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Göpel W, Kribs A, Roll C, Wieg C, Teig N, Hoehn T, Welzing L, Vochem M, Hoppenz M, Bührer C, Mehler K, Hubert M, Eichhorn J, Schmidtke S, Rausch TK, König IR, Härtel C, Roth B, Herting E. Multicentre randomised trial of invasive and less invasive surfactant delivery methods showed similar spirometry results at 5-9 years of age. Acta Paediatr 2022; 111:2108-2114. [PMID: 35896864 DOI: 10.1111/apa.16499] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/05/2022] [Revised: 07/23/2022] [Accepted: 07/26/2022] [Indexed: 11/28/2022]
Abstract
AIM We explored whether subnormal forced expiratory volume within one second (FEV1 ) at 5-9 years of age was lower in children born preterm who received less invasive surfactant administration (LISA) rather than surfactant via an endotracheal tube. METHODS The multicentre, randomised Nonintubated Surfactant Application trial enrolled 211 preterm infants born at 23-26 weeks of gestation from 13 level III neonatal intensive care units from April 2009 to March 2012. They received surfactant via LISA (n=107) or after conventional endotracheal intubation (n=104). The follow-up assessments were carried out by a single team blinded to the group assignments. The main outcome was FEV1 <80% of predicted values. RESULTS Spirometry was successful in 102/121 children. The other children died or were lost to follow up. Median FEV1 was 93% (interquartile range 80-113%) of predicted values in the LISA group and 86% (interquartile range 77-102%) in the control group (p=0.685). Rates of FEV1 < 80% were 11/57 (19%) and 15/45 (33 %) respectively, which was an absolute risk reduction of 14% (95% confidence interval -3.1% to 31.2%, p=0.235). There were no differences in other outcome measures. CONCLUSION The proportion of children aged 5-9 years with subnormal FEV1 was not significantly different between the groups.
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Affiliation(s)
- W Göpel
- Department of Paediatrics, University Hospital of Schleswig-Holstein, University of Lübeck, Lübeck, Germany
| | - A Kribs
- Department of Paediatrics, Faculty of Medicine and University Hospital of Cologne, Cologne, Germany
| | - C Roll
- Department of Neonatology, Vest Children's Hospital Datteln, University Witten-Herdecke, Datteln, Germany
| | - C Wieg
- Children's Hospital Aschaffenburg-Alzenau, Aschaffenburg, Germany
| | - N Teig
- Department of Neonatology, University Children's Hospital, Ruhr University Bochum, Bochum, Germany
| | - T Hoehn
- Department of General Paediatrics, University Hospital Düsseldorf, Düsseldorf, Germany
| | - L Welzing
- Department of Paediatrics, Hospital Köln-Porz, Germany
| | - M Vochem
- Olgahospital Stuttgart, Stuttgart, Germany
| | - M Hoppenz
- Department of Neonatology and Paediatric Intensive Care Medicine, Children's Hospital, Cologne, Germany
| | - C Bührer
- Department of Neonatology, Charité Universitätsmedizin Berlin, Berlin, Germany
| | - K Mehler
- Department of Paediatrics, Faculty of Medicine and University Hospital of Cologne, Cologne, Germany
| | - M Hubert
- Department of Neonatology and Paediatric Intensive Care, DRK-Children's Hospital, Siegen, Germany
| | - J Eichhorn
- Children's Hospital Leverkusen, Leverkusen, Germany
| | - S Schmidtke
- Department of Neonatology, Asklepios Klinik Barmbek, Hamburg, Germany
| | - T K Rausch
- Institute of Medical Biometry and Statistics, University of Lübeck, Germany
| | - I R König
- Institute of Medical Biometry and Statistics, University of Lübeck, Germany
| | - C Härtel
- Children's Hospital, University of Würzburg, Würzburg, Germany
| | - B Roth
- Department of Paediatrics, Faculty of Medicine and University Hospital of Cologne, Cologne, Germany
| | - E Herting
- Department of Paediatrics, University Hospital of Schleswig-Holstein, University of Lübeck, Lübeck, Germany
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Thomale UW, Auer C, Spennato P, Schaumann A, Behrens P, Gorelyshev S, Bogoslovskaia E, Shulaev A, Kabanian A, Seliverstov A, Alexeev A, Ozgural O, Kahilogullari G, Schuhmann M, Jimenez-Guerra R, Wittayanakorn N, Sukharev A, Marquez-Rivas J, Linsler S, Damaty AE, Vacek P, Lovha M, Guzman R, Stricker S, Beez T, Wiegand C, Azab M, Buis D, Sáez M, Fleck S, Dziugan C, Ferreira A, Radovnicky T, Bührer C, Lam S, Sgouros S, Roth J, Constantini S, Cavalheiro S, Cinalli G, Kulkarni AV, Bock HC. TROPHY registry - status report. Childs Nerv Syst 2021; 37:3549-3554. [PMID: 34184098 PMCID: PMC8578079 DOI: 10.1007/s00381-021-05258-w] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/29/2021] [Accepted: 06/08/2021] [Indexed: 11/25/2022]
Abstract
INTRODUCTION The TROPHY registry has been established to conduct an international multicenter prospective data collection on the surgical management of neonatal intraventricular hemorrhage (IVH)-related hydrocephalus to possibly contribute to future guidelines. The registry allows comparing the techniques established to treat hydrocephalus, such as external ventricular drainage (EVD), ventricular access device (VAD), ventricular subgaleal shunt (VSGS), and neuroendoscopic lavage (NEL). This first status report of the registry presents the results of the standard of care survey of participating centers assessed upon online registration. METHODS On the standard of treatment forms, each center indicated the institutional protocol of interventions performed for neonatal post-hemorrhagic hydrocephalus (nPHH) for a time period of 2 years (Y1 and Y2) before starting the active participation in the registry. In addition, the amount of patients enrolled so far and allocated to a treatment approach are reported. RESULTS According to the standard of treatment forms completed by 56 registered centers, fewer EVDs (Y1 55% Y2 46%) were used while more centers have implemented NEL (Y1 39%; Y2 52%) to treat nPHH. VAD (Y1 66%; Y2 66%) and VSGS (Y1 42%; Y2 41%) were used at a consistent rate during the 2 years. The majority of the centers used at least two different techniques to treat nPHH (43%), while 27% used only one technique, 21% used three, and 7% used even four different techniques. Patient data of 110 infants treated surgically between 9/2018 and 2/2021 (13% EVD, 15% VAD, 30% VSGS, and 43% NEL) were contributed by 29 centers. CONCLUSIONS Our results emphasize the varying strategies used for the treatment of nPHH. The international TROPHY registry has entered into a phase of growing patient recruitment. Further evaluation will be performed and published according to the registry protocol.
