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Biomedical subjects

G Zobel

Publications and source records attributed to G Zobel.

105 records · Page 6Linked to original sources
PubMed1986

[Glucose tolerance in intensive care premature infants with a birth weight below 1,500 g in the first 5 days].

UNLABELLED: Plasma insulin and blood glucose values were studied in 11 stressed premature infants with birth weight below 1 500 g during the first five days after birth under increasing fluid and glucose infusion rates. The group 11 small premature neonates was subdivided; group A consisted of 6 stressed premature infants with respiratory distress syndrome (RDS stage III-IV) and/or intraventricular haemorrhage (IVH stage III-IV), and group B of 5 slightly stressed premature infants with RDS (stage I-II and/or IVH (stage I-II). During the first two days there was no difference in caloric and fluid intake in both groups. From the third day on caloric intake was much higher in group B than in group A (day 5: group A: 61.33 +/- 13.01 kcal/kg BW; group B: 78.2 +/- 18.49 kcal/kg BW). Plasma insulin values increased in both groups during the first five days after birth (group A: day 1: mean plasma insulin values 8.18 +/- 7.59 microU/ml; day 4: 27.22 +/- 32.85 microU/ml; group B: day 1: mean plasma insulin values 4.34 +/- 2.62; day 4: 11.18 +/- 8.38). Blood glucose and plasma insulin values were significantly higher in group A than in group B. CONCLUSION: Impaired glucose utilisation in severely stressed premature infants with parenteral nutrition might be due to stress induced peripheral insulin resistance.

Birth Weight↗
PubMed1983

[Changes in thyroxine conversion (low T3 syndrome) in children at the time of their first manifestation of type I diabetes].

Measurements of T4, T3, rT3, and TSH were done in 27 children with newly diagnosed type I diabetes mellitus prior to institution of treatment. Serum T4 concentrations were low in 18%, serum T3 concentrations were low in 37%. Serum rT3 concentrations were elevated in 59%; the ratio rT3/T3 was elevated in 78%. The ratio rT3/T3 was significantly higher in the group of patients with the low pH, the low bicarbonate levels, the high blood glucose, and the high serum osmolality values than in the group of patients with the high pH, the high bicarbonate levels, the low blood glucose, and the low serum osmolality values.

Adolescent↗
PubMed1976

[Studies on the activity, properties and isoenzymes of acid phosphatase in the erythrocytes of swine, horse, dog, cat, duck and chicken].

Acid phosphatase of erythrocytes of several species was investigated, with three isozymes having been recorded from swine (three types), three (two types) from horse, four (one type) from dog, two (two types) from cat, two (three types) from duck, and two (one type) from fowl. The Michaelis constant of the enzyme varied between 3.5 and 5 X 10(-4) M for the species involved. The species, however, differed slightly for the optimum pH of the enzyme. The average enzymatic activities were (5.68 +/- 0.42 for dog, 4.46 +/- 1.0 for horse, 3.8 +/- 0.24 for swine, 3.72 for cat, 2.5 +/- 0.62 for duck, and 1.9 +/- 0.8 for fowl. All values are units per gram haemoglobin. Even relatively low concentrations (0.2 or 1 mM) of copper, mercury, and cadmium ions were found to be strong inhibitors of the acid erythrocyte phosphatase.

Acid Phosphatase↗
PubMedDate not supplied

Catheter-directed thrombolysis with recombinant tissue plasminogen activator for acute pulmonary embolism after fontan operation.

We report the case of a 3-year-old girl who presented with near-lethal pulmonary thrombembolism 3 weeks after an uneventful Fontan operation. Complete occlusion of the left lower lobe pulmonary artery had occurred together with a cerebral infarction. Recombinant tissue plasminogen activator (rt-Pa) was used for thrombolysis because of its short half-life and its clot-selective properties. To further minimize the systemic effects of rt-PA, local catheter-directed lysis was performed. A prolonged course of low-dose rt-PA therapy achieved complete lysis without side effects.

Catheterization↗
PubMedDate not supplied

[Which therapy is necessary for prenatally diagnosed multicystic kidney dysplasia?].

Multicystic dysplastic kidneys (MCD) were found in 17 of 114 neonates with prenatal diagnosis of urinary tract malformations. Distribution of side and of sex was not different. Contralateral malformations were present in 3 infants. One of them with contralateral renal dysplasia and cardiac malformation died at the age of 4 weeks. All other children so far have a normal renal function. Three neonates presented with a palpable abdominal mass, 2 infants had urinary infections during the first year of life. Two neonates had obstruction of the contralateral kidney caused by the giant MCD which relieved after nephrectomy. Hypertension or development of malignancy were not noted. Nephrectomy was performed in 10 infants at the mean age of 3.2 months. Six infants had conservative treatment and a complete regression was noted in 5 of them within a period of 8 to 18 months. Prenatal diagnosis of MCD enables early recognition of contralateral urinary malformations and of problems caused by the MCD itself. Conservative treatment is recommended in all asymptomatic patients. Studies of the natural history may show that regression of MCD is the rule and could account for many cases with apparent unilateral renal agenesis.

