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Biomedical subjects

P W Nars

Publications and source records attributed to P W Nars.

At least 19 recordsLinked to original sources
PubMed2001

Vaccination rate and age of premature infants weighing <1500 g: a pilot study in north-western Switzerland.

UNLABELLED: In Switzerland, there are no special vaccination recommendations for premature and low-birthweight infants with respect to a particular target vaccination age. Incomplete and delayed vaccination bears the inherent risk of preventable infections. Therefore, the vaccination rate and age of 60 premature infants in north-western Switzerland born in 1994/95 were investigated in a retrospective case-control study. For this group of patients these are the first data ever available for this region. At the age of 4-5 y, the vaccination rates for polio and diphtheria, tetanus, pertussis (DTP acellular) as well as Haemophilus influenzae b (Hib) were similar in both preterm and full-term infants. In both groups, the fourth dose of vaccine against DTP, Hib and polio was far less frequently administered than the first three. The vaccination age in preterm infants for most vaccinations was significantly higher than in age-matched full-term controls. This was particularly obvious for the first dose of vaccine against polio and DTP. In preterm infants, the median age (5th; 95th percentile) at the date of the first polio vaccination was 131 (89; 270) d and 82 (60; 182) in full-term controls (p < 0.00001). The age difference was even larger for the first DTP vaccination (62 d, p < 0.00001). The main reasons for delayed vaccination may include insufficient information given to parents as well as prolonged hospitalization. CONCLUSION: Vaccination of preterm infants should be discussed in every discharge communication, with emphasis on vaccine administration at the appropriate chronological age.

Age Factors↗
PubMed1998

Pregnancy and lactation in homozygous beta-thalassemia major.

Successful pregnancies in patients with transfusion-dependent homozygous beta-thalassemia major are rare. We report the course of a pregnancy and newborn data during lactation and desferrioxamine therapy in the mother. The twin-pregnancy was complicated by preeclampsia. Besides normal iron level in breast milk, no clinical or hematological abnormalities due to desferrioxamine therapy could be shown in the newborns. Our observation suggests that chelating therapy during lactation does not alter iron excretion in breast milk or iron metabolism in offsprings. Breast feeding in newborns from patients with thalassemia major and desferrioxamine therapy seems justified.

Adult↗
PubMed1994

Congenital tetraplegia, respiratory insufficiency, and hypoplasia of medulla oblongata.

A term infant with normal delivery presented with congenital tetraplegia and respiratory insufficiency just after birth. Magnetic resonance tomography on days 8 and 72 of life revealed an extreme thinning of the lower medulla oblongata. Endoscopy confirmed this and demonstrated the presence of vascular anomalies around the lesion which were not detectable by angiography. It is presumed that this is a malformation of the lower medulla oblongata.

Arteries↗
PubMed1990

A comparative study of two different percutaneous venous catheters in newborn infants.

Between 1985 and 1988 the use of percutaneous venous catheters in the intensive care of newborn infants was evaluated. A total of 140 polyurethane catheters used in 91 patients were compared with 143 silicone catheters in 121 neonates. Patients of both series were comparable regarding sex, weight, gestational age and severity of disease. Insertion technique, puncture site care and infusions remained the same for both observation periods. Peripheral insertion of silicone catheters required more venous cutdowns but threading them to a central vein or the right atrium was more often successful. Fewer local complications (i.e. reddening or swelling along the peripheral venous access) resulted in a longer catheter duration and a less frequent need for an additional venous access in the silicone group. On the other hand, silicone catheters caused more technical problems (i.e. rupture or obstruction). Upon removal, more silicone than polyurethane catheter tips were colonized with bacteria. This was independent of catheter duration and was never followed by clinical signs of infection. The silicone catheter gave better results, especially in very small newborn infants of low gestational age, but was associated with more technical problems.

Bacteria↗
PubMed1984

[Development over 10 years of children with birth weight less than 1501 g].

170 Children born between 1971 and 73 and hospitalised at the neonatal intensive care unit of the Hospital for Children of the University of Basel because of very low birth weight and/or IRDS are re-examined at the age of 10 years. First analyses show high mortality amongst the children with very low birth weight (38% of 122 died up to the age of 10 years) and a physical development (weight and height) below that of a representative sample of children of the same age.

