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Biomedical subjects

U Sitka

Publications and source records attributed to U Sitka.

At least 19 recordsLinked to original sources
PubMed1998

[Mendelson syndrome in infancy and childhood].

Acute pulmonary failure caused by gastric acid aspiration is designated as Mendelson's syndrome. It is characterized by a trias of symptoms comprising bronchial obstruction, pulmonary oedema, and right ventricular failure. The pathomorphological pulmonary alterations show the typical symptoms of ARDS and allow the differentiation of three phases. The initial phase of injury is characterized by cauterization of the bronchial and alveolar epithelium. It is followed by the exsudative second phase during which alveolar oedema are developing. They impair the pulmonary surfactant synthesis and the formation of hyaline membranes. Fibrosis processes are typical of the proliferative third phase. Every of the mentioned three phases may be classified by their corresponding clinical symptoms. The therapy is entirely symptomatic and follows the intensive medical standards of the ARDS-therapy.

Child↗
PubMed1997

[Effect of the beta-2 mimetic drug terbutaline of growth hormone secretion in prepubertal asthmatic children].

Asthmatics display a tendency to retarded growth and hyposomia in childhood. The reasons for this are not yet clear, although the atopic disposition seems to occupy a key role. It is a known fact that stimulation of the beta-2 receptors results in inhibiting growth hormone secretion. The purpose of our study was to find out whether the beta-2 mimetic terbutalin, often used in asthma therapy, exercises a negative influence on the spontaneous release of growth hormone in children suffering from asthma. The growth hormone release was studied in 10 prepuberal children suffering from atopic asthma who received intravenous therapeutic doses of terbutalin: testing was done for a total period of 24 hours before and during administration. Terbutalin effected significant inhibition of growth hormone secretion merely during the waking phase (6.2 +/- 1.0 to 3.7 +/- 0.7 ng/ml), but not during the sleep phase (13.1 +/- 1.8 to 12.5 +/- 2.0 ng/ml) and the 24-hour period (11.0 +/- 1.0 to 9.8 +/- 1.5 ng/ml). There was also no significant influence on the average group value for the maximum growth hormone peak (40.8 +/- 9.5 to 42.7 +/- 11.0 ng/ml). These results point to a short-term inhibition of growth hormone secretion, exercised by intravenously administered terbutalin. Terbutalin does not seem to be responsible for any clinically relevant inhibition of growth and development.

Adolescent↗
PubMed1994

Investigations of the rhythmic function of heart rate, blood pressure and temperature in neonates.

Over a period of 24-30 h in 10 min intervals, the systolic diastolic and mean arterial blood pressure, heart rate, rectal and skin temperature were measured simultaneously in 17 full-term babies on the 2nd day of life, and in 11 of them again at the age of 4 weeks. Each profile was analysed individually by the Cosinor method. On the 2nd day of life, a statistically significant circadian rhythm could be detected in 12 of the 17 neonates for systolic blood pressure and heart rate, in 16 for skin temperature and in all 17 neonates for rectal temperature. Summarizing the data of the 17 newborns the circadian rhythm was the most frequent component in all functions. A high portion of ultradian rhythms was observed as well. With increasing postnatal age, the variance of acrophases decreased, particularly for the temperature rhythms. This means that synchronization with the environment is beginning. Furthermore, we found an increase in the mesor of heart rate and blood pressure and an increase in amplitude of temperature.

Blood Pressure↗
PubMed1994

The development of circadian rhythmicity in neonates.

Eleven healthy, full-term babies were studied on the second day (d2) after birth and again 4 weeks (w4) later. The babies lived in natural lighting conditions and were fed every 4 h. Blood pressure, heart rate, skin (abdomen) and rectal temperatures were measured at 10-min intervals for 24 h. Behavioural states (deep sleep, light sleep, drowsy, alert, crying) were measured at the same times, and used to purify the raw data. Both the raw and purified data were assessed for circadian (24-h) rhythmicity by cosinor analysis. Circadian rhythms in heart rate and blood pressure were poorly developed at d2 and w4. By contrast, skin and rectal temperatures showed circadian rhythmicity that increased in amplitude between d2 and w4; this increase was seen in both raw and purified data. The masking effect due to sleep changed also; the depression caused by "deep sleep" became greater between d2 and w4. The results indicate that the development of circadian rhythmicity in body temperature was not secondary to that of a circadian pattern of sleep and activity, and presumably derives from a body clock that is beginning to develop independently.

Activity Cycles↗
PubMed1990

[The startle reaction of the newborn infant].

