PubMed Health⌕ Search

Biomedical subjects

J A Schipper

Publications and source records attributed to J A Schipper.

8 recordsLinked to original sources

[Wheezing and cough related to congenital airway abnormalities in young infants].

Two girls developed symptoms of wheezing which started shortly after birth. The symptoms did not respond to bronchodilators. At the age of 5 months, the first infant developed severe respiratory distress with decreased left-sided breathing sounds on auscultation. The chest X-ray showed left-sided hyperinflation. Bronchoscopy revealed isolated malacia of the left main stem bronchus. The second patient, who had a history ofcor vitium, was referred to a paediatric pulmonologist in an academic hospital for chronic coughing and wheezing. Bronchoscopy and CT angiogram, performed at the age of 14 months, revealed tracheal malacia due to compression from a right descending aortic arch. Broncho- and tracheomalacia are disorders which may rarely result in severe respiratory distress. These disorders should be considered when unexplained symptoms of wheezing or coughing are present in young infants, especially if the symptoms start shortly after birth and persist without signs of viral infection.

Bronchi↗

[Anaemia in two infants due to fetomaternal transfusion].

In two neonates, a boy suffering from persistent pulmonary hypertension of the newborn and a girl with fetal distress, massive fetomaternal haemorrhage was diagnosed (290 ml). In both cases fetal monitoring showed a sinusoidal heart rate pattern and the Kleihauer-Betke test was positive. Both children were intubated and ventilated and were given an erythrocyte transfusion. They both recovered. Differentiation between acute and chronic fetomaternal haemorrhage is essential when deciding on treatment: blood transfusion in acute fetomaternal haemorrhage and exchange transfusion in chronic fetomaternal haemorrhage with normoor hypervolemia. Differentiation is difficult. Little is known about the prognosis of fetomaternal haemorrhage. Because of the nature of perinatal problems and the possibility of neurological damage, long-term follow-up is recommended.

Adult↗

The impact of surfactant replacement therapy on cerebral and systemic circulation and lung function.

UNLABELLED: The influence of surfactant administration on cerebral and systemic circulation and on lung function was evaluated in 12 premature mechanically ventilated infants (mean birth weight 1,560 +/- 770 g, mean gestational age 30.0 +/- 3.2 weeks) with respiratory distress syndrome (RDS) receiving surfactant replacement therapy. We measured mean cerebral blood flow velocity (MCBFV), heart rate (HR), mean arterial pressure (MAP), static compliance (Crs), resistance of respiratory system (Rrs), functional residual capacity (FRC) and fraction of inspired oxygen (FiO2). In addition to a very low compliance and a moderately elevated resistance of the respiratory system a significant drop in MAP, HR, MCBFV and FiO2 was noticed after surfactant administration. After 30 min HR, MAP and MCBFV values returned to baseline levels. We postulate that the drop in MCBFV, MAP, HR and FiO2 with a minor, though not significant improvement of the FRC can most likely be explained by a "relative" hypovolaemia in other organs and parts of the body due to expansion of the lung vascular bed. Compensation for the redistribution of circulatory volume occurred within several minutes. Blood pressure control and treatment of hypovolaemia is mandatory before surfactant is administered. CONCLUSION: In RDS patients there is a significant drop of MAP, HR, MCBFV and FiO2 after bolus surfactant administration.

Airway Resistance↗

Retrieval from a large, integrated HIS-database through formal descriptions and SQL.

This paper outlines the realization of rich retrieval facilities and comprehensive data administration in an existing, large, integrated Hospital Information System (HIS) using SQL as a query-language and using a large collection of formal data descriptions stored in the Data Dictionary and Directory System (DD/DS). It is emphasized that the approach to enhance the access to the database is more important than the technology. Nevertheless, the facilities are presented that support non-routine retrieval. The Data Dictionary and Directory System functions as a catalog of the information system. The vehicle that facilitates the communication with the database is an implementation of SQL-in a number of appearances. It is stressed that only full benefit can be gained through a combined action of a large integrated HIS, a complete and correct DD/DS, and strong retrieval functions.

Hospital Information Systems↗

Testicular dysgenesis and mental retardation in two incompletely masculinized XY-siblings.

Aberrations of fetal sexual development were studied in two retarded phenotypic female 46,XY dysgonadal sisters from a consanguineous marriage. Endocrine evaluation revealed an inadequate response of plasma-testosterone to human chorionic gonadotropin (hCG) stimulation and a normal response to adrenocorticotropic hormone (ACTH) administration. At exploratory laparotomy dysgenetic testes and remnants of the Müllerian and of the Wolffian duct were found. Loss of testicular function, resulting in male pseudohermaphroditism (MPH), can occur at different times during intrauterine development, resulting in a variety of clinical manifestations. A thorough evaluation is warranted in all patients in order to reach a correct diagnosis which is of importance for appropriate gender assignment and genetic counseling.

Adolescent↗