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Niedermann K, Rausch AK, Braun J, Becker H, Böhm P, Bräm R, Gilliam-Feld G, Kiefer D, Kurz R, Schönfelder M, Stamm T, Kiltz U. [Lay version of the 2018 EULAR recommendations for physical activity in people with inflammatory arthritis and osteoarthritis : Translation into German and linguistic validation in German-speaking countries with people affected]. Z Rheumatol 2023; 82:22-29. [PMID: 34618207 PMCID: PMC9832088 DOI: 10.1007/s00393-021-01079-z] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/05/2021] [Indexed: 01/14/2023]
Abstract
BACKGROUND Physical activity and exercise are beneficial for people with rheumatic diseases; however, recommendations for the management of rheumatoid arthritis (RA), spondyloarthritis (SpA) and hip- and knee osteoarthritis (HOA/KOA) are usually unspecific with respect to mode and dose of exercise. This is why the 2018 EULAR recommendations for physical activity in people with inflammatory arthritis and osteoarthritis were formulated. The recommendations consist of 4 overarching principles and 10 recommendations. These were also published as a lay version in the English language. AIM Translation of the lay version into German and its linguistic validation in Austria, Germany and Switzerland. METHODS A professional translation was reviewed by the authors, including people with, RA, SpA, HOA/KOA from the three German-speaking countries, which provided a prefinal lay version. Subsequently, eight interviews with people with RA, SpA, HOA/KOA were conducted in each country to evaluate understandability, wording, completeness and feasibility of the prefinal lay version. Finally, the authors, i.e. those with RA, SpA, and osteoarthritis, anonymously rated their agreement to the final lay version on a 0-10 scale. RESULTS The professional translation was substantially revised by the authors and based on the interviews. Formulations were adapted to increase readability and understandability and specify statements. Comments that would have changed content or structure were not considered. Average agreement with the particular recommendations was between 10 (SD 0) and 7.6 (SD 1.67). DISCUSSION For people with RA/SpA/HOA/KOA the EULAR physical activity recommendations should be available in their mother language. The final German lay version is valid and accepted across all three German-speaking countries. Thus, the physical activity recommendations can be provided to people with rheumatic diseases in an understandable and feasible way.
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Affiliation(s)
- K. Niedermann
- grid.19739.350000000122291644Department Gesundheit, Institut für Physiotherapie, Zürcher Hochschule für Angewandte Wissenschaften ZHAW, Katharina-Sulzer-Platz 9, 8401 Winterthur, Schweiz
| | - A. K. Rausch
- grid.19739.350000000122291644Departement Gesundheit, Institut für Physiotherapie, Zürcher Hochschule für Angewandte Wissenschaften, Winterthur, Schweiz
| | - J. Braun
- grid.5570.70000 0004 0490 981XRheumazentrum Ruhrgebiet, Ruhr-Universität Bochum, Herne, Deutschland
| | - H. Becker
- Schweizerische Polyarthritiker Vereinigung, Zürich, Schweiz
| | - P. Böhm
- Deutsche Vereinigung M. Bechterew, Schweinfurt, Deutschland
| | - R. Bräm
- Schweizerische Vereinigung M. Bechterew, Zürich, Schweiz
| | - G. Gilliam-Feld
- grid.491693.00000 0000 8835 4911Rheuma-Liga Nord-Rhein-Westfalen, Deutsche Rheumaliga, Essen, Deutschland
| | - D. Kiefer
- grid.5570.70000 0004 0490 981XRheumazentrum Ruhrgebiet, Ruhr-Universität Bochum, Herne, Deutschland
| | - R. Kurz
- Österreichische Vereinigung Morbus Bechterew, Wien, Österreich
| | | | - T. Stamm
- grid.22937.3d0000 0000 9259 8492Institut für Outcomes Research, Medizinische Universität Wien, Wien, Österreich
| | - U. Kiltz
- grid.5570.70000 0004 0490 981XRheumazentrum Ruhrgebiet, Ruhr-Universität Bochum, Herne, Deutschland
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Schulz M, Seidlitz A, Kurz R, Bärenwald R, Petzold A, Saalwächter K, Thurn-Albrecht T. The Underestimated Effect of Intracrystalline Chain Dynamics on the Morphology and Stability of Semicrystalline Polymers. Macromolecules 2018. [DOI: 10.1021/acs.macromol.8b01102] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Affiliation(s)
- Martha Schulz
- Institut für Physik, Martin-Luther-Universität Halle-Wittenberg, von-Danckelmann-Platz 3, 06120 Halle, Germany
| | - Anne Seidlitz
- Institut für Physik, Martin-Luther-Universität Halle-Wittenberg, von-Danckelmann-Platz 3, 06120 Halle, Germany
| | - Ricardo Kurz
- Institut für Physik, Martin-Luther-Universität Halle-Wittenberg, von-Danckelmann-Platz 3, 06120 Halle, Germany
| | - Ruth Bärenwald
- Institut für Physik, Martin-Luther-Universität Halle-Wittenberg, von-Danckelmann-Platz 3, 06120 Halle, Germany
| | - Albrecht Petzold
- Institut für Physik, Martin-Luther-Universität Halle-Wittenberg, von-Danckelmann-Platz 3, 06120 Halle, Germany
| | - Kay Saalwächter
- Institut für Physik, Martin-Luther-Universität Halle-Wittenberg, von-Danckelmann-Platz 3, 06120 Halle, Germany
| | - Thomas Thurn-Albrecht
- Institut für Physik, Martin-Luther-Universität Halle-Wittenberg, von-Danckelmann-Platz 3, 06120 Halle, Germany
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Kurz R, Schulz M, Scheliga F, Men Y, Seidlitz A, Thurn-Albrecht T, Saalwächter K. Interplay between Crystallization and Entanglements in the Amorphous Phase of the Crystal-Fixed Polymer Poly(ϵ-caprolactone). Macromolecules 2018. [DOI: 10.1021/acs.macromol.8b00809] [Citation(s) in RCA: 30] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Affiliation(s)
- Ricardo Kurz
- Institut für Physik, Martin-Luther-Universität Halle-Wittenberg, 06099 Halle (Saale), Germany
| | - Martha Schulz
- Institut für Physik, Martin-Luther-Universität Halle-Wittenberg, 06099 Halle (Saale), Germany
| | - Felix Scheliga
- Institut für Technische und Makromolekulare Chemie, Universität Hamburg, Bundesstr. 45, 20146 Hamburg, Germany
| | - Yongfeng Men
- State Key Laboratory of Polymer Physics and Chemistry, Changchun Institute of Applied Chemistry, Chinese Academy of Sciences, Renmin Street 5625, 130022 Changchun, P. R. China
| | - Anne Seidlitz
- Institut für Physik, Martin-Luther-Universität Halle-Wittenberg, 06099 Halle (Saale), Germany
| | - Thomas Thurn-Albrecht
- Institut für Physik, Martin-Luther-Universität Halle-Wittenberg, 06099 Halle (Saale), Germany
| | - Kay Saalwächter
- Institut für Physik, Martin-Luther-Universität Halle-Wittenberg, 06099 Halle (Saale), Germany
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Damron JT, Ma J, Kurz R, Saalwächter K, Matzger AJ, Ramamoorthy A. The Influence of Chemical Modification on Linker Rotational Dynamics in Metal-Organic Frameworks. Angew Chem Int Ed Engl 2018; 57:8678-8681. [PMID: 29782692 PMCID: PMC6289050 DOI: 10.1002/anie.201805004] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2018] [Indexed: 11/11/2022]
Abstract
The robust synthetic flexibility of metal-organic frameworks (MOFs) offers a promising class of tailorable materials, for which the ability to tune specific physicochemical properties is highly desired. This is achievable only through a thorough description of the consequences for chemical manipulations both in structure and dynamics. Magic angle spinning solid-state NMR spectroscopy offers many modalities in this pursuit, particularly for dynamic studies. Herein, we employ a separated-local-field NMR approach to show how specific intraframework chemical modifications to MOF UiO-66 heavily modulate the dynamic evolution of the organic ring moiety over several orders of magnitude.
