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  • 1
    Electronic Resource
    Electronic Resource
    Infliximab induces potent anti-inflammatory and local immunomodulatory activity but no systemic immune suppression in patients with Crohn’s disease (2001)
    Oxford UK : Blackwell Science Ltd
    Alimentary pharmacology & therapeutics 15 (2001), S. 0 
    Details
    ISSN: 1365-2036
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: Anti-TNFα therapy with infliximab is effective for Crohn’s disease. Infliximab neutralizes the biological activities of TNFα, a cytokine involved in host-defence against certain infections.〈section xml:id="abs1-2"〉〈title type="main"〉Aim:To evaluate the effects of infliximab on the gut and peripheral immune system functions.〈section xml:id="abs1-3"〉〈title type="main"〉Methods:Biopsies and blood samples from three clinical trials of infliximab in Crohn’s disease were analysed. Pharmacokinetics, changes in leucocyte counts and T cell subsets, T cell function, and cytokine profiles of lamina propria mononuclear cells (LPMC) and peripheral blood mononuclear cells (PBMC) were analysed.〈section xml:id="abs1-4"〉〈title type="main"〉Results:Infliximab has a serum half-life of 9.5 days and is still detectable in serum 8 weeks after infusion. Leucocyte counts showed consistent changes from baseline toward normal values after therapy. Monocytes and lymphocytes were modestly increased, while neutrophils were decreased 4 weeks after treatment. Lymphocyte subsets and T cell proliferative responses were not altered after therapy. The proportion of PBMCs capable of producing IFNγ and TNFα did not change, while Th1 cytokine production by stimulated LPMC was decreased after infliximab therapy.〈section xml:id="abs1-5"〉〈title type="main"〉Conclusion:The clinical efficacy of infliximab is based on local anti-inflammatory and immunomodulatory effects in the bowel mucosa, without generalized suppression of systemic immune functions in Crohn’s disease patients.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1046/j.1365-2036.2001.00956.x
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  • 2
    Electronic Resource
    Electronic Resource
    Steigende Inzidenz der bronchopulmonalen Dysplasie? Eine 8-Jahres-Retrospektive mit Analyse der Risikofaktoren (1996)
    Springer
    Monatsschrift Kinderheilkunde 144 (1996), S. 895-900 
    Details
    ISSN: 1433-0474
    Keywords: Schlüsselwörter Frühgeborene ; Atemnotsyndrom ; Bronchopulmonale Dysplasie ; Logistische Regressionsanalyse ; Key words Preterm infants ; Respiratory distress syndrome ; Bronchopulmonary dysplasia ; Logistic regression analysis
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Summary Background: BPD still remains a serious complication in very prematurely born infants. In order to assess the incidence and risk factors we analyzed the data of preterm infants (birth weight ≤ 1751 g) born between January 1985 and December 1992. Patients and Methods: Preterm infants requiring intubation on day 1 were enrolled retrospectively. BPD was defined as need for artificial ventilation or oxygen dependency (FiO2 〉 0.3) on day 28. Infants with BPD were compared with matched controls in order to identify risk factors using a logistic regression analysis. Results: A total of 274 infants were enrolled, 76 (28 %) of whom developed BPD, 48 died and 150 survived without BPD. A significant increase in survival and decreasing rate of BPD could be observed during the study period. Low gestational age and birth weight, vaginal delivery, high oxygen requirements and low body weight loss during week 1 were significantly associated with BPD. Administration of natural surfactant was associated with a reduced risk for BPD only in very preterm infants (GA ≤ 28 weeks). Conclusions: Improved outcome in preterm infants with RDS could be demonstrated in terms of increased survival with reduced risk for BPD. Knowledge of risk factors should be translated into preventive concepts.
