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Bandell RAM, Dekkers T, Semmekrot BA, de Wildt SN, Fleuren HWHA, Warlé-van Herwaarden MF, Füssenich P, Gerrits GP, Kramers C. Macrolide prescription in Dutch children: compliance with guidelines. Eur J Clin Microbiol Infect Dis 2019; 38:675-681. [PMID: 30680574 DOI: 10.1007/s10096-019-03473-7] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2018] [Accepted: 01/02/2019] [Indexed: 01/25/2023]
Abstract
For reasons of antibiotic resistance and side effects, macrolides should be prescribed with care in the pediatric population. We evaluated the adherence to Dutch guidelines of macrolide prescription in children and estimated the risk of Mycoplasma pneumoniae-associated pneumonia based on Fischer's decision tree. In this retrospective study, we included children aged 0-18 years who were treated with azithromycin or clarithromycin for pulmonary disease in four settings from general practice to hospital ward for (1) the prescriptions not in accordance with the guideline of the Dutch Association of Pediatrics and (2) the risk of M. pneumoniae in patients with community-acquired pneumonia (CAP) according to Fischer's decision tree. The latter suggests that children older than three years with a fever lasting more than two days are at high risk for M. pneumoniae and that it is therefore justified to treat them with macrolides. In total, 189 macrolide prescriptions from 2015 until 2017 were analyzed: 139 children used macrolides for a pulmonary indication (75%); 18% (n = 25) of the prescriptions were not in accordance with Dutch guidelines. Only 9.1% of patients with CAP were classified as having a high risk of M. pneumoniae according to Fischer's decision tree. A significant proportion of macrolide prescriptions for Dutch children with a pulmonary disease appears not to be in accordance with the guidelines. Most patients with CAP treated with a macrolide actually had a low risk of having M. pneumoniae according to Fischer's decision tree. Both observations suggest overuse of macrolides in children.
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Affiliation(s)
- Rosa A M Bandell
- Department of Pediatrics, Canisius Wilhelmina Hospital, Weg door Jonkerbos 100, 6532 SZ, Nijmegen, The Netherlands.
- Department of Clinical Pharmacy, Canisius Wilhelmina Hospital, Nijmegen, The Netherlands.
| | - Tanja Dekkers
- Department of Internal Medicine, Radboudumc, Nijmegen, The Netherlands
| | - Bernardus A Semmekrot
- Department of Pediatrics, Canisius Wilhelmina Hospital, Weg door Jonkerbos 100, 6532 SZ, Nijmegen, The Netherlands
| | - Saskia N de Wildt
- Department of Pharmacology-Toxicology, Radboudumc, Nijmegen, The Netherlands
- Intensive Care and Department of Pediatric Surgery, Erasmus MC Sophia, Rotterdam, The Netherlands
| | - Hanneke W H A Fleuren
- Department of Clinical Pharmacy, Canisius Wilhelmina Hospital, Nijmegen, The Netherlands
| | | | - Peter Füssenich
- General Practice, Füssenich and Dral, Groesbeek, The Netherlands
| | - Gerardus P Gerrits
- Department of Pediatrics, Canisius Wilhelmina Hospital, Weg door Jonkerbos 100, 6532 SZ, Nijmegen, The Netherlands
| | - Cornelis Kramers
- Department of Clinical Pharmacy, Canisius Wilhelmina Hospital, Nijmegen, The Netherlands
- Department of Pharmacology-Toxicology, Radboudumc, Nijmegen, The Netherlands
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Pollmann N, van der Steeg HJJ, Semmekrot BA. [A girl looking pregnant]. Ned Tijdschr Geneeskd 2017; 161:D967. [PMID: 28466797] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
We describe a 13-year-old girl with abdominal complaints and looking pregnant. MRI investigation showed an adnexal mass (28 x 19 x 12 cm), which was surgically removed. Histolpathological investigation revealed a mature cystic teratoma with no signs of malignant transformation.
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Affiliation(s)
- N Pollmann
- Canisius-Wilhelmina Ziekenhuis, afd. Kindergeneeskunde, Nijmegen
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Matthijsse PR, Semmekrot BA, Liem KD. [Skin to skin contact and breast-feeding after birth: not always without risk!]. Ned Tijdschr Geneeskd 2016; 160:D171. [PMID: 27484419] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
Skin-to-skin contact after birth is propagated to facilitate breast-feeding and mother-child bonding. We describe two term infants with sudden unexpected postnatal collapse (SUPC) during skin-to-skin contact. The infants were found with abnormal colour, hypotonia and apnoea, in a prone position on the chest of their mothers, both of whom were primipara with a high BMI. After stimulation, both infants recovered completely. No specific potential cause, other than the position, could be found. These cases illustrate that skin-to-skin contact after birth is not without risk. In available literature, risk factors for SUPC include primiparity and infant orientation such as prone and lateral positions. These positions are also risk factors for sudden infant death syndrome (SIDS). To improve safety, a primipara should be supervised during skin-to-skin contact and not be left alone in the first hours after delivery; the infant should be guaranteed a free airway, especially when the mother has a high BMI.
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Schots M, Verlaak R, Haarbrink PH, Semmekrot BA. [A 9-year-old boy with 'pinpoint pain' caused by pyomyositis]. Ned Tijdschr Geneeskd 2016; 160:D577. [PMID: 27966403] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
BACKGROUND Pyomyositis is a rare bacterial infection of striated muscle, usually caused by Staphylococcus aureus. CASE DESCRIPTION A healthy 9-year-old boy was referred to us because of pain in the hip and fever. We noticed he could point to the pain with one finger; this is referred to as 'pinpoint pain'. An MRI indicated a diagnosis of pyomyositis of the iliacus muscle and piriformis. The infection was caused by S. aureus. The boy recovered completely and swiftly with antibiotic therapy. CONCLUSION This specific type of pyomyositis in the hip is rare, especially in children. Being able to localise the pain with one finger is a typical characteristic of this condition. MRI is the investigation of first choice to confirm this diagnosis.
