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Biomedical subjects

J Costil

Publications and source records attributed to J Costil.

At least 37 records · Page 2Linked to original sources
PubMed1990

Preliminary report: extracorporeal lung support for neonatal acute respiratory failure.

A technique for ventilatory support of life-threatening neonatal acute respiratory failure by use of apnoeic oxygenation and low-frequency positive-pressure ventilation, with extracorporeal membrane CO2 removal through a single-cannula perfusion circuit, is described. 20 severely ill babies with respiratory failure were treated with this technique, 17 of whom survived with no clinical evidence of pulmonary handicap or neurological deficit at discharge from hospital. All 10 patients followed up at 6 months showed normal growth and development.

Acute Disease↗
PubMed1990

[Cystic fibrosis in infants revealed by severe respiratory distress. Mid-term course].

We report the follow-up of 13 infants aged 2.5 to 24 months in whom cystic fibrosis disease presented as respiratory distress. All infants received an intensive treatment. Mean clinical, radiological and microbiological follow-up was 3.1 years. Ten children aged 1.5 to 8.5 years are still alive. One of them presents with serious respiratory failure, with a Shwachman score of 50. The Shwachman score is between 85 and 70 for 8 of 13 and 65 for one. The prognosis of this group did not differ from the one usually observed in the disease. It depends partially on early intensive care management and is not altered by mechanical ventilation.

Child, Preschool↗
PubMed1989

[Etiologic diagnosis of severe acute pneumopathies in infants and children].

In infants and children suffering from severe acute lung disease the problem of aetiological diagnosis arises in two sets of circumstances. In cases of diffuse primary pneumonitis, which occurs mainly in immunocompromised subjects, broncho-alveolar lavage is the ideal technique to discover opportunistic infections; besides, the technique is little invasive and well tolerated. It is only when its results are negative that lung biopsy still has a few indications. In hospital-acquired lung diseases occurring in children under mechanical ventilation the results of broncho-alveolar lavage are more difficult to evaluate owing to possible contamination by tracheal organisms. The various ways of solving this problem (bacterial counts, sampling by means of a protected brush operated by remote control) are discussed.

Acute Disease↗
PubMed1988

[Bilirubin-albumin-binding function of 2 human albumin preparations (placental and plasma). Comparison of their efficacy in the icteric premature infant].

Two albumin preparations obtained by Cohn fractionation of either plasma of blood donors (plasmatic albumin) or human placental blood (placental albumin) were studied in vitro and in vivo regarding their bilirubin-binding function. Analysis of this function during the industrial processing of the two preparations indicated that alcoholic fractionation and, to a lesser extent, stabilizers, were responsible for the decrease of (a) the association constants between albumin and bilirubin, (b) bilirubin-binding capacity of albumin. Unexpectedly, improvement of bilirubin-binding parameters was observed after the final heating stage. Stabilizers were reversibly bound as suggested by a further improvement of binding function seen after a brief contact of the preparations with red blood cells. The changes were similar for the two preparations. Fifty-one sick premature hyperbilirubinemic neonates were randomly infused either with placental or plasmatic albumin (1.5 g/kg). Albuminemia, bilirubinemia, erythrocytic bilirubin, unbound bilirubin (peroxidase method) were evaluated before and 3 hours after infusion. Improvement of bilirubin-binding parameters was frequently observed but without clear-cut relation with change in bilirubin/albumin molar ratio. No difference was noted between the two albumin preparations. In spite of a decrease of their association constants with bilirubin, the two albumins retained a high binding potency for bilirubin in vivo.

Bilirubin↗
PubMed1987

Use of total inspiratory pressure-volume curves for determination of appropriate positive end-expiratory pressure in newborns with hyaline membrane disease.