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Affiliation(s)
- U. W. Thomale
- Pediatric Neurosurgery, Campus Virchow Klinikum, Charité Universitätsmedizin, Berlin Augustenburger Platz 1, 13353 Berlin, Germany
| | - C. Auer
- Division of Pediatric Neurosurgery, Kepler Universitätsklinikum, Linz, Austria
| | - P. Spennato
- Pediatric Neurosurgery, AORN Santobono Pausilipon, Naples, Italy
| | - A. Schaumann
- Pediatric Neurosurgery, Campus Virchow Klinikum, Charité Universitätsmedizin, Berlin Augustenburger Platz 1, 13353 Berlin, Germany
| | - P. Behrens
- Pediatric Neurosurgery, Campus Virchow Klinikum, Charité Universitätsmedizin, Berlin Augustenburger Platz 1, 13353 Berlin, Germany
| | - S. Gorelyshev
- Pediatric Neurosurgery, Moscow Bashlyaeva Pediatric Hospital, Moscow, Russia
| | - E. Bogoslovskaia
- Pediatric Neurosurgery, Surgut Clinical Perinatal Center, Surgut, Russia
| | - A. Shulaev
- Pediatric Neurosurgery, Children’s Republic Clinical Hospital, Kazan, Russia
| | - A. Kabanian
- Pediatric Neurosurgery, Children’s Regional Hospital, Krasnodar, Russia
| | - A. Seliverstov
- Pediatric Neurosurgery, Kemerovo Regional Pediatric Hospital, Kemerovo, Russia
| | - A. Alexeev
- Pediatric Neurosurgery, Chelyabinsk Regional Children’s Clinical Hospital, Chelyabinsk, Russia
| | - O. Ozgural
- Neurosurgery, Ankara University, Ankara, Turkey
| | | | - M. Schuhmann
- Pediatric Neurosurgery, University Hospital of Tübingen, Tubingen, Germany
| | - R. Jimenez-Guerra
- Neonatal Neurosurgery, National Institute of Perinatology, Mexico City, Mexico
| | - N. Wittayanakorn
- Surgery, Queen Sirikit National Institute of Child Health, Bangkok, Thailand
| | - A. Sukharev
- Pediatric Neurosurgery, Regional Children Hospital, Yekaterinburg, Russia
| | | | - S. Linsler
- Neurosurgery, Saarland University Hospital, Homburg, Saarland Germany
| | - A. El Damaty
- Pediatric Neurosurgery, Heidelberg University Hospital, Heidelberg, Germany
| | - P. Vacek
- Neurosurgery, University Hospital and Faculty of Medicine in Pilsen, Charles University, Pilsen, Czech Republic
| | - M. Lovha
- Neurosurgery, Volyn Regional Pediatric Hospital, Lutsk, Ukraine
| | - R. Guzman
- Neurosurgery, Universitätskinderspital Beider Basel, Basel, Switzerland
| | - S. Stricker
- Neurosurgery, Universitätskinderspital Beider Basel, Basel, Switzerland
| | - T. Beez
- Neurosurgery, Heinrich-Heine-University, Duesseldorf, Germany
| | - C. Wiegand
- Neurosurgery, Marienhospital, Osnabrück, Germany
| | - M. Azab
- Neurosurgery, Damietta Specialized Hospital, Damietta, Egypt
| | - D. Buis
- Neurosurgery, Amsterdam University Medical Centres, Amsterdam, Netherlands
| | - M. Sáez
- Neurosurgery, Hospital La Paz, Madrid, Spain
| | - S. Fleck
- Neurosurgery, University Medicine Greifswald, Greifswald, Germany
| | - C. Dziugan
- Pediatric Neurosurgery, Ann & Robert H. Lurie Children’s Hospital of Chicago, Chicago, USA
| | - A. Ferreira
- Neurosurgery, Centro Hospitalar Universitário São João, Porto, Portugal
| | - T. Radovnicky
- Neurosurgery, Masaryk Hospital, Usti Nad Labem, Czech Republic
| | - C. Bührer
- Pediatric Neurosurgery, Campus Virchow Klinikum, Charité Universitätsmedizin, Berlin Augustenburger Platz 1, 13353 Berlin, Germany
| | - S. Lam
- Pediatric Neurosurgery, Ann & Robert H. Lurie Children’s Hospital of Chicago, Chicago, USA
| | - S. Sgouros
- Pediatric Neurosurgery, Iaso Childrens Hospital, Athens, Greece
| | - J. Roth
- Pediatric Neurosurgery, Tel Aviv Medical Center, Tel Aviv, Israel
| | - S. Constantini
- Pediatric Neurosurgery, Tel Aviv Medical Center, Tel Aviv, Israel
| | - S. Cavalheiro
- Pediatric Neurosurgery, Federal University of Sao Paulo, Sao Paulo, Brazil
| | - G. Cinalli
- Pediatric Neurosurgery, AORN Santobono Pausilipon, Naples, Italy
| | - A. V. Kulkarni
- Pediatric Neurosurgery, Sick Children Hospital, University of Toronto, Toronto, Canada
| | - H. C. Bock
- Pediatric Neurosurgery, University Medical Center Göttingen, Gottingen, Germany
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Wu J, Ma J, Gu H, Dong D, Bührer C, Tsuchiya C, Simonella L, Ran X, Liu C, Launonen A. PCN34 The Societal IMPACT of Obinutuzumab in the First-LINE Treatment of Follicular Lymphoma in China. Value Health Reg Issues 2020. [DOI: 10.1016/j.vhri.2020.07.084] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Schneider K, Metze B, Bührer C, Cuttini M, Garten L. Therapieentscheidungen bei Frühgeborenen an der Grenze zur Lebensfähigkeit – eine Umfrage unter Neonatologen aus Deutschland, Österreich und der Schweiz. Geburtshilfe Frauenheilkd 2020. [DOI: 10.1055/s-0039-3402977] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022] Open
Affiliation(s)
- K Schneider
- Abteilung für Neonatologie, GFO Kliniken Bonn
| | - B Metze
- Klinik für Neonatologie, Charité – Universitätsmedizin Berlin
| | - C Bührer
- Klinik für Neonatologie, Charité – Universitätsmedizin Berlin
| | - M Cuttini
- Clinical Care and Management Innovation Research Area, Ospedale Pediatrico Bambino Gesù, Rom, Italien
| | - L Garten
- Klinik für Neonatologie, Charité – Universitätsmedizin Berlin
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Rudloff S, Bührer C, Jochum F, Kauth T, Kersting M, Körner A, Koletzko B, Mihatsch W, Prell C, Reinehr T, Zimmer KP. Vegetarische Kostformen im Kindes- und Jugendalter. Monatsschr Kinderheilkd 2018. [DOI: 10.1007/s00112-018-0547-6] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Berrington JE, Clarke P, Embleton ND, Ewer AK, Geethanath R, Gupta S, Lal M, Oddie S, Shafiq A, Vasudevan C, Bührer C. Retinopathy of prematurity screening at ≥30 weeks: urinary NTpro-BNP performance. Acta Paediatr 2018; 107:1722-1725. [PMID: 29617052 DOI: 10.1111/apa.14354] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/11/2018] [Revised: 03/27/2018] [Accepted: 03/28/2018] [Indexed: 11/29/2022]
Abstract
AIM Urinary N-terminal B-type natriuretic peptide NTproBNP levels are associated with the development of retinopathy of prematurity (ROP) in infants <30 weeks of gestation. The incidence of ROP in more mature infants who meet other ROP screening criteria is very low. We therefore aimed to test whether urinary NTproBNP predicted ROP development in these infants. METHODS Prospective observational study in 151 UK infants ≥30 + 0 weeks of gestation but also <32 weeks of gestation and/or <1501 g, to test the hypothesis that urinary NTproBNP levels on day of life (DOL) 14 and 28 were able to predict ROP development. RESULTS Urinary NTproBNP concentrations on day 14 and day 28 of life did not differ between infants with and without ROP (medians 144 vs 128 mcg/mL, respectively, p = 0.86 on DOL 14 and medians 117 vs 94 mcg/mL, respectively, p = 0.64 on DOL28). CONCLUSION The association previously shown for infants <30 completed weeks between urinary NTproBNP and the development of ROP was not seen in more mature infants. Urinary NTproBNP does not appear helpful in rationalising direct ophthalmoscopic screening for ROP in more mature infants, and may suggest a difference in pathophysiology of ROP in this population.
