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U Korsten-Reck1, K Korsten1, K Haeberle1, K Kromeyer-Hauschild3, H H Dickhuth1, E Schulz21Department of Rehabilitative and Preventive Sports Medicine, University Medical Center, University of Freiburg, Freiburg, Germany; 2Department of Child and Adolescent Psychiatry, University of Freiburg, Freiburg, Germany; 3Institute of Human Genetics and Anthropology, Friedrich-Schiller-University Jena, Jena, GermanyAbstract: The psychosocial situation of obese children at the beginning of the Freiburg Intervention Trial for Obese Children (FITOC) program influences the course and outcome of intervention therapy. At the beginning of FITOC, mothers of 30 children (12 M age 10.5 ± 1.4, 18 F; 10.2 ± 1.3) rated the psychopathological symptoms using the Child Behavior Checklist (CBCL) and the quality of life of their children (Inventar zur Erfassung der Lebensqualität [ILK]). 46.6% of mothers rated their children to be disturbed (normal population group, 2% disturbed). There was no correlation between the body mass index of the child and the CBCL score. On the ILK, the obese children themselves selected “good” while the mother’s view of their childrens’ quality of life varied around “poor”. The stress on the mother increased with the degree of the child’s obesity and number of critical life events (p = 0.030). The CBCL and the ILK at the beginning of treatment serve as a good screening instrument for psychopathology and distress in children with obesity.Keywords: obesity, childhood, screening instruments, therapy

Introduction: Respiratory syncytial virus (RSV) causes acute respiratory tract infection (ARTI) and reinfects adults throughout life, posing a risk for hospitalization in older adults (>60 years) with frailty and comorbidities., Methods: To investigate serum and mucosal antibodies for protection against RSV infections, baseline serum samples were compared for RSV-pre- and -post-fusion (F) binding, and RSV-A2 neutralizing IgG antibodies between symptomatic RSV-ARTI ( N = 30), non-RSV (RSV negative) ARTI ( N = 386), and no ARTI ( N = 338). Mucosal RSV-pre-F IgA and IgG levels, as well as serum RSV-G IgG antibodies, were analyzed to determine their association with protection from symptomatic RSV-ARTI in a subset study., Results: Using a receiver operating characteristic (ROC) analysis, we established thresholds of 1.4- to 1.6-fold change (FC) for RSV-pre-F and -post-F, and RSV-A2 neutralizing IgG antibodies, respectively, enabling the identification of asymptomatic RSV cases with high sensitivity and specificity (>80% and >90%, respectively). As a result, serum RSV-pre-F, RSV-G IgG, and mucosal pre-F binding IgA antibodies showed correlations with protection against symptomatic RSV infection. RSV-pre-F IgG antibodies were correlated with protection from RSV infections irrespective of the symptoms., Discussion: This study provides insights into antibody-mediated protection for symptomatic RSV infection in a community-dwelling older-adult population and establishes a threshold to identify asymptomatic RSV infection using a data-driven approach., Competing Interests: DÖ, SB-J, MC, AB, KT, SO, and JA were employed at the time the work was performed by Janssen Pharmaceuticals, a Johnson & Johnson company, and may be Johnson & Johnson stockholders. CV and AM were employed by Sanofi at the time the work was performed and may be Sanofi stockholder. CV is now employed by Vaccines Europe, Brussels, Belgium. BS and JD are employed by GlaxoSmithKline and may be GlaxoSmithKline stockholders. CB has participated in two virtual Advisory Boards for Moderna relevant to RSV vaccination on 30 March 2023 and 18 May 2023 and received payments. TV has received grant from Innovative Medicines Initiative European Commission, in which Biomerieux, Abbott, BD, BioRad, Janssen contributed ValueDx project, NIHR for project on cellulitis, and NHS UK regional funding for project on respiratory tract infections. He have been on the Advisory Board of a US study on lower respiratory tract infections in primary care EAST-PC funded by the Agency for Healthcare Research and Quality. He is a member of the Dutch Health Council. SD has provided consultancy and/or investigator roles in relation to product development for Janssen, AstraZeneca, Pfizer, Moderna, Valneva, MSD, iLiAD and Sanofi with fees paid to St George’s, University of London. SD has been on the RSV advisory board Sanofi Pasteur and received fees. SD also received support for travel for chairing a conference session, fees paid to his institution SGUL. SD is a member of the UK Department of Health and Social Care’s DHSC Joint Committee on Vaccination and Immunisation JCVI RSV subcommittee and Medicines and Healthcare products Regulatory Agency’s MHRA Paediatric Medicine Expert Advisory Group PMEAG. JW is investigator for clinical trials funded by pharmaceutical companies including AstraZeneca, Merck, Pfizer, Sanofi, and Janssen and investigator for clinical trials funded by IMI/Horizon2020 and ZonMw, with payments paid to her institution. She was a speaker at Sanofi sponsored symposium ESPID, payments paid to her institution. JW participated in the advisory board of Janssen RSV older adults and Sanofi advisory board with fees paid to UMCU. AP is part of EC IMI Programme RESCEU, payments paid to his institution. He has received grants from Gates, Wellcome, CEPI, MRC, NIHR, Serum Institute of India, AstraZeneca, and EC, with payments paid to his institution. Oxford University has entered into a partnership with AZ for development of COVID-19 vaccines. AP is a contributor to intellectual property licensed by Oxford University Innovation to AstraZeneca. AP is chair of the UK Department of Health and Social Care’s DHSC Joint Committee on Vaccination and Immunisation JCVI, NIHR Senior Investigator, member of the Academy of Medical Sciences AMS and was a member of WHO’s SAGE until January 2022. AP’s institution received funding from the European Commission’s IMI programme for the conduct of this study. Oxford University has entered a partnership with AstraZeneca for the development of COVID-19 vaccines. PO received honoraria GSK, Pfizer Inc, Sanofi Pasteur, Seqirus, Moderna and Janssen for participation in advisory boards and expert meetings and for acting as a speaker in congresses outside the scope of the submitted work. PO is also a principal investigator in the INFLAMMAGE trial co-funded by the Medical Research Council UK and GSK as part of the EMINENT consortium to promote inflammation research. He received grants from UKRI-MRC/DHSC NIHR Grant award MR/V027859/1, and UKRI-BEIS for human infection challenge with SARS-CoV-2 and had roles as school governor Sidcot, Somerset. LB has regular interaction with pharmaceutical and other industrial partners. He has not received personal fees or other personal benefits. UMCU has received major funding >€100,000 per industrial partner for investigator-initiated studies from AbbVie, MedImmune, AstraZeneca, Sanofi, Janssen, Pfizer, MSD and MeMed Diagnostics. UMCU has received major funding for the RSV GOLD study from the Bill and Melinda Gates Foundation. UMCU has received major funding as part of the public private partnership IMI-funded RESCEU and PROMISE projects with partners GSK, Novavax, Janssen, AstraZeneca, Pfizer and Sanofi. UMCU has received major funding from Julius Clinical for participating in clinical studies sponsored by MedImmune and Pfizer. UMCU received minor funding €1,000-25,000 per industrial partner for consultation and invited lectures by AbbVie, MedImmune, Ablynx, Bavaria Nordic, MabXience, GSK, Novavax, Pfizer, Moderna, AstraZeneca, MSD, Sanofi, Genzyme, Janssen. LB is the founding chairman of the ReSViNET Foundation. The remaining authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2024 Öner, Vernhes, Balla-Jhagjhoorsingh, Moureau, Crabbe, Salaun, Bastian, Thys, De Smedt, Ooft, Korsten, Adriaenssens, Coenen, Butler, Verheij, Drysdale, Wildenbeest, Pollard, Openshaw, Bont and Aerssens.)