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Affiliation(s)
- Joshua T. Damron
- Department of Chemistry, University of Michigan, 930 N.
University Ave., Ann Arbor, MI 48109-1055, USA, ,
| | - Jialiu Ma
- Department of Chemistry, University of Michigan, 930 N.
University Ave., Ann Arbor, MI 48109-1055, USA, ,
| | | | | | - Adam J. Matzger
- Department of Chemistry, University of Michigan, 930 N.
University Ave., Ann Arbor, MI 48109-1055, USA, ,
- Macromolecular Science and Engineering, University of
Michigan, 2300 Hayward Avenue, Ann Arbor, MI 48109-1055, USA
| | - Ayyalusamy Ramamoorthy
- Department of Chemistry, University of Michigan, 930 N.
University Ave., Ann Arbor, MI 48109-1055, USA, ,
- Biophysics Program, University of Michigan, 930 N.
University Ave., Ann Arbor, MI 48109-1055, USA
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Damron JT, Ma J, Kurz R, Saalwächter K, Matzger AJ, Ramamoorthy A. The Influence of Chemical Modification on Linker Rotational Dynamics in Metal–Organic Frameworks. Angew Chem Int Ed Engl 2018. [DOI: 10.1002/ange.201805004] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Affiliation(s)
- Joshua T. Damron
- Department of Chemistry University of Michigan 930 N. University Ave. Ann Arbor MI 48109-1055 USA
| | - Jialiu Ma
- Department of Chemistry University of Michigan 930 N. University Ave. Ann Arbor MI 48109-1055 USA
| | | | | | - Adam J. Matzger
- Department of Chemistry University of Michigan 930 N. University Ave. Ann Arbor MI 48109-1055 USA
- Macromolecular Science and Engineering University of Michigan 2300 Hayward Avenue Ann Arbor MI 48109-1055 USA
| | - Ayyalusamy Ramamoorthy
- Department of Chemistry University of Michigan 930 N. University Ave. Ann Arbor MI 48109-1055 USA
- Biophysics Program University of Michigan 930 N. University Ave. Ann Arbor MI 48109-1055 USA
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Pfeiffer KP, Haidmayer R, Kerschhaggl P, Kurz R, Kenner T. Statistical Evaluation of the Respiratory Pattern as a Risk Factor for the Sudden Infant Death Syndrome. Methods Inf Med 2018. [DOI: 10.1055/s-0038-1635322] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Abstract
SummaryTo evaluate the respiratory pattern of infants with regard to a possible risk for SIDS, two characteristic values (MA and GA) were computed from the distribution of apneas. For the computation of one of these characteristic values (GA), a weight function for apneas was used to consider the diagnostic information content of apneas of different durations. The distribution of apneas is approximately exponential where apneas up to 20 s and longer have been found. Using these characteristic numerical values of the respiratory pattern, infants of different age groups were classified into risk and non-risk cases. This classification was performed in the way that an optimal agreement between clinical and numerical classification was achieved. For both numerical values an agreement of about 90% with clinical classification was achieved.To consider the differing impact of misclassification, a weighted classification procedure was proposed.
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Kurz R, Achilles A, Chen W, Schäfer M, Seidlitz A, Golitsyn Y, Kressler J, Paul W, Hempel G, Miyoshi T, Thurn-Albrecht T, Saalwächter K. Intracrystalline Jump Motion in Poly(ethylene oxide) Lamellae of Variable Thickness: A Comparison of NMR Methods. Macromolecules 2017. [DOI: 10.1021/acs.macromol.7b00843] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/30/2023]
Affiliation(s)
| | | | - Wei Chen
- Department of Polymer Science, The University of Akron, Akron, Ohio 44325-3909, United States
| | | | | | | | | | | | | | - Toshikazu Miyoshi
- Department of Polymer Science, The University of Akron, Akron, Ohio 44325-3909, United States
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Kurz R. False memories, false innocence belief syndrome (FIBS) and ‘mind control’. Eur Psychiatry 2017. [DOI: 10.1016/j.eurpsy.2017.01.892] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
IntroductionChild sexual abuse allegations are extremely tricky matters to deal with as situations can range from ritual violence at one extreme to complete fabrication by vested interests at the other. A level headed approach is required that does not fall into the trap of categorizing all early childhood memories as ‘false memories’ while also being alert to possible ‘mind control’ coaching of false allegations.ObjectivesThe presentation covers the origins of the false memory syndrome group and the implantation of false memories that is seemingly practiced by vested interests.AimsChild custody and criminal cases are frequently decided based on testimony of mental health professionals who routinely appear to be poorly informed and blatantly biased.MethodsA review of articles in the BPS publication ‘The Psychologist’ uncovered a large amount of materials written by advocates of the BFMS prompting further research.ResultsThere appears to be a multitude of articles written by BFMS associates in The Psychologist. Furthermore, instances of BPS ‘censorship’ are disconcerting. On top of this, concerns have been raised in the US about the ethics of Elizabeth Loftus–the academic ‘darling’ of the false memory movement. Finally cases have come to light where false memories were seemingly implanted by vested interests to ‘snatch’ children into authority care.ConclusionsThe mine field of child sexual abuse needs to be tackled with an even-handed manner considering the full range of possibilities in assessment.Disclosure of interestThe author has not supplied his/her declaration of competing interest.
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Kurz R. From Hampstead to Norwich: Ritual violence or coaching? Eur Psychiatry 2017. [DOI: 10.1016/j.eurpsy.2017.02.273] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/19/2022] Open
Abstract
IntroductionVideo-recorded disclosures of two siblings emerged describing ritual violence activities in a Hampstead “cult” including human sacrifice murder. The UK court processes judged that the mother “coached” the children to make false allegations. In parallel, Marie Black, Jason Adams and Michael Roger were found guilty of child sexual abuse purely based on historical accounts of five children.ObjectivesThe presentation outlines two cases that illustrate the “unbelievable” nature of organized child abuse and what aspects make court rulings “unsafe”.AimsThe presentation aims to compare the Hampstead where the videos were watched by 4 million individuals world-wide with the little that is known about the “Norwich Three” case due to court reporting restrictions.MethodsMaterials posted on websites, books and videos were reviewed alongside discussions with whistle-blowers, relatives and friends of people involved.ResultsThe disclosures in the Hampstead case were very extreme but similar accounts can be found in books by Sara Scott (UK) and De Camp (US). Those accused of sexual abuse claim that the children have been coached by their mother to make these allegations–the view that the judge adopted. In the Norfolk case, 7 of the 10 defendants were cleared of child sexual abuse allegations but three individuals were found guilty. It remains unclear what the basis was for the conviction as the disclosures could have been classed as the result of “coaching”.ConclusionsAnyone operating in forensic settings should familiarise themselves with the “hall of mirrors” that cases involving child sexual abuse routinely constitute.Disclosure of interestThe author has not supplied his declaration of competing interest.
