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Biomedical subjects

D De Wolf

Publications and source records attributed to D De Wolf.

At least 37 records · Page 2Linked to original sources
PubMed1996

Reduced decrease of peripheral vascular resistance during exercise in young type I diabetic patients.

OBJECTIVE: In normal subjects, peripheral vascular resistance decreases during dynamic exercise. We studied blood pressure and peripheral vascular resistance responses to dynamic exercise in young normotensive type I diabetic patients. RESEARCH DESIGN AND METHODS: Thirty adolescent diabetic patients (9-19 years of age) underwent a maximal exercise test on a cycle ergometer. In a subset of 14 patients, cardiac output was measured by a CO2 rebreathing method and peripheral vascular resistance was calculated. Twenty-four normal individuals, age and sex matched, served as control subjects. RESULTS: Diastolic blood pressure was significantly higher in diabetic patients at intermediate workload (77 +/- 2 vs. 71 +/- 1 mmHg) and peak exercise (86 +/- 2 vs. 73 +/- 2 mmHg). Peripheral vascular resistance was significantly higher in diabetic patients at intermediate workload (17.0 +/- 1.1 vs. 12.6 +/- 0.5 mmHg.l-1.min-1.m-2) and peak exercise (16.3 +/- 1.3 vs. 11.4 +/- 0.5 mmHg.l-1.min-1.m-2). There were no significant correlations with the patient's age, diabetes duration, or diabetes control. CONCLUSIONS: We observed the decrease of vasodilator response during dynamic exercise in normotensive young type I diabetic patients.

Adolescent↗
PubMed1994

Fetal hypothyroidism as a complication of amiodarone treatment for persistent fetal supraventricular tachycardia.

We present a case of persistent fetal supraventricular tachycardia where transplacental and direct fetal treatment with amiodarone caused an iatrogenic hypothyroidism. This condition was successfully managed with the intra-amniotic instillation of 250 micrograms of L-thyroxine weekly, for 3 weeks. A male infant was delivered at 32 weeks by Caesarean section. The neonatal electrocardiogram showed Wolf-Parkinson-White (WPW) syndrome, which was controlled by digoxin alone. Thyroid function normalized quickly and the baby is developing normally.

Adult↗
PubMed1994

Adenosine-tri-phosphate treatment for supraventricular tachycardia in infants.

Adenosine is an endogenous nucleoside acting on coronary perfusion and myocardial conduction. Although the anti-arrhythmic effects of adenosine have been known for decades, interest in the use of adenosine or adenosine-triphosphate (ATP) (a precursor of adenosine) in termination of supraventricular tachycardia (SVT) has been renewed. We studied the use of striadyne (ATP and a mixture of other nucleosides including adenosine) in 22 infants younger than 6 months in order to evaluate efficiency and safety of the drug in this particular age group. Striadyne stopped SVT in 17 cases and was diagnostic in another 4 cases. Ten out of 17 successfully converted infants showed one or more reinitiations of SVT, which were easily controlled. The results support the efficiency of ATP for the termination of re-entry types of tachycardia, as well as its diagnostic value and its lack of serious side-effects.

Adenosine Triphosphate↗
PubMed1994

Adenosine triphosphate treatment for supraventricular tachycardia in infants.

UNLABELLED: Adenosine is an endogenous nucleoside acting on coronary perfusion and myocardial conduction. Although the anti-arrhythmic effects of adenosine have been known for decades, interest in the use of adenosine or adenosine triphosphate (ATP- a precursor of adenosine) in termination of supraventricular tachycardia (SVT) has been renewed. We studied the use of Striadyne (ATP and a mixture of other nucleosides including adenosine) in 22 infants younger than 6 months in order to evaluate efficacy and safety of the drug in this particular age group. Striadyne stopped SVT in 17 cases and was diagnostic in another 4 cases. Ten out of 17 successfully converted infants showed one or more reinitiations of SVT, which were easily controlled. The results support the efficacy of ATP for the termination of re-entry types of tachycardia, as well as its diagnostic value and its lack of serious side-effects. CONCLUSION: Adenosine or ATP could be the drug of choice for the treatment of junctional tachycardia in infants after vagal manoeuvres have failed. Provided continuous ECG monitoring is performed during injection, adenosine or ATP may be diagnostic in other types of supraventricular tachycardia and even in wide-complex tachycardia. We suggest a bolus injection of 0.5-1.0 mg/kg to be used prior to transport to the paediatric cardiology unit.

Adenosine Triphosphate↗
PubMed1994

Bradycardia and gastroesophageal reflux in term and preterm infants: is there any relation?

