Abteilung fur Kinder und Jugendmedizin

Velbert, Germany

Abteilung fur Kinder und Jugendmedizin

Velbert, Germany
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von Kries R.,Ludwig Maximilians University of Munich | Weiss S.,Ludwig Maximilians University of Munich | Falkenhorst G.,Robert Koch Institute | Wirth S.,Witten/Herdecke University | And 18 more authors.
PLoS ONE | Year: 2011

Background: We determined antibodies to the pandemic influenza A (H1N1) 2009 virus in children to assess: the incidence of (H1N1) 2009 infections in the 2009/2010 season in Germany, the proportion of subclinical infections and to compare titers in vaccinated and infected children. Methodology/Principal Findings: Eight pediatric hospitals distributed over Germany prospectively provided sera from in- or outpatients aged 1 to 17 years from April 1 st to July 31 st 2010. Vaccination history, recall of infections and sociodemographic factors were ascertained. Antibody titers were measured with a sensitive and specific in-house hemagglutination inhibition test (HIT) and compared to age-matched sera collected during 6 months before the onset of the pandemic in Germany. We analyzed 1420 post-pandemic and 300 pre-pandemic sera. Among unvaccinated children aged 1-4 and 5-17 years the prevalence of HI titers (≥1:10) was 27.1% (95% CI: 23.5-31.3) and 53.5% (95% CI: 50.9-56.2) compared to 1.7% and 5.5%, respectively, for pre-pandemic sera, accounting for a serologically determined incidence of influenza A (H1N1) 2009 during the season 2009/2010 of 25,4% (95% CI: 19.3-30.5) in children aged 1-4 years and 48.0% (95% CI: 42.6-52.0) in 5-17 year old children. Of children with HI titers ≥1:10, 25.5% (95% CI: 22.5-28.8) reported no history of any infectious disease since June 2009. Among vaccinated children, 92% (95%-CI: 87.0-96.6) of the 5-17 year old but only 47.8% (95%-CI: 33.5-66.5) of the 1-4 year old children exhibited HI titers against influenza A virus (H1N1) 2009. Conclusion: Serologically determined incidence of influenza A (H1N1) 2009 infections in children indicates high infection rates with older children (5-17 years) infected twice as often as younger children. In about a quarter of the children with HI titers after the season 2009/2010 subclinical infections must be assumed. Low HI titers in young children after vaccination with the AS03 B-adjuvanted split virion vaccine need further scrutiny. © 2011 von Kries et al.

Thiel M.T.,Abteilung fur Kinder und Jugendmedizin | Thiel M.T.,Witten/Herdecke University | Findeisen B.,Abteilung fur Kinder und Jugendmedizin | Langler A.,Abteilung fur Kinder und Jugendmedizin | Langler A.,Witten/Herdecke University
Forschende Komplementarmedizin | Year: 2011

Background: Numerous varieties of interventions have decreased the mortality and morbidity of preterms. Due to the fact that more infants survive, developmental care has become a crucial topic. In this context, music therapy offers some interesting aspects for parents and children. Starting as an emotional approach, music therapy has developed towards a systematic therapeutic option in neonatal care. Objectives: To assess the relevance of music therapy for neonates. Methods: We present 3 typical case reports and give an overview of the current literature regarding music therapy in neonatology. Case Reports: Case 1: Focus on the child, especially the respiratory system. Case 2: Focus on care and assistance for the mother. Case 3: Focus on mother-father-child interaction. Discussion: These cases show the varieties of indications and possible effects of music therapy. We discuss our own experience ranging over 20 years and give a review on the literature concerning the different aspects of music therapy in neonates. Conclusion: Probably without any severe adverse effects, music therapy has positive effects on basic vital signs, the reduction of pain and on neurological development. Furthermore, it grants the parents' wish to participate in the well-being of their child. Nevertheless, the need for a specific setting, its methods, and its positive as well as possible negative effects are still open issues and need scientific evaluation. Copyright © 2011 S. Karger AG, Basel.

Riedler J.,Abteilung fur Kinder und Jugendmedizin
Monatsschrift fur Kinderheilkunde | Year: 2015

Bronchial asthma is one of the most common chronic diseases in childhood with a prevalence of approximately 10 % in German-speaking countries. Typical symptoms are wheezing, narrowing of the chest and dyspnea. The diagnosis is made based on clinical symptoms and the most important objective parameter is proof of airway obstruction. National and international guidelines provide a standardized treatment. The main pillars of management are anti-inflammatory drugs, beta- 2- agonists, compliance testing, instruction on the correct inhalation technique, comprehensively structured patient educational programs and in selected cases allergen immunotherapy. © 2015, Springer-Verlag Berlin Heidelberg.

A 1-year old child fall ill with meningitis and sepsis due to Streptococcus pneumoniae serotype 19F despite two pneumococcal vaccinations. Obviously two pneumococcal vaccinations not in time turned out to an inadequate production of antibodies against serotype 19F.

