Anja Lange - Academia.edu (original) (raw)
Papers by Anja Lange
BMC Pregnancy and Childbirth, Feb 19, 2014
Background: The subject of "pregnancy and disease" is of particular importance for maternal well-... more Background: The subject of "pregnancy and disease" is of particular importance for maternal well-being and neonatal outcomes. The international literature has focused on acute diseases during pregnancy; however, there are only a few studies investigating chronic diseases in pregnant women. The focus of this study is on diseases of women in childbearing age that are not related to the pregnancy. The objective of the paper is to deliver population based prevalences of chronic dieases in childbearing women and compare the two groups of chronically ill women and healthy women in detail regarding sociodemography, peri-and prenatal parameters and birth outcomes. Methods: Data of n = 5320 childbearing women were evaluated in the context of the population-based Survey of Neonates in Pomerania (SNiP). Data were obtained via face-to-face interviews, self-applied questionnaires, and abstraction from medical records at the time of giving birth. Sociodemographic and health status data were assessed, including chronic diseases that were taken out of medical records. A comprehensive set of pre-and perinatal varaiables were assessed. Results: In the SNiP, every fifth pregnant woman suffers from at least one chronic disease, and higher prevalence rates have been reported in the literature. There was a significant difference between chronically ill women and healthy women in age, education and income. Prenatal complications were more frequent in the healthy group than in the chronic disease group. Women with chronic diseases delivered by Cesarean section more frequently than women in the healthy group. Every tenth woman with at least one chronic disease gave birth to a premature infant, while only one in every 13 woman in the healthy control group gave birth to a premature infant. Conclusions: This analysis is the first population-based study in which all chronic diseases could be taken into consideration. The population-based prevalences rates in the SNiP data are consistently lower than those found in the literature. There are differences between chronically ill women and healthy women in peri-and prenatal variables as well as birth outcome on the population level. However, they are less frequent than expected and further analyses are need focusing on specific diseases.
BMC Pregnancy and Childbirth, Jul 29, 2016
Background: Congenital toxoplasmosis is associated with severe complications. German state health... more Background: Congenital toxoplasmosis is associated with severe complications. German state health insurance covers rubella, but not toxoplasmosis, immunity screening. We analysed the effect of socioeconomic factors on the efficiency of private toxoplasmosis screening during pregnancy. Methods: Toxoplasmosis and rubella screening data (n = 5402 mothers) were collected within the population-based Survey of Neonates in Pomerania (SNiP). Results: At the first-trimester screening, 34.4 % (88.1 %) of expecting mothers were immune to toxoplasmosis (rubella). Susceptibility for toxoplasmosis (rubella) was observed in 39.6 % (8.9 %) and 25.8 % (2.95 %) were not tested. Data on a 2 nd screening were available in a subgroup of women with negative immunity showing less than 45 % participation rate. Active toxoplasmosis (no rubella) infection was observed in 0.3 % (n = 17) of pregnant women. A multiple logistic regression model (AIC = 719.67; AUC = 0.725) revealed that the likelihood of participating in a second toxoplasmosis screening increased among women with a good level of education and a steady partnership and decreased with paternal unemployment and the absence of breastfeeding. The highest probability of non-participation in toxoplasmosis screening was found among women with temporal burden and family responsibilities. A cost-benefit analysis showed that covering general screening for toxoplasmosis with health insurance saved costs. Conclusion: Toxoplasmosis carried a substantial risk of infection during pregnancy. Although increased socioeconomic status was positively associated with the participation in toxoplasmosis screening, this was not the case when pregnant women had strong temporal burden and family responsibilities. This data supports the need for toxoplasmosis screening among pregnant women as a general healthcare benefit covered by insurance.
Orthopade, Jan 26, 2014
Diese Studie wurde vom Bundesministerium für Bildung und Forschung (BMBF) im Rahmen des Förderpro... more Diese Studie wurde vom Bundesministerium für Bildung und Forschung (BMBF) im Rahmen des Förderprojekts Community Medicine an der Universität Greifswald (NBL3 program, reference 01 ZZ 0403) unterstützt. Weitere Förderung erfolgte durch ein Stipendium der Universitätsmedizin Greifswald (A.L.).
Archives of Disease in Childhood, Oct 1, 2012
Conclusion The IHPS incidence declined by about 38% nationwide. The wide variation in time and di... more Conclusion The IHPS incidence declined by about 38% nationwide. The wide variation in time and different regions is significantly correlated with maternal age and history of migration.
