[Gonadal function in the infant and child. Physiopathological concepts and exploration].
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Biomedical subjects
Publications and source records attributed to L Sann.
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During an 18-month period, 11 cases of necrotizing enterocolitis (NEC) were diagnosed in infants treated in Neonate Department. This represents 1% of total admissions. Six cases occurred during hospitalization. Clinically, the disease took three different forms: surgical form, medical form responding well to exclusive parenteral feeding and isolated haemorrhagic form, which deserves discussion. Seven of these infants had cytomegalovirus (CMV) infection. NEC accounted for 22% of clinical symptoms in CMV infection. These data suggest that the cytomegalovirus may act as aggravating factor in NEC.
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The authors report the results of the immunonephelometric determination of 9 proteins in the serum of 74 newborns: CRP, orosomucoid, haptoglobin, alpha-1-antitrypsin, C3, C4, transferrin, prealbumin and apo B have been studied. The influence of gestational and postnatal ages are shown. Results are compared with those of the literature. The respective role of the transfer of plasma proteins from mother to foetus and of foetal synthesis in the concentration of a protein in the serum of a neonate is discussed.
A study of 214 neonates (with 87 premature infants) reveals that C-reactive protein (CRP), orosomucoid and prealbumin are the most interesting proteins for the diagnosis of neonatal sepsis and for studying its follow-up. Orosomucoid is high in 85% of bacterial infections and CRP in 75%. Early type strep B infections give often false negative results. The evolution of CRP and of prealbumin corresponds to the effects of treatment and the evolution of orosomucoid is parallel to the healing of the patients. The ratio orosomucoid/prealbumin allows an earlier appreciation of the healing.
The evolution of plasma glucose concentration was investigated in 8 dysmature and 5 appropriate-for-gestational-age (AGA) preterm infants. Mean (+/- 1 SD) plasma glucose decreased from 3,3 +/- 0,8 to 2,3 +/- 1,2 mmol/l in 30 minutes (p less than 0,01) with two values below 1,8 mmol/l. It then increased to 2,7 +/- 0,7 mmol/l at 60 minutes with no values below 1,8 mmol. In 4 (AGA) preterm infants plasma glucose decreased from 2,73 +/- 0,76 to 2,04 +/- 1,6 mmol/l at 60 minutes. One preterm infant treated with theophylline showed an increase from 4,91 to 6,05 mmol/l at 60 minutes. A negative correlation was observed only in dysmature infants between the rate of glucose infusion and the maxima drop of plasma glucose (r = 0,77 ; p less than 0,01). In dysmature infants, a drop in plasma glucose appears in correlation to the previous infusion rate of glucose. However a counterregulation appears in all dysmature infants.
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The aim of the present study was to measure the plasma concentrations of amino acids under different diets in preterm neonates whose birthweights were less than 1,350 g and gestational ages less than 34 weeks, and to compare these results with the plasma concentrations of amino acids in full term infants who were exclusively breast fed. At the end of the second month, these concentrations in preterm breast fed infants were similar to those in full term infants except for significantly lower levels of lysine. The addition of 46% humanized formula to breast milk did not change the concentrations of amino acids. The blood levels of urea nitrogen and ammonia were not different in preterm and full term infants; they were not altered by the addition of the formula.
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A retrospective study of the occurrence of hyponatremia (i.e. less than 135 mmol/l) was carried out in 17 control preterm neonates and 25 infants treated with theophylline. These infants had a birthweight lower than 1,301 g and a gestational age less than 36 weeks. Despite a similar sodium and water intake in both groups, hyponatremia was detected at the age of 7-8 days in 37% infants treated with theophylline and none of the control infants. Their mean weight loss was 11% with theophylline and 5% in the controls. These data suggest that theophylline may play a role in the occurrence of hyponatremia of very low birthweight infants.
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