Klinische Padiatrie最新文献

{"title":"The Subdiaphragmatic Angle Of The Gastric Tube In Neonates - A Potential Predictor For Perforations?","authors":"Sonja Diez, Hilda Bartos, Anna Siemes, Hubert Gerleve, Alexandra Schock, Manuel Besendörfer, Andreas H Mahnken, Christel Weiß, Ursula Felderhoff-Müser, Hanna Müller","doi":"10.1055/a-2187-5404","DOIUrl":"https://doi.org/10.1055/a-2187-5404","url":null,"abstract":"<p><strong>Background: </strong>Traumatic subdiaphramatic perforation of esophagus or stomach in neonates represents a rare clinical complication following the insertion of a gastric tube and is associated with high morbidity and mortality. The aim of the present study was to evaluate whether the angle of the gastric tube depicted on a plain radiograph may serve as a diagnostic tool to predict subdiaphragmatic traumatic (or iatrogenic) perforation.</p><p><strong>Patients and methods: </strong>Thoraco-abdominal radiographs of 128 preterm and term neonates without perforation and 15 neonates with perforation of the esophagogastric junction or the stomach were retrospectively analysed.</p><p><strong>Results: </strong>The angle of the gastric tube increases with postnatal age (p=0.0380). In the control group, the angle of the gastric tube varied between 13° and 48° (median: 31°), whereas the values ranged from -31° to 42° (median: 11°) in neonates with subdiaphragmatic perforation. Perforation should thus be suspected in cases with an angle of<20° (sensitivity: 93.3%; specificity: 91.4%). Moreover, an unusual localization of the tip beyond the gastric bubble is highly indicative of perforation.</p><p><strong>Discussion: </strong>The present study emphasizes the importance of verifying the correct course of an inserted gastric tube.</p><p><strong>Conclusions: </strong>In daily clinical practice, an angle of<20° should be followed by thorough physical examination, abdominal ultrasound and if applicable contrast medium examinations to exclude perforation.</p>","PeriodicalId":17846,"journal":{"name":"Klinische Padiatrie","volume":null,"pages":null},"PeriodicalIF":1.0,"publicationDate":"2023-12-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138806561","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 Characteristics of Children with Combined Pituitary Hormone Deficiency and the Effects of Growth Hormone Treatment.","authors":"Özge Besci, Reyhan Deveci Sevim, Kübra Yüksek Acinikli, Korcan Demir, Gönül Çatlı, Bayram Özhan, Tolga Ünüvar, Ahmet Anık, Ayhan Abacı, Ayça Altıncık","doi":"10.1055/a-2186-9304","DOIUrl":"https://doi.org/10.1055/a-2186-9304","url":null,"abstract":"<p><strong>Aim: </strong>We aimed to describe the clinical characteristics of patients with congenital combined pituitary hormone deficiency (CPHD) and evaluate the first-year growth responses of individuals with CPHD and isolated growth hormone deficiency (IGHD) in order to establish the influence of other hormone deficiencies on growth response.</p><p><strong>Patients and methods: </strong>This retrospective study was conducted in four tertiary care centers in Turkey. The records of patients diagnosed with CPHD (n=39) and severe IGHD (n=50) were collected. Cases with acquired lesions or chronic diseases were not included in the study. Data are presented as median (interquartile range).</p><p><strong>Results: </strong>Among 39 patients (13 females; 33%) with a diagnosis of CPHD, the majority of patients (64%) presented initially with combined deficits at baseline examination, whereas isolated deficiencies (36%) were less prevalent. Among all patients with GH deficiency, TSH, ACTH, FSH/LH, and ADH deficiencies were present in 94%, 74%, 44%, and 9% of patients, respectively. Patients with CPHD were diagnosed at a younger age (4.9 (8.4) vs. 11.6 (4.1), p<0.001, respectively) and had lower peak GH concentrations (0.4 (1.8) vs. 3.7 (2.9), p<0.001, respectively) than patients with IGHD. Patients with IGHD and CPHD had similar first-year growth responses (Δheight SD score of 0.55 (0.63) vs. 0.76 (0.71), respectively, p=0.45).</p><p><strong>Conclusions: </strong>We established the nature and timing of numerous hormonal deficits emerging over time. We also identified that the existence of CPHD did not hinder growth response.