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Biomedical subjects

R Lindemann

Publications and source records attributed to R Lindemann.

At least 19 recordsLinked to original sources

[Delivery on the mother's or the infant's premises?].

A delivery should take place on the infant's premises. The mother's wishes and needs should also be taken into consideration, however, as long as they do not involve hazard to the child. The mother should have the right to take leave of absence at least four weeks before term and approximately one year after delivery. ABC-principles (Alternative Birth Care) during pregnancy and labour could be applied by making a hospital delivery more like a home delivery.

Delivery, Obstetric

Congenital heart defects, hamartomas of the tongue and polysyndactyly in a sister and brother.

We report a sister and brother with congenital heart defects, hamartomas of the tongue and polydactyly. Both had coarctation of the aorta, which was repaired in early infancy. In addition, the girl had atrioventricular canal. She died postoperatively at age 4 years. The boy had subaortic stenosis and died of pneumonia at age 2 years. Both children had normal psychomotor development. The parents were healthy and unrelated. The familial occurrence could be due to a previously unrecognized autosomal recessive syndrome or parental gonadal mosaicism for a dominant syndrome.

Abnormalities, Multiple

[Perinatal HIV-infection. Epidemiologic, social and ethical aspects].

More HIV-infected women are becoming pregnant and delivering their baby. The rate of perinatal transmission is about 30-40%. Two thirds of the verified HIV-positive Norwegian women are infected by heterosexual contact. For this reason the obstetric interview is of major importance in order to identify women at risk. We discuss the HIV-screening programme now being run in Norway. Approximately 250,000 pregnant women have been tested and only 19 HIV-positive women have been detected. We discuss the ethical and social problems connected with day care centres, information to health services and the problems that arise when the mother or both parents develop AIDS and die.

Acquired Immunodeficiency Syndrome

[Perinatal HIV-infection. Symptomatology, diagnosis and treatment].

Perinatally acquired HIV-infection is an increasing problem. Nine infants were born of HIV-infected mothers in Norway in 1988, and ten in 1989. Pediatric AIDS may involve a wide spectrum of clinical diseases with a high affinity to the central nervous system. The time from birth to development of clinical symptoms is relatively short. The overall mortality rate is extremely high in all age groups. Two children with perinatal HIV-infection are discussed in light of our treatment regimen. Children with immunosuppression and/or clinical symptoms are treated with zidovudine (azidotymidin/AZT) perorally. Children with repeated bacterial or opportunistic infections are also given immunoglobulin intravenously every 3rd to 4th week.

Acquired Immunodeficiency Syndrome

Unsupplemented breastfeeding in the maternity ward. Positive long-term effects.

Feeding routines in the maternity ward were investigated in 204 mother-infant pairs before and in 203 after a change towards earlier, more frequent breastfeeding and elimination of routine substitute feeds. In the intervention group, the volume of breast-milk increased, while the use of formula and sugar solution decreased correspondingly. The infants in the intervention group lost more weight during the first 2-3 days (6.4% versus 4.6%), but regained their birth weight faster than the supplemented control group. The incidence of hyperbilirubinemia was not significantly different in the two groups. No cases of hypoglycemia were diagnosed. At 6 months, 87% of the infants in the intervention group were still fed at the breast, compared with 66% in the control group. The weight curves were comparable up to 9 months, when intervention group infants were found to weigh slightly less. These follow-up results must be interpreted with some caution due to the low but comparable response rate of the two groups. Thus the intervention study demonstrated that healthy, full-term infants usually have no need for supplements to their mothers' milk provided they have had a satisfactory start in life with early and frequent feeds at the breast. The follow-up study indicated that a more "physiological" start of breastfeeding may have had a positive long term effect on the overall duration of the lactational period.

Breast Feeding

[A historical birth tragedy. Neonatal infections still of interest today as they were 300 years ago].

Neonatal bacterial infections are still important causes of perinatal mortality and morbidity, as they were 300 years ago. Queen Anne (1655-1714) underwent 18 pregnancies without producing any successors, probably because the children died of perinatal infection. Some women are unable to produce a specific IgG-antibody against Group B streptococcus (GBS). They may have normal IgM production and are thereby self-protected, while their infants risk developing neonatal GBS septicaemia. Listeria monocytogenes may cause repeated miscarriages, stillbirths and neonatal infections and, even today, is an important cause of perinatal deaths. The miscarriages and neonatal deaths of Queen Anne are believed to have been caused by an asymptomatic listeria monocytogenes infection. The importance of recognizing women at risk for these types of infections is discussed.

Abortion, Spontaneous

[Transportation of newborn infants. A 6-year case load].

We have evaluated neonatal transports to Ullevål hospital over a six-year period. These were either carried out by helicopter, using a trained transportation team, or by ambulance, the transport being improvised from one transport to another. The investigation shows great variation in the handling of the transports, with the most significant problems in the group without a structured transport system. In addition to generally rather casual and often hazardous transport, particular problems arose in connection with maintaining an adequate body temperature. In addition, the transports were very inadequately documented.

Aircraft

[Metabolic diseases causing acidosis in the neonatal period].

The diagnosis of metabolic diseases during the newborn period is difficult because symptoms and findings are similar to those generally encountered in newborn babies who are ill. Moreover, metabolic diseases are often complicated by infections and cerebral hemorrhages. The article presents a short clinical review of metabolic diseases associated with metabolic acidosis in the newborn and discusses appropriate investigations and differential diagnoses. It is important to remember the possibility of metabolic diseases as the cause of metabolic acidosis in the newborn period.

Acidosis

Erythropoiesis-inhibiting factor(s) (EIF): methodologic studies.

Erythropoiesis-inhibiting factors (EIF) have been demonstrated in plasma from hypertransfused animals and from polycythemic individuals during periods of hyperoxia, but there is a decided discrepancy in the data published. In the present paper methodologic variations of a bioassay for demonstrating the erythropoiesis-inhibiting factor are discussed. In these studies no inhibitor of erythropoiesis could be demonstrated in plasma from hypoxia-induced polycythemic mice (HPM) on posthypoxic day 5. Injections of RBC or an equal amount of hemolyzed RBC were capable of suppressing the stimulatory effects of ESF, indicating that a red cell constituent may be responsible for the inhibitory effect observed. Transfusion-induced polycythemic mice (TPM) were therefore considered to be less suitable for demonstrating erythropoiesis inhibitors. Our results from testing several doses of a urinary EIF in normal mice, TPM and HPM, indicated that the HPM provided the most sensitive assay system. A similar effect was obtained with hypoxia-induced polycythemic rats. The most marked effect was seen in HPM when the EIF was injected shortly before administering the ESF, while the effect was less pronounced when the EIF was injected 24 hr before or after the ESF.

Animals

Erythropoiesis inhibiting factor(s) (EIF). The specificity and toxicity of urinary EIF studied in vivo and in vitro.

The specificity and toxicity of the urinary erythropoiesis inhibiting factor (EIF) has been tested both in vivo and in vitro. When EIF was given to ESF stimulated erythropoietically suppressed polycythaemic mice and to mice at maximal endogenous erythropoietic stimulation, a reduction of the erythroid bone marrow cells, the erythropoietic 3H-TdR L.I. and the total number of bone marrow cells were observed. No effect was seen on the myelopoietic bone marrow cells. An unspecific toxic effect was unlikely, since addition of EIF did not alter the proliferation of lymphoblastic cells nor change the glucose utilization of bone marrow cells in vitro. Neither did the amount of dead bone marrow cells increase after being incubated with EIF for 72 h. The results indicate that the urinary EIF is a non-toxic, cell specific inhibitor on erythropoiesis.

Animals