Background. The German maternity guidelines require regular medical checkup (MC) during pregnancy... more Background. The German maternity guidelines require regular medical checkup (MC) during pregnancy as a measure of prevention. Socioeconomic factors such as education, profession, income and origin, but also age and parity may influence the preventive and health behavior of pregnant women. The aim was to investigate the influence of these factors on the participation rate in MC of pregnant women.Method. The current analysis is based on the prospective population-based birth cohort study Survey of Neonates in Pomerania, which was conducted in Western Pomerania, Germany. The data of 4092 pregnant women from 2004 to 2008 were analyzed regarding the antenatal care and health behavior. Up to 12 MC were regularly offered; participation in 10 MC is defined as standard screening according to maternity guidelines.Results. Women participated in the first preventive MC on average in the 10th (± 3.8 SD) week of pregnancy. 1343 (34.2 %) women participated in standard screening and 2039 (51.9 %) t...
Background: The prevalence of pre-pregnancy underweight (BMI (body mass index) <18.5 kg/m²) va... more Background: The prevalence of pre-pregnancy underweight (BMI (body mass index) <18.5 kg/m²) varies between 3% in Europe and 17% in Asia. Illness and low socioeconomic status may be associated with pre-pregnancy underweight which then may result in adverse pregnancy and neonatal outcome.Methods: We analysed pre-pregnancy BMI categories using data from the population-based birth cohort Survey of Neonates in Pomerania 2002-2008 (SNiP) in north-eastern Germany. Multivariable regression analyses adjusted for confounding were used to investigate a) socio-economic risk factors for underweight before pregnancy and b) associations of underweight with pregnancy and neonatal outcomes.Results: Chronic pre-pregnancy diseases were not more frequent in underweight pregnant women. Bivariate analyses showed that underweight women were younger by three years (p<0.001), smoked twice as often (p<0.001), and less likely graduated from high school (p<0.001) compared to women with normal weigh...
Archives of Disease in Childhood, Oct 1, 2014
In Vivo
Background/Aim: The typical insulin deficiency in type 1 diabetes mellitus has general effects on... more Background/Aim: The typical insulin deficiency in type 1 diabetes mellitus has general effects on metabolism and also affects bone quality. Materials and Methods: Two diabetic rat lines (BB/OK; BB.6KWR) and two non-diabetic rat strains (KWR and BB.14+18KWR), as control group, were included in the study. Bone mineral density, bone mineral content and body structure measurements were performed. The measurements took place before the onset of diabetes mellitus Results: A comparison of the groups showed increased bone density values of the diabetic rats in relation to the control groups. A new finding of increased bone density in the diabetic rats occurs. Conclusion: Diabetic rats showed no osteoporotic bone metabolism before the onset of clinically relevant type 1 diabetes mellitus, but rather increased bone metabolic activity.
Journal of Human Lactation, 2022
Introduction: Breastfeeding is a recognized preferred method of infant feeding; however, for many... more Introduction: Breastfeeding is a recognized preferred method of infant feeding; however, for many women, difficulties in breastfeeding result in termination before the recommended period of time. Acupuncture is suggested to be a promising option to treat lactation insufficiency and enhance the production of maternal milk. Main Issue: We have reported the case of a woman with lactation insufficiency due to Caesarean section and congenital unilateral invaginated nipple. Milk production started on the 3rd day following delivery. The newborn was not provided with any food or fluids other than mother’s milk. At 5 days of life, the newborn required long feeding periods and lost 4% of his birth weight, with the participant reporting lactation insufficiency described by the perception of inadequate milk production. Management: Despite the implementation of conventional measures to improve lactation, the difficulties in breastfeeding persisted. Acupuncture was tried on Day 6 of life, and enh...
JPEN. Journal of parenteral and enteral nutrition, Jan 30, 2018
Preterm infants are at risk of oxidative stress from neonatal intensive care interventions. 8-Oxo... more Preterm infants are at risk of oxidative stress from neonatal intensive care interventions. 8-Oxo-2'-deoxyguanosine (8-oxodG), generated by oxygen radical attack on DNA, is a potential marker of oxidative stress. The aim of the present study was to investigate the impact of quality and source of enteral nutrition (EN) on renal excretion of 8-oxodG in preterm infants. Spontaneous urine samples were collected on postnatal days 26-31 in 33 preterm infants. Infants were fed either breast milk (BM), formula (FM), or BM/FM mixtures. Daily iron (Fe) supplementation was started day 28 ± 1 postnatally. 8-oxodG was determined by highperformance liquid chromatography-electrochemical detection (HPLC-EC). The 8-oxodG/creatinine ratio was significantly higher in infants fed FM vs FM/BM (38.7 ± 28.7 vs 16.7 ± 12.2 nmol 8-oxodG/mmol creatinine, P < 0.0001) or BM (11.6 ± 10.4 nmol 8-oxodG/mmol creatinine, P < 0.0001). There was no significant effect of Fe supplementation (P = 0.547). 8-Oxo...