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Affiliation(s)
- M Schots
- Canisius Wilhelmina Ziekenhuis, Nijmegen
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Semmekrot BA, Brouwer ML, Gerrits GPJM, Voorhoeve PG. [Cerebral damage due to hypoglycaemia in otherwise healthy breast-fed term infants]. Ned Tijdschr Geneeskd 2008; 152:2367. [PMID: 19024071] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/27/2023]
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de Jonge GA, Ruys JH, Semmekrot BA, Brand R. [Serious concerns regarding research linking cot death with child day care]. Ned Tijdschr Geneeskd 2008; 152:1446-1447. [PMID: 18624011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/26/2023]
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7
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de Jonge GA, Ruys JH, Semmekrot BA, Brand R. [More cot deaths in child care settings than during the same hours at home: 10-year statistics]. Ned Tijdschr Geneeskd 2008; 152:1377-1381. [PMID: 18664216] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/26/2023]
Abstract
OBJECTIVE To determine whether the incidence of sudden infant death syndrome (SIDS) in child care settings (child care centres or child minders) is different from that in the home setting, and to search for any differences in the prevalence of SIDS risk factors in both settings. DESIGN Descriptive and comparative. METHOD All SIDS cases (< 2 years), that occurred between September 1996-August 2006 and known to the 'Landelijke Werkgroep Wiegendood' (the National Cot Death Study Group) of the Dutch Paediatric Association were analysed. The percentage of children involved in child care and the mean duration of their participation in child care, was calculated from national surveys carried out in well-baby clinics. RESULTS In the 10 years of the study, 216 cases of SIDS became known to the Cot Death Study Group. In the first year of life, the number was 75% of the number registered by Statistics Netherlands. 28 of these infants died from SIDS between the ages of 3-6 months and on Monday-Friday between 8:00 am-5:00 pm: the usual hours of opening of child care facilities. Based on the uptake of child care during this period, 15% of this mortality was expected to have occurred in a child care setting and 85% at home. In reality, 61% (17/28) of the deaths occurred at a child care facility and 39% (11/28) at home. The relative risk was 8.8 (95% CI: 4.1-19.0). This high incidence of SIDS in a child care setting did not appear to be due to a higher prevalence of known risk factors for SIDS at child care facilities i.e. sleeping position (prone or side), passive smoking, heat congestion, or use of a quilt or pillow. CONCLUSION For infants aged 3-6 months, the relative risk ofSIDS during child care appeared to be increased 8.8 times (95% CI: 4.1-19.0) when compared with home settings in The Netherlands in September 1996-August 2006.
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Affiliation(s)
- G A de Jonge
- Canisius-Wilhelmina Ziekenhuis, afd. Kindergeneeskunde, Nijmegen
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Semmekrot BA, Severijnen RSVM, Nijhuis JG. [Chance finding of foetal and neonatal ovarian cysts on echography]. Ned Tijdschr Geneeskd 2007; 151:329-30; author reply 330. [PMID: 17326479] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/14/2023]
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de Jonge GA, Semmekrot BA. [Sudden infant death syndrome in playpens]. Ned Tijdschr Geneeskd 2005; 149:1279-82. [PMID: 15960134] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/03/2023]
Abstract
OBJECTIVE To explain the increase in the number of deaths due to sudden infant death syndrome (SIDS) that occurred while the infant was in a playpen or on a playpen mat placed outside of the pen. 13 deaths were reported in the period 1 September 1996-31 August 2004, in contrast to 0 deaths in the years 1984/'96. DESIGN Descriptive. METHOD Data on the 13 infants that were reported to the National Study Group on SIDS were analysed and the presence of risk factors for SIDS was assessed. RESULTS Of the 13 infants, 9 were male and 4 were female. 12 were aged less than 12 months and 1 was aged 13 months. Known risk factors for SIDS were often present and frequently occurred in combinations: male sex (n = 9), higher birth order (n = 9), age 1-8 months (n = 12), parental smoking (n = 6), primary prone sleeping position (n = 4), secondary prone (n = 6, often the first time), face down (n = 9), no adult present (n = 13). CONCLUSION There was no clear explanation for the observed increase in SIDS that occurred in a playpen or on a playpen mat placed outside of the pen.
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Affiliation(s)
- G A de Jonge
- Canisius-Wilhelmina Ziekenhuis, afd. Kindergeneeskunde, Nijmegen
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Serrarens-Janssen VML, Steegers EAP, van den Bos A, van Heijst AFJ, Pereira R, Semmekrot BA. Experiences with fetomaternal alloimmune thrombocytopenia in the Netherlands over a 2-year period. Acta Obstet Gynecol Scand 2005; 84:203; author reply 204. [PMID: 15683387 DOI: 10.1111/j.0001-6349.2005.00653.x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Semmekrot BA, de Vries MC, Gerrits GPJM, van Wieringen PMV. [Optimal breastfeeding to prevent hyperbilirubinaemia in healthy, term newborns]. Ned Tijdschr Geneeskd 2004; 148:2016-9. [PMID: 15553997] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/01/2023]
Abstract
In a newborn infant, frequent bowel movements diminish the enterohepatic circulation of bilirubin, thereby increasing bilirubin excretion. In breastfed newborn infants, the frequency of latching on and administration of supplementary feeds are associated with serum bilirubin concentrations. Frequent breast feeding (at least 8 times a day) and fewer supplementary feeds will result in increased breast milk intake, less weight loss, and lower bilirubin concentrations. In the case of a breastfed infant presenting with neonatal hyperbilirubinaemia, the advice should be to breastfeed more frequently and to withhold supplementary feedings. An icteric newborn infant should be seen and weighed daily. If the infant has lost more than 10% of its birth weight, drinks poorly, or fails to gain weight despite latching onto the breast frequently, it should be referred to the paediatrician for further diagnosis and treatment. To ensure optimal production of breast milk during the first days after birth, early latching on is recommended, preferably within one hour after birth.
