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Alopecia areata is a form of inflammatory hair loss that has been known for a long time, but its cause is largely unexplored. It is characterized by the patient's hair falling out in a circular pattern, which is why this disease is also called circular hair loss. This occurs in 80% of cases in the head area but can also affect the beard in men and in exceptional cases the entire body hair.

A video conference enables real-time exchange between two or more participants at different locations via audio and video communication. In terms of the visualization of the discussion partners, a videoconference thus differs from a classic telephone conference and expands it to include the visual component. The term videoconferencing system refers to the technological setup or infrastructure behind such a videoconference, the videoconferencing technology. This refers to the hardware and software components that are required to carry out a videoconference technically.

A drug used successfully in veterinary medicine to treat mast cell tumors in dogs may be effective against COVID-19 and some other viral diseases in humans, according to laboratory experiments and preclinical studies published in Science 2021 [1]. Coronaviruses also require such enzymes. After entering the cells, their genome is first converted into 2 polyproteins, which must be broken down into smaller units. This task is performed by 2 proteases. This is once the main protease 3CL (also called Mpro or nsp5). The 2nd enzyme is the "papain-like" protease, abbreviated PLpro. Drugs that block one of these enzymes could prevent the viruses from replicating in the cells and thus stop the progression of the infection.

The relevance of inexpensive but at the same time highly effective medicines is steadily increasing in today's society. It is, therefore, no wonder that medicinal honey, whose antibacterial effect was already known in Ancient Egypt, is becoming increasingly popular . The active principles of medicinal honey have been largely deciphered today: The most important component of honey promoting the healing process is considered to be the enzyme glucosidase.

Sternoclavicular joint cysts are extremely rare in children. We report the 6th case of a ganglion of the sternoclavicular joint in a child, which was diagnosed by ultrasonography.

Lymphangiomas are benign lesions of vascular origin that show lymphatic differentiation. They occur in many anatomic locations. Complete resection is difficult in some cases and recurrences are common. A pediatric chart review was carried out in 16 cases. The authors summarized their experience of abdominal lymphangiomas in children.

We report of a young African child with a giant retinoblastoma originating from the left orbital space. The mother and the child left Cameroon seeking medical support at the Department of Pediatrics. To date of arrival, the extensive tumor was exulcerating and not curable. Only palliative support was possible.

The condition of a wandering spleen is described as the untypical movement of the spleen to an ectopic abdominal or pelvic point. It is the result of weakened ligaments in the peritoneum. There is a wide range of findings. A classification of wandering spleen does not exist. This study makes recommendations concerning a new classification for wandering spleen.

Infantile hemangiomas (IH) are benign forms of endothelial proliferation in the first 8 weeks of life. Leaute-Labreze et al. published the first spontaneous cases of IH treated with beta blockers in 2008 due to their cardiac disease in the New England Journal of Medicine. This was a revolutionary new understanding of treatment in infantile hemangioma (IH). Not only systemic but also topical beta blockers seem to be an effective treatment option for small infantile hemangioma. Efficacy and safety of topical beta blockers in the treatment of infantile hemangioma (IH) were proved in systematic reviews and meta-analysis.

Kawasaki syndrome or mucocutaneous lymph node syndrome (MCLS) is an acute, febrile, systemic illness characterized by inflammation (necrotizing vasculitis) of the small and medium-sized arteries. In addition, systemic inflammation is present in many organs. The cause is unknown; an infectious origin is suspected, favored by a hereditary basis.

SARS-CoV-2 has kept the world on tenterhooks for half a year. In this short time, millions of data and clinical findings have been collected, the amount of which astonishes even the scientific community. But the majority of them concern adult patients. Knowledge about the clinical course, complications and therapy of COVID-19 in children and adolescents, on the other hand, has been limited to date [2]. And the data that have been collected internationally illustrate once again that "children are not small adults." This is because the incidence of infection in this age group appears to differ, in some cases markedly, from that of elderly and senior patients.

