Search PubMed⌕ Search

Biomedical subjects

B Roth

Publications and source records attributed to B Roth.

At least 343 records · Page 19Linked to original sources
PubMedDate not supplied

[Evaluation of the delayed skin reaction in chronically ill children].

The evaluation of delayed cutaneous hypersensitivity by using a standardized test system offers an assessment of cell-mediated immunity. The number and diameter of positive responses induced by seven antigens result in a score. The study included 21 healthy children, 20 children with bacterial infections as well as 20 patients with chronic renal insufficiency. In addition, 16 children with cystic fibrosis were also studied. No differences in the skin reactions was found in children with bacterial infections, showing a score of 13 +/- 6 mm. But children with cystic fibrosis or with renal insufficiency exhibited a severe impaired cell-mediated immunity. To what extent the alteration of cell-mediated immunity affects the course of the various diseases, has to be investigated by further prospective studies.

Adolescent↗
PubMedDate not supplied

A staged protocol for the treatment of persistent pulmonary hypertension of the newborn.

The purpose of this report is to propose a staged therapeutic protocol for the treatment of persistent pulmonary hypertension of the newborn (PPHN) based on retrospective clinical experience. We analysed the clinical course of 19 term and near-term neonates with severe PPHN treated between 1991 and 1993, before the introduction of inhalational nitric oxide (NO) therapy. Basic therapy consisted of continuous sedation, and analgesia, circulatory support with dobutamine, dopamine and substitution of 5% albumin or packed red blood cells, mechanical hyperventilation, alkalisation with sodium bicarbonate and surfactant instillation. Consecutive therapy included the administration of norepinephrine, high frequency oscillatory ventilation (HFOV), Prostacyclin (PGI2) and extracorporeal membrane oxygenator (ECMO) therapy with entry criteria for each stage of treatment. From our observations we suggest that firstly, an early increase in systemic mean arterial pressure due to norepinephrine and secondly, HFOV trials are beneficial in patients with PPHN. The staged protocol shall be applicable in most neonatal intensive care units in which inhalational NO and ECMO therapies are not available and includes our present entry criteria for both therapies.

Birth Weight↗
PubMedDate not supplied

Artificial abdominal hernia for the treatment of hepatomegaly in a neonate with stage 4S neuroblastoma.

Surgical widening of the abdomen by a silastic pouch has been used very rarely in the management of critically ill infants with hepatomegaly due to neuroblastoma stage 4S. A female newborn baby was referred on the second day of life because of local compressive effects of a massive hepatomegaly, which lead to multiorgan failure. An artificial abdominal hernia was created on the third day of life using a silastic pouch. During the operation oxygenation and ventilation improved and urinary output returned. After chemotherapeutic reduction of hepatic metastases and primary tumor the pouch was successfully removed on day 57 without local complications. The child has survived for more than 1 year and is in complete remission. An artificial abdominal hernia should be considered more often in the critically ill neonate with stage 4S neuroblastoma and massive hepatomegaly.

Decompression↗
PubMedDate not supplied

Vulvar cicatricial pemphigoid of childhood.

We report a 9-year-old girl with a vulvar autoimmune bullous dermatosis. A diagnosis of localized bullous pemphigoid or cicatricial pemphigoid was made on the basis of immunohistologic data. Since the lesions were unresponsive to topical corticosteroids but healed completely on dapsone at a dosage of 1.5 mg/kg/day, we favor the diagnosis of vulvar cicatricial pemphigoid. Only two such cases have been reported thus far. The diagnostic criteria and therapeutic modalities are discussed.

Child↗
PubMedDate not supplied

Milia-like idiopathic calcinosis cutis.

Milia-like idiopathic calcinosis cutis is a rare entity. Only 17 cases have been reported so far. Two-thirds of these have been associated with Down syndrome. We report the fifth case occurring in a child without Down syndrome. Milia-like idiopathic calcinosis cutis has long been regarded as a peculiar subtype of idiopathic calcinosis cutis. The pathogenesis of the disorder remains unclear.

Adolescent↗
PubMedDate not supplied

Pharmacological studies on lamotrigine, a novel potential antiepileptic drug: I. Anticonvulsant profile in mice and rats.

Lamotrigine (LTG), 3,5-diamino-6-(2,3-dichlorophenyl)-1,2,4-triazine, is a structurally novel anticonvulsant. The anticonvulsant profile of LTG following oral administration in two standard anticonvulsant tests, the maximal electroshock (MES) test in mice and rats and the pentylenetetrazol (PTZ) infusion test in mice, was studied in comparison with the known anticonvulsant drugs phenytoin (PHT), phenobarbitone, diazepam, carbamazepine (CBZ), sodium valproate, ethosuximide (ETH), and troxidone (TROX). ED50 values for the abolition of hindlimb extension (HLE) in the MES test and PTZ infusion tests and doses increasing the latency of PTZ-evoked clonus were determined. The duration of action of LTG was examined in rats and mice in the MES test by determining ED50 values for the abolition of HLE at various drug intervals to shock administration. In the MES test, LTG was well absorbed in both species, with peak activity at 1 h and persistence at this level of potency for at least 8 h. Of the drugs examined, LTG was ranked the most potent and persistent in both species. LTG also abolished PTZ-evoked HLE, while ETH and TROX were inactive. Clonus latency was not increased by LTG, PHT, or CBZ, but was significantly increased (p less than 0.05) by the remaining anticonvulsants. Thus, LTG resembled PHT and CBZ in its ability to block HLE but not to increase PTZ-induced clonus latency. Acute behavioural studies in mice and rats have suggested a wide separation between anticonvulsant doses and those producing behavioural impairment. These results suggest that LTG may be of value in the treatment of generalised tonic-clonic and partial seizures.

