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Biomedical subjects

F Pohlandt

Publications and source records attributed to F Pohlandt.

At least 109 records · Page 6Linked to original sources
PubMed1987

Diagnostic audit of C-reactive protein in neonatal infection.

A prospective study of 250 consecutive neonatal admissions to a regional perinatal referral centre and of 10 additional consecutive cases with culture-proven neonatal septicaemia was undertaken. Quantitative C-reactive protein (CRP) determination, white cell count and differential were performed on blood samples obtained from all babies on admission, as well as 10-14 h and 22-26 h later. Using clinical signs, chest X-rays, blood cultures, tracheal aspirates obtained within 4 h of delivery and an abnormal immature/total neutrophil ratio (I/T), infected babies were defined as belonging to one of the following groups: culture-proven septicaemia (n = 19); clinical septicaemia (n = 35); congenital pneumonia (n = 28). The sensitivity, specificity, positive and negative predictive value of CRP were calculated for each sampling time and patient group. No baby had a rise in CRP (greater than 6 mg/l) before an abnormal I/T ratio was first detected. A delayed rise in CRP concentration in the majority of infected babies occurred approximately 12-24 h after the abnormal I/T ratio was first detected. The overall specificity of a CRP level of greater than or equal to 10 mg/l remained approximately constant (97%-94%) while sensitivity increased from 22%-61% with increasing time after admission. The same pattern emerged if each patient group was considered separately. The positive predictive value for a CRP level of greater than or equal to 10 mg/l 22-26 h after admission was 83% and the negative predictive value 82%. CRP had no value in the early diagnosis of neonatal infection. Its main role lies rather in the exclusion or confirmation of infection 24 h after the first clinical suspicion.

C-Reactive Protein↗
PubMed1986

Skeletal growth in fetal rats. Effects of glucose and amino acids.

The modified hyperglycemia-hyperinsulinism hypothesis, which characterizes intrauterine growth of diabetic pregnancy, was studied in fetal rats. From day 19 to day 21 postconception, pregnant rats were constantly infused with saline, amino acids, or glucose. In the fetus, serum somatomedin activity was determined, with the porcine bioassay and the incorporation of 3H-thymidine into rib cartilage and isolated chondrocytes in vivo in response to serum from normal maternal or fetal rats. In comparison with control fetuses, body weights were decreased in glucose-exposed fetuses (4.66 +/- 0.25 versus 3.75 +/- 0.99, N = 121; P less than 0.001), and increased (4.87 +/- 0.57, N = 105; P less than 0.05) in amino acid-exposed fetuses. Serum somatomedin activity (U/ml) was higher in glucose-treated (0.79 +/- 0.40, N = 11; P less than 0.05) and amino acid-treated animals (0.90 +/- 0.16, N = 10; P less than 0.001) than in controls (0.55 +/- 0.04, N = 13). In vivo labeling with thymidine resulted in a higher radioactivity of cartilage in small fetuses compared with large fetuses when the dams had been infused with saline (r = -0.531, N = 56; P less than 0.001) or amino acids (r = -0.292, N = 52; P less than 0.01). Opposite results were obtained in hyperglycemic animals (r = 0.542, N = 54; P less than 0.001). When isolated chondrocytes were incubated with serum from normal fetal rats, the incorporation of thymidine was about 10 times higher into cells from small fetuses than from large fetuses, irrespective of the infusion regimen.(ABSTRACT TRUNCATED AT 250 WORDS)

Amino Acids↗
PubMed1986

[Exchange transfusion via a peripheral arteriovenous vascular access in premature infants].

Exchange transfusions were performed in two very low birth weight infants using peripheral arteries and veins. Patient 1, a 1020 g infant of 34 weeks gestation developed cholestatic jaundice with plasmatic coagulation disturbance and hyperkalemia, patient 2 a 820 g preterm baby of 26 weeks gestation manifested hyperbilirubinemia. After cannulation of the radial artery blood was withdrawn from the arterial catheter, while simultaneously equal volumes of warmed donor blood were replaced by a second operator through a venous catheter. Subependymal hemorrhage which was demonstrated by ultrasound in both patients prior to the exchange transfusion did not enlarge.

Arteries↗
PubMed1984

Immunoreactive parathyroid hormone, calcium, and magnesium in human cerebrospinal fluid.

