Universitäts Kinder Frauenzentrum

Mastocytoses are characterized by clonal proliferation of mast cells in various tissues. In childhood, cutaneous mastocytosis (CM) occurs almost exclusively. It is confined to the skin, and has a good prognosis. The most common form is the maculopapular cutaneous mastocytosis (MPCM), formerly called urticaria pigmentosa. A distinction is made between a monomorphic variant of MPCM with multiple small, roundish maculopapular skin lesions and the - more common - polymorphic variant with larger lesions of variable size. One quarter of CM diagnosed in childhood are mastocytomas, which often occur solitary or at multiple sites. The diffuse variant of CM (DCM), which affects 5% of children with CM, should be distinguished from these forms. Systemic mastocytoses (SM) with mast cell infiltrates in the bone marrow or other extracutaneous tissues, such as the gastrointestinal tract, occur predominantly in adults. The diagnosis of CM is usually made clinically: Manifestation in infancy, typical morphology and distribution, pathognomonic Darier sign. Basal serum tryptase is determined if DCM or systemic mastocytosis are to be diagnosed. Children with mastocytosis should be managed in a specialized outpatient clinic. For affected families, detailed information about the clinical picture including prognosis assessment is essential. Mast cell mediated symptoms are controlled by oral non-sedating antihistamines if needed.

In diesem Beitrag widme ich mich der Frage nach den konkreten Belastungen für Wissenschaftler:innen im Forschungsfeld zu sexualisierter Gewalt. Im deutschsprachigen Raum wird sich im Unterschied zur internationalen Forschungslandschaft wenig mit der Rolle von Traumatisierungen in der qualitativen Forschung auseinandergesetzt, obwohl dies mit Blick auf die Prävalenzen in diesem Feld nahezu unumgänglich ist. Ausgehend von dieser Annahme stelle ich die Ansätze der Psychotraumatologie und deren Konzepte der sekundären Traumatisierung, der compassion fatigue theory und des vicarious trauma vor. Diese verknüpfe ich im Anschluss an Georg SIMMEL, Max WEBER, Georges DEVEREUX und der feministischen Tradition mit den Überlegungen zu den erkenntnistheoretischen Möglichkeiten der eigenen Vulnerabilität. Ich plädiere für eine traumasensitive qualitative Forschung insbesondere im Feld sensitiver Themen, um die Belastungen und vor allem erkenntnistheoretischen Chancen der Forschenden in den Blick zu nehmen.

In diesem Beitrag beschftigen wir uns mit der Frage, inwiefern die Wohnsituation einen Effekt auf die Integration und das Wohlbefinden von Geflchteten hat. Quantitative und qualitative Forschungen zu Geflchteten beziehen sich vorwiegend auf in Sammelunterknften lebende Personen. Welche Vernderungen mit dem Erhalt einer eigenen Wohnung einhergehen und welchen Effekt die

Longitudinal research on the adverse consequences of childhood maltreatment has recently gained significant traction. However, systematic attrition, partly due to specific subsample recruitment needs, threatens the validity of this research. Furthermore, studies specifically analyzing these factors in the field of maltreatment research remain scarce. We utilized data from a longitudinal study comprising N = 863 participants ( M Age = 10.23 years, 47.5% female) and their caregivers at T1, and 616 participants ( M Age = 17.95 years, 50.0% female) at T2. We determined the attrition rate and analyzed psychosocial and socioeconomic predictors of attrition. Additionally, we examined differences in re-assessment efforts between maltreated and non-maltreated youth for T2. Findings indicate a comparatively low attrition rate of 28.6% over nearly 8 years. Participants’ maltreatment experiences, externalizing symptoms, and lower household income predicted higher attrition risk, while interim subsample study participation reduced this risk. Maltreatment experiences, lower household income, and higher age were also associated with increased re-assessment effort. Our study provides insights into predictors of systematic attrition in a longitudinal study with maltreated and non-maltreated youth. It highlights the need for tailored retention strategies, frequent contact with families, and targeted resource allocation to mitigate systematic attrition.

