PubMed Health⌕ Search

Biomedical subjects

L J Gerards

Publications and source records attributed to L J Gerards.

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

Early neonatal group B streptococcal disease: degree of colonisation as an important determinant.

During a period of 5 years (1 January 1977 to 1 January 1982) 145 infants colonised with group B streptococci (GBS) were admitted to the neonatal intensive care unit of the University Children's Hospital, Utrecht. In 87 of these infants (60%) vertical transmission of GBS was established; in 43 of these 87 infants (49%) the degree of colonisation was moderate to heavy. Early-onset (EO) GBS disease arose in 21 of 145 infants (attack rate: 14.5%). Of the 43 infants moderately to heavily colonised with GBS, however, 19 suffered from EO GBS disease (attack rate: 44.2%), whereas there were only two cases among the 44, lightly colonised infants (attack rate: 4.5%), a highly significant difference (P less than 0.0005). Similarly, probable sepsis (PS), defined as signs and symptoms of sepsis but without positive blood cultures, was observed significantly more often in moderately to heavily colonised infants (15/43, attack rate: 34.9%) compared with those lightly colonised (4/44, attack rate: 9.1%) (P less than 0.005). Infants moderately to heavily colonised with GBS at birth appear to have a significantly higher risk of developing serious GBS disease (EO or PS) than do infants only lightly colonised.

Adolescent↗
PubMed1985

Opsonic defense to Staphylococcus epidermidis in the premature neonate.

The determinants of opsonic defense to Staphylococcus epidermidis were studied in 47 premature newborns. Opsonic activity for S. epidermidis in serum from premature newborns proved to be proportional to gestational age (r = .664, P less than .001). The level of IgG antibodies to staphylococcal peptidoglycan in neonatal sera was similarly proportional to gestational age (r = .604, P less than .001). However, all opsonic activity of premature neonatal serum proved to be heat labile, i.e., dependent on activation of complement. Thus, no heat-stable, IgG-dependent opsonic activity to S. epidermidis was detected in any of the preterm sera, despite the presence of IgG antibodies to peptidoglycan. Further studies with purified IgG isolated from paired sera from term neonates and their mothers revealed that at similar concentrations the opsonic activity to S. epidermidis of neonatal, transplacentally derived IgG was only 26% of the activity of maternal IgG, a finding that may explain the absence of heat-stable opsonic activity in preterm newborns.

Antibodies, Bacterial↗
PubMed1984

Passive-active immunisation of neonates of HBsAg positive carrier mothers: preliminary observations.

Screening of pregnant women for hepatitis B surface antigen (HBsAg) in three areas of Holland led to the identification of HBsAg carriers, 20 of whom were subsequently delivered. Within two hours after birth all infants received hepatitis B immune globulin (0.5 ml/kg body weight) and, after randomisation, hepatitis B vaccine (10 micrograms) was given either at 0, 1, and 2 months of age or at 3, 4, and 5 months of age, the latter concomitantly with DPTP vaccination. Eighteen infants complying with the protocol were followed up for at least six months. No side effects were observed after either passive or active immunisation. All infants developed high concentrations of anti-HBs antibodies; no interference of high dose passive immunisation with active immunisation was observed. Concentrations of anti-HBs at three months were significantly lower in infants given delayed active immunisation than in those given early active immunisation. These data suggest that passive-active immunisation against hepatitis B virus infection is well tolerated by neonates under 3 months of age and that both early and late active immunisation in combination with passive immunisation will result in excellent anti-HBs production.

Carrier State↗
PubMed1984

An outbreak of gastroenteritis due to Escherichia coli 0142 H6 in a neonatal department.

An outbreak of gastroenteritis due to Escherichia coli 0142 H6 in a neonatal ward is described. The epidemic affected 16 of 24 infants (infection-rate 66 per cent), of whom one died due to necrotizing enterocolitis. Administration of antibiotics was of limited value in treatment or in eradicating E. coli 0142 H6 from the stools. Termination of the epidemic was only accomplished by isolating the patients, accompanied by strict hygienic measures, including the use of disposable gloves. Gastroenteritis due to this organism occurred only in prematurely born infants during the first 2 weeks of life.

Cross Infection↗
PubMed1984

Partial trisomy 11q due to paternal t(11q;18p); further delineation of the clinical picture.

We describe an eleven-months-old girl with a partial trisomy 11q due to a paternal t(11;18)(q142;p1131). Clinical symptoms include severe psychomotor retardation, microcephaly, cleft palate, large, beaked nose, micrognathia, short hands and proximally placed thumbs. Moreover, a partial agenesis of the callosal body and a perineal mid-line malformation are present. The clinical picture of the index case is compared with relevant findings in patients with a partial trisomy (11q) and partial monosomy (18p) (Aksu 1977).

Abnormalities, Multiple↗
PubMed1984

Familial partial monosomy 5p and trisomy 5q; three cases due to paternal pericentric inversion 5 (p151q333).

