Monatsschr Kinderh
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A new respiration system is described. The system has been developed for the therapy of very ill newborn and premature infants (RDS stage IV, gestation age less than 28 weeks, severe pneumonia etc.). The special feature of the new respiratory device is an alternating between cycles with low frequencies and relatively high amplitudes, and breathes with low amplitudes and relatively high frequencies.
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Already in newborns almost all congenital and acquired disorders of hemostasis can be encountered. Especially gestational age and developmental peculiarities of hemostasis influence the incidence of the different causes for hemorrhages. Due to laboratory progress the well-known question of vitamin K deficiency and related bleeding has again become a point of interest and can be answered more clearly now than some years ago. ⋯ Disseminated intravascular coagulation is a pathogenetically important and frequent complication of numerous diseases in term as well as particularly in preterm infants. Ultrasonography gave new information about frequency and prognosis of intracranial hemorrhages in affected newborns. Finally, qualitative and quantitative disorders of the platelets present always a true challenge for the neonatologist in terms of differential diagnosis and differential therapy.
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Antiarrhythmic treatment was required in 35 patients aged one day to 11 8/12 years (average 5 7/12 years) for one or several of the following arrhythmias: paroxysmal supraventricular tachycardia (17), ventricular extrasystole (16), ventricular tachycardia (17), ventricular extrasystole (16), ventricular tachycardia (4), junctional tachycardia (4), and atrial flutter (3). 300 mg/m2/day oral propafenone was administered in 3 to 4 divided doses. The arrhythmia in 21 of the 35 patients had been unsuccessfully treated by digoxin (6), verapamil (5), ajmalin (4), propranolol (3), spartein (1), phenytoin (1), and lidocain (1) prior to the propafenone therapy. ⋯ In two other patients propafenone led to atrioventricular conduction disturbances and had to be discontinued. Propafenone is an effective well tolerated antiarrhythmic drug without major side effects in pediatric patients.
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A 3-year-old boy had an accident with a blunt chest trauma, 9 years later a left ventricular aneurysm was diagnosed by echocardiography and angiography. The 12-year-old-boy was operated successfully. The pathogenesis of cardiac lesions in association with blunt chest traumas is described, and frequent control examinations in the affected patients are recommended.