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Dudeck J, Kutschera J, Kugel HG. Concepts for digital recording of ECGs. Adv Cardiol 2015; 16:182-5. [PMID: 775909 DOI: 10.1159/000398392] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
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Raith W, Kutschera J, Müller W, Urlesberger B. Active Ear Acupuncture Points in Neonates with Neonatal Abstinence Syndrome (NAS). Am J Chin Med 2012; 39:29-37. [DOI: 10.1142/s0192415x11008622] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
The aim of the study was to determine the presence of acupuncture ear points in neonates with Neonatal Abstinence Syndrome (NAS). NAS occurs in the first days of life in neonates whose mothers have a history of drug abuse, and may also occur in neonates whose mothers are currently following substitution therapy. The patients are neonates with NAS admitted over one year to the Division of Neonatology at the University Hospital Graz. The examination took place on the third day after delivery (mean value 70.3 hours) and was performed by a neuronal pen (PS 3 © Silberbauer, Vienna, Austria). An integrated sound and optical signal detected the active ear points that were then placed on an ear map. We investigated six neonates (four male, two female). All investigated neonates showed the presence of active ear acupuncture points. The psychovegetative rim was the most common organic area of the children, following by a few organic points. This corresponds with the results found in healthy neonates. In all neonates with NAS, we found the presence of psychic ear points. The identified psychic ear points are the frustration-point, R-point and the psychotropic area nasal from the incisura intertragica. In all neonates with NAS, active organic and psychic ear points were detectable in both ears. In the future, it could be possible to use active ear points for diagnostic and therapeutic purposes.
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Affiliation(s)
- Wolfgang Raith
- Research Group for Paediatric Traditional Chinese Medicine, Medical University of Graz, Austria
- Division of Neonatology, Department of Paediatrics, Medical University of Graz, Austria
| | - Jörg Kutschera
- Research Group for Paediatric Traditional Chinese Medicine, Medical University of Graz, Austria
- Division of Neonatology, Department of Paediatrics, Medical University of Graz, Austria
| | - Wilhelm Müller
- Division of Neonatology, Department of Paediatrics, Medical University of Graz, Austria
| | - Berndt Urlesberger
- Research Group for Paediatric Traditional Chinese Medicine, Medical University of Graz, Austria
- Division of Neonatology, Department of Paediatrics, Medical University of Graz, Austria
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Raith W, Kutschera J, Müller W, Urlesberger B. Akupunkturpunkte am Ohr bei Neugeborenen mit Neonatalem Abstinenzsyndrom (NAS) aufgrund mütterlicher Substitutionstherapie. Z Geburtshilfe Neonatol 2010; 214:103-7. [DOI: 10.1055/s-0030-1254141] [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: 10/19/2022]
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Großauer K, Reiterer F, Kutschera J, Pfleger A, Urlesberger B, Müller W. Intrauterin geshunteter bilateraler Hydrothorax und Kongenitale Pulmonale Lymphangiektasie (PL) bei einem Frühgeborenen. Klin Padiatr 2010. [DOI: 10.1055/s-0030-1261513] [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] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Kutschera J, Haim M, Seles M, Riccabona M, Urlesberger B, Müller W. Congenitaler frontonasaler Tumor – Nasales Gliom? Klin Padiatr 2010. [DOI: 10.1055/s-0030-1261624] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Raith W, Sapetschnig I, Kutschera J, Ziehenberger E, Litscher G, Mueller W, Urlesberger B. Thermografische Messung der Hauttemperatur bei Anwendung der Laserakupunktur beim Frühgeborenen. Klin Padiatr 2010. [DOI: 10.1055/s-0030-1261517] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Kutschera J, Reiterer F, Pfleger A, Rehak T, Urlesberger B, Müller W. Kongenitales zentrales Hypoventilationssyndrom – eine seltene Ursache für fehlende Spontanatmung postpartal. Z Geburtshilfe Neonatol 2009. [DOI: 10.1055/s-0029-1223064] [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: 10/20/2022]
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Raith W, Pichler G, Zotter H, Kutschera J, Müller W, Urlesberger B. Herzfrequenzveränderungen unter Laserakupunktur. Z Geburtshilfe Neonatol 2009. [DOI: 10.1055/s-0029-1223094] [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: 10/20/2022]
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Pristauz G, Bader AA, Schwantzer G, Kutschera J, Lang U. Assessment of risk factors for survival of neonates born after second-trimester PPROM. Early Hum Dev 2009; 85:177-80. [PMID: 18829187 DOI: 10.1016/j.earlhumdev.2008.09.012] [Citation(s) in RCA: 10] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/07/2008] [Revised: 09/06/2008] [Accepted: 09/08/2008] [Indexed: 11/19/2022]
Abstract
OBJECTIVE Assess fetal risk factors which impact survival of infants delivered after second-trimester PPROM. STUDY DESIGN Clinical records of 87 patients, who all had second-trimester rupture of membranes between 14+0 and 24+6 weeks of gestation treated January 1998 to July 2005 were reviewed regarding perinatal outcome. This study is based on 25 surviving infants. RESULTS 13 of these 25 infants died in the hospital. Survivors had a higher birth weight (p=0.008) and higher Apgar scores after 5 min (p=0.005) than those infants dying. No differences in UA pH, the need of catecholamines and no association between histological verified chorioamnionitis and early onset sepsis were seen between survivors and nonsurvivors. CONCLUSION Higher gestational age at birth, higher birth weight, the absence of histologically verified chorioamnionitis and 5 min Apgar scores of >or= than 6 have positive prognostic value for survival of neonates delivered preterm after second-trimester PPROM.
