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Biomedical subjects

M Frand

Publications and source records attributed to M Frand.

At least 19 recordsLinked to original sources
PubMed1996

Adenosine for the treatment of paroxysmal supraventricular tachycardia in full-term and preterm newborn infants.

Adenosine has been approved for intravenous use for paroxysmal supraventricular tachycardias (SVT) in adults and children. However, effectiveness and safety of intravenous adenosine in preterm infants are not well established. Thirteen episodes of SVT in three preterm and two full-term neonates were treated with intravenous adenosine. All had narrow QRS tachycardia at 230 to 260 beats/min. Adenosine prepared as a sterile 1 mg/mL solution was given as an intravenous bolus starting at 0.05 mg/kg, and increased by 0.05 mg/kg until tachycardia was terminated. Termination of tachycardia was achieved within 12 to 25 seconds in all patients. In one, termination of SVT was followed by temporary suppression of the sinus node, followed by resumption of normal sinus rhythm. No other side effects were noted. Adenosine is a safe and effective agent for treating preterm infants with SVT. However, further investigation of adenosine in this group of patients is warranted.

Adenosine↗
PubMed1990

Cerebral embolization from an inferior vena cava thrombus in tetralogy of Fallot.

Cerebrovascular accident (CVA) complicating cyanotic congenital heart disease (CCHD) is most frequently attributed to cerebral venous thrombosis, only rarely to in situ cerebral arterial thrombosis. Cerebrovascular accident due to paradoxical embolization from an inferior vena cava (IVC) thrombus in a patient with tetralogy of Fallot (TF) is described. This case is the first antemortem documentation of a venous embolic source that caused paradoxical embolization to the brain in a patient with CCHD, and illustrates the importance of noninvasive screening for a venous source of emboli in these patients.

Child, Preschool↗
PubMed1989

[Pectus excavatum from chronic upper airway obstruction].

4 patients with enlarged tonsils and adenoids associated with pectus excavatum are presented. 2 also had signs of pulmonary hypertension and congestive heart failure. All 4 underwent adenoidectomy and tonsillectomy. Respiratory distress and congestive heart failure were rapidly relieved, while the pectus deformity improved gradually and completely disappeared in 6 months to 2 years after surgery.

Adenoidectomy↗
PubMed1988

Reappraisal of the approach to the child with heart murmurs: is echocardiography mandatory?

The performance of cross-sectional echocardiography on every child with a heart murmur poses a heavy load and economic burden on pediatric cardiology services. We prospectively studied 100 consecutive patients newly referred to our clinic for evaluation of a heart murmur. After a thorough clinical assessment and review of the electrocardiogram and chest radiograms, 50 patients were diagnosed as having "innocent murmurs". Cross-sectional echocardiography confirmed the initial diagnosis in 48 patients (96%). Two patients had bicuspid aortic valve. Among the patients with echocardiographically proved innocent murmur, left ventricular anomalous bands were demonstrated in 15 patients (31%), right ventricular anomalous bands in 5 patients (10%) and increased left ventricular shortening fractions (greater than or equal to 0.5) in 10 patients (21%). Among the remaining 50 patients, the initial diagnosis was "suspected heart disease" in 10 patients, and "pathological murmurs" in 40 patients. Cross-sectional echocardiography was most useful in these patients providing the diagnosis in 80% (eight) of the former group and 95% (38) of the later group. Echocardiography need not be routinely performed in children initially diagnosed, by a pediatric cardiologist, as having an "innocent murmur".

Adolescent↗
PubMed1988

Infective endocarditis in children with congenital heart disease: the changing spectrum, 1965-85.

Thirty-five episodes of infective endocarditis in 35 children with congenital heart disease, from January 1965 to December 1984, were reviewed. The incidence of infective endocarditis in cyanotic congenital heart defects increased with a concomitant decrease in the frequency of lesions with left to right shunt. The incidence of postoperative endocarditis decreased from 1:52 during the first decade to 1:1033 during the second decade. The time interval between onset of symptoms and the establishment of diagnosis and treatment shortened from 7.8 +/- 3.2 weeks (mean +/- SD) to 2.1 +/- 0.9 weeks. During the latter decade, positive blood cultures were obtained in 100% of patients, as compared with 60% during the former decade (P less than 0.05). Echocardiography demonstrated vegetations in 70% of the cases. Over the entire time period, streptococcus viridans was the most frequent pathogen (46%) and staphylococcus aureus second most frequent (17%). Six patients died, all were under two years of age and all had congestive heart failure. Early surgical correction of the congenital heart disease may offer the best form of prevention.

Adolescent↗
PubMed1987

The clinical course and echocardiographic features of Marfan's syndrome in childhood.

