[Early history of pediatrics in Mecklenburg. 3: Health resorts for children]. / Zur Frühgeschichte der Kinderheilkunde in Mecklenburg. Teil 3: Das Kinderkurwesen.

The groundwork for spa facilities intended for the treatment of children was performed by Dr. Carl von Mettenheimer in Schwerin with the foundation of a "Verein für die Errichtung von Kinderheilstätten an deutschen Seeküsten" ("Association for the Establishment of Pediatric Sanatoria on German Coasts"). The contribution describes the construction and development of the first sanatorium for children at Mürtiz on the Baltic coast. Attention is also drawn to the establishment, development and importance of the children's sanatorium "Bethesda" at Sülze. The importance of the role played by the hygiene specialist Prof. Uffelmann (Rostock) and the pediatricians Dr. Carl von Mettenheimer (Schwerin) and Prof. Herrmann Brüning (Rostock) in the development of child care and pediatrics even beyond the borders of Mecklenburg cannot be overestimated.

[The early history of pediatrics in Mecklenburg. 2: The first specialized facilities for handicapped children, child and infant mortality, clinical facilities for pediatrics in Mecklenburg]. / Zur Frühgeschichte der Kinderheilkunde in Mecklenburg. Teil 2: Erste Spezialeinrichtungen für geschädigte Kinder, Kinder- und Säuglingsterblichkeit, Klinische Einrichtungen für Kinderheilkunde in Mecklenburg.

Particular attention is given to social and regional aspects in this report on the development of special care facilities for handicapped children, infant and child mortality in Mecklenburg, and an analysis of their causes. The restricted opportunities available for influencing the relevant conditions and for introducing prophylactic measures are described. The establishment and development of medical facilities for treating sick children in Mecklenburg are outlined, special emphasis being placed on the hospitals at Ludwigslust, the importance of Schwerin's Anna Hospital and their facilities for hospital, surgical and outpatient treatment of children.

[Early history of pediatrics in Mecklenburg. 1: On the history of Mecklenburg--medical service and child welfare--the school system]. / Zur Frühgeschichte der Kinderheilkunde in Mecklenburg. Teil 1: Zur Geschichte Mecklenburgs--Medizinalwesen und Kinderfürsorge--Das Schulwesen.

Since no complete description of public child care and pediatric activities in Mecklenburg has been given in the past, the present publication is intended to do more than fill an existing gab in regional pediatric history. Starting with a brief outline of the history of Mecklenburg, it describes in addition the development of medical legislation, medical, personnel, child care facilities, care for the poor and education, and the work of Mecklenburg's first creche in Schwerin.

[The problem of child abuse and neglect. 1: Analysis of hospital treated pediatric and pediatric surgical patients]. / Zur Problematik der Kindesmisshandlung und -vernachlässigung. Teil 1: Analyse stationär behandelter pädiatrischer und kinderchirurgischer Patienten.

Definitions, legal aspects, epidemiology and the author's experience in 58 relevant cases between 1966 and 1986 are described and recommendations for diagnosis, notification and prevention are given. The author underlines the importance of the early detection of the maltreatment and neglect of children and the conclusions to be drawn.

A study on the Rett syndrome in the GDR.

Of 44 subjects identified by the screening procedure, 31 were enrolled in the study. Using the modified Vienna Rett score, we divided the patients into three groups: typical the Rett syndrome (RS) (n = 10), incomplete forms of RS (n = 5) and non-RS (n = 16). Genetic investigations were performed in some cases and abnormalities were found in two. EEG and cranial computerized tomography findings are discussed.

[Incidence, differential diagnosis and follow-up of respiratory affective seizures (rage seizures) in children]. / Zur Häufigkeit, Differentialdiagnose und zum Verlauf von respiratorischen Affektkrämpfen (Wutkrämpfen) im Kindesalter.

The anamneses, course, general and specific findings in 99 cases of respiratory affective spasm in children between 1960 and 1983 were carefully studied. The clinical records, which sometimes lacked details, were augmented by a comprehensive questionnaire which also contained catamnestic questions. The author gives diagnostic and therapeutic recommendations and instructions for talks with the parents. Correctly diagnozed respiratory affective spasm is an absolutely harmless disease of limited duration with a good prognosis for the child's development.

[Diagnosis and treatment of acute otitis media in children. An analysis of the status in the Rostock district]. / Diagnostik und Therapie der akuten Otitis media bei Kindern. Eine Analyse der Situation im Bezirk Rostock.

Over a period of 3 months a complete record was kept in 8 large medical institutions (in the Rostock county) of all children with acute otitis media and an analysis was made of the customary medical procedures followed by doctors for the diagnostics and treatment of these cases. Of the 761 patients (407 boys and 354 girls) 90% were babies and infants; more then 50% of these cases were suffering from otitis media serosa; 25% of the total did not receive antibiotics. A systemic antibiotic therapy was usually prescribed "blindly" and preference (83.7%) was given to penicillins and Berlocombin (a trimethoprim sulfonamide compound). In more than 2/3 of the cases the treatment was given by a paediatrician alone, in less than 10% of the cases only by the ENT specialist and the rest were treated by both departments. It would be advisable to start now to rethink the medical procedures related to initial bacteriological diagnostics as well as the local treatment of the auditory channel. In addition, there is an urgent need for a general "Recommendation on the diagnostics and therapy of otitis media acuta in children". This is now being prepared and should be approved by both specialist associations.

[The prognosis of encephalitis in childhood]. / Zur Prognose der Enzephalitis im Kindesalter.

Follow-up examination of 95 former patients who had been suffering from encephalitis in infancy were performed. The coincidence of disturbance of consciousness, pathological-EEG and neurological irritation- and deficiency symptoms proved to be an unfavourable prognosis. These patients are especially handicapped in their concentration and motorial performances. Only 50% of the group with a severe course of the disease achieved a complete vocational training.

A contribution regarding the Rett syndrome.

Andreas Rett described a "cerebral atrophic syndrome accompanying hyperammonemia" for the first time in 1966, and by 1983 over 80 such cases had been identified and described not only in Austria but also in other countries. If the information at our disposal is correct, we have reported on what we believe is the first case of a patient with a definite Rett syndrome in the German Democratic Republic. We are, regrettably, still unable to contribute decisively to the clarification of the etiology and pathogenesis of the disease, but will, through further publications and papers at pediatric and child-neuropsychiatric meetings, continue to spread the knowledge of the symptomatology. It is remarkable that in the present case neither computer tomography nor electroencephalography showed definite abnormalities despite much effort. Definite proof of cerebral atrophy cannot, therefore, yet be furnished. But we still have no doubt that our diagnosis is correct. We intend, within the framework of a joint study being conducted by the University Pediatric Hospital Rostock and the Ludwig Boltzmann Institute, Vienna, as part of the scientific and technical cooperation between the Republic of Austria and the German Democratic Republic, to investigate further the epidemiology and etiology of this disease in cooperation with our Departments of Metabolic Disturbances and Genetics.