Klinische Padiatrie最新文献

There has been much debate about the appropriateness of over-the-counter (OTC) cough and common cold medications (CCM). The aim of this nationwide study was to analyse the incidence of CCM intoxications in the Czech paediatric population from 2014 to 2023.We performed a retrospective study on the incidence of CCM intoxications in the Czech paediatric population (ages 0-18 years) from 2014 to 2023.There were 7,056 cases of CCM intoxication in children, of which 6,406 resulted from unintentional intoxication. No lethal doses were reported, but there were 1,769 documented toxic doses. Unintentional CCM intoxications represented 15.60% of all unintentional medication intoxication cases across all ages and medication types. Of the 6,406 unintentional intoxication cases, 5,465 (85.31%) were in children aged 0 to 6 years, including 1,564 (24.41%) in children aged 0 to 2 years. Children aged 0 to 6 years had a significantly higher risk of CCM intoxication compared to those aged 7 to 18 years (RR 9.5, p<0.00001). The annual incidence of unintentional CCM intoxication was 69.26 per 100,000 children aged 0 to 6 years and 7.29 per 100,000 children aged 7 to 18 years.Based on our data, we believe there is low awareness among parents and Czech paediatricians regarding the potential risks of CCM and the lack of proven efficacy of these medications.Our data may contribute to political discussions regarding the general prohibition of CCM use in children younger than six years.

The management of congenital lung malformations (CLM) remains controversial. The aim of this study was to analyze the timing, approach, and outcomes of surgical treatment in children with CLM.A cohort study was conducted comparing children with CLM who underwent thoracoscopic resection with open resection via thoracotomy. All children were treated according to an institutionalized multidisciplinary coordinated treatment algorithm.Between 2002 and 2019, 68 children with CLM were treated. Thoracoscopic resection of CLM (n=44) resulted in a statistically significant longer operative time (mean 169 vs. 97 minutes, p=0.04) but shorter hospital stay (mean 7.2 vs. 16.7/12 days, p=0.01) compared to thoracotomy (n=15) or after conversion to thoracotomy (n=9). There were no major complications in either group. At a mean follow-up of 32.2 months (range 0.5-163), patients after thoracoscopic resection had statistically significantly fewer rip fusions than patients after open resection (n=0 vs. 2/2, p≤0.004) and less chest wall asymmetry than after conversion (n=0 vs. 2, p=0.004).Thoracotomy proved to be a fast and safe surgical approach in respiratory unstable CLM patients. In respiratory stable CLM patients, thoracoscopic resection was feasible in early infancy with good surgical and musculoskeletal outcomes.Thoracoscopic resection of CLM offers advantages over resection by thoracotomy in terms of surgical recovery and musculoskeletal function. Therefore, it should be offered to respiratory-stable patients in specialized centers.

Childhood obesity is a global health problem with increasing prevalence, leading to long-term cardiovascular complications. Research conducted on adults has established a correlation between serum uric acid to creatinine ratio (SUA/Cr) and metabolic syndrome (MetS) components. The study investigates the relationship between SUA/Cr and hypertension (HT) and MetS components in children with obesity.A total of 103 children with obesity who underwent ambulatory blood pressure measurement (ABPM) were included the study and patients were divided into two groups "HT" (n=60) and "Normal" (n=43). Demographic, anthropometric, and laboratory characteristics were retrospectively analyzed.The study included 103 children (42 female, 61 male) with a mean age of 13.7±2.9 years. HT prevalence was significantly higher in patients with severe obesity and dyslipidemia (p=0.045, p=0.01). Males exhibited significantly higher SUA/Cr than females (p<0.001). However, SUA/Cr showed no significant differences between patients with and without HT, MetS, dyslipidemia, or hyperglycemia (p=0.69, p=0.64, p=0.90, p=0.37). Furthermore, linear regression analysis did not establish a significant effect of SUA/Cr on ABPM parameters (p>0.05).In our cohort, no significant association was found between SUA/Cr and HT, as well as MetS components in children with obesity. These findings highlight the need for further investigation into the complex mechanisms regulating uric acid metabolism, obesity, and cardiovascular risk in children.

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.

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.