In Japan, new developments in the field of robotics are being received with interest and enthusiasm by the population and used in everyday life. This can be explained on the one hand by a long tradition of stories that report positively on artificial servants for humans. These stories continue into modern manga comics. Robots take on positive roles, expanding the capabilities of humans and being of service to them. On the other hand, Japanese religions and philosophies such as Buddhism and Shintoism influence attitudes towards robots.

The new SARS-CoV-2 coronavirus has spread worldwide from China. The metropolis of Wuhan in Hubei province was the center of the outbreak. The associated disease is called Coronavirus Disease 2019 (COVID-19). The SARS-CoV-2 virus has spread very efficiently from person to person in the short time since it was first detected in December 2019, particularly through droplet infection, but also through aerosol infection. Coronaviruses (CoVs) can cause human illnesses ranging from mild colds to more severe illnesses such as Middle East Respirator Syndrome (MERS) and Severe Acute Respiratory Syndrome (SARS).

COVID-19 is a severe coronavirus disease spreading all over the world. To date of this publication, 2.501.156 people were infected with COVID-19, and 171.810 deaths were found in 185 countries (John Hopkins Coronavirus Resource Center, date 21 april 2020). This overwhelming death rate makes intensive research activities necessary all over the world. To date, the US will be slayed by the number of deaths per day, suggesting an uncontrollable state of spreading infection. SARS-CoV-2 binds to the angiotensin II receptor on various tissues in the human body, especially in the oral cavity and tongue. SARS-CoV-2 requires the cheerful TMPRSS2 to pro-activate for this sluggishness. SARS-CoV-2 uses the ACE2 receptor as an access portal to the lungs [1]. The SARS-CoV-2 virus binds with the top protein to the ACE2 receptor [1].

Since the outbreak near a fish market in Wuhan, China, in December 2019, researchers have been searching for an effective therapy to control the spreading of the new coronavirus SARS-CoV-2 and inhibit COVID-19 infection. Many countries like Italy, Spain, and the USA were ambushed by this viral agent. To date, more than 2.5 million people were infected with SARS-CoV-2. There is no clear answer, why SARS-CoV-2 infects so many people so fast. To date of April 2020, no effective drug has been found to treat this new severe viral infection. There are many therapy options under review and clinical trials were initiated to get clearer information, what kind of drug can help in this devastating and serious situation. The world has no time.

COVID-19 the world is shocked. Globally, 896450 confirmed cases and 45525 deaths (WHO, situation report 73, 2 April 2020) reveal that a viral agent is spreading in an exponential way all around the world with to date unknown killing potential. What we know, the virus came from Wuhan, China, with a rapid spreading the world never had seen before

According to the latest research, the novel coronavirus uses the protein angiotensin-converting enzyme 2 (ACE-2) as a receptor for docking to the host cell. Essential for entry is the priming of the spike (S) protein of the virus by host cell proteases. A broadly based team led by infection biologists from the German Primate Centre and with the participation of the Charité Hospital in Berlin, the Hanover Veterinary University Foundation, the BG-UnfallklinikMurnau, the LMU Munich, the Robert Koch Institute and the German Centre for Infection Research wanted to find out how SARS-CoV-2 enters host cells and how this process can be blocked [1]. They have published their findings in the journal "Cell" [1]. The team of scientists was initially able to confirm that SARS-CoV-2 docks to the host cell via the ACE-2 receptor. They also identified Transmembrane serine protease 2 (TMPRSS2) as the cellular protein responsible for entry into the cell [1-3].

In early December 2019, a series of pneumonia cases of unknown origin occurred in Wuhan, Hubei Province, China. Most of these patients reported that they had come into contact with many species of live animals in the Huanan seafood wholesale market. In China, the disease has spread rapidly domestically and in other parts of the country

The abuse of benzodiazepines by pregnant women can cause intoxication in the neonate. Benzodiazepines can diffuse readily across the placenta to the fetus because of their high lipid solubility. After the sixth month of pregnancy, the loss of the cytotrophoblasts from the placenta further facilitates the transport of benzodiazepines across the placenta. They may persist for at least a week in pharmacologically active concentrations after administration of high dosages to the mother. We report about a floppy, drowsy and pulmonary impaired newborn delivered in the 36th week of gestation. The mother was a regular user of clorazepate, a long-acting benzodiazepine during pregnancy.

