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A Lischka

Publications and source records attributed to A Lischka.

At least 19 recordsLinked to original sources
PubMed2000

Preterm infants with low immunoglobulin G levels have increased risk of neonatal sepsis but do not benefit from prophylactic immunoglobulin G.

OBJECTIVE: In a prospective, randomized, placebo-controlled, multicenter study, we evaluated the prevention of neonatal infections with intravenous immunoglobulin G (IVIgG) prophylaxis for preterm infants (gestational age <33 weeks) with umbilical cord blood IgG levels < or =4 g/L. STUDY DESIGN: Intravenous IgG or placebo (albumin), 1 g/kg body weight, was given on days 0, 3, 7, 14, and 21 to 81 infants with umbilical cord blood IgG levels < or =4 g/L: (1) IVIgG group, n = 40, mean (SD) gestational age 27.5 (2.2) weeks and birth weight 1.06 (0.39) kg; (2) placebo group, n = 41, mean (SD) gestational age 27.7 (2.5) weeks and birth weight 1.13 (0.38) kg. Infants with umbilical cord blood IgG levels >4 g/L (n = 238) served as a separate comparison group. Neonatal infections according to European Society of Pediatric Infectious Disease criteria were monitored until 28 days of life. RESULTS: Infants with IgG levels < or =4 g/L at birth who received IVIgG had no significant reduction in infectious episodes or mortality rate when compared with those given placebo. However, infants with a serum concentration of IgG >4 g/L at birth had significantly fewer infectious episodes (culture-proven sepsis) than infants with low serum concentrations of IgG (< or =4 g/L) when compared at the same gestational ages (26 to 29 weeks, P <.003). CONCLUSIONS: Prophylactic immunotherapy with IVIgG did not improve the immune competence in preterm infants with low serum IgG concentrations at birth. We speculate that a spontaneously high serum IgG concentration at birth reflects placenta function and is an indicator of a more mature immune system capable of protecting the preterm infant against severe neonatal infections.

Cross Infection↗
PubMed1998

Decreasing reticulocyte counts associated with declining post-dose erythropoietin plasma levels in anaemia of prematurity.

UNLABELLED: A prospective sequential, multicentre trial was conducted to determine the association between erythropoietin (EPO) plasma levels and the erythropoietic response to recombinant human erythropoietin (r-HuEPO) during long-term treatment of premature infants. Twenty-nine infants, gestational ages 26-34 weeks and postnatal ages more than 14 days, received 600 IU r-HuEPO per kg per week divided into three doses subcutaneously for haemoglobin levels less than 120 g/l or haematocrit less than 36% over a period of 4 weeks. Eight additional patients were studied for a total of 10 weeks. EPO plasma concentrations and haematologic parameters were measured prior to the onset of treatment and at 2-weekly intervals thereafter. Treatment with r-HuEPO resulted in a median increase in corrected reticulocyte counts of 2.5% (range 0.2-4.6%) above patient's baseline, thereafter a decrease was observed. In the 8 patients followed for 10 weeks reticulocyte counts declined significantly during weeks 6-10 when compared with the first 4 weeks (p < 0.005). Median 72-hour post-dose EPO plasma levels increased significantly (p < 0.0001) to 57.3 mU/ml (range 5.0-160) above patient's baseline after the first injection, but declined progressively thereafter until they approached baseline values at week 10. CONCLUSION: R-HuEPO treatment after the first month was associated with a decrease in post-injection plasma levels and a decrease in erythropoietic response. This decrease in erythropoietin's efficacy and the decline observed in post-dose EPO plasma levels may be causally related.

Anemia↗
PubMed1998

Topographical EEG analysis of rolandic spikes.

We performed topographic EEG investigation with instant voltage mapping in 57 patients with a Rolandic spike focus including 35 patients with benign Rolandic epilepsy. A pronounced maximal negativity of "Rolandic" spikes could be demonstrated over central or mid-temporal electrodes, with a spread to parietal or upper frontal areas with a dipole formation (centrotemporal negativity, frontal positivity) and involvement of midline. There was a moderate correlation between spike amplitude or duration with spread to adjacent areas. No other focal abnormalities such as focal slowing could be revealed by visual or FFT EEG analysis. During light sleep spike activity was pronounced and often associated with generalized spike wave activity. Thus, a functional disturbance rather than a structural lesion can be assumed.

