Possibilities and challenges of a large international benchmarking in pediatric diabetology-The SWEET experience.

Aim: Despite the existence of evidence-based guidelines for the care of children with diabetes, widespread gaps in knowledge, attitude, and practice remain. The purpose of this paper is to present a review of benchmarking practices and results of this process within SWEET, moreover focusing on current challenges and future directions.

Methods: Biannually, members electronically transfer de-identified clinic data for 37 parameters to the SWEET database.

Assessment of quality of life in adolescent patients with cancer and adolescent survivors of childhood cancer.

Purpose: The aim of the study was to assess the quality of life (QoL) of adolescents with cancer and survivors of childhood cancer as well as the effect of various demographic factors upon it.

Design And Methods: The sample of the study included 82 adolescents aged 13-20 years who had been diagnosed with any type of cancer. Twenty-six of them received treatment and 56 survivors of childhood cancer had successfully completed their treatment.

Perceptions of children and their parents about the pain experienced during their hospitalization and its impact on parents' quality of life.

Objective: The aim of the study was to assess pain levels and perceptions concerning pain by both children and their parents during hospitalization, as well as the impact of that pain upon parents' quality of life.

Methods: The sample of the study consisted of 92 pediatric cancer patients, 159 pediatric patients with musculoskeletal problems and one of their parents. The study was performed between November 2010 and May 2011.

Surgical management of congenital torticollis in children older than 7 years with an average 10-year follow-up.

The aim of the present study is to present the results of the surgical management of late presenting cases of congenital muscular torticollis. Between 1990 and 2010, 31 cases of late presenting congenital muscular torticollis were managed surgically in our department. Postoperatively, head halter traction was applied for 10 days; a cervical brace was applied for 5 weeks, followed by a soft one collar for 3 months.

Long-term outcome of pediatric kidney transplantation: A single-center experience from Greece.

Pediatric kidney Tx has critically altered the outcome in ESRD pediatric patients. The aims of this study were to determine long-term graft and patient survival in a homogeneous ethnic population. We reviewed the medical charts of pediatric kidney Tx performed between 1990 and 2012 in Greece.

Assessment of quality of life of children and adolescents with cancer during their treatment.

Objective: The purpose of this study was to evaluate the quality of life of children and adolescents with any type of cancer in all phases of their treatment.

Methods: Fifty-six newly diagnosed patients diagnosed with malignancy and hospitalized in a Pediatric Hematology-Oncology Unit in Athens were included in the study. Minneapolis-Manchester Quality of Life Instrument was used for data collection from July 2010 to December 2012.

Gluten Introduction and the Risk of Coeliac Disease: A Position Paper by the European Society for Pediatric Gastroenterology, Hepatology, and Nutrition.

Background: The European Society for Paediatric Gastroenterology, Hepatology and Nutrition recommended in 2008, based on observational data, to avoid both early (<4 months) and late (≥7 months) introduction of gluten and to introduce gluten while the infant is still being breast-fed. New evidence prompted ESPGHAN to revise these recommendations.

Objective: To provide updated recommendations regarding gluten introduction in infants and the risk of developing coeliac disease (CD) during childhood.

Treatment for spondylolysis and spondylolisthesis in children.

Purpose: To review outcome of 44 children who underwent conservative or surgical treatment for spondylolysis or spondylolisthesis.

Methods: Records of 25 male and 19 female children aged 5 to 14 (mean, 10.2) years who underwent conservative (n=39) or surgical (n=5) treatment for spondylolysis (n=19) or spondylolisthesis (n=25) were reviewed.

Body composition of patients with Duchenne muscular dystrophy: the Greek experience.

Unlabelled: Greece ranks among the first countries suffering from the obesity epidemic globally. The aim of the study was to evaluate body composition in Greek patients with Duchenne muscular dystrophy (DMD). We hypothesized that able-bodied patients would not differ from controls, in terms of adiposity, based on clinical observations during everyday practice.

Pediatric Masked Mastoiditis Associated with Multiple Intracranial Complications.

Masked mastoiditis is a distinct form of mastoiditis with little or no symptomatology, characterized by its potential to generate severe otogenic complications. Therefore, suspected masked mastoiditis should be diagnosed and treated without delay. This study reports a rare case of masked mastoiditis, manifested by multiple intracranial complications in an immunocompetent girl.

Valproate in the treatment of epilepsy in girls and women of childbearing potential.

This document provides guidance on the use of valproate in girls and women of childbearing age from a joint Task Force of the Commission on European Affairs of the International League Against Epilepsy (CEA-ILAE) and the European Academy of Neurology (EAN), following strengthened warnings from the Coordination Group for Mutual Recognition and Decentralised Procedures-Human (CMDh) of the European Medicines Agency (EMA), which highlight the risk of malformations and developmental problems in infants who are exposed to valproate in the womb. To produce these recommendations, the Task Force has considered teratogenic risks associated with use of valproate and treatment alternatives, the importance of seizure control and of patient and fetal risks with seizures, and the effectiveness of valproate and treatment alternatives in the treatment of different epilepsies. The Task Force's recommendations include the following: (1) Where possible, valproate should be avoided in women of childbearing potential.

Open reduction internal fixation of lateral humeral condyle fractures in children. A series of 105 fractures from a single institution.

