Homöopathie an der Universität: Ist eine Integration möglich?

Background and Objective:The Dr. von Hauner Children's Hospital Munich has conducted a pilot project for 4 years, aiming at the integration of homeopathic concomitant treatment into daily clinical practice. This study was carried out to clarify whether the project is successful and accepted by physicians, nurses, and parents. Methods: Questionnaires, all standardized and anonymous, were handed out to 137 physicians, 212 nurses and paramedics, and 1,048 parents of children treated at the hospital. Results: 69% of the physicians appreciated concomitant homeopathic treatments, more than 60% believed the integration of homeopathy is suggestive, 75% saw a need for clinical research in homeopathy. 25% of the staff now had a more positive view towards homeopathy. 63% of the parents appreciated concomitant treatment, but only 19% are willing to participate in double-blind studies. Conclusions: Integration of homeopathy in a university hospital is possible. Therapeutic work should be accompanied by scientific research

Whole lung lavage therapy for pulmonary alveolar proteinosis: a global survey of current practices and procedures

Background: Whole lung lavage (WLL) is the current standard of care treatment for patients affected by pulmonary alveolar proteinosis (PAP). However, WLL is not standardized and international consensus documents are lacking. Our aim was to obtain a factual portrayal of WLL as currently practiced with respect to the procedure, indications for its use, evaluation of therapeutic benefit and complication rate. Methods: A clinical practice survey was conducted globally by means of a questionnaire and included 27 centers performing WLL in pediatric and/or adult PAP patients. Results: We collected completed questionnaires from 20 centres in 14 countries, practicing WLL in adults and 10 centers in 6 countries, practicing WLL in pediatric patients. WLL is almost universally performed under general anesthesia, with a double-lumen endobronchial tube in two consecutive sessions, with an interval of 1-2 weeks between sessions in approximately 50 % of centres. The use of saline warmed to 37 degrees C, drainage of lung lavage fluid by gravity and indications for WLL therapy in PAP were homogenous across centres. There was great variation in the choice of the first lung to be lavaged: 50 % of centres based the choice on imaging, whereas 50 % always started with the left lung. The choice of position was also widely discordant;the supine position was chosen by 50 % of centres. Other aspects varied significantly among centres including contraindications, methods and timing of follow up, use of chest percussion, timing of extubation following WLL and lung isolation and lavage methods for small children. The amount of fluid used to perform the WLL is a critical aspect. Whilst a general consensus exists on the single aliquot of fluid for lavage (around 800 ml of warm saline, in adults) great variability exists in the total volume instilled per lung, ranging from 5 to 40 liters, with an average of 15.4 liters/lung. Conclusions: This international survey found that WLL is safe and effective as therapy for PAP. However these results also indicate that standardization of the procedure is required;the present survey represents the a first step toward building such a document

Whole lung lavage therapy for pulmonary alveolar proteinosis: a global survey of current practices and procedures

Background: Whole lung lavage (WLL) is the current standard of care treatment for patients affected by pulmonary alveolar proteinosis (PAP). However, WLL is not standardized and international consensus documents are lacking. Our aim was to obtain a factual portrayal of WLL as currently practiced with respect to the procedure, indications for its use, evaluation of therapeutic benefit and complication rate. Methods: A clinical practice survey was conducted globally by means of a questionnaire and included 27 centers performing WLL in pediatric and/or adult PAP patients. Results: We collected completed questionnaires from 20 centres in 14 countries, practicing WLL in adults and 10 centers in 6 countries, practicing WLL in pediatric patients. WLL is almost universally performed under general anesthesia, with a double-lumen endobronchial tube in two consecutive sessions, with an interval of 1-2 weeks between sessions in approximately 50 % of centres. The use of saline warmed to 37 degrees C, drainage of lung lavage fluid by gravity and indications for WLL therapy in PAP were homogenous across centres. There was great variation in the choice of the first lung to be lavaged: 50 % of centres based the choice on imaging, whereas 50 % always started with the left lung. The choice of position was also widely discordant;the supine position was chosen by 50 % of centres. Other aspects varied significantly among centres including contraindications, methods and timing of follow up, use of chest percussion, timing of extubation following WLL and lung isolation and lavage methods for small children. The amount of fluid used to perform the WLL is a critical aspect. Whilst a general consensus exists on the single aliquot of fluid for lavage (around 800 ml of warm saline, in adults) great variability exists in the total volume instilled per lung, ranging from 5 to 40 liters, with an average of 15.4 liters/lung. Conclusions: This international survey found that WLL is safe and effective as therapy for PAP. However these results also indicate that standardization of the procedure is required;the present survey represents the a first step toward building such a document

Zusammenarbeit von Pädiatrie und Sozialpädiatrie — Schaffung einer biopsychosozialen Medizin für komplex chronisch kranke Kinder und Jugendliche

Pediatrics in Germany is going through a~crisis in which healthcare, especially for children and adolescents with medical complexity, is seriously compromised.Specialized outpatient clinics are being closed and hospital beds for inpatient treatment - even where specially allocated - cannot be occupied due to shortcomings in care. A~multitude of critical factors are coming together, leading to and intensifying the current crisis. To improve the situation, appropriate political will and fundamental changes in healthcare policy are required.Nevertheless, pediatrics can make important contributions on its own. Based on intelligent network solutions in which pediatrics and social pediatrics closely cooperate in tandem structures, with regards to both organizational structure and content, they can jointly further develop correspondingly realistic biopsychosocial medicine in pediatrics as needed. This way, pediatrics could take the reins and not only join in the call for high-quality health centers but actively participate in shaping the structure of such centers. Pediatrics has the chance to become a~driving force in the further development of structural changes in the German health system and thus secure and improve healthcare for those who are most dependent on it: children with medical complexity

Die Chronik der Kinderklinik an der Lachnerstrasse - "Lachnerklinik"

Die arbeit gibt einen Überblick über die Enstehung einer der ersten Kinderkliniken in München und über die Entstehung der Kinderheilkund