Adolescent↗
PubMed1998

Factor V Leiden and prothrombin gene G 20210 A variant in children with ischemic stroke.

OBJECTIVE: To investigate if the factor V Leiden mutation (F-V-LM) and/or the prothrombin gene G 20210 A variant (P-G20210A-V) are risk factors for acute stroke in Austrian children. PATIENTS: 33 children with acute ischemic stroke documented by computer tomography and/or magnetic resonance imaging of the brain were enrolled in an open multicenter survey. RESULTS: 6/33 children had F-V-LM (5 heterozygous, 1 homozygous). This represents 18% (95% CI: 6.7-39.9%) of our pediatric stroke population and thus exceeds the expected prevalence in the Austrian population of 4,6% (Fischer's exact test, p = 0.01). F-V-LM was not found in 11 children with neonatal stroke but in 6/22 children with stroke after the neonatal period. 5/6 children with F-V-LM had an underlying disorder that is a risk factor for stroke in children. The P-G20210A-V was detected in 1/26 (3.85%; 95% CI: 0.1-21.4%) patients. Comparison of the prevalence of P-G20210A-V in our study with that in the general population of Austria of 1% revealed no statistical significance (Fischer's exact test, p = 0.38). CONCLUSION: Our data suggest that the F-V-LM is a risk factor for acute stroke in Austrian children beyond the neonatal period. The P-G20210A-V apparently does not represent a risk factor for stroke in Austrian children.

Activated Protein C Resistance↗
PubMed1996

The functional organization of the interictal spike complex in benign rolandic epilepsy.

PURPOSE: We studied the functional organization of the interictal epileptic spike complex in patients with benign rolandic epilepsy of childhood (BREC). METHODS: We recorded interictal epileptiform spikes and somatosensory evoked potentials after median nerve stimulation, providing a biologic marker for the location of the central sulcus in 12 patients with BREC. We used multiple dipole modeling to assess the number, the three-dimensional intracerebral location, and the time activity of the underlying neuronal sources. RESULTS: Although the interictal spike complex could be modeled by a single tangential dipolar source in seven patients (group 1), in the remaining five patients, two sources-a radial and a tangential dipole-were necessary adequately to explain the interictal spikes (group 2). The tangential source was located deeper than the radial source and was characterized by a frontal positivity and a centroparietal negativity with a phase reversal across the central sulcus, suggesting that the interictal spikes originated in the anterior wall of the central sulcus. The radial source showed a single electronegativity over the ipsilateral central region, which would be compatible with involvement of the top of either the pre- or postcentral gyrus. Both sources showed biphasic time patterns with an average latency difference of 30 ms. CONCLUSIONS: Our results indicate that in some patients with typical BREC, the interictal epileptiform spike complex is generated by multiple, simultaneously active neuronal populations within the central region and that epileptiform activity is propagated between these two adjacent cortical areas.

Adolescent↗
PubMed1995

Diaphragmatic paresis in newborns due to phrenic nerve injury.

Phrenic nerve lesions as a result of birth trauma have been reported as a cause of acute respiratory distress infrequently. We report recent diagnostic and therapeutic experiences in four newborns with birth-traumatic phrenic nerve injury: one bilaterally, and three unilaterally, all right-sided. In each case, mechanical ventilation was required for at least 16 days. Ultrasound examination of the diaphragm and phrenic nerve conduction studies turned out to be the diagnostic methods of choice. Spontaneous recovery occurred in two children and two became asymptomatic after operative treatment. One improved after plication of diaphragm and one after autologous nerve transplantation.

Birth Injuries↗
PubMed1995

Quantitative EEG in young diabetics.

The aim of this study was to investigate the influence of metabolic control on quantitative electroencephalographic (EEG) abnormalities in young diabetic patients. We compared quantitative EEGs of 44 insulin-dependent diabetic patients with age-matched controls. Furthermore, differences in EEG variables of diabetic patients and controls were correlated with the age of onset and duration of diabetes, hemoglobin A1c concentrations, and episodes with severe hypoglycemia. We found a correlation between high values of hemoglobin A1c and decreased relative power of the alpha band. Patients with previous ketoacidotic episodes had increased relative power of the delta/theta band and decreased relative power of the alpha band. Patients with hemoglobin A1c values less than 8.5% exhibited slowing of background activity compared with normal controls. We conclude that metabolic control influences the EEG and that improvement of glucose metabolism is an important factor in avoiding EEG abnormalities in young diabetic patients.