Startle characterized by a spontaneous or reflecting motoric symptom like brisk, shortlasting and generalized contraction of limb and trunk muscles influence considerably the cardio-respirogram of neonates. The dependence of startles on behaviour, gestational age and postnatal age as well as on levels of blood glucose, calcium and magnesium in serum has been studied in 12 premature infants and in 24 full term neonates by means of polygraphic conditions. The average of 3.6 +/- 3.0 complete startles in premature infants and of 10.6 +/- 8.7 startles in full term neonates per hour non rapid eye movement-sleep, observed on second day after birth, was significantly higher than the frequency of startles in rapid eye movement-sleep measured as 0.6 +/- 0.9 and 1.9 +/- 2.1 complete startles respectively. In an age of 4 weeks there were no complete startles demonstrable in full term neonates and only 0.2 complete startles/h in non rapid eye movement sleep could be observed in premature infants. There was no correlation between frequency of startles and investigated chemical parameters in serum.

Arousal↗
PubMed1982

[Mezlocillin in neonatal medicine].

The acylureido penicillin mezlocillin was tested clinically and pharmacologically in neonates and young infants who received the antibiotic for prophylactic and therapeutic reasons. On the basis of blood level determinations following the administration of various dosages, we consider a dose of 200 mg/kg per day necessary for premature babies and 300-400 mg/kg per day for full-term babies. Pharmacokinetic data showed age-dependent features. The clinical results were good in 40 children treated with mezlocillin. Twenty of these children received a combination of mezlocillin and gentamicin. No child died of an infection. Therapy was not successful in three babies suffering from productive bronchopulmonary infections. Important side-effects were not observed.

Bacterial Infections↗
PubMed1982

The antenatal use of ambroxol (bromhexine metabolite VIII) to prevent hyaline membrane disease: a controlled double-blind study.

A prospective double-blind clinical trial was carried out to determine whether ambroxol (bromhexine metabolite VIII) treatment (1000 mg/day for a period of 5 days) reduces the risk of hyaline membrane disease (HMD) in potentially premature infants. Amniocentesis was performed before the first and 24 h after the last application of ambroxol or placebo to assess the development of the total phospholipid phosphorus content, the L/S ratio, the P/S ratio, and the properties of the surface tension of the amniotic fluid after ambroxol or placebo. There were 246 infants born to 224 mothers. Of the 116 infants with less than or equal to 36 completed weeks' gestation, 56 were in the ambroxol and 60 in the placebo group. No differences between groups occurred in risk factors for HMD (diabetes, asphyxia, male sex, cesarean section). Statistically significant differences in favor of the infants in the ambroxol group were found in the HMD incidence: 23.2% in the ambroxol group compared with 41.7% in the placebo group (p less than 0.05). There was no reduction of the HMD incidence in the less than or equal to 32-week gestational age category in the ambroxol group compared with the placebo group inspite of the fact that all the examined parameters for determining lung maturity reflected a stimulatory effect of ambroxol compared with the results of the placebo group, particularly before the 33rd week of gestation. Prolonged rupture of the membranes played no protective role against HMD.

Ambroxol↗
PubMed1980

[Pharmakokinetic and clinical studies with azlocillin in paediatrics (author's transl)].

Azlocillin, an acylureido penicillin with bactericidal activity, is particularly effective against Pseudomonas, enterococci and Haemophilus influenzae. It is also very active against E. coli, various Proteus species and Bacteroides. Pharmacokinetic studies were carried out in 138 children of various ages (prematures, newborns, infants, schoolchildren) after administering 50-75-100 mg/kg/ body weight azlocillin via the i.v. or i.m. routes; The constant of elimination and the distribution volumes were calculated besides the serum levels. In prematures and newborns, therapeutically effective serum levels were obtained on administering 50 or 100 mg/kg body weight twice daily. Infants and older children required 100 or 75 mg/kg body weight t.i.d. Determination of azlocillin in the bronchial secretion after i.v. doses of 75 mg/kg body weight showed good elimination. Azlocillin was always identified up to the 5th hour post injectionem. Inspite of parenteral administration, azlocillin was identified in different concentrations in the meconium as well. 39 children were treated with azlocillin, 35 of whom had Pseudomonas infection. Very good results were obtained in infections of the urinary tract, wound infections, conjunctivitis, dacryocystitis and in one case of meningitis. Bronchopulmonary diseases did not take an equally good course, but in these cases the conditions had not been favourable. No serious side effects were revealed by testing several laboratory parameters.

Azlocillin↗
PubMed1980

Pharmacokinetics of azlocillin in neonates.

The pharmacokinetics of the acylureido-penicillin, azlocillin, were studied after intravenous or intramuscular injections in 53 premature and full-term infants with infections. Effective concentrations wer" achieved in premature babies after doses of 50 mg/kg every 12 h and in full-term infants with 100 mg/kg every 12 h. No untoward effects of azlocillin were observed. On the basis of these studies, a dosage schedule for azlocillin has been established.

