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1.
Semin Thromb Hemost ; 27(2): 169-74, 2001.
Artigo em Inglês | MEDLINE | ID: mdl-11372772

RESUMO

For the improvement of thrombolytic therapy with recombinant tissue-plasminogen activator (rt-PA) in children, more clinical data are needed. We retrospectively analyzed the clinical course of 20 patients (age ranging from 1 day to 16 years) with venous thrombosis (n = 16), arterial thrombosis (n = 2), and purpura fulminans by meningococcosis (n = 2). The venous thromboses were localized in the iliac-femoral veins (n = 9), brachiocephalic-jugular-subclavian veins (n = 6), and the superior caval vein (n = 1). The arterial occlusions were localized in the abdominal aorta and in the left pulmonary artery. Central venous catheters were of pathogenetic importance in seven cases. The patients were treated with rt-PA for 3 hours to 13 days. The dose ranged between 0.2 and 0.5 mg/kg for the initial bolus and 1.0 to 2.0 mg/kg/d for the continuous infusion. Nineteen patients received simultaneously low-dose unfractionated heparin. Complete clot lysis was detected in 11 cases, a partial lysis in 1, and in 8 patients thrombolytic therapy was not successful. An episode of hematemesis in one patient represented the only serious side effect observed in our study. A systemic decrease in fibrinogen concentration was also rare. In conclusion, thrombolysis with rt-PA represents an effective and safe therapy for children at the dosage used.


Assuntos
Fibrinolíticos/uso terapêutico , Trombose/tratamento farmacológico , Ativador de Plasminogênio Tecidual/uso terapêutico , Criança , Pré-Escolar , Humanos , Lactente , Recém-Nascido , Proteínas Recombinantes/uso terapêutico
2.
J Pediatr Hematol Oncol ; 23(2): 134-8, 2001 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-11216707

RESUMO

Cerebral involvement of systemic mastocytosis and intracranial sarcoma of myelogenic origin are well known entities. An 8-year-old girl with an isolated cerebral mast cell tumor is presented. Specific histopathologic stains were used to confirm the diagnosis detecting immunophenotype and proliferative activity. Treatment with irradiation, intrathecal cytarabine, and interferon-alpha2b did not induce regression whereas polychemotherapy did. Systemic combination chemotherapy led to marked transient tumor regression in this proliferating mast cell sarcoma in an unusual intracranial location.


Assuntos
Sarcoma de Mastócitos/tratamento farmacológico , Lobo Parietal/patologia , Neoplasias Supratentoriais/tratamento farmacológico , Lobo Temporal/patologia , Protocolos de Quimioterapia Combinada Antineoplásica/administração & dosagem , Protocolos de Quimioterapia Combinada Antineoplásica/uso terapêutico , Criança , Terapia Combinada , Irradiação Craniana , Citarabina/administração & dosagem , Citarabina/uso terapêutico , Daunorrubicina/administração & dosagem , Progressão da Doença , Etoposídeo/administração & dosagem , Evolução Fatal , Feminino , Cefaleia/etiologia , Humanos , Fatores Imunológicos/uso terapêutico , Injeções Espinhais , Interferon alfa-2 , Interferon-alfa/uso terapêutico , Sarcoma de Mastócitos/diagnóstico , Sarcoma de Mastócitos/patologia , Sarcoma de Mastócitos/radioterapia , Sarcoma de Mastócitos/cirurgia , Náusea/etiologia , Recidiva Local de Neoplasia , Cuidados Paliativos , Papiledema/etiologia , Lobo Parietal/cirurgia , Prednisolona/administração & dosagem , Teleterapia por Radioisótopo , Proteínas Recombinantes , Indução de Remissão , Neoplasias Supratentoriais/diagnóstico , Neoplasias Supratentoriais/patologia , Neoplasias Supratentoriais/radioterapia , Neoplasias Supratentoriais/cirurgia , Lobo Temporal/cirurgia , Falha de Tratamento , Vômito/etiologia
3.
J Clin Oncol ; 17(12): 3736-44, 1999 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-10577845