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Affiliation(s)
- B A Semmekrot
- Canisius-Wilhelmina Ziekenhuis, afd. Kindergeneeskunde, Postbus 9015, 6500 GS Nijmegen.
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Semmekrot BA, Severijnen RSVM, Bongaerts GPA. [Non-respiratory cyanosis in the newborn]. Ned Tijdschr Geneeskd 2004; 148:1705-6; author reply 1706. [PMID: 15453124] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 04/30/2023]
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Abstract
BACKGROUND In the Netherlands, there is a very low incidence of sudden infant death syndrome (SIDS) due to effective preventive campaigns. METHODS During the period September 1996 to August 2002, nationwide 161 deaths from SIDS (about 85% of all cases of SIDS during that time) were investigated by the Cot Death Committee of the Dutch Paediatric Association. RESULTS AND DISCUSSION Over 10% of cases of SIDS took place during some type of child care. From a national survey carried out in 2000/01 information was available on the child care attendance of 2000 Dutch infants aged 3-6 months. Based on the hours usually spent in child care by these infants, the number of similarly aged infants that died from SIDS while attending child care was 4.2 times higher than expected. Remarkably, the prevalence of known risk factors for SIDS, such as sleeping position and parental smoking, was favourable in the SIDS cases in child care settings. The adherence of child care facilities to the safe sleeping recommendations is high in the Netherlands, and no explanation as to why child care settings may be associated with an increased risk of SIDS is apparent. The possibility of other explanations, such as stress and change in routine care, is hypothesised.
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Affiliation(s)
- G A de Jonge
- Free University, Amsterdam, Prins Bernhardlaan 50, 2341 KL Oegstgeest, Netherlands.
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Semmekrot BA, Rodrigues Pereira R, Oudesluys-Murphy AM, Schölvinck EH, Tolboom J. [Guideline 'Treating asthma in children' for pediatric pulmonologists (2nd revised edition). I. Diagnosis and prevention]. Ned Tijdschr Geneeskd 2004; 148:245-6; author reply 246. [PMID: 14983583] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 04/29/2023]
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Hameleers SJ, Bergman KA, Rulo HF, Kuiper H, Semmekrot BA. [Diagnostic image (143). A neonate with a skin disorder. Congenital cutaneous candidiasis]. Ned Tijdschr Geneeskd 2003; 147:1173. [PMID: 12845837] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 03/03/2023]
Abstract
A premature neonate was born with a generalized eruption of vesicles, within a day developing into an erythrodermia, with bullae and widespread desquamation, due to congenital cutaneous candidiasis.
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MESH Headings
- Antifungal Agents/therapeutic use
- Candidiasis, Cutaneous/congenital
- Candidiasis, Cutaneous/drug therapy
- Candidiasis, Cutaneous/pathology
- Female
- Fluconazole/therapeutic use
- Humans
- Infant, Newborn
- Infant, Premature, Diseases/drug therapy
- Infant, Premature, Diseases/microbiology
- Infant, Premature, Diseases/pathology
- Skin/pathology
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Affiliation(s)
- S J Hameleers
- Canisius-Wilhelmina Ziekenhuis, afd. Kindergeneeskunde, Postbus 9015, 6500 GS Nijmegen
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Semmekrot BA. [Breast feeding and bottle feeding in the first 4 months of life in 4438 neonates]. Ned Tijdschr Geneeskd 2003; 147:86; author reply 86. [PMID: 12602075] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 03/01/2023]
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Christmann V, Liem KD, Semmekrot BA, van de Bor M. Changes in cerebral, renal and mesenteric blood flow velocity during continuous and bolus infusion of indomethacin. Acta Paediatr 2002; 91:440-6. [PMID: 12061361 DOI: 10.1080/080352502317371698] [Citation(s) in RCA: 20] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 09/30/2022]
Abstract
UNLABELLED Vasoconstriction induced by bolus injection of indomethacin reduces organ perfusion and has been related to the well-known side effects of indomethacin given for closure of the patent ductus arteriosus (PDA). The aim of the study was to compare the changes in cerebral, renal and mesenteric blood flow velocities after continuous infusion versus bolus injection of indomethacin for closure of the PDA. Thirty-two preterm infants (range 26-35 wk gestational age) with PDA were randomly assigned to receive the same amount of indomethacin either as three bolus injections (n = 14) or as a continuous infusion (n = 18) over 36 h. Blood flow velocities were measured in the internal carotid, right renal and superior mesenteric arteries at baseline and serially at 10, 30, 60 and 120 min and 12, 24, 36 and 48 h after the start of indomethacin treatment. There were no differences in blood flow velocities between both groups at baseline. During continuous infusion of indomethacin there was no significant change in the cerebral, renal and mesenteric blood flow velocities, whereas the flow velocities in the infants receiving bolus injections decreased significantly during the first 2 h after indomethacin administration in all arteries measured. There was a transient, but significant reduction in urine output after bolus injection of indomethacin. CONCLUSION In contrast to bolus injections, decrease of organ blood flow and impairment of urine output do not accompany continuous infusion of indomethacin over 36 h.
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Affiliation(s)
- V Christmann
- Department of Paediatrics, University Medical Centre Nijmegen, The Netherlands.