Animals↗
PubMedDate not supplied

Influence of the antiseptic agents polyhexanide and octenidine on FL cells and on healing of experimental superficial aseptic wounds in piglets. A double-blind, randomised, stratified, controlled, parallel-group study.

The main target of the combination of octenidine with phenoxyethanol (Octenisept) is the antisepsis of acute wounds, whereas polyhexanide combined with polyethylene glycol in Ringer solution (Lavasept) is the agent of choice for antisepsis of chronic wounds and burns. Because comparative data for both agents on the effects on wound healing are lacking, we investigated the influence of preparations based on polyhexanide and octenidine versus placebo (Ringer solution) in experimental superficial aseptic skin wounds (n = 108) of 20 mm diameter, using a double-blind, randomised, stratified, controlled, parallel-group design in piglets. Computerised planimetry and histopathological methods were used for the assessment of wound healing. Histologically, no significant differences could be verified at any time between the 3 groups. However, in the early phase (day 9 after wounding), the octenidine-based product retarded wound contraction to a significantly greater extent than placebo and polyhexanide, whereas in the later phase (days 18 and 28), polyhexanide promoted contraction significantly more than did placebo and octenidine. The consequence is complete wound closure after 22.9 days using polyhexanide, in comparison to the placebo after 24.1 days (p < 0.05) and octenidine after 28.3 days (no statistical difference to placebo). This may be explained by the better tolerance of polyhexanide in vitro, which was demonstrated with dose and time dependence in cytotoxicity tests on human amnion cells.

Animals↗
PubMedDate not supplied

Effects of total parenteral nutrition on lipid metabolism in rats.

BACKGROUND: The pathophysiologic mechanisms behind the development of liver steatosis during total parenteral nutrition (TPN) and the possible relationship to alterations of lipoprotein lipase activities in different tissues are not fully known. It is also unknown whether continuous and discontinuous administration of TPN affect lipid metabolism differently. METHODS: TPN, including 8.4 g of triglycerides per kilogram per day, was given for 10 days to two groups of male Sprague-Dawley rats that received the infusions discontinuously and continuously, respectively. Freely fed rats were used as controls. RESULTS: TPN led to hyperlipidemia and accumulation of triglycerides in the liver. High-density lipoproteins were enriched in triglycerides, whereas high-density lipoprotein cholesterol and phospholipid levels were low. The activities of hepatic lipase were markedly decreased, and lipoprotein lipase activities in adipose tissue and in cardiac muscle were both up-regulated. The increased levels of cholesterol and phospholipids in the serum of TPN animals were more pronounced after discontinuous administration. CONCLUSIONS: TPN including lipids interferes with the normal regulation of lipid metabolism. Although the mechanisms remain obscure, the elevation of lipoprotein lipase activities seems functionally important to accommodate the increased input of triglycerides during TPN. Possibly, the observed alterations in lipase activities may be attributed to a state of hypothyroidism.

Animals↗
PubMedDate not supplied

Esophageal motility patterns in patients with and without coronary heart disease and healthy controls.

BACKGROUND/AIMS: The aim of the study was to evaluate esophageal motility patterns in patients with chest pain with and without coronary artery disease, in order to elucidate the question: Does "non-cardiac" chest pain really exist? METHODOLOGY: Patients with chest pain and normal coronary angiograms, patients with chest pain and coronarographically diagnosed coronary artery disease and controls were prospectively studied with long-term manometry. RESULTS: The pressure amplitudes were 38.3 (NCA)/39.82(CAD) and 30 (CG) mmHg (p<0.02, p<0.02) distally and 30/28.1 and 25.5 mmHg (p<0.02) proximally. The percentage of propulsive contractions were 51.5%/45% and 53.5% (p<0.05) and of simultaneous contractions were 18.5%/23% and 10% (p<0.0005, p<0.0001). CONCLUSIONS: Esophageal motility patterns of patients with chest pain and normal coronary angiograms and coronary artery disease differ significantly from controls. Both patient groups show a considerable overlap in motility disturbances. These data indicate that the term "non-cardiac" chest pain in fact does not sufficiently characterize patients' status.

Angina Pectoris↗
PubMedDate not supplied

[Foster care for adolescents with severe psychic disorders].

