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Biomedical subjects

B Salle

Publications and source records attributed to B Salle.

At least 73 records · Page 4Linked to original sources

[High frequency ventilation by oscillation in the treatment of the hyaline membrane disease in severe form].

Seventeen premature babies were ventilated with high frequency oscillation (HFO) for severe hyaline membrane disease. The results were compared to a group of 16 babies ventilated with classical positive pressure ventilation and presenting with hyaline membrane disease of the same severity. The results demonstrated an improvement of the mortality rate with HFO without any significant difference of pulmonary or neurologic complications. Furthermore, a controlled study in order to demonstrate an improvement of this type of ventilation is required.

Carbon Dioxide↗

[Influence of the mode of delivery on perinatal mortality in infants less than 32 weeks gestational age].

Survival rate of 96 low-birth-weight infants less than 32 weeks post-conceptional age at birth was studied in relation with the mode of delivery. Twenty-two infants were delivered by elective cesarean section because of abnormalities during pregnancy with 3 neonatal deaths. Seventy-four infants were born after untreatable premature onset of labor with 9 intrapartum and 7 neonatal deaths. Poor prognosis was associated with gestational age (less than 29 weeks), non cephalic vaginal delivery and multiple births. In these cases, cesarean section should be discussed.

Delivery, Obstetric↗

Increased percentage of activated Ia+ T lymphocytes in peripheral blood of neonates following exchange blood transfusion.

The expression of Ia-like antigens in peripheral blood T lymphocytes from newborns receiving postnatal total blood exchange was analyzed. A significantly increased percentage of Ia-positive T lymphocytes (Ia+ T cells) was observed 2 days after postnatal transfusion with total blood in comparison to data observed on Days 0, 5, and 15. Ia+ T cells were also significantly higher than in normal control newborns tested in the same period. When newborns received the blood exchange with irradiated total blood or with leukocyte-depleted blood, no increase in Ia+ T cells was observed and the percentage of these cells remained in the normal range (1-7%) on all the days tested (0, 2, 5, 15 days). For easy identification of the origin of Ia+ T cells, sex-incompatible blood was used for exchange, and a karyotype analysis was carried out for the detection of the Y chromosome on Ia+ T cells separated from peripheral blood on Day 2 and then cultured with interleukin 2 (IL-2) for 48 hr. It was thus established that Ia+ T cells were not of donor origin. Simultaneously with the expression of Ia-like antigens, host T cells also carried the interleukin-2 receptor (TAC). An allogeneic response, comparable to a host-versus-graft reaction, was probably responsible for the activation of T cells 2 days after total blood exchange in newborns.

Exchange Transfusion, Whole Blood↗

Effect of stimulus intensity variation on brain-stem auditory evoked potentials: comparison between neonates and adults.

Brain auditory evoked potentials (BAEPs) were recorded from 40 adult subjects and 40 neonates at 80 and 60 dB (nHL) to compare the effects of stimulus intensity variation on waves I, III and V and on intervals I-III, III-V and I-V. The results show that the changes in latency for wave, I, I-III and I-V intervals are significantly greater in neonates than in adults. So the effects of stimulus intensity variation on BAEPs are different in neonates and in adults and a major effect is in the peripheral auditory mechanism.

Acoustic Stimulation↗

Brainstem auditory evoked responses alteration in twin neonates.

The authors obtained BAER recordings for 20 premature twins and 20 premature non-twins. The two groups were comparable as to conceptional age (36-37 weeks), gestational age, chronological age, birthweight, sex ratio and head size. The results showed a prolongation of the central conduction time (I-V interval) in the premature twins. This may be due to the intra-uterine growth retardation of twins.

Birth Weight↗

Energy balance and composition of body weight.

Weight gain composition of growing very low birthweight (VLBW) premature infants can be assessed by a combined technique of nutrient balance and indirect calorimetry measurement. Both protein and energy intakes play an important role in the rate of growth and in the amount of non-protein energy (i.e. fat) storage. High energy intake is not always correlated with a higher rate of growth and can lead to high fat storage.

Body Composition↗

Supplementation of pooled human milk with casein hydrolysate: energy and nitrogen balance and weight gain composition in very low birth weight infants.

Growth and nitrogen and energy balances were studied with a combined technique of nutrient balance and indirect calorimetry measurement in two groups of eight very low birth weight infants fed pooled pasteurized human milk (HM) or cow's milk casein hydrolysate supplemented HM (HM-Pr). There was no difference in the amount of energy absorbed (91 +/- 17 kcal/kg/day with HM-Pr versus 95 +/- 8 with HM-P) or in the growth rate. The infants fed HM-Pr had a higher nitrogen intake (602 +/- 80 versus 395 +/- 64 mg/kg/day; p less than 0.001), urinary nitrogen excretion (160 +/- 64 versus 78 +/- 16 mg/kg/day; p less than 0.005) and nitrogen retention (326 +/- 32 versus 252 +/- 48 mg/kg/day; p less than 0.01). They also had increased plasma concentrations of essential amino acids, urea nitrogen, and total protein without metabolic imbalance. Energy expenditure was higher (58 versus 49 kcal/kg/day; p less than 0.005) and energy storage lower (33 versus 47 kcal/kg/day; p less than 0.05) with HM-Pr. In percent of weight gain, protein and fat accretion represented 12 and 14% in HM-Pr group versus 10 and 27% in HM group. Very low birth weight infants fed casein hydrolysate supplemented pooled HM achieved a growth rate and a weight gain composition similar to the fetus.

Body Weight↗

[Supplementary parenteral nutrition in premature infants. Adaptation to amino acid intake].