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Affiliation(s)
- Gunda Pristauz
- Department of Gynecology and Obstetrics, Medical University of Graz, Graz, Austria.
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Kutschera J, Haim M, Raith W, Sovinz P, Müller W. Enterococcus faecium Meningitis bei einem frühgeborenen Zwilling mit 30 Wochen. Z Geburtshilfe Neonatol 2008. [DOI: 10.1055/s-2008-1079025] [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: 10/21/2022]
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Reiterer F, Kutschera J, Zotter H, Pichler G, Urlesberger B, Müller W. Atemunterstützung mit binasalem NCPAP bei Frühgeborenen >30 SSW mit postpataler Atemnotsymptomatik: Air leak Inzidenz und Intubationsrate. Z Geburtshilfe Neonatol 2008. [DOI: 10.1055/s-2008-1078851] [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: 10/21/2022]
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Pichler G, Heinzinger J, Kutschera J, Zotter H, Müller W, Urlesberger B. Forearm and Calf Tissue Oxygenation in Term Neonates Measured with Near-Infrared Spectroscopy. J Physiol Sci 2007; 57:317-9. [DOI: 10.2170/physiolsci.sc004407] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2007] [Accepted: 10/04/2007] [Indexed: 11/05/2022]
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Kutschera J, Reiterer F, Müller W, Urlesberger B. Surfactanttherapie unter Nasen-CPAP bei Frühgeborenen über 28+0 Wochen – Erhöhte Pneumothorax Rate? Z Geburtshilfe Neonatol 2007. [DOI: 10.1055/s-2007-983048] [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: 10/21/2022]
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Marschitz I, Kutschera J, Rödl S, Raffeiner R, Strele A, Urlesberger B. Reduktion der Anzahl an CD4+ Lymphozyten sowie der CD45RA-Expression von CD4+ Zellen bei Neu- und Frühgeborenen mit Early-Onset Sepsis. Z Geburtshilfe Neonatol 2007. [DOI: 10.1055/s-2007-983287] [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: 10/21/2022]
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Pichler G, Gaster E, Peichl A, Zotter H, Kutschera J, Müller W, Urlesberger B. Periphere Oxygenierung gemessen mit Nahinfrarot-Spektroskopie in Abhängigkeit von der Rekapillarisationszeit und als mögliche frühe Diagnostik einer neonatalen Infektion. Z Geburtshilfe Neonatol 2007. [DOI: 10.1055/s-2007-983289] [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: 10/21/2022]
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Abstract
The aim of this study was to analyse changes in peripheral oxygenation in healthy term neonates within the first week of life with near-infrared spectroscopy and venous occlusion. Oxygen delivery did not change with increasing age. Oxygen consumption and fractional oxygen extraction increased, whereas tissue oxygenation index decreased with increasing age.
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Affiliation(s)
- G Pichler
- Division of Neonatology, Department of Pediatrics University of Graz, Medical University, Graz, Austria.