Thirty newborns with hyaline membrane disease were treated by mechanical ventilation with individualized appropriate positive end-expiratory pressure (APEEP) from inspiratory pressure-volume curves of the total respiratory system. APEEP was started before H24 in group 1 (19 patients), and after H24 in group 2 (11 patients). Until APEEP, the 2 groups had classical PEEP levels (lower than 0.8 kPa) either without or with incomplete improvement in arterial hypoxia. The mean APEEP of each group was greater than classical PEEP (p less than 0.001). In group 1 the time of exposure to FiO2 greater than 0.4 was shorter (23.8 +/- 13.7 h) than in group 2 (88.6 +/- 56.9 h) (p less than 0.001) and rapid improvement in blood gas exchanges was seen in group 1 compared to group 2 that was independent of the severity of the disease. Tolerance was excellent. APEEP ventilation started before H24 is of special interest in the management of newborns with severe alveolar injury.

Hemodynamics↗
PubMed1987

[A rare cause of neonatal ulcero-necrotizing enterocolitis: aortic coarctation syndrome].

The authors report a case of necrotizing enterocolitis which appeared in the first hours of life of a full-term neonate without signs of sepsis. This neonate presented with a severe hypoplasia of the horizontal aorta and very tight coarctation responsible for hepatic, renal and mesenteric ischemia. Reports of enterocolitis as a complication of congenital heart disease are rare and related most often to hypoplastic left heart than to coarctation of the aorta.

Aorta, Thoracic↗
PubMed1984

[Hemodialysis in a newborn infant with acute renal failure].

A 10-day old newborn with post-operative acute renal failure and in whom peritoneal dialysis was impossible was successfully treated by haemodialysis. The technique requires close monitoring and has some particular features, such as difficult vascular approaches, filling of the extracorporeal circuit prior to dialysis, low blood flow rate, sodium bicarbonate in the dialysis bath and high glucose intake. No major complication occurred in the 14 sessions which made it possible to overcome the acute phase of renal failure. Renal function was almost normal at the age of 9 months.

Acute Kidney Injury↗
PubMed1984

[Extensive cerebral infarction in a case of hemolytic-uremic syndrome].

A hemolytic-uremic syndrome is reported in a 9 month-old girl. It was remarkable because of the severity of the renal lesions, which ended in terminal renal failure; there were also neurologic changes, responsible for a coma of 3 month-duration and for right-sided hemiplegia. Two CT scan examinations showed a left hemispherical hypodensity, resulting from a largely extended infarction in the sylvian area. After a 3 year's follow-up, the magnitude of the clinical improvement shows the possibility of neurologic recovery in children.

Cerebral Infarction↗
PubMed1983

[Familial form of total digestive aganglionosis with absence of nerve fibers].

Two familial cases of intestinal aganglionosis with lack of innervation concerning the whole digestive tract from the rectum to the esophagus are reported. The relationships between this histologic picture and that found in classical Hirschsprung's disease are discussed. The lack of obstructive symptom makes the diagnosis difficult; however, it should be suspected in the presence of intraluminal calcifications in the small bowel. The familial incidence of the condition seems to be high. A recessive autosomal transmission is likely. Neurologic signs resembling those in dysautonomia lead to suspect an extensive disorder of the development of the neural crest.

Diagnosis, Differential↗
PubMed1982

[Congenital candidiasis of the skin (author's transl)].

A typical case of congenital candidiasis of the skin is reported. In these babies the eruption, already widespread at birth, is initially macular to become papulo-pustular, then dries up with desquamation of the skin. The finding of Candida albicans in the amniotic fluid and in placental smears confirms that the infection was present before birth. The condition regresses after local treatment and oral nystatin, but the need for parenteral treatment is controverted.

Candidiasis↗
PubMed1982

[Segmental dilatation of the ileum in a neonate. Study of the myenteric plexus with a silver staining preparation (author's transl)].

A case of segmental dilatation of the ileum in a neonate is reported. Conventional staining methods failed to show any abnormality, but a study of the myenteric plexus with a silver preparation demonstrated reduction in the number of agyrophil neurons and irregular and altered neuron cell bodies. Occurring in a neonate, therefore without previous clinical history, this case, together with various published data suggests that in some cases segmental dilatation of the ileum is due to congenital damage to the myenteric plexus.

Dilatation, Pathologic↗