Padiatrie und Grenzgebiete最新文献

More than 30% of the children suffering from an advanced solid tumour disease or tumour recurrence cannot be cured despite intensive oncological treatment. A new possible therapy is the application of whole-body hyperthermia in childhood in combination with chemotherapy and radiation treatment. The fundamental principles and the method of the whole-body thermochemotherapy are briefly explained. The treatment of one patient with a neuroblastoma recurrence is reported as a clinical example for the effectiveness of whole-body thermochemotherapy in childhood and the course of therapy is discussed.

The results of measurements of the electrical resistance of lung tissue are reported in order to estimate quantitatively the influence of air and blood filling on the conductivity. Experiments were done on isolated lung tissue of fetal and infantile guinea pigs. The ohmic resistance was measured by a minimised 4-electrode technique: isolated fetal lungs empty of air, or artificially aerated ones on the one hand, isolated lungs of infantile animals with spontaneous respiration and normal lung blood flow on the other hand. The increase of the electrical resistance produced by aeration is reduced by at least 50% by the synchronously increasing blood flow in spontaneously respired lungs. These experiments in the described animal model offer an opportunity for a more precise interpretation of the electrocardiogram of human adults changing with respiratory phases.

The article presents a report about the work over 20 years (in the seventies and eighties) of the Rostock pediatric oncologic-hematologic treatment center in the field of the diagnoses leukemia and lymphogranulomatosis. The author describes newer aspects of ward care, out-patient care and care limited to a few hours at the day-care ward for the ill children and their parents. One resulting aspect is the importance of psycho-social and rehabilitative guidance for periods of time.

Capnography has not yet achieved wide application as a noninvasive method for monitoring and optimizing assisted ventilation in neonatological intensive care medicine. The development of new equipment will probably make it possible for capnography to find its place as a routine examination. The aim of this work is to evaluate the existing methods for CO2-analysis in newborns and infants using data from existing literature. A mainstream capnograph (Novametrix 7000) was used to demonstrate typical capnographic curves in newborns and prematurely born children. The results offer new possibilities for the optimization of assisted ventilation.

The communication between the responsible physician and the family of the phenylketonuric patient requires an extended period of time in the treatment centre. Computer software was developed for the centre to ensure individual treatment of all patients according to the dietary recommendations. The program is additionally able to document all clinical data and to handle the correspondence with the family of the patient.

Sixty-seven stuttering and 50 non-stuttering children, all of them aged between three and five years, were investigated regarding their social conditions in an interdisciplinary study. Numerous studies so far conducted into family circumstances of stuttering children and adolescents have supported diverse conclusions regarding the parent-child relationship, personality traits of parents as well as their style of child raising and social status. Most of the resulting publications have concentrated on children from whom stuttering symptoms had been recordable for several years, so that it was not safely verifiable whether the parental behaviour described had been one of the causal factors for stuttering of children or a belated response to that stuttering. The author's own investigations showed significant differences with regard to presence in a day nursery in the child's first year, space conditions at home, attention given to the child, physical exercise, occupational satisfaction of mothers and self-appraising qualities of fathers. These differences, on balance, are interpreted to the effect that in the individual case stuttering may be affected by psychosocial conditions and would then call for therapeutic action, although it appears to be obvious that there are no stutter-specific social factors. These results are likely to confirm experience obtained from work with stuttering individuals by numerous medical doctors, teachers in lalopathology and psychologists who found that in general manifestations of stuttering may be caused and affected by a number of factors, both endogenic and exogenic.

In cases of severe hearing loss in babies an early rehabilitation should prevent a delay in development. More than a half of all hearing disorders in children are acquired; to a large extend these hearing disorders are caused by premature birth and can be detected by suitable screening. Two methods are used for testing: (1) reflex audiometry with a standardized stimulus generator; and (2) bedside recording of brainstem potentials. Having tested the method of bedside recording of brainstem potentials a group of 60 premature infants of varied body weights and no additional diseases was examined as "normal" control group. Only premature birth with all signs of maturation adequate for gestational age is not a greater risk for hearing disorders. In premature infants with birth weights less than 1500 g, having marked hyperbilirubinemia and extensive intracranial bleeding always increased wave V latencies has been observed. In about 10% of these children severe hearing disorders were diagnosed and after leaving the premature department were sent to a paedaudiological dispensaire.

The existence of catharreal respiratory symptoms (such as pharyngitis, tracheitis, bronchitis etc.) is established as the usual manifestation of "exanthema subitum" due to acute human herpesvirus-6 (HHV-6) infection. But so far pneumonia, purulent sinusitis, purulent otitis media and/or acute obstructive bronchitis (bronchiolitis) in infants and children have not been described. Here we report the results of observations of 2 children with bronchopneumonia/sinusitis maxillaris and severe bronchiolitis associated with an acute HHV-6 infection. Other respiratory viruses were excluded as agents causing the ARD.

From January 1971 until the end of 1989, 94 infants suffering from meningitis caused by Haemophilus influenzae were treated in the Department of Pediatrics of the University of Leipzig. The anamnestic data, signs and symptoms, laboratory findings, the courses and final results of treatment are described. 88 children survived; in eight of them neurological or mental sequelae were found on discharge. Generally, a certain stagnation regarding treatment results is observed over the observation period. Therefore vaccination against Haemophilus influenzae type B should be encouraged.