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10
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Kurz R, Fecht S. Complex Trauma, Somatoform Dissociations & Energetics Therapy. Eur Psychiatry 2017. [DOI: 10.1016/j.eurpsy.2017.01.1317] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
IntroductionMental health professionals find it very challenging to provide counselling and therapy when confronted with disclosures of ritual, satanic and extreme abuse. Psychometric and muscle testing can facilitate diagnosis and healing in this context. Psychiatrists of renown such as David Hawkins and Colin Ross have embraced and written about energetic medicine in their practice.ObjectivesThe presentation explains how somatoform dissociations are tell-tale indications of abuse and neglect of early childhood trauma and how ‘Energetics’ therapy facilitates healing.AimsDelegates will learn to recognise somatoform dissociation symptoms, understand advances and limitations of psychometric assessment tools, appreciate energetics approaches as an adjunct to other intervention methods and gain an insight into the origins of complex trauma.MethodsTwo case studies are used to illustrate causes, impact, diagnosis and healing of complex trauma.ResultsA set of psychometric assessments helped to unravel a chilling revictimisation crime series. ‘Twice Exceptional’ characteristics were very high IQ coupled with Dyslexia, very weak auditory memory and psychic capabilities. In another case that stemmed from extreme abuse of ancient, commercial and high-tech varieties muscle testing and energetics therapy lead to a remarkable recovery.ConclusionsPsychometric and muscle testing can inform diagnosis, therapy and healing. Energetics can be used to bring about profound healing for those who have repressed severe trauma. This method has many advantages in that parts of it are easily learned, it is non-invasive, has no side effects, gives patients control over their reactions, eliminates triggers and offers healing.Disclosure of interestThe authors have not supplied their declaration of competing interest.
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11
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Kurz R. Fitness to practice and fitness to regulate. Eur Psychiatry 2017. [DOI: 10.1016/j.eurpsy.2017.01.873] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
IntroductionIn 2012, forensic psychology Professor Jane Ireland published initial research claiming that two third of psychological assessment reports sampled from UK family courts were ‘poor’ or ‘very poor’. ‘Fitness to practice’ concerns were raised by vested interest and dismissed after a 1-week hearing – four years later.ObjectivesThe presentation outlines the nature of various UK institutions, such as family courts, HCPC and GMC as well as their practices which raise questions about their fitness to regulate.AimsDelegates will start to learn how institutions that purport to serve public interest yet can be easily exploited by vested interests.MethodsCase studies are used to illustrate how extremely serious concerns were ignored but persecution concerns upheld.ResultsIn one case, four courts appointed experts ignored an obvious child trafficking process where a toddler was raped to cover up birth and disappearance of a newborn baby that succeeded from incestuous rape. In spite of a clinical psychologist failing to cover the two index incidents, the concerns did not meet the HCPC ‘Standard of Acceptance’. A ‘revenge concern’ was raised by vested interests. In another case, the GMC refused to investigate a psychiatrist who had lied and rather absurdly claimed that repeatedly seeking return of her children was evidence for a mother's personality disorder. In a widely publicized case Psychiatrist Dr Hibbert accused of unnecessarily, breaking up families was investigated but cleared of misconduct by the GMC.ConclusionsInstitutions tasked with protecting public safety and fairness appear to be unduly biased towards shielding inadequate professionals and persecuting whistle-blowers.Disclosure of interestThe author has not supplied his/her declaration of competing interest.
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Zwink N, Choinitzki V, Baudisch F, Hölscher A, Boemers TM, Turial S, Kurz R, Heydweiller A, Keppler K, Müller A, Bagci S, Pauly M, Brokmeier U, Leutner A, Degenhardt P, Schmiedeke E, Märzheuser S, Grasshoff-Derr S, Holland-Cunz S, Palta M, Schäfer M, Ure BM, Lacher M, Nöthen MM, Schumacher J, Jenetzky E, Reutter H. Comparison of environmental risk factors for esophageal atresia, anorectal malformations, and the combined phenotype in 263 German families. Dis Esophagus 2016; 29:1032-1042. [PMID: 26541887 DOI: 10.1111/dote.12431] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
Esophageal atresia with or without tracheoesophageal fistula (EA/TEF) and anorectal malformations (ARM) represent the severe ends of the fore- and hindgut malformation spectra. Previous research suggests that environmental factors are implicated in their etiology. These risk factors might indicate the influence of specific etiological mechanisms on distinct developmental processes (e.g. fore- vs. hindgut malformation). The present study compared environmental factors in patients with isolated EA/TEF, isolated ARM, and the combined phenotype during the periconceptional period and the first trimester of pregnancy in order to investigate the hypothesis that fore- and hindgut malformations involve differing environmental factors. Patients with isolated EA/TEF (n = 98), isolated ARM (n = 123), and the combined phenotype (n = 42) were included. Families were recruited within the context of two German multicenter studies of the genetic and environmental causes of EA/TEF (great consortium) and ARM (CURE-Net). Exposures of interest were ascertained using an epidemiological questionnaire. Chi-square, Fisher's exact, and Mann-Whitney U-tests were used to assess differences between the three phenotypes. Newborns with isolated EA/TEF and the combined phenotype had significantly lower birth weights than newborns with isolated ARM (P = 0.001 and P < 0.0001, respectively). Mothers of isolated EA/TEF consumed more alcohol periconceptional (80%) than mothers of isolated ARM or the combined phenotype (each 67%). Parental smoking (P = 0.003) and artificial reproductive techniques (P = 0.03) were associated with isolated ARM. Unexpectedly, maternal periconceptional multivitamin supplementation was most frequent among patients with the most severe form of disorder, i.e. the combined phenotype (19%). Significant differences in birth weight were apparent between the three phenotype groups. This might be attributable to the limited ability of EA/TEF fetuses to swallow amniotic fluid, thus depriving them of its nutritive properties. Furthermore, the present data suggest that fore- and hindgut malformations involve differing environmental factors. Maternal periconceptional multivitamin supplementation was highest among patients with the combined phenotype. This latter finding is contrary to expectation, and warrants further analysis in large prospective epidemiological studies.
