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Biomedical subjects

K Bauer

Publications and source records attributed to K Bauer.

376 records · Page 21Linked to original sources
PubMedDate not supplied

[Oral sugar solutions in pain therapy of neonates and premature infants].

OBJECTIVES: We review the efficacy of oral sugar solutions for treating procedural pain in neonates and address the following questions: Do newborns need analgesic therapy for procedural pain during blood sampling? How do sugars influence pain-reactions of neonates? What is the efficacy of sugar solutions in clinical practice? METHODS: We searched for relevant articles in the PubMed database from 1990 to September 2000. RESULTS: Treatment of procedural pain in newborns is desirable because they are more sensitive to pain than adults, they show marked pain reactions during blood sampling and repeated acute pain in the newborn period results in longterm behavioural changes. Oral sugar solutions have been studied for treatment of procedural pain in neonates. Their initial effect is the result of orotactile stimulation by the intraoral fluid. The orogustatory stimulation by the sweet taste prolongs the effect for up to 10 minutes through endorphin release. In randomized-controlled trials oral sugar solutions (2 ml of 25% sucrose or 30% glucose) reduced pain reactions and crying and attenuated the heart rate increase after capillary and venous blood sampling in term and preterm neonates. They are more effective than traditional calming strategies, like cuddling by parents, use of a pacifier, or breast feeding. Yet, sugar solutions provide no adequate analgesia for more severe pain, e.g. during circumcision. CONCLUSIONS: Sugar solutions effectively relieve procedural pain during blood sampling in neonates. Additional studies are needed to determine the minimal effective dose and the efficacy and side effects of repeated sugar doses in the same patient.

Analgesia↗
PubMedDate not supplied

[Intrauterine therapy and outcome in four pregnancies of one mother with anti ro-autoantibody positive Sjoegren's syndrome].

Autoantibodies against 52/60kD-Ro proteins, frequently present in patients with Sjoegren's Syndrome or systemic lupus erythematosus, are transmitted to the fetus during pregnancy. These autoantibodies can damage the cardiac conductive system of the fetus and cause a complete atrioventricular block, with a mortality of 30 %. We report the intrauterine therapy during four pregnancies of the same mother with high 52/60kD-Ro autoantibodies and the outcome of her infants. Our patient with primary Sjoegren's Syndrome suffered an early miscarriage during her first pregnancy. During the second pregnancy, a fetal atrioventricular block was observed at 23 weeks of gestation. Although subsequently dexamethasone therapy and daily plasmaphereses were started, a cesarean section was necessary at 26 weeks due to hydrops fetalis. The girl died from the atrioventricular block after two days. During the third and fourth pregnancies, dexamethasone therapy was begun already at 7 weeks, and regular plasmaphereses at 15 weeks. The children were delivered by cesarean section at 32 and 36 weeks because of growth retardation. Both had normal electrocardiograms after birth and after 2 and 4 years. In pregnant women with connective tissue diseases, monitoring of anti Ro-autoantibodies and fetal heart function is important. Intrauterine therapeutic options are dexamethasone therapy to suppress maternal and fetal inflammatory reactions and repeated plasmaphereses to reduce autoantibody levels. Postnatal follow up of the infants for atrioventricular block and rheumatic manifestations is necessary.

Antibodies, Antinuclear↗
PubMedDate not supplied

[Parenteral nutrition associated cholestasis in the newborn].

Parenteral nutrition associated cholestasis in preterm infants and newborn children is a frequent and serious disease with an incidence of 23% depended on duration of parenteral nutrition and birthweight. The incidence of liver cirrhosis is 40% when parenteral nutrition is given 74-242 days. The pathogenesis remains unclear. Several predisposing factors are discussed like immaturity, lack of hormonal stimulation by oral feeding, bacterial infection, liver toxicity of aminoacids and their products of photooxidation, lack of taurine, lack of antioxidation substances, hypermanganesaemia and pollution of infusion solutions. Furthermore sepsis during parenteral nutrition seems to multiply the risk of cholestasis. For prevention controlled studies recommend: 1. Early enteral nutrition. 2. The reduction of parenteral amino acids to less than 3 g/kg/d. 3. Light protection for parenteral solutions. 4. Cyclic infusion of parenteral nutrition. 5. The application of antibiotics (metronidazole, gentamicin) during parenteral nutrition. The most important therapeutic intervention is the beginning of oral feeding. Most of the time this leads to a decrease of icterus within two weeks. An icterus persisting longer than 3 weeks should be treated because of the risk of liver cirrhosis. Further therapeutic interventions are: 1. Cholecystokinin, good results in case studies which still has to be verified by a controlled study. 2. Ursodeoxycholic acid, its choleretic effectiveness is verified in several liver diseases by controlled studies, but it is not proven in parenteral nutrition associated cholestasis. 3. Laparoscopic biliary irrigation, successful in several case studies.

Cholestasis↗
PubMedDate not supplied

Association of elevated blood levels of pentachlorophenol (PCP) with cellular and humoral immunodeficiencies.