Azlocillin↗
PubMed1980

Amoxicillin in paediatrics, with special reference to its excretion into bronchial secretion.

Pharmacokinetic examinations with amoxicillin in neonates and prematures are reported. Good values of up to 5 mcg/ml after 24 hours were achieved with two doses of 50 mg/kg amoxicillin daily. Amoxicillin was also found in the meconium, although quantities varied greatly. Amoxicillin is recommended for the treatment of disorders of the respiratory tract because of its good absorption, tissue penetration and tolerance. Examinations to assess the excretion of amoxicillin into the bronchial secretion were therefore carried out in 88 children in different age groups. Two artificial respiration bronchoscopies were carried out with an interval of 7 days, and the bronchial secretion collected and tested for organisms and for amoxicillin concentrations. After the first bronchoscopy, patients were given amoxicillin for 7 days, in doses of 125 to 750 mg t.i.d., corresponding to 40-100 mg/kg body weight. Some very high amoxicillin values were found, especially in those groups from whom the secretion was taken 2, 3, or 4 hours after the last amoxicillin treatment. The values were widely scattered. We recommended 50-100 mg/kg for broncho-pulmonary diseases.

Absorption↗
PubMed1979

[Experience with sisomicin in pediatrics (author's transl)].

Sisomicin, an aminoglycoside antibiotic, is especially effective against Escherichia coli, Klebsiella, Enterobacter, Citrobacter, Serratia, indole-positive and indole-negative Proteus species, Pseudomonas aeruginosa, Salmonella and Staphylococcus aureus. It has a bactericidal action. Although sisomicin is similar to the other aminoglycoside antibiotics, there is not complete cross-resistance to them. Our own pharmacokinetic investigations showed that a dose of 2--3 mg/kg body weight of sisomicin twice daily is necessary in the neonatal period. Infants should be given 2.5 mg/kg body weight three times daily, and school children 1.5--20 mg/kg body weight, likewise three times daily. Excretion of sisomicin in the urine is lower in children than in adults, amounting within 24 hours to only 10--20% in newborns, and 30--40% in school-children. Sisomicin induces excretion of some enzymes in higher quantities from the tubular part of the kidneys, especially alaninaminopeptidase. A report is given on 58 patients, especially newborns and prematures, who were treated for about seven days with sisomicin. The results obtained with a wide variety of infections (such as omphalitis, aspiration of amniotic fluid with broncho-pneumonia, phlegmons of the galea, and also pyelonephritis and mucoviscidosis with pulmonary complications) can be described as good, with a success rate of 85%. On only seven occasions were insignificant transitory side-effects, such as slight increase in transaminases, toxic-allergic exanthema and pain in the region in injection, observed.

Age Factors↗
PubMed1979

[Pediatric pharmacology of azlocilin (author's transl)].

Pharmacokinetic investigations of acylureido-penicillins azlocillin in newborns, infants and school shildren showed age dependend results. The differences were especially evident in a prolongation of the serum half-life to 2,56 hours in newborns compared to 0.94 hours in school children. On the basis of our pharmacokinetic results and of the dosages resulting from the data the antibiotic was used clinically in twenty eight patients with Pseudomonas aeruginosa infections and one patient with a Proteus mirabilis infection. The results were much better in infections of the urinary tract than in infections of the respiratory tract. This might be due to an observe bacterial presistence in spite of highly effective levels of azlocillin in bronchial secretion. The tolerance to the antibiotic was good.

Child↗
PubMed1979

[On the excretion of azlocillin with bronchial secretion in children (author's transl)].

This pharmacokinetic study involved school children who were treated with 6-[(R)-2-(2-oxo-imidazolidine-1-carboxamido)-2-phenyl-acetamido]-penicillanic acid sodium walt (azlocillin, Securopen) at doses of 50 mg/kg bodyweight or 75 mg/kg body weight i.v. Kinetics of the first order were found for the concentrations measured at the same time, being proportionate to the administered dose, while there was no dose dependence for the relative distribution volume. The elimination half-life was about 55 min. In 25 children of different age who had to undergo bronchoscopy for diagnositic and therapeutic reasons, the azlocillin concentrations in the bronchial secretions were measured 1 h and 4 h after the administration of 75 mg/kg quantity of bronchial secretion was obtained, azlocillin concentrations of 30 - 240 microgram/g were found. Measurements of azlocillin concentration in the bronchial secretion and in the serum, which were made at the same time, did not show any correlation.

Adolescent↗