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Biomedical subjects

E Gladtke

Publications and source records attributed to E Gladtke.

At least 19 recordsLinked to original sources
PubMed1990

[Pregnancy outcome with intensified insulin therapy in manifest diabetes].

In 1981, the intensified insulin therapy for achievement of euglycaemia in pregnant diabetics was introduced at the University Department of Obstetrics and Gynaecology in Cologne. This study compares the results of 112 pregnancies in women with overt diabetes monitored before (1971-1980) or after (1981-1988) changing the therapeutic regimen. In the period from 1981 to 1988, the proportion of euglycaemic patients (preconceptionally 19%, before delivery 79%) was clearly higher than from 1971 to 1980 (n = 42; 7% and 9%, respectively). The tight blood glucose control resulted in a doubling of hypoglycaemic episodes during pregnancy. The proportion of preterm deliveries was reduced from 47% to 24%. The rate of caesarean sections was nearly constant (1971-1980: 38%, 1981-1988: 34%). The marked success of therapy was the decrease of perinatal mortality from 20.9% to 2.9%. The perinatal morbidity also diminished, as shown by the decreasing rates (30-90%) of foetopathy, macrosomy, respiratory distress syndrome, birth trauma, hypoglycaemia, hypocalcaemia and polycythaemia. The malformation rate, however, remained high (1971-1980 = 7%, 1981-1988 = 11%). The results demonstrate the necessity of a strict blood glucose control during pregnancy, beginning before the time of conception.

Adult↗
PubMed1989

Severe intra-uterine growth retardation: obstetrical management and follow up studies in children born between 1970 and 1985.

Peri- and postnatal data of 263 children with severe intra-uterine growth retardation (IUGR) born between 1970-75 (n = 145) and between 1976-85 (n = 118) are presented. The incidence of premature delivery in IUGR patients rose from 15% (1970-75) to 34% (1976-85). The rate of perinatal asphyxia in premature children with IUGR decreased from 64% during 1970-75 to 45% during 1976-85. Perinatal mortality in preterm SFD babies was higher in 1976-85 (20%) than in 1970-75 (14%), due to an 8-fold higher incidence of very low birth weight (less than or equal to 1000 g) SFD babies. Without this high-risk group perinatal mortality ranged between 2 and 3% in both groups. The incidence of deliveries by Cesarean section increased from 19 to 45% while vaginal deliveries decreased from 73 to 52% during 1976-85 compared with the 1970-75 age group. Follow up studies were carried out in 63 patients (1970-75) and in 41 patients (1976-85). Deficits of body height and weight persisted in one third of the patients, being severe in 10-20%. Infantile developmental milestones were retarded in 22-32%. Neurologic sequelae mostly of a mild degree were seen in 29% (1970-75) and 37% (1976-85). Psychologic testing showed abnormalities in 38% of the older age group, using the Göttinger Formreproduktionstest and in 21% of the younger age group, where the Denver Developmental Screening Test was performed. EEG investigations demonstrated unspecific abnormalities of a mild to moderate degree in one third of the patients.(ABSTRACT TRUNCATED AT 250 WORDS)

Body Height↗
PubMed1987

[Reye syndrome].

Clinical course, laboratory findings and histopathological features of Reye's syndrome as described. Etiological and pathogenetic aspects are still under discussion although a viral infection preceding Reye's syndrome is a very common finding. Preceding Influenza B, Influenza A and varicella infections were most often seen in the United States. A genetic disposition seems to exists in some cases. Exogenic factors of pathogenetic relevances are aflatoxin, emulging agents, insecticides, paracetamol, acetylsalicylic acid and valproate. In the United States and Great Britain the incidence of Reye's syndrome is about ten times higher than in other European countries, as demonstrated by reports from Spain, Denmark and France. Results of an inquiry in Western Germany on Reye's syndrome between 1983 and 1985 are presented. 99 major pediatric hospitals were included into the study. Clinical data were obtained from 85 hospitals. The incidence of Reye's syndrome in Western Germany during 1983-1985 was 0.04-0.05 cases per 100,000 children under 18 years. 15 cases of Reye's syndrome were reported, i.e. an average of 5 cases per year. 8 children died. 3 patients had been treated with acetylsalicylic acid and 2 patients with paracetamol shortly before the onset of the disease.

Child↗
PubMed1979

Superoxide dismutase and glutathione peroxidase in polymorphonuclear leucocytes.

Superoxide dismutase (SOD) and glutathione peroxidase (GPX) protect aerobic organisms against the toxic superoxide anion and hydrogen peroxide, which are generated during phagocytosis by polymorphonuclear leucocytes (PMNs). PMNs of children with bacterial infections and with infectious hepatitis contained significantly elevated SOD activity, whereas GPX activity remained in the normal range. In contrast, PMNs of children with viral infections and rheumatoid arthritis exhibited a decreased SOD activity, while GPX activity was again unchanged. The children's age, sex or treatment did not effect the enzyme activities in PMNs. Since SOD generates bactericidal hydrogen peroxide and regulates the release of the toxic superoxide radical into the surrounding tissues, this study may add new understanding to the pathophysiological aspects of acute and chronic inflammatory processes.

