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Biomedical subjects

R Michaelis

Publications and source records attributed to R Michaelis.

At least 37 records · Page 2Linked to original sources
PubMed1983

[Mortality and neurological morbidity in prematurely born infants and low birthweight infants born at term].

In a follow-up study the fate and development of 245 prematures with a birthweight below 1,500 g and of 230 infants with a birth weight of 1,501-2,500 g are reported. The mortality of infants with a birthweight below 1,500 g was 29.8%, in the group of infants with higher birthweights 9.1%. The frequency of severe neurological sequelae in infants with very low birthweight was 8.2%, in the other group of infants 3.5%. Minor handicaps and developmental abnormalities were found in a frequency of 12.2%, and 4.7% respectively. These results meet the present international standard in centers for perinatal medicine. Prospective investigations are mandatory to recognize causal factors for later severe handicaps.

Attention Deficit Disorder with Hyperactivity↗
PubMed1982

Evaluation of infants with acidosis using a perinatal "negative factor" score.

Using Prechtl's concept of optimal conditions as modified by Michaelis et al. [7] we analysed the case records of 50 acidotic newborn infants (umbilical artery pH of 7,250 or less) and of 34 controls. Acidotic infants had a significantly higher negative (or adverse) factor score. There was a correlation between the degree of acidosis and the negative factor score. There were, however, no relations between scores in isolated subgroups of negative factors and fetal acidosis though the same was not true for some combinations of subgroups (such as pre-eclampsia, operative delivery, fetal bradycardia in the second stage of labour).

Acidosis↗
PubMed1982

[6 years of psychiatry in a general hospital].

Six years of experience in the psychiatric and neurologic department of the General Hospital at Itzehoe (122 beds, including 78 psychiatric patients and 44 neurological patients; 5 assistant physicians, 1 psychologist, 2 senior physicians, 1 Medical Director [Head]; 38 nurses, 1 social worker, 2 occupational therapists) allow us to summarize initially the efficiency of such an institution: A department like this is basically able to take over full responsibility for the psychiatric care of a community district including the town and adjacent areas of other districts (totalling 120,000 inhabitants). The prerequisites--as is the case in the Steinburg district--are that a hospital is available for patients with chronic mental diseases; close cooperation with an established sociopsychiatric service; and, last but not least, a possibility of transferring patients for the purpose of long-term rehabilitation and withdrawal treatment in relevant institutions. Hence, it is absolutely out of place to label such work performed by "small" departments as "gilded" or "miniature psychiatry". Such departments are increasingly becoming the representatives of a type of psychiatry which definitely has a future because it operates near the patients' domiciles. However, it will be necessary to revise the job schedules, since the number of personnel employed in this type of work is by no means sufficient for conducting a type of psychiatry which is in line with modern concepts and requirements.

Community Mental Health Services↗
PubMed1980

Prenatal origin of congenital spastic hemiparesis.

Using Prechtl's concept of optimal conditions, 13 out of 20 children suffering from congenital spastic hemiparesis presented reduced optimal obstetric and postnatal conditions which were within the 3rd and 80th percentiles of the reduced optimal conditions found in a population of 400 randomly selected newborns. In the 7 children with higher numbers of reduced optimal scores only items indicating perinatal asphyxia accounted for the higher risk. But no correlation could be found between the severity of handicap and perinatal complications. Therefore one may argue that newborns with prenatal cerebral lesions are more likely to suffer perinatal asphyxia, which does not necessarily cause a further damage to the brain. No specific peri- or postnatal complications could be found which would explain the origin of the hemiparesis in the 20 children. CAT-scan examinations in some children showed lesions of the gray or the white matter, but there were also scans without any abnormal findings at all. No correlation between the kind of cerebral lesion and the neurological findings could be drawn.

Asphyxia Neonatorum↗
PubMed1980

[Craniofacial amniogenic malformations within the Adam complex (author's transl)].

Four children are described with amniotic deformities in the craniofacial region. Besides encephaloceles, hydrocephalus, facial clefts, amniotic bands and furrows we observed in three of these children the deformities of the extremities which are characteristic of amniogenic malformations, such as syndactylias and mutilations, associated with ring constructions. The article describes the state of knowledge with regard to pathogenesis. Epidemiology of the disease permits to assume a very low risk of repeat occurrence with the parents concerned.

Abnormalities, Multiple↗
PubMed1980

[Obstetrical and postnatal complications in children of chronically alcoholic mothers (author's transl)].

The histories of mothers addicted to chronic abuse of alcohol always present severe complications during pregnancy and for most of their children during the peri- and postnatal period as well. The question arises to what extent peri- and postnatal complications may influence the clinical aspect of the alcoholembryopathy (AE) in these children. In 35 children with AE all details of their histories could be traced. By using Prechtl's concept of optimal conditions two different populations could be found amongst the children with AE, one with and the other without severe peri- and postnatal complications (exclusively peri- and postnatal asphyxia). No correlation could be found between the severity of AE and perinatal asphyxia. The result suggests reservation in rating peri- and posnatal asphyxia as an always potent factor causing brain damage.

Asphyxia Neonatorum↗
PubMed1979

[Results and consequences using Prechtl's concept of optimal conditions. Obstetrical and Postnatal complications (author's transl)].