Since December2019, cases of SARS-CoV-2 coronavirus infection have been reported in Wuhan, Hubei province, and the epidemic continues to spread. SARS-CoV-2 infections in children seem to progress more mild and slowly as compared to adult courses with severe and some times fatal outcome. Severe or fatal cases in children are yet not described supposing any molecular difference in viral-receptor binding between spike protein and angiotensin II receptor. This manuscript presents a first and completely new classification of clinical findings and treatment options in children infected with SARS-CoV-19 virus.

Pediatric vaccination is an important field in the daily pediatric care practice of pediatricians in Germany. According to the STIKO recommendations, children were vaccinated up to 20 times till the age of 17. A new technique of vaccination will be presented vaccinate a child taking both hands, one makes the injections, the other one holds the needle in the skin due to relieve pain and not to damage nociceptors. The importance of this technique is to avoid movement of the needle inside the skin after injection to avoid damage of nociceptors in the skin.

The use of complementary medical treatment in wound management has continued to grow throughout the world. There is a large body of evidence to support the use of honey as a wound dressing for a wide range of types of wounds. Clear guidelines for the use of honey in pediatric wound care do not exist. We present an update of present knowledge using honey as a form of complementary medicine in pediatric wound management.

Background: The use of complementary medical treatment in wound management has continued to grow throughout the world. There is a large body of evidence that supports the use of honey as a wound dressing for a wide range of wound types. The authors present an update of present knowledge about honey as a form of complementary medicine in paediatric wound management. Methods: The literature cited was found by searching the PubMed, BIOSIS and ISI Web of Science databases for the phrase ‘honey and wound’. Papers where honey was used in a mixture with other therapeutic substances were excluded. Randomised controlled trials as well as case studies were taken into consideration. Results: This paper reviews data on the effectiveness of honey in wound healing; 80 citations or references were found that matched the criteria. Furthermore, the wound-healing properties of honey are described and the mechanism of action discussed. The authors' data show that honey induced enhanced epithelialisation, minimised scar formations and had an anti-microbiotic effect. Conclusion: These results should encourage the use of medical honey in the field of paediatrics. It is a safe and natural substance that induces wound healing at a greater rate than conventional methods.

Background: The role of complementary alternative medicine (CAM) in pediatrics has considerably increased in the last years. The knowledge about potential side effects and possible interactions with conventional drugs is still limited, and often pediatricians do not know whether their patients use CAM. This can be critical, as in order to diagnose and treat illnesses properly physicians need to know about the full extent of the self-administered therapy of their patients. Many studies have been conducted in other countries in order to assess the extent of CAM use and the types of substances that are consumed, but in Germany data in regard to pediatric interventions are lacking. We therefore developed a questionnaire to evaluate the frequency of CAM use among German pediatric patients. Patients and Methods: 115 parents visiting the pediatric day center in Epe between September and November 2011 responded to the questionnaire. The survey contains questions concerning the prevalence of CAM use and data about socioeconomic factors. Results: A total of 75.7% of all children enrolled in the study had already been treated with CAM by their parents, while only 43.6% of the parents knew that there can be interactions with CAM and prescribed drugs. In only half of the cases (50.6%) the pediatrician knew about the CAM usage of the child. Conclusion: The frequency of CAM usage among children is higher than anticipated. It is essential that pediatricians know about possible interactions with conventional medicine, and it lies in their responsibility to include the question about CAM usage in their standard protocols.

