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Biomedical subjects

V von Loewenich

Publications and source records attributed to V von Loewenich.

At least 19 recordsLinked to original sources
PubMed2000

[Postpartum risk factors in the development of children born to opiate-addicted mothers; comparison between mothers with and without methadone substitution].

In a retrospective case control study at the University of Frankfurt, Germany, 101 babies born to opiate-addicted mothers were identified from birth charts from 1988 to 1995. After birth, they developed a withdrawal syndrome (neonatal abstinence syndrome). Fifty control infants and their mothers were selected from neonatal wards. The group of opiate-exposed babies was subdivided into a group born to mothers without methadone treatment (n = 48) and a group born to mothers who were enrolled in a methadone program (n = 51). The methadone infants had a significantly higher mean birth weight (2822 g) than children in the group without methadone (2471 g). The abstinence syndrome was much more intense in the methadone group (convulsions 47.1%) than in heroin-exposed babies without methadone treatment (convulsions 27.1%). Women in methadone maintenance programs lived in more stable socioeconomic conditions than opiate-addicted women without methadone substitution. Moreover, they cared significantly better for their babies: 81.3% of the methadone mothers visited their children on a regular basis and 90.9% cared adequately. The data emphasize the need in future research to look more closely at the role of methadone treatment programs in the development of opiate-exposed babies.

Adult↗
PubMed1998

A prospective, randomized, multicenter trial of high-frequency oscillatory ventilation compared with conventional ventilation in preterm infants with respiratory distress syndrome receiving surfactant.

OBJECTIVES: To compare high-frequency oscillatory ventilation (HFOV) and intermittent positive pressure ventilation (IPPV) as a primary ventilation mode in preterm infants with respiratory distress syndrome. Primary end points were survival and maintenance of the randomized ventilation mode. STUDY DESIGN: Prospective, multicenter, randomized clinical trial. SETTING: Level III neonatal intensive care units at three university children's hospitals. PATIENTS: Ninety-six premature infants (gestational age < 32 weeks) randomly assigned to HFOV or IPPV within the first 2 hours of life. All patients received a natural surfactant. No differences were found between the study groups with respect to the demographic data or the severity of respiratory distress syndrome. Infants were stratified at randomization, by birth weight, into two groups: 750 to 1000 gm (n = 32) and 1001 to 1500 gm (n = 64). The centers involved complied with a study protocol that planned a reduction in respiratory pressures when the infant's oxygen requirement had reached a fractional concentration of inspired oxygen of 0.6. RESULTS: Five patients in the HFOV group died, and eight patients did not respond to the randomized ventilation mode; whereas four patients in the IPPV group died, and nine were switched to HFOV. No differences were found in gas exchange or ventilator support over the first 72 hours. Premature infants with a birth weight < 1000 gm had a significantly shorter course to reach fractional concentration of inspired oxygen of 0.21 while receiving IPPV than those receiving HFOV (9.3+/-4.5 days vs 27.5+/-10.2 days, p = 0.01). No differences were found between the groups in extraalveolar air (HFOV seven; IPPV, seven) and intracranial bleeding (HFOV, nine; IPPV, eight). CONCLUSION: After surfactant treatment, HFOV, as a primary ventilation mode in premature infants with respiratory distress syndrome, is as safe and efficacious as conventional ventilation.

Female↗
PubMed1998

Invasive pulmonary aspergillosis in a critically ill neonate: case report and review of invasive aspergillosis during the first 3 months of life.

We report a fatal case of invasive pulmonary aspergillosis in a severely ill neonate and review 43 additional cases of invasive aspergillosis reported from 1955 through 1996 that occurred during the first 3 months of life. Eleven of the 44 patients had primary cutaneous aspergillosis, 10 had invasive pulmonary aspergillosis, and 14 had disseminated disease. Most infections were nosocomial in origin. Prematurity (43%); proven chronic granulomatous disease (14%); and a complex of diarrhea, dehydration, malnutrition, and invasive bacterial infections (23%) accounted for the majority of underlying conditions. At least 41% of the patients had received corticosteroid therapy before diagnosis, but only one patient had been neutropenic. Among patients who received medical and/or surgical treatment, outcome was relatively favorable, with an overall survival rate of 73%. Invasive aspergillosis may occur in neonates and young infants and warrants consideration under certain circumstances. Current therapeutic approaches consist of high-dose amphotericin B and appropriate surgical interventions.

Amphotericin B↗
PubMed1993

Development of thyroid gland volume during the first 3 months of life in breast-fed versus iodine-supplemented and iodine-free formula-fed infants.

The spontaneous development of thyroid gland volume (TGV) during the first 3 months of life was studied in entirely breast-fed infants (n = 21) and compared to those fed an iodine-supplemented formula (n = 19), an iodine-free formula (n = 5), or partially breast-fed in addition to an iodine-free (n = 4) or an iodine-supplemented formula (n = 16). The TGV of the infants and their mothers was determined sonographically in addition to their urinary iodine concentrations 5-7 days postpartum and 3 months later. In ten additional lactating mothers the breast milk concentrations of thyroid hormones and iodine were determined. It was shown that at 3 months of age an infant consuming about 1000 ml breast milk per day receives about 2 micrograms thyroid hormones and 55 micrograms iodine per day. At the end of their first week of life the infants showed a TGV between 0.28 and 1.5 ml (median 0.61 ml) and a urinary iodine concentration between 0.03 and 16.3 micrograms/dl (median 3.0 micrograms/dl). At 3 months of age the TGV of the breast-fed infants had decreased by a median of 0.24 ml (= -34%; median of percentage changes) whereas those fed a formula without iodine had increased by a median of 0.26 ml (= +50%; median of percentage changes). Those receiving an iodine-supplemented formula showed a TGV reduction of 0.14 ml (= +2%; median of percentage changes). The TGV development of the partially breast-fed infants lay between those being exclusively breast or formula fed.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1993

Urinary malondialdehyde concentration in preterm neonates: is there a relationship to disease entities of neonatal intensive care?

