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Biomedical subjects

P Monin

Publications and source records attributed to P Monin.

At least 55 records · Page 3Linked to original sources

Regional cerebral blood flow during bicuculline-induced seizures in the newborn piglet: effect of phenobarbital.

The changes in cerebral blood flow (CBF) during and after bicuculline-induced seizures were studied by the radioactive microsphere technique in 12 newborn, urethan-anesthetized piglets, 6 piglets pretreated with phenobarbital (10 mg/kg) and 6 without phenobarbital. The mean arterial blood pressure (MABP), PaO2, PaCO2 and the cerebral tissue pH (CtpH) were measured. CBF was increased during seizure, more in basal ganglia (98 and 106% in the control and phenobarbital group, respectively) than in brainstem, cerebellum and cortex. 15 min after seizure, CBF has returned to preseizure values. There was no significant difference at any time between the control and phenobarbital group. The increase in CBF was correlated with an increase in MABP (r = 0.753, p less than 0.01), suggesting a loss of cerebral autoregulation. CBF was significantly correlated with PaCO2 before and after seizure, but not during seizure. Finally, the increase in CBF was significantly correlated with an early increase in CtpH (r = 0.570, p less than 0.05), suggesting that brain acidosis is not involved in the pathogenesis of the increased CBF during seizures.

Acid-Base Equilibrium↗

[Management of Pierre-Robin syndrome].

Pierre Robin syndrome continuously raises problems of intensive care that are difficult to surmount. A peak has to be overcome, the date of which varies as a function of the severity of the affection, following which the infant remains a neonate at high risk. Intensive care of these infants during the neonatal period involves avoidance of the sequence of disturbances provoked by the disorders of ventilation and deglutition. Surveillance of biological variables, feeding and the fight against glossoptosis are mainly the concern of medical procedures: from orthostatic nipples to continuous gastric feeding, from procubitus to intubation with assisted ventilation, and including pharyngeal catheters and physiotherapy. Surgery is required only exceptionally at this stage, mainly in the form of hyomandibulopexy.

Abnormalities, Multiple↗

Effect of a rocking bed on apnoea of prematurity.

We describe a rocking bed for use in incubators. Its effect was studied in 12 preterm infants with idiopathic apnoea, using each as his own control. All but one had less apnoea when the bed was rocking than when it was still. Apnoea associated with a significant fall in transcutaneous PO2 was less frequent, and fewer interventions were needed to terminate apnoeic attacks.

Apnea↗

[Spectral analysis of frequencies by conventional Doppler effect examination of the supra-aortic trunks (author's transl)].

Using a directional Doppler (4 MHz) coupled to a frequency analyser, authors investigate the supra-aortic trunks on 90 patients documented by arteriography. The analyser is made of a 16 filter bank system giving a spectrum composed of 16 frequency bands within range of 160 Hz to 4,800 Hz. Data analysis is made on a computer using the comparison means test and the discriminant analysis. Authors compare frequencies on normal common carotid arteries between a group (N = 102) with internal and external carotid arteries free of lesions on one hand, and a group (N = 75) with stenosis or occlusion of internal and/or external carotid arteries on the other hand. They don't note any significant difference for each on of the 16 frequency bands. Comparison of frequencies between normal subclavian arteries (N = 115) and subclavian arteries with proximal stenosis or occlusion (N = 24) shows a significant difference concerning the following bands : F12, F14, F15, F16 (p = 0.05), F13 (p = 0.01). Comparison of frequencies between normal internal carotid arteries (N = 108) and stenosed internal carotid arteries (N = 57) shows significant difference concerning : F11 (p = 0.05), F7, F8, F9, F12, F13, F14, F15, F16 (p = 0.01). On the other side, the discriminant function distinguishes a normal internal carotid artery from a stenosed internal carotid artery in 90% of cases, whatever the stenosis degree is. A discriminant function, added to this analyser, could obtain a frequency analysis easier and less expensive than by fast Fourier transform.

