Hydrocephalus im Kindesalter

Ohne Zusammenfassung     

Fernsehen im Kindesalter

From the very beginning, the public has discussed potential risks of television (TV) consumption, with many of these discussions being based on myths and unproven anecdotes. The present article reviews international empirical studies that have not only explored possible potentials of TV viewing but also tested different hypotheses concerning inhibitory effects of TV on children’s academic achievement. As a main result, findings indicate that the relationship between TV consumption and school achievement is more complicated than is typically assumed. Results of several studies indicate that the relationship may be nonlinear and that effects of excessive TV consumption may vary as a function of children’s family backgrounds and their intellectual abilities. Recent German studies also confirm that findings from the United States may not be easily generalized to European settings, although basic similarities exist. Finally, the review documents the educational potential of TV programs, which has not been sufficiently exploited in the past.     

Ektoparasitosen im Kindesalter

Parasites are specialized creatures that live totally or in part at the expense of other species. Relevant to the skin are ectoparasites, especially arthropods and worms, which live permanently (scabies mites, head lice) or temporarily (bugs, fleas, ticks, harvest mites, cercaria) on or in the skin. During childhood pediculosis capitis, scabies, reactions to insect bites, trombidioses, and cercarial dermatitis play the most important role and are described below.     

Emotionsregulationsdefizite im Kindesalter

Emotion regulation

The ability to regulate emotions represents an important developmental step in childhood. Emotion regulation is significantly influenced by various factors, such as neurological development, child’s temperament, and parenting behavior.

Deficits in emotion regulation

Current research shows that deficits in emotion regulation (i.e., the frequent use of dysfunctional regulation strategies and a lack of use of functional strategies) are associated with psychosocial impairment. In addition, a basic association could be detected between emotion regulation deficits and externalizing and internalizing disorders in childhood.

Therapy

By focusing on emotion regulation in well-directed treatment approaches, promising effects can be observed. A crucial task for future research is to further investigate the specific function of emotion regulation for psychopathology and to integrate this ability into treatment approaches for children.     

Lungenfunktionsuntersuchungen im Kindesalter

Zusammenfassung Lungenfunktionsuntersuchungen sind für die Diagnosestellung und Verlaufsbeobachtungen von pneumologischen Erkrankungen eminent wichtig. Die Spirometrie inklusive der forcierten exspiratorischen Fluss-Volumen-Kurve stellt nach wie vor die Basisuntersuchung im Kindesalter dar. Hierdurch können obstruktive, restriktive und auch kombinierte Ventilationsstörungen erkannt werden. Die Bodyplethysmographie erlaubt die gleichzeitige Messung des intrathorakalen Gasvolumens und des Atemwegswiderstands. Beider Verfahren bedient man sich auch zur Messung der bronchialen Hyperreagibilität (z. B. nach körperlicher Belastung, Kaltlufthyperventilation, Inhalation von pharmakologischen Substanzen) und der Reversibilität einer obstruktiven Ventilationsstörung (Bronchospasmolysetest). Im vorliegenden Artikel werden die Vor- und Nachteile dieser und verschiedener anderer Untersuchungsverfahren erläutert sowie Richtlinien zur Methodik und zur Interpretation der Ergebnisse zitiert.     

Hirntumoren im Kindesalter

Zusammenfassung An der Univesitäts-Kinderklinik Wien lagen vom 1. 1. 1946 bis 31. 12. 1964 75 Kinder mit intrakraniellen Tumoren, über deren Krankheitsverlauf wird hier berichtet. Wegen verschiedener morphologischer und durch die Entwicklung bedingter Besonderheiten haben Hirntumoren im Kindesalter eine deutlich schlechtere Prognose als bei Erwachsenen. Fast ein Charakteristikum vieler kindlicher Hirntumoren ist deren erschreckende Größe, an der sicher auch eine, nicht nur bei einem Großteil unserer Patienten beobachtete, erschreckend lange Anamnese Schuld hat. Da nur bei frühzeitiger Diagnose Aussichten für eine erfolgreiche Therapie bestehen, haben wir uns bemüht, besonders die in unserem Krankengut angegebenen Frühsymptome hervorzuheben. Klinisches Bild, zur Diagnose führende Untersuchungsmethoden und die Resultate der Therapie werden diskutiert.