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Affiliation(s)
- N Zwink
- Division of Clinical Epidemiology and Aging Research, German Cancer Research Center, Heidelberg, Germany
| | - V Choinitzki
- Institute of Human Genetics, University of Bonn, Bonn, Germany
| | - F Baudisch
- Institute of Human Genetics, University of Bonn, Bonn, Germany
| | - A Hölscher
- Department of Pediatric Surgery and Urology, University Hospital Cologne, Cologne, Germany
| | - T M Boemers
- Department of Pediatric Surgery and Urology, University Hospital Cologne, Cologne, Germany
| | - S Turial
- Department of Pediatric Surgery, University Hospital Mainz, Mainz, Germany
| | - R Kurz
- Department of Pediatric Surgery, University Hospital Bonn, Bonn, Germany
| | - A Heydweiller
- Department of Pediatric Surgery, University Hospital Bonn, Bonn, Germany
| | - K Keppler
- Institute of Human Genetics, University of Bonn, Bonn, Germany
| | - A Müller
- Department of Neonatology and Pediatric Intensive Care, Children's Hospital, University of Bonn, Bonn, Germany
| | - S Bagci
- Department of Neonatology and Pediatric Intensive Care, Children's Hospital, University of Bonn, Bonn, Germany
| | - M Pauly
- Department of Pediatric Surgery, Asklepios Children's Hospital St. Augustin, St. Augustin, Germany
| | - U Brokmeier
- Department of Pediatric Surgery, Asklepios Children's Hospital St. Augustin, St. Augustin, Germany
| | - A Leutner
- Department of Pediatric Surgery, Medical Center Dortmund, Dortmund, Germany
| | - P Degenhardt
- Department of Pediatric Surgery, Charité University Medicine Berlin, Berlin, Germany
| | - E Schmiedeke
- Department of Pediatric Surgery and Urology, Center for Child and Youth Health, Klinikum Bremen-Mitte, Bremen, Germany
| | - S Märzheuser
- Department of Pediatric Surgery, Charité University Medicine Berlin, Berlin, Germany
| | - S Grasshoff-Derr
- Unit of Pediatric Surgery, University Hospital Wurzburg, Wurzburg, Germany
| | - S Holland-Cunz
- Department of Pediatric Surgery, University Hospital Heidelberg, Heidelberg, Germany
| | - M Palta
- Department of Pediatric Surgery, Evangelisches Krankenhaus Hamm, Hamm, Germany
| | - M Schäfer
- Department of Pediatric Surgery and Urology, Cnopf'sche Kinderklinik, Nürnberg, Germany
| | - B M Ure
- Center of Pediatric Surgery Hannover, Hannover Medical School and Bult Children's Hospital, Hannover, Germany
| | - M Lacher
- Center of Pediatric Surgery Hannover, Hannover Medical School and Bult Children's Hospital, Hannover, Germany
| | - M M Nöthen
- Institute of Human Genetics, University of Bonn, Bonn, Germany.,Department of Genomics, Life and Brain Center, University of Bonn, Bonn, Germany
| | - J Schumacher
- Institute of Human Genetics, University of Bonn, Bonn, Germany.,Department of Genomics, Life and Brain Center, University of Bonn, Bonn, Germany
| | - E Jenetzky
- Division of Clinical Epidemiology and Aging Research, German Cancer Research Center, Heidelberg, Germany.,Department of Child and Adolescent Psychiatry and Psychotherapy, Johannes-Gutenberg University, Mainz, Germany.,Child Center Maulbronn gGmbH, Hospital for Pediatric Neurology and Social Pediatrics, Maulbronn, Germany
| | - H Reutter
- Institute of Human Genetics, University of Bonn, Bonn, Germany.,Department of Neonatology and Pediatric Intensive Care, Children's Hospital, University of Bonn, Bonn, Germany
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Kurz R. Challenging MCMI-III Results With In-Depth Psychometric Assessment and Lacter & Lehmann (2008) Complex Trauma Guidelines. Eur Psychiatry 2016. [DOI: 10.1016/j.eurpsy.2016.01.1894] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/21/2022] Open
Abstract
IntroductionComplex trauma resulting from neglect and abuse in early childhood is frequently misdiagnosed.ObjectiveThis presentation shares emerging “best assessment practices” that help to differentiate complex trauma from Schizophrenia.AimsThe case study demonstrates that a wide-ranging psychometric assessment and the application of Lacter & Lehmann (2008) guidelines provide accurate results while MCMI-III results can be spurious.Method“Unbelievable” disclosures of an adult survivor prompted a search for scientific references, experiences in the survivor scene and historical examples. Work-related personality questionnaires, in-depth ability tests and Lacter & Lehmann (2008) guidelines were deployed to differentiate complex trauma from an erroneous diagnosis based largely on MCMI-III results.ResultsThe research identified measurement issues with the MCMI-III clinical personality questionnaire that generated spurious elevations on Narcissistic, Delusional and Paranoid scales. Work-related personality questionnaires provided much more useful information showing no “personality disorder” risks at all. WAIS results confirmed an earlier “Twice Exceptional” ability pattern with very high verbal IQ (95%ile) and extraordinarily poor auditory working memory (2nd%ile) i.e. a “Dyslexia” performance pattern. Lacter & Lehmann (2008) guidelines showed that none of the 42 schizophrenia indicators applied and only 1/3 of the complex trauma indicators.ConclusionMental health professionals must remain cognizant to the chilling notion that extreme abusers may “frame” victims in order to make them “appear” schizophrenic. As MCMI-III was developed originally for those seeking therapy, its use in forensic settings with the general population should be avoided. Tests do not diagnose people – people do!Disclosure of interestThe authors have not supplied their declaration of competing interest.
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Kurz R. Poor Quality of Mental Health Assessment Reports in UK Family Courts: A ‘call to Action’. Eur Psychiatry 2016. [DOI: 10.1016/j.eurpsy.2016.01.1674] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/21/2022] Open
Abstract
IntroductionProf. Jane Ireland found that 65% of assessment reports sampled from UK family courts were ‘poor’ or ‘very poor’.ObjectiveThe presentation raises international awareness of the problem and explains the contextual factors that contribute to malpractice.AimsThe paper highlights typical deficiencies in family court assessments and forensic processes in order to reduce the risk of unsafe custody rulings.MethodDue to the paucity of published academic literature ‘ad hoc’ Internet searches were utilised to collect source material and identify advocates. A range of conferences, seminars and continued professional development (CPD) events revealed the background for some of the persistent problems.ResultsThe suppression of the trauma-centric approach to mental health issues and its re-emergence are central to understanding the trajectory and how to improve professional practice.Organised Ritualised Crime Abuse Networks (ORCANs) seem to be at work infiltrating institutions that are supposed to uphold law and order.Inadequate psychometric instruments appear to beguile some mental health professionals into wrong diagnosis and testimony.ConclusionThe standard of UK family court assessments must improve. Scrapping ‘forced adoption’ legislation that drives the ‘child snatching’ culture in UK social services department would benefit society including citizens from abroad whose governments vocally criticise the removal of their children through clandestine UK ‘child protection’ procedures.Disclosure of interestThe author has not supplied his declaration of competing interest.
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Kurz R. Emotional agility – a new language and paradigm for psychiatry. Eur Psychiatry 2016. [DOI: 10.1016/j.eurpsy.2016.01.507] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
Abstract
IntroductionEmotional Agility constitutes an alternative to the DSM-5 personality trait model.ObjectiveThe presentation outlines how Emotional Agility is conceptualised and measured through self-report and multi-rater questionnaires.AimsThe paper highlights the development of a short Emotional Agility trait questionnaire and a corresponding behavioural measure with 18 items.MethodData (n = 929) from a substantial personality questionnaire with 161 questions was utilised to create a 54 question ‘short form’ that measures the Big 5 personality factor plus Need for Achievement through 18 facet scales of 3 items each. Data on the same subjects from a 50-item criterion measure was reduced to 18 items that are structurally aligned to the 18-predictor facets.ResultsPredictor reliabilities averaged 0.752 at Factor as well as Facet level. The unit weight sum of the 54 questions achieved an uncorrected validity of 0.28 (n = 929) against external ratings of effectiveness. Joint factor analysis showed good discrimination between the six factors. A ‘positive manifold’ of Emotional Agility scales emerged as expected which could be conceptualised as the opposite of the MMPI2 ‘Demoralisation Factor’.ConclusionThe Emotional Agility approach could ground mental health assessments firmly in positive approaches that use every-day terminology. It seems preferable to vague scales claiming to measure obscure ‘clinical’ constructs through hugely overlapping items that are often not fit for purpose.Disclosure of interestThe author has not supplied his/her declaration of competing interest.
