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Biomedical subjects

G Duc

Publications and source records attributed to G Duc.

At least 73 records · Page 4Linked to original sources
PubMed1989

[Clinical assessment of a new glucose reflectance meter (Glucoscot II) for the detection of neonatal hypoglycemias].

Glucoscot II, a new glucose reflectance meter and the corresponding test strip "Glucopat" were evaluated for their accuracy in the detection of neonatal hypoglycemia. In 100 neonatal blood samples of 44 neonates glucose was estimated with the reflectance meter and the results were compared with those from a reference method (Beckman-Glucose-Analyser). Hypoglycemia was defined as blood glucose of less than 2.2 mmol/l (40 mg/dl). The correlation between the values obtained by the test strip and the reference values was high (= 0.95). Test sensitivity was 100%, specificity 99% and the predictive value for hypoglycemia was 94%. The incidence of a blood sugar less than 2.2 mmol/l in our study population was 15%. Thirteen percent of glucose values determined with the reflectance meter deviated from the reference value by more then 20%. If our data can be confirmed by others we conclude that the Glucoscot II/Glucopat-system can be recommended as screening-test for hypoglycemia in neonates.

Blood Glucose↗
PubMed1988

Neonatal metatarsus adductus, joint mobility, axis and rotation of the lower extremity in preterm and term children 0-5 years of age.

A total of 484 premature children and a control group of 114 healthy term children underwent orthopaedic follow-up from birth to 5 years of age. At birth, metatarsus adductus was found to be more frequent in twins than in single infants (41% vs 16%; P less than 0.01), but occurred with equal frequency in single preterm and term infants (16% vs 12%). By 5 years of age, metatarsus adductus had resolved in all the term but only in 81% of the preterm children (P less than 0.05). In the preterm and term groups, knee axis (mean intermalleolar distance 22.0 mm vs 20.1 mm), tibial torsion (mean angle -1.2 degrees vs + 0.6 degrees) and angle of gait (mean angle + 1.5 degrees vs + 0.7 degrees) at 5 years were statistically insignificant. Hip function at 5 years was similar in normal preterm and term children but significantly decreased in preterm children with cerebral palsy, more so with regard to abduction (56 degrees vs 39 degrees, P less than 0.05) and extension (22 degrees vs 8 degrees, P less than 0.01). The difference between the sexes was insignificant in both the preterm and term groups.

Child, Preschool↗
PubMed1988

Does caffeine prevent hypoxaemic episodes in premature infants? A randomized controlled trial.

Fifty spontaneously breathing, preterm infants 48 h old, of 32 weeks' gestation or less, were assigned randomly to receive caffeine citrate (loading dose 20 mg/kg, maintenance dose 10 mg/kg per day) or a placebo (NaCl 0.9%). The study hypothesis was that caffeine reduces the proportion of infants with recurrent hypoxaemic episodes (decrease in transcutaneous PO2 of 20% within 20 s) from 50% to 25%. Transcutaneous oxygen tension (tcPO2) and heart rate were recorded continuously for 50 h and analysed by computer. The two groups were similar in gestational age, birth weight, delivery mode, sex distribution, and Apgar scores. The mean serum concentration (+/- SD) of caffeine 2 h after the second maintenance dose was 96.0 (+/- 34.5) mumol/l in the group receiving caffeine and 9.3 (+/- 12.8) mumol/l in the group receiving a placebo. The mean proportion of infants with more than six hypoxaemic episodes per 12 h in the caffeine groups was higher (57%) than in the control group (51%). The mean proportion of infants with more than six episodes of bradycardia per 12 h was not statistically different in the caffeine group (79%) from the control group (86%). Our results suggest that prophylactic caffeine has little if any effect on the risk of developing hypoxaemic episodes and bradycardia in small preterm infants and the supposed 50% reduction which was considered clinically important at the start of the trial can be rejected with confidence.

Blood Gas Monitoring, Transcutaneous↗
PubMed1988

[Magnetic resonance in pediatric research and clinical practice. I. What can we expect from this new method?].

