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Biomedical subjects

A Gillor

Publications and source records attributed to A Gillor.

12 recordsLinked to original sources
PubMed2005

VDD-pacemaker in children--a long-term therapy?

AIMS: Transvenous AV-synchronous pacing in children started with the invention of smaller sized VDD leads and miniaturization of pacemakers. Whether or not this is a favourable long-term therapy was retrospectively investigated by us based on data from our records. METHODS: From May 1977 to July 2001 we implanted pacemakers in 104 children younger than 15 years of age. In 55 patients transvenous leads were implanted. Twelve of these (21.8 %) received a VDD pacemaker for hemodynamic reasons. RESULTS: Ages ranged from 11 months to 14.5 years (mean 7.7 +/- 4.3 y). Sizes of the children ranged from 67 to 141 cm (mean 105.9 +/- 15.5 cm) and body weight ranged from 5.3 to 62.0 kg (mean 22.5 +/- 9.8 kg). The mean follow-up period was 47.5 +/- 15.1 months. In 86.3 % of the time during follow-up pacemakers of which we obtained data were working in the VDD mode. Five of the twelve VDD patients (41.7 %) had to be reoperated because of severe traction on the leads. In all five patients the VDD systems were explanted and the patients changed to dual chamber pacemakers. The period of time between implantation and VDD lead explantation ranged from 24 to 74 months (48.6 +/- 18.5). CONCLUSIONS: VDD pacemakers can be implanted safely even in children with a low complication rate perioperatively. 41.7 % of our VDD patients had to be reoperated within the surveillance time because of severe lead tension due to thoracic growth. In our experience VDD pacemakers in smaller children seem to be a temporary solution to bridge AV-synchrony from a young age to DDD pacing in young adulthood.

Child↗
PubMed1993

[Secondary myocardial hypertrophy in a very small premature infant treated with dexamethasone].

BACKGROUND: There is an increasing number of reports about the use of dexamethasone in the treatment of preterm infants at high risk for bronchopulmonary dysplasia. The possibility of myocardial hypertrophy developing during this treatment has not been examined. METHODS: As an example the course of one patient is described. We examined seven preterm infants (mean birth weight 791 g, mean gestational age 26 weeks) with eight treatments of dexamethasone retrospectively. The therapy was associated with a significant increase of the mean thickness of the interventricular septum and of the left ventricular posterior wall. After the termination of dexamethasone therapy the abnormal echocardiographic findings disappeared. CONCLUSION: We suggest careful monitoring of preterm infants treated with dexamethasone by performing serial echocardiographic investigations.

Bronchopulmonary Dysplasia↗
PubMed1992

[Familial manifestation of idiopathic atrial flutter].

We describe, to the best of our knowledge for the first time, the occurrence of idiopathic atrial flutter (AF) in two male children of a family. The two brothers are the third and sixth of seven children, and the only males. The parents do not suffer from any heart disease. The first sister died in Turkey at the age of twenty days. The parents do not know the cause of death. The fourth sister died at de age of five years, also in Turkey, probably because of meningitis. Electrocardiograms of the parents and the other three sisters are normal. Besides the unique familial occurrence, the AF themselves offer some unusual features. In the first patient, the AF could not be converted to sinus rhythm. In the second patient, the AF occurred paroxysmally, and in addition to the AF, the electrocardiogram tracings revealed paroxysmal atrial tachycardia.

Adolescent↗
PubMed1989

[Congestive heart failure in rickets caused by vitamin D deficiency].

We describe a case of a three and half month old infant presenting with a congestive heart failure due to hypocalcemic cardiomyopathy. Vitamin D deficiency rickets was found to be the cause for the hypocalcemia. The heart failure responded promptly to adequate Calcium therapy accompanied by usual anticongestive therapy.

Cardiomyopathy, Dilated↗
PubMed1989

[Magnetic resonance tomography in pediatric cardiology].

Magnetic resonance imaging (MR) is a relatively new non-invasive imaging method that has not been used as a routine procedure in pediatric cardiology. To evaluate MR in pediatric cardiology we performed 110 examinations in 91 children during the period from December, 1984, to November, 1987. The children were divided into the following groups: 1) Diseases of the great vessels (54 examinations in 39 children); 2) Cardiac diseases (42 examinations in 39 children); 3) Diseases of the pericardium (four examinations in three children); 4) Ten children without cardiovascular diseases (imaging of the heart in conjunction with examination of other organs). The ages of the children ranged from five weeks to 19 years in the following distribution: 13% infants, 20% children 2-5 years, 30% children 6-14 years, 37% adolescents from 15 to 19 years. On the basis of our experiences we conclude that MR can be used as an additional diagnostic tool in pediatric cardiology, especially for imaging of areas that are not well visualized by echocardiography, i.e., the great vessels and their branches and in addition, the right ventricle, in older children.