</p>","PeriodicalId":17846,"journal":{"name":"Klinische Padiatrie","volume":null,"pages":null},"PeriodicalIF":1.0,"publicationDate":"2023-12-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138482515","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":"The oracle of D-A-Ch - Results of a Delphi Survey for the development of the evidence- and consensus-based tool \"My Logbook\".","authors":"Liesa J Weiler-Wichtl, Alina Stefanie Kollmann, Verena Fohn-Erhold, Carina Schneider, Verena Rosenmayr, Rita Hansl, Maximilian Hopfgartner, Jonathan Fries, Kristina Herzog, Ulrike Leiss","doi":"10.1055/a-2135-4337","DOIUrl":"https://doi.org/10.1055/a-2135-4337","url":null,"abstract":"<p><strong>Objective: </strong>The present report describes the results of four delphi surveys conducted within the quality improvement project \"My Logbook\" which aims to translate evidence-based standards for psychosocial care in pediatric oncology into a practical consensus-based tool.</p><p><strong>Methods: </strong>In four consecutive delphi surveys a total of n=153 international, multi-disciplinary experts rated the content, method, and design of the different booklets of \"My Logbook\" which a local expert group had conceptualized. After each survey, the feedback was incorporated, and the changes were evaluated in a final consensus vote by the quality assurance panel of the PSAPOH.</p><p><strong>Results: </strong>While some surveys led to a review on a page level, most booklets as a whole reached the consensus-level of approval. Over the course of the surveys, any revisions and comments were incorporated in the booklets, and approval rates increased steadily.</p><p><strong>Discussion: </strong>The delphi surveys ensured the integration of multi-disciplinary, international expertise, uncovering issues such as language barriers and the need for a user manual that would not have been evident in first line . The incorporation of the input led to a continuous improvement of the tool, reflected in steadily increasing acceptance rates in the consecutive survey rounds.</p><p><strong>Conclusion: </strong>The incorporation of the expert input as well as the additional development of a user manual resulted in a final version of the \"My Logbook\" apt for the interdisciplinary application in pediatric oncology in the entire DACH-region.</p>","PeriodicalId":17846,"journal":{"name":"Klinische Padiatrie","volume":null,"pages":null},"PeriodicalIF":1.0,"publicationDate":"2023-12-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138482516","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":"[Frequency of Utilization of Medical and Paramedical Care in Infants with Excessive Crying: Cross- Sectional Analysis and Parent Survey].","authors":"Jochen Kittel, Lena Nonnenmacher, Christian Apfelbacher, B Seelbach-Göbel, Michael Kabesch, Michael Melter, Susanne Brandstetter","doi":"10.1055/a-2160-2608","DOIUrl":"10.1055/a-2160-2608","url":null,"abstract":"<p><strong>Background: </strong>Infants can present in the first year of life with excessive, recurrent crying without an apparent illness or failure to thrive. The excessive crying results in a wide variety of problems for infants, parents and health care service.</p><p><strong>Objectives: </strong>This study aimed at evaluating how often parents of children with excessive crying seek help in the medical and paramedical health care system and which therapies are prescribed.</p><p><strong>Materials and methods: </strong>This study uses data collected within KUNO Kids health study. Families who participated completed questionnaires 4 weeks after birth and answered questions which screened for excessive crying. Families whose child was screened positive completed an additional questionnaire on symptoms, parental management and health care utilization. Data were analysed using descriptive statistics.</p><p><strong>Results: </strong>We received 238 questionnaires from children with excessive crying, 105 fulfilled the modified Wessel criteria. Of these 37 children (36%) were seen by a pediatrician because of crying. 57 (55%) received medications by the pediatrician. 51 (49%) of the parents specified that they also used paramedical therapies due to crying or whining, most often osteopathy. 45 (43%) adapted their own nutrition or their child's nutrition.</p><p><strong>Conclusions: </strong>Our study shows that parents experience problems in dealing excessive crying. Frequent consultations with pediatricians or use of paramedical therapies are common, demanding additional resources. The parents received different diagnoses for excessive crying. Available drugs like Simeticon, homeopathy or manual therapy are recommended and applied despite largely missing evidence.