To see the other types of publications on this topic, follow the link: Neonatologie.
Dissertations / Theses on the topic 'Neonatologie'
Create a spot-on reference in APA, MLA, Chicago, Harvard, and other styles
Consult the top 50 dissertations / theses for your research on the topic 'Neonatologie.'
Next to every source in the list of references, there is an 'Add to bibliography' button. Press on it, and we will generate automatically the bibliographic reference to the chosen work in the citation style you need: APA, MLA, Harvard, Chicago, Vancouver, etc.
You can also download the full text of the academic publication as pdf and read online its abstract whenever available in the metadata.
Browse dissertations / theses on a wide variety of disciplines and organise your bibliography correctly.
1
Blanco, C. E. "Neonatologie een volwassen specialisme /." Maastricht : Maastricht : Maastricht University ; University Library, Maastricht University [Host], 1989. http://arno.unimaas.nl/show.cgi?fid=12902.
Full text
2
Korten, Insa. "Dopplersonographische Normalwerte für Blutflussparameter der Niere bei gesunden Neugeborenen am ersten und dritten Lebenstag." Doctoral thesis, Universitätsbibliothek Leipzig, 2015. http://nbn-resolving.de/urn:nbn:de:bsz:15-qucosa-165027.
Full textAbstract:
Eine Vielzahl von Faktoren können am Lebensanfang eine ausreichende
Perfusion der Niere gefährden und ihre Funktion beeinträchtigen. Umgekehrt
spiegelt eine suffiziente Nierendurchblutung meist auch eine stabile systemische
Hämodynamik des Neugeborenen wieder. Laborwerte sind in diesem Alter wenig
aussagefähig bezüglich der Nierenfunktion. Ziel dieser Studie war die Erstellung
von dopplersonographischen Normalwerten der Blutflussparameter beim
gesunden Neugeborenen am ersten und dritten Lebenstag.
Es wurden Mittelwerte für die systolische, mittlere und diastolische arterielle
Flussgeschwindigkeit in der A. renalis am ersten und dritten Lebenstag beim
gesunden Neugeborenen durch dopplersonographische Messung bestimmt.
Es konnten dopplersonographische Referenzparameter der Durchblutung der
Niere ermittelt werden, die als unkompliziert messbare Parameter in der
neonatologischen Praxis zur Einschätzung systemisch hämodynamischer
Veränderungen sowie funktioneller Störungen der Niere bis zum akuten
Nierenversagen benutzt werden können.
3
CHAUVEL, LE ROLLAND MARIE-CHRISTINE. "Les potentiels evoques auditifs en neonatologie." Rennes 1, 1994. http://www.theses.fr/1994REN1M087.
Full text
4
CHARLES, EMMANUELLE. "Interet nutritionnel de la taurine en neonatologie." Strasbourg 1, 1992. http://www.theses.fr/1992STR15027.
Full text
5
FARCETTE, JEAN-LUC. "Reflexions sur une pratique pedopsychiatrique dans un centre de neonatologie." Reims, 1988. http://www.theses.fr/1988REIMM037.
Full text
6
BOUCHART, DUGENET ANNAIK. "Polykystose renale autosomique dominante : un cas en neonatologie a la guadeloupe." Rennes 1, 1992. http://www.theses.fr/1992REN1M004.
Full text
7
Sandig, Jan [Verfasser], and Jochen [Akademischer Betreuer] Weil. "Kardiale Biomarker und Impedanzkardiographie in der Neonatologie / Jan Sandig ; Betreuer: Jochen Weil." Hamburg : Staats- und Universitätsbibliothek Hamburg, 2017. http://d-nb.info/1143868684/34.
Full text
8
Brávková, Markéta. "Design novorozeneckého inkubátoru." Master's thesis, Vysoké učení technické v Brně. Fakulta strojního inženýrství, 2015. http://www.nusl.cz/ntk/nusl-232079.
Full textAbstract:
The topic of this master’s thesis is design of infant incubator. The thesis concerns own design of infant incubator that meet the basic technical, ergonomical and social requirements and also brings a new look and shape as solution to the main topic. The infant incubator is designed in regard to modern materials and technologies.
9
Carlitscheck, Jessica [Verfasser], and Andreas [Akademischer Betreuer] Eckert. "Familienzentrierte Betreuung in der Neonatologie - Situationsanalyse und Zukunftsperspektiven / Jessica Carlitscheck. Gutachter: Andreas Eckert." Köln : Universitäts- und Stadtbibliothek Köln, 2013. http://d-nb.info/1038485517/34.
Full text
10
Lißner, Mareike. "Epidemiologie nosokomialer Infektionen und die Abhängigkeit krankenhausassoziierter Komplikationen von der Personalbesetzung in der Neonatologie." Doctoral thesis, Universitätsbibliothek Leipzig, 2011. http://nbn-resolving.de/urn:nbn:de:bsz:15-qucosa-69074.
Full textAbstract:
Nosokomiale Infektionen bei Früh- und Neugeborenen stellen aufgrund ihrer hohen Inzidenz und Mortalität eine große Herausforderung für die moderne Versorgung dar. Außerdem sind sie Indikatoren für die Pflegequalität, wie auch Verletzungen und Gefäßschädigungen. In dieser retrospektiven Querschnittsstudie wurden die epidemiologische Situation nosokomialer Infektionen auf den neonatologischen Stationen der Universitätskinderklinik Leipzig für das Jahr 2006 beleuchtet, die Abhängigkeit der genannten Komplikationen von Plegepersonalqualifikation und –quantität untersucht, sowie die Stationsauslastung und Personalbesetzung mit deutschen Empfehlungen verglichen. Die Inzidenz systemischer Infektionen lag sowohl auf der neonatologischen Intensiv- als auch auf der Nachsorgestation unter dem deutschlandweiten Durchschnitt. Dagegen traten Lokalinfekte wie Windel-/ Mundsoor und Konjunktivitiden häufig auf. Das beobachtete Keimspektrum zeigte das aus der Literatur bekannte Bild, multiresistente Keime traten nicht auf. Bei der Untersuchung der Abhängigkeiten zeigte sich für die Intensivstation eine signifikante Häufung von Candidainfektionen bei geringerer Stationsauslastung und höherer Personalbesetzung, unabhängig von der Qualifikation des Personals. Auf der Nachsorgestation wurde eine vermehrte Zahl systemischer Infektionen bei höherem Anteil von Schwestern am Gesamtpersonal festgestellt. Beide Stationen waren gegenüber den Empfehlungen fast das ganze Jahr überbelegt und unterbesetzt.
Gründe für die gefundenen Abhängigkeiten wurden vermutet in Informationsverlust und Trittbrettfahrerproblemen in größeren Kollektiven und verstärkter minimal-handling-Pflege und verstärkter Hygiene-Compliance in Stresssituationen. Die geringe Inzidenz systemischer Infektionen spricht für eine sichere Pflege und ist demnach sehr positiv zu bewerten, trotzdem sollten die Hintergründe für das Auftreten der Lokalinfekte, auch wenn sie meist einen milden Verlauf zeigten, überprüft werden.
Eine Gesamtbeurteilung der Pflege ist anhand der gemachten Untersuchungen nicht möglich, da aufgrund der Retrospektive keinerlei Faktoren wie Belastungseinschätzung der Schwestern, Lerneinschätzung der Schüler oder Betreuungseinschätzung der Eltern einfließen konnten.
11
GAY, FREDERIQUE. "Caracteres epidemiologiques de 30 souches de staphylocoques coagulase negatifs responsables de septicemies en neonatologie." Lyon 1, 1993. http://www.theses.fr/1993LYO1M122.
Full text
12
RAVIER, CATHERINE. "Transfert en neonatologie des enfants nes a la maternite de bourg-en-bresse en 1991." Lyon 1, 1993. http://www.theses.fr/1993LYO1M082.
Full text
13
GROSJEAN, CHRISTINE. "Prevalence des infections nosocomiales en maternite : enquete realisee sur 5 jours." Nancy 1, 1993. http://www.theses.fr/1993NAN10205.
Full text
14
Trepy, Francis. "Contribution à l'étude des posologies en néonatalogie, utilisation d'un logiciel." Paris 5, 1994. http://www.theses.fr/1994PA05P152.
Full text
15
Lázňovský, Jakub. "Analýza dýchacích cest předčasně narozených dětí na základě MRI a CT dat." Master's thesis, Vysoké učení technické v Brně. Fakulta elektrotechniky a komunikačních technologií, 2020. http://www.nusl.cz/ntk/nusl-413140.
Full textAbstract:
Předkládaná Diplomová práce se zabývá analýzou a tvorbou modelů dýchacích cest předčasně narozených dětí. Nejprve je položen teoretický základ v oblasti vývoje dýchacího ústrojí a tvorby modelů dýchacích cest. Poté jsou představeny využité zobrazovací modality a popsány metody pro práci s obrazovými daty. Praktická část práce se zabývá vytvořením modelů dýchacích cest tří novorozenců. Všechny tyto modely jsou vytvořeny na základě klinických CT a MRI dat novorozenců narozených ve 30. týdnu gestačního věku. U těchto vytvořených modelů jsou dále analyzovány vybrané parametry související s anatomickou strukturou dýchacích cest. Na základě analýzy těchto parametrů byl následně navrhnut reprezentativní model, odpovídající dýchacím cestám novorozence daného gestačního věku.
