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Biomedical subjects

H Devlieger

Publications and source records attributed to H Devlieger.

At least 91 records · Page 5Linked to original sources
PubMed1991

The diaphragm of the newborn infant: anatomical and ultrasonographic studies.

In the newborn infant, the diaphragm seems badly adapted to perform the burden of respiratory work. Indeed, due to the large angle of insertion on the rib cage and the small area of apposition, the flat diaphragm of the newborn infant seems better designed to suck in the rib cage rather than air. To better understand this paradox, and get insight in the structure-function relationship, the anatomical connections between the diaphragm and the rib cage were studied in 16 infants of various postmenstrual and postnatal ages. It was concluded (1) that the diaphragm inserts on the rib cage border only in the anterior costo-diaphragmatic triangle. From antero-laterally to posteriorly it inserts at increasingly greater distance from the rib cage border; (2) that the dorsal diaphragm ends its free course at the 11th rib and continues caudally as a spur ending between the 12th rib and the crista iliaca. From echographic studies of the right diaphragm with simultaneous measurement of the caudad displacement of the diaphragm and abdominal circumference change, the dynamics of the diaphragmatic movements could be better understood. It was concluded that, in contrast with the adult diaphragm, acting as a piston within the rib cage, the diaphragm of the newborn infant acts as a below moving mainly in the posterior part.(ABSTRACT TRUNCATED AT 250 WORDS)

Apnea↗
PubMed1990

Opitz C syndrome and pseudohypoaldosteronism.

The C syndrome of multiple congenital anomalies is described in a male infant with pseudohypoaldosteronism. The association of these 2 rare autosomal recessive conditions is discussed.

Abnormalities, Multiple↗
PubMed1990

Infant feeding and cardiorespiratory maturation.

134 preterm infants were investigated in their ability to coordinate sucking and breathing. Of those infants who did not coordinate, 79% showed immature cardiorespiratory control whereas of those who suck and breathe simultaneously only 12% had poor cardiorespiratory control. This finding suggests that in infants with poor coordination of sucking and breathing an investigation of cardiorespiratory control might be indicated.

Apnea↗
PubMed1990

Neonatal haemochromatosis.

Four cases of neonatal haemochromatosis presenting as fulminant hepatic failure in the newborn were diagnosed by autopsy. In all four cases the diagnosis was made by histochemical demonstration of excessive iron deposition in hepatocytes and extrahepatic parenchymal cells, particularly pancreatic acinar epithelium, thyroid follicular epithelium and distal renal tubules. No haemosiderin was detectable in the extrahepatic mononuclear-phagocytic cells of the spleen, lymph nodes and bone marrow. The liver was the most severely affected organ. The hepatic haemosiderosis was associated with massive hepatocellular necrosis of prenatal onset in three patients, one of whom showed formation of regenerative nodules, establishing true congenital cirrhosis. Other inconstant findings included giant cell transformation, diffuse sinusoidal fibrosis with segregation of small groups of hepatocytes and cholestasis with pseudoacinar change of liver cell plates. The fetal liver disease had its onset in the late second trimester of pregnancy and was reflected clinically by severe panhypoproteinaemia with non-immune hydrops; hyperbilirubinaemia and haemorrhagic diatheses were apparent in the newborn. Neonatal haemochromatosis is a metabolic disorder, probably of autosomal recessive inheritance. The site and nature of the basic defect remain uncertain. Pathologists should be aware of this condition and its potential recurrence in subsequent pregnancies.

Female↗
PubMed1990

Neonatal sepsis due to Streptococcus pneumoniae.

A 20-year-old primigravida in the 33rd week of gestation was delivered of a girl weighing 1,790 g 23 h after spontaneous rupture of the membranes. 13 h after birth, the child showed signs of shock. Cultures of blood, conjunctiva and nasopharyngeal aspirate grew Streptococcus pneumoniae of serotype 11. Cultures from the mother's cervix and from the placenta and membranes also grew S. pneumoniae of the same serotype. The infant responded well to ampicillin and netilmicin. The early-onset pneumococcal septicemic cases reported over the last 20 years are reviewed.

Adult↗
PubMed1989

Malassezia furfur fungaemia in infants receiving intravenous lipid emulsions. A rarity or just underestimated?

Malassezia furfur fungaemia is reported in six preterm infants receiving a parenteral fat emulsion through a deep central venous catheter. The fungus was detected in blood cultures drawn through the catheter. The features of these cases are compared to those reported since 1981, when M. furfur was described for the first time as a cause of deep tissue infection. Clinical signs such as fever, in spite of broad-spectrum antibiotics, and the presence of pulmonary infiltrates, associated with leucocytosis and thrombocytopenia in neonates with cardiac or pulmonary disease should raise the suspicion of M. furfur fungaemia. The laboratory should be informed of this possibility since routine blood culture techniques are not appropriate for the isolation of this lipid-dependent organism. Treatment of the condition consists in removal of the catheter and discontinuation of the lipid administration. Effects and choice of antifungal therapy should be further investigated.

Fat Emulsions, Intravenous↗
PubMed1989

Perinatal morbidity in Belgium.

This paper reviews the results of published and unpublished epidemiological studies on perinatal morbidity in Belgium. The most frequently studied variables are birthweight and gestational age, which are not only morbidity indicators but also morbidity and mortality predictors. Congenital anomalies are studied in Belgium through the results gathered by two regional birth defects registries, which have been operating since 1979. Major results of these registries are presented and discussed with relation to their implications on prevention policy. Subjective and reported health indicators are less commonly available for epidemiological studies, although some were collected in an interview survey conducted in 1981 in three districts of Wallonia. The results show important social inequalities and geographical disparities. Finally, the long-term consequences of perinatal problems are presented and discussed. A prospective study conducted at Leuven University Hospital on infants born between 1981 and 1986 suggests that improving survival of low-birthweight infants with appropriate perinatal care will not increase the number of handicapped children.

