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Biomedical subjects

H C Mansmann

Publications and source records attributed to H C Mansmann.

At least 19 recordsLinked to original sources
PubMed1999

The possible role of magnesium in protection of premature infants from neurological syndromes and visual impairments and a review of survival of magnesium-exposed premature infants.

The survival rate of very preterm, low birth weight infants (weighing less than 1500 g) is 85 per cent in the USA and is ever increasing, while 42 to 75 per cent of extremely premature infants (weighing 751-1000 g) survive. Of great concern is the lack of consistent decrease in neurological syndromes and associated visual impairments. Because of short gestations, these infants have not had time to accrue up to 80 per cent of magnesium normally present at term. These very preterm infants are at highest risk for cerebral hypoxia/ischemia (H/I), intracranial hemorrhage (ICH), periventricular leukomalacia (PVL) or cystic PVL (CPVL), and possible sequelae, cerebral palsy (CP) and mental retardation (MR). These syndromes are associated with damage to optic structures and the visual pathways which traverse the brain. Visual defects are common in surviving preterm infants. Increased levels of harmful neurochemical mediators that have been reported in these conditions include oxygen free radicals, excitatory amino acids, tumor necrosis factor-alpha (TNF-a), and thromboxane A2 (TXA2) which are aggravated in magnesium deficiency and may be ameliorated by magnesium. We review the published data concerning the effects of prenatal magnesium supplementation on ICH, CPVL, CP and MR and available reports concerning survival. Further considerations on the safety and efficacy of magnesium sulphate administration given prenatally to the preterm neonate await the outcome of three trials that are continuing for more than a year on three continents.

Humans↗
PubMed1997

Treatment of severe respiratory failure during status asthmaticus in children and adolescents using high flow oxygen and sodium bicarbonate.

OBJECTIVE: Status asthmaticus with respiratory failure is a potentially fatal complication of bronchial asthma. To prevent a fatality in status asthmaticus with respiratory failure, treatment with intravenous isoproterenol or mechanical ventilation has been advocated. These interventions also have serious potential complications, however, and while continuous inhalation of beta agonists has shown promise, the optimal therapy of severe status asthmaticus remains unclear. This paper describes our experience with a treatment protocol used in status asthmaticus with respiratory failure that seeks to avoid intravenous isoproterenol or assisted ventilation. STUDY DESIGN: Case series of pediatric intensive care patients with severe respiratory failure due to status asthmaticus. Six children and adolescents experienced a total of nine episodes of severe respiratory failure due to status asthmaticus. RESULTS: In seven of the nine episodes the patients were managed without either intravenous isoproterenol or mechanical ventilation. Hypercarbia persisted for an average of 25 hours (range 17 to 40 hours) in these seven episodes. All subjects recovered without notable sequelae. In two episodes, clinical and blood gas deterioration led to mechanical ventilation. Ventilation was required for 112 and 42 hours, respectively, in these episodes and the patients developed either pneumothorax or pneumomediastinum during ventilation. CONCLUSION: Using a protocol initiated in 1978 for correction of hypoxia and acidemia, many patients with severe respiratory failure from status asthmaticus can be treated without isoproterenol or mechanical ventilation. Since those treatments have significant risks, consideration should be given to this intervention before resorting to them.

Acidosis, Respiratory↗
PubMed1992

Efficacy and safety of cetirizine therapy in perennial allergic rhinitis.

A double-blind, placebo-controlled trial was undertaken to assess the safety and efficacy of once daily cetirizine in alleviating the symptoms of perennial allergic rhinitis. Subjects were adults with perennial allergic rhinitis, characterized by nasal congestion, postnasal discharge, sneezing, rhinorrhea, nasal itching, lacrimation, ocular itching, and itching of the roof of the mouth, and a total pretreatment symptom severity score of greater than or equal to 8. Patients were randomized to treatment with 10 mg cetirizine, 20 mg cetirizine, or placebo for 4 weeks. Efficacy was assessed in 215 patients and safety in 216. Cetirizine in once daily dosages of 10 or 20 mg proved to be effective in relieving the overall symptoms of perennial allergic rhinitis and particularly postnasal discharge and sneezing. The 10-mg dose afforded optimal symptomatic relief, and the 20-mg dose provided little or no additional benefit. Cetirizine was well tolerated, and the frequency of somnolence was not significantly greater in patients receiving this drug than in those given placebo.

Adult↗
PubMed1991

Pentigetide nasal solution: a multicenter study evaluating efficacy and safety in patients with seasonal allergic rhinitis.