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Semmekrot BA. [Kernicterus in a full-term male infant a few days old]. Ned Tijdschr Geneeskd 2002; 146:1712-3; author reply 1713. [PMID: 12244778] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 04/19/2023]
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20
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Abstract
Nosocomial bloodstream infections (BSI) in premature neonates are an important cause of morbidity and mortality. The early and efficient diagnosis of a neonatal BSI and the differentiation between bacterial and fungal BSI remains a challenging task. We compared the clinical features and blood test results in preterm infants with proven candidal or bacterial BSI in order to identify potential risk factors for developing a candidal BSI. Preterm infants with proven candidal BSI were significantly more prematurely born (mean age of gestation 27.7 vs. 29.8 weeks), had previously received significantly more antibiotics of multiple classes (mean 4.4 vs. 1.2) for significantly longer periods (mean 19.3 vs. 3.2 days), were ventilated more intensively, had a significantly longer stay at the neonatal intensive care unit before the onset of the BSI (mean 26.5 vs. 9.4 days), and had C-reactive protein values even higher than in preterm infants with a bacterial BSI (mean 90 vs. 71 mg l(-1)). The presence of thrombocytopenia ( < 150 x 10(9) cells l(-1)) in all the preterm infants with candidal BSI was a significant difference. No differences were seen with regard to birth-weight, use of central intravascular catheters, total parenteral nutrition, white blood cell count and differentiation. In conclusion, candidal BSI can be strongly expected after the third week of admittance in the most premature neonates on a respirator and treated with multiple classes of antibiotics for a prolonged period of time. The presence of these risk factors in a 'septic' premature infant on antibiotic treatment justifies the empiric use of antifungals.
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Affiliation(s)
- A Warris
- Department of Neonatology, University Medical Center Nijmegen, The Netherlands.
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van den Elzen AP, Semmekrot BA, Bongers EM, Huygen PL, Marres HA. Diagnosis and treatment of the Pierre Robin sequence: results of a retrospective clinical study and review of the literature. Eur J Pediatr 2001; 160:47-53. [PMID: 11195018 DOI: 10.1007/s004310000646] [Citation(s) in RCA: 111] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
UNLABELLED We performed a retrospective study of all children with Pierre Robin sequence (PRS), admitted to our hospital from 1981-1998 in order to evaluate diagnosis, treatment and prognosis. Patients were divided into two categories: isolated PRS (group 1) and PRS plus, i.e. PRS as part of a more complex syndrome (group 2). A total of 74 patients with PRS were found, 29 (39%) males and 45 (61%) females of whom 47 (63.5%) could be categorised as isolated PRS and 27 (36.8%) as PRS plus. The most frequent diagnoses in patients with PRS plus were Stickler syndrome and the velocardiofacial syndrome. Ophthalmological and fluorescent in situ hybridisation of chromosome 22 investigations should therefore be performed in all patients, as soon as the diagnosis of PRS is established. Some form of airway treatment was necessary in the majority of patients (52 of 74), most could be treated conservatively with prone/lateral positioning and close observation. Endotracheal intubation was necessary in one child from group 1 versus five from group 2. Tracheostomy was performed in three children from group 1 and two from group 2. Feeding problems occurred in about 25% of all PRS patients and stunted growth was seen especially in boys with isolated PRS before the age of 10 months. CONCLUSION In our series, 33% of patients with Pierre Robin sequence plus had Stickler and velocardiofacial syndromes. Conservative airway management was a sufficient treatment for respiratory problems in the majority of patients. Feeding and growth need special attention in patients with Pierre Robin sequence.
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Affiliation(s)
- A P van den Elzen
- Department of Paediatrics, University Hospital Nijmegen, The Netherlands
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22
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Gaytant MA, Steegers EA, van Cromvoirt PL, Semmekrot BA, Galama JM. [Incidence of herpes neonatorum in Netherlands]. Ned Tijdschr Geneeskd 2000; 144:1832-6. [PMID: 11020838] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/17/2023]
Abstract
OBJECTIVE Investigation of the incidence of neonatal herpes in the Netherlands between 1992 and 1998. DESIGN Inventory questionnaire survey. METHODS All virological laboratories in the Netherlands were sent a questionnaire on the number of culture proven cases of neonatal herpes recorded between 1992 and 1998 and on the type of herpes simplex virus (HSV-1 or HSV-2). The gynaecological and paediatric departments of all university hospitals and of half of the general hospitals were sent questionnaires as well. Gynaecologists were asked how often caesarean section was performed in order to prevent neonatal herpes and how frequently pregnant women were seen with genital herpes. Paediatricians were asked how often they observed neonatal herpes, the type of HSV and the possible transmission route. Based on these data the figures for the whole of the Netherlands were estimated. RESULTS The incidence of neonatal herpes in the Netherlands in the period 1992 to 1998 was 2.4 per 100,000 neonates. HSV-1 was the cause of neonatal herpes in 73%, HSV-2 in 9%, and in 18% of the cases the type of infection was not recorded. The number of pregnant women with genital herpes had increased, but, in agreement with a consensus statement, the gynaecologists hardly performed caesarean sections any more to prevent neonatal herpes (2 per year). CONCLUSIONS The incidence of neonatal herpes in the Netherlands had not increased. There was no predominant role of HSV type 2 causing neonatal herpes.
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Affiliation(s)
- M A Gaytant
- Afd. Obstetrie en Gynaecologie, Universitair Medisch Centrum St Radboud, Nijmegen.