16
Lenze, Miriam. "Anatomischer Korridor zur Anlage einer Thoraxdrainage in der Neonatologie : Topographie subkutaner Thoraxwandgefässe beim Früh- und Neugeborenen /." Köln, 2008. http://opac.nebis.ch/cgi-bin/showAbstract.pl?sys=000253630.
Full text
17
Haase, Berit Christin [Verfasser]. "Immunologische und klinische Einflussfaktoren von Infektionen mit koagulase-negativen Staphylokokken in der Neonatologie / Berit Christin Haase." Lübeck : Zentrale Hochschulbibliothek Lübeck, 2011. http://d-nb.info/1020114452/34.
Full text
18
Brisken, Kathrin [Verfasser]. "Topographische Anatomie der herznahen venösen Gefäße zur Anlage eines zentralen Venenkatheters in der Neonatologie / Kathrin Brisken." Köln : Deutsche Zentralbibliothek für Medizin, 2010. http://d-nb.info/1010831690/34.
Full text
19
Erdmann, Anna Lucia [Verfasser], Heiner [Gutachter] Fangerau, and Thomas [Gutachter] Höhn. "Therapiebegrenzung in der Neonatologie- Leitlinien oder individualisierte Entscheidungsfindung? / Anna Lucia Erdmann ; Gutachter: Heiner Fangerau, Thomas Höhn." Düsseldorf : Universitäts- und Landesbibliothek der Heinrich-Heine-Universität Düsseldorf, 2018. http://d-nb.info/1153347296/34.
Full text
20
FRANCINEAU, PHILIPPE. "Consequences cliniques et microbiologiques du changement d'un aminoside en premiere intention dans un service de neonatologie : surveillance epidemiologique comparative de deux cohortes." Clermont-Ferrand 1, 1992. http://www.theses.fr/1992CLF13814.
Full text
21
Le, Roux-Dowlatshahi Nadège. "Concept de protection des personnes en recherche biomedicale : application dans le cadre de l'evaluation ethique des pratiques de recherche." Paris 5, 2000. http://www.theses.fr/2000PA05N083.
Full text
22
Willhelm, Christiane [Verfasser], and Sascha [Akademischer Betreuer] Meyer. "Die Bedeutung der Cochrane Review Datenbank für die Neonatologie im 21. Jahrhundert / Christiane Willhelm. Betreuer: Sascha Meyer." Saarbrücken : Saarländische Universitäts- und Landesbibliothek, 2013. http://d-nb.info/1053032366/34.
Full text
23
DOUVIER, PIERRE-YVES. "Les nouveau-nes de la maternite claude bernard (oullins) transferes en service de neonatologie pendant l'annee 1985." Lyon 1, 1989. http://www.theses.fr/1989LYO1M433.
Full text
24
Machul, Dörthe. "Frühgeburt." Doctoral thesis, Humboldt-Universität zu Berlin, Philosophische Fakultät IV, 2009. http://dx.doi.org/10.18452/15966.
Full textAbstract:
Eltern zu früh geborener Kinder erhalten in neonatologischen Kliniken heute vielfältige Unterstüt-zungsangebote. Vertreter verschiedener Berufsgruppen informieren, beraten und begleiten die Eltern während des stationären Aufenthalts und zum Teil darüber hinaus. Elternorientierte Unterstützungskonzepte für einen Bedarf zu entwerfen, der theoretisch und empirisch begründet werden kann und sowohl interdisziplinär kommunizierbar ist als auch in Beziehung zu den von den Eltern selbst geäußerten Bedürfnissen steht, ist eine aktuelle Herausforderung. Studien zum elterlichen Bedarf beziehen sich bislang meist auf nur eine der relevanten Perspektiven und/oder nicht auf die hier fokussierte Untersuchungsgruppe, lassen jedoch eine Vielfalt möglicher Bedarfsarten erkennen. Der elterliche Unterstützungsbedarf bei Frühgeburt wurde daher im Rahmen eines explorativ und multiperspektivisch angelegten Forschungsprojekts mit dem Ziel einer fallübergreifenden Bedarfsanalyse untersucht. Bedarfsbezogene Selbst- und Fremdeinschätzungen während des Klinikaufenthalts der Kinder wurden innerhalb eines qualitativen Studiendesigns mittels leitfadengestützter Interviews erfasst. Datenerhebung und -auswertung fanden in mehreren, flexibel aufeinander bezogenen Phasen statt. Anhand der Gesprächsprotokolle erfolgte eine materialgestützte Kategorienbildung. Geeignete Auswertungskategorien wurden für eine nachfolgende qualitative Bedarfsbeschreibung unter Berücksichtigung unterschiedlicher Wahrnehmungsperspektiven herangezogen. Fallübergreifende Erkenntnisse zum Bedarf sind für die weitere Ausarbeitung professioneller "Elternbetreuungskonzepte" dringend erforderlich. Klar strukturierte und begründete Konzepte stecken den professionellen Handlungsrahmen ab, können Hinweise auf notwendige Kompetenzen des Klinikpersonals geben und sind ein wichtiger Beitrag zur Qualitätssicherung professioneller Routinehandlungen.Today parents of preterm infants receive various forms of support in neonatal (intensive) care units. Health care providers inform, advise and accompany parents while their infants are hospitalized and beyond. The development of parent centered support concepts which have a strong theoretical as well as an empirical foundation constitutes a challenge, since such concepts have to be communicated across disciplines and also meet the needs of parents. Research on parents’ needs has often focused on one perspective only and/or not on this specific sample group. Even so, a variety of needs types can be identified. In this study, an exploratory and multi-perspective investigation was designed and conducted to examine the support needs of parents of preterm infants as perceived by parents themselves and by professional health care providers. In order to investigate and identify parents'' support needs during their infants'' hospitalization time a qualitative approach was chosen (guided interviews). Data was collected and analyzed in repeated, flexible interrelated phases. The transcribed interviews were used to analyze inherent ideas and to generate codes. Proven categories of analysis were used for the qualitative description of parents'' needs while different perspectives were considered. Research findings about parental needs which can be generalized are increasingly necessary for future development of professional parent-support concepts. Highly structured und well-justified concepts may outline the scope of professional responsibility and competencies and thus contribute to high-quality professional health care in neonatology.
25
Vincent, Marie-Claire. "Depistage neonatal des hemoglobinopathies : apport de l'isoelectrofocalisation et l'hplc, application d'un protocole experimental dans une maternite pilote du bas-rhin." Strasbourg 1, 1995. http://www.theses.fr/1995STR15114.
Full text
26
Gibb, Nicole. "Inzidenz der Frühgeborenenretinopathie an der Klinik für Neonatologie der Universität Leipzig vor und nach Einführung eines neuen Sauerstofftherapiemanagements." Doctoral thesis, Universitätsbibliothek Leipzig, 2017. http://nbn-resolving.de/urn:nbn:de:bsz:15-qucosa-218155.
Full textAbstract:
Die Frühgeborenenretinopathie (Retinopathia praematurorum (RPM)) ist
eine Erkrankung der Netzhaut, die vor allem sehr unreife Frühgeborene
betrifft und in ihrem Endstadium zur Erblindung führen kann. Ein gesicherter Risikofaktor für die Entwicklung einer RPM ist die Gabe von hohen Konzentrationen an Sauerstoff nach der Geburt. Gegenstand dieser Arbeit war die Frage, ob nach der Einführung eines Sauerstoffprotokolls 2007 das Auftreten höherer Stadien der RPM reduziert werden konnte. Das Sauerstoffprotokoll hatte zum Ziel die Gabe von inspiratorischem Sauerstoff nach Möglichkeit zu senken und übermäßige Fluktuationen zu vermeiden. Hierfür wurden 268 Frühgeborene mit einem Gestationsalter < 32Wochen bei Geburt, welche in den Jahren von 2005 bis 2006 (pre-Gruppe) und 2008 bis 2009 (post-Gruppe) in der Universitätsklinik Leipzig geboren und einem RPM-Screening unterzogen wurden, verglichen. Es konnte gezeigt werden, dass die Inzidenz der RPM nach 2007 signifikant niedriger war. So erkrankten in der pre-Gruppe 12 von 102 Kinder an einer höhergradigen RPM (>Stadium 3), wohingegen diese Stadien in der post-Gruppe nicht mehr beobachtet wurden. Demzufolge reduzierte sich auch die Notwendigkeit einer Therapie von 7,4 % auf 0 % (jeweils p = 0.0005). In Hinblick auf die Kerndaten wie Gestationsalter, Geburtsgewicht, Körpergröße, sowie dem Auftreten schwerer Begleiterkrankungen wie u.a. der nekrotisierenden Enterokolitis oder der bronchopulmonalen Dysplasie fanden sich keine Unterschiede zwischen den Gruppen. Allerdings wies die post-Gruppe eine höheren Anteil an männlichen Frühgeborenen auf. Die Mortalität zeigte keine signifikante Veränderung nach der Intervention und lag bei 7.8 % in der pre- bzw. 6.6 % in der post-Gruppe (p = 0.81). Die Auswertung der pulsoximetrisch gemessenen Sauerstoffsättigung (SpO2) und der inspiratorischen Sauerstofffraktion (FiO2) zeigte, dass der SpO2 leicht und der FiO2 deutlich reduziert werden konnte. Ein signifikanter Unterschied ergab sich hier jedoch lediglich für den FiO2, insbesondere in den ersten 14 Lebenstagen. Die logistische Regressionsanalyse legt nahe, dass hohe SpO2- und FiO2-Werte sowie das Auftreten von intrakraniellen Blutungen mit schwerwiegenden ROP-Stadien korrelieren. Ein bedachter Umgang in der Sauerstofftherapie Frühgeborenen könnte in der Lage sein das Auftreten der Frühgeborenenretinopathie zu reduzieren ohne eine Erhöhung der Mortalitätsrate zu riskieren.