RESUMO

PURPOSE: To further reduce therapy-related late effects in patients with pediatric Hodgkin's disease (HD) while maintaining the high cure rates achieved with vincristine, prednisone, procarbazine, and doxorubicin (OPPA) or OPPA/cyclophosphamide, vincristine, prednisone, and procarbazine (COPP) chemotherapy and involved-field radiotherapy. The risk of testicular dysfunction was addressed by substituting etoposide for procarbazine (OEPA) in the induction therapy for boys. Radiation doses and fields were further reduced. PATIENTS AND METHODS: Three hundred nineteen boys and 259 girls younger than 18 years with previously untreated HD, enrolled onto the study between 1990 and 1995, were allocated to treatment group (TG)1 (early stages), TG2 (intermediate stages), or TG3 (advanced stages). All groups underwent two cycles of OEPA (boys) or OPPA (girls) for induction chemotherapy. TG2 and TG3 continued on additional two or four cycles, respectively, of COPP. Low-dose radiotherapy was given to the initially involved sites, ie, reduced involved fields. RESULTS: Initial response to OPPA or OEPA induction was virtually identical. Eight of 578 patients experienced early progression of HD. Thirty-seven relapses, three secondary tumors, and no secondary leukemias have been recorded, with a median follow-up duration of 5.1 years (maximum, 8.1 years). Thirteen of 578 patients died. The probability of 5-year event-free survival/overall survival is 91%/98% in the total group, 94%/97% with OPPA, and 89%/98% with OEPA induction therapy. Risk factor analysis showed two significant prognostic factors: histologic subtype NS2 and "B" symptoms. OEPA induction therapy, large mediastinal tumor, and age were not significant. Preliminary studies of testicular function indicate a lower risk of germ cell damage than previously documented with OPPA. CONCLUSION: OEPA is a satisfactory alternative to OPPA. Radiotherapy can be confined to involved sites when combined with appropriate chemotherapy. The DAL-HD-90 regimen represents a comprehensive treatment program for all stages of pediatric HD and offers a favorable benefit/risk ratio, combining excellent disease control, moderate acute toxicity, and reduced long-term toxicity.


Assuntos
Protocolos de Quimioterapia Combinada Antineoplásica/uso terapêutico , Doença de Hodgkin/tratamento farmacológico , Adolescente , Áustria , Criança , Pré-Escolar , Terapia Combinada , Ciclofosfamida/administração & dosagem , Doxorrubicina/administração & dosagem , Feminino , Alemanha , Doença de Hodgkin/radioterapia , Humanos , Masculino , Prednisona/administração & dosagem , Procarbazina/administração & dosagem , Doses de Radiação , Fatores de Risco , Resultado do Tratamento , Vincristina/administração & dosagem
4.
Semin Thromb Hemost ; 24(5): 453-61, 1998.
Artigo em Inglês | MEDLINE | ID: mdl-9834013

RESUMO

Endothelium derived substances may play a role in the physiological adaptation processes at the time of birth. The aim of this study was to investigate plasma concentrations of activation markers of the endothelium (endothelin-1, thrombomodulin, von Willebrand factor), of the coagulation and the fibrinolytic systems (thrombin-antithrombin III complex, D-dimer, plasmin-alpha2-antiplasmin complex) during the first days of life. Venous blood from peripheral veins was collected from 79 healthy newborns and for comparison from 38 healthy infants and schoolchildren, as well as from 17 healthy adults. Except for endothelin and von Willebrand factor, the concentrations of activation markers were significantly higher in the newborn group. During the first 12 days of life thrombomodulin, thrombin-antithrombin III complex, and plasmin-alpha2-antiplasmin complexes showed a continuous decline whereas the concentrations of endothelin, von Willebrand factor and D-dimer did not change. The highest D-dimer concentrations were found at low umbilical arterial pH and after birth by vaginal operation suggesting an influence of birth stress. Thrombomodulin was correlated with endothelin (r=+0.471) and with von Willebrand factor (r=-0.415). In conclusion, endothelial, coagulation, and fibrinolytic systems are activated in newborns which might occur during birth by the mechanical stress, the adaptation of circulation, and the short-term hypoxic state. An additional intrauterine activation should also be considered.