Nuclear Magnetic Resonance (NMR) was first observed over 40 years ago and has recently also entered the field of human medicine. It currently attracts increasing attention from biologists and clinicians alike, and the scope of its different applications is in a phase of explosive development. Two principle developments of the MR method are taking place over the recent years and are of special interest for pediatricians and neonatologists. One involves the possibility of obtaining images from any part of the human body, somewhat similar to those obtained with computer tomography (CT), but without any radiation hazard. Today clinicians are most familiar with this mode of MR application. The other development tries to adapt the MR method of elucidating the structure of molecules used in physics, molecular biology and organic chemistry for applications in medicine, allowing to study metabolism in vivo under non-invasive conditions. Again, such studies pose no health hazards and are, therefore, applicable to neonates and small infants. They will enhance our understanding of metabolic processes during normal development and disease, especially in organs like the brain, where biopsies are virtually impossible. Recent developments combine the two methods mentioned above, in order to obtain morphological as well as metabolic information from the same organ at the same time, which may provide even better insight into pathophysiological mechanisms and their response to therapeutic measures. This article attempts to give an overview to the medical researcher, the clinician, and especially the pediatrician and neonatologist of what MR is and what we can expect from it.

Brain↗
PubMed1988

[Assessment of neonatal hypoglycemia with 2 test strip methods].

We evaluated two glucose test strips for their accuracy in detecting hypoglycemia in newborn infants. Reflotest-Hypoglycemia and Haemo-Glucotest and the reflectance meter technique Reflomat I and Reflolux II respectively were used for screening blood sugar values, and compared with laboratory glucose determination using an automatic analyzer (glucose oxidase method). In 134 neonatal blood samples of 56 newborn infants glucose was quantified with the three methods. Hypoglycemia was defined as blood glucose of less than 2.2 mmol/l (less than 40 mg/dl). Test sensitivity was 71%, specificity 97% for Reflomat I, 88% and 82% for Reflolux II, respectively. Analysing the falsely normoglycemic values measured by Reflomat I, no true blood sugar value below 2 mmol/l (less than 36 mg/dl) was found, and no value below 1.2 mmol/l (less than 22 mg/dl) measured by Reflolux II. Defining hypoglycemia as a blood glucose value of less than 2 mmol/l (less than 36 mg/dl) the sensitivity for Reflomat I would be 100%; therefore, significant hyoglycemia should not be missed with this test. Both tests give some false-positives; 3 of 100 Reflomat I and 18 of 100 Reflolux II readings were falsely below 2.2 mmol/l (less than 40 mg/dl). From these data we conclude that Reflomat I is an accurate screening-test for hypoglycemia in neonates; while the use of Reflolux II would cause too much unnecessary treatment.

Birth Weight↗
PubMed1987

[Ambulatory childbirth. The neonatologist's viewpoint].

Outpatient delivery (delivery in hospital with early discharge of mother and child) is a compromise between delivery at home and in hospital. This new mode of delivery is acceptable with respect to the health of the neonate under the conditions outlined. This paper summarizes the experience of the neonatologist at the University Hospital, Zurich.

Community Health Nursing↗
PubMed1987

[Neonatal respiratory distress syndrome in Switzerland. Data for 1984 and comparison with 1974].

In a retrospective study (questionnaire) covering all the neonatal special care units of Switzerland, information was obtained on, the problem cases in 84% of all babies born in 1984. 8.3% were hospitalized. Clinical respiratory distress syndrome (RDS) was diagnosed in 31% of these infants and hyaline membrane disease (HMD) in 6.3%. Mortality in clinical RDS was 7.1% and in HMD 19%. Mortality showed a high degree of correlation with birth-weight. Comparison of the 1984 data with a similar study in 1974 showed no significant change in the incidence of clinical RDS. The incidence of HMD (diagnosis by the same criteria) has fallen from 10.1% to 6.3%. Overall mortality in hospitalized newborns in Switzerland has decreased from 8.8% in 1974 to 4% in 1984.

Cross-Sectional Studies↗
PubMed1987

Is pulse oximetry reliable in detecting hyperoxemia in the neonate?

We tested the hypothesis that hyperoxemia defined as arterial PO2 above 12 kPa can be detected by pulse oximetry using 95% oxygen saturation as the upper limit. Thirty artificially ventilated neonates with an indwelling arterial catheter were studied registrating transcutaneous oxygen saturation (Ohmeda Biox 3700 Pulse Oximeter) and transcutaneous PO2 continuously during a 4-hour period and measuring arterial oxygen saturation and PO2 intermittently. 46 episodes of arterial hyperoxemia were observed. Pulse oximetry had a sensitivity of 30%, detecting 14 of these 46 hyperoxemic episodes, and a specificity of 93%. The accuracy for separating hyperoxemia from normoxemia by pulse oximetry could be improved by shifting the cut-off point from 95% to 92%. With this optimal cut-off point sensitivity was 70% and specificity 62%. We conclude that pulse oximetry is not reliable for detection of hyperoxemia.

