Kinderkrankenhaus auf der Bult

Skin diseases can greatly impair quality of life (QoL) of pediatric patients and their families. The Infants and Toddlers Dermatology Quality of Life questionnaire (InToDermQoL) is the first skin-generic instrument assessing QoL in children ≤4years, as reported by their caregiver. This study aimed to psychometrically validate the German version of the InToDermQoL. The psychometric properties of the InToDermQoL were examined in a sample of 148 children with various skin diseases (age groups [n]: <1 [44]; 1-2 [68]; 3-4 [36]). Exploratory factor analysis suggested a unidimensional structure of the version for children <1year, and a two- and three-factor structure for the two older age groups, respectively. Internal consistency was excellent (Cronbach's alpha, 0.904-0.922). Two-week test-retest reliability was good, except in children aged 1-2 years (intraclass correlation coefficient [ICC], 0.430). The InToDermQoL demonstrated good convergent validity with other QoL questionnaires. The German InToDermQoL is a valid and reliable QoL measure in children ≤4years with any skin disease. Application of the tool in research and clinical practice will contribute to a better understanding of the impact of pediatric dermatoses, and optimize care and support for affected families.

BackgroundAdolescents and young adults (AYA) with rare forms of diabetes – including Wolfram syndrome (WS), Alström syndrome (AS), Bardet-Biedl syndrome (BBS), and maturity-onset diabetes of the young (MODY) – face unique challenges during the transition to adult care. These challenges are intensified by multisystem endocrine involvement, neurocognitive and sensory impairments, and limited adult provider expertise.ObjectiveThis narrative review describes transition-specific barriers in rare diabetes syndromes, explores current initiatives, and proposes recommendations for care models and health system reform.Key issuesSyndromic forms of diabetes often involve complex endocrine dysfunctions beyond glycemic control, including diabetes insipidus, hypogonadism, and thyroid or pituitary anomalies. Transitions are further hindered by diagnostic uncertainty, fragmented care structures, and insufficient interdisciplinary coordination. Pediatric care is often proactive and family-centered, while adult services are fragmented and reactive. Dedicated multidisciplinary transition services remain scarce.RecommendationsBest practices include early transition planning, syndrome-specific education, the use of patient-reported outcome measures (PROMs), and integration of digital tools. Structured collaboration between pediatric and adult providers – including virtual models – should be supported. Patient-centered approaches must address both medical and psychosocial readiness, with tailored communication for those with sensory or cognitive impairments.Health system and policy needsSustainable transition programs require dedicated funding, institutional prioritization, and policy inclusion in national and European rare disease frameworks. Without adequate financial support, disparities in care continuity and outcomes are likely to persist.ConclusionA coordinated, multidisciplinary, and resourced transition model is essential to safeguard health, autonomy, and long-term outcomes in AYA with rare diabetes syndromes.Plain language summaryYoung people with rare forms of diabetes – such as Wolfram syndrome (WS), Alström syndrome (AS), Bardet-Biedl syndrome (BBS), or maturity-onset diabetes of the young (MODY) – face special challenges when moving from pediatric to adult healthcare. These rare conditions often affect more than just blood sugar and can involve vision, hearing, and other parts of the body. As they grow older, these adolescents must not only manage their complex health needs but also learn to take more responsibility for their care. This article explains why the transition to adult care is especially difficult for this group. It shares experiences from families and healthcare providers and describes what can help: early preparation, teamwork between child and adult doctors, digital tools, and emotional support. The authors call for stronger guidelines and better cooperation across healthcare systems so that young people with rare diabetes can stay healthy and feel supported during this important time in life.Graphical abstract

