Papers by Angelika Berger
Pediatric research, Jan 13, 2017
Pentoxifylline (PTX), a methylxanthine derivate with immunomodulating properties, has been used a... more Pentoxifylline (PTX), a methylxanthine derivate with immunomodulating properties, has been used as adjunctive treatment in severe neonatal sepsis. The aim of the study was to investigate PTX's anti-inflammatory effects on LPS stimulated monocytes of preterm neonates in vitro compared to monocytes from term infants and adult controls. Whole cord blood and control adult blood samples were incubated with LPS and PTX. The expression of surface markers, phagocytosis, cytokine secretion and Toll-like-receptor (TLR)4 signaling of monocytes were assessed by flow cytometry. Changes of TLR4-mRNA levels were confirmed by RT- PCR. The expression of CD14, CD11b, CD64, CD71 and CD80 was downregulated by PTX in a dose dependent manner, the greatest affect was observed on CD14 and CD11b in preterm infants. PTX markedly down-regulated LPS induced TNF-α, IL-1β and IL-6 levels in all age groups. Early IL-10 production was significantly downregulated by PTX in term and preterm neonates, while remai...
Zeitschrift für Geburtshilfe und Neonatologie, 2009
Acta Paediatrica
AimThe aim of this study was to measure the brain activity of preterm infants treated with caffei... more AimThe aim of this study was to measure the brain activity of preterm infants treated with caffeine citrate and doxapram for preterm apnea, using amplitude-integrated electroencephalography (aEEG), to identify any adverse effects on cerebral function.Methods We analysed the aEEG tracings of 13 preterm infants < 30 weeks of gestation before, during and after doxapram treatment, with regard to background activity (percentages of continuous and discontinuous patterns), occurrence of sleep-wake cycling and appearance of electrographic seizure activity. They were also compared to 61 controls without doxapram treatment.ResultsDuring doxapram treatment, aEEG tracings showed an increase in continuous background activity (19% ± 30% before treatment, 38% ± 35% during treatment) and a decrease in discontinuous patterns. In addition, they showed more frequent electrographic seizure activity (0% before treatment, 15% ± 37% during treatment) and less frequent sleep-wake cycling (92% ± 27% befo...
PloS one, 2015
To determine whether the complementary approach of visceral manipulative osteopathic treatment ac... more To determine whether the complementary approach of visceral manipulative osteopathic treatment accelerates complete meconium excretion and improves feeding tolerance in very low birth weight infants. This study was a prospective, randomized, controlled trial in premature infants with a birth weight <1500 g and a gestational age <32 weeks who received a visceral osteopathic treatment 3 times during their first week of life or no treatment. Passage of the last meconium occurred after a median of 7.5 days (95% confidence interval: 6-9 days, n = 21) in the intervention group and after 6 days (95% confidence interval: 5-9 days, n = 20,) in the control group (p = 0.11). However, osteopathic treatment was associated with a 8 day longer time to full enteral feedings (p = 0.02), and a 34 day longer hospital stay (Median = 66 vs. 100 days i.e.; p=0.14). Osteopathic treatment was tolerated well and no adverse events were observed. Visceral osteopathic treatment of the abdomen did not acc...
The Pediatric Infectious Disease Journal, 2010
To test the hypothesis that a considerable number of preterm infants acquire respiratory syncytia... more To test the hypothesis that a considerable number of preterm infants acquire respiratory syncytial virus (RSV) within the hospital during the postnatal stay, a prospective epidemiologic survey was performed. Nasopharyngeal swabs were taken twice weekly for a period of 8 weeks from preterm infants, medical/nursing staff, and parents during the peak of RSV season 2007/2008 and tested for RSV by polymerase chain reaction. Of 1002 samples, only 4 tested positive (2 from a patient, 2 from staff). Sequence analyses of the G protein demonstrated that nosocomial transmission did not occur between these individuals.
