[A diagnostic algorithm--infantile hypotonia (the "flabby" child)].
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Biomedical subjects
Publications and source records attributed to V Popescu.
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The authors reviewed the up to date conceptions concerning the temporary alterations of the host defense mechanisms in the neonatal period (natural barriers, macrophages, complement system, cell-mediated and humoral immunity). They try to establish correlations between this temporary alterations and the high infectious risk and the severity of most of the infections in the newborn. A special attention is paid to the peculiar situation of the premature, and also to the modifications needed in the therapeutic schedules for serious neonatal infections.
The main inborn errors of metabolism are described and the methods used for their screening. The recent technical progress in the screening tests are envisaged as well as the diagnosis and treatment aspects, insisting upon the fact that the neonatal screening undertaken in this areas are of vital importance, since the treatment of a number of specific inborn errors of metabolism constitutes a main trait of actual preventive pediatrics.
The paper reports, starting from recent data in the literature, an important aspect in a pediatric practice, referring to the congenital qualitative platelet disorders. The authors present a modern classification of platelet disorders, based on functional and biochemical defects: defects of adhesion, of primary aggregation, abnormalities of secretion and procoagulant activity. It is discussed the pathogeny, clinical aspects and laboratory tests of each disease. The authors also present some entities recently individualised an the basis of the most topical literature data and the treatment means used, the evolution and prognosis.
The problem of the drug induced pulmonary toxicity (cytotoxic and non-cytotoxic drugs) is discussed. This domain of modern pathology is in continuous development, although yet insufficiently delineated. The essential pathogenic mechanisms are presented as well as the main histopathological lesions (i.e., interstitial pneumonia and pulmonary fibrosis). The usual lesional aspects specific to certain drugs are also reviewed. For the principal chemical substances in this category, the clinical and radiological aspects are given, also the various treatment indicated, the evolution and the prognosis of the drugs induced pulmonary disease.
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The most common dermatoses during early infancy are: seborrheic dermatitis, atopic dermatitis and diaper dermatitis. It is important to differentiate these conditions for prognostic and therapeutic reasons.
The hematologic disorders that occur in HIV infected children are analysed by the authors, on the basis of some recent studies from current literature. There are emphasized the importance of the frequency of anemia, leukopenia and granulocytopenia. There are also stressed the pathogenic mechanisms of these disorders, their predictive significance and the rationale basis for therapeutics (actual and future treatment methods).
The authors presented a new classification of the neonatal convulsions, based on prolonged EEG registrations related to concomitant clinical or videorecording of fits. They focussed on the atypical neonatal convulsions and on the differential diagnosis between epileptic and nonepileptic seizures. Finally, they discussed the therapeutical consequences of these new conceptions about the conclusions in the neonate.
The authors presents the particular aspects of recurrent abdominal pain in children. After the definition, they underline the main elements that characterise this syndrome. An important place is assigned to the classification of recurrent abdominal pain, three different conceptual methods being analysed in this article, concerning the etiopathogenesis of this syndrome. The methodological errors that occurred from the practical study of recurrent abdominal pain are emphasised in order to the first bivariant model (psychogenic and organic, J. Apley, 1958). Advances in investigations of children with recurrent abdominal pain in the last ten years demonstrate that organic recurrent abdominal pain occur more often than in was considered before, in other studies. More than that, in the last years, a new concept has been considered--dysfunctional recurrent abdominal pain (without organic or psychogenic support)--in order to the trivariant model purposed by R. Barr (1981). Finally, the authors present the last conceptual model (1984) which presumes the complex interactions between four primary forces that interfere in recurrent abdominal pain modulation.
The authors present a case of cystic fibrosis in a 3 months old infant. Clinically, the first manifestation was a severe anemia secondary to iron deperdition through a hemorrhage due to an acquired trouble of thrombin formation. The late was explained by the vitamin K malabsorption and by the hepatocellular insufficiency.
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