Clinical Chemistry and Laboratory Medicine (CCLM), 2017
Background:Newborn screening (NBS) is an established screening procedure in many countries worldw... more Background:Newborn screening (NBS) is an established screening procedure in many countries worldwide, aiming at the early detection of inborn errors of metabolism. For decades, dried blood spots have been the standard specimen for NBS. The procedure of blood collection is well described and standardized and includes many critical pre-analytical steps. We examined the impact of contamination of some anticipated common substances on NBS results obtained from dry spot samples. This possible pre-analytical source of uncertainty has been poorly examined in the past.Methods:Capillary blood was obtained from 15 adult volunteers and applied to 10 screening filter papers per volunteer. Nine filter papers were contaminated without visible trace. The contaminants were baby diaper rash cream, baby wet wipes, disinfectant, liquid infant formula, liquid infant formula hypoallergenic (HA), ultrasonic gel, breast milk, feces, and urine. The differences between control and contaminated samples were ...
Geburtshilfe und Frauenheilkunde, 2015
Background: The shortage of skilled personnel is ubiquitous, basic and further training is a key ... more Background: The shortage of skilled personnel is ubiquitous, basic and further training is a key aspect in the recruitment of new medical colleagues. The significance of the nursing practicum in its function as gateway to the gynaecology and obstetrics discipline is practically unexplored. Methods: In an online questionnaire, medical students in all German faculties were questioned about the practica in their courses. The questionnaire reached 9079 medical students. 149 participants in nursing practica were selectively asked to answer 140 questions. We analysed those students who could, on the basis of their experiences in nursing practica, imagine undertaking an internship (clinical elective) in gynaecology (internship yes "Iy") separately from those who could not or were still undecided (internship no "In" or, respectively, internship perhaps "Ip"). Results: Altogether 149 medical students who participated in a nursing practicum in the gynaecology discipline were selected, of these 94.9 % were female. 92 (61.7%) of the students replied that, after their gynaecological nursing practicum, they wanted to undertake an internship in gynaecology (Iy); 39 (26.2 %) answered negatively (In) and 18 (12.1 %) were still undecided (Ip). With regard to the parameters gender, age and duration of study, there were no significant differences among the 3 groups (χ 2 0.83). Besides the didactic and professional quality of the training, Iy also mentioned having had a higher practical orientation. They attained their aims more frequently, were better integrated in the health-care team and acquired more practical competences. Satisfaction with the practicum was evaluated as highest among the Iy. Discussion: Those students who could imagine taking an internship in gynaecology were seen to be more satisfied with their practica than those participants who declined or were undecided.
Alcohol consumption in pregnancy was investigated in 5402 pregnant women between 2002-2008 as par... more Alcohol consumption in pregnancy was investigated in 5402 pregnant women between 2002-2008 as part of the population-based Survey of Neonates in Pommerania (SNiP). The women filled in an anonymous questionnaire (AUDIT-C, incl. index of dependence). Neonatal outcome parameters were recorded: size, weight, head circumference, APGAR and possible symptoms of a fetal alcohol syndrome (FAS) like stigmata, muscular hypotonia and being small for gestational age. Statistical analysis was performed using SPSS and Stata-Statistic. Conclusions In our cohort study, we were able to encourage nearly 90% of mothers to give detailed information on alcohol consumption in pregnancy. Although more than 20% of the questioned women had a regular alcohol consumption, the drinking quantity was low. This may explain the lack of association of alcohol consumption and possible symptoms of FAS. However, alcohol consumption in pregnancy was associated with higher school education and higher risk of premature delivery. This is of particular importance with respect to preventive measures. In the small group of mothers who did not fill in the questionnaire, an association between alcohol consumption and possible symptoms of FAS was found. These women should be regarded as a group at risk. Therefore, follow up of their offspring is extremely important.
