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Biomedical subjects

D Willard

Publications and source records attributed to D Willard.

At least 73 records · Page 4Linked to original sources

[Neonatal bacterial infections. Kinetic study of C-reactive protein and orosomucoid].

Changes in serum concentrations versus time of C reactive protein and orosomucoid were investigated in 134 neonates with either materno-foetal infection (group A, n = 111) or nosocomial infection (group B, n = 23). Both proteins were significantly elevated in group A neonates, with mean +/- S.E.M. values of 0.029 +/- 0,003 g/l for C reactive protein (n = 111) and 0.56 +/- 0.003 g/l for orosomucoid (n = 37). In cases with superinfection serum levels of both proteins rose before clinical symptoms developed. Changes in orosomucoid concentrations occurred a few hours after changes in C reactive protein concentrations. Monitoring C reactive protein and orosomucoid levels, in an excellent means of assessing the effectiveness of treatment and of deciding on its withdrawal when both proteins return to normal values.

Bacterial Infections↗

[Megalo-urethra. Single-stage neonatal correction. Review of the literature].

A scaphoid megalo-urethra was diagnosed in a premature, free of other associated malformations. Surgical correction by Nesbitt technic was performed at 2 500 g weight. The follow-up was uneventful and the cosmetic appearance of the penis is good. High rate of consanguinity is noted. The reported case is exceptional because 75% of the patients exhibited severe upper urinary tract anomalies. Prune belly and imperforate anus are also frequently associated.

Humans↗

C-reactive protein measurement: a reliable method of diagnosing and monitoring the infected newborn for the assessment of a mezlocillin therapeutic trial.

Clinical and bacteriological efficacy of mezlocillin was evaluated in 41 neonates (including 12 premature babies) with clinical and laboratory evidence of bacterial infection, as shown by elevated C-reactive protein serum concentrations. They received intravenous mezlocillin (80 to 100 mg/kg/dose) every 8 h for 10.4 days. The mean serum concentration (+/- S.E.M.) of mezlocillin in full-term neonates was 214 +/- 19.8 mg/l 1 h after the infusion and 52.0 +/- 9.3 mg/l prior to the next infusion. In premature neonates these mean concentrations were respectively 167 +/- 23.4 mg/l and 40.7 +/- 6.7 mg/l. The efficacy of mezlocillin was documented by the decrease in C-reactive protein serum concentrations and by improvement in clinical condition. Therapy with mezlocillin alone proved to be safe and effective when used for non-nosocomial infections during the neonatal period.

Bacteria↗

[Exfoliatin in neonatal staphylococcal infections].

An outbreak of staphylococcal skin infection in neonates was investigated clinically, bacteriologically and epidemiologically with the following findings: (1) In 8 out of 13 cases, exfoliatin-producing staphylococci were present in the bullae, which is unusual with bullous lesions occurring at other ages; (2) exfoliatin producing staphylococci were present in all children with bullous lesions, as well as in carriers; (3) 39% of the phage II group staphylococci studied produced exfoliatin; (4) purulent lesions due to phage II staphylococci which did not produce exfoliatin were observed. The contaminating agent could be identified in most cases.

Animals↗

[Value of C-reactive protein in neonatal bacterial infections].

C reactive protein (CRP) levels were measured in the serum of 2 groups of neonates before and after the 12th hour of life. One group consisted of controls, the other of children with neonatal sepsis. The means (+/- standard error) for CRP serum level were 6 +/- 0.7 mg/l and 7.7 +/- 0.8 mg/l respectively before and after 12 hours of life in controls (n = 100); they were 19.7 +/- 3.4 mg/l and 67.5 +/- 6.6 mg/l in the group of infected neonates (n = 54). For both times of sampling, levels were significantly higher (p less than 0.001) in infected neonates. The low percentage of false-positives and false-negatives suggests that this dosage is almost specific for neonatal sepsis.

Bacterial Infections↗

[Drug treatment of apnoea in premature infants (author's transl)].

