Biomedical subjects
Publications and source records attributed to M Heidl.
A survey about the Reye-syndrome including diagnosis, symptoms, therapy, and differential diagnosis is actually presented. The related problems of its pathogenesis, etiology and epidemiology are discussed. It is recommended to diagnosis this disease for registrating its frequency and distribution on the area of Germany.
Basing of a review of the world literature the problems of the live attenuated varicella vaccine are presented. The vaccine is well tolerated and immunogenic. Side effects are unimportant. The vaccination is associated with a decrease of the chickenpox attack rate following an intensive exposure to varicella-zoster virus conferring about 80% protection in immunocompromised children over a period of 3-5 years. The vaccination provide an excellent protection against severe varicella in children with acute lymphocytic leukemia who remain on remission as well as in children with solid tumors. The incidence rate of zoster following vaccination is not higher than following natural varicella infection.
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Varicella arthritis is a rare disease, so it might be justified to report three own observations and to discuss the related problems. Varicella arthritis is a self-limited arthritis, occurring in close temporal association with clinical varicella, which is usually monarthric, involving the knee. It is important to differentiate this condition from septic arthritis.
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Cryptosporidiosis in Children. During an 11-month survey, Cryptosporidium oocysts were found in the stools of 20 of 142 children admitted with gastroenteritis. Five of these 20 patients also excreted other enteropathogens. The clinical findings in 18 children infected with cryptosporidia could be analyzed. All patients were immunocompetent. Watery diarrhea, vomiting and anorexia were the most frequent symptoms. Differences in the clinical findings were observed between children aged one to two years and older children. The older children remained ill for 4.1 days compared to 19.9 days in the younger children. The younger children also presented a history of recurrent diarrhea. Problems of etiology and therapy are discussed. Cryptosporidia should be considered as a cause of diarrhea in children.
Both aciclovir and brivudin are effective in the treatment of immunocompromised children with varicella-zoster virus infection. To determine which drug is preferable, a prospective randomized trial aciclovir vs. brivudin was conducted. Forty-three immunocompromised children were randomly assigned to receive aciclovir intravenously at a dose of 1,500 mg/m2/d and brivudin orally at a dose of 15 mg/kg/d, respectively. Twenty-two patients were treated with aciclovir and 21 with brivudin. In all children the general status improved within two days. The eruption of new lesions stopped within one to five days, fever stopped within one to nine days, complete remission occurred within five to six days after introduction of the virustatic therapy. There was no difference in therapeutic efficacy between aciclovir and brivudin. Two children in each group did not respond to the medication. No myelo-, hepato- and nephrotoxic side effects due to aciclovir or brivudin were observed. All obviously immunocompromised children with varicella or zoster may be treated with aciclovir or brivudin.