Period].","authors":"Sigrid Hahn, Christoph Bührer, Monika Berns","doi":"10.1055/a-2974-2741","DOIUrl":"https://doi.org/10.1055/a-2974-2741","url":null,"abstract":"<p><strong>Background: </strong>Kernicterus resulting from excessive bilirubin concentrations can be effectively prevented by early diagnosis and therapy. The postnatal rise of bilirubin peaks at a time of life most newborn infants have been discharged home while the next scheduled well baby visit is several weeks ahead.</p><p><strong>Aim: </strong>Evaluating a post-discharge bilirubin follow-up program established in 2010.</p><p><strong>Methods: </strong>Retrospective analysis of newborns seen 2010-2024 at the Berlin University Medical Center bilirubin outpatient clinic, exchange transfusions performed in the same time period, and infants admitted for phototherapy in 2022.</p><p><strong>Results: </strong>The median annual number of infants consulting the outpatient clinic was 616 in 2010-2016, as compared to 1858 in 2017-2024. In 2022, 6% of newborns seen at the outpatient clinic were admitted for treatment of hyperbilirubinemia at a median age of 6 [5-7] days, with a total serum bilirubin concentration of 20.5 [19.3-21.4] mg/dl). The 2 top indications for the 81 exchange transfusions performed in 78 patients were rhesus incompatibility (n=44; 56%) and gestational alloimmune liver disease (n=24; 31%). The bilirubin level immediately prior to exchange transfusion was 15.5 [12.5-20.0] mg/dl (highest measured value 38.1 mg/dl).</p><p><strong>Conclusion: </strong>A post-discharge program attached to a neonatal unit can effectively bridge the gap in care between discharge and scheduled well-baby visits several weeks ahead. A mandatory U2a could standardize follow-up care for neonatal hyperbilirubinemia in the future.</p>","PeriodicalId":17846,"journal":{"name":"Klinische Padiatrie","volume":" ","pages":""},"PeriodicalIF":0.8,"publicationDate":"2026-10-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149224405","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":"Why Complete Pediatric Cancer Registration in Germany Requires Cross-Sector Reporting Obligations: A Registry Comparison Study.","authors":"Michael Abele, Ines B Brecht, Klaus Kraywinkel, Friederike Erdmann, Claudia Trübenbach, Ulla Graeßner, Marina Kunstreich, Antje Redlich, Dominik T Schneider, Michaela Kuhlen","doi":"10.1055/a-2975-8698","DOIUrl":"https://doi.org/10.1055/a-2975-8698","url":null,"abstract":"<p><strong>Background: </strong>Complete, high-quality cancer registration is essential for epidemiological research and evidence generation in children and adolescents, particularly for very rare entities. We compared population-based and pediatric clinical cancer registration in Germany and benchmarked the patterns against U.S. Surveillance, Epidemiology, and End Results data.</p><p><strong>Patients/methods: </strong>We evaluated new cancer diagnoses in individuals younger than 18 years (2010-2022) from the German Center for Cancer Registry Data, the German Childhood Cancer Registry, and the U.S. Surveillance, Epidemiology, and End Results (SEER) program. As completeness varied by federal statse, German Center for Cancer Registry Data analyses focused on Baden-Württemberg and Bavaria. Age-standardized incidence rates were calculated using Segi World Standard Population.</p><p><strong>Results: </strong>The German Center for Cancer Registry Data contained 27,425 new diagnoses (Baden-Württemberg and Bavaria: 8,366), the German Childhood Cancer Registry 30,051 (Baden-Württemberg and Bavaria: 8,747), and the U.S. Surveillance, Epidemiology, and End Results program 92,707. The overall incidence rates per 1,000,000 were 162.1 (German Center for Cancer Registry Data Baden-Württemberg and Bavaria), 174.4 (German Childhood Cancer Registry Baden-Württemberg and Bavaria), and 205.8 (U.S. Surveillance, Epidemiology, and End Results). Between the German Center for Cancer Registry Data and the German Childhood Cancer Registry, incidence rates for Baden-Württemberg and Bavaria diverged markedly for leukemias (41.1 vs. 52.5), central nervous system tumors (36.0 vs. 39.4) and epithelial malignancies (13.1 vs. 6.2). Age patterns showed a stronger contribution of late adolescence to epithelial entities in German Center for Cancer Registry Data and data from the U.S. Surveillance, Epidemiology, and End Results program.