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Biomedical subjects

G Boehm

Publications and source records attributed to G Boehm.

At least 91 records · Page 5Linked to original sources
PubMed1988

[Calcium and phosphorus homeostasis of hypotrophic newborn infants fed breast milk].

In a randomized prospective study in 26 low birth weight infants (LBWI) small for gestational age (SGA) the concentrations of calcium and phosphorus as well as the activity of alkaline phosphatase in serum were measured up to the 42nd day of life. In addition the renal excretions of calcium and phosphorus were estimated in 12 of these infants. 42 very low birth weight infants (VLBWI) and 83 LBWI, both appropriate for gestational age (AGA), were included in the study as controls. There are changes in direction of lower concentrations of phosphorus and higher activities of alkaline phosphatase in the serum of SGA infants if compared to the control groups, but all values were within the normal range and all differences between the study groups are not significant. In contrast to this small differences of the serum parameters the renal excretion of phosphorus is significantly lower and the excretion of calcium significantly higher in the SGA group than in the control groups even on the third day of life. In the VLBWI, AGA such signs of a phosphorus deficiency appear later. The results suggest that infants born as SGA are not sufficiently provided with phosphorus during the intrauterine development. Thus, phosphorus supplementation has to be started immediately after birth in SGA infants. The measurement of renal excretions of calcium and phosphorus is more effective than that of serum parameters for monitoring the calcium-phosphorus-homöostasis during the first weeks of life.

Alkaline Phosphatase↗
PubMed1988

Calcium and phosphorus homeostasis in very-low-birth-weight infants appropriate for gestational age fed human milk.

The concentrations of calcium and phosphorus and the activity of alkaline phosphatase in serum were evaluated in 42 very-low-birth-weight (VLBW) and 83 low-birth-weight (LBW) infants on the 7th, 21st, and 42nd day of life. 9 VLBW and 16 LBW infants were randomized for measurement of the renal excretion of calcium and phosphorus on the 3rd, 5th, 7th, 21st, and 42nd day of life during human milk feeding and 14 VLBW-infants fed human milk supplemented with 1 mmol NaH2PO4 per 100 ml. All serum parameters were found to be normal. Supplementation of human milk with NaH2PO4 leads to a tendency of higher concentrations of phosphorus than found in VLBW-infants exclusively fed with native human milk, but all differences between the two groups were not significant. VLBW-infants appeared more than LBW-infants to be conserving phosphorus and wasting calcium during human milk feeding. Supplementation of human milk with NaH2PO4 results in higher phosphorus lower calcium excretion in urine of VLBW-infants, but they do not reach the values of LBW-infants. Because the activity of alkaline phosphatase was not different between the feeding groups and in all cases within the normal range a delayed bone mineralisation cannot be assumed in the infants studied. Thus, the phosphorus deficiency which is shown by the renal excretion of calcium and phosphorus in the VLBW-infants can be considered to be latent. In the light of our data the concentration of phosphorus in human milk seems to be too low and the calcium/phosphorus ratio too high for the optimal mineral metabolism in VLBW-infants. The supplementation used improves the situation, but the phosphorus intake seems still too low. Further investigations are needed to detect the optimal phosphorus intake for these infants. The calcium/phosphorus ratio in the urine is a good marker to estimate a latent phosphorus deficiency in VLBW-infants.

Alkaline Phosphatase↗
PubMed1987

Improvements of metabolic imbalances after enteral sodium bicarbonate supplementation in infants of very low birth weight (VLBW).

One of the main points of clinical care is the catch-up growth of VLBW infants especially those of small gestational age (SGA). The required high amounts of protein are often not tolerated [1]. Metabolic imbalances due to immaturities of protein metabolism are described [2, 3] also in infants SGA feeding amounts of proteins comparable to mature newborns [4]. Remarkable signs of overloading by proteins are the elevation of amino acid and the bile acid concentrations in the serum [3, 5, 6]. In some of those cases [7] late metabolic acidosis (LMA) is to be seen. There is evidence in the literature that sodium bicarbonate influences nitrogen [8] and ionic balances [9] in newborn animals without any signs of acidosis, besides its simple buffer function. The aim of this study was to control changes of metabolic imbalances after bicarbonate supplementation before development of acidosis in predisposed infants. Therefore we determined parameters, which were significantly changed with LMA [6] during two feeding schedules: firstly, during bolus supplementation in infants feeding (2.0 +/- 0.4) g/kg BW.d protein and secondly during chronic supplementation of bicarbonate to (3.0 +/- 0.4) g/kg BW.d protein. In relation to the improvement of the nitrogen balance in growing lambs [7] we supposed comparable effect of bicarbonate on metabolic imbalances caused by protein overloading.

