Results of palliative procedures for tetralogy of Fallot in infants and young children.
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Biomedical subjects
Publications and source records attributed to G Benzing.
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The group C streptococci have emerged as important human pathogens. A case of group C streptococcal sinusitis in a 6-year-old girl is reported and four cases of group C streptococcal sinusitis are reviewed. Age less than 18 years, central nervous system complications, and a delay in the institution of adequate therapy were features common to all five cases. Three patients were bacteremic with group C streptococci and two patients died. These cases suggest that when beta-hemolytic streptococci are isolated from sinus culture, serogrouping should be performed. When group C streptococci are identified, appropriate antimicrobial therapy should be instituted and one should be alert for suppurative intracranial complications.
A child developed severe, generalized muscle weakness which persisted for 6 weeks, after receiving muscle relaxants for 1 week while requiring ventilator support. Electrodiagnostic studies indicated a presynaptic disorder of the neuromuscular junction which improved with high-frequency stimulation, similar to findings in Lambert-Eaton syndrome. Muscle specimens exhibited neurogenic targetoid fiber atrophy. Ultrastructure of the neuromuscular junction indicated terminal axon degeneration and atrophy with depletion of the secretory vesicles. Most reported patients with post-ventilator paresis have received steroids and muscle relaxants; muscle weakness commonly has been brief and attributed to steroids. We believe that this reversible myasthenic syndrome probably represents neurotoxicity due to high doses of steroidal nondepolarizing blocking agents; however, available data are insufficient to resolve this controversy.
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A high-precision hemofiltration system appropriate for use in neonatal, pediatric, or adult patients has been developed. The system incorporates computer-monitored and -regulated pumps for control of blood, dialysate, and drain solutions and weighing scales for measurement of fluid infused into and removed from the patient. The overall accuracy of the fluid infusion and withdrawal is +/- 3.5 grams. The system incorporates four pressure transducers to monitor pressures. It includes alarm limits for pressure, solution volumes versus time, temperature, air leak, and blood detection in the drain effluent. The computer stops all pumps in alarm conditions. The system also can be easily adapted for other extracorporeal procedures such as hemofiltration, ultrafiltration, plasmapheresis, and extracorporeal membrane oxygenation.