Background: Urinary tract infections are responsible for a significant worldwide disease burden. Performing urine culture is time consuming and labor intensive. Urine flow cytometry might provide a quick and reliable method to screen for urinary tract infection., Methods: We analyzed routinely collected urine samples received between 2020 and 2022 from both inpatients and outpatients. The UF-4000 urine flow cytometer was implemented with an optimal threshold for positivity of ≥100 bacteria/μL. We thereafter validated the prognostic value to detect the presence of urinary tract infection (UTI) based on bacterial (BACT), leukocyte (WBC), and yeast-like cell (YLC) counts combined with the bacterial morphology (UF gram-flag)., Results: In the first phase, in 2019, the UF-4000 was implemented using 970 urine samples. In the second phase, between 2020 and 2022, the validation was performed in 42,958 midstream urine samples. The UF-4000 screen resulted in a 37% (n = 15,895) decrease in performed urine cultures. Uropathogens were identified in 18,673 (69%) positively flagged urine samples. BACT > 10.000/μL combined with a gram-negative flag had a >90% positive predictive value for the presence of gram-negative uropathogens. The absence of gram-positive flag or YLC had high negative predictive values (99% and >99%, respectively) and are, therefore, best used to rule out the presence of gram-positive bacteria or yeast. WBC counts did not add to the prediction of uropathogens., Conclusion: Implementation of the UF-4000 in routine practice decreased the number of cultured urine samples by 37%. Bacterial cell counts were highly predictive for the presence of UTI, especially when combined with the presence of a gram-negative flag., (© 2024 The Authors. Journal of Clinical Laboratory Analysis published by Wiley Periodicals LLC.)

Background: Respiratory syncytial virus (RSV) causes a considerable disease burden in young children globally, but reliable estimates of RSV-related costs and health-related quality-of-life (HRQoL) are scarce. This study aimed to evaluate the RSV-associated costs and HRQoL effects in infants and their caregivers in four European countries., Methods: Healthy term-born infants were recruited at birth and actively followed up in four European countries. Symptomatic infants were systematically tested for RSV. Caregivers recorded the daily HRQoL of their child and themselves, measured by a modified EQ-5D with Visual Analogue Scale, for 14 consecutive days or until symptoms resolved. At the end of each RSV episode, caregivers reported healthcare resource use and work absenteeism. Direct medical costs per RSV episode were estimated from a healthcare payer's perspective and indirect costs were estimated from a societal perspective. Means and 95% confidence intervals (CI) of direct medical costs, total costs (direct costs + productivity loss) and quality-adjusted life-day (QALD) loss per RSV episode were estimated per RSV episode, as well as per subgroup (medical attendance, country)., Results: Our cohort of 1041 infants experienced 265 RSV episodes with a mean symptom duration of 12.5 days. The mean (95% CI) cost per RSV episode was €399.5 (242.3, 584.2) and €494.3 (317.7, 696.1) from the healthcare payer's and societal perspective, respectively. The mean QALD loss per RSV episode of 1.9 (1.7, 2.1) was independent of medical attendance (in contrast to costs, which also differed by country). Caregiver and infant HRQoL evolved similarly., Conclusion: This study fills essential gaps for future economic evaluations by prospectively estimating direct and indirect costs and HRQoL effects on healthy term infants and caregivers separately, for both medically attended (MA) and non-MA laboratory-confirmed RSV episodes. We generally observed greater HRQoL losses than in previous studies which used non-community and/or non-prospective designs., Competing Interests: Declaration of Competing Interest The authors declare the following financial interests/personal relationships which may be considered as potential competing interests: 'PB reported consulting fees from Pfizer, GSK on 2 occasions for discussions on economic evaluation, for a total of <€3000 combined, paid 100% directly to the University of Antwerp. NH reported grants from Janssen Vaccines & Prevention BV (R-11873) for collection of social contact data relevant for the spread of respiratory pathogens including SARS-CoV-2, RSV, influenza. NH reports consulting fees from Janssen Global Services for participation in advisory board related to RSV disease transmission modelling; payments made to Hasselt University. LB has regular interaction with pharmaceutical and other industrial partners. He has not received personal fees or other personal benefits. UMCU has received major funding (>€100,000 per industrial partner) for investigator initiated studies from AbbVie, MedImmune, Janssen, the Bill and Melinda Gates Foundation, Nutricia (Danone) and MeMed Diagnostics. UMCU has received major cash or in kind funding as part of the public private partnership IMI-funded RESCEU project from GSK, Novavax, Janssen, AstraZeneca, Pfizer and Sanofi. UMCU has received major funding by Julius Clinical for participating in the INFORM study sponsored by MedImmune. UMCU has received minor funding for participation in trials by Regeneron and Janssen from 2015-2017 (total annual estimate less than €20,000). UMCU received minor funding for consultation and invited lectures by AbbVie, MedImmune, Ablynx, Bavaria Nordic, MabXience, Novavax, Pfizer, Janssen (total annual estimate less than €20,000). Dr. Bont is the founding chairman of the ReSViNET Foundation. SC reported IMI – RESCEU grant funding (as detailed in manuscript), with fees paid to the University of Edinburgh. FM-T has received honoraria from GSK group of companies, Pfizer Inc, Sanofi Pasteur, MSD, Seqirus, Biofabri and Janssen for taking part in advisory boards and expert meetings and for acting as a speaker in congresses outside the scope of the submitted work. FM-T has also acted as principal investigator in randomized controlled trials of the above-mentioned companies as well as Ablynx, Gilead, Regeneron, Roche, Abbott, Novavax, and MedImmune, with honoraria paid to his institution. TH has received honoraria for lectures and/or participation in advisory boards or data monitoring committees from Janssen, Sanofi Pasteur, Enanta and MSD. MDS acted until September 2022 on behalf of the University of Oxford as an Investigator on research studies funded or supported by the vaccine manufacturers GlaxoSmithKline, Janssen, AstraZeneca, Novavax, MCM vaccines and Pfizer. He received no direct personal benefit for this work. From September 2022 he has been an employee at Moderna Biotech UK and holds stock options in this company. AJP is a member of AMS and Senior Investigator of NIHR. KK has received fees for interview for expert opinion considering the burden of RSV in older adults with IQVIA (part of Janssen) as well as interview for expert opinion considering the burden of RSV in older adults with Deallus. AD has participated as sub-investigator in clinical trials and observational studies for Novavax, MedImmune, Janssen GSK, Pfizer, Merk, Sharp Donme, ReViral, Enanta Pharmaceuticals. All payments were made to the institution and no direct payment was received. MJP is a member of JCVI and reports stock or stock options for HealthEcore (25% of shares) and PAG BV (100% of shares). All other authors report no potential conflicts of interest., (Copyright © 2023 Elsevier Ltd. All rights reserved.)

