[Spontaneous oscillations of heart rate in the normal newborn infant].
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Biomedical subjects
Publications and source records attributed to J Messer.
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A single combined transcutaneous sensor for PO2 and PCO2 was evaluated in a neonatal intensive care unit. The values obtained with the combined sensor were compared with the values obtained with two separate electrodes monitoring respectively PO2 and PCO2. Adequate correlations were found. The combined sensor represents an improvement on individual electrodes as it spares available skin surface and needs less handling.
Five neonates born to women who had had varicella late in pregnancy or in the post-partum were admitted to our unit during the last year. In utero transmission of varicella-zoster virus occurred in 2 cases. One of them had no clinical eruption but specific IgM at a titer of 1/200. The mother presented with varicella 15 days before delivery. The other developed severe neonatal congenital varicella (with disseminated eruption, pneumonia and seizures). She was treated by Aciclovir (15 mg/kg/8 h). The mother presented with chickenpox 24 hours after birth. Varicella occurring in a pregnant woman from 4 days before to 2 days after delivery is dangerous because the baby will lack maternal antibodies. It may develop severe neonatal varicella (mortality: 20-30%). A neonate in critical condition was successfully given a prophylactic treatment by Aciclovir IV (15 mg/kg/8 h for 5 days) and varicella-zona immunoglobulins (2 ml on days 1, 2, 3). This approach may be the best treatment for babies at risk for severe neonatal varicella.
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Ophthalmoscopic examinations were performed on 5678 prematures, born between 1964 and 1984, by the same investigator in the same neonatal care unit. Three periods can be differentiated. In the first period (1964-1970) retinal disorders were frequent (20%), a quarter of them severe (stages 3-5). The inspiratory fraction of oxygen was the only oxymetric factor that was monitored. In the second period (1970-1977), less severe forms were observed, but still 4.5% of stage 1 and 8.7% of stage 2 (mild forms) were assessed. During this period, oxygen partial pressure was measured every 6 h in arterial blood whenever the inspiratory fraction of oxygen exceeded 0.3. In the last period (1977-1984), no severe forms were observed and mild forms amounted to only 0.9%. In this period, oxygen partial pressure was continuously monitored transcutaneously, whenever the inspiratory fraction of oxygen exceeded 0.21. Such data show that there is an association between better oxygen monitoring and the dramatically reduced incidence of retinopathy in prematures (RP).
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To assess the reliability of the erythrocytic sedimentation rate (ESR) as a measure of clinical activity in inflammatory bowel disease, we analyzed the correlations of ESR with a global assessment of clinical activity in 77 patients with varying extents of Crohn's disease and ulcerative colitis. Analysis of all 141 ESR determinations in all 77 patients showed a highly significant correlation between mean ESR and clinical activity score (r = 0.54, p less than 0.001). Analysis of 133 ESR determinations in these 77 patients when their disease activity was either mild, moderate, or severe showed some significant differences among certain disease categories. The highest mean ESRs were in patients with the most extensive colon involvement (Crohn's colitis 40.7 +/- 3.3, universal ulcerative colitis 31.0 +/- 3.9), whereas the lowest mean ESRs were in patients with the most limited disease (ulcerative proctitis and proctosigmoiditis 19.2 +/- 2.1). The rate of increase in ESR with progressively increasing clinical activity from mild to moderate was the same in all disease categories, with the exception of Crohn's disease limited to the small bowel (ileitis or jejunoileitis), in which the ESR was relatively unchanged in a small sample of patients. By the time clinical activity became severe, however, patients in all disease categories manifested similarly high ESRs, with the exception of ulcerative proctitis in which the ESR remained low in the single patient tested.(ABSTRACT TRUNCATED AT 250 WORDS)
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Lower gastrointestinal bleeding colonic varices is infrequent. We report a patient in whom the diagnosis was made by angiography and in whom portosystemic shunt has been helpful. We believe that the treatment of choice for colonic varices is portosystemic shunt, as attempts at resection, judged by the reports in the literature, have usually resulted in death.
Changes in serum concentrations versus time of C reactive protein and orosomucoid were investigated in 134 neonates with either materno-foetal infection (group A, n = 111) or nosocomial infection (group B, n = 23). Both proteins were significantly elevated in group A neonates, with mean +/- S.E.M. values of 0.029 +/- 0,003 g/l for C reactive protein (n = 111) and 0.56 +/- 0.003 g/l for orosomucoid (n = 37). In cases with superinfection serum levels of both proteins rose before clinical symptoms developed. Changes in orosomucoid concentrations occurred a few hours after changes in C reactive protein concentrations. Monitoring C reactive protein and orosomucoid levels, in an excellent means of assessing the effectiveness of treatment and of deciding on its withdrawal when both proteins return to normal values.
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Duplications are congenital lesions, spherical or tubular in shape and composed of a muscular wall with a gastrointestinal lining. They may be found at any level from the mouth to the anus, and are usually intimately attached to some portion of the gastrointestinal tract (1, 2). The endoscopic removal of both primary duodenal polyps and prolapsing antral polyps which cause outlet obstruction has been previously described. We report a case of a symptomatic duplication cyst of the apex of the duodenal bulb, which was removed endoscopically. A patient with outlet obstruction symptoms due to a duplication cyst of the duodenal apex is described. Complete cessation of symptoms followed endoscopic removal of the cyst.
Twenty-four children suspected of having apnea induced by lymphoid pharyngeal obstruction were studied by nocturnal polygraphy. The data recorded were: instantaneous cardiac frequency, thoracic movements, naso-oral flux, transcutaneous PO2 and PCO2. Episodes of hypoxemia and of hypercapnia related to obstructive apneas were found in 19 children; the mean of the lowest values of PtcO2 during sleep was 58.4 mmHg versus 85 mmHg during wakefulness. The mean od the highest values of PtcCO2 was 50 mmHg during sleep versus 40 mmHg during wakefulness. Six children presented with marked hypoxemia (PtcO2 less than or equal to 50 mmHg). Transcutaneous blood gas monitoring is indicated in all children presenting with sleep disorders due to pharyngeal obstruction. The finding of a marked hypoxemia should suggest removal of the obstacle concerned.
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