Klinische Padiatrie最新文献

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.

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.

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.

Background: 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.

Objectives: 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.

Materials and methods: 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.

Results: 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.

Conclusions: 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.

Aim: 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.

Patients and methods: 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).

Results: 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).

Conclusions: 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.

Purpose: The purpose of the present paper was to evaluate the clinical and chest radiographic features of pediatric patients with serologically proven Mycoplasma pneumoniae pneumonia.

Materials and methods: The clinical records and chest radiographs of 55 consecutive patients (28 male, 27 female) with serologically positive IgG mycoplasma pneumonia were reviewed. The pneumonic infiltrates were described on chest radiography into 3 different patterns as a peribronchovascular infiltration, reticulonodular infiltration and consolidation.

Results: More than 91% of patients presented with cough and 70% of patients had fever. Chest radiographs displayed three different patterns: (i) peribronchovascular infiltration (n=33, 60%); (ii) reticulonodular infiltration (n=12, 22%); (iii) consolidation (n=10, 18%). Bilateral peribronchovascular infiltration in central and middle lung zones were frequently seen (n=33, 60%). Other radiological features were unilateral lesions in 51% of patients, pleural effusion in 18%, and hilar lymphadenopathy in 20%.

Conclusion: There are various radiological features of mycoplasma pneumonia in children. Bilateral peribronchovascular infiltration confined to central and middle lung regions seems to be more closely associated with mycoplasma infection.