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Kurz R, Bachour H, Müller A, Bartmann P, Geipel A, Berg C, Gembruch U, Born M, Müller AM, Kalff JC, Heydweiller A. Ergebnisse von Kindern mit angeborenen Lungenfehlbildungen: Bericht über ca. 7 Jahre Erfahrung in der Kinderchirurgie der Uniklinik Bonn. Z Geburtshilfe Neonatol 2015. [DOI: 10.1055/s-0035-1566477] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Kurz R, Cobo MF, de Azevedo ER, Sommer M, Wicklein A, Thelakkat M, Hempel G, Saalwächter K. Avoiding bias effects in NMR experiments for heteronuclear dipole-dipole coupling determinations: principles and application to organic semiconductor materials. Chemphyschem 2013; 14:3146-55. [PMID: 23780575 DOI: 10.1002/cphc.201300255] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2013] [Revised: 05/03/2013] [Indexed: 11/06/2022]
Abstract
Carbon-proton dipole-dipole couplings between bonded atoms represent a popular probe of molecular dynamics in soft materials or biomolecules. Their site-resolved determination, for example, by using the popular DIPSHIFT experiment, can be challenged by spectral overlap with nonbonded carbon atoms. The problem can be solved by using very short cross-polarization (CP) contact times, however, the measured modulation curves then deviate strongly from the theoretically predicted shape, which is caused by the dependence of the CP efficiency on the orientation of the CH vector, leading to an anisotropic magnetization distribution even for isotropic samples. Herein, we present a detailed demonstration and explanation of this problem, as well as providing a solution. We combine DIPSHIFT experiments with the rotor-directed exchange of orientations (RODEO) method, and modifications of it, to redistribute the magnetization and obtain undistorted modulation curves. Our strategy is general in that it can also be applied to other types of experiments for heteronuclear dipole-dipole coupling determinations that rely on dipolar polarization transfer. It is demonstrated with perylene-bisimide-based organic semiconductor materials, as an example, in which measurements of dynamic order parameters reveal correlations of the molecular dynamics with the phase structure and functional properties.
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Affiliation(s)
- Ricardo Kurz
- Institut für Physik-NMR, Martin-Luther-Universität Halle-Wittenberg, Betty-Heimann-Str. 7, 06120 Halle (Germany)
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Wenzel LB, Osann K, Gross J, Kurz R, Nelson EL, Karlan BY. BRCA mutation carriers: Risk factors for psychosocial and physiologic disruption. J Clin Oncol 2011. [DOI: 10.1200/jco.2011.29.15_suppl.9139] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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Linder P, Trzewik J, Rüffer M, Artmann GM, Digel I, Kurz R, Rothermel A, Robitzki A, Temiz Artmann A. Contractile tension and beating rates of self-exciting monolayers and 3D-tissue constructs of neonatal rat cardiomyocytes. Med Biol Eng Comput 2009; 48:59-65. [PMID: 19924460 DOI: 10.1007/s11517-009-0552-y] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2008] [Accepted: 10/24/2009] [Indexed: 10/20/2022]
Abstract
The CellDrum technology (The term 'CellDrum technology' includes a couple of slightly different technological setups for measuring lateral mechanical tension in various types of cell monolayers or 3D-tissue constructs) was designed to quantify the contraction rate and mechanical tension of self-exciting cardiac myocytes. Cells were grown either within flexible, circular collagen gels or as monolayer on top of respective 1-mum thin silicone membranes. Membrane and cells were bulged outwards by air pressure. This biaxial strain distribution is rather similar the beating, blood-filled heart. The setup allowed presetting the mechanical residual stress level externally by adjusting the centre deflection, thus, mimicking hypertension in vitro. Tension was measured as oscillating differential pressure change between chamber and environment. A 0.5-mm thick collagen-cardiac myocyte tissue construct induced after 2 days of culturing (initial cell density 2 x 10(4) cells/ml), a mechanical tension of 1.62 +/- 0.17 microN/mm(2). Mechanical load is an important growth regulator in the developing heart, and the orientation and alignment of cardiomyocytes is stress sensitive. Therefore, it was necessary to develop the CellDrum technology with its biaxial stress-strain distribution and defined mechanical boundary conditions. Cells were exposed to strain in two directions, radially and circumferentially, which is similar to biaxial loading in real heart tissues. Thus, from a biomechanical point of view, the system is preferable to previous setups based on uniaxial stretching.
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Affiliation(s)
- P Linder
- Centre for Biotechnology and Biomedicine, Molecular Biological-Biochemical Processing Technology, University of Leipzig, 04103, Leipzig, Germany.
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Sieder R, Kraft D, Schilling B, Kessler G, Grünes G, Kurz R. Rechnergestützte Blutdruckregelung nach Herzoperationen. BIOMED ENG-BIOMED TE 2009. [DOI: 10.1515/bmte.1988.33.s2.73] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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Schober P, Kurz R, Musil H, Jarosch E. Streßadaptierte parenterale Aminosäurensubstitution bei operierten Früh- und Neugeborenen. Transfus Med Hemother 2009. [DOI: 10.1159/000222346] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
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Kurz R, Musil HE, Jarosch E. Parenterale Aminosäurensubstitution bei operierten Neugeborenen. Transfus Med Hemother 2009. [DOI: 10.1159/000221357] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
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Karlan B, Wenzel LB, Osann K, Kurz R, McClure L. Cancer screening distress in a clinic-based population of BRCA mutation carriers. J Clin Oncol 2008. [DOI: 10.1200/jco.2008.26.15_suppl.20570] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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Litscher G, Pfurtscheller G, Kurz R, Fritsch G. Hirnstammfunktionsuntersuchungen an Säuglingen mit Apnoe-Syndrom unter Verwendung akustisch evozierter Hirnstammpotentiale und der Herzratenvariabilität. KLIN NEUROPHYSIOL 2008. [DOI: 10.1055/s-2008-1060933] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Abstract
The main ethical imperative of all paediatric actions is the demand to do everything "in the best interests of children". Relevant guidelines can be derived from the UN Declaration on the Rights of Children, whereupon every child has the fundamental right to life and dignity, and is entitled to optimal medical care. Paediatric care in general includes the responsibility to achieve the highest level of knowledge, consideration of the child-specific somatic, mental and social development, empathic and trustworthy communication with the child and parents, observance of the recommendations of the Charter of the Rights of Children in Hospital, and cooperation with experts in related professions. Good communication is based on respect for the dignity of the child as a person and on the use of child-specific language, recognizing the rights of the child to be involved in consent or assent. Good clinical practice dictates and demands high standards of practice in therapeutics, research and medical interventions involving children. Decision making in extreme situations with regard to continuation, withholding or withdrawing life supporting measures is amongst the most complex and ethically difficult tasks of a doctor. Ethical issues with regard to neglect, maltreatment, abuse and addictions involving children need scrupulous consideration. Paediatricians have a prime responsibility to promote and protect the well being of children.