An introduction to the concept and practical implementation of a project entitled "Care in families for young people with mental disorders" is presented. In a project five adolescents were placed in fostering families. Continuous care is provided by a professional family care team and the treatment as out-patients at the Department of Child und Adolescent Psychiatry and Psychotherapy, in which they were previously treated, is continued.

Adolescent↗
PubMedDate not supplied

[Pregnancy in Addison disease and diabetes mellitus].

Pregnancies in patients with Addison's disease and Diabetes mellitus are rarely observed. A case of pregnancy in such patient is reported. The course of pregnancy and the fetal development show, that pregnancy can be finished without great problems, if there is therapeutical full compensation of metabolic derangement by hydrocortisone and insulin. There are less complications due to Addison's disease than to Diabetes mellitus. Thus the management of delivery should be the same as in isolated Diabetes mellitus.

Addison Disease↗
PubMedDate not supplied

Renal lesions in subacute encephalomyelopathy (Leigh's disease).

A case of subacute necrotizing encephalomyelopathy (SNE; Leigh's disease) in an infant aged 19 months is reported. In addition to the typical central nervous lesions, hyperlactatemia and hyperpyruvatemia and morphological changes in the kidney were documented and have been identified as a tubulo-interstitial disease with a focal sclerosing glomerulopathy.

Brain Diseases, Metabolic↗
PubMedDate not supplied

The effect of oral essential amino acids and their ketoanalogues on children receiving regular haemodialysis.

The plasma aminogram in uremic children receiving conservative treatment or undergoing hemodialysis demonstrated a similar profile to that first described in adults and children. We were able to demonstrate that dialysis did not correct the abnormal plasma amino acid pattern and that free amino acid losses in the dialysate during hemodialysis could not be compensated for by children receiving an adequate protein intake. Oral supplementation with essential amino acids (EAA) or ketoanalogues (KAA) only partially corrected the amino acid abnormalities and biochemical improvement in protein metabolism was not observed, however, increasing the relative proportions of branch chain amino acids in the supplement might be associated with improvement in metabolism. These data are in contrast to previous studies on the use of EAA or KAA in adults and children in which patients received a reduced protein intake, whereas in the present study protein intake was not restricted. The raised plasma levels of methionine and 3-methyl-histidine were not associated with side effects.

Administration, Oral↗
PubMedDate not supplied

Phenprocoumon therapy during pregnancy: case report and comparison of the teratogenic risk of different coumarin derivatives.

The case report is about an infant suffering from coumarin embryopathy and coumarin syndrome after its mother underwent phenprocoumon treatment (Marcumar, Falithrom) during pregnancy (until 26th week of gestation). Interestingly, a hearing disorder was diagnosed, which had never been described in context with this substance. The coumarin derivatives warfarin, acenocoumarol and phenoprocoumon were compared with regards to spontaneous abortion rate, perinatal mortality and teratogenic risk. Eye anomalies or malformations seem to appear only under warfarin treatment, whereas CNS-malformations are more frequent under phenprocoumon. As a consequence, phenprocoumon treatment of fertile women seems rather doubtful. Upon discovery of a pregnancy under coumarin treatment, vitamin K should immediately be substituted in order to minimize the risk of anomalies and malformation.

Abnormalities, Drug-Induced↗
PubMedDate not supplied

Noninvasive detection of increased glycine content by proton MR spectroscopy in the brains of two infants with nonketotic hyperglycinemia.

Using localized 1H-MR spectroscopy (1H-MRS) an inborn error of metabolism within human brain could be demonstrated, while 1H-MR imaging did not show any pathologic findings like demyelination. In two children suffering from nonketotic hyperglycinemia, the proton spectrum exhibited a large glycine signal at 3.55 ppm. In patient 1 (49-day-old girl), the pathologic signal of the inhibitory neurotransmitter glycine was of similar size in the parietooccipital white matter and in the basal ganglia region. In patient 2 (a 10-day-old girl), follow-up studies within the first 4 months of life revealed a time course of cerebral glycine content that differed from the course in plasma and cerebrospinal fluid. The continuing reduction of glycine in brain tissue corresponded more reliably with clinical findings than the stable values in plasma and cerebrospinal fluid. 1H-MRS allows the noninvasive demonstration of glycine in patients with nonketotic hyperglycinemia. This new technique may be useful to control the effect of a sodium benzoate therapy by monitoring the cerebral glycine concentration directly.

Amino Acid Metabolism, Inborn Errors↗
PubMedDate not supplied

Renal tubular dysgenesis: a report of two cases.

Renal tubular dysgenesis, a congenital disorder of renal tubular development, was diagnosed in two newborns with oligohydramnios and Potter phenotype. Renal tubular dysgenesis (RTD) is a recently recognized congenital disorder of renal tubular development associated with oligohydramnios, Potter phenotype, and neonatal respiratory and renal failure. We report two newborn siblings with typical clinical and anatomic features of RTD. The diagnosis was proven by autopsy in one child. The pediatrician should consider the diagnosis of RTD in a child with congenital anuria and structurally normal kidneys on ultrasound, especially if a maternal history of late trimester oligohydramnios is present.

Anuria↗