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Marschitz I, Rödl S, Kutschera J, Urlesberger B, Zobel G. Anstieg der CD40-Expression bei der RSV-Bronchiolitis des jungen Säuglings, nicht aber bei „Early-Onset“ Sepsis des Neu- und Frühgeborenen. Z Geburtshilfe Neonatol 2007. [DOI: 10.1055/s-2007-983286] [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: 10/21/2022]
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Kutschera J, Rotky-Fast C, Müller W. Das Syndrome of Inappropriate Secretion of Antidiuretic Hormone mit Hyponatriämie bei einem 29 Wochen Frühgeborenem nach mütterlicher Fluoxetintherapie in der Schwangerschaft. Z Geburtshilfe Neonatol 2006. [DOI: 10.1055/s-2006-946152] [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: 10/19/2022]
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Pichler G, Klaritsch P, Zotter H, Heinzinger J, Kutschera J, Müller W, Urlesberger B. Peripheral Oxygenation In Term Neonates With In Utero Exposure To Smoking. Z Geburtshilfe Neonatol 2006. [DOI: 10.1055/s-2006-946280] [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: 10/19/2022]
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Schallmoser K, Kutschera J, Macher S, Ulrich S, Eichler P, Panzer S, Lanzer G. Delayed detectability of anti-HPA-3a by the MAIPA assay in a severe neonatal alloimmune thrombocytopenia, but successful transfusion of incompatible donor platelets: a case report. Vox Sang 2006; 91:181-3. [PMID: 16907881 DOI: 10.1111/j.1423-0410.2006.00809.x] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
- K Schallmoser
- Department of Blood Group Serology and Transfusion Medicine, Medical University of Graz, Austria.
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Schmolzer G, Urlesberger B, Haim M, Kutschera J, Pichler G, Ritschl E, Resch B, Reiterer F, Müller W. Multi-modal approach to prophylaxis of necrotizing enterocolitis: clinical report and review of literature. Pediatr Surg Int 2006; 22:573-80. [PMID: 16775708 DOI: 10.1007/s00383-006-1709-5] [Citation(s) in RCA: 31] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 05/08/2006] [Indexed: 12/23/2022]
Abstract
For the first time a multimodal approach to NEC prophylaxis is reported, consisting of early trophic feeding with human breast milk, and enteral administration of an antibiotic, an antifungal agent, and probiotics. A retrospective analysis of local protocol of NEC prophylaxis is presented. Included were all VLBWI admitted to the NICU, including transfers within the first 28 days of life. These infants were divided into two groups, an "inborn group" (infants admitted within the first 24 h of life) and an "outborn group" (infants admitted after the onset of their second day of life). Prophylaxis of NEC according to protocol was started at the day of admission, and was continued until discharge. Between 1998 and 2004, 405 VLBWI were admitted, including all transfers within the first 28 days of life. A total of 334 (82%) infants were admitted within the first 24 h of life (inborn group), and 71 (18%) were admitted after 24 h of life (outborn group). Five infants developed clinical features of necrotizing enterocolitis. The inborn group showed a NEC incidence of 0.7% (two infants), whereas the outborn group showed a NEC incidence of 4.5% (three infants), respectively. This difference was significant (P=0.049, Fisher's exact test). A surgical treatment with bowel resection was performed in two infants (both from the outborn group). The present study used a combination of different strategies, all having shown to have some beneficial effect, but not having brought a clinical breakthrough in single administration studies. Combinated were the beneficial effects of human breast milk feeding, oral antiobiotics, oral antifungal agents, and the administration of probiotics. In a homogenous group of preterm infants, using this protocol of multimodal NEC prophylaxis, there was a very low incidence of NEC, when started within the first 24 h of life.
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Affiliation(s)
- G Schmolzer
- Division of Neonatology, Department of Pediatrics, Medical University of Graz, Auenbruggerplatz 30, 8036, Graz, Austria.
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Pichler G, Klaritsch P, Zotter H, Heinzinger J, Kutschera J, Müller W, Urlesberger B. Peripheral Oxygenation In Term Neonates With In Utero Exposure To Smoking. Z Geburtshilfe Neonatol 2006. [DOI: 10.1055/s-2006-943365] [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: 10/19/2022]
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Kutschera J, Rotky-Fast C, Müller W. Das Syndrome of Inappropriate Secretion of Antidiuretic Hormone mit Hyponatriämie bei einem 29 Wochen Frühgeborenem nach mütterlicher Fluoxetintherapie in der Schwangerschaft. Z Geburtshilfe Neonatol 2006. [DOI: 10.1055/s-2006-943237] [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: 10/19/2022]
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Sommer C, Urlesberger B, Maurer-Fellbaum U, Kutschera J, Müller W. Neurodevelopmental outcome at 2 years in 23 to 26 weeks old gestation infants. Klin Padiatr 2006; 219:23-9. [PMID: 16586271 DOI: 10.1055/s-2006-921341] [Citation(s) in RCA: 12] [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] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
BACKGROUND Assessment of neurologic and developmental outcome at 2 years age of infants with gestational age (GA)<27 weeks, born between 1996-2001. PATIENTS A total of 110 live-born preterm infants with GA<27 weeks. METHODS Main outcome criterions: Neurologic examination (according to Touwen) and classification of cerebral palsy by using the Gross Motor Function Classification System (GMFCS) at the corrected age of 1 and 2 years; assessment of mental and psychomotor development by using the Griffith Mental Development scales at the corrected age of 2 years; growth assessment at birth, 1 and 2 years. RESULTS Mortality was 52%. Regular follow up was performed in 48 (91%) of the 53 surviving infants. Neurologic outcome: at 1 year age: 2% nonambulant cerebral palsy, 25% mild neurologic signs and 73% normal; at 2 years age: 4% nonambulant cerebral palsy, 2% ambulant cerebral palsy, 4% mild neurologic signs and 90% normal neurology. Developmental outcome at 2 years age: 40% DQ>-1 SD, 6% DQ between -1 SD and -2 SD (mild delay), 35% DQ between -2 SD and -3 SD (moderate delay) and 19% DQ<-3 SD (severe delay). Overall disability was found in 64%, severe disability in 27% of the infants. Profound growth failure in weight and head circumference<3rd centile at 2 years age was recorded in 39 and 19% of the infants, respectively. CONCLUSION Developmental delay is very common in preterm infants<27 GA and exceeds the number of neurological disabilities (including cerebral palsy).
