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Biomedical subjects

P Wunderlich

Publications and source records attributed to P Wunderlich.

At least 19 recordsLinked to original sources
PubMed1990

[Current aspects of the therapy of bronchial asthma in childhood].

The management goals common to all age groups are to reduce symptoms, to permit a normal physically active lifestyle, and to prevent irreversible airway obstruction. Main measures are environmental manipulation (avoidance of allergen contact, cigarette smoke and pets; psychotherapeutic management), assessment of severity, training for self management, hyposensitization (pollen, HDM, insect venoms) and pharmacotherapy. Medication should be adapted to age and severity of the disease, and the different drugs should be used stepwise. The first step includes the application of bronchodilators in which beta-2-stimulants are to be preferred. If we use spacers or jet nebulizers infants can also be treated successfully. The value of xanthines is discussed controversially. The next steps tend to reduce the inflammatory reaction. In this direction sodium cromoglycate and ketotifen are useful especially in childhood, and inhaled steroids have increasing importance. The use of oral corticosteroids should be the last step.

Adolescent↗
PubMed1990

Value of inhaled antibiotics in cystic fibrosis patients.

The authors give a survey of problems concerning the use of antibiotic aerosols in cystic fibrosis patients. They give recommendations when and how to use this form of treatment. The combination of inhaled antibiotics with the oral or intravenous antibiotic therapy can be recommended best for patients with a chronic lung infection with Pseudomonas aeruginosa.

Administration, Inhalation↗
PubMed1990

[Obstructive bronchitis and bronchial asthma: attempt at a status determination].

Despite some similarities and fluent changes of the clinical feature it is proposed to distinguish on principle between bronchiolitis, obstructive bronchitis and asthma. Main reasons for such a practice are: age-related peculiarities of the respiratory system, different aetiology and pathogenesis, variable therapeutic measures and a different prognosis.

Asthma↗
PubMed1990

[Some new treatment strategies for lung involvement in patients with mucoviscidosis].

Autogenic drainage, PEP mask breathing as well as physical exercise are now well established in the treatment of pulmonary disease in cystic fibrosis, but there are different opinions about oxygen therapy over a long period as well as corticosteroid treatment. First reports on amiloride inhalations seem to be hopeful, but there is no experience with cystic fibrosis children till now, therefore clinical use can not be recommended. Heart lung transplants are not to consider as an alternative treatment for all cystic fibrosis patients, in special cases it may be successful.

Child↗
PubMed1990

[The development of pediatric bronchology].

The authors give a statistical survey about the development of paediatric bronchology in the German Democratic Republic since 1957. They draw conclusions from this survey about the future trends in this field, which is part of paediatric bronchopneumology.

Bronchial Diseases↗
PubMed1990

[Malignant tumors of the lung and bronchi in children and adolescents. 2. Analysis of 66 cases of the East German National Cancer Registry (1961-1985)].

In the National Cancer Registry of the GDR from 1961 to 1985 only 66 cases malignant (and semimalignant) tumors of the bronchi and lung in patients under 20 years of age were collected. These amounted to 0,037 per cent of all tumor cases of this localization. These tumors affected 37 boys and 29 girls. Tumors of mesenchymal origin prevailed (32 cases = 48.4 per cent) in comparison to those of epithelial (37.8 per cent) and embryonal origin (10.7 per cent). Among these cases were 10 bronchial carcinomas and 10 bronchial adenomas. 51.5 per cent of all patients died in the clinic. Less than half of the patients were due to adequate therapy discharged free of any tumor. Data about the late prognosis of these patients were not available.

Adolescent↗
PubMed1990

[BCG osteitis. A case report].

Report of a 8 month old girl with a BCG-Ostitis in the head of the left humerus. The diagnosis was ascertained by typical radiological, histological and immun-histochemical changes. Tuberculostatic therapy resulted in healing. The value of the BCG-vaccination remains beyond all question.

Antitubercular Agents↗
PubMed1989

[The effect of bronchologic studies on blood gases and hemodynamics in children].

During 78 bronchological examinations in children of all age groups out of 6 centers of children bronchology of the GDR PaO2, PaCO2 and pH were registered, in a part of them additionally pulse, systolic and diastolic blood pressure. Following to the intubation--under ventilation with 100% oxygen or a halothane-NO2-oxygen mixture--there was a marked rise of PaO2, which normalized after extubation quickly. After extubation a slight hypoxemia occurred for a short period, a quick rise of PaCO2 and a slight acidosis, too. Besides, the hearth rate, systolic and diastolic blood pressure elevated following to the intubation and diminished after extubation.

