Biomedical subjects
Publications and source records attributed to C Fessard.
Six infants with life-threatening fainting fits are reported; five had bronchopulmonary dysplasia and one Pierre Robin anomaly. Clinically unsuspected episodes of hypoxaemia, related to an underlying respiratory pathology, appear to be the origin of these fits.
A prospective study concerning 66 prematures born after 32 weeks of gestation showed a 33% incidence of positive rolandic sharp waves (PRSW) on EEGs. The results showed a good sensitivity (Se = 95%) and specificity (Sp = 93%) of PRSW for the diagnosis of periventricular ischemia with motor sequelae. A PRSW frequency higher than one per minute and its persistence on 2 successive EEGs constitutes an indication of severity of the lesions. This study emphasizes the necessity of several EEG recordings in prematures.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
During a 6 years period, 25 newborns admitted to a neonatal intensive care unit died suddenly in the first year of life. The risk of sudden death in this specific population is 5% and reaches 7.4% in the low birth weight population (less than or equal to 2,500 g). In 12 infants, the sudden death was partially explained; in 7 infants, the sudden death remained unexplained on the basis of clinical and necropsic findings; in 6 infants, the clinical data did not justify the sudden death but necropsies were not performed. A comparison with matched living control infants showed that there was a significant increase of minor malformations of the branchial arch system and that in the sudden infant death group, threatening premature labour was more frequent during the mothers' pregnancies.
Explore the source record for details and available documents.
Two cases of bilateral posterolateral diaphragmatic hernia are reported, due to their rarity. Both rapidly led to death. One of them was associated with severe malformations of the upper limbs. An abnormality of the cervical segment of the neural crest at the end of the first month of pregnancy may explain both types of malformations.
Four cases of periventricular ischemia without hemorrhage in premature infants are described in which positive rolandic sharp waves (PRSW) were predominant in the electroencephalogram (EEG). These findings suggest the relationship of PRSW to periventricular ischemia rather than to intraventricular hemorrhage, per se, as has been considered by most investigations in the past. These PRSW can provide an early indication of periventricular leukomalacia.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
60 low birthweight (less than or equal to 1,500 g) are distributed according to existence or not, and intensity of brain disturbances, during the neonatal period; appreciated by neurological examinations, early EEG and brain imaging during the second month of life. At 18 months, at least, neurological outcome is normal for 46 children (but 6 had transient neuromotor anomalies), 14 have sequelae (7 mild, 7 major). All children with clinical neurological examination carried out during the neonatal period are normal at follow up. It is true also for the children without EEG anomaly and normal brain imaging. The early prediction of neurological outcome can be made easily with consideration of these three data. Standardised test are proposed, during the neonatal period, for these low birth weight infants.
Platelet aggregation of an afibrinogenaemic patient's platelet rich plasma (PRP) was greatly decreased when ADP was used for stimulation. In the presence of collagen or arachidonic acid the changes in light transmission recorded during platelet aggregation of patient's PRP were similar to those observed with normal PRP but the size of aggregates appeared to be smaller in comparison with those observed with normal platelets. In addition, thrombin-induced aggregation of washed platelets was similar to normal platelets. The interpretation was made possible because the fibrinogen level in plasma and in platelets was found to be almost nil as demonstrated by both an Elisa procedure described here and the determination of fibrinopeptide A (fpA). Furthermore, fibrinogen fragments, which could result from abnormal synthesis and therefore replace fibrinogen in platelet aggregation, were undetectable by immunological analysis using specific antibodies against A alpha, B beta and gamma chains and 10 different monoclonal antibodies against fibrin degradation products.
Serum creatine kinase activity was measured during the first post-natal days in healthy full-term and premature infants. The CK isoenzymes (CK-MM, MB and BB) were separated using ion-exchange column chromatography. Total CK activity is lower for premature infants than for full-term infants at the same time-periods. However the separation of the CK isoenzymes shows that the same normal values for the CK-BB (expressed as U/l) may be used for the two groups of infants.
Explore the source record for details and available documents.
The values of red blood cell bilirubin and unconjugated plasma bilirubin have been measured simultaneously in 31 blood samples of 21 new-born infants with deep jaundice. The methods of measurement used by the authors have proved quite reliable and there is good correlation between both values. The concentrations rise together with the bilirubin/albumin molecular ratio. Nevertheless even with a low ratio, the red blood cell bilirubin rises to high levels when acidosis is present.
Diffuse placental metastases brought about an early onset of labour and neo-natal death of the infant without cancer being found at autopsy. They were evidence of the generalised blood spread of the immature epidermoid cancer which was responsible for the death of the mother six months after delivery.
16 premature infants with normal trophicity were studied during the 1st week of life using serum parathormone (IPTH) dosage and evaluation of renal tubule maturation by the effect of exogenous parathormone (PTE) on urinary elimination of 3':5'-cyclic adenosine monophosphate (cAMP). As of the 1st day, IPTH levels reached or surpassed those in the adult. Prematurity thus does not appear to influence parathormone response. Given the specificity of the dosage antiserum, it appears reasonable that the PTH detected is biologically active. After PTE, urinary elimination of cAMP does not appreciably increase until the 6th day, while still remaining much lower than adult levels. The lower the weight of the premature infant, the less intense the response of the kidney. It thus seems possible that the later development of renal parathormone receptor in the premature infant may be a factor responsible for neonatal hypocalcemia with hyperphosphatemia.
Explore the source record for details and available documents.