PubMed Health⌕ Search

Biomedical subjects

G Boehm

Publications and source records attributed to G Boehm.

At least 109 records · Page 6Linked to original sources
PubMed1986

Evidence for amino acid induced cholestasis in very-low-birth-weight infants with increasing enteral protein intake.

In the present investigation 32 very-low-birth-weight (VLBW) infants fed at three different levels of protein intake (2.92 g/kg/d from human milk, 3.22 and 4.06 g/kg/d from formula) were studied at the mean age of 21 days. Serum total alpha-amino nitrogen concentration correlated directly to total bile acid concentration. The serum and urine alpha-amino nitrogen and the serum bile acid concentration correlated with protein intake. The increase in protein intake was accompanied by a concomitant decrease in the intraluminal bile acid concentration in the AGA infants. The results offer indirect evidence of decreased bile flow in VLBW-infants on excessive oral protein intake. The cholestatic effect could be mediated by an increase in the plasma amino acid concentration.

Amino Acids↗
PubMed1986

Effects of bacterial sepsis on protein metabolism in infants during the first week.

In the presence of bacterial infection during the first week of life a catabolic state evolves more rapidly than in the later life. Hyperaminoacidaemia and subsequent hyperaminoaciduria, elevated urea concentrations in serum, and increased renal nitrogen losses are the most important metabolic changes. These findings correlate with the clinical course of the disease and refer to the primary disturbance of cell metabolism as the cause of the metabolic changes observed. While no relation could be observed between metabolic response and bacterial species, there is a significant dependence on the time interval from the occurrence of first clinical symptoms at the beginning of antibiotic treatment. If this period is longer than 8 h, serious metabolic disturbances will usually be found. Due to the limited amino acids utilization, especially by the liver, an adequate energy intake should be the primary aim of nutrition, whereas a protein intake of more than 2.0 to 2.5 g/kg X day may further aggravate the metabolic imbalance.

Bacterial Infections↗
PubMed1986

[Nutrition of very low birth-weight premature infants with enriched breast milk during the adjustment phase].

To enable an enteral nutrition in very low birth weight infants appropriate for gestational age, adapted to the high nutritional requirements, pooled human milk from mothers delivered preterm was enriched with human milk lyophilisate 6 g/100 ml. The concentrations of protein increase from 11.8 +/- 1.2 to 15.8 +/- 2.1 g/l and the non-protein energy substrates raise in the same proportion. Osmolality increases from 291.6 +/- 11.2 to 384.9 +/- 19.6 mosmol/l. The higher protein intake was tolerated without relevant metabolic imbalances. Only small increasing of amino acids concentrations in serum and a higher renal excretion of amino acids could be observed. The nitrogen balance was equalized during the first two days of life and positive from the 3rd day of life. Nitrogen retention was significantly higher in the group fed human milk lyophilisate enriched human milk from the 2nd day of life. Also the postnatal weight losses were significantly lower and the birth weight was reached significantly earlier. Human milk lyophilisate enriched human milk can be recommended for nutrition of very low birth weight infants appropriate for gestational age from the first day of life.

Amino Acids↗
PubMed1986

Influence of protein intake and liver function on acid base balance in premature infants.

In 43 patients with late metabolic acidosis (LMA) the factors promoting LMA were investigated. Postnatal adaptation was distributed in all cases, in 35 patients acidosis developed after introduction of formula feeding. Whereas no differences were observed in renal function (urine volume and renal molar excretion) between acidotic and non-acidotic patients, there was a significantly higher concentration of bile acids in serum (26.1 +/- 9.6 vs 98.6 +/- 21.6 mumol/l), a significantly increased fractional volume of stools (8.2 +/- 1.3 vs 11.4 +/- 1.9% of intake, and higher faecal fat excretion (26.5 +/- 5.2 vs 39.1 +/- 6.6% of faecal weight) in LMA patients than non-acidotic formula-fed infants. It is suggested that impaired postnatal development of liver function caused by severe disturbances of postnatal adaptation (respiratory distress, persistent fetal circulation, sepsis) is one of the most important factors in the pathogenesis of LMA. Thus, liver function should be checked before a protein intake surpassing that of a breastfed infant is introduced. Concentration of the serum bile acid level seems a reliable marker of LMA.

Acidosis↗
PubMed1986

Bile acids in the serum and duodenal content of newborn infants of different classification.