Age Factors↗
PubMed1979

[Pharmacokinetics and dosage regimen in children (author's transl)].

Dosage recommandations are mostly established empirically. With many drugs more accurate dosage is necessary and possible: antibiotics, cytostatic drugs, but also heart glycosides and anticonvulsives. Some pharmacokinetic standard values vary according to age. The distribution volume in infants is normally substantially greater than in older children. For infants the first or single dose has to be higher in relation to body weight to get the same concentration as for older children. In general, the elimination rate is slower in younger children. Therefore in long-time therapy the interval between doses has to be longer. After the 6th to 12th week the differences in elimination rates are negligible. The absorption from the rectum is neither reliable nor predictable. Suppositories are only allowed if it is possible to calculate the effect of a drug on the patient. Enteral absorption in infants is slower than in older children. Therefore maximum concentration will be reached later and will be not as high as in older children. The local concentration correlates well with plasma concentration. Drugs in bib or feeder have no effect.

Age Factors↗
PubMed1979

[Pharmacokinetics of Azlocillin in premature and newborn infants (author's transl)].

In 13 newborns and 12 prematures the pharmacokinetic parameters of 6-[(R)-2-(2-oxo-imidazolidine-1-carboxamido)-2-phenyl-acetamido]-penicillanic acid sodium salt (azlocillin, Securopen), were investigated after a single i.v. load of 50 mg/kg body weight. From the concentration-time curve an open two-compartment model could be postulated. The values of the microconstants indicate that there is a rapid diffusion from the peripheral compartment into the central one. The elimination half-life calculated from the beta-slope is 2.6-2.5 h. differences between newborns and prematures are lacking. To reach an average steady-state concentration C-infinity between 50 and 80 microgram/ml plasma, 100-200 mg azlocillin/kg body weight during 24h must be given. The accumulation rates for a dosage interval of 6 or 8 h are 0.6 and 0.45.

Azlocillin↗
PubMed1979

[Diabetes insipidus, diabetes mellitus, optic atrophy and labyrinthine deafness: the DIDMOAD-syndrome (author's transl)].

The DIDMOAD syndrome is a combination of diabetes mellitus, diabetes insipidus, optic atrophy and labyrinthine deafness. The inheritance is autosomalrecessive. Diagnostic and therapeutic possibilities are discussed on the basis of a further case of this pathogenetically not yet clarified disease pattern. Early detection of this syndrome in juvenile diabetics is important for long-term prognosis and genetic family advice.

Child↗
PubMed1978

[Intestinal tuberculosis and differential diagnosis against Crohn's disease in children (author's transl)].

The case of a 9-year-old girl treated elsewhere for anemia due to iron deficit is described. The first diagnosis of Crohn's disease made by us and for which the girl received treatment had to be revised, because an intestinal tuberculosis was later accepted to be the correct diagnosis. The authors emphasize the importance of safe diagnostic distinctions between Crohn's disease and intestinal tuberculosis. Diagnostic and therapeutic procedures are discussed.

Anemia, Hypochromic↗
PubMed1978

[Enteral absorption of sulfasomidine depending on age (author's transl)].

After intravenous and oral application of 25 mg 6-(sulfanilamido)-2,4-dimethyl-pyrimidine (sulfasomidin)/kg body-weight to 29 newborns, 8 infants and 9 older children the completeness and rate of absorption were determined. Sulfasomidine was completely absorbed in newborns (mean value 95.7%) as well as in older children (mean value 94.4%). Concerning the rate of absorption there were age-dependent differences. Using the Bateman function for the kinetic model of intestinal absorption the rate constant of invasion k1 was significantly lower in the first week of life compared to that in older children. In agreement with these data the time tmax of the maximum serum concentration was significantly prolonged in newborns compared to that of older children.

Administration, Oral↗
PubMed1978

[Rectal absorption of phenobarbital in children as affected by different vehicles].

68 infants received 7--15 mg phenobarbital and sodium-phenobarbital/kg body weight by suppositories of different melting-points and hydroxyl-values (Witepsol H 12, W 35, E 76). The kinetic analysis of the serum concentration curve shows that the rate of rectal absorption is significantly increased if sodium-phenobarbital instead of phenobarbital is applied. The absorption rate is faster using suppositories with a lower melting-point (32.5 degrees C) compared to suppositories with a higher one (37.5 degrees C). Increasing the amount of hydroxyl values in the vehicle the absorption rate of phenobarbital becomes faster. Comparing the area under the serum concentration curve after intravenous and rectal application in 8 infants the absorption ratio was 74%.

Chemical Phenomena↗