Pediatric research, 2015
Specific probiotics prevent necrotizing enterocolitis (NEC). A mixture of lactobacilli and bifido... more Specific probiotics prevent necrotizing enterocolitis (NEC). A mixture of lactobacilli and bifidobacteria (Infloran) was highly effective in Asian very-low-birth-weight (VLBW) infants. We analyzed the effect of Infloran on NEC, NEC severity, and the influence of enteral feedings (breast milk vs. formula) on NEC prevention in a cohort of European VLBW infants. Infloran was implemented for routine use at our department. VLBW infants receiving probiotics were prospectively followed (2010-2012) and compared with historic controls (2008-2009). Data on NEC, neonatal morbidity, feeding tolerance, and descriptive parameters on NEC cases were analyzed. Infloran had no statistically significant impact on NEC (controls: 24/233 (10.3%); probiotics: 16/230 (7%); P = 0.2). However, NEC was significantly reduced in infants of the probiotics group who were fed any breast milk (20/179 (11.2%) vs. 10/183 (5.5%); P = 0.027), whereas it was ineffective in infants exclusively fed formula (4/54 (7.4%) vs...
Molecular and Cellular Pediatrics, 2014
Biology of The Neonate, 2003
Background: The bactericidal efficacy of aminoglycosides is directly related to maximum serum con... more Background: The bactericidal efficacy of aminoglycosides is directly related to maximum serum concentrations, particularly the initial one. Therefore, several groups have recommended an aminoglycoside loading dose. Our goal was to develop a simplified dosage regimen for preterm infants which would result in therapeutic maximum serum concentrations early in the course of therapy. Methods: Open, noncomparative study during November 2000 to
Journal of Parenteral and Enteral Nutrition, 2015
The present study provides data on the clinical application of the recently launched "Numeta bags... more The present study provides data on the clinical application of the recently launched "Numeta bags" (Baxter, Deerfield, IL) for the parenteral nutrition (PN) of preterm infants. These bags are the first ready-to-use bags designed for PN or partial PN of infants weighing <1500 g. However, data on adequate supplementation with nutrients according to European Society for Pediatric Gastroenterology, Hepatology and Nutrition guidelines and data on costs have been missing so far. Therefore, this study compared the intake of nutrients between Numeta and individually prescribed PN solutions. These calculations were performed with a new prescription software for PN solutions (catoPAN; Cato Software Solutions, Becton Dickinson, Vienna, Austria). This software is a useful PN prescription tool considering enteral intake and 24-hour medication. Therefore, the software provides exact data on fluid management and entire nutrition intake. The results of the study report on the clinical application of new PN tools and therefore contribute to an improvement in the PN of preterm infants.
Pharmacology & Therapeutics, 2015
The Poly(I:C)-induced maternal immune activation model in preclinical neuropsychiatric drug disco... more The Poly(I:C)-induced maternal immune activation model in preclinical neuropsychiatric drug discovery, Pharmacology and Therapeutics (2015), Abstract Increasing epidemiological and experimental evidence implicates gestational infections as one important factor involved in the pathogenesis of several neuropsychiatric disorders. Corresponding preclinical model systems based upon maternal immune activation (MIA) by treatment of the pregnant female have been developed. These MIA animal model systems have been successfully used in basic and translational research approaches, contributing to the investigation of the underlying pathophysiological mechanisms at the molecular, cellular and behavioural levels. The present article focusses on the application of a specific MIA rodent paradigm, based upon treatment of the gestating dam with the viral mimic polyinosinic-poly cytidilic acid (Poly(I:C)), a synthetic analog of double-stranded RNA (dsRNA) which activates the Toll-like receptor 3 (TLR3) pathway. Important advantages and constraints of this animal model will be discussed, specifically in light of gestational infection as one vulnerability factor contributing to the complex aetiology of mood and psychotic disorders, which are likely the result of intricate multi-level gene x environment interactions. Improving our currently incomplete understanding of the molecular pathomechanistic principles underlying these disorders is a prerequisite for the development of alternative therapeutic approaches which are critically needed in light of the important drawbacks and limitations of currently available pharmacological treatment options regarding efficacy and side effects. The particular relevance of the Poly(I:C) MIA model for the discovery of novel drug targets for symptomatic and preventive therapeutic strategies in mood and psychotic disorders is highlighted in this review article.