Acta Paediatrica, 2019
Maternal breast milk lowers the incidence of severe complications of preterm birth, such as necro... more Maternal breast milk lowers the incidence of severe complications of preterm birth, such as necrotising enterocolitis (NEC), 1 retinopathy of prematurity (ROP) 2 and nosocomial infections 3 compared with artificial formula. A study of 1422 very low birth weight (VLBW) infants from the German Neonatal Network showed that exclusively feeding infants maternal breast milk was associated with a reduced risk for NEC of a factor of 12.6, for ROP, it was 1.8 and for bronchopulmonary dysplasia, (BPD) it was 2.6. 4 However, this study also showed that the proportion of exclusively breastfed infants was low, at 15.6%. 4 Other studies have showed that acute complications were associated with impaired psychomotor development and that reducing these improved longterm outcomes. 5 In addition, feeding preterm infants with maternal breast milk has been associated with better neurodevelopment. 6,7
BMC Pediatrics, 2019
Background Recent guidelines recommend a cranial ultrasound (CU) in neonates born at
Molecular and Cellular Pediatrics, 2019
Background Neonate immune cell functions lack full protection against pathogens. This could be ei... more Background Neonate immune cell functions lack full protection against pathogens. This could be either defect or protective mechanism against overshooting proinflammatory immune responses. We here analysed the function of classical, pro- and anti-inflammatory monocytes and granulocytes from neonates in comparison with adults to investigate if suppressed functions of subpopulations are causative for the unique neonatal immune status. Therefore, reactive oxygen species (ROS) and surface activation markers were quantified in subpopulations. Methods In a prospective, longitudinal study granulocyte and monocyte subpopulations were analysed in healthy term infants (> 37 week; n = 13) in comparison with healthy young adults (n = 11). Percentage (%) of cells expressing surface marker (HLA-DR, CD11b, CD62L, CD32, Toll-Like-Receptor-2) and expression per cell, determined by mean fluorescence intensity (MFI), were measured by flow cytometry. ROS production was induced by fMLP, PMA and E. col...
BMC Pregnancy and Childbirth, 2018
BMC Pregnancy and Childbirth, 2016
Background: Congenital toxoplasmosis is associated with severe complications. German state health... more Background: Congenital toxoplasmosis is associated with severe complications. German state health insurance covers rubella, but not toxoplasmosis, immunity screening. We analysed the effect of socioeconomic factors on the efficiency of private toxoplasmosis screening during pregnancy. Methods: Toxoplasmosis and rubella screening data (n = 5402 mothers) were collected within the population-based Survey of Neonates in Pomerania (SNiP). Results: At the first-trimester screening, 34.4 % (88.1 %) of expecting mothers were immune to toxoplasmosis (rubella). Susceptibility for toxoplasmosis (rubella) was observed in 39.6 % (8.9 %) and 25.8 % (2.95 %) were not tested. Data on a 2 nd screening were available in a subgroup of women with negative immunity showing less than 45 % participation rate. Active toxoplasmosis (no rubella) infection was observed in 0.3 % (n = 17) of pregnant women. A multiple logistic regression model (AIC = 719.67; AUC = 0.725) revealed that the likelihood of participating in a second toxoplasmosis screening increased among women with a good level of education and a steady partnership and decreased with paternal unemployment and the absence of breastfeeding. The highest probability of non-participation in toxoplasmosis screening was found among women with temporal burden and family responsibilities. A cost-benefit analysis showed that covering general screening for toxoplasmosis with health insurance saved costs. Conclusion: Toxoplasmosis carried a substantial risk of infection during pregnancy. Although increased socioeconomic status was positively associated with the participation in toxoplasmosis screening, this was not the case when pregnant women had strong temporal burden and family responsibilities. This data supports the need for toxoplasmosis screening among pregnant women as a general healthcare benefit covered by insurance.
European journal of nutrition, Jan 25, 2018
Data from recent adult studies suggest a decline of median urinary iodine concentrations (UIC) in... more Data from recent adult studies suggest a decline of median urinary iodine concentrations (UIC) in Germany, but since 1996 no German study investigated UIC in neonates. The aim of our study was to investigate UIC and serum thyroid-stimulating hormone (TSH) levels in neonates from Germany. We used data from 399 neonates, which were born between April 2005 and November 2006 in the Northeast of Germany. UIC were evaluated by a photometric procedure with Sandell and Kolthoff reaction and afterwards corrected to be comparable with an ICP-MS method. TSH was determined from capillary blood, which was taken within 5 days after birth, by DELFIA. Median UIC were 150 µg/L (25th percentile: 104 µg/L; 75th percentile: 196 µg/L) and differed between boys (153.3 µg/L) and girls (131.5 µg/L; p = 0.012). The prevalence of serum TSH levels > 5 mIU/L was 14%. Neonates from mothers with intake of iodine supplementation (150 µg/L) had significantly higher median UIC than neonates from mothers without ...
Deutsche medizinische Wochenschrift (1946), 2017
Background German medical students have to perform a nursery internship of three month duration. ... more Background German medical students have to perform a nursery internship of three month duration. While this internship is widely discussed, there is a lack of student evaluation data. Objectives Here, for the first time, student evaluation of a nursery internship in internal medicine (IM) is investigated. Moreover, the question was raised, whether the early experience during this internship may influence students' attitude towards the specialty. Methods In a nation-wide online-survey, 767 German medical students (mean age 22.8 years; 58 % female) evaluated a nursery internship on an IM ward concerning integration in medical teams, teachers, structure and quality of teaching, and satisfaction. Multivariate comparisons were conducted following the question, whether students could imagine choosing IM for a clinical elective after this nursery internship. Results 71 % of the students felt well integrated in the medical team, most was learned from the nurses, and most students indica...
