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  • 1
    Electronic Resource
    Electronic Resource
    Ergometrie im Kindes- und Jugendalter (1997)
    Springer
    Monatsschrift Kinderheilkunde 145 (1997), S. 1326-1336 
    Details
    ISSN: 1433-0474
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Um Belastungen, die aus soziologischer, psychologischer und präventivmedizinischer Sicht förderlich sind, eindeutig von solchen abzugrenzen, die potentiell schädlich sein können, ist in vielen Fällen eine Belastungsuntersuchung (Ergometrie) unerläßlich. Diese Arbeit soll eine Übersicht über Indikationen und Kontraindikationen sowie Durchführung und Beurteilung einer Ergometrie im Kindes- und Jugendalter geben.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s001120050235
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  • 2
    Electronic Resource
    Electronic Resource
    Massive digoxin intoxication in childhood (1978)
    Springer
    Intensive care medicine 4 (1978), S. 199-201 
    Details
    ISSN: 1432-1238
    Keywords: Digoxin intoxication ; Serum digoxin concentration ; Serum potassium level ; Diphenylhydantoin ; Atropine
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract In a 10 year old boy 8 hours after taking about 16 mg β-acetyl-digoxin a maximum serum digoxin level of 31.8 ng/ml was measured radioimmunologically. This is the highest digitalis level in childhood described to date. The serum potassium level rose to 7.4 mmol/l. Complete atrio-ventricular block, and salves of ventricular premature beats were the most serious rhythm disturbances. The absence of life threatening rhythm disturbances is attributed to the early use of diphenylhydantoin in small frequent doses.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF01902547
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  • 3
    Electronic Resource
    Electronic Resource
    The effect of nifedipine alone or combined with low dose acetylsalicylic acid on endotoxin-induced pulmonary hypertension in the piglet (1988)
    Springer
    Intensive care medicine 14 (1988), S. 595-601 
    Details
    ISSN: 1432-1238
    Keywords: Endotoxin ; Pulmonary hypertension ; Nifedipine ; ASA
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Cardiovascular responses to the calcium antagonist nifedipine, alone and combined with low dose acetylsalicylic acid (ASA), were evaluated in a piglet model of endotoxin-induced pulmonary hypertension. All animals were anesthetized, paralyzed and mechanically ventilated. Cardiac output (CO), pulmonary artery pressure (PAP), aortic blood pressure (SAP), pulmonary capillary wedge pressure (PCWP), right strial pressure (RAPM) and arterial blood gases were measured before and after induction of pulmonary hypertension by E. coli endotoxin and after treatment. Results of treated groups were compared to a control group of piglets subjected to the same dose (0.15 μg/kg i.v.) of endotoxin. Control animals responded to a bolus injection of endotoxin within 15 min with an increase in mean PAP by 110%. Pulmonary vascular resistance (PVR) increased by 144%. Mean arterial pressure did not change significantly from baseline values. In animals treated with a single dose of 1 mg/kg ASA prior to endotoxin, the initial pulmonary response was not quantitatively different from control values, whereas ASA 20 mg/kg abolished the pulmonary vascular reaction. The increase of systemic vascular resistance (SVR) produced by endotoxin was aggravated by high dose ASA. In piglets treated with nifedipine (4 μg/kg/min) over 30 min after the application of endotoxin with and without additional infusion of nifedipine 60 min prior to endotoxin the PVR could be attenuated. The combination of nifedipine and low dose ASA showed synergistic effects compared to control. The increase of mean PAP was significantly reduced, the PVR remained in base-line range due to a marked elevation of cardiac output.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF00256762
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  • 4
    Electronic Resource
    Electronic Resource
    Continuous monitoring of mixed venous oxygen saturation in infants after cardiac surgery (1989)
    Springer
    Intensive care medicine 15 (1989), S. 228-232 
    Details
    ISSN: 1432-1238
    Keywords: Infants ; Continuous SvO2 ; Cardiac surgery
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Continuous mixed venous oxygen saturation SvO2c was measured in 16 infants immediately after cardiac surgery. A polyurethane 4F, dual channel catheter (Opticath, Modell U440, Oximetrix) with fiberoptic filaments was introduced into the pulmonary artery during cardiothoracic surgery. The catheters were left in place for an average of 67.5 h (range 27 h – 125 h) and there were no catheter-related complications. Correlation between continuous in vivo SvO2 values and in vitro values was satisfactory (r=0.85), whereas a correlation between SvO2c and arterial oxygen saturation (SaO2) was not found (r=0.07). The sampled arterial lactate values were inversely correlated to the simultaneously measured SvO2c, but the corelation coefficient was only r=-0.4. There was an inverse correlation between SvO2c and arteriovenous oxygen content difference (Ca−vDO2c) (r=-0.82), and a marked inverse correlation to the calculated oxygen utilization ratio (r=-0.97). Therefore SvO2c continuously reflects the overall balance between oxygen consumption and delivery, but the use of SvO2 as a predictor of blood lactate levels is unreliable. A further purpose of the present study was to demonstrate the clinical applications and to show the usefulness of SvO2c-monitoring; particularly as a surveillance and early warning system, as a guide for assessing therapy and its relevance in interpreting other monitored parameters. In our opinion continuous SvO2 measurement is a reliable and valuable indicator of cardiopulmonary function in the immediate post-operative period, even in infants with complicated repair of cardiac malformations.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF00271056