27
Grassin, Marc. "Les arrets de reanimation et les arrets de vie en neonatologie : responsabilite et transgression ; l'ethique clinique en question." Paris 5, 1999. http://www.theses.fr/1999PA05N128.
Full text
28
Rodríguez, Fanjul Javier. "Neuroprotección mediante terapia combinada (Hipotermia+Alopurinol) en un modelo animal de daño cerebral hipóxico-isquémico." Doctoral thesis, Universitat de Barcelona, 2018. http://hdl.handle.net/10803/664192.
Full textAbstract:
INTRODUCCIÓN: La encefalopatía hipóxico-isquémica (EHI) es una de les causas más importantes de daño cerebral neonatal. La hipotermia terapéutica (HT) es el tratamiento establecido en la actualidad para los neonatos a término, afectos de una EHI. A pesar de ello, la HT no consigue una tratamiento neuroprotector completo. El alopurinol ha demostrado ser en diversos estudios animales un buen fármaco neuroprotector, pero nunca ha sido evaluado conjuntamente con la HT. En los últimos años los hallazgos clínicos han demostrado que los niños de sexo masculino afectos de EHI presentan peores resultados cuando se comparan con las de sexo femenino en resultados cognitivos. A pesar de ello, hay poco estudios que hayan evaluado el efecto de las terapias neuroprotectoras teniendo en cuenta el género en los resultados. El objetivo del presente estudio es evaluar el efecto aditivo potencial neuroprotector del alopurinol cuando se administra conjuntamente con la HT en un modelo roedor de EHI moderada. Las diferencias neuroprotectoras respecto el género fueron también evaluadas.
MÉTODOS:
Crías de rata de sexo masculine y sexo femenino de 10 días de vida (P10) fueron sometidas a un evento HI (modelo Rice-Vannucci) y randomizadas en cinco grupos: intervención shame (control), no tratamiento (HI), hipotermia (HIH), alopurinol (HIA) y tratamiento dual (hipotermia y alopurinol) (HIHA). Para evaluar la eficacia neuroprotectora, 24 horas después del evento HI los niveles de caspasa3 fueron medidos. El área dañada del hipocampo y del cerebro fue medida a las 72 horas del evento HI. El test geotaxis negativo fue realizado para evaluar los reflejos precoces motores. El aprendizaje de memoria temporo-espacial fue medido a través del Laberinto Acuático de Morris (LAM) a los 25 días de vida.
RESULTADOS:
El área cerebral dañada y el volumen preservado del hipocampo fue diferente entre los grupos ( p=0.001). La lesión de mayor tamaño fue observada en el grupo HI, seguido por el HIA. No se objetivaron diferencias entre grupo control, HIH y HIHA. Cuando el proceso de aprendizaje fue analizado, no se objetivaron diferencias. Las hembras del grupo HIA presentaron resultados similares a los del grupo HIH y HIHA. Al analizar los resultados de la caspasa3 se objetivó incrementada en ambos grupos HI y HIA. A pesar de ello, los niveles de caspasa3 en hembras sólo se encontraba elevada en el grupo HI. Todos los animales tratados presentaron una mejoría en los test funcionales tanto en los resultados a corto (test geotaxis negativo) como a largo plazo (LAM). A pesar de ellos, las hembras tratadas presentaron mejores resultados. En los resultados a corto plazo no se objetivaron diferencias de sexo.
CONCLUSIONES:
Nuestros resultados sugieren que la terapia dual confieren a una gran neuroprotección después de un evento HI. Hubo mejorías a nivel functional, histológico y molecular en todos los grupos tratados. Estas diferencias fueron más importantes en las hembras que en los machos. No se objetivaron diferencias estadísticamente significativas entre los grupos HIH y HIHA, ambos presentaron una gran mejoría. Nuestros resultados confirman la idea de diferentes mecanismos y vías de muerte celular, dependiendo del sexo.BACKGROUND: Hypoxic-ischemic encephalopathy (HIE) is one of the most important causes of neonatal brain injury. Therapeutic hypothermia (TH) is the standard treatment for term newborns after perinatal hypoxic ischemic injury (HI). Despite this, TH does not provide complete neuroprotection. Allopurinol seems to be a good neuroprotector in several animal studies, but it has never been tested in combination with hypothermia. Clinical findings show that male infants with (HI) fare more poorly than matched females in cognitive outcomes. However, there are few studies about neuroprotection taking gender into account in the results. The aim of the present study was to evaluate the potential additive neuroprotective effect of allopurinol when administrated in association with TH in a rodent model of moderate HI. Gender differences in neuroprotection were also evaluated. METHODS: P10 male and female rat pups were subjected to HI (Vannucci model) and randomized into five groups: sham intervention (Control), no treatment (HI), hypothermia (HIH), allopurinol (HIA), and dual therapy (hypothermia and allopurinol) (HIHA). To evaluate a treatment's neuroprotective efficiency, 24 hours after the HI event caspase3 activation was measured. Damaged area and hippocampal volume were also measured 72 hours after the HI event. Negative geotaxis test was performed to evaluate early neurobehavioral reflexes. Learning and spatial memory were assessed via Morris Water Maze (MWM) test at 25 days of life. RESULTS: Damaged area and hippocampal volume were different among treatment groups (p = 0.001). The largest tissue lesion was observed in the HI group, followed by HIA. There were no differences between control, HIH, and HIHA. When learning process was analyzed, no differences were found. Females from the HIA group had similar results to the HIH and HIHA groups. Cleaved caspase 3 expression was increased in both HI and HIA. Despite this, in females cleaved caspase-3 was only differently increased in the HI group. All treated animals present an improvement in short-term (Negative geotaxis) and long-term (WMT) functional tests. Despite this, treated females present better long-term outcome. In short-term outcome no sex differences were observed. CONCLUSIONS: Our results suggest that dual therapy confers great neuroprotection after an HI event. There were functional, histological, and molecular improvements in all treated groups. These differences were more important in females than in males. No statistically significant differences were found between HIHA and HIH; both of them present a great improvement. Our results support the idea of different regulation mechanisms and pathways of cell death, depending on gender
29
Obrecht, Denise [Verfasser], and Dominique [Akademischer Betreuer] Singer. "Elektrische Kardiometrie als noninvasives HZV-Monitoringverfahren in der Neonatologie und pädiatrischen Intensivmedizin : ein Methodenvergleich / Denise Obrecht. Betreuer: Dominique Singer." Hamburg : Staats- und Universitätsbibliothek Hamburg, 2015. http://d-nb.info/1080721096/34.
Full text
30
Obrecht, Denise Verfasser], and Dominique [Akademischer Betreuer] [Singer. "Elektrische Kardiometrie als noninvasives HZV-Monitoringverfahren in der Neonatologie und pädiatrischen Intensivmedizin : ein Methodenvergleich / Denise Obrecht. Betreuer: Dominique Singer." Hamburg : Staats- und Universitätsbibliothek Hamburg, 2015. http://nbn-resolving.de/urn:nbn:de:gbv:18-76443.
Full text
31
Gollwitzer, Hans. "Eine resorbierbare Poly-D,L-Laktid-Beschichtung zur Ausrüstung medizinischer Implantate mit antithrombogenen Oberflächen in der Neonatologie und antiinfektiven Oberflächen in der Orthopädie /." [S.l.] : [s.n.], 2002. http://deposit.ddb.de/cgi-bin/dokserv?idn=964811146.
Full text
32
Lechner, Monika [Verfasser], and Ernst Rainer [Akademischer Betreuer] Weissenbacher. "Infektiologische Ursachen und Folgen von Frühgeburt : Auswertung von Daten aus der Neonatologie des Klinikums Großhadern und literarisches Kompendium / Monika Lechner. Betreuer: Ernst Rainer Weissenbacher." München : Universitätsbibliothek der Ludwig-Maximilians-Universität, 2013. http://d-nb.info/1045561320/34.
Full text
33
Heyne, Tim [Verfasser], and Bettina [Akademischer Betreuer] Bohnhorst. "Einfluss von Känguru-Pflege auf kardiorespiratorische Parameter bei Frühgeborenen / Tim Oliver Heyne. Bettina Bohnhorst. Abteilung für Pädiatrische Pneumologie und Neonatologie der Medizinischen Hochschule Hannover." Hannover : Bibliothek der Medizinischen Hochschule Hannover, 2010. http://d-nb.info/1000380769/34.
