Children who participate in competitions or regularly participate in team training should undergo an assessment for capability to partake in sports for early recognition of orthopedic or internistic problems. The assessment of capability to participate in sports should consist of controlling the long-term and family medical history, a comprehensive internistic and orthopedic examination and a 12-lead electrocardiogram (ECG). After the introduction of an obligatory standardized sports capability examination in Italy, including a 12-lead ECG, the incidence of sudden death could be reduced by 89 %. However, in most countries and for most forms of sport a preparticipation physical examination before training and competitions is neither obligatory nor standardized. The Austrian Society for Pediatrics and Adolescent Medicine (A-GKJ) and the Austrian Society for Sports Medicine and Prevention (A-GSMP) have therefore published joint recommendations on the performance of a sports preparticipation physical examination. This should be carried out by an experienced physician (e.g. sports physician, specialist for pediatrics and adolescent medicine or pediatric cardiologist) on starting team training in connection with a competition or before participation in a sports competition and should be repeated at least every 2 years.

Chest trauma in children is an indicator of injury severity and is associated with a high mortality rate. The aim of this study was to investigate the impact of pulmonary contusion-laceration on short and long-term outcome of pediatric patients after blunt thoracic trauma. A retrospective analysis of records of 41 children aged 10 months to 17 years who were treated for pulmonary and associated injuries between 1986 and 2000 was done concerning mode of injury, types of injuries, management and outcome. In addition, a follow-up investigation was performed 4.5±1 years after injury. Of the patients 27 were involved in motor vehicle accidents (MVA group) and 14 patients suffered other types of accidents (others group). The mean injury severity score (ISS) was 30±2 (range 9–75) with no significant difference between the groups. Patients from the MVA group suffered more frequently bilateral pulmonary lesions and needed more often chest tube placement (p<0.05), 5 patients died (12%) all from the MVA group. The follow-up investigation of 34 patients showed unremarkable chest x-rays and normal lung function in all but 1 patient with bronchial asthma. In conclusion, children who recover after a pulmonary contusion-laceration trauma do not suffer from significant late respiratory problems.

From 1975 to 1991, 132 patients with necrotizing enterocolitis (NEC) were treated at the Department of Pediatric Surgery in Graz. Two of 49 conservatively treated patients died (4%), 1 of these was not operated upon due to complex additional malformations, and the other, a baby with 860 g birth weight (BW), could not be resuscitated sucessfully. Eighty-three patients were treated operatively, 78% with intestinal resection and exteriorization of the bowel. The mean gestational age (GA) was 36 weeks, the mean BW 2,400 g. Nearly all the patients had a medical history of one or more of the well-known predisposing risk factors; 65% had an intestinal perforation at laparotomy, 25% a transmural intestinal necrosis, and 10% pneumatosis or hemorrhagic inflammation of the intestine. Overall mortality in operated patients was 21.7% (n = 18), including 4 deaths in patients with total intestinal necrosis. There were 12 operative deaths, mainly due to progressive septicemia or total intestinal necrosis, and 6 late deaths due to infection, congenital heart disease, or cerebral disease. The mortality declined from 34% before 1985 to 7.7% after 1985 and 6.3% in the last 5 years of this study. Thirty operative complications consisted chiefly of late stenoses, ileus, or late anastomotic complications. Among these patients, only 1 with septicemia after ileostomy closure died. In contrast, all major nonoperative complications caused death, primarily due to infectious problems with septicemia. Mature granulocytes at admission were significantly higher among operated survivors (42.9% vs 23.0%) and represented a valuable predictor of patient survival. In conclusion, despite some differences in this population group with respect to the literature (higher GA and BW), the results show a definite increase in survival, reaching more than 90% of operated patients with NEC.