KLINISCHE PADIATRIE

Sonographic and Anthropometric Measurements for Body Composition and Their Relationship with Functioning in Adolescent Obesity
Avar-Aydin PO, Koyuncu EG, Dogan D, Ates NK, Gurel E, Arda N and Ozcakar L
Obesity is one of the most common chronic diseases seen in children and adolescents. This study aims to examine the impact of obesity on body composition, assessed by sonographic and anthropometric measurements, and health-related quality of life (HRQoL) in adolescents.Anthropometric measurements, sonographic measurements of subcutaneous fat, quadriceps muscle, Achilles tendon thickness, and HRQoL were performed in children between 12-18 years of age. Comparisons between adolescents with obesity and normal body mass index (BMI) were examined.A total of 300 adolescents with similar physical activity levels, 28.7% with obesity, were enrolled. The thickness of mid-forearm/mid-thigh subcutaneous fat tissue and quadriceps muscle was significantly higher in participants with obesity (p≤0.001). Moderate-to-strong correlation with BMI and waist circumference was observed (r>0.40, p<0.01). Participants with longer duration of obesity had thicker quadriceps muscle irrespective of the severity of obesity or presence of metabolic syndrome. Achilles tendon thickness did not differ between the groups. HRQoL was significantly lower in adolescents with obesity and indicated a negative moderate correlation between physical functioning and subcutaneous fat thickness (r<- 0.50, p<0.01).An important relationship between sonographic and anthropometric measurements, and physical functioning was demonstrated in adolescents. Ultrasound seems to have a role in the evaluation of body composition in obesity beyond what is captured by overall BMI. Significantly increased quadriceps muscle thickness in adolescents with obesity, coupled with its relation to the duration of obesity, implies potential temporal association between excess body weight and adaptation of quadriceps muscle.
Pre-chewing of infant food - expectations towards an old, traditional feeding habit for potential allergy prevention
Meixner L, Kalb B, Schnadt S, Sturmfels M, Blumchen K, Beyer K and Ahrens B
Premastication is a traditional feeding method whereby solids are pre-chewed by the mother or sometimes by other relatives and then given to the infant along with the oral microbiota. The aim of this study was to assess if premastication is known or performed among the German population as well as to evaluate the expectations regarding this feeding method, particularly in the context of allergy prevention. Two surveys about premastication were conducted. For the survey of the "general population (GP)" 10,000 participants (18 to 65 years old) were randomly selected from the official population register of Berlin. The survey of the "selected population (SP)" was conducted by the patient organization German Allergy and Asthma Association (DAAB). 526 people from the GP and 220 participants from the SP completed the questionnaire. 15.3% (n=114) of all respondents had previously heard of premastication, 1.5% (n=7/455) of the people with children reported that they have performed premastication for their child. 42.8% (n=225) of the GP as well as 36.4% (n=80) of the SP could imagine performing premastication for their future child or grandchild. 59.3% (n=312) of the GP stated that they at least partially think premastication may help to prevent the development of allergies.Premastication appears to be barely known and practiced among the German population. However, a considerable proportion of participants would consider giving pre-chewed food to their infant. A high rate of respondents, especially among the GP, believed that premastication may have a positive impact on the prevention of allergies.
[Drug-induced liver injury induced by nicotinamide: a case report]
Nadler J, Wettstein I, Krieg P, Stedtler U and Hermanns-Clausen M
Evaluation of the Cow's Milk and Hen's Egg Ladder in Daily Practice: A Parent Perspective
Bozic M, Roth MS, Martin L, Werder A and Bellutti Enders F
Evaluation of the cow's milk (CM) and hen's egg (HE) ladder to improve medical care of children with CM and/or HE allergy. Through an anonymous retrospective online questionnaire, we investigated parent perspectives regarding the therapy option of a CM and HE ladder in children with CM and/or HE allergy. Of the 54 families contacted, 29 took part in the study. 19/29 children had already completed the ladders when the survey took place. 19/29 children showed an allergic reaction during the treatment of whom 17 presented skin rashes. 16/29 parents were anxious to rise to the next step in the protocol. 15/29 had difficulties with the implementation of the therapy due to the child refusing the offered food and organizational issues. Medical support as well as the ladder as a therapy option were scored satisfactory. The participating parents were satisfied with the therapy option and medical care. We identified two main areas for improvement: First, the suggested food for every step should be more diverse, according to the families' culture background and nutritional needs/demands. Second, to reduce anxiety regarding the therapy, parents must be informed that although allergic reactions are common, they remain mild. Furthermore, we will suggest step changes under medical supervision, especially in families with a slow progression of the food ladder. With these improvements, the duration of therapy could be shortened, thus reducing the risk of an allergic reaction, the need for medical care by an allergist and therefore reducing healthcare costs.
