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Introduction: Evidence concerning delivery room management in extremely low birth weight infants (ELBW) has grown substantially within the last 20 years, leading to several guidelines and recommendations. However, it is unknown in which extent local treatment strategies have changed and if they reflect current recommendations. Methods: A detailed questionnaire about treatment strategies for ELBW infants was sent to all German neonatal intensive care units (NICUs) treating ELBW infants in 1997. A follow-up survey was conducted in 2011 and sent to all NICUs in Germany, Austria and Switzerland. Results on delivery room management were compared to the first survey. Results: In 1997 and 2011, 63.6 and 66.2% of the approached hospitals responded. In 2011 similar results were observed between university and non-university hospitals as well as NICUs of different size. Differences between Germany, Austria and Switzerland were minimal. Changes over time were a lower initially applied fraction of inspired oxygen (FiO2) and peak inspiratory pressure (PiP) in 2011 compared to 1997. A longer time of apnea was tolerated before tracheal intubation is performed; the time of apnea was less frequently a sole criterion for intubation and surfactant was applied at lower FiO2 in 2011. The time of no thorax excursions and transport of the infant were considered an indication for intubation in 30.2 and 22.5%, and did not change in the observation period. Conclusion: Treatment strategies for delivery room management in ELBW infants changed significantly between 1997 and 2011 and largely reflect current recommendations.

AIM: To evaluate intellectual outcome, motor skills and anthropometric data of children with congenital hypothyroidism (CH). METHODS: Children with permanent CH who were born in 1999 in Bavaria were eligible for this prospective, population-based study. Cognitive performance was evaluated by the Kaufman Assessment Battery for Children and motor skills were assessed by the motor test, Motoriktest fur vier-bis sechsjahrige Kinder (MOT) 4-6. RESULTS: Eighteen of 21 eligible children participated (86%). Median age of the children was 5.5 years (range 4.9-5.8). Treatment with levothyroxine was started after a median of 7.2 days (range 4-15) with a median dose of 12.0 microg/kg (range 7.2-17.0). Mean intelligence quotient (IQ) of the children was 100.4 (standard deviation [SD] 10.1): no children had IQ values below the normal range. Reactivity and speed of movement were significantly reduced in children with CH. Children with an initial thyroid-stimulating hormone (TSH) value of >200 mU/L performed significantly worse than children with TSH value of

UNLABELLED Evidence for target values of arterial oxygen saturation (SaO2), CO2, and pH has changed substantially over the last 20 years. A representative survey concerning treatment strategies in extremely low-birth-weight infants (ELBW) was sent to all German neonatal intensive care units (NICUs) treating ELBW infants in 1997. A follow-up survey was conducted in 2011 and sent to all NICUs in Germany, Austria, and Switzerland. During the observation period, NICUs targeting SaO2 of 80, 85, and 90 % have increased, while units aiming for 94 and 96 % decreased (all p

Anaemia of prematurity (AOP) is a common sequela of preterm birth.1 It remains largely unknown how individual neonatal intensive care units (NICUs) manage AOP and whether treatment strategies have changed over time. We present the results of a standardised multicentre survey to assess the alterations in the treatment of AOP in NICUs caring for extremely low birthweight (ELBW) infants comparing Germany in 1997 (n=125 NICUs) to German-speaking countries in 2011 (n=129): Germany (n=110), Austria (n=10) and Switzerland (n=9).2 Preparation strategies for red blood cells (RBCs), transfusion volume, and rate and protocols for erythropoietin administration were analysed. High response rates (63.6%, 1997; 66.2%, 2011) make our results representative for German-speaking countries: Treatment strategies for AOP …

In 2006, 115 children hospitalized with measles in Germany were reported. Detailed information could be obtained for 96 cases from a pediatric hospital surveillance system. The most frequent symptoms and complications were pneumonia, respiratory insufficiency, other respiratory disorders, otitis media, feeding problems, and other gastrointestinal symptoms. Two children died of measles inclusion body encephalitis.

Background: A measles outbreak was recently observed in Coburg, Bavaria, in a population with vaccination rates of 76.5% in 5- to 6-year-old children in the years preceding the outbreak. Only a small proportion of children had received 2 vaccinations against measles. Vaccine effectiveness is estimated in a household contact study and also by a screening method. Methods: A household contact study was conducted in families with at least 1 measles case by standardized computer-assisted telephone interviews to assess secondary attack rate and to estimate vaccine effectiveness. Vaccine effectiveness was also estimated with Farrington's screening method with information from school entry examinations and from questionnaires of confirmed measles cases in the Coburg outbreak. Results: Thirty-eight children were primary cases. Of their contacts, 20 children were included in the study as secondary cases (1 vaccinated), and 23 children were contacts who did not develop measles (12 vaccinated once and 4 vaccinated twice), resulting in a vaccine effectiveness of 90% (95% confidence interval, 35–97%) for one vaccine dose. The proportion of the population vaccinated reached 81.5% during the outbreak and the proportion of the cases vaccinated was 10.9%, resulting in a vaccine effectiveness estimated using the screening method of 97.2% (95% confidence interval, 95.7–98.3%). Conclusions: With the use of 2 approaches to estimate the effectiveness of measles vaccination, a consistently high vaccine effectiveness of 90% or above was shown during a measles outbreak in Western Europe.

AIM To compare treatment strategies for respiratory failure in extremely low birth weight (ELBW) infants in Germany in 1997 to Germany, Austria and Switzerland in 2011. METHODS A detailed questionnaire about treatment strategies for ELBW infants was sent to all German centres treating ELBW infants in 1997. A follow-up survey was conducted in 2011 in Germany, Austria and Switzerland. RESULTS In 1997 and 2011, 63.6% and 66.2% of the hospitals responded. In 2011 the response rate was higher in Switzerland than in Germany, and in university hospitals versus non-university hospitals. Treatment strategies did not differ between university and non-university hospitals as well as NICUs of different sizes in 2011. Differences between Germany, Austria and Switzerland were minimal. Administration of caffeine increased significantly, whereas theophylline and doxapram declined (all p

OBJECTIVES: False-positive results of anti-tissue-transglutaminase (tTG) IgA autoantibodies have been reported in subjects with a genetic risk for celiac disease (CD). The aims of this retrospective study were to assess the prevalence of false-positive tTG titers in patients at risk of CD compared with symptomatic children and to evaluate the influence of age and indication for testing on tTG titers. PATIENTS AND METHODS: All tTG results measured in our institution during a 33-month period were evaluated. Patients with known CD were excluded. Indications for testing were either symptoms suggestive of CD (group 1) or history of being at risk for CD (group 2). Duodenal biopsies were recommended if titers were positive (> or =10 U/mL) and offered if borderline (> or =4 to

The recording of vaccination rates is indispensable for recognizing and closing regional immunization gaps, and for the planning, implementation and evaluation of vaccination schedules. Within the framework of school-entry examinations in Bavaria, the immunization status of every child examined is recorded, and evaluated by the Bavarian Health and Food Safety Authority. With regard to the vaccinations recommended by the STIKO, the overall immunization rate is satisfactory, although there are deficits for some types of vaccination, e. g. the second inoculation against measles, mumps and rubella. Thanks to improved vaccination documentation, the basis for a differentiated recording of vaccination rates during the school-entry examination has been created. All physicians in private practice should therefore take every opportunity to check and document vaccination status, and, where necessary, update it.

Objective: The variety of human functioning and rehabilitation research makes it difficult to overview the whole area with respect to journals, societies and conferences of potential relevance to a research question in focus. The objective of this paper is thus to provide an outline of scientific jour nals, societies and conferences of major relevance to human functioning and rehabilitation research. Methods: A systematic search for journals relevant to human functioning and rehabilitation research was performed. The resulting journal list was used to identify affiliated societies and conferences. In addition, an informal expert survey was conducted for the identification of further relevant societies, conferences and additional journals. Results: A total of 6416 journal articles referring to human functioning and rehabilitation research were identified and analysed. A total of 231 journals, 153 societies and 115 conferences relevant to human functioning and rehabilitation research were selected from the systematic search and the informal expert survey. The societies and conferences are published via the website of this journal. Conclusion: The list of journals presented will be of use to scientists entering human functioning and rehabilitation research or engaging in an interdisciplinary perspective. It may serve as an initial guide for identifying possibilities for the submission of publications, sources of scientific information and platforms for the scientific exchange and discourse.

The relationship between breast-feeding and childhood obesity is of great interest. Since 2000, sixteen studies have been published with conflicting data regarding the potential protective effect of breast-feeding on childhood obesity. A narrative review of Dewey in 2003 suggested a protective effect of breast-feeding, but an editorial in the British Medical Journal later that year cited two more recent studies without such an effect and stated there was inconclusive evidence A recent meta-analysis, however, has suggested a small, but significant, protective effect of breast-feeding. This paper summarizes this meta-analysis and discusses the strengths and limitations of the meta-analysis approach.

Background and Aims Evidence based knowledge in neonatal care has substantially increased during the last years. We tried to evaluate how well guidelines and evidence from studies have been implemented into clinical practice during the last 15 years. Methods Detailed questionnaires were sent 15 years apart to all neonatal units potentially treating VLBW infants in Germany (1995) and all German speaking countries (2010). Results The response rate was 66% both times. Whereas in 1995 2 / 3 of the units used 100% oxygen and ¼ 50% to start respiratory support in the delivery room, in 2010 only 3% and 5% of the units used 100% and 50% oxygen, respectively. Caffeine and Theophylline were used to treat apnoea of prematurity by 50% and 87% of the units in 1995 compared to 96% and 10% in 2010, respectively. Pasteurization of breast milk was done in 24% of the units in 1995 compared to 53% in 2010. In 1995, 37% of the units routinely used erythropoietin in ELBW infants compared to 27% in 2010. Conclusions Treatment of VLBW infants changed significantly within the last 15 years and some of the existing guidelines and evidence seem to be transferred into clinical practice in most units.