Klinische Pädiatrie
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Klinische Pädiatrie · May 1993
Randomized Controlled Trial Clinical Trial[Effect of body position and positioning changes on lung function of ventilated premature and newborn infants].
We studied 21 intubated premature infants (wts 800-2800 g) with respiratory distress syndrome between day 2 and 10 to evaluate the effect of body position on lung mechanics and gas exchange. The dynamic compliance of the total respiratory system was similar in the prone and supine position. ⋯ Positioning did not significantly affect the dynamic compliance, the minute volume or pCO2. In circulatory stable premature infants a change of the body position probably alters the regional ventilation to perfusion ratio and leads to a reduction of intrapulmonary venous admixture.
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Klinische Pädiatrie · Jan 1992
Randomized Controlled Trial Comparative Study Clinical Trial[Elimination of fat emulsions of various concentrations from the blood. Observational study in the intravenous administration of Lipovenös 10% and 20% in premature infants with very low birth weight].
Within the scope of an observation study 40 premature low birth weight infants requiring parenteral nutrition received either 10% or 20% lipid emulsions (Lipovenös) for 7 days. The 10% lipid emulsion differs from the 20% lipid emulsion in the higher phospholipid/triglyceride-ratio (0.06 resp. 0.12). Lipid infusion was commenced at 0.5 g triglyceride/kg/24 hours and increased steadily to 2 g triglyceride/kg/24 hours. ⋯ Significant increases in the triglyceride and cholesterol content were observed only in the serum of the patients who were given the 10% Lipovenös. The reduced lipid serum clearance is attributable to the higher content of phospholipids in the 10% lipid emulsion. With regard to the risk of high cholesterol concentrations and an abnormal LPX serum accumulation, administration of 20% lipid emulsion is preferable to 10% lipid emulsion, also during the neonatal period.
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Klinische Pädiatrie · May 1987
Randomized Controlled Trial Clinical Trial[Medulloblastoma therapy studies MBL 80 and MED 84 of the Society of Pediatric Oncology and the Société Internationale d'Oncologie Pédiatrique (SIOP)].
In both trials the principle of "sandwich" chemotherapy (administered between surgery and postoperative irradiation) is studied in medulloblastoma. GPO-MBL 80 was essentially a one-arm trial; results after a mean observation period of 3 years show an expected event-free survival rate of 46% at 6 years. "Maintenance" chemotherapy with CCNU and vincristine did not further improve the results. Preliminary results of the joint, prospective, randomised forearm SIOP-GPO trial MED 84 are presented. It is apparently too early to answer any of the two main questions asked by this trial: a) is "sandwich" chemotherapy (as administered) of any value? b) can radiotherapy doses to the supratentorial area and to the spine be moderately reduced in so-called "low risk" patients without compromising long-term results? Thus far, we cannot observe any prognostic influence of the "classical" risk factors as established by other studies.
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Klinische Pädiatrie · May 1985
Randomized Controlled Trial Comparative Study Clinical Trial[Results of the COSS-77 and COSS-80 studies on adjuvant chemotherapy in osteosarcoma of the extremities].
In the first study, COSS-77, 100 patients with OS were treated for 12 months according to a CT-protocol consisting of high-dose methotrexate (HD-MTX), adriblastine (ADR) and cyclophosphamide (CP). At 40 months the expected continuous disease-free survival (CDFS) rate of the 71 evaluable patients was 55%. After exclusion of local recurrences (n = 2) and fatal chemotherapy toxicities (n = 0) a reduced group of 69 patients remained and the expected CDFS rate at 40 months became 56%. ⋯ This is significantly better (p less than 0.05) than the results obtained from the COSS-77 group. No differences were found between the CPL and BCD arms of the COSS-80 group or between the arms receiving or not receiving IF. A significant increase in the CDFS rate for young (less than 12 years) and male patients over that in COSS-77 was observed in COSS-80, probably due to the increased MTX dose.(ABSTRACT TRUNCATED AT 250 WORDS)