Klinische Pädiatrie
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Klinische Pädiatrie · Jan 1992
Randomized Controlled Trial Comparative Study Clinical Trial[Elimination of fat emulsions of various concentrations from the blood. Observational study in the intravenous administration of Lipovenös 10% and 20% in premature infants with very low birth weight].
Within the scope of an observation study 40 premature low birth weight infants requiring parenteral nutrition received either 10% or 20% lipid emulsions (Lipovenös) for 7 days. The 10% lipid emulsion differs from the 20% lipid emulsion in the higher phospholipid/triglyceride-ratio (0.06 resp. 0.12). Lipid infusion was commenced at 0.5 g triglyceride/kg/24 hours and increased steadily to 2 g triglyceride/kg/24 hours. ⋯ Significant increases in the triglyceride and cholesterol content were observed only in the serum of the patients who were given the 10% Lipovenös. The reduced lipid serum clearance is attributable to the higher content of phospholipids in the 10% lipid emulsion. With regard to the risk of high cholesterol concentrations and an abnormal LPX serum accumulation, administration of 20% lipid emulsion is preferable to 10% lipid emulsion, also during the neonatal period.
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Klinische Pädiatrie · Nov 1991
Review[Treatment of obstruction and thrombosis due to central venous catheterization].
Thrombolytic treatment with urokinase (5000 U/ml) or streptokinase can restore patency in central venous catheters occluded by thrombosis. In pediatric patients preferable urokinase should be used. The therapy in case of catheter-induced central venous thrombosis is a continuous urokinase infusion (125,000 U/1.73(2)/h) for about 3 to 8 days, followed by a long-term heparinization. ⋯ The treatment of choice in case of chemical obstructions in patients with long-term parenteral nutrition is the injection of 0.1 N HCl in combination with Heparin. By these procedures most of obstructed central venous catheters can be reopened and maintained in place. This preserves the count of possible catheter implantation sites.
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Klinische Pädiatrie · Jul 1991
Multicenter Study Clinical Trial[Testicular function after OPA/COMP chemotherapy without procarbazine in boys with Hodgkin's disease. Results in 25 patients of the DAL-HD-85 study].
Gonadal function was evaluated in 25 boys treated for Hodgkin's disease according to the DAL-HD-85 protocol with OPA- or OPA/COMP-chemotherapy (vincristine-prednisone-adriamycine/cyclophosphamide-vincristine-m ethotrexate- prednisone). All boys were in first continuous complete remission for 6 to 45 months at chronological ages varying from 14.0 to 18.9 years. Testosterone, basal and GnRH-stimulated LH- and FSH-levels were measured. ⋯ Again, no major testicular damage was noted, though some patients had increased stimulated LH-levels possibly indicating compensated Leydig cell-insufficiency. Our results demonstrate, that testicular function is not severely affected when patients are treated for Hodgkin's disease without procarbazine even if cyclophosphamide is given in cumulative doses below 3800 mg/m2. The previously documented severe testicular damage in boys treated according to the DAL-studies HD-78 and HD-82 is thus a result of the gonadotoxic action of procarbazine.
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Klinische Pädiatrie · Sep 1990
[Psychosomatic, sedative and hemodynamic reactions following preoperative administration of midazolam in children].
Since children's intellectual perception is limited, the preoperative visit by an anesthesiologist alone can rarely help to free the small patients from fear and restlessness prior to elective surgery. In order to relieve anxiety which should be the primary goal of premedication in any patient - children need anxiolytic premedication agents. Drugs for premedication administered by intramuscular or rectal route in children often cause pain, fear and discomfort. ⋯ Side effects prior and during induction phase of anesthesia were documented. The personal data are representative for a normal population of children with typical urological diseases. Oral administered midazolam had only a mild or non sedative effect in 76-84% of the children 70-84% of the small patients showed an indifferent or euphoric state of mind and 67-88% behaved cooperatively or passively.(ABSTRACT TRUNCATED AT 250 WORDS)
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Klinische Pädiatrie · May 1990
[In-vivo activation of the 4th component of the complement system (C4) in premature and term infants with generalized bacterial infections].
The concentrations of the complement components C3 and C4 and their activation products C3dg and C4d were determined in EDTA-stabilized serum of 25 premature and term infants. EDTA plasma and EDTA serum obtained from 30 normal blood donors were used as controls. According to clinical, laboratory and/or microbiological findings, six of the 25 children had infections. ⋯ Observation of the course and comparison with CrP showed that elevated C4d values may occur earlier. In the authors' view, these findings indicate that in bacterial infections of premature and term infants the fourth complement component is activated, while the extent to which the third complement component is involved in the activation process is not measurable. Further studies are needed to establish whether early diagnosis of neonatal sepsis can be improved by determining C4d.