To determine the extent of progress in the treatment of sacrococcygeal teratomas (SCTs), the experience of 25 patients over a period of 30 years between 1972 and 2002 was evaluated. The medical records of the children were reviewed for demographics, histology, clinical course, bladder, anorectal and sexual function, and outcome. In particular, analysis of long-term cosmetic results after surgery for SCT was performed. The follow-up period ranged from 1 day to 396 months (median, 212 months). In more than half of the cases, unsatisfactory cosmetic long-term results after surgery for SCT were found. This study demonstrates that poor cosmetic results in the buttock region were the most common long-term complication after surgery for SCT, possibly leading to further corrective operations in later life. A better surgical procedure for closing the buttock region in the treatment of SCT should be discussed. Early assessment of bladder, anorectal, and sexual function along with long-term cosmetic results should be integrated into the well-established long-term oncology follow-up program. Moreover one has to keep in mind that cesarean section could become necessary as the primary delivery technique in female patients who have had surgery for SCT. More evaluations concerning this aspect are necessary.

Benzocaine is a widely used topical anaesthetic and has been reported to cause toxic methaemoglobinaemia in otherwise healthy individuals with no predisposing risk factors. This article reports on a rare case of benzocaine-induced methaemoglobinaemia following adenotonsillectomy in a 5-year-old girl. Topical benzocaine was applied orally for the relief of postoperative wound pain on the eighth postoperative day. Two hours after application, generalized cyanosis, mild dyspnoea and some degree of agitation developed. The methaemoglobin level was 38.5%. Treatment with methylene blue was initiated immediately. Symptoms completely disappeared 4 hours after initiation of methylene blue therapy. The further course was uneventful. Therefore, all health professionals should be aware that topical anaesthetics after surgery can induce methaemoglobinaemia in children, even after a prolonged interval, and especially when applied on wound surfaces.

Potential advantages of paediatric day-surgery are cost saving, improved utilization of staff and hospital facilities, and reduction of stress for the paediatric patient and their family. A successful programme requires careful case selection, full operating and anaesthetic facilities and good follow-up. Current practice is reviewed with regard to initial assessment, preparation for surgery and overall management during the day admission. To provide information on how patients and their parents experience essential aspects of daycare paediatric surgery, a questionnaire-based study on parental satisfaction of paediatric day-surgery was performed. Most children were back to normal, within a few days. Recovery from paediatric day-surgery was rapid and the overall level of parent satisfaction was high.

We report the case of a 4-monthold baby with a large infantile haemangioma of the left shoulder treated successfully with systemic propranolol. Therapy results were documented by photography. The baby was treated for 4 weeks with oral propranolol with a dosage of 8 mg/day. There was a significant change in colour from dark red to a lighter shade of red and partially even to skin colour. No side-effects occurred during the therapy. Clear guidelines for betablocker treatment for infantile haemangiomas are necessary. Beta blockers seem to be the treatment of choice in paediatric haemangioma.

Topical honey treatment has been shown to possess antimicrobial properties, promote autolytic debridement, stimulate growth of wound tissues to hasten healing, and to start the healing process in dormant wounds, stimulating anti-inflammatory activity that rapidly reduces pain, oedema and exudate production. This article provides an overview of the use of honey as a medicinal substance, particularly its use in wound treatment, and reviews the published data concerning honey as a form of complementary and alternative medicine in paediatric wound management. The literature reviewed was found by searching the PubMed, BIOSIS, and ISI Web of Science databases for the term honey. Exclusion criteria were articles where honey was used in a mixture with other therapeutic substances.

Objective Biliary atresia is the result of a fibrosing destructive inflammatory process affecting intrahepatic and extrahepatic bile ducts, which lead to cirrhosis and portal hypertension. Without surgical intervention, mortality reaches 100%. The 5-year survival rate after portoenterostomy ranges from 13% to 60%, with approximately 60% of patients requiring liver transplantation at a later stage because of insufficient bile flow. Methods This retrospective analysis includes 30 consecutive patients undergoing portoenterostomy for biliary atresia at our hospital. Results The 5-year actuarial survival of the 30 patients was 68%. Thirteen patients (43.3%) died 3 days to 7 years after portoenterostomy. Four patients (13.3%) underwent liver transplantation 3 to 24 months after the Kasai procedure with a 100% survival. In 65% of patients without presence of cirrhosis, the portoenterostomy was successful, compared with 35% of cases with liver cirrhosis (p = 0.0148). Liver cirrhosis with extrahepatic biliary atresia alone was present in 5 of 17 patients (29%) as compared with 8 of 12 patients (66%) with intrahepatic biliary hypoplasia in addition to extrahepatic biliary atresia and cirrhosis. Conclusions Portoenterostomy remains the treatment of choice for patients with extrahepatic biliary atresia. However, the presence of cirrhosis portends a poorer prognosis and may be an indication for early transplantation. Cirrhosis is more commonly present in the setting of intrahepatic biliary hypoplasia and may account for the lower success rates of portoenterostomy in this group of patients. Five-year survival of the female patients was 88% as compared with 55% of the male patients.

