Lessons Learned-The Impact of the Third Wave of the COVID-19 Pandemic on German Waldorf Parents' Support Needs and Their Rating of Children's Health-Related Quality of Life: A Cross-Sectional Online Survey.

BACKGROUND: COVID-19-related lockdowns and homeschooling have imposed a substantial burden on school-aged children and parents. Waldorf education is a reform-educational concept. Little is known about the situation of German Waldorf families under pandemic conditions. METHODS: A cross-sectional, online, parent-proxy survey was conducted regarding the third pandemic wave. The primary outcome was parents' support needs, assessed with questions from the German COPSY (COVID-19 and PSYchological Health) study; the secondary outcome was children's HRQoL (KIDSCREEN-10, proxy version). RESULTS: We analyzed questionnaires from 431 parents of 511 Waldorf students aged 7 to 17 years. While 70.8% of Waldorf parents (WPs) reported a general need for support in dealing with their children, 59.9% of COPSY parents (CPs) indicated this need. WPs' support needs in dealing with their children's academic demands were similar to CPs' needs but relatively higher in terms of dealing with emotions and moods, behavior, and relationships within the family. WPs sought support mainly from school and teachers (65.6%). Support needs were high, although WPs rated their children's HRQoL higher than CPs. CONCLUSIONS: Our results underline the substantial pandemic-related burden on families across school types. WPs participating in this survey gave evidence that supports should focus on academic demands as well as psychosocial issues.

Sinus histiocytosis with massive lymphadenopathy (Rosai-Dorfman disease) and cirrhosis of the liver: A case report and literature review.

Patients with cirrhosis of the liver usually present with a small shrunken liver and a large spleen. The presence of an unusually huge liver should prompt the treating doctor to look for another cause, as this may be treatable and improve the patient's outcome. In South Africa tuberculosis and lymphoma in the presence of HIV infection should be excluded. Sinus histiocytosis with massive lymphadenopathy and cirrhosis is a rare combination and has not been reported before in the literature. This case is intended to make clinicians aware of this rare combination of diseases.

Hemorrhage after low-energy pelvic trauma.

BACKGROUND: Severe pelvic hemorrhage after low-energy trauma has been described in some reports of single cases only. However, it might not be as rare and unique as generally expected. The aim of this study was therefore to present a case series of 11 patients with severe pelvic hemorrhage after sustaining low-energy trauma and to discuss relevant considerations for the management of these patients. METHODS: A consecutive series of eleven patients with pelvic hemorrhage and the need for arterial embolization after sustaining low-energy pelvic trauma was identified. A contrast-enhanced computed tomography (CT) scan was performed in all patients, if pelvic hemorrhage was suspected due to a relevant hemoglobin (Hb) drop. After the CT scans showed active arterial bleeding, arterial embolization was immediately performed. RESULTS: All patients sustained low-energy pelvic injuries after simple falls from standing height. The mean initial Hb level was 13.0 g/dL.Contrast-enhanced CT scans were performed after a mean of 14.3 hours after trauma and showed contrast medium extravasations in all patients. The mean Hb level at the time of CT scan was 9.0 g/dL. Embolization was successfully performed in all patients within a mean of 4.5 hours. CONCLUSIONS: Geriatric patients are prone to arterial hemorrhage after low-energy pelvic trauma. They should be admitted as an inpatient for observation with repeated control of the Hb level to diagnose hemorrhage at an early stage. Contrast-enhanced CT scans is the preferred imaging method for the assessment of pelvic hemorrhage, whereas arterial embolization is highly successful in terms of hemostasis.

The epidemiology of sports-related injuries in older adults: a central European epidemiologic study.

BACKGROUND AND AIMS: The population is rapidly aging and remaining more active over the age of 65. An increasing number of sports related injuries in individuals 65 and older are thus anticipated. The aim of this study is to analyze the epidemiology of sports injuries in the age group aged 65 and older. METHODS: Data from the medical records of adults aged 65 years and older who were treated for sports-related injuries at a level one trauma center between December 1994 and February 2008 was collected and statistically analyzed. RESULTS: A total of 2635 patients met our inclusion criteria. There were 1647 men (62.5%) and 988 women (37.5%) with a mean age of 70.9 years. The yearly number of injuries doubled during the study period (1996-2007). The most common mechanism of injury was a simple fall from standing height (69%). Nearly 75% of all injuries occurred during alpine skiing, cycling or mountain climbing. The median Injury Severity Score was 4. Minor injuries and wounds (40%) were recorded most commonly followed by fractures (27%), sprains, ligament injuries (19%) and injuries of muscles and tendons (6%). The most frequent diagnoses were minor injuries to the head and ligament injuries around the knee joint. Injuries to the upper extremities occurred in 33.7%, injuries to the lower extremities in 29.4% and injuries to the head occurred in 20% of the patients. Women sustained substantially more fractures than men. CONCLUSION: Adults aged 65 and older are remaining active in sports, which results in higher numbers of sports related injuries in this age group. Identification of type, mechanism and distribution of the injuries can help with the recognition of risk factors for injury. This may enable us to develop appropriate preventative measures to reduce the incidence, and morbidity of such injuries.

Early identification of bacteria leading to central venous catheter contamination.

UNLABELLED: Catheter-related bloodstream infections (CRBSI) are a common problem in patients after central venous catheterization. Using DNA analysis we compared bacteria found on the tip of central venous catheters removed because of clinical signs of CRBSI with bacteria found on needle, dilator, and guidewire used for insertion of these catheters. In five of seven central venous catheters removed because of clinical signs of CRBSI, bacteria on the catheter tip were genetically identical to bacteria found on the insertion device, proving that catheter contamination in these cases was caused by contacting bacteria during the initial puncture. These findings may be important for antibiotic prophylaxis or therapy in patients at risk for CRBSI. IMPLICATIONS: In five of seven central venous catheters removed because of clinical signs of catheter-related blood infections, DNA analysis showed bacteria found on the catheter tip to be identical with bacteria found on the puncture kits used for insertion of these catheters.