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Biomedical subjects

J Hertel

Publications and source records attributed to J Hertel.

At least 55 records · Page 3Linked to original sources
PubMed1985

Influence of the maternal plasma glucose concentration at delivery on the risk of hypoglycaemia in infants of insulin-dependent diabetic mothers.

Plasma glucose concentrations at birth and at two hours of age were measured in 53 infants of insulin-dependent mothers (IDMs). The plasma glucose concentrations at delivery were measured in the mothers of 17 IDMs and in the remaining 36 mothers, glucose was estimated by interpolation from concentrations achieved just before and after delivery. Clinical and laboratory data from the two groups were otherwise similar, so the groups were combined for further analyses. The maternal plasma glucose at delivery correlated positively with the glucose concentration of the IDMs at birth (rho = 0.82, p less than 0.001) and negatively with the glucose concentration at two hours of age (rho = -0.46, p less than 0.001). Maternal plasma glucose concentration was higher in mothers delivered by caesarean section than in vaginally delivered mothers (p less than 0.05). Eleven IDMs became hypoglycaemic at two hours of life (plasma glucose less than or equal to 1.7 mmol/l). These infants had higher cord plasma glucose concentrations at birth than those who remained normoglycaemic; the maternal glucose concentration was also higher. None of the IDMs became hypoglycaemic if the maternal glucose concentration at delivery was less than 7.1 mmol/l. In 28 IDMs the simultaneous plasma concentrations of non-antibody bound immunoreactive insulin (IRI) were recorded. Cord plasma IRI correlated with glucose and IRI at two hours of age (rho = -0.73, p less than 0.001 and rho = 0.77, p less than 0.001, respectively). Cord plasma IRI was higher in IDMs who became hypoglycaemic than in the remaining infants.(ABSTRACT TRUNCATED AT 250 WORDS)

Blood Glucose↗
PubMed1985

Plasma noradrenaline and adrenaline in newborn infants of diabetic mothers: relation to plasma lipids.

No significant differences in plasma noradrenaline and adrenaline concentrations were found between 14 infants of diabetic mothers (IDMs) and 7 infants of non-diabetic mothers at birth or at 2 hours of age, although the mean values were higher in the IDMs. The mean blood glucose concentration declined from birth to 2 hours of age and it was lower at 2 hours of age in the IDMs although only one IDM became hypoglycaemic. Plasma non-antibody bound insulin concentrations were approximately 12 fold higher at birth and at 2 hours of age in the IDMs than in the control infants. Similar increases in plasma free fatty acids and free glycerol concentrations from birth to 2 hours of age were observed in the 2 groups. At 2 hours of age positive correlations were found between plasma noradrenaline and free fatty acids (r = 0.85, p less than 0.01) and free glycerol (r = 0.65, p less than 0.05) and between plasma adrenaline and free glycerol (r = 0.71, p less than 0.05) and the rise in free glycerol from birth to 2 hours of age (r = 0.65, p less than 0.05) in the IDMs. At birth positive correlations between plasma free fatty acids and plasma noradrenaline (r = 0.69, p less than 0.02) and plasma adrenaline (r = 0.88, p less than 0.01) were found in the IDMs. No correlations were found in the control infants. These findings indicate that the catecholamines counteracts the inhibitory effect of insulin on lipolysis in IDMs.

Blood Glucose↗
PubMed1985

Catecholamine response to chest physiotherapy and endotracheal suctioning in preterm infants.

Adrenaline and noradrenaline was measured just before and just after chest physiotherapy and endotracheal suctioning in 13 preterm, ventilated, newborn infants. Mean aortic blood pressure was also recorded. Eight of the infants received phenobarbitone. Catecholamine levels were five-fold higher in the 5 infants with blood pH less than 7.30 compared to the other 8 infants. After the procedure, both adrenaline and noradrenaline were significantly higher than baseline levels. The adrenaline response to the procedure was a two-fold increase and significantly greater than the noradrenaline response. Analysis of the effects of phenobarbitone treatment and acidosis on catecholamine responses by multiple linear regression demonstrated that the adrenaline response was reduced by phenobarbitone while the noradrenaline response was unaffected. There were no associations of blood pressure, responses with catecholamine responses, with acidosis or with phenobarbitone treatment.

Acidosis↗
PubMed1984

Hydrops foetalis in 3 infants of a mother with acquired chronic pure red cell aplasia: transitory red cell aplasia in 1 of the infants.

