Search

Copyright of Der Urologe A is the property of Springer Nature and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Hintergrund: Erwachsene Elite-Kletterer sind klein mit einem geringen Body Mass Index und niedrigem Körperfettgehalt. Diese Charakteristika werfen Besorgnis auf, dass jugendliche Nachwuchskletterer durch forcierte Körperfettreduktion ihre körperliche Entwicklung zum Nachteil beeinflussen und somit ihre Gesundheit gefährden. Diese Entwicklung würde die Diskussion rechtfertigen, dass ein Mindest-BMI, ähnlich wie beim Skispringen, für die Wettkampfteilnahme erforderlich ist. Ziel dieser Studie ist es, die Auswirkungen eines im Hochleistungsbereich durchgeführten Kletterns auf die hormonelle und körperliche Entwicklung von Jugendlichen zu untersuchen. Methodik: 16 Mitglieder der deutschen Jugendnationalmannschaft Sportklettern des DAV (9m: 16,8±2,3 J; 7 w: 17,2±2,8 J) sowie 14 nicht kletternde Jugendliche (8 m: 15,9±1,8 J, 6 w: 16,3±2,5 J) wurden anamnestisch, klinisch sowie laborchemisch bezüglich ihrer körperlicher Entwicklung untersucht. Anamnestisch wurden Ernährungsgewohnheiten, Trainings- und Kletterparameter, Pubertät sowie die Entwicklungsbiologie der Eltern erhoben. Klinisch erfolgte die Erhebung der Körperzusammensetzung (Hydratation, Körperfett), des Weiteren wurden Körpergröße, Gewicht, Armspannweite und Fettfaltendicke erfasst. Laborchemisch wurden neben Blutbild, Elektrolyten, Eisen und Transferrin, Sexual- und Schilddrüsenhormone sowie Leptin und Ghrelin untersucht. Ergebnisse: Das Kletterniveau der Buben lag im Mittel bei 10-, der Mädchen bei 9-(UIAA). Der BMI der Buben lag bei 20,1±1,9, der Mädchen bei 19,3±1,8. Die Kadermädchen waren signifikant (p<0,05) leichter als die Kontrollgruppe mit signifikant weniger Muskelmasse und einer signifikant geringeren Fettfaltendicke. Leptin und Ghrelin waren ohne Signifikanz. Die Kaderjungen hatten signifikant weniger Körperfett und unterschieden sich signifikant in Bezug auf Leptin von der Kontrollgruppe. Bei der Bestimmung des Soll-Leptins der Kadergruppen zeigte sich, dass die Mädchen signifikant unter ihrem Soll lagen, während die Buben nicht signifikant zu tief lagen. Die weiteren Hormonwerte waren unauffällig. Schlussfolgerung: Obgleich die Kadergruppe in Bezug auf Gewicht und Körperfett signifikant unterschiedlich zur Vergleichsgruppe war, liegen die Werte innerhalb des Normbereichs. Der signifikante Unterschied im Leptin zwischen männlichem Kader und Vergleichsgruppe begründet sich durch einen erhöhten (im Vergleich zum Soll) Leptinspiegel in der Kontrollgruppe. Die Kadermädchen allerdings zeigten erniedrigte (im Vergleich zum Soll) Leptinwerte, die unauffällig im Vergleich zur Kontrollgruppe waren, da diese ebenfalls erniedrigte Werte aufwies. Diese erste derartige Untersuchung zeigt letztendlich, dass der Jugendkader des DAV in Bezug auf körperliche und hormonelle Entwicklung keinen biologisch relevanten Unterschied zur Normalbevölkerung zeigt. Aus den bisher vorliegenden Ergebnissen und Untersuchungsbefunden ergeben sich bislang keine Anhaltspunkte, die einer Ausbelastung aus orthopädischer Sicht bezüglich des Knochenstoffwechsels im Wege stehen. Es bedarf jedoch weiterer dezidierter Langzeituntersuchungen, um den exakten Pubertätsverlauf und die Entwicklung gerade auch von sehr jungen Spitzenkletterern im Einzelnen zu erfassen. [Copyright &y& Elsevier]

Competing Interests: Die Autoren geben an, dass kein Interessenkonflikt besteht.

The Cologne statement resulted from both regional and nationwide controversial discussions about meaning and purpose of an initial examination for infectious diseases of refugees with respect to limited time, personnel and financial resources. Refugees per se are no increased infection risk factors for the general population as well as aiders, when the aiders comply with general hygiene rules and are vaccinated according to the recommendations of the German Standing Committee on Vaccination (STIKO). This is supported by our own data. Based on individual medical history, refugees need medical care, which is offered purposeful, economic, humanitarian and ethical. In addition to medical confidentiality, the reporting obligation according § 34 Infection Protection Act (IPA) and the examination concerning infectious pulmonary tuberculosis according to § 36 (4) IPA must be considered., (© Georg Thieme Verlag KG Stuttgart · New York.)