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MESH Headings
- Body Weight
- Brain Damage, Chronic/diagnosis
- Brain Damage, Chronic/mortality
- Cephalometry
- Cerebral Palsy/diagnosis
- Cerebral Palsy/mortality
- Child, Preschool
- Comorbidity
- Developmental Disabilities/diagnosis
- Developmental Disabilities/mortality
- Disabled Children/classification
- Female
- Follow-Up Studies
- Humans
- Infant
- Infant, Extremely Low Birth Weight
- Infant, Newborn
- Infant, Premature, Diseases/diagnosis
- Infant, Premature, Diseases/mortality
- Male
- Neurologic Examination
- Pregnancy
- Pregnancy Trimester, Second
- Survival Rate
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Affiliation(s)
- C Sommer
- Division of Neonatology, Department of Pediatrics, University Hospital, Graz, Austria
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Pichler G, Urlesberger B, Grossauer K, Klaritsch P, Kutschera J, Müller W. Altersabhängige peripher muskuläre Oxygenierung bei reifen gesunden Neugeborenen. Z Geburtshilfe Neonatol 2005. [DOI: 10.1055/s-2005-871403] [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: 10/19/2022]
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Kutschera J, Schallmoser K, Macher S, Posch U, Wagner T, Panzer S, Lanzer G, Müller W. Human Platelet Antigen-3a Antikörper als seltene Ursache einer ausgeprägten Form einer neonatalen Alloimmun-Thrombozytopenie. Z Geburtshilfe Neonatol 2005. [DOI: 10.1055/s-2005-871428] [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: 10/19/2022]
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Kutschera J, Tomaselli J, Maurer U, Mueller W, Urlesberger B. Minor neurological dysfunction, cognitive development, and somatic development at the age of 3 to 7 years after dexamethasone treatment in very-low birth-weight infants. Early Hum Dev 2005; 81:281-7. [PMID: 15814210 DOI: 10.1016/j.earlhumdev.2004.07.004] [Citation(s) in RCA: 4] [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] [Received: 11/18/2003] [Revised: 07/29/2004] [Accepted: 07/29/2004] [Indexed: 11/12/2022]
Abstract
The objective of this study was to assess minor neurological dysfunction, cognitive development, and somatic development after dexamethasone therapy in very-low-birthweight infants. Thirty-three children after dexamethasone treatment were matched to 33 children without dexamethasone treatment. Data were assessed at the age of 3-7 years. Dexamethasone was started between the 7th and the 28th day of life over 7 days with a total dose of 2.35 mg/kg/day. Exclusion criteria were asphyxia, malformations, major surgical interventions, small for gestational age, intraventricular haemorrhage grades III and IV, periventricular leukomalacia, and severe psychomotor retardation. Each child was examined by a neuropediatrician for minor neurological dysfunctions and tested by a psychologist for cognitive development with a Kaufman Assessment Battery for Children and a Draw-a-Man Test. There were no differences in demographic data, growth, and socio-economic status between the two groups. Fine motor skills and gross motor function were significantly better in the control group (p<0.01). In the Draw-a-Man Test, the control group showed better results (p<0.001). There were no differences in development of speech, social development, and the Kaufman Assessment Battery for Children. After dexamethasone treatment, children showed a higher rate of minor neurological dysfunctions. Neurological development was affected even without neurological diagnosis. Further long-term follow-up studies will be necessary to fully evaluate the impact of dexamethasone on neurological and cognitive development.