A young woman with acquired chronic pure red cell aplasia (PRCA) gave birth to 3 infants with foetal hydrops. The 1st infant died shortly after birth, while the 2nd was stillborn with severe anaemia. Both had signs of increased erythropoiesis at autopsy. The 3rd infant was saved by foetal intrauterine red cell transfusions into the hepatic part of the umbilical vein. This infant had red cell aplasia lasting for about 3 months after birth, but then recovered. We believe that antibodies to red cell progenitors in the bone marrow were transferred transplacentally from mother to foetus, giving rise to severe affection of these infants. To the best of our knowledge this has not been reported previously in PRCA.

Antibodies↗
PubMed1984

Congenital chylothorax: management by ligature of the thoracic duct.

Congenital chylothorax in a male infant persisted for 10 weeks despite repeated thoracocenteses and dietary regimens which included total parenteral nutrition for 37 days and a peroral semielementary diet with medium-chain triglyceride content for 19 days. Thoracotomy disclosed a small leak in the thoracic duct. The duct was ligated above and below the leak, as attempted repair was unsuccessful. There was no recurrence of pleural effusion after the operation and no distal lymphoedema was observed.

Chylothorax↗
PubMed1982

Metabolic events in infants of diabetic mothers during first 24 hours after birth. I. Changes in plasma glucose, insulin and glucagon.

Changes in plasma glucose, nonantibody-bound insulin and glucagon concentrations were studied in 32 newborn infants of diabetic mothers (IDM) during the first 24 hours after birth. Ten infants were born to White class A mothers and 22 to class B-F mothers. The infants were kept fasting during the investigative period and blood was sampled from an umbilical artery catheter. At birth, plasma glucose and glucagon levels were similar in the class A and B-F infants, whereas nonantibody-bound insulin levels were approximately 15-fold higher in the class B-F infants than in the class A infants (p less than 0.001). After birth, plasma glucose fell in all infants, the nadir being reached at two hours (p less than 0.01). Plasma glucose fell by approximately 35% in the class A infants and 63% in the class B-F infants (p less than 0.01). Eight IDM had asymptomatic hypoglycemia (plasma glucose less than 1.9 mmol/l) and four of these infants had glucose levels below 1.7 mmol/l and were withdrawn from further study. In the remaining four hypoglycemic IDM, plasma glucose was about 1.6-fold higher (p less than 0.01) and insulin about 11-fold higher (p less than 0.001) at birth compared to the 24 normoglycemic IDM. The hypoglycemia was attended by unchanged insulin levels in the class A infants, whereas insulin fell in the class B-F infants (p less than 0.01). However, during the whole investigative period, plasma insulin of the class B-F infants was higher than that of the class A infants (p less than 0.01). After birth, plasma glucagon increased slowly in all IDM and peak values were reached after 12 hours in the class A infants (p less than 0.05) and 24 hours in the class B-F infants (p less than 0.01). Only those infants who became hypoglycemic after birth exhibited a significant increment in plasma glucagon from 0.2 hours (p less than 0.05). These results suggest that neonatal hypoglycemia of IDM results from high plasma levels of nonantibody-bound insulin together with a very retarded increment in plasma glucagon levels. The degree of neonatal hypoglycemia and hyperinsulinemia of an individual IDM seems to be positively correlated to the severity of the diabetes of the mother.

Adult↗
PubMed1982

Metabolic events in infants of diabetic mothers during first 24 hours after birth. II. Changes in plasma lipids.

Changes in plasma glycerol (FG), free fatty acids (FFA) and triglyceride (TG) were studied in 24 normo- and 8-hypoglycemic infants of diabetic mothers (IDM). In both groups a normal rise in plasma FG 2 hours after birth was found indicating unimpaired lipolysis. The rise in plasma FFA, however, was only about 50% of normal in normoglycemic IDM and about 25% of normal in hypoglycemic IDM. The rise in plasma TG was normal in normoglycemic and about 70% of normal in hypoglycemic IDM. The 2 hour rise in plasma FFA correlated with the 2 hour concentration of insulin and glucose, whereas the rise in plasma FG and TG did not. Maternal plasma FFA correlated with fetal FFA retention (umbilical vein minus artery (V-A) FFA concentrations). No correlations were found between maternal plasma FFA values and birth-weights nor between umbilical V-A FFA concentrations and birth-weights.

Adult↗
PubMed1982

Metabolic events in infants of diabetic mothers during first 24 hours after birth. III. Changes in plasma amino acids.