Lateral humeral condyle fractures account for 17 % of the distal humeral condyle fractures. Displaced and/or rotated fractures require appropriate reduction and stabilisation. There are, however, a number of controversies in the surgical management of these patients.

European Society for Pediatric Gastroenterology, Hepatology, and Nutrition syllabus for subspecialty training: moving towards a European standard.

The requirements for and conditions of subspecialty training in paediatric gastroenterology, hepatology, and nutrition (PGHN) are rather variable across European countries. The European Society for Pediatric Gastroenterology, Hepatology, and Nutrition (ESPGHAN) agreed on a training syllabus aimed to foster a harmonised European PGHN curriculum and to support national PGHN societies and governmental bodies to promote and establish high-quality training programmes and levels of certification in the field. The document provides PGHN training prerequisites and objectives and the basic knowledge elements to acquire the clinical, technical, and management skills needed.

Do pediatricians apply the 2009 NASPGHAN-ESPGHAN guidelines for the diagnosis and management of gastroesophageal reflux after being trained?

Background: According to a recent survey, the 2009 North American Society for Pediatric Gastroenterology, Hepatology, and Nutrition-European Society for Pediatric Gastroenterology, Hepatology, and Nutrition gastroesophageal reflux guidelines are poorly adhered to by European primary care pediatricians. The main issue raised from the survey was the prescription of unnecessary acid suppressive medications, especially in infants. No inquiry into the reasons was made.

Successful management of a small infant with Kasabach-Merritt phenomenon using vincristine: a case report.

Kasabach-Merritt Phenomenon (KMP) is characterized by profound thrombocytopenia, microangiopathic haemolytic anaemia and consumptive coagulopathy in the presence of an enlarging vascular lesion. The syndrome usually develops in infancy and is associated with a high morbidity and mortality rate. We report a case of successful management of refractory KMP in a very small infant with the use of vincristine.

European pediatricians' approach to children with GER symptoms: survey of the implementation of 2009 NASPGHAN-ESPGHAN guidelines.

Objective: The aim of this study was to evaluate the current implementation of the 2009 North American Society for Pediatric Gastroenterology, Hepatology, and Nutrition-European Society for Pediatric Gastroenterology, Hepatology, and Nutrition guidelines, and to assess proton pump inhibitors' (PPIs) prescribing patterns among pediatricians from different European countries.

Methods: A randomly identified sample of general pediatricians distributed across 11 European countries. They were asked to complete a case report-structured questionnaire investigating their approaches to infants, children, and adolescents with symptoms suggestive of gastroesophageal reflux.

Peripherally inserted central venous catheters: frequency of complications in premature newborn depends on the insertion site.

Objective: The use of peripherally inserted central venous catheters (PICC lines) has reduced the mortality and morbidity of premature newborns. The usual sites of insertion are the veins in the upper arms but other locations are being used as well.

Study Design: To examine whether using the axillary vein as a site of insertion of a PICC line affects the frequency of complications.

Management guidelines of eosinophilic esophagitis in childhood.

Objectives: Eosinophilic esophagitis (EoE) represents a chronic, immune/antigen-mediated esophageal disease characterized clinically by symptoms related to esophageal dysfunction and histologically by eosinophil-predominant inflammation. With few exceptions, 15 eosinophils per high-power field (peak value) in ≥1 biopsy specimens are considered a minimum threshold for a diagnosis of EoE. The disease is restricted to the esophagus, and other causes of esophageal eosinophilia should be excluded, specifically proton pump inhibitor-responsive esophageal eosinophilia.

Adolescent immunization.

During the last century National Immunization Program (NIP) were implemented worldwide. The program started with a small number of vaccines for universal administration to infants and young children. In the second half of the century an evolution (slow in the start and rapid later) occurred in the structure of NIPs especially in developed countries.

Pediatric Monteggia fractures: a single-center study of the management of 40 patients.

Introduction: Early identification and conservative management of pediatric Monteggia fractures has been shown to correlate with good results. Nevertheless, several authors advocate more aggressive management with open reduction and internal fixation (ORIF) for unstable fractures. We herein present the experience of a tertiary pediatric hospital in the management of Monteggia fractures.

Parental attitudes towards head lice infestation in Greece.

Background: Pediculosis capitis constitutes a growing problem worldwide and is usually considered as an inconvenience. Parents often handle this infestation on their own initiative.

Objective: We conducted a survey in order to depict the parental attitudes towards head lice infestation in Greece.

Serial plasma concentrations of PYY and ghrelin during chemotherapy in children with acute lymphoblastic leukemia.

Purpose: To investigate peptide YY (PYY) and ghrelin secretion, at diagnosis and during chemotherapy in children with acute lymphoblastic leukemia (ALL).

Patients And Methods: Measurements were performed at diagnosis, after the induction-consolidation phase and at standard time points before each cycle in 9 patients with ALL aged 2 to 7 years (median 4.3 y).

[Liaison child psychiatry and the interpersonal relationships in the context of the general child hospital].

The staff of a big general hospital is a community of people with all the alliances and conflicts developing within it. The child psychiatrist works primarily with the pediatricians and the nurses but also with other specialized people of this community. Pediatricians require a prompt answer to their call, clarity of communication and effectiveness.