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van Kuijck MA, Verbeek AM, Klevering BJ, Semmekrot BA. [Facial dysmorphism due to complicated congenital nasolacrimal duct obstruction]. Ned Tijdschr Geneeskd 2000; 144:873-7. [PMID: 10821033] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/16/2023]
Abstract
Congenital nasolacrimal duct obstruction (in the literature also called congenital nasolacrimal mucocele or dacryocystocele) presents either as a simple nasolacrimal obstruction with epiphora or as a complicated obstruction on both sides of the lacrimal sac with midfacial deformation and respiratory insufficiency. Five neonates were treated for such complicated congenital nasolacrimal duct obstruction. Symptoms varied from an inner canthal purple-red swelling in the medial corner of the eye, with epiphora, to a serious midfacial deformation with respiratory insufficiency. The presence of a bilateral nasolacrimal mucocele leads to a broadened nasal bridge, which may be falsely interpreted as a dysmorphic feature of a congenital syndrome. Recognition of the condition allows a quick and efficient diagnosis and prevents unnecessary diagnostic procedures and anxiety. Differential diagnosis mainly includes frontobasal encephalocele and haemangioma. Treatment consists of massage, and catheterization if necessary.
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ten Donkelaar HJ, Wesseling P, Semmekrot BA, Liem KD, Tuerlings J, Cruysberg JR, de Wit PE. Severe, non X-linked congenital microcephaly with absence of the pyramidal tracts in two siblings. Acta Neuropathol 1999; 98:203-11. [PMID: 10442561 DOI: 10.1007/s004010051070] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Abstract
In two siblings (a female and a male neonate), severe microcephaly, bilateral absence of the pyramids, severe hypoplasia of the cerebral peduncles, and dysplasia of the inferior olives was found together with microphthalmia, facial malformations and multiple contractures of the extremities. In both cases, the cerebral hemispheres otherwise showed a more or less normal gyral pattern with the insula incompletely covered by the opercula, and a tom but otherwise intact corpus callosum. In case 2, congenital cataract was also observed. The present cases can be characterized as a rapidly fatal, familial syndrome, probably transmitted as an autosomal recessive trait, and have several features in common with the Neu-Laxova syndrome. They differ in having a less severe form of microcephaly, a rather normal cytoarchitecture of the cerebral cortex, an apparently normal corpus callosum, no gross cerebellar abnormalities, and no other organ malformations. The present cases belong to a group of heterogeneous syndromes which have microcephaly, ocular and facial malformations, multiple contractures, and ichthyosis-like skin in common.
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Affiliation(s)
- H J ten Donkelaar
- Department of Neurology, University Hospital Nijmegen, The Netherlands.
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25
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Semmekrot BA, de Man AJ, Boekkooi PF, van Dijk BA. [Irregular blood group antibodies during pregnancy: screening is mandatory]. Ned Tijdschr Geneeskd 1999; 143:1449-52. [PMID: 10443258] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/13/2023]
Abstract
During pregnancy irregular blood group antibodies, originating either from earlier pregnancies or from blood transfusions, may severely jeopardize both mother and child. Three patients are described with pregnancy-associated blood group incompatibility. In one case of Kell antagonism a previous child had reportedly died of cot death, but in retrospect it had most probably suffered from erythroblastosis fetalis as a result of anti Kell antibodies. In the second case, a twin pregnancy, the diagnosis of neonatal haemolytic anaemia on the basis of blood group incompatibility with a very rare antibody (anti-Kpb) had been established in the previous child. No precautions had been taken during this pregnancy, putting both mother and children at risk. All three children recovered, the twins after repeated transfusion of Kpb-free erythrocytes. The described cases emphasize the importance of being informed about the presence of antibodies during pregnancy. Such information can only be obtained by assessing the antibody status during pregnancy. In the Netherlands, the screening of all pregnant women for the presence of irregular antibodies was introduced last year.
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Affiliation(s)
- B A Semmekrot
- Afd. Kindergeneeskunde, Academisch Ziekenhuis, Nijmegen
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26
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van Heijst AF, Semmekrot BA, Kollée LA, van de Bor M. [Clinical thinking and decision making in practice: a full-term neonate with misunderstood respiratory insufficiency]. Ned Tijdschr Geneeskd 1999; 143:1256-60. [PMID: 10396336] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/13/2023]
Abstract
A fullterm newborn boy developed severe respiratory insufficiency, multiple air leaks and severe pulmonary hypertension, leading to his death on the third day of life. Family history revealed that a sister of the patient had died earlier after a similar course with respiratory problems. The most common causes of respiratory insufficiency could be subsequently excluded. After extensive postmortem investigation alveolar proteinosis was found in the lung tissue. DNA investigation was then performed in the parents, and both appeared to be heterozygotic for the 121ins2 mutation. This finding suggests both children in this family to have been homozygotic for the 121ins2 mutation resulting in a lack of synthesis of surfactant protein B (SP-B). Homozygotic SP-B deficiency in the newborn is a fatal disease with no curative perspectives, except for lung transplantation and gene therapy.
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27
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van Heteren CF, Nijhuis JG, Semmekrot BA, Merkus JM. [Discordant fetal growth in multiple pregnancy: intervention should be based on chorionicity]. Ned Tijdschr Geneeskd 1999; 143:1017-21. [PMID: 10368726] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/12/2023]
Abstract
In three women, aged 28, 35, and 38 years, with multiple pregnancies and discordant foetal growth, the question arose what to do in case of (threatening) intrauterine death of one twin. In one monochorionic pregnancy with single foetal death the survivor suffered irreversible neurological damage and died at the age of five months, in one monochorionic pregnancy the survivor was born healthy and in one dichorionic pregnancy both twins were born healthy although one twin showed severe intrauterine growth retardation. The problem concerning single foetal death in a monochorionic pregnancy is whether to terminate the pregnancy and accept the risk of premature birth to the surviving twin, or to continue the pregnancy and accept the risk of damage to the survivor. In a dichorionic pregnancy foetal death of one twin does not entail any great risk of damage to the survivor; in such a pregnancy single foetal death in a premature phase may be accepted and the pregnancy may be continued. Sonographic determination of the chorionicity in multiple pregnancy at an early stage is essential because it also determines the policy if foetal problems occur.