Wiener Klinische Wochenschrift, 2003
Neonates are sensitive to pain and vulnerable to both its short-term and long-term effects. Manag... more Neonates are sensitive to pain and vulnerable to both its short-term and long-term effects. Management of analgesia is thought to be hampered by lack of awareness that newborns are capable of experiencing pain and by fears about adverse effects associated with analgesics. The purpose of this study was to assess current medical practice in preventive analgesia and sedation in the neonate throughout Austria. This report details the results of a survey in 28 neonatal intensive care units (NICUs) in Austria. Data collection took place from October to December 2001. All NICUs reported the capability of newborns to experience and express pain and nearly all stated the possibility of pain affecting morbidity. Validated scores for pain assessment were used by 11% of NICUs, standardized protocols for analgesia existed in 75%, and 100% practiced non-pharmacological treatment strategies. The use of preventive measures in routinely performed painful procedures ranged from 8% to 96%. For example, only 8% of NICUs prevent distress and pain prior to umbilical vessel catheterization, 29% prior to subcutaneous injections and 46% prior to heel lancing. Nearly all NICUs apply analgesia before lumbar puncture and thoracic-drain placement, and all use analgesic and/or sedative medication in elective intubation. There is widespread awareness among neonatologists of the importance and effects of distress caused by pain in newborns. However, the necessity of providing sufficient analgesia is underestimated. Further information on the safety of analgesic drugs in neonatology is imperative.
Ultrasound in Medicine & Biology, 2005
The purpose of the study was to assess reference ranges for lateral ventricular volume of very lo... more The purpose of the study was to assess reference ranges for lateral ventricular volume of very low birth weight (VLBW) infants using 3-D ultrasound (US). A total of 108 patients with birth weights <1500 g or mother's postmenstrual age <32 weeks were examined prospectively in a longitudinal study. Infants in conditions considered being potential confounders such as intraventricular haemorrhage (IVH) and periventricular leukomalacia (PVL) were not included in the calculations. Hence, 77 subjects remained for final statistical analysis. Mean postmenstrual age at birth was 194.5 (27 weeks and 5.5 days) ؎ 14 SD days, mean birth weight was 972.5 ؎ 236.3 SD g. Reference ranges for lateral ventricle volume were established from serial images. The exponential regression analyses revealed a weekly increase in volume of 6.3% (95% CI 4.4%-8.3%) and 6.6% (95% CI 4.7%-8.6%) in respect to the left and the right ventricle (p < 0.001). Postmenstrual age correlated significantly p < 0.015) with ventricle volume. No significant association to head circumference could be determined. Establishment of reference values for the lateral ventricle volume of VLBW infants should facilitate application of 3-D US in routine diagnostics in neonatal intensive care units and detection of ventricular enlargement as a prediction of risk for poor neurodevelopmental outcome in high-risk cohorts. (E-mail: [email protected]) © 2005 World Federation for Ultrasound in Medicine & Biology.
Thrombosis and Haemostasis, 2004
Erythropoietin (Epo) is frequently administered to premature infants to stimulate erythropoiesis.... more Erythropoietin (Epo) is frequently administered to premature infants to stimulate erythropoiesis. There is evidence from studies in animals and healthy adults that Epo also interacts with thrombopoiesis and platelet function. This study investigates the effect of Epo therapy on platelet reactivity, peripheral platelet counts and thiazole orange-positive (TO+) platelets in extremely low birth weight (ELBW) infants. In a randomised-controlled trial, ELBW infants with a birth weight &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt; or =800 g and a gestational age &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt; or =32 weeks were either randomised to a group receiving Epo during the first weeks of life or to a control group. Our results show that thrombin receptor-activating peptide (TRAP-6) -induced expression of P-selectin increased significantly during the first two weeks of Epo treatment. With the exception of week five, the number of TO+ platelets was significantly higher during the first eight weeks in Epo-treated infants compared to controls. The increase of TO+ platelets was not paralleled by an increase in total platelet count. We can conclude that Epo therapy has a short-lasting effect on platelet reactivity toTRAP-6 in ELBW infants during the first two weeks of life. Furthermore, Epo therapy is associated with an increase in the number of TO+ platelets compared to controls.
