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  • 1
    ISSN: 1432-1076
    Keywords: Key words Mucopolysaccharidoses ; Mitral regurgitation ; Aortic ; regurgitation ; Doppler ; echocardiography
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract In echocardiographic and necropsy studies nodular thickening of the mitral valve and, less frequently, of the aortic valve has been found in 60%–90% of patients with mucopolysaccharidoses (MPS). Little is known about the haemodynamic consequences of these morphological changes. In this study 84 unselected patients with different enzymatically proven MPS and 84 age and sex matched, healthy persons were studied prospectively by colour Doppler flow mapping. The patients' age ranged from 1 to 47 years (median 8.1 years). Mitral and aortic regurgitation were defined as a holosystolic or holodiastolic jet originating from the valve into the left atrium or the left ventricular outflow tract, respectively, with peak velocities exceeding 2.5 m/s. Of the 84 patients with satisfactory studies, mitral regurgitation was detected in 64.3% and aortic regurgitation in 40.5%, respectively. Regurgitation was severe in 4.8% of mitral valves and 8.3% of aortic valves. The frequency of aortic and/or mitral regurgitation was 75% in all patients, 89% in MPS I, 94% in MPS II, 66% in MPS III, 33% in MPS IV, and 100% in MPS VI. Combined mitral and aortic regurgitation was present in 29% of our patients. None of the control persons showed mitral or aortic regurgitation. Conclusion Aortic and mitral regurgitation are more frequent in patients with MPS than previously thought and that therefore these patients should have regular colour Doppler flow mapping and antibiotic prophylaxis when required.
    Type of Medium: Electronic Resource
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  • 2
    ISSN: 1433-0474
    Keywords: Schlüsselwörter Kreuzotter ; Vergiftungssymptome ; Schlangenbisse ; Key words Common viper ; Toxic reaction ; Adder bite
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Summary The vast majority of adder bites among children in Germany is caused by the common viper (vipera berus). The venom that is applicated by the viper contains several enzymes, some of them with hemorrhagic and neurotoxic activity. Adder bites among children may be without any symtoms but as well may cause severe intoxication. Case report: We report a six year old boy who was bitten into his left ankle by a common viper. He displayed symptoms of severe intoxication like strong swelling of the leg, the edema starting to spread over his body, and signs of anaphylactic reaction. The application of antivenom was necessary twice. Discussion: Because the application of antivenom of equine origin may cause an allergic reaction it is recommended in severe cases only. As far as possible antivenin with purified Fab fragment antibodies from sheep should be used, which less frequently causes allergic reactions.
    Notes: Zusammenfassung Toxische Schlangenbißverletzungen bei Kindern sind in Deutschland fast ausschließlich durch Kreuzottern (Vipera berus) bedingt. Die Kreuzotter injiziert ein Gift aus verschiedenen Enzymen und hämorrhagischen sowie neurotoxischen Faktoren. Kreuzotterbisse bei Kindern können symptomarm sein, jedoch auch schwerste Vergiftungserscheinungen verursachen. Fallbericht: Wir berichten über einen knapp 6jährigen Jungen, welcher von einer Kreuzotter in den linken Außenknöchel gebissen wurde. Der Patient zeigte schwere toxinbedingte Vergiftungssymptome mit einer ausgeprägten Schwellung der Extremität, ein auf den Rumpf übergreifendes Ödem und anaphylaktische Reaktionen. Die klinische Symptomatik erforderte eine 2malige Gabe von Schlangengiftimmunserum. Diskussion: Die Verabreichung von nebenwirkungsreichen heterologen Pferdeantiseren ist nur bei schweren Fällen gerechtfertigt. Nach Möglichkeit sollte das gut verträgliche Antivenin mit gereinigten Fab-Fragment-Antikörpern vom Schaf verwendet werden.
    Type of Medium: Electronic Resource
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