Biomedical subjects
Publications and source records attributed to F Mimouni.
Specular microscopy was performed on 24 patients with an history of blunt ocular trauma, after a 2 to 35 months follow up. In 29.1% of the patients, there was a cellular loss greater than 5%. No significant association was noted between cell loss and angle recession. This data should be evaluated in medico-legal examinations.
Two premature infants who had episodes of hemolysis following blood transfusion are described. No incompatibility was found between donor and infant in either case. Further investigation of the donors' blood excluded other possible causes of hemolysis. The only anomaly found was that the donors were glucose-6-phosphate dehydrogenase (G6PD) deficient, while the infants had normal G6PD activity. Our report describes a new possible cause of hemolysis in preterm infants, and suggests that screening for G6PD deficiency may be necessary before blood is transfused to a preterm infant.
A 33-week-gestation infant with respiratory distress syndrome is reported. At five days of age, acute life-threatening tracheal obstruction occurred, which was relieved after removal of a plug during bronchoscopy. Histologic examination of the plug revealed partially necrotic tracheal mucosa, compatible with the diagnosis of necrotizing tracheobronchitis. At 31 days of age, obstruction recurred due to the development of a tracheal stricture, which resolved after tracheal reintubation (to maintain patency) and corticosteroid therapy. Tracheal stricture may be a long-term complication of necrotizing tracheobronchitis, when the initial episode does not lead to death from obstruction.
The efficacy of sulfisoxazole prophylaxis was evaluated in 32 otitis-prone children in a double-blind cross-over clinical trial. During the sulfisoxazole therapy, seven patients (22%) had nine episodes of acute otitis media (AOM) while 20 patients (63%) receiving placebo had 36 episodes of AOM (P = .001). Although sulfisoxazole appeared to be beneficial in patients aged 2 to 5 years, statistically significant efficacy was noted only in children under 2 years of age. Otitis media with effusion persisting for more than five weeks was observed in ten children (31%) during sulfisoxazole therapy and in 14 children (44%) during the placebo period (P greater than .975). Sulfisoxazole therefore appears effective in preventing recurrent symptomatic AOM but not in reducing the frequency of persistent otitis media with effusion. The importance of careful follow-up of children receiving long-term sulfisoxazole therapy for prevention of recurrent AOM is stressed.
Primary nocturnal enuresis (PNE) is a common paediatric problem of multifactorial aetiology. Growth and skeletal maturation were studied in 35 otherwise healthy children with PNE, 26 boys and 9 girls aged 6-14 years, and comparison was made with a control (CTR) group of 19 boys and 3 girls aged 6-13 years of similar ethnic origin. There was no significant difference between the mean height and weight centiles of the two groups. Bone age (BA) determined by the TW-2 method showed a significant lag behind chronological age (CA); the CA-BA difference being 1.46 +/- 1.56 years in the PNE group and -0.08 +/- 0.8 years in the CTR group (P less than 0.001). In 11 of the PNE group (31%) the BA retardation was greater than 24 months: in 4 it was between 24 to 36 months and in 7 the difference was greater than 36 months. In all these children T4 and TSH were found to be normal. It is hypothesised that the retarded bone age in children with PNE may reflect delayed maturation of regulatory CNS functions.
During a 2-month period all male newborns were examined prospectively to determine the normal characteristics of the penis. Of the 274 neonates examined 3 were excluded because of hypospadias with chordee. The spontaneous direction of the shaft was in the midline in 76.8 per cent, to the left side in 15.5 per cent and to the right side in 7.7 per cent. Partial absence of the prepuce was observed in 10 per cent of the patients, while an unretractable foreskin was seen in 23.2 per cent. The mean meatal aperture was 2.6 plus or minus 0.8 mm. Deviation of the median raphe was present in 10 per cent of the newborns and was associated with deviation of the meatus in 2.2 per cent. Mild torsion of the penis was noted in 1.5 per cent, while isolated torsion of 90 degrees was seen in 0.7 per cent of the patients. Early diagnosis and followup of these newborns might be helpful in determining further treatment.
Spleen tip size was determined in 470 full-term appropriate-for-gestational-age infants within the first 24 hours of life. The spleen was palpable in 17.9 percent of them. It was palpated less than 1 cm below the costal margin in 11.7 percent, between 1 and 2 cm in 3.6 percent, and 2 cm or more in 2.6 percent. No cause for spleen enlargement was found except in two infants with ABO hemolytic disease.
Deciduous tooth eruption (DTE) was studied in 366 Jewish Israeli children: 193 boys and 173 girls. The number of erupted teeth (NET) at different ages was similar in both sexes. No statistically significant correlation was found between NET and anthropometric measurements at birth (weight and length) or subsequently, after eliminating the influence of age, between NET and weight, height, and head circumference. The high normal variability in NET at a given age is demonstrated.
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The distance between the right costal margin and the liver edge at the mid-clavicular line was measured within the first 24 hours of life and before discharge (between 72 and 96 hours of life) in 367 healthy, full-term infants. No significant difference was found between the measurements during the first day of life and at discharge, or in the different groups of gestational age (range, 37 to 41 weeks). The mean +/- SD distance of the liver edge below the costal margin was 3.0 +/- 0.7 cm, with a normal range from 1.6 to 4.4 cm. According to our results, we recommend investigation for hepatomegaly when the liver is palpated more than 4.4 cm below the costal margin.
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A newborn infant with postaxial polydactyly of the hands, preaxial polydactyly of the feet, syndactyly and craniofacial dysmorphism (Greig's Syndrome) is reported. The radiographic manifestations in the neonatal period are described. The advanced bone age, the unusual shape of the iliac bones and the supernumerary prehallux toe are new radiological findings in Greig's Syndrome at this age. The diffuse distribution of skeletal anomalies suggests a more complex problem of the intrauterine process of ossification.
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The mathematical relationship between blood viscosity and hematocrit levels was studied in 93 venous blood samples drawn within the first 6 hours of life from 20 full-term infants with weight appropriate for gestational age. A highly significant linear correlation (r = .948) between the logarithm of the viscosity at all the shear rates examined and the Hct was found. This indicates an exponential relationship between the blood viscosity and the Hct levels for every value of the Hct greater than 42%. A new dynamic definition of neonatal polycythemia, which takes into consideration the time of sampling, is suggested. By determining the mean + 2 SD, the upper limit of the normal Hct at the age of 2 hours was 71% and at the age of 6 hours was 68%.