Finding of a Homozygous SLC26A3 Mutation in a German Newborn with Congenital Chloride Diarrhea Presenting with Polyhydramnios and Dilated Bowel Loops
Fecher P, Frieauff E, Paul R and Wirbelauer J
Correction: Pre-chewing of infant food - expectations towards an old, traditional feeding habit for potential allergy prevention
Meixner L, Kalb B, Schnadt S, Sturmfels M, Blumchen K, Beyer K and Ahrens B
Importance of Cerebral-Placental Ratio in the Prenatal Diagnosis, Management, and Postnatal Outcome of a Fetus with Giant Cardiac Rhabdomyoma
Bekler Ö, Yozgat CY and Yozgat Y
[Structured Assessment of Mental Health Issues in Preventive Health Examinations - Findings from the Cluster-Randomized PSYCH-U Study]
Schmidt H, Menrath I, Mertens S and Pawils S
Early detection of psychological problems is crucial to prevent chronic progression. The Psych-U study evaluated the added value of structured assessment of psychological issues during U-screenings compared to routine screenings without such assessment.
[Pediatric pneumological aspects in the care of children with neuromuscular diseases with focus on Duchenne muscular dystrophy]
Fuchs H, Gunst L, Wendt A, Becker S, Grychtol RM, Vlajnic D, Aschmann-Muehlhans D, Wuerfel C, Steindor M and Stehling F
Duchenne muscular dystrophy is the most common inherited neuromuscular disease in children. In addition to the progressive loss of motor skills and cardiac involvement, respiratory muscle weakness leads to a restrictive lung disease and cough insufficiency. Specific respiratory interventions have significantly improved survival and quality of life of the affected boys. The pediatric pulmonologist's tasks include monitoring of the lung function, polysomnography, starting and adjusting of non-invasive or invasive nocturnal ventilation and optimizing of secretion management. Providing of vaccinations, enhancing of nutrition, treatment of intercurrent infections, and provision of advice and training are important tasks for the pediatric pulmonologist. This article emphasizes on the tasks for the pediatric pulmonologist in the treatment of children with neuromuscular diseases i. e. Duchenne muscular dystrophy in interaction with the other specialist disciplines.
Three Birds With One Stone: Successful Management Of Peritonitis Induced Pediatric Septic Shock With Peritoneal Washing
Demir OO, Erdemir GN, Kesici S, Türer ÖB, Özsürekci Y and Demirbilek H
Do Systemic Inflammatory Indices, Urinalysis, and Radiological Findings Vary by Causative Pathogen in Neonatal Urinary Tract Infections?
Elbayiyev S, Kadıoğlu Şimşek G, Çevirici T, Karaçağlar NB, Kanmaz Kutman HG and Canpolat FE
Urinary tract infections (UTI) are the most common occult infections in infants under three months of age with high fever, caused by various pathogens, and can progress with different symptoms from mild to severe. We planned to explore and compare pathogen-specific systemic inflammatory indices, urinalysis, and radiological findings in newborns.
Evaluation of Postnatal Echocardiographic Screening for Congenital Heart Defects - a Prospective Cohort Study at a German University Hospital
Haberkern VD, Kilarski LL and Schaible T
Congenital heart defects (CHD) being the most common congenital malformation, significantly impact mortality and morbidity in children and adults. Early detection greatly improves treatment and prognosis. Routine pulse oximetry screening and fetal echocardiography in Germany have advanced early CHD diagnosis. However, a diagnostic gap persists, leaving some CHD cases undetected, worsening prognosis. This study aimed to evaluate echocardiographic screening in newborns at a German university hospital as well as to record numerous potential risk factors in a database.
Quality of Life and Related Factors in Patients Diagnosed with Mucopolysaccharidosis and Their Caregivers
Yekedüz MK, Cilesiz K, Kara İS, İnci A, Kose E, Tümer L and Eminoğlu FT
Quality of life (QoL) is directly associated with physical-psychological well-being, family and environmental factors in patients with Mucopolysaccharidosis (MPS). The present study aims to investigate the factors affecting QoL in both MPS patients and their caregivers.
Advancing Prognostic Prediction in Pediatric Trauma: The Role of Inflammatory Markers
Özel A, Yuce S and Ilbegi EN
This study aimed to evaluate the prognostic value of various inflammatory markers and indices derived from complete blood counts in predicting mortality among pediatric trauma patients admitted to the Pediatric Intensive Care Unit (PICU).
