Akute Hepatopathie mit Fettstoffwechselstörung Atypische Erstmanifestation der Mukoviszidose

Zusammenfassung Ein 11 Wochen alter Junge erkrankte akut mit Bewu?tseinsst?rung und Hepatopathie mit Cholestase und Gerinnungsst?rung, allerdings normalen Ammoniakwerten. Trotz mehrfach nachgewiesener Dikarbons?ureausscheidung im Urin lie? sich kein Enzymdefekt im Fetts?ureabbau nachweisen. Aufgrund einer zunehmenden Atemwegsobstruktion in Verbindung mit Fettstühlen wurde die Diagnose Mukoviszidose vermutet und mittels Schwei?test und Genanalyse best?tigt. Die intensive Therapie der Mukoviszidose führte zur raschen Normalisierung s?mtlicher pathologische Befunde. Diskussion: Dieser Fall zeigt, da? bei Reye-?hnlichen Krankheitsbildern und einer Dikarbons?ureausscheidung im S?uglingsalter auch an eine Mukoviszidose gedacht werden mu?.      

Kalium- und Natriumgehalt in Neugeborenen- und Erwachsenenerythrocyten

Zusammenfassung Es besteht kein sicherer Unterschied zwischen dem Natrium- und Kaliumgehalt von Neugeborenen- und Erwachsenenerythrocyten. Der absolute Gehalt der Erythrocyten an Kationen hängt weitgehend von der Vorbehandlung der Zellen und von der Meßmethodik ab. Am geeignetsten für Studien über die Permeabilität der Erythrocytenmembran für Kationen ist die hier angewandte flammenphotometrische Bestimmung im Erythrocytenbrei nach Waschen der Zellen mit Cholinchlorid. Die mit dieser Methode bestimmten Kationenkonzentrationen sind relativ niedrig. Die Natriumkonzentrationen stimmen gut mit Ergebnissen anderer Autoren überein, die nach Korrektur des Plasmafaktors gewonnen wurden.Mit Unterstützung durch die Deutsche Forschungsgemeinschaft.     

Sport- und Wettkampftauglichkeitsuntersuchungen im Kindes- und Jugendalter

Background

Children over 8 years old and at the latest 10 years old who participate in club competitions must be medically examined to ensure that they are fit enough to participate in competitive sports.

Objective

It is the duty of the examining physician to carry out examinations to test the capability to participate in competitive sports in such a way that the children, parents and trainers can be sure that there are no tangible risks which prohibit participation in the type of sport or competitive sports

Material and methods

The medical examination must include the medical and family history, the general and training history as well as a clinical and pediatric examination including postural behavior and the musculoskeletal system. In order to exclude congenital risk factors it must be obligatory to carry out a resting electrocardiogram (ECG). The medical examination must be carried out at least once. In order to detect intercurrent pediatric problems, e.g. growth surges, infections, injuries and overexertion injuries and pathological compensation problems of the cardiovascular system, the examination should be optimally carried out annually.

Results and discussion

Using a standardized investigation form the frequency of cardiovascular events can be reduced and damage due to congenital or acquired pathologies of the musculoskeletal system can be prevented. This results in the greatest possible safety for parents, trainers and athletes that only children who are suitable for the sports selected for them can participate in competitions. By regularly carrying out adequate medical physical examinations stress-related damage and injury due to the sport can be kept to a minimum.     

Wasser und Elektrolyte in Plasma und Erythrocyten

Ohne ZusammenfassungMit Unterstützung durch die Deutsche Forschungsgemeinschaft.     

Laktat und Trainingssteuerung bei Kindern und Jugendlichen

Background

Lactate is the product of anaerobic glycolysis, a metabolic carbon intermediate with high energy content and a substrate of cellular respiration and gluconeogenesis. Additionally, lactate modulates glycolytic energy production and oxidative combustion of lactate in mitochondria.

Blood lactate concentration and intensity zones

The blood lactate concentration (BLC) increases with increasing exercise intensity which is termed the lactate power curve (LPC). The LPC discriminates between subjects with different performance capacities and distinct testing protocols. During prolonged constant power exertion the BLC can remain close to the resting level (intensity zone I), show a steady state above resting BLC (intensity zone II) or increase continuously until termination of physical exertion (intensity zone III). The maximal lactate steady state (MLSS) depicts the transition from intensity zone II to III. Lactate thresholds detect LPC points which indicate the transition from intensity zone I to II or II to III.

Intensity zones in the training process

Intensity zone I serves for training sessions lasting up to 6 h. Intensity zone II is utilized for extensive and intensive endurance training sessions sustainable for between 30 min and 90 min. Interval and tempo training sessions are performed at intensity zone III.

Blood lactate concentration measurement for training control

Measurement of BLC not only detects performance changes under laboratory and field conditions but can also be used to assess the metabolic stress of selected training sessions. If adolescents perform training volumes which require a training intensity distribution comparable to adult high performance athletes then BLC monitoring of selected training sessions is advised. Corresponding training BLC measurements are not required in performance-oriented training of prepuberty and early puberty children.     

Anorexia und Bulimia nervosa im Kindes- und Jugendalter

Anorexia (AN) and Bulimia nervosa (BN) are common psychiatric disorders in adolescent girls. AN has the highest mortality rate of child- and adolescent psychiatric disorders. In the last decade the understanding of the etiology, maintaining conditions and therapy has changed. Besides familial and psychosocial factors there is evidence contributing to the etiologic relevance of temperament and biological factors, e.g. a vulnerability of the serotonergic system in the state of starvation. In the following clinical and somatic symptoms will be summarized. Modern theories of Anorexia and Bulimia nervosa will be discussed to give support for diagnostics and treatment.     

