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Biomedical subjects

D Valleur

Publications and source records attributed to D Valleur.

8 recordsLinked to original sources
PubMed2004

[Mid and long-term neurological prognosis of preterm infants less than 28 weeks gestational age].

The study of the long-term outcome of extremely premature babies is specially difficult because data in the literature is very heterogeneous. Recruitment (inborn, outborn), type of obstetrical management, and criteria and means used for interrupting curative treatment have varied greatly. We present the outcome of 204 infants born before 28 weeks of gestation between 1992 and 1997. The minimal follow up is 6 years. 82 infants (40.2%) died during the neonatal period. Significantly associated with neonatal death were absence of prenatal steroid course, male gender, elevated lactic acid at birth, and occurrence of pulmonary complications. When major neurological lesions (ventricular hemorrage stage III or IV and kryptic leucomalacia) developed, most infants died following a decision to stop active treatment. Out of the 114 survivors, 17 (14.9%) developed cerebral palsy (CP) or a low IQ. 31 (27.2%) had minor disorders, 66 (57.9%) were completely normal. The predictive factors of CP were major brain lesions, elevated lactic acid at the time of birth and multiple pregnancy. We also detail the minor neurological sequelae, cognitive behavioral, and psychological disorders observed in this population of extremely premature children and discuss the need for early and continuous care for these high risk babies.

Cerebral Palsy↗
PubMed1984

[Outcome of 404 premature infants born before 32 weeks of gestation in 1978-1980].

The outcome of 404 prematures born before 32 weeks of gestation and admitted on the first day of life to the Institut de Puériculture (IP) in 1978-1980 was studied with respect to post-menstrual age and birth weight: 83 (20,5%) died during the hospitalization. Of the 321 still alive after the neonatal hospitalization, 71% were followed until at least 2 years of age; 3,1% died unexpectedly at home. There was a 8% handicap rate (9 with cerebral palsy and 9 with psychomotor deficiency) in the survivors. The problems of the children without handicap consisted mostly of strabismus and psychosocial disturbances. Thus, on admission to the IP on the first day of life during 1978-1980, according to gestational age (a) less than 28 weeks, (b) between 28 and 29 weeks 6 days (c) between 30 and 31 weeks 6 days, a premature presented the following risks: death during hospitalization: (a) 47%, (b) 20% and (c) 15%; death at home (b) 5%, (c) 1%; handicap (a) 3%, (b) 10%, (c) 5%; normal survival (a) 47%, (b) 63%, (c) 75%. This study shows the value of gestational age in estimating the outcome of prematures and the utility of analysing the results according to the 2 variables of gestational age and birth weight.

Persons with Disabilities↗
PubMed1983

[Bronchopulmonary dysplasia].

A retrospective study of 2 125 preterm infants, who were ventilated at the Institut de Puériculture in Paris over 9 years (1974-1982) for respiratory distress at birth, showed that 45 (2%) developed clinical and radiological bronchopulmonary dysplasia (BPD): 8 minimal forms, 23 moderate forms and 14 severe forms, 30 of these patients survived (66%). The pathogenesis of this chronic respiratory disease is multifactorial: oxygen + pressure + duration + endotracheal intubation. Efforts should be made to limit the damaging effect of each of these factors, which should be kept down to the minimum values compatible with adequate oxygenation. The presence of emphysema and of a patent ductus arteriosus has also been incriminated, but they may reflect the severity of the initial lung lesion. Rickets, whose incidence was found to be 27%, majors respiratory distress. In the ensuing months, babies with BPD are susceptible to recurrent viral or bacterial respiratory tract infection, failure to thrive and cor pulmonale. The presence of the mother and the care of a psychomotor development specialist are needed for these infants who will be confined for months in conditions which are unsuited to their sensory, physical, emotional and cognitive development.

Autopsy↗
PubMed1982

Zinc balances in preterm infants.

Zinc balances were studied in three groups of preterm babies. The first group received bank human milk of 25% concentration, the second group bank human milk enriched with 1 g/100 ml of lactalbumin hydrolysate, and the third group an industrial formula in which 40% of the fats were replaced with medium chain triglycerides (MCT). Zn intakes (microgram/kg/day) were, respectively, 796 +/- 136 (group 1), 689 +/- 231 (group 2), and 252 +/- 67 (group 3). In all 3 groups, fecal Zn excretion was very high: range; 6,862-635 micrograms/kg/day (group 1), 3,022-194 micrograms/kg/day (group 2), and 304-27 micrograms/kg/day (group 3), respectively. Zn retentions were mostly negative for groups 1 and 2 (7/8 and 18/23, respectively), and mostly positive (12/14), for group 3. Zn absorption was found to be related to fecal fat (p less than 0.001) in all groups, and in group 1 and 2 to fecal N (p less than 0.001) and Zn intake (p less than 0.02). Positive zinc balances were obtained when fat and nitrogen absorption exceeded 90%. This was achieved at 280 days of postmenstrual age in preterm babies fed bank human milk, but much sooner in preterm babies fed with MCT.

Diet↗
PubMed1981

[Treatment of ventricular septal defects with pulmonary hypertension in infancy (author's transl)].

188 infants presenting with ventricular septal defects associated with pulmonary hypertension underwent early surgical treatment. Overall death rate was 10% (6% since 1979 and even 0% in case of single defects operated on between the ages of 6 and 12 months). Surgical results were excellent in 48 controlled cases operated on during the 1st year of life. When surgery was performed later, risk of residual pulmonary hypertension remained in cases with equal pressure levels. Our results suggest that all the infants who do not respond properly to medical treatment must be operated on and that those with a major pulmonary hypertension have to be operated on during there second semester of life.

Heart Septal Defects, Ventricular↗
PubMed1978

[Cerebro-costo-mandibular syndrome. Three new cases (author's transl)].

The cerebro-costo-mandibular syndrome combines bucco-mandibular abnormalities similar to those of the Pierre Robin syndrome, delayed psychomotor development and characteristic costal malformations. On each side, several ribs are interrupted in their dorsal portion. In the three children studied here, there were only eleven pairs of ribs. This brings the number of cases in the literature to twelve. The prognosis of the cerebro-costo-mandibular syndrome is severe, since eight of the children described died during the first months of life.

Abnormalities, Multiple↗