    Notes: Zusammenfassung Hintergrund: Zur Analyse von Häufigkeit und Risikofaktoren der bronchopulmonalen Dysplasie (BPD) auf dem Hintergrund der sich ändernden Bedingungen der perinatalen Medizin untersuchten wir retrospektiv die Verläufe Frühgeborener, die in der Zeit von Januar 1985–Dezember 1992 an unserer Klinik betreut wurden. Material und Methoden: Während des 1. Lebenstags beatmungsbedürftige Frühgeborene eines Geburtsgewichts von 〈 1751 g wurden in die retrospektive Studie einbezogen. Die BPD wurde definiert als Beatmungsnotwendigkeit bzw. Sauerstoffbedarf von 〉 30 % am 28. Lebenstag. Kinder mit BPD wurden mit einer Kontrollgruppe (Geburtsgewicht 〈 1751 g) verglichen, wobei die Auswahl nach Geburtsjahrgängen und Geburtsgewicht erfolgte. Die Risikofaktoren wurden mittels logistischer Regressionsanalyse berechnet. Ergebnisse: Von insgesamt 274 Kindern wurde bei 76 (28 %) eine BPD diagnostiziert, 150 überlebten ohne BPD, während 48 Kinder verstarben. Risikofaktoren für die BPD stellten bei einer signifikant steigenden Überlebensrate und sinkenden BPD-Inzidenz in der logistischen Regressionsanalyse ein niedriges Gestationsalter sowie Geburtsgewicht, vaginale Geburt, hoher Sauerstoffbedarf, geringe Gewichtsabnahme während der 1. Lebenswoche und fehlende Surfactanttherapie dar. Schlußfolgerung: Wir fanden eine verbesserte Überlebensrate beatmungsbedürftiger Frühgeborener bei Reduktion der BPD-Häufigkeit im Untersuchungszeitraum. Die Kenntnis der BPD-Risikofaktoren sollte in präventive Konzepte umgesetzt werden.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s001120050056
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  • 3
    Electronic Resource
    Electronic Resource
    Do cardiac output and serum lactate levels indicate blood transfusion requirements in anemia of prematurity? (1996)
    Springer
    Intensive care medicine 22 (1996), S. 472-476 
    Details
    ISSN: 1432-1238
    Keywords: Anemia ; Preterm infants ; Serum lactate ; Cardiac output ; Oxygen saturation ; Blood transfusion ; Oxygen delivery
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Background Whether and when to transfuse in anemia of prematurity is highly controversial. Some authors suggest transfusions simply if the hemoglobin (Hb) level is below a defined normal range. Others propose the use of clinical or laboratory parameters in anemic patients to decide whether to transfuse or not. Hypothesis A decreasing amount of circulating Hb should cause a compensatory increase in cardiac output (CO) and an increase in arterial serum lactate. Materials and methods In 56 anemic preterm infants (not in respiratory or hemodynamic failure) we analyzed CO after the first week of life using a Doppler sonographic method. At the same time serum lactate levels. Hb levels and oxygen saturation were registered. Nineteen of these patients were given transfusion when they demonstrated clinical signs of anemia by tachycardia 〉180/min, tachypnea, retractions, apneas and centralization (group 2). The remaining 37 patients were not transfused (group 1). Serum lactate, CO, heart rate (HR), oxygen delivery, respiratory rate, capillary refill and Hb were analyzed in both groups and in group 2 before and 12–24 h after transfusion. Data between groups 1 and 2 and in group 2 before and after transfusion were compared. Results In the 56 patients studied no linear correlation between Hb and CO or between Hb and serum lactate was found. Nor could any correlation be demonstrated between the other variables studied Examining the subgroups separately a negative linear correlation was demonstrated between serum lactate and oxygen delivery in group 2. No other significant correlations were detected. However, when the pre- and post-transfusion data were compared in group 2 (increase of Hb from 9.45 (SD 3.44) to 12.5 (SD 3.8) g/100 ml), the CO decreased from 281. 