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  • Disseminated intravascular coagulation  (3)
  • Combination chemotherapy  (2)
  • Newborn infants  (2)
  • 1
    Electronic Resource
    Electronic Resource
    Alpha1-antitrypsin and alpha2-macroglobulin in newborn infants (1978)
    Springer
    European journal of pediatrics 129 (1978), S. 125-132 
    Details
    ISSN: 1432-1076
    Keywords: Blood coagulation ; Newborn infants ; Alpha1-antitrypsin ; Alpha2-macroglobulin ; Antithrombin III ; Fibrinogen ; Plasminogen
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract The following tests were performed within the first week of life in 129 newborn infants: determination of alpha1-antitrypsin, alpha2-macroglobulin, antithrombin III, fibrinogen, prothrombin, accelerin, convertin and plasminogen. The newborns were divided into three groups: group (a), healthy newborns with a normal obstetric history (n=62); group (b), newborns without clinical signs of illness, but a complicated obstetric history (n=49); group (c), newborns suffering from various diseases (n=18). For statistical analysis correlation coefficients and t-tests were used. The mean values of the coagulation factors showed no significant differences between the three groups, but the standard deviation, was found to be markedly greater in group (c). This can be explained by higher production and an increased turnover of coagulation factors in these newborns. Significant correlations were found between fibrinogen, prothrombin, plasminogen and the inhibitors alpha1-antitrypsin, alpha2-macroglobulin and antithrombin III. According to this investigation the fibrin forming system and fibrinolysis are influenced by many complications in the newborn period. Alpha2-macroglobulin was found to be significantly reduced in 15 out of 18 sick newborn infants and appears to be a sensitive indicator for various coagulation defects. Alpha1-antitrypsin was reduced in infants with severe disturbances of the clotting system. Therefore, alpha2-macroglobulin and alpha1-antitrypsin may be useful for the determination of mild and severe coagulation disorders.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF00442372
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  • 2
    Electronic Resource
    Electronic Resource
    Alpha1-antitrypsin and alpha2-macroglobulin in newborn infants (1978)
    Springer
    European journal of pediatrics 129 (1978), S. 117-124 
    Details
    ISSN: 1432-1076
    Keywords: Newborn infants ; Alpha1-antitrypsin ; Alpha2-macroglobulin
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract The levels of alpha1-antitrypsin and alpha2-macroglobulin in the plasma of 129 newborns were determined. The infants were divided into 3 groups according to their perinatal history. In healthy newborns with an uneventful perinatal history the normal values for alpha1-antitrypsin were 1.97±0.44 g/l, and for alpha2-macroglobulin 3.11±0.69 g/l. No changes in these levels were found during the first week of life. The levels of alpha1-antitrypsin and alpha2-macroglobulin showed significant correlation to each other. In healthy newborns with different complications in the obstetric history the levels of alpha1-antitrypsin were not influenced, whereas alpha2-macroglobulin decreased slightly during the first week of life. The levels of alpha1-antitrypsin and of alpha2-macroglobulin showed no further correlation to each other. In sick term and preterm newborns (n=18) alpha1-antitrypsin was increased in 5 of 7 babies suffering from bacterial infections and lowered in 4 of 9 cases with respiratory disturbances. Alpha2-macroglobulin was lowered in 15 babies. These results indicate different kinetics of the two antiproteases in vivo.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF00442371
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  • 3
    Electronic Resource
    Electronic Resource
    Efficiency of heparin in the treatment of newborn infants with respiratory distress syndrome and disseminated intravascular coagulation (1980)