Assuntos
Coagulação Sanguínea , Endotélio Vascular/fisiologia , Adulto , Envelhecimento/sangue , Biomarcadores , Criança , Pré-Escolar , Humanos , Recém-Nascido
5.
Med Pediatr Oncol ; 30(1): 18-21, 1998 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-9371384

RESUMO

As far as we know, this is the first report of a non-Hodgkin lymphoma developing after successful treatment of neuroblastoma. A boy was found to have a mediastinal T-cell lymphoma at the age of 5. He had been treated for a neuroblastoma of the left adrenal region 4 years before, when by intensive chemotherapy and radiation a complete remission of the primary tumor was achieved. The second malignancy has also been controlled without evidence of recurrence 1 year after termination of treatment. We conclude that treatment of a neuroblastoma by cytostatic drugs and radiation may lead to a non-Hodgkin lymphoma as a second malignancy.


Assuntos
Linfoma não Hodgkin/etiologia , Segunda Neoplasia Primária/etiologia , Neuroblastoma/terapia , Humanos , Lactente , Masculino
6.
Semin Thromb Hemost ; 24(6): 513-21, 1998.
Artigo em Inglês | MEDLINE | ID: mdl-10066146

RESUMO

Blood samples from 42 newborns, 78 infants and schoolchildren, and 81 healthy adults were tested for the parameters of primary hemostasis. Only whole blood techniques were used. Agonist-induced aggregation and release-reaction studies were performed in a whole blood lumi-aggregometer simultaneously. The release of adenosine triphosphate (ATP) was detected by the luciferin-luciferase method. The in vitro bleeding time was measured by the PFA 100 system. The results of these studies were ostensibly influenced by blood cells. Many aggregation phenomena were correlated with the platelet count. Aggregation and release reaction by collagen were inversely correlated with the hematocrit. In the PFA 100, hematocrit and leukocyte count were also inversely correlated with the closure time and the maximal blood flow velocity. Both parameters were diminished in newborns. The aggregation response to adenosine diphosphate (ADP) was similar in the three groups. The same was true for the aggregation and release reaction by arachidonic acid and for the agglutination by ristocetin. The aggregation and release reaction by collagen were diminished in the specimens from newborns. For the explanation of this transient hypofunction, only theoretical considerations exist. Beyond the postnatal period and during childhood, no remarkable differences from the adult norm were found.


Assuntos
Trifosfato de Adenosina/sangue , Plaquetas/metabolismo , Agregação Plaquetária , Testes de Função Plaquetária/métodos , Trifosfato de Adenosina/metabolismo , Adolescente , Adulto , Tempo de Sangramento/métodos , Contagem de Células Sanguíneas , Plaquetas/fisiologia , Criança , Pré-Escolar , Colágeno/sangue , Humanos , Lactente , Recém-Nascido , Ristocetina/sangue
7.
Am J Hematol ; 56(4): 259-65, 1997 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-9395189

RESUMO

In whole blood samples from thrombocytopenic patients, large amounts of ATP were released by ADP, exceeding the level obtained with samples from normal persons by far. Because we suspected that the high potential of ATP in erythrocytes would be the main source for this phenomenon, the release of ATP by ADP was measured in whole blood samples from normal, thrombocytopenic, and leukocytopenic persons and in suspensions of washed erythrocytes. The release was recorded by a Whole Blood Lumi-Aggregometer type 500 VS (Chrono-Log Corporation, Havertown, PA) using the luciferin-luciferase system. Not only in samples from thrombocytopenic persons but also with normal platelet count, increasing amounts of ATP were released with increasing ADP concentrations, finally exceeding the ATP releasable from thrombocytes by thrombin. The amounts of ADP required to match the ATP release of thrombin were closely correlated with the platelet counts in the samples. With lower platelet counts, the release mechanism from erythrocytes could be stimulated more easily by low concentrations of ADP. The binding of ADP to platelets occurred with ostensibly higher affinity. The phenomenon of overshooting ATP release was also observed in samples from extremely leukocytopenic patients. A very large release of ATP was also achieved in suspensions of washed erythrocytes. In this way our hypothesis of ATP release from erythrocytes by ADP was confirmed again. The mechanism of the release from erythrocytes remains unclear. We speculate that its purpose is to regulate extracellular nucleotides in the circulating blood.


