Dignity of the perinatal optimality score of Prechtl.
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Biomedical subjects
Publications and source records attributed to H Manzke.
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A case of a 10-year old boy suffering from asthma bronchiale following pleuropneumonia is reported. Paradoxically, bronchospasmolysis tests using physiological saline + salbutamol or ipratropium bromide impaired the lung function of this patient. Salt solutions inhaled in increasing doses until 1.4% generated severe bronchoconstriction, however, inhalation of DNCG + salbutamol normalized the lung function completely.
The protective effects of inhaled MgS04 on exercise-induced asthma were studied in 13 children aged 6-13 years. The patients performed 6 min. running test on 3 separate days. Spirometry (FEV1, SRAW, VK, PF) was recorded on each test day 10 min. after medicament inhalation directly before and instantly, 2, 5, 10 and 20 min after the running test. t-tests on the mean revealed no significant effects on spirometric measurements (p less than 0.1), but in 6 patients MgS04-inhalation prevented FEV1--decreases greater than 20%. The combination gave better protection compared to salbutamol alone demonstrated from the measurements after exercise testing. Thus, MgS04-inhalation could be useful in the protective treatment of asthma.
Two healthy volunteers were treated with hypoxanthine 3 x 1 g and allopurinol 3 x 100 mg daily for 1 week. During this treatment serum oxypurine concentration and urinary oxypurine excretion increased as expected. No side effects were observed except for some mild daytime drowsiness and lethargy. Measurements of urinary serotonin (5-HT) excretion showed decreases to as much as 60% below initial values. Decreased urinary 5-HT excretion was also found in a patient with incomplete Lesch-Nyhan syndrome during treatment with high doses of hypoxanthine. His neurological symptoms improved slightly. The results suggest that high doses of hypoxanthine exert a nonspecific sedative effect on both patients with Lesch-Nyhan syndrome and healthy controls. The cause is probably a reduced synthesis or release of 5-HT.
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Extremely low birth weight infants are particularly prone to rickets (osteopenia) due to their rapid growth and to deficient intake of calcium and phosphate. In some premature infants suffering from phosphate depletion hypercalcemia syndrome may precede bone demineralisation. Additionally, the adverse effects of calciprivic drugs (phenytoin, phenobarbital, glucocorticoids, furosemide, heparin) contributing to the development of neonatal rickets are discussed. Phosphorus depleted or heparin treated experimental animals develop impairment of mineralisation as manifested by rickets or osteomalacia. Some clinical cases of neonatal rickets are reported and a dosage schedule for parenteral infusion of minerals is given.
Within the sample of 1783 children from the prospective study "Schwangerschaftsverlauf und Kindesentwicklung" (Course of pregnancy and development of children) followed-up until the age of 6 years the mothers of 182 suffered from late gestosis (10.2%). The values of the systolic blood pressure and of the protein concentration in the urine of the mothers measured at their last examination before onset of labour were crucial for the diagnosis of gestosis. According to this definition 95 mothers with systolic pressure greater than or equal to 150 mm Hg were classified as hypertensive (group of the hypertension children) and 87 mothers with both systolic pressure greater than or equal to 150 mm Hg and proteinuria greater than 1 g/l as being preeclamptic (group of the preeclamptic children). The control groups contained the same number of children (matched pairs). There were no significant differences in the findings between the different groups. Apparently, the prognosis of the child's development is favourable provided that the gestosis does not last long and does not lead to placental insufficiency.
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Among 1115 newborns who died during 1957--1976, 136 (12.2%) showed macroscopic renal uric acid infarctions. The incidence depended on the age of the infants and their fluid supply during the first days of life. After introduction of parenteral alkali-glucose infusion in the treatment of perinatal complications, the incidence of renal uric acid infarctions decreased from 19.3% to less than 1.0%. Analysis of the oxypurines in the renal uric acid infarctions of three newborns revealed high percentages of hypoxanthine (31.1%, 21.8% and 11.0%) along with the uric acid. Hypoxanthine ratios above 15% retrospectively point to chronic hypoxia of the newborn.
The concentration of hypoxanthine, xanthine and uric acid in the first 24-h urine of 105 newborn infants was measured densitometrically by thin-layer chromatography. 45 of them had moderate or severe perinatal complications. Among these newborns, 26 infants with perinatal complications (58%) and 4 infants without perinatal complications (7%) had an elevated urinary excretion rate of hypoxanthine. Urinary xanthine was not increased, uric acid was slightly higher in the group of infants with perinatal complication. It seems that a crucial mark is involved, if the rate of hypoxanthine exceed 15% of the total urinary oxypurine excretion, or, if related to urinary creatinine, more than 0.075 mumol hypoxanthine/mumol creatinine. Apparently, with hypoxic newborns increased values of urinary hypoxanthine excretion can be used to quantify the lack of oxygen retrospectively.
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