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Biomedical subjects

R Pothmann

Publications and source records attributed to R Pothmann.

At least 19 recordsLinked to original sources
PubMed2005

[Intramuscular injections in children].

Intramuscular injections are still part of routine care in the treatment of children. Vaccines, premedications and analgesics are administered by this route. The pain associated with an intramuscular injection is severe, the risk of complications is increased, and pharmacodynamics and pharmacokinetics are unpredictable. In many cases, equivalent alternatives of rectal, oral or intranasal routes of administering pharmacologic agents exist. Intramuscular injection of analgesics and premedications to children are-except in case of emergencies-obsolete. This demand corresponds to the guidelines of the World Health Organization (WHO) and the International Association for the Study of Pain (IASP).

Analgesics↗
PubMed2002

[Treatment of idiopathic headache in childhood - recommendations of the German Migraine and Headache Society (DMKG)].

According to the principles of evidence-based medicine, the controlled studies on the treatment of idiopathic headache in childhood have been analysed and compiled to treatment recommendations. For the acute treatment of migraine attacks or tension-type headache, ibuprofen (10 mg per kg body weight) or acetaminophen (15 mg per kg body weight) are recommended with highest evidence, intranasal sumatriptan (10 to 20 mg) can be given as second choice. For the prophylaxis of migraine, betablockers (propranolol and metoprolol), flunarizine, and valproic acid are recommended. Flunarizine is the drug of first choice in the treatment of migraine-related disorders. No controlled studies are available for the treatment of further headache types. First line methods for the non-drug treatment of headache in childhood are relaxation therapies, biofeedback, and specific training schedules.

Acetaminophen↗
PubMed2001

[Evaluation of applied kinesiology in nutritional intolerance of childhood].

BACKGROUND: Because nutritional intolerances generally are difficult to be diagnosed, Applied Kinesiology (AK) often is discussed as an alternative in this field. AIM: The uncertain scientific situation makes it necessary to assess the diagnostic value of AK. The method was compared with established laboratory tests such as RAST, lactose breath hydrogen test and a specific IgG test (Cytolisa). METHODS: 315 children and adolescents, 0-17 years old, with different chronic diseases such as headache, abdominal pain, chronic eczema, hyperactivity, and bronchial asthma were studied by means of AK for 2 years. RESULTS: We found a moderate test-retest reliability (intraclass-kappa 0.62) but no inter-tester reliability (intraclass-kappa -0.01). Moreover, there was no statistically significant agreement with either RAST and Cytolisa (sensitivity 73.6%, specificity 45.2%) or lactose breath hydrogen test (sensitivity 77.1%, specificity 43.2%). CONCLUSIONS: In general, AK cannot be recommended for diagnosing nutritional intolerance. However, due to its high sensitivity, it could be a valuable tool to give some preliminary results.

Adolescent↗
PubMed2000

[Acute treatment of episodic childhood tension-type headache with flupirtine and paracetamol - a double-blind crossover-study].

BACKGROUND: About 10% of all schoolchildren are suffering from migraine and 50% from tension-type headache. Headache of acute onset usually will be treated with analgesic substances like paracetamol, acetylsalicylic acid or ibuprofen, the first one being the reference drug for tension-type headache in childhood. In case of lacking improvement or side-effects there is demand for an alternative safe substance for the acute analgesic therapy. METHODS: In a double-blind randomised investigation flupirtine and paracetamol were given in two consecutive attacks of episodic tension-type headache. 30 children, 6-12 years old, were included. Dosage was determined according to age and weight. The children documented the acute headache intensity and duration in a special diary. RESULTS: Headache intensity was reduced during 2 h after intake in 89% of the 19 children treated. The reduction was 6,5 to 3,1 for flupirtine and 6,9 to 3,3/10 for paracetamol. There was no statistically significant difference between the two substances. Relevant side-effects could not be observed. CONCLUSION: Flupirtine has shown a convincing clinical effect treating acute episodic tension-type headache for children. The substance was well tolerated by the patients. In addition, flupirtine provides a high degree of safety.

Clinical Trial↗
PubMed1999

Cenesthetic pain sensations illustrated by an artist suffering from migraine with typical aura.

In addition to attacks with the well-known pulsating characteristics of migrainous headache, migraine patients may experience a variety of peculiar pain sensations which are phenomenologically similar to the spontaneous sensations occurring in patients with thalamic disturbances and to the cenesthesias described as basic symptoms in functional psychoses. A 36-year-old artist with a history of migraine with typical aura provided impressive illustrations of cenesthetic pain sensations experienced during his migraine attacks, including sensations of pressure and sensations of pulling. It is suggested that cenesthetic pain sensations represent aura symptoms of migraine indicative of focal cerebral dysfunction, probably in the thalamic region. The occurrence of cenesthetic pain sensations as a migraine symptom supports the notion of an organic etiology of cenesthesias, as postulated in Huber's concept of basic symptoms of functional psychoses.

Adult↗
PubMed1998

A comparison of psychological and pharmacological treatment of pediatric migraine.

A comparison was carried out of the efficacy of psychological and drug treatments for children with migraine. Forty-three children aged between 8 and 16 years (mean age: 11.3 years) who suffered from migraine received either progressive relaxation or cephalic vasomotor feedback, both with stress management training, or metoprolol, a beta-blocker. Psychological treatment was administered in ten sessions lasting six weeks and the drug treatment lasted ten weeks. Relaxation and stress management training reduced the headache index (frequency x intensity of headache episodes), more effectively than metoprolol with cephalic vasomotor feedback and stress management training in between. An overall improvement over time was found with regard to frequency and intensity of headache episodes and analgesics intake. When comparing pre- to post-treatment data, children treated with relaxation training improved significantly in headache frequency and intensity, whereas those treated with cephalic vasomotor feedback improved significantly in headache frequency and duration as well as mood. The clinical improvement was stable at an 8-months follow-up.