The authors report a controlled study of the use of 2 types of amino-acid solutions for premature infants nutrition in the first days of life, one of the solution (solution I) being adapted for prematures. The average amino-acid blood levels in prematures receiving solution I were close to those observed in cord blood; Plasma taurine, alanine and arginine concentrations were significantly lower with normalized levels of aromatic amino-acids, lysine, taurine and proline; serum ammonia level was also lower. This study shows that using an amino-acid solution adapted to prematures as a supplement to parenteral nutrition during the first days of life allows to progressively increase the nitrogen intakes without inducing dangerous plasma levels of some amino-acids.

Amino Acids↗

[Involvement of the urinary tract in a syndrome of congenital epidermolysis bullosa and atresia of the pylorus].

Epidermolysis bullosa associated with pyloric atresia is a rare autosomal recessive condition, usually fatal in the first few months of life. Since 1983 urinary tract disease is known to be another manifestation of this syndrome which becomes the main problem in children surviving beyond infancy. The case of a 2 1/2 year-old boy with mild cutaneous manifestations of junctional epidermolysis bullosa, corrected pyloric atresia and renal disease is reported. Hematuria, dysuria, obstruction of the uretero-vesical junction and worsening hydronephrosis led to bilateral ureterostomy (ureteral reimplantation was not attempted because the thickness of the bladder wall and the extensive ureteral fibrosis).

Child, Preschool↗

[Periventricular leukomalacia in the premature infant with gestational age less than or equal to 32 weeks. Circumstances of onset and echographic aspects].

In a retrospective study of 83 preterm newborns of 32 weeks of gestation or less, isolated periventricular leukomalacia was found in 7 cases (8.4%). Ultrasonographic diagnosis was made in all cases during the first 3 days of life and cystic lesions always occurred during the first 40 days. Five of the 7 newborns suffered from in utero asphyxia, 4 had an Apgar score below 5 at 5 min, and only 4 presented a respiratory distress syndrome. Thus the diagnosis of periventricular leukomalacia can be established early by ultrasonography. In utero asphyxia seems to be a critical determinant of ischaemic brain lesions.

Apgar Score↗

[Respiratory ultradian variations of mean and low frequencies (from 2-80 cycles per day) in premature human infants].

Oxygen consumption (VO2) and carbon dioxide production (VCO2) were continuously measured in premature human (mean gestation age of 31 weeks at birth), nursed in incubators within a neutral thermal environment and submitted to a continuous lighting. At a mean postnatal age of 30 days, and for a mean body weight of 1.8 kg, spectral analysis shows VO2 and VCO2 ultradian variations of mean and low frequencies (2 less than f less than 80 c.day--1; i.e. periods 12 greater than t greater than 0.3 hr). It is hypothesized that these periodic variations can be compared to those previously evidenced in small laboratory vertebrates and in macaques.

Carbon Dioxide↗

[Cesarean section before the end of 32 weeks of amenorrhea].

The authors report the results of 59 caesarean operations in which 74 children were born before the end of the 32nd week of amenorrhoea. The gross mortality was 21.9% and the corrected mortality 18.5%. 7.9% of the infants had major neurological sequellae and 8.6% mild sequellae. 65.2% are alive and well with normal psychomotor development. The follow-up has been between 1 and 5 years. The factors that influence survival and the indications for caesarean section at this time are reviewed and discussed.

Birth Weight↗

[Neonatal testicular torsion].

Twenty-six cases of neonatal torsion of spermatic cord were studied and compared to 171 cases reported in the literature. In a few cases, the torsion was antenatal and this may explain some absent testes. Diagnosis is sometimes difficult to make; symptoms were comparable to those in other disorders: peritoneo-vaginal tunnel, testicular inflammation or testicular tumor. In these cases, surgery can make the exact diagnosis although it cannot save the testis even if it is performed early.

Atrophy↗

[Pharmacokinetics of injectable phenobarbital in the premature infant. Study of a new lyophilized form].

A lyophilized preparation of phenobarbital was studied in newborns without cerebral palsy. Plasma levels were determined using gas chromatograph fitted with thermo ionic probe after either an intra-muscular (IM) injection in premature infants or an intravenous (IV) injection over single dose of phenobarbital 10 mg/kg within 6 hours after birth. Five term babies were included in the study as controls and received an IM injection. The results showed rapid increase in plasma concentration after IM injection in 10 of 13 subjects with a peak concentration reached 60 minutes after injection. The mean ratio (maximal concentration/dose) was 1.25 and 1.10 for term infants and preterm infants respectively. In all cases, the drug was well tolerated. In 15 preterm infants (n: 7 IM and n: 8 IV) the plasma concentrations were followed over a period of 15 days. The disappearance curve was biphasic; it varied the first 7 days, then remained constant for the following week (apparent half life 106 hours).

Freeze Drying↗

[Fate of infants weighting less than 1,500 grams].

Between 1981 and 1983, 251 premature infants with a birth weight of less than 1 500 grams were admitted to the Neonatal Pathology Unit of the E. Herriot hospital (malformations excluded). Forty two (17%) died during the neonatal period. These premature births resulted essentially from pathological pregnancies: multiple pregnancies (1/5 cases), renal pathology (1/3 cases), placental abnormalities (10%) and fetoplacental infections (10%). In half of all cases delivery was by cesarian section, indicated in 85% of cases because of acute or chronic fetal distress. These premature infants suffered from respiratory (including 40% hyaline membrane disease), neurological (abnormal cerebral echotomography with dilatation or intracranial haemorrhage in 35% of cases), infectious (6%) and digestive (6% necrosing enterocolitis) pathology. Of the 208 surviving children, 12 (i.e. 6% of the survivors) had major sequelae (with follow-up of one year or more).

Humans↗