Parathyroid hormone (PTH) was measured radioimmunologically in simultaneous plasma and cerebrospinal fluid (CSF) samples obtained from 72 patients aged 20 to 80 years without endocrine or psychiatric diseases and from 2 patients aged 40 and 70 years with secondary hyperparathyroidism due to renal insufficiency. They underwent routine diagnostic lumbar puncture because of suspected prolapse of a disc. Total calcium (Ca) and magnesium (Mg) were also determined in these samples by complexometry . The following findings were obtained (ng/ml, median, range in brackets): Plasma PTH 1.7 (0.7-6.6); CSF PTH 0.8 (0.5-2.3), respectively. No correlation was found between PTH concentrations in plasma and CSF in all 74 samples. The Ca concentrations in plasma, with a median of 2.3 mmol/l (2.1-2.6) were significantly higher than the Ca concentrations in CSF (median 1.1 mmol/l, range 0.4-1.3). The correlation between PTH and calcium levels in CSF was only weak (r = 0.284 P less than 0.05). The Mg levels in CSF (median 1.1 mmol/l, range 0.7-1.6) were higher than Mg concentrations in plasma (median 0.9 mmol/l, range 0.6-1.1). No correlation was found between PTH and Mg in CSF. Our study demonstrated that in man PTH is a normal constituent of CSF.

Adult↗
PubMed1981

[Haemolysis as initial sign of Clostridium perfringens septicaemia in newborn (author's transl)].

Cases of Clostridium perfringens, septicaemia are subject to a very gloomy prognosis in adults. This applies likewise to the rare cases reported in paediatric literature. The present report describes the fatal case of a newborn with Clostridium perfringens septicaemia. The principal sign was a severe haemolysis which failed to respond to blood exchange transfusions and antibiotic treatment. The characteristic changes of colour of the skin usually observed in septicaemia of newborn had probably been masked for some time by the reddish discolouration caused by the haemolysis, so that diagnosis was established at a late stage only.

Anemia, Hemolytic↗
PubMed1981

Tubular proteinuria after perinatal hypoxia.

Urinary total protein (UTP) and urinary protein pattern have been studied in 23 newborn infants with Apgar scores less than or equal to 3 at one minute or acidosis (pH less than or equal to 7.15) on the first day. On the first and second day UTP excretion was increased in 13 out of 18 patients. At this time the excretion of low molecular weight microproteins (T-4 and T-5) was elevated in 12 patients without increased plasma urea concentration in any case. The increased excretion of the smallest microproteins T-4/T-5 is an early sign of an impaired tubular function.

Acidosis↗
PubMed1979

[Influence of dental caries prophylaxis using fluor-vigantoletten 1000 on plasma fluoride levels in infants (author's transl)].

A group of 57 newborns was divided into two: group I (27 subjects) received solely 1,000 I.U. vitamin D3 per day for 6 months, whereas group II (30 subjects) were given a combination of 1,000 I.U. vitamin D3 and 0.25 mg fluoride. At the end of the time of observation there was a significant difference between the plasma concentrations in the two groups. The median value was 13.06 microgram/l (range: 8:18-39.4 microgram/l) in group I and 16.54 microgram/l (range: 9.9--41.2 microgram/l) in group II. Fluoride is obviously available to infants when administered in combination with Vitamin D3. In addition, it could be proven, that after 6 month administration of fluoride there are no signs of cumulation, overdosage or even intoxication.

Cholecalciferol↗
PubMed1978

Plasma amino acid concentrations in newborn infants breast-fed ad libitum.

Plasma amino acid concentrations were measured in peripheral venous blood of 40 newborn infants breast-fed ad libitum. When these data are compared with amino acid concentrations of umbilical cord artery plasma, only lysine and threonine show a striking decrease after birth: the concentrations of hydroxyproline, asparagine, glutamine, proline, cystine, leucine, tyrosine, and ornithine significantly increase during the first days of life. The high-protein concentration of colostrum and transitional milk may explain this observation.

Amino Acids↗
PubMed1978

Plasma amino acid concentrations in umbilical cord vein and artery of newborn infants after elective cesarean section or spontaneous delivery.

Twenty-four infants delivered by elective cesarean section and 23 spontaneously born infants were studied for plasma amino acid concentrations of the umbilical cord vein and artery. Normal labor was not found to influence plasma amino acid concentrations. In both spontaneously and operatively born infants, similar venous-arterial gradients were found for all essential and five nonessential amino acids. Based on the differences of venous and arterial concentrations and the umbilical cord blood flow, the daily fetal retention of single amino acids was calculated.

