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J C Roze

Publications and source records attributed to J C Roze.

30 records · Page 2Linked to original sources

[Evaluation of perinatal policy. Result of a survey about birth in Pays de Loire].

A survey was undertaken in 3 French departments of the Pays de Loire from January 1, 1986 to December 31, 1986. Among the 32,876 neonate (NN) population, the authors studied the 2,753 NN who were hospitalized and a control group of 1,458 NN representative of the population of 30,123 NN who were not hospitalized. Socioeconomic patterns of mothers, of their pregnancies and deliveries were studied in both groups. The control group was compared with the data obtained in 1981 at the national level and in 1982 at the local level. This group was used as a reference for the study of hospitalized NN. Intrauterine growth retardation rate was 2.4%, prematurity rate 4.6% of live births, very premature rate (as defined by a gestational age less than 32 weeks) was 0.45% of births. Among the group of hospitalized NN, which represent 8.5% of the general population, the NN were regrouped according to Cullen's classification and their care load estimated according to the Omega score. Thus 2 subgroups were defined: the 2,298 ordinarily hospitalized (Cullen's classes I and II) and the 455 severely sick NN (classes III and IV) i.e. 1.3% of births. One third of the severely ill NN were very prematures. The 2 other thirds presented with respiratory (24%), infectious (24%), malformative (19%) or neurological (13%) diseases. Lengths of stay and Omega scores varied according to the causes for hospitalizations and were inversely correlated with gestational ages (p less than 0.001). Neonatal mortality was 3.3 p. 1,000 births and rate of stillbirths 6.5 p. 1,000.

Adult↗

[Cephalhematoma infection in neonatal septicemia].

Most cephalhematomas resorb spontaneously; intervention by means of needle aspiration may introduce infection. In our case, a neonatal septicemia was associated with a large parietal cephalhematoma. The newborn was discharged after treatment of sepsis. Three days later, the diagnosis of infected cephalhematoma was apparent, associated with meningitis and septicemia. The authors discuss the physiopathology of the infection, antimicrobial therapy and careful aspiration when a serious infection is associated with cephalhematoma.

Cerebral Hemorrhage↗

[Contribution of bactericidal rate in the initial treatment of severe staphylococcal infections in children].

Rapid bactericidal effect is essential for therapy of severe Staphylococcus aureus infections in children. The in vitro activity of clinically achievable levels of vancomycin and its combinations with gentamicin, amikacin and rifampin plus amikacin was studied with the time-kill curve method at 2.5, 4, 6, 24 and 48 hours against 20 strains of Staphylococcus aureus isolated from children with severe staphylococcal infection. Vancomycin alone exerted a bactericidal effect at 48 hours. However, with the combinations vancomycin plus gentamicin, vancomycin plus amikacin and vancomycin plus amikacin plus rifampin a bactericidal effect was respectively observed at 24, 6 and 4 hours. Most rapid killing was achieved with vancomycin plus rifampin plus amikacin. Thus this antibiotic combination seems the most appropriate for initial treatment of severe staphylococcal infections in children.

Anti-Bacterial Agents↗

Evaluation of pediatric intensive care in Europe. A collaborative study by the European Club of Pediatric Intensive Care.

There are no reports analyzing the results of pediatric intensive care in Europe. We evaluated quantitatively the severity of illness and the amount of care required for 714 consecutively admitted patients. We used simultaneously the Clinical Classification System (CCS) the Acute Physiology Score (APS) and the Therapeutic Intervention Scoring System (TISS). Overall mortality at 1 month was 15%. The mortality rate was higher for CCS Class IV patients (32.3%) than for CCS III (4.5%) and CCS II (3.2%). The difference was significant between CCS IV and CCS III and II respectively (p less than 0.001) but no difference was observed between CCS III and CCS II. The patients were also classified among 7 major organ system failures: cardio vascular, respiratory, neurologic, gastro intestinal, renal, metabolic, hematologic. Three of them were primarily involved: respiratory (44.9%) cardio-vascular (20.7%), neurologic (18.8%). Among these 3 groups the highest mortality was observed in cardio-vascular patients (p less than 0.01 v.s. respiratory, p less than 0.05 v.s. neurologic). The death rate was 22% among the 264 neonates, 9.7% among the 247 infants (p less than 0.01) and 12.6% among the 198 children. APS and TISS scores increased significantly with the CCS classes.(ABSTRACT TRUNCATED AT 250 WORDS)