Total serum bile acids were determined in 83 infants of different classification. In 33 mature infants total bile acids were measured after feeding human milk (n = 17) or formula (Milasan). Statistically significant elevations of total bile acids were found on the 14th day of life, if mature infants were formula fed. In low-birth-weight infants appropriate for gestational age total bile acids are not higher on the 8th day of life than in mature infants, but on the 14th day of life the elevations become significant. Low-birth-weight infants small for gestational age and infants suffering from fetal distress syndromes show the highest total bile acids with great variations. Low-birth-weight infants small for gestational age had serum total bile acid concentrations related to the degree of fetal growth retardation (r = -0.871). Some newborns suffering from late metabolic acidosis had lowest intraluminal total bile acids, especially dihydroxy bile acids. We found a direct hyperbolic dependence between total bile acids in the serum and the duodenal content (r = +0.93). In cases of serum total bile acids above 50 mumol/l, concentrations in duodenal content do not exceed 2 mmol/l. Therefore, the degree of fetal growth retardation, fetal distress syndromes, and the nutrition after birth have great influence on bile acid metabolism.

Aging↗
PubMed1985

[Protein metabolism in the small for gestational age newborn in relation to the severity of fetal malnutrition].

The daily nitrogen balance, the amino acid concentrations in serum and urine, and the bile acid concentrations in the serum on the eighth day of life were estimated in newborn infants small for gestational age with different degrees of fetal malnutrition. The amino acid concentrations in urine and serum as well as the total nitrogen losses by urine increase in dependence on the severity of fetal malnutrition. In addition the bile acid concentrations were elevated whereas the urea concentrations in serum remained unchanged. These results point to a deranged liver function which depends on the degree of fetal malnutrition. These special metabolic conditions have to be considered in the nutrition of such infants. The bile acid concentrations seem to be an efficient parameter to estimate this metabolic situation.

Amino Acids↗
PubMed1985

Nutrition of newborns small for gestational age with human milk lyophilisate enriched human milk during the first week of life.

In 24 very low birth weight infants appropriate or small for gestational age, the metabolic response to nutrition with human milk lyophilisate enriched human milk was estimated during the first week of life. In contrast to newborns appropriate for gestational age, in newborns small for gestational age signs of metabolic overloading could be observed: increased urinary amino acid excretion and neonatal cholestasis. Both depended on the degree of fetal growth retardation. It was concluded that nutrition with human milk lyophilisate enriched human milk cannot be recommended for very low birth weight infants during the first week of life. In newborns small for gestational age the metabolic situation has to be estimated before starting a high protein diet. If the level of total bile acids amounts to more than 30 mumol/l, protein intake should be increased carefully during the first week of life.

Amino Acids↗
PubMed1984

[Glomerular filtration in low birthweight neonates].

The glomerular filtration rate (GFR) was estimated in mature newborns appropriate for gestational age (AGA), mature newborns small for gestational age (SGA) and premature newborns AGA on the 2nd day and the end of the 3rd week of life. The GFR was determined by mannitol using the slope-clearance technique. On the 2nd day the GFR is significantly diminished in mature newborns SGA (1.21 ml/kg X min) compared to mature newborns AGA (1.84 ml/kg X min) as well as premature newborns AGA (1.54 ml/kg X min). During the first 3 weeks of life the GFR increases significantly in mature newborns both AGA (2.20 ml/kg X min) and SGA (1.65 ml per kg X min), whereas the increase is insignificant in premature newborns AGA (1.70 ml per kg X min). Therefore there is no difference between mature newborns SGA and premature newborns AGA at the end of the 3rd week of life. The decreased GFR of newborns SGA during the first weeks of life has to take into consideration for dosage of drugs tending to cumulate and for composition of parenteral nutrition.

Glomerular Filtration Rate↗
PubMed1983

[Pollen and inanimate dust particles as cause of obstructive airway diseases].

A survey of pollen production, especially in anemophilous plants is first given, because pollen frequently causes respiratory symptoms. Afterwards the use of the Burkard apparatus for volumetric sampling is described, in which the amounts of pollen and fungal spores in a certain volume of air can be caught. It is recommended that, in the country under investigation, several places with different climates each should have an apparatus continuously in operation. then flowering calendars can be constructed to show the various seasons of flowering, and pollen and spore production, and how they vary throughout the country. Meteorological data may also be included in these graphs. G. BOEHM's 'Individual Pollen Collector' is then described. This device is very useful for 'problem patients' with hayfever. Dark stripes of varying intensity resulting from inanimate particles such as dust and soot can also be seen in the daily specimens of the Burkard device. In this case a semiquantitative measurement is possible with a pherogramme evaluator, which is available in every modern clinic. Finally information about the frequency of pollinosis in the population, especially children with asthma, hayfever etc. is given. The prognosis for these patients is discussed and it is noted that there should be more long-term investigations of patients suffering from pollinosis. It would then be better, to give better prognoses for these allergic illnesses.

Air Pollution↗