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H Spiess

Publications and source records attributed to H Spiess.

At least 19 recordsLinked to original sources
PubMed1991

Carrying as colic "therapy": a randomized controlled trial.

In healthy infants, crying behavior is reduced significantly by "supplemental" carrying; that is, increased carrying throughout the day in addition to that which occurs during feeding and in response to crying. To determine whether the recommendation to increase carrying would be effective as a therapy for colic, 66 mothers of infants 4 weeks of age or less who came to their pediatricians with complaints of crying problems ("colic") were randomized to receive standard pediatric advice (standard group) or standard advice plus the recommendation to increase supplemental carrying by 50% (supplemental group). Overall, the supplemental group carried their infants 6.1 hours/d throughout the intervention period, an increase of 2.2 hours/d (56%) more than that provided by the standard group. Despite this significant increase in carrying, there was no difference between groups in the duration or frequency of crying, fussing, or cry/fuss at any time throughout the intervention period. When the greatest treatment effect was expected at 6 weeks, the supplemental group infants cried only 3 minutes less per day (95% confidence interval: 37 minutes less to 32 minutes more per day). We conclude that, compared with standard pediatric advice to be "responsive," supplemental carrying does not reduce crying and fussing behavior further in infants who have colic. In marked contrast to healthy infants, this apparent resistance to increased carrying may indicate an important difference in state regulation and control in infants with colic.

Colic↗
PubMed1990

The reverse protraction factor in the induction of bone sarcomas in radium-224 patients.

More than 50 bone sarcomas have occurred among a collective of about 800 patients who had been injected in Germany after World War II with large activities of radium-224 for the intended treatment of bone tuberculosis and ankylosing spondylitis. In an earlier analysis [H. Spiess and C. W. Mays, in Radiation Carcinogenesis. (C. L. Sanders et al., Eds.) pp. 437-450. USAEC Symposium Series 29, CONF-720505, 1973] it was concluded that, at equal mean absorbed doses in the skeleton, patients with longer exposure time had a higher incidence of bone sarcomas. The previous analysis was based on approximations; in particular, it did not account for the varying times at risk of the individual patients. In view of the implications of a reverse protraction factor for basic considerations in radiation protection, the need was therefore felt to reevaluate the data from the continued follow-up by more rigorous statistical methods. A first step of the analysis demonstrates the existence of the reverse dose-rate effect in terms of a suitably constructed rank-order test. In a second step of the analysis it is concluded that the data are consistent with a linear no-threshold dose dependence under the condition of constant exposure time, while there is a steeper than linear dependence on dose when the exposure times increase proportionally to dose. A maximum likelihood fit of the data is then performed in terms of a proportional hazards model that includes the individual parameters, dose, treatment duration, and age at treatment. The fit indicates proportionality of the tumor rates to mean skeletal dose with an added factor (1 + 0.18.tau), where tau is the treatment time in months. This indicates that a protraction of the injections over 15 months instead of 5 months doubles the risk of bone sarcoma.

Adolescent↗
PubMed1989

[Radiation cataract following injection of radium 224].

The Spiess Ra-224 series ist presented. It consists of 900 patients who were repeatedly injected intravenously with known dosages (microCi/kg) of the alpha-particle emitter Ra-224 for the intended treatment of tuberculosis and ankylosing spondylitis between 1943 and 1952/1965. 682 patients had been treated as adults after the age of 20 years, and 218 hat been injected as "juveniles" aged 20 years or younger. All 218 "juvenile" patients except one who had suffered from ankylosing spondylitis, had been injected for tuberculosis. Among the 218 patients 91 have died leaving 127 alive. Of the "juvenile" patients 9 were examined at the Eye Hospital of the Universität München including histopathology of an autopsy eye in one case. Of the 9 patients 8 proved to have some cataracts and 2 appeared morphologically similar to age-related cataract. In 6 patients there was a posterior subcapsular cataract which was a dense round plaque with a clear subcapsular zone of about 0.5 to 0.6 mm. This clear zone corresponds well to newly deposited lens fibres during the period of about 40 years from treatment to examination.

Adolescent↗
PubMed1988

[Spinal claudication following ileocaval venous thrombosis].

The case is reported of a young male who presented with intermittent claudication after thrombosis of the right common femoral, iliac and caval vein. The symptoms were explained by the severe proximal venous obstruction. The patient, however, also complained of lumbar pain during and long after walking, and showed signs of irritation of nerve roots L4 to S1 on the right side. Venography and CT-scan disclosed venous collateral circulation leading through the spinal canal. The blood drained through the foramina intervertebralia to the caval vein, causing compression of the nerve roots depending on their filling. Thus, the claudication was "venous" in two ways, muscular (due to inadequate drainage) and spinal (due to intermittent compression of lumbar nerve roots by the collateral circulation).