Body Height↗
PubMed1984

Aberrant umbilical vein.

In a female premature baby an aberrant umbilical vein was identified after catheterization of the umbilical vessels. This rare variation of the umbilical vessels consists of a connection between the umbilical vein and the inferior vena cava.

Humans↗
PubMed1984

[Feeding very small premature infants with concentrated breast milk].

The use of concentrated breast milk was prospectively studied in 26 very small premature babies with a birth weight of 1,010-1,500 g. 57 premature babies of the same birth weight group born in the two preceding years and fed normal pooled breast milk served as a control group. Fresh breast milk was enriched using lyophilized breast milk yielding a calory content of 103 cal/100 ml. Early intermittent nasogastric feeding using this milk enabled full oral calory supply from the 5th day on. 130 ml/kg/day of enriched breast milk yields 134 cal/kg per day with somewhat less fat but more protein (2.8 g/kg vs 2.2 g/kg) and sodium (1.9 mmol vs 1.5 mmol) than 200 ml/kg/day of ordinary breast milk. About 50% of the study patients and the control group needed intensive care with mechanical ventilation. Mortality was 15% and 28%, respectively. Necrotizing enterocolitis was rare in both groups (3.3 vs 3.5%). Due to extragastric complications oral feeding had to be reduced in 18% (study group) and in 27% (ordinary breast milk), the most frequent indication was a patent ductus arteriosus with heart insufficiency. Postnatal weight gain was comparatively good with a mean increment of 112 g in the second and 150 g in the third week. Growth of body length during the first three weeks was on average 0.72 cm/week, head circumference increased 0.57 cm/week. However, in the control group similar results were noted. During the second week of life patients fed concentrated breast milk had somewhat higher plasma sodium und urea values.(ABSTRACT TRUNCATED AT 250 WORDS)

Humans↗
PubMed1983

Successful conservative management of a solitary liver abscess in a premature baby.

A case report of a very small premature baby with a solitary intrahepatic abscess is presented. The diagnosis was suspected by the presence of a gas bubble on plain X-ray and confirmed by ultrasonography. Conservative therapy was successful. The value of ultrasonography in the diagnosis and follow-up of intrahepatic abscess in the newborn is stressed.

Anti-Bacterial Agents↗
PubMed1982

Acylureido penicillins in neonatal intensive care. Preliminary communication.

The antimicrobial sensitivity of 232 bacteria isolated from patients in a newborn intensive care unit was tested. Practically all organisms were sensitive to a combination of mezlocillin-aminoglycoside; a few were resistant to azlocillin-aminoglycoside. Eighteen patients, all severely ill, were treated with the combination acylureidopenicillin-aminoglycoside. Nine patients died, eight due to non-infectious diseases and one very small premature baby due to Serratia marcescens meningitis. The other patients showed good clinical improvement. The only side-effect observed was a macular rash in one patient.

Azlocillin↗
PubMed1982

[Transcutaneous bilirubin determination in the newborn infant. Recommendations of the Swiss Neonatology Group].

The clinical usefulness of transcutaneous bilirubinometry with the Minolta-Air Shield bilirubinometer was evaluated at four obstetrical neonatology units (Basle, Berne, Lucerne and Zurich). Transcutaneous bilirubin (TcB), expressed as bilirubin index, was compared with simultaneous serum bilirubin estimations in healthy Caucasians babies born at term with a birth weight of more than 2500 g. TcB measured over the forehead: 926 determinations in 629 newborns. TcB measured over the sternum: 404 estimations in 260 newborns. TcB estimations over the sternum produced a closer correlation (r = 0.93) with serum bilirubin than estimations over the forehead (r = 0.81). Mean serum bilirubin value as well as the corresponding 5th and 95th percentiles were calculated for each TcB index. From the data obtained the following practical conclusions can be drawn: TcB estimations are reliable for giving the indication to perform serum bilirubin determinations. In patients with risk factors for kernikterus serum bilirubin should be determined at a TcB index of greater than or equal to 18, in babies without risk factors at a TcB index of greater than or equal to 21.

Bilirubin↗