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Affiliation(s)
- J Kutschera
- Department of Paediatrics, University Hospital, Auenbruggerplatz 30, Graz A-8036, Austria.
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Resch B, Gallistl S, Kutschera J, Mannhalter C, Muntean W, Mueller WD. Thrombophilic polymorphisms--factor V Leiden, prothrombin G20210A, and methylenetetrahydrofolate reductase C677T mutations--and preterm birth. Wien Klin Wochenschr 2004; 116:622-6. [PMID: 15515881 DOI: 10.1007/s00508-004-0223-9] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.0] [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: 10/25/2022]
Abstract
AIM OF THE STUDY To evaluate the influence of three common thrombophilic polymorphisms, factor V Leiden (FV), prothrombin G20210A (PT), and methylenetetrahydrofolate reductase (MTHFR) C677T mutations, on preterm birth of unknown cause. PATIENTS AND METHODS A single-centre case-control study of women with preterm infants < or =35 weeks of gestation, in whom obvious maternal, uterine, and fetal causes responsible for preterm birth were excluded (n = 35). The controls were 54 women with term infants hospitalised in the same ward. RESULTS There were no significant differences between the groups of mothers in history of fetal loss, venous or familial thrombosis, or previous preterm birth. FV was found in 8.6% of the cases, PT in 5.7%, and MTHFR mutation (homozygous) in 4.8% compared with 5.4% (p=0.292, OR 1.594, CI95% 0.303-8.384), 7.4% (p=0.379, OR 0.758, CI95% 0.131-4.374), and 4.5% (p = 0.485, OR 1.050, CI95% 0.090-12.276), respectively, in the controls. Differences in the three thrombophilic polymorphisms in the two groups of infants were also not significant. CONCLUSION We could not demonstrate a distinct association between these thrombophilic polymorphisms and preterm birth.
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Affiliation(s)
- Bernhard Resch
- Department of Pediatrics, University Hospital Graz, Graz, Austria.
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Kutschera J, Tomaselli J, Maurer U, Mueller W, Urlesberger B. Kognitive, neurologische und somatische Entwicklung im Alter von 3 bis 11 Jahren von Frühgeborenen unter 1500g mit persistierenden periventrikulären Echodensitäten. Z Geburtshilfe Neonatol 2004. [DOI: 10.1055/s-2004-829403] [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: 10/20/2022]
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Schmölzer G, Urlesberger B, Reiterer F, Haim M, Kutschera J, Resch B, Müller W. [Inhalation therapy with nitric oxide in pulmonary hypertension: Comparison of preterm infants versus newborn infants]. Klin Padiatr 2003; 215:257-61. [PMID: 14520586 DOI: 10.1055/s-2003-42668] [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] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
BACKGROUND Inhaled nitric oxide (iNO) is used as a vasodilator in pulmonary hypertension (PH) of the newborn infant. PATIENTS AND METHODS Retrospective analysis of patients, who were treated at our department with iNO in the period from 1994-2001. Response was defined as an increase of the paO (2)/FiO (2) Ratio > or = 20 % and/or a decrease of the oxygenation index (OI) >/= 20 % after 2 h (early response), and consecutively after 24 h (late response). The patients were divided into a) primary persistent pulmonary hypertension of the newbom (PPHN), or b) pulmonary hypertension secondary to meconium aspiration syndrome (MAS), sepsis or congenital diaphragmatic hernia (CDH). RESULTS Between 1994 and 2001 we treated 47 patients with iNO at our neonatal intensive care unit. We included 16 (35 %) preterm infants (GA 34,5 [25 - 37] weeks, GG 2061 [680 - 3410] g) (Median/Range) and 31 (65 %) newbom (GA 40 [38 - 42] weeks, GG 3510 [2550 - 4560] g). 18 (38 %) patients suffered from primary PPHN, 29 (62 %) from secondary PPHN (14 MAS [30 %], 8 sepsis [17 %], 4 CDH [8 %]). 8 (50 %) preterm and 20 (64 %) term infants showed a positive iNO response after 2 h, again 8 (50 %) preterm and 20 (64%) term infants showed a positive iNO response after 24 h. There was neither a significant difference between term and preterm infants at 2 h, nor at 24 h. Between 2 h and 24 h 10 patients changed in their response to iNO. 5 (18 %) patients with early response showed a significant degradation after 24 h, whereas 5 (26 %) of the patients without early response showed a significant improvement of the oxygenation alter 24 h. Alltogether 13 (72 %) patients with PPHN, 8 (57 %) with MAS, 2 (50 %) with CDH, 4 (50 %) with sepsis showed a positive iNO response after 24 h. In regard to the oxygenation parameters at start of iNO-therapy, the patients with early response did not differ from the patient without response (median OI: 20,0 versus 21,8, median paO (2)/FiO (2) Ratio: 59,3 versus 55,0 mmHg at the start of the iNO therapy). CONCLUSION In regard to iNO response, there was no significant difference between term and preterm infants. Due to the changing response, a positive iNO-response after 2 h had no predictive value for the further prognosis of the oxygenation situation under iNO therapy.