Female↗
PubMedDate not supplied

[Coronary aneurysm in Kawasaki syndrome: incidence and prognosis].

Out of 10 pediatric patients with coronary aneurysms after Kawasaki-syndrome 9 were reinvestigated 1 to 9 years after their initial illness. Out of 21 aneurysms of all types and sizes 2 showed early and 1 late, silent thrombosis leading to myocardial infarction. 8 aneurysms regressed spontaneously and another 8 became smaller. The tendency to regress or to decrease in diameter war greatest in the group of patients with a low Asai-Score and initially small aneurysms. Myocardial infarction was only seen in the group of giant aneurysms (over 8 mm of diameter). A simple prophylaxis with anti-platelet agents does not seem to be adequate especially in over-sized aneurysms. Those should be prevented now by gamma-globulin therapy. If they occur, however, thrombosis should be prevented by the use of anticoagulants.

Angiocardiography↗
PubMedDate not supplied

[Use of continuous arteriovenous hemofiltration in diuretic-resistant hypervolemia and electrolyte disorders].

CAVH was carried out in 10 olig/anuric children with diuretic resistant hypervolemia. In addition, three children had hypercalcemia and one child hypernatremia. All but one needed artificial ventilation for pulmonary edema and positive inotropic cardiac support. Mean duration of CAVH for correction of fluid- and electrolyte imbalance was 51.5 hours (range 20-144 hours). The mean fluid removal of 1715 +/- 1479 (SD) ml decreased mean body weight from 21.4 +/- 18.9 (SD) kg to 19.2 +/- 17.0 (SD) kg. The electrolyte disorders were corrected within 18-24 hours. After correction of fluid overload and electrolyte imbalance 7 children could be extubated and cardiac support could be stopped. Two children died because of multiple organ system failure. CAVH was well tolerated by all children, no hemofiltration related complications occurred. CAVH is an effective and safe extracorporal renal replacement therapy system to correct fluid- and electrolyte imbalances in critically ill children. It can be installed easily and quickly, can be performed in every pediatric intensive care unit and is well tolerated even by small children.

Anuria↗
PubMedDate not supplied

[Control of breathing in the central alveolar hypoventilation syndrome with and without a phrenic pacemaker].

Primary central alveolar hypoventilation (CAHV) is a rare disorder described in newborns, children, and adults. We report a 2 9/12 year old child with CAHV of unknown etiology. The evaluation of her ventilatory control system showed abnormalities awake and in the different sleep states. Hypoventilation was found to be more severe during non-REM sleep than during REM sleep and awake state. She had central apnea, an irregular respiratory rhythm in the non-REM sleep too, and diminished ventilatory response to inhaled 5%-6% CO2 in both REM and non-REM sleep. Her ventilation decreased when she was breathing 50% and 100% oxygen. During breathing 15% oxygen she did not arouse in spite a transcutaneous pO2 of 10 mmHg. She was first treated with mechanical ventilation during sleep and has now received bilateral simultaneous phrenic pacemaker support during quiet sleep for about one year. With the phrenic pacemaker she has normal minute volume and transcutaneous blood gases during sleep. During a respiratory infection she needed again mechanical ventilation via her tracheostoma 24 hours a day for one week. This case of a CAHV demonstrates a dysfunction of the central and partially also of the peripheral chemoreceptors. The abnormalities of the ventilation were demonstrable not only in the non-REM sleep but also in the REM sleep and awake state.

Child, Preschool↗
PubMedDate not supplied

[Acute erythromelalgia with hypertension in a 5-year old boy].

BACKGROUND: Burning pain of red and warm hands and/or feet are the classical symptoms of erythromelalgia. CASE REPORT: We describe the symptoms of acute idiopathic erythromelalgia and arterial hypertension in a five-year-old boy. Five days after a gastroenteritis the patient developed burning hands and feet in combination with arterial hypertension. Typically continuous cooling of all affected limbs was necessary to relieve the pain. Drug therapy with sodium nitroprusside only relieved the pain and dropped the blood pressure temporarily. Five weeks after onset of the disease all symptoms disappeared and the patient is still free of complaints (follow up period: 2 years). In the view of the presented case we discuss the differential diagnoses as well as therapeutical options.