Bicarbonates↗
PubMed1987

Cholestasis in late metabolic acidosis of prematurely born infants.

Serum concentrations of bile acids and tyrosine were determined in 14 premature infants with late metabolic acidosis and in 13 comparable controls without acidosis (protein intake 2 g/kg X d). At the same time the bile acids and the catalytic activity concentrations of lipase and trypsin were estimated in the duodenal juice. The daily faecal excretion and the percentage of fat eliminated were measured. In 8 patients with late metabolic acidosis the duodenal studies were repeated one week after late metabolic acidosis. Infants with late metabolic acidosis showed significantly higher concentrations of bile acids and tyrosine in the serum than the controls (p less than 0.0005). In the duodenal juice the activities of lipase and trypsin and the concentration of bile acids--especially of dihydroxy bile acids--were decreased (p less than 0.001). The faecal excretion during late metabolic acidosis was significantly increased, with high percentage of fat. Eight days after late metabolic acidosis all duodenal parameters equalled the range of the control group. The relations between acidosis, cholestasis, and amino acid transport to the liver are discussed.

Acidosis↗
PubMed1987

The application of redissolved human milk lyophilisate for nutrition of very low birth weight infants.

In the second month of life the nitrogen and fat balances were studied in 21 very low birth weight infants fed with native human milk or redissolved human milk lyophilizate. Caused by fat losses during the lyophilization procedure and decreased fat absorption rate as consequence of heating of the milk before lyophilization, the available energy is significantly lower in infants fed with redissolved human milk lyophilizate than in those fed with native human milk. The reduced energy intake leads to a decreased protein utilization, as well as to a poor weight gain. In addition, hyperaminoacidaemia and hyperaminoaciduria appear in these infants. Thus, supplementation with medium-chain triglycerides must be recommended if redissolved human milk lyophilizate is used for feeding very low birth weight infants.

Body Weight↗
PubMed1987

Metabolic consequences of high protein intake in premature infants appropriate for gestational age.

The metabolic consequences of different levels of protein intake were studied in premature infants appropriate for gestational age (birth weight between 1500 and 2000 g) during the third week of life. The different protein intake was the result of different nutrition, human milk and two formulae containing 1.7 and 2.1 g protein/100 ml, respectively. The increasing protein intake causes an increase in the alpha-amino-nitrogen as well as the urea concentration in the serum, an elevation of total and alpha-amino-nitrogen losses in urine, increased amounts of stool accompanied by increased total nitrogen as well as fat excretion. The results indicate that a protein intake of more than 2.5 g/kg X 24 h creates a metabolic overloading without any advantages. Thus, human milk of mothers delivering preterm is a sufficient nutrition for these infants, also with regard to protein requirements, if feeding volumes of 180 to 200 ml/kg X 24 h are tolerated. Supplementation of human milk or nutrition with high protein formulae can be justified only in infants who cannot tolerate sufficient feeding volumes.

Amines↗
PubMed1987

[Sodium homeostasis in neonatal infection of eutrophic premature infants].

In 14 premature infants suffering from bacterial sepsis during the first week of life the daily renal sodium and potassium losses as well as the concentrations in serum of both electrolytes were measured before and during the period of infection. 24 hours before appearance of first clinical symptoms of sepsis the sodium concentration in urine increases and the balance becomes negative. Hyponatraemia occurs later and is in correlation with the clinical course of the disease. Thus, the hyponatraemia is caused more by shifting of sodium from the extracellular space than by renal sodium excretion. To prevent this hyponatraemia the sodium intake has to be increased to 6 mmol/kg X 24 h as a minimum and the fluid intake has to be decreased to 80 ml/kg X 24 h as a maximum in the same time when antibiotic treatment is started. A short-term control of serum electrolytes is an important premise for a sufficient treatment. Increased sodium concentrations in urine of more than 50 mmol/l or again increasing concentrations beyond the second day of life can be appreciated as early signs of neonatal sepsis.

Humans↗
PubMed1986

A new parallelism acceptance criterion for validating large plate bioassay results.

Large plate bioassays are normally assessed by analysis of variance. The British Pharmacopoeial approach requires a validation of the assay through a test for parallelism. This approach is shown to be impractical as it does not allow for improvements in technique which tend to reduce the error mean square value for the bioassay and hence increase the F ratio for parallelism. A new parallelism acceptance criterion is proposed in which a critical value for parallelism mean square is determined by multiplying the appropriate critical F value for parallelism by the value for error mean square which provides a limiting value for the fiducial limits. This approach allows for improved bioassay technique but does not lead to the acceptance of doubtful assay results. The results of 15 months of bioassays covering over 500 assays using the proposed parallelism acceptance criterion are discussed.

Biological Assay↗