P. Bartmann - Academia.edu (original) (raw)

Papers by P. Bartmann

Research paper thumbnail of Long term cardiac follow up of severe twin to twin transfusion syndrome after intrauterine laser coagulation

Heart, 2006

To assess long term changes in cardiac morphology and function in survivors of severe twin to twi... more To assess long term changes in cardiac morphology and function in survivors of severe twin to twin transfusion syndrome (TTTS) after intrauterine laser coagulation of placental anastomoses. Design: Prospective follow up of fetuses with severe TTTS treated by laser coagulation of intrauterine placental anastomoses. Fetal echocardiography and Doppler studies of feto-placental haemodynamic function were performed at the time of laser coagulation (median gestational age of 21.7 weeks). Postnatal cardiac follow up included a detailed echocardiographic study of systolic and diastolic cardiac function at a median age of 21.1 months. Setting: Paediatric cardiology unit. Patients: 89 survivors from 73 consecutive pregnancies with severe TTTS. Results: Before laser treatment, 28 of 51 (54.9%) recipient twins had typical signs of cardiac dysfunction due to volume overload and 9 of 38 (23.7%) donors had absent or reversed end diastolic flow in the umbilical artery. Echocardiography was normal in 87.6% of the survivors (34 of 38 donors, 44 of 51 recipients). The prevalence of congenital heart disease and particularly of pulmonary stenosis, which was recorded only in recipients, was increased in comparison with the general population (congenital heart disease, 10 of 89 (11.2%) v 0.3%; pulmonary stenosis, 4 of 51 (7.8%) v 0.03%). Findings before laser treatment were not correlated with the development of structural heart disease. Conclusions: Despite the high rate and severity of prenatal cardiac overload in recipients, the majority of cases of TTTS are normalised after laser treatment. However, given the increased prevalence of congenital heart disease and in particular pulmonary stenosis, intrauterine and postnatal follow up is warranted.

Research paper thumbnail of The Influence of Dexamethasone on Lymphocyte Proliferation in Whole Blood Cultures of Neonates

Pediatric Research, 1994

After tracheal instillation o f S, changes o f blood presaure (nP) and o f cerebral blood flow ve... more After tracheal instillation o f S, changes o f blood presaure (nP) and o f cerebral blood flow velocities have been observed. Can sucli circulatory disturbances he avoided by instill;ition o f hlSD? A r e oxygenation and pulmonary S distribution affected by lltis inatillatir~n n~etllod? I n Y adult r;ibhi~s, rea iratory dislrcss was induced 11y repeated haline lu11 lavages (until 1'20, XI S <& tnnlllg with Fi0,=1.0). S (CuroaurO labelled wilk colored micrr~aphc?cs (CMS) w;~s ~natilled either as U (1 x 2OC rn-/kg) r~r as M S D (5 x 50 rng/kg). A r t e r~a l blood 'ares and UP were rnoniloref: determine S distribution, the lungs o f cacti 'anim:il were cut into 60-70 pieces to measure lhe n~r t i~h c r crf ChlS In cacli ~licce. After B. 1'20, increased l o >300 m m l l g within 2 rriin and rcm:~ined at;thle. Mean UI' d r r~l r J , tr;~!isicntly frrlm H0+2.1 1c1 62+ 6.0 m m l l-(rnc:~n+ SEhI). l'ulrnonary S ~s t r~h u t~o n was fairly I~r~niogeneous. Afler ~s I) , l'n0, r o w atcpwi\c to >300 ~n l i~l l g. 11111 dccrc:~\cd :~g;~in ;lf~cr 1 11. Ill' tlrrrl~l~c(f 1ro111 ')I 22.1 111 75 + 10 IIIIII~ Ig. S d i \ t r i l~~t l i~~~~ \v:1\ vcr LIIICVCII Will1 MSI> o f S it~rtc:ltl o f one I1olu6. 116 cll:lngc;

Research paper thumbnail of Congenital chylothorax: lymphopenia and high risk of neonatal infections

Acta Paediatrica, 2007

To describe the clinical course of patients with congenital chylothorax focusing on infectious co... more To describe the clinical course of patients with congenital chylothorax focusing on infectious complications. Congenital chylothorax is a common manifestation of non-immune hydrops fetalis (NIHF). The drainage of chyle leads to loss of cellular and plasmatic factors that influence the patient's immune response and increase the risk of infections. Methods: In a retrospective analysis of 24 preterm infants with NIHF treated between 1998 and 2002, congenital chylothorax was diagnosed in 7 patients. Results: All 7 patients were treated conservatively with pleural drainage over a median period of 22 d (range 10-36 d). Lymphopenia was found in all patients (median of minimal lymphocyte counts 285/ml, range 80-770). The nadir was on day 5 (2-6 d). Lymphopenia lasted for 12 d median (range 4-39 d) and was significantly correlated with the duration of lymph drainage (p = 0.001). Cell-surface analysis of peripheral blood lymphocytes was performed in two patients. Both patients had a decreased number of total T cells. Four out of seven (57%) patients developed nosocomial infections. This incidence of nosocomial infections in patients with congenital chylothorax is about three times higher than that in other neonatal patients. None of the children suffered from fungal or viral infection. Although there was a very high incidence of infections, no correlation between lymphopenia and the occurrence of infections could be shown. Conclusion: Drainage of congenital chylothorax results in the loss of lymphocytes and bears a high risk of infections.