Study question: Does intracervical and intravaginal application of seminal plasma affect endometrial and subendometrial vascularisation, endometrial volume or life birth rate?

BACKGROUND: Early warning scores (EWS) are considered an effective tool for the early detection of clinical deterioration in hospital settings. However, their implementation poses complex demands on institutional structures, processes, and culture. METHODS: As part of a modified Delphi study, experts from the Initiative Qualitätsmedizin network with practical experience in EWS implementation were invited to identify necessary structures, processes, and common pitfalls across the project phases of preparation, implementation, evaluation, and anchoring. In three rounds, recommendations were collected, thematically clustered, and rated (0-10, 10 = maximally relevant). Finally, the recommendations were consolidated in a consensus meeting. RESULTS: Eight participants completed all rounds. From 505 responses, 51 consolidated recommendations were identified, all considered as highly relevant (≥ 7 points) in the various rounds. Top priorities were the training of all professional groups (mean 9.3) and transparent communication of results and actions (mean 9.0). Common barriers included lack of information technology (IT) integration, unclear responsibilities, and insufficient feedback. Key success factors were interdisciplinary project teams, early evaluation, and embedding into clinical routines. CONCLUSION: The consensus-based recommendations can support decision-makers in the systematic implementation of EWS. Structured project planning, interprofessional training, and continuous feedback are key success factors. For sustainable integration, EWS should be embedded into quality systems, continuing education, and clinical routines.

Zusammenfassung Für die Insomnie im Kindes- und Jugendalter ist wie für die Erwachsenen auch die kognitive Verhaltenstherapie für Insomnie (CBT‑I; deutsch KVT-I) die erste Wahl, jedoch ist sie für die Familien, Kinder und Jugendliche oft nicht ohne Weiteres verfügbar. Das hier präsentierte Stepped-Care-Modell für das Kindes- und Jugendalter (SCM-KJ; englisch SCM-CA) stellt ein Stufenmodell zur vernetzten und evidenzbasierten Versorgung von Kindern und Jugendlichen mit Insomnie dar. Das SCM-KJ berücksichtigt die unterschiedlichen Altersgruppen und stellt eine Präventions- und Interventionspyramide dar, die auf dem Konzept des gesunden Schlafs und der CBT‑I für Kinder und Jugendliche basiert und allmählich an klinischer Intensität und Komplexität zunimmt. Hierdurch sollen diagnostische und therapeutische Behandlungslücken verringert werden, sodass nicht nur mehr Familien erreicht werden können, sondern auch die klinischen Ressourcen effektiver verteilt werden können. Damit das SCM-KJ angemessen umgesetzt wird, sollten altersspezifische Diagnostikinstrumente und Wissen verbreitet werden. Es sollten nur evidenzbasierte CBT-I-Behandlungen für das Kindes- und Jugendalter im Rahmen des Modells gefördert werden. Die im Rahmen des SCM-KJ beteiligten Kliniker*innen sollten qualifiziert sein, um CBT im Kindes- und Jungendalter (CBT-KJ) durchführen zu können, und über eine entsprechende Fortbildung verfügen. Fachkräfte, die im Rahmen von Präventionsprogrammen oder frühen Interventionen beteiligt sind, die nicht im engeren Sinne zum Behandlungsspektrum des SCM-KJ gehören, aber damit in Verbindung stehen, sollten ebenfalls über gute Diagnostikkenntnisse und differenzialdiagnostisches Wissen verfügen, um eine korrekte Zuweisung oder Weiterleitung zu den entsprechenden Interventionsmöglichkeiten zu gewährleisten.