Acid-Base Equilibrium↗
PubMed1989

[Diagnosis of mucoviscidosis by examination of sweat: value of conductometry].

Two methods for the determination of sodium in the sweat after stimulation by pilocarpine-iontophoresis were compared in 227 patients, among them 27 with a known cystic fibrosis. These two methods were 1. the standardized method by flame fotometry (State Pharmacopoeia of the German Democratic Republic) and 2. the determination of the sweat conductance by the new apparatus "CF-Conductognost". Both methods showed a good correlation. We recommend the conductometry for the decentralized screening because it saves time and gives results immediately. But in all patients with a questionable or pathologic value of conductance the sweat test should be repeated with the standardized method. This concerns only about 10 per cent of all patients.

Adolescent↗
PubMed1989

[Mucoviscidosis and marathon running. Evaluation of physical endurance in patients with cystic fibrosis].

The authors give a survey on the problems of sport activities in CF patients, which is based on own experience and the data of the literature. All these patients should take part in endurance sport. The regular training program should be carefully planned according to the state of each single patient. Regular medical supervision of it is necessary. Only in selected cases CF patients, too, can take part in marathon races.

Adolescent↗
PubMed1989

[Pulmonary complications in AIDS].

Adult patients suffering from infection with the HIV-virus acquire pneumocystis carinii pneumonia in nearly 80 per cent and in the half of all patients the basic disease AIDS has been detected by this lung infection. In childhood the patients with AIDS show most frequently interstitial lung diseases due to pneumocystis carinii or to lymphoid interstitial pneumonia. Also recurrent bacterial pneumonia may frequently occur, likewise infections with the cytomegalovirus or the Epstein-Barr-virus causing atypical pneumonia. The identification of the aetiology of these lung diseases is more difficult in children than in adults. In future it should be necessary to include more often AIDS as the basic disease into the differential diagnostic considerations in cases of such lung infections.

Acquired Immunodeficiency Syndrome↗
PubMed1989

[Malignant tumors of lungs and bronchi in children and youths. 1. Compilation of 175 cases from the literature].

The authors collected data of 175 malignant and semimalignant tumors in children and adolescents. 74.3 per cent of all reported cases were epithelial tumors (44.0 per cent bronchial adenomas and 30.3 per cent carcinomas), 15.4 per cent of embryonal and 10.3 per cent of mesenchymal origin. All age groups were affected. In children under one year of age embryonal tumors prevailed, in preschool age carcinomas and embryonal tumors dominated while in schoolchildren more often bronchial adenomas and carcinomas were found. All these tumors are very unusual in the pediatric age group. Therefore the right diagnosis is often missed for a longer time.

Adolescent↗
PubMed1988

[Bronchopulmonary infections in mucoviscidosis].

Cystic fibrosis (CF) is the most common genetic disease of Caucasians and also the most important lung disease of the first decades of life associated with infections by a variety of bacteria species especially Pseudomonas aeruginosa and Staphylococcus aureus. During the last two decades chronic Pseudomonas infection has emerged as the most difficult problem. Pseudomonas bacteria are able to synthesize numerous extracellular factors (virulence factors) contributing to its pathogenicity. Immunological defense mechanisms against Pseudomonas (and other bacteria species) have been demonstrated, but a complete elimination from infected lungs has not been observed. Therapy of Pseudomonas infections includes frequently combinations of antibiotics of the beta-lactam and aminoglycoside type.

Cystic Fibrosis↗
PubMed1988

[Acute foreign body aspiration as a respiratory emergency in childhood].

From 1957 to 1987 altogether 206 cases of tracheobronchial foreign body aspiration were diagnosed. Two third of the patients were one or two years old. Boys prevailed with 57 per cent. 55 per cent of all foreign bodies were nuts. Only 10 per cent were radiopaque (screws, nails, needles or pieces of bones). The attempt to eliminate the foreign body via the bronchoscope was successful in 96 per cent and failed in seven cases. Six children had to undergo a thoracotomy. In one third of the cases the foreign body remained two weeks or longer in the bronchial tree. 66 children with such a "chronic" foreign body were later on examined by bronchography, which showed in 29 per cent severe deformations of the bronchial wall and in 14 per cent even bronchiectasis. An acute foreign body aspiration should always be considered and handled as an emergency.

Bronchi↗