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Biomedical subjects

J P Relier

Publications and source records attributed to J P Relier.

At least 55 records · Page 3Linked to original sources
PubMed1984

Serum angiotensin I-converting enzyme activity in premature and full-term infants.

Serum angiotensin I-converting enzyme activity (SCEA) was investigated in 15 healthy premature (gestational age ranging from 30 to 36 weeks) and in 14 healthy full-term (gestational age ranging from 37 to 41 weeks) newborns as well as in 16 healthy adults (32.0 +/- 2.6 years). SCEA mean values in the three groups, respectively, 23.3 +/- 1.3, 24.4 +/- 1.6 and 23.2 +/- 1.7 nM . min-1 . ml-1, did not differ significantly from each other and in the newborns there was no correlation between SCEA values and gestational age.

Gestational Age↗
PubMed1984

Paradox of REM sleep.

Explore the source record for details and available documents.

Functional Residual Capacity↗
PubMed1984

[Long-term fate of very-low-birth-weight children].

75 neonates with birth weights less than or equal to 1,250 g were admitted to a neonatal intensive care unit. 34 were followed up for about 4 years. 44% (15) of the surviving children are normal; 35% (12) present with minor sequellae compatible with normal familial, social and school life; 14.7% (5) presents with moderate sequellae; 6% (2) present with major sequellae. None presents with hydrocephalus, bedridden encephalopathy, deafness or blindness. Among these 34 children, 12 have growth retardation. All children with sequellae presented with important neurologic involvement during the neonatal period. No silent period was observed during follow-up. An early screening for the disorders is possible. The neonatal risks, often unappreciated or underestimated are, in most cases, foreseeable when taking into account the mother's history and course of pregnancy. Thanks to improvement of in utero screening techniques, proper cooperation between obstetricians and pediatricians should allow for selecting a better management for all very low birth weight prematures.

Brain Damage, Chronic↗
PubMed1984

[Costs of the initial care of children with birth weight less than or equal to 1500 g in 1981].

In 1981, 151 neonates with birth weight (B.W.) less than or equal to 1500 g were admitted to the Port-Royal Intensive Care Unit (ICU) (31% of admissions), 81% being born outside. Total mortality was 26% (53% less than or equal to 1000 g). For children who died, the median hospital stay was 9 days; in survivors, it was 69d (109d for BW less than or equal to 1000 g 71d for BW 1001-1250 g, 61d for BW 1251-1500 g), similar in hypotrophic and eutrophic infants. Average weight at direct discharge from Port-Royal ICU was 2627 +/- 565 g. The smaller the infants were at birth, the later they were discharged after assumed term. Complications (more frequent in smaller infants) played a major part in discharge delay. The cost of initial care included every step from birth to final discharge, all hospital charges and transports. Average cost per survivor was 200,356 F, but it reached 336,545 F, in patients with bronchopulmonary dysplasia and 354,605 F in those with necrotizing enterocolitis. Although the mostly good quality of survival justifies these expenses, the authors advocate increased prevention of very early prematurity and severe intra-uterine growth retardation, and development of maternal transport, as well as of prenatal call for a neonatal team in cases of unexpected birth out a of a perinatal center.

Costs and Cost Analysis↗
PubMed1983

Functional residual capacity and sleep states in the premature newborn.

Functional residual capacity (FRC) variations in relation to sleep state changes were studied in 11 premature infants with birth weights of 1.68 +/- 0.48 kg and gestational ages of 32.7 +/- 2.2 weeks (mean +/- SD). Helium dilution was used to measure FRC, and sleep states were identified using neurophysiologic criteria. No significant difference in FRC could be demonstrated between data collected during active sleep (AS) and quiet sleep. However a relationship was shown between AS and paradoxical breathing (p less than 0.02) and between AS and irregular breathing (p less than 0.05). Several factors are discussed which might explain the discrepancy between the present data in premature infants and the previously published data in term infants. (1) Neurophysiologic identification of sleep states does not include breathing pattern whereas behavioral identification does. It is therefore possible that lung volume changes are related to breathing pattern changes and not to sleep state changes per se. (2) Maturational changes may occur among the mechanisms which control FRC, leading to a progressive stabilisation of FRC, the variation of which could become related to sleep state changes.

Functional Residual Capacity↗
PubMed1983

Necrotizing enterocolitis in full-term newborns.

