Zentrum für Kinderheilkunde

Background Despite growing scientific evidence and health guidelines, the global health paradox persists, with rising lifestyle-related diseases and escalating healthcare costs exposing the inadequacy of current efforts. Objective Three multidisciplinary congresses were held to generate evidence-based conclusions aimed at addressing the global health paradox. Methods A total of 58 experts from 62 entities participated in the international research and knowledge-exchange panels. Experts reviewed the latest findings to develop practical strategies and identify key research and policy priorities, focusing on the Healthy Eating & Active Living (HEAL) approach. Results, conclusion, and relevance The expert consortium endorsed a 33 evidence-based consensual-statement policy roadmap for addressing global health challenges, emphasizing that the HEAL approach can significantly contribute to the “Prevention First” appeal and broad ethical, social, ecological, and economic advantages, and ultimately supporting policy change.

The treatment of systemic lupus erythematosus in childhood and adolescence (juvenile SLE) requires patient-oriented multidisciplinary care that takes the heterogeneity of the disease into account. For adults, adolescents and children, the treat to target (T2T) approach is becoming established as the basis for SLE treatment with the aim of achieving remission. This requires patients and families to be empowered to decide on treatment hand in hand with the care team through participatory decision making. The S2‑k guidelines on juvenile SLE enables a state-of-the-art care for patients with jSLE in routine clinical practice. The article explains the key areas of treatment management and the particular challenges in the care of jSLE patients based on these guidelines. Aparticular focus is placed on the actual implementation and interdisciplinarity. The recommendations of these guidelines were developed based on the T2T principle and participatory decision-making process by amultiprofessional team of experts in this field in accordance with the rules of the Association of Scientific Medical Societies in Germany (AWMF). The consensus comprises 2 core statements, 11 overarching principles (OAP), 12overarching treatment strategies (OATS) and 40recommendations. In addition to defining treatment goals, the clinical challenge is the development of treatment strategies that are in agreement with patients and their families. There is alack of evidence in this area. This makes it all the more important to regularly revisit and evaluate both, taking the disease damage, medication side effects, comorbidities and the achievement of agood quality of life into account.

Protocols concerning classification, monitoring and treatment were developed for the oligoarticular form of juvenile idiopathic arthritis (JIA) as part of aconsensus process. The group of authors formulated 23statements and circulated them in an online survey to medical members of the Society for Paediatric and Adolescent Rheumatology (GKJR). Atotal of80 of the 124 paediatric and adolescent rheumatologists took part in the survey, which corresponds to just under 65% of the paediatric and adolescent rheumatologists who were active at the time. In afinal online meeting, comments from the survey were incorporated into the statements and then agreed upon by the group of authors. For newly occurring oligoarticular JIA, 20statements and asummary consensus treatment protocol were developed to optimise the treatment of persistent oligoarticular JIA.

ZusammenfassungJungen mit Klinefelter-Syndrom (KS) zeigen trotz durchschnittlicher Intelligenz häufig spezifische schulische Schwierigkeiten, insbesondere im sprachlichen, kognitiven und sozialen Bereich. Der folgende Beitrag beleuchtet die psychologischen Aspekte des KS im schulischen Kontext und beschreibt häufige Herausforderungen sowie mögliche Unterstützungsmaßnahmen. Ein Fallbeispiel veranschaulicht typische Problemfelder. Ziel ist es, pädiatrisch tätige Fachpersonen für das vielfältige Erscheinungsbild des KS zu sensibilisieren und Empfehlungen für die schulische Förderung zu geben.

Psychosomatik in der Pädiatrie erfüllt wesentliche Aufgaben in der Behandlung von Kindern und Jugendlichen mit akuten und chronischen Erkrankungen, Somatisierungsstörungen und neurotischen Symptombelastungen. Der Beitrag beschreibt ein innovatives Konzept der Versorgung zwischen Kinderheilkunde, Psychotherapie und Pädagogik. Anhand einer Fallvignette aus der stationären Therapie werden typische Fragestellungen und produktive Krisen in Behandlungsprozessen skizziert. Perspektiven einer empirischen Evaluation dieser Verläufe werden aufgezeigt. Die besonderen Herausforderungen dieses interdisziplinären Konzepts für Behandler werden im Kontext typischer Gegenübertragungsreaktionen herausgearbeitet. Es zeigt sich, dass pädiatrische Psychosomatik ein besonders relevantes und anspruchsvolles Gebiet der Psychosomatik darstellt.