</p>","PeriodicalId":17846,"journal":{"name":"Klinische Padiatrie","volume":null,"pages":null},"PeriodicalIF":1.0,"publicationDate":"2023-11-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138291322","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":"Secondary Erythrocytosis Presenting as Persistent Hiccup in a Child With Cyanotic Heart Disease.","authors":"Yasemin Nuran Dönmez, Ilyas Aydin, Serdar Epçaçan","doi":"10.1055/a-2149-1456","DOIUrl":"https://doi.org/10.1055/a-2149-1456","url":null,"abstract":"","PeriodicalId":17846,"journal":{"name":"Klinische Padiatrie","volume":null,"pages":null},"PeriodicalIF":1.0,"publicationDate":"2023-11-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136398029","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":"About the Usage and Usability of Central Venous Catheters in Children with TPN: the Parents' Viewpoint.","authors":"Ludger Tüshaus, Kathrin Kelly, Julia Siebert, Martina Kohl-Sobania","doi":"10.1055/a-2196-8630","DOIUrl":"https://doi.org/10.1055/a-2196-8630","url":null,"abstract":"<p><strong>Background: </strong>Medical devices are important components of medical care. Therefore, they must be safe and useful for patients. This study aimed to analyze the situation of children with central venous catheters (CVCs) for long-term parenteral nutrition from the parents' perspective with respect to patient safety and usefulness.</p><p><strong>Methods: </strong>An online cross-sectional survey was conducted using a quantitative research approach, with a German patient support group for children with chronic intestinal failure.</p><p><strong>Results: </strong>61 responses were collected between November 202 and January 2021. Concerning the usability of the CVCs, the caregivers assessed overall satisfaction, patient safety, usability, learnability of handling, \"self-explanatory ability, \" and mental load. Furthermore, various suggestions for improvements have been documented.</p><p><strong>Conclusion: </strong>Although CVCs can cause a variety of complications in the context of long-term use, the usage for parents in everyday life is feasible. Insufficient fixation and protection outside of the body have been identified as unmet clinical needs. In addition to the underlying disease of chronic intestinal failure, the catheter adds an extra mental burden to families' lives. Furthermore, parents articulated the need for further information and training.</p>","PeriodicalId":17846,"journal":{"name":"Klinische Padiatrie","volume":null,"pages":null},"PeriodicalIF":1.0,"publicationDate":"2023-11-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136398026","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":"Heart Tumor in a Girl with Nephrotic Syndrome, a Possible Association or a Rare Coincidence?","authors":"Patrik Konopásek, Veronika Stara, Martin Kočí, Jakub Zieg","doi":"10.1055/a-2183-8302","DOIUrl":"https://doi.org/10.1055/a-2183-8302","url":null,"abstract":"","PeriodicalId":17846,"journal":{"name":"Klinische Padiatrie","volume":null,"pages":null},"PeriodicalIF":1.0,"publicationDate":"2023-11-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136398028","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":"Bridging the gap: A quality improvement project to implement psychosocial care standards into clinical practice in pediatric oncology.","authors":"Liesa J Weiler-Wichtl, Verena Fohn-Erhold, Carina Schneider, Agathe Schwarzinger, Kerstin Krottendorfer, Thomas Pletschko, Verena Rosenmayr, Johannes Gojo, Andreas Peyrl, Karin Dieckmann, Alina Stefanie Kollmann, Rita Hansl, Irene Slavc, Jonathan Fries, Maximilian Hopfgartner, Ulrike Leiss","doi":"10.1055/a-2104-1049","DOIUrl":"10.1055/a-2104-1049","url":null,"abstract":"<p><strong>Background: </strong>Psychosocial guidelines and standards systematically describe stressors and resources in particularly challenging situations and hence serve as a basis for interventions to achieve defined psychosocial goals. Despite fundamental principles and guidelines for psychosocial methods, the quality of provided care varies considerably depending on setting, provision, and profession. The purpose of the present protocol is to illustrate the development and evaluation of the standardized psychological intervention \"My Logbook\", a practical guide accompanying children through all stages of treatment by directly translating current quality standards of psychosocial care into practice.