[Failure to thrive in childhood].

Failure to thrive is a state of malnutrition in a child due to inadequate caloric intake, inadequate caloric absorption, or excessive caloric expenditure. This all can lead to underweight and retarded growing, but also to a possible impairment of the immune system, as well as an impairment of the psychomotoric and cognitive development of a child. The aim of this article is to offer sound knowledge to the practising physician about definition, prevalence, etiology, diagnostic evaluation and therapy of failure to thrive.

[Follow up care of the preterm infant].

The birthrate of preterm infants in Switzerland has remained stable over the last few years with 7.3 % of all live births in 2011. Although outcome and survival have significantly improved in the last decades, morbidity and mortality of preterm infants are still challenging the health care system.

Recommendations for reporting results of diagnostic genetic testing (biochemical, cytogenetic and molecular genetic).

Genetic test results can have considerable importance for patients, their parents and more remote family members. Clinical therapy and surveillance, reproductive decisions and genetic diagnostics in family members, including prenatal diagnosis, are based on these results. The genetic test report should therefore provide a clear, concise, accurate, fully interpretative and authoritative answer to the clinical question.

[Fever without focus and fever of unknown origin in childhood].

Fever is one of the most common presenting symptoms in children. In the majority of cases the underlying cause is easily diagnosed and if necessary a treatment initiated. In case of absent localising symptoms and signs (fever without a focus) investigations rapidly need to be undertaken in particular in newborns and infants.

[Measures to improve gait in patients with cerebral palsy].

Gait disorders in patients with cerebral palsy result in excessive energy consumption due to spasticity and faulty biomechanics. Instrumented gait analysis shows these problems best and provides the optimal base for the orthopaedic treatment. Modern therapy options consist of muscle lengthenings, muscle shortenings, corrections of torsions and stabilisations of joints.

[Influenza in children--an epidemiological problem].

Influenza is an acute viral disease which mainly affects the respiratory tract and occurs in all age groups with yearly epidemics during the cold season. It is a frequent and occasionally severe disease in children, particularly in young infants and school age children with a high rate of complications (mainly secondary bacterial infections) which frequently require hospitalization. Children are usually the first victims of the yearly epidemics and effectively distribute the virus in the community and their families.

[Malformations of the lower extremities].

Malformations with deficiencies of the lower extremities are rare. They are usually caused by toxic influences during pregnancy between the 4th and the 12th week of gestation. Some malformations have a genetic origin.

[Partial rupture of the quadriceps tendon in a 6-year-old boy].

In children, avulsion fractures of the patella are observed more frequently than ruptures of the quadriceps tendon. In cases of suspected lesions of the quadriceps tendon, conventional x-ray imaging and ultrasound comparison of both patellae is recommended. Arthroscopy is helpful for diagnosing concomitant intra-articular knee lesions and permits evacuation of the hemarthrosis.

[New options in prenatal and preimplantation diagnosis of genetic disorders].

During recent years the progress with the most important practical impact in prenatal diagnosis has been the implementation of first trimester risk screening for common aneuploidies leading to a much improved identification of pregnancies at risk. Molecular methods for a rapid, cost-effective, but selective aneuploidy diagnosis such as interphase FISH or QF-PCR have been around for years, do have their specific indications, but will unlikely replace conventional cytogenetic tools in routine diagnosis. They apparently do also play a role as marketing instruments in the competition among cytogenetic laboratories.

[Prevalence of perianal streptococcal dermatitis in children and adolescents].

Perianal streptococcal dermatitis (PSD), caused by group A beta-haemolytic streptococci (GABHS), is a frequently overlooked medical entity. We investigated the prevalence of PSD at the University Children's Hospital Basel, Switzerland, from October 2000 to May 2001. Two hundred fifty randomly selected patients were studied for signs of PSD by history, examination, and culture.

[Idiopathic thrombocytopenic purpura in children].

In children the rate of acute, transient ITP is much higher than the chronic form of ITP. Often acute childhood ITP is a para- or postinfectious event. Pathophysiologically bleeding symptoms mainly depend on the ratio between normal or increased platelet production and early destruction of platelets.

[Genetic testing in pregnancy].

First trimester risk screening is probably the major methodological advance in identifying pregnancies at increased risk for genetic disease during recent years with an impact on all pregnancies. The high detection rate with moderate false positive rates will reduce the over-all number of invasive procedures as compared to the traditional approach based on maternal age exclusively, in particular considering the demographic shift towards higher mean maternal age. Non-invasive prenatal diagnosis from fetal cells or DNA in the maternal circulation remains an experimental approach, despite a growing number of reports on successful diagnoses of single gene disorders.

[Myoclonic-astatic epilepsy in early childhood: review of clinical signs, EEG features, etiology, and therapy].

Myoclonic-astatic epilepsy in early childhood: review of topical knowledge of clinical signs, electroencephalographic characteristics, etiology and therapy. The classification of epilepsy in childhood is discussed continuously. On the basis of some selected cases, the clinical and electrophysiological characteristics of myoclonic-astatic epilepsy in early childhood are described.

[Congenital anomalies of the spine].

Congenital anomalies of the spine usually originate in (toxic) disturbances during pregnancy. There are occasional hereditary types. These are characterized by the presence of multiple anomalies.

Perioperative management of a child with very-long-chain acyl-coenzyme A dehydrogenase deficiency.

Very-long-chain acyl-coenzyme A dehydrogenase deficiency is an inborn error of fatty acid metabolism. The clinical presentation of this disease in children is either a severe form with onset of symptoms in the first months of life, cardiomyopathy, metabolic acidosis, myopathy and a high mortality, or a less severe form manifesting mainly with hypoglycaemia. Perioperative fasting and (even emotional) stress can trigger metabolic decompensation through the altered metabolism of endogenous fatty acids resulting in hypoglycaemia, acute cardiac and hepatic dysfunction and rhabdomyolysis.

[The use of cuffed endotracheal tubes in infants and small children].

The use of endotracheal tubes with a cuff is controversial in infants and small children. Often anaesthetists advocate extreme opinions and whereas some propagate the use of cuffed tubes in all cases without restriction, others condemn their use in infants and small children under all circumstances. In this article, the discussion concerning the use of cuffed endotracheal tubes in infants and small children is based on current data and arguments.