Klinische Padiatrie最新文献

Twenty years after the first robotic pediatric surgery, robotic surgery still plays a limited role in pediatric surgery. A better understanding of the current application of robotic pediatric surgery, could be valuable for the further development and implementation of minimally invasive and robotic pediatric surgery. The aim of this study was to analyze the nationwide distribution of robotic surgery in children and its acceptance among pediatric surgeons. The national database of administrative claims data from the Institute for the Remuneration System in Hospitals (InEK) and the quality reports in Germany were analyzed to determine the number of pediatric patients who underwent surgery using a robotic system and the number of pediatric surgical departments having access to this system. Additionally, an electronic questionnaire was developed for a nationwide cross-sectional survey within the DGKCH. From 2019 to 2024, the number of robot-assisted surgeries in children increased from 105 cases in 2019 to 376 cases in 2024. The majority of procedures are urological surgeries. The online survey was completed by 39 pediatric surgeons between December 2022 and March 2023. The survey identified and mapped differences in the use of robotic systems, the patient population treated, and the assessment of outcomes, complication rates, and patient satisfaction. This study is the first to document the varying views on pediatric robotic surgery in Germany.

This study examined serum uric acid levels in children with migraine compared to healthy controls, and explored links with gender and attack frequency.A retrospective analysis was conducted on pediatric migraine patients and controls seen between August 2019 and January 2025. Uric acid, Hb, Hct, iron, and TIBC levels were recorded.No significant difference in uric acid levels was found between groups or by attack frequency. However, male patients had higher uric acid levels than females (p=0.046). Other blood parameters were similar.Uric acid is not a reliable standalone marker for pediatric migraine, though gender differences suggest potential hormonal influences. Further research is needed.

Crimean-Congo hemorrhagic fever (CCHF) is one of the most common viral hemorrhagic fevers. After entering the body, the virus replicates in regional lymph nodes and tissues, then spreads via lymph and monocytes, causing systemic inflammatory response syndrome, septic shock, and disseminated intravascular coagulation (DIC).Sociodemographic, clinical, and hematological data of children (0-18 years) diagnosed with CCHF at the Pediatric Infectious Diseases Clinic of Erzurum Training and Research Hospital between September 2018 and June 2020 were analyzed.Of 19 patients, 14 were male and 5 female, with a mean age of 14.2±3.2 years. Common presenting symptoms included fever, fatigue, and myalgia. Initial lab results showed a white blood cell count of 3012±1559/mm³, platelet count of 102.105 ± 50.350/mm³, and PT of 17.3±3.5 seconds. Two patients with persistent fever (>5 days) developed CCHF-associated hemophagocytic syndrome and received intravenous immunoglobulin in addition to ribavirin. Eleven patients with severe thrombocytopenia and/or bleeding received apheresis platelet concentrates; six received fresh frozen plasma.CCHF should be considered in patients-regardless of tick exposure-presenting with sudden fever, fatigue, leukopenia, thrombocytopenia, abnormal coagulation, and elevated liver enzymes.

Background: 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.

Methods: An online cross-sectional survey was conducted using a quantitative research approach, with a German patient support group for children with chronic intestinal failure.

Results: 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.

Conclusion: 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.

Background: Pediatrics places highest demands on interprofessional teams. Although training and studies are evolving, interprofessional teaching units are regularly lacking in German-speaking countries. Analog and digitally convertible formats are rare.

Method: Since 2018, a voluntary one-day team training named "SICKO Junior" for nursing trainees and medical students has been conducted regularly in analog and in the meantime digitally. Evaluation results on the analog and digital format are compared. The content of the one-day workshop is based on a concept for medical employees. Exemplary communication in the ward round is reflected in simulations, training on the simulator for lumbar punctures serves the change of perspective.

Results: A total of 104 participants took part, 21 of them digital. The recommendation rate is 100%. All of the participants are convinced that the workshop has a positive impact on collaborative interprofessional work. There were no significant differences in the evaluation of the different workshop elements between the digital and analog trainings.

Discussion: The present work sheds light on the positive influence independent of the digital/analogue form. The presentation forms a blueprint for dissemination. A curricular integration seems worthwhile.Conclusion Voluntary interprofessional team training for nursing trainees and medical students with a focus on communication and error culture is as popular in digital as in analog form. Future studies should prove the influence on competence development and safety culture.