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Affiliation(s)
- JE Berrington
- Newcastle Neonatal Service; Newcastle upon Tyne Hospitals NHS Foundation Trust; Newcastle upon Tyne UK
- Institute of Cellular Medicine; Newcastle University; Newcastle upon Tyne UK
| | - P Clarke
- Norfolk and Norwich University Hospitals NHS Foundation Trust; Norfolk UK
| | - ND Embleton
- Newcastle Neonatal Service; Newcastle upon Tyne Hospitals NHS Foundation Trust; Newcastle upon Tyne UK
- Institute of Health and Society; Newcastle University; Newcastle upon Tyne UK
| | - AK Ewer
- Birmingham Womens Hospital; Birmingham UK
| | | | - S Gupta
- University Hospital of North Tees; Stockton UK
| | - M Lal
- South Tees NHS Foundation Trust; Middlesbrough UK
| | - S Oddie
- Bradford Teaching Hospitals NHS Foundation Trust; Bradford UK
| | - A Shafiq
- Department of Ophthalmology; Newcastle Upon Tyne Hospitals NHS Foundation Trust; Newcastle upon Tyne UK
| | - C Vasudevan
- Bradford Teaching Hospitals NHS Foundation Trust; Bradford UK
| | - C Bührer
- Charité Universitätsmedizin; Berlin Germany
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Segler A, Schwickert A, Weiß CR, Bührer C, Braun T, Henrich W. Feasibility of umbilical cord blood (UCB) collection in neonates at high risk of brain damage. Geburtshilfe Frauenheilkd 2018. [DOI: 10.1055/s-0038-1671454] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022] Open
Affiliation(s)
- A Segler
- Charite Virchow Berlin, Klinik für Geburtsmedizin, Berlin, Deutschland
| | - A Schwickert
- Charite Virchow Berlin, Klinik für Geburtsmedizin, Berlin, Deutschland
| | - CR Weiß
- Charite Virchow Berlin, Klinik für Geburtsmedizin, Berlin, Deutschland
| | - C Bührer
- Charite Virchow Berlin, Klinik für Neonatologie, Berlin, Deutschland
| | - T Braun
- Charite Virchow Berlin, Klinik für Geburtsmedizin, Berlin, Deutschland
| | - W Henrich
- Charite Virchow Berlin, Klinik für Geburtsmedizin, Berlin, Deutschland
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Faensen A, Lehmann H, Metze B, Berns M, Hinkson L, Henrich W, Bührer C, Bamberg C. Differential association of prenatal blood flow patterns with death and neurodevelopmental retardation in preterm infants with intrauterine growth restriction. Geburtshilfe Frauenheilkd 2018. [DOI: 10.1055/s-0038-1671137] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022] Open
Affiliation(s)
- A Faensen
- Charité – Universitätsmedizin Berlin, Charité Centrum Frauen-, Kinder- & Jugendmedizin mit Perinatalzentrum & Humangenetik CC 17, Geburtsmedizin, Berlin, Deutschland
| | - H Lehmann
- Charité – Universitätsmedizin Berlin, Charité Centrum Frauen-, Kinder- & Jugendmedizin mit Perinatalzentrum & Humangenetik CC 17, Geburtsmedizin, Berlin, Deutschland
| | - B Metze
- Charité – Universitätsmedizin Berlin, Charité Centrum Frauen-, Kinder- & Jugendmedizin mit Perinatalzentrum & Humangenetik CC 17, Neonatologie, Berlin, Deutschland
| | - M Berns
- Charité – Universitätsmedizin Berlin, Charité Centrum Frauen-, Kinder- & Jugendmedizin mit Perinatalzentrum & Humangenetik CC 17, Neonatologie, Berlin, Deutschland
| | - L Hinkson
- Charité – Universitätsmedizin Berlin, Charité Centrum Frauen-, Kinder- & Jugendmedizin mit Perinatalzentrum & Humangenetik CC 17, Geburtsmedizin, Berlin, Deutschland
| | - W Henrich
- Charité – Universitätsmedizin Berlin, Charité Centrum Frauen-, Kinder- & Jugendmedizin mit Perinatalzentrum & Humangenetik CC 17, Geburtsmedizin, Berlin, Deutschland
| | - C Bührer
- Charité – Universitätsmedizin Berlin, Charité Centrum Frauen-, Kinder- & Jugendmedizin mit Perinatalzentrum & Humangenetik CC 17, Neonatologie, Berlin, Deutschland
| | - C Bamberg
- UKE, Geburtsmedizin, Hamburg, Deutschland
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Koletzko B, Bührer C, Jochum F, Kauth T, Körner A, Mihatsch W, Prell C, Reinehr T, Zimmer KP. Erratum zu: Folgenahrungen für Kleinkinder im Alter von einem bis 3 Jahren (sog. Kindermilchgetränke). Monatsschr Kinderheilkd 2018. [DOI: 10.1007/s00112-017-0356-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
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Huhn EA, Visca E, Vogt DR, von Felten S, Tinner Oehler EM, Bührer C, Surbek D, Zimmermann R, Hoesli I. Decreased neonatal pain response after vaginal-operative delivery with Kiwi OmniCup versus metal ventouse. BMC Pregnancy Childbirth 2017; 17:47. [PMID: 28143599 PMCID: PMC5282794 DOI: 10.1186/s12884-017-1231-x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2015] [Accepted: 01/20/2017] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Vaginal delivery, especially operative assisted vaginal delivery, seems to be a major stressor for the neonate. The objective of this study was to evaluate the stress response after metal cup versus Kiwi Omnicup® ventouse delivery. METHODS The study was a secondary observational analysis of data from a former prospective randomised placebo controlled multicentre study on the analgesic effect of acetaminophen in neonates after operative vaginal delivery and took place at three Swiss tertiary hospitals. Healthy pregnant women ≥35 weeks of gestation with an estimated fetal birth weight above 2000 g were recruited after admission to the labour ward. Pain reaction was analysed by pain expression score EDIN scale (Échelle Douleur Inconfort Nouveau-Né, neonatal pain and discomfort scale) directly after delivery. For measurement of the biochemical stress response, salivary cortisol as well as the Bernese Pain Scale of Newborns (BPSN) were evaluated before and after an acute pain stimulus (the standard heel prick for metabolic testing (Guthrie test)) at 48-72 h. RESULTS Infants born by vaginal operative delivery displayed a lower pain response after plastic cup than metal cup ventouse delivery (p < 0.001), but the pain response was generally lower than expected and they recovered fully within 72 h. CONCLUSIONS Neonatal pain response is slightly reduced after use of Kiwi OmniCup® versus metal cup ventouse. TRIAL REGISTRATION Trial was registered under under NCT00488540 on 19th June 2007.
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Affiliation(s)
- E A Huhn
- Department of Obstetrics and Gynaecology, University Hospital Basel, Spitalstrasse 21, 4031, Basel, Switzerland.
| | - E Visca
- Department of Obstetrics and Gynaecology, Cantonal Hospital Baselland, Liestal, Switzerland
| | - D R Vogt
- Clinical Trial Unit, University Hospital Basel, Basel, Switzerland
| | - S von Felten
- Clinical Trial Unit, University Hospital Basel, Basel, Switzerland
| | - E M Tinner Oehler
- Department of Paediatrics, Insel Hospital, University of Bern, Bern, Switzerland
| | - C Bührer
- Department of Neonatology, Charité University Medical Center, Berlin, Germany
| | - D Surbek
- Department of Obstetrics and Gynaecology, Insel Hospital, University of Bern, Bern, Switzerland
| | - R Zimmermann
- Department of Obstetrics and Gynaecology, University Hospital Zurich, Zurich, Switzerland
| | - I Hoesli
- Department of Obstetrics and Gynaecology, University Hospital Basel, Spitalstrasse 21, 4031, Basel, Switzerland
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Kleinwechter H, Schäfer-Graf U, Bührer C, Hoesli I, Kainer F, Kautzky-Willer A, Pawlowski B, Schunck K, Somville T, Sorger M. Gestationsdiabetes mellitus (GDM) –Diagnostik, Therapie und Nachsorge
,. DIABETOL STOFFWECHS 2016. [DOI: 10.1055/s-0042-113788] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Affiliation(s)
- H. Kleinwechter
- diabetologikum kiel, Diabetes-Schwerpunktpraxis und Schulungszentrum, Kiel
| | - U. Schäfer-Graf
- Berliner Diabeteszentrum für Schwangere, Klinik für Gynäkologie und Geburtshilfe, St. Joseph Krankenhaus, Berlin
| | - C. Bührer
- Klinik für Neonatologie, Charité Universitätsmedizin, Berlin
| | - I. Hoesli
- Frauenklinik, Geburtshilfe und Schwangerschaftsmedizin, Universitätsspital Basel, Basel/CH
| | - F. Kainer
- Klinik Hallerwiese, Abteilung für Geburtshilfe und Pränatalmedizin, Nürnberg
| | - A. Kautzky-Willer
- Medizinische Universitätsklinik Wien, Klinik für Innere Medizin III, Abteilung für Endokrinologie und Stoffwechsel, Gender Medicine Unit, Wien/A
| | - B. Pawlowski
- Klinik für Stoffwechselkrankheiten, Universitätsklinikum Düsseldorf und Deutsches Diabetes-Zentrum, Düsseldorf
| | - K. Schunck
- Klinik für Kinder- und Jugendmedizin, Krankenhaus im Friedrichshain, Berlin
| | - T. Somville
- Klinik für Geburtshilfe und Pränatalmedizin, Universitätsklinikum Hamburg-Eppendorf, Hamburg
| | - M. Sorger
- Medizinische Poliklinik, Universitätsklinikum Bonn, Bonn
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Kleinwechter H, Schäfer-Graf U, Bührer C, Hoesli I, Kainer F, Kautzky-Willer A, Pawlowski B, Schunck K, Somville T, Sorger M. Diabetes und Schwangerschaft. DIABETOL STOFFWECHS 2016. [DOI: 10.1055/s-0042-113789] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Affiliation(s)
- H. Kleinwechter
- Diabetologikum Kiel, Diabetes-Schwerpunktpraxis und Schulungszentrum, Kiel
| | - U. Schäfer-Graf
- Berliner Diabeteszentrum für Schwangere, Klinik für Gynäkologie und Geburtshilfe, St. Joseph Krankenhaus, Berlin
| | - C. Bührer
- Klinik für Neonatologie, Charité Universitätsmedizin, Berlin
| | - I. Hoesli
- Frauenklinik, Geburtshilfe und Schwangerschaftsmedizin, Universitätsspital Basel, Basel
| | - F. Kainer
- Klinik Hallerwiese, Abteilung für Geburtshilfe und Pränatalmedizin, Nürnberg
| | - A. Kautzky-Willer
- Medizinische Universität Wien, Klinik für Innere Medizin III, Abt. für Endokrinologie und Stoffwechsel, Wien
| | - B. Pawlowski
- Deutsche Diabetes-Klinik, Deutsches Diabetes-Zentrum, Düsseldorf
| | - K. Schunck
- Klinik für Kinder- und Jugendmedizin, Krankenhaus im Friedrichshain, Berlin
| | - T. Somville
- Klinik für Geburtshilfe und Pränatalmedizin, Universitätsklinikum Hamburg-Eppendorf, Hamburg
| | - M. Sorger
- Medizinische Poliklinik, Universitätsklinikum Bonn, Bonn
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Mücke S, Nagel M, Siedentopf J, Bührer C, Hüseman D. Neonatal Abstinence Syndrome: Twelve Years of Experience at a Regional Referral Center. Klin Padiatr 2016; 229:32-39. [PMID: 27723910 DOI: 10.1055/s-0042-115300] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
Infants exposed to opiates antenatally display withdrawal symptoms after birth referred to as neonatal abstinence syndrome (NAS).A total of 366 newborns (166 females, 10 twins) from 361 mothers were diagnosed with NAS from 2000 to 2011 at a single large metropolitan referral center.Retrospective chart review of all newborn infants exposed to opiates in utero.20% were premature (gestational age<37 weeks), 32% were small-for-gestational-age (<10th percentile). 70% of infants (195/278) antenatally exposed to methadone (racemic methadone or levomethadone) required pharmacological treatment for 11 (1-55) days (median; range); however, 45% of infants (28/62) exposed to buprenorphine required pharmacological treatment for a median of only 5 (1-20) days (p=0.014). Pharmacological treatment of infants with phenobarbital (n=189) took a median of 9 (1-53) days, but treatment with morphine (n=39) took 19 (3-55) days (p<0.001). The median duration of hospitalization increased from 11 days in 2000-2004 to 19 days in 2008-2011 (p<0.001). The increased durations of neonatal hospitalization were associated with similar increases in the average dosages of maternal methadone.Use of buprenorphine, rather than methadone, for treatment of opiate-addicted pregnant women is associated with fewer and shorter neonatal withdrawal symptoms. The duration of hospitalization and treatment for NAS has increased over time.