BMC Pregnancy and Childbirth, Feb 19, 2014
Background: The subject of "pregnancy and disease" is of particular importance for maternal well-... more Background: The subject of "pregnancy and disease" is of particular importance for maternal well-being and neonatal outcomes. The international literature has focused on acute diseases during pregnancy; however, there are only a few studies investigating chronic diseases in pregnant women. The focus of this study is on diseases of women in childbearing age that are not related to the pregnancy. The objective of the paper is to deliver population based prevalences of chronic dieases in childbearing women and compare the two groups of chronically ill women and healthy women in detail regarding sociodemography, peri-and prenatal parameters and birth outcomes. Methods: Data of n = 5320 childbearing women were evaluated in the context of the population-based Survey of Neonates in Pomerania (SNiP). Data were obtained via face-to-face interviews, self-applied questionnaires, and abstraction from medical records at the time of giving birth. Sociodemographic and health status data were assessed, including chronic diseases that were taken out of medical records. A comprehensive set of pre-and perinatal varaiables were assessed. Results: In the SNiP, every fifth pregnant woman suffers from at least one chronic disease, and higher prevalence rates have been reported in the literature. There was a significant difference between chronically ill women and healthy women in age, education and income. Prenatal complications were more frequent in the healthy group than in the chronic disease group. Women with chronic diseases delivered by Cesarean section more frequently than women in the healthy group. Every tenth woman with at least one chronic disease gave birth to a premature infant, while only one in every 13 woman in the healthy control group gave birth to a premature infant. Conclusions: This analysis is the first population-based study in which all chronic diseases could be taken into consideration. The population-based prevalences rates in the SNiP data are consistently lower than those found in the literature. There are differences between chronically ill women and healthy women in peri-and prenatal variables as well as birth outcome on the population level. However, they are less frequent than expected and further analyses are need focusing on specific diseases.
BMC Pregnancy and Childbirth, Jul 29, 2016
Background: Congenital toxoplasmosis is associated with severe complications. German state health... more Background: Congenital toxoplasmosis is associated with severe complications. German state health insurance covers rubella, but not toxoplasmosis, immunity screening. We analysed the effect of socioeconomic factors on the efficiency of private toxoplasmosis screening during pregnancy. Methods: Toxoplasmosis and rubella screening data (n = 5402 mothers) were collected within the population-based Survey of Neonates in Pomerania (SNiP). Results: At the first-trimester screening, 34.4 % (88.1 %) of expecting mothers were immune to toxoplasmosis (rubella). Susceptibility for toxoplasmosis (rubella) was observed in 39.6 % (8.9 %) and 25.8 % (2.95 %) were not tested. Data on a 2 nd screening were available in a subgroup of women with negative immunity showing less than 45 % participation rate. Active toxoplasmosis (no rubella) infection was observed in 0.3 % (n = 17) of pregnant women. A multiple logistic regression model (AIC = 719.67; AUC = 0.725) revealed that the likelihood of participating in a second toxoplasmosis screening increased among women with a good level of education and a steady partnership and decreased with paternal unemployment and the absence of breastfeeding. The highest probability of non-participation in toxoplasmosis screening was found among women with temporal burden and family responsibilities. A cost-benefit analysis showed that covering general screening for toxoplasmosis with health insurance saved costs. Conclusion: Toxoplasmosis carried a substantial risk of infection during pregnancy. Although increased socioeconomic status was positively associated with the participation in toxoplasmosis screening, this was not the case when pregnant women had strong temporal burden and family responsibilities. This data supports the need for toxoplasmosis screening among pregnant women as a general healthcare benefit covered by insurance.
Orthopade, Jan 26, 2014
Diese Studie wurde vom Bundesministerium für Bildung und Forschung (BMBF) im Rahmen des Förderpro... more Diese Studie wurde vom Bundesministerium für Bildung und Forschung (BMBF) im Rahmen des Förderprojekts Community Medicine an der Universität Greifswald (NBL3 program, reference 01 ZZ 0403) unterstützt. Weitere Förderung erfolgte durch ein Stipendium der Universitätsmedizin Greifswald (A.L.).
Archives of Disease in Childhood, Oct 1, 2012
Conclusion The IHPS incidence declined by about 38% nationwide. The wide variation in time and di... more Conclusion The IHPS incidence declined by about 38% nationwide. The wide variation in time and different regions is significantly correlated with maternal age and history of migration.