Full text
34
Vivan, Maria Carolina Ribeiro [UNESP]. "Correlação dos níveis de lactato sanguíneo com o estado neurológico e cardiorrespiratório de filhotes de cães nascidos de parto normal ou cesariana sob anestesia geral inalatória." Universidade Estadual Paulista (UNESP), 2010. http://hdl.handle.net/11449/92186.
Full textAbstract:
Made available in DSpace on 2014-06-11T19:25:37Z (GMT). No. of bitstreams: 0
Previous issue date: 2010-09-28Bitstream added on 2014-06-13T19:32:59Z : No. of bitstreams: 1
vivan_mcr_me_araca.pdf: 2758803 bytes, checksum: a64192b41cf9bd2f30e7b776b50e6f69 (MD5)Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)
Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)
A avaliação da perfusão tecidual com macroparâmetros não permite a detecção precoce de alteração na microvasculatura. A anestesia da gestante requer avaliação da perfusão e a eficácia do lactato na identificação de complicações em crianças após o parto já foi descrita. O presente estudo objetivou validar o lactato sanguíneo e correlacioná-lo a métodos, na avaliação de neonatos de parto normal ou cesariana eletiva sob anestesia geral inalatória. Foram utilizadas oito cadelas para realização de parto normal ou cesariana eletiva, com o protocolo composto de morfina, propofol e sevofluorano. Foram avaliados 24 neonatos de parto normal (GN) e 30 de cesariana (GC), com exames de sangue umbilical no nascimento para dosagem de lactato, hemogasometria, hematócrito, glicose e eletrólitos. No nascimento e aos 10 minutos de vida foram realizadas avaliações Apgar e neurológica. O lactato foi avaliado aos 10 minutos, 4 e 30 dias de vida. Os filhotes apresentaram acidose respiratória, acidemia e hipoxemia ao nascimento, mais elevada no GC. Os animais do GC apresentaram notas de Apgar e resposta neurológica menores ao nascimento, com melhora aos 10 minutos. O lactato sanguíneo foi maior nos animais do GN no nascimento, e foi maior nos animais que morreram. A correlação entre o lactato e as variáveis ocorreu em GN. O lactato sanguíneo associado aos demais parâmetros foi útil na avaliação dos neonatos do GN, porém nos animais do GC não houve correlação com a condição clínica dos animais no momento do nascimento. O procedimento anestésico influencia nos valores de lactato, e a determinação do melhor intervalo para sua avaliação nesses pacientes é necessária.
The assessment of tissue perfusion using macro parameters does not allow early detection of changes in the microvasculature. Anesthesia for pregnant patient requires evaluation of perfusion, and the lactate effectiveness in identifying complications in children after birth has been described. This study aimed to validate the blood lactate and its correlation with other methods, in the evaluation of neonates born from vaginal delivery or elective cesarean section under inhalator anesthesia. Eight dogs were used to perform normal delivery or cesarean section, with the protocol consisting of morphine, propofol and sevoflurane. At birth were evaluated 24 neonates born from vaginal delivery (NG) and 30 born from cesarean section (CG) using umbilical blood to test lactate, blood gas, hematocrit, glucose and electrolytes. Apgar score and neurologic tests were performed at birth and at 10 minutes of life. Lactate levels were evaluated at 10 minutes, 4 and 30 days of life. The puppies showed respiratory acidosis, hypoxemia and acidemia at birth, higher in the CG. The animals of CG presented lower Apgar scores and neurological response at birth, which improved in 10 minutes. Blood lactate was higher in NG animals at birth, and was higher in those who died. The correlation between lactate and the variables occurred on NG. Association of blood lactate with other parameters was useful in the evaluation of neonates on NG, but in the animals of CG there was no correlation with the clinical condition of animals at birth. Anesthesia influences the lactate values, and it is necessary to determine the best interval for evaluation in these patients.
35
Vivot, Laurence. "Stabilité galénique de mélanges ternaires destinés à la nutrition parentérale en néonatologie." Paris 5, 1998. http://www.theses.fr/1998PA05P110.
Full text
36
Baudet, Géraldine. "Détermination des sérotypes et des profils estérasiques de souches de streptocoques du groupe B isolées chez le nouveau-né et relation avec la virulence." Paris 5, 1995. http://www.theses.fr/1995PA05P193.
Full text
37
Airiau, Caroline. "Mai͏̈trise des apports nutritionnels en néonatalogie : développement d'un logiciel de prescription et de formulation de la nutrition parentérale et entérale mixte." Paris 5, 1997. http://www.theses.fr/1997PA05P179.
Full text
38
Gibb, Nicole [Verfasser], Jens [Gutachter] Dawczynski, and Hans [Gutachter] Proquitté. "Inzidenz der Frühgeborenenretinopathie an der Klinik für Neonatologie der Universität Leipzig vor und nach Einführung eines neuen Sauerstofftherapiemanagements / Nicole Gibb ; Gutachter: Jens Dawczynski, Hans Proquitté." Leipzig : Universitätsbibliothek Leipzig, 2017. http://d-nb.info/1240696981/34.
Full text
39
Lißner, Mareike [Verfasser], Eva [Akademischer Betreuer] Robel-Tillig, Volker [Gutachter] Schuster, and Thorsten [Gutachter] Orlikowsky. "Epidemiologie nosokomialer Infektionen und die Abhängigkeit krankenhausassoziierter Komplikationen von der Personalbesetzung in der Neonatologie / Mareike Lißner ; Gutachter: Volker Schuster, Thorsten Orlikowsky ; Betreuer: Eva Robel-Tillig." Leipzig : Universitätsbibliothek Leipzig, 2011. http://d-nb.info/123781829X/34.
Full text
40
Esteve-Solé, Ana. "Primary and secondary immunodeficiencies of the IL-12/IFN-γ axis." Doctoral thesis, Universitat de Barcelona, 2018. http://hdl.handle.net/10803/663924.
Full textAbstract:
IL-12/IFN-γ axis is a principal pathway for intramacrophagic pathogens immunity such as leishmania or mycobacteria. Alterations in this axis, being both congenic (causing the primary immunodeficiency Mendelian Susceptibility to Mycobacterial Disease, MSMD) or acquired (treatment with anti-TNF-α drugs) cause susceptibility to this type of microbes. MSMD causes susceptibility mainly to non-pathogenic mycobacteria, salmonella and candida; besides, MSMD- causing mutations have been detected in Mycobacterium tuberculosis and Leishmania patients. On the other hand, the death of an anti-TNF-α in-utero exposed infant after BCG vaccination together with the effect of anti-TNF-α drugs in tuberculosis reactivation in adults and the known tole of TNF-α in B cell maturation reveal the need for an in-depth study of in-utero exposition to anti-TNF-α drugs. With that our hypothesis is that patients with extrapulmonary Mycobacterium tuberculosis infection or visceral leishmaniasis have a primary dysfunction of the IL-12/IFN-γ axis and that exposure to anti-TNF-α antibodies during whole pregnancy in children born to mothers with inflammatory bowel disease affects the normal development of the neonatal immune system, conferring a secondary immunodeficiency, which includes a dysfunction of the IL- 12/IFN-γ axis.
Both extrapulmonary tuberculosis (n=23) and visceral leishmaniasis (n=24) patients presented alterations in the IL-12/IFN-γ pathway; however, we did not detect any complete defect. Concretely, the patients with extrapulmonary tuberculosis had a diminished response to IFN-γ while visceral leishmaniasis patients had a diminished production of IFN-g. Genetic study of these patients to unravel mutations causing partial forms of susceptibility to intramacrophagic infections is then needed. Besides, we detected an IL-12Rβ1 defect in a Peruvian patient that was misdiagnosed as multi-resistant tuberculosis, being a disseminated infection by the vaccine strain BCG. After the detection of the genetic defect, the patient was transferred to the National Institute of Health in the USA, where she received the appropriate treatment and the microbiological diagnosis was corrected resulting in the resolution of the infection. This case remarks the fact that suspicion of this forms of immune deficiency and their detection changes the prognostics and outcome of the patient.
The study of the effect of anti-TNF-α on the exposed infant immune system (n=7) revealed a T and B cell maturation defect that was corrected at 12 months, normal cell proliferation after mitogen stimulation and normal immunoglobulin production and vaccine response without an increase of severe infections. On the other hand, Treg cell frequency was low in exposed infants, without reaching normalization at 12 months of age. Treg cell frequency in neonates inversely correlated with anti-TNF-α through level in the mother during third trimester of pregnancy and with T cell proliferation after a mild mitogen stimulation. These data with the increased atopia/allergy in the studied infants suggest the need of a long-term follow-up for Treg cells and the advent of immune dysregulation events. Antimycobacterial response was diminished in exposed infants and not totally recovered after washing the drug from the blood in the culture. On the other hand, coinciding with the decrease of the drug levels in blood, the production of IL-12, IFN-γ and TNF-α increased. We conclude that the effects of anti-TNF-α exposure during pregnancy are not permanent and that BCG vaccination in these population should be avoided until, at least, 12 months of age.
