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Biomedical subjects

J G Koppe

Publications and source records attributed to J G Koppe.

At least 55 records · Page 3Linked to original sources
PubMed1989

Dioxins and furans in the mother and possible effects on the fetus and newborn breast-fed baby.

Due to pollution of the environment with PCBs, dioxins and furans these highly poisonous chemicals have accumulated in the adipose tissue of human beings. In breast milk of 14 mothers concentrations of dioxins and furans were found in milk fat, close to or in the range of the concentrations necessary to induce enzymes in "in vitro" rat liver cells (80-132 ppt). The hypothesis is that the above mentioned chemicals can be responsible for a vitamin K deficiency in the babies resulting in a bleeding analogous with phenobarbital. Both the pure TCDD content in milk fat and the content of dioxins and furans expressed as toxic equivalents (Nordic model) were higher in milk given to babies that presented a bleeding (4 out of 14). However, the sample size is too small for statistical analysis. No relation with age, parity, overweight, fish eating or smoking of the mother and dioxin content of her breast milk was seen in our small sample size.

Adult↗
PubMed1989

[Ethical problems in perinatology].

Ethical problems in the neonatal period and in the unborn baby are discussed. The different categories of babies where ethical problems arise are summarized and ethical values, reasons for justification and the question of who decides are discussed. Medical strategies nowadays used in different countries are presented and a procedure is described how to make a decision to stop or not to start treatment.

Asphyxia Neonatorum↗
PubMed1984

Severe asphyxia and outcome of survivors.

Fifty-four infants born severely asphyxiated with birth weights of more than 2500 g and gestational ages older than 37 weeks were studied with help of careful review of the case files. To establish a relationship between the time elapsed after birth to spontaneous regular active respiration and later outcome, the infants were divided into three groups: group A of 34 children, established spontaneous active respiration within 15 min; group B of 7 children recovered in 15-30 min, and group C of 13 children recovered 30 min after birth. The outcome in group C, in which the infants also had a history of prolonged intrapartum asphyxia, was uniformly bad. The absence or presence of an audible heart beat at birth was not a reliable clinical sign for a prognosis. The time that elapsed between the start of resuscitation and the first gasp had to be doubled to indicate the likely start of regular active respiration in one third of our babies. The results indicated that the combination of prolonged intrapartum asphyxia and a delay in onset of spontaneous regular respiration of more than 30 min following birth predicted a uniformly bad prognosis. Attempts at resuscitation after this interval did not appear to be warranted.

Acid-Base Equilibrium↗
PubMed1984

[Treatment results in 951 newborn infants with IRDS (idiopathic respiratory distress syndrome), especially in relation to artificial respiration from 1967 through 1981].

UNLABELLED: Evaluation of intermittent positive pressure ventilation (IPPV) in newborn children is presented by analysis of the data of all 951 children with hyaline membrane disease (HMD) treated in the Wilhelmina Gasthuis during the years 1967-1981. Gestational age varied from 24 to 39 weeks. Birthweight varied from 600-4660 grams. RESULTS: Overall survival was 64.9%. The incidence of pneumothorax, intracranial hemorrhage and bronchopulmonary dysplasia (BPD) was 11.5%, 18.2% and 11.3% respectively, related to the total number of patients. The overall survival did not change. The mean gestational age decreased from 31.6 in the first 5 years to 30.7 in the last 5 years. The mean birthweight decreased from 1873 to 1588 grams. The incidence of IPPV rose from 32.8 to 57.3%. For a separated group artificially ventilated children with gestational ages of greater than or equal to 28 weeks and less than or equal to 33 weeks and with birthweight greater than or equal to 1000 grams and less than or equal to 2499 grams survival increased from 36 to 50% and mean birthweight decreased from 1636 to 1489 grams. Introduction of continuous positive airway pressure (CPAP) did not change either incidence of IPPV or incidence of BPD. The most important determinants of a poor prognosis are low gestational age, low birthweight and necessity of IPPV. The prognosis of the individual patient is improved. The continuously bad prognosis for children with very low birthweight (less than 1000 grams) with HMD makes the search for other ventilation techniques worthwhile.

Birth Weight↗
PubMed1983

Normal ranges of T4 screening values in low birthweight infants.

Thyroxine (T4) screening values in infants of low birthweight in relation to birthweight and gestational age are reported. There were 86 healthy infants of low birthweight (group 1), and 29 preterm infants with respiratory distress syndrome (group 2). All the group 2 infants and 36% of those in group 1 had a T4 screening value below the cut-off point (-2.1 SD). In group 1 there was a significant increase in T4 with birthweight at a given gestational age, as well as with gestational age at a given birthweight. In group 2 there was also a significant increase in T4 values in relation to birthweight and gestational age, but it could not be ascertained whether this increase existed at a given gestational age or birthweight. A statistical model giving normal ranges of T4 for both groups of infants is presented, which, if applied to low birthweight infants, makes it possible to estimate the effect of low birthweight on T4 screening values, provided the birthweight and gestational age are known. In this manner the sensitivity of screening for congenital hypothyroidism is enhanced and the recall rate reduced.

Birth Weight↗
PubMed1983

Threatened preterm labor: the influence of time factors on the incidence of respiratory distress syndrome.

The interval between the first symptoms of threatened preterm labor and delivery was studied and found to be correlated with the incidence of respiratory distress syndrome (RDS), independent of treatment with corticosteroids or betamimetics and the state of the membranes. The incidence and severity of RDS decreased when labor was postponed for a period ranging from 12 hours to three weeks after admission. The decrease was most marked in a steroid-treated group but also occurred in the placebo-treated and untreated groups. The combination of orciprenaline and betamethasone was more effective in postponing delivery in early pregnancies than was the combination of orciprenaline and placebo. Treatment with betamimetics and corticosteroids is therefore indicated in cases of active preterm labor.

Adult↗
PubMed1982

Congenital toxoplasmosis: long-term follow-up.

The incidence in Europe is high, about 6 in 1000 births. Five percent of these babies either die or are severely damaged by the disease. In the others most infections are clinically asymptomatic in the neonatal period. In +/- 70% of all infants with congential infections relapses of chorioretinitis give rise to scars in their eyes after a follow-up of 16 years. The relapses were occurring later on both in treated and untreated infants. Most scars were in the periphery of the retina, but scars in the neighbourhood of the macula can threaten the vision. In 1--2% of these children later on uveitis impairing vision due to congenital toxoplasmosis will occur. As a control 117 children in the age 12--14 years without congenital toxoplasmosis were studied. No chorioretinitis-scars were found in the eyes although +/- 50--60% had antibodies against toxoplasmosis, resulting from an acquired infection. The problem of prevention is unsolved. There is no vaccine. Deliberately infecting girls before pregnancy is too dangerous. Screening of pregnant women is possible but no clear-cut safe therapy is available. Screening of the baby after birth is too late.

Adolescent↗