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Biomedical subjects

R Behrens

Publications and source records attributed to R Behrens.

71 records · Page 4Linked to original sources
PubMed1978

[False-positive exercise ECG in women without organic heart disease (author's transl)].

Exercise ECGs (bicycle ergometry in recumbency) were obtained in 252 women (aged 20-49 years) without evidence of organic heart disease. In 51 (20%) there was a false-positive change in the ECG with horizontal or descending S-T depression greater than or equal to 1 mm. The frequency of this change increased with increasing age. In group I (20-29 years) it was 5%, in group II (30-39 years) 20%, in group III (40-49 years) 38%. In 34 of the 51 women abnormal repolarisation changes were present even at rest. The S-T depression during exercise in most cases amounted to less than 2 mm and often occurred only on maximum exercise during the first or second minute of the recovery phase. These "ischaemia" changes disappeared in 29 of 41 women after administration of 100 mmol potassium chloride. Nine of 12 women in whom the positive ECG signs persisted after KCl, coronary angiography failed to demonstrate any abnormalities.

Adult↗
PubMedDate not supplied

Enteral nutritional support by percutaneous endoscopic gastrostomy in children with congenital heart disease.

One of the major problems of children with severe congenital heart disease (CHD) is their poor nutritional status. Among other consequences, it influences the surgical outcome. Retrospectively we present our experience with percutaneous endoscopic gastrostomy (PEG) in 15 children with CHD. This technique allows enteral nutritional support without the disadvantages related to long-term nasogastric tube feeding. Major complications were absent, and minor complications were rare both at PEG insertion, which was performed under deep sedation, and during feeding via PEG tube. In 4 of the 8 children who were followed for at least 6 months the age-matched body weight increased more than one standard deviation. In 2 other patients it increased more than 0.5 standard deviations. In 7 children the tube was removed after 2.5 to 42 months since enteral support was no longer necessary. Apart from initial reservations the parental acceptance of PEG was good. We conclude that the PEG is a safe and reliable technique to support enteral nutrition in children with severe CHD.

Enteral Nutrition↗
PubMedDate not supplied

[Two rare complications of percutaneous endoscopic gastrostomy: obstruction of the pylorus and gastrocolic fistula occurring in one patient].

UNLABELLED: We report an 10 month old male infant, who developed an obstruction of the pylorus by dislocation of the retention disk 5 months after percutaneous endoscopic gastrostomy (PEG). This could be corrected under endoscopic control. Two years after PEG insertion diarrhoe occurred immediately after feeding caused by a gastrocolic fistula with dislocation of the retention disk in the colon transversum. An excision of the fistula and a resection of the colon segment were performed successfully. CONCLUSION: In patients with PEG and unclear abdominal symptoms a tube dislocation has to be kept in mind at any time.

Colon↗
PubMedDate not supplied

[Sedation versus general anesthesia in pediatric endoscopy].

Upper endoscopy was performed in 567 patients: 237 under general anesthesia, 261 in intravenous sedation with midazolam and etomidat (mean dosage 0.26 mg/kg bodyweight), 69 without any premedication. In these many patients defended strongly and some investigations have to been interrupted. On the other hand general anaesthesia needed much more time and personnel and produced more costs. In our experience sedation with midazolam and etomidat is most comfortable for patient and endoscopist and the time needed is shorter than in general anaesthesia. Therefore we recommend this method even in therapeutic endoscopy, except only in sclerotherapy of esophageal varices.

Adolescent↗
PubMedDate not supplied

[Chronic inflammatory intestinal disease and nephritis].

An 11 year old CD-patient developed an interstitial nephritis and acute kidney failure following treatment with Mesalazine (5-ASA) and Salazosulfapyridine (SASP). After removal of the medication and treatment with hemofiltration and prednisone there was only an incomplete recovery of the renal function (creatinine-clearance 34 ml/1,73 m2/min). It is thought that an hyperergic-allergic reaction due to SASP and 5-ASA causes interstitial nephritis in inflammatory bowel disease (IBD). This reaction can be induced by re-exposition too. On the other hand IBD can be associated with glomerulonephritis. This could be a not very well known extraintestinal manifestation in IBD caused by immune-complexes in serum and glomerula. A rapid histological verification of the renal disease is necessary for successful treatment. In both renal manifestations chronic courses are possible. These observations should not lead to avoid SASP/5-ASA in treatment of IBD, but renal function should be routinely investigated.

Acute Kidney Injury↗
PubMedDate not supplied

[Cholangiodysplastic pseudocirrhosis].

Non-cystic cholangiodysplastic pseudocirrhosis of the liver was found in a 7 month old infant. Hepatomegaly was the first clinical sign. The cause of this disease entity ist believed to be a developmental disturbance of the small bile ducts. The etiology is unknown and the clinical course is hard to control. The transition to cirrhosis and the development of hepatocellular carcinoma are described.

Bile Ducts↗
PubMedDate not supplied

[Percutaneous endoscopic gastrostomy in childhood and adolescence].

BACKGROUND: Nasogastric tube-feeding often is necessary in the treatment of chronically ill patients. The disadvantage (irritation of the hypopharynx, dislocation, stigma) can be avoided by the percutaneous endoscopic gastrostomy (PEG). In childhood there is only limited experience with this techniques. PATIENTS AND METHOD: We report about 89 children with PEG. Indications were central dysphagia (67), dystrophy caused by chronic renal failure or congenital heart disease (15), application of special diets (6) and gastric volvulus (1). The endoscopy was done in sedation. RESULTS: The PEG was placed in the stomach (73) or duodenum (16). 14 Complications were observed: inflammation at the insertion site (2), perforation (2, healing under conservative treatment), dislocation of the duodenal part into the stomach or occlusion (6) and distraction of the retention disk (4). There were no procedures-related deaths. The mean duration of the PEG was more than 1 year. The affected persons were very pleased with the efficacy of this treatment. CONCLUSIONS: In all patients (including infants) requiring long-term tube-feeding the option of a PEG should be taken into consideration. In our experience the PEG is associated with a low rate of complications and provides a major improvement for children who are dependent on tube feeding.

Adolescent↗