Background: Respiratory syncytial virus (RSV) is a major cause of hospitalisation in infants. The burden of RSV infection in healthy term infants has not yet been established. Accurate health-care burden data in healthy infants are necessary to determine RSV immunisation policy when RSV immunisation becomes available., Methods: We performed a multicentre, prospective, observational birth cohort study in healthy term-born infants (≥37 weeks of gestation) in five sites located in different European countries to determine the health-care burden of RSV. The incidence of RSV-associated hospitalisations in the first year of life was determined by parental questionnaires and hospital chart reviews. We performed active RSV surveillance in a nested cohort to determine the incidence of medically attended RSV infections. The study is registered with ClinicalTrials.gov, NCT03627572., Findings: In total, 9154 infants born between July 1, 2017, and April 1, 2020, were followed up during the first year of life and 993 participated in the nested active surveillance cohort. The incidence of RSV-associated hospitalisations in the total cohort was 1·8% (95% CI 1·6-2·1). There were eight paediatric intensive care unit admissions, corresponding to 5·5% of 145 RSV-associated hospitalisations and 0·09% of the total cohort. Incidence of RSV infection in the active surveillance cohort confirmed by any diagnostic assay was 26·2% (24·0-28·6) and that of medically attended RSV infection was 14·1% (12·3-16·0)., Interpretation: RSV-associated acute respiratory infection causes substantial morbidity, leading to the hospitalisation of one in every 56 healthy term-born infants in high-income settings. Immunisation of pregnant women or healthy term-born infants during their first winter season could have a major effect on the health-care burden caused by RSV infections., Funding: Innovative Medicines Initiative 2 Joint Undertaking, with support from the EU's Horizon 2020 research and innovation programme and European Federation of Pharmaceutical Industries and Associations., Competing Interests: Declaration of interests LJB has regular interaction with pharmaceutical and other industrial partners. He has not received personal fees or other personal benefits. UMCU has received major funding (>€100 000 per industrial partner) for investigator initiated studies from AbbVie, MedImmune, AstraZeneca, Sanofi, Janssen, Pfizer, MSD, and MeMed Diagnostics. UMCU has received major funding for the RSV GOLD study from the Bill & Melinda Gates Foundation. UMCU has received major funding as part of the public private partnership IMI-funded RESCEU and PROMISE projects with partners GSK, Novavax, Janssen, AstraZeneca, Pfizer, and Sanofi. UMCU has received major funding by Julius Clinical for participating in clinical studies sponsored by MedImmune and Pfizer. UMCU received minor funding (€1000–25 000 per industrial partner) for consultation and invited lectures by AbbVie, MedImmune, Ablynx, Bavaria Nordic, MabXience, GSK, Novavax, Pfizer, Moderna, Astrazeneca, MSD, Sanofi, Genzyme, and Janssen. LJB is the founding chairman of the ReSViNET Foundation. SC has provided consultancy or investigator roles in relation to product development for Ablynx, Janssen, MedImmune, AstraZeneca, Pfizer, GSK, Vertex, AbbVie, Valneva, Fibrogen, and Boehringer Ingelheim, with fees paid to the University of Edinburgh. FM-T reports honoraria from GSK group, Pfizer, Sanofi Pasteur, MSD, Seqirus, Biofabri, and Janssen for taking part in advisory boards and expert meetings and for acting as a speaker in congresses, outside the submitted work; and principal investigator-role in randomised controlled trials for GSK, Pfizer, Sanofi Pasteur, MSD, Seqirus, Biofabri, Janssen, Ablynx, Gilead, Regeneron, Roche, Abbott, Novavax, and MedImmune, with honoraria paid to his institution. MDS acts as an investigator on behalf of the University of Oxford on research studies funded by vaccine manufacturers including GSK, Janssen, MCM vaccines, Novavax, AtraZeneca, and Pfizer. MDS was an National Institute for Heath and Care Research (NIHR) Senior Investigator and received salary support from the NIHR Oxford Biomedical Research Centre during the course of this work. MDS is currently an employee of Moderna. SBD had received honoraria from MSD and Sanofi Pasteur for taking part in advisory boards and has provided consultancy or investigator roles in relation to product development for Janssen, AstraZeneca, Pfizer, Valneva, MSD, and Sanofi Pasteur with fees paid to St George's University of London. TH has received honoraria for lectures or participation in advisory boards or data monitoring committees from Janssen, Sanofi Pasteur, Enanta, and MSD. BR is a full-time employee of the GSK group and holds shares and restricted shares in the GSK group as part of their employee remuneration. AJP is currently Chair of the Department of Health Social Cares Joint Committee on Vaccination and Immunisation and was previously a member of WHO Scientific Advisory Group for Emergencies and chair of the European Medicine's Agency Scientific Advisory Group on Vaccines. All other authors declare no competing interests., (Copyright © 2023 Elsevier Ltd. All rights reserved.)