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Affiliation(s)
- S Mücke
- Klinik für Neonatologie, Charité Universitätsmedizin Berlin, Berlin, Germany
| | - M Nagel
- Department of Obstetrics, Charité University Medical Center, Berlin, Germany
| | - J Siedentopf
- Department of Obstetrics, Charité University Medical Center, Berlin, Germany
| | - C Bührer
- Klinik für Neonatologie, Charité Universitätsmedizin Berlin, Berlin, Germany
| | - D Hüseman
- Pediatrics, Klinikum Barnim GmbH, Eberswalde, Germany
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Kusztrich A, Hüseman D, Garten L, Neitzel H, Bührer C. [Survival, Medical Care and Quality of Life in Children with Trisomy 13 and 18]. Klin Padiatr 2016; 228:240-4. [PMID: 27617759 DOI: 10.1055/s-0042-113131] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
BACKGROUND While infants with trisomy 13 (T13) and trisomy 18 (T18) are known to die early, parents want to know more about life expectancy and quality of life. METHODS 30-year single-center retrospective chart analysis (1980-2010) of cytogenetically confirmed T13 and T18 cases. Mothers of infants who had lived 3 months or longer were approached to judge their infant's quality of life and talk about their experiences with medical staff. RESULTS Data of 18/20 T13 infants and 18/21 T18 infants could be retrieved. Median survival times were 5 d for T13 and 19 d for T18. One T13 and 2T18 children survived past 1 year. Out of 5 mothers whose infants had survived at least 3 months, 4 described their infant as friendly, happy and peaceful. They observed some degree of psychomotor development and were in favour of the numerous medical and surgical interventions performed. They wished to have had a doctor coordinating these interventions and missed an active offer for psychological help. CONCLUSION While most infants with T13 or T18 die as neonates, mothers of infants surviving longer periods of time have positive memories about their infants' quality of life.
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Affiliation(s)
- A Kusztrich
- Charité University Medical Center, Clinic of Neonatology, Berlin
| | - D Hüseman
- Department of Pediatrics, Klinikum Barnim, Werner Forßmann Krankenhaus, Eberswalde
| | - L Garten
- Charité University Medical Center, Clinic of Neonatology, Berlin
| | - H Neitzel
- Charité University Medical Center, Institute of Human Genetics, Berlin
| | - C Bührer
- Charité University Medical Center, Clinic of Neonatology, Berlin
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Kleinwechter H, Schäfer-Graf U, Bührer C, Hoesli I, Kainer F, Kautzky-Willer A, Pawlowski B, Schunck K, Somville T, Sorger M. Gestationsdiabetes mellitus (GDM) –Diagnostik, Therapie und Nachsorge. DIABETOL STOFFWECHS 2015. [DOI: 10.1055/s-0035-1566816] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Affiliation(s)
- H. Kleinwechter
- diabetologikum kiel, Diabetes-Schwerpunktpraxis und Schulungszentrum, Kiel
| | - U. Schäfer-Graf
- Berliner Diabeteszentrum für Schwangere, Klinik für Gynäkologie und Geburtshilfe, St. Joseph Krankenhaus, Berlin
| | - C. Bührer
- Klinik für Neonatologie, Charité Universitätsmedizin, Berlin
| | - I. Hoesli
- Frauenklinik, Geburtshilfe und Schwangerschaftsmedizin, Universitätsspital Basel, Basel/CH
| | - F. Kainer
- Klinik Hallerwiese, Abteilung für Geburtshilfe und Pränatalmedizin, Nürnberg
| | - A. Kautzky-Willer
- Medizinische Universitätsklinik Wien, Klinik für Innere Medizin III, Abteilung für Endokrinologie und Stoffwechsel, Gender Medicine Unit, Wien/A
| | - B. Pawlowski
- Klinik für Stoffwechselkrankheiten, Universitätsklinikum Düsseldorf und Deutsches Diabetes-Zentrum, Düsseldorf
| | - K. Schunck
- Klinik für Kinder- und Jugendmedizin, Krankenhaus im Friedrichshain, Berlin
| | - T. Somville
- Klinik für Geburtshilfe und Pränatalmedizin, Universitätsklinikum Hamburg-Eppendorf, Hamburg
| | - M. Sorger
- Medizinische Poliklinik, Universitätsklinikum Bonn, Bonn
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Kleinwechter H, Schäfer-Graf U, Bührer C, Hoesli I, Kainer F, Kautzky-Willer A, Pawlowski B, Schunck K, Somville T, Sorger M. Gestationsdiabetes mellitus (GDM) –Diagnostik, Therapie und Nachsorge ,. DIABETOL STOFFWECHS 2015. [DOI: 10.1055/s-0035-1553529] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Affiliation(s)
- H. Kleinwechter
- diabetologikum kiel, Diabetes-Schwerpunktpraxis und Schulungszentrum, Kiel
| | - U. Schäfer-Graf
- Berliner Diabeteszentrum für Schwangere, Klinik für Gynäkologie und Geburtshilfe, St. Joseph Krankenhaus, Berlin
| | - C. Bührer
- Klinik für Neonatologie, Charité Universitätsmedizin, Berlin
| | - I. Hoesli
- Frauenklinik, Geburtshilfe und Schwangerschaftsmedizin, Universitätsspital Basel, Basel/CH
| | - F. Kainer
- Klinik Hallerwiese, Abteilung für Geburtshilfe und Pränatalmedizin, Nürnberg
| | - A. Kautzky-Willer
- Medizinische Universitätsklinik Wien, Klinik für Innere Medizin III, Abteilung für Endokrinologie und Stoffwechsel, Gender Medicine Unit, Wien/A
| | - B. Pawlowski
- Klinik für Stoffwechselkrankheiten, Universitätsklinikum Düsseldorf und Deutsches Diabetes-Zentrum, Düsseldorf
| | - K. Schunck
- Klinik für Kinder- und Jugendmedizin, Krankenhaus im Friedrichshain, Berlin
| | - T. Somville
- Klinik für Geburtshilfe und Pränatalmedizin, Universitätsklinikum Hamburg-Eppendorf, Hamburg
| | - M. Sorger
- Medizinische Poliklinik, Universitätsklinikum Bonn, Bonn
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Vitezica I, Bührer C, Henrich W. Fetales Urinom – eine seltene pränatale Diagnose. Z Geburtshilfe Neonatol 2015. [DOI: 10.1055/s-0035-1566665] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Kleinwechter H, Schäfer-Graf U, Bührer C, Hoesli I, Kainer F, Kautzky-Willer A, Pawlowski B, Schunck K, Somville T, Sorger M. Diabetes und Schwangerschaft. DIABETOL STOFFWECHS 2015. [DOI: 10.1055/s-0035-1553530] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Affiliation(s)
- H. Kleinwechter
- Diabetologikum Kiel, Diabetes-Schwerpunktpraxis und Schulungszentrum, Kiel
| | - U. Schäfer-Graf
- Berliner Diabeteszentrum für Schwangere, Klinik für Gynäkologie und Geburtshilfe, St. Joseph Krankenhaus, Berlin
| | - C. Bührer
- Klinik für Neonatologie, Charité Universitätsmedizin, Berlin
| | - I. Hoesli
- Frauenklinik, Geburtshilfe und Schwangerschaftsmedizin, Universitätsspital Basel, Basel
| | - F. Kainer
- Klinik Hallerwiese, Abteilung für Geburtshilfe und Pränatalmedizin, Nürnberg
| | - A. Kautzky-Willer
- Medizinische Universität Wien, Klinik für Innere Medizin III, Abt. für Endokrinologie und Stoffwechsel, Wien
| | - B. Pawlowski
- Deutsche Diabetes-Klinik, Deutsches Diabetes-Zentrum, Düsseldorf
| | - K. Schunck
- Klinik für Kinder- und Jugendmedizin, Krankenhaus im Friedrichshain, Berlin
| | - T. Somville
- Klinik für Geburtshilfe und Pränatalmedizin, Universitätsklinikum Hamburg-Eppendorf, Hamburg
| | - M. Sorger
- Medizinische Poliklinik, Universitätsklinikum Bonn, Bonn