Background. The German maternity guidelines require regular medical checkup (MC) during pregnancy... more Background. The German maternity guidelines require regular medical checkup (MC) during pregnancy as a measure of prevention. Socioeconomic factors such as education, profession, income and origin, but also age and parity may influence the preventive and health behavior of pregnant women. The aim was to investigate the influence of these factors on the participation rate in MC of pregnant women.Method. The current analysis is based on the prospective population-based birth cohort study Survey of Neonates in Pomerania, which was conducted in Western Pomerania, Germany. The data of 4092 pregnant women from 2004 to 2008 were analyzed regarding the antenatal care and health behavior. Up to 12 MC were regularly offered; participation in 10 MC is defined as standard screening according to maternity guidelines.Results. Women participated in the first preventive MC on average in the 10th (± 3.8 SD) week of pregnancy. 1343 (34.2 %) women participated in standard screening and 2039 (51.9 %) t...
Background: The prevalence of pre-pregnancy underweight (BMI (body mass index) <18.5 kg/m²) va... more Background: The prevalence of pre-pregnancy underweight (BMI (body mass index) <18.5 kg/m²) varies between 3% in Europe and 17% in Asia. Illness and low socioeconomic status may be associated with pre-pregnancy underweight which then may result in adverse pregnancy and neonatal outcome.Methods: We analysed pre-pregnancy BMI categories using data from the population-based birth cohort Survey of Neonates in Pomerania 2002-2008 (SNiP) in north-eastern Germany. Multivariable regression analyses adjusted for confounding were used to investigate a) socio-economic risk factors for underweight before pregnancy and b) associations of underweight with pregnancy and neonatal outcomes.Results: Chronic pre-pregnancy diseases were not more frequent in underweight pregnant women. Bivariate analyses showed that underweight women were younger by three years (p<0.001), smoked twice as often (p<0.001), and less likely graduated from high school (p<0.001) compared to women with normal weigh...
Archives of Disease in Childhood, Oct 1, 2014
In Vivo
Background/Aim: The typical insulin deficiency in type 1 diabetes mellitus has general effects on... more Background/Aim: The typical insulin deficiency in type 1 diabetes mellitus has general effects on metabolism and also affects bone quality. Materials and Methods: Two diabetic rat lines (BB/OK; BB.6KWR) and two non-diabetic rat strains (KWR and BB.14+18KWR), as control group, were included in the study. Bone mineral density, bone mineral content and body structure measurements were performed. The measurements took place before the onset of diabetes mellitus Results: A comparison of the groups showed increased bone density values of the diabetic rats in relation to the control groups. A new finding of increased bone density in the diabetic rats occurs. Conclusion: Diabetic rats showed no osteoporotic bone metabolism before the onset of clinically relevant type 1 diabetes mellitus, but rather increased bone metabolic activity.
Journal of Human Lactation, 2022
Introduction: Breastfeeding is a recognized preferred method of infant feeding; however, for many... more Introduction: Breastfeeding is a recognized preferred method of infant feeding; however, for many women, difficulties in breastfeeding result in termination before the recommended period of time. Acupuncture is suggested to be a promising option to treat lactation insufficiency and enhance the production of maternal milk. Main Issue: We have reported the case of a woman with lactation insufficiency due to Caesarean section and congenital unilateral invaginated nipple. Milk production started on the 3rd day following delivery. The newborn was not provided with any food or fluids other than mother’s milk. At 5 days of life, the newborn required long feeding periods and lost 4% of his birth weight, with the participant reporting lactation insufficiency described by the perception of inadequate milk production. Management: Despite the implementation of conventional measures to improve lactation, the difficulties in breastfeeding persisted. Acupuncture was tried on Day 6 of life, and enh...
JPEN. Journal of parenteral and enteral nutrition, Jan 30, 2018
Preterm infants are at risk of oxidative stress from neonatal intensive care interventions. 8-Oxo... more Preterm infants are at risk of oxidative stress from neonatal intensive care interventions. 8-Oxo-2'-deoxyguanosine (8-oxodG), generated by oxygen radical attack on DNA, is a potential marker of oxidative stress. The aim of the present study was to investigate the impact of quality and source of enteral nutrition (EN) on renal excretion of 8-oxodG in preterm infants. Spontaneous urine samples were collected on postnatal days 26-31 in 33 preterm infants. Infants were fed either breast milk (BM), formula (FM), or BM/FM mixtures. Daily iron (Fe) supplementation was started day 28 ± 1 postnatally. 8-oxodG was determined by highperformance liquid chromatography-electrochemical detection (HPLC-EC). The 8-oxodG/creatinine ratio was significantly higher in infants fed FM vs FM/BM (38.7 ± 28.7 vs 16.7 ± 12.2 nmol 8-oxodG/mmol creatinine, P < 0.0001) or BM (11.6 ± 10.4 nmol 8-oxodG/mmol creatinine, P < 0.0001). There was no significant effect of Fe supplementation (P = 0.547). 8-Oxo...