By last, the transition between the intra- and extra-uterine world is a special life-situation where the immune system plays a major role. We studied it in healthy cord blood donors, with special
attention to the IL-12/IFN-γ pathway and B cell compartment, including regulatory B cells (Breg). Breg cells, defined as CD24hiCD38hi B cells, were expanded in cord blood, with capacity to produce IL-10 and to inhibit IL-4 and IFN-γ production by T cells with a similar phenotype when compared with adult Bregs. Besides, response to mycobacterial challenge was diminished. Interestingly, the diminished production of IFN-γ was associated with Breg cell frequency, opening the door to new research studying the role of these cells in different neonatal conditions as well as in cord blood derived stem cell transplantation.Esta tesis explora la vía de IL-12/IFN-g, central en la inmunidad a gérmenes intramacrofágicos, en el contexto de defectos primarios y secundarios. Los defectos primarios en esta vía causan susceptibilidad mendeliana a las micobacterias (MSMD), una inmunodeficiencia primaria que cursa con susceptibilidad a micobacterias no patogénicas principalmente, pero en la que se han descrito pacientes con infecciones por Mycobacterium tuberculosis y con leishmaniasis. En este escenario, la hemos estudiado en pacientes pediátricos con tuberculosis extrapulmonar y leishmaniasis visceral, revelando que no existían defectos completos de la vía, pero sí una alteración funcional en ésta en los dos grupos de pacientes estudiados. Esto reveló la necesidad de un estudio genético exhaustivo para revelar defectos parciales causantes de esta susceptibilidad. El diagnóstico la deficiencia de IL-12Rβ1 en una niña con infección diseminada por BCG, inicialmente diagnosticada como tuberculosis multirresistente, permitió el tratamiento adecuado que llevó a su curación, mostrando la relevancia del diagnóstico temprano del MSMD. Por otro lado, el hecho que se describiera un caso de muerte tras la vacunación con BCG de un neonato expuesto a fármacos anti-TNF-α durante el embarazo hizo pensar que la exposición a estos fármacos durante el embarazo pudiera llevar a defectos en el sistema inmunitario del neonato. Tras su estudio, observamos una inmadurez transitoria del compartimiento B y T; por otro lado, la disminución de la frecuencia de células T reguladoras que no normalizó con la edad juntamente con un aumento de la presencia de atopia o alergia en este grupo. Además, observamos una disminución de la respuesta a micobacterias en los niños expuestos, que mejoró con la edad. Concluimos que los efectos de los niños expuestos a anti-TNF-α durante el embarazo no parecen ser permanentes y que la vacunación con BCG de esta población debe ser evitada hasta los 12 meses de edad. El estudio de sangre de cordón de neonato sano reveló un aumento de la población de células B reguladoras. Además, la frecuencia de estas células se asoció inversamente con la producción de IFN-γ tras el estímulo con micobacterias, que se encontró disminuido en el neonato. Abriendo la puerta a nuevas investigaciones para estudiar su papel en diferentes condiciones del neonato, así como en el trasplante de progenitores hematopoyéticos.
41
Alsina, Casanova Miguel M. "Disfunción multiorgánica en el recién nacido con Encefalopatía hipóxico-isquémica en la era de la Hipotermia terapéutica." Doctoral thesis, Universitat de Barcelona, 2018. http://hdl.handle.net/10803/664113.
Full textAbstract:
La aproximación al paciente asfíctico desde el punto de vista neurológico es fundamental por las implicaciones a corto y largo plazo, sin embargo el insulto hipóxico-isquémico altera la homeostasis global del recién nacido afectando a los diferentes órganos y sistemas. La evidencia científica acerca del daño extraneural en el recién nacido asfíctico hasta el momento actual es escasa y los estudios pertenecen a la era previa a la implantación de la hipotermia terapéutica que ha supuesto un cambio de paradigma clínico en este tipo de pacientes. Por otra parte, dado que la mayor parte de recién nacidos con encefalopatía hipóxico-isquémica nacen en centros que no disponen de hipotermia terapéutica, estos pacientes necesitarán ser trasladados en hipotermia pasiva a centros de referencia. El transporte de estos pacientes supone un reto, principalmente por la necesidad de mantener la temperatura en el rango de seguridad.
Esta tesis, en base al estudio de una serie amplia de pacientes con el espectro completo de encefalopatía hipóxico-isquémica, ha abordado aspectos determinantes y hasta el momento desconocidos en el manejo del recién nacido asfíctico como son, en primer lugar, la correlación del daño multiorgánico y la encefalopatía hipóxico-isquémica en la era de la hipotermia terapéutica, aportando datos de gran utilidad clínica. Podemos concluir que la disfunción de otros órganos es prácticamente universal en el paciente con cualquier grado de encefalopatía hipóxico-isquémica en la era de la hipotermia terapéutica. El daño extraneural se correlaciona con la gravedad de la encefalopatía hipóxico-isquémica, sin embargo esta correlación se funda básicamente en la diferencia en el grado de afectación multiorgánica entre los pacientes con encefalopatía grave y los pacientes con encefalopatía moderada y leve. De esta manera, podemos establecer los siguientes patrones de afectación sistémica según el grado de EHI: 1) En el paciente con encefalopatía grave se debe anticipar una disfunción moderada o grave de otros órganos desde las primeras 24 horas de vida. En caso de no producirse, es preciso descartar exhaustivamente otras causas de encefalopatía neonatal. 2) Los pacientes con encefalopatía moderada con frecuencia presentan afectación orgánica de escasa relevancia clínica, pero una minoría de casos puede presentar
afectación sistémica moderada o grave. 3) Los pacientes con encefalopatía leve presentan habitualmente afectación sistémica leve y resuelven con rapidez las alteraciones en la homeostasis. Respecto al perfil de afectación orgánica, el hígado y el medio interno son los órganos o sistemas que se afectan con mayor frecuencia en el recién nacido con encefalopatía hipóxico-isquémica, sin embargo los órganos afectados con mayor gravedad son el sistema respiratorio y cardiovascular. La disfunción renal y hematológica se producen con menor frecuencia que el resto de órganos o sistemas, sin embargo en el caso del daño renal, su afectación es con frecuencia clínicamente relevante. Así mismo, el daño extraneural en el paciente con encefalopatía hipóxico-isquémica es más intenso en las primeras 24 horas de vida. Los pacientes que sobreviven presentan una tendencia a mejorar a lo largo de las primeras 72 horas de vida.
En segundo lugar, el estudio del curso del transporte del recién nacido con encefalopatía hipóxico isquémica nos ha permitido dilucidar como la gravedad de la encefalopatía hipóxico-isquémica se correlaciona inversamente con la temperatura durante el transporte en hipotermia pasiva. Los pacientes con encefalopatía grave presentan un mayor riesgo de sobreenfriamiento durante el transporte en hipotermia pasiva. Por otra parte, los eventos adversos más frecuentemente descritos durante el transporte interhospitalario en hipotermia pasiva son el deterioro cardiovascular, la presencia de hipoglucemia y sangrado endotraqueal, estos podrían disminuir con una mejor estabilización previa al transporte y con un mejor control de la temperatura.Perinatal asphyxia is a major cause of multiorgan dysfunction in the newborn. Only scarce data about the correlation of extracerebral damage and the severity of hypoxic-ischemic encephalopathy are available. This information might help to anticipate the evolution of multiorgan dysfunction according to the severity of hypoxic-ischemic encephalopathy and vice versa. On the other hand, hypoxic-ischemic encephalopathy has become a time- dependent emergency after clinical trials demonstrated the efficacy of cooling started within 6 hours of birth in reducing the risk of death or disability. Most asphyxiated infants are born in non-tertiary neonatal units and they must be transferred urgently to a center equipped with a hypothermia program. To start hypothermia as soon as possible, transferred infants are passively cooled. Nevertheless, studies do not outline medical complications during transport nor indicate whether the efficacy in maintaining target temperatures and complications are related to the severity of the hypoxic-ischemic encephalopathy in the first 6 h of life. This is the first study to evaluate the correlation of multiple organ dysfunction with the severity of hypoxic-ischemic encephalopathy. In the hypothermia era, multiple organ damage continues to be almost universal in newborns with hypoxic-ischemic encephalopathy. There is a high correlation between the severity of hypoxic-ischemic encephalopathy and multiple organ injury during the first 3 days of life. Therefore, a high index of suspicion of relevant multiorgan dysfunction is required in infants admitted with a diagnosis of severe hypoxic-ischemic encephalopathy. Patients with moderate hypoxic-ischemic encephalopathy present wide variability in the severity of multiorgan dysfunction. Finally, in the absence of multiorgan dysfunction a perinatal hypoxic-ischemic origin of acute severe neonatal encephalopathy should be carefully reconsidered. Secondly, this study shows that the risk of overcooling during transport is greater in newborns with severe hypoxic- ischemic encephalopathy and those with more severe acidosis at birth. The most common adverse events during transport are related to physiological deterioration and bleeding from the endotracheal tube. This observation provides useful information to identify those asphyxiated infants who require closer clinical surveillance during transport.