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Karachunsky AI, Rumyantseva YV, Lagoiko SN, Bührer C, Tallen G, Aleinikova OV, Bydanov OI, Korepanova NV, Baidun LV, Nasedkina TV, Stackelberg AV, Novichkova GA, Maschan AA, Litvinov DV, Ponomareva NI, Kondratchik KL, Mansurova EG, Fechina LG, Streneva OV, Yudina NB, Sharapova GR, Shamardina AV, Gerbek IE, Shapochnik AP, Rumyantsev AG, Henze G. [Age-related characteristics of the efficacy of different glucocorticosteroids in the therapy of acute lymphoblastic leukemia]. TERAPEVT ARKH 2015; 87:41-50. [PMID: 26390724 DOI: 10.17116/terarkh201587741-50] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
AIM To determine predictors for decision-making on a differential approach to choosing glucocorticosteroids (GCS) for children and adolescents with acute lymphoblastic leukemia (ALL). SUBJECTS AND METHODS The analysis covered 1064 primary patients aged to 1 to 18 years with ALL who had been registered at the clinics of Russia and Belorussia in April 2002 to November 2006. Before induction therapy, the patients were randomized into a dexamethasone (DEXA) 6 mg/m2 group (n=539) and a methylprednisolone (MePRED) 60 mg/m2 one (n=525). RESULTS The entire group showed no statistically significant differences in survival rates between the patients receiving DEXA or MePRED. However, an analysis of age groups revealed the benefits of DEXA in children younger than 14 years (the event-free survival (EFS) was 76±2 and 71±2%, respectively (p=0.048); the overall survival (OS) was 81±2 and 77±2%, respectively (p=0.046); therapy-induced mortality was 6.4% (DEXA) andl 1.1% (MePRED) (p=0.01 4); the rate of isolated extramedullary relapses was 1.5% (DEXA) and 4.4% (MePRED) (p=0.009). At the same time, EFS and OS in 14-to-18-year-old adolescents were statistically significantly higher than in those who used MePRED (EFS, 65±6 and 52±6%, respectively (p=0.087); OS, 72±6 and 61±6%, respectively; (p=0.l 7). CONCLUSION The findings suggest that it is possible that the choice of a GCS for ALL therapy must be also based on a patient's age. There is a need for further studies of this matter in prospective randomized multicenter trials in children and adolescents.
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Affiliation(s)
- A I Karachunsky
- D. Rogachev Federal Research Clinical Center of Pediatric Hematology, Oncology, and Immunology, Moscow, Russia; N.I. Pirogov Russian National Research Medical University, Ministry of Health of Russia, Moscow, Russia
| | - Yu V Rumyantseva
- D. Rogachev Federal Research Clinical Center of Pediatric Hematology, Oncology, and Immunology, Moscow, Russia; N.I. Pirogov Russian National Research Medical University, Ministry of Health of Russia, Moscow, Russia
| | - S N Lagoiko
- D. Rogachev Federal Research Clinical Center of Pediatric Hematology, Oncology, and Immunology, Moscow, Russia
| | - C Bührer
- Department of Pediatric Oncology/Hematology, Charité-Universitätsmedizin Berlin, Germany
| | - G Tallen
- Department of Pediatric Oncology/Hematology, Charité-Universitätsmedizin Berlin, Germany
| | - O V Aleinikova
- Republican Research and Practical Center for Pediatric Oncology and Hematology, Minsk, Belarus
| | - O I Bydanov
- D. Rogachev Federal Research Clinical Center of Pediatric Hematology, Oncology, and Immunology, Moscow, Russia; Republican Research and Practical Center for Pediatric Oncology and Hematology, Minsk, Belarus
| | - N V Korepanova
- D. Rogachev Federal Research Clinical Center of Pediatric Hematology, Oncology, and Immunology, Moscow, Russia
| | - L V Baidun
- Russian Children's Clinical Hospital, Ministry of Health of Russia, Moscow, Russia
| | - T V Nasedkina
- D. Rogachev Federal Research Clinical Center of Pediatric Hematology, Oncology, and Immunology, Moscow, Russia
| | - A Von Stackelberg
- Department of Pediatric Oncology/Hematology, Charité-Universitätsmedizin Berlin, Germany
| | - G A Novichkova
- D. Rogachev Federal Research Clinical Center of Pediatric Hematology, Oncology, and Immunology, Moscow, Russia; N.I. Pirogov Russian National Research Medical University, Ministry of Health of Russia, Moscow, Russia
| | - A A Maschan
- D. Rogachev Federal Research Clinical Center of Pediatric Hematology, Oncology, and Immunology, Moscow, Russia; N.I. Pirogov Russian National Research Medical University, Ministry of Health of Russia, Moscow, Russia
| | - D V Litvinov
- D. Rogachev Federal Research Clinical Center of Pediatric Hematology, Oncology, and Immunology, Moscow, Russia; N.I. Pirogov Russian National Research Medical University, Ministry of Health of Russia, Moscow, Russia
| | - N I Ponomareva
- Russian Children's Clinical Hospital, Ministry of Health of Russia, Moscow, Russia
| | - K L Kondratchik
- N.I. Pirogov Russian National Research Medical University, Ministry of Health of Russia, Moscow, Russia; Morozov City Children's Clinical Hospital, Moscow Healthcare Department, Moscow, Russia
| | - E G Mansurova
- N.I. Pirogov Russian National Research Medical University, Ministry of Health of Russia, Moscow, Russia
| | - L G Fechina
- Regional Children's Clinical Hospital One, Yekaterinburg, Russia
| | - O V Streneva
- Regional Children's Clinical Hospital One, Yekaterinburg, Russia
| | - N B Yudina
- Voronezh Regional Children's Clinical Hospital One, Voronezh, Russia
| | - G R Sharapova
- Nizhnevartovsk District Children's Clinical Hospital, Nizhnevartovsk, Khanty-Mansi Autonomic District-Yugra, Russia
| | - A V Shamardina
- Nizhny Novgorod Regional Children's Clinical Hospital, Nizhny Novgorod, Russia
| | - I E Gerbek
- Tomsk Regional Clinical Hospital, Tomsk, Russia
| | - A P Shapochnik
- Orenburg Regional Clinical Oncology Dispensary, Orenburg, Russia
| | - A G Rumyantsev
- D. Rogachev Federal Research Clinical Center of Pediatric Hematology, Oncology, and Immunology, Moscow, Russia
| | - G Henze
- Department of Pediatric Oncology/Hematology, Charité-Universitätsmedizin Berlin, Germany
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Hartenstein S, Müller B, Metze B, Czernik C, Bührer C. Blood flow assessed by color Doppler imaging in retinopathy of prematurity. J Perinatol 2015; 35:745-7. [PMID: 25950917 DOI: 10.1038/jp.2015.45] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/19/2014] [Revised: 03/09/2015] [Accepted: 03/17/2015] [Indexed: 11/09/2022]
Abstract
OBJECTIVE To quantify central retinal arterial and venous blood flow using ultrasound color Doppler imaging. STUDY DESIGN In this prospective observational study, eyes of eight preterm infants with retinopathy of prematurity stage 2 and of eight preterm infants without retinopathy (gestational age <30 weeks, birth weight <1500 g) were evaluated by color Doppler imaging. RESULT Ocular blood flow velocities measured at 28±1 days of life did not differ significantly in the eyes of preterm infants who subsequently did and did not develop retinopathy. Development of retinopathy was associated with highly significant (P<0.0001 each) increases in central retinal vein maximum velocities (from 1.99±0.36 to 3.72±0.61 cm s(-1)), central retinal artery systolic flow velocities (from 6.44±1.52 to 9.87±1.99 cm s(-1)) and flow velocity integrals (from 1.27±0.30 to 2.17±0.50 cm) at 64±13 days of life. In infants without retinopathy, no significant changes were observed except for an increase in central retinal vein maximum velocities (from 1.96±0.22 to 2.62±0.44 cm s(-1), P=0.003). CONCLUSION Retinopathy of prematurity appears to be accompanied by increased retinal blood flow.