</p><p><strong>Methods: </strong>In an evidence-based set-up, using face-to-face discussions and telephone conferences, a multi-professional team of local experts decide on critical disease-related issues, structure, content (information and intervention elements) and design of the quality improvement tool. Via delphi surveys an extended expert team is asked to rate the content, method, and design of all booklets which is concluded by a final agreement by the specialist group for quality assurance of the psychosocial working group in the Society for Pediatric Oncology (PSAPOH). The developed tools are piloted in an international multicenter study to evaluate the patient-reported outcome and feasibility and to integrate practical views of patients, as well as psychosocial and interdisciplinary professionals into the further development of the \"My Logbook\".</p><p><strong>Discussion: </strong>The iterative development of the \"My Logbook\" including local and international experts as well as the patient and practical perspective allow for the design of a process-oriented, consensus - and evidence-based tool directly translating the S3-Guideline into clinical practice. Feasibility and applicability are fostered through an iterative process of constant evaluation and adaptation of the tool by international experts and through the clinical experience gathered in the multi-centered pilot study. Furthermore, the systematic evaluation of the tool by patients, psychosocial, and interdisciplinary professionals enables the identification of persisting gaps between evidence-based standards and clinical practice, discrepancies between the various stakeholders' perspectives as well as regional differences in feasibility, thereby directly linking practice and research. The preliminary results emphasize that psychological support can be standardized, enabling an evaluation and optimization of psychosocial care which future studies need to assess in multicenter clinical randomized controlled trials.</p>","PeriodicalId":17846,"journal":{"name":"Klinische Padiatrie","volume":null,"pages":null},"PeriodicalIF":1.0,"publicationDate":"2023-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10635755/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9930573","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Case report: Unclear Inflammatory Reaction in an Eleven-Year-Old-Girl - Meningioma].","authors":"Maxi Bettkober, Verena A Wiegering, Christoph Härtel, Krauss Jürgen, Daniela Genzel, Clemens Wirth, Camelia Monoranu, Matthias Nothhaft, Mathias Woelfl, Paul G Schlegel","doi":"10.1055/a-2144-5474","DOIUrl":"10.1055/a-2144-5474","url":null,"abstract":"","PeriodicalId":17846,"journal":{"name":"Klinische Padiatrie","volume":null,"pages":null},"PeriodicalIF":1.0,"publicationDate":"2023-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41149545","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":"[Updated AWMF Guideline on the Diagnosis and Treatment of Langerhans cell Histiocytosis in Children and Adolescents].","authors":"Thomas Lehrnbecher, Martina Ahlmann, Michael Albert, Anke Elisabeth Barnbrock, Karin Beutel, Konrad Bochennek, Carl Friedrich Classen, Susanne Holzhauer, Caroline Hutter, Karoly Lakatos, Roland Meisel, Luciana Porto, Christian Vokuhl, Thomas Vraetz, Milen Minkov","doi":"10.1055/a-2135-3175","DOIUrl":"10.1055/a-2135-3175","url":null,"abstract":"<p><p>Langerhans cell Histiocytosis is a rare neoplastic disease, which occurs mainly in children and adolescents. The disease may affect any organ, and therefore, the clinical symptoms vary widely. Some patients have a spontaneous remission of the disease, whereas others experience a rapid and potentially lethal clinical course. The therapeutic approach depends on the extent of the disease, and reaches from a watch-and-wait strategy to chemotherapy with the standard drugs vinblastine and prednisone. The identification of mutations in the MAPK-pathway resulted in growing interest in targeted therapy using compounds such as the BRAF inhibitors. Chronic relapses and permanent sequelae are important problems of LCH and are the focus of current research.</p>","PeriodicalId":17846,"journal":{"name":"Klinische Padiatrie","volume":null,"pages":null},"PeriodicalIF":1.0,"publicationDate":"2023-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10144995","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}