Biomedical subjects
Publications and source records attributed to A Mandelberg.
A case of prenatal diagnosis of hypoplastic left ventricle by means of echocardiography is presented. The method of detecting this syndrome is described and the importance of its prenatal diagnosis emphasized.
Left ventricular (LV) performance was assessed by echocardiography in 19 premature infants with severe respiratory distress syndrome. Measurements of LV size and function were made from digitized M-mode echocardiographic data in 14 babies (group 1) before and during treatment with mechanical ventilation and positive end-expiratory pressure. During ventilation, maximum LV dimension decreased (p = .001) as did peak filling rate (p = .01). LV shortening fraction decreased slightly (p = .05). There were marked reductions in calculated stroke volume (SV) (p = .001) and cardiac output (p = .0001) but systemic BP was unchanged, presumably due to peripheral vasoconstriction. The effect of simultaneous volume loading was studied in five other babies (group 2) who were ventilated under similar conditions. Blood transfusion with packed cells (10 mg/kg) prevented the fall in LV filling rate, while LV dimensions (max, p = .01; min, p = .02), SV (p = .05), cardiac output (p = .05), and systolic BP (p = .05) increased. This indicates that a low preload was responsible for the decreases observed in group 1.
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OBJECTIVE: Evaluation of the importance of pleuro-pulmonary involvement in paediatric patients with blunt splenic trauma. METHOD: A retrospective chart review of 27 patients, aged 2-16 years, treated for blunt splenic injury between 1992 and 1999 was performed. RESULTS: All patients except one were treated conservatively. In 12 patients (44.4%) left-sided pleuro-pulmonary involvement was diagnosed as primary traumatic injury or as a late complication. While Grade I and II splenic injuries were prevalent, pleuro-pulmonary involvement patients had a more severe degree of splenic injury. Chest pain, dyspnoea and diminished respiratory sounds were present on primary examination in patients with chest trauma. Body temperature during the first 5 post-trauma days was significantly higher among pleuro-pulmonary involvement patients. Specific pleuro-pulmonary involvement diagnoses on admission in six children with primary chest trauma were: lung contusion, pleural thickness, or haemo-pneumothorax. Three of them developed delayed pleural effusion. In the other six children with pleuro-pulmonary involvement, late complications appeared during 2-5 days post-trauma. CONCLUSIONS: Pleuro-pulmonary involvement was observed in almost half of patients with blunt splenic trauma. Pleuro-pulmonary involvement occurred either early as a result of direct chest trauma or was delayed. High suspicion, careful monitoring of body temperature and repeated chest X-ray studies are recommended for early diagnosis and treatment of delayed pleuro-pulmonary involvement.