Assuntos
Difosfato de Adenosina/farmacologia , Trifosfato de Adenosina/metabolismo , Sangue/metabolismo , Eritrócitos/metabolismo , Sangue/efeitos dos fármacos , Plaquetas/efeitos dos fármacos , Plaquetas/metabolismo , Relação Dose-Resposta a Droga , Eritrócitos/efeitos dos fármacos , Luciferina de Vaga-Lumes/efeitos dos fármacos , Luciferina de Vaga-Lumes/metabolismo , Humanos , Técnicas In Vitro , Leucopenia/sangue , Contagem de Plaquetas/efeitos dos fármacos , Trombina/administração & dosagem , Trombocitopenia/sangue
8.
Thromb Res ; 84(3): 157-65, 1996 Nov 01.
Artigo em Inglês | MEDLINE | ID: mdl-8914215

RESUMO

The influence of erythrocyte and thrombocyte content on the release of adenosine triphosphate (ATP) in whole blood was tested. Citrated blood from 39 healthy persons was diluted gradually. The release reaction was induced by arachidonic acid (1.25 mM), adenosine diphosphate (ADP; 30 microM) and collagen (1.0 and 5.0 micrograms/ml). The peak of the obtained curves was transformed into percent values of the maximal deflection by the undiluted sample (PEAK IN RELATION) and into ATP concentrations (ABSOLUTE PEAK). By rising dilution an increase of the peak in relation with all inducers was observed which was mainly due to the luminescence-optical effect. As expected the absolute peak decreased but only under arachidonic acid and collagen. Under ADP despite of the rising dilution constant amounts of ATP were released suggesting an additional release from other blood cells. High ATP release curves in response to ADP were observed in patients with pancytopenia and with thrombocytopenia when compared to health persons. ADP seems not to be suited for the measurement of ATP release reaction in whole blood. Collagen at a final concentration of 1.0 micrograms/ml was found as the optimal inducer. The ATP standard is essential for the quantification of release reaction.


Assuntos
Trifosfato de Adenosina/sangue , Difosfato de Adenosina/farmacologia , Ácido Araquidônico/farmacologia , Colágeno/farmacologia , Relação Dose-Resposta a Droga , Humanos , Técnicas In Vitro , Pancitopenia/sangue , Trombocitopenia/sangue
9.
Klin Padiatr ; 208(2): 68-72, 1996.
Artigo em Alemão | MEDLINE | ID: mdl-8901185

RESUMO

Only few reports about ALL after aplastic anaemias in childhood exist. It remains still unclear which immunophenotypes of the leukaemias must be expected thereafter. Here it is reported about two children with quite different immunophenotypes of the leukaemic cells. In the first one the most common type was found, the constellation of a c-ALL, whereas in the other the precise classification was impossible at all. Myeloic and T-cell markers were present at the same time. This form of leukaemia was not influenced therapeutically in a sufficient manner. The patient died after recovery phases of only short duration. After aplastic anaemias with fast recovery by prednisolone ALL of different constellation has to be expected. Therefore the antileukaemic treatment immediately after recovery of the aplastic anaemia should be taken into consideration.


Assuntos
Anemia Aplástica/patologia , Leucemia-Linfoma Linfoblástico de Células Precursoras/patologia , Anemia Aplástica/tratamento farmacológico , Medula Óssea/efeitos dos fármacos , Medula Óssea/patologia , Criança , Pré-Escolar , Ciclosporina/administração & dosagem , Ciclosporina/efeitos adversos , Quimioterapia Combinada , Evolução Fatal , Humanos , Imunofenotipagem , Masculino , Metilprednisolona/administração & dosagem , Metilprednisolona/efeitos adversos , Leucemia-Linfoma Linfoblástico de Células Precursoras B/patologia
12.
Mycoses ; 37 Suppl 1: 89-96, 1994.
Artigo em Alemão | MEDLINE | ID: mdl-7854373