</p><p><strong>Conclusion: </strong>We identified substantial discrepancies and under-ascertainment in pediatric cancer registration in Germany compared with the U.S. Surveillance, Epidemiology, and End Results data. Existing registries capture partly different segments of the pediatric cancer spectrum, with large gaps for adolescent epithelial malignancies. Improved completeness and cross-sector case ascertainment are needed for robust epidemiological research and evidence-informed, age-adapted care recommendations, especially for very rare pediatric tumors.</p>","PeriodicalId":17846,"journal":{"name":"Klinische Padiatrie","volume":" ","pages":""},"PeriodicalIF":0.8,"publicationDate":"2026-10-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149224437","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":"Acute Compartment Syndrome of the Forearm and Hand Following Epinephrine Extravasation in an Infant.","authors":"Mehmet Emir Eren, Ayşen Durak Aslan, Eda Eyduran, Nijat Babaev, Elçin Işılgan, Ayşe Sena Kum, Merve Havan, Tanıl Kendirli","doi":"10.1055/a-2975-0135","DOIUrl":"https://doi.org/10.1055/a-2975-0135","url":null,"abstract":"","PeriodicalId":17846,"journal":{"name":"Klinische Padiatrie","volume":" ","pages":""},"PeriodicalIF":0.8,"publicationDate":"2026-10-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149224383","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":"Isolated Perforated Appendicitis Mimicking Volvulus in a Very Small Preterm Infant at 43 Weeks' Postmenstrual Age: A Case Report.","authors":"Hasan Akduman, Gülsen Biçer, Tuğba Dikmen Gülser, Hüseyin Başkan, Ahmet Furkan Atan","doi":"10.1055/a-2974-2789","DOIUrl":"https://doi.org/10.1055/a-2974-2789","url":null,"abstract":"","PeriodicalId":17846,"journal":{"name":"Klinische Padiatrie","volume":" ","pages":""},"PeriodicalIF":0.8,"publicationDate":"2026-10-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149207274","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":"[Abernethy Malformation Congenital Portosystemic Shunts and the Transition Toward Minimally Invasive Therapy].","authors":"Julian Kolorz, Carsten Müntjes, Michael Berger, Simone Kathemann","doi":"10.1055/a-2982-0734","DOIUrl":"https://doi.org/10.1055/a-2982-0734","url":null,"abstract":"","PeriodicalId":17846,"journal":{"name":"Klinische Padiatrie","volume":" ","pages":""},"PeriodicalIF":0.8,"publicationDate":"2026-10-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149182475","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":"[Autoantikörperpositivität und Entwicklung rheumatologischer Erkrankungen bei Kindern nach intravenöser Immunglobulintherapie: eine retrospektive Kohortenstudie].","authors":"Halil Kazanasmaz, Firat Gundogmus, Ender Can Eroglu, Mukaddes Kalyoncu","doi":"10.1055/a-2970-7567","DOIUrl":"10.1055/a-2970-7567","url":null,"abstract":"<p><strong>Background: </strong>Intravenous immunoglobulin (IVIg) may cause transient autoantibody positivity, but its clinical significance in children is unclear. We evaluated post-IVIg autoantibody positivity and its association with later rheumatologic diagnoses.</p><p><strong>Methods: </strong>T1 was defined as the first clinically indicated autoantibody measurement obtained within 6 months after IVIg, and T2 as the follow-up autoantibody measurement obtained approximately 6 months after IVIg. Antinuclear antibodies (ANA) were assessed by indirect immunofluorescence using the International Consensus on ANA Patterns (ICAP) classification, and extractable nuclear antigens (ENA) by immunoblot.</p><p><strong>Results: </strong>Of 205 patients, 93 (45.4%) were ANA-positive. Seven (3.4%) developed rheumatologic disease (5 juvenile systemic lupus erythematosus, 1 dermatomyositis, 1 juvenile idiopathic arthritis), all within the ANA-positive group. ENA positivity occurred in 60/93 (64.5%), most often DFS70 (51.7%) and SSA/Ro (35.0%). From T1 to T2, ENA intensity decreased significantly for DFS70, SSA/Ro, Ro52, histones, nucleosomes, AMA-M2, dsDNA, and Sm. ANA intensity was inversely associated with time since IVIg.