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Biomedical subjects

D Stamm

Publications and source records attributed to D Stamm.

14 recordsLinked to original sources
PubMed1992

Streptococcal toxic shock syndrome in children.

Two children with toxic shock-like syndrome due to streptococcal infection are reported. In both cases (one fatal) the site of infection was in the soft tissues. Both strains of group A hemolytic streptococci isolated from blood culture produced large amounts of erythrogenic toxin B (ET B) small amounts of ET C but no ET A. This report confirms the implication of Streptococcus pyogenes in toxic shock like syndromes. When ET A seems to be responsible for most cases observed in the USA, our cases and others observed in Europe could be related to strains producing large amounts of ET B.

Child↗
PubMed1992

[Tracheotomy in children. Indications, major surgical principles, importance of nursing].

Tracheotomy in children has two main fields of indication: 1) obstructions of the upper respiratory tract, the main cause being today the post-intubation stenosis; 2) long term mechanical ventilation. When performed in good conditions, with adapted care, there are few complications, among them the accidental denaculation being the most worrying. When long-term tracheotomy is needed, parent-education, together with special equipment and adapted environment may allow the return of the tracheotomised child at home in secure conditions. Special attention with preventive measures during intubation is recommended in order to reduce the number of tracheotomies for post-intubation stenosis.

Child↗
PubMed1991

Interleukin-2 and lymphokine-activated killer cells in 15 children with advanced metastatic neuroblastoma.

A phase II trial using interleukin-2 (IL2) and lymphokine-activated killer (LAK) cells was carried out in an attempt to treat children with end-stage neuroblastoma. Fifteen patients (median age, 7 years) were enrolled in the study. Twelve were in relapse after massive chemotherapy and autologous bone marrow transplantation (ABMT), and three had a primary refractory disease after conventional chemotherapy. IL2 was administered as an 18 x 10(6) IU/m2/d continuous infusion. One course consisted of a double 5-day treatment period separated by a 6-day break. Cytapheresis to harvest LAK progenitor cells was performed during the rest period. After a 4-day in vitro culture, LAK cells were reinjected during the second cycle of therapy. A phenotypic and functional analysis of immunologic parameters was conducted along with the therapeutic protocol. Toxicity was significant with two toxic deaths (cardiotoxicity and respiratory distress). The reinfusion of large amounts of LAK cells was clearly involved in one case, but this particularly severe toxicity has to be related to the patient's status (ie, heavy pretreatment). No significant clinical response was seen. The immunologic monitoring showed phenotypic and functional modifications in these patients before initiation of treatment and an unexpected absence of evolution of these parameters during IL2 therapy. Although the origin of these immune dysfunctions is not clear, they could be involved in the failure of IL2 therapy. Future studies of IL2 therapy in neuroblastoma should be undertaken earlier in the course of the disease.

Antibodies, Monoclonal↗
PubMed1991

[Abnormal implantation of the left coronary artery on the aorta: potentially lethal malformation in children].

The authors report on the case of a 10 year-old girl who died suddenly after exercise. The autopsy showed abnormal origin of the left coronary trunk from the right sinus of Valsalva, with proximal course of the vessel between the aorta and pulmonary trunk. We discuss on the mechanism of myocardial ischemia; the opportunity to diagnose such an anomaly when the patient is alive is rare, and cause of death is most frequently determined by necropsy.

Aorta, Thoracic↗
PubMed1991

[Resuscitation during renal transplantation in children].

Over a 4 yr-period, 60 children (aged 10 months to 17 yr) received 66 kidney transplants with the same surgical intensive care program, the fist 48 hr-period of which has been analysed in this study. Thirty percent of recipients were transplanted without previous dialysis and in 8%, body weight was below 10 kg at the time of surgery. The duration of anesthesia was 4.4 +/- 1.0 h and 32% received locoregional anesthesia. The mean duration for cold ischemia was 14.7 +/- 11.7 h and 26 +/- 7 min for warm ischemia; diuresis began during the operation in 79% of the patients. Routine vascular filling consisted of standard isotonic solute (11 +/- 4 ml/kg/h) associated with mannitol infusion; 59% of recipients required 20% human serum albumin and 42% blood transfusion. Post-operative diuresis was 7.4 +/- 6.0 ml/kg/h during the first 24 h, and sometimes resulted in hypovolemic episodes; 9% of the patients had primary non-functioning kidneys (4 transient acute tubular necrosis; 2 vascular thrombosis) and 4% required dialysis; the 1-yr survival rate was 82% for the grafts and 98% of the patients.

Adolescent↗
PubMed1979

Reference materials and reference methods in clinical chemistry.

In clinical chemistry today there are often several different methods and instruments in use for the analysis of a particular constituent. When these different methods and instruments are used for careful analysis of the same control specimen, as in assigned value determinations, the assigned values obtained may be significantly different, and these differences may be of clinical importance. In order to determine the reasons for such differences, reference systems or reference points are needed. The reference systems for calibration (calibration materials, standard reference materials) and control (control materials), where the matrices of these different materials must have quite different characteristics, are referred to jointly as reference materials. In order to compare methods, reference methods are needed with known, high reliability. Because of the amount of specimen material needed, the time needed for analysis and the facilities required, reference methods are not suitable for routine analysis. IDeally, standard reference materials are developed first, followed by a definitive method, which is then used to evaluate a candidate reference method. This is currently the case for only a small number of the constituents analyzed in the clinical chemistry laboratory. In this paper the characteristics of the different kinds of reference materials and of reference methods are described. The differences in terminological usage found in the literature are discussed. Limitations of knowledge and technique may necessitate certain compromises, with respect to the ideal characteristics of reference materials and reference methods. Possible compromises are discussed, and the various sources of error associated with them are pointed out. However, these compromises can also lead to improvement in the reliability and comparability of analytical results from different laboratories. As an example of such improvement, the results are presented for assigned value determinations by highly qualified reference laboratories on control specimens for interlaboratory surveys; the decision limits are included and the results are compared with those of the survey participants. Thus various ways are indicated for the use of reference materials and reference methods to improve the reliability and comparability of analytical results, suited to the current state of the art.

Animals↗
PubMed1975

[Determination of clinical chemical parameters in laboratory animals. Report of the workshop conference of the German Society for Clinical Chemistry held in Bad König/Odenwald, Germany, on the 11th and 12th of October 1974 (author's transl)].

Clinical chemical analyses are carried out in many animal experiments performed for medicinal research. For the evaluation of the analytical results fundamentals which have been tried tested and proven in human medicine are still frequently missing, such as reliability criteria, reference values, condition of specimen collecting and the knowledge of other important influences. The workshop conference of the German Society for Clinical Chemistry therefore prepared an inventory, and the most important problems were discussed with examples; guide-lines were worked out for planning, performance and evaluation of clinical chemical investigations on laboratory animals.

Age Factors↗