During a 17-month period, 19 full-term newborn infants were hospitalized for necrotizing enterocolitis (NEC). 10 of these infants had no apparent risk factors. Only 7 suffered acute fetal distress. 16 of the 19 infants were born in the same hospital. Toxicological and bacteriological investigations of possible cause revealed no specific agent. Virological analysis of 8 stool samples revealed the presence of corona virus in 5 of the 8.

Bacteroides↗
PubMed1983

[Controlled trial of intravenous lyophilized indomethacin in the treatment of persistent ductus arteriosus in premature infants].

As a result of randomized assignment, 24 premature infants with symptomatic patent ductus arteriosus (PDA) were either treated by 0,2 mg I.V. indomethacin just after diagnosis (12) or left untreated for 48 hours (12). Clinical, radiological, and biological data before trial were remarkably similar. In the 12 "treated" infants, the DA closed within 4 to 26 hours of the first dose in 8 cases. In all 12 "non-treated" infants, PDA persisted for at least 48 h, then 10 infants were treated ad libitum by I.V. (5) or oral (5) indomethacin. Three deaths (late) did not appear to be associated with either PDA or treatment. Two surgical closures were required (1 in each group). Four spontaneous closures occurred after more or less delay: 2 in the 2 never treated infants, and 2 after a double failure of I.V. or oral indomethacin. Treatment (even when unsuccessful) was usually followed by some water retention and blood dilution, sometimes of striking magnitude but always transient. To date, I.V. indomethacin can be given earlier than orally and offers slightly better chances for closure of PDA, thereby reducing the needs for surgical closure which should be reserved for badly tolerated failures of pharmacologic closure.

Clinical Trials as Topic↗
PubMed1982

[Clinical and radiological findings in 203 cases of delayed resorption of pulmonary fluid (author's transl)].

Among 1 186 neonates admitted consecutively to the Post-Royal intensive care Unit, 203 had respiratory distress, a chest roentgenogram typical of delayed resorption of lung fluid, and no other findings. Mean gestational age (GA) was 33 weeks and mean birth-weight (BW) was 1 948 g. Hood oxygen alone was used in 129 cases and intubation-ventilation-PEEP in 74 cases (46 of which were intubated before admission). The occurrence of radiological features was similar in ventilated and non-ventilated neonates : ground-glass pattern (70-80% of the cases), increased vascular markings (70-76%) enlarged right fissure (45%), thin lateral pleural density (24%) and normal cardio-thoracic ratio. The analysis of other prognostic factors showed that ventilated neonates had a significantly lower birth weight (1 689 g versus 2 097 g) and a significantly younger gestational age (31.9 versus 33.6). The study of DAa02 in non-ventilated neonates demonstrated wide individual variations, and the possibility of an early normal DAa02 but also of a late abnormal DAa02, with the associated risks of early hyperoxia or prolonged oxygen needs. In ventilated neonates, the mean duration of intubation was 4 days 13 hours; this duration decreased as the birth-weight rose. In view of the major role of BW and GA, the Port-Royal team advocates the direct admission to a neonatal intensive care unit of neonates with delayed resorption of lung fluid and a BW under 2 000 g. In this way, Pa02 can be closely monitored and artificial ventilation is readily available.

Humans↗
PubMed1982

Changes in the cellular environment of differentiating type II pneumocytes. Quantitative study in the perinatal rat lung.

The changes occurring in the cellular environment of differentiating type II pneumocytes have been studied using the perinatal rat lung as a model. The various cellular types in contact with type II pneumocytes during late fetal and neonatal period have been identified. The percentage of type II cells in contact with each cellular type has been calculated, and the extent of the contact areas has been measured. During the studied period, type II pneumocytes are in contact with other epithelial cells (type I or type II pneumocytes) on their lateral sides. On their basal side, they are facing lipid loaded fibroblasts and endothelial cells of the capillary walls. The results of the measurements show that from day 19 of gestation on, the contact area between type II pneumocytes and other epithelial cells decreases, whereas the luminal and especially the basal sides increase. On day 19, the whole basal side of type II pneumocytes in lined by lipofibroblasts. As maturation proceeds thereafter, contact is gradually made with endothelial cells. But the extent of these contacts remains always smaller than the contacts between type Ii pneumocytes and lipofibroblasts. The developmental significance of these results is discussed.

Animals↗
PubMed1982

[Very low birth weight neonates. Results of management. Future prospects].