BackgroundChildhood obesity is a growing global health crisis, driven by poor diet, reduced physical activity, and psychosocial distress. The COVID-19 pandemic amplified these factors, contributing to rising BMI and impaired health-related quality of life (HrQoL). Telehealth offers a promising, scalable modality to deliver multimodal obesity care. This study evaluated the long-term effectiveness of a structured pediatric telehealth intervention compared to historical in-person treatment.MethodsThis retrospective cohort study analyzed data from 237 children and adolescents with obesity treated at a single academic center. Between 2020 and 2022, 117 participants received a 12-month structured lifestyle intervention via telehealth. A historical cohort (n = 120; 2017–2019) received the same intervention in person. Clinical outcomes were assessed at baseline and after 12 months; the telehealth group was additionally followed up at 24 and 36 months. Primary outcome was change in BMI standard deviation score (BMI SDS). Secondary outcomes included physical fitness (6-min walk test), insulin resistance (HOMA index), lipid profile, dietary behavior (K-FFL), eating regulation (K-FEV), and HrQoL (KINDL-R).ResultsBoth groups achieved significant reductions in BMI SDS after 12 months, with sustained improvements in the telehealth group through 36 months (Δ = −0.18; p < 0.05). Physical performance and HOMA index improved in both cohorts. Telehealth participants showed greater improvements in healthy dietary behavior, cognitive appetite regulation, and Health-related quality of life HrQoL, especially in emotional and family domains. No adverse events occurred; adherence exceeded 85 %.ConclusionA structured telehealth lifestyle intervention is safe, effective, and sustainable for pediatric obesity management. These findings support telehealth as a clinically viable and sustainable model for pediatric obesity care, recognizing that both weight reduction and weight stabilization may contribute to improved long-term outcomes.

Abstract Food allergies are associated with considerable psychosocial stress and restrictions in quality of life. While parents often report food allergies in their children, studies show that the perceived prevalence is often higher than the actual diagnosed prevalence. Epidemiological studies show an increasing prevalence worldwide, with significant regional differences. In Europe, self-reported prevalence varies widely, from less than 1% to over 10%, depending on region, age and foods analysed. In North America and Northern Europe, peanut and egg allergies are more common, while shellfish and fish allergies dominate in Asia. Environmental factors, ethnicity, genetic predisposition, dietary habits and socioeconomic conditions play a significant role in the development and distribution of food allergies. These factors must be taken into account when developing prevention and treatment strategies.

ABSTRACTBackgroundFood allergies are a major health concern with rising prevalence. Dietary habits are changing, and information about cashew‐induced anaphylaxis is limited.MethodsCases of tree nut‐induced anaphylaxis (TIA) registered from 2007 until April 2024 were extracted from the European Anaphylaxis Registry and analyzed.Results1389 cases of TIA out of 5945 registered food‐induced reactions (23%) were identified. 1,083 cases with confirmed elicitor status, including 845 children (median age 4 years, 61% male) and 238 adults (38 years, 40% male), were selected for further analysis. The most frequent elicitors among children were cashew (n = 334), hazelnut (n = 211) and walnut (n = 146). The proportion of cashew‐induced anaphylaxis increased from 2007 to 2024, and reactions were frequently caused by small amounts (< 1 teaspoon). Adults reacted frequently to hazelnut (n = 105), walnut (n = 47) but also almond (n = 35) and to higher amounts. Potential cofactors were present in 50% of the adult patients and 17% of children. The reaction severity was age‐independent, and only a minority of patients was previously aware of their allergy (children 23%, adults 21%). The use of adrenaline was low in lay treatment (children 13%, adults 3%) and reached approximately 40% upon professional treatment.ConclusionCashew is an increasing, relevant allergen leading to anaphylaxis and is now the most frequent cause of TIA among children. These findings highlight the need for effective prevention and treatment measures. Almond was a frequent elicitor among adults and should be further monitored. The acute management requires improvement to comply with current guidelines.

Automated insulin delivery (AID) systems, which consist of an insulin pump, a continuous glucose monitoring system and a software algorithm to automate insulin delivery based on real time glycaemic data, are rapidly evolving. AID is now strongly recommended as the insulin delivery method of choice for people with type 1 diabetes. This article reviews the features and current multinational availability of the Omnipod® 5 Automated Insulin Delivery System and summarizes the latest evidence in support of its efficacy, safety and optimal use. It also provides a series of clinical vignettes illustrating advanced issues related to the initiation and ongoing optimization of insulin therapy using the system, including how to personalize settings and optimize glycaemic outcomes in a variety of clinical circumstances.