Clinical Chemistry and Laboratory Medicine (CCLM), 2017
Background:Newborn screening (NBS) is an established screening procedure in many countries worldw... more Background:Newborn screening (NBS) is an established screening procedure in many countries worldwide, aiming at the early detection of inborn errors of metabolism. For decades, dried blood spots have been the standard specimen for NBS. The procedure of blood collection is well described and standardized and includes many critical pre-analytical steps. We examined the impact of contamination of some anticipated common substances on NBS results obtained from dry spot samples. This possible pre-analytical source of uncertainty has been poorly examined in the past.Methods:Capillary blood was obtained from 15 adult volunteers and applied to 10 screening filter papers per volunteer. Nine filter papers were contaminated without visible trace. The contaminants were baby diaper rash cream, baby wet wipes, disinfectant, liquid infant formula, liquid infant formula hypoallergenic (HA), ultrasonic gel, breast milk, feces, and urine. The differences between control and contaminated samples were ...
Geburtshilfe und Frauenheilkunde, 2015
Background: The shortage of skilled personnel is ubiquitous, basic and further training is a key ... more Background: The shortage of skilled personnel is ubiquitous, basic and further training is a key aspect in the recruitment of new medical colleagues. The significance of the nursing practicum in its function as gateway to the gynaecology and obstetrics discipline is practically unexplored. Methods: In an online questionnaire, medical students in all German faculties were questioned about the practica in their courses. The questionnaire reached 9079 medical students. 149 participants in nursing practica were selectively asked to answer 140 questions. We analysed those students who could, on the basis of their experiences in nursing practica, imagine undertaking an internship (clinical elective) in gynaecology (internship yes "Iy") separately from those who could not or were still undecided (internship no "In" or, respectively, internship perhaps "Ip"). Results: Altogether 149 medical students who participated in a nursing practicum in the gynaecology discipline were selected, of these 94.9 % were female. 92 (61.7%) of the students replied that, after their gynaecological nursing practicum, they wanted to undertake an internship in gynaecology (Iy); 39 (26.2 %) answered negatively (In) and 18 (12.1 %) were still undecided (Ip). With regard to the parameters gender, age and duration of study, there were no significant differences among the 3 groups (χ 2 0.83). Besides the didactic and professional quality of the training, Iy also mentioned having had a higher practical orientation. They attained their aims more frequently, were better integrated in the health-care team and acquired more practical competences. Satisfaction with the practicum was evaluated as highest among the Iy. Discussion: Those students who could imagine taking an internship in gynaecology were seen to be more satisfied with their practica than those participants who declined or were undecided.
Alcohol consumption in pregnancy was investigated in 5402 pregnant women between 2002-2008 as par... more Alcohol consumption in pregnancy was investigated in 5402 pregnant women between 2002-2008 as part of the population-based Survey of Neonates in Pommerania (SNiP). The women filled in an anonymous questionnaire (AUDIT-C, incl. index of dependence). Neonatal outcome parameters were recorded: size, weight, head circumference, APGAR and possible symptoms of a fetal alcohol syndrome (FAS) like stigmata, muscular hypotonia and being small for gestational age. Statistical analysis was performed using SPSS and Stata-Statistic. Conclusions In our cohort study, we were able to encourage nearly 90% of mothers to give detailed information on alcohol consumption in pregnancy. Although more than 20% of the questioned women had a regular alcohol consumption, the drinking quantity was low. This may explain the lack of association of alcohol consumption and possible symptoms of FAS. However, alcohol consumption in pregnancy was associated with higher school education and higher risk of premature delivery. This is of particular importance with respect to preventive measures. In the small group of mothers who did not fill in the questionnaire, an association between alcohol consumption and possible symptoms of FAS was found. These women should be regarded as a group at risk. Therefore, follow up of their offspring is extremely important.
Acta Paediatrica, 2019
Maternal breast milk lowers the incidence of severe complications of preterm birth, such as necro... more Maternal breast milk lowers the incidence of severe complications of preterm birth, such as necrotising enterocolitis (NEC), 1 retinopathy of prematurity (ROP) 2 and nosocomial infections 3 compared with artificial formula. A study of 1422 very low birth weight (VLBW) infants from the German Neonatal Network showed that exclusively feeding infants maternal breast milk was associated with a reduced risk for NEC of a factor of 12.6, for ROP, it was 1.8 and for bronchopulmonary dysplasia, (BPD) it was 2.6. 4 However, this study also showed that the proportion of exclusively breastfed infants was low, at 15.6%. 4 Other studies have showed that acute complications were associated with impaired psychomotor development and that reducing these improved longterm outcomes. 5 In addition, feeding preterm infants with maternal breast milk has been associated with better neurodevelopment. 6,7
BMC Pediatrics, 2019
Background Recent guidelines recommend a cranial ultrasound (CU) in neonates born at
Molecular and Cellular Pediatrics, 2019
Background Neonate immune cell functions lack full protection against pathogens. This could be ei... more Background Neonate immune cell functions lack full protection against pathogens. This could be either defect or protective mechanism against overshooting proinflammatory immune responses. We here analysed the function of classical, pro- and anti-inflammatory monocytes and granulocytes from neonates in comparison with adults to investigate if suppressed functions of subpopulations are causative for the unique neonatal immune status. Therefore, reactive oxygen species (ROS) and surface activation markers were quantified in subpopulations. Methods In a prospective, longitudinal study granulocyte and monocyte subpopulations were analysed in healthy term infants (> 37 week; n = 13) in comparison with healthy young adults (n = 11). Percentage (%) of cells expressing surface marker (HLA-DR, CD11b, CD62L, CD32, Toll-Like-Receptor-2) and expression per cell, determined by mean fluorescence intensity (MFI), were measured by flow cytometry. ROS production was induced by fMLP, PMA and E. col...