An extended list of Prechtl's list of optimal obstetric conditions was used to describe the history of 200 newborns, randomly chosen from a defined population born in 1972. Differences between the population from Groningen (Prechtl's) and Tübingen, and different definitions of the items used in the list are discussed. Reduced optimal conditions in the history of the mother effectively reduced the optimal conditions in the newborn aswell. This was particularly so in case of: Preterm deliveries and miscarriages, bleedings in the first trimester, preterm onset of labour, operative deliveries, less than 38 weeks of gestational age, and an Apgar score below 7.

Abortion, Spontaneous↗
PubMed1979

[Distribution of obstetrical and postnatal risk-factors in 400 randomly selected newborns. A study using Prechtl's concept of optimal conditions (author's transl)].

The distribution of obstetrical and postnatal risk-factors in a population of 400 newborns was investigated. For documentation, an extended list of Prechtl's list of optimal obstetric conditions was used. The newborns had been selected randomly from two populations, born 1972 in two different hospitals (County hospital, University hospital). The reduction of optimal conditions was calculated by percentiles. It was found that the number -3 (of 52 items, representing full optimal conditions) defined the 10th percentile of the population; number -5 the median, and number -10 the 90th percentile. In addition, percentiles were calculated regarding the history of the mother and the history of the infant respectively. Using the distribution of reduced obstetrical and postnatal optimal conditions allows to compare the history of a single newborn or the histories of a population of newborns with defined problems. Newborns with rather low negative numbers of reduced optimal conditions are at lower risk regarding their psychomotor development wheras newborns with high negative numbers carry a much higher irsk in this respect.

Birth Injuries↗
PubMed1978

[Results of intensive care and intensive therapy of very low birth-weight infants (author's transl)].

Newborns of less than 1500 g birth-weight are thought to be especially at risk with regard to their psychomotor development. Among 71 such infants admitted to the University Childrens Clinic, Tübingen, in 1974-1975, 43 survived (38% mortality). All but two of them were followed serially and assessed for their psychomotor development. Five were found to be abnormal (12%), three of them most probably having sustained CNS damage prenatally.

Child, Preschool↗
PubMed1976

[Clinical aspects of pathogenesis of alcohol embryopathy (author's transl)].

68 cases of alcohol embryopathy are reported. The main symptoms are intrauterine and postnatal growth retardation (91%), microcephaly (87 per cent), psychomotor and mental retardation (84 per cent) and a typical craniofacial dysmorphism. Other malformations are frequently found such as cardiac defects (31 per cent), anomalies of joints (23 per cent) and genitalia (50 per cent). There is a marked variation in the intensity of the malformations. Taking into account the extent of the craniofacial dysmorphism and the cerebral damage, a classification into three types (I-111) of alcohol embryopathy is proposed. That ethanol has a teratogenic effect seems to be confirmed. The mother's clinical history suggests that the quantity of alcohol consumed has no marked influence on birth weight, length of gestation and severity of the symptoms. Possibly a defective ethanol metabolism in the severely affected mothers may account for the dysplasias.

Abnormalities, Drug-Induced↗
PubMed1976

[On the embryo-fetal alcohol syndrome (author's transl)].

The symptomatology in 24 patients with the embryo-fetal alcohol syndrome in this study corresponded essentially to the clinical picture described by Lemoine et al., and Jones et al., although we were not able to confirm the maxillary hypoplasia and microphthalmia mentioned in the latter. In addition, we observed in 2 girls a virilization of the genitalia which corresponded to female pseudohermaphroditism. Auxologically a nearly regular pattern of the parameters measured was found. The intra-uterine hypotrophy continues after birth. In particular, the head circumference, reflecting the brain growth, remains low. The cerebral damage leads to oligophrenia with a typical pattern of psychic and motor behaviour. Moderate cases tend to improve. Concerning the pathogenesis, the clinical observations in connexion with recent animal experiments permit the following conclusions. Neither the malnutrition nor the liver damage of the mothers are necessary presuppositions. Ethanol itself appears to play the main teratogenetical rôle. Acetaldehyde, which is the primary metabolite of ethanol, is cytotoxic too. However, the liver of the embryo and the fetus, in consequence of its deficient alcohol dehydrogenase content, is not able to metabolize ethanol.

Abnormalities, Drug-Induced↗
PubMed1975

A rare type of low birthweight dwarfism: the Dubowitz syndrome.

Two patients with the Dubowitz syndrome are presented. This presumably recessive inherited syndrome was first defined by Grosse et al. (1971). So far 11 patients with this syndrome have been described. Major clinical findings are intrauterine and postnatal growth retardation, considerable microcephaly, mild mental retardation, hyperactivity, hyperextensibility of joints, eczema and a characteristic appearance of the face due to marked epicanthic folds, blepharophimosis, broadening of the bridge and tip of the nose and retrognathia. Minor anomalies as clinodactylyl of the firth digits, cutaneous syndactyly of toes, foot deformity, sacral dimple and cryptorchidism may be seen. The exclusion of the non genetic fetal alcohol syndrome presents serious diagnostic problems.

Birth Weight↗