Übergewicht und Adipositas im Kindes- und Jugendalter

Zusammenfassung Übergewicht ist eines der größten Gesundheitsprobleme in der westlichen Welt. Aktuelle Studien zeigen einen alarmierenden Anstieg in der Prävalenz von Übergewicht und Adipositas im Kindes- und Jugendalter. Seit 1976 stieg die Häufigkeit in Deutschland um mindestens 50% an. Eine kürzlich vorgestellte deutsche Studie des Robert Koch-Instituts an 17.000 Kindern und Jugendlichen zeigte, dass insgesamt 15% aller deutschen Kinder und Jugendlichen übergewichtig sind, 6,3% leiden unter Adipositas. Aus übergewichtigen Kindern entwickeln sich in den meisten Fällen übergewichtige Erwachsene mit hohen Risiken für akute und chronische Folgeerkrankungen wie Bluthochdruck, Fettstoffwechselstörungen, koronare Herzkrankheit, Krebs, Gicht, psychosoziale Störungen und orthopädische Erkrankungen. Die Prävention von Übergewicht muss bereits ab der frühen Kindheit erfolgen. Bisher werden nur etwa 20% der übergewichtigen Kinder diagnostiziert und behandelt.Korrespondenzadresse:Prof. Dr. B. KoletzkoAbteilung Stoffwechselkrankheiten und Ernährungsmedizin, Dr. von Haunersches KinderspitalKlinikum der Ludwigs-Maximillians-UniversitätLindwurmstraße 480337 München     

Angeborene und vererbte Netzhaut- und Papillenstörungen

Changes of retina or optic nerve in childhood can be due to developmental malformations, infections, inborn errors of metabolism, prematurity upon delivery or malignant transformation. This paper presents a synopsis.     

Anorexia und Bulimia nervosa im Kindes- und Jugendalter

Eating disorders are among the most common chronic illnesses in female adolescents and for some patients these psychiatric disorders are potentially fatal. This article defines anorexia and bulimia nervosa and goes on to describe the epidemiology, etiology, pathogenesis, comorbidities and differential diagnosis of these disorders. Details concerning eating disorder symptoms, hyperactivity, psychiatric symptoms, such as distorted self-image and obsessive fear of gaining weight are given, as well as somatic complications. A plan of treatment of eating disorders is provided in a multimodal therapy approach consisting of somatic rehabilitation, psycho-education, individual psychotherapy, involvement of family members and medication. Finally, recommendations for pediatricians, often the first to be notified by patients and their families and therefore fulfilling an important role in the initial diagnosis and referral to other specialists, are provided.     

Postpartale Hypotonie und Darmfehlbildung bei Polyhydramnion und dilatierten Darmschlingen

Ohne Zusammenfassung     

Alkoholmissbrauch und -abhängigkeit bei Kindern und Jugendlichen

Alcohol use in children is starting earlier and has become a problem of public concern. Despite the fact that alcohol use in Austria has decreased in the last 30 years, the attitude toward public drinking, especially in children and adolescents (such as binge drinking), has became a problem for paediatric hospitals. Children with alcohol intoxication react differently than adults do. First, the enzyme alcohol dehydrogenase is“untrained,” and second, they do not drink as part of a meal but in order to get drunk instantly. Sometimes drinking so-called alco-pops increases the speed of intoxication because young people do not recognize the amount of alcohol they are drinking. Because paediatric hospitals in Austria, Switzerland, and Germany decided to begin accepting adolescents, the recognition and treatment of alcohol intoxication became part of our duties. Distinguishing between a first-time drinking “accident” and problematic alcohol use is crucial for psychosocial assessment and treatment planning.     

Nachweis und Wertbestimmung von Hormonen und Vitaminen im Tierexperiment

Ohne Zusammenfassung     

Ursachen und Folgen von Adipositas im Kindes- und Jugendalter

Ohne Zusammenfassung Dr.M.Holub Abteilung für Neonatologie, angeborene St?rungen und Intensivmedizin, Universit?tsklinik für Kinder- und Jugendheilkunde,W?hringer Gürtel 18–20, 1090 Wien, ?sterreich, E-Mail: margareta.holub@akh-wien.ac.at     

Basophile und eosinophile Granulocyten bei gesunden und kranken Kindern

Summary The total leucocytes, the basophils and the eosinophils were counted on 30 healthy and 62 sick children. The counting of the basophils and eosinophils was done simultaneously.Children with infectious hepatitis had during the acute stage a low number of basophils, when the liver function becomes normal again the number of basophils is rising, sometimes over the middle value of the healthy children.Also on children with scarlet fever and other infections the basophils and eosinophils had a rising tendency. Eosinophilia and basophilia were marked during the acute stage of the scarlet fever. There was a correlation between the numbers of the basophils and the eosinophils.Four hours and one day after tonsillectomy there was a marked decrease of eosinophils and basophils; five days after the operation the blood count became normal again. Also the total leucocytes were increased during these five days.If children with allergic diseases had an increased number of eosinophils also the basophils were increased.     

Genese und Struktur der "NS-Kinder- und Jugendlicheneuthanasie"

Zusammenfassung Es wird ein Überblick über die Vorgeschichte, den Anstoß ("Kind K."), die Planung und die Durchführung der "Kinder- und Jugendlicheneuthanasie" im nationalsozialistischen Deutschland gegeben. Die 30 bislang sicher identifizierten, so genannten "Kinderfachabteilungen" werden aufgelistet. Gesondert wird die Beteiligung der deutschen Pädiater am "Euthanasie"-Programm diskutiert.

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