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LTRS represents a common management strategy in children and adolescents with a variety of disorders. Census reports such as this one provide the basis for appropriate planning of resource allocation. The age distribution of our patients shows the need for structured transition into adult care.

SummaryBackgroundThe use of digital communication media is becoming increasingly important, with the primary aim of improving both treatment quality and patients' quality of life. In an effort to optimize telemedicine in the field of dermatology, we conducted a survey among dermatologists in Austria.MethodsStatistical analysis of a questionnaire that was developed by a working group and sent to 769 Austrian dermatologists.ResultsOverall, 243 dermatologists (132 women/111 men) participated in the survey. Forty‐seven percent of male respondents and 55 % of female respondents had already received requests for teledermatology consultations. Seventy‐three percent felt that telemedicine was able to contribute to relieving the economic burden on the health care system. Telecommunication between dermatologists and experts (in a given field of dermatology) was deemed to be particularly useful. While telemedicine was also considered to be appropriate for patient follow‐up, it was viewed to be less useful for initial consultations. Roughly 50 % of respondents used telemedicine to get a second opinion; one‐third used it for initial consultations.ConclusionsOur survey shows that the majority of participants consider teledermatology to be a useful supplement to the current practice of dermatology. Given its particular usefulness for triage purposes, teledermatology can help reduce the number of trips to the hospital and subsequent waiting times. This in turn leads to cost reduction and saves time for both patients and doctors. Legal regulations that include provisions for appropriate reimbursement of physicians would make using teledermatology more attractive.

The objective of this investigation was to compare different scoring systems to assess the severity of illness in infants with bronchiolitis admitted to a tertiary paediatric intensive care unit (PICU). Over an 18-year period (1990-2007), infants with bronchiolitis aged up to 12 months and admitted to the PICU were prospectively scored using the Pediatric Risk of Mortality III (PRISM III) score, the Organ System Failure (OSF) score and the Acute Physiologic Score for Children (APSC) within 24 h. Infants were compared as to whether or not bronchiolitis was associated with respiratory syncytial virus (RSV). There was no difference between 113 RSV-positive and 80 RSV-negative infants regarding gestational age, birth weight, rate of premature delivery or bronchopulmonary dysplasia (BPD). The PRISM III score differed significantly between RSV-positive and RSV-negative cases (3.27 ± 0.39 vs. 1.96 ± 0.44, p = 0.006), as did the OSF score (0.56 ± 0.05 vs. 0.35 ± 0.06, p = 0.049) and the APSC (5.16 ± 0.46 vs. 4.1 ± 0.53, p = 0.048). All scores were significantly higher in the subgroup with mechanical ventilation (p < 0.0001). The mean time of ventilation was significantly higher in the RSV-positive group compared to the RSV-negative group (6.39 ± 1.74 days vs. 2.4 ± 0.47 days, p < 0.001). Infants suffering from RSV-positive bronchiolitis had higher clinical scores corresponding with the severity of bronchiolitis.

Arthralgia in childhood is an unspecific symptom. One rare cause of arthralgia is hypertrophic osteoarthropathy associated with digital clubbing. We present a child where hypertrophic osteoarthropathy led to the rare diagnosis of an inflammatory pseudotumour of the lung. In a 12-year-old girl with arthralgia and digital clubbing, a chest radiograph disclosed a large round mass in the right upper lobe, and the following chest computed tomography scan showed a large solid homogenous, round, well marginated lesion with little contrast enhancement. A lobectomy of the right upper lobe was performed, and histological examination showed an inflammatory pseudotumour. The postoperative course was without problems: arthralgia and digital clubbing disappeared.