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T Nicolai

Publications and source records attributed to T Nicolai.

82 records · Page 5Linked to original sources

[Are there risk factors for stenosing laryngitis? Results of the Southern Bavaria pseudo-croup study].

We tried to find a correlation between elevated air pollution levels and incidences of laryngitis (pseudocroup). Clinical data-obtained by questionnaire-from 418 children with laryngitis, viral shedding in rhinal secretion and data on air pollution as SO2, NO2 and dust levels were compared via correlation analyses. Boys with allergic diathesis and with signs for bronchial hyperreactivity were identified as a high risk group. The high incidence of laryngitis especially seen in the month of October could be explained by the increased number of RSV positive patients. There was no significant correlation between laryngitis and the air pollution levels during the time of observation.

Air Pollution↗

[Long-term follow-up of lung function and standing height following scoliosis surgery in children and adolescents].

Previous investigations have reported conflicting results on the development of lung function and body height after operative correction of scoliosis at young age. Partly the number of patients or the duration of observation were relatively small. 120 patients were followed for at least 10 years (10-14, average 12 years) after surgical correction of scoliosis at the age of 18.2 +/- 6.8 years. Standing height and vital capacity were measured 1, 2, 5 and 10 years after operation. Height was expressed as percentile for age and vital capacity as % expected for actual height. The primary diagnoses were idiopathic scoliosis (n = 84, average Cobb angle 90 degrees), congenital scoliosis (n = 20, 83 degrees), poliomyelitis (n = 10, 128 degrees), neurofibromatosis (n = 6, 101 degrees). We found an initial decrease in lung function after 1 year, which was probably due to post-operative immobilization and increased by the gain in body height achieved by the operation. During the rest of the observation period a significant (p less than 0.05) increase of vital capacity (% of expected for actual height) was observed. The gain was maximal for idiopathic scoliosis (+6%). In congenital scoliosis body height %ile and relative vital capacity appeared fixed at the preoperative level. Interestingly patients with an initial vital capacity below 50% expected (n = 29) or preoperative Cobb angle above 90 degrees showed the best results. They also lacked the initial deterioration of lung function in the first postoperative year and had a significant gain of vital capacity (+14%) over 10 years.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗

[Hypertrophic osteoarthropathy in a patient with cystic fibrosis].

An 11-year-old boy with cystic fibrosis additionally suffered from hypertrophic osteoarthropathy. Despite a mild pulmonary involvement the polyarthritis was surprisingly long-standing and resistant to antiinflammatory treatment. The arthropathy completely disappeared within two months after antibiotic therapy of the bronchopulmonary staphylococcus infection.

Arthrography↗

Innominate artery enlargement in congenital arteriovenous fistula with subsequent tracheal compression and stridor.

To demonstrate that airway obstruction may be the first manifestation of a congenital fistula, a female newborn is reported who presented with increasing stridor during her first 23 months of life. Magnetic resonance imaging and Doppler echocardiography revealed an enlarged innominate artery with turbulent flow. Angiography demonstrated an arteriovenous fistula between the right subclavian artery and right subclavian vein and an abnormal origin of the right internal thoracic artery. Bronchoscopy showed a pulsating compression of the middle section of the trachea. Closure and division of the fistula and aortotruncopexy were performed. The stridor disappeared, and there was marked relief of the tracheal obstruction, confirmed by bronchoscopy. It is concluded that, a search for enlarged vessels is necessary in cases of airway obstruction.

Airway Obstruction↗

Adenovirus infection in cystic fibrosis patients: implications for the use of adenoviral vectors for gene transfer.

Clinical trials using replication-deficient adenovirus as vectors for gene transfer into the airways of cystic fibrosis (CF) patients are in progress. However, little is known about the prevalence of wild-type adenovirus infections in patients with cystic fibrosis and their effect on lung function. To answer these questions, serum IgG and IgM antibody titers against adenovirus type 5 were prospectively measured by an indirect immunofluorescence assay in 199 CF outpatients and in a control group of 45 healthy children and young adults. In addition, we performed pulmonary function tests when the patients were in stable clinical condition. IgM antibodies against adenovirus were present in 104 of the 199 cystic fibrosis patients (52.3%). IgG antibodies against adenovirus were detected in 192 of the 199 cystic fibrosis patients (96.5%), and were significantly higher in cystic fibrosis patients older than 7 years than in younger patients and in age matched controls. IgG antibody titers measured a second time 11.8 months later in 143 of the 199 patients had increased in 48 (33.6%) patients. In 27 of these 48 patients, who had at least a 2-fold increase in antibody titer, FVC and FEV1 decreased by 9.8% (p < 0.05) and 8.3% (p = 0.05), respectively, over 45 months. In a comparison group matched for age, sex, and chronic Pseudomonas aeruginosa infection but no increase in antibody titers, FVC and FEV1 were unchanged. The results indicate that wild-type adenovirus infections are prevalent in cystic fibrosis patients and that wild-type adenovirus infections in cystic fibrosis patients seem to be associated with deterioration in lung function. These observations may have important implications for efficacy and safety considerations when using adenoviral vectors for gene therapy.

Adenoviridae Infections↗

[Home ventilation of pediatric patients - description of a program]

OBJECTIVE: To describe a German program for home ventilatory support, and to analyze the possibility of applying it in Brazil. MATERIALS AND METHODS: We assessed Dr. von Haunersches Kinderklinikacute;s Pediatric Intensive Care Unity - Ludwig-Maximilians - Universität - München (Munich, Germany) home ventilatory support program between April 1997 and June 1998. RESULTS: Patients aged between 1 and 21 years - 11 boys and 15 girls - participated in the study. Fifteen out of 26 children presented neuromuscular pathologies, 8 of them had ventilatory problems of central causes, and 3 children presented obstructive pulmonary diseases. Twelve (46.2%) were receiving noninvasive ventilatory assistance, and 19 (73.1%) only needed intermittent ventilatory support. CONCLUSION: The program relies on a permanent multidisciplinary staff to treat intercurrent diseases. Patients, at predetermined periods, are re-evaluated as to the evolution of respiratory insufficiency. The adequate system organization provides patients and their families with security, and accounts for the success of the home ventilatory support program. A great deal of organizational efforts should be consolidated before implementing similar programs in Brazil.

Journal Article↗

[Optimizing radiotherapy for carcinomas of the tongue and floor of the mouth. Measurement of oncoradiogenic enzyme peaks of GPI].

After a first irradiation with 2 and 5 Gy blood samples were collected at 30 minutes' intervals for 24 hours in 19 tongue cancer patients to assess the activity of the glycosis enzyme glucose-6-phosphate isomerase (GPI) and the creatine kinase (CK). In all patients the GPI activity exhibited peaks at reproducible points in time. Observed for the very first time, this GPI peak had a height at 15 to 18 hours following radiation that correlated with the tumor volume and the irradiation dose. We refer to it as the oncoradiogenic enzyme peak. The frequency of the appearance of a late enzyme peak is significantly related to the presence of regional lymph node metastases. The radiobiological considerations regarding the potential causes for such post-irradiation increases in enzyme activity are discussed. The impact of demonstrating oncoradiogenic GPI peaks for optimizing radiotherapy is outlined.

Adult↗