Biomedical subjects
Publications and source records attributed to H Helwig.
In a premature twin boy (gestational age 34 weeks) two-dimensional echoencephalography, computed tomography, and NMR tomography revealed a brain tumor. The exact diagnosis was confirmed by stereotactic biopsy from the brain. Up to now the clinical course of the child has been surprisingly benign.
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Explore the source record for details and available documents.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
Bacterial meningitis in 20 children was treated with cefotaxime. 17 children received this antibiotic throughout the disease as monotherapy, three were changed to Penicillin G (2) or ampicillin (1), after sensitivity of the pathogen was known, although cefotaxime had been effective. All bacterial isolates were highly susceptible to cefotaxime. All CSF cultures were sterile at second tap, performed 24 to 48 hrs after therapy was started. Cefotaxime and desacetyl-cefotaxime concentrations in CSF, measured by HPLC in 9 patients were in the range of 4 to 34 (average 17.6) mg/l and 2.1 to 82 (average: 15.1) mg/l, representing a CSF-serum ratio of 8 to 74% (average 45.6%) for cefotaxime and 25 to 151% (average: 73.7%) for desacetyl-cefotaxime. Clinical outcome was favourable in 17 patients. There were one death and late neurological deficits in three. Cefotaxime monotherapy is recommended instead of standard therapy with chloramphenicol and/or ampicillin because of superior antibacterial activity, lower toxicity and lesser side-effects for primary meningitis in children caused by N. meningitides, S. pneumoniae, or H. influenzae type b.
Infectious mononucleosis, described for the first time many years ago, is still nowadays a frequent disease in children. History, etiology, pathogenesis and immunologic response to infectious mononucleosis are described. The value and limitations of diagnostic tests are discussed. The differential diagnosis, prognosis and possible complications are outlined. Data from the literature are compared with results of our own experience with 35 serologically proven infections in children of different ages.
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Enteritis by Campylobacter jejuni/coli is by far the most frequent clinical entity of campylobacter-infection. It may be compared to salmonella-enteritis as for its epidemiologic importance. The course of the disease may be dramatic, but can be successfully treated as soon as the pathogen is known. In prematures and newborn babies infections with Campylobacter fetus ssp. fetus are life-threatening and early diagnosis is of life-saving importance. Five observations of campylobacter-enteritis in children aged 2, 8, and 10 years are reported. They were characterized by high fever frequent loose, watery stools with blood, leucocytosis or leucopenia and elevated BSR. All children became asymptomatic with symptomatic treatment, without specific antibacterial therapy. The importance of campylobacter-infections, their diagnosis and course of disease in children are discussed.
A now 12 year old boy developed diabetes mellitus when he was 7 years old. From 9 years on he developed progressive optic atrophy and deafness. Type I diabetes mellitus, together with progressive optic atrophy and several other symptoms like deafness, diabetes insipidus and ectasy of urinary tract are known for more than 40 years as autosomal-recessively inherited conditions. Therefore, in case of diabetes mellitus combined with optic atrophy it is necessary to search for further symptoms, developing during the course of the disease. Genetic counselling to the families is mandatory.
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Cefotaxim was administered to ten children with purulent meningitis. All isolated micro-organisms were highly sensitive to it in serial dilution, except for one case, and were quickly removed from blood and CSF by the administration of cefotaxim alone. Blood and CSF concentrations measured in eight children were much above the minimal inhibitory concentration for the particular micro-organism. Thus cefotaxim has a high antibacterial activity and satisfactory CSF passage in purulent meningitis caused by sensitive, especially gram-negative, bacteria and is well suitable for therapy, if penicillins alone or combined are not applicable or effective.
A Consensus Development Conference on Febrile Seizures was held at the National Institutes of Health in USA in May 1980. The purpose of this paper is to present the consensus statement in German and to compare it with the literature. This should be helpful to make accessible the current knowledge about febrile seizures to a larger number of physicians. Special attention has been paid to the consequences of febrile seizures, the diagnostic procedures needed and the risks and benefits of therapy.
Computer tomography of the head is now firmly established as an examination procedure in pediatric radiology. It is non-invasive, but on the other hand time-consuming and above all costly. Repeated follow-ups represent a level of radiation exposure which should not be underestimated. Two-dimensional sonography (B-scan) has extended the range of possibilities in intracranial diagnostics in neonates and infants, especially since the large fontanelle and the still-open cranial sutures were recognized as "acoustic windows". Five cases are presented, which show that the cranial cavity can be demonstrated reliably and reproducibly, in particular the lateral ventricles. Determining vascular pulsations (real-time) aids orientation and permits conclusions to be drawn regarding the intracranial circulation. Follow-ups can be carried out simply, without submitting the child to exposure stress, and permitting early identification of a developing hydrocephalus. The examination can be performed with standard commercially available parallel-scan units, such as are already used in many clinics for abdominal diagnosis.
Soft tissue inflammation is a rare manifestation of H. influenzae infection. It is known in the anglo-american literature as "cellulitis". Usually there is concomitant bacteremia or septicemia. The combination of cellulitis and meningitis is rare and not well known in German pediatric literature. Three children with facial cellulitis together with H. influenzae meningitis are described. In comparison to the literature some unusual observations were made: Early appearance of cellulitis at the age of six weeks in two infants, cellulitis of the lower extremities at the same time in one, and biphasic course with cellulitis and meningitis secondary to mastoiditis in another infant.
A brief survey of the last 200 years of diagnosing and treating meningitis is followed by a critical analysis and comparison of therapeutic results since the introduction of effective chemotherapy 44 years ago. This reveals nearly as good results during the early years as compared to nowadays. Modern age and pathogen dependent therapeutic regimes are discussed and valued. New ways of therapy are not yet generally necessary for the common causes of bacterial meningitis in childhood. The increasing resistance of some strains of H. influenzae or pneumococci, however, will necessitate the development of new antibiotics. Own experience and results in treating 76 patients with purulent meningitis are reported and compared with the literature, where pathogen or therapy dependent mortality is welldocumented but detailed data on follow-up studies are sporse.