Background: Respiratory syncytial virus (RSV) surveillance is heavily dependent on the influenza-like illness (ILI) case definition from the World Health Organization (WHO). Because ILI includes fever in its syndromic case definition, its ability to accurately identify acute respiratory tract infections (ARTI) caused by RSV in older adults is uncertain., Methods: The accuracy of the WHO ILI and a modified ILI (requiring only self-reported fever) case definitions in identifying patients with PCR-confirmed RSV-ARTI was evaluated in community-dwelling older adults (≥60 years) from the prospective European RESCEU cohort study., Results: Among 1040 participants, 750 ARTI episodes were analyzed including 36 confirmed RSV-ARTI. Due to a general lack of fever, sensitivity for RSV-ARTI was 33% for modified ILI and 11% for ILI. The area under the curve for both ILI definitions was 0.52 indicating poor discrimination for RSV. RSV-ARTI could not be distinguished from all other ARTI based on clinical symptoms., Conclusions: The use of ILI underestimated the occurrence of RSV-ARTI in community-dwelling older adults up to 9-fold (11% sensitivity). Because worldwide RSV surveillance depends largely on ILI, there is an urgent need for a better approach to measure the occurrence of RSV disease and the impact of future RSV vaccine introduction. Clinical Trials Registration. NCT03621930., Competing Interests: Potential conflicts of interest. C. B. reports personal fees from Roche, and grants and personal fees from Jannsen Pharmaceuticals. L. B. has regular interaction with pharmaceutical and other industrial partners and is founding chairman of the ReSViNET Foundation; he has not received personal fees or other personal benefits. His institution has received major funding (>€100 000 per industrial partner) for investigator initiated studies from AbbVie, MedImmune, Janssen, Bill and Melinda Gates Foundation, Nutricia (Danone), and MeMed Diagnostics; major cash or in kind funding as part of the public private partnership IMI-funded RESCEU project from GSK, Novavax, Janssen, AstraZeneca, Pfizer, and Sanofi; major funding from Julius Clinical for participating in the INFORM study sponsored by MedImmune; minor funding for participation in trials by Regeneron and Janssen from 2015 to 2017 (total annual estimate less than €20 000); and minor funding for consultation and invited lectures by AbbVie, MedImmune, Ablynx, Bavaria Nordic, MabXience, Novavax, Pfizer, and Janssen (total annual estimate less than €20 000). T. V. reports grants from Abbott, Becton Dickinson, Bio-Merieux, and Janssen Pharmaceuticals outside the submitted work. All other authors report no potential conflicts. All authors have submitted the ICMJE Form for Disclosure of Potential Conflicts of Interest. Conflicts that the editors consider relevant to the content of the manuscript have been disclosed., (© The Author(s) 2021. Published by Oxford University Press for the Infectious Diseases Society of America.)

Background: Knowledge about how older adults get a respiratory infection is crucial for planning preventive strategies. We aimed to determine how contact with young children living outside of the household affects the risk of acute respiratory tract infections (ARTI) in community-dwelling older adults., Methods: This study is part of the European RESCEU older adult study. Weekly surveillance was performed to detect ARTI throughout 2 winter seasons (2017-2018, 2018-2019). Child exposure, defined as having regular contact with children under 5 living outside of the subject's household, was assessed at baseline. The average attributable fraction was calculated to determine the fraction of ARTI explained by exposure to these children., Results: We prospectively established that 597/1006 (59%) participants experienced at least 1 ARTI. Child exposure increased the risk of all-cause ARTI (adjusted odds ratio [aOR], 1.58; 95% confidence interval [CI], 1.21 -2.08; P = .001). This risk was highest in those with the most frequent contact (aOR, 1.80; 95% CI, 1.23-2.63; P = .003). The average attributable fraction of child exposure explaining ARTI was 10% (95% CI, 5%-15%)., Conclusions: One of 10 ARTI in community-dwelling older adults is attributable to exposure to preschool children living outside of the household., Clinical Trials Registration: NCT03621930., Competing Interests: Potential conflicts of interest. C. B. reports personal fees from Roche, and grants and personal fees from Jannsen Pharmaceuticals. L. B. has regular interaction with pharmaceutical and other industrial partners and is founding chairman of the ReSViNET Foundation; he has not received personal fees or other personal benefits. His institution has received major funding (>€100 000 per industrial partner) for investigator initiated studies from AbbVie, MedImmune, Janssen, Bill and Melinda Gates Foundation, Nutricia (Danone), and MeMed Diagnostics; major cash or in kind funding as part of the public private partnership IMI-funded RESCEU project from GSK, Novavax, Janssen, AstraZeneca, Pfizer, and Sanofi; major funding from Julius Clinical for participating in the INFORM study sponsored by MedImmune; minor funding for participation in trials by Regeneron and Janssen from 2015 to 2017 (total annual estimate less than €20 000); and minor funding for consultation and invited lectures by AbbVie, MedImmune, Ablynx, Bavaria Nordic, MabXience, Novavax, Pfizer, and Janssen (total annual estimate less than €20 000). T. V. reports grants from Abbott, Becton Dickinson, Bio-Merieux, and Janssen Pharmaceuticals outside the submitted work. All other authors report no potential conflicts. All authors have submitted the ICMJE Form for Disclosure of Potential Conflicts of Interest. Conflicts that the editors consider relevant to the content of the manuscript have been disclosed., (© The Author(s) 2021. Published by Oxford University Press for the Infectious Diseases Society of America.)