Blood Gas Monitoring, Transcutaneous↗
PubMed1987

Effect of vitamin E substitution in very low birth weight infants. Active and inactive forms of vitamin E in plasma and red cells after moderate intramuscular supplementation.

Vitamin E supplementation was investigated in 38 very low birth weight infants after intramuscular substitution with two doses of 25 mg given on the 1st and 3rd day of life. Plasma and red cell concentrations of the biologically inactive tocopherol acetate and the active tocopherol were followed during the first month of life. Plasma levels of this substitution regime were compared with recent clinical studies. Although the applied dose was low in comparison to other studies, the levels obtained exceed the critical concentration of 12 microM which was reported to prevent retinopathy. Concentrations associated with side effects (84 microM) were found in nearly 50% of the babies but only for short duration (24 h). In more than 80% of the infants, biologically inactive tocopherol acetate was detected in plasma up to 1 day after substitution but not in red cells.

Erythrocyte Membrane↗
PubMed1987

[Neonatal respiratory distress syndrome in Switzerland--a comparison of a survey and official statistics].

A survey in all neonatal intensive care units in Switzerland showed that most children with a birth weight below 2000 g (identified in the birth statistics) are hospitalised in those units. Also comparison with the official neonatal mortality statistics shows that most neonatal deaths occur in these units. High agreement was found between diagnosis in hospitalised children and those recorded on death certificates. 40% of neonatal mortality in Switzerland are still due to neonatal respiratory distress syndrome.

Cross-Sectional Studies↗
PubMed1987

Intratracheal suctioning in sick preterm infants: prevention of intracranial hypertension and cerebral hypoperfusion by muscle paralysis.

In a prospective nonrandomized study, using each baby as his or her own control, we compared intracranial pressure (anterior fontanel pressure as measured with the Digilab pneumotonometer), cerebral perfusion pressure, BP, heart rate, transcutaneous Po2, and transcutaneous Pco2 before, during, and after endotracheal suctioning, with and without muscle paralysis, in 28 critically ill preterm infants with respiratory distress syndrome. With suctioning, there was a small but significant increase in intracranial pressure in paralyzed patients (from 13.7 [mean] +/- 4.4 mm Hg [SD] to 15.8 +/- 5.2 mm Hg) but a significantly larger (P less than .001) increase when they were not paralyzed (from 12.5 +/- 3.6 to 28.5 +/- 8.3 mm Hg). Suctioning led to a slight increase in BP with (from 45.3 +/- 9.1 to 48.0 +/- 8.7 mm Hg) and without muscle paralysis (from 45.1 +/- 9.4 to 50.0 +/- 11.7 mm Hg); but there was no significant difference between the two groups. The cerebral perfusion pressure in paralyzed infants did not show any significant change before, during, and after suctioning (31.5 +/- 9.1 mm Hg before v 32.0 +/- 8.7 mm Hg during suctioning), but without muscle paralysis cerebral perfusion pressure decreased (P less than .001) from 32.8 +/- 9.7 to 21.3 +/- 13.1 mm Hg. Suctioning induced a slight decrease in mean heart rate and transcutaneous Po2, but pancuronium did not alter these changes. There was no statistical difference in transcutaneous Pco2 before, during, and after suctioning with and without muscle paralysis.(ABSTRACT TRUNCATED AT 250 WORDS)

Blood Gas Monitoring, Transcutaneous↗
PubMed1986

Language development of term and preterm children during the first five years of life.

Language development during the first five years is reported for 114 high-risk preterm children (20 with varying degrees of cerebral palsy) and 97 healthy term children. Most stages of language development occurred at slightly later ages among the neurologically unimpaired preterm children than among those born at term. Preterm children with cerebral palsy were more delayed and had more articulation defects compared with neurologically unimpaired preterm children. Girls were more advanced in early language development and showed less articulation defects than boys. The perinatal optimality score was significantly correlated with the ages at which the stages of language development were reached, and with language performance at five years in preterm children, but much less in term children. Birthweight and gestational age were negatively correlated with language development at all ages. Socio-economic status and birth order had an age-related influences on language development, but no correlation was found with the number of minor congenital malformations.

Articulation Disorders↗
PubMed1986

Transcutaneous carbon dioxide tension in newborn infants: reliability and safety of continuous 24-hour measurement at 42 degrees C.