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Affiliation(s)
- C F van Heteren
- Afd. Obstetrie en Gynaecologie, Academisch Ziekenhuis St. Radboud, Nijmegen
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28
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Affiliation(s)
- R S Agbeko
- Department of Neonatology, University Hospital Nijmegen, The Netherlands
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29
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van Heteren CF, Nijhuis JG, Semmekrot BA, Mulders LG, van den Berg PP. Risk for surviving twin after fetal death of co-twin in twin-twin transfusion syndrome. Obstet Gynecol 1998; 92:215-9. [PMID: 9699754 DOI: 10.1016/s0029-7844(98)00159-8] [Citation(s) in RCA: 44] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
OBJECTIVE To determine neonatal outcome of surviving twins in pregnancies complicated by twin-twin transfusion syndrome and fetal deaths of co-twins. METHODS We retrospectively reviewed medical records of 11 women seen during 1990-1996 in our hospital who had pregnancies complicated by twin-twin transfusion syndrome and death of one fetus. RESULTS The median interval between fetal death and delivery (six by cesarean delivery and five vaginally) was 2 weeks (range, 1 day to 7 weeks). Three of the 11 surviving twins died soon after birth (gestational ages at birth 32, 31, and 34 weeks; fetal death-delivery intervals 3, 7, and 7 weeks, respectively). Two survivors were severely handicapped (gestational ages at birth 29 and 33 weeks; fetal death-delivery interval 1 and 2 weeks, respectively). Two children showed cerebral echodensities on ultrasound after birth but developed normally, and four did not show any abnormalities on cerebral and abdominal ultrasound and developed normally. Five of 11 surviving twins, each born 1 week or more after fetal death of the co-twin, either died or experienced serious morbidity. In the two infants born within 1 day of fetal death, no problems were detected. CONCLUSION In monochorionic twin gestations complicated by twin-twin transfusion syndrome, approximately half of surviving twins will experience mortality or serious morbidity when co-twins die in utero.
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Affiliation(s)
- C F van Heteren
- Department of Obstetrics and Gynecology, University Hospital Nijmegen St. Radboud, The Netherlands
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30
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Claahsen HL, Semmekrot BA, van Dongen PW, Mattijssen V. Successful fetal outcome after exposure to idarubicin and cytosine-arabinoside during the second trimester of pregnancy--a case report. Am J Perinatol 1998; 15:295-7. [PMID: 9643634 DOI: 10.1055/s-2007-993946] [Citation(s) in RCA: 20] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Chemotherapeutic agents administered to the mother during pregnancy may severely jeopardize the fetus. We describe a newborn girl who had been exposed to idarubicin and cytosine-arabinoside during the second and third trimesters of pregnancy due to treatment of newly diagnosed acute myeloid leukemia in the mother. The child had no structural congenital abnormalities. Adverse effects observed were prematurity, growth retardation, mildly disturbed transaminases and erythroblastosis, all of which were self-limiting with no permanent sequelae.
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Affiliation(s)
- H L Claahsen
- Department of Neonatology, University Hospital St. Radboud, Nijmegen, The Netherlands
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31
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van Heijst RF, Semmekrot BA, van der Staak FH, Nijhuis JG. [Finishing a pregnancy in an infaust fetal prognosis]. Ned Tijdschr Geneeskd 1998; 142:485-6. [PMID: 9562766] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
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32
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Semmekrot BA, Wesseling P, Bruinenberg JF, Gabreëls FM, ter Laak H, Sengers RC. Infantile motor neuron disease with autonomic dysfunction and bunina bodies. Acta Neuropathol 1998; 95:104-6. [PMID: 9452828 DOI: 10.1007/s004010050771] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
A 2-month-old girl developed motor neuron disease (MND) with autonomic disturbances and died at the age of 5 months. Neuropathological examination revealed Bunina bodies (BBs) in the lower motor neurons of the lumbar spinal cord. The significance of the presence of BBs and the classification of the MND in this child are discussed.
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Affiliation(s)
- B A Semmekrot
- Department of Pediatrics, University Hospital Nijmegen, The Netherlands
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33
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Semmekrot BA, Monnens LA. A warning for the treatment of hyperkalaemia with salbutamol. Eur J Pediatr 1997; 156:420. [PMID: 9177992] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
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34
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35
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de Boode WP, Semmekrot BA, ter Laak HJ, van der Burgt CJ, Draaisma JM, Lommen EJ, Sengers RC, van Wijk-Hoek JM. Myopathology in patients with a Noonan phenotype. Acta Neuropathol 1996; 92:597-602. [PMID: 8960317 DOI: 10.1007/s004010050566] [Citation(s) in RCA: 20] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
Two patients with a Noonan phenotype and progressive hypertrophic obstructive cardiomyopathy are described, in whom abnormal histopathological changes in striated musculature were detected. In both patients an increased density of muscle spindles was found at biopsy. The significance of an increased density of muscle spindles in patients with Noonan phenotype can only be speculated. The question is raised of whether these changes are a distinct feature within the spectrum of patients with Noonan phenotype.
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Affiliation(s)
- W P de Boode
- Department of Pediatrics, University Hospital Nijmegen, The Netherlands
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36
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Jira PE, Semmekrot BA, Vree TB, Monnens LA. [Theophylline poisoning in children]. Ned Tijdschr Geneeskd 1996; 140:1608-11. [PMID: 8768816] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
Three infants aged 1, 3 and 9 months with severe theophylline intoxication are reported. Maximum serum theophylline concentrations were 65, 44 and 156 mg/l, respectively. Vomiting, agitation and tachycardia are the classical features. Seizures and cardiac arrhythmias suggest severe intoxication. The third patient underwent immediate peritoneal dialysis. All patients survived and recovered without sequelae. Haemoperfusion is considered to be the definite treatment for severe forms of theophylline intoxication.