Adolescent↗
PubMed1988

[Noninvasive determination of oxygen saturation using pulse oximetry in pediatric cardiology].

Pulse oximetry is a relatively new noninvasive method to measure arterial oxygen saturation (SO2). We evaluated the reliability of a pulse oximeter (N-100, Nellcor/Drger, Lübeck) in single and continuous measurements of SO2. During cardiac catheterisation we compared pulse oximeter (puls.SO2) measurements to those in simultaneously taken arterial samples (art.SO2), and obtained 203 pair measurements in 85 patients, mostly newborns and infants; in 20 of them before and during the breathing of oxygen through a mask. We also have 67 pair measurements of capillary blood samples (kap.SO2) and puls.SO2. Continuous measurements with the pulse oximeter were carried out in 17 patients for up to 116 h. Our main results are: 1. In the puls.SO2 range of 66% to 100% the measurements with the pulse oximeter were accurate (r = 0.97, Syx = 2.1). Below 66% the puls.SO2 values were on average much higher than the art.SO2 values, with an increased variance. Intraindividual oxygenation changes before and during the breathing of oxygen were accurately measured. 2. Pulse oximetry is much more informative than kap.SO2 measurements, because its information about the SO2 before blood sampling (= resting value) and following SO2 changes during the painful procedure (= stress values). 3. Continuous measurements with the pulse oximeter are very simple and very reliable and are not associated with skin injury. Because the pulse oximeters responses rapid to oxygenation changes and does not need calibration it is very valuable in the assessment of therapeutic procedures in patients with cyanotic heart disease. We conclude that the pulse oximeter is a very important new diagnostic tool in pediatric cardiology.

Blood Gas Monitoring, Transcutaneous↗
PubMed1986

[Diagnosis and treatment of cardiac rhabdomyomas].

A diagnosis of primary cardiac tumors was achieved by two-dimensional echocardiography in 3 patients. Two of them were female neonates, born of the 29th and 40th gestational week who had shown intrauterine arrhythmias. Subsequently, we were able to diagnose tuberous sclerosis in both. The third child, a 121/2 year old boy, with already diagnosed tuberous sclerosis, presented an electrocardiographical preexcitation syndrome. Because of the multiplicity of the tumors and the association with tuberous sclerosis we presumed that the tumors were rhabdomyomas. As it is known that rhabdomyomas show no, or only a minimal postnatal growth, we decided neither to perform a heart catheterization nor to treat them surgically unless the children show hemodynamical deterioration, although the tumors were huge in both neonates. The subsequent 14 months showed a clear regression in the size of the tumors. One of the neonates was successfully treated with amiodarone because of ventricular tachycardia. The second neonate didn't require any treatment. We conclude that: Surgical management is only necessary in patients presenting with cardiac insufficiency and/or arrhythmias that are resistant to conventional medical treatment. Primary cardiac tumors should be looked for in patients presenting with arrhythmias, even when occurring already during intrauterine life. Diagnostic measures in order to diagnose tuberous sclerosis in patients with cardiac tumors are necessary and vice versa.

Adolescent↗
PubMed1984

Deficiency of antithrombin III in children with hemolytic-uremic syndrome.

In nine patients with hemolytic-uremic syndrome, the plasma activity and plasma concentrations of antithrombin III were determined on admission to the hospital and during the clinical course of the disease. Hemodialysis was necessary in six of the patients. In seven children the plasma AT III activity was moderately to markedly below the lower limit of normal at 75%, and did not rise after plasmapheresis with fresh frozen plasma. Replacement therapy with AT III concentrate was started in these patients. During the first 2 days an average dose of AT III concentrate of 2.1 U/kg in 24 h was necessary to raise plasma AT III activity by 1%. No side effects were observed. An already pre-existing procoagulant status and the administration of heparin may lead to AT III deficiency in hemolytic-uremic syndrome.

Antithrombin III Deficiency↗
PubMed1983

Plasmapheresis as a therapeutic measure in hemolytic-uremic syndrome in children.

Three children with hemolytic-uremic syndrome (HUS) were successfully treated with plasmapheresis (HUS) were successfully treated with plasmapheresis (PP) combined with early hemodialysis and administration of Aspirin and dipyridamole. Stimulation of vascular prostacyclin release with patients' plasma was measured before and after PP. It was reduced before and increased after plasma exchange. The data indicate that PP might be a useful tool in treatment of (HUS) in children.

Aspirin↗