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Metabolic factors acting during limited and sensitive time periods of pre- and postnatal development can induce lasting effects on health and disease risk in later life up to old age, including later obesity risk, which is referred to as early metabolic programming of long-term health. Three meta-analyses of observational studies found that obesity risk at school age was reduced with early breastfeeding compared to formula feeding. We assumed that breastfeeding protects against later obesity by reducing the occurrence of high weight gain in infancy and that one causative factor is the lower protein content of human milk compared to usual infant formulas (the "early protein hypothesis"). We are testing this hypothesis in the European Childhood Obesity Project, a double-blind, randomized clinical trial enrolling 1,678 infants in five countries (Belgium, Germany, Italy, Poland, Spain). We have randomized healthy infants born at term to receive for the first year infant formula and follow-on formula with higher or lower protein contents, respectively. The follow-up data obtained at age 2 years indicates that feeding formula with reduced protein content normalizes early growth relative to a breastfed reference group and the current WHO growth standard, which may furnish a significant long-term protection against later obesity. We conclude that infant feeding practice has a high potential for long-term health effects. The results obtained should stimulate the review of recommendations and policies for infant formula composition.

For the first time in the German speaking area 8 cases of neonatal immunothrombocytopenia caused by platelet-specific P1A1 antibodies could be ascertained. The disease is caused by fetomaternal incompatibility against platelet antigens. All mothers were healthy. The children showed a postnatal tendency for petechial haemorrhages. Cerebral haemorrhages occurred in two cases. Optimal treatment consists of administration of P1A1-negative platelets (perhaps of the mother). Demonstration of platelet antibodies is possible nowadays by adequate serological methods.

Hintergrund: Der populationsbezogene Einsatz von Physiotherapie bei Kindern und Jugendlichen wurde bisher ausschließlich anhand von Krankenkassendaten analysiert, die weder anamnestische noch soziale Faktoren berücksichtigen können. Mit Hilfe der KiGGS-Basisdaten ist es möglich die[zum vollständigen Text gelangen Sie über die oben angegebene URL], 14. Deutscher Kongress für Versorgungsforschung

Objectives: Health economic evaluations (HEEs) of vaccines are commonly considered during immunization introduction decision-making processes in most industrialized countries. Despite the availability of guidelines advocating more standardization for such HEEs, there are still several infection/immunization-specific particularities that are debated in the scientific community. An international expert-workshop was convened to identify good practices for (i) how to conduct HEEs of vaccines and (ii) how to consider results of HEE in vaccine introduction decision-making. Methods: A systematic literature search was conducted to identify prevailing opinions and remaining issues of HEE in vaccination. Twentytwo experts in the field of health economics and immunization decision-making were invited to a workshop and were asked to answer a survey-questionnaire based on the systematic literature search beforehand to inform the preparation of group work sessions (GWS). In GWS, issues focusing on 'mathematical modeling', 'health economics', and 'decision-making' were discussed and summarized. Results: The GWS (based on systematic literature search) included topics such as cost-components, quality of life (QoL), discounting, and perspectives leading to suggestions such as including caregiver QoL impact and applying decreasing time-related discount rates. Since vaccination often causes indirect effects, the use of dynamic models is required and exceptions should be justified. In order to facilitate transparent decision-making, the results of HEE should present parameter and methodological uncertainty as well as cumulative and time-specific figures. The majority of countries in Europe use results from HEEs in an informal judgment-process without willingness to pay (WTP) threshold. The expert-group emphasized that transparency should be maximized in decisionmaking process. Conclusions: The deliberations led to suggestions on several HEE issues. However, vaccines not always need to be considered differently in HEE since other interventions might share similar characteristics. Transparency in the conduct and presentation of HEE, and subsequent decision-making is essential, especially in the absence of explicit WTP thresholds.