In 58 newborn infants a new iridium oxide sensor was evaluated for transcutaneous carbon dioxide (tcPCO2) monitoring at 42 degrees C with a prolonged fixation time of 24 hours. The correlation of tcPCO2 (y; mm Hg) v PaCO2 (x; mm Hg) for 586 paired values was: y = 4.6 + 1.45x; r = .89; syx = 6.1 mm Hg. The correlation was not influenced by the duration of fixation. The transcutaneous sensor detected hypocapnia (PaCO2 less than 35 mm Hg) in 74% and hypercapnia (PCO2 greater than 45 mm Hg) in 74% of all cases. After 24 hours, calibration shifts were less than 4 mm Hg in 90% of the measuring periods. In 86% of the infants, no skin changes were observed; in 12% of infants, there were transitional skin erythemas and in 2% a blister which disappeared without scarring. In newborn infants with normal BPs, continuous tcPCO2 monitoring at 42 degrees C can be extended for as many as 24 hours without loss of reliability or increased risk for skin burns.

Blood Gas Monitoring, Transcutaneous↗
PubMed1986

Anterior fontanel: size and closure in term and preterm infants.

Size and closure of the anterior fontanel from birth to 24 months of age and their relationships to growth parameters, bone age, and gestational age are reported in 111 term and 128 preterm infants. Great variability of both fontanel size and age when fontanel closed was observed. There were no significant differences in size and age at closure of the anterior fontanel between term and preterm infants or between the sexes. At ages beyond term, fontanel size was negatively correlated with weight and length; however, only a few correlations reached statistical significance. No significant relationships were noted between anterior fontanel size and head circumference or bone age. Age at closure of the anterior fontanel was also not significantly related to any of the growth parameters or bone age.

Age Factors↗
PubMed1985

Early development of locomotion: significance of prematurity, cerebral palsy and sex.

Data on the development of locomotion during the first two years of life were collected for 128 preterm infants (21 with varying degrees of cerebral palsy) and for 111 healthy term infants. Most stages of locomotion occurred at slightly later ages among the neurologically unimpaired preterm infants than among those born at term (age corrected for prematurity). There was no difference between preterm and term infants with regard to the number and types of pathways of locomotion, or to age at onset and type of first movements through space. By 9.5 months of age, 95 per cent of term infants and 92 per cent of preterm infants showed some ability to move through space. The infants with severe cerebral palsy had considerable delay in the development of locomotion, but this occurred to only a minor extent when the degree of cerebral palsy was mild or moderate. Most stages of locomotion occurred at slightly earlier ages for boys than for girls, but these differences were not significant at any age. The number and types of pathways of locomotion, and types of first movements, were comparable in both sexes.

Cerebral Palsy↗
PubMed1985

[Effectiveness of low- and high-dose caffeine on idiopathic bradycardia and hypoxemia in premature infants].

The efficacy of low and high dose caffeine on idiopathic bradycardia and hypoxaemia was tested in premature infants. Among 41 infants admitted to the study 21 fulfilled the criterion for treatment, e.g. greater than 3 bradycardia or greater than 3 hypoxaemia during 6 h, and received a low dose of caffeine citrate (loading dose 10 mg/kg, maintenance dose 5 mg/kg/24 h) resulting in serum concentrations of 42 +/- 19 mumol/l (M +/- SD). Four infants had to be excluded later because a possible cause for the increased frequency of bradycardia and hypoxaemia was found. Ten infants met the treatment criterion once more and got a double dose of caffeine resulting in serum concentrations of 90 +/- 35 mumol/l. The efficacy of caffeine was evaluated by comparing for each infant the 12-h period preceding the treatment with three 12-h periods during treatment. Low dose caffeine reduced significantly the frequency of bradycardia (less than 0.01), but not the frequency of hypoxaemia. In those infants with insufficient response, who consequently got high dose caffeine, the frequency of bradycardia decreased significantly (p less than 0.01), whereas the frequency of hypoxaemia did not. These results have to be confirmed in a randomized placebo controlled trial.

Bradycardia↗
PubMed1984

Correlation between serum antibody-levels against group B streptococci and gestational age in newborns.

Sera from 33 newborn infants with gestational ages ranging from 27 to 41 weeks were tested by radioimmunoassay for IgG antibodies to surface antigens of group B streptococci (GBS) types Ia, Ib, II and III. Antibody levels to GBS antigens were positively correlated to gestational age and birthweight. However, only the correlations for anti-Ia and anti-II antibody levels reached statistical significance. Mean antibody concentrations in infants below 34 weeks of gestation were significantly lower for type Ia (P less than 0.001), type II (P less than 0.001) and type III (P = 0.05) than in infants above this limit. These findings might explain the higher rate of serious GBS-infections found among prematures as compared to full-term infants.

Antibodies, Bacterial↗