Acute Disease↗
PubMedDate not supplied

[Successful treatment of therapy refractory shock lung in a newborn infant with congenital varicella using extracorporeal membrane oxygenation].

A newborn with congenital varicella complicated by varicella pneumonia was transferred to our hospital on day 16 of life for the consideration of extracorporeal membrane oxygenation (ECMO). The newborn received varicella zoster immunoglobulin 13 hours after birth since the mother developed a varicella exanthema two days before delivery. On day 10 of life the newborn became clinically symptomatic with red macules and pustules. The chest roentgenogram revealed reticular pulmonary infiltrates in the right upper lobe. Antibacterial chemotherapy was initiated. In the following days the cutaneous lesions progressed, and respiratory symptoms like tachypnoea and oxygen dependence occurred. Chest roentgenograms revealed diffuse reticular and patchy pulmonary infiltrates. On day 14 of life antiviral chemotherapy with acyclovir was started. ECMO was initiated in the veno-arterial mode on day 17 due to severe respiratory failure despite maximal conventional assisted ventilation and carried out for 14 days. With the age of 10 weeks he was discharged from the hospital with mild chronic lung disease without oxygen requirements and without neurological handicap. ECMO might be considered as life saving support in newborns with severe congenital varicella, considered to have a high mortality risk.

Acyclovir↗
PubMedDate not supplied

Continuous arteriovenous hemofiltration as emergency procedure in severe hyperkalemia.

Severe hyperkalemia due to acute renal failure occurred in a preterm infant of a diabetic mother. Despite infusions of calcium gluconate, sodium bicarbonate, glucose, and insulin, the rapidly increasing serum potassium concentration resulted in ventricular flutter. After cardiac resuscitation, continuous arteriovenous hemofiltration was started for potassium elimination. Within 3 h of extracorporeal renal replacement therapy, serum potassium was lowered from 9.4 to below 7 mEq/l. Because of persisting oliguria continuous arteriovenous hemofiltration was continued for 60 h. The infant was discharged from the hospital at the age of 4 weeks with normal physical and neurological findings.

Acute Kidney Injury↗
PubMedDate not supplied

Continuous arteriovenous hemofiltration in infants.

Renal replacement therapy is sometimes necessary in small infants with acute renal failure or severe metabolic disorders. Of the available methods hemodialysis and peritoneal dialysis are not always feasible in small infants. We used continuous arteriovenous hemofiltration as renal replacement therapy in five small infants. This report describes the technique and efficiency of this new extracorporal treatment modality. Azotemia and hypervolemia can be controlled easily by spontaneous or suction supported arteriovenous hemofiltration. Furthermore it allows adequate parenteral nutrition in anuric infants and eliminates toxic products in amino acid disorders. Arteriovenous hemofiltration is well tolerated by small infants and can be performed in every pediatric intensive care unit.

Acute Kidney Injury↗
PubMedDate not supplied

Arteriovenous hemodiafiltration in children.

Continuous arteriovenous hemofiltration is a safe and effective renal replacement therapy system for critically ill patients. In hypercatabolic states urea elimination is too low resulting in high serum urea levels. The aim of this report is to describe the technique of arteriovenous hemodiafiltration and its efficiency on urea elimination. Using two different hemofilters urea clearances achieved by means of arteriovenous hemodiafiltration approximately doubled when compared with spontaneous arteriovenous hemofiltration (urea clearance: 1.25 +/- 0.24 ml/min.-CAVH versus 2.6 +/- 0.59 ml/min.-CAVHDF-0.1sqm hemofilter and 11.77 +/- 1.82 ml/min.-CAVH versus 21.63 +/- 2.63 ml/min.-CAVHDF-0.6sqm hemofilter). Arteriovenous hemodiafiltration is a safe and simple extracorporal technique well tolerated by children. It's a useful adjunct to spontaneous arteriovenous hemofiltration to control azotemia in critically ill hypercatabolic patients.

Acute Kidney Injury↗
PubMedDate not supplied

Acute renal failure due to atraumatic rhabdomyolysis in coma diabeticum.

A case report of a twelve year old boy with coma diabeticum and atraumatic rhabdomyolysis is presented. At admission the patient was comatose. Hyperglycemia and hyperosmolarity were the main metabolic disorders. 32 hours after admission marked myoglobinuria due to atraumatic rhabdomyolysis led to acute renal failure. At first uremia was compensated by arteriovenous hemofiltration and later by conventional hemodialysis. During the sixth week after admission urinary output started and serum creatinine and urea levels gradually declined to normal. Special attention should be paid to atraumatic rhabdomyolysis in patients with coma diabeticum. Continuous arteriovenous hemofiltration is an effective extracorporal therapeutic technique to compensate uremia in critically ill patients.

Acute Kidney Injury↗