Amino Acids, Essential↗
PubMed1978

[Precision and accuracy of 21 methods in clinical chemistry using diluted samples (author's transl)].

The precision and accuracy of 21 methods in clinical chemistry (sodium, potassium, calcium, chloride, phosphorus, iron, copper, bilirubin, uric acid, urea, creatinine, total serum protein, triglycerides, glutamate-oxalacetate-transaminase, glutamate-pyruvate-transaminase, alpha-hydroxybutyrate-dehydrogenase, alkaline phosphatase, lactate dehydrogenase, gamma-glutamyl-transpeptidase, acid phosphatase, amylase) were studied after diluting samples 1 : 2 and 1 : 4. Dilution of 1 : 2 did not show any significant effect on the precision and accuracy of the studied methods. In case of chloride, phosphorus, iron, bilirubin, uric acid, urea, creatinine, total serum protein, triglycerides, glutamate-oxalacetate-transaminase and alkaline phosphatase reliable results were obtained also after 1 : 4 dilution.

Bilirubin↗
PubMed1978

[Aspiration of meconium stained amniotic fluid (author's transl)].

Respiratory distress following aspiration of meconium stained amniotic fluid can be found in about 3% of newborn infants. The lethality rate of this disease is high. Pathophysiology and variability of the clinical course as well as radiological findings and further diagnostic procedures are being described. The therapeutic concept requires recognition of meconium stained amniotic fluid as early as possible, early suctioning of the nasopharynx, intubation and endotracheal suction. Further therapy consists in physical procedures, i. e. lavage, suctioning, positioning, vibration and percussing of the chest, and inhalation. Antibiotics can only be recommended if infection of the amniotic fluid has been proven.

Amniotic Fluid↗
PubMed1978

[Progress in diagnosis and treatment of pregnancies with low birthweight infants (author's transl)].

In order to prove the progress in diagnosis and treatment of pregnancies with low birthweight we performed a retrospective computer-analysis of three groups of patients including newborns below 2750 g delivered dumping the last 10 years. The first group contains the years 1967/68; the deliveries of low birthweight infants were monitored without cardiotocogram. The second group of patients from the years 1971/72 was monitored continuously during delivery by cardiotocogram. The endocrinologic diagnostic methods for detection of a possible placental insufficiency in low weight fetus were applied regularly (DHEA-S-loading test, oestriol, HPL). The treatment of premature newborns with respiratory distress syndrome was facilitated by CPAP. A thorough ultrasound diagnosis was available additionally for the third group of patients. Long term treatment with Partusisten was applied in cases of premature labour in this group and betamethasone-therapy was used for accelleration of fetal lung maturation. With a nearly constant number of preterm eutrophic newborns, preterm infants with retarded growth and mature infants with retarded growth over a period of ten years the unpurified mortality rate decreased from 14.3% to 6.7% when the pregnancies and deliveries had intensive (obstetrical medical) care. With the help of Shirodkar procedure and tocolytic treatment the birthweight could be shifted significantly into the favourable group over 2000 g. The prenatal prophylactical treatment of the respiratory distress syndrome with beta-methasone and the postnatal CPAP-therapy decrease the mortality rate caused by respiratory deficiency from 13.7% to 6.4%. The preventive caesarean section in cases of low birthweight infants with abnormal positions in utero helped to reduce the mortality rate from 21% to 10.6% in these cases. The accuracy of prenatal diagnosis of intrauterine retarded fetal growth by hormone analysis and ultrasonic measurement of the fetus was improved from 24% to 66%.

Female↗
PubMed1977

Treatment of septicaemia in the newborn infant: choice of initial antimicrobial drugs and the role of exchange transfusion.

The therapeutic success of antibiotics used at the beginning of treatment and the effect of exchange transfusion in cases of septicaemia were tested in 22 newborn infants. The clinical course of these patients was compared with the outcome of 11 newborn infants who received antibiotic treatment without exchange transfusion. The following results were obtained: 1) All 6 patients initially receiving antibiotics, which were ineffective in vitro, died. In this group of patients the incidence of septic organ involvements (meningitis, ventriculitis, peritonitis) was significantly increased. 2) Following exchange transfusion, an impressive clinical improvement was consistently observed. 3) In patients who had initially received effective antibiotics and exchange transfusion, the lethality was significantly lower than in patients without exchange transfusion. 4) Our bacteriological findings show that continuous monitoring of cultures from blood, CSF and stool is necessary to choose the most effective antibiotic in the prevailing nosocomical circumstances.

Anti-Bacterial Agents↗