Child↗

[Epidemiological study of severe forms of infectious purpura in 1984. National survey of the Club Français de Réanimation Pédiatrique].

A retrospective national study undertaken by the Club Français de Réanimation Pédiatrique found 103 children hospitalized in intensive care units for severe infectious purpura in 1984, i.e. 1.08 case per department. A great heterogeneity in the geographic distribution was observed. The responsible agent was identified in 65% of cases. Short-term evolution was severe: death in 48%.

Adolescent↗

[Prognosis of hemolytic uremic syndrome in children. Importance of extrarenal involvement].

The prognosis of hemolytic uremic syndrome was studied in 37 children hospitalized between January 1980 and January 1985. 75% of affected children were less than 3 years of age. Twenty-two (60%) presented with anuria or oliguria (mean duration of anuria: 10.7 days). In this last group, severe extrarenal manifestations occurred: 12 cases of neurological involvement (6 involving hypervolemia), gastrointestinal involvement in 5 cases, including a case of ileal necrosis; pancreatic involvement in another. Three children died during the first month of the disease (overall death-rate: 8%). Thirty-two children were followed with a mean 24 months follow-up (6 months to 60 months). Six (19%) presented with sequellae, of which 3 were severe: one severe arterial hypertension and two with chronic renal failure of which one terminal with severe neurologic sequellae. The existence of extrarenal manifestations implies a poor prognosis. Among the 22 children with anuria or oliguria, 8 had no extra-renal manifestations. All of these recovered. Three of 11 children with one extrarenal manifestation had an unfavorable outcome. The course was unfavorable in the 3 cases with multiple extrarenal involvement.

Anuria↗

Prophylactic ibuprofen versus placebo in very premature infants: a randomised, double-blind, placebo-controlled trial.

BACKGROUND: Patent ductus arteriosus is a common complication of prematurity that frequently requires surgical or medical treatment. The benefit of prophylactic treatment by indometacin, a cyclo-oxygenase inhibitor, remains uncertain compared with curative treatment. This benefit could be improved with ibuprofen, another cyclo-oxygenase inhibitor with fewer adverse effects than indometacin on renal, mesenteric, and cerebral perfusion. We aimed to compare prophylactic and curative ibuprofen in the treatment of this abnormality in very premature infants. METHODS: We did a randomised controlled trial in infants younger than 28 weeks of gestation, who were randomly assigned to receive either three doses of ibuprofen or placebo within 6 h of birth. After day 3, symptomatic patent ductus arteriosus was treated first by open curative ibuprofen, then back-up indometacin, surgery, or both. The primary endpoint was need for surgical ligation. Analysis was per protocol. FINDINGS: The study was stopped prematurely after 135 enrollments because of three cases of severe pulmonary hypertension in the prophylactic group. 65 infants received prophylactic ibuprofen, and 66 received placebo. Prophylaxis reduced the need for surgical ligation from six (9%) to zero (p=0.03), and decreased the rate of severe intraventricular haemorrhage from 15 (23%) to seven (11%) (p=0.10). However, survival was not improved (47 [71%] placebo vs 47 [72%] treatment, p=1.00), because of high frequency of adverse respiratory, renal, and digestive events. INTERPRETATION: In premature infants, prophylactic ibuprofen reduces the need for surgical ligation of patent ductus arteriosus, but does not reduce mortality or morbidity. Therefore, it should not be preferred to early curative ibuprofen.

Anti-Inflammatory Agents, Non-Steroidal↗