Conflicting data are published regarding the influence of acid gastroesophageal reflux on the heart rate. In this study, heart rate was monitored simultaneously with esophageal pH in 50 infants with symptoms suggestive of gastroesophageal reflux disease (frequent vomiting and regurgitations). The data of 25 preterm infants (born at 28-36 6/7 weeks) were compared to those of 25 term infants (born after 37 weeks of gestation). However, both groups were investigated at identical postconceptional age of 47-49 weeks. Not one significant bradycardia (heart rate < or = 80/min during > or = 10 s) was recorded, although 71 "relative bradycardia episodes" (heart rate < or = 80/min during > or = 5 beats) were detected, none lasting for > 5 s. Although the number of infants with relative bradycardia episodes did not differ between groups, the relative bradycardia episodes occurred more frequently in some preterm infants (53 episodes in preterm infants vs. 18 in term babies). Acid gastroesophageal reflux episodes were observed in 46 infants (92%). Neither the number of reflux episodes nor their duration was different in both groups. Simultaneous relative bradycardia episodes and acid reflux episodes were observed in three of 23 preterm and two of 23 term infants (NS). It is concluded that in a population of preterm and term infants with symptoms suggestive of a moderate gastroesophageal reflux pathology, investigated at comparable postconceptional age, most reflux episodes are not time-related to changes in heart rate.

Bradycardia↗
PubMed1994

A case of term mors in utero in a chromosome 11p linked long QT syndrome family.

Isolated congenital long QT syndrome is an autosomal dominant disorder characterized by recurrent syncopes, ventricular arrhythmias, or sudden death often accompanied by a prolonged QTc interval on ECG. On the occasion of a pregnancy complicated by an intra-uterine death of a full term baby with prolonged bradycardia a long QT syndrome was diagnosed in the mother. Familial examination revealed a prolonged QTc in her mother, brother and sister, all with positive history of syncopes. DNA linkage analysis was subsequently performed in this family with DNA markers on the short arm of chromosome 11. Four of the children in the family, younger than 5 years, were found to be asymptomatic carriers. Three of them showed a clear QTc prolongation on a 12 lead ECG. Another showed QTc prolongation during Holter monitoring but had a normal basic ECG. Measurement of QTc interval in families affected by the long QT syndrome is helpful but does not always permit an accurate diagnosis. Familial screening with DNA linkage analysis especially in families where a member is affected by the syndrome, can reveal "masked" cases which can further be investigated with Holter or effort ECG. The identification of locus heterogeneity of the long QT syndrome complicates genetic diagnosis. Only prospective studies in more families with long QT syndrome can show the additional diagnostic and prognostic value of DNA linkage.

Adult↗
PubMed1994

Right ventricular hypoplasia: outcome after conservative perinatal management.

Isolated right ventricular hypoplasia is a rare congenital cardiac anomaly. A case described in which prenatal diagnosis was made by echocardiography. Conservative perinatal management produced a favourable short-term outcome without compromising the definitive surgical intervention later. The decisions were based on principles used in the treatment of pulmonary atresia with intact interventricular septum.

Cardiac Catheterization↗
PubMed1994

Ectopic atrial tachycardia in a young athlete.

We report the case of a young boy on routine sports medical examination, who presented an incessant atrial tachycardia. At the slightest exercise the ventricular rhythm accelerated to 160 beats.min-1. Exercise capacity was excellent, and a treatment with propafenone suppressed the tachyarrhythmia.

Child↗
PubMed1993

Diagnosis and management of catheter-related infected intracardiac thrombosis in premature infants.

Infected right atrial thrombosis is an uncommon but severe complication of the use of central indwelling catheters in children. Massive thrombi around a right atrial catheter were seen in two critically ill premature infants after 3 weeks of parenteral nutrition. A catheter-related sepsis had previously occurred and had been treated by antibiotics. Subsequently, protracted thrombocytopenia, fluctuating hepatomegaly, and increasing respiratory distress were found in both cases. A right atrial mass was detected by 2 dimensional echocardiography. Cardiotomies for removal of the infected thrombus were performed with success in both cases. In one infant, weighing only 900 gm, surgical removal was accomplished with the aid of inflow stasis. Premature infants with catheter-related sepsis appear at greater risk for intracardiac thrombosis and should undergo echocardiography as part of their evaluation. Infected atrial thrombi can be safely removed by cardiotomy even in the very small premature infant.

Candidiasis↗
PubMed1989

Antenatal diagnosis of urological disorders by ultrasound: a critical review.

The suspected diagnosis of urological disorders made on the basis of antenatal ultrasonography was compared with the final outcome in 23 cases. In 18 cases the initial diagnosis could be confirmed, whereas 5 showed no postnatal urological anomalies. Further efforts should be undertaken to improve prenatal diagnosis in order to facilitate treatment as early as possible.

Female↗
PubMed1988

Congenital hypothyroid goiter and amiodarone.

Amiodarone is an anti-arrhythmic drug with a content of 39% Iodine. No adverse effects on fetal thyroid function have previously been observed with maternal ingestion of Amiodarone during pregnancy. A case of severe congenital hypothyroidism with goiter, associated with maternal ingestion of 200 mg Amiodarone daily from the 13th week of pregnancy, is described here. No other environmental causes of goiter, nor a congenital organic thyroid disorder could be demonstrated.

Adult↗
PubMed1986

Influence of xanthines on gastroesophageal reflux in infants at risk for sudden infant death syndrome.