In a retrospective study, urinary malondialdehyde concentration in 45 preterm neonates (25-35 weeks' gestation) during their first month of life was measured by HPLC. Urine was collected on different days of life as a 3-h sample. The frequency of urine collection and measurement varied between one (n = 22) and seven times (n = 8) per child. The study group was divided into three categories according to birth weight: low-birth-weight infants (LBW) (n = 16), very low-birth-weight infants (VLBW) (n = 17) and extremely low-birth-weight infants (ELBW) (n = 12). Urinary malondialdehyde concentration was highest in the ELBW group: 1.15 (0.66, 2.12) mumol/l (median and quartiles) versus 0.58 (0.34, 1.18) mumol/l in the VLBW and 0.60 (0.40, 1.06) mumol/l in the LBW groups (ELBW versus VLBW, p < 0.005; ELBW versus LBW, p < 0.02). In oxygen-treated neonates, significantly higher malondialdehyde values were found compared to those without supplementary oxygen (0.89 (0.48, 1.74) versus 0.58 (0.32, 0.89) mumol/l; p < 0.005). Likewise, a higher malondialdehyde concentration was found in infants requiring mechanical ventilation (intermittent mandatory IMV or high frequency ventilation) compared to those breathing spontaneously (intermittent mandatory ventilation: 0.80 (0.42, 1.66); p > 0.05 and high frequency ventilation: 1.20 (0.83, 2.13); p < 0.001 versus 0.57 (0.33, 0.88) mumol/l). Malondialdehyde concentrations correlated significantly with FiO2 values of the individual patients (r = 0.22; p < 0.02). Comparing urinary malondialdehyde concentrations in infants with and without bronchopulmonary dysplasia, a significantly higher malondialdehyde concentration was found in the former group (0.96 (0.51, 2.07) versus 0.60 (0.32, 0.98) mumol/l; p < 0.005)).(ABSTRACT TRUNCATED AT 250 WORDS)

Birth Weight↗
PubMed1984

[Postpartum care of premature and newborn infants].

The most important task of the physician in the delivery room is the initial and continued assessment of the premature or mature newborn. The sequence of resuscitative efforts is determined by the respiratory and circulatory changes in the baby. The procedure is summarised in an action flow sheet. If spontaneous respiration is inadequate, artificial ventilation should be begun; if the heart rate remains below 80/min cardiac massage should be instituted. There are special indications for the intubation of the trachea and the tracheal suction. In some cases catecholamines and infusions are required. One must be certain that the necessary equipment is available and properly prepared.

Female↗
PubMed1983

[Cefotaxime and desacetylcefotaxime in cerebrospinal fluid of newborn and premature infants].

On the occasion of clinically indicated lumbar of cisternal punctures in 19 newborn and premature babies treated with Cefotaxime 33 CSF-levels of Cefotaxime (CTX) and it's metabolite Desacetyl-Cefotaxime (D-CTX) were measured by means of HPLC. 6 of the 19 infants suffered from meningitis. The highest CTX-levels were found 2 to 4 hours after the last infusion of CTX (50 or 100 mg/kg within 20 min, each 12 hours). Patients with meningitis showed CTX-levels between 20 mg/l and less than 0.5 mg/l (limit of detection), those without meningitis between 11 mg/l and less than 0.5 mg/l. Because of the widely scattered CTX-levels any dependence from CTX-dosage or from degree of meningeal inflammation is not to be shown. With two exceptions D-CTX-levels ranged from 2 to 20 mg/l. Up to 9 1/2 hours after the last CTX-dose no clear decrease of the D-CTX-concentration in CSF may be seen. On the other hand, D-CTX-levels are also widely scattered. Nevertheless D-CTX apparently stays significantly longer in the CSF than CTX does. An influence of meningeal inflammation on the D-CTX-levels can not be observed. In E. coli- and in Klebsiella-spp. The geometrical means of MIC are found to range below 0.5 mg/l for CTX and below 2 mg/l for D-CTX. Therefore CTX might be recommended for treatment of meningitis caused by these germs. This recommendation may be supported by some reports about good clinical results, from our unit and from the literature as well.

Bacterial Infections↗
PubMed1983

T4 levels in methylxanthine-treated premature newborns.

The respiratory stimulants caffeine and theophylline are able to control apneic spells in premature newborns. However both substances have goitrogenic properties in rats on low-iodine diet. They lower T4 serum levels and inhibit TSH- and GH-release probably by enhancing hypothalamic somatostatin secretion. The retrospective study described here was carried out in an attempt to clarify whether treatment of premature children with methylxanthines has adverse effects on thyroid function. The results are as follows: 1) There is no significant correlation between caffeine- and theophylline-concentrations and circulating T4 levels in single blood specimen of unselected premature infants. 2) In none of the infants was a low T4-serum value accompanied by a rise in serum TSH during methylxanthine treatment. Thus methylxanthines are not associated with the induction of primary hypothyroidism but the possibility of tertiary hypothyroidism cannot be excluded. In order to avoid adverse effects on thyroid function the lowest therapeutically active dose should be chosen.

Apnea↗