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Affiliation(s)
- G Schmölzer
- Klinische Abteilung für Neonatologie, Universitätsklinik für Kinder- und Jugendheilkunde Graz, Osterreich.
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Kutschera J, Tomaselli J, Urlesberger B, Maurer U, Häusler M, Gradnitzer E, Burmucic K, Müller W. Absent or reversed end-diastolic blood flow in the umbilical artery and abnormal Doppler cerebroplacental ratio--cognitive, neurological and somatic development at 3 to 6 years. Early Hum Dev 2002; 69:47-56. [PMID: 12324182 DOI: 10.1016/s0378-3782(02)00039-7] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.0] [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: 11/22/2022]
Abstract
UNLABELLED The objective of this study was to examine the cognitive, neurological and somatic developments of children who had in utero an absent or reversed end-diastolic blood flow (ARED) in the umbilical artery or an abnormal cerebroplacental ratio (ABF). METHODS 16 children with ARED blood flow and 15 children with ABF were each matched to children with the same gestational age, appropriate for gestational age, the same sex and born within 4 months. Data were assessed at the age of 3-6 years. Children with asphyxia, neonatal infection, malformation or major surgical interventions in the neonatal period were excluded. Each child underwent a neuropediatrical examination; furthermore, a Kaufman Assessment Battery for Children, a Snijders-Oomen Intelligence Scale for Children and a Man-Drawing Test were used to evaluate cognitive development. The socioeconomic status was also assessed. RESULTS Children in the ARED group remained lighter and had a higher frequency of microcephaly. In the Kaufman Assessment Battery for Children and the Snijders-Oomen Intelligence Scale for Young Children, cognitive development was impaired in the ARED and the ABF groups compared to the control group. The ARED and the ABF groups, however, showed no differences. The Man-Drawing Test and the Denver Development Test did not show any differences. DISCUSSION ARED blood flow and ABF showed impaired cognitive development. The degree of impairment was the same in the ARED and the ABF groups. Long-term follow-up studies until adulthood are necessary to see if impaired cognitive development remains significant in these groups of patients.
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Affiliation(s)
- J Kutschera
- Division of Neonatology, Department of Pediatrics, University Hospital Graz, Auenbruggerplatz 30, A-8036 Graz, Austria.
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Abstract
Aim of this study was to examine breast feeding behaviour in Styria, Austria in the years 1994 and 2000. Differences were documented and possibilities for better support were outlined. 1994 106 and 2000 60 mothers were questioned about breast feeding behaviour of the last child after delivery of a newborn in our hospital. The social status of the parents, breast feeding duration and frequency, problems while breast feeding and contraception were documented. The mothers were also asked about the breast feeding behaviour they planed for the newborn. 1994 83% and 2000 88% of the mothers breast fed their babies for at least 1 month. The average breast feeding duration increased from 4.8 months in 1994 to 5.3 months in 2000. The frequency of breast feeding also increased. Low social status was correlated with shorter breast feeding duration. Support for breast feeding was used by 53% of the mothers in 1994 and by only 28% of the mothers in 2000. 27% of the mothers wish to breast-feed the newborn longer than the last child in 2000. Breast feeding duration has increased in Styria, Austria from 1994 to 2000. Since mothers want to breast feed even longer, support to breast feeding mothers should be offered as often as possible.
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Affiliation(s)
- J Kutschera
- Klinische Abteilung für Neonatologie, Universitätsklinik für Kinder- und Jugendheilkunde, Auenbruggerplatz 30, A-8036 Graz.
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Kutschera J, Urlesberger B, Maurer U, Müller W. [Small for gestational age - Somatic, neurological and cognitive development until adulthood]. Z Geburtshilfe Neonatol 2002; 206:65-71. [PMID: 12015637 DOI: 10.1055/s-2002-30139] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.6] [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: 10/16/2022]
Abstract
BACKGROUND The somatic, neurological and cognitive development of children born small for gestational age (SGA) until adulthood was assessed in recent studies. Studies that assessed mortality, morbidity, somatic, neurological and cognitive development of SGA children were compared. MATERIALS AND METHODS In the studies very low birth weight SGA children were compared to very low birth weight appropriate for age children (AGA, birth weight below 1500 g or 1250 g). Full-term SGA children were compared to full-term appropriate for age children. Growth of SGA children remained under the 10th percentile, if catch up growth did not occur until the end of the second year. Cerebral palsy appeared more often in VLBW-AGA than in VLBW-SGA children. Cognitive development problems appeared in VLBW-SGA and FT-SGA children more often than in VLBW-AGA and FT-AGA children. These cognitive development problems were observed mainly as poor school performance. When reaching adulthood, the differences in cognitive function seem to be less significant. Low socioeconomic status and persistence of microcephaly were associated with problems in neurological and cognitive development. CONCLUSIONS AND DISCUSSION Growth and cognitive development problems appeared more often in SGA children. More longterm studies are necessary to show, if these cognitive development problems remain significant until adulthood.
