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Biomedical subjects

W Kienast

Publications and source records attributed to W Kienast.

25 records · Page 2Linked to original sources
PubMedDate not supplied

[Lactobacillus paracasei endocarditis in an 18-yeard-old patient with trisomy 21, atrioventricular septal defect and Eisenmenger complex: therapeutic problems].

Endocarditis caused by lactobacilli is very rare and so far has been rarely published in adults with cardiac valve diseases especially after dental manipulations. Because of diagnostic and therapeutical problems we hereby report on one case of a female adolescent with Down's syndrome who did not undergo surgical correction of atrioventricular septal defect because of early development of Eisenmenger's syndrome. The onset was subacut and the diagnostic procedures were considerably delayed. Risk factors for the development of endocarditis in this case were preceding antibiotic treatments which increased the risk of selective growth of the causative germs as well as the tricuspidal valve incompetence with simultaneous pulmonary hypertension. The antimicrobial treatment was difficult due to resistance to antibiotic drugs generally applied in such cases and the restricted bacteriological diagnostic methods. Finally we had successfully administered chloramphenicol. The course was complicated by cerebral embolic events. FACIT: Lactobacillus species are facultative pathogenic which should be consideration in cases of subacute endocarditis in children and adolescents with ventricular septal defects and valve diseases. The determination of minimal bactericidal concentration of antibiotic agents and time-kill studies of combined antibiotics are recommended. For initial therapy we recommend high dose penicillin combined with an aminoglycoside. In cases of resistance chloramphenicol should be taken into account as second choice antibiotic drug. The duration of antibiotic therapy should at least over six weeks. In cases of risk systemic embolization is suspected therapy with low dose acetylsalicyclic acid or cardiosurgery should be assumed as therapeutic options.

Administration, Oral↗
PubMedDate not supplied

[Delayed fontanelle closure in infants with cyanotic cardiomyopathies].

In comparison with infants not suffering from cyanotic heart failures a different size (width and length) as well as a delayed time of closure of the anterior fontanelle in infants with congenital cyanotic heart failures were detected. In these patients typical phenomenons by ultrasound examinations are described also.

Cephalometry↗
PubMedDate not supplied

[Experiences in therapy of bradycardic cardiac arrhythmias in childhood with ipratropium bromide].

Ipratropiumbromid is used in adults for a variety of bradyarrhythmias. In contrast this therapy has not yet been established in childhood, where symptomatic bradyeardias are less frequent. Since Ipratropiumbromid has less side effects (especially concerning the central nervous system) and a longer half time than atropin, we investigated the efficacy of Ipratropiumbromid in 12 children (mean age 7.2 yrs.) in the course of 2 1/2 years. We found a significant increase of the minimal and mean heart rate in Holter-Eeg-recordings. Only in 7 of 12 patients we obtained a sufficient therapeutic effect. In one patient we had to terminate the therapy because of side effects. In two patients with atrioventricular block and two children with higher degree sinus node dysfunction could be removed only by implantation of a pacemaker. In another case we observed the proarrhythmical effect of Ipratropiumbromid. Summarizing we think, that the therapy with Ipratropiumbromid may be useful in symptomatical supranodal bradyarrhythmias in childhood in regard of side effects.

Adolescent↗