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Biomedical subjects

J Bourgeois

Publications and source records attributed to J Bourgeois.

At least 37 records · Page 2Linked to original sources
PubMed1987

[High-risk congenital diaphragmatic aplasia and hernia (apropos of 64 cases)].

The prognosis of high risk congenital diaphragmatic hernia and eventration diagnosed in the early neonatal period (before 24 h) is studied based on a series of 64 cases. Eventration has a poor prognosis with 5 deaths out of 7 cases. The replacement of the hemidiaphragm by an abdominal muscular flap seems to be the best surgical procedure (2 recoveries on 4 cases). A high mortality rate remains in the diaphragmatic hernias which are undiagnosed before birth. Out of 54 operated cases with systematic homolateral drainage, there were 35 survivors (65%). Post-operative alveolar-arterial PO2 difference less than 53 kPa appears to be a reliable criterion of good prognosis with a survival rate of 91% in this series. Thus, despite major progresses in post-operative resuscitation, the recovery rate in high risk neonatal congenital diaphragmatic hernia and eventration is only 75%. This seems to be partly related to the existence of lethal forms due to bilateral pulmonary hypoplasia and structural anomalies of the pulmonary arteries.

Blood Gas Analysis↗
PubMed1987

[Gastroesophageal reflux and esophageal atresia].

In 210 surviving cases of oesophageal atresia treated by anastomosis, 34% presented a gastro-oesophageal reflux. Half of these patients needed surgical treatment of the reflux to prevent complications.

Esophageal Atresia↗
PubMed1986

Effects of prematurity and dysmaturity on growth at age 5 years.

Forty-two term and 106 preterm appropriate for gestational age (AGA), and 43 term and 31 preterm small for gestational age (SGA) children were observed from birth to age 5 years. Parents' weight and height were also measured in 193 subjects including 97 couples. The percentage of short children was higher in SGA (17%) than in AGA (3.4%) children (P less than 0.01). This difference was significant in the preterm but not in the term children, suggesting that early failure of growth in utero can result in reduced growth in children. The findings were similar for weight and head circumference, but microcephaly was more frequent in term SGA (30%) than in preterm SGA (6.4%) children (P less than 0.05), suggesting that late impaired growth in utero can result in poor growth of the head. Height at the age of 5 years correlated with the parents' height only in AGA children, and with length at birth in SGA children. Weight of the 5-year-old children correlated with the mother's weight only in AGA children. Multivariate analysis in 66 couples and their children confirmed a greater tendency toward the influence of parental factors in AGA children and a more significant relationship with perinatal factors in SGA children.

Birth Weight↗
PubMed1986

[Neonatal bilateral interstitial emphysema. Surgical treatment. Apropos of 1 case].

The authors report a case of respiratory distress secondary to inhalation of meconial amniotic fluid treated by mechanical ventilation, which was complicated by severe interstitial emphysema. Treatment by pleurotomy allowed a favorable evolution. The various therapies of interstitial emphysema of the neonate, in particular surgical technics are described.

Humans↗
PubMed1985

Pharmacokinetics of vitamin K1 in low-birth-weight neonates.

The pharmacokinetics of vitamin K1 was studied in 21 newborn infants. 11 neonates had received no parenteral loading dose prior to the study (group I), while 10 had been injected 5-10 mg vitamin K1 at birth (group II). At postnatal age 2-9 h, 1 mg of vitamin K1 was injected intravenously, and small samples of blood (less than or equal to 500 microliter) were collected at different times during 6 h. Serum vitamin K1 and its epoxide were assayed by high-performance liquid chromatography (HPLC). In both groups, the disappearance curve showed two exponential components: a fast distribution component during the 1st h and a slower elimination component during the next 5 h. In group I, the plasma half-life of the first component was between 18 and 52 min (median 23 min), and the half-life of the second was between 67 and 179 min (median 109 min). Both half-lives were significantly higher in group II. The volumes of distribution were suggestive of distribution into plasma during the first phase and roughly into the extracellular water for the second component. Epoxide was detected in most patients 15 min after vitamin K1 injection, and after 3 h its concentration was higher than the concentration of vitamin K1. These data suggest that the kinetics of vitamin K1 in neonates is not very different from that in adults. The newborn infant is able to oxidize vitamin K1, a phenomenon in keeping with the gamma carboxylation of glutamic acid.

Adult↗
PubMed1984

Evolution of serum prealbumin, C-reactive protein, and orosomucoid in neonates with bacterial infection.