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Affiliation(s)
- R Kurz
- Children's University Hospital, Temple Street, Dublin 1, Ireland
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Zotter H, Kerbl R, Schwantzer G, Kurz R, Einspieler C. Sudden infant death syndrome risk questionnaire: a mirror of parental awareness rather than a prospective diagnostic tool. Acta Paediatr 2004; 93:255-7. [PMID: 15046284 DOI: 10.1080/08035250310021046] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 04/29/2023]
Abstract
AIM In 1989, a scoring system that aimed to identify infants at risk of sudden infant death syndrome (SIDS) by a structured questionnaire [SIDS risk questionnaire (SRQ)] consisting of 25 items was introduced in Styria (Austria). It was the aim of the study to compare SIDS rates in the population that had access to the SRQ with the population that had no access. Furthermore, for the population receiving the SRQ, the responding (compliant) and non-responding (non-compliant) groups were compared concerning the incidence of SIDS. METHODS Within the study period, 53 865 births and 57 SIDS cases were recorded (incidence 1.06/1000) and analysed retrospectively. RESULTS The incidence of SIDS was significantly higher in the non-responding population (2.36/ 1000) than in the responding group (0.81/1000, p < 0.001). However, the incidence of SIDS was not significantly different in the population that had access to the risk questionnaire (1.29/1000) and the group without access (0.86/1000, p = 0.145). CONCLUSION The value of any questionnaire used for SIDS prevention may be limited by the existence of a non-compliant population which represents a risk group and should be targeted by other preventive measures.
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Affiliation(s)
- H Zotter
- Department of Paediatrics, University of Graz, Auenbruggerplatz 30, A-8036 Graz, Austria.
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Kurz R, Steinhilper U, Buck J, Laqua D, Heinkelein J. [Ileocoecal intussusception of the terminal ileum caused by a carcinoid tumor]. Z Gastroenterol 2003; 41:659-62. [PMID: 12858237 DOI: 10.1055/s-2003-40545] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
Intussusception of the intestine is a frequent reason for intestinal obstruction in infants; the course is acute but the causes are often not recognizable. In adults intussusception is the cause for bowel obstruction in only 1% of cases. The course is subacute and in over 90% a benign or malignant process in this part of the intestine is found. We report the case of a 45-year-old male with abdominal discomfort, increasing over weeks. The preoperative ultrasonography and computed tomography of the abdomen revealed the typical finding of ileocoecal intussusception. An ileocoecal resection was performed. The histopathological workup showed a small carcinoid tumour of the terminal ileum.
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Affiliation(s)
- R Kurz
- Abteilung Innere Medizin II der Kreisklinik München-Pasing.
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Kerbl R, Zotter H, Schenkeli R, Hoffmann E, Perrogon A, Zötsch W, Kurz R. Persistent hypercapnia in children after treatment of obstructive sleep apnea syndrome by adenotonsillectomy. Wien Klin Wochenschr 2001; 113:229-34. [PMID: 11383382] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/20/2023]
Abstract
Obstructive sleep apnea syndrome (OSAS) in childhood is frequently in part a consequence of enlarged adenoids and/or tonsils and may lead to hypoxemia and hypercapnia during sleep. Whereas long-term blood gas alterations are well documented in adults, only few polygraphic data are available for children. It was the aim of this study to document blood gas alterations before and after treatment in this population. 9 children with OSAS (6 male, 3 female, median age 5.9 years, range 1.1-13.5 years) were investigated by polysomnography before and after adenotonsillectomy. Prior to intervention most children presented with moderate hypercapnia (ETCO2 mean 44.3 +/- 3.8 mm Hg, ETCO2 maximum 53.2 +/- 5.2) and hypoxemic episodes (oxygen saturation mean 93.2 +/- 3.2%, minimum 74.4 +/- 16.5%). Following adenotonsillectomy subsequent polygraphic investigations displayed normalisation of oxygen saturation (saturation mean 96.1 +/- 0.8%, minimum 90.1 +/- 3.1%). In contrast, moderate hypercapnia in several patients persisted up to five months after treatment (ETCO2 mean 44.9 +/- 2.8 mm Hg, ETCO2 maximum 51.2 +/- 3.6). Persistent hypercapnia most likely reflects an adaptation process of chemosensitivity and respiratory control due to preceding long-term hypercapnia.
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Affiliation(s)
- R Kerbl
- Universitätsklinik für Kinder- und Jugendheilkunde Graz, Austria
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Kurz R. Decision making in extreme situations involving children: withholding or withdrawal of life supporting treatment in paediatric care. Statement of the ethics working group of the Confederation of the European Specialists of Paediatrics (CESP). Eur J Pediatr 2001; 160:214-6. [PMID: 11317641 DOI: 10.1007/pl00008430] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Abstract
Infection with actinomycosis israeli (an anaerobic, gram-positive bacterium) presents as chronic inflammation with tendency to fibrosis and suppuration with formation of external sinuses. Cervicofacial, thoracic and abdominal forms of the disease made up 95% of cases of actinomycosis. A 53-year-old woman was admitted to the hospital because of a pelvic mass which was thought to be malignant. A laparotomy was performed and the histologic examination showed actinomycosis. The patient first received penicillin followed by tetracyclin and the pelvic mass shrunk. One year later no more mass was detectable. We think that the IUP in place over years is the source for this infection.
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Affiliation(s)
- R Kurz
- Abteilung Innere Medizin II, Akademisches Lehrkrankenhaus München-Pasing
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Ipsiroglu OS, Kerbl R, Urschitz M, Kurz R. [4th Austrian SIDS Consensus-Consultation and the Viennese SIDS prevention campaign "Secure Sleep"]. Wien Klin Wochenschr 2000; 112:187-92. [PMID: 10763529] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/16/2023]
Abstract
Despite numerous investigations the pathophysiologic mechanisms of SIDS have not been fully elucidated. In large epidemiologic studies highly variable SIDS mortality rates were noted between different countries and cultures. This presumably is due not only to differences in diagnostics and classification of SIDS but also in lifestyle and newborn care. The common denominator is the identification and prevention of the main risk factors: smoking, sleeping in the prone position, over-heating, wrong "bedding". SIDS prevention campaigns that have focussed upon these risk factors have led to a dramatic reduction in the incidence of SIDS. In preparation for the SIDS prevention campaign of Vienna ("Safe Sleep") the content, strategy and procedure of the Austrian prevention campaigns were analysed. The current focus is to convey a clear and uniform message in personal conversations before and after birth of the child. These conversations with parents are the most important tool to detect SIDS related anxiety and a possibly increased risk of SIDS. In the last 30 years various polysomnographic parameters were published that were associated with an increased risk of SIDS. Today there is international consent that polysomnography is not an efficient screening method to demonstrate increased risk of SIDS. Therefore the use of polysomnography, besides research purposes, has been limited to investigating clinical symptoms of infants and children. Concerning monitoring it is important to note that--in contrast to the undisputed importance of monitoring breathing disorders--the effectiveness in SIDS prevention is unproven. State of the art are instruments that monitor heart and breathing rate and have adequate storage functions. The duration of monitoring should encompass the symptomatic period as well as a safety period of three months. The monitor should not be routinely prescribed for a year. The guiding principle is "As short as possible with stringent indication". Prerequisite for the monitoring is good instruction of the parents and a continuous consultation by competent outpatient clinics.
