[Rehabilitation of Children and Adolescents with Chronic Skin Diseases]. / Rehabilitation von Kindern und Jugendlichen mit chronischen Hauterkrankungen.

Chronic skin diseases are a common indication for inpatient rehabilitation in children and adolescents. Atopic eczema and psoriasis play the most important role. But other rare congenital dermatoses such as ichthyoses or epidermolysis bullosa can also be rehabilitated. Patients with skin diseases are often considerably stigmatized and report a limited quality of life and participation. The somatic and psychosocial development of the children is also often severely affected by severe forms of the diseases. The concept of inpatient rehabilitation is, on the one hand, the development of an individually adapted topical therapy plan, which often follows a step concept and is adapted to the severity of the skin symptoms. On the other hand, the disease management of children and affected families is promoted. Specific skills such as dealing with itching, learning of cream and dressing techniques, as well as the targeted application of medical baths with suitable additives are taught and practiced. In addition, the motivation for an adapted dealing with the disease and specific resources is promoted in order to comply better with the considerable psychosocial burdens.The results after the rehabilitation show, depending on the basic disease, not only an improved skin condition but also an improved quality of life and participation.

Differentiation of typical and atypical Parkinson syndromes by quantitative MR imaging.

BACKGROUND AND PURPOSE: The differential diagnosis of Parkinson syndromes remains a major challenge. Quantitative MR imaging can aid in this classification, but it is unclear which of the proposed techniques is best suited for this task. We, therefore, conducted a head-to-head study with different quantitative MR imaging measurements in patients with IPS, MSA-type Parkinson, PSP, and healthy elderly controls. MATERIALS AND METHODS: Thirty-one patients and 13 controls underwent a comprehensive quantitative MR imaging protocol including R2*-, R2- and R1-mapping, magnetization transfer, and DTI with manual region-of-interest measurements in basal ganglia regions. Group differences were assessed with a post hoc ANOVA with a Bonferroni error correction and an ROC. RESULTS: The best separation of MSA from IPS in patients and controls could be achieved with R2*-mapping in the PU, with an ROC AUC of ≤0.96, resulting in a sensitivity of 77.8% (with a specificity 100%). MD was increased in patients with PSP compared with controls and to a lesser extent compared with those with IPS and MSA in the SN. CONCLUSIONS: Among the applied quantitative MR imaging methods, R2*-mapping seems to have the best predictive power to separate patients with MSA from those with IPS, and DTI for identifying PSP.

Acupuncture in children and adolescents with bronchial asthma: a randomised controlled study.

OBJECTIVE: This randomised controlled trial evaluates the immediate effects of acupuncture as an add-on therapy in in-patient rehabilitation of children and adolescents with bronchial asthma. PATIENTS AND METHODS: In a pre-post design, the severity of symptoms, lung function, illness-specific quality of life (Paediatric Asthma Quality of Life Questionnaire - PAQLQ) and general and asthma-specific level of anxiety (State-Trait Anxiety Inventory for Children - STAIC) were investigated in 46 acupuncture and 47 control patients. In addition to asthma sports, climate therapy and behavioural training, the intervention group received acupuncture treatment with a standardised needle pattern (12 × 30 min.). RESULTS: With acupuncture, the peak expiratory flow variability differs significantly (p<0.01) from that of the control patients' group. Moreover, the acupuncture group differs significantly in their rehabilitation response at the time of discharge concerning perceived anxiety (STAIC-S). The lung function tests do not present differences between groups. CONCLUSION: After additional acupuncture, amelioration of peak expiratory flow variability and anxiety can be shown, without any difference in objective lung function tests and quality of life between study groups. Further studies might evaluate the effects of acupuncture on childhood asthma in an outpatient setting.

[Education programs on atopic eczema. Design and first results of the German Randomized Intervention Multicenter Study]. / Neurodermitisschulung. Konzept und aktueller Stand der German Randomized Intervention Multizentre Study.

Atopic eczema (AE) is a common, chronically relapsing, inflammatory skin disease with an early onset during infancy associated with a high loss of quality of life and socioeconomic burden. In the past few years, an Atopic Eczema Prevention Program was established to improve disease management and the quality of life of patients with atopic eczema. In Germany, the Task Force on Education Programs for Atopic Eczema (AGNES = Arbeitsgemeinschaft Neurodermitis Schulung) for children, youths, and parents was founded as well as the Task Force on Dermatological Prevention (ADP) for adults. These groups ensure structure and process quality of the prevention programs and organize train-the-trainer workshops. In a randomized prospective controlled trial (the German Randomized Intervention Multicenter Study = GRIMS), we are currently comparing the effectiveness of an atopic eczema group intervention program in (1) parents of atopic eczema children aged 0-7 years, (2) parents and children 7-12 years old, and (3) youths with AE aged between 13 and 18 years. The groups were randomized and compared with a waiting control group. The design and first results will be reported.