Plasma amino acid concentration (AAC) were studied in 31 diabetic mothers (10 of White class A, 10 of B-C and 11 of D-F) and their 32 infants during the first 24 hours after birth. Only minor differences between the 3 groups were found at birth and 2 hours, and none at 12 and 24 hours after birth. The individual AAC in umbilical vein plasma did not correlate with birthweight. All AAC except aspartic acid, asparagine, cystine and glutamic acid were higher in umbilical venous plasma than in maternal plasma. Umbilical venous-arterial differences of amino acids did not correlate with maternal or umbilical vein insulin concentrations except for threonine and valine. In general essential amino acids decreased after birth. In 8 infants with hypoglycemia and hyperinsulinism at 2 hours of age several plasma amino acids were lower than in the normoglycemic infants.

Adult↗
PubMed1982

Plasma noradrenaline and adrenaline in infants of diabetic mothers at birth and at two hours of age.

Plasma noradrenaline and adrenaline in the umbilical artery were very high in many infants of both diabetic mothers (IDM) and non-diabetic mothers (controls) compared to values obtained in adults. Blood pH was slightly but significantly lower in IDM than in controls at delivery. There was a significant negative correlation between plasma noradrenaline and blood pH in IDM at birth, but no correlation between plasma noradrenaline and blood glucose, birth weight and Apgar scores. Plasma noradrenaline decreased significantly from birth to two hours of age both in IDM and controls. At two hours of age plasma noradrenaline and adrenaline were significantly greater in IDM compared to controls whereas blood glucose concentration was lower in the former group. There was a close inverse correlation between plasma noradrenaline and adrenaline, respectively, and blood glucose in IDM at two hours of age but not in controls. The elevated plasma noradrenaline at delivery in IDM may be explained by clinically undetectable acidosis whereas elevated plasma catecholamines at two hours are probably due to hypoglycaemia.

Blood Glucose↗
PubMed1980

Gut transit time and lactose malabsorption during phototherapy. I. A study using lactose-free human mature milk.

Sixty newborn infants with normal birth weight suffering from uncomplicated hyperbilirubinemia were studied. They were fed human mature milk from which lactose had been eliminated, whereafter either sucrose ("sucrose milk") or lactose ("lactose milk") was added. 30 infants received ordinary phototherapy and 30 intensive phototherapy (blue double light). 15 in each group had "sucrose milk" and 15 "lactose milk". There was no significant difference between the increase in blood glucose (delta BS) by lactose tolerance tests performed before phototherapy (LTT1) and by those performed during phototherapy (LTT11), neither in infants treated with ordinary nor with intensive phototherapy. All infants had normal delta BS-LTT11, except one receiving ordinary phototherapy. There was no significant difference in gut transit time between infants having "sucrose milk" and infants having "lactose milk", neither in those treated with ordinary nor with intensive phototherapy. Gut transit time was significantly shorter in infants treated with intensive phototherapy than in infants treated with ordinary phototherapy without there being any significant difference in delta BS-LTT11. The infant with flat LTT11 may have developed lactose malabsorption during the phototherapy. Thus, lactose malabsorption is not the usual cause of the reduced gut transit time during phototherapy and must be a rare complication in phototherapy.

Bilirubin↗
PubMed1980

Gut transit time and lactose malabsorption during phototherapy. II. A study using raw milk from the mothers of the infants.

Thirty newborn infants with normal birth weight suffering from uncomplicated hyperbilirubinemia were studied. 15 infants received ordinary phototherapy and 15 intensive phototherapy (blue double light). All infants received their mothers' milk or fresh milk from mothers of other newborn infants of the same age. All infants had normal lactose tolerance test during the phototherapy, except one infant receiving ordinary transit time was relatively long. The gut transit time was significantly shorter in the infants treated with intensive phototherapy than in those treated with ordinary phototherapy without there being any significant difference in the increase in blood glucose by lactose tolerance tests. It is concluded that lactose malabsorption is not the usual cause of the reduced gut transit time during phototherapy even if the infants receive their mothers' milk.

Bilirubin↗
PubMed1979

Congenital ascites due to mesenteric vessel constriction caused by malrotation of the intestines.

A newborn premature girl with congenital, non-chylous ascites is presented. The ascites recurred although laparocentesis was performed three times. The ascites was probably due to a superior mesenteric vein constriction caused by a malrotation of the intestines. After division of the Ladd-bands no ascites recurred. Non-chylous, congenital ascites may have a surgically treatable cause.

Ascites↗