    Springer
    European journal of pediatrics 133 (1980), S. 47-49 
    Details
    ISSN: 1432-1076
    Keywords: Respiratory distress syndrome ; Disseminated intravascular coagulation ; Heparin
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Forty newborns with severe shock and disseminated intravascular coagulation were randomized for treatment with heparin or placebo. Mortality was equal in both groups. The heparin group required significantly shorter periods of artificial ventilation. The coagulation system improved faster, and the coagulation pattern showed normal values in the treatment group. Due to the low number of cases, these differences could not be statistically confirmed.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF00444754
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  • 4
    Electronic Resource
    Electronic Resource
    Anticoagulant therapy by continuous heparin-abtithrombin III infusion in newborns with disseminated intravascular coagulation (1985)
    Springer
    European journal of pediatrics 144 (1985), S. 191-194 
    Details
    ISSN: 1432-1076
    Keywords: Antithrombin III ; Newborns ; Disseminated intravascular coagulation ; Anticoagulant therapy
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract In ten newborns with severe alteration of the coagulation system due to DIC, AT III concentrate was infused continuously after prior activation with heparin. The rise in AT III activity showed a great variability among the infants and for one child during the course of the therapy. The mean rise of AT III activity by 40 U/kg per day heparin was 8.7%. If AT III concentrate (40 U/kg per day) was activated with 200 U/kg per day heparin, excessive anticoagulatory effect was only observed in one child. In four children who had failed to respond to prior heparin therapy, improvement of the coagulation status was achieved within 2 days.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF00451912
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  • 5
    Electronic Resource
    Electronic Resource
    Randomized comparison of rotational chemotherapy in high-risk acute lymphoblastic leukaemia of childhood — follow up after 9 years (1996)
    Springer
    European journal of pediatrics 155 (1996), S. 640-648 
    Details
    ISSN: 1432-1076
    Keywords: Acute lymphoblastic leukaemia ; Childhood ; Combination chemotherapy ; Rotation of drugs
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract A frequent change of drug combinations may circumvent drug resistance in the treatment of patients with acute lymphoblastic leukaemia (ALL). In study COALL 85/89 201 children with high-risk ALL were randomized to receive over a period of 8 months rotational chemotherapy with six drug combinations given either in slow rotation (SR) (each combination given twice in succession) or in rapid rotation (RR) (cach combination given once with a repetition of the drug combinations). Treatment of central nervous system leukaemia consisted of cranial irradiation and intrathecal methotrexate. Both SR and RR treatment groups were then given continuation chemotherapy of oral 6-mercaptopurine and methotrexate until 2 years after the date of diagnosis. The 9-year eventfree survival (EFS) rate for the whole group is 69%±3%, and the survival rate 75%±3% at a median follow up of 5.8 years. Failure to achieve remission at day 28 was the most important prognostic factor (EFS 12%±7% vs. 75%±3% in the remission group). In the RR group, 11/100 patients were not in remission at day 28 opposed to 7/101 patients in the SR group. Children aged 〈1 year (6/6 relapses) or aged 〉=10 years had a worse prognosis (EFS 64%±5% vs. 77%±4% in patients 1–10 years old). After 5 years EFS was inferior in the RR group attributable to a significantly higher relapse rate in children with a WBC〉=100/nl. The EFS at 9 years for all patients, however, is similar in both groups (SR 72%±5% vs. RR 67±5%).
