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Biomedical subjects

D Karch

Publications and source records attributed to D Karch.

23 records · Page 2Linked to original sources
PubMedDate not supplied

The influence of methylphenidate on the sympathoadrenal reactivity in children diagnosed as hyperactive.

In order to investigate whether catecholamines play a role in the hyperkinetic child syndrome, we determined noradrenaline and adrenaline plasma levels before and after treatment with methylphenidate. The children were separated into drug responders and non-responders according to the efficacy of methylphenidate on behavioral symptoms. 21 children, 6-13 years of age, participated in this double-blind placebo controlled cross-over study. Conners' questionnaire was used to estimate the extent of the hyperactivity and to assess the drug response. Blood samples were drawn under resting and exercise conditions and plasma catecholamine concentrations determined as an indication of the amine release rate and the reactivity of the sympathoadrenal system. The results may be summarized: The postexercise noradrenaline levels of untreated hyperkinetic children were slightly, but not significantly higher than those of an age-matched control group. After 3-4 weeks of stimulant medication the noradrenaline release induced by physical exercise was significantly lower than after placebo. 12 out of 21 children showed an alleviation of their symptoms during methyl- phenidate therapy and thus could be assumed as drug-responders. When children were separated into drug-responders and non-responders according to the degree of the clinical improvement, both groups showed the same catecholamine release in response to exercise. Methylphenidate reduced the noradrenaline release in 9 out of 11 children in the responder group and in 7 out of 9 children in the non-responder group. In conclusion, catecholamines may be involved in the hyperkinetic child syndrome, but because of the heterogenity of this syndrome the depression of the plasma catecholamines as observed under methylphenidate could not differentiate between drug-responders and non-responders.

Adolescent↗
PubMedDate not supplied

[Diagnosis of cerebral function disorders and subsequent brain damage in newborn infants under intensive care].

Possibilities of recognizing cerebral function disturbances in newborns as early as the acute phase of the condition, and of prognosticating permanent brain damage are described. Clinical findings such as lethargy or spasms in the second and third weeks of life following hypoxia indicate severe function disturbances with poor prognosis. In contrast, the same symptoms in the first week after a hypoxia or following a cerebral hemorrhage are only of relatively slight prognostic significance. Metabolic parameters such as lactate, hypoxanthine, CK-BB, and ammoniemia are elevated in the first few hours and days after a perinatal hypoxia and correlate with the current disturbances in the central nervous system. However, they are not indicative of a possible occurrence of later brain damage. Cerebral sonography furnishes excellent information concerning gross structural changes and cerebral hemorrhages. The extent of the hemorrhages, classified in 4 stages, correlates well with the later development. Less severe functional disturbances can also be identified by electroencephalography together with observation of behavior (polygraphy). Here also, findings correlate well with the children's subsequent development. The combination of sonographic findings and neurophysiological diagnosis is at present the best source of information concerning the later occurrence of brain damage.

Acidosis↗
PubMedDate not supplied

[Treatment of developmental disorders--principles, methods and indication].

In a review article, the basic principles of special education and therapies for children with developmental disabilities are discussed. Physiotherapy, occupational therapy, speech therapy and psychomotor therapy are the most widely used treatment methods. In addition there are many preschool programs of special schools. The essence of all these activities (infant stimulation, parent education, and home based services) should have the aim to challenge active and self-guided movements or plays which have the highest likelihood to effect an improvement and success of early intervention. Perhaps one of the most important goals of early intervention programmes is to stimulate comprehension the parents and the families and capabilities of their children.

Child↗
PubMedDate not supplied

[Prenatal diagnosis and prevention of neural tube defects].

Measurement of the alpha-fetoprotein level (A.F.P.) in amniotic fluid is the best test to diagnose a neural tube defect (N.T.D.) in early pregnancy of women who have had one N.T.D. infant. Measurements of the serum-A.F.P. level, which might be performed in all pregnancies, have a high rate of false positive results. Serum-A.F.P. and amniotic fluid-A.F.P. both are raised only in open spina-bifida and/or anencephaly. The prospective studies about a possible prevention of N.T.D. by periconceptional vitamin supplementation are discussed. The first results are encouraging. So we recommend a multivitamin supplementation at least 28 days before the conception.

Acetylcholinesterase↗