Integrating terminologies into standard SQL: a new approach for research on routine data.

Background: Most electronic medical records still contain large amounts of free-text data. Semantic evaluation of such data requires the data to be encoded with sufficient classifications or transformed into a knowledge-based database.

Methods: We present an approach that allows databases accessible via SQL (Structured Query Language) to be searched directly through semantic queries without the need for further transformations.

From single-case analysis of neonatal deaths toward a further reduction of the neonatal mortality rate.

Background The infant mortality rate (IMR), a key indicator of the quality of a healthcare system, has remained at approximately 3.5‰ for the past 10 years in Germany. Generic quality indicators (QIs), as used in Germany since 2010, greatly help in ensuring such a good value but do not seem to be able to further reduce the IMR.

Ingeborg Syllm-Rapoport (1912-2017): An Exemplary Life for Children and Paediatrics.

Ingeborg Syllm-Rapoport, the first Chair in neonatology in Europe, passed away on March 23. Her biography illustrates how medical and scientific work has been influenced by social, ideological, and economic frames and boundaries in the 20th century. Regarded as a "Half-Jew" by the Nazi racist laws, she was denied her medical doctorate.

Dead space reduction by Kolobow's endotracheal tube does not justify the waiving of volume monitoring in small, ventilated lungs.

In ventilated preterm infants the flow sensor contributes significantly to the total apparatus dead space, which may impair gas exchange. The aim of the study was to quantify to which extent a dead space reduced Kolobow tube (KB) without flow sensor improves the gas exchange compared with a conventional ventilator circuit with flow sensor [Babylog 8000 (BL)]. In a cross-over trial in 14 tracheotomized, surfactant-depleted (saline lavage) and mechanically ventilated newborn piglets (age <12 h; body weight 705-1200 g) BL and KB was applied alternately for 15 min and blood gases were recorded.

A comparison of conventional surfactant treatment and partial liquid ventilation on the lung volume of injured ventilated small lungs.

As an alternative to surfactant therapy (ST), partial liquid ventilation (PLV) with perfluorocarbons (PFC) has been considered as a treatment for acute lung injury (ALI) in newborns. The instilled PFC is much heavier than the instilled surfactant and the aim of this study was to investigate whether PLV, compared to ST, increases the end-expiratory volume of the lung (VL). Fifteen newborn piglets (age <12 h, mean weight 678 g) underwent saline lung lavage to achieve a surfactant depletion.

Standardized diaper care regimen: a prospective, randomized pilot study on skin barrier function and epidermal IL-1α in newborns.

Adaptation of skin barrier function and interleukin-1α (IL-1α) content in diapered and nondiapered skin are poorly characterized in newborns receiving standard skin care. In a monocentric, prospective pilot study 44 healthy, full-term neonates were randomly assigned to skin care with baby wipes (n = 21) or water-moistened washcloth (n = 23) at each diaper change. Transepidermal water loss (TEWL), skin hydration, skin-pH, IL-1α, and epidermal desquamation were measured on days 2, 14, and 28 postpartum.

Effect of standardized skin care regimens on neonatal skin barrier function in different body areas.

The effect of topical skin care products on neonatal skin barrier during first 8 weeks of life has not been scientifically evaluated. In a prospective, randomized clinical study, we compared the influence of three skin care regimens to bathing with water on skin barrier function in newborns at four anatomic sites. A total of 64 healthy, full-term neonates (32 boys and 32 girls) aged <48 hours were randomly assigned to four groups receiving twice-weekly: WG, bathing with wash gel (n = 16); C, bathing and cream (n = 16); WG + C, bathing with wash gel plus cream (n = 16); and B, bathing with water (n = 16).

Radiation exposure in 212 very low and extremely low birth weight infants.

Objective: We determined the frequency and estimated effective radiation dose (E) from conventional diagnostic radiographs for infants who had birth weight of
Methods: Entrance skin doses were experimentally measured for all standard weight-dependent exposure settings. For each radiograph in the radiologic file, the exposed area on the film was measured manually.

Comparison of lung volume measurements by multiple-breath heptafluoropropane washout and computed tomography in small ventilated piglets.

Background: Knowledge of lung volume is essential for monitoring and optimizing mechanical ventilation. The aim of this study was to compare lung volume measurements by multiple-breath heptafluoropropane (HFP) washout (MBW) and by respiratory gated computed tomography (CT) in ventilated newborn piglets.

Material/methods: In 6 ventilated piglets (age: <12 h, median weight: 945 g) blood gases, respiratory mechanics, and lung volumes were measured in both the supine and prone positions.

Is volume and leak monitoring feasible during nasopharyngeal continuous positive airway pressure in neonates?

Objective: To investigate tidal volume (VT) and leak measurements during continuous positive airway pressure (CPAP) in neonates using a commercial ventilatory device equipped with a flow sensor at the Y-piece.

Design: Randomized cross-over trial.

Setting: Neonatal intensive care unit level III.

Impaired somatic growth and delayed lung development in infants with congenital diaphragmatic hernia--evidence from a 10-year, single center prospective follow-up study.

Purpose: In infants with congenital diaphragmatic hernia (CDH), somatic growth and pulmonary development are key issues beyond the time of intensive care treatment. The aim of the study was to investigate the somatic growth and pulmonary function after discharge and to compare CDH patients with a group of matched controls.

Methods: Anthropometric measurements and lung function tests were performed in 26 infants after surgical repair of CDH and 26 non-CDH intensive care patients, matched for gestational age and birth weight.