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF01957144
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  • 6
    Electronic Resource
    Electronic Resource
    Randomized comparison of rotational chemotherapy in high-risk acute lymphoblastic leukaemia of childhood – follow up after 9 years (1996)
    Springer
    European journal of pediatrics 155 (1996), S. 640-648 
    Details
    ISSN: 1432-1076
    Keywords: Key words Acute lymphoblastic ; leukaemia ; Childhood ; Combination chemotherapy ; Rotation of drugs
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract A frequent change of drug combinations may circumvent drug resistance in the treatment of patients with acute lymphoblastic leukaemia (ALL). In study COALL 85/89 201 children with high-risk ALL were randomized to receive over a period of 8 months rotational chemotherapy with six drug combinations given either in slow rotation (SR) (each combination given twice in succession) or in rapid rotation (RR) (each combination given once with a repetition of the drug combinations). Treatment of central nervous system leukaemia consisted of cranial irradiation and intrathecal methotrexate. Both SR and RR treatment groups were then given continuation chemotherapy of oral 6-mercaptopurine and methotrexate until 2 years after the date of diagnosis. The 9-year event-free survival (EFS) rate for the whole group is 69% ± 3%, and the survival rate 75% ± 3% at a median follow up of 5.8 years. Failure to achieve remission at day 28 was the most important prognostic factor (EFS 12% ± 7% vs. 75% ± 3% in the remission group). In the RR group, 11/100 patients were not in remission at day 28 opposed to 7/101 patients in the SR group. Children aged 〈 1 year (6/6 relapses) or aged ^ 10 years had a worse prognosis (EFS 64% ± 5% vs. 77% ± 4% in patients 1–10 years old). After 5 years EFS was inferior in the RR group attributable to a significantly higher relapse rate in children with a WBC ^ 100/nl. The EFS at 9 years for all patients, however, is similar in both groups (SR 72% ± 5% vs. RR 67 ± 5%). Conclusion The COALL 85/89 treatment protocol with early intensive therapy and rotation of different drug combinations offers long-term disease-free survival for children with high-risk ALL. A continuous 4-week exposure to one drug combination may be necessary to achieve optimal results, especially in children with a high leukaemic cell burden.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF01957144
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  • 7
    Electronic Resource
    Electronic Resource
    Etiopathology and classification of acquired coagulation disorders in the newborn infant (1979)
    Springer
    Journal of molecular medicine 57 (1979), S. 81-86 
    Details
    ISSN: 1432-1440
    Keywords: Blutgerinnung bei Neugeborenen ; Vitamin K-Mangel ; Disseminierte intravasale Gerinnung ; Blood coagulation in newborns ; Vitamin K deficiency ; Disseminated intravascular coagulation
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Summary In the newborn period low vitamin K dependent coagulation factors are frequently found in connection with normal global tests. To investigate this peculiar coagulation status studies were performed in 54 newborns who were divided into three groups according to their clinical course and the existence of bleeding. The results are compared to coagulation tests used for the diagnosis of disseminated intravascular coagulation (DIC). An early sign of an increased turnover of coagulation factors is a difference in the fibrinogen concentration determined by an immunological technique and a coagulation test which is sensible to fibrin(ogen)-degradation-products (FDP's). At this stage factor II, V and VII levels are still within the normal range suggesting an increased production. In a more severe disturbance of the clotting system the increased turnover is no longer compensated by an increased production, and platelets and later on factor II and VII levels are lowered. At this early stage of DIC the vitamin K dependent factors are correlated to the factors I and V. Finally factors I and V drop as well. This stage in most infants is accompanied by the clinical symptom of bleeding. The clotting tests results are well correlated to the severity of the disease.
    Notes: Zusammenfassung Bei Neugeborenen sind trotz normaler Globaltests die Vitamin K abhängigen Gerinnungsfaktoren häufig vermindert. Um diesen Befund näher zu untersuchen, wurden Gerinnungstests bei 54 Neugeborenen durchgeführt, die je nach ihrem klinischen Zustand und dem Auftreten von Blutungen in 3 Gruppen aufgeteilt wurden. Die Ergebnisse wurden mit Tests verglichen, die eine Verbrauchskoagulopathie anzeigen. Ein frühes Anzeichen eines Verbrauchs von Gerinnungsfaktoren ist die Diskrepanz zwischen dem immunologisch bestimmten und dem gerinnungsaktiven Fibrinogen. Bekanntlich können die Spaltprodukte die Fibrinogenbestimmung mit Thrombin erschweren, während sie immunologisch wie Fibrinogen bestimmt werden können. In diesem Stadium sind die Faktoren II, V and VII noch im Normbereich, was auf eine erhöhte Neubildung schließen läßt. Mit zunehmendem Verbrauch kommt es zuerst zu einer Abnahme der Plättchenzahl sowie der Faktoren II und VII. In diesem Stadium der Verbrauchskoagulopathie korrelieren die Vitamin K abhängigen Faktoren mit den Faktoren I und V. Klinisch kommt es in diesem Stadium häufig zu Blutungen. Die Ergebnisse der Gerinnungsuntersuchungen korrelieren gut mit dem Schweregrad der Erkrankung.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF01491339
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