Paternal Body Mass Index (BMI) Is Associated with Offspring Intrauterine Growth in a Gender Dependent Manner

Background: Environmental alternations leading to fetal programming of cardiovascular diseases in later life have been attributed to maternal factors. However, animal studies showed that paternal obesity may program cardio-metabolic diseases in the offspring. In the current study we tested the hypothesis that paternal BMI may be associated with fetal growth. Methods and Results: We analyzed the relationship between paternal body mass index (BMI) and birth weight, ultrasound parameters describing the newborn’s body shape as well as parameters describing the newborns endocrine system such as cortisol, aldosterone, renin activity and fetal glycated serum protein in a birth cohort of 899 father/mother/child triplets. Since fetal programming is an offspring sex specific process, male and female offspring were analyzed separately. Multivariable regression analyses considering maternal BMI, paternal and maternal age, hypertension during pregnancy, maternal total glycated serum protein, parity and either gestational age (for birth weight) or time of ultrasound investigation (for ultrasound parameters) as confounding showed that paternal BMI is associated with growth of the male but not female offspring. Paternal BMI correlated with birth parameters of male offspring only: birth weight; biparietal diameter, head circumference; abdominal diameter, abdominal circumference; and pectoral diameter. Cortisol was likewise significantly correlated with paternal BMI in male newborns only

Intraventricular catheter placement by electromagnetic navigation safely applied in a paediatric major head injury patient

INTRODUCTION: In the management of severe head injuries, the use of intraventricular catheters for intracranial pressure (ICP) monitoring and the option of cerebrospinal fluid drainage is gold standard. In children and adolescents, the insertion of a cannula in a compressed ventricle in case of elevated intracranial pressure is difficult; therefore, a pressure sensor is placed more often intraparenchymal as an alternative option. DISCUSSION: In cases of persistent elevated ICP despite maximal brain pressure management, the use of an intraventricular monitoring device with the possibility of cerebrospinal fluid drainage is favourable. We present the method of intracranial catheter placement by means of an electromagnetic navigation technique

Geschlossene Reposition und perkutane Osteosynthese der Schenkelhalsfraktur im Kindesalter

Kontraindikationen Allgemeine Faktoren bzw. Patientenkonditionen, die eine Narkose verbieten. Relative Kontraindikationen können bei pathologischen Frakturen bestehen. Operationstechnik Reposition der Schenkelhalsfraktur unter Bildwandlerkontrolle durch Längszug, Innenrotation und ggf. leichte Abduktion und Flexion in der betroffenen Hüfte – entweder durch Positionierung der Beinhalterung im Extensionstisch oder manuell durch 1 bis 2 Assistenzen auf dem normalen Operationstisch; mehrere Stichinzisionen oder ein kleiner Hautschnitt (ca. 3 cm) lateralseits auf Höhe des Trochanter minor zum Aufsuchen des Eintrittspunktes für die Kirschner-Drähte oder Schrauben; Positionieren derselbigen entweder als 2er- oder als 3er-Konfiguration sowie je nach knöcherner Dimension des Schenkelhalses. Die Frakturlokalisation (basizervikal oder subkapital) bestimmt, ob die Implantate die Wachstumsfuge kreuzen müssen oder nicht. Weiterbehandlung Teilbelastung (ca. 20 % des Körpergewichtes) bis zur gesicherten Frakturheilung in der Regel nach 6 Wochen. Entweder unter Benutzung von Unterarmgehstöcken oder durch Mobilisierung in den Kinderwagen oder Rollstuhl. Ergebnisse Wir berichten exemplarisch von einem eigenen Fall eines 9‑jährigen Mädchens mit dislozierter Schenkelhalsfraktur links (Typ Delbet II), die geschlossen reponiert und mit 2 Schrauben fixiert wurde. Die Frakturheilung und bisherige Verlaufsbeobachtung gestaltete sich komplikationsfrei. Demgegenüber stellen wir die aktuelle internationale Literatur dar. = OBJECTIVE To achieve anatomical reduction and stable fixation. Preservation of the proximal femoral physis is in this regard secondary. INDICATIONS Nondisplaced and displaced femoral neck fractures Delbet types II and III. Incomplete fractures are debatable. No age restrictions. CONTRAINDICATIONS Any patient condition that does not allow for general or regional anesthesia. Pathologic fractures requiring primarily an open approach. SURGICAL TECHNIQUE Anatomical reduction is achieved via axial tension, internal rotation and gentle abduction or flexion of the affected hip and verified under image intensification; several stab incisions or a small single incision (3 cm) laterally at the level of the lesser trochanter to determine the entry points for the K‑wires or screws; inserting and positioning the K‑wires either as a configuration of two or three; depending on the bony dimensions fixation of the fracture with the K‑wires or replacing them with cannulated screws; the localization of the main fracture line (basicervical or subcapital) determines whether the implants should cross the physis. POSTOPERATIVE MANAGEMENT Partial weight bearing/touch ground (about 20% of bodyweight) for 6 weeks; either by using crutches or via mobilization in buggy or wheelchair. RESULTS As an example, we present a case of a 9-year-old girl suffering from a displaced femoral neck fracture (Delbet type II) on the left side, who underwent closed reduction and internal screw fixation. Fracture healing and follow-up until today were uneventful. A brief review of the published literature is also provided

Distal humeral epiphyseal separation

Distal humeral epiphyseal separation is a rare orthopedic condition of the newborn (incidence 1:35'000) that requires immediate surgical correction. Untreated, the condition can lead to elbow cubitus varus deformity or dysfunction (1, 2). Diagnosis is challenging as the condition can be easily overlooked or misinterpreted as a brachial plexus palsy or an elbow dislocation. We present the case of a newborn patient whom we treated in multidisciplinary collaboration with our colleagues at the Department of Pediatric Orthopedic and Trauma Surgery and Radiology at the University Children’s Hospital of Zurich

Operative Wachstumslenkung im Kindesalter

Die Epiphysiodese ist eine einfache und effiziente Methode zur Behandlung von Beinlängendifferenzen zwischen 3 und 5 cm sowie von schwerwiegenden Achsenfehlstellungen im Kindesalter.Die permanente Epiphysiodese mittels perkutanen Anbohrens und Auskürettierens oder die temporäre perkutane Schraubenepiphysiodese wird primär zur Behandlung von Beinlängendifferenzen eingesetzt. Die temporäre Epiphysiodese unter Verwendung von «eight-plates» oder mittels perkutaner Schraubenepiphysiodese stellt die Standardtherapie für Achsenfehlstellungen der unteren Extremitäten im Kindesalter dar und ermöglicht eine frühzeitige Korrektur schwerer Deformitäten. Sehr schwerwiegende Beinlängendifferenzen bedingen eine Kallusdistraktion, die mit einer Verkürzungsosteotomie oder Epiphysiodese der Gegenseite kombiniert werden kann, bzw. erfordern die Anlage einer Orthes