Theophylline and caffeine are two drugs frequently administered to infants at risk for sudden infant death syndrome, because of their stimulatory effects on the respiratory system. These drugs are known to increase gastric acid secretion and to decrease lower esophageal sphincter pressure that, in turn, possibly increases gastroesophageal reflux (GER). Thirty babies were tested for GER before and during caffeine treatment. Eighteen were studied under the same conditions while undergoing theophylline treatment. All results of pH monitoring before treatment were within normal ranges. Episodes of GER increased significantly (P less than .001) in about 50% of the group treated with caffeine and in 66% of the group treated with theophylline. These results were independent of plasma xanthine concentrations (within or below therapeutic ranges) and of the efficacy of the drug. In addition, an increase was noted for the number of episodes of GER in 24 hours (from 5.3 to 17.1 in the caffeine group and from 5.3 to 24.3 in the theophylline group) and for the time pH was less than 4 (from 0.87% to 6% in the caffeine group and up to 13% in the theophylline group). Because GER is another known risk factor for sudden infant death syndrome, the administration of xanthine derivatives in babies at risk for sudden infant death syndrome should be carefully considered in each case.

Administration, Oral↗
PubMedDate not supplied

Embolization of a coronary fistula with a controlled delivery platinum coil in a 2-year-old.

Congenital coronary artery disorders are rare. Elective closure is proposed in view of the morbidity reported later in life. Excellent results have been reported with surgery, and recently catheter occlusions have been successful. We report the case of a 2-year-old girl whose coronary artery fistula was occluded with a special controlled delivery coil system.

Cardiac Catheterization↗
PubMedDate not supplied

Percutaneous closure by a vascular plug of a fistula between the superior caval vein and the left atrium.

We report the case of a 7-year-old boy with a history of pulmonary atresia and intact septum who developed a fistula between the remnant of the ligated superior caval vein and the left atrium after bidirectional superior cavopulmonary (Glenn) anastomosis. The close proximity to the right pulmonary veins made closure by a standard occluder impossible. An Amplatzer vascular plug without rim enabled us to close the connection percutaneously without obstructing the pulmonary venous flow. The technique appeared to be easy, safe, and effective.

Child↗
PubMedDate not supplied

Changes in perceived health of children with congenital heart disease after attending a special sports camp.

Sports camps for children with cardiac anomalies have existed for many years. However, no formal evaluation of the benefits of attending such camps has been undertaken heretofore. We assessed potential changes in the self-perceived health of children with congenital heart disease who attended a special sports camp. Thirty-one children with cardiac anomalies attended a 3-day multisports camp. Sixteen children, all of whom were 10 years or older, literate, and Dutch- or French-speaking, completed the Child Health Questionnaire (CHQ-CF87) before and after attending the camp. The scores of the children were compared with those of healthy peers by calculating mean standardized differences. After attendance at the sports camp, the children achieved significant improvements in the self-perception of their physical functioning, role functioning due to emotional problems, role functioning due to behavioral problems, mental health, and general behavior. The children's self-esteem and general behavior after the camp were significantly better than that of their healthy counterparts. We conclude that children with congenital heart disease who participate in activities at special sports camps may reap benefits in terms of their subjective health status. Although further research is needed, we recommend the participation in sport activities by children with heart defects, and more specifically their participation in sports camps.

Adolescent↗
PubMedDate not supplied

Is morbidity influenced by staging in the fontan palliation? A single center review.

In a retrospective study of 32 consecutive patients undergoing a total cavopulmonary connection (TCPC), we tried to determine if the trend for decreasing age at Fontan completion and reducing the intervals between the staged procedures during the past decade was associated with a change in morbidity and outcome. In 8 patients the Fontan circulation was completed in one stage and in 24 patients an intermediate step by hemi-Fontan or bidirectional cavopulmonary anastomosis was performed before Fontan completion. Mean age at TCPC and mean interval since the previous palliation have decreased significantly during the past decade. Although major complications were significantly reduced over time the occurrence and duration of postoperative pleural effusions were not. Decreasing age as well as intervals in staged Fontan palliation have beneficial influence on major complications and outcome, without significantly affecting the duration of pleural effusions at Fontan completion.

Child, Preschool↗
PubMedDate not supplied

Incidence of gastroesophageal reflux in sleep, awake, fasted, and postcibal periods in asymptomatic and symptomatic infants.

The incidence of gastroesophageal reflux (GER) in infants has been shown to be dependent on different factors, e.g., position, feeding, age. Using continuous esophageal pH monitoring, we examined 30 asymptomatic (15 were 1.5-2.5 months old; 15 were 2.5-4.5 months old) and 20 symptomatic infants (1.5-4.5 months old) for GER. The occurrence of GER was analyzed in different periods of interest: awake, asleep, fasted, and postcibal periods. The increasing incidence of GER we reported previously in asymptomatic infants according to their age appeared to be due to an increased occurrence in the awake (and postcibal) periods. In symptomatic infants, however, the increase was noticed mostly during the sleep (fasted) periods as far as the reflux index, the duration of the longest reflux episode, and the number of reflux episodes of greater than 5 min are concerned.

Eating↗