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Affiliation(s)
- P E Jira
- Afd. Kindergeneeskunde, Academisch Ziekenhuis, Nijmegen
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37
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van Heijst AF, Nijhuis JG, Bult P, Hulsbergen-van de Kaa CA, Monnens LA, Semmekrot BA. Renal failure in the surviving monochorionic twin after death of the co-twin in utero. Pediatr Nephrol 1996; 10:51-4. [PMID: 8611356 DOI: 10.1007/bf00863443] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
Renal failure in the newborn infant is mainly determined by vascular causes. In this report we describe a patient with a particular vascular cause of renal failure. The patient was the product of a twin pregnancy in which the twin partner died in utero. In retrospect, the twins appeared to be monozygotic. As the pregnancy was studied carefully prenatally by ultrasound, we were able to observe the development of this condition, characterized by oliguria, oligohydramnios, and lung hypoplasia: the oligohydramnios sequence. After organ development had been normal initially, renal function was lost and the oligohydramnios sequence developed in the survivor after the co-twin had died in utero.
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Affiliation(s)
- A F van Heijst
- Department of Pediatrics, University Hospital Nijmegen, The Netherlands
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38
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de Haas V, Raaijmaakers BC, Semmekrot BA, Kollée LA. [Treatment of anemia in premature infants using recombinant human erythropoietin]. Ned Tijdschr Geneeskd 1995; 139:773-6. [PMID: 7723878] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Affiliation(s)
- V de Haas
- Academisch Ziekenhuis, afd. Kindergeneeskunde, Nijmegen
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39
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Abstract
Congenital pulmonary lymphangiectasis can be a cause of respiratory distress of the newborn infant. We present a case of congenital pulmonary lymphangiectasis presenting as a unilateral hyperlucent lung. Such a presentation has only once been previously described.
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Affiliation(s)
- C W Verlaat
- Department of Paediatrics, University of Nijmegen, The Netherlands
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40
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Semmekrot BA, Monnens LA. [Atrial natriuretic peptide in newborn infants]. Ned Tijdschr Geneeskd 1993; 137:1229-35. [PMID: 8327006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
Affiliation(s)
- B A Semmekrot
- Academisch Ziekenhuis, afd. Kindergeneeskunde, Nijmegen
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41
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Voeten EA, Semmekrot BA, Weemaes CM. [Immunoglobulin levels in premature infants on a neonatology unit]. Tijdschr Kindergeneeskd 1993; 61:87-93. [PMID: 8211941] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
Abstract
Serum IgG, IgA and IgM concentrations of premature infants, 21 boys and 17 girls, gestational age 29.8 +/- 2.5 weeks, birth weight 1243 +/- 378 gram, were measured during the first weeks post partum. At birth, IgG concentrations of newborn infants correlate with gestational age. Subsequently a gradual decline of IgG concentrations occurs. Infants of 25-29 weeks gestational age appeared to have significantly lower IgG concentrations if compared to infants of 29-32 weeks gestational age. IgA concentrations remained below the detection limit during the period covered by this study, whereas serum IgM concentrations showed a gradual increase. Significantly more infants from the group with IgG < 400 mg/dl, measured at the first day of life, had infections if compared to the group with IgG > 400 mg/dl. Exchange transfusions and administration of fresh frozen plasma (FFP) resulted in a rise of immunoglobulin concentrations, whereas administration of packed cells (PC's) and pasteurised plasma protein solution (GPO) did not.
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Affiliation(s)
- E A Voeten
- Subafd. Neonatologie, Academisch Ziekenhuis Nijmegen St. Radboud
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42
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Bok LA, Semmekrot BA, Monnens LA. [Symptomatology and treatment of neonatal hypertension]. Tijdschr Kindergeneeskd 1992; 60:44-8. [PMID: 1641845] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
A newborn child of a diabetic mother is described, who developed neonatal hypertension after birth. Clinical signs were not specific and the diagnosis would have been missed if blood pressure had not been measured. The cause of the neonatal hypertension appeared to be a thrombus in the left renal artery, probably originating from the ductus arteriosus Botalli. Control of the neonatal hypertension according to a stepwise treatment regime was very difficult. Based on our experience and on study of the literature it is advised to start treatment in the acute stage with nifedipine orally or with sodium nitroprusside intravenously.
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43
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Semmekrot BA, Haraldsson A, Weemaes CM, Smeets DF, Geven WB, Brunner HG. Absent thumb, immune disorder, and congenital anemia presenting with hydrops fetalis. Am J Med Genet 1992; 42:736-40. [PMID: 1632450 DOI: 10.1002/ajmg.1320420523] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
A patient is described who presented with severe congenital anemia, hydrops fetalis, immune disorder, and absent thumbs. No toxic, infectious, or metabolic cause was found to explain these symptoms. Immunologic and cytogenetic studies excluded several syndromes that combine radial ray anomalies with hematological involvement. After careful study of the literature, it is concluded that the disorder described here represents a new syndrome that can be added to a growing list of hematological-radial syndromes.
