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Biomedical subjects

S Wiersbitzky

Publications and source records attributed to S Wiersbitzky.

At least 91 records · Page 5Linked to original sources
PubMed1990

[Clinical and immunologic effects following oral immunization against influenza in children in day care and infection susceptible young children].

57 infants and small children (9 months - 3.1 years) were orally immunized by an inactivated influenza vaccine (Mississippi 1/85; dosage: 110 micrograms HA); the control group (n = 15) received placebo. After three months the influenza specific Ig-concentrations of serum and secretions demonstrated a controverse course: Specific IgG (serum) decreased and specific IgA (nasale secretions) increased statistically significant (p less than 0.025), especially in children suffering from frequently relapsing respiratory infections (n = 31). Moreover the immunized children had also a better clinical outcome in the following 3 months: the number of days with cough, febrile symptoms and the antibiotics therapy were significantly decreased. Recommendations are given for an improvement of the orale influenza vaccine and its indicated administration in small children.

Administration, Oral↗
PubMed1990

[Laboratory diagnostic monitoring of blood gas parameters in children during bronchologic studies].

Changes in PaO2 and parameters of acid-base-status during bronchological investigations were studied. 20 patients of both sexes with chronic nonspecific respiratory diseases have been investigated. The most important results were a respiratory acidosis after intubation and simultaneous hyperoxigenation during controlled (manual) ventilation. A respiratory acidosis with a small metabolic part was observed during extubation and change to normal respiration. In some cases acidosis was decomposated. These changes were found to be more extensive after bronchography than after bronchoscopy. Acidosis was normalized latest 60 minutes after extubation in all cases. The used method of bronchological examination has caused a favourable influence on the conditions of ventilation.

Acid-Base Equilibrium↗
PubMed1990

[The saccharin test in the pediatric broncho-pneumonologic outpatient clinic. A noninvasive screening method for the assessment of ciliary function of the respiratory tract in children].

The Saccharin test is a non-dangerous, inexpensive, suitable and repeatable method for assessing the mucociliary function of the respiratory epithelium. A small quantity of Saccharin (R) is deposited on the inferior nasal concha; the chemical agent will be transported by the respiratory epithelium (kinocilia) from the nasopharynx to the oropharynx and can be tasted here as "sweet". The time interval between the deposition of Saccharin and the "sweet" taste is the "nasal mucociliary transport time (nmctt)"; data in minutes. In 381 children (age: 3-17 years) we found an average nmctt of 6.6 (+/- 4.8) min (healthy controls) and 8.8 (+/- 5.2) min resp. (CNSRD children). A nmctt longer than 30 min leads one to suspect disturbances of the mucociliary function, the aetiology of which can be analysed by mucosa biopsy and subsequent examination under the electron microscope. We hold the view that Saccharin test is an essential part of the diagnostic program for children suffering from CNSRD; after 3 tests the mucociliary function can be evaluated correctly. The test can be used both for diagnosing the aetiology of respiratory diseases and for the assessment of the efficiency of therapeutic and prophylactic measures.

Adolescent↗
PubMed1989

[Vascular purpura and other cardiovascular alterations in children with acute parvovirus B19 infection. Report of 3 personal cases].

Most frequent skin manifestation of parvovirus B19 infection is the erythema infectiosum (fifth disease; Sticker's disease). Vascular purpura (some cases of Henoch-Schönlein purpura) has been reported in virus infections such as infectious mononucleosis (Epstein-Barr virus), hepatitis B, cytomegalovirus etc., and human parvovirus B19 could be another cause. Clinical course, procedure of diagnostics and therapy in 3 own serologically established cases of vascular purpura or severe alterations of the blood circulation due to parvovirus B19 infection are presented. Parvovirus B19 (or other viruses) as a trigger for vascular purpura and alteration of the blood vessel wall and blood circulation could explain the childhood predominance and seasonal clustering of that disease. Furthermore an individual disposion (in form of special HLA type?) for the development of vascular purpura can be suggested.

Cardiovascular Diseases↗
PubMed1989

[The critical 3-day fever-exanthema in young children (exanthema subitum, Zahorsky roseola infantum)--what is new?].

As to the present knowledge the critical rose rash of infants (exanthema subitum, roseola infantum) means to be an exanthematous infectious disease that, occurring preferably in elder babes and younger infants (1st--3rd year of life), is caused by the newly detected herpesvirus (now the sixth one) pathogenic for man. The natural contamination in our latitude is intense (60-75%), and the probably lifelong immunity in the majority of cases is acquired in infancy. Though experts in the clinical subject do stress all the time the exanthema subitum to be the most frequent exanthematous disease in early infancy and infancy, infection chains tested to exanthema, respectively epidemics are observed decidedly seldom. Consequently, most of all infections use to develop clinically inperceptibly or even with other symptoms (and without an exanthema); the exanthema up to now obligatory for establishing the diagnosis uses to appear only in the minority of all cases and in the great majority of them the seroconversion is clinically silent. The prognosis of the exanthema subitum is in force to be good; the disease is the special field of activity for ambulatorily acting physicians (paediatrist, general practitioner). To begin with, the status diagnostically unclear and high-febrile for several days, the central-nervous excitability occurring in many cases, and in some children the appearing of dramatic febrile convulsions, as well as gastroenteric symptoms perpetually give rise to differential diagnostic considerations and sometimes even to a (false) antibiotic therapy. In case of an affection by herpesviruses principally a latency (persistence) of the virus lasting for years (possibly even lasting for life) in human beings is to be taken into account; this condition is also current for HHV 6. On occurring of an immune debility a release and a discharge of herpesviruses--not only by children suffering from an exanthema subitum (!)--are possible so that human beings of each age may come into question to be the source of infection. Double infections of human immune cells (for instance HHV 6 and HIV 1 simultaneously) already have been found. The necessary studies in order to clarify essential clinical and virological problems are world-widely in full activity, and new cognitions (further symptoms of diseases associated with HHV 6, possibly affections in prenatal infections and so on) are soon to be taken into account.