The safety and efficacy of pentigetide (Pentyde) nasal solution, administered as 1 mg into each nostril four times daily, was compared with placebo for controlling symptoms associated with seasonal allergic rhinitis. This was a randomized, multicenter, double-blind, parallel-group trial involving 431 patients divided equally between pentigetide and placebo treatment. The study was conducted during the 1986 spring allergy season and consisted of 1 week of baseline followed by 2 weeks of treatment. Physicians evaluated the frequency and severity of nasal symptoms at study entry (day 1) and the final visit (day 22). Physicians and patients assessed the global condition of the patient at the end of the study and patients also recorded the severity of symptoms in a daily diary. Pentigetide-treated patients showed a statistically significant greater reduction in the frequency (P = .004) and severity (P = .05) of total nasal symptom score (sneezing, nasal congestion, and rhinorrhea) and in the individual nasal symptom scores compared with placebo-treated patients. Diary results showed consistently lower total nasal symptom scores on each treatment day for pentigetide-treated patients (P = .02). Both the physicians and patients globally rated more pentigetide-treated patients improved than placebo-treated patients. The incidence and types of adverse experiences were similar between treatment groups and there were no reports of sedation or fatigue in the pentigetide group. No clinically significant changes occurred for laboratory tests, physical examination parameters or vital sign measurements. Pentigetide nasal solution was safe and effective for the treatment of seasonal allergic rhinitis.

Administration, Intranasal↗
PubMed1987

Microassay for the simultaneous determination of theophylline and dyphylline in serum by high-performance liquid chromatography.

An improved and simplified high-performance liquid chromatographic method is presented for the simultaneous determination of theophylline and dyphylline in serum. The internal standard, beta-hydroxyethyltheophylline (20 microliters of a 100 micrograms/ml solution) is added to 50 microliters of serum. Serum proteins are precipitated by the addition of 30 microliters of 40% trichloroacetic acid solution. The mobile phase consists of a sodium acetate buffer with 6% acetonitrile. Chromatogram run time is 6 min. The sensitivity limit for both compounds is 0.25 micrograms/ml. This method is interference-free from the major metabolites of theophylline and other drugs commonly coadministered with theophylline.

Chromatography, High Pressure Liquid↗
PubMed1987

A new simplified assay for the quantitation of theophylline and its major metabolites in urine by high-performance liquid chromatography.

A high-performance liquid chromatographic technique is presented for the simultaneous determination of theophylline, 3-methylxanthine, 1-methyluric acid, 1,3-dimethyluric acid, and caffeine in urine using beta-hydroxyethyl theophylline (BHET) as an internal standard. Following centrifugation of the sample, 2 mL of urine was placed onto a Sep-Pak C18 cartridge (Waters Associates, Milford, MA, USA) that was prepared with 5 mL of methanol followed by 10 mL of distilled water. The compounds were eluted with 2.5 mL of a methanol:water (50:50) mixture. An aliquot of the filtered urine sample (100 microL) was added to 40 microL of an internal standard solution (BHET; 100 micrograms/mL). Distilled water (60 microL) was added to yield a volume of 200 microL. The mixture was vortexed and centrifuged, and 100 microL was injected onto a C8 column maintained at 55 degrees C. Inter- and intraday variability of the assay for all compounds was less than 5.7%. Sensitivity ranged from 0.10 microgram/mL for caffeine to 0.68 microgram/mL for 1-methyluric acid. Drugs commonly coadministered with theophylline did not interfere with the assay.

Asthma↗
PubMed1987

Long-term IgG4 determinations in hymenoptera-sensitive treated patients.

Honey bee and vespid venom immunotherapy have been practiced for the past 10 years. Several studies have evaluated the short-term effects of this therapy. The current study evaluated the long-term effects using venom-specific IgG4 determinations. Forty-six patients ranging in age from 3 to 67 years were followed for periods up to 6 1/2 years. All patients included in the study demonstrated Hymenoptera sensitivity on intradermal testing using 0.2 mL of venom extract at concentrations of 0.01 microgram/mL, 0.1 microgram/mL, or 1 microgram/mL. IgE-specific venom antibody levels were tested and found to be elevated. During the first year following institution of venom immunotherapy, 46/46 patients demonstrated an increase in venom-specific IgG4. After the first year of treatment, values reached a plateau. The IgG4 venom-specific antibodies remained relatively constant over the second and third years of the study. Thirty of the 46 patients were followed for more than 3 years. All of the 30, treated greater than 3 years with continuous immunotherapy, demonstrated a gradual decline in IgG4 levels. Despite very low or negligible levels of venom-specific IgG4 antibodies, six patients accidentally stung were still clinically protected. This study suggests that long-term immunity is not mediated in the same manner as that of short-term protection.

Adolescent↗
PubMed1986

New simplified microassay for the quantitation of theophylline and its major metabolites in serum by high-performance liquid chromatography.

A high-performance liquid chromatographic technique is presented for simultaneous determination of theophylline, 3-methylxanthine, 1-methyluric acid, 1,3-dimethyluric acid and caffeine in serum using beta-hydroxyethyltheophylline (BHET) as an internal standard. An aliquot of a serum sample (100 microliters) was added to 40 microliters of an internal standard solution (BHET; 100 micrograms/ml) and vortexed. A 20% trichloroacetic acid solution (60 microliters) was then added; the mixture was vortexed, centrifuged and 100 microliters were injected onto a C8 column maintained at 45 degrees C. Inter- and intra-day variability of the assay for all compounds was less than 4.3%. Sensitivity ranged from 10 ng/ml for 1-methyluric acid to 25 ng/ml for theophylline. Drugs commonly coadministered with theophylline did not interfere with the assay.

