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  • 1
    Electronic Resource
    Electronic Resource
    Mitral and aortic insufficiency in polyarticular juvenile rheumatoid arthritis (1994)
    Springer
    Pediatric cardiology 15 (1994), S. 151-153 
    Details
    ISSN: 1432-1971
    Keywords: Echocardiography ; Juvenile rheumatoid arthritis ; Valvular involvement
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary Valvar heart disease is a rare complication of juvenile rheumatoid arthritis (JRA), the aortic valve being most commonly affected. Reported cases with symptomatic mitral involvement are rare. We describe a 13-year-old boy with seronegative, polyarticular onset of JRA in whom mitral and aortic valve insufficiency was diagnosed by clinical and laboratory investigations. Two-dimensional and continuous-wave Doppler echocardiography confirmed mild pericardial effusion with moderate mitral and mild aortic insufficiency. Cardiac assessment and echocardiogrphic follow-up are recommended in all patients with JRA.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF00796329
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    Paper (German National Licenses)
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  • 2
    Electronic Resource
    Electronic Resource
    Head-Up Tilt Test: A Highly Sensitive, Specific Test for Children with Unexplained Syncope (1996)
    Springer
    Pediatric cardiology 17 (1996), S. 86-90 
    Details
    ISSN: 1432-1971
    Keywords: Key words: Head-up tilt test — Children — Syncope — Sensitivity — Specificity
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract. Unexplained syncope may cause diagnostic and therapeutic problems in children. The head-up tilt test has been shown to be a useful tool for investigating unexplained syncope, especially for diagnosis of neurally mediated syncope. In this study 20 patients aged 9–18 years (12.0 ± 2.5 years) with syncope of unknown origin and 10 healthy age-matched children were evaluated by head-up tilt to 60° for 25 minutes. The test was considered positive if syncope or presyncope developed in association with hypotension, bradycardia, or both. If tilting alone did not induce symptoms (syncope or presyncope), isoproterenol infusion was administered with increasing doses (0.02–0.08 μg/kg per minute). During the tilt test, symptoms were elicited in 15 (75%) of the patients with unexplained syncope but in only one (10%) of the control group (p 〈 0.001). The sensitivity of the test was 75% and its specificity 90%. Three patterns of response to upright tilt were observed in symptomatic patients: vasodepressor pattern with an abrupt fall in blood pressure in 67%; cardioinhibitory pattern with profound bradycardia in 6%; and mixed pattern in 27%. In patients with positive head-up tilt, there were sudden decreases in systolic blood pressure (from 130 ± 15 to 61 ± 33 mmHg) and in mean heart rate (from 147 ± 26 to 90 ± 38 beats per minute) (p 〈 0.001) during symptoms. Treatments with atenolol 25 mg/day has shown complete suppression of syncope in positive responders during a mean follow-up period of 18 ± 6 months. The head-up tilt test is a noninvasive, sensitive, specific diagnostic tool for evaluating children with unexplained syncope.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s002469900019
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    Paper (German National Licenses)
    Fulltext
  • 3
    Electronic Resource
    Electronic Resource
    Parameters of Iron Deficiency in Children with Cyanotic Congenital Heart Disease (1996)
    Springer
    Pediatric cardiology 17 (1996), S. 150-154 
    Details
    ISSN: 1432-1971
    Keywords: Key words: Iron deficiency — Children — Cyanotic congenital heart disease
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract. A group of 67 children with cyanotic congenital heart disease (CCHD) were studied, and 35 were given iron treatment according to a regimen that gives iron to patients with a hematocrit (Hct) below 60%. The patients were categorized as iron-deficient and iron-sufficient according to their transferrin saturation and ferritin values. The pretreatment hemoglobin (Hb) and Hct values of the groups were similar. The mean Hct was nearly three times as much as the mean Hb in the iron-sufficient group and more than three times as much as the Hb in the iron-deficient group. Excessive erythrocytosis in the iron-deficient group was impressive. Mean corpuscular volume (MCV) values were below 72.7 fl in all of the iron-deficient patients. After treatment the Hb, Hct, transferrin saturation, and ferritin increased significantly in both groups, with the increments greater in the iron-deficient group. Increments in the erythrocyte (RBC) count were significant in the iron-sufficient group but insignificant in the iron-deficient one. Increments of MCV in the iron-deficient group were significant but insignificant in the iron-sufficient group. Our study demonstrated that prediction of Hb, RBC count, and MCV, measurements of which are easy and inexpensive and require little blood, can suffice for the diagnosis of iron deficiency in patients with CCHD without altering systemic perfusion.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s002469900033
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    Paper (German National Licenses)
    Fulltext
  • 4
    Electronic Resource
    Electronic Resource
    The role of serotonin re-uptake inhibitors in preventing recurrent unexplained childhood syncope – a preliminary report (1997)
    Springer
    European journal of pediatrics 156 (1997), S. 747-750 
    Details
    ISSN: 1432-1076
    Keywords: Key words Syncope ; Head-upright tilt ; Sertraline ; Children
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract To assess the efficacy of a serotonin re-uptake inhibitor, sertraline hydrochloride, in preventing recurrent neurocardiogenic syncope, we studied 15 patients (10 female; mean age 12.9 ± 2 years) with positive head-upright tilt test and resistant to standard pharmacotherapy, atenolol or disopyramide. The patients were given 50 mg oral sertraline hydrochloride daily for 6 weeks. Intolerance to the drug was seen in 3 patients and 2 had syncopal episodes during the therapy. A head-upright tilt table test was then repeated in 10 patients. Six were tilt negative and asymptomatic over a mean follow up period of 7 ± 3 months while four remained tilt positive: two experienced marked hypotension and bradycardia, characterized as mixed type syncope, and two had cardiac asystole, lasting 〉10 s, during tilting, thereby exhibiting a cardio-inhibitory response. Conclusion Sertraline hydrochloride may be useful in preventing recurrent neurocardiogenic syncope resistant to standard pharmacotherapy but careful clinical studies are essential before such a treatment strategy can be recommended since serious asystole could develop.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s004310050704
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    Paper (German National Licenses)
    Fulltext
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