A family is described in which the mother's 9 pregnancies ended in the birth of 2 healthy girls, 4 spontaneous abortions and 3 infants with multiple congenital malformations as bird-headed appearance, pre- and postnatal growth deficiency, microcephaly, micrognathia with small mouth and cat-like cry. Two of the three affected sibs had complex cardiac malformations incompatible with life; the third had a bicuspid aortic valve. Chromosomal investigation revealed an abnormal karyotype: 46,XX,rec(5),dupq,inv(5)(p151q333)pat, leading to a partial monosomy 5p and partial trisomy 5q. A large pericentric inversion of chromosome 5 was found in the father: 46,XY,inv(5)(p151q333) as well as in the firstborn healthy female sib. The clinical features partly fit the partial monosomy 5p as well as the partial trisomy 5q syndrome.

Adult↗
PubMed1984

Prophylactic bromocriptine treatment during pregnancy in women with macroprolactinomas: report of 13 pregnancies.

Ten women with a macroprolactinoma had prophylactic bromocriptine treatment during 13 pregnancies in the second and third trimesters. One patient had signs of tumour enlargement during the first trimester, but none of them showed tumour enlargement during prophylactic bromocriptine treatment. Prolactin levels were reduced in both maternal and cord sera, but they were normal in amniotic fluid. All pregnancies progressed to term. Thirteen healthy infants were born without congenital malformations and growth and psychomotor development were normal during the follow-up period (7 months to 5 years). The safety of bromocriptine treatment during pregnancy is discussed and our current policy of management of patients with prolactinomas is outlined.

Adult↗
PubMed1983

A lethal neonatal variant of carbamoyl-phosphate synthetase deficiency in combination with an intermediate activity of L-ornithine: 2-oxoglutarate amino-transferase.

Shortly after birth, a newborn girl developed anorexia, hypotonia, apneic attacks and seizures. After 61 h the child died in coma. Biochemically, a highly elevated blood ammonia level was found together with an increased plasma level of the amino acids mainly involved in ammonia detoxication. Enzyme studies in post-mortem liver tissue material revealed a deficiency of carbamoyl-phosphate synthetase (0.9% of the mean value in controls) in combination with an intermediate activity of L-ornithine: 2-oxoglutarate aminotransferase (40% of the mean value in controls).

Amino Acid Metabolism, Inborn Errors↗
PubMed1982

Maternal carriage and neonatal acquisition of group B streptococci.

Vaginal, cervical, and rectal swabs were obtained from 762 women early in pregnancy to culture group B streptococci (GBS). The overall carrier rate was 13.9% and the rectal, vaginal, and cervical carrier rates were 10.6%, 7.9%, and 6.3%, respectively, GBS were isolated only from the rectum in 33%, so the rectum is an important reservoir. Seventy-five percent of the culture-positive women were permanent or intermittent carriers. Ninety percent of all women positive at labor were positive before the 20th week; acquisition of GBS late in pregnancy was rare. The frequency of transmission to the neonates was 63.4% among permanent carriers. Other determinants for transmission were the number of positive sites, the heaviness of colonization, and the (cervical) localization of GBS at labor. The serotypes of GBS isolated from the mothers and neonates were the same. Serotype distribution fluctuated during pregnancy. Types III (29%) and Ib (27%) were predominant, followed by types II (12%) and Ic (10%).

Carrier State↗
PubMed1982

The influence of group B streptococcal-carriership on pregnancy outcome.

762 women were screened for GBS-carriership in the first trimester of pregnancy. The mean age of carriers was 27.2 years. Follow-up was performed in 64 initially positive and 97 negative cases. Persistent carriership was the most important determinant for neonatal GBS-acquisition. Race, birth-weight, gestational-age, interval between rupture of the membranes and birth could not be associated with GBS-carriership or neonatal acquisition. The number of neonates with fetal distress was significantly higher amongst those born to all GBS-carriers; the number of S.G.A.-infants was significantly elevated amongst those born to permanently positive women. Vertical transmission was found in 86% of the mother-infant pairs. GBS serotype III and Ib were predominant. Serotype III was significantly more isolated from non-caucasian women. The transmission frequency of all types was equal (46%), except for type IIc (22%). None of the serotypes was especially associated with fetal distress or smallness for gestational age.

Adult↗
PubMed1981

May mothers taking acenocoumarol breast feed their infants?

In 20 women receiving Sintrom post partum, the acenocoumarol concentration in serum and breast milk at different times was measured. Even at the time of maximal serum concentration, or for the following 6 h, no acenocoumarol could be detected in the breast milk. In accordance with this finding, no effect of breast feeding on Thrombotest values of the infants could be demonstrated. These data suggest that mothers taking acenocoumarol for a short period may safely breast feed their infants.

Acenocoumarol↗