It has long been suspected that pentachlorophenol (PCP) exerts a damaging influence on the immune system. In this study, the possible relationship between blood levels of PCP and immune function was studied in 190 patients who had been exposed for more than 6 mo to PCP-containing pesticides. The patients suffered from frequent respiratory infections and general fatigue. Lymphocyte subpopulations, in-vitro responses to mitogens, allogeneic stimulator cells, plasma neopterin, cytokines, soluble cytokine receptors, soluble adhesion molecules, and immunoglobulin autoantibodies were determined. A dose-response relationship between blood levels of PCP and cellular and humoral immune parameters was established. Blood levels of PCP were associated negatively with (a) total lymphocyte counts (p = .0002), CD4/CD8 ratios (p = .0015), and absolute counts of CD3+ (p < .0001), CD4+ (p < .0001), CD16+ (p < .0001), CD25+ (p = .0003), DR+ (p < .0001), CD8+/56+ (p = .020), and CD19+ cells (p = .092); (b) plasma levels of interleukin-2 (IL-2) (p < .0001), soluble IL-2R (p < .0001), IL-6 (p < .0001), IL-10 (p = .0039), interferon-gamma (IFN-gamma) (p < .0001), tumor necrosis factor-alpha (TNF-alpha) (p < .0001), transforming-growth factor-beta2 (p = .023), soluble IL-1 receptor antagonist (sIL-1 RA) (p < .0001), soluble intercellular adhesion molecule-1 (p = .0003); and (c) immunoglobulin (Ig) M-anti-Fab type autoantibodies (p = .0353). PCP levels were associated positively with (a) number of impaired stimulation assays per patient (p = .041); (b) number of circulating CD11b+ monocytes (p = .0015); and (c) plasma levels of neopterin (p < .0001), IL-4 (p = .020), and sIL-6R (p = .020). Compared with patients who had PCP plasma levels that were less than or equal to 10 microg/l, patients with blood levels of PCP that exceeded 10 microg/l experienced the following more often: low numbers of total blood lymphocytes (p = .054), CD3+ (p = .0014), CD4+ (p = .0001), DR+ (p = .0003), CD16+ (p = .0033), and CD25+ cells (p = .0033). In addition, the same aforementioned patients experienced the following more frequently: undetectable plasma levels of IL-2 (p = .0057), IL-6 (p = .042), IL-8 (p = .038), IL-10 (p = .0001), TNF-alpha (p = .0062), and IFN-gamma (p = .016); and impaired in-vitro responses of lymphocytes (p = .071). The authors concluded that increased blood levels of PCP were associated significantly with cellular and humoral immunodeficiencies. Recurrent respiratory infections and general fatigue could originate from PCP-associated immunosuppression.

Adolescent↗
PubMedDate not supplied

Impaired in-vitro lymphocyte responses in patients with elevated pentachlorophenol (PCP) blood levels.

Immune parameters were examined in 188 patients who were exposed for more than 6 mo to pentachlorophenol-containing pesticides. Blood levels of pentachlorophenol, lymphocyte subpopulations, in-vitro responses to mitogenic and allogeneic stimulation, plasma neopterin levels, and plasma cytokine and cytokine receptor levels were determined. Impaired in-vitro lymphocyte stimulation responses were impaired in 65% of the patients. The likelihood of impaired lymphocyte stimulation increased significantly with levels of pentachlorophenol that exceeded 10 microliters/l (p < .05). Patients who had high blood levels of pentachlorophenol and abnormal lymphocyte stimulation also had increased proportions of blood monocytes in blood (p < .05), as well as increased IL-8 serum levels (p < .02). Eleven patients who had abnormal mitogen stimulation experienced decreased CD4/CD8 ratios of < 1.0; 5 of these patients had decreased CD4+ lymphocyte counts of < 500/microliters, and 3 patients had increased plasma neopterin of > 15 nmol/l. These results indicate that increased levels of pentachlorophenol in blood can lead to severe T lymphocyte dysfunction.

Adolescent↗
PubMedDate not supplied

Structures of BAY o 6997 and BAY q 1313 microbial ACE inhibitors.

BAY o 6997 and BAY q 1313 are two novel ACE inhibitors produced by Streptomyces WS 464 and Streptomyces WS 1065, respectively. Their structures were elucidated by NMR and MS analysis of the inhibitors and a substance which formed on decomposition of BAY o 6997 on heating in 4 M acetic acid. Both inhibitors are composed of the same amino acids, namely His and 2-methylamino-4-aminobutyric acid. The 2-amino group of His and the 4-amino group of the 2-methylamino-4-aminobutyric acid are bridged by differently substituted ethylene moieties. As determined by gas chromatography on a chiral phase, both amino acids isolated from the total hydrolysate after derivatisation, at least in BAY o 6997, possess the L-configuration.

Aminobutyrates↗
PubMedDate not supplied

[How do mothers experience skin contact with their very immature (gestational age 27-30 weeks), only days old premature infants?].