Arterial Occlusive Diseases↗

Pharmacokinetics of indomethacin in the premature infant.

Indomethacin (I) pharmacokinetics was evaluated in 6 premature infants who received the drug for treatment of patent ductus arteriosus. Administered by oral or rectal route, I (0.2 mg/kg/24 h X 3) was promptly absorbed with peak plasma concentrations attained within 1 and 3 h. The elimination of I appeared to follow two compartment open model kinetics, with terminal plasma half-lives ranging from 30 to 90 h. Apparent plasma clearance values were between 0.076 and 0.335 ml/min/kg. Ductal closure was observed in 4 of the 6 infants. Data point to a possible relationship between therapeutic effects and I plasma concentrations.

Creatinine↗

[Pre-occlusive stenosis of the internal carotid artery. Haemodynamic study by Doppler effect, phonoangiography-oculoplethysmography and arteriography (author's transl)].

The diagnosis of near total occlusion of the internal carotid artery was made on a group of 122 patients (90 symptomatic - 32 asymptomatic) by Doppler examination on one hand and carotid phonoangiography and oculoplethysmography, used together, on the other hand. The angiographic examination, including the study of the extra cranial arteries and the intra cerebral vessels, was performed. It has shown that a stenosis (greater than or equal to 90% of an internal carotid artery was the only lesion on 65 patients (53.3%) and that in 57 cases (46.7%) there were multiple lesions. 96 patients (76 symptomatic - 20 asymptomatic) were operated on. 4 patients (4.2%) died but the mortality was none in the group of 20 asymptomatic patients. 19 patients refused the operation and we have noted 7 occlusions of the internal carotid artery and 2 patients died (10.2%). On 7 patients with a surgical contra indication we have noted 1 secondary occlusion. We have to consider a near total occlusion of the internal carotid artery as an emergency. Its diagnosis by non invasive techniques must be followed by heparin therapy and angiographic examination. The carotid endarterectomy will respect the external carotid artery patency.

Angiography↗

[Neonatal hyperparathyroidism secondary to maternal hypoparathyroidism (author's transl)].

Three cases of neonatal hyperparathyroidism are reported: 2 children born to a mother with idiopathic hypoparathyroidism and a boy born to a mother with pseudohypoparathyroidism. Severe demineralization, decreased plasma calcium levels and very low phosphorus levels were seen in all three cases. The PTH level was high in the two cases in which is was measured. In the second of these, the lack of vitamin D administration since birth led to very severe rickets lesions at the age of 7 weeks. This is an argument for the role of hyperparathyroidism-induced vitamin depletion in the lesions observed and in the maintenance of secondary hyperparathyroidism. Analysis of 10 previously reported cases reveals the severity of the calcium deficiency induced in the fetus in this manner, the frequency of prematurity, of dysmaturity. With calcium and vitamin treatment, biological and radiological findings become normal.

Adult↗

Giant lobar emphysema--neonatal diagnosis.

Giant emphysema of a lung lobe has distinctive features. Classically there is overdistension of the affected lung lobe, with one lobe only being involved, and, 50% of cases occur in the newborn infant [1, 4, 8]. The authors describe a particularly severe example with marked mediastinal shift and initially the hemithorax on the side of the lesion was opaque. Angiography was carried out and followed by resection when the infant was 4 months old.

Angiocardiography↗

Transcutaneous PO2 monitoring (tcPO2) in the newborn during apneic spells, convulsions, cardiac catheterizations, and exchange transfusions.

Continuous transcutaneous PO2 recording improves the monitoring of critically ill infants and newborns submitted to invasive procedures such as exchange transfusions or cardiac catheterization. The measurement of tcPO2 in babies with apneic spells or seizures gives a better understanding of these respiratory disorders. It is reasonable to recommend the continuous monitoring of PO2 with a transcutaneous electrode in neonatal intensive care units.

Apnea↗