[Neuropsychiatric disorders in very-low-birthweight newborn infants (VLBW-infants)--before and after the introduction of modern perinatal medicine. 3. Discussion of trends in quality of survival (CNS morbidity) and conclusions]. / Neuropsychiatrische Störungen bei Neugeborenen mit sehr niedrigem Geburtsgewicht (VLBW-infants)--vor und nach Einführung der modernen Perinatalmedizin. 3. Mitteilung: Diskussion zu Trends der Uberlebensqualität (ZNS-Morbidität) und Schlussfolgerungen.

The reduction of both the severe CNS-disturbances (major CNS-handicaps) as a whole and the infantile cerebral palsies (ICP), epilepsies, and mental retardations (oligophrenias) especially, can be attributed to the comprehensively improved pre-, intra- and postnatal care since the 60/70-ies. The best indicator is the decreasing ICP, because 60% of this disturbance is caused perinatally. It is closely associated with cerebral hemorrhages. In several centers, in Sweden and in West-Australia, an isolated recrudescence of ICP was noted. This fact is probably caused by a very active management of respirator therapy in some perinatological centers. However, today there is an effective therapy of several potential causes of perinatal cerebral lesions, i.e. hypoglycemia, hypothermia, asphyxia, RDS, and hyperbilirubinemia. The therapy of these diseases is simultaneously a prevention of the possible consecutive cerebral lesion as well. In the past, only two causes for CNS-disturbances have scarcely been influenced: cerebral hemorrhage, and nosocomial infections. Conclusions for the strategy of the further perinatal care can be deduced from these analyses: prevention of the extremely preterm deliveries, improvement of the perinatal care, prevention of cerebral hemorrhages and nosocomial infections, and responsible ethical decision about the application of the respirator therapy in the individual case.

[Neuropsychiatric disorders in newborn infants with very low birth weight (VLBW infants)--before and following introduction of modern perinatal medicine. 2. Infantile cerebral palsy, epilepsy and mental handicap (oligophrenia)]. / Neuropsychiatrische Störungen bei Neugeborenen mit sehr niedrigem Geburtsgewicht (VLBW-infants)--vor und nach Einführung der modernen Perinatalmedizin. 2. Mitteilung: Infantile Cerebralparesen (ICP), Epilepsie und geistige Behinderungen (Oligophrenien).

Simultaneously with the introduction of modern perinatal intensive therapy the infantile cerebral palsies (ICP) of VLBW infants dropped on the average from 23 to 5.9 per cent. In Swedish and West-Australian ICP studies a considerable decrease in the ICP incidence was found in the 60's, but there was again a slight increase in the 70's. A decrease in the epilepsies was found on an average from 9 to 1.6 per cent, whereby in 10 of 16 actual studies mostly performed at early follow-up age no epilepsies were reported. A decrease in the mental retardations (oligophrenias) was found on an average from 22 to 10.6 per cent. There was especially noteworthy a reduction of the severe mental retardations from 8 to 10 per cent to an average of 2.3 per cent.

[Neuropsychiatric disorders in newborn infants with very low birth weight (VLBW infants)--before and following introduction of modern perinatal medicine. 1. Overview of the problem, criteria for quality of survival, major CNS disorders (major handicap)]. / Neuropsychiatrische Störungen bei Neugeborenen mit sehr niedrigem Geburtsgewicht (VLBW-infants)--vor und nach Einführung der modernen Perinatalmedizin. 1. Mitteilung: Ubersicht zum Problem, Kriterien der Uberlebensqualität, schwere ZNS-Störungen ("major handicap").

The survival quality of very low birthweight infants (VLBW infants) is highly actual just even in the time of modern perinatal medicine. Through the development and permanent improvement of the perinatal intensive therapy the survival chances of VLBW infants could be improved significantly in the last 25 years. In the 70's survival rates of 60-84 per cent were achieved in VLBW infants, in the leading centers even rates of 86 and 90.5 percent, respectively. In the 70's an enormous improvement in the survival rates from 20-45 per cent was achieved in tiny premature infants (birth weight 1,000 gm and less), too. However, the efforts of gynecologists and neonatologists to reduce the mortality of low birth-weight infants are again and again blamed for possibly obtaining successes with an increase in CNS morbidity. The parallel analysis of some brain damage groups in VLBW infants seems suitable to gain a clear statement if modern perinatal medicine contributes to reduce the frequency of early infantile cerebral damages and their consecutive handicaps altogether. In an extensive review of literature it is tried to prove this for the major CNS handicaps altogether and separately for the infantile cerebral palsies, epilepsies and mental retardations (oligophrenias). Simultaneously with an average increase from 29.7 to 69.5 per cent of the healthy surviving children, there was a reduction of major CNS handicaps on the average from 36 to 12 per cent.

[Position of the delayed-action neuroleptic penfluridol (Longperidol/Janssen) in psychiatric therapy]. / Zur Stellung des Langzeit-Neuroleptikum Penfluridol (Longoperidol/Janssen) in der psychiatrischen Therapie

Longoperidol/Janssen, an orally administered neuroleptic with a five- to seven-day duration of effects, was clinically tested in six mental hospitals in the G.D.R. where the agent was administered to subjects of chronic to subacute schizophrenia. It was not possible for fully consistent results to be obtained in these tests. Workers at mental hospitals in Leipzig and Mühlhausen recommended that the drug should be imported, whereas those at the four other centers (Dresden, Halle, Jena, and Schwerin) did not consider the medication to be indispensable, although they were also able to observe the good effects of the agent.