PubMed Health⌕ Search

Biomedical subjects

A Calame

Publications and source records attributed to A Calame.

At least 73 records · Page 4Linked to original sources
PubMed1984

Real-time ultrasonography in the neonate: a systematic study of a high-risk infants population.

During a 12-month period a prospective and systematic study was carried out by means of portable real-time ultrasound (US) scanner in order to detect cerebral lesions in a population of high-risk neonates. Newborn infants were allocated into two groups: group A: all premature infants (n = 83) of less than or equal to 34 weeks' gestation or less and group B: neonates (n = 36) of more than 34 weeks' gestation presenting with abnormal neurological signs. Group A: the overall incidence of periventricular haemorrhage (PVH) was 47% (15 grade I, 16 grade II, 3 grade III, 1 Plexus choroid haemorrhage, 1 isolated intraventricular haemorrhage). Infants of 30 weeks or less were at highest risk to develop a PVH. The degree of severity did not depend on gestational age. Repeated scans accurately timed the onset of PVH; 67% developed a PVH within the first 24 hours of life and 31% within the first 6 hours. A post-haemorrhagic ventricular dilatation was noted in 50% of the 28 infants who survived more than 28 days (4 transient, 7 arrested and 3 rapidly progressive). Group B: 15 of 36 infants had US abnormalities. Cerebral lesions were miscellaneous. Diagnosis of PVH, leukomalacia, agenesis of corpus callosum, calcifications in the basal ganglia, hydranencephaly were made and confirmed at autopsy in 9 fatal cases. US has proved useful for the detection of cerebral lesions among high-risk newborn infants in a Neonatal Unit.

Birth Weight↗
PubMed1983

Systematic pH-measurements in the umbilical artery: causes and predictive value of neonatal acidosis.

Subpartal and neonatal blood gas analyses have attracted increasing interest during the past 20 years. Different studies have been carried out to investigate the causes and immediate consequences of perinatal acidosis. It was the aim of this study to examine the long term outcome of acidotic-born babies. During 16 consecutive months all deliveries in the Obstetric Department of the Centre Hospitalier Universitaire Vaudois (CHUV) were investigated with regard to incidence and causes of a perinatal acidosis (pHa.umb. less than 7.15). The psycho-motor development of all acidotic newborns was followed up for an average of 15 months. Out of 1922 deliveries a blood sample was available in all but 11 cases (0.57%). Seven newborns were excluded from the study on the assumption that their acidosis and outcome might be related to the underlying condition (congenital malformation and infection, extreme prematurity) rather than perinatal events. From the remaining 1904 deliveries 6.4% (N = 121) had a pHa.umb. less than 7.15 (Tab. I). The incidence of certain perinatal factors was compared in the acidotic and the non acidotic groups (Tab. II). The percentage of acidotic newborns is significantly higher in primipareae, in deliveries done on peridural analgesia in cord complications and premature rupture of the membranes, and in forceps deliveries. No difference could be found with regard to multiple pregnancies, meconiumstained amniotic fluid, cesarean sections, prematurity of 28-37 weeks, and sex. The relationship between CTG score and pHa.umb. is summarized in Tab. III.(ABSTRACT TRUNCATED AT 250 WORDS)

Acidosis↗
PubMed1983

High risk appropriate for gestational age (AGA) and small for gestational age (SGA) preterm infants. Neurological handicap and developmental abnormalities at five years of age.

Outcome at five years of age of 110 high risk AGA, 71 high risk SGA preterm infants with similar birth weight and 102 term control infants was studied. Mean IQ in the 3 groups was not statistically different. Major handicaps were found in 16.3% of the AGA and in 8.5% of the SGA preterms. There was no major handicap among the controls. Minor neurodevelopmental abnormalities were present in 25.6% of AGA, 28.2% of SGA and 19.6% of controls. The types of neurodevelopmental handicaps were different in the 3 groups and generally more severe in the AGA group. All the major handicaps among AGA preterms were found in children with severe neonatal complications. In the SGA preterm group, only 1/3 of the major handicaps can be related to perinatal complications. Affective and behavior disorders were probably related in some way to neurodevelopmental achievement. This study showed that preterm infants with GA less than or equal to 32 weeks are more at risk than more mature SGA preterms with similar birth weight.