PEDIATRICS, 2006
OBJECTIVES. Erythropoietin is frequently administered to premature infants to stimulate erythropo... more OBJECTIVES. Erythropoietin is frequently administered to premature infants to stimulate erythropoiesis. The primary goal of erythropoietin therapy is to reduce transfusions, but the efficacy of erythropoietin has not been convincingly demonstrated in this regard. The aim of this trial was to investigate whether combined administration of vitamin B 12 , folic acid, iron, and erythropoietin could decrease transfusion requirements in extremely low birth weight infants.
Medical and Pediatric Oncology, 1994
We used the fluorescence in situ hybridization (FISH) technique and centromere-specific probes fo... more We used the fluorescence in situ hybridization (FISH) technique and centromere-specific probes for chromosomes 1, 6, 8, 10, 12, 17, 18, X, and Y to investigate the presence and number of the respective chromosomes in interphase nuclei of 14 cases of childhood acute lymphoblastic leukemia (ALL) which were shown to be hyperdiploid by DNA flow cytometry irrespective of their cytogenetic pattern. Numerical anomalies for one or more chromosomes were detected in all 14 cases. The FISH results were compared with those obtained by conventional cytogenetic analysis. A hyperdiploid karyotype was evident in 5 cases, the others were either normal or lacking cytogenetic results because of technical failure. In the 5 cytogenetically hyperdiploid cases, 14 numerical abnormalities were observed with both techniques, whereas 4 numerical deviations were found only with FISH. In 9 other cases which had a DNA content indicating hyperdiploidy, 34 trisomies and 2 tetrasomies were detected by FISH analysis. Furthermore, in 1 case duplication of the Y chromosome and in 3 male cases duplication of the X chromosome were evident. Double-target FISH experiments in 2 patients allowed the correlation of numerical aberrations of 2 chromosomes in one and the same cell. By such analyses, detection of subpopulations of tumor cells was found to be relatively easy. Our results indicate that the FISH technique with chromosome-specific repetitive centromeric probes is a rapid, simple to use, and easy to interpret technique for the evaluation of numerical chromosomal aberrations in interphase nuclei of leukemias.
Neonatology, 2009
Background-In the early weeks of life, very low birth weight (VLBW) infants experience intense la... more Background-In the early weeks of life, very low birth weight (VLBW) infants experience intense laboratory blood sampling leading to clinically significant anemia and the need for red blood cell transfusion. Although controversial, treatment with recombinant human erythropoietin (EPO) and iron has been recommended to stimulate erythropoiesis; optimal dosing of EPO and iron is still uncertain.
Klinische Pädiatrie, 2010
Klinische Pädiatrie, 2010
Journal of Perinatal Medicine, 2000
The association between elevated interleukin (IL)-8 concentrations in amniotic fluid and preterm ... more The association between elevated interleukin (IL)-8 concentrations in amniotic fluid and preterm delivery is well described. Little consideration has been given to the impact of different groups of microorganisms within the amniotic cavity on IL-8 concentration. We collected amniotic fluid, placental tissue and amniotic membranes during preterm cesarean sections for bacterial culture. In addition, we determined IL-8 concentrations in maternal serum, amniotic fluid and cord blood and correlated them with the various intra-amniotic pathogens isolated by bacterial culture. IL-8 concentrations were determined in amniotic fluid in 107 cases, in cord blood in 185 cases and in maternal blood in 158 cases. Women with intra-amniotic Ureaplasma urealyticum infection had significantly higher amniotic fluid concentrations of IL-8 than those without (P&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt; 0.001). In cord blood, we found significantly elevated IL-8 concentrations due to intra-amniotic infection with U. urealyticum (P=0.045) and other pathogens (P=0.04). In maternal sera, we found no significant elevation of maternal IL-8 in any of the groups. Intrauterine infection with U. urealyticum seems to play a profound role in the cascade of inflammation and increases IL-8 concentrations in amniotic fluid and cord blood.
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Papers by Angelika Berger