PubMed Health⌕ Search

Biomedical subjects

D Loeff

Publications and source records attributed to D Loeff.

4 recordsLinked to original sources
PubMed1994

[General practice of salmonella control from the viewpoint of the public health office--a report of experiences from Cottbus and the Brandenburg area].

Internationally, an enhanced incidence of the PT4 plasmid is seen in S. enteritidis. Parallel to this, the incidence is also increasing in the new German Land of Brandenburg. The Federal law governing the control of epidemics--which is now also valid in Brandenburg due to the reunification of Germany--demands that strict controls are enforced wherever there are institutions for children, including controls of the environment of such institutions. As a result of this enforcement, it was possible to identify 947 salmonella infections in the Cottbus district in 1992, 82.15% of which were due to S. enteritidis with identification of PT4 plasmid. The question is now raised as to whether the high infectious dose of S. enteritidis with PT4 plasmid still applies and whether the prescribed antiepidemic measures are still necessary in respect of assuming--as the law demands--that strains with PT4 plasmids are to be considered equal in respect of all other salmonella serovars. More than 1000 children under 2 years of age are being cared for in the kindergartens and crèches of Cottbus who would be particularly exposed to infections not transmitted by food intake alone. But there is a shortage of funds which is a serious obstacle to antiepidemic measures. A note of warning is sounded against restricting investigations to food intake only. Particular attention is drawn to the crying need for more research, for interdisciplinary cooperation and stricter measures to fight infection.

Adolescent↗
PubMed1989

Management of esophageal atresia and tracheoesophageal fistula.

We can draw several conclusions from an analysis of our series: 1. Although prematurity remains to be an important factor in the survival of infants with major surgical or medical disease, the more important risk factor in esophageal atresia and tracheoesophageal fistula concerns: a. Severity of associated anomalies that are uncorrectable and fatal b. Associated complication from the disease or surgery (especially in infants less than 1500 gm). Complications such as tracheal perforation and gastric perforation are not tolerated well and can be fatal (the case in two of our patients). 2. Premature infants weighing even less than 1500 gm tolerate a major thoracotomy well with correction of an esophageal anomaly. In this series, the smallest weighed 1220 gm. This infant had an uneventful recovery with a good outcome. 3. Simultaneous correction of associated anomalies also is well tolerated by these patients. Judgment, however, should be exercised as to the extent and length of operative procedures performed. 4. Staged reconstruction is still an excellent alternative when one is dealing with a premature infant with concomitant surgical procedures, although lengthening operations with primary anastomosis for the most part have replaced the need for staging esophageal reconstruction. 5. Radiographs indicating a high upper pouch lesion also require bronchoscopic identification of the fistula prior to operative intervention to provide a guide to the proper surgical approach to the lesion. 6. Acute anastomotic leaks should be treated aggressively by antibiotics and immediate thoracotomy, with cervical esophagostomy, closure of the distal esophagus, drainage of the mediastinum, and gastrostomy placement. immediate intervention will result in better survival.(ABSTRACT TRUNCATED AT 250 WORDS)

Esophageal Atresia↗
PubMed1989

Neonatal intestinal obstruction.

Our experience in the management of 138 infants with various causes of intestinal obstruction has provided us with important principles of diagnosis and treatments that we adhere to in the course of our practice. 1. The overall mortality of neonates suffering from intestinal obstruction should be fewer than 5 per cent. The high survival rate is accounted for by improved care these patients receive in specialized units. 2. Prematurity did not appear to play a significant factor in the outcome of these infants with intestinal obstruction. Our experience shows that premature infants tolerate operative procedures well, even in those instances in which an associated surgically correctable lesion is simultaneously repaired. 3. The major risk factor in any neonate with intestinal obstruction is the delay in diagnosis and operative intervention, especially in infants diagnosed to have midgut volvulus. The additional second risk factor is the association of chromosome abnormality. 4. Traditional diagnostic studies such as plain films of the abdomen supplemented by either an upper GI or lower GI contrast study for specific indications have been very effective in obtaining an accurate diagnosis of intestinal bowel obstruction. 5. Hirschsprung's disease can be diagnosed in the neonatal period if the index of suspicion for this is high. 6. Special surgical techniques as described should be used whenever indicated to minimize morbidity. 7. The traditional Wangensteen-Rice evaluation of a patient with imperforate anus is accurate, and specialized studies should be deferred for the postoperative period. Collaborative care provided by the neonatologist, pediatric anesthesiologist, and pediatric surgeon for these patients is the key to a favorable outcome.

Abnormalities, Multiple↗