Auf der Bult Kinder und Jugendkrankenhaus

Hannover, Germany

Auf der Bult Kinder und Jugendkrankenhaus

Hannover, Germany
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Richter M.F.,Auf der Bult Kinder und Jugendkrankenhaus | Guthmann F.,Auf der Bult Kinder und Jugendkrankenhaus | Richter J.W.,Auf der Bult Kinder und Jugendkrankenhaus
Padiatrische Praxis | Year: 2017

In newborn infants infections are a feared risk for morbidity and mortality in a considerable number of cases. In general bacterial infection seemed to be the common pathogen but meanwhile it is known that up to 25% of undetected sepsis is caused by viral agents, mostly picornaviridae. This is the reason why, bacteriological as well as virological diagnostics is very important at the earliest time. Infections with picornaviridae show a very widespread clinical presentation. This fact leads to thorough investigations (lab, sonography) to pre-estimate possible severe complications. As described in older and immnunocompetent patients, infection with picornaviridae leads to harmless nonspecific symptoms like common cold, gastroenteritis, rush. But in immunocompromised patients, especially in newborns, the symptoms can reach to aseptic meningitis, necrotizing hepatitis or enterocolitis and myocarditis. These severe causes of disease are often combined with hemolytic anemia and/or coagulation disorder. Indeed there exist no specific therapy strategies in these cases, but in case reports several times immunoglobulin therapy improved the cause of disease. In diagnostics it is not merely the virological testing but rather the medical imaging, like abdominal sonography and echocardiography, which detects ascites, hepatitis signs and myocardial insufficiency. It should be performed repetitively because specific symptoms may occur suddenly. On a regular basis it is important to check for coagulopathy and to treat disseminated intravascular coagulation (DIC) consequently if necessary. Despite all procedures a lethal outcome occurs in some cases especially in patients of NICU (neonatal intensive care units). For prevention it is very important to regard all hygienic procedures. In case of nosocomial transmission isolation of index patients has to be performed as soon as possible.


Anderson B.J.,Baylor College of Medicine | Laffel L.M.,Joslin Diabetes Center | Domenger C.,Sanofi S.A. | Danne T.,Auf der Bult Kinder und Jugendkrankenhaus | And 7 more authors.
Diabetes Care | Year: 2017

OBJECTIVE Our objective was to characterize diabetes-specific health-related quality of life (D-HRQOL) in a global sample of youth and young adults with type 1 diabetes (T1D) and to identify the main factors associated with quality of life. RESEARCH DESIGN AND METHODS The TEENs study was an international, cross-sectional study of youth, 8-25 years of age, with T1D. Participants (N= 5,887)were seen in clinical sites in 20 countries across 5 continents enrolled for 3 predetermined age groups: 8-12, 13-18, and 19-25 years of age. To assess D-HRQOL, participants completed the PedsQL DiabetesModule 3.0 and were interviewed about family-related factors. Specifics about treatment regimen and self-management behaviors were collected from medical records. RESULTS Across all age groups, females reported significantly lower D-HRQOL than didmales. The 19-25-year age group reported the lowest D-HRQOL. Multivariate linear regression analyses revealed that D-HRQOL was significantly related to HbA1c; the lower the HbA1c, the better the D-HRQOL. Three diabetes-management behaviors were significantly related to better D-HRQOL: advanced methods used to measure food intake;more frequent daily blood glucose monitoring; and more days per week that youth had 30 min of physical activity. CONCLUSIONS In all three age groups, the lower the HbA1c, the better the D-HRQOL, underscoring the strong association between better D-HRQOL and optimal glycemic control in a global sample of youth and young adults. Three diabetes-management behaviors were also related to optimal glycemic control, which represent potentially modifiable factors for clinical interventions to improve D-HRQOL as well as glycemic control.

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