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  • Newborns  (4)
  • Disseminated intravascular coagulation  (3)
  • Rotation of drugs  (2)
  • 1
    Electronic Resource
    Electronic Resource
    Vitamin K in infancy (1988)
    Springer
    European journal of pediatrics 147 (1988), S. 106-112 
    Details
    ISSN: 1432-1076
    Keywords: Vitamin K deficiency ; Acarboxy-prothrombin ; Prophylaxis of vitamin K deficiency ; Newborns ; Infants
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Vitamin K has regained paediatric interest due to a recurrence of bleeding caused by deficiency of the vitamin in newborns and young infants. Increasing awareness of these clinical problems, the development of new methods for the detection of vitamin K deficiency and the direct measurement of vitamin K in tissues have stimulated research. Much new data obtained from these studies has proved helpful to the understanding of vitamin K deficiency in infancy. For example low concentrations of vitamin K have been found in fetal and neonatal livers. The implications of these findings with respect to manifest vitamin K deficiency and to new methods for detection of subclinical vitamin K deficiency are discussed. Breast-feeding is a major risk factor for classical haemorrhagic disease of the newborn and for late onset bleeding due to vitamin K deficiency in young infants. The interdependencies between breast-feeding and vitamin K deficiency are discussed on the basis of new data obtained from direct measurement of vitamin K in maternal milk. The review further focusses on pathophysiological concepts of bleeding due to vitamin K deficiency in infancy and current concepts of vitamin K prophylaxis.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF00442204
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  • 2
    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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  • 3
    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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  • 4
    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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  • 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: 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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  • 6
    Electronic Resource
    Electronic Resource
    The clinical relevance of factor VIII: C and factor VII R: Ag determination in newborns (1981)
    Springer
    European journal of pediatrics 137 (1981), S. 189-194 
    Details
    ISSN: 1432-1076
    Keywords: Factor VIII: C ; Factor VIII R: Ag ; Newborns ; DIC ; Diagnosis of hereditary bleeding disorders
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Higher levels of factor VIII: C and factor VIII R: Ag were found in healthy newborns (n=60) as compared to adults. This could be explained as a stress reaction due to birth and the adaptation to extrauterine life. A further stress factor is disease. The highest values for factor VIII R: Ag were found in ill (n=32) and in severely ill newborns (n=21). The large ranges of factor VIII: C and of the ratio of factor VIII: C/VIII R: Ag in healthy newborns can be explained by an increased turnover of coagulation factors. Diseases in the newborn period lead to an increase of this process, resulting in even larger ranges of factor VIII: C and of the ratio of factor VIII: C/VIII R: Ag in ill and extremely ill newborns. Consumption of factor VIII: C with a low ratio of factor VIII: C/VIII R: Ag predominates in extremely ill newborns. The ratio of factor VIII: C/VIII R: Ag is more valuable than factor VIII: C for diagnosis of DIC in newborns. A diagnosis of hemophilia and von Willebrand's disease cannot be established with certainty in severely ill newborns. Stress and DIC may influence the characteristic changes of laboratory parameters.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF00441315
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  • 7
    Electronic Resource
    Electronic Resource
    Vitamin K in the newborn: influence of nutritional factors on acarboxy-prothrombin detectability and factor II and VII clotting activity (1987)
    Springer
    European journal of pediatrics 146 (1987), S. 123-127 
    Details
    ISSN: 1432-1076
    Keywords: Vitamin K deficiency ; Newborns ; Breast feeding ; Acarboxy-prothrombin
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract The incidence of acarboxy-prothrombin and the clotting activity of factors II and VII were evaluated on the fifth day of life in 183 healthy newborns, who had received no vitamin K prophylaxis. Acarboxy-prothrombin was detected in 93/183 newborns. All acarboxy-prothrombin-negative babies had factors II and VII clotting activities above 25% whereas a great variability was observed in acarboxy-prothrombin-positive babies: 21/93 had factor II and 14/93 had factor VII activities below 25%. Seventy-two of the acarboxyprothrombin-positive babies had normal factor II and VII clotting times on the fifth day of life. These babies must be suspected to have had vitamin K deficiency on one of the first 4 days, as acarboxy-prothrombin has a 50% disappearance rate of 50 h. Acarboxy-prothrombin ws mainly observed in breastfed infants (84/122) and only rarely detectable in infants receiving supplementary (7/44) or exclusive formula feeding (2/17). The type of milk feeding however might be less important for the babies' vitamin K supply than the actual milk intake. All acarboxy-prothrombin-positive babies had received small amounts of milk on the first 4 days of life. In those with low factor II and VII clotting activities the milk intake was low throughout the first 4 days of life, whereas babies with acarboxy-prothrombin and and normal clotting activities had increased their milk intake to more than 100 ml on the third and fourth day of life. Recommendations for vitamin K prophylaxis in newborns should be given with regard to the feeding on the first days of life.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF02343215
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  • 8
    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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