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Affiliation(s)
- B A Semmekrot
- Department of Pediatrics, University Hospital, Nijmegen, The Netherlands
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44
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Wiesel PH, Semmekrot BA, Grigoras O, Heumann C, Guignard JP. Pharmacological doses of atrial natriuretic peptide ameliorate the acute renal dysfunction induced by systemic hypoxemia. J Pharmacol Exp Ther 1990; 254:971-5. [PMID: 2144321] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022] Open
Abstract
The acute renal effects of systemic hypoxemia and the ability of atrial natriuretic peptide (ANP) to reverse these effects were assessed in seven anesthetized and mechanically ventilated adult rabbits. Throughout the experiment, arterial pH, PaCO2 and HCO3 remained unchanged. Hypoxemia induced a significant increase in rabbit-ANP plasma levels from 151 +/- 26 to 246 +/- 65 pg/ml. During the normoxemic period (PaO2 = 131 +/- 12 mm Hg), glomerular filtration rate (GFR), renal blood flow (RBF), renal vascular resistance (RVR) and urinary sodium excretion (UNaV) were similar in both kidneys. The subsequent hypoxemic period (PaO2 = 30 +/- 1 mm Hg) caused a decrease in right and left kidney function: GFR, -26 +/- 5 and -29 +/- 6%; RBF, -17 +/- 9 and -29 +/- 8%; RVR, +28 +/- 16 and +59 +/- 30%; urine flow rate, -38 +/- 6 and -36 +/- 6%; and UNaV, -51 +/- 7 and -50 +/- 7%, respectively. Human-ANP infusion in the left renal artery (100 ng/min) during sustained systemic hypoxemia induced a significant improvement in GFR (+57 +/- 18%), RBF (+21 +/- 8%), RVR (-20 +/- 7%), urine flow rate (+151 +/- 27%) and UNaV (+270 +/- 48%) in the left experimental kidney, as compared with the preceding hypoxemic period. In contrast, the function of the right control kidney remained impaired.
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Affiliation(s)
- P H Wiesel
- Department of Pediatrics, Centre Hospitalier Universitaire Vaudois, Lausanne, Switzerland
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45
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Abstract
Plasma levels of atrial natriuretic peptide (ANP) and the effect of exogenous ANP on renal function have been studied in newborn and adult rabbits. In order to investigate an age difference in responsiveness to ANP, we studied the renal effects of alpha-human ANP (1-28) administered at the same dose per kg body weight in adult and neonatal rabbits. Plasma basal ANP levels were similar in 18 newborn (4- to 11-day-old) compared to 7 adult rabbits (150 +/- 16 and 151 +/- 28 pg/ml, resp.). Eleven newborn and 11 adult rabbits were anesthetized and mechanically ventilated. After a control period, each animal received an hANP loading dose (3 micrograms/kg i.v.), followed by an infusion of 0.3 micrograms/kg/min. Blood gases remained stable throughout the experiment in both groups. Mean blood pressure decreased in newborn (28.5 +/- 0.8 to 26.2 +/- 1.0 mmHg) and adult (92 +/- 3 to 84 +/- 3 mmHg) animals. Percent hANP-induced changes in renal functions in newborn and adult rabbits were, respectively: urine flow rate: -21 +/- 4% and +57 +/- 8%; urinary sodium excretion: +4 +/- 7% and +81 +/- 11%; glomerular filtration rate (GFR): -19 +/- 4% and -4 +/- 6%; renal blood flow (RBF): -22 +/- 4% and -11 +/- 5%. As expected, diuresis and natriuresis increased in adult rabbits. Failure of hANP to increase natriuresis and diuresis in newborn rabbits could be related to the marked decrease in GFR, receptor immaturity and/or interactions with other hormonal systems.
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Affiliation(s)
- B A Semmekrot
- Unité de Néphrologie, Centre Hospitalier Universitaire Vaudois, Lausanne, Switzerland
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46
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Semmekrot BA, Baadenhuijsen H, Monnens LA. [The aluminum level of infant food; effect of the preparation method. Consequences in kidney dysfunction?]. Tijdschr Kindergeneeskd 1989; 57:21-4. [PMID: 2711366] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Abstract
Stimulated by reports in literature concerning high aluminium content of human milk formulas, ten Dutch formulas were investigated. The aluminium content appeared to be rather low. Conventional home preparation induced a pronounced rise of aluminium content (3 to 100 fold). Even in this way prepared, milk formula is safe.
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Affiliation(s)
- B A Semmekrot
- Afd. Kindergeneeskunde, St. Radboudziekenhuis, Nijmegen
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47
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Semmekrot BA, Strijk SP, Schröder CH, de Vries JD, Monnens LA. [Neonatal adrenal gland hemorrhage. The importance of echography in diagnosis and follow-up]. Tijdschr Kindergeneeskd 1987; 55:92-7. [PMID: 3303438] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
Neonatal Adrenal Haemorrhage (NAH) is a condition, which often presents with a palpable abdominal mass and prolonged jaundice. Supra-renal calcifications, seen on routine X-ray films, often result from adrenal haemorrhage in early life. Disturbed renal function at the ipsilateral side, as can be seen from excretory urography and renal scintigraphy, is a much less known condition in association with NAH. The case history of three patients is described. The presentation, diagnostical approach and course of NAH is discussed. Echography is the most important diagnostic tool. Echographic follow up discriminates NAH from other conditions presenting with a palpable abdominal mass and allows for a waiting attitude.
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Semmekrot BA, Rotteveel JJ, Bakker-Niezen SH, Logt F. Occurrence of an astrocytoma in a patient with Williams syndrome. Pediatr Neurosci 1985; 12:188-91. [PMID: 3843262 DOI: 10.1159/000120245] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
The Williams elfin facies syndrome (Williams-Beuren syndrome) is a disorder characterized by a typical facies, supravalvular aortic stenosis and mental retardation. Its coexistence with a brain tumor has, so far, never been described. Recently, we treated a patient who was previously diagnosed as having Williams syndrome for a cerebral astrocytoma. In view of the incidence of astrocytomas in children and the occurrence of Williams syndrome, we want to report this coincidence.
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