PubMed Health⌕ Search

Biomedical subjects

R Pothmann

Publications and source records attributed to R Pothmann.

33 records · Page 2Linked to original sources
PubMed1987

Magnetic resonance imaging in non-specific discitis.

In this 20-month-old girl with non-specific spondylodiscitis the typical clinical presentation was absent. A definite diagnosis was made by radiological examination. Several reports have appeared in the literature concerning the importance of MRI as a new imaging modality in the diseases of the spine, including spondylodiscitis. In the present report we discuss the potential role of MRI in early diagnosis of spondylodiscitis in childhood.

Female↗
PubMed1987

[Prevention of migraine with flunarizine and acetylsalicylic acid. A double-blind study].

UNLABELLED: 30 children between 7 and 17 years suffering from at least 2 attacks/month of common or classical migraine since more than 1 year were studied. After clinical exclusion of symptomatic headache 4 weeks were documented by means of a migraine diary. Prophylaxis with Calcium entry blocker Flunarizine (Sibelium) or Thromboxane A inhibitor Acetylsalicylic acid (ASS) was carried out in a double blind design for 3 months. Medication was given as one dosage in the evening: 2-5 mg/kg KG ASS or 5-10 mg Flunarizine. Documented attack frequency and duration were controlled at monthly physical examinations. Final results showed no differences in significant reduction of attack frequency or symptoms between both different therapeutic principals. 72.4% (ASS 73.3%; Flunarizine 71.4%) of patients were attack-free or had at least a 50% reduction. Migraine frequency of initially 7-8 was reduced to 1-2 attacks/month. Duration remained constant in both groups (1-3 h). Side effects were slight body weight gain or abdominal pain after intake, prophylaxis had not to be interrupted therefore. Longtime prognosis is not yet possible because the time of observation is too short so far. CONCLUSION: Both substances are definitely useful and have few side effects in childhood migraine. If the response to one is insufficient the other substance should be tried.

Adolescent↗
PubMed1985

[Attention and distractibility in hyperkinetic children. Methods and results of research].

Sustained attention in children was investigated with a new method in which 4 measures of attention are recorded simultaneously over a period of 30 minutes during a self-paced operant task. A preliminary study with 56 normal children revealed that performance speed and brief lapses in attention have low validity as measures of attention, but errors and especially impulsive reactions have high validity. Impulsive behavior is thus characteristic not only for hyperactive children but also for normal children with attentional problems in everyday situations. The subjects in the main investigation were 12 hyperactive boys aged 8 to 11 years old. Hyperactivity had to be the major complaint, with the diagnosis substantiated by a pediatrician's findings and by a high motor-activity score in a teacher's assessment. Twelve normal boys matched for age, IQ and grade in school served as control subjects. All children attended regular schools and were of normal intelligence. The validity of the selection procedure was confirmed by the significantly lower heart rate found in the hyperactive group. Attention was assessed for 30 minutes under quiet and distraction conditions. The groups differed significantly in number of errors and number of impulsive reactions, but only in the absence of distraction. The stress of sustained attention for 30 minutes did not increase the differences; on the contrary, they decreased. A special type of attentional deficit in hyperactive children could not be confirmed. Our results do not support the hypothesis that hyperactive children are more distractible, have more frequent brief lapses in attention or have a poorer ability to sustain attention than normal children. Rather, they suggest that the attentional deficits represent a personality trait.

Attention↗
PubMed1984

[Longtime care of spina bifida patients. Therapy and prognosis in the last 20 years].

206 patients with spina bifida were followed up during the last 20 years; they were examined from the pediatric, neurosurgical, urological and orthopedic point of view. Evaluation of the intellectual development was also performed. Most of the 92 children of the first group were born after Lorber in 1971 proposed a selective policy of treatment of newborn infants, 144 (group 2) prior to this time. Shunting devices to alleviate hydrocephalus were necessary in two thirds of all patients. The incidence of shunt obstruction most commonly of the ventricular end was very high during the first two years of age but decreased sharply thereafter. Radiological screening disclosed pathological changes of the upper urinary tract in more than one fourth of all children, especially in girls. In the older group 28% of the patients over 5 years of age were mainly bound to a wheelchair, as opposed to 14% in the younger group. Epileptic seizures occurred in 27 cases. Children with thorakolumbar lesions proved to have a poorer intellectual development than those with lumbosacral lesions. Low IQs (less than 90) were also evaluated in every second patient with a shunt dependent hydrocephalus. Since the adoption of selective treatment the percentage of patients with severe handicap has decreased significantly.