CFTR Modulator Treatment in Children<12 Years of Age - Status Quo and Challenges
Funken D, Schütz K and Dittrich AM
Cystic fibrosis (CF) is a genetic disease that results from mutations in the CFTR gene. It primarily affects the lungs and digestive system. Recent advancements in the treatment of CF have been driven by highly effective therapies that modulate the function of the cystic fibrosis transmembrane conductance regulator (CFTR) protein, which target the underlying molecular defects in CFTR function. These modulators have been demonstrated to significantly improve lung function, weight gain, and quality of life for 90% of individuals with CF, particularly those with the F508del mutation. HEMT has also demonstrated potential benefits for pancreatic and liver function, and its early use in young children may delay or prevent disease progression. However, challenges remain in optimizing biomarkers and outcome measures for younger children, addressing side effects, and developing novel therapies for mutations not responsive to current treatments. This review focuses on the efficacy, safety, and future perspectives of HEMT in children under 12 years of age, emphasizing the importance of early intervention to improve long-term outcomes in CF patients.Mukoviszidose (CF) ist die häufigste genetisch bedingte Stoffwechselerkrankung durch Mutationen im CFTR-Gen. Sie betrifft insbesondere die Lunge und das Verdauungssystem. Die jüngsten Fortschritte in der Behandlung der CF sind das Resultat von hochwirksamen Therapien (HEMT), welche die Funktion des CFTR-Proteins (Cystic Fibrosis Transmembrane Conductance Regulator) modulieren und damit eine kausale Therapie ermöglichen. Diese führt nachweislich zu einer Verbesserung der Lungenfunktion und Gewichtszunahme, sowie einer Steigerung der Lebensqualität bei 90% der Menschen mit Mukoviszidose, insbesondere bei denen, die mindestens eine F508del-Mutation aufweisen. Zusätzlich besteht ein potenzieller Nutzen für die Funktion der Bauchspeicheldrüse und der Leber. Eine frühzeitige Anwendung von HEMT bei Kleinkindern kann das Fortschreiten der Krankheit voraussichtlich weiter verzögern oder gar verhindern. Herausforderungen bestehen in der Etablierung valider Biomarker - insbesondere für jüngere Kinder, unerwünschten Arzneimittelwirkungen und der Entwicklung neuartiger Therapien für Mutationen, die auf die HEMT nicht ansprechen. Die vorliegende Übersichtsarbeit beschreibt die Effektivität und Sicherheit bei Kindern unter 12 Jahren, sowie das zukünftige therapeutische Potential der HEMT. Ein besonderes Augenmerk wird dabei auf die Notwendigkeit eines frühzeitigen Therapiebeginns zur Verbesserung des langfristigen Verlaufs gelegt.
Development of Chondroblastic Variant of Osteosarcoma After Root Channel Treatment in the Base of Maxillary Sinus
Balsak S, Çelik FY, Atasoy B, Yurtsever I, Yozgat CY, Akcay A, Yuzkan S and Alkan A
Long-term evaluation of neurological outcomes in chemotherapy-associated posterior reversible encephalopathy (PRES) syndrome in children
Reis İskenderoğlu GP, Dilber B, Eyüboğlu İ, Bahadır A and Erduran E
Posterior reversible encephalopathy syndrome (PRES) is a clinical syndrome with numerous etiologies, mostly characterized by magnetic resonance imaging (MRI) abnormalities in the posterior cerebral white and gray matter and acute neurological symptoms.
Would Neonatal Healthcare Professionals Disclose Personal Opinions When Counseling Parents About Value-laden Decisions?
Arnold C, Eychmüller J, Hediger D, Baumann L, Jaisli S and Kidszun A
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.
A Training for Parents Prevents Clinically Relevant Handling Errors in the Use of Long-Term Antiseizure Medication
Kaune A, Schumacher PM, Neininger MP, Syrbe S, Hiemisch A, Bernhard MK, Merkenschlager A, Kiess W, Bertsche A and Bertsche T
Medication handling errors (ME) in long-term antiseizure medication (ASM) compromise patient safety. Training programs to prevent those errors by parents are scarce.
SGLT2 Inhibition: A New Glimmer of Hope to Slow Chronic Kidney Disease Progression in Children?
Leventoğlu E and Bakkaloğlu SA
Severe Neonatal Episodic Laryngospasm (SNEL) due to Mutation in the SCN4A Gene as a Rare Differential Diagnosis in Paroxysmal Inspiratory Stridor with Cyanosis in Infancy
Westhoff J, Schuler R, Nährlich L and Hahn A