RESUMO

In 1992 black yeasts of the species Exophiala dermatitidis were isolated for the first time from patients at the University Clinics in Dresden. Since that time this relatively rarely detected fungus has been frequently cultivated from clinical specimens. Our observations were: Patient with acute lymphatic leukaemia: In a 3 1/2 years old boy E. dermatitidis was isolated from 8 blood cultures during a septicaemic phase. Elimination of the fungus and decreasing of the fever were reached after removing a central venous catheter and treatment with amphotericin B and 5-fluorocytosine for 3 weeks. In this patient E. dermatitidis was assessed to be the cause of the septicaemia setting in via catheter. Patients with cystic fibrosis: In 8 of 51 mycologically surveyed patients E. dermatitidis was frequently - in 2 cases for a long time up to 7 months - isolated from sputum specimens. The occurrence of this fungus was considered to be a colonization with subclinical development. In these patients no fungal invasion or systemic mycosis were seen. The administration of itraconazole for 4 respectively 7 months did not succeed in eliminating E. dermatitidis out of the respiratory tract. It is recommended to include mycological longtime cultures in the surveillance of cystic fibrosis patients for detection of E. dermatitidis.


Assuntos
Fibrose Cística/complicações , Exophiala/isolamento & purificação , Fungemia/microbiologia , Micoses/microbiologia , Leucemia-Linfoma Linfoblástico de Células Precursoras/complicações , Adolescente , Adulto , Criança , Pré-Escolar , Fungemia/complicações , Humanos , Masculino , Micoses/complicações
13.
Padiatr Grenzgeb ; 31(3): 159-69, 1993.
Artigo em Alemão | MEDLINE | ID: mdl-8259307

RESUMO

In the district of Bautzen two different systems of care in nephrologic patients had been established since 1974. After the clinical diagnostics and treatment in the district hospital they had been transmitted to pediatric practices for after-treatment care. Beside it diagnostics and treatment in such patients was performed primarily in an outpatient department and the after-treatment care was done by the same pediatrician. In 78.4 percent of the children treated clinically an after-treatment care had been obtained, as was detected by a questionnaire. This must be of disadvantage. Relapses of the urinary tract infection occurred in more than 50 percent and after quite different intervals. In 27.6 percent of patients getting after-treatment care it was discontinued early. In the outpatient department 91.1 percent of all patients were under control regularly and for a sufficient time. More patients with chronic pyelonephritis had been recognized in the region of that outpatient department. The advantage of this system is given by a thorough supervision by the same physician above all. Without doubt the care for nephrologic patients can be carried out with high quality too by physicians in a private practice conscious of the importance of this task.


Assuntos
Assistência ao Convalescente/métodos , Nefropatias/terapia , Pielonefrite/terapia , Doenças Urológicas/terapia , Adolescente , Criança , Pré-Escolar , Feminino , Seguimentos , Humanos , Lactente , Nefropatias/diagnóstico , Masculino , Pielonefrite/diagnóstico , Recidiva , Infecções Urinárias/diagnóstico , Infecções Urinárias/terapia , Doenças Urológicas/diagnóstico
14.
Monatsschr Kinderheilkd ; 139(6): 368-70, 1991 Jun.
Artigo em Alemão | MEDLINE | ID: mdl-1896052

RESUMO

Side effects on the central nervous system by antileukemic treatment have been well known for a long time. We report on 2 patients suffering from a severe encephalopathy during antileukemic therapy. Furthermore the results of cerebral computer tomography in 50 children with acute leukemia have been analysed. In 21 patients morphological findings were evident. Four patients had CCT-changes already before the beginning of their treatment. Initially in 2 patients leukemic cerebral infiltrations were detected. The importance of the computer tomography for the detection of cerebral affections by disease and treatment is demonstrated.


