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  • 1
    Electronic Resource
    Electronic Resource
    Springer
    European journal of pediatrics 151 (1992), S. 596-600 
    ISSN: 1432-1076
    Keywords: Respiratory distress syndrome ; Surfactant protein A
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Surfactant-associated protein (SP-A) was measured in tracheal aspirates of ventilated infants with (n=51) and without (n=21) respiratory distress syndrome (RDS). SP-A concentrations in samples collected after birth were significantly lower in RDS than in infants ventilated for other reasons than RDS (median 0.03 vs. 1.60 μg/ml). As a biochemical test to diagnose RDS early after birth, the sensitivity of measuring SP-A in tracheal aspirates was 87% and specificity 81%. SP-A content in tracheal aspirates of infants with RDS was monitored during the first 7 days of life. A significant (P〈0.001) increase within the first 4 days was found in those infants who survived, whereas no such change was found in those infants who died.
    Type of Medium: Electronic Resource
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  • 2
    ISSN: 1432-1076
    Keywords: Mechanical ventilation ; Preterm infant ; Extra-alveolar air leakage ; Randomised trial
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Two different ventilation techniques were compared in a seven-centre, randomised trial with 181 preterm infants up to and including 32 completed weeks gestational age, who needed mechanical ventilation because of lung disease of any type. Technique A used a constant rate (60 cycles/min), inspiratory time (IT) (0.33s) and inspiratory: expiratory ratio (I∶E) (1∶2). The tidal and minute volume was only changed by varying peak inspiratory pressure until weaning via continuous positive airway pressure. Technique B used a lower rate (30 cycles/min) with longer IT (1.0s). The I∶E ratio could be changed from 1∶1 to 2∶1 in case of hypoxaemia. Chest X-rays taken at fixed intervals were evaluated by a paediatric radiologist and a neonatologist unaware of the type of ventilation used in the patients. A reduction of at least 20% in extra-alveolar air leakage (EAL) or death prior to EAl was supposed in infants ventilated by method A. A sequential design was used to test this hypothesis. The null hypothesis was rejected (P=0.05) when the 22nd untied pair was completed. The largest reduction in EAL (−55%) was observed in the subgroup 31–32 weeks of gestation and none in the most immature group (〈28 weeks). We conclude that in preterm infants requiring mechanical ventilation for any reason of lung insufficiency, ventilation at 60 cycles/min and short IT (0.33s) significantly reduces EAL or prior death compared with 30 cycles/min and a longer IT of 1s. We speculate that a further increase in rate and reduction of IT would also lower the risk of barotrauma in the most immature and susceptible infants.
    Type of Medium: Electronic Resource
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  • 3
    ISSN: 1432-1076
    Keywords: l-Selectin ; Lymphocytes ; Infection ; Newborn
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract l-Selectin, a leukocyte surface glycoprotein involved in white blood cell extravasation, is rapidly down-regulated after leukocyte activation. We prospectively determined lymphocytel-selectin expression in freshly obtained cord blood samples of 98 neonates (gestational age 25–42 weeks). In eight infants with bacterial infection, the mean percentage ofl-selectinhigh lymphocytes was 32.5% (SD 20.1%), compared to 60.1% (SD 18.7%) in the control group (P〈0.01). A percentage ofl-selectinhigh lymphocytes of less than 42% had a sensitivity of 75% and a specificity of 82% in identifying infected newborns. Cord blood lymphocytel-selectin expression was independent of gestational age, birth weight, umbilical artery pH, hematocrit, white blood cell count, absolute neutrophil count, C-reactive protein level, or maternal fever before delivery while there was a weak correlation with the newborn's immature/total ratio and platelet count. To our knowledge, this is the first report demonstrating downregulation of human lymphocytel-selectin expression following activation of the immune system in vivo.
    Type of Medium: Electronic Resource
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  • 4
    Electronic Resource
    Electronic Resource
    Springer
    European journal of pediatrics 114 (1973), S. 293-299 
    ISSN: 1432-1076
    Keywords: Newborn ; Blood glucose estmation ; Dexstrostix ; Reflectance meter ; Hexokinase method
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Zusammenfassung Eine neue Möglichkeit der Blutzuckerbestimmung mittels Dextrostix/Reflektometer wurde mit der Hexokinasemethode an 45 Vergleichsmessungen bei Neugeborenen überprüft. Es ergab sich ein Korrelationskoeffizient vonr=0,89. Die mit der Dextrostix/Reflektometer-Methode ermittelten Werte lagen fast ausnahmslos niedriger als die der Hexokinasemethode. Verschiedene Hypothesen für diese Abweichung werden diskutiert. Für die Blutzuckerbestimmung bei Neugeborenen bietet die Dextrostix/Reflektometer-Methode keinen entscheidenden Vorteil gegenüber der bisherigen Suchmethode Dextrostix/Farbskalavergleich.