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  • 5
    Electronic Resource
    Electronic Resource
    Echocardiographic diagnosis of Candida endocarditis of the tricuspid valve and of the right atrium in a young infant (1983)
    Springer
    Pediatric cardiology 4 (1983), S. 49-51 
    Details
    ISSN: 1432-1971
    Keywords: Echocardiography ; Candida endocarditis ; Tricuspid valve ; Right atrial thrombus
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary Systemic candidiasis developed in a seven-week-old premature baby after 6 weeks treatment with antibiotics for suspected septicemia. At that time the echocardiogram showed a dense layer of echoes posteriorly to the anterior tricuspid leaflet during atrial systole. The diagnosis of Candida endocarditis with vegetations on the tricuspid valve and with right atrial thrombus secondary to the Candida infection was verified by autopsy.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF02281007
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  • 6
    Electronic Resource
    Electronic Resource
    Untersuchungen über die Beurteilung der Hautdurchblutung durch zentrale und periphere Temperaturmessungen (1974)
    Springer
    European journal of pediatrics 116 (1974), S. 305-317 
    Details
    ISSN: 1432-1076
    Keywords: Shock ; Skin temperature ; Peripheral blood flow ; Temperature difference ΔT
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Zusammenfassung Zur Diagnose und Therapie eines Schockgeschehens sind neben zentralen Parametern auch Angaben über die periphere Durchblutung notwendig. Das am einfachsten zu erreichende Capillargebiet ist das der Haut. Die Hautdurchblutung stellt den wichtigsten Regulator für den Wärmestrom dar, so daß ein Zusammenhang zwischen Hauttemperatur und Hautdurchblutung zu erwarten ist. Vergleiche der tatsächlichen Hautdurchblutung gemessen durch Δλ mit verschiedenen Hauttemperaturen, integrierte Hauttemperatur und Burton-Indices ließen keinen Zusammenhang erkennen. Jedoch ist die Korrelation mit der Rectum-Zehen-Temperaturdifferenz ΔT statistisch hoch signifikant. Sie kann ohne technischen Aufwand als orientierendes Maß der Hautdurchblutung in der Diagnose des Schocks eingesetzt werden.
    Notes: Abstract Diagnosis and therapy of shock necessitates precise information on the peripheral blood flow as well as consideration of parameters relating to the central circulatory condition. The skin is the capillary area of easiest access. Peripheral circulation implies the most effective regulating system in heat transport; therefore one may expect a relationship between skin temperature and skin blood flow. Comparisons of the blood flow through the skin, as recorded by means of a Hensel Fluvograph and ascertained as Δλ, with the actual skin temperature (average skin temperature; Burton indices) did not reveal any correlation. The correlation with the difference between rectal and big toe temperature, however, is statistically highly significant. The determination of the proportion between the two values (rectal versus big toe temperature) can be used without technical difficulties as an orienting measure of skin blood flow in the diagnosis of shock.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF00436955
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  • 7
    Electronic Resource
    Electronic Resource
    Verweildauer und renale Ausscheidung niedermolekularer Dextrane bei Neugeborenen und Säuglingen (1969)
    Springer
    European journal of pediatrics 106 (1969), S. 298-307 
    Details
    ISSN: 1432-1076
    Keywords: Schock-Plasmaexpander ; Verweildauer von niedermolekularen Dextranen (NMD) ; Ausscheidung von NMD
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Zusammenfassung Die Therapie aller Schockformen muß auf die Normalisierung des Capillarkreislaufes ausgerichtet sein. Die hier abgelaufenen Veränderungen entscheiden über die Prognose und den Verlauf. Durch die desaggregierenden Eigenschaften und die gute Volumenwirkung sind niedermolekulare Dextrane dafür besonders gut geeignet. Das Ziel der vorliegenden Arbeit war, den Einfluß der verminderten Nierenleistung und der unterschiedlichen Verteilung der Flüssigkeitsräume des Neugeborenen und des Säuglings gegenüber den Erwachsenen auf die Verweildauer und Ausscheidung von niedermolekularen Dextranen zu untersuchen. Erstmals kam eine neue Mikroliterbestimmung für Dextran routinemäßig zur Anwendung. Dabei ergab sich, daß der Abfall des Dextranspiegels und die Verweildauer im Serum dem der Erwachsenen entspricht. Nicht gelöst ist, warum jedoch beim Neugeborenen die Urinausscheidung von niedermolekularem Dextran niedriger ist als beim älteren Säugling, während der Abfall des Serumspiegels gleichsinnig verläuft. Es wird eine schnellere Verwertung im Stoffwechsel angenommen. Auf Grund der raschen Ausscheidung empfiehlt sich niedermolekulares Dextran als “Initialtherapie” im Schock, auch bei Neugeborenen und Säuglingen.