Background: Respiratory syncytial virus (RSV) causes a substantial burden in older adults. Viral load in RSV-infected adults is generally lower compared to young children, which could result in suboptimal sensitivity of RSV diagnostics. Although the Xpert® Xpress Flu/RSV assay has been used in routine clinical care, its sensitivity to diagnose RSV infection in older adults is largely unknown. We aimed to compare the performance of the Xpert® Xpress Flu/RSV assay with real-time reverse-transcription polymerase chain reaction (RT-PCR) in home-dwelling older adults (≥60 years of age)., Methods: Nasopharyngeal swabs were tested with Xpert® Xpress Flu/RSV and compared to RSV RT-PCR in older adults with acute respiratory tract infections with different levels of disease severity., Results: We studied 758 respiratory samples from 561 older adults from 2 consecutive RSV seasons. Thirty-five (4.6%) samples tested positive for RSV by at least 1 of the assays, of which 2 samples were negative by Xpert® Xpress Flu/RSV and 3 samples by real-time RT-PCR. The positive percentage agreement (PPA) was 90.9% (95% confidence interval [CI], 76.4%-96.8%) and negative percentage agreement was 99.7% (95% CI, 99.0%-99.9%). Viral loads were low (≤103 copies/mL or cycle threshold value ≥34) in all cases with discordant results for the 2 assays., Conclusions: The PPA of Xpert® Xpress Flu/RSV compared to routine RT-PCR is high for RSV detection in home-dwelling older adults. The assay is fast and easy to use at the point of care., Clinical Trials Registration: NCT03621930., Competing Interests: Potential conflicts of interest. N. A. reports grants and nonfinancial support from European Union’s Horizon 2020 Research and Innovation Programme and EFPIA, during the conduct of the study. O. G. reports personal fees from GSK, outside the submitted work. C. B. reports grants from the European Union, during the conduct of the study; and personal fees from Roche, grants and personal fees from Janssen Pharmaceuticals, and grants from the National Institute of Health Care Research, outside the submitted work. S. C. reports grants and nonfinancial support from the European Union’s Horizon 2020 Research and Innovation Programme and EFPIA, during the conduct of the study. L. J. B. has regular interaction with pharmaceutical and other industrial partners, but has not received personal fees or other personal benefits. He is also the founding chairman of the ReSViNET Foundation. University Medical Centre Utrecht has received major funding (>€100,000 per industrial partner) for investigator-initiated studies from AbbVie, MedImmune, Janssen, the Bill & Melinda Gates Foundation, Nutricia (Danone), and MeMed Diagnostics; major cash or in-kind funding as part of the public-private partnership IMI-funded RESCEU project from GSK, Novavax, Janssen, AstraZeneca, Pfizer, and Sanofi; major funding by Julius Clinical for participating in the INFORM study sponsored by MedImmune; minor funding for participation in trials by Regeneron and Janssen from 2015 to 2017 (total annual estimate <€20,000); and minor funding for consultation and invited lectures by AbbVie, MedImmune, Ablynx, Bavaria Nordic, MabXience, Novavax, Pfizer, and Janssen (total annual estimate <€20,000). All other authors report no potential conflicts of interest. All authors have submitted the ICMJE Form for Disclosure of Potential Conflicts of Interest. Conflicts that the editors consider relevant to the content of the manuscript have been disclosed., (© The Author(s) 2022. Published by Oxford University Press for the Infectious Diseases Society of America.)

Background: Respiratory syncytial virus (RSV) and influenza virus infections result in a considerable mortality and morbidity among the aging population globally. Influenza vaccination for older adults before the seasonal influenza epidemic has been evaluated to be cost-effective in many countries. Interventions against RSV in older adults are in the pipeline, and evaluating their cost-effectiveness is crucial for decision making. To inform such evaluations, our aim was to estimate average costs and health-related quality of life (HRQoL) in older adults with RSV and influenza infection., Methods: The European RESCEU observational cohort study followed 1040 relatively healthy community-dwelling older adults aged 60 years and older during 2 consecutive winter seasons. Health care resource use and HRQoL were collected and analyzed during RSV episodes, and also during influenza episodes. Country-specific unit cost data were mainly obtained from national databases. Direct costs were estimated from a patient, health care provider, and health care payers' perspective, whereas indirect costs were estimated from a societal perspective. Due to small sample size, no formal statistical comparisons were made., Results: Thirty-six RSV and 60 influenza episodes were reported, including 1 hospitalization. Means (median; first-third quartile) of €26.4 (€5.5; 0-47.3) direct and €4.4 (€0; 0-0) indirect costs were reported per nonhospitalized RSV episode, and €42.5 (€36; 3.3-66.7) direct and €32.1 (€0; 0-0) indirect costs per nonhospitalized influenza episode. For RSV episodes, the utility value decreased from 0.896 (0.928; 0.854-0.953) to 0.801 (0.854; 0.712-0.937) from preseason to 1 week after symptom onset; for influenza, the change was from 0.872 (0.895; 0.828-0.953) to 0.664 (0.686; 0.574-0.797)., Conclusions: The average costs and HRQoL estimates of older adults treated outside the hospital can be used to inform the design of future studies and the decision making regarding interventions to prevent RSV infection in older adults. Larger studies are needed to provide better country-specific and complementary cost estimates and to allow for formal statistical comparison of costs between RSV and influenza., Clinical Trials Registration: NCT03621930., Competing Interests: Potential conflicts of interest. L. B. declares regular interaction with pharmaceutical and other industrial partners, but has not received personal fees or other personal benefits. The University Medical Center Utrecht (UMCU) has received major funding (>€100 000 per industrial partner) for investigator-initiated studies from AbbVie, MedImmune, Janssen, Pfizer, the Bill and Melinda Gates Foundation, and MeMed Diagnostics; major cash or in-kind funding as part of the public private partnership IMI-funded RESCEU project from GSK, Novavax, Janssen, AstraZeneca, Pfizer, and Sanofi; and major funding from Julius Clinical for participating in the INFORM study. P. B. declares consulting fees from Pfizer and GSK on two occasions for discussions on economic evaluation and the payments were made to the University of Antwerp. N. H. declares grants from Janssen Vaccines & Prevention BV (R-11873) to collect social contact data relevant for the spread of respiratory pathogens including SARS-CoV-2, RSV, and influenza; and consulting fees from Janssen Global Services to participate in an advisory board related to RSV disease transmission modelling and the payments were made to Hasselt University. All other authors report no potential conflicts of interest. All authors have submitted the ICMJE Form for Disclosure of Potential Conflicts of Interest. Conflicts that the editors consider relevant to the content of the manuscript have been disclosed., (© The Author(s) 2022. Published by Oxford University Press for the Infectious Diseases Society of America. All rights reserved. For permissions, e-mail: journals.permissions@oup.com.)