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MESH Headings
- Adolescent
- Adult
- Anthropometry
- Brain Damage, Chronic/diagnosis
- Brain Damage, Chronic/mortality
- Brain Damage, Chronic/psychology
- Cephalometry
- Cerebral Palsy/diagnosis
- Cerebral Palsy/mortality
- Cerebral Palsy/psychology
- Child
- Child, Preschool
- Cognition Disorders/diagnosis
- Cognition Disorders/mortality
- Cognition Disorders/psychology
- Female
- Follow-Up Studies
- Humans
- Infant
- Infant, Newborn
- Infant, Premature, Diseases/diagnosis
- Infant, Premature, Diseases/mortality
- Infant, Premature, Diseases/psychology
- Infant, Small for Gestational Age
- Infant, Very Low Birth Weight
- Intelligence
- Male
- Pregnancy
- Reference Values
- Risk Factors
- Survival Rate
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Affiliation(s)
- J Kutschera
- Klinische Abteilung für Neonatologie, Univ.-Klinik für Kinder- und Jugendheilkunde Graz, Germany.
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Viktil KK, Enstad M, Kutschera J, Smedstad LM, Schjøtt J. Polypharmacy among patients admitted to hospital with rheumatic diseases. Pharm World Sci 2001; 23:153-8. [PMID: 11599202 DOI: 10.1023/a:1011909827909] [Citation(s) in RCA: 17] [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] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
AIM This study describes polypharmacy among patients admitted to hospital with rheumatic diseases. METHODS The study was performed in departments of rheumatology at nine Norwegian hospitals during five weeks in 1998. Pharmacists recorded all drugs on admittance among patients 18 years or older with rheumatic diseases. RESULTS Sixty percent of 313 patients had polypharmacy defined as the concurrent use of five or more drugs, and this was most frequent among the older patients. However, they used fewer antirheumatic drugs compared to the younger patients. With regard to the three most common drug groups, older patients used more corticosteroids, and less nonsteroidal antiinflammatory drugs (NSAIDs) and disease modifying antirheumatic drugs (DMARDs), compared to the younger. Eighty-four percent of patients on methotrexate used folic acid, but only 52% of the patients who used corticosteroids used calcium supplements. CONCLUSION Polypharmacy among patients with rheumatic diseases is common, and the present description could be useful for drug-related interventions.
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Affiliation(s)
- K K Viktil
- Haukeland Hospital Pharmacy, Bergen, Norway.
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Berger R, Kutschera J, Künzel W. Blood pH in the umbilical artery at birth: an analysis of data from patients delivered in Hesse between 1986 and 1989. Eur J Obstet Gynecol Reprod Biol 1996; 66:3-10. [PMID: 8735751 DOI: 10.1016/0301-2115(95)02373-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [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: 02/01/2023]
Abstract
OBJECTIVE Measuring blood pH in the umbilical artery at birth is an important means of maintaining obstetrical quality. Consideration of the interrelations between low umbilical blood pH and perinatal risk factors may enable obstetricians to provide better care of the mother and child during pregnancy and delivery. We therefore studied the incidence of measuring blood pH at birth, the distribution and normal range of umbilical blood pH at birth, and the correlation between umbilical blood pH and pre-, sub-, and postnatal risk factors in patients delivered in Hesse between 1986 and 1989. SUBJECTS Over this period 2053 women were delivered between 30 and 32 weeks and 128,654 between 39 and 41 weeks of gestation. Each of these two groups was further subdivided according to the mode of delivery (spontaneous vaginal delivery; operative vaginal delivery; Cesarean section). Of the patients delivered between 39 and 41 weeks of gestation, 24,315 had exhibited no risk factors during pregnancy or delivery. RESULTS The overall incidence of measuring umbilical blood pH at birth was about 70%, whereas pH measurements were taken in only 60% of preterm babies delivered vaginally. The percentage of preterm neonates with an umbilical blood pH < 7.10 was considerably higher than that of term fetuses (5.0% vs. 1.3%). Of the neonates born of women displaying no risk factors during pregnancy and delivery, 22.4% had an umbilical blood pH < or = 7.25. In patients delivered at term hardly any correlation was found between prenatal risk factors and umbilical blood pH. This contrasted to the situation in patients delivered between 30 and 32 weeks of gestation. In most subgroups a close correlation could be demonstrated between umbilical blood pH and both sub- and postnatal risk factors. No correlation was detected between umbilical blood pH and perinatal mortality. CONCLUSION In view of the aim of maintaining and improving obstetrical quality in Hesse, the incidence of measuring umbilical blood pH at birth should be increased, especially in preterm fetuses. Since 22.4% of all babies from patients exhibiting no risk factors during pregnancy and delivery had an umbilical blood pH < or = 7.25, we have to reflect once again on the range of 'normal' umbilical blood pH at birth. Consideration of the various interrelations between umbilical blood pH and pre-, sub-, and postnatal risk factors demonstrated in this study may enable obstetricians to reduce the incidence of severely compromised fetuses at birth.