The clinical and echocardiographic manifestations in 25 patients with Marfan's syndrome diagnosed during infancy and childhood (mean [+/- SD] age, 8.1 +/- 4.8 years; range 0 to 16 years) were evaluated. Twenty-one patients (84%) had a midsystolic click, 11 patients (44%) had mitral regurgitation (MR), and five patients (20%) had combined MR and aortic regurgitation (AR). Echocardiography demonstrated mitral valve prolapse in all 25 patients, aortic root dilatation in 20 patients (80%), AR in seven patients (28%), and aortic aneurysm in five patients (20%). During the follow-up period (mean, 5 +/- 4.5 years), progressive AR and aortic aneurysm were documented in four patients, progressive MR in three patients, and progressive aortic root dilatation in two patients. Five patients (22%) died during the follow-up period. Among patients with a positive family history of Marfan's syndrome, MR was less frequent as compared with sporadic cases (29.4% vs 75%, respectively). Progressive cardiovascular involvement was more frequent among patients diagnosed before 10 years of age compared with those diagnosed later (60% vs 12.5%, respectively). Cardiovascular involvement was a common feature of childhood Marfan's syndrome, causing significant morbidity and mortality. Sporadic cases and children diagnosed before 10 years of age represented a particularly high-risk group.

Adolescent↗
PubMed1987

Cardiovascular complications in the Ehlers-Danlos syndrome with minimal external findings.

Ehlers-Danlos syndrome (EDS) is clinically and genetically a heterogeneous disorder of connective tissue. Eleven different types of EDS have been documented, several of which have major cardiovascular complications as part of their clinical manifestations. The purpose of this report is to call attention to a form of EDS with minimal external features but severe internal vascular complications.

Aneurysm↗
PubMed1985

Assessment of intestinal and cardiorespiratory function in children with congenital heart disease on high-caloric formulas.

Fourteen infants with congenital heart disease were investigated for failure to thrive. Assessment of intestinal function revealed minor absorptive abnormalities (mild steatorrhea in three patients, bile salt loss in four patients), delayed gastric emptying, and abnormal triglyceride loading tests. Low caloric intake (88.3 +/- 19.3 kcal/kg/day) seemed the main reason for failure to gain weight. Weight accession and cardiorespiratory rates were monitored daily during voluntary intake, a high-caloric diet by mouth, and nasogastric tube feeding. Providing 169 +/- 29 kcal/kg/day by tube resulted in weight gain with mild and transient elevation of respiratory rate at the end of the meal and increased heart rate 90 min after the meal. This regimen is a metabolically inexpensive and efficient method of supporting weight gain in children with congenital heart disease.

Age Factors↗
PubMed1984

Ampicillin-resistant Hemophilus influenzae type B infections in hospitalized pediatric patients.

Thirty-two pediatric patients with invasive Hemophilus influenzae type B (HITB) infections were evaluated according to the frequency of resistant strains and the clinical profile. The incidence of resistant strains was 28% (9/32), all of them due to beta-lactamase-producing bacteria. The rate of ampicillin resistance was significantly higher among patients who had received beta-lactam antibiotics. The initial treatment of HITB infections in our region should therefore include chloramphenicol; the indiscriminate day-to-day use of beta-lactam antibiotics should be reconsidered.

Ampicillin↗
PubMed1984

Clinical spectrum and natural history of isolated mitral valve prolapse in 30 children.

Thirty pediatric patients with isolated mitral valve prolapse were studied in order to elucidate the clinical manifestations and the natural history of this condition in children. The mean age at the time of diagnosis was 9.5 years, with a mean follow-up of 5 years. The evaluation of all 30 patients included: clinical examination by a pediatric cardiologist, ECG, chest X-ray, echocardiography and Holter monitoring. Two patients underwent cardiac catheterization and angiography, and two patients required antiarrhythmic medication for symptomatic ventricular tachycardia. No progression of mitral insufficiency was observed during the follow-up period. There were no instances of subacute bacterial endocarditis, cerebral vascular accident or sudden death. The prognosis of mitral valve prolapse appears to be favorable in childhood.

Adolescent↗
PubMed1983

Corticosteroid treatment of laryngotracheitis v spasmodic croup in children.

We compared the efficacy of high-dose dexamethasone sodium phosphate (0.6 mg/kg) in laryngotracheitis (LT) v spasmodic croup (SC) in 72 children (age range, 8 months to 8 years) using a double-blind randomized protocol that measured the individual change in respirations as an objective variable to evaluate the outcome. Administration of dexamethasone did not change the respirations in the patients with LT and significantly decreased the respirations in the patients with SC, compared with the placebo group. Since, in most cases, the pediatrician will be able to differentiate between LT and SC at admission by history and clinical signs, it seems that steroid treatment should be avoided in cases of LT and may be of benefit in some cases of SC.

Acute Disease↗