BMC Pregnancy and Childbirth, 2018
BMC Pregnancy and Childbirth, 2016
Background: Congenital toxoplasmosis is associated with severe complications. German state health... more Background: Congenital toxoplasmosis is associated with severe complications. German state health insurance covers rubella, but not toxoplasmosis, immunity screening. We analysed the effect of socioeconomic factors on the efficiency of private toxoplasmosis screening during pregnancy. Methods: Toxoplasmosis and rubella screening data (n = 5402 mothers) were collected within the population-based Survey of Neonates in Pomerania (SNiP). Results: At the first-trimester screening, 34.4 % (88.1 %) of expecting mothers were immune to toxoplasmosis (rubella). Susceptibility for toxoplasmosis (rubella) was observed in 39.6 % (8.9 %) and 25.8 % (2.95 %) were not tested. Data on a 2 nd screening were available in a subgroup of women with negative immunity showing less than 45 % participation rate. Active toxoplasmosis (no rubella) infection was observed in 0.3 % (n = 17) of pregnant women. A multiple logistic regression model (AIC = 719.67; AUC = 0.725) revealed that the likelihood of participating in a second toxoplasmosis screening increased among women with a good level of education and a steady partnership and decreased with paternal unemployment and the absence of breastfeeding. The highest probability of non-participation in toxoplasmosis screening was found among women with temporal burden and family responsibilities. A cost-benefit analysis showed that covering general screening for toxoplasmosis with health insurance saved costs. Conclusion: Toxoplasmosis carried a substantial risk of infection during pregnancy. Although increased socioeconomic status was positively associated with the participation in toxoplasmosis screening, this was not the case when pregnant women had strong temporal burden and family responsibilities. This data supports the need for toxoplasmosis screening among pregnant women as a general healthcare benefit covered by insurance.
European journal of nutrition, Jan 25, 2018
Data from recent adult studies suggest a decline of median urinary iodine concentrations (UIC) in... more Data from recent adult studies suggest a decline of median urinary iodine concentrations (UIC) in Germany, but since 1996 no German study investigated UIC in neonates. The aim of our study was to investigate UIC and serum thyroid-stimulating hormone (TSH) levels in neonates from Germany. We used data from 399 neonates, which were born between April 2005 and November 2006 in the Northeast of Germany. UIC were evaluated by a photometric procedure with Sandell and Kolthoff reaction and afterwards corrected to be comparable with an ICP-MS method. TSH was determined from capillary blood, which was taken within 5 days after birth, by DELFIA. Median UIC were 150 µg/L (25th percentile: 104 µg/L; 75th percentile: 196 µg/L) and differed between boys (153.3 µg/L) and girls (131.5 µg/L; p = 0.012). The prevalence of serum TSH levels > 5 mIU/L was 14%. Neonates from mothers with intake of iodine supplementation (150 µg/L) had significantly higher median UIC than neonates from mothers without ...
Deutsche medizinische Wochenschrift (1946), 2017
Background German medical students have to perform a nursery internship of three month duration. ... more Background German medical students have to perform a nursery internship of three month duration. While this internship is widely discussed, there is a lack of student evaluation data. Objectives Here, for the first time, student evaluation of a nursery internship in internal medicine (IM) is investigated. Moreover, the question was raised, whether the early experience during this internship may influence students' attitude towards the specialty. Methods In a nation-wide online-survey, 767 German medical students (mean age 22.8 years; 58 % female) evaluated a nursery internship on an IM ward concerning integration in medical teams, teachers, structure and quality of teaching, and satisfaction. Multivariate comparisons were conducted following the question, whether students could imagine choosing IM for a clinical elective after this nursery internship. Results 71 % of the students felt well integrated in the medical team, most was learned from the nurses, and most students indica...