42
Brandão, Maria Angela Bellomo 1967. "Pesquisa da frequencia do citomegalovirus na colestase neonatal intra-hepatica, por meio dos seguintes metodos : sorologia, reação em cadeia de polimerase, imunohistoquimica e histologia." [s.n.], 2006. http://repositorio.unicamp.br/jspui/handle/REPOSIP/309395.
Full textAbstract:
Orientadores: Gabriel Hessel, Sandra Cecilia Botelho CostaTese (doutorado) - Universidade Estadual de Campinas, Faculdade de Ciencias Medicas
Made available in DSpace on 2018-08-07T22:25:30Z (GMT). No. of bitstreams: 1 Brandao_MariaAngelaBellomo_D.pdf: 1559118 bytes, checksum: 46a37bd9b6548c781556e1780d459ae7 (MD5) Previous issue date: 2006
Resumo: A colestase neonatal pode ser a manifestação inicial de um grupo muito heterogêneo de doenças. O citomegalovírus (CMV) está entre as possíveis etiologias e os critérios para o diagnóstico não estão ainda definidos. A freqüência do CMV como causa de colestase intra-hepática (CIH) varia em função do método utilizado para o diagnóstico. O objetivo do presente estudo foi estabelecer a freqüência do CMV na colestase neonatal intra-hepática por meio dos seguintes métodos: sorologia para CMV (IgM-ELISA), N-PCR e imunohistoquímica no fragmento da biópsia hepática parafinada, e indicadores de histologia (célula de inclusão citomegálica e microabscesso) e verificar a concordância entre os métodos diagnósticos citados. Participaram do estudo 101 pacientes com o diagnóstico de CIH e que realizaram biópsia hepática . A idade dos pacientes na 1ª consulta variou de 13 dias a 7 meses, com mediana de 1 mês e 21 dias. Para determinar a freqüência da infecção por citomegalovírus foram calculados os valores de sensibilidade, especificidade, valor preditivo positivo, valor preditivo negativo e acurácia, considerando o método de N-PCR como referência. Para verificar a concordância entre os métodos, foi calculado o coeficiente kappa. A freqüência de positividade para o CMV por meio da sorologia foi de 8% (5/62), por PCR foi também de 8% (6/77), por imunohistoquímica foi de 2% (1/44). Pela avaliação histológica, nenhum em 84 pacientes apresentava células de inclusão citomegálica e 17/84 (20%) apresentavam microabscesso. A sensibilidade da sorologia em relação à N-PCR foi nula, a especificidade de 88,89%, o valor preditivo positivo nulo, o valor preditivo negativo de 90,91% e a acurácia foi de 81,63. Na pesquisa de microabscessos a sensibilidade foi de 50% em relação à N-PCR, a especificidade de 77,05%, o valor preditivo positivo de 17,65%, o valor preditivo negativo de 94% e a acurácia de 74,63%. Não houve concordância para a pesquisa de CMV entre os métodos de sorologia (ELISA-IgM) e N-PCR e fraca concordância entre os demais métodos isolados ou agrupados. Conclusões: 1. A freqüência de positividade para o citomegalovírus variou de 2% a 20% dependendo do método diagnóstico empregado, 2. Não houve concordância entre os métodos, 3. Não foram encontradas células de inclusão citomegálica e a imunohistoquímica foi positiva em apenas 1/44 casos, 4. A sorologia (ELISA-IgM) e a presença de microabscessos não foram sensíveis em relação à N-PCR para a determinação do diagnóstico de CMV na CIH, mas foram úteis, quando negativos, para predizer resultado negativo da N-PCR. Palavras chaves: lactente, hepatite
Abstract: A heterogeneous group of diseases may present initially as neonatal cholestasis, a syndrome made up of jaundice, coluria and fecal hypo or acolia. Cytomegalovirus (CMV) is one of the most common causes of neonatal intrahepatic cholestasis (IHC), but the CMV best diagnostic criteria is not yet established since the positivity of different diagnostic tests varies considerably. The aim of this study was to determine the CMV frequency in neonatal intrahepatic cholestasis and to compare results of different diagnostic tests: IgM by ELISA test, IHQ and PCR in paraffin-embedded hepatic biopsy sample and a review of liver histological features (liver microabscess and cytomegalic inclusion cells). The study has included 101 patients neonatal IHC patients who had been submitted to a liver biopsy during investigation. Median age at the first medical visit was 1 month and 21 days (13 days to 7 months). Sensibility, specificity, negative predictive value, positive predictive value and accuracy were calculated of each test in relation to N-PCR. To analyze concordance among laboratorial methods Kappa (?) coefficient was calculated. Frequency of CMV positive tests: CMV ELISA - IgM was positive in 5/62 (8%), N-PCR in 6/77 (8%), and IHQ in 1/44 (2%). Liver histological features showed 0/84 cytomegalic inclusion cells and 17/84 (20%) liver microabscess. Sensibility of serology was null, specificity was 88,98%, negative predictive value was 90,91%, positive predictive value was null, and accuracy was 81,63%. Sensibility of searching for microabscess was 50%, specificity was 77,05%, negative predictive value was 17,65%, positive predictive value was null94%, and accuracy was 74,63%.There was no concordance between ELISA-IgM and N-PCR (Value of ? =-0, 1) and weak concordance between other methods when considered as a group or individually. Conclusions: 1. Frequency of CMV varied of 2% to 20%, according the diagnostic test. 2. There was no concordance among tests. 3. Searching for inclusion cells was null and IHQ was 2%( 1/44). 4. ELISA-IgM and microabscess sensitivity were poor in relation to N-PCR, but if these methods are negative, probably N-PCR will be negative too. Key words: hepatitis, infant
Doutorado
Pediatria
Doutor em Saude da Criança e do Adolescente
43
Araujo, Acacira Oliveira Bezerra de. "Uso de concentrado de hemacias em neonatologia : o panorama brasileiro." [s.n.], 2007. http://repositorio.unicamp.br/jspui/handle/REPOSIP/310655.
Full textAbstract:
Orientador: Marcelo Addas de Carvalho, Abimael Aranha Neto.Dissertação (mestrado) - Universidade Estadual de Campinas, Faculdade de Ciencias Medicas
Made available in DSpace on 2018-08-10T05:18:05Z (GMT). No. of bitstreams: 1 Araujo_AcaciraOliveiraBezerrade_M.pdf: 782094 bytes, checksum: 803757c0eadf299c0497a605f75a5973 (MD5) Previous issue date: 2007
Resumo: A transfusão de concentrado de hemácias (CH) é parte freqüente do arsenal terapêutico de suporte avançado nas unidades de terapia intensiva neonatal (UTINeo); o número de transfusões utilizadas depende de fatores como idade gestacional e peso ao nascer, porém observam-se grandes variações quando comparadas crianças em mesmas condições clínicas em diferentes centros, pois não existem indicações claramente estabelecidas para transfusão neonatal baseada em estudos controlados. Assim, o objetivo do presente trabalho foi comparar e descrever a prática transfusional de CH: suas indicações, repercussões e técnicas hemoterápicas utilizadas; avaliando a presença e a adequação a protocolos, por meio de estudo científico, descritivo, observacional, direto, extensivo; através de análise qualitativa e quantitativa de respostas a questionários em 42 serviços de UTINeo do Brasil. Deste modo, sugerindo um protocolo mais uniforme para a utilização de concentrado de hemácias em neonatologia no Brasil. Das 42 unidades hospitalares pesquisadas, 20 são hospitais universitários, onde 17 ligados a instituições de ensino público e 03 instituições de ensino particular. Quanto ao tipo de atendimento, 26 unidades pertencem à rede do SUS, 09 têm atendimento particular ou ligado a convênios ou planos de saúde e 07 atendimento misto (público e privado). Representando 04 regiões do país: 11 no Nordeste, 21 no Sudeste, 03 no Centro-oeste e 07 no Sul do Brasil; abrangendo 670 leitos de UTI neonatal e 450 leitos de unidades intermediárias; captadas através do CNES - Cadastro Nacional de Estabelecimentos de Saúde. Os dados obtidos foram submetidos à análise estatística resultando nas freqüências absolutas simples e acumuladas assim como as freqüências relativas de cada questão trabalhada dos questionários aplicados. Não encontramos diferenças significativas no tocante à utilização, preparo e indicações quando analisamos serviços particulares e ligados a instituições de ensino, porém nos serviços públicos não ligados a universidades ou faculdades, sobretudo nas regiões Norte e Nordeste e nas instituições geograficamente distantes das capitais, há dificuldades de acesso às informações hospitalares, de implementação e uso de tecnologias específicas. Na maioria dos serviços há falta de interação entre os serviços de hemoterapia e as UTINeo; dificultando discussão envolvendo os profissionais que prestam assistência direta. Há elevado número de serviços que consideram parâmetros clínicos associados ao nível de hemoglobina (Hb) e outros que associam dados clínicos e laboratoriais associados ao hematócrito (Ht) como base para indicação de uso de CH. Concluindo, a decisão de transfundir um paciente deve ser sempre do médico assistente levando em consideração parâmetros técnicos, médicos, éticos e legais alicerçados na utilização de protocolos com indicações transfusionais mais legítimas adaptadas aos recursos de cada instituição, porém protegendo os pacientes do risco de transfusões inadequadas
Abstract: The transfusion of Red Blood Cells (RBC) is often one of the therapeutical tools in advanced support in newborn intensive care units (NICU); the number of transfusions required depends on factors such as pregnancy duration and weight at birth. However, great variations are observed when comparing children in similar clinical conditions in different centers, as there are no controlled studies with established indications for newborn transfusion. Thus, the goal of the present study is to compare and describe the use of RBC transfusion through the qualitative and quantitative analysis of questionnaires in 42 services of NICUs in Brazil, focusing on its indications, repercussions and techniques; evaluating the presence and the adequacy of the protocols established from a scientific, descriptive, observational and longitudinal study. From this analysis, a more uniform protocol for the transfusion of RBC in Brazilian newborns is suggested. From the 42 hospital units studied, 20 are university hospitals, of which 17 are public institutions and 03 are private institutions. With respect to the service type, 26 units belong to SUS, 09 have private or insurance service and 07 work with both services (public and private). Furthermore, the institutions represent 4 regions of the country: 11 in the Northeast, 21 in the Southeast, 03 in Center-west and 07 in the South of Brazil; representing 670 NICU beds and 450 intermediate unit beds. The data collected was submitted to statistical analysis calculating the absolute and cumulative frequencies as well as the relative frequencies of each question of the applied questionnaires. No significant differences with respect to the use, preparation and indications were found when we analyzed private and educational institutions. However, the North and Northeast regions and the institutions geographically distant from the capitals, public services unrelated to universities have difficulty to access the hospital information, implementation and use of specific technologies. In the majority of the services, there is no interaction between the blood transfusion services and the NICUs; resulting in a difficult task for the professionals providing direct assistance. There are a large number of services that consider clinical parameters associated to the hemoglobin level (Hb) while others consider parameters associated to hematocrit (Hct) levels as a reference for the indication of transfusion of RBC. In conclusion, the decision of performing a transfusion in a patient must always be made by the leading doctor taking technical, medical, ethical and legal parameters into account, based on the use of protocols with more precise transfusion indications, adapted to the resources of each institution, in order to protect the patients from the risk of badly indicated transfusions
Mestrado
Ciencias Basicas
Mestre em Clinica Medica
44
Takada, Silvia Honda. "Efeitos da anóxia neonatal no encéfalo de ratos: estudo da distribuição de neurônios imunorreativos a Fos." Universidade de São Paulo, 2009. http://www.teses.usp.br/teses/disponiveis/42/42131/tde-02062009-164926/.