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Affiliation(s)
- S Hartenstein
- Department of Neonatology, Charité University Medical Center, Berlin, Germany
| | - B Müller
- Department of Ophthalmology, Charité University Medical Center, Berlin, Germany
| | - B Metze
- Department of Neonatology, Charité University Medical Center, Berlin, Germany
| | - C Czernik
- Department of Neonatology, Charité University Medical Center, Berlin, Germany
| | - C Bührer
- Department of Neonatology, Charité University Medical Center, Berlin, Germany
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Bruns N, Metze B, Bührer C, Felderhoff-Müser U, Hüseman D. Electrocortical Activity at 7 Days of Life is Affected in Extremely Premature Infants with Patent Ductus Arteriosus. Klin Padiatr 2015; 227:264-8. [PMID: 25875399 DOI: 10.1055/s-0035-1547309] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
BACKGROUND The aim of this study was to determine whether the aEEG at 7 days of life is influenced by the presence of a PDA in non-sedated extremely low gestational age preterm infants. PATIENTS We prospectively recruited infants born at less than 28 weeks of gestation between 11/2007 and 12/2009. METHOD aEEGs were recorded at seven days of life and assessed by using the Burdjalov score and the electronically assessed lower border (eLBA). Kruskal-Wallis-Test and linear regression analysis were performed to determine how GA and a PDA affect the aEEG score and the eLBA. Using linear regression analysis we tested which components of the score are affected by a PDA. RESULTS We recruited 44 infants with a GA of 26.5/7 (23.4/7-27.6/7) weeks and a birth weight of 837 (461-1230) g. The total sum of score points increased from 4 (1-6) to 8 (5-9) points in infants born at 23/24 weeks and 27 weeks of gestation, respectively. In infants with relevant PDA the aEEG scored lower with 8 (3-10) points compared to those with PDA: 5 (1-8) points. Linear regression analysis showed a positive influence of GA and a negative influence of a PDA on the total score. GA had a positive influence on SWC and the visually assessed LBA. A PDA had a negative influence on continuity. The eLBA increased from 4.61 (3.18-5.53) µV to 5.27 (3.38-6.51) µV in infants of 23/24 vs. 27 gestational weeks, but was not significantly influenced by a PDA. CONCLUSION A PDA has a negative influence on the total Burdjalov score and continuity at 7 days of age in infants born at less than 28 weeks of gestation. The electrocortical disturbances may be the consequence of a diminished cerebral perfusion in the presence of a PDA.
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Affiliation(s)
- N Bruns
- Department of Pediatrics I, University Hospital Essen, Essen, Germany
| | - B Metze
- Neonatology, Charité University Hospital Berlin, Berlin, Germany
| | - C Bührer
- Neonatology, Charité University Hospital Berlin, Berlin, Germany
| | | | - D Hüseman
- Department of Pediatrics, Hospital Barnim, Eberswalde, Germany
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Bührer C, Felderhoff-Müser U, Kribs A, Roll C, Völkner A, Gembruch U, Hecher K, Kainer F, Maier R, Vetter K, Krones T, Lipp V, Steppat S, Wirthl HJ. Frühgeborene an der Grenze der Lebensfähigkeit. Z Geburtshilfe Neonatol 2015; 219:12-9. [DOI: 10.1055/s-0034-1395575] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Kleinwechter H, Schäfer-Graf U, Bührer C, Hoesli I, Kainer F, Kautzky-Willer A, Pawlowski B, Schunck K, Somville T, Sorger M. Gestationsdiabetes mellitus (GDM) –Diagnostik, Therapie u. Nachsorge. DIABETOL STOFFWECHS 2015. [DOI: 10.1055/s-0034-1385414] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Affiliation(s)
- H. Kleinwechter
- diabetologikum kiel, Diabetes-Schwerpunktpraxis und Schulungszentrum, Kiel
| | - U. Schäfer-Graf
- Berliner Diabeteszentrum für Schwangere, Klinik für Gynäkologie und Geburtshilfe, St. Joseph Krankenhaus, Berlin
| | - C. Bührer
- Klinik für Neonatologie, Charité Universitätsmedizin, Berlin
| | - I. Hoesli
- Frauenklinik, Geburtshilfe und Schwangerschaftsmedizin, Universitätsspital Basel, Basel / CH
| | - F. Kainer
- Klinik Hallerwiese, Abteilung für Geburtshilfe und Pränatalmedizin, Nürnberg
| | - A. Kautzky-Willer
- Medizinische Universitätsklinik Wien, Klinik für Innere Medizin III, Abteilung für Endokrinologie u. Stoffwechsel, Gender Medicine Unit, Wien/A
| | - B. Pawlowski
- Klinik für Stoffwechselkrankheiten, Universitätsklinikum Düsseldorf und Deutsches Diabetes-Zentrum, Düsseldorf
| | - K. Schunck
- Klinik für Kinder- und Jugendmedizin, Krankenhaus im Friedrichshain, Berlin
| | - T. Somville
- Klinik für Geburtshilfe und Pränatalmedizin, Universitätsklinikum Hamburg-Eppendorf, Hamburg
| | - M. Sorger
- Medizinische Poliklinik, Universitätsklinikum Bonn, Bonn
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Kleinwechter H, Schäfer-Graf U, Bührer C, Hösli I, Kainer F, Kautzky-Willer A, Pawlowski B, Schunck K, Somville T, Sorger M. Diabetes und Schwangerschaft. DIABETOL STOFFWECHS 2015. [DOI: 10.1055/s-0034-1385413] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Affiliation(s)
- H. Kleinwechter
- diabetologikum kiel, Diabetes-Schwerpunktpraxis und Schulungszentrum, Kiel
| | - U. Schäfer-Graf
- Berliner Diabeteszentrum für Schwangere, Klinik für Gynäkologie und Geburtshilfe, St. Joseph Krankenhaus, Berlin
| | - C. Bührer
- Klinik für Neonatologie, Charité Universitäsmedizin, Berlin
| | - I. Hösli
- Frauenklinik, Geburtshilfe und Schwangerschaftsmedzin, Universitätsspital Basel, Basel
| | - F. Kainer
- Klinik Hallerwiese, Abteilung für Geburtshilfe und Pränatalmedizin, Nürnberg
| | - A. Kautzky-Willer
- Medizinische Universität Wien, Klinik für Innere Medizin III, Abt. für Endokrinologie & Stoffwechsel, Wien
| | - B. Pawlowski
- Deutsche Diabetes-Klinik, Deutsches Diabetes-Zentrum, Düsseldorf
| | - K. Schunck
- Klinik für Kinder- und Jugendmedizin, Krankenhaus im Friedrichshain, Berlin
| | - T. Somville
- Klinik für Geburtshilfe und Pränatalmedizin, Universitäsklinikum Hamburg-Eppendorf, Hamburg
| | - M. Sorger
- Medizinische Poliklinik, Universitätsklinikum Bonn, Bonn
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Bührer C, Genzel-Boroviczény O, Jochum F, Kauth T, Kersting M, Koletzko B, Mihatsch W, Przyrembel H, Reinehr T, Zimmer P. Warnung vor Verwendung unzureichend geprüfter Muttermilch. Monatsschr Kinderheilkd 2014. [DOI: 10.1007/s00112-014-3150-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Kleinwechter H, Schäfer-Graf U, Bührer C, Hoesli I, Kainer F, Kautzky-Willer A, Pawlowski B, Schunck K, Somville T, Sorger M. Gestational diabetes mellitus (GDM) diagnosis, therapy and follow-up care: Practice Guideline of the German Diabetes Association(DDG) and the German Association for Gynaecologyand Obstetrics (DGGG). Exp Clin Endocrinol Diabetes 2014; 122:395-405. [PMID: 25014091 DOI: 10.1055/s-0034-1366412] [Citation(s) in RCA: 61] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Affiliation(s)
- H Kleinwechter
- Diabetologikum Kiel, Diabetes-Schwerpunktpraxis und Schulungszentrum, Kiel
| | - U Schäfer-Graf
- Berliner Diabeteszentrum für Schwangere, Klinik für Gynäkologie und Geburtshilfe, St. Joseph Krankenhaus, Berlin
| | - C Bührer
- Klinik für Neonatologie, Charité Universitätsmedizin, Berlin
| | - I Hoesli
- Frauenklinik, Geburtshilfe und Schwangerschaftsmedizin, Universitätsspital Basel, Basel/CH
| | - F Kainer
- Klinik und Poliklinik für Frauenheilkunde und Geburtshilfe, Perinatalzentrum Klinikum Innenstadt LMU, München
| | - A Kautzky-Willer
- Medizinische Universitätsklinik Wien, Klinik für Innere Medizin III, Abteilung für Endokrinologie u. Stoffwechsel, Gender Medicine Unit, Wien/A
| | - B Pawlowski
- Klinik für Stoffwechselkrankheiten, Universitätsklinikum Düsseldorf und Deutsches Diabetes-Zentrum, Düsseldorf
| | - K Schunck
- Klinik für Kinder- und Jugendmedizin, Krankenhaus im Friedrichshain, Berlin
| | - T Somville
- Klinik für Geburtshilfe und Pränatalmedizin, Universitätsklinikum Hamburg-Eppendorf, Hamburg
| | - M Sorger
- Medizinische Poliklinik, Universitätsklinikum Bonn, Bonn
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Bührer C, Genzel-Boroviczény O, Jochum F, Kauth T, Kersting M, Koletzko B, Mihatsch W, Przyrembel H, Reinehr T, Zimmer P. Ernährung gesunder Säuglinge. Monatsschr Kinderheilkd 2014. [DOI: 10.1007/s00112-014-3129-2] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