Research paper thumbnail of IgG2 deficiency in children with human immunodeficiency virus infection

European Journal of Pediatrics, 1991

Infection with the human immunodeficiency virus (HIV) induces a polyclonal B-cell activation. Des... more Infection with the human immunodeficiency virus (HIV) induces a polyclonal B-cell activation. Despite elevated serum immunoglobulin levels, a significant deterioration of the antigen specific humoral immune response exists in most cases. We studied the influence of HIV infection on the serum levels of IgG subclasses in children. We investigated 76 children (aged 15 months to 18 years) with HIV-1-infection. Most children (88%) showed elevated serum immunoglobulin levels. IgA (87%) and IgM (74%) were more often above normal levels for age than IgG (60%). IgG subclass serum levels were significantly altered. The increase in total IgG was mainly due to a marked augmentation of the IgG1 fraction. In most cases IgG3 was simultaneously elevated. Ten children (13%) had very low IgG4 levels (less than 0.03 g/l). Out of 61 patients older than 2 years 8 (13%) had a profound IgG2 deficiency with normal or elevated total IgG. Four of them also had low IgG4 levels (less than 0.03 g/l). A correlation between IgG2 deficiency and HIV infection according to the Centres for Disease Control classification for acquired immunodeficiency syndrome could not be demonstrated (three patients with symptomatic and five with asymptomatic infection).

Research paper thumbnail of Klinische und immunologische Charakteristika des variablen Immundefektsyndroms

ABSTRACT Erste Hinweise auf eine Störung der Immunantwort lassen sich aus dem klinischen Bild erk... more ABSTRACT Erste Hinweise auf eine Störung der Immunantwort lassen sich aus dem klinischen Bild erkennen. Eine erhöhte Anfälligkeit gegenüber bakteriellen und viralen Infektionen, insbesondere der Atemwege und des Gastrointestinaltraktes, können auf einen Immundefekt hinweisen. Eine pathologische Infektanfälligkeit durch primären Immundefekt kann die Folge von Störungen der unspezifischen Abwehr sein, z.B. Komplement- oder Phagozytendefekte, oder sie kann durch Störungen der spezifischen Immunabwehr bedingt sein, d.h. durch Störungen des T- und/oder B-Zell-Systems [1].

Research paper thumbnail of Long term cardiac follow up of severe twin to twin transfusion syndrome after intrauterine laser coagulation

Heart, 2006

To assess long term changes in cardiac morphology and function in survivors of severe twin to twi... more To assess long term changes in cardiac morphology and function in survivors of severe twin to twin transfusion syndrome (TTTS) after intrauterine laser coagulation of placental anastomoses. Design: Prospective follow up of fetuses with severe TTTS treated by laser coagulation of intrauterine placental anastomoses. Fetal echocardiography and Doppler studies of feto-placental haemodynamic function were performed at the time of laser coagulation (median gestational age of 21.7 weeks). Postnatal cardiac follow up included a detailed echocardiographic study of systolic and diastolic cardiac function at a median age of 21.1 months. Setting: Paediatric cardiology unit. Patients: 89 survivors from 73 consecutive pregnancies with severe TTTS. Results: Before laser treatment, 28 of 51 (54.9%) recipient twins had typical signs of cardiac dysfunction due to volume overload and 9 of 38 (23.7%) donors had absent or reversed end diastolic flow in the umbilical artery. Echocardiography was normal in 87.6% of the survivors (34 of 38 donors, 44 of 51 recipients). The prevalence of congenital heart disease and particularly of pulmonary stenosis, which was recorded only in recipients, was increased in comparison with the general population (congenital heart disease, 10 of 89 (11.2%) v 0.3%; pulmonary stenosis, 4 of 51 (7.8%) v 0.03%). Findings before laser treatment were not correlated with the development of structural heart disease. Conclusions: Despite the high rate and severity of prenatal cardiac overload in recipients, the majority of cases of TTTS are normalised after laser treatment. However, given the increased prevalence of congenital heart disease and in particular pulmonary stenosis, intrauterine and postnatal follow up is warranted.

