Monatsschrift fur Kinderheilkunde最新文献

An attempt is made to show the connexion between bronchial asthma and interaction within the family in the case of a 3 1/2 years old girl. Relationships within the family structure giving rise to illness should be taken into account during treatment, and dissolved at the same time by therapeutic means within the family.

Case reports including light- and electron microscopy about 4 children with infantile nephrotic syndrome are given. Histologic lesions were microcystic renal disease ("Finnish type"), diffuse glomerular mesangial sclerosis, glomerular mesangial proliferation and minimal changes in the 4 patients, respectively. Knowledge of the individual histologic lesion is essential for adequate therapy and the prognosis in all infants with nephrotic syndrome, except in cases with data proving the Finnish type; in some cases, the identification of individual histologic type will lead to adequate genetic counselling of the family.

As a consequence of the widespread humbug in Medicine today the number of law suits against medical outsiders causing damage to patients is visibly increasing. Quackery is unmasked by typical features common to nearly all occult sciences. In cases of failure or doing harm to patients medical outsiders have to face indictment more than scientifically treating physicians. Sometimes there is even suspicion of deliberate cheating, if not mental disorder. Legislation is urged to bring to an end this humiliating form of quackery.

By means of fluorescein-angiography diabetic microangiopathy can be earlier revealed than by means of ophthalmoscopy. 36 children with diabetes (aged 6,25-15,5 years, x 11,6 years) with a duration of the diabetes between 0 and 12,75 years (x 3,9) were submitted to fluorescein - angiography, in 20 cases a follow up study was performed. Pathological changes were found in 21 cases, in 10 of 15 children with normal angiograms the duration of the disease was less than 5 years. More than 50% of all patients followed up showed an increase of diabetic microangiopathy.

Arguments used by advocates and opponents of Cytotherapy, supported by numerous quotations are set against each other. Any agreement is made rather difficult by attitudes of Cytotherapeutists which are characterized by pseudoscientific reasoning. Coarse examples of this particular way of arguing are given. Furthermore, indication inventories appear vastly exaggerated, documentation is incomplete, judgment of alleged successes and incidents are highly disputable, and angry reactions against learned critics were published. Since alleged successes could not be proved on examination, and because of lack of any scientific proof of efficiency, the warning of the Scientific Advisory Board of the German Federal Arztekammer issued in 1976 must be considered as well-founded. The same goes for the 1972 Federal Social Court's ruling which excludes any reward by social health insurance bodies of expenses incurred by Cytotherapy.

C.S.F. lactate- and lysozyme concentrations were determined in 74 children with bacterial and aseptic meningitis, combined with other laboratory findings (white-cell count, differential blood count, total protein, glucose). Lactate and lysozyme concentrations proved to be best for the differentiation between bacterial and aseptic meningitis.

In 6 groups of children and juveniles (aged 8-16 ys) the exercise induced changes (cross country skiing of different durations) in various blood-parameters (Na, K, Ca, Mg, glucose, lactic acid, free fatty acids, glycerol, triglycerides, cholesterol, urea, CK-activity) are shown in contrast to changes in adults. It was found, that there are differences in the matabolic behaviour of the groups examined; previous data in adults must be applied, with restrictions, to results found in children or juveniles. Single parameters are not sufficient to obtain informations about influences of intensive endurance training in juveniles. Remarkable changes after long-lasting exercise must be expected in the blood values of K, Mg, urea, insulin and STH.

The present study is based on the assumption that accidents in childhood may be interpreted as a possible result of conflicts between the children and their social environment. Questioning of 100 children who had suffered from accidents, and of their parents showed that children having incomplete families were largely overrepresented in the study group. They also had already experienced a greater number of prior accidents. Their child-development was less favourable, more parents reported unusual behavior and possible psychosomatic symptoms. The social situation of the single-parents' families was characterized by difficult economic conditions. These families mainly belonged to lower social classes. The results underline the necessity not only to consider medical (therapeutic and rehabilitating) measures but also soci-pedagogical or socio-therapeutic support.

In childhood there exists a considerable risk of overwhelming sepsis after splenectomy with a high mortality rate. To prevent this complication conservative treatment of traumatic splenic rupture should be attempted. Peritoneoscopy is an important diagnostic aid and facilitates the indication for conservative treatment. If laparotomy is necessary, splenorraphy is often possible. The authors' experiences are reported.