OBJECTIVE: To examine whether the rate of HLA similarity among 609 primarily infertile couples is higher than would be expected by chance. DESIGN: Clinical Trial. SUBJECTS: 609 primary infertile couples (mean age women: 34.35 years, men: 37.59 years) were recruited before undergoing IVF or ICSI therapy. Couples with former pregnancies, tubal factor, azoospermia or donor therapies were excluded. INTERVENTION: For each of the partners, exons encoding the corresponding antigen recognition sites of HLA-A, -B, -C, -DRB1, -DQB1, and -DPB1 were sequenced by using next-generation sequencing. HLA similarity between partners was determined based on the probability of homozygous offspring and the observed probability of heterozygous offspring in the sample of primary infertile couples was comparted to the probability for random pairing using bootstrapping. MAIN OUTCOME MEASURES: HLA similarity of infertile couples compared to randomly assigned couples. RESULTS: In each of the loci, infertile pairs shared more alleles than expected by chance. This result was significant for all HLA class 2 loci (-DRB1, -DQB1, -DPB1), as well as for the HLA class I locus -C, while HLA-A and -B showed a nonsignificant trend towards higher similarity. CONCLUSION: These data suggest that HLA similarity between couples relates to primary infertility.

Neue Schumanniana

INTRODUCTION: Safe initial surgery is crucial in treating ectopic ureteroceles that cause subvesical obstruction. This study evaluates the feasibility and effectiveness of pneumovesicoscopic incision of ectopic ureteroceles. METHODS: We conducted a cohort study analyzing outcomes in patients with ectopic ureteroceles and bladder neck obstruction who underwent pneumovesicoscopic surgery between 2013 and 2022. During vesicoscopy, the obstructing portion of the ureterocele adjacent to the bladder neck was resected. Postoperatively, patients were assessed for vesicoureteral reflux and voiding dysfunction. RESULTS: Fourteen patients aged 0-10 years underwent the procedure safely. Ten girls presented with duplex kidneys, and four boys had single moieties. The mean operative time was 57 min. Postoperative resolution of subvesical obstruction was achieved in all cases (100 %). The median follow-up was 5.9 years. Preoperative voiding dysfunction, observed in nine patients, improved in all and completely resolved in four. CONCLUSION: The pneumovesicoscopic approach appears to be a safe and effective surgical option for pediatric patients with obstructive ureteroceles.

Abstract Driven by the electrification of industries and economic, the global demand for electricity is anticipated to rise in the coming decades. In this framework there is a growing interest in fusion energy devices as a sustainable energy solution. Among the different concepts, SPARC stands out as one of the most promising ones: a compact high – field tokamak built with high temperature superconductors (HTS) with the ambitious goal of being the world’s first confined net energy fusion system (Q>1) [1]. In this quest, Commonwealth Fusion Systems (CFS) has developed groundbreaking HTS magnets that enable for significantly stronger magnetic fields in the plasma that permit for a much smaller device size. However, with these technical solutions, a critical need arises for structural materials capable of withstanding significantly higher stresses to counteract the increasing Lorentz forces in smaller sections. Under these extreme conditions, FXM-19 austenitic stainless steel, known for its exceptional strength and corrosion resistance, has emerged as a promising candidate for structural components within these compact devices. FXM-19, a nitrogen-strengthened austenitic stainless steel, exhibits a promising combination of mechanical properties at cryogenic temperature, but it necessitates precise forging techniques for its full utilization in large scale components. Through extensive cryogenic material characterization at 4 K, including tensile testing and fracture toughness assessment, this study provides critical insights into the behaviour at low-temperature of FXM-19. Additionally, microstructural and chemical analysis, contribute to a comprehensive understanding of FXM-19’s properties and its potential as structural component for high field tokamaks. These findings deepen our comprehension of this high strength austenitic stainless-steel grade, crucial for fusion energy applications.

Fragestellung: Die Hepatische Enzephalopathie (HE) zeigt in höheren Stadien eine große Bandbreite motorischer Symptome wie Ataxie, Mini-Asterixis und Asterixis. Inwieweit bereits bei Leberzirrhotikern ohne HE und in frühen HE-Stadien motorische Symptome vorliegen, ist jedoch bislang nicht bekannt.