Adult↗
PubMed1988

Time and dose dependency of bone-sarcomas in patients injected with radium-224.

The time course and dose dependency of the incidence of bone-sarcomas among 900 German patients treated with high doses of radium-224 is analysed in terms of a proportional hazards model with a log-normal dependency of time to tumor and a linear-quadratic dose relation. The deduced dose dependency agrees well with a previous analysis in terms of a non-parametric proportional hazards model, and confirms the temporal distribution which has been used in the Radioepidemiological Tables of NIH. However, the linear-quadratic dose-response model gives a risk estimate for low doses which is somewhat less than half that obtained under the assumption of linearity.

Adult↗
PubMed1988

An epidemiological assessment of lens opacifications that impaired vision in patients injected with radium-224.

The incidence of lens opacifications that impaired vision (cataract) was analyzed among 831 patients who were injected with known dosages of 224Ra in Germany shortly after World War II. The dependence of the incidence on dosage, i.e., injected activity per unit body weight, and on time after treatment was determined. The observations are equally consistent with proportionality of the incidence of cataract to the square of dosage or with a linear dependence beyond a threshold of 0.5 MBq/kg. The possibility of a linear dependence without threshold was strongly rejected (P less than 0.001). The analysis of temporal dependences yielded a component that was correlated with the injected amount of 224Ra and a component that was uncorrelated. The former was inferred by a maximum likelihood analysis to increase approximately as the square of the time after treatment. The component unrelated to the treatment was found to increase steeply with age and to become dominant within the collective of patients between age 50 and 60. The relative magnitudes of the two components were such that a fraction of 55 to 60% of the total of 58 cataracts had to be ascribed to the dose-related incidence. Impaired vision due to cataract was diagnosed before age 54 in 25 cases. In terms of injected activity per unit body weight no dependence of the sensitivity on age was found; specifically there was no indication of a faster occurrence of the treatment-related cataracts in patients treated at older ages.

Adult↗
PubMed1987

Computed tomography in Hallervorden-Spatz disease.

We report computed tomography (CT) findings of an autopsy-proven case of late-infantile Hallervorden-Spatz disease (HSD). The patient's symptoms started in preschool age with dystonic posture, leading shortly to complete loss of verbal communication and ambulation with marked torsion dystonia. She died aged 23 years. Cranial CT, performed at the age of 18 years, showed moderate infratentorial atrophy, but cortical cerebral atrophy, ventricular enlargement and caudate atrophy were all absent; there were symmetrical areas of increased density in the globus pallidus, and ironstaining pigment deposits at this site were confirmed post mortem. In the appropriate clinical setting such CT findings may be diagnostically helpful in the late-infantile form of HSD. However, experience with CT as well as with magnetic resonance imaging in HSD is still very limited.

Adult↗
PubMed1986

[Varicella and herpes zoster].

The identity of the virus for herpes zoster and chickenpox has long been guessed by pediatricians and eventually proven in 1958. The patients are infectious 2 days before the rash appears until 7 days later. Specific antibodies are found 2 days after the rash appeared. Varicella induce life long immunity which can weaken in old age or during immuno suppressive therapy, so that reactivation of the virus, most likely located in the spinal ganglia, causes the clinical symptoms of herpes zoster. About 7% of women in child-bearing age have no antibodies against the virus. Varicella during pregnancy may induce abortion or especially during the first 3 months severe embryopathies with organic lesions. Therefore young women who have not had the illness should be tested along with the test for rubella-antibodies, and subsequently vaccinated, at least 3 months before any planned pregnancy. The rather expensive varicella vaccination is justified in immunodeficient patients without varicella-antibodies, or in patients under immunosuppressive therapy without varicella-antibodies (minimal requirements of 1200 lymphocytes, interruption of cytostatics one week before and until 1 week after the vaccination, no irradiation for 3 months), or in women planning pregnancy, personnel caring for pregnant women or personnel who has no antibodies in intensive-care units for hematological-onkological patients.

Adolescent↗
PubMed1985

Surgery and granulocyte transfusions for life-threatening infections in chronic granulomatous disease.

We report two patients with chronic granulomatous disease (CGD) and life-threatening infections: a 10 10/12-year-old boy had Aspergillus fumigatus spondylitis with destruction of the 11th vertebral body and paravertebral abscess formation, and an 8 5/12-year-old boy had multiple Staphylococcus aureus hepatic abscesses with subphrenic abscess formation. Both patients failed to respond to intense antimicrobial therapy but showed a remarkable recovery following surgical drainage combined with granulocyte transfusions. These results suggest that antimicrobial therapy and surgical drainage followed by granulocyte transfusions may be the ideal mode of treatment for severe infections in patients with CGD.

Amphotericin B↗