Primary apnoea in premature infants can be treated by three categories of drugs. Drugs of the first category act on chemoreceptors and include doxapram and possibly almitrine if the latter proves non-toxic during the neonatal period. Phenobarbitone is so far the only representative of the second category of drugs which alter the pattern of sleep. As for the third category, it has the second messenger of respiratory centres for target and includes the phosphodiesterase's inhibitor (not yet tried in man) and the xanthines. At the moment, xanthines are the drugs of choice, since they are both effective and safe, provided dosage is adjusted to each patient.

Apnea↗

[Ductus arteriosus in neonatal cyanotic cardiopathies. Value of the recording of the cutaneous partial pressure of oxygen].

Adaptation to extrauterine life is always precarious in the newborn with cyanotic cardiac malformations. Limited survival is possible in cases with obstructive lesions of the right heart providing ductal closure is delayed. This was monitored in 3 cyanotic neonates with ductal dependant cardiac malformations (tricuspid atresia, transposition of the great arteries with atresia or severe stenosis of the pulmonary valve) by continuous measurement of the cutaneous pO2. The value of cutaneous pO2 monitoring has already been established. It is a reliable indicator of arterial pO2 in the neonatal period. Its major advantage, apart from the possibility of continuous monitoring, is that it is non-invasive and may be performed at the bedside. Analysis of curves recorded over several hours or days showed the cyclical nature of cutaneous pO2, probably related to slow variations in ductal diameter equilibrating effective pulmonary flow, arterial pO2 and ductal constriction. Prolonged hyperoxygenation of these desaturated children does not usually improve their condition; progressive deterioration due to the constrictive effect of oxygen on the ductus may be observed. When a clear decrease in the amplitude of oscillation is recorded ductal closure is imminent and palliative surgery should be undertaken whenever possible.

Ductus Arteriosus, Patent↗

[Survey on retrolental fibroplasia in France].

From 1964 to 1976, 20 cases of retrolental fibroplasia were recorded in the south of France while 38 cases were recorded in the north from 1970 to 1977. The more children are immature, the more they are liable to suffer from this disease. Etiological factors are apparently not limited to oxygen, which however plays the most important part in the process.

France↗

[Aortic arch interruption and cutaneous PO2].

In three neonates with cardiac failure and coarctation the cutaneous PO2 (cPO2) has been measured during the administration of a high concentration of oxygen. One sensor was fitted to the skin just below the right clavicle (preductal) and the other on one of the legs (postductal). The difference in the cPO2 provided evidence for a large right to left shunt through the duct. This finding in conjunction with the clinical syndrome of co-arctation is characteristic, in our view, of atresia of the aortic arch. The results of the test, with clinical and echocardiographic details enable more accurate decisions to be made before catheterisation and surgery.

Aortic Coarctation↗

[Peripheral retinal lesions in the premature infant].

The periphery of the retina was examined with the use of contact lenses at the age of 5 years in children who were born prematurely and weighed less than 1,500 g at birth. In this retrospective series 65% of the children were found to have lesions similar to the classical findings in retrolental fibroplasia although only to a minor degree. Low oxygen levels with a short duration of the exposure cannot completely prevent these sequalae. This retinopathy which is limited to the periphery, may account for the frequency and severity of myopia in children who were premature. Later in childhood and more rarely retinal detachment or tears may occur which cause severe visual impairment.

Child, Preschool↗

Right-to-left ductal shunt and transcutaneous PO2.

The continuous monitoring of the PO2 with double sensors, pre- and post-ductal, is very interesting during the neonatal period; the magnitude of the right-to-left ductal shunting, related to high pulmonary vascular resistance, is well evaluated by the hyperoxemia test. This noninvasive method allows a reliable observation of the pulmonary vascular response to oxygen, alkaline solutions, or tolazoline infusion.

Blood Gas Analysis↗

[Present status of retrolental fibroplasia in France].

A national survey showed that retrolental fibroplasia still exists in France, as it does in other countries of the world. Retrolental fibroplasia is a condition that principally affects low birth weight premature babies in whom oxygen therapy has not been adequately controlled. The premature babies who have apnaeic attacks are most risk. Strict control of all oxygen therapy, preferably using continuous monitoring techniques together with other changes in the methods of treatment should reduce the incidence of this condition.

Apnea↗