PubMed Health⌕ Search

Biomedical subjects

J C Mathe

Publications and source records attributed to J C Mathe.

17 recordsLinked to original sources

[Medical informatics (hospital information systems) in neonatology: reality and insufficiencies].

The generalized implementation in France of hospital information systems (HIS) is often considered by the medical practitioners as a useless constraint. Nevertheless, they are now largely used by the administrative authorities for their economical evaluation of medical care. In neonatology HIS is applied to the hospitalized sick neonates as well as to the healthy newborn infants during their maternity hospital stay with their mother following birth. This paper focuses on the practical aspects and difficulties of the current French HIS in neonatology.

Diagnosis-Related Groups↗

Preliminary report: extracorporeal lung support for neonatal acute respiratory failure.

A technique for ventilatory support of life-threatening neonatal acute respiratory failure by use of apnoeic oxygenation and low-frequency positive-pressure ventilation, with extracorporeal membrane CO2 removal through a single-cannula perfusion circuit, is described. 20 severely ill babies with respiratory failure were treated with this technique, 17 of whom survived with no clinical evidence of pulmonary handicap or neurological deficit at discharge from hospital. All 10 patients followed up at 6 months showed normal growth and development.

Acute Disease↗

[Etiologic diagnosis of severe acute pneumopathies in infants and children].

In infants and children suffering from severe acute lung disease the problem of aetiological diagnosis arises in two sets of circumstances. In cases of diffuse primary pneumonitis, which occurs mainly in immunocompromised subjects, broncho-alveolar lavage is the ideal technique to discover opportunistic infections; besides, the technique is little invasive and well tolerated. It is only when its results are negative that lung biopsy still has a few indications. In hospital-acquired lung diseases occurring in children under mechanical ventilation the results of broncho-alveolar lavage are more difficult to evaluate owing to possible contamination by tracheal organisms. The various ways of solving this problem (bacterial counts, sampling by means of a protected brush operated by remote control) are discussed.

Acute Disease↗

Use of total inspiratory pressure-volume curves for determination of appropriate positive end-expiratory pressure in newborns with hyaline membrane disease.

Thirty newborns with hyaline membrane disease were treated by mechanical ventilation with individualized appropriate positive end-expiratory pressure (APEEP) from inspiratory pressure-volume curves of the total respiratory system. APEEP was started before H24 in group 1 (19 patients), and after H24 in group 2 (11 patients). Until APEEP, the 2 groups had classical PEEP levels (lower than 0.8 kPa) either without or with incomplete improvement in arterial hypoxia. The mean APEEP of each group was greater than classical PEEP (p less than 0.001). In group 1 the time of exposure to FiO2 greater than 0.4 was shorter (23.8 +/- 13.7 h) than in group 2 (88.6 +/- 56.9 h) (p less than 0.001) and rapid improvement in blood gas exchanges was seen in group 1 compared to group 2 that was independent of the severity of the disease. Tolerance was excellent. APEEP ventilation started before H24 is of special interest in the management of newborns with severe alveolar injury.

Hemodynamics↗

[A rare cause of neonatal ulcero-necrotizing enterocolitis: aortic coarctation syndrome].

The authors report a case of necrotizing enterocolitis which appeared in the first hours of life of a full-term neonate without signs of sepsis. This neonate presented with a severe hypoplasia of the horizontal aorta and very tight coarctation responsible for hepatic, renal and mesenteric ischemia. Reports of enterocolitis as a complication of congenital heart disease are rare and related most often to hypoplastic left heart than to coarctation of the aorta.

Aorta, Thoracic↗

[Hemodialysis in a newborn infant with acute renal failure].

A 10-day old newborn with post-operative acute renal failure and in whom peritoneal dialysis was impossible was successfully treated by haemodialysis. The technique requires close monitoring and has some particular features, such as difficult vascular approaches, filling of the extracorporeal circuit prior to dialysis, low blood flow rate, sodium bicarbonate in the dialysis bath and high glucose intake. No major complication occurred in the 14 sessions which made it possible to overcome the acute phase of renal failure. Renal function was almost normal at the age of 9 months.

Acute Kidney Injury↗

[Familial form of total digestive aganglionosis with absence of nerve fibers].

Two familial cases of intestinal aganglionosis with lack of innervation concerning the whole digestive tract from the rectum to the esophagus are reported. The relationships between this histologic picture and that found in classical Hirschsprung's disease are discussed. The lack of obstructive symptom makes the diagnosis difficult; however, it should be suspected in the presence of intraluminal calcifications in the small bowel. The familial incidence of the condition seems to be high. A recessive autosomal transmission is likely. Neurologic signs resembling those in dysautonomia lead to suspect an extensive disorder of the development of the neural crest.

Diagnosis, Differential↗

[Vomiting in infants].

Explore the source record for details and available documents.

Adrenocortical Hyperfunction↗

[Severe neonatal respiratory distress with linear inspiratory pressure-volume curve].

Twenty-four newborns with severe respiratory distress, treated by mechanical ventilation, are investigated by inspiratory pressure-volume curve. The curves are obtained by slow continuous inflation technique. Two shapes are described: concave curve, ten newborns (group I), linear curve, fourteen newborns (group II). The gestational age is over 36 weeks in both groups. Determination of respiratory mechanics is indicated when mean AaDO2 is higher than 500 torr in both groups, and when there is a hypercapnia (PaCO2 = 53 +/- 11 torr, with p less than 0.05) in group II. Mechanical ventilation is conducted with individually adjusted PEEP in group I, and without PEEP in group II. Twelve hours after; mean AaDO2 in group I (260 +/- 101 torr) and in group II (420 +/- 188 torr) are significantly different (p less than 0.05). The variance analysis in group II shows that PaCO2 and pH are normalized (p less than 0.001). All the newborns in group I recovered. Three newborns in group II died. Group I can be assimilated to hyaline membrane disease in full-term neonates. Practically, the cases of neonatal respiratory distress in which PEEP is not indicated can be identified by the functional characteristics of group II.

Analysis of Variance↗

[Severe allergic cutaneovisceral vasculitis in children. Apropos of 6 cases].

Six children aged between 10 months and 13 years with allergic vasculitis are described. The features they had in common were necrotic skin lesions, involvement of various viscera and signs of hypersensitivity reactions. Histological changes of allergic vasculitis were present in the small vessels of the skin. This condition has features in common with both polyarteritis nodosa and with anaphylactoid purpura. Severe cases that do not respond to corticosteroids may respond to immuno-suppression with cyclophosphamide.

Adolescent↗