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  • 1
    Electronic Resource
    Electronic Resource
    Springer
    Infection 28 (2000), S. 282-286 
    ISSN: 1439-0973
    Keywords: Key Words Chronic ; Osteomyelitis ; Therapy ; Children ; Ewing's sarcoma
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary Background: Presently, most children with chronic osteomyelitis undergo surgery with the inherent risk of damage to their growth plate. We demonstrate a treatment regimen based on imaging procedures focussing on antibiotics in order to reduce the rate of surgical interventions. Patients and Methods: We retrospectively evaluated all 11 patients with clinically suspected chronic osteomyelitis who were treated at our institution from 1989 to 1995. Patients underwent open biopsy and surgical treatment only if imaging procedures showed signs indistinguishable from malignancy, or if they were highly suggestive for the presence of pus, joint infection or osteonecrosis. The patients were followed up for a minimum of 3 years. Results: All five patients treated solely with antibiotics recovered completely. Three patients were subjected to open biopsy and surgical treatment since they showed radiological signs indistinguishable from malignancy, and two patients due to pus or osteonecrosis. In follow-up, there was one relapse of chronic osteomyelitis 11 months after the first treatment course with surgery and antibiotics. One patient suffering from Ewing's sarcoma as detected by open biopsy was excluded. Conclusion: Our diagnostic procedure was useful to reduce the rate of surgery. Surgical treatment of chronic osteomyelitis is not always neccessary especially in cases of missing necrosis, joint infection and abscess as demonstrated by the complete recovery of our patients treated solely with antibiotics.
    Type of Medium: Electronic Resource
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  • 2
    Electronic Resource
    Electronic Resource
    Springer
    Der Schmerz 14 (2000), S. 319-323 
    ISSN: 1432-2129
    Keywords: Schlüsselwörter Schmerz ; Kinder ; Impfung ; Verbrennung ; Injektion ; Keywords Pain ; Children ; Vaccination ; Burn ; Injection
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Abstract Phenomenon pain. While pain is one of the main reasons for an unscheduled visit to the paediatrician, pain due to painful procedures is of major importance in scheduled visits. Actual pain therapy is illustrated in the treatment of burns. Incomplete analgesia may have an unfavourable impact on morbidity and mortality. The pain score does not correlate with the extent of the burned area, and is regularly underestimated. General anaesthesia or analgo-sedation are warranted during the care of the burned patient. Unsufficient analgesia. Consequence of insufficient analgesia during primary care is an increased need of analgesics, and an increased pain treatment failure rate during subsequent procedures. Pain is interfering with anxiety, sleep disturbancies and post-tramatic psychologic alterations. All those symptoms must be treated adequately. Acute illness and injections. This article covers pain from otitis media, pharyngitis, Guillain-Barré syndrome, purpura fulminans, Toxic Epidermal Nekrolysis, as well as the usage of local anaesthesia during injections, not to forget the application of non-pharmacologic methods for pain therapy and prophylaxis.
    Notes: Zusammenfassung Phänomen Schmerz. Das Phänomen “Schmerz” begleitet fast alltäglich den Kontakt zwischen Arzt und krankem Kind. Auf der einen Seite sind Schmerzen der häufigste Grund für eine ungeplante Kinderarztkonsultation, auf der anderen Seite sind bei geplanten Kinderarztbesuchen häufig schmerzhafte Prozeduren durchzuführen. Anhand der starken Schmerzen bei den im Kleinkindalter häufigen Verbrennungen werden schmerztherapeutische Prinzipien konkretisiert: Schmerztherapeutische Prinzipien. Unzureichende Analgesie kann Morbidität und Mortalität ungünstig beeinflussen. Das Schmerzmaß korreliert nicht mit der Ausdehnung der Verbrennung und wird vom Behandler regelmäßig unterschätzt. In vielen Fällen der Erstversorgung sind Allgemeinanästhesie oder Analgosedierung gerechtfertigt, ähnliches gilt für den Verbandwechsel. Ungenügende Analgesie bei der Erstversorgung führt zu erhöhtem Analgetikaverbrauch und schmerztherapeutischen Misserfolgen bei Folgeeingriffen. Wechselwirkungen zwischen Schmerzen und anderen Symptomen wie Angst, Schlafstörungen oder postraumatischen psychischen Veränderungen sind zu beachten und adäquat zu therapieren. Akute Erkrankungen + Injektionen. Weiter wird auf Schmerzen bei Otitis media, Pharyngitis, Guillain-Barré-Syndrom, Purpura Fulminans und Toxischer Epidermaler Nekrolyse sowie den Einsatz von Lokalanästhetika bei Injektionen eingegangen. Schließlich haben auch nicht pharmakologische Methoden ihren Platz in Schmerztherapie und Prophylaxe.
    Type of Medium: Electronic Resource
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