70 neonates with birth weights (BW) less than 1 250 g were treated at the intensive care unit for neonates (USINN), hôpital Port-Royal, from April 1st 1976 to July 31st 1977. 16 of them had intra-uterine growth retardation. In 20, BW cas under 1 000 g. Assisted ventilation was necessary in 54 (77%). 43 children (61%) survived, those who were born in the same hospital did so more often (88%) than those who came from other hospitals (53%) (p less than 0.01). These results show the needs and risks of the management of very low birth weight neonates: preventing hypothermia, assisted ventilation of long duration and risk of persisting ductus arteriosus, prolonged parenteral nutrition, risk of intracranial hemorrhage more especially as respiratory distress is more severe. In survivors, the high rate of respiratory sequellae (around 30%) suggests that the duration and intensity of assisted ventilation should be reduced as much as possible.

Follow-Up Studies↗
PubMed1982

[Arterial pressure in newborn infants during the first 72 hours of life].

Arterial pressure (AP) (systolic, mean and diastolic) was recorded during the first 72 hours of life in 93 neonates, 27 to 42 weeks of gestational age and weighing 800 to 4,600 g, i.e. in stable hemodynamic and respiratory conditions. 4,464 measurements were performed. Results show that the 3 AP parameters increase with gestational age and birth weight and that AP increases with age after birth in full term as well as premature children. The physiologic variability of AP in full term and premature children accounts for the difficulty of establishing standards and for the need of a permanent recording of this parameter.

Age Factors↗
PubMed1981

The efficacy of caffeine in the treatment of recurrent idiopathic apnea in premature infants.

This prospective controlled study was aimed at evaluating the efficacy of caffeine in treating recurrent idiopathic apnea in the premature infant. Eighteen preterm infants (29 to 35 weeks' gestation) were studied. Recordings during the first 24 hours and on the fifth day of caffeine treatment showed a significant decrease of severe apnea (P less than 0.01) and of mild apnea (P less than 0.001) in the treated group (group 1) as compared with the control group (group II). No treatment of apnea other than caffeine was required in group I, whereas six neonates in group II had such severe and frequent apneic episodes for more than 48 hours that withholding additional treatment was believed to be unethical. No undesirable side effects of caffeine treatment were observed.

Apnea↗
PubMed1981

[Acute retinopathy of prematurity following oxygen therapy: current concepts (author's transl)].

Five cases of retinopathy of prematurity have been observed among 1,750 premature infants at the Florence Geller Center in Cochin-Port-Royal--C.H.U. over a period of four years. In all cases, arterial PaO2 was more than 100 mmHg at least once. In the two worst cases, oxygen therapy given only during the first had been hours of life. The authors insist on the dangers of oxygen overdose immediately after birth or during transport to a Premature Infants Center. Laser photocoagulation was employed in four eyes: 2 with regression, 1 with cicatrisation, 1 with fibroplasia. Retinopathy of prematurity remains a danger in France, even if it is not as frequent as in the U.S.A. or Japan. Indirect ophthalmoscopy is essential for diagnosis and fluorography very useful to determine prognosis and treatment.

Acute Disease↗
PubMed1980

[Glucose and insulin blood levels in low birth weight neonates under exclusive parenteral nutrition (author's transl)].

In 31 low birth weight neonates under exclusive parenteral nutrition, insulin levels were studied and compared to blood glucose levels. Mean birth weight was 1,261 g (950 to 1,500). Gestational age was 30 weeks (27 to 40). Before the 48th hour of life, mean blood glucose level (+/- standard error) was 3.61 (+/- 0.24) mmol/l. Insulin level was 116 (+/- 30) pmole/l. After the 48th hour, the values were 4.36 (+/- 0.58) and 158 (+/- 46) respectively. There is a significant correlation between blood glucose and insulin levels (r = 0.62 p < 0.001). Hyperglycemia was present in 4 cases (> 7 mmol/l) and revealed severe pathology. These 4 children were those with the highest insulin levels. There was no significant relationship between insulin level, gestational age, postnatal age or birth weight.

Blood Glucose↗
PubMed1980

[The value of fibrinogen concentrations in neonatal bacterial infections of maternal origin (author's transl)].

The changes of fibrinogen levels in the neonatal period have been systematically studied in the neonatal intensive care unit at Port-Royal Hospital. A prospective study has been performed in 29 children with bacterial infections which were definitely of maternal origin. High fibrinogen levels persist as long as the infection remains active. Return of fibrinogen levels to normal could be considered as a criterion, if not of cure, at least of the efficacy of treatment.

Bacterial Infections↗