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Affiliation(s)
- O S Ipsiroglu
- Universitätskliniken für Kinder- und Jugendheilkunde Wien, Osterreich.
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Chambers TL, Kurz R. Ethical overview of paediatric research and practice in Europe from the Ethical Working Group of the Confederation of European Specialists in Paediatrics (CESP). Eur J Pediatr 1999; 158:537-40. [PMID: 10412809 DOI: 10.1007/s004310051141] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Affiliation(s)
- T L Chambers
- Department of General Paediatrics, Southmead Hospital, Westbury-on-Trym, Bristol, UK
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Aglas F, Pilgram E, Kremser A, Artner B, Aglas I, Einspieler C, Kurz R. Der plötzliche Säuglingstod als psychosoziales Problem. Monatsschr Kinderheilkd 1998. [DOI: 10.1007/s001120050327] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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Pfleger A, Kerbl R, Kurz R. Kapnographie zur Bestimmung obstruktiver Apnoen. Monatsschr Kinderheilkd 1997. [DOI: 10.1007/s001120050230] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Kurz R, Eder A, Buck J, Heinkelein J. [Mesenteric infarct in primary antiphospholipid antibody syndrome]. Z Gastroenterol 1997; 35:669-72. [PMID: 9432819] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
The mesenteric infarction is a rare but life threatening cause of acute abdomen. A 55-year-old woman was referred to the hospital because of acute mesenteric infarction and in the history claudication. In the absence of risk factors (atrial fibrillation, atherosclerosis, nicotin abusus) a postoperative work up was started to identify the cause of the arterial occlusions. A primary antiphospholipid-antibody syndrome was found. The patient is now receiving low-dose aspirin and anticoagulation therapy. The follow-up over now 14 months shows no further events.
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Affiliation(s)
- R Kurz
- Abteilung Innere Medizin II, Akademisches Lehrkrankenhaus München-Pasing
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Kurz R. [Importance for pediatrics of the quality of training in pediatric nursing]. Kinderkrankenschwester 1997; 16:201-3. [PMID: 9274288] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Affiliation(s)
- R Kurz
- Universitätsklinik für Kinder- und Jugendheilkunde, Graz/Osterreich
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Kurz R. [Making ethical decisions--to preserve life at all costs?]. Kinderkrankenschwester 1997; 16:26-8. [PMID: 9077189] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Affiliation(s)
- R Kurz
- Universitätsklinik für Kinder- und Jugendheilkunde, Graz/Osterreich
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Kerbl R, Litscher H, Grubbauer HM, Reiterer F, Zobel G, Trop M, Urlesberger B, Eber E, Kurz R. Congenital central hypoventilation syndrome (Ondine's curse syndrome) in two siblings: delayed diagnosis and successful noninvasive treatment. Eur J Pediatr 1996; 155:977-80. [PMID: 8911900 DOI: 10.1007/bf02282890] [Citation(s) in RCA: 38] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
UNLABELLED Congenital central hypoventilation syndrome (CCHS, Ondine's curse syndrome) is a rare respiratory disorder; less than 100 cases have been reported. Familiality of the disease has been discussed, but only few familial cases have been reported so far. In this report we describe the occurrence of CCHS in two male siblings. Diagnosis was established only at the age of 4 years in the first case, although the patient had disease related symptoms since early infancy. The second patient was one of dizygotic twins, he was diagnosed with CCHS at the age of 8 months. Up to that age only moderate desaturations had been observed. The other twin was unaffected by the disease. Both patients were successfully treated by nocturnal positive-pressure ventilation via a specially adapted face mask. They show satisfactory physical and neurologic development. CONCLUSION Our cases support the assumption of familiality in CCHS although the mode of inheritance remains to be clarified. Polygraphic recordings including capnography should be performed in siblings of CCHS patients early in life in order to avoid secondary complications. Noninvasive treatment by ventilation via special face masks is feasible.
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Affiliation(s)
- R Kerbl
- Department of Paediatrics, University of Graz, Austria
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Kurz R, Buck J, Heinkelein J. [Ileus of the small intestine caused by an enterolith]. Z Gastroenterol 1994; 32:497-9. [PMID: 7801656] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Abstract
Adhesions, tumours and hernias are frequent reasons for an ileus of the small intestine in adults. We describe the rare case of an ileus of small intestine caused by a big enterolith which was formed in a duodenal diverticulum. As a predisposing condition we identified a bone of a chicken.
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Affiliation(s)
- R Kurz
- Abteilung Innere Medizin II, Akademisches Lehrkrankenhaus München-Pasing
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Reiterer F, Einspieler C, Haidmayer R, Kurz R, Schober P. [Experience of parents in home monitoring of apnea for prevention of sudden infant death (SIDS)]. Padiatr Padol 1993; 28:141-144. [PMID: 8247596] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/22/2023]
Abstract
89 of 119 parents of infants with apnea home monitoring answered to a standard questionnaire concerning different aspects of home monitoring. In almost all cases the home monitoring was finished at the begin of the study, lasting from six months to 12 months. The indications for an apnea monitor were: apparent life threatening event (n = 8), SIDS-sibling (n = 24), sleep apnea syndrome (n = 40) and parents pressing request (n = 17). 90% of parents felt to have got enough information about the function of the apnea monitor (mostly Graseby MR-10 monitor) and what they have to do when there is an apnea alarm. 6% of parents changed the monitor because of technical problems. Most of the alarms were registrated by almost all parents between 24 h and 6 h. 35% of parents stimulated their infants in case of an apnea alarm gently to vigorously, one infant had a mouth to mouth resuscitation. Questions concerning the psychological and social impact of home monitoring on parents demonstrated that there was some stress like anxiety, sleep disturbances mainly in the mothers. We conclude from parents experience with apnea home monitoring the need for an adequate medical, technical and psychological support.
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Affiliation(s)
- F Reiterer
- Universitäts-Kinderklinik Graz, Osterreich
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43
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Abstract
BACKGROUND Although the existence of myocardial mechanoelectrical feedback is well established, the mechanism of arrhythmia induction by ventricular dilatation or stretch remains insufficiently defined. In particular, controversy exists when comparing the arrhythmogenic potential of chronic versus acute myocardial stretch. Also, assessment of cellular electrophysiological effects of myocardial stretch has been incomplete. METHODS AND RESULTS To evaluate the electrophysiological and arrhythmogenic effects of slow versus rapid ventricular wall stretch, we developed an isolated Langendorff-perfused rabbit heart model in which left ventricular (LV) volume can be changed by a computer-controlled servopump. Cellular electrophysiological effects and premature ventricular excitations (PVEs) and their origin produced by the volume increases were assessed by a multiple-site monophasic action potential (MAP) recording system and by volume-conducted ECGs obtained by immersing the entire preparation in a saline-filled tank. Volume was increased either gradually with slow volume ramps (0.1 ml/sec) or suddenly by volume pulses of varying pulse waveforms (three different amplitudes and five different rise velocities) applied randomly 250-350 times to each of eight hearts. Gradual LV volume loading caused gradual decreases in MAP resting and action potential amplitude, whereas rapid, transient volume pulses caused transient depolarizations. Despite similar membrane potential effects of stretch, gradual volume increases rarely (11%) produced PVEs, even with large volume loads, whereas rapid volume pulses of moderate amplitudes regularly triggered PVEs (45-100% of interventions). Logistic regression analysis showed that the probability of PVE occurrence increased independently with both the amplitude and the velocity of the volume increase, with the greatest sensitivity to stretch velocity exhibited at low and intermediate pulse amplitudes. Faster volume pulse rise velocities triggered PVEs at a lower instantaneous pulse amplitude than lower rise velocities, further corroborating the dependence of stretch-activated arrhythmias on the velocity of stretch. In contrast, an increase in the basic ventricular volume had no effect on the probability of PVE occurrence during the volume pulses. The MAP recordings demonstrated spatial variability in the extent of local depolarizations and site of PVE origin; transient depolarizations occurred, and PVEs originated most often in the posterolateral region of the left ventricle. CONCLUSIONS Membrane depolarization is caused by both gradual and rapid ventricular stretch, but PVEs are more easily elicited by rapid stretch. Regions of greater myocardial compliance that experience greater relative stretch may act as "foci" for stretch-activated arrhythmias during dynamic ventricular loading. These whole-heart data corroborate the existence of stretch-activated membrane channels in ventricular myocardium and may help explain ventricular ectopy under conditions of differential ventricular loading, as in ventricular dyskinesia, or regional muscle traction, as in mitral valve prolapse syndrome.
