Dtsch Arztebl Int
-
Acute infectious enteritis is one of the more common childhood diseases worldwide, especially in the first three years of life. Every year, in Germany, one in six children under age 5 is taken to a physician at least once because of infectious diarrheal disease. 10% of the children presenting with rotavirus infection are admitted to hospital. The existing national and international recommendations for the treatment of acute infectious diarrheal disease are inadequately followed, despite the high level of evidence on which they are based. ⋯ The therapeutic goal is to replace the fluid and electrolyte losses resulting from diarrhea and vomiting. The administration of a hypotonic oral rehydration solution (ORS) is indicated to treat impending dehydration (infants aged up to 6 months with diarrhea and/or more than 8 watery stools in the last 24 hours and/or more than 4 episodes of vomiting in the last 24 hours), or when mild or moderate dehydration is already present. Oral rehydration with ORS given in frequent, small amounts over 3-4 hours is successful in more than 90% of cases. Regular feeding can be begun immediately afterward. Laboratory testing of blood or stool is usually unnecessary. Children who can be rehydrated orally or through a nasogastric tube should not be given intravenous fluids.
-
Review Meta Analysis
Angiotensin blockade to reduce microvascular damage in diabetes mellitus.
Diabetic retinopathy and microalbuminuria are often thought of as distinct disease entities despite their common pathophysiology. Many studies have addressed the prognostic significance of these conditions and their treatment. ⋯ Diabetic retinopathy and microalbuminuria are expressions of microvascular damage. They often appear together and point toward possible future macrovascular events. Multifactorial intervention can lessen the consequences of these pathological conditions.
-
The late descent of a testicle into the scrotum may impair its development. Reduced fertility is the main risk of primary cryptorchidism even after timely treatment, as histopathological changes (Leydig cell hypoplasia) already become apparent in the first few months of life. There is evidence, however, that treatment is often delayed. Hormonal and surgical treatments complement each other and should be provided before the child's first birthday. ⋯ Hormone therapy is the best initial treatment in most cases, with a few exceptions. If this is unsuccessful, surgery should be performed without delay. The success of treatment depends on the initial position of the testicle. Treatment does not lessen the risk of malignancy. Parents must be informed about this risk. The undescended testicle is the most common genital malformation in boys. When diagnosed, it should be treated hormonally and/or surgically before the child's first birthday to minimize the risk of impaired fertility. Successful treatment before age 13 appears not to lessen the risk of testicular cancer, but it does facilitate early detection by enabling physical examination of the testicle.
-
10% to 30% of all children worldwide suffer from headaches at least once a week, potentially constituting a serious health problem that may lead to impairment in multiple areas. Therefore, one aim of the epidemiological longitudinal study "Children, Adolescents, and Headache" (KiJuKo) is the study of potential risk factors for the development of recurrent headaches. ⋯ These findings are in accordance with those of other studies showing that, for boys, the frequency of quarreling in the family and the extent of leisure time are major factors in the development of recurrent headaches. For girls, the manner in which the parents respond to the child's headache seems to be important.
-
"Spice" and other herbal blends were marketed in Germany until January 2009 as substances purportedly exerting similar effects to cannabis, yet containing no cannabinoids. These products were recently forbidden in Germany under the provisions of the German Narcotics Law after they were found to contain undeclared, synthetic cannabinomimetic substances. The authors describe physical withdrawal phenomena and a dependence syndrome that developed after the consumption of "Spice." ⋯ The authors interpret the symptoms and signs described above as a dependence syndrome corresponding to the ICD-10 and DSM-IV criteria for this entity. The physical withdrawal syndrome closely resembles that seen in cannabis dependence. The authors postulate that the syndrome in the patient described was due to an admixture of synthetic cannabinomimetics such as JWH-018 and CP 47497 in "Spice Gold," in combination with the patient's daily consumption in very large amounts.