[Life expectancy in Down syndrome infants and children with congenital heart defects, 1974-1997]. / A Down-szindrómás szívbeteg csecsemók és gyermekek életkilátása 1974-1997 között.

Authors analysed 359 cases with Down's syndrome and congenital heart defects registered between 1974-1997 in Hungary. The total death rate was 19.9% (70 cases). Mortality in the operated group (85 cases) was 10.5% (9 patients), in the non-operated group (274 cases) 22.2% (61 patients). The death rate was lower in the group with early primary reconstruction (2.3%) than in the group with palliation + reconstruction (15.3%), or in the group with only palliative procedure (20%). These results indicate that the life expectancy of infants and children with Down's syndrome and congenital heart disease after early primary reconstructive procedure is the same as in Down syndrome patients without cardiac defects. The prognosis depends on the patient's social circumstances. The results after correct surgical procedure in patients with the same cardiac defect are similar to that of the patients with or without Down's syndrome.

[Successful multi-step management of developmental heart defects after intrauterine diagnosis]. / Intrauterin diagnosztizált összetett szívfejlódési rendellenesség többlépcsós sikeres sebészi korrigálása.

At 28th week of gestation a conotruncal malformation with ventricular septal defect was diagnosed by fetal echocardiography. Postnatal echocardiographic and angiocardiographic examinations confirmed the diagnosis of conotruncal malformation (pulmonary atresia, ventricular septal defect, patent ductus arteriosus, aortopulmonary collateral arteries). The unifocalization (age: 11 months) and total correction with aortic homograft (age: 7 years) were performed. To our knowledge our case is the first whose intrauterine diagnosis of complex congenital heart disease was confirmed after delivery and had successful two-stage surgical management.

[Total cavo-pulmonary anastomosis in heart surgery for the correction of univentricular heart]. / Teljes cavopulmonalis anasztomózis az univentricularis szív sebészi korrekciójában.

The total cavopulmonary anastomosis is one of the alternative surgical procedures which can be performed in the management of the most complicated congenital heart diseases. It was the first time in Hungary that this surgical management was performed successfully in a girl with univentricular heart, pulmonary valve stenosis, malposition of the great arteries, who was operated on palliative procedure previously.

Evaluation of a simple device for bacteriological sampling of respirator-generated aerosols.

The Aerotest sampler (Olympic Medical Corp., Seattle, Wash.) is designed to detect bacterial contamination of respirator-generated aerosols in a simple one-step process. The sampler was evaluated by controlled contamination of Bennett AP-5, PR-2, and MA-1 respirators with Escherichia coli, Pseudomonas aeruginosa, and Acinetobacter. Bacteria present as viable 1.4 to 3.5-mum particles in each of 77 aerosols were quantitated by using the Andersen viable-particle sampler, and the results were compared with those of colonies obtained from 10-s or 15-cycle Aerotest samples. All aerosols containing counts greater than expected in hospital air were detected by the Aerotest method. Thirteen of 14 aerosols containing less than 20 bacteria/0.028 m3 showed fewer than 5 colonies, whereas all aerosols containing greater than 1,000 bacteria/0.028 m3 showed at least 40 colonies. Aerosols with intermediate counts fell in between. Under the conditions described here, the Aerotest sampler was able to discriminate between the low levels of bacteria commonly found in hospital air and the bacterial contamination associated with nosocomial pneumonia. The Aerotest sampler provides a practical method for surveillance sampling of respirator nebulizers.