The simultaneous changes in serum prealbumin, orosomucoid (alpha-acidglycoprotein, AGP), and C-reactive protein (CRP) were evaluated in 36 newborn infants with septicemia (n = 20), meningitis (n = 10), arthritis (n = 5), and peritonitis (n = 1). In 29 patients with a favorable outcome the values for serum prealbumin and CRP showed a rapid return toward normal: in 2 to 3 days serum prealbumin increased by 84% from the basal value and remained at (mean +/- 1 SD) 0.11 +/- 0.02 gm/L. Serum CRP decreased from 85 +/- 75 mg/L (range 0.15 to 206 mg/L) to 49 +/- 64 mg/L (2 to 210 mg/L) at 3 to 4 days of evolution and to normal values at day 13 to 16. The changes in serum orosomucoid values were slower, from 1.33 +/- 0.75 gm/L to 1.16 +/- 0.75 gm/L at day 13 to 16, with normalization after 20 to 30 days. Serum orosomucoid values returned to the normal range with the clinical improvement. In some patients the orosomucoid/prealbumin ratio decreased earlier than the serum orosomucoid concentration. Seven patients died, and in four of these in whom at least three values could be determined serum CRP and orosomucoid remained very high, whereas serum prealbumin did not increase or subsequently decreased. These data show an inverse change in serum CRP and prealbumin concentrations in infected neonates. The immediate decrease in CRP reflects the effect of treatment, whereas the later decrease in serum AGP parallels the clinical course of the infection. Thus the determination of these proteins can help to guide the treatment of infection in newborn infants.

Acute-Phase Proteins↗
PubMed1984

Open-angle glaucoma associated with posterior polymorphous dystrophy. A clinicopathologic study.

Clinical and histopathologic features of a 62-year-old black man with posterior polymorphous dystrophy and open-angle glaucoma requiring trabeculectomy are reported. The surgical procedure was modified to allow en bloc resection of the deep limbal tissue and peripheral iris. Light and electron microscopy of the specimen revealed a high insertion of the iris into the posterior portion of the trabecular meshwork with compression of the intertrabecular spaces. These findings are similar to changes that have been reported in primary congenital glaucoma and suggest a developmental anomaly of the anterior chamber angle in this form of glaucoma associated with posterior polymorphous dystrophy.

Cornea↗
PubMed1984

[Fever during labor].

The authors have studied the progress of labour and the neonatal consequences for 100 patients who started labour with a high temperature. A control group consisted of 100 patients with normal temperature and the comparison showed that there was a raised risk of dystocia and of fetal distress during labour. The maternal and neonatal complications were studied in relationship to the aetiology, which was most frequently premature rupture of the membranes. The authors suggest the way these cases should be managed to lessen the maternal and neonatal risk which is associated with pyrexia in labour. These are: culturing blood, urine and a vaginal or, better still, endocervical swab; giving penicillin with gentamycin and metronidazole throughout the labour and in the first few days after delivery. Very careful monitoring should also be carried out.

Bacterial Infections↗
PubMed1983

[Prolonged curarization in the newborn infant under assisted ventilation for idiopathic respiratory distress].

We studied the effects of prolonged pancuronium administration in 10 neonates under assisted ventilation for hyaline membrane disease. Pancuronium bromide was administered from the time of intubation with a load dose of 0.1 mg/kg followed by a continuous infusion of 0.03-0.07 mg/kg/h. Tolerance, especially cardiovascular, was excellent after 72 to 525 h of therapy (mean 173 h). Oxygen needs, incidence of mechanical complications and the general evolution of idiopathic respiratory distress were not significantly affected by muscle relaxation. The benefits of systematic pancuronium administration during respiratory intensive care in neonates with hyaline membrane disease appear to be of little value when considering the necessary constraints (corneal, cutaneous, vesical and tracheal supervision).

Hemodynamics↗
PubMed1983

[Syndrome of terminal deletion of the long arm of chromosome 4. Apropos of a personal case with a review of the literature].

With one personal case and thirteen cases from literature about distal deletion of the long arm of chromosome 4 (4 q-), authors try to describe a clinical syndrome related to deletion of segment 4 q 31 leads to q ter. This syndrome includes a normal intrauterine growth, a growth and mental retardation. Morphological abnormalities consist in microcephaly, palato-cheiloschisis with micrognathia, hypertelorism with epicanthald folds, large nose bridge with anteverted nases, various anomalies of ears; clinodactily of Vth finger and toe, various cardiac defects. New banding techniques (prometaphase) have led to more precise delineation of break point, but this very distal deletion could not bring any new information for the gene mapping.

Abnormalities, Multiple↗
PubMed1983

[Hyperextension of the fetal head associated with hyperextension of the dorso-lumbar spine. Apropos of a case diagnosed in utero].

The authors report a case where hypertonicity resulted in extension of the cerebral spine in a fetus. They think that they are reporting a case of congenital hyperextension of the lumbar spine, which is otherwise called "the newborn stiff-man syndrome". The outlook for this child is good in spite of the gross abnormality that is revealed on the X-rays of the fetus. Caesarean section is therefore indicated.

Cesarean Section↗