Assuntos
Protocolos de Quimioterapia Combinada Antineoplásica/efeitos adversos , Encefalite/induzido quimicamente , Leucemia Mieloide Aguda/tratamento farmacológico , Leucemia-Linfoma Linfoblástico de Células Precursoras/tratamento farmacológico , Tomografia Computadorizada por Raios X , Protocolos de Quimioterapia Combinada Antineoplásica/uso terapêutico , Neoplasias Encefálicas/diagnóstico por imagem , Criança , Pré-Escolar , Terapia Combinada , Irradiação Craniana , Diagnóstico Diferencial , Encefalite/diagnóstico por imagem , Feminino , Humanos , Leucemia Mieloide Aguda/diagnóstico por imagem , Masculino , Leucemia-Linfoma Linfoblástico de Células Precursoras/diagnóstico por imagem
15.
Ann Intern Med ; 113(1): 27-32, 1990 Jul 01.
Artigo em Inglês | MEDLINE | ID: mdl-2112352

RESUMO

STUDY OBJECTIVE: To assess whether the hepatitis B virus (HBV), the hepatitis C virus (HCV), and the human immunodeficiency virus (HIV) are transmitted to hemophiliacs by a high-purity factor VIII concentrate in which the method of virus inactivation is pasteurization. DESIGN: Hepatitis B virus markers, the antibody to HCV (anti-HCV), the antibody to HIV (anti-HIV), and aminotransferases were measured on serum samples collected before the first concentrate infusion and at regular time intervals thereafter. SETTING: Seventeen hemophilia centers in Italy, the Federal Republic of Germany, Belgium, Austria, and the Democratic Republic of Germany. PATIENTS: Twenty-nine patients with hemophilia A who had not received a previous transfusion with blood products and who had normal alanine and aspartate aminotransferases (ALT and AST) were included in the final analysis. MEASUREMENTS AND MAIN RESULTS: No patient became positive for anti-HCV or anti-HIV or developed sustained increases in aminotransferase levels. Similarly, none of the 15 unvaccinated patients developed markers of HBV infection. CONCLUSION: This prospective study conducted in previously untransfused hemophiliacs highly susceptible to developing post-transfusion hepatitis shows that a large-pool clotting factor concentrate treated with pasteurization carries a low risk for transmitting HCV, the major causative agent of post-transfusion hepatitis.


Assuntos
Contaminação de Medicamentos/prevenção & controle , Fator VIII/administração & dosagem , Hemofilia A/terapia , Hepatite C/prevenção & controle , Hepatite Viral Humana/prevenção & controle , Adolescente , Adulto , Alanina Transaminase/sangue , Criança , Pré-Escolar , Ensaios Enzimáticos Clínicos , Ensaios Clínicos como Assunto , Infecções por HIV/prevenção & controle , Anticorpos Anti-Hepatite/análise , Hepatite B/prevenção & controle , Hepatite C/diagnóstico , Hepatite C/transmissão , Humanos , Lactente , Masculino , Fatores de Risco , Testes Sorológicos
16.
Artigo em Alemão | MEDLINE | ID: mdl-1714850

RESUMO

The joint condition in 98 children and adolescents with severe or moderate types of haemophilia participating in a summer camp between 1987 and 1989 had been analyzed. This was done by the centers' report and on the other hand with testing the patients by aid of the score system recommended by the World Federation of Hemophilia. According to the centers' reports more than 50% of all patients seem to be free of joint contractures. But according to the more sensitive score system more patients are affected by discrete symptoms of the chronic arthropathy. There had been discovered big differences between the centers and an increase of the patient's score by age. Not seldom an impairment of the findings within a single year was recognized. The joint problems in haemophiliacs are solved by the prophylactic treatment in an incomplete manner only. Lacks in the sophisticated evaluation of joints, with the management of prophylactic treatment as well as adjustment to prevention lead to avoidable damage crippling the patient on later age.