</p><p><strong>Conclusions: </strong>Most post-IVIg ANA/ENA positivities in children appear transient and clinically silent. Repeat testing at about 6 months may reduce misinterpretation, while further rheumatologic evaluation should be guided primarily by compatible clinical findings rather than persistent seropositivity alone.</p>","PeriodicalId":17846,"journal":{"name":"Klinische Padiatrie","volume":" ","pages":""},"PeriodicalIF":0.8,"publicationDate":"2026-10-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149081378","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":"Is Intravenous Lipid Emulsion Therapy Effective in Propafenone Intoxication?","authors":"Zekiye Şahin Tapsız, Cihan İnan, Bayram Bayramov, Emel Uyar, Serhan Özcan, Serhat Emeksiz","doi":"10.1055/a-2951-8340","DOIUrl":"https://doi.org/10.1055/a-2951-8340","url":null,"abstract":"","PeriodicalId":17846,"journal":{"name":"Klinische Padiatrie","volume":" ","pages":""},"PeriodicalIF":0.8,"publicationDate":"2026-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149030813","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":"Pulmonary Hemorrhage in Extremely Low Birth Weight Infants: Risk Factors and Preventive Measures for an Increased Incidence.","authors":"Jonas Fritsch, Sören Wiesner, Florian Guthmann, Manuela F Richter","doi":"10.1055/a-2954-5687","DOIUrl":"10.1055/a-2954-5687","url":null,"abstract":"<p><strong>Background: </strong>Pulmonary hemorrhage is a severe respiratory complication with high mortality in preterm infants; no causal treatment exists. This study aimed to identify risk factors for pulmonary hemorrhage in extremely low birth weight infants (birth weight <1,000 g) treated in a German neonatal unit and to relate these factors to a local three-fold increase in pulmonary hemorrhage incidence over 10 years.</p><p><strong>Patients and methods: </strong>In this retrospective cohort study spanning approximately 10 years, 319 extremely low birth weight infants (including 12 with pulmonary hemorrhage) were divided into low- and high-incidence periods. Perinatal characteristics and therapeutic measures were recorded, and associations between risk factors, time period, and pulmonary hemorrhage incidence were analyzed statistically.</p><p><strong>Results: </strong>Multiple gestation (odds ratio: 23.83), small for gestational age (odds ratio: 7.01), a low 1-minute Apgar score (odds ratio: 1.57 per 1-point decrease), and higher fluid intake during the first 2 days of life (odds ratio: 1.36 per additional 10 mL/kg/d) were independent risk factors for pulmonary hemorrhage.</p><p><strong>Discussion and conclusions: </strong>A 1.5-fold increase in the small for gestational age rate over the study period may have contributed to the increased pulmonary hemorrhage incidence. Comparison of low- and high-incidence periods further suggested possible associations between an initial surfactant dose and use of binasal CPAP (Continous Positive Airway Pressure) devices. Based on these findings, a five-point catalog of preventive measures was developed.</p>","PeriodicalId":17846,"journal":{"name":"Klinische Padiatrie","volume":" ","pages":""},"PeriodicalIF":0.8,"publicationDate":"2026-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148906591","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":"Neutrophil-to-Lymphocyte Ratio, Mean Platelet Volume and Red Cell Distribution Width as Biomarkers in Diagnosis: Which Ratio Should Be Chosen to Predict the Diagnosis of Pediatric Tuberculosis?","authors":"Merve Kılıç Çıl, Ayşe Hitay Telefon, Elif Afat Turgut, Tuğba Kandemir Gülmez, Ümit Çelik","doi":"10.1055/a-2734-8740","DOIUrl":"10.1055/a-2734-8740","url":null,"abstract":"<p><strong>Background: </strong>This study aims to evaluate the diagnostic and follow-up utility of complete blood count-derived biomarkers -neutrophil-to-lymphocyte ratio, mean platelet volume, and red cell distribution width - in pediatric tuberculosis.