ABSTRACT
Careful analysis of current adjudication reveals increasing demand of adequate record-keeping as well as meticulously documented informed consent forms regarding all aspects of medicine. Although standardized informed consent forms or explicit guidelines for obtaining procedural consent already exist in surgical disciplines there is strong evidence that, however, in neonatology (and paediatric intensive care) these processes are still incomplete and qualitatively insufficiently implemented. Therefore the author discussed all existing information prescriptions with the legal department and quality management of a large German clinic group especially in terms of relevant legislation, recent case law and specialist literature in order to obtain potential for improvement. Based on the results of this audit of expert opinions improved recommendations could be implemented in the daily practise of a department of neonatology and paediatric intensive care on a tertiary level.
Subject(s)
Documentation/standards , Intensive Care Units, Pediatric/legislation & jurisprudence , Neonatology/legislation & jurisprudence , Neonatology/standards , Parental Consent/legislation & jurisprudence , Quality Assurance, Health Care/legislation & jurisprudence , Germany , Intensive Care Units, Pediatric/standards , Quality Assurance, Health Care/standardsSubject(s)
Colitis/diagnosis , Colitis/virology , Constriction, Pathologic/diagnosis , Constriction, Pathologic/etiology , Cytomegalovirus Infections/diagnosis , Cytomegalovirus Infections/pathology , Milk, Human/virology , Colitis/complications , Cytomegalovirus Infections/transmission , Histocytochemistry , Humans , Infant , Infectious Disease Transmission, Vertical , MaleABSTRACT
We report on a 4 month old male infant with respiratory syncytial virus (RSV) infection leading to acute respiratory distress syndrome (ARDS). A diagnostic algorithm including extended infectiological and immunological work-up revealed absence of CD40-ligand. ARDS was treated successfully with a complex respiratory therapy plus intravenous immunoglobulin substitution. Molecular analysis detected mutations in the CD40L gene (Hyper-IgM syndrome Type 1). The case underlines the importance of an extended diagnostic work-up in an uncommonly severe course of respiratory infection in early infancy.
Subject(s)
CD40 Ligand/deficiency , CD40 Ligand/genetics , Cytomegalovirus Infections/diagnosis , Hyper-IgM Immunodeficiency Syndrome, Type 1/diagnosis , Opportunistic Infections/diagnosis , Respiratory Distress Syndrome/diagnosis , Respiratory Syncytial Virus Infections/diagnosis , Algorithms , Critical Care/methods , Cytomegalovirus Infections/genetics , Cytomegalovirus Infections/therapy , DNA Mutational Analysis , Diagnosis, Differential , Exons , Humans , Hyper-IgM Immunodeficiency Syndrome, Type 1/genetics , Hyper-IgM Immunodeficiency Syndrome, Type 1/therapy , Infant , Male , Opportunistic Infections/genetics , Opportunistic Infections/therapy , Respiratory Syncytial Virus Infections/genetics , Respiratory Syncytial Virus Infections/therapyABSTRACT
Rhabdomyolysis induced acute renal failure as a rare complication of influenza A infection has been mainly described in adults. Consideration of this potentially life-threatening complication in pediatric patients presenting with influenza is important as clinical symptoms may be unspecific and early diagnosis leading to prompt treatment is essential to decrease associated morbidity and mortality. We report a 9 year old girl who developed severe rhabdomyolysis with myoglobinuric renal failure associated with influenza A virus infection. Receiving supportive therapy including intensive care management the patient recovered renal function completely.