Riedler J.,Abteilung fur Kinder und Jugendmedizin
Monatsschrift fur Kinderheilkunde | Year: 2015

Protracted bacterial bronchitis (PBB) is defined as a chronic (several weeks) bronchial infection and inflammation caused by bacteria, the presence of isolated chronic wet cough and absence of pointers suggestive of other specific chronic airway diseases. Primarily, it is diagnosed clinically and the cough resolves only after a prolonged course of appropriate antibiotics. Almost half of the affected children need several courses of antibiotics and many show a relapse. In these children further investigations, such as imaging, bronchoscopy, bronchoalveolar lavage and exclusion of alternative causes are warranted. The most common pathogens found in bronchial secretions of children with PBB are Haemophilus influenzae, Moraxella catarrhalis and Streptococcus pneumonia. Not yet sufficiently investigated additional treatment options are inhalation of beta agonists and/or hyperosmolar solutions, physiotherapy and long-term administration of azithromycin. © 2015, Springer-Verlag Berlin Heidelberg.

Rauchenzauner M.,Abteilung fur Kinder und Jugendmedizin
Zeitschrift fur Epileptologie | Year: 2015

During growth and puberty profound changes in metabolic/endocrine compartments are paralleled by the maturation of various hormone systems (e. g. sex-steroid axis, bone health, lipid and glucose homeostasis). On the one hand, things often change with epilepsy and the disease per se might influence enzyme systems. On the other hand, antiepileptic drugs (AED) are well known to elicit diverse neuroendocrine changes. Data concerning the thyroid axis are far from conclusive but regular measurement of serum hormones is recommended. Monitoring of bone health in children and adolescents with epilepsy comprises a thorough evaluation of the risk profile and periodic determination of vitamin D concentrations. To achieve maximum safety, the use of an oral contraceptive containing a progestin dose above that needed to inhibit ovulation without a pill-free interval (a so-called “long cycle”) is suggested. Furthermore, the use of additional barrier methods or – alternatively – classic or levonorgestrel-releasing intrauterine devices should be taken into consideration. In the case of pregnancy, extensive instruction concerning sleep and compliance, as well as frequent determination of AED serum levels are necessary. When lamotrigine is combined with an oral contraceptive, physicians should be aware of decreasing lamotrigine concentrations, whereas mid-cycle bleedings might point towards loss of contraceptive safety. To sum up, a multidisciplinary approach is necessary to monitor possible neuro-endocrine alterations that warrant further examination and treatment, especially in adolescent girls and boys. © 2015, Springer-Verlag Berlin Heidelberg.

Fischer E.,Abteilung fur Kinder und Jugendmedizin | Reese J.,Abteilung fur Kinder und Jugendmedizin
Gynakologische Praxis | Year: 2010

We report the rare case of a neonatal salmonella infection. The term infant was infected with salmonella enteritidis perinatally and showed the clinical signs of a septicemia on the first day of life. On the second day greenish, mucic, bloody feces were seen. Salmonella enteritidis was detected in the stool culture and the aural swab. Under therapy with gentamicin, ampicillin and cefotaxim clinical improvement was seen and no complications occurred. Although a taken stool culture from the mother was negative we suppose that an asymptomatic salmonella infection of the mother was the cause of the neonatal infection. Retrospectively it is not possible to say if the infection was transmitted transplacentally or vertically. In pregnant women with diarrhea a stool culture should be taken and if a salmonella infection is proved an antibiotic therapy should be discussed. In neonatal infections without an identificated agent a salmonella infection has to be considered. Because of the foudroyant course of neonatal salmonella infections neonates and infants until the third month of life with a proven salmonella infection should always be treated with antibiotics.

Demirakca S.,Universitatsmedizin Mannheim | Hinrichs B.,Abteilung fur Kinder und Jugendmedizin | Nicolai T.,Ludwig Maximilians University of Munich
Monatsschrift fur Kinderheilkunde | Year: 2013

Background: Respiratory emergencies in childhood are frequent and are caused by the airway geometry, the number of relevant malformations, and the susceptibility for infections. Therapeutic algorithm: Therapeutic interventions include the use of unspecific (e.g., oxygen) as well as specific (corticosteroids) measures. According to the ABC (A: airway, B: breathing, C: circulation) guidelines of the European Resuscitation Council, this algorithm should help to identify, classify, and treat such emergencies, giving those who are less experienced a tool for the management of respiratory illness in children. Due to the large number of known respiratory emergencies, the presented algorithm focuses on the main symptoms observed in this age group. © 2013 Springer-Verlag Berlin Heidelberg.

Kunze W.,Abteilung fur Kinder und Jugendmedizin | Groger H.-U.,Abteilung fur Kinder und Jugendmedizin
Padiatrische Praxis | Year: 2014

One defines as peri-operative antibiotic prophylaxis the administration of a single dose of antibiotics in surgical interventions carrying a risk of infection. The investigation included retrospectively 212 patients having undergone open surgical or laparoscopic appendectomy by sling/ligature. The patient records were analysed with respect to diagnosis (ICD-10-GM Version 2010) and peri-operative antibiotic prophylaxis. Peri-operative antibiotic prophylaxis is recommended in all forms of appendicitis. Today a more differentiated procedure is recommended in appendectomy depending on the intra-operative findings and the course of the operation.

PubMed | Abteilung fur Kinder und Jugendmedizin
Type: Case Reports | Journal: Klinische Padiatrie | Year: 2010

We present a 9-year-old girl who developed acute muscular weakness of proximal muscles of the upper and lower limbs. Investigations revealed a common acute lymphoblastic leukemia. The neuromuscular symptoms are classified as a paraneoplastic neurological syndrome (PNS). Under chemotherapy according to ALL-BFM-2000 protocol symptoms resolved within 4 weeks. This case presents a rare manifestation of acute lymphoblastic manifestation.

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