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Summary From Jan. 1, 1946 to Dec. 31, 1964 in the Pediatric University Clinic of Vienna 75 children with intracranial tumours were admitted, the detailed course of the disease has been mentioned in the above article. Because of the developmental and morphological peculiarities of the childhoodage, brain tumours in infancy and childhood have a more serious outlook and a worse prognosis than in adult age. One characteristic feature of the brain tumours in this age is the tremendous size, one of the causes of this characteristic is the alarmingly long period of previous history observed not only in a great number of our patients, but also by other authors. As an early diagnosis is the only chance of a successful therapy, it was our special intention to emphasize the early symptoms of these cases; symptomes observed on admission of the children, methods of investigation which led to the diagnosis and the results of therapy are discussed.

     

Malariainfektionen im Kindesalter

ZusammenfassungHintergrund Malaria ist die wichtigste tropische Infektionskrankheit, die alljährlich für den Tod von 1–2 Mio. Kindern verantwortlich ist. Angesichts der hohen Reisetätigkeit, der steigenden Zahl international zusammengesetzter Familien und der zzt. stattfindenden Ausdehnung des Malariagürtels ist anzunehmen, dass die Inzidenz von Malariainfektionen im Kindesalter auch hierzulande zunehmen wird.Patienten Bei 5 Kindern im Alter zwischen 4 Monaten und 12 Jahren werden Symptome, Befunde und Verlauf einer Malaria tropica beschrieben. Drei Kinder wiesen einen schweren Verlauf entsprechend den Kriterien der WHO auf. Alle Kinder überstanden die Erkrankung ohne Folgeschäden.Schlussfolgerungen An Malaria ist immer beim Symptom Fieber nach Tropenaufenthalt zu denken. Der Parasitennachweis erfolgt über den gefärbten Blutausstrich; eine Therapie muss ohne Zeitverzögerung eingeleitet werden. Ein einmalig negativer Blutausstrich schließt die Malaria keinesfalls aus, insbesondere dann nicht, wenn vorher antibiotisch anbehandelt wurde. Kinder, die ihre Eltern bei Tropenreisen begleiten, sollten durch Expositions- und ggf. Chemoprophylaxe vor einer Malariainfektion geschützt werden.     

Dystonien im Kindesalter

Childhood dystonias represent a heterogeneous group of mostly inherited disorders. In this age group, generalized dystonias predominate and cause significant disability. A functional disturbance in the striatal control of the internal globus pallidus causing altered thalamic control of cortical motor areas seems to represent the pathophysiological background. We discuss the etiologic differentiation of primary dystonias from acquired/exogenous causes and heredodegenerative disorders. With the exception of dopa-responsive dystonia, treatment of dystonia is difficult. Besides medical therapy, neurosurgical procedures like bilateral pallidal stimulation show significant clinical benefit in special etiologic groups of dystonia, i.e., primary generalized dystonia.     

Leishmaniosen im Kindesalter

Leishmaniosis is a protozoan infection that is acquired by the bites of sandflies. It is prevalent on all continents including various vacation areas for German tourists (e.g. Mediterranean countries and islands). Depending on the parasite species and strain as well as on the host immune response, the infection leads to papules or ulcers (cutaneous leishmaniosis) or to fever, hepatosplenomegaly and pancytopenia (visceral leishmaniosis). Diagnosis is made by the detection of the pathogen (histology, PCR and culture) in specialised laboratories. Unlike cutaneous leishmaniosis which requires a specific therapy only under certain conditions, visceral leishmaniosis must be treated. The drug of choice is liposomal amphotericin B. Despite successful treatment, later reactivation of the disease can occur during immunosuppression. There is no commercial vaccine available. The only prophylaxis is protection against sandfly bites.     

Stottern im Kindesalter

Stuttering in childhood is etiologically not homogenous; it is conceivable only on the basis of the individual case. This idiographic view regards stuttering as a multifactorial, multimodal phenomenon in which each stuttering child acquires his or her disorder from completely different physiologic/organic, psycholinguistic, and psychosocial factors that are responsible for the onset, development, and maintenance of the stuttering. The differentiation of stuttering from disfluency (“physiological stuttering”) and the individual multivariate frame of conditions can be revealed only by extensive differentiated multidimensional diagnostics, which determine the contents of the subsequent therapy. Only consistent early therapy can improve the prognosis of stuttering.     