Background: Respiratory syncytial virus (RSV) infection in older adults is recognised as an important health issue. We aimed to assess the community burden of RSV in Europe in older adults aged ≥60 years., Methods: This international, prospective, observational cohort study is part of work by the REspiratory Syncytial virus Consortium in EUrope (RESCEU). Participants were recruited through general practitioners' (GPs) offices before two independent RSV seasons. Participants reported weekly about symptoms of acute respiratory tract infection (ARTI) during one RSV season. ARTI patients were tested for RSV during home visits and completed a daily symptom diary. RSV illness included PCR-confirmed ARTI and those showing seroconversion over the season. RSV ARTI was based on PCR alone (ClinicalTrials.gov, NCT03621930)., Results: We recruited 1040 participants (527 in season 2017-2018 and 513 in season 2018-2019) with a median age of 75 years (range 60-100 years). Of these, 1023 (99%) lived independently at home at baseline. RSV illness incidence was 22 out of 527 (4.2%) and 37 out of 513 (7.2%) in the respective seasons. RSV illness did not affect frailty or cardiopulmonary status during the course of the study. No patients were hospitalised or died from RSV illness. In the 36 patients with PCR confirmed RSV ARTI, symptom duration averaged 19 days, while a doctor's visit took place in 11 out of 36 cases (31%). RSV ARTI could not be differentiated clinically from all other ARTIs based on symptoms., Conclusion: This European study showed that RSV is prevalent in community-dwelling older adults and rarely causes severe disease. This suggests that watchful waiting, using a continuity of care approach to identify those who do need more intensive care, is often justified when RSV is suspected in family practice., Competing Interests: Conflict of interest: K. Korsten has nothing to disclose. Conflict of interest: N. Adriaenssens has nothing to disclose. Conflict of interest: S. Coenen reports grants and non-financial support from European Union (EU) Horizon 2020 research and innovation programme and the European Federation of Pharmaceutical Industries and Associations (EFPIA) Innovative Medicines Initiative 2 (IMI-2) Joint Undertaking (grant: 116019), during the conduct of the study. Conflict of interest: C. Butler reports grants from the National Institute for Health Research (NIHR) (as NIHR Senior Investigator), grants from the EU Horizon 2020 programme to support the study, grants from the NIHR Health Protection Research Unit on Health Care Associated Infections and Antimicrobial Resistance, grants from the NIHR Health for the MedTech and In Vitro Diagnostics Cooperative for innovative diagnostics and monitoring technology to enhance community healthcare, during the conduct of the study; personal fees for advisory board work from Pfizer and Roche Molecular Systems; and grants from Roche Molecular Diagnostics. Conflict of interest: B. Ravanfar has nothing to disclose. Conflict of interest: H. Rutter has nothing to disclose. Conflict of interest: J. Allen has nothing to disclose. Conflict of interest: A. Falsey reports grants from Janssen, Merck, Sharpe and Dohme, and Pfizer, as well as non-financial support for meeting attendance from Sanofi Pasteur, outside the submitted work. Conflict of interest: J-Y. Pirçon is an employee of GlaxoSmithKline Vaccines. Conflict of interest: O. Gruselle is an employee of GlaxoSmithKline. Conflict of interest: V. Pavot is an employee of Sanofi Pasteur. Conflict of interest: C. Vernhes is an employee of Sanofi Pasteur. Conflict of interest: S. Balla-Jhagjhoorsingh is an employee of Janssen Vaccines & Prevention. Conflict of interest: D. Öner is an employee of Janssen Pharmaceutica NV and reports grants from the IMI-2 Joint Undertaking (grant: 116019), during the conduct of the study. Conflict of interest: G. Ispas is an employee of Janssen Pharmaceutica NV. Conflict of interest: J. Aerssens is an employee of Janssen Pharmaceutica NV. Conflict of interest: V. Shinde has nothing to disclose. Conflict of interest: T. Verheij reports grants from Janssen Pharmaceuticals, Becton Dickinson, Abbott and Biomerieux, outside the submitted work. Conflict of interest: L. Bont has regular interaction with pharmaceutical and other industrial partners. He has not received personal fees or other personal benefits; however, University Medical Center Utrecht has received major funding for investigator-initiated studies from AbbVie, MedImmune, Janssen, the Bill and Melinda Gates Foundation, Nutricia (Danone) and MeMed Diagnostics; has received major cash or in kind funding as part of the public–private partnership, IMI-2 funded REspiratory Syncytial virus Consortium in EUrope (RESCEU) project from GlaxoSmithKline, Novavax, Janssen, AstraZeneca, Pfizer and Sanofi; has received major funding from Julius Clinical for participating in the INFORM study sponsored by MedImmune; has received minor funding for participation in trials by Regeneron and Janssen from 2015–2017; and has received minor funding for consultation and invited lectures by AbbVie, MedImmune, Ablynx, Bavaria Nordic, MabXience, Novavax, Pfizer and Janssen. L. Bont is also the founding chairman of the ReSViNET Foundation. Conflict of interest: J. Wildenbeest has nothing to disclose., (Copyright © ERS 2021.)

Background: Respiratory syncytial virus (RSV) causes significant morbidity and mortality in infants worldwide. Although prematurity and cardiopulmonary disease are risk factors for severe disease, the majority of infants hospitalized with RSV are previously healthy. Various vaccines and therapeutics are under development and expected to be available in the near future. To inform the use of these new vaccines and therapeutics, it is necessary to determine the burden of RSV disease in Europe. We will prospectively follow-up a birth cohort to obtain incidence data on RSV acute respiratory tract infection (ARTI)., Methods: Multicenter prospective study of a birth cohort consisting of 10 000 healthy infants, recruited during 3 consecutive years. RSV associated hospitalization in the first year of life will be determined by questionnaires and hospital chart reviews. A nested cohort of 1000 infants will be actively followed. In case of ARTI, a respiratory sample will be collected for RSV molecular diagnosis., Results: The primary outcome is the incidence rate of RSV-associated hospitalization in the first year of life. In the active cohort the primary outcome is RSV associated ARTI and MA-ARTI., Conclusions: We will provide key information to fill the gaps in knowledge about the burden of RSV disease in healthy infants., Clinical Trials Registration: NCT03627572., (© The Author(s) 2020. Published by Oxford University Press for the Infectious Diseases Society of America. All rights reserved. For permissions, e-mail: journals.permissions@oup.com.)

Background: Respiratory syncytial virus (RSV) is a major cause of hospitalization in infants. Early detection of RSV can optimize clinical management and minimize use of antibiotics. BinaxNOW RSV (BN) is a rapid antigen detection test that is widely used. We aimed to validate the sensitivity of BN in hospitalized and nonhospitalized infants against the gold standard of molecular diagnosis., Methods: We evaluated the performance of BN in infants with acute respiratory tract infections with different degrees of disease severity. Diagnostic accuracy of BN test results were compared with molecular diagnosis as reference standard., Results: One hundred sixty-two respiratory samples from 148 children from October 2017 to February 2019 were studied. Sixty-six (40.7%) samples tested positive for RSV (30 hospitalizations, 31 medically attended episodes not requiring hospitalization, and 5 nonmedically attended episodes). Five of these samples tested positive with BN, leading to an overall sensitivity of BN of 7.6% (95% confidence interval [CI], 3.3%-16.5%) and a specificity of 100% (95% CI, 96.2%-100%). Sensitivity was low in all subgroups., Conclusions: We found a low sensitivity of BN for point-of-care detection of RSV infection. BinaxNOW RSV should be used and interpreted with caution., (© The Author(s) 2020. Published by Oxford University Press for the Infectious Diseases Society of America. All rights reserved. For permissions, e-mail: journals.permissions@oup.com.)