Child, Preschool↗
PubMed1989

[Day care management].

With the changing structure of pediatrics the emphasis of medical care (also of specialized care) has more and more shifted to the outpatient departments. For complicated diagnostic procedures of intermediate treatment in acute illness day-care on a special ward is a useful compromise with increasing importance. Own experiences in this way of medical care are exemplarily discussed.

Child↗
PubMed1989

[Diagnosis and treatment of acute otitis media in children. An analysis of the status in the Rostock district].

Over a period of 3 months a complete record was kept in 8 large medical institutions (in the Rostock county) of all children with acute otitis media and an analysis was made of the customary medical procedures followed by doctors for the diagnostics and treatment of these cases. Of the 761 patients (407 boys and 354 girls) 90% were babies and infants; more then 50% of these cases were suffering from otitis media serosa; 25% of the total did not receive antibiotics. A systemic antibiotic therapy was usually prescribed "blindly" and preference (83.7%) was given to penicillins and Berlocombin (a trimethoprim sulfonamide compound). In more than 2/3 of the cases the treatment was given by a paediatrician alone, in less than 10% of the cases only by the ENT specialist and the rest were treated by both departments. It would be advisable to start now to rethink the medical procedures related to initial bacteriological diagnostics as well as the local treatment of the auditory channel. In addition, there is an urgent need for a general "Recommendation on the diagnostics and therapy of otitis media acuta in children". This is now being prepared and should be approved by both specialist associations.

Adolescent↗
PubMed1989

[New knowledge of Zahorsky exanthema subitum (critical 3-day fever-exanthema, roseola infantum].

A survey is given on the history, characteristic symptoms and recent data of the etiology of exanthem subitum (Zahorsky's disease, sixth disease, roseola infantum). Some cases are presented and modern diagnostic techniques for atypical cases are discussed. The disease is caused by an infection with the human herpesvirus-6 (HHV 6; syn.:, "human B-lymphotropic virus", HBLV). Most babies and small children have an asymptomatic infection usually leading to lifelong immunity. The typical "exanthem subitum" develops only in a minority of the infected and susceptible persons. We suggest that the novel human herpesvirus-6 also has the potential of lifelong persistence in humans and can then be shedd at any age in case of acquired immunodeficiencies. World-wide research in this field is carried out by several working groups and new data will be available in a few years.

Antibodies, Viral↗
PubMed1989

Uric acid serum concentrations in CF-children after pancreatic enzyme supplementation.

In 16 CF-patients (age: 7-23 years; 7 females, 9 males) we analysed the serum concentration of uric acid after a standard meal and pancreatic enzyme supplementation by PANKREON FORTE or PANGROL 400 "neu" (both 2800-3000 U lipase/kg body mass/meal). Simultaneously we measured the uric acid excretion into the urine. We found an effective digestion and subsequent resorption of triglycerides and glucose but no significant changes of the uric acid serum levels during the 8-hours-test period. The uric acid excretion was lower than in the nocturnal period before the test. We conclude that a dangerous hyperuricemia and/or hyperuricosuria do not usually occur in pancreatic enzyme supplementation.

Adolescent↗
PubMed1989

[Congenital toxoplasmosis with delayed immune response].

In typical cases the diagnosis "toxoplasmosis connata" is based on clinical symptoms and positive serological findings. When the infection of the fetus occurred a short time before birth the neonate seems still normal and the disease develops in the postnatal period. In such cases the specific antibody production may be delayed. We present a case report with well documented first infection of the mother between the 15th and 30th gestational week but with no specific treatment. The baby was born without clinical signs of a toxoplasmosis infection and developed the disease 2-3 weeks later; the serological test (complement fixation test, KBR) was negative at the 24th postnatal day. Specific antimicrobial therapy could be started after serological conversion between the 4th and 5th postnatal week. Problems of diagnostics and delayed therapy are discussed.

Animals↗
PubMed1988

[Bronchopulmonary infections in mucoviscidosis].

Cystic fibrosis (CF) is the most common genetic disease of Caucasians and also the most important lung disease of the first decades of life associated with infections by a variety of bacteria species especially Pseudomonas aeruginosa and Staphylococcus aureus. During the last two decades chronic Pseudomonas infection has emerged as the most difficult problem. Pseudomonas bacteria are able to synthesize numerous extracellular factors (virulence factors) contributing to its pathogenicity. Immunological defense mechanisms against Pseudomonas (and other bacteria species) have been demonstrated, but a complete elimination from infected lungs has not been observed. Therapy of Pseudomonas infections includes frequently combinations of antibiotics of the beta-lactam and aminoglycoside type.

Cystic Fibrosis↗