Full textAbstract:
Com objetivos de validar o modelo de anóxia neonatal apresentado e analisar a distribuição de neurônios imunorreativos à proteína Fos (IR-Fos) no encéfalo de ratos neonatos submetidos ao insulto anóxico, foram utilizados 24 ratos wistar neonatos machos divididos em dois grupos: Anóxia (n=12) e Controle (n=12). O grupo Anóxia apresentou decréscimo de 75% no valor da saturação periférica de oxigênio durante a exposição ao nitrogênio, enquanto o Controle não apresentou alterações nos valores (97%±0,5). A análise do número de células IR-Fos mostrou ativação de áreas encefálicas relacionadas ao controle da respiração, estruturas límbicas e núcleos da rafe. Tais dados sugerem que o modelo experimental de anóxia neonatal utilizado é eficiente em produzir privação temporária de oxigênio em ratos neonatos, levando a respostas condizentes com a anóxia. Espera-se, com estes resultados, facilitar a compreensão dos eventos relacionados à neurodegeneração e neurorregeneração após anóxia neonatal e, se possível, abrir caminho para novas abordagens e perspectivas terapêuticas.The aim of this study is to validate the experimental model of neonatal anoxia and evaluate by Fos imunoreactivity (Fos-IR) the effects of anoxic insult. Twenty-four male wistar neonates (weighting 6-8g) were divided in two groups: Anoxia (n=12) and Control (n=12). The anoxic group presented decrease of 75% in the value of the peripheric saturation of oxygen during exposure to the nitrogen while control group did not present alterations in the values of the peripheric saturation of oxygen during the studied time (97 % ± 0,5). These data suggest that the experimental model of neonatal anoxia presented is efficient in producing temporary deprivation of oxygen in neonates rats, leading to responses that characterize anoxia. Fos-IR neurons analisis showed important activation of respiratory regions, limbic strutures and raphe nuclei in anoxic group when compared to control group. We hope facilitate the understanding of neonatal anoxia neurodegeneration and neuroregeneration and possibly contribute for new approaches and therapeutic perspectives.
45
Marques, Eduardo Carvalho. "Avaliação clínica da substituição do leite materno por colostro diluído na alimentação de bezerros holandeses nos primeiros 60 dias de vida." Universidade de São Paulo, 2012. http://www.teses.usp.br/teses/disponiveis/10/10136/tde-22052013-143145/.
Full textAbstract:
Com o objetivo de avaliar os parâmetros clínicos e zootécnicos dos efeitos da substituição do leite in natura por colostro na alimentação de bezerros até 60 dias de vida, foram utilizados bezerros machos Holandeses, do nascimento aos 60 dias de vida. Os animais, em número de 24, foram trabalhados dentro de um delineamento em blocos casualizados, formando-se quatro blocos de seis animais, com repetição dentro de blocos, para atender a três tratamentos. Os blocos foram formados com neonatos, cuidando-se para que a diferença de idade dentro de bloco não superasse 21 dias. Os tratamentos compreenderam em misturas iniciadoras idênticas e feno de coast cross, fornecidas desde a primeira semana de vida, e leite mais colostro nas seguintes formas: Grupo 1, colostro diluído em água na proporção 2:1 até os 60 dias de idade, Grupo 2, colostro diluído em água na proporção 2:1 até os 30° dia de idade e leite in natura do 30° ao 60° dia, Grupo 3, leite in natura até os 60° dia de idade. Todos os animais receberam colostro materno (4,0 kg por animal/dia) durante os três primeiros dias de vida. Amostras de sangue foram colhidas nas idades de 0, 24, 48, 72 horas, 5° dia, 7° dia, 15° dia, 30° dia, 60° dia para avaliação do proteinograma. Semanalmente foi executadas pesagens para avaliar ganhos de peso. Não foi encontrado nos diferentes tratamentos alterações significantes no proteinograma e ganho de peso dos animais. Conclui-se que a diluição de colostro nos tratamentos estudados é viável na alimentação dos bezerros.In order to evaluate clinical and zootechinical effects of the use of diluted colostrum as maternal milk replacement on Holstein Friesian calves feeding on the first 60 days of life, twenty four new born male calves were enrolled and randomly allocated on 4 blocks of six animals, with repetition of blocks in order to attend to three treatments. Animals from the same block should not have more than 21 days of age difference. Treatments consisted on starter mix, coast cross hay and liquid diet presented as: Group 1 diluted colostrum on water (2:1) for 60 days; Group 2 diluted colostrum on water (2:1) until 30 days and milk from 31 to 60 days, and Group 3 milk for 60 days. Blood samples were collected on 0 h, 24 h, 48 h, 72h and on days 5, 7, 15, 30, and 60 in order to evaluate serum protein. Weight gain and was evaluated every weekly. Solid and liquid intakes were evaluated daily. No significant difference was found among the treatments for serum protein and weight gain. Therefore, the colostrums dilution is viable option on calf feeding.
46
Abreu, Hudson Felipe Porto de. "Estudo da variabilidade da frequência cardíaca materna, fetal e neonatal em bubalinos da raça Murrah." Botucatu, 2019. http://hdl.handle.net/11449/183107.