humeral metaphysis and diaphysis. Needle aspiration of the shoulder joint revealed infection with Staphylococcus aureus, and the therapy was changed to flucloxacillin. The child was discharged from hospital at the decision of his mother. He presented 1 week later, with his shoulder badly swollen, warm, erythematous, and immobile. His leukocyte count was 15800/mm3 and his erythrocyte sedimentation rate 100 mm/h. X-rays taken the same day showed progressive osteolysis of the humeral epiphysis and metaphysis. Periosteal widening was found, together with extensive inflammation of the diaphyseal humerus. Operative revision of the left shoulder was therefore necessary. Intraoperatively, massive necrotic debris and pus were found around the periosteum and removed. The humeral head was soft and destroyed by inflammation. A drainage tube was inserted for 9 days. Intravenous treatment with vancomycin and clindamycin was started and continued for 2 weeks. Ten days after the introduction of this new antibiotic therapy, an X-ray showed no further bone destruction. On the day of discharge from the hospital the erythema and swelling of the shoulder had been relieved, although his shoulder mobility was still restricted. The erythrocyte sedimentation rate was 50 mm/h and a normal leukocyte count was noted. Oral clindamycin was given for a further 8 weeks, when a final clinical check showed normal function and painless movement in the shoulder joint. An X-ray proved normal, and no further clinical investigation was necessary. Unfortunately, the immunological ability of the patient was not proved.

Hydranencephaly is an extremely rare anomaly of cerebral structures that occurs in-utero. Cerebral hemispheres are destroyed with transformation into a membranous sac with cerebrospinal fluid and parts of cortex and white matter. The disorder has an incidence of 0.2% in children. Clinical symptoms in neonates are seizures, respiratory failure, flaccidity or decerebrate posturing. Complete absence of the cerebral hemispheres and falx is present. We present a case of a male newborn with hydranencephaly. A possible correlation with in utero exposure to vasoactive drugs will be discussed.

Background Parental satisfaction with a pediatric day center is essential for the medical treatment of children, since it is closely related to compliance. In order to ascertain factors which predict parental satisfaction as well as to discover possible weak points, we developed a questionnaire. Methods 127 parents visiting the pediatric day center from October to November 2010 were asked to respond to a questionnaire. The survey was given to them directly by the doctor after their visit and it provided the opportunity to determine subjective and soft factors in quality management, which is essential for a pediatric practice. The questionnaire consisted of 27 items divided into three scales. The scales were as follows: satisfaction concerning the infrastructure and organization, satisfaction concerning the communicative and empathic competence of the doctor as well as the other staff, and finally the results and the overall impression. Moreover, the survey asked the respondents for their comments on the pediatric day center and sociodemographic data were queried. Results A total of 67 parents (52,7%) responded to the survey. The mean parental satisfaction concerning infrastructure and organization achieved 3,61 (scale 1-very unsatisfied-through 4-very satisfied). The mean satisfaction with the expertise of the doctor and the staff was 3,56 and the overall satisfaction was 3,65. Ninety-one percent of the parents would visit the pediatric practice again and 84,2% would definitely recommend the practice to others. Conclusion Surveys on parental satisfaction are essential for the success of a pediatric day center. Apart from the doctors abilities to interact with the parents, other factors, such as a short waiting period, a friendly and helpful staff, as well as appealing premises are essential for a high overall level of satisfaction.