Nierenarterienstenose im Kindesalter

Background.

Although renal artery stenosis (RAS) is relatively rare, renovascular hypertension is the most common form of potentially correctable hypertension in children over 1 year of age. RAS has multiple reasons including intrinsic lesions of the renal arteries and extrinsic compressive lesions.

Case report.

In this case report we describe the successful therapy of a significant unilateral RAS in a 12 year old girl in whom successful management was only possible using a special ballon angioplasty technique ("cutting balloon").

Conclusion.

The current diagnostic and therapeutic options for renovascular hypertension are discussed based on a review of the literature.     

Proteinurie im Kindesalter

The excretion of a nearly protein-free urine is one of the most important tasks of human kidneys. To achieve this, the glomeruli of an adult human filter around 180?l of a nearly protein-free primary urine every day. Glomerular damage is the main cause of a substantial protein loss through the kidneys, called proteinuria and needs to be distinguished from damage to the tubular system; however, proteinuria is not only a marker of renal damage but also an independent risk factor for progression of chronic kidney disease and for the development of cardiovascular complications. The exact diagnosis and therapy of proteinuria during childhood and adolescence are therefore crucial, especially in patients suffering from chronic kidney disease. This article describes a structured diagnostic approach, to give insights into the underlying pathogenesis and current therapeutic approaches of proteinuria and to outline the importance of proteinuria in daily clinical routine.     

Pruritus im Kindesalter

Zusammenfassung Kinder leiden überwiegend im Rahmen dermatologischer Krankheitsbilder an Juckreiz, seltener bei systemischen oder genetisch bedingten Erkrankungen. Zumeist tritt Pruritus bei Atopischer Dermatitis auf. Weitere häufige dermatologische Differenzialdiagnosen juckender Erkrankungen im Kindesalter sind Skabies, Impetigo, Varizellen, Mykosen, Urtikaria, Mastozytose und Psoriasis vulgaris. Da Kinder den Schaden durch Kratzen nicht einschätzen können, gehen juckende Erkrankungen bei ihnen meist mit schweren Kratzartefakten einher. Diese Patientengruppe benötigt daher eigene Therapiekonzepte. Der Einsatz topischer und systemischer Medikamente hängt von der Ursache, dem Schweregrad der Erkrankung und dem individuellen Hautzustand ab. Aufgrund des ungünstigen Verhältnisses von Körpervolumen zu Körperoberfläche insbesondere bei Säuglingen und Kleinkindern können topisch applizierte Substanzen schneller zu Intoxikationen führen. Die Dosierung systemischer Medikamente muss angepasst und die Indikation zur UV-Phototherapie mit großer Vorsicht gestellt werden. In dieser Arbeit werden die Hauptursachen des Pruritus im Kindesalter beleuchtet und die Eckpunkte der antipruritogenen Therapie dargestellt, und zwar unter Berücksichtigung eigener klinischer Erfahrungen und der aktuellen Literatur.      

Lebervenenverschlusserkrankung im Kindesalter

Hepatic veno-occlusive disease (HVOD) is a life-threatening complication mostly occurring after high-dose cytoreductive chemotherapy and hematopoietic stem cell transplantation (HSCT).The presenting symptoms of the syndrome are a variable combination of unexplained weight gain,hyperbilirubinemia, painful hepatomegaly, ascites and edema, not infrequently heralded by an unexplained refractory thrombocytopenia.The disease can be classified as mild,moderate and severe.While mild and moderate diseases often recover independently of therapeutic intervention, severe disease is ridden with a significant morbidity and a mortality reaching over 90%.The pathophysiology is poorly understood,predisposing risk factors are identified but the disease often occurs outside the target population.The diagnostic tools are not satisfactory for early intervention. There is no “gold standard” of prophylaxis and treatment options beyond supportive care are limited.Despite significant progress, HVOD remains a major problem of treatment modalities that use high-dose chemotherapy.This article will give a concise presentation of the syndrome with a focus on specific pediatric aspects and will summarize recent advances in the field.     

Erythematodes im Kindesalter

Ohne Zusammenfassung