Assuntos
Hemofilia A/fisiopatologia , Artropatias/prevenção & controle , Articulações/fisiopatologia , Adolescente , Fatores Etários , Artrite/prevenção & controle , Acampamento , Criança , Contratura/prevenção & controle , Alemanha Oriental , Hemofilia A/reabilitação , Humanos , Artropatias/complicações , Artropatias/diagnóstico
17.
Artigo em Alemão | MEDLINE | ID: mdl-1697828

RESUMO

There is reported about the treatment of refractory thrombocytopenia in a 9 years old boy following the autologous bone marrow transplantation for acute lymphoblastic leukaemia. The megakaryocytes were found diminished in the bone marrow smears. Controls of the thrombocyte count and the kinetics with radioactively labeled platelets of a donor spoke in favour of immunothrombocytopenia. Threatening bleeding complications challenged the use of all treatment possibilities. The irradiation of the spleen was without any success. After the splenectomy the thrombocyte count increased slowly, but after a remarkable lag phase, however. A diminished reproduction capacity of the bone marrow graft for special cell sorts has to be taken into account in such cases. The usual cytodynamics after splenectomy cannot be expected at all.


Assuntos
Transplante de Medula Óssea/efeitos adversos , Leucemia-Linfoma Linfoblástico de Células Precursoras/cirurgia , Trombocitopenia/etiologia , Criança , Humanos , Masculino , Contagem de Plaquetas , Leucemia-Linfoma Linfoblástico de Células Precursoras/sangue , Esplenectomia , Trombocitopenia/terapia , Transplante Autólogo
18.
Kinderarztl Prax ; 57(1): 37-42, 1989 Jan.
Artigo em Alemão | MEDLINE | ID: mdl-2709690

RESUMO

In a mature newborn the symptoms of a disseminated HSV infection were evident at the 6th day of life. Later on bleeding occurred as a result of severe consumption coagulopathy. During treatment with Acyclovir the bleeding situation was controlled by fibrinogen replacement. The infant survived and is under normal psychologic and motorical development now. The treatment result is taken for the good virostatic efficacy of Acyclovir. It inhibits the DNA polymerases and therefore the DNA replication within the herpes viruses selectively. This high degree of selectivity is caused by its selective penetration into the infected cells, its faster transformation by the viral thymidine kinase as well as by its stronger affinity for HSV coded polymerase in detail. The diagnosis had been confirmed by detection of herpes viruses within the blister fluid and cerebrospinal fluid as well as by serological findings.


Assuntos
Coagulação Intravascular Disseminada/congênito , Herpes Simples/congênito , Aciclovir/uso terapêutico , Herpes Simples/tratamento farmacológico , Humanos , Recém-Nascido , Masculino
19.
Artigo em Inglês | MEDLINE | ID: mdl-2465234

RESUMO

The diagnostic importance of coagulation parameters was tested in 438 children with septicaemia by discriminant analysis. The values of 756 patients with other diseases had been analysed for comparison. After the selection of the parameters by multivariate analyses discriminant functions were calculated for different subgroups. The best discriminant functions were found for septic newborns up to the age of 3 days. Their use may be helpful for diagnostics in practice. A more weak discrimination power was evident in newborns beyond the 3rd day of life. A simultaneous comparison of 7 subgroups of newborns with different illnesses by 3 discriminant functions led to lower sensitivity rate and don't suit for practice. Beyond the postnatal period the diagnostic importance of coagulation parameters for septicemia is even lower. The low reparation capacity of thrombopoiesis in neonates may be a cause for the good discriminant functions for septicaemia. The reason for the better discrimination in the newborns up to the 3rd day could be the more profound defects in the coagulation system.


Assuntos
Testes de Coagulação Sanguínea , Sepse/diagnóstico , Humanos , Recém-Nascido
20.
Acta Med Scand ; 224(3): 275-80, 1988.
Artigo em Inglês | MEDLINE | ID: mdl-3266421

RESUMO

The frequency of different types of von Willebrand's disease (vWD) was studied in the southern part of the GDR and during investigations of relatives of already diagnosed patients. Among 111 patients diagnosed, vWD was found to be type I in 85 cases, type II in 13 cases and severe recessive type in 13 cases. The patients with type I belonged to 46 different families. Two families with type II had the II A variant and another a variant similar to II C. No patients with type II B were diagnosed. The incidence of severe recessive vWD was estimated to be lower than in Sweden but higher than in Italy and France.


Assuntos
Doenças de von Willebrand/epidemiologia , Eletroforese em Gel de Ágar , Alemanha Oriental , Humanos , Doenças de von Willebrand/sangue , Doenças de von Willebrand/classificação
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