Child, Preschool↗
PubMed1981

[Disorders of the mother-child relationship in newborn infants with low birth weight].

The influence of premature birth or intrauterine growth retardation (IUGR) on the mother-child relationship has been studied in 80 children with birth-weight below 2000 g, treated in the Neonatology Unit of the Pediatric Department of Lausanne University. 40 children with birth-weight over 2500 g and without perinatal complications born in the Obstetrical Department of the same hospital were used as controls. The 80 infants with low birth-weight presented only minor neonatal disturbances and showed later on a normal psychomotor development. The mother-child relationship was evaluated by free and structured interviews accompanied by a questionnaire and by regular contacts throughout the first 12 months. With the exception of the professional work of the mother during and after pregnancy, all the family and social factors were not significantly different in the 3 groups. The mothers of premature children showed significantly more disturbances of their family relationship than the mothers in the control group. On the other hand, a significantly higher number of attachment problems is the only difference observed in the group of mothers of IUGR-babies. There was no mathematical correlation between these problems and the characteristics of the family and social-economic environment of the mothers. The importance of subjective, i.e. psychological, factors as cause of difficulties in the mother-child relationship is stressed.

Adult↗
PubMed1981

[Cerebral distress in full-term newborns: method of early prognosis of the quality of long-term survival].

A study on 122 full-term newborns with cerebral distress has given the basis for a mathematical model allowing to calculate the risk of poor evolution due to neurological disorders occurring in the first week of life. For each patient a score on his neurological status is established at 3 or 7 days of age. Only four essential neurological characteristics have to be considered: primary reflexes, convulsions, apathy or swallowing disorders, respiratory disorders. All possible score combinations are listed, and each of them is associated with a risk factor (in percent) for poor evolution. A long-term prognosis can therefore be obtained by simple clinical observation, making a score and consulting the list.

Adaptation, Psychological↗
PubMed1977

[Familial oculo-cutaneous hypopigmentation of dominant transmission due to a disorder in melanocyte formation. Association of Prader-Willi syndrome with a chromosome abnormality in one of the subjects involved].

Four members of a Swiss family were affected with oculo-cutaneous hypopigmentation of dominant transmission which differed from the previously described cases of dominant oculo-cutaneous albinism by its ultrastructure. The hypopigmentation described here is characterized by the formation of numerous, but very small, melanosomes. Melanocytic tyrosinase activity was normal in light microscopy. However, on electron microscopy, tyrosinase activity was strong in premelanosomes of stage I only, and decreased rapidly in the later stages. One of the affected members also presented a Prader-Willi syndrome and a chromosomal anomaly, both being probably unrelated to the pigmentary disorder.

Adult↗
PubMed1977

Outcome of infants of very low birthweight treated in neonatal intensive care unit.

The neonatal survival rate of 500 VLBW (less than or equal to 1 500 g) treated in the neonatal unit of the Departement of Paediatrics in Lausanne (C.H.U.V.) was studied according to changing patterns of nursing and medical care occurring in four successive periods (1961 IX-1963, X-1963 - 1965, 1966-1968, IV-1971-1973). The survival rate at 28 days increased from 35.5% to 47.7% between 1961 and 1965. Earlier start of feeding, intravenous fluid therapy, better control of ambient temperature and better oxygenotherapy are the main changes during this period. Further improvement in neonatal care did not affect the 28-day survival rate. 213 VLBW out of 500 (42.6%) survived at 28 days, 13 (6.1%) out of these died within the first two years of life, 36 (16.9%) were lost for the follow-up. The remaining 164 VLBW were followed until ages between 18 months and 8 years. The improvement in neonatal care was associated with a decrease in the incidence of major neurological sequels from 21.1% to 12.2% between 1961 and 1973. Cerebral palsy and epilepsy are responsible for this decrease. The incidence of mental retardation (DQ or IQ less than 80) also decreased from 17.5% to 4.9% during the same period. However, the incidence of retrolental fibroplasia remained stable. The outlook for VLBW infants is now much more encouraging. Further improvement in perinatal care is likely to further reduce the incidence of major handicaps. but it is not clear whether they will affect the incidence of minor problems such as learning difficulties or poor school performances. More prospective studies are necessary to clarify these points and to ensure early detection of these developmental problems.