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Kanti V, Bonzel A, Stroux A, Proquitté H, Bührer C, Blume-Peytavi U, Bartels NG. Postnatal maturation of skin barrier function in premature infants. Skin Pharmacol Physiol 2014; 27:234-41. [PMID: 25059975 DOI: 10.1159/000354923] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2013] [Accepted: 08/08/2013] [Indexed: 11/19/2022]
Abstract
BACKGROUND In preterm infants, skin barrier maturation entails regional variability. OBJECTIVES To characterize postnatal skin barrier development in covered, uncovered and diapered regions in healthy premature infants over a longitudinal observation period. METHODS Transepidermal water loss (TEWL), stratum corneum hydration (SCH), pH and sebum were measured at postnatal ages of 1-7 days and 2-7 weeks on the forehead, abdomen, thigh and buttock of preterm infants (gestational age 30-37 weeks; n = 48) under monitored ambient conditions. A standard minimal skin care regimen was practised. RESULTS TEWL increased significantly on the buttock (p = 0.007), while remaining stable on the forehead, abdomen and thigh. SCH and sebum remained stable in all studied body regions with increasing age. On the buttock, pH increased (p = 0.049), while other body regions exhibited a significant decrease (p ≤ 0.019). TEWL (p < 0.001) and SCH (p ≤ 0.002) revealed significantly higher values on the buttock, compared to other body regions. CONCLUSIONS Stable TEWL, SCH and sebum values may indicate a lack of skin barrier maturation. Postnatal decrease in skin pH suggests an adaptation process with acid mantle formation. Differences in skin barrier development were observed between anatomical regions. SCH, TEWL and pH values demonstrated a distinct course in the diaper area, indicating an impaired skin barrier function in this region.
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Affiliation(s)
- V Kanti
- Department of Dermatology and Allergy, Clinical Research Center for Hair and Skin Science, Charité-Universitätsmedizin Berlin, Berlin, Germany
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Brodkorb S, Röhr CC, Proquitté H, Bührer C. Schwere neonatale Sepsis mit Oralstreptokokken. Z Geburtshilfe Neonatol 2013. [DOI: 10.1055/s-0033-1361428] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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Kanti V, Bonzel A, Stroux A, Proquitté H, Bührer C, Blume-Peytavi U, Garcia Bartels N. Postnatale Reifung der Hautbarriere bei Frühgeborenen. Z Geburtshilfe Neonatol 2013. [DOI: 10.1055/s-0033-1361465] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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Bamberg C, Brauer M, Hinkson L, Longardt AC, Rothe K, Horn D, Bührer C, Henrich W. Dreidimensionale Ultraschall Darstellung einer schweren Makroglossie bei einem Feten mit Beckwith-Wiedemann-Syndrom. Z Geburtshilfe Neonatol 2013. [DOI: 10.1055/s-0033-1361254] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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Kanti V, Ifert C, Stroux A, Bührer C, Blume-Peytavi U, Garcia Bartels N. Einfluss von Sonnenblumenöl auf die Hautbarrierefunktion von Frühgeborenen: eine kontrollierte, randomisierte klinische Studie. Z Geburtshilfe Neonatol 2013. [DOI: 10.1055/s-0033-1361466] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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Kleinwechter H, Schäfer-Graf U, Bührer C, Hösli I, Kainer F, Kautzky-Willer A, Pawlowski B, Schunck K, Somville T, Sorger M. Diabetes und Schwangerschaft. DIABETOL STOFFWECHS 2013. [DOI: 10.1055/s-0033-1350557] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Affiliation(s)
- H. Kleinwechter
- diabetologikum kiel, Diabetes-Schwerpunktpraxis und Schulungszentrum, Kiel
| | - U. Schäfer-Graf
- Berliner Diabeteszentrum für Schwangere, Klinik für Gynäkologie und Geburtshilfe, St. Joseph Krankenhaus, Berlin
| | - C. Bührer
- Klinik für Neonatologie, Charité Universitäsmedizin, Berlin
| | - I. Hösli
- Frauenklinik, Geburtshilfe und Schwangerschaftsmedzin, Universitätsspital Basel, Basel
| | - F. Kainer
- Klinik und Poliklinik für Frauenheilkunde und Geburtshilfe, Perinatalzentrum Klinikum Innenstadt LMU, München
| | - A. Kautzky-Willer
- Medizinische Universität Wien, Klinik für Innere Medizin III, Abt. für Endokrinologie & Stoffwechsel, Wien
| | - B. Pawlowski
- Deutsche Diabetes-Klinik, Deutsches Diabetes-Zentrum, Düsseldorf
| | - K. Schunck
- Klinik für Kinder- und Jugendmedizin, Krankenhaus im Friedrichshain, Berlin
| | - T. Somville
- Klinik für Geburtshilfe und Pränatalmedizin, Universitäsklinikum Hamburg-Eppendorf, Hamburg
| | - M. Sorger
- Medizinische Poliklinik, Universitätsklinikum Bonn, Bonn
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Kleinwechter H, Schäfer-Graf U, Bührer C, Hoesli I, Kainer F, Kautzky-Willer A, Pawlowski B, Schunck K, Somville T, Sorger M. Gestationsdiabetes mellitus (GDM) –Diagnostik, Therapie u. Nachsorge. DIABETOL STOFFWECHS 2013. [DOI: 10.1055/s-0033-1350552] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Affiliation(s)
- H. Kleinwechter
- diabetologikum kiel, Diabetes-Schwerpunktpraxis und Schulungszentrum, Kiel
| | - U. Schäfer-Graf
- Berliner Diabeteszentrum für Schwangere, Klinik für Gynäkologie und Geburtshilfe, St. Joseph Krankenhaus, Berlin
| | - C. Bührer
- Klinik für Neonatologie, Charité Universitätsmedizin, Berlin
| | - I. Hoesli
- Frauenklinik, Geburtshilfe und Schwangerschaftsmedizin, Universitätsspital Basel, Basel / CH
| | - F. Kainer
- Klinik und Poliklinik für Frauenheilkunde und Geburtshilfe, Perinatalzentrum Klinikum Innenstadt LMU, München
| | - A. Kautzky-Willer
- Medizinische Universitätsklinik Wien, Klinik für Innere Medizin III, Abteilung für Endokrinologie u. Stoffwechsel, Gender Medicine Unit, Wien/A
| | - B. Pawlowski
- Klinik für Stoffwechselkrankheiten, Universitätsklinikum Düsseldorf und Deutsches Diabetes-Zentrum, Düsseldorf
| | - K. Schunck
- Klinik für Kinder- und Jugendmedizin, Krankenhaus im Friedrichshain, Berlin
| | - T. Somville
- Klinik für Geburtshilfe und Pränatalmedizin, Universitätsklinikum Hamburg-Eppendorf, Hamburg
| | - M. Sorger
- Medizinische Poliklinik, Universitätsklinikum Bonn, Bonn
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Jerzyk N, Spors B, Juran R, Puch-Kapst K, Bührer C, Hüseman D. Reduktion der Strahlenexposition durch konventionelle Röntgenuntersuchungen bei sehr untergewichtigen Frühgeborenen. ROFO-FORTSCHR RONTG 2013. [DOI: 10.1055/s-0033-1352559] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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Börner N, Sponholz S, König K, Brodkorb S, Bührer C, Roehr CC. [Google translate is not sufficient to overcome language barriers in neonatal medicine]. Klin Padiatr 2013; 225:413-7. [PMID: 23946092 DOI: 10.1055/s-0033-1349062] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
Language barriers hinder the interaction with patients and relatives. The use of language services increases knowledge, satisfaction and the use of medical care and thus improves patient's clinical outcome. The recommended use of professional interpreters (PI) is not always feasible. We tested an online translation tool as an alternative for PI for the transla-tion of standardized sentences from a neonatal doctor-/nurse-relative-interview.Translation of 20 sentences from a German neonatal intensive care unit parent information brochure to English, Portuguese and Arabic, using Google Translate (GT). Assessment of accuracy concerning grammar and content, in a second step simplification of all incorrect sentences, translation by GT and critical re-assessment and evaluation.An average of 42% of the sentences was correctly translated concerning grammar and content. The proportion of incorrectly translated sentences varied between 45-70%. By simpli-fication another 23% were translated correctly.Translations by GT were often incorrect in content and grammar. We suppose that the design of GT, which is a statistical translation engine, might be an explanation for this phenomenon. Presently, GT cannot guarantee unambiguous translations and cannot substitute PIs, only in particular circumstances, the use of GT or similar engines may be justified. For future use of electronic translation services, we suggest to compile a catalogue of sentences containing central information, which can be translated into defined foreign languages without misinterpretation or loss of information.