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Affiliation(s)
- R Berger
- Department of Obstetrics and Gynecology, University of Giessen, Germany
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Tolckmitt W, Lohmann A, Kutschera J. [Digestion of fat and protein and its relation to the activity of faecal enzymes in mucoviscidosis infants under substitution therapy with pancreatic enzymes (author's transl)]. Klin Padiatr 1981; 193:365-9. [PMID: 6912903 DOI: 10.1055/s-2008-1034498] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Abstract
The article reports on a study to determine the influence of different dosage schedules of a pancreas enzyme preparation on the digestion of fat and protein and on the lipolytic, tryptic and chymotryptic activity of the faeces in children suffering from mucoviscidose. After administration of the pancreatin preparation at the low dose level, the quantity of faeces, the excretion of fatty acids and of nitrogen are reduced and the absorption coefficient is improved. The faecal tryptic and chymotryptic activity increases, whereas the lipase activity in the faeces merely shows a tendency to rise. Increasing the pancreatin dose up to a still tolerable value by doubling the dosage does not result in further reduction of the excretion of fat and nitrogen although it enhances the proteolytic activity of the faeces while the lipase activity remains unaffected. Determination of the lipolytic, tryptic or chymotryptic activity is, therefore, unsuitable for assessing the fat and protein digestion and for estimating the required dose of pancreatic enzyme. No increase in uric acid excretion was seen in the urine collected for 24 hours after administration of both enzyme doses.
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Jäger W, Kutschera J, Wendeberg H, Kauschmann R, Riese W, Pietsch U, Berger E, Bennert C. [The continuous measurement of platelet aggregation without the addition of aggregation inducers. II. Experimental results and testing of aggregation inducers]. Blut 1974; 29:251-9. [PMID: 4417045 DOI: 10.1007/bf01635546] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
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Jäger W, Kutschera J, Wendeberg H, Kauschmann R, Riese W, Pietsch U, Berger E, Bennert C. [The continuous measurement of platelet aggregation without addition of aggregation stimulators. I. Methods and clinical results]. Blut 1974; 29:184-94. [PMID: 4411130 DOI: 10.1007/bf01634121] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
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Lins G, Kutschera J. [Colorimetric evaluation of green rot in the skin of corpses as part of an integrated program of colour measurement (author's transl)]. Z Rechtsmed 1974; 75:201-12. [PMID: 4450809 DOI: 10.1007/bf01882703] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
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Retiene K, Schulz F, Kutschera J, Schierle H. [Experimental and clinical studies on a new synthetic corticotropin with 18 amino acids]. Arzneimittelforschung 1974; 24:1057-60. [PMID: 4368135] [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: 01/10/2023]
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Breddin K, Ehrly AM, Fechler L, Frick D, König H, Kraft H, Krause H, Krzywanek HJ, Kutschera J, Lösch HW, Ludwig O, Mikat B, Rausch F, Rosenthal P, Sartory S, Voigt G, Wylicil P. [Short-term fibrinolytic treatment in acute myocardial infarction]. Dtsch Med Wochenschr 1973; 98:861-73. [PMID: 4571884 DOI: 10.1055/s-0028-1106921] [Citation(s) in RCA: 57] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
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Beyer J, Haupt E, Cordes U, Kutschera J, Schöffling K. Different amounts of insulin secretion following an equal total decrease of blood glucose as an indication of possible extrapancreatic activities of different sulfonylurea drugs. Horm Metab Res 1973; 5:9-13. [PMID: 4196346 DOI: 10.1055/s-0028-1093992] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
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