[Vaccination against Haemophilus influenzae].
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Biomedical subjects
Publications and source records attributed to E G Huber.
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The vaccines which are now at our disposal have been largely perfected, are constantly examined and have proved most successful. It is owing to their use that epidemics have been eradicated and tremendous suffering has been relieved. It is a matter of course that all vaccination recommendations are to be constantly monitored and also revised in case new situations come about; however, it would be foolish not to make use of this excellent possibility offered by prophylactic medicine.
A preliminary report is presented on oral vaccination against whooping cough. 23 babies younger than, and 2 older than nine weeks and 12 newborn infants were vaccinated orally. No side effects were observed. Serum antibody titres did not increase markedly, but no child was seronegative after vaccination. An evident antibody titre rise to a higher level than in serum was found in the saliva. These results point toward an adequate local immunity. At present a definite statement about the efficacy of this oral vaccination is difficult to make. Further investigations are necessary.
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Explore the source record for details and available documents.
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The individual physical efficiency was ascertained according to a method developed by RUTENFRANZ, where the criterion was taken as being the particular performance which resulted in a pulse rate of 170 beats per minute. This was termed the p.w.c. 170 (physical working capacity), and was measured on a bicycle ergometer, with increasing loading of 1, 2, and 3 watt per kilogram of body weight. During this loading the E.C.G. was watched telemetrically on an oscilloscope, and recorded each minute. The p.w.c. 170 was ascertained both graphically and arithmetically from the respective pulse rate in the 6th minute of each load level. Initially, twenty healthy children were tested, so as to arrive at normal values. The average reading for these children was about 5% below the normal values given by RUTENFRANZ. Subsequently, fifty five obese children were examined, so as to clarify the question as to whether there was a linear correlation between overweight and physical efficiency. Indeed, it was possible to establish a regression equation according to which each 10% of overweight lead to a decrease of physical efficiency of 5.8%. The results of further examinations will be reported in the next paper.
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If children who were originally fully capable and active according to their respective age groups, remain more than 50% overweight for a period of more than 3 years, develop a significantly lower motor, intellectual and social activity. They tend to develop an anxious auto-aggressive behavior, because it is difficult for them to transmit to others the social pressures to which they are subject. The probability of a permanent therapeutic success diminishes as the duration of the period of overweight increases. Only physically and emotionally orientated therapy is rational as 78% of our overweight children come from neurotically disturbed families. Overweight can often be due to lack of love where intensity of affection is wrongly applied.
Following a first field trial in the year 1966 a second field trial was carried out in the Pediatric Clinic of the University of Vienna in the years 1967 und 1968, in which 420 children were vaccinated against measles by various methods. Apart from the observations of the clinical reactions the chief purpose of the examination was to establish the height of the antibodies achieved, how long they persisted and whether the primary vaccination with split-vaccine had any influence on the level and persistance of antibodies. The results following the combined vaccination were compared with those following with Schwarz-strain alone, whereby no significant differences appeared. The serological follow-up examinations were made after a month, a year, after 3 and finally after 7 years. Whilst in the first year the combined vaccinated children showed an average higher titre, the average antibody titre following single live vaccination were somewhat higher after 7 years and showed a lesser degree of scatter. The values of antibody titres are impart so high that one has to assume a silent booster effect since none of the examined children were taken ill with measles. The single live vaccination by means of Schwarz-vaccine has thus been proved outstanding, is to be regarded as the general method of choice and should be applied as widely as possible since the morbidity risk of measles is considerably high and vaccination is not dangereous. The use of split-vaccine is indicated only with chronically ill children for instance with leukaemia, mucoviscidosis etc. and in infants in the first year of life, if one wants to protect them against measles. If we reach our aim of through-vaccination of the population against measles, infants will no longer be in danger and a prevaccination in the first year of life will not be indicated.
In order to carry out investigations in the course of sport activities of children an efficient telemetering device is essential, which can also be used on children. The Kinderspital Salzburg has developed a telemetry system in cooperation with the Technische Versuchs- und Forschungsanstalt der Technischen Hochschule Wien and the Messerschmitt-Bölkow-Blohm-Werke München. For the first time in this field a Pulse Code Modulation (P.C.M.) System was utilized, implying high accuracy on data transmission and recovery as required for scientific examinations. The children's physical capacity is determined on a bicycle ergometer, and the performance measured in this fashion is then compared with the performance achieved in sport.
This is a report of 6 single cases of prenatal virus myocarditis originated from an endemic region around Salzburg. The cardiac involvement showed different grades dependent too on time of infection and on transfer of maternal antibodies to the child. Infections immediately before delivery cause severe illness, but infections some weeks before birth less severe damage. Symptoms of meningitis were not noticed. The diagnosis of myocarditis by Coxsackie virus was certain in two deceased newborns (Patient 1 and 2), very probable in one decreased baby (Patient 3) and probable in the surviving children (Patient 4, 5 and 6).
A report is given on a new method of treating obesity in children. In the summer of 1973 two "therapy camps" were held by the Vienna Univeristy Children's Clinic in co-operation with the Salzburg section of the Osterreichisches Jugendferienwerk (Holidays for Young People) in a particularly beautiful area of the Austrian countryside. For the duration of the camps the children were served with a diet containing very little easily digestible carbohydrate (simple sugar) but unlimited calories, and at the same time given physical training and encouraged to spontaneous activity. In addition to a satisfactory loss of weight, the children's habits were considerably altered. The changes in attitude necessary to maintaining the diet and the required level of physical activity were retained in a high percentage of cases over the six months' follow-up period of observation. Medically the therapy camps correspond approximately to stationary hospitalized reducing therapy but have the advantages of being more attractive to the child and considerably preferable for physiological and paedagogical reasons since they offer an effective means of providing the child with a better motivation for achieving a normal weight. In addition, therapy camps are much more economic and can be held on a much broader baiss without blocking hospital beds that are needed for other cases. For these reasons the above-mentioned groups intent to hold therapy camps throughout the next years.
Hitherto there have been hardly any paediatric investigation into the effect of sport on children,--apart from physiological ones, (Rutenfranz). Yet these days children take part in sporting activities as a matter of course, and frequently very heavy demands are made on them. It therefore appeared appropriate to initiate these investigations. The basic requirements for the evaluation of the physical capacity of each individual child are successive examinations of the effects of each type of sport on the cardiovascular system, pulmonary function, locomotor system, metabolism, and the psychology of healthy children. The following investigations are therefore deemed desirable: electrocardiogram, respiration rate, respiratory volume, respiratory gas analysis, blood pressure, body temperature, electro-encephalogram, electro-myogram, gravity and pressure (acceleration) effects, and psychological assessment. It is necessary to examine both the immediate stress and strain, on the child, which can at times assume dangerous proportions, as well as the more long-term effects which can be of a positive nature (effect of training), or of a negative nature (detriments). A further basic of paediatric sport investigations is the evaluation of consequences of climate and altitude in relation to sport. But one must also examine the effects of individual types of sport on children with diseases of the heart, lungs, metabolism, locomotor system, and central nervous system, from the point of view as to which type of sport can be expected of such children which might be beneficial or might be detrimental. Paediatric sport examination should also demonstrate ways and means how disadvantageous effects of sport can be avoided and as a consequence, the results of the serial investigations must be of benefit in the assessment and counselling of the individual child.