Adolescent↗
PubMed1998

Comparison of biofeedback and relaxation in the treatment of pediatric headache and the influence of parent involvement on outcome.

The relative efficacy of EMG-frontalis feedback and progressive relaxation was examined in children with tension-type or combined headaches (8-14 yrs. old). Furthermore, the influence of parent involvement, in the form of a three-session educational approach, on training outcome was systematically explored (2 x 2 factor design). Fifty children took part in the study, 40 were randomly assigned to the four different treatment conditions, 10 children participated in the self-monitoring control group. The training comprised 6 sessions of 1 hr each in the relaxation treatment and 12 sessions of 1/2 hr duration in the biofeedback group. Headache diaries were kept by children and parents for 4-week period prior to therapy, and for a similar length of time at post-treatment and follow-up (6 months). Multivariate analyses of variance on the headache diary data yield no significant main or interaction effects of treatment format or of parent involvement, but only a main effect of period, indicating a general efficacy of the four treatment conditions. At follow-up the reduction of headache activity is even more prominent. A different evaluative approach points to the superiority of biofeedback revealing a mean effect size for biofeedback training that reflects a good to excellent improvement rate. Correlations between headache data from children and parents are high.

Adolescent↗
PubMed1996

[Special features of acute pain in the paediatric age group].

Treatment of acute pain in children is a very important part of every doctor's work, and requires well-founded knowledge of this particular age group. Even in preterm infants pain apperception is fully developed, so that adequate analgesia is necessary. During infancy and childhood the individual developmental stage must be taken into account; the ability to cope with pain often differs distinctly from that in adults. At the starting of an analgesic regimen nonsteroidal analgesics are sufficient in most cases. If pain is severe iv morphine should be used much more often in children, because it is very effective and side effects can be avoided. In contrast to chronic pain management, pain-dependent analgesic management can be considered as beneficial. Good knowledge of a small number of drugs with their pharmacological profile is sufficient for effective analgesic results even in severe pain states in children. Behavioural medicine should be integrated into paediatric pain management as soon as possible. An early start of pain reduction and prophylaxis is the best basis for development in the direction of competent pain coping behaviour in adult life.

English Abstract↗
PubMed1993

Contingent negative variation in childhood migraine.

Adult migraineurs without aura have an increased amplitude of the Contingent Negative Variation (CNV) between attacks. Given the potential diagnostic importance of this finding and the difficulties associated with diagnosing migraine in childhood it seemed important to assess CNV in children suffering from this disorder. Ninety-seven children aged between 8 and 14 years were recruited. Forty-two suffered from migraine, 34 from tension-type headache. Twenty-one healthy controls were also studied. CNV was recorded from Fz, Cz and Pz referenced to linked earlobes during 20 trials consisting of two tones of moderate intensity with an interstimulus interval (ISI) of 4 sec and an intertrial interval (ITI) of 10 to 14 sec. The second tone of each trial required a button press. EOG was recorded from the left eye. The 10 CNV responses with the least EOG artefact were selected and averaged. Children with migraine had a highly significantly more negative mean CNV amplitude at all three electrode sites than children with tension-type headache and also a more pronounced Post-Imperative-Negative-Variation (PINV). Migrainous children differed from controls only at Cz (ISI). There was also a highly significant increase of mean CNV amplitude and PINV at all three electrode sites in the control group compared to the tension headache group.

Adolescent↗
PubMed1993

Topographic EEG mapping in childhood headaches.

The clinical distinction between migraine without aura and tension headache is more difficult in young children than it is in adults. The objective of this study was to examine the usefulness of topographic EEG mapping, as one method among other diagnostic techniques, for establishing a diagnosis. The clinical diagnosis of tension headache and migraine in children between 6 and 15 years of age was established according to criteria of the International Headache Society classification. Children with migraine and tension headache were examined during and between attacks. EEG mapping showed lateralized parietal diminution of alpha-power more frequently during an attack of migraine than during tension headache, which regressed between attacks. Compared to other methods, such as visual evoked potentials, EEG mapping may have the advantage of helping to diagnose each single headache, which could be useful in patients with combined headaches.

Adolescent↗
PubMed1989

[Assessment of fine motor skills in young children and school children].

With the - limited - exception of the Frostig test, a standardized assessment of fine-motor coordination in young children is not yet possible. Only handedness or visuomotor coordination can be examined with the Steingruber's hand dominance test (HDT) or, in schoolchildren, with the Göttingen form reproduction test (GFT). The semiquantitative neurological examination described by Touwen and Prechtl has only an orientational character. In adults, fine-motor coordination can already be measured electronically in a standardized manner with the Motorische Leistungsserie after Schoppe and the Viennese reaction device (VRD). In a normal population of 296 kindergarten and school children aged between 4 and 12 years, this method has now been standardized for use in children. Validation was effected in hyperactive children and children with fine-motor deficits prior to and during stimulation treatment, and also in hemiplegic children. The results demonstrate the good, age-dependent differentiation of Fleishman's nine factors of handedness. The procedure will be suitable for clinical diagnosis of fine-motor disorders of varying genesis, and also for treatment and course monitoring in pre-school and school children.

Age Factors↗