Background: Nutrition of children with end-stage renal disease and peritoneal dialysis (PD) is often difficult. Tube feeding via a gastrostoma is discussed controversially, and some authors consider this as a contraindication because of the risk of peritonitis., Methods: In our centre 16 infants and children with end-stage renal disease were treated with PD and tube feeding over a gastrostoma in the last 12 years. The patients showed dystrophy (mean BMI -1.73 SDS) and were too small (mean body length -4.56 SDS). Seven of them (median age 11 months) received a gastrostoma before insertion of a Tenkhoff-catheter and start of PD. Nine children (median age 5 months) had PD primarily before insertion of the gastrostoma and start of tube feeding., Results: Patients with start of PD while a gastrostoma was already inserted had 15 events with peritonitis in the observation time of 91 months (1.98 per patient year). Patients with primary start of PD had 12 events with peritonitis in a total time of 43 month (3.34 per patient year), after insertion while PD was already running the number of events fell significantly to 25 peritonitis events in a total of 271 months (1.11 per patient year, p < 0.01). The children had a benefit from tube feeding via a gastrostoma in regard of body weight (BMI + 1.61 SDS, p < 0.01) as well as growth (body height + 2.29 SDS, p < 0.05)., Conclusion: Tube feeding via a gastrostoma is a good and safe option for alimentation, even under peritoneal dialysis. A decrease of PD-associated peritonitis under tube feeding was observed while physical development was positively influenced., (Georg Thieme Verlag KG Stuttgart. New York.)

Intrauterine growth restriction (IUGR) is associated with an increased prevalence of renal malfunction. Two principal pathogenetic pathways appear to be involved: on the one hand non-renal mechanisms such as hypertension and type 2 diabetes, both associated with previous IUGR, predispose to secondary renal damage; on the other hand, renal mechanisms are involved such as the reduced number of nephrons in low-birth-weight children, which is a risk factor for future renal failure. In addition, glomerular diseases show a severer course in IUGR children. The course of the nephrotic syndrome is less favourable, and IgA nephropathy is associated with a higher prevalence of glomerular sclerosis. Data from animal experiments suggest an increased susceptibility of glomeruli to inflammatory stimuli and reduced regenerative capacities. However, not only prenatal environment, but also postnatal hyperalimentation is responsible for the manifestation of renal disease after IUGR., (2009 S. Karger AG, Basel.)

Objective: Childhood obesity is a growing health problem among German children. Birth weight is considered to have a major influence on the course of postnatal weight. The present study investigates the relation between birth weight and body weight at health examination prior to school entry. We tested other parameters influencing childhood obesity, and hypothesized that within a 5-year interval the prevalence of obesity in children has increased significantly., Methods: Our study is based on the retrospective analysis of the school enrolment health examinations of 4610 children in North Bavaria, e. g. the town Erlangen and administrative district Erlangen-Hoechstadt in 1995/96 and 2000/01., Results: A higher birth weight was associated with a higher weight and BMI at school entry examination (p < 0.0001). An increased birth weight is therefore a considerable risk factor for later overweight in childhood. Hypotrophic newborn, however, gain less weight and exhibit a lower BMI in our study group. In general, boys were significantly heavier than girls (p < 0.001). Children of foreign origin were heavier and had a higher BMI corrected for age than German pupils but they were also 0.07 years older. Our regional survey revealed local differences in the prevalence of obesity. Comparing the cohorts 1995/96 and 2000/01 at school entry, a significant increase of BMI in the latter was found (p < 0.0001)., Conclusions: A highly significant increase in the prevalence of infantile overweight has to be faced. Early prevention of childhood obesity is therefore mandatory to avoid the complications and higher morbidity.

A 14 weeks old infant was admitted to the intensive care unit with life-threatening hypocalcemic-hyperphosphatemic spasms. Hypocalcemia-hyperphosphatemia was found to have been caused by feeding a high phosphate/ low calcium soy milk. The daily uptake of calcium was calculated to have been 3.3-6 mmol that of phosphate 30 mmol. The parents strongly believed that soy milk formulas were equivalent to breast milk and cow's milk formulas and lived on a strictly vegetarian diet. Therapy with calcium (at an initial dose of 2.25 mmol/kg/day) and 1.25 OH vitamin D3 (Rocaltrol, 0.25 microgram/day) normalized Ca, PO4, vitamin D and parathyroid hormone levels rapidly. Vegetarian feeding had led to life-threatening hypocalcemic hyperphosphatemic spasms in the infant. We conclude that malnutrition and false nutritional beliefs have to be included as a potential cause of early hypocalcemia in infants.