Adolescent↗
PubMed1982

[Chronic cholestasis and progressive neuromyopathy. Diagnostic problems and therapeutic possibilities in a vitamin E deficiency disease (author's transl)].

A 15-year-old female developed a slowly progressive gait disturbance starting from the age of two. She was suffering from congenital choleostatic jaundice. Neurological examination revealed cerebellar ataxia, hyporeflexia and hyposensitivity. The initial vitamin E level in serum was extremely low with 0.4 mcg/ml (normal 5-20 mcg/ml). Muscle biopsy changes were similar to those in experimental vitamin E deficient animals. Pathological data of children with longstanding choleostatic jaundice showed degeneration of the posterior column and selective loss of large-caliber, myelinated axons in peripheral nerves. Similar to one other report in the literature the only effective treatment was the intramuscular injection of 50-100 mg Vitamin E twice a week which normalized the serum levels, stopped the progression of the disease and showed improvement of some neurological functions after half a year. A very early treatment seems to be important to keep these children walking.

Adolescent↗
PubMed1980

Efficiency of heparin in the treatment of newborn infants with respiratory distress syndrome and disseminated intravascular coagulation.

Forty newborns with severe shock and disseminated intravascular coagulation were randomized for treatment with heparin or placebo. Mortality was equal in both groups. The heparin group required significantly shorter periods of artificial ventilation. The coagulation system improved faster, and the coagulation pattern showed normal values in the treatment group. Due to the low number of cases, these differences could not be statistically confirmed.

Disseminated Intravascular Coagulation↗
PubMed1980

[Valvulography for the evaluation of the cerebrospinal shunt in childhood hydrocephalus (author's transl)].

Infection and obstruction of the cerebrospinal shunt are the most important disturbances in the management of childhood hydrocephalus. Often an occlusion of the shunt cannot be localized by conventional diagnostic means. Therefore the patency of Heyer-Systems was studied in 28 hydrocephalic children aged 2 months to 15 years with clinical signs of an increased intracranical pressure. The so-called valvulography with 99mTc-pertechnetate or Metrizamide (Amipaque). In more than 96% the results were confirmed during operation. The advantages of the X-ray method are: instrument and contrast medium are available at any time and the combination with cranial computertomography gives more precise data than scintigraphy alone.

Adolescent↗
PubMedDate not supplied

The influence of methylphenidate on the sympathoadrenal reactivity in children diagnosed as hyperactive.

In order to investigate whether catecholamines play a role in the hyperkinetic child syndrome, we determined noradrenaline and adrenaline plasma levels before and after treatment with methylphenidate. The children were separated into drug responders and non-responders according to the efficacy of methylphenidate on behavioral symptoms. 21 children, 6-13 years of age, participated in this double-blind placebo controlled cross-over study. Conners' questionnaire was used to estimate the extent of the hyperactivity and to assess the drug response. Blood samples were drawn under resting and exercise conditions and plasma catecholamine concentrations determined as an indication of the amine release rate and the reactivity of the sympathoadrenal system. The results may be summarized: The postexercise noradrenaline levels of untreated hyperkinetic children were slightly, but not significantly higher than those of an age-matched control group. After 3-4 weeks of stimulant medication the noradrenaline release induced by physical exercise was significantly lower than after placebo. 12 out of 21 children showed an alleviation of their symptoms during methyl- phenidate therapy and thus could be assumed as drug-responders. When children were separated into drug-responders and non-responders according to the degree of the clinical improvement, both groups showed the same catecholamine release in response to exercise. Methylphenidate reduced the noradrenaline release in 9 out of 11 children in the responder group and in 7 out of 9 children in the non-responder group. In conclusion, catecholamines may be involved in the hyperkinetic child syndrome, but because of the heterogenity of this syndrome the depression of the plasma catecholamines as observed under methylphenidate could not differentiate between drug-responders and non-responders.

Adolescent↗
PubMedDate not supplied

[Diagnosis and therapy of pain in pediatric oncology].

Pain in pediatric oncology must be taken care of after years of neglection. On an average of 62% of tumours pain is of therapeutic relevance. In cancer relapse and final states incidence of pain increases up to 90%. Treatment of acute pain is not difficult, chronic pain however affords a special procedure: individual dosage with optimal suppression of pain whole day long, often combination of different methods, will give sufficient longtime results. Around 4/5 of pediatric cancer pain can be treated by pharmacological regime using central and antiphlogistic analgesics. Additional methods are local anesthesia, transcutaneous nerve stimulation, physiotherapy, psychotherapy and seldom neurosurgical intervention. The optimal treatment of cancer pain is part of a consequent oncological procedure. Some more effort is necessary to reach the most possible quality of life in these children.

Analgesics↗