Research paper thumbnail of The Influence of Dexamethasone on Lymphocyte Proliferation in Whole Blood Cultures of Neonates

Pediatric Research, 1994

After tracheal instillation o f S, changes o f blood presaure (nP) and o f cerebral blood flow ve... more After tracheal instillation o f S, changes o f blood presaure (nP) and o f cerebral blood flow velocities have been observed. Can sucli circulatory disturbances he avoided by instill;ition o f hlSD? A r e oxygenation and pulmonary S distribution affected by lltis inatillatir~n n~etllod? I n Y adult r;ibhi~s, rea iratory dislrcss was induced 11y repeated haline lu11 lavages (until 1'20, XI S <& tnnlllg with Fi0,=1.0). S (CuroaurO labelled wilk colored micrr~aphc?cs (CMS) w;~s ~natilled either as U (1 x 2OC rn-/kg) r~r as M S D (5 x 50 rng/kg). A r t e r~a l blood 'ares and UP were rnoniloref: determine S distribution, the lungs o f cacti 'anim:il were cut into 60-70 pieces to measure lhe n~r t i~h c r crf ChlS In cacli ~licce. After B. 1'20, increased l o >300 m m l l g within 2 rriin and rcm:~ined at;thle. Mean UI' d r r~l r J , tr;~!isicntly frrlm H0+2.1 1c1 62+ 6.0 m m l l-(rnc:~n+ SEhI). l'ulrnonary S ~s t r~h u t~o n was fairly I~r~niogeneous. Afler ~s I) , l'n0, r o w atcpwi\c to >300 ~n l i~l l g. 11111 dccrc:~\cd :~g;~in ;lf~cr 1 11. Ill' tlrrrl~l~c(f 1ro111 ')I 22.1 111 75 + 10 IIIIII~ Ig. S d i \ t r i l~~t l i~~~~ \v:1\ vcr LIIICVCII Will1 MSI> o f S it~rtc:ltl o f one I1olu6. 116 cll:lngc;

Research paper thumbnail of Congenital chylothorax: lymphopenia and high risk of neonatal infections

Acta Paediatrica, 2007

To describe the clinical course of patients with congenital chylothorax focusing on infectious co... more To describe the clinical course of patients with congenital chylothorax focusing on infectious complications. Congenital chylothorax is a common manifestation of non-immune hydrops fetalis (NIHF). The drainage of chyle leads to loss of cellular and plasmatic factors that influence the patient's immune response and increase the risk of infections. Methods: In a retrospective analysis of 24 preterm infants with NIHF treated between 1998 and 2002, congenital chylothorax was diagnosed in 7 patients. Results: All 7 patients were treated conservatively with pleural drainage over a median period of 22 d (range 10-36 d). Lymphopenia was found in all patients (median of minimal lymphocyte counts 285/ml, range 80-770). The nadir was on day 5 (2-6 d). Lymphopenia lasted for 12 d median (range 4-39 d) and was significantly correlated with the duration of lymph drainage (p = 0.001). Cell-surface analysis of peripheral blood lymphocytes was performed in two patients. Both patients had a decreased number of total T cells. Four out of seven (57%) patients developed nosocomial infections. This incidence of nosocomial infections in patients with congenital chylothorax is about three times higher than that in other neonatal patients. None of the children suffered from fungal or viral infection. Although there was a very high incidence of infections, no correlation between lymphopenia and the occurrence of infections could be shown. Conclusion: Drainage of congenital chylothorax results in the loss of lymphocytes and bears a high risk of infections.

Research paper thumbnail of IgG2 deficiency in children with human immunodeficiency virus infection

European Journal of Pediatrics, 1991

Infection with the human immunodeficiency virus (HIV) induces a polyclonal B-cell activation. Des... more Infection with the human immunodeficiency virus (HIV) induces a polyclonal B-cell activation. Despite elevated serum immunoglobulin levels, a significant deterioration of the antigen specific humoral immune response exists in most cases. We studied the influence of HIV infection on the serum levels of IgG subclasses in children. We investigated 76 children (aged 15 months to 18 years) with HIV-1-infection. Most children (88%) showed elevated serum immunoglobulin levels. IgA (87%) and IgM (74%) were more often above normal levels for age than IgG (60%). IgG subclass serum levels were significantly altered. The increase in total IgG was mainly due to a marked augmentation of the IgG1 fraction. In most cases IgG3 was simultaneously elevated. Ten children (13%) had very low IgG4 levels (less than 0.03 g/l). Out of 61 patients older than 2 years 8 (13%) had a profound IgG2 deficiency with normal or elevated total IgG. Four of them also had low IgG4 levels (less than 0.03 g/l). A correlation between IgG2 deficiency and HIV infection according to the Centres for Disease Control classification for acquired immunodeficiency syndrome could not be demonstrated (three patients with symptomatic and five with asymptomatic infection).

Research paper thumbnail of Klinische und immunologische Charakteristika des variablen Immundefektsyndroms

ABSTRACT Erste Hinweise auf eine Störung der Immunantwort lassen sich aus dem klinischen Bild erk... more ABSTRACT Erste Hinweise auf eine Störung der Immunantwort lassen sich aus dem klinischen Bild erkennen. Eine erhöhte Anfälligkeit gegenüber bakteriellen und viralen Infektionen, insbesondere der Atemwege und des Gastrointestinaltraktes, können auf einen Immundefekt hinweisen. Eine pathologische Infektanfälligkeit durch primären Immundefekt kann die Folge von Störungen der unspezifischen Abwehr sein, z.B. Komplement- oder Phagozytendefekte, oder sie kann durch Störungen der spezifischen Immunabwehr bedingt sein, d.h. durch Störungen des T- und/oder B-Zell-Systems [1].