ABSTRACT
In this study we first try to answer the question, whether it is possible to make a successful treatment for obese children in an interdisciplinary program. Second it is asked whether a transfer of this program to further regions in Germany leads to comparable results. In FITOC children from the age of 8-11 years and over the 97. BMI-percentile are integrated in this program. The goals weight management, increased physical fitness and improvement of the cardiac risk profile are checked by weight, height, fasting blood serum, a standardized cycle ergometry and a medical measurement at the beginning, after treatment and at all check-ups. The recorded medical data show clearly that the intervention leads to a significant improvement in almost all checked parts. The successful treatment can be recorded after 8 months, likewise after 2.5 years as a long-term result. The further cornerstones of FITOC nutrition and psychology are not subject of this publication. In future the psychological part in FITOC will be evaluated by standardized inventories. The group from Düren has a success in therapy according to the definition of the program. Thereby it is shown that FITOC is extendable, if teams are trained intensively and the conditions are comparable. FITOC is able to treat obese children successfully over a long period of time. In consideration of the rising prevalence of obesity in childhood and the limited financial resources in health care this outpatient interdisciplinary program is an effective choice of treatment.
Subject(s)
Feeding Behavior , Life Style , Obesity/therapy , Physical Fitness , Child , Combined Modality Therapy , Female , Germany , Humans , Male , Obesity/etiology , Patient Care TeamSubject(s)
Chromosome Deletion , Chromosomes, Human, Pair 1 , Female , Humans , Infant , Karyotyping , PhenotypeABSTRACT
The antenatal diagnosis of fetal ascites by ultrasonography is possible by the typical finding of a zone free of echos in the fetal abdomen. Among 7,833 newborns 2 live born infants with fetal ascites were observed. The fetal prognosis can be improved by early diagnosis and differential diagnostic tests during the pregnancy. The antenatal diagnosis includes a search for hydrops, congenital anomalies of the heart, anomalies of the lower urinary tract, intra-abdominal calcifications and diagnosis of the sex. Infectious causes such as syphilis, toxoplasmosis, cytomegaly and hepatitis must be excluded. Delivery may have to be by cesarean section paracentesis of the fetal ascites through the maternal abdominal wall may be necessary. A neonatalogist must be present at birth. The neonatal diagnosis of the ascites starts with a flat plate of the abdomen in search of calcifications, bowel distensions, and pneumoperitoneum. Intravenous pyelogram and cystography show urine-ascites which has the best therapeutic prognosis. The investigation should be finished within 12 hours after birth. Acute respiratory distress may require neonatal paracentesis.
Subject(s)
Ascites/diagnosis , Prenatal Diagnosis/instrumentation , Ascites/congenital , Female , Humans , Infant, Newborn , Infant, Newborn, Diseases/diagnosis , Male , UltrasonographyABSTRACT
A rare modification of true Hermaphroditism is demonstrated in a ten-year-old child we have observed since birth. The cytogenetic analysis revealed a XX/XY-mosaicism. Two kinds of origin are discussed: 1. an ovum with two nuclei was fertilized by two different sperm cells, 2. two heterosexual zygotes fused. -- We could not find tissue of the testes but confirmed the diagnosis of a hermaphroditism by the detection of the HY-antigen and by typical endocrinological findings. Two different cell populations found in erythrocytes and by GPT-isoenzymes indicated a chimerism. By knowledge of these findings, we could help the child to undergo a positive psychological and social development.
Subject(s)
Disorders of Sex Development/diagnosis , H-Y Antigen/analysis , Biopsy , Child , Chimera , Disorders of Sex Development/immunology , Disorders of Sex Development/pathology , Erythrocytes , Female , Humans , Male , MosaicismABSTRACT
Today there is a controversy about the demand for the preservation of human life at any price. Special difficult problems result from intensive care of premature and newborn infants. The clinical criterions of cerebral death are different to those of adults, special investigations are restricted in their application. Often you cannot be sure of the prognosis in spite of knowing the diagnosis. Should the competent parents decide with us about the renunciation of a -- further -- intensive care? It is necessary to value all available factors to take the right decision. The paper wants to inform about some important criterions and stimulate the discussion.
Subject(s)
Critical Care , Infant, Newborn, Diseases/therapy , Infant, Premature, Diseases/therapy , Brain Death , Ethics, Medical , Germany, West , Humans , Infant, Newborn , Jurisprudence , PrognosisABSTRACT
In epileptic children the long-term therapy with anticonvulsant drugs is absolutely necessary. However, anticonvulsant drugs have been suspected to be mutagenic and teratogenic. To investigate this problem metaphase chromosome observations were performed using short-time culture of peripheral blood lymphocytes from twenty children. Ten of the children had been treated with phenytoin and the other ten with primidone on monotherapy. The long-term administration of anticonvulsant drugs was monitored by measurement of the serum concentrations of phenytoin and primidone, by seizure anamnesis, and by repeated EEG investigations. Analyzing 100 mitoses from each proband, we found no increase of structural or numerical aberrations in our patients compared with six controls. In adults, however, anticonvulsant drugs have been found to cause structural aberrations and chromosomal damage. The absence of these lesions in children may reflect the higher efficiency of DNA-repair in local DNA-damage.
Subject(s)
Chromosomes, Human/ultrastructure , Epilepsy/genetics , Phenytoin/therapeutic use , Primidone/therapeutic use , Adolescent , Cells, Cultured , Child , Child, Preschool , Chromosome Aberrations , Epilepsy/drug therapy , Humans , Lymphocytes/ultrastructureABSTRACT
Amniocentesis was prompted by an hydramnion which existed before the 30th week of pregnancy. Examination of amniotic fluid revealed trisomy 18 with increased alpha-fetoprotein values. Interruption of pregnancy was considered but refused by the patient. This enabled control fetal development during the subsequent weeks. After the patient has given birth to a dead female fetus in the 18th of pregnancy, pathological examination of the foetus confirmed the existence of trisomy 18.
Subject(s)
Chromosomes, Human, 16-18 , Polyhydramnios/diagnosis , Prenatal Diagnosis , Trisomy , Ultrasonography , Adult , Chromosome Mapping , Female , Fetal Growth Retardation/diagnosis , Humans , PregnancyABSTRACT
We report upon the development of a special stretcher which allows the transportation of ventilated children without problem. It is a stretcher according to DIN 13025 with a guide-rail for a respirator, a suction pump, a heart rate monitor. There are two oxygen cylinders with accessories in a wooden box under the stretcher, which is detachable and portable.
Subject(s)
Emergency Medicine/instrumentation , Transportation of Patients , Child , Child, Preschool , HumansABSTRACT
We report upon 30 critically ill premature and newborn infants (mean birth weight: 2,350 g). In all cases we applied initially total parenteral nutrition with increasing supplies, subsequently partial parenteral nutrition. Donors of nutritive substance and calories were a 6% mother-milk adapted amino-acid solution, a glucose solution 10% and 20% and a 20% lipid emulsion. Serum electrolytes, urea, glucose, serum aminograms and nitrogen balances were determined at regular intervals. Serum aminograms were found altogether acceptable in relation to those of breast-fed newborns and small infants and to normal values, which we evaluated among 45 premature and newborn infants before supplying protein.
