PURPOSE: Children with von Willebrand disease (vWD) are at greater risk for hemorrhage following adenotonsillar surgery. We report the favorable results of 12 consecutive adenotonsillar procedures performed since 1989 in children with vWD, with minimal use of blood products. MATERIALS AND METHODS: Patients were prospectively managed with careful local control, desmopressin (DDAVP), and antifibrinolytic agents. Cryoprecipitate or intermediate purity factor VIII concentrates containing von Willebrand factor (vWF) were used for three patients who did not tolerate DDAVP. RESULTS: Based on this experience, we propose a prospective treatment protocol. CONCLUSIONS: The literature regarding the use of DDAVP is reviewed, and our screening algorithm and treatment protocol for managing these challenging cases is presented.

Adenoidectomy↗

PubMedDate not supplied

Application of ICP-MS for the assessment of thorium excretion in urine.

A method for rapid and sensitive determination of thorium in urine by inductively coupled plasma mass spectometry (ICP-MS) is described. The method is sufficiently sensitive to detect 1 ng/L 232Th in urine without any sample preparation. The mean urinary 232Th excretion in 23 unexposed subjects was 6.2 +/- 3.3 ng/d.

Adolescent↗

PubMedDate not supplied

Studies on electrolyte and trace metal metabolism applying stable isotopes as tracers.

Tracer-kinetic investigations provide a useful tool for the assessment of body composition regarding electrolytes and trace elements. This paper demonstrates the feasibility of stable isotopes as tracers in studies on calcium and iron metabolism in risk groups like children. By applying both radioisotopes and stable isotopes simultaneously, in adults, a good intra-individual agreement was obtained for the derived figures of intestinal absorption. Using only stable isotopes, intestinal calcium absorption in children with renal failure was found to follow a similar pattern to that in adult patients.

Adult↗

PubMedDate not supplied

Calcium kinetic investigations and their clinical use.

Pool sizes and internal fluxes of minerals can be quantitatively determined by tracer-kinetic investigations and compartmental analysis. Investigations performed in 252 patients revealed characteristic patterns for calcium pools and fluxes with respect to disease. The method provides a useful diagnostic tool in the early detection of metabolic bone disorders and in problems of differential diagnostics.

Bone Diseases, Metabolic↗