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Biomedical subjects

J Laugier

Publications and source records attributed to J Laugier.

At least 199 records · Page 11Linked to original sources

[Cardiac malpositions. Apropos of 5 observations in the neonatal period].

Five cases of cardiac malpositions, discovered in the neonatal period, with early death are reported. The determination of the position of the cardiac cavities is essential for appropriate studies of angiocardiograms and appreciation of the possibilities of surgical treatment.

Angiocardiography↗

[Cerebral lesions observed in a twin after the in utero death of the other twin. Fetal anoxia-ischemia can be the possible mechanism (3 cases)].

BACKGROUND: The death of one twin in utero may result in visceral lesions, of possible vascular origin, in the surviving twin when the pregnancy is monochorionic and diamniotic. CASES REPORT: Case n. 1: The death of one twin and enlargement of the ventricular system in the other were seen by ultrasonography at 24 weeks of pregnancy, 8 weeks after the mother had a fall on the stairs. The heterogeneous imaging in the inferior part of placenta suggested a clot in this area. The pregnancy was terminated at 28 weeks because the ventricular dilatation continued to increase. The newborn died a few minutes later and examination of the placenta showed that the pregnancy was monochorionic and monoamniotic. Case n. 2: The death of one twin with macerating features was seen by ultrasonography at 31 weeks. The other twin was born at 32 weeks of a dichorionic, diamniotic pregnancy. Injection of milk into the placental vasculature failed to visualize any vascular anastomoses between the two placentas, but ultrasonography showed bilateral cystic lesions in the frontal lobes of the brain. Case n. 3: Acute polyhydramnios developed at 21 weeks of pregnancy; it was treated by 3 amniocenteses, while ultrasonography of the twins was normal. A fetal transfusion syndrome was observed at birth, the pregnancy being monochorionic and diamniotic. Cranial ultrasound on day 6 was normal in the recipient twin, but showed numerous cerebral cavities in the donor, which was confirmed at autopsy after that this twin suddenly died at 2 months of age. CONCLUSIONS: Brain lesions of vascular origin, can be observed in any type of twin pregnancies. They may be the result of transfusion of clot or thromboplastin-rich blood from the donor fetus through vascular anastomoses in a monochorionic placenta. They also may be due to anoxo-ischemic lesions in the absence of such anastomoses, or, in the fetal transfusion syndrome, to circulatory difficulties in one of the twins, as observed in premature singletons. In the cas of anoxo-ischemic lesions, anticipating the birth of the surviving twin is not justified.

Brain Injuries↗

[Effects of PGE1 in neonatal aortic coarctation].

In order to estimate the efficacity of prostaglandine E1 (PGE1) to dilate the obstruction in coarctation of the aorta (CoAo), we studied 16 full term neonates with heart failure. Over the 16 neonates, there was 5 with isolated CoAo and 11 with an intracardiac shunt. Over the 11 neonates, 7 had pulmonary hypertension. PGE1, at a dose of 0.05 microgram/kg/min associated to the classical treatment of heart failure were given on the 6 day of life. Effects of PGE1 were evaluated on clinical basis (presence of femoral pulse, blood pressure), echocardiographical basis (ductus arteriosus and aortic isthmus diameter) and morphological basis. In 15 neonates, the ductus arteriosus was open, in all cases CoAo diameter was the same. In 7 neonates with pulmonary hypertension, femoral pulse appeared. In conclusion, PGE1 increases post ductal perfusion by a right to left shunt through the ductus arteriosus, only in cases where pulmonary hypertension is present. No direct action on the aortic isthmus was observed.

Alprostadil↗

[Fate of orally administered antibiotic sensitive "Escherichia coli" in the intestine of the newborn (author's transl)].

In an intensive care unit, 14 newborns, without antibiotic intake, received orally 1 ml of culture broth from an antibiotic-sensitive strain of Escherichia coli marked with resistance to sodium azide. The purpose was to study the fate of the E. coli administered and to determine whether an interaction was obtained between that strain and antibiotic-resistant enterobacteria in the gut flora. In 3 infants the strain administered developed and was the only enterobacterium excreted during the first week; in 4 others the strain was recovered during one week or more, in quantities greater than 10(6)/g of stools. In 6 others, the strain appeared for less than one week, and/or in quantity less than 10(6)/g of stools. In 1 child the strain could not be recovered at all. These data show what is obtained in "holoxenic" newborns in spite of challenge with many other bacteria. They have been obtained with an ubiquitus E. coli and can be used as a control for further studies.

Age Factors↗

[Guidelines for antibiotic therapy in an infectious risk unit].

This surveillance made possible an immediate check up for an appropriate use of guidelines, allowing an optimal usage of antimicrobial agents. It's interest at term is to document audits (yearly for example) to discuss the effectiveness of our guidelines and, if necessary, to make new therapeutic choices, proven to be effective after investigation for clinical and microbiological data. Our surveillance system can be easily investigated by the physicians. It consists in checking on a weekly sheet all the new antimicrobial therapy courses, with name of patient, age, cause of antimicrobial therapy and hospitalization, bacteria, antibiotics used, for infection, before superinfection, previous superinfection, prophylaxis. A shift in usage of antibiotics can be observed, with consequences in antimicrobial therapy and hospital hygiene.

Ampicillin↗