3 (SD 162.6) to 224 (SD 95.7) ml/kg per min (p〈0.01) and serum lactate decreased significantly from 3.23 mmol/l (SD 2.07) before to 1.71 (SD 0.83) after transfusion. Oxygen delivery was 35.8 (±0.19) ml/kg per min group 1, 27.8 (±0.05) pre- and 43.4 (±0.07) post-transfusion in group 2 (p〈0.01). Conclusions CO measurements and serum lactate levels add little information to the decision-making process for blood transfusions, as neither CO nor serum lactate levels correlate with Hb levels in an otherwise asymptomatic population of preterm infants. In infants where the indication for blood transfusion is made based on traditionally accepted clinical criteria, serum lactate is an additional laboratory indicator of impaired oxygenation, as it correlates significantly with oxygen delivery. A significantly lower oxygen delivery in patients in whom blood transfusion is indicated and an increase in oxygen induced by transfusion demonstrate the value of these criteria in identifying preterm infants who benefit from transfusion.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF01712170
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  • 4
    Electronic Resource
    Electronic Resource
    Do cardiac output and serum lactate levels indicate blood transfusion requirements in anemia of prematurity? (1996)
    Springer
    Intensive care medicine 22 (1996), S. 472-476 
    Details
    ISSN: 1432-1238
    Keywords: Key words Anemia ; Preterm infants ; Serum lactate ; Cardiac output ; Oxygen saturation ; Blood transfusion ; Oxygen delivery
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Background: Whether and when to transfuse in anemia of prematurity is highly controversial. Some authors suggest transfusions simply if the hemoglobin (Hb) level is below a defined normal range. Others propose the use of clinical or laboratory parameters in anemic patients to decide whether to transfuse or not. Hypothesis: A decreasing amount of circulating Hb should cause a compensatory increase in cardiac output (CO) and an increase in arterial serum lactate. Materials and methods: In 56 anemic preterm infants (not in respiratory or hemodynamic failure) we analyzed CO after the first week of life using a Doppler sonographic method. At the same time serum lactate levels, Hb levels and oxygen saturation were registered. Nineteen of these patients were given transfusion when they demonstrated clinical signs of anemia by tachycardia 〉180/min, tachypnea, retractions, apneas and centralization (group 2). The remaining 37 patients were not transfused (group 1). Serum lactate, CO, heart rate (HR), oxygen delivery, respiratory rate, capillary refill and Hb were analyzed in both groups and in group 2 before and 12–24 h after transfusion. Data between groups  1 and 2 and in group 2 before and after transfusion were compared. Results: In the 56 patients studied no linear correlation between Hb and CO or between Hb and serum lactate was found. Nor could any correlation be demonstrated between the other variables studied. Examining the subgroups separately, a negative linear correlation was demonstrated between serum lactate and oxygen delivery in group 2. No other significant correlations were detected. However, when the pre- and post-transfusion data were compared in group 2 (increase of Hb from 9.45 (SD 3.44) to 12.5 (SD 3.8) g/100 ml), the CO decreased from 281.3 (SD 162.6) to 224 (SD 95.7) ml/kg per min (p〈0.01) and serum lactate decreased significantly from 3.23 mmol/l (SD 2.07) before to 1.71 (SD 0.83) after transfusion. Oxygen delivery was 35.8 (±0.19) ml/kg per min group 1, 27.8 (±0.05) pre- and 43.4 (±0.07) post-transfusion in group 2 (p〈0.01). Conclusions: CO measurements and serum lactate levels add little information to the decision-making process for blood transfusions, as neither CO nor serum lactate levels correlate with Hb levels in an otherwise asymptomatic population of preterm infants. In infants where the indication for blood transfusion is made based on traditionally accepted clinical criteria, serum lactate is an additional laboratory indicator of impaired oxygenation, as it correlates significantly with oxygen delivery. A significantly lower oxygen delivery in patients in whom blood transfusion is indicated and an increase in oxygen induced by transfusion demonstrate the value of these criteria in identifying preterm infants who benefit from transfusion.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF01712170
    Library Location Call Number Volume/Issue/Year Availability
    BibTip Others were also interested in ...
    Paper (German National Licenses)
    Fulltext
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