Full textAbstract:
Orientador: Simone Biagio ChiacchioResumo: A bubalinocultura tem assumido cada vez mais importância econômica devido às suas características zootécnicas como a rusticidade e melhor qualidade do leite para a fabricação de derivados lácteos quando comparada ao leite de vaca. A morte embrionária e fetal é um importante fator de diminuição da eficiência reprodutiva pois aumenta o intervalo entre partos e causa perdas econômicas pela diminuição da lactação. O eletrocardiograma materno-fetal permite a avaliação da frequência cardíaca fetal (FCF) e variabilidade da frequência cardíaca (VFC) mediante análise de indicadores da VFC (HR, RR, RMSSD, SDNN, LF, HF e a relação LF/HF). Foram avaliadas semanalmente nove búfalas e neonatos saudáveis da raça murrah, nos momentos -28, -21, -14, -7 dias antes do parto e nos dias 7, 14, 21 e 28 dias após o parto. Nas búfalas foi observada diferença significativa na frequência cardíaca na fase pré-parto e com diminuição gradual conforme proximidade do parto. Já os índices RMSSD e SDNN não apresentaram diferença significativa mas demonstraram predomínio parassimpático. O componente de baixa frequência (LF) apresentou aumento significativo na fase pré-parto e o componente de alta frequência (HF) apresentou diminuição significativa, compatível com predomínio simpático. Embora não significativa, a relação LF/HF apresentou aumento na fase pré-parto e equilíbrio vagal pós-parto. Já os bezerros apresentaram variação significativa na fase pré-parto, com aumento gradativo conforme a proximidade dest... (Resumo completo, clicar acesso eletrônico abaixo)
Abstract: Bubalinoculture has become increasingly important economically due to its zootechnical characteristics such as the rusticity and better quality of milk for the manufacture of dairy products when compared to cow's milk. Embryonic and fetal death is an important factor in decreasing reproductive efficiency because it increases the interval between births and causes economic losses due to decreased lactation. The maternal-fetal electrocardiogram allows the assessment of fetal heart rate (HRF) and heart rate variability (HRV) by analyzing HRV indicators (HR, RR, RMSSD, SDNN, LF, HF and the LF / HF ratio). Nine murrah buffaloes and healthy newborns were evaluated weekly at -28, -21, -14, -7 days before delivery and at 7, 14, 21 and 28 days after delivery. In buffaloes, a significant difference in heart rate was observed in the pre-partum phase and with a gradual decrease as the childbirth approached. The RMSSD and SDNN indices did not present significant difference but showed a parasympathetic predominance. The low frequency component (LF) showed a significant increase in the prepartum phase and the high frequency component (HF) showed a significant decrease, compatible with sympathetic predominance. Although not significant, the LF / HF ratio showed an increase in the prepartum phase and postpartum vagal balance. Calves, on the other hand, presented significant variation in the pre-partum phase, with gradual increase according to its proximity, with subsequent postpartum fall. Th... (Complete abstract click electronic access below)
Mestre
47
Cotreuil, Marie-Hélène. "L'incubateur en néonatologie : approches concrètes dans le domaine de l'hygiène." Paris 5, 1995. http://www.theses.fr/1995PA05P171.
Full text
48
Lingner, Sandra [Verfasser], and Ulrich [Akademischer Betreuer] Maus. "Adjuvant activity of carbon black particles in a murine model of allergic asthma / Sandra Lingner. Pädiatrische Pneumologie, Allergologie und Neonatologie der Medizinischen Hochschule Hannover. Betreuer: Ulrich Maus." Hannover : Bibliothek der Medizinischen Hochschule Hannover, 2012. http://d-nb.info/1023139359/34.
Full text
49
Baptista, Rafaela Speranza [UNESP]. "Proteinograma sérico de cordeiros nascidos a termo ou prematuros." Universidade Estadual Paulista (UNESP), 2016. http://hdl.handle.net/11449/146742.
Full textAbstract:
Submitted by RAFAELA SPERANZA BAPTISTA null (rafa.baptista@terra.com.br) on 2016-12-21T10:55:12Z
No. of bitstreams: 1
DISSERTAÇÃO RAFAELA SPERANZA BAPTISTA.pdf: 2858885 bytes, checksum: 10670fa21899fbde7f86a510301fcf2d (MD5)Approved for entry into archive by Felipe Augusto Arakaki (arakaki@reitoria.unesp.br) on 2016-12-22T12:48:47Z (GMT) No. of bitstreams: 1 baptista_rs_me_araca.pdf: 2858885 bytes, checksum: 10670fa21899fbde7f86a510301fcf2d (MD5)
Made available in DSpace on 2016-12-22T12:48:47Z (GMT). No. of bitstreams: 1 baptista_rs_me_araca.pdf: 2858885 bytes, checksum: 10670fa21899fbde7f86a510301fcf2d (MD5) Previous issue date: 2016-12-09
Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)
Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)
Ao final da gestação o neonato deve estar preparado, por meio de modificações funcionais e estruturais de órgãos e sistemas para dar início à vida extra-uterina. Os animais prematuros nascem antes deste processo estar completo, apresentando falhas na maturação. O objetivo deste estudo foi tentar identificar por meio da técnica de eletroforese em gel de poliacrilamida em dodecil sulfato de sódio (SDS-PAGE) proteínas de fase aguda, dentre elas, albumina, ceruloplasmina, transferrina, haptoglobina, glicoproteína ácida e imunoglobulinas A e G, que possam indicar a maturação no neonato prematuro. Os cordeiros foram divididos em seis grupos experimentais (parto normal, cesárea a termo, cesárea prematura, cesárea prematura com administração pré-parto materna de dexametasona, cesárea com administração de surfactante nos prematuros e cesárea prematura com administração pré-parto materna de dexametasona e surfactante ao neonato). Os resultados indicaram que após a administração de colostro, independente do tratamento, os valores séricos de proteína total e imunoglobulinas G aumentaram, indicando que há transferência de imunidade passiva através do trato gastrointestinal. A transferrina tem seus teores superiores em animais com idade gestacional superior, demonstrando potencial para ser utilizado como marcador de maturação neonatal.
At the end of gestation the neonate should be prepared, with functional and structural modifications of organs and systems to initiate extrauterine life. Premature animals are born before this process is complete, presenting maturation failures. The aim of this study was to identify an acute phase protein, such as albumin, ceruloplasmin, transferrin, haptoglobin, acid glycoprotein and immunoglobulins A and G, that demonstrates that different treatments indicate a maturation in the premature neonate using sodium dodecyl sulfate polyacrylamide gel electrophoresis technique (SDS-PAGE). The lambs were divided into six experimental groups (normal birth, full-term cesarean section at normal time of gestation, premature cesarean section, premature cesarean section whose mothers received prepartum dexamethasone, cesarean section giving surfactante to the prematures and premature cesarean giving prepartum dexamethasone to the mothers and surfactant to the neonate). The results indicated that after administration of colostrum, regardless of treatment, total serum protein and immunoglobulins increased, showing the transfer of passive immunity through the gastrointestinal tract. Transferrin has higher levels in animals with higher gestational age, demonstrating potential as a marker of neonatal maturation.
FAPESP: 2011/18810-3
50
Vivan, Maria Carolina Ribeiro. "Correlação dos níveis de lactato sanguíneo com o estado neurológico e cardiorrespiratório de filhotes de cães nascidos de parto normal ou cesariana sob anestesia geral inalatória /." Araçatuba : [s.n.], 2010. http://hdl.handle.net/11449/92186.
Full textAbstract:
Orientador: Valéria Nobre Leal de Souza OlivaBanca: Paulo Sérgio Patto dos Santos.
Banca: Rodrigo Cardoso Rabelo.
Resumo: A avaliação da perfusão tecidual com macroparâmetros não permite a detecção precoce de alteração na microvasculatura. A anestesia da gestante requer avaliação da perfusão e a eficácia do lactato na identificação de complicações em crianças após o parto já foi descrita. O presente estudo objetivou validar o lactato sanguíneo e correlacioná-lo a métodos, na avaliação de neonatos de parto normal ou cesariana eletiva sob anestesia geral inalatória. Foram utilizadas oito cadelas para realização de parto normal ou cesariana eletiva, com o protocolo composto de morfina, propofol e sevofluorano. Foram avaliados 24 neonatos de parto normal (GN) e 30 de cesariana (GC), com exames de sangue umbilical no nascimento para dosagem de lactato, hemogasometria, hematócrito, glicose e eletrólitos. No nascimento e aos 10 minutos de vida foram realizadas avaliações Apgar e neurológica. O lactato foi avaliado aos 10 minutos, 4 e 30 dias de vida. Os filhotes apresentaram acidose respiratória, acidemia e hipoxemia ao nascimento, mais elevada no GC. Os animais do GC apresentaram notas de Apgar e resposta neurológica menores ao nascimento, com melhora aos 10 minutos. O lactato sanguíneo foi maior nos animais do GN no nascimento, e foi maior nos animais que morreram. A correlação entre o lactato e as variáveis ocorreu em GN. O lactato sanguíneo associado aos demais parâmetros foi útil na avaliação dos neonatos do GN, porém nos animais do GC não houve correlação com a condição clínica dos animais no momento do nascimento. O procedimento anestésico influencia nos valores de lactato, e a determinação do melhor intervalo para sua avaliação nesses pacientes é necessária.
Abstract: The assessment of tissue perfusion using macro parameters does not allow early detection of changes in the microvasculature. Anesthesia for pregnant patient requires evaluation of perfusion, and the lactate effectiveness in identifying complications in children after birth has been described. This study aimed to validate the blood lactate and its correlation with other methods, in the evaluation of neonates born from vaginal delivery or elective cesarean section under inhalator anesthesia. Eight dogs were used to perform normal delivery or cesarean section, with the protocol consisting of morphine, propofol and sevoflurane. At birth were evaluated 24 neonates born from vaginal delivery (NG) and 30 born from cesarean section (CG) using umbilical blood to test lactate, blood gas, hematocrit, glucose and electrolytes. Apgar score and neurologic tests were performed at birth and at 10 minutes of life. Lactate levels were evaluated at 10 minutes, 4 and 30 days of life. The puppies showed respiratory acidosis, hypoxemia and acidemia at birth, higher in the CG. The animals of CG presented lower Apgar scores and neurological response at birth, which improved in 10 minutes. Blood lactate was higher in NG animals at birth, and was higher in those who died. The correlation between lactate and the variables occurred on NG. Association of blood lactate with other parameters was useful in the evaluation of neonates on NG, but in the animals of CG there was no correlation with the clinical condition of animals at birth. Anesthesia influences the lactate values, and it is necessary to determine the best interval for evaluation in these patients.
Mestre