Central Nervous System Diseases↗
PubMed1977

Hypoglycorrhachia in neonatal intracranial hemorrhage. Relationship to posthemorrhagic hydrocephalus.

The level of cerebrospinal fluid (CSF) glucose may be lowered after subarachnoid hemorrhage. This was observed in each of 18 cases of proven posthemorrhagic hydrocephalus in infants (study group). In one of these children with a hemorrhagic spinal fluid and hypoglycorrhachia unaccompanied by clinical signs of intracranial hemorrhage or hydrocephalus, the axial tomography showed a significant although asymptomatic hydrocephalus. To further evaluate the significance of this finding (hypoglycorrhachia), we compared the incidence of hypoglycorrhachia (CSF glucose less than 40 mg) and lowered CSF glucose/blood glucose ratio (ratio less than 0.4) at three similar time intervals from the presumed time of the intracranial hemorrhage in the study group with that of a control group of 40 neonates with similar neonatal associated pathology (mainly premature infants with hyaline membrane disease) but who did not later develop posthemorrhagic hydrocephalus or cerebral palsy. There was a statistically greater frequency of these anomalies in the hydrocephalic group. Only 3 of the 40 control patients had hypoglycorrhachia and low ratio. Hypoglycorrhachia in the absence of other known causes for decreased CSF glucose is a good index of a probably significant meningeal hemorrhage with a high risk of secondary hydrocephalus which may or may not be symptomatic. Hypoglycorrhachia may be used as an indication of the frequency of clinically inapparent subarachnoid hemorrhage in these high risk newborns.

Cerebrospinal Fluid Proteins↗
PubMed1976

Psychological and neurodevelopmental outcome of high risk newborn infants.

Among 142 high-risk-newborns, 111 could be regularly followed-up to 3 years of age. 79 (71%) are normal, 6 (5.5%) have minor neurological sequels, 9 (8.1%) have major neurological sequels, associated in 4 cases with mental deficiency, 16 (14.5%) have developmental abnormalities (speech delay, behavioral problems, perceptual-motor and praxis disturbances), and one mental deficiency without neurological sequels. Neonatal cerebral distress proved to be the most dangerous clinical situation with regard to the ultimate neurodevelopmental prognosis (73.6% of neurological sequels or developmental abnormalities). The presence of transient abnormalities of tone in the course of the first year of life was associated with ultimate developmental abnormalities in 33.3% of the cases. Social and cultural status seemed to play a role in the intellectual, linguistic and perceptual-motor performance of this group of infants. In spite of these encouraging results, the need for a systematic long term follow-up of high risk newborns is stressed, since neurological sequels and developmental abnormalities are approximately 4 times more frequent in this group than in a normal infantile population.

Asphyxia Neonatorum↗
PubMed1976

Cerebral distress in full-term newborns and its prognostic value. A follow-up study of 90 infants.

The history of 90 full-term infants with neonatal cerebral distress was examined. Informations concerning pregnancy, delivery, neonatal status, clinical and laboratory evolution were compared with final outcome in each case. It was then possible to distinguish certain clinical features significantly associated with poor prognosis. After statistical analysis, different adverse criteria were selected, such as severe neonatal asphyxia, associated respiratory disorders, acute anemia, and especially neurological signs with regard to their chronology. This part of the study has resulted in a classification of the neurological signs and has permitted the description of both malignant and benign cerebral distress syndromes.

Anemia, Neonatal↗