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P Groneck

Publications and source records attributed to P Groneck.

30 records · Page 2Linked to original sources
PubMed1993

[Secondary myocardial hypertrophy in a very small premature infant treated with dexamethasone].

BACKGROUND: There is an increasing number of reports about the use of dexamethasone in the treatment of preterm infants at high risk for bronchopulmonary dysplasia. The possibility of myocardial hypertrophy developing during this treatment has not been examined. METHODS: As an example the course of one patient is described. We examined seven preterm infants (mean birth weight 791 g, mean gestational age 26 weeks) with eight treatments of dexamethasone retrospectively. The therapy was associated with a significant increase of the mean thickness of the interventricular septum and of the left ventricular posterior wall. After the termination of dexamethasone therapy the abnormal echocardiographic findings disappeared. CONCLUSION: We suggest careful monitoring of preterm infants treated with dexamethasone by performing serial echocardiographic investigations.

Bronchopulmonary Dysplasia↗
PubMed1991

[Ureaplasma urealyticum--a new problem pathogen in neonatology].

Some previous studies showed that Ureaplasma urealyticum is the most common germ that appears in the birthway of pregnant women and which is also frequently found in skin swabs and secretions of newborn and premature babies. The colonization of pregnant women by Ureaplasma urealyticum makes a premature birth more likely. Another factor of risk for a premature infant is a premature rupture of membranes for more than 24 hours which also makes an infection possible. There exists an association between pulmonary infection by Ureaplasma urealyticum and the development of a bronchopulmonary dysplasia especially for premature babies. According to our observations acute exacerbations of severe pneumonia can appear even after month. An attempt of therapy of pulmonary infection should be undertaken with erythromycin, if sensitive serotypes are present. In the case of erythromycin resistance chloramphenicol can be used but only under frequent controls of blood levels. We were able to observe rapid improvements with this effective therapy.

Anti-Bacterial Agents↗
PubMed1991

[Lung mechanics in premature infants with severe respiratory distress syndrome].

Serial pulmonary function tests were performed in 13 preterm infants with severe RDS and 16 premature neonates with healthy lungs (8 intubated because of hypovention after birth, 8 were breathing spontaneously). Airflow was measured by a pneumotachograph, pressure changes were determined by airway pressure in ventilated infants or esophageal pressure in spontaneously breathing neonates. Pulmonary mechanics were calculated by a computerized system (PEDS/Medical Associated Services, Hatfield, Pennsylvania). In mechanically ventilated infants with RDS dynamic compliance of the respiratory system was low during the first 6 days. On Day 7-10 there were higher values for infants who could be extubated within the first 10 days compared to those, who had to be ventilated for more than 10 days. In the course of the disease, improvement in gas exchange preceded increase of compliance. Intraindividual comparisons in the acute and recovery phase of RDS and in infants with normal lungs showed higher values for compliance and lower values for airway pressure and resistance during spontaneous breaths. The differences between dynamic compliance of the respiratory system measured during mechanical ventilation, and dynamic lung compliance recorded during spontaneous breaths are due to influences of the respirator on the infant's lung.

Airway Resistance↗
PubMed1989

[Congestive heart failure in rickets caused by vitamin D deficiency].

We describe a case of a three and half month old infant presenting with a congestive heart failure due to hypocalcemic cardiomyopathy. Vitamin D deficiency rickets was found to be the cause for the hypocalcemia. The heart failure responded promptly to adequate Calcium therapy accompanied by usual anticongestive therapy.

Cardiomyopathy, Dilated↗
PubMed1983

[The extremely immature newborn--a dilemma of the obstetrician and paediatrician].

The uncertain prognosis of premature newborn with an extremely low birth weight has so far resulted in uncertainty regarding the therapeutic measures to be taken, both with obstetricians and with paediatricians. However, the follow-up studies made up to now show that such infants do not have bad prospects. Prematurely born infants with a birth weight of 1000-1500 g are without any later handicaps with a quota of 85-90% provided they are given well-organized intensive-care treatment. Children between 750-1000 g birth weight are without psychomotor anomalies with an average incidence of 75-80%. However, the few available studies conducted on even more severely immature infants point towards a rapidly rising probability of physical disability if the birth weight is below 750 g or the duration of pregnancy less than 26 weeks. It seems that this denotes the present limit value of perinatal intensive-care medicine.

Brain Damage, Chronic↗
PubMed1982

[Posthaemorrhagic hydrocephalus and periventricular cerebral atrophy in preterm infants with birth weights of 1,500 gm or less. Determination of incidence by brain ultrasound].

Real time ultrasound examinations were performed on 80 consecutive born and surviving infants whose birth weights were 1,500 gm or less. Prior to discharge from the hospital 8 children were shown to have morphologic abnormalities caused by cerebral ischaemia or intraventricular haemorrhage. 6 children (7.5%) had non-progressive enlargement of parts of the ventricular system. 2 children (2.5%) developed a post haemorrhagic hydrocephalus. In one case ventriculostomy was performed, the other had spontaneous arrest. Ultrasound examination of the infant's brain is an ideal screening method to identify children at risk for later development.