    Notes: Summary The therapy of all types of shock must aim at a normalization of the peripheral circulation. The changes that take place in this region are decisive for the prognosis and the progress of the disease. Low molecular weight dextrans seem to be best suited because of their desaggregating quality and their influence on the volume. The present investigation was conducted to show the effect of the reduced renal output and the different fluid distribution in newborns and infants on the persistence and excretion of low molecular weight dextran as compared to adults. A new routine microliter determination for dextran was used. It was found that the decrease and the persistence of the dextran serum level was similar to that of adults. It is, however, not clear why the excretion of low molecular weight dextran in newborns is lower than that observed in older infants although the decrease of the serum level takes place in a similar manner. It is thought that a faster metabolic utilization might be the reason for this observation. Because of the fast excretion low molecular weight dextran is recommended as “initial therapy” of shock in newborns as well as infants.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF00439835
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  • 8
    Electronic Resource
    Electronic Resource
    Congenital sinus bradycardia combined with congenital total atrioventricular block (1977)
    Springer
    European journal of pediatrics 125 (1977), S. 219-224 
    Details
    ISSN: 1432-1076
    Keywords: Congenital Sinus bradycardia ; Sick-Sinus-Syndrome ; Total atrioventricular block ; Bundle of His EG
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Sinus bradycardia and total atrioventricular block were found at the age of seven months in a boy who is now 161/2 years old. According to Yaters (1929) criteria, these are likely to be congenital disorders. While the frequency of the ventricular impulse generator in the upper bundle of His only slowed in accordance with age during the period of observation, the sinus node activity deteriorated considerably. Finally potentials could only be sporadically demonstrated. Under heavy stress and with a simultaneous slight increase in ventricular frequency, a re-occurence of regular but slow sinus node activity came about. The cause of this binodal disorder of rhythm is unknown. There is no indication of family affliction or of myocarditis in early childhood. Congenital heart disease could also be excluded.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF00480600
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  • 9
    Electronic Resource
    Electronic Resource
    Die myokardiale Sarcoidose (1965)
    Springer
    European journal of pediatrics 95 (1965), S. 53-60 
    Details
    ISSN: 1432-1076
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Summary Participation of the myocardium in sarcoidosis has been rarely described, but is nevertheless an important complication of this disease. Depending upon the localisation of the focus of the disease, disturbances of heart rhythm and of conduction or general heart insufficiency are observed. A case of sarcoidosis of the myocardium is reported. Frequent controls of the electrocardiogram may warrant speedy treatment of this complication.
    Notes: Zusammenfassung Eine nicht unerhebliche, aber klinisch selten beschriebene Komplikation der Sarc. ist der Befall des Myokards. Je nach Lokalisation des Krankheitscherdes kommt es dabei zu Herzrhythmusstörungen, Störungen des Erregungsablaufes oder zur allgemeinen kardialen Insuffizienz. Über einen Fall mit myokardialer Sarc. wird berichtet. Häufige EKG-Kontrollen können eine rechtzeitige Behandlung dieser Komplikation gewährleisten.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF00438670
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  • 10
    Electronic Resource
    Electronic Resource
    Tachyarrhythmic syncopes in children with structurally normal hearts with and without QT-prolongation in the electrocardiogram (1982)
    Springer
    European journal of pediatrics 138 (1982), S. 206-210 
    Details
    ISSN: 1432-1076
    Keywords: QT-syndrome ; Adams-Stokes-attack ; Ventricular tachyarrhythmia
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Forty children with presumed ventricular tachyarrhythmic syncopes in the absence of structural heart disease were studied. Twenty-nine patients, one of whom was deaf, had a prolonged QT-interval in the resting electrocardiogram (Group 1); eleven patients had a normal QT-interval (Group 2). The median QTc-interval was 0.51s in Group 1 and 0.40s in Group 2. Familial occurence suggesting autosomal dominant inheritance was found in 21 of 28 normally hearing patients in Group 1 and in 2 of 11 patients in Group 2. Syncopes were definitely stress-induced in 22 patients in Group 1 and in all 11 patients in Group 2. Of 23 patients in Group 1 in whom an electrocardiogram was obtained during physical exercise, only one showed severe ventricular dysrhythmia. In contrast, all eleven patients in Group 2 developed severe ventricular dysrhythmia with exercice. Treatment with beta-blocking medication prevented further syncopes in 15 of 19 patients with several previous attacks in Group 1 and in 3 of 5 patients of Group 2. Four of the 29 patients in Group 1 died suddenly and one more remained apallic after an attack. Of the 11 patients in Group 2, four died suddenly and one retains severe cerebral damage after resuscitation from ventricular fibrillation. We conclude that, besides the group of patients with the long QT-syndrome, there may be a distinct group of patients with a consistently normal QT-interval and severe ventricular dysrhythmia with exercise. Patients of both groups are threatened by sudden death and are improved by treatment with beta-blocking medication.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF00441203
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