En præsentation og eksemplificering af begrebet erindringssted med udgangspunkt i svenskernes mislykkede storm på København den 11.2.1659 og de efterfølgende 350 års fejring og politiske brug af begivenheden.

The article "Social management in the system of providing assistance to victims of domestic violence: the experience of the Paula Panke Women's Center (Paula Panke e. V.) in Berlin (Germany)" investigates the role and features of management in ensuring the high-quality provision of social assistance to women who have experienced domestic violence. The relevance of the topic is determined by the severity of the problem of violence against women, which requires systemic regulation and the minimization of serious psychological and social consequences. The aim of the article is to define the role of management in ensuring effective assistance to women who have suffered from domestic violence and to analyze management practices using the German center Frauenzentrum Paula Panke e.V. as an example. The author establishes that quality management is a fundamental prerequisite for forming a clear system of procedures, control, and rules that ensures the effectiveness and transparency of a social organization's activities. Management is viewed as a complex set of functions covering the planning, organization, execution, and control of resources, and it consists of managerial, financial, operational, informational, logistical, investment, and other subsystems. A special emphasis is placed on the analysis of external and human resource (HR) management. External management is a critically important link that ensures the informing of target groups, feedback, and the adjustment of programs according to clients' needs. The specifics of the center's HR management include the selection of specialists capable of working in a multicultural environment, as well as systematic prevention of staff emotional burnout. The author concludes that effective management of a women's center must be dynamic, adaptive, and human-centered, aimed at creating a safe environment. The experience of Frauenzentrum Paula Panke e.V. demonstrates that the management system is not just a mechanism for ensuring operations but also a key prerequisite for minimizing harm from violence and the successful social reintegration of women.

Abstract Background Sleep problems are common in infancy, childhood, and adolescence, affecting up to 30% of individuals. Parents often seek help for such problems, for example by consulting their pediatrician. In addition to child and adolescent psychotherapists and specialists in sleep centers educated in classical cognitive behavioral therapy (CBT), treatments are also offered by sleep coaches on the internet. However, the quality and content of these offers remain unclear. Methods In this study, the websites of 153 pediatric sleep coaches in Germany, Austria, and Switzerland were screened with regard to aspects such as educational background, training, sleep-related services, screening and diagnostics, and types of treatment for sleep disturbances offered as well as regarding media presence. All authors were involved in this process. Results Of the 153 pediatric sleep coaches, 25.5% had a medical or psychological background, 7.3% a health-related background, 23.5% a pedagogical background, and 13.1% had other backgrounds; 35.9% offered no information about their background. Whereas 72.5% of the sleep coaches reported having participated in a sleep coach training, 27.5% did not mention any form of sleep-treatment education; 63.4% mentioned no sleep certification, but 32.7% reported some kind of certification. Coaches with a medical or health-related background were less likely to have participated in a sleep training. The addressed sleep problems were mostly related to insomnia. The target group was most often babies. As a screening or diagnostic procedure, only the sleep log was mentioned. Most sleep coaches offered single sessions. Costs for sessions ranged from 20 up to 199 €. A huge number of pediatric sleep coaches were active on social media. Conclusion This study provides a critical overview of pediatric sleep coaches in German-speaking countries. We hope that these preliminary observations will inspire additional research and discussion on this important topic, e.g., on educational processes or networking structures, as has been mentioned in the stepped-care model for childhood insomnia.

Regina Ille-Kopp: Württembergischer Schützenverband 1850-2000. Von der Stadtverteidigung zum Schießsport: Württembergs Schützenwesen seit dem Mittelalter. Hrsg, vom Württembergischen Schützenverband 1850 e.V. Konrad Theiss Verlag Stuttgart 2000. 272 Seiten mit zahlreichen, meist farbigen Abbildungen. Gebunden DM 69,-