BACKGROUND: Mothers are offered skin-to-skin contact with their preterm infants with the intention to promote bonding. But it is not known if the mother of a very immature fragile infant perceives skin-to-skin contact as a helpful intervention or a stressful situation. PATIENTS AND METHODS: Mothers of singleton preterm infants (gestational age 27-30 weeks) began skin-to-skin contact as soon as the infant was breathing spontaneously. They prospectively documented frequency and duration of skin-to-skin contact, they rated their anxiety or confidence and their attachment to the infant and described their observations of the infant daily for 14 days in a semi-structured questionnaire. RESULTS: 17 of 25 mother-infant-pairs in the observation period fulfilled the entry criteria, 14 questionnaires about 196 skin-to-skin periods could be analyzed (median gestational age 27.5 weeks (27-30), median birth weight 1130 g (695-1300). Skin-to-skin contact began at a median age of 3 days [2-7]. The median duration of the skin-to-skin periods was increased at maternal request from 60 to 120 minutes between day 1 and 14 (p = 0.004). Even then 21% of the mothers wanted a still longer duration of skin-to-skin contact. Mothers reported anxiety only 5 times. 82% of the mothers reported positive own feelings during skin-to-skin contact and 78% felt that skin-to-skin contact increased their attachment to their infant. CONCLUSION: The mothers studied perceived skin-to-skin contact with their very immature infants as a positive and helpful intervention. Skin-to-skin contact took place regularly and for increasing periods of time.

Adult↗
PubMedDate not supplied

Complement C3 cleavage product in synovial fluids detected by immunofixation.

54 synovial fluids (SFs), 46 of them derived from various inflammatory diseases (30 rheumatoid arthritis (RA) SFs, 8 undefined arthritis (UA) SFs, 8 psoriatic arthritis (PSA) SFs) and 8 SFs from degenerative joint diseases (OA) were tested for C3c split product, using the immunofixation method. There were significant differences in the C3c product between the four groups investigated. In the OA group in the mean the percentage of C3c was low in comparison to the native C3 (C3c = 2.95%). RA SFs and UA SFs showed considerably higher values (20.1% for RA and 23.2% for UA) which were statistically significant in comparison to the OA SFs. With the exception of one SF the PSA SFs exhibited a relatively low percentage of the cleavage product. Despite the one high value the average C3c content of the PSA SFs was not statistically different from the OA SFs. In contrast to this low percentage of the C3c split product the PSA SFs showed the highest C3 concentration of all groups (87.0 +/- 36.5 mg/100 ml). Immunofixation is a simple and effective tool to determine the C3c split product in SFs. It might also be helpful for establishing the differential diagnosis of PSA vs RA on the basis of the C3 level of the SF in those patients where an elevated level of C3 is present.

Arthritis, Psoriatic↗
PubMedDate not supplied

[Protein synthesis in lymphocytes of patients with various stages of chronic polyarthritis].

Protein synthesis in lymphocytes of patients suffering from rheumatoid arthritis shows various levels according to the stage of the disease. Incorporation of 3H-isoleucine is markedly increased in progredient cases (compared to normal subjects + 75%). Additional treatment of these patients with corticosteroids has no effect on the protein synthesis in the lymphocytes. This seems to be in contrast to investigations using in vitro incubation of lymphocytes in media containing steroids. Because of completely different conditions in these investigations exact comparison of the results is not possible. Protein synthesis in lymphocytes from patients with early stages of rheumatoid arthritis or ankylosing spondylitis shows no statistically significant difference to normal controls.

Arthritis, Rheumatoid↗
PubMedDate not supplied

Novel microbial inhibitors of ACE. Isolation and characterization.

Two novel microbial ACE-inhibitors BAY o 6997 and BAY q 1313 were detected in the fermentation broths of streptomyces spec. WS 464 and spec. WS 1065, respectively. Both were isolated and purified by ion exchange chromatography as initial steps, and final purification was achieved by HPLC or additional chromatography of the Cu-chelate (BAY q 1313). Both inhibitors are reversibly inactivated on chelation with Cu2+ or Zn2+. Irreversible inactivation occurs on standing in aqueous and acidic solution or in ammonium hydroxide at room temperature and more rapidly on heating. In 4 M sodium hydroxide solutions BAY o 6997 is completely stable, and BAY q 1313 still remarkably stable even on longer heating to 80 degrees C. Thus, BAY o 6997 was alternatively and advantageously isolated after heating of its solution in 4 M sodium hydroxide to 37 degrees C for 2 days and subsequent fractional precipitation with ethanol in a relatively pure state. Total hydrolysis yielded His, 2-methylamino-4-amino-butyric acid and alpha-keto butyric acid (BAY o 6997) and pyruvic acid (BAY q 1313) respectively. The unusual stability of both inhibitors in sodium hydroxide solution on the one hand and their instability on heating and storage in aqueous or acidic solutions on the other hand clearly prove that the constituents are not linked by amide bonds.

Ammonium Hydroxide↗