Biomedical subjects

L Pedespan

Publications and source records attributed to L Pedespan.

8 recordsLinked to original sources

PubMed2006

[Vaccinal status in children with seizures: a retrospective study conducted in the Bordeaux child hospital].

UNLABELLED: Vaccination is a common act in medicine. Some serious side effects are always feared in a preventive action, mainly among high-risk patients such as epileptic children or children having already experienced a seizure. OBJECTIVES: To study consequences of such background on the vaccine medical practice. POPULATION AND METHODS: A retrospective study comparing the vaccine statute of children with or without case history of seizures was carried out by the neurologic and paediatric emergencies departments. The study compared 55 with seizures versus 109 without. RESULTS: On the whole, the 2 groups were insufficiently vaccinated. A statistically significant difference was highlighted between the 2 groups for the vaccination coverage by vaccine DTP (diphtheria-tetanus-pertussis) (P=0.017) and MMR (measles-mumps-rubella) (P=0.004). However, concerning the vaccination against hepatitis B, no difference was found. CONCLUSION: The usual contra-indications of these vaccines do not explain this difference and progress must be made to improve the vaccination coverage of epileptic children.

Child↗

PubMed2005

[Rehospitalization of very preterm infants in the first year of life. Comparison of 2 groups: 1997 and 2002].

OBJECTIVE: The aim of the study was to compare the rehospitalization rate in the first year of life between 2 groups of very preterm infants born on 1997 and 2002; then we compared the very preterm infants' rehospitalization rate between our retrospective 1997 group and literature (including French cohort Epipage). PATIENTS AND METHODS: Our retrospective study included all neonates born<or=33 GA, living in Gironde, discharged from neonatal unit at children's hospital of Bordeaux on 1997 and 2002 and rehospitalized during their first year of life. RESULTS: Respectively 29.1% and 30.1% premature infants were rehospitalized (at least once) in 1997 and 2002 (38.2% in Epipage cohort, no statistical difference). Mean number of rehospitalizations was 1.66 in 1997 and 1.77 in 2002. Mean duration of rehospitalization was 11.8 days in 1997 and 16.8 days in 2002. These data