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Affiliation(s)
- N Börner
- Klinik für Neonatologie, Charité-Universitätsmedizin, Berlin
| | - S Sponholz
- Klinik für Neonatologie und Pädiatrische Intensivmedizin, Helios Klinikum Erfurt
| | - K König
- Department of Pediatrics, Mercy Hospital for Women, Melbourne, -Australia
| | - S Brodkorb
- Klinik für Neonatologie, Charité-Universitätsmedizin, Berlin
| | - C Bührer
- Klinik für Neonatologie, Charité-Universitätsmedizin, Berlin
| | - C C Roehr
- Klinik für Neonatologie, Charité-Universitätsmedizin, Berlin
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Garten L, von der Hude K, Rösner B, Klapp C, Bührer C. Familienzentrierte Sterbe- und individuelle Trauerbegleitung an einem Perinatalzentrum. Z Geburtshilfe Neonatol 2013; 217:95-102. [DOI: 10.1055/s-0033-1347207] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Affiliation(s)
- L. Garten
- Klinik für Neonatologie, Charité Universitätsmedizin Berlin
| | | | - B. Rösner
- Klinik für Neonatologie, Charité Universitätsmedizin Berlin
| | - C. Klapp
- Klinik für Geburtsmedizin, Charité Universitätsmedizin Berlin
| | - C. Bührer
- Klinik für Neonatologie, Charité Universitätsmedizin Berlin
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Bührer C, Genzel-Boroviczény O, Jochum F, Kauth T, Kersting M, Koletzko B, Mihatsch W, Przyrembel H, Reinehr T, von Kries R, Zimmer K. Vitamin-K-Prophylaxe bei Neugeborenen. Monatsschr Kinderheilkd 2013. [DOI: 10.1007/s00112-012-2827-x] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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Garten L, Nazary L, Metze B, Bührer C. Pilot study of experiences and needs of 111 fathers of very low birth weight infants in a neonatal intensive care unit. J Perinatol 2013; 33:65-9. [PMID: 22460545 DOI: 10.1038/jp.2012.32] [Citation(s) in RCA: 37] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
OBJECTIVE To study the experiences and needs of the fathers of very low birth weight (VLBW, <1500 g) infants in a neonatal intensive care unit (NICU). STUDY DESIGN An anonymous self-report questionnaire was administered to fathers of VLBW infants born between Jan 1, 2008 and December 31, 2009 at two tertiary NICUs. RESULT A total of 111 of 273 fathers responded to the questionnaire. Responses to a variety of items, including self-perception, parenting attitudes, confidence, emotional pressure to satisfaction and self-efficacy as a parent were similar for the fathers of this survey and previous results for mothers of VLBW infants. Fathers judged direct bedside support by the NICU team as sufficient. However, 54.4% of fathers reported missing nonbedside interventions such as VLBW father-specific baby care courses, seminars or workshops, and platforms or chatrooms on the internet. CONCLUSION Bedside support of fathers, accomplished by the NICU team, could be complemented by additional father-specific non-bedside support, such as peer-education measures or interactive mass media.
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Affiliation(s)
- L Garten
- Department of Neonatology, Charité University Medical Center, Berlin, Germany.
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Kleinwechter H, Schäfer-Graf U, Bührer C, Hoesli I, Kainer F, Kautzky-Willer A, Pawlowski B, Schunck K, Somville T, Sorger M. Gestationsdiabetes mellitus (GDM) – Diagnostik, Therapie u. Nachsorge. DIABETOL STOFFWECHS 2012. [DOI: 10.1055/s-0032-1325335] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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Verlohren S, Bührer C. Präeklampsie und Diabetes mellitus in der Schwangerschaft. Monatsschr Kinderheilkd 2012. [DOI: 10.1007/s00112-012-2726-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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Pohl-Schickinger A, Feiterna-Sperling C, Weizsäcker K, Bührer C. [Postnatal therapy for congenital toxoplasmosis: a comparison of 2 different treatment approaches]. Z Geburtshilfe Neonatol 2012; 216:73-6. [PMID: 22517047 DOI: 10.1055/s-0032-1308959] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Abstract
Protocols recommended in the USA and Germany for the postnatal treatment of congenital toxoplasmosis are mainly based on the National Collaborative Chicago-based Congenital Toxoplasmosis Study that calls for daily administration of pyrimethamine in combination with sulfadiazine for several months, then 3 times a week. The recommended total duration of treatment is 12 months. This scheme necessitates frequent white blood cell counts that often result in the discontinuation of treatment because of severe neutropenia even with the concomitant administration of folinic acid. In contrast, the administration of pyrimethamine with sulfadoxine every 2 weeks for 2 years, as used by a referral centre in Toulouse, France, is associated with less toxicity. The efficacy may even be improved, as judged by the rate of new chorioretinal lesions. In the absence of larger randomised studies the Toulouse protocol appears to have several advantages when a decision has to be made to treat infants with congenital toxoplasmosis.
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Kleinwechter H, Schäfer-Graf U, Bührer C, Hoesli I, Kainer F, Kautzky-Willer A, Pawlowski B, Schunck K, Somville T, Sorger M. Gestationsdiabetes mellitus (GDM) - Diagnostik, Therapie u. Nachsorge. DIABETOL STOFFWECHS 2012. [DOI: 10.1055/s-0031-1283723] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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Abstract
Methylnaltrexone, a peripherally acting µ-opioid receptor antagonist, has been studied in adults for the treatment of opioid-induced constipation in advanced illness. Here, the authors document the first neonate to receive methylnaltrexone in an attempt to resolve morphine-induced urinary retention. An asphyxiated term newborn infant underwent induced hypothermia and received morphine by continuous intravenous infusion. After 36 h, the patient developed progressive urinary retention (calculated bladder volume 63 ml), followed by venous congestion of the lower extremities. Attempted bladder catheterisation was unsuccessful. Voiding occurred within 20 min after intravenous administration of methylnaltrexone (0.15 mg/kg body weight). A relapse of urinary retention 24 h later responded well to a second dose of methylnaltrexone. There were no adverse effects and no opioid withdrawal symptoms. The neonate had normal findings in cranial MRI that was performed after elective cessation of induced hypothermia.
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Affiliation(s)
- L Garten
- Klinik für Neonatologie, Charité Universitätsmedizin Berlin, Augustenburger Platz 1, Berlin, Germany.
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Koppelstäetter A, Bührer C, Kaindl A. Treating Neonates with Levetiracetam: A Survey among German University Hospitals. Klin Padiatr 2011; 223:450-2. [DOI: 10.1055/s-0031-1287822] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/15/2022]
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Kleinwechter H, Bührer C, Hösli I, Kainer F, Kautzky-Willer A, Pawlowski B, Schäfer-Graf U, Schunck K, Somville T, Sorger M. Diabetes und Schwangerschaft. DIABETOL STOFFWECHS 2011. [DOI: 10.1055/s-0031-1283712] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/15/2022]
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Kleinwechter H, Schäfer-Graf U, Bührer C, Hoesli I, Kainer F, Kautzky-Willer A, Pawlowski B, Schunck K, Somville T, Sorger M. Gestationsdiabetes mellitus (GDM). DIABETOL STOFFWECHS 2011. [DOI: 10.1055/s-0031-1283757] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/15/2022]
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Bührer C. Kühlung von Neugeborenen nach perinataler Asphyxie. Geburtshilfe Frauenheilkd 2011. [DOI: 10.1055/s-0031-1292722] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/15/2022] Open
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