Biomedical subjects

B Milbauer

Publications and source records attributed to B Milbauer.

18 recordsLinked to original sources

PubMed1996

[Complications of exchange transfusion in term and preterm newborns].

Exchange transfusion has an important role in the treatment of hyperbilirubinemia of the newborn. It is used in attempts to prevent kernicterus when bilirubin levels are high. We describe our experience in 203 exchange transfusions performed on 143 infants (81 males and 62 females) with hyperbilirubinemia during 1983-1992. In only 30% of cases was there a specific etiological diagnosis of the jaundice based on a positive Coombs test, G6PD deficiency, or the presence of sepsis or maternal diabetes; the rest were idiopathic. 57% of the neonates were premature (26-36 weeks of gestation). Premature neonates underwent more transfusions than full-term infants (1.6 vs 1.2). There was no direct death from exchange transfusion; morbidity was 6.3% (including bradycardia, apnea, thrombocytopenia, hypoglycemia and hyponatremia). Most complications occurred in preterm infants and those severely ill. All complications were treated immediately and there were no sequelae.

Exchange Transfusion, Whole Blood↗

PubMed1996

Failure of early postnatal dexamethasone to prevent chronic lung disease in infants with respiratory distress syndrome.

OBJECTIVE: To study the effect of early postnatal dexamethasone (days 1-3) on the incidence and severity of chronic lung disease in preterm infants with respiratory distress syndrome. METHODS: A multicentre, randomised, placebo controlled, blinded study was carried out in 18 neonatal intensive care units in Israel. The primary outcome measure was survival to discharge without requirement for supplemental oxygen therapy beyond 28 days of life. The secondary outcome measures were requirement for mechanical ventilation at 3 and 7 days, duration of ventilation or oxygen therapy, need for subsequent steroids for established chronic lung disease and incidence of major morbidities. RESULTS: The study consisted of 248 infants (dexamethasone n = 132; placebo n = 116). No differences were found in the outcome variables except for a reduction in requirement for mechanical ventilation at age 3 days in treated infants (dexamethasone 44%, placebo 67%; P = 0.001). Gastrointestinal haemorrhage, hypertension, and hyperglycaemia were more common in treated infants, but no life threatening complications, such as gastrointestinal perforation, were encountered. CONCLUSIONS: These data do no support the routine use of early postnatal steroids, but may justify further study in a selected, high risk group of infants.

Birth Weight↗

PubMed1995

Diurnal variation in serum bilirubin concentrations in infants with neonatal jaundice.

We investigated whether there are independent intradaily changes in bilirubin levels in neonates. Healthy term newborn infants (n = 124) with neonatal jaundice bilirubin >/t171 mmol/L (10mg/dl) were studied for at least 3 consecutive days. Starting from the second day of life, consistent intradaily changes were observed in bilirubin levels (morning levels were greater than evening levels; p < 0.001), and body weight steadily increased. This diurnal variation in bilirubin levels should be considered in the follow-up and treatment of neonatal jaundice.

Bilirubin↗

PubMed1987

Seasonal variation in paired maternal-newborn serum 25-hydroxyvitamin D and 24,25-dihydroxyvitamin D concentrations in Israel.

Seasonal changes were observed in the vitamin D status of mothers and their newly born infants in sunny Israel. Maternal and newborn serum levels of 25-hydroxyvitamin D (25-OHD) were lower (less than 0.01) in March-April (n = 45 pairs), than in September-October (n = 33 pairs). Parallel seasonal changes were also found in serum 24,25-dihydroxyvitamin D [24, 25-(OH)2D] concentrations. In the spring, 20% of the mothers and 40% of their infants had vitamin D deficiency or borderline serum 25-OHD levels. In the autumn, in contrast, none of the mothers and only one newborn were vitamin D-deficient, and one mother and two newborns had borderline serum 25-OHD levels. The results demonstrate that even in Mediterranean climates there are seasonal changes in maternal vitamin D status, which have a significant effect on the serum levels of vitamin D metabolites in their newborn infants. This raises the question as to whether vitamin D supplements should be given to pregnant women in Israel, at least during the winter.

24,25-Dihydroxyvitamin D 3↗

PubMed1985

Lactose malabsorption is not a cause of diarrhea during phototherapy.

Lactose malabsorption is not a cause of diarrhea during phototherapy. Jaundiced neonates under phototherapy develop diarrhea or loose stools during the treatment. These phenomena were attributed to an induced lactase deficiency caused by bilirubin breakdown products. We investigated lactose malabsorption in 59 neonates--29 normals and 30 jaundiced under phototherapy. Five-hour hydrogen breath tests were performed. Preprandial and postprandial (at 30, 60, 120, 180, 240, and 300 min) expired air samples were analyzed for hydrogen. Ten controls and five jaundiced neonates had positive hydrogen breath tests. Eighteen controls and 16 neonates under phototherapy had preprandial hydrogen (concentrations above 5 ppm). In our hands, lactase deficiency and lactose malabsorption were not induced by phototherapy. Lactase deficiency is therefore not the cause of diarrhea associated with phototherapy.

Breath Tests↗

PubMed1979

Response of neonatal hypocalcaemia to 1 alpha-hydroxyvitamin D3.

Administration of 1 alpha-OH-D3 to hypocalcaemic neonates (mean +/- SD, serum calcium 1.50 +/- 0.13 mmol/l) significantly increased serum calcium in all 24 infants within 48 hours after starting therapy (mean +/- SD 1.83 +/- 0.23 mmol/1). The time required to correct hypocalcaemia was significantly shorter (2.04 +/- 0.56 days) in infants treated with 1 alpha-OH-D3, than in 24 infants treated with calcium gluconate infusions (4.12 +/- 1.0 days). Treatment with 1 alpha-OH-D3 was effective, easy to maintain, and produced no side effects.

Calcium Gluconate↗

PubMed1979