Background: Because diagnosing asthma in school-aged children is challenging, a variety of proxies for asthma are used in clinical practice and research settings as indicators of this disease. We aimed to provide insight into the agreement between various asthma indicators based on parental report, medical diagnosis and spirometry., Methods: Children from the WHISTLER birth cohort performed spirometry and were followed up with parental ISAAC (International Study of Asthma and Allergies in Childhood) questionnaires about asthma at 5 and 8 years of age. Medical data were extracted from primary care records. We compared 15 asthma indicators based on parental report, medical diagnosis and spirometry using positive agreement, κ statistics and latent class cluster analysis., Results: At 5 years of age, 1007 children completed a study visit, while 803 children visited at 8 years of age. Depending on the indicator, the responder and child's age, the asthma prevalence ranged from 0.2% to 26.6%. Cluster analysis revealed classes related to the presence of recent symptoms and a decreased lung function. Agreement between parents and doctors was generally low with κ coefficients ranging from 0.07 (recent wheeze) to 0.52 (recent asthma medication). Additionally, parental report showed to be sensitive to recall bias over time., Conclusions: Dependent on the asthma indicator, the responder and the age of the child, substantial differences in agreement were observed between commonly used indicators associated with asthmatic disease in school-aged children. Most agreement between parents and doctors was seen for objective and recent indicators such as the recent use of asthma medication. We advocate caution when literature with different asthma indicators is compared., Competing Interests: Conflict of interest: K. Korsten has nothing to disclose. Conflict of interest: C.A. Naaktgeboren has nothing to disclose. Conflict of interest: L.J. Bont is the founding chairman of the ReSViNET Foundation. L.J. Bont has regular interaction with pharmaceutical and other industrial partners. He has not received personal fees or other personal benefits. UMCU has received major funding (greater than €100 000 per industrial partner) for investigator-initiated studies from AbbVie, MedImmune, Janssen, the Bill and Melinda Gates Foundation, Nutricia (Danone) and MeMed Diagnostics. UMCU has received major cash or in-kind funding as part of the public–private partnership IMI-funded RESCEU project from GSK, Novavax, Janssen, AstraZeneca, Pfizer and Sanofi. UMCU has received major funding by Julius Clinical for participating in the INFORM study sponsored by MedImmune. UMCU has received minor funding for participation in trials by Regeneron and Janssen from 2015–2017 (total annual estimate less than €20 000). UMCU received minor funding for consultation and invited lectures by AbbVie, MedImmune, Ablynx, Bavaria Nordic, MabXience, Novavax, Pfizer, Janssen (total annual estimate less than €20 000). Conflict of interest: C.K. van der Ent reports grants from GSK, Nutricia, TEVA, Gilead, Vertex, ProQR, Proteostasis and Galapagos NV, outside the submitted work. Conflict of interest: M.L.A. de Hoog has nothing to disclose., (Copyright ©ERS 2020.)

Severe respiratory syncytial virus (RSV) infection during infancy is associated with ongoing respiratory morbidity. In a large birth cohort of 2210 healthy preterm infants born at 32-35 weeks of gestation, we aimed to determine the role of atopy in the link between RSV hospitalization and current wheeze at age 6. We defined current wheeze as parent-reported wheeze or the use of respiratory medication in the past 12 months. Based on a positive family history of atopic disease, we distinguished between children with and without atopic predisposition. Six-year follow-up data was obtained in 997/1559 (64%) children of which 102 (10.2%) children had been hospitalized with RSV during infancy. Current wheeze was present in 184/997 (18.6%) children. RSV hospitalization was an independent risk factor for current wheeze in children without atopic predisposition (aOR 4.05 [95% CI 1.22-12.52]) but not in children with this atopic background (aOR 1.50 [95% CI 0.81-2.71]).Conclusion: This is the largest published birth cohort demonstrating that in late preterm infants, atopic predisposition defines the relationship between RSV hospitalization and current wheeze. Future RSV prevention trials aiming to prevent ongoing respiratory symptoms should be analyzed separately for atopic status. What is Known: • RSV infection is responsible for a significant burden of disease in young children worldwide. • Severe RSV infection in early life is associated with asthmatic symptoms later in life. What is New: • This is the largest published birth cohort reporting about the role of atopic predisposition in the link between severe RSV infection and current wheeze at school age. • We show that RSV hospitalization in infancy is an independent risk factor for current wheeze in late preterm children without atopic predisposition at age 6. This was not seen in children with atopic predisposition.

Background: Recurrent wheezing in young infants has a high prevalence, influences quality of life, and generates substantial health care costs. We previously showed that respiratory syncytial virus infection is an important mechanism of recurrent wheezing in moderate preterm infants. We aimed to provide population-attributable risks (PAR) of risk factors for recurrent wheezing during the first year of life in otherwise healthy moderate preterm infants., Methods: RISK is a multicentre prospective birth cohort study of 4424 moderate preterm infants born at 32-35 weeks gestation. We estimated PAR of risk factors for recurrent wheezing, which was defined as three or more parent-reported wheezing episodes during the first year of life., Results: We evaluated 3952 (89%) children at 1 year of age, of whom 705 infants (18%) developed recurrent wheezing. Fourteen variables were independently associated with recurrent wheezing. Hospitalisation for respiratory syncytial virus bronchiolitis had a strong relationship with recurrent wheezing (RR 2.6; 95% confidence interval, CI, 2.2, 3.1), but a relative modest PAR (8%; 95% CI 6, 11%) which can be explained by a low prevalence (13%). Day-care attendance showed a strong relationship with recurrent wheezing (RR 1.9; 95% CI 1.7, 2.2) and the highest PAR (32%; 95% CI 23, 37%) due to a high prevalence (67%). The combined adjusted PAR for the 14 risk factors associated with recurrent wheezing was 49% (95% CI 46, 52%)., Conclusions: In moderate preterm infants, day-care attendance has the largest PAR for recurrent wheezing. Trial evidence is needed to determine the potential benefit of delayed day-care attendance in this population., (© 2016 John Wiley & Sons Ltd.)