Asphyxia Neonatorum↗
PubMed1988

The syndrome of diaphragmatic hernia, abnormal face and distal limb anomalies (Fryns syndrome): report of two sibs with further delineation of this multiple congenital anomaly (MCA) syndrome.

We describe 2 sibs with the syndrome of diaphragmatic hernia, abnormal face, and distal limb anomalies. Both infants died shortly after birth with severe respiratory distress. Postmortem examination showed gross internal anomalies: Dandy-Walker malformation, ventricular septal defect, and renal cystic dysplasia. This combination of anomalies, also termed the Fryns syndrome, appears to be a distinct MCA syndrome with variable expression and probable autosomal recessive inheritance. Prenatal ultrasonographic diagnosis was successful in both patients.

Abnormalities, Multiple↗
PubMed1988

Feeding, behavioural state and cardiorespiratory control.

The aim of the present study was to examine whether immaturity of cardiorespiratory control corresponds to a less mature behavioural state pattern and/or to less efficient feeding behaviour. Fifty-four infants were observed and data polygraphically recorded for 6 hours; a feeding session was included. It was found that infants with immature cardiorespiratory control spent more time in REM-sleep, less time in the active awake state, and were more likely to be inefficient feeders. In addition, 100 infants were observed for risk signs of sudden infant death syndrome and their parents were asked to answer a questionnaire on the sleeping and feeding behaviour of their infants. The majority of the infants with immature cardiorespiratory control were described as bad feeders but good sleepers. We conclude that gathering information about sleeping and feeding behaviour is useful when screening for immaturity of cardiorespiratory control.

Apnea↗
PubMed1988

[Tracheobronchial stenosis of the premature infant. Treatment by balloon dilatation].

The case of a 30th week preterm newborn infant, ventilated because of hyaline membrane disease and presenting with localized stenoses of the carina involving both main-stem bronchi is described. The diagnosis was made on bronchoscopy and bronchography after a period of recurrent atelectases and lobar emphysema. Due to severe broncho-pulmonary dysplasia, surgical reconstruction was impossible. A balloon dilatation was successfully performed while the infant was still ventilated. He died however at the age of 180 days.

Bronchial Diseases↗
PubMed1988

[Paroxysmal cardiorespiratory attacks in infants].

In a group of 46 fullterm infants, with a history of paroxysmal cardiorespiratory attacks, the anamnestic characteristics of the attacks were found to be heterogeneous. A 48 hours polygraphic recording was carried out in order to detect signs of immature cardiorespiratory control. Thirty seven percent of these infants were classified as having an immature cardiorespiratory control defined as abnormally long apneic episodes of 15 seconds or more, bradycardia or a high percentage (more than 10% of the time) of periodic breathing. In a group of normal control infants, those signs of immature cardiorespiratory control were significantly less frequently observed (8%). From this it is concluded that those symptoms might be considered as indicators of an increased risk for sudden infant death.

Apnea↗
PubMed1987

Congenital eventration of the diaphragm: an unusual cause of intractable neonatal respiratory distress with variable etiology.

We describe two infants dying neonatally of respiratory failure despite all attempts at resuscitation. The most striking finding at autopsy was eventration and reduced muscle content of the diaphragm. Microscopic examination of the skeletal muscles, in combination with retrospective evaluation of the family history, disclosed severe X-linked centronuclear myopathy in the first patient and congenital myotonic dystrophy in the second. These disorders are probably more frequent than reported before. Their identification is important, not only for genetic counseling of the involved families but also for providing the neonatologist a sufficient explanation for the failure of resuscitation.

Diaphragmatic Eventration↗
PubMed1987

X-linked centronuclear myopathy as a cause of floppy baby.

Two families with X-linked recessive centro-nuclear myopathy (XLR-CNM) are described. Evidence is accumulating that XLR-CNM forms a distinct entity, in contrast to the commoner later-onset forms. Family history often provides a clue to the diagnosis. Pregnancy is very often complicated by hydramnios and reduced fetal movements. We describe two families with five affected male babies who all died. An isolated case with severe fetal brady-arrhythmias in combination with acute increase in polyhydramnios is mentioned. The neonatal mortality in all recorded cases is 80 percent, with respiratory insufficiency as the cause of death. An attempt is made to establish early prenatal diagnosis and the possibility of carrier detection is briefly discussed.

Adult↗
PubMed1987

Electrolyte composition of the amniotic fluid in Bartter syndrome.

In three patients with neonatal Bartter syndrome associated with polyhydramnios, analysis of the amniotic fluid showed normal sodium, normal-to-low potassium, but high chloride concentrations. This finding clearly suggests a renal chloride reabsorption defect as the primary cause of the neonatal form of Bartter syndrome. It is suggested that whenever polyhydramnios occurs, the electrolyte composition of the amniotic fluid should first be analysed in order to establish the diagnosis of Bartter syndrome.

Adult↗
PubMed1986

Nutritive and non-nutritive sucking in preterm infants.

Nutritive and non-nutritive sucking was studied in 9 preterm infants with postmenstrual ages ranging from 28 to 33 weeks and postnatal ages ranging from 0 to 8 weeks. During nutritive sucking, sucking bursts were longer than sucking pauses. During non-nutritive sucking the opposite was seen. The sucking rate was lower during nutritive sucking. During nutritive sucking the respiratory rate was higher during the pauses than during the bursts. During non-nutritive sucking the respiratory rate was higher during sucking. It is concluded that non-nutritive sucking cannot serve as a model for studying feeding mechanisms in the preterm infant.

Electromyography↗