</p><p><strong>Patients: </strong>A total of 52 children diagnosed with tuberculosis and 55 healthy controls, followed between 2020 and 2023 at a tertiary pediatric infectious disease clinic, were retrospectively analyzed.</p><p><strong>Method: </strong>Laboratory values were recorded at diagnosis, the second month of treatment, and at least 6 months post-treatment. Receiver operating characteristic analysis was performed to assess diagnostic performance.</p><p><strong>Results: </strong>At diagnosis, the neutrophil-to-lymphocyte ratio and red cell distribution width levels were significantly higher in the tuberculosis group than in control group (<i>p</i><0.001), while mean platelet volume showed no significant difference (<i>p</i>=0.096). During treatment, the neutrophil-to-lymphocyte ratio and red cell distribution width values progressively decreased. Receiver operating characteristic analysis demonstrated good diagnostic performance with optimal cut-off values of 1.7 for the neutrophil-to-lymphocyte ratio and 15.4 for the red cell distribution width.</p><p><strong>Discussion: </strong>The neutrophil-to-lymphocyte ratio and red cell distribution width are accessible, cost-effective biomarkers that may support the diagnosis of tuberculosis and monitor treatment responses in children.</p><p><strong>Conclusions: </strong>While promising as supportive tools, the diagnostic specificity of these markers is subject to study limitations, including an age-unmatched control group. Therefore, they should be considered complementary to existing diagnostic methods, especially when microbiological confirmation is challenging in pediatric cases.</p>","PeriodicalId":17846,"journal":{"name":"Klinische Padiatrie","volume":" ","pages":"280-284"},"PeriodicalIF":0.8,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145596745","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":"Would Neonatal Healthcare Professionals Disclose Personal Opinions When Counseling Parents About Value-laden Decisions?","authors":"Christine Arnold, Julian Eychmüller, Dina Hediger, Lukas Baumann, Sophie Jaisli, André Kidszun","doi":"10.1055/a-2480-9686","DOIUrl":"10.1055/a-2480-9686","url":null,"abstract":"<p><strong>Abstract: </strong>BACKGROUND: To explore the attitudes of neonatal healthcare professionals towards disclosing personal opinions when counseling parents about value-laden decisions using scripted video animations, with a view to comparing these later with the attitudes of parents of preterm infants.</p><p><strong>Abstract: </strong>METHODS: An exploratory study was conducted during the 5th Annual Meeting of the Joint European Neonatal Societies in Rome. Data were collected via a web-based survey during a live session. Two scripted video animations were presented and discussed, one with and one without disclosure of the physician's personal opinion.</p><p><strong>Abstract: </strong>RESULTS: Sixty-nine healthcare professionals from 19 countries were enrolled. Forty-seven (68.1%) respondents stated that disclosing personal opinions would \"unduly influence\" the parents' decision-making process. Thirty-seven (53.6%) participants would not have given their personal opinion in the case presented, and 45 (65.2%) participants stated that disclosure of the physician's personal opinion would result in parents being less prepared for decision-making. Discussions were dominated by underlying values and culture rather than the process of sharing opinions.</p><p><strong>Abstract: </strong>DISCUSSION AND CONCLUSIONS: The study provides new insights into the opinions of healthcare professionals on the disclosure of personal opinions when making difficult treatment decisions, but further research may require a more nuanced approach in different scenarios. Further research with a larger sample and different scenarios is needed to explore in more depth healthcare professionals' and parents' attitudes of autonomous decision-making.</p>","PeriodicalId":17846,"journal":{"name":"Klinische Padiatrie","volume":" ","pages":"247-253"},"PeriodicalIF":0.8,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142895690","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}