Adolescent↗
PubMed1995

Comparison of high dose therapy of rhEPO, given two or three times a week in premature infants.

We investigated the question whether there is a difference in the response to high dose human recombinant erythropoietin (rhEPO) given twice or three times weekly in premature infants. 48 premature infants were randomly assigned to receive 300 U/kg rhEPO three times a week or 450 U/kg two times a week for at least 4 weeks and up to 6 weeks. Concomitant oral iron supplementation was compulsory, median daily dosage reached 6.6 mg/kg, doses exceeding 8 mg/kg/d were not tolerated. Our data showed no differences in the two groups in regard to hematocrit (HCT), reticulocytes and ferritin levels. A marked increase in reticulocyte counts could be observed in both groups. Serum ferritin decreased as expected. Premature infants starting with a baseline HCT lower than 32% showed a steady increase in HCT without any initial decline. No adverse effects could be observed in either group. Since there is no difference in the response to high dose rhEPO given two or three times weekly, we therefore conclude that the twice weekly regimen is compatible with outpatient treatment.

Anemia↗
PubMed1994

Kappa/lambda ratio as parameter for evaluation of therapy-resistant epilepsy of childhood.

In a prospective study we tested the hypothesis whether an alteration in the immunoglobulin light chain kappa and lambda is an expression of an autoimmune mechanism. We investigated 152 children (84 boys, 68 girls, age 12 months to 16 years). Immunoglobulins were analyzed by kinetic nephelometry. The patients were grouped according to clinical and laboratory parameters. A high kappa/lambda ratio caused by high concentration of the kappa-chain was found in children with therapy-resistant epilepsy. 58% showed a high kappa/lambda ratio, in 28% no distinct association was possible and in 14% false-positive results were obtained. In seizure-free children immunological markers were specific in 71%, whilst 25% could not be characterized and 4% showed false-positive results. This alteration of immunoglobulins therefore can be used as a diagnostic parameter.

Adolescent↗
PubMed1993

Recent evaluation of prognostic risk factors in esophageal atresia--a multicenter review of 223 cases.

In this study, 223 cases of esophageal atresia (Type IIIb: 85.7%; Type II: 5.8%; Type IIIc: 4.0%; Type IIIa: 2.2%; Type IV: 2.2%) from 6 pediatric surgery centers of Austria, were retrospectively examined for the following parameters and their influence on the prognosis: Birth weight (2494.7 +/- 702.0 g), gestation week (range 27-42 weeks; mean 37.3 +/- 3.1 weeks), sex (male: n = 128; female: n = 95), long-gap atresia (> or = 2 cm: n = 33), Tracheomalacia (n = 16), associated malformations (n = 122; cardiac 27.4%, renal 17.9%, skeletal 17.0%, anal: 10.3%, intestinal 9.9%, mediastinal 7.6%, chromosomal 2.2%), preoperative aspiration (n = 92), pneumonia (n = 96), anastomotic insufficiency (n = 45), empyema (n = 5), mediastinitis (n = 8), sepsis (n = 32), other medical complications (n = 122, in 80 infants), other surgical complications (n = 57). The mortality rate was 41.3% overall, from 1975 to 1991; however, it was 25% from 1987 to 1991 and 0% in 1991. A statistically significant correlation was found between prognosis and the following factors: Cardiac malformations (p = 0.0001), medical complications except aspiration and pneumonia (p = 0.0001), empyema (p = 0.0081), mediastinitis (p = 0.0214), and sepsis (p = 0.0295). These 5 significant factors were given different points and a prognostic score was calculated by the addition of these points. This score was predictive for survival in 90.6% of cases and for mortality in 94% of cases.(ABSTRACT TRUNCATED AT 250 WORDS)

Austria↗
PubMed1993

Absence status.

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Adolescent↗