Variations of Apgar score of very low birth weight infants in different neonatal intensive care units.

Objective: The Apgar score should be an objective method to assess the state of newborns; however, its applicability in preterm infants is hampered by large variations among different observers. The study tested whether physicians that give low scores to written case descriptions also apply lower scores to preterm infants.

Patients And Methods: Descriptions (BMJ 2004; 329: 143-4) were sent to 14 neonatal units.

Vascular endothelial growth factor as marker for tissue hypoxia and transfusion need in anemic infants: a prospective clinical study.

Objective: Oxygen-carrying capacity of blood is reduced in anemic infants because of low hemoglobin levels. Red blood cell transfusions become necessary if low hematocrit causes tissue hypoxia. No reliable parameters exist for detecting chronic tissue hypoxia.

Comparison of 2-h versus 3-h enteral feeding in extremely low birth weight infants, commencing after birth.

Aim: Immaturity is associated with problems in enteral nutrition of extremely low birth weight (ELBW) infants. Different time intervals between single feedings are used; however, no data are available to show a benefit of either regime.

Methods: In January 2001 enteral feeding regime was changed from 2-h to 3-h intervals.

Intratracheal perfluorocarbons diminish LPS-induced increase in systemic TNF-alpha.

Perfluorocarbons (PFC) reduce the production of various inflammatory cytokines, including TNF-alpha. The anti-inflammatory effect is not entirely understood. If anti-inflammatory properties are caused by a mechanical barrier, PFC in the alveoli should have no effect on the inflammatory response to intravenous LPS administration.

Which information will be given to parents of preterm infants--a comparison of estimates and local data.

Objective: Parents of preterm infants require information on morbidity and duration of common interventions performed in the NICU. Since locally achieved data are often not available, information is mainly based on educated guesses of health care professionals. The present study compares estimates of neonatal nurses or medical doctors (MDs) in two separate NICUs with local data.

Impact of maternal angiotensinogen M235T polymorphism and angiotensin-converting enzyme insertion/deletion polymorphism on blood pressure, protein excretion and fetal outcome in pregnancy.

Objective: To test the hypothesis that genetically determined alterations of the renin-angiotensin system are associated with hypertensive disorders in pregnancy.

Methods: A genetic association study was conducted at the obstetrics department of the Charité university hospital, Berlin, Germany. A total of 1068 Caucasian women were consecutively included after delivery and genotyped for the angiotensinogen M235T polymorphism and the angiotensin-converting enzyme (ACE) insertion/deletion polymorphism.

Alterations of alveolar type II cells and intraalveolar surfactant after bronchoalveolar lavage and perfluorocarbon ventilation. An electron microscopical and stereological study in the rat lung.

Background: Repeated bronchoalveolar lavage (BAL) has been used in animals to induce surfactant depletion and to study therapeutical interventions of subsequent respiratory insufficiency. Intratracheal administration of surface active agents such as perfluorocarbons (PFC) can prevent the alveolar collapse in surfactant depleted lungs. However, it is not known how BAL or subsequent PFC administration affect the intracellular and intraalveolar surfactant pool.

Isolated left-sided congenital diaphragmatic hernia: cardiac axis and displacement before fetal viability has no role in predicting postnatal outcome.

Objectives: The purpose of this retrospective study was to determine whether objective assessment of cardiac shifting on two-dimensional ultrasonography can predict postnatal outcome in fetuses with isolated left-sided congenital diaphragmatic hernia (CDH).

Materials And Methods: Still images at the level of the four-chamber view were obtained in 23 fetuses with left-sided CDH. A group of 12 fetuses (3 non-survivors and 9 survivors) were examined at two periods, between 20 and 30 weeks and between 31 and 40 weeks.

Perfluorocarbons decrease Chlamydophila pneumoniae-mediated inflammatory responses of rat type II pneumocytes in vitro.

Chlamydophila pneumoniae alter the expression of Toll-like receptor (TLR) 4 in alveolar type II (ATII)-cells. Subsequently nuclear factor kappaB (NF-kappaB) is activated and tumor necrosis factor-alpha (TNF-alpha) and macrophage inflammatory protein 2 (MIP-2) are produced. Perfluorocarbons (PFC) are beneficial in animals with bacterial pneumonia and reduce production of TNF-alpha.

Observational study to compare the clinical efficacy of the natural surfactants Alveofact and Curosurf in the treatment of respiratory distress syndrome in premature infants.

Introduction: Natural surfactants have been shown to be superior to synthetic surfactants in the treatment of neonatal respiratory distress syndrome (RDS). In Germany, Alveofact (A) and Curosurf (C) are the most frequently used natural surfactant preparations. The aim of this retrospective, observational study was to compare the effects of A and C on gas exchange and outcome in premature infants.

Functional residual capacity measurement by heptafluoropropane in ventilated newborn lungs: in vitro and in vivo validation.

Objective: Heptafluoropropane is an inert gas commercially used as propellant for inhalers. Since heptafluoropropane can be detected in low concentrations, it could also be used as a tracer gas to measure functional residual capacity and ventilation homogeneity. The aim of the present study was to validate functional residual capacity measurements by heptafluoropropane wash-in/wash-out (0.

Somatostatin or octreotide as treatment options for chylothorax in young children: a systematic review.

Objective: Chylothorax is a rare but life-threatening condition in children. To date, there is no commonly accepted treatment protocol. Somatostatin and octreotide have recently been used for treating chylothorax in children.