Atrophy↗
PubMed1977

Quantitative aspects of transplantation of experimentally induced tumors of the nervous system.

Quantitative aspects of transplantation have been studied experimentally in ethylnitrosourea-induced nervous system tumors. The number of cells needed for successful transplantation, the biological behaviour-increase of malignancy-of the tumor in relation to the number of cells used during the various passages, and the relationship between number of grafted cells and induction time have been examined. A "critical" number of cells was necessary to ensure a positive result; thereafter, the induction time was directly related to the logarithm of the number of cells implanted.

Animals↗
PubMedDate not supplied

Candida infection in very low birth-weight infants: outcome and nephrotoxicity of treatment with liposomal amphotericin B (AmBisome).

Systemic fungal infection occurs in 2 to 4.5% of very low birth-weight (VLBW) infants (< 1,500 g) and may be fatal in 25 to 54%. Candida sp. is the major pathogen and amphotericin B the treatment of choice. To reduce side effects and optimize drug action, a formulation of amphotericin B encapsulated in liposomes (AmBisome) has been introduced. Data on 21 VLBW infants who received a full course of AmBisome was collected and its toxic effects with emphasis on nephrotoxicity and hypokalemia assessed. The median gestational age was 25 weeks (range 23-31) with a median birth-weight of 730 g (range 450-1,370). Antifungal therapy was started at a median age of 13 days (range 1-49). The median dose given was 2.6 mg/kg/day (range 1-5), and the median duration of therapy was 28 days (range 11-79), corresponding to a median cumulative dose of 71 mg/kg (range 12-271). Hypokalemia (< 3.0 mmol/l) was observed in 30% before, and 15% during AmBisome treatment. Twenty-one days after the termination of therapy, hypokalemia was not present in any patient. Median maximum daily potassium supplementation did not exceed doses usually recommended for VLBW infants. The median of the maximum creatinine levels before treatment was 121 mumol/l (range 71-221) and fell to 68 mumol/l (range 31-171) during treatment and 46 mumol/l (range 26-62) 21 days after the termination of therapy. All patients treated with AmBisome eradicated fungi and recovered clinically. AmBisome showed no certain nephrotoxicity in VLBW infants in this study.

Amphotericin B↗
PubMedDate not supplied

[Perinatal glucocorticosteroid therapy: time for reconsideration].

Glucocorticosteroids are administered antenatally and postnatally to decrease pulmonary morbidity of preterm neonates. One course of antenatal corticosteroids decreases mortality, and the frequency of respiratory distress syndrome and intraventricular hemorrhage. However, multiple courses may be associated with impaired brain development. Follow-up studies are needed to assess long-term consequences. The use of betamethasone may be of advantage compared to dexamethasone. Postnatally, steroids are given to treat or prevent bronchopulmonary dysplasia (BPD). However, recent studies have shown that treatment with dexamethasone increases the rate of cerebral palsy in preterm infants. Postnatal treatment of BPD with steroids should be restricted to life-threatening situations.

Betamethasone↗
PubMedDate not supplied

[Pathogenesis of bronchopulmonary dysplasia].

Bronchopulmonary dysplasia of preterm infants has a multifactorial etiology. Pulmonary immaturity, oxygen toxicity, formation of oxygen radicals and mechanical lung trauma as well as additional factors (pulmonary hyperhydration, infection a.o.) may contribute to pulmonary damage. A pulmonary inflammatory reaction is thought to play a central role in the pathogenesis of chronic lung disease. It is characterized by the presence of inflammatory cells and various inflammatory mediators including proteases, chemoattractants, cytokines, leukotrienes and others. Due to the immaturity of several protective systems (antiproteases, antioxidants, surfactant system) the inflammatory response seems to be aggravated. Moreover, the magnitude and persistence of inflammation may eventually lead to pulmonary fibrosis.

Adolescent↗
PubMedDate not supplied

[Meconium aspiration syndrome].

Meconium aspiration syndrome (MAS) is found in 0.2-6 per 1000 lifeborn neonates. Aspiration of meconium particles may occur before, during or after delivery, associated with deep inspiratory movements due to fetal depression. Aspiration of meconium may cause mechanical obstruction of the airways, chemical pneumonitis, and surfactant inactivation. The disease is commonly associated with the development of pulmonary hypertension and severe respiratory insufficiency. MAS may be prevented, at least in some infants, by appropriate suctioning at birth. Great progress has been made in the treatment: early administration of surfactant improves gas exchange in many neonates. High frequency oscillatory ventilation, NO-inhalation and extracorporal membrane oxygenation have a role in severe respiratory failure.

Female↗