The University Children’s Hospital Basel (UKBB) is an independent, university-based centre of competence for paediatric and juvenile medicine, as well as for teaching and research."The UKBB exists since 1999. On January 29, 2011, after several years of planning and constructing, the UKBB started operations in its new location at Spitalstrasse 33 in Basel. The colourful front of the building is its landmark. Nearly 900 staff members from different departments take care of around 6’700 stationary infants, children and adolescents and perform around 84’000 ambulant treatments each year. The biggest children's orthopaedics department and one of the biggest children's emergency units are located at the UKBB.The Children's Hospital Basel was founded on 2 January 1862, when it opened as a new hospital on the banks of the Rhine in Kleinbasel (Lesser Basel). The hospital continued to grow until 1999, when the UKBB was created from the merging of the Basel Children's Hospital and the Bruderholz Children's Clinic. Dr. med. Conrad E. Müller has been CEO of the clinic since May 2008. Dr.
The neurodevelopmental impact of sagittal synostosis (SS) remains controversial, with conflicting evidence regarding long-term cognitive and functional outcome. This report reviews the literature on neurodevelopmental outcome in SS and presents our experience with 488 children who underwent open, wide, strip craniectomy and were evaluated for long-term functional outcome. A narrative literature review was conducted using PubMed and Google Scholar to identify studies reporting neurodevelopmental, cognitive, or functional outcomes in children with SS. In parallel, a retrospective cohort included children who underwent early, wide, open strip craniectomy for isolated SS between 1999 and 2022, with a minimum follow-up of two years. Functional outcomes were assessed using structured parental telephone questionnaires. Twenty-two original research articles and six review studies met inclusion criteria, showing heterogeneous methodologies but generally normal long-term neurodevelopmental outcome with occasional mild, domain-specific vulnerabilities. In our cohort, 488 children (397 males) had a mean follow-up of 9.4 ± 6.3 years (range 2–25). The majority demonstrated normal functional development. Educational support was rarely required, and no neurodevelopmental or functional limitations related to surgery were identified in adulthood. Among 386 children of school age, mild reading difficulties were reported in 8 children (2.3
Current chemotherapy protocols for treatment of embryonal brain tumors in children may recommend administration of intrathecal chemotherapy, either by a lumbar tap or via an Ommaya reservoir. Children with concurrent hydrocephalus and shunts may have subtherapeutic levels of chemotherapy in the CSF due to constant CSF drainage to extra-CNS compartments. We present our experience in delivery of chemotherapy to children via programmable valves. A retrospective analysis of children with CNS malignancies together with hydrocephalus treated with a shunt and a programmable valve (CERTAS™ Plus Programmable Valves—Integra Life Sciences, proGAV®—Miethke) was conducted. Eighteen children up to 16 years of age (mean age 5 years) were included. Main pathologies included medulloblastomas (7) and atypical rhabdoid teratoid tumor (5). Each patient underwent 3–55 intrathecal injections (17 ± 14). One patient developed symptomatic hydrocephalus during the injection, which resolved with valve resetting. There were no infections, leaks, or major complications. One child required a wound revision due to exposure of the proximal catheter related to extremely thin skin. One patient experienced a “stuck” setting of the valve. Eight children are alive with no active disease, 25–80 months after shunt placement (52 ± 21). There were no late effects related to IT chemotherapy. Programmable ventriculoperitoneal valves are a safe method for delivery of intra-ventricular chemotherapy in children. This technique may potentially have an added value for children with concurrent shunts and may also obviate the need for an additional ventricular access device (such as an Ommaya reservoir).
BACKGROUND:The issue of late termination of pregnancy (abortion after a certain gestational age, depending on different definitions) is a topic of intense debate among healthcare professionals and the public, as it involves balancing the divergent interests and needs of the pregnant person and the foetus. Some jurisdictions recognize severe mental distress as a valid criterion for allowing late termination of pregnancy. However, the unavailability of a clear definition presents challenges in clinical practice. METHODS:A scoping literature review was conducted to examine how the criterion of severe mental distress is operationalised in the context of late termination of pregnancy. In addition, we conducted a qualitative content analysis of clinical ethics consultation reports dealing with requests for late termination of pregnancy in a Swiss university hospital. RESULTS:The scoping review of the literature yielded that 23 publications distributed worldwide were relevant to the question. Regarding the concept of severe mental distress, there is no uniform terminology. The indication for abortion is referred to as psychiatric, psychosocial, or sociomedical indication, or maternal emergency. Various criteria are mentioned that can contribute to categorising a condition as a severe mental crisis to varying degrees, including age, psychiatric illnesses, psychological conditions, foetal malformations, socio-economic conditions, or criminological circumstances. The qualitative content analysis of 20 clinical ethics consultation reports revealed a range of ethical challenges that arise in clinical practice, namely how the risk of severe mental distress can be assessed, whether the termination of pregnancy is suitable to avert the distress, and whether the termination of pregnancy is proportionate. We identified several recurring criteria that require clarification to aid decision making, such as whether treatment options and alternatives have been adequately discussed and presented, whether the request is consistent and enduring, and whether there are causes of severe mental distress that could be eliminated otherwise. CONCLUSIONS:For jurisdictions that allow late-term abortion based on severe mental distress, we propose a set of guiding questions to support healthcare professionals engaging in careful decision making.
Pediatric cholecystitis and cholelithiasis management is heterogeneous. We surveyed European centers to map current practices, training exposure, and outcomes of pediatric biliary cholecystectomy. A 24-item cross-sectional international survey was developed by the European Union of Medical Specialists (UEMS) Section of Paediatric Surgery and distributed to centers in 31 UEMS member states. Items covered institutional resources, indications and timing, surgical approach and adjuncts (ERCP, ICG), training exposure, and center-level outcomes; results are reported as n (
Pertussis (whooping cough), a vaccine-preventable disease that affects people of any age, has resurged globally after the COVID-19 pandemic. Key reasons for recent pertussis outbreaks include suboptimal pertussis vaccination coverage (particularly for vaccination during pregnancy) and growing vaccination hesitancy. During the 2023–2024 pertussis outbreaks in Europe, adolescents aged 10–14 years and 15–19 years had the first and third highest incidence rates, respectively. To reduce pertussis burden, it is essential to strengthen vaccination programs in the indicated target groups. This requires increased awareness among healthcare professionals about the local epidemiology of pertussis and its clinical presentation, alongside reinforcement of the benefits of vaccination for disease prevention. In parallel, robust surveillance systems and strong public health capacity for early disease detection and response are crucial to effectively manage outbreaks and build resilience against future outbreaks. Infants remain at high risk for pertussis, with complications, hospitalisation, and death being more common than in other age groups. Immunisation programmes combining vaccination during pregnancy, to protect newborn infants until their primary immunisation series has induced immunity, and infant immunisation are key to reducing morbidity and mortality. Strategies to improve pertussis vaccination uptake among adolescents and adults, especially those with high-risk medical conditions, are also essential. Strengthening global collaborations to invest in and build surveillance systems capable of identifying and responding to future outbreaks, to align national policies, to scale up immunisation during pregnancy, and to adopt a life-long immunisation approach are needed to better control endemic pertussis and manage future outbreaks.