Hintergrund und Fragestellung: Vor dem Hintergrund des Risikos der Chronifizierung von Kopfschmerzen sind präventive Strategien von besonderer Bedeutung. Die Herausforderung bei der Kopfschmerzprävention: Identifikation von präventablen Risikofaktoren, Bestimmung von deren attributablem[for full text, please go to the a.m. URL], Prävention zwischen Evidenz und Eminenz; 15. Jahrestagung des Deutschen Netzwerks Evidenzbasierte Medizin

OBJECTIVE: Whether specific combinations of risk factors in very early life might allow identification of high-risk target groups for overweight prevention programs was examined. DESIGN AND METHODS: Data of n = 8981 children from the German KiGGS study were analyzed. Using a classification tree approach, predictive risk factor combinations were assessed for overweight in 3-6, 7-10, and 11-17-year-old children. RESULTS: In preschool children, the subgroup with the highest overweight risk were migrant children with at least one obese parent, with a prevalence of 36.6 (95% confidence interval or CI: 22.9, 50.4)%, compared to an overall prevalence of 10.0 (8.9, 11.2)%. The prevalence of overweight increased from 18.3 (16.8, 19.8)% to 57.9 (46.6, 69.3)% in 7-10-year-old children, if at least one parent was obese and the child had been born large-for-gestational-age. In 11-17-year-olds, the overweight risk increased from 20.1 (18.9, 21.3)% to 63.0 (46.4, 79.7)% in the highest risk group. However, high prevalence ratios were found only in small subgroups, containing

Streptokokken der Serogruppe B (GBS) sind die häufigsten Erreger der neonatalen Sepsis und verursachen eine signifikante Morbidität und Mortalität. Zwischen 2001 und 2003 wurde in Deutschland eine erste ESPED-Studie zur Erfassung von Inzidenz und klinischen Eigenschaften neonataler GBS-Infektionen[for full text, please go to the a.m. URL], 21. Jahrestagung der Deutschen Gesellschaft für Pädiatrische Infektiologie (DGPI)

Objective: To evaluate if percentile-specific effects of genetic, environmental and lifestyle obesity risk factors on body mass index (BMI) might reflect gene-environment interactions with respect to the development of overweight. Design and Methods: Retrospective study with data of 2,346 children from the Avon Longitudinal Study of Parents and Children (ALSPAC), using quantile regression with body fat mass index (FMI) for children at the age of 9 years as outcome variable. We assessed interactions of an “obesity-risk-allele-score” with environmental and nutritional factors. Results: There was no evidence of interactions between the obesity-risk-allele score and the environmental variables except for maternal overweight. However, we found a significant interaction with respect to intake of mono- and polyunsaturated fatty acids at the age of 7. In children with low intake, genetic risk was associated with increasing effect sizes by FMI percentile. Conclusions: Our results suggest an interaction between a low dietary content of unsaturated fatty acids and genetic risk factors for overweight on FMI. This effect is likely to be stronger in children with higher FMI. &nbsp

Noise can affect well-being and performance of individuals and might be associated with an increased risk of cardiovascular events. To date most epidemiological studies considered exposure from a single source of noise. The EU Environmental Noise Directive (2002/49/EC) requires a summative measurement of ambient noise. This study aimed to capture the participants' exposure to environmental noise by means of personal noise dosimetry.Children (n=628, participation=61%, age 8-12 years), adolescents (n=632, participation=58%, age 13-17 years) and adults (n=482, participation=40%, age 18-65 years) were selected randomly from the population registry of 4 Bavarian towns and were invited to participate in a 24-h measurement using noise dosimetry. Noise exposures during day and night were analyzed separately. In addition, predictors of noise exposure were assessed.For daytime noise exposure mean±standard deviation were in children 80.0±5.8dB(A), in adolescents 76.0±6.2dB(A), in adults 72.1±6.1dB(A) (pANOVA

Fragestellung: Die Hüftlateralisation bei Kindern mit Cerebralparese hängt von der schwere der motorischen Beeinträchtigung ab und kann zu einer milden Beeinträchtigung, bis hin zu starken Schmerzen führen. Über den Zusammenhang zwischen der Lateralisation der Hüfte[for full text, please go to the a.m. URL], Süddeutsche Tage der Kinder- und Jugendmedizin; 61. Jahrestagung der Süddeutschen Gesellschaft für Kinder- und Jugendmedizin und der Süddeutschen Gesellschaft für Kinderchirurgie und dem Berufsverband für Kinder- und Jugendärzte – Landesverband Bayern