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Affiliation(s)
- M R Franz
- Cardiology Division, Stanford University, Calif
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Slavc I, Urban C, Ritter J, Ambros PF, Haas OA, Köller U, Kurz R. Paraparesis secondary to a spinal mass as the presenting feature of erythroleukaemia in a 10-month-old child. Eur J Pediatr 1992; 151:332-5. [PMID: 1396885 DOI: 10.1007/bf02113251] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
Severe neurological impairment as the first symptom of acute leukaemia is a rather uncommon finding. We report the case of a 10-month-old infant who presented with acute paralysis of the lower extremities due to cord compression by an epidural tumour composed of malignant erythrocyte precursor cells. Diagnosis of erythroleukaemia (EL) was made by needle biopsy of the spinal epidural mass and confirmed by bone marrow aspiration. Antileukaemic treatment in combination with radiotherapy to the epidural tumour led to haematological remission and neurological recovery with disappearance of the mass lesion as demonstrated by MRI. However, haematological relapse occurred with death of the patient 7 months after diagnosis. This is the first reported case of EL presenting with paraparesis due to an epidural tumour. The clinical symptoms, results of cytogenetic and immunological studies and the clinical course are described.
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Affiliation(s)
- I Slavc
- Department of Paediatrics, University of Graz, Austria
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45
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Einspieler C, Sutter-Holzer A, Kurz R, Löscher WN, Kerbl-Meyer U, Roll P, Kenner T, Haidmayer R. [The Graz SIDS Risk Questionnaire: I. Development and validation]. Klin Padiatr 1992; 204:84-8. [PMID: 1583856 DOI: 10.1055/s-2007-1025328] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
Based on the results from semistructured interviews with parents of fifty SIDS victims and of fifty matched controls we developed a SIDS risk questionnaire, the so-called SRFB Graz. In a retrospective study this questionnaire was applied to 65 SIDS victims and 195 comparable controls. By statistical analysis a cut point was computed, which discriminates SIDS cases from controls with a sensitivity of 86% and a specificity of 95%.
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Kerbl R, Hoffmann E, Kurz R, Spannring R, Krenn G, Reiterer F, Einspieler C, Haidmayer R. [Sudden infant death. Risks and possibilities of prevention]. Kinderkrankenschwester 1992; 11:96-7. [PMID: 1567777] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
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47
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Einspieler C, Löscher WN, Kurz R, Rosanelli K, Rosegger H, Bachler I, Klug EM, Reiterer F, Schenkeli R, Kerbl R. [The Graz SIDS Risk Questionnaire: prospective study of 6,000 infants]. Klin Padiatr 1992; 204:88-91. [PMID: 1583857] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
In a prospective study (1988-1990) the SIDS risk questionnaire SRFB was applied to 6000 infants born in the Department of Obstetrics, University Hospital Graz. In all infants at an increased statistical risk for SIDS a standardized intervention including pediatric and polysomnographic investigations was performed. As a result the SIDS incidence decreased from an average of 1.92 per thousand lifeborns (1984-1988) to 0.83 per thousand lifeborns (1989-1990) in our test group, which means a striking reduction of the SIDS incidence by 57%. In addition to this effect, the intensified information of parents and physicians about possible signs of an increased risk for SIDS lead to a general reduction of SIDS in Styria.
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Carpenter WT, Kurz R, Kirkpatrick B, Hanlon TE, Summerfelt AT, Buchanan RW, Waltrip RW, Breier A. Carbamazepine maintenance treatment in outpatient schizophrenics. Arch Gen Psychiatry 1991; 48:69-72. [PMID: 1670617 DOI: 10.1001/archpsyc.1991.01810250071010] [Citation(s) in RCA: 22] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
A double-blind crossover trial was used to evaluate carbamazepine as the sole maintenance treatment of chronic, nonmanic schizophrenic outpatients whose conditions had been stabilized with the use of neuroleptics prior to study. Criteria of treatment effectiveness included the number of patients relapsing and time to relapse over a 95-day neuroleptic-free period during which either carbamazepine or placebo was administered. Relapse was determined by the concordance of psychiatric ratings and independent clinical judgements indicating significant worsening. Results for 27 patients (13 receiving carbamazepine and 14 receiving placebo) involved in the first phase of this treatment comparison were nondifferentiating. Corroborating descriptive findings in the second phase were available for 14 of these patients. There was no evidence supporting the existence of a treatment-relevant subgroup defined by episodic dyscontrol phenomena.
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Affiliation(s)
- W T Carpenter
- Maryland Psychiatric Research Center, Baltimore 21228
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49
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Löscher WN, Einspieler C, Klug EM, Haidmayer R, Gallasch E, Kurz R, Kenner T. Neurological status, sleep apnea frequency and blood oxygenation in six weeks old infants. Early Hum Dev 1990; 24:119-30. [PMID: 2076687 DOI: 10.1016/0378-3782(90)90142-6] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
A study was carried out to investigate the correlation between sleep apnea frequency, blood oxygenation and neurological condition in 21 infants at six weeks of age with inconspicuous medical history. Polygraphic recordings of respiratory behaviour and transcutaneous blood gas monitoring lasted for at least five hours. To quantify the results of the neurological examination we established a neurological optimality score (NOS). We found statistically significant correlations between several indexes of apneas and indexes of blood oxygenation and NOS. Thus, a reduced NOS was strongly correlated with higher apnea frequencies and with pronounced drops of transcutaneous PO2-values. In addition all but one infant who were diagnosed as having a sleep apnea syndrome showed a greater than ten percent reduction of NOS. Some pathophysiological considerations to explain our findings are put forward and the possible role of the neuromodulator adenosine is emphasized.
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Affiliation(s)
- W N Löscher
- Department of Physiology, University of Graz Harrachg, Austria
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50
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Havel M, Teufelsbauer H, Laczkovics A, Kurz R, Wolner E. Cytomegalovirus hyperimmunoglobulin prophylaxis in the prevention of cytomegalovirus infection in immunosuppressed heart transplant patients. Transplant Proc 1990; 22:1805-6. [PMID: 2167533] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Affiliation(s)
- M Havel
- 2nd Department of Surgery, University of Vienna, Austria
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