Background: New vaccines and RSV therapeutics have been developed in the past decade. With approval of these new pharmaceuticals on the horizon, new challenges lie ahead in selecting the appropriate target population. We aimed to improve a previously published prediction model for prediction of RSV-hospitalization within the first year of life., Methods: Two consecutive prospective multicenter birth cohort studies were performed from June 2008 until February 2015. The first cohort (RISK-I, n=2524, 2008-2011) was used to update the existing model. The updated model was subsequently validated in the RISK-II cohort (n=1564, 2011-2015). We used the TRIPOD criteria for transparent reporting., Results: 181 infants (n=127 in RISK-I, n=54 in RISK-II) were hospitalized for RSV within their first year of life. The updated model included the following predictors; day care attendance and/or siblings (OR: 5.3; 95% CI 2.8-10.1), birth between Aug. 14th and Dec. 1st (OR: 2.4; 1.8-3.2), neonatal respiratory support (OR 2.2; 1.6-3.0), breastfeeding ≤4 months (OR 1.6; 1.2-2.2) and maternal atopic constitution (OR 1.5; 1.1-2.1). The updated models' discrimination was superior to the original model in the RISK-II cohort (AUROC 0.72 95% CI 0.65-0.78 versus AUROC 0.66, 95% CI 0.60-0.73, respectively). The updated model was translated into a simple nomogram to be able to distinguish infants with high versus low risk of RSV-hospitalization., Conclusion: We developed and validated a clinical prediction model to be able to predict RSV-hospitalization in preterm infants born within 32-35 weeks gestational age. A simple nomogram was developed to target RSV therapeutics to those children who will benefit the most., (Copyright © 2016. Published by Elsevier Ireland Ltd.)

Purpose: Despite previous studies the management of Rockwood type III acromioclavicular (AC) dislocations remains controversial and the debate continues about whether patients with Rockwood type III AC injuries should be treated conservatively or operatively. In this study, we will review the current literature and present an overview of the outcome of conservative versus operative treatment of Rockwood type III dislocations., Methods: The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines was used to conduct this review. A systematic search was performed in the Pubmed, Cochrane library, Embase, Scopus and Cumulative Index to Nursing and Allied Health Literature databases. Titles and abstracts were screened using predefined criteria and articles were critically appraised on relevance and validity., Results: After critical appraisal eight articles were included in the study. The objective and subjective shoulder function outcome was better in the operative group, especially in young adults, though the rate of complications and radiographic abnormalities were higher. The rehabilitation time was shorter in the conservative group, however the cosmetic outcome was worse., Conclusions: This review showed no conclusive evidence for the treatment of Rockwood type III AC dislocations. Overall, physically active young adults seem to have a slight advantage in outcome when treated operatively.

The psychosocial situation of obese children at the beginning of the Freiburg Intervention Trial for Obese Children (FITOC) program influences the course and outcome of intervention therapy. At the beginning of FITOC, mothers of 30 children (12 ♂ age 10.5 ± 1.4, 18 ♀; 10.2 ± 1.3) rated the psychopathological symptoms using the Child Behavior Checklist (CBCL) and the quality of life of their children (Inventar zur Erfassung der Lebensqualität [ILK]). 46.6% of mothers rated their children to be disturbed (normal population group, 2% disturbed). There was no correlation between the body mass index of the child and the CBCL score. On the ILK, the obese children themselves selected "good" while the mother's view of their childrens' quality of life varied around "poor". The stress on the mother increased with the degree of the child's obesity and number of critical life events (p = 0.030). The CBCL and the ILK at the beginning of treatment serve as a good screening instrument for psychopathology and distress in children with obesity.

Objective: This paper reports the frequency, type, and degree of dyslipidemia in obese children before therapeutic intervention. The relationships between lipid values and weight status, as well as lipid values and physical fitness, of these children were also investigated., Design and Methods: The initial examination of the Freiburg Intervention Trial for Obese Children (FITOC) measured the values of triglycerides (TG), total cholesterol (C), low-density lipoprotein cholesterol (LDL-C), and high-density lipoprotein cholesterol (HDL-C) in 546 obese children aged 7-12 (body mass index [BMI] > 97th percentile), and compared these values with those of the age- and sex-specific reference group in the Lipid Research Clinics Population Studies Data Book (LRC). Four groups were selected according to the following scheme: A, Normolipidemia; B, Hyper-LDL-cholesterolemia alone; C, Hypo-HDL-C + hypertriglyceridemia; D, Combined hyperlipidemia = Hyper-LDL-C + hypertriglyceridemia. Body mass index, BMI-SDS (corrected BMI), and physical performance in watt/kg body weight were measured., Results: A total of 45.8% of the overweight children showed an abnormal lipid profile. Ten percent of the children had high LDL-C levels (group B), while 15% had increased LDL-C and increased TG (group D) (higher prevalence in boys). In 18.9% we found increased TG, combined with decreased HDL-C values (group C)., Conclusion: Obese children are at risk of dyslipoproteinemia and related diseases. Children with the highest BMI-SDS and lowest physical fitness have the lowest HDL-C values and increased TG, indicating a higher risk for the metabolic syndrome.

Obesity is considered to be epidemic worldwide. Stopping further progression interdisciplinary, outpatient intervention therapy programs for obese children have become increasingly important. FITOC (Freiburg Intervention Trial for Obese Children) consists of a combination of organized sports, behavioral therapy and nutritional advice. The effectiveness of the therapy is determined on the basis of anthropometrical and physical performance data. The purpose of this report is to give a differentiated view of the motor abilities of obese children and to describe changes in the course of the therapy program FITOC. Data were collected on n = 49 obese children (BMI > 97th percentile) aged 8 - 12 in a pretest at the beginning and posttest at the end of the intensive phase of the therapy. These data were compared with an age-matched German reference group. Besides the General Sports-Motor Test (Allgemeiner Sportmotorischer Test [AST]), the BMI-SDS values, the body fat mass (FM %) and the aerobic capacity (Watt/kg body weight) were recorded. In the pretest, the running exercise results and the aerobic capacity checked ranged significantly below the values of the reference group. The performance in the coordinative tests of the AST was differentiated. The medicine-ball toss was significantly above average of the reference group. In the posttest, the BMI-SDS values and the body fat mass (% FM) decreased (p < 0.001) and the aerobic capacity improved (p < 0.001). Performance in all motor abilities tests improved and the difference between the strength of the obese children and the strength of the reference group decreased. This study demonstrates that in obese children weight-bearing activities are below average but not all motor abilities.