    Notes: Abstract A new “reflectance meter” capable of reading and assessing a quantitative assessment of the color change on Dextrostix used for blood glucose estimation, was tested using capillary blood samples from 45 newborn infants. The correlation of the blood glucose readings with those obtained with a hexokinase method wasr=0.89. The blood glucose concentration shown by the reflectance meter was lower than that obtained by the hexokinase method in nearly all cases. Various hypotheses are discussed for an explanation. The reflectance meter has no advantage over the Dextrostix color-scale method.
    Type of Medium: Electronic Resource
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  • 5
    Electronic Resource
    Electronic Resource
    Springer
    European journal of pediatrics 131 (1979), S. 219-228 
    ISSN: 1432-1076
    Keywords: Neonatal lung ; Respiratory distress syndrome ; Phospholipids, pulmonary ; Surfactant, artificial ; Surfactant, substitution
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract A mixture of synthetic phospholipids containing 90% Dipalmitoylphosphatidylcholine and 10% Dipalmitoylphosphatidylglycerol was tested for its suitability as surfactant substitute. Different methods of preparation were employed. The substance was studied by chromatography, Wilhelmy balance, and in rabbits after tracheal instillation during mechanical ventilation. When prepared as suspension of multilamellar liposomes in NaCl, the phospholipid samples displayed the essential surfactant features of adsorption from the subphase, spreading to a monolayer and lowering the surface tension to 3.7 dyn/cm at compression. For a dose of 2.55 μg/cm2, the stability index was 1.83±0.29. Samples prepared with ultrasound were not surface-active. Sonication also destroyed the surface-tension-lowering ability of previously active samples. No signs of local toxicity were found in the treated animals. When radioactive DPPC/DPPG was instillated into the trachea of the ventilated rabbit, autohistoradiography demonstrated radioactive material in the alveoli covering the alveolar wall with a thin layer. Provided that proper techniques of preparation and administration are employed, the phospholipids tested are a promising surfactant substitute worthy of clinical study.
    Type of Medium: Electronic Resource
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  • 6
    Electronic Resource
    Electronic Resource
    Springer
    European journal of pediatrics 147 (1988), S. 399-404 
    ISSN: 1432-1076
    Keywords: Anaemia, non-physiological ; preterm infant ; Diagnostic blood sampling ; Blood transfusion
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Sixty very low birth weight infants (birth weight 560–1450g) were studied during the first 28 days of life. The infants were classified as group A (n=19 infants who never required ventilator support), group B (n=20 infants mechanically ventilated for minor respiratory problems), and group C (n=21 infants ventilated for respiratory distress syndrome). Diagnostic blood sampling was measured, infants were checked for clinical symptoms and laboratory signs of anaemia 24 h before and after the transfusion of packed red cells. A total of 7998 punctures (average: 4.8 per infant per day) were performed, the mean blood loss due to diagnostic sampling was 50.3 ml/kg per 28 days (range 7–142) for all infants. A high correlation (r s=+0.91) was found between the blood volumes sampled and transfused. In group A, the mean blood loss was 24 ml/kg, and a total of 29 blood transfusions were administered. The most frequent symptoms of anaemia were poor weight gain and apnoeic spells. In group B, the mean blood loss was 60 ml/kg and a total of 97 blood transfusions were administered. In group C, the mean blood loss was 67 ml/kg and a total of 116 blood transfusions were administered. In both groups B and C, poor weight gain, pallor and distended abdomen were the most frequent symtoms of anaemia. Following the blood transfusion, haematocrit rose and blood pressure remained unchanged. The symptoms that responded most favourably to the blood transfusion were: poor weight gain, oxygen requirement, and distended abdomen. The results emphasize the need for miniaturizing laboratory techniques and monitoring blood sampling.
    Type of Medium: Electronic Resource
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  • 7
    Electronic Resource
    Electronic Resource
    Springer
    European journal of pediatrics 152 (1993), S. 232-235 
    ISSN: 1432-1076
    Keywords: Cerebral arteries ; Blood flow velocity ; Newborn infant ; Tobacco smoke ; Pregnancy
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Cerebral blood flow velocities (CBFV) were measured by the pulsed Doppler method in 41 infants of smoking mothers and in 59 apparently healthy control infants. Although gestational age, birth weight, and systolic blood pressure were lower in infants exposed to tobacco smoke prenatally, systolic (65±11 vs. 47±12 cm/s, mean ±SD;P〈0.001), mean (36±6 vs. 25±6 cm/s;P〈0.001), and diastolic (17±4 vs 13±4 cm/s;P〈0.001) CBFVs in the anterior cerebral artery were significantly higher when compared to control infants. Similar differences were seen in the internal carotid and in the basilar arteries. Multiple regression analysis did not reveal differences other than maternal smoking to explain these observations. We conclude that prenatal tobacco smoke exposure is related to increased CBFVs in newborn infants. Further studies should determine whether this relation is not only statistical but causal and whether increased CBFVs are an indicator of prolonged effects of prenatal tobacco smoke exposure.
    Type of Medium: Electronic Resource
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  • 8
    Electronic Resource
    Electronic Resource
    Springer
    European journal of pediatrics 157 (1998), S. 724-730 
    ISSN: 1432-1076
    Keywords: Key words Opiate-exposed infants ; Drug withdrawal ; Clinical and neurodevelopmental outcome ; Griffiths Developmental Scale ; Prevention
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract To study the developmental effects of prenatal exposure to opiates, a prospective follow up study of 34 drug-exposed (opiates and nicotine) and 42 reference infants (nicotine exposure only) was conducted from January 1992 to September 1995. At the time of delivery, 12 of 34 mothers used opiates without medical control. Twenty-two mothers participated in a methadone maintenance programme. At 1 year, the average Griffiths Developmental Quotient (DQ) was lower in the drug-exposed group (mean: 100.5 vs. references 107.9; P 〈 0.001). This difference was mainly due to lower subscales “locomotor” (mean 100.8 vs. 111.4; P 〈 0.05) and “intellectual performance” (mean 100.8 vs. 108.5; P 〈 0.05) in the drug-exposed group. Severe developmental retardation mean DQ (−2 SD) was diagnosed in 2 drug-exposed infants. Mild developmental retardation (mean DQ: 1 SD– 〉 2 SD) was found in 7 drug-exposed and in 3 reference infants (P 〈 0.05). Neurological abnormalities were found more frequently in the drug-exposed group (11 vs. 3 infants; P 〈 0.01). Among the opiate-exposed infants, the subscales “hearing and speech” and “intellectual performance” were lower in the uncontrolled drug-using than in the methadone group. The 17 fostered infants showed no difference in developmental outcome compared with the 10 infants living with their biological parents (mean DQ: 100.0 versus 101.3). Conclusions At 1 year infants prenatally exposed to opiates are at risk for mild psychomotor developmental impairment.
    Type of Medium: Electronic Resource
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  • 9
    Electronic Resource
    Electronic Resource
    Springer
    European journal of pediatrics 158 (1999), S. 653-657 
    ISSN: 1432-1076
    Keywords: Key words Drug addiction ; Hearing thresholds ; Newborn infants ; Risk factor
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract To investigate effects of maternal drug abuse on neonatal hearing, auditory brain-stem evoked potentials were recorded in 132 consecutive newborn infants of mothers who had taken heroin or methadone during pregnancy, alongside 1016 neonates with and 483 hospitalized neonates without risk factors, as defined by the Joint Committee on Infant Hearing. In infants antenatally exposed to opiates, the rate of severe bilateral hearing impairment (≥50 dB) did not differ from that of hospitalized neonates without risk factors (1.5% vs 2.5%). In contrast, intra-uterine toxoplasmosis, syphilis, or cytomegalovirus infection, bilirubin serum concentrations 〉25 mg/dl, craniofacial anomalies, and mechanical ventilation for 5 days or more were independently associated with increased rates of severe hearing impairment by analysis of all 1631 infants studied. Conclusion Newborns of opiate-addicted mothers are not at increased risk for early onset hearing loss.
    Type of Medium: Electronic Resource
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  • 10
    ISSN: 1432-1076
    Keywords: Artificial surfactant ; Lung phospholipids ; Premature rabbit fetus ; Respiratory distress syndrome ; Surfactant substitution
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Sixty-eight rabbit fetuses of 27 days gestation were tracheotomised, artificially ventilated, and their lung mechanics studied in a body-enclosing plethysmograph. The animals were treated by tracheal instillation of natural surfactant concentrate or large unilamellar vesicles containing dipalmitoyl-phosphatidylcholine: egg phosphatidylglycerol, 9∶1. Both preparations were highly surface active in terms of film adsorption and surface tension-lowering potential. Before treatment, the lung mechanics were analysed to indicate the presence of respiratory distress syndrome (RDS). Controls received 0.15 M saline. Differences were found between the in vitro and in vivo activities of both preparations in some animals. In 30 preterm animals with partial lung maturity and without respiratory distress syndrome, no significant effect could be achieved with either the natural or the artificial surfactant. In 38 animals with severe RDS, the tidal volume and compliance increased markedly within 15 min of substitution of both preparations. Compliance increased to 178% of the initial value in ventilated, control animals, to 391% in animals treated with natural, and to 344% in animals treated with artificial surfactant.
    Type of Medium: Electronic Resource
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