Klinische Padiatrie最新文献

The researchers identified cases of multisystem inflammatory syndrome in children, which was linked to COVID-19 starting in 2020. Multisystem inflammatory syndrome in children is associated with significant cardiovascular morbidity in the acute phase. A small number of articles in the literature have recorded the long-term myocardial effects of multisystem inflammatory syndrome in children treated in pediatric intensive care units. Our study aimed to investigate the late cardiac outcomes of multisystem inflammatory syndrome in children using cardiac magnetic resonance imaging.A median of 16 months had passed after the onset of the disease in multisystem inflammatory syndrome in children. Ejection fraction (%), cardiac output (L/min), stroke volume (mL), end-diastolic volume index (mL/m²), cardiac index (L/min/m²), and stroke volume index (mL/m²) were all significantly lower in multisystem inflammatory syndrome in children. During at least a 1-year follow-up, minor cardiac damage was discovered in 26% of individuals who underwent cardiac magnetic resonance imaging. In addition, none of the 23 infants showed symptoms of late gadolinium enhancement or pericardial effusion. While all patients underwent cardiac magnetic resonance imaging, the transthoracic echocardiogram evaluation revealed normal heart function.Our study found no evidence of late gadolinium enhancement, which indicates cardiac fibrosis in cardiac magnetic resonance imaging performed after a prolonged hospitalization in multisystem inflammatory syndrome in children who were admitted to the intensive care unit. This absence of late gadolinium enhancement is a reassuring finding, suggesting that the long-term cardiac outcomes of multisystem inflammatory syndrome in children may not be as severe as initially feared. However, the long-term cardiac magnetic resonance imaging results revealed mild left ventricular dysfunction in these patients that could not be detected via a transthoracic echocardiogram.

Pulmonary problems are common in children with Downsyndrome/trisomy 21, alongside other health issues, but are often given too little attention. The aim of this review is to summarize these aspects for pediatric pulmonologists. Narrow nasal passages, a small pharynx and larynx, in combination with relative macroglossia, other airway malformations, and generalized muscular hypotonia, lead to glossoptosis, which in very young infants frequently causes obstructive sleep apnea syndrome. If left untreated, this is associated with impaired cognitive development. The children also suffer from chronic rhinitis. Together with recurrent silent aspirations resulting from the typical dysphagia of children with Trisomie 21 and immune dysregulation, lower respiratory tract infections are common and often severe. Viral infections caused by RSV, influenza, and SARS-CoV-2 more frequently lead to hospitalizations and have a much higher mortality rate than in healthy children. Children with Down syndrome are also more likely to develop chronic wheezing. The development of pulmonary hypertension may rarely occur even without an associated heart defect. This article summarizes the diagnostic and therapeutic tasks related to pulmonary problems in children with Down syndrome for the pediatric pulmonologist.

Leukemic infiltration of the lungs is rarely reported in children. Clinical symptoms are often variable and nonspecific, making diagnosis challenging. The actual frequency of pulmonary involvement, the severity of local findings, and typical imaging characteristics in pediatric patients remain largely unclear. Most literature studies on the radiological features of leukemic lung infiltration have focused on adults, leaving a significant gap in pediatric data. This lack of information can hinder clinical and radiological assessment in children. Here, we present a case of leukemic pulmonary infiltration in an adolescent with nonspecific symptoms and markedly abnormal computed tomographic findings. We describe the morphological abnormalities, discuss differential diagnoses, and review the limited literature on pulmonary involvement in childhood leukemia. Further studies are needed to better characterize the frequency, types, and imaging features of leukemic pulmonary infiltration in children.

Pediatrics in general and pediatric oncology in particular place the high demands on interprofessional teams. For teamwork, psychological safety is a basic prerequisite. Establishing it in pediatrics and their subspecialties requires extensive knowledge. While much is known about psychological safety in other industries, descriptions of psychological safety in pediatrics are lacking. Therefore, the aim of this scoping review was to (i) describe the current state of the literature, (ii) identify facilitating and hindering factors in individual areas, and (iii) highlight approaches in terms of best practice examples. In the period between March 25, 2024, and April 14, 2024, PubMed was searched in accordance with the PRISMA Guidelines Scoping Review Extension. The initial search retrieved 924 articles. Twenty-seven papers were included for final analysis. The main reasons for exclusion were a lack of thematic relevance, non-availability of a full text and languages other than English and German. Factors influencing psychological safety in interprofessional teams are discussed. In particular, the influences of communication, the working environment, and employees' mental health are explained. In view of the of the increasing shortage of skilled workers, team turnover, and intention to leave, psychological safety in pediatrics should be addressed. Future studies should elucidate which interventions have a persistent positive influence on psychological safety in pediatrics.