Chromatography, High Pressure Liquid↗
PubMed1985

Recertification in allergy and immunology: an historical review with special emphasis on the 1983 examination.

Recertification offers a method of evaluating a diplomate's cognitive knowledge of allergy and immunology. In 1983 candidates for the American Board of Allergy and Immunology recertification examination were offered the entire certifying examination but were informed that they would, for recertification purposes, be held responsible only for a subset of questions judged to be particularly clinically relevant. All 40 candidates elected to take the entire certifying examination. Differences between the performance of certifying and recertifying candidates on the recertifying questions were small. Except for the five-choice questions, the differences in performance between the two groups on the remaining questions were also small in an absolute sense. Recertification performance was not related to the time of original certification. Ninety-eight percent of the candidates completed a questionnaire after the examination. Ninety percent stated that they would encourage their colleagues to participate in the recertification process.

Allergy and Immunology↗
PubMed1985

The effect of phenobarbital on theophylline disposition in children with asthma.

The disposition of theophylline was examined in seven children with asthma on two occasions before and on one occasion after chronic phenobarbital dosing (2 mg/kg/day). There was little intrapatient variability in apparent theophylline clearance between the two baseline assessments (0.081 versus 0.073 L/hr/kg). After 19 days of phenobarbital therapy, there was a significant increase in apparent theophylline clearance (0.104 versus 0.077 L/hr/kg), accompanied by a 30% decrease in the mean steady-state serum theophylline concentration (12.0 versus 8.4 micrograms/ml). The inducing effect of phenobarbital on theophylline metabolism may require theophylline dosage adjustment in patients with asthma who receive both drugs concurrently to maintain a given average steady-state theophylline concentration.

Asthma↗
PubMed1985

The relationship of cerebrospinal fluid and plasma theophylline concentrations in children and adolescents taking theophylline.

Ten ambulatory subjects with asthma experienced a seizure while they were receiving oral theophylline preparations and were evaluated prospectively according to a set protocol. The protocol included a lumbar puncture that permitted the simultaneous determination of plasma and cerebrospinal fluid (CSF) theophylline concentrations. A constant relationship was observed between the plasma theophylline concentration and that of the CSF. It was found that the theophylline concentrations in these two biologic fluids could be characterized by the regression equation y = 0.41 X + 0.7 where y is the CSF theophylline concentration and X is the plasma theophylline concentration. Two infants with hydrocephalus treated by ventriculoperitoneal shunt were also simultaneously evaluated for plasma and CSF theophylline concentrations. These infants demonstrated greater than expected entry of theophylline into the CSF. Some central nervous system abnormalities may be characterized by increased theophylline entry into the CSF.

Adolescent↗
PubMed1984

Zinc status of asthmatic, prednisone-treated asthmatic, and non-asthmatic children.

To assess interrelationships between asthma, corticosteroid therapy, growth, and zinc status in children, measurements of height, zinc and copper in serum and hair, taste acuity, and dietary intakes of energy, protein, zinc,and copper were analyzed for 29 asthmatic, 11 prednisone-treated asthmatic, and 21 non-asthmatic subjects, 6 to 20 years old. Reduced height attainment was significant only for the prednisone-treated asthmatic group and was not correlated with clinical or dietary indexes of zinc status. Dietary intake data were similar for all three groups; in comparison with the RDAs, daily intakes were adequate for both energy and zinc (80% to 90%), high for protein (185% to 225%), and low for copper (35% to 60%). Results confirmed earlier reports of growth retardation in corticosteroid-treated asthmatics; significant indications that reduced food intake or impaired zinc status played a major part were not evident.

Adolescent↗
PubMed1983

Cellular immunity and IgE levels in asthmatic children.

Several reports have suggested that asthmatic children may be particularly vulnerable to viral respiratory infections, in addition to this, abnormal cellular regulation has been suggested as an explanation for the increased IgE levels in atopy. Despite such evidence there have been few studies evaluating cellular immune function in asthmatic children. This study has examined in vivo and in vitro aspects of cellular immune function in twenty-six atopic asthmatic children and compared them with nineteen age-matched non-atopic control subjects. In vivo cellular immunity was assessed by quantitating the cutaneous delayed hypersensitivity (CDH) response to four ubiquitous antigens. Lymphocyte responsiveness to three polyclonal mitogens was measured in vitro. The serum IgE level was determined in all study subjects. The results indicate that CDH to Candida antigen is significantly diminished among the asthmatic subjects and lessened to streptokinase/streptodornase. Lymphocyte mitogen response did not differ significantly between the study groups. No correlation could be shown between in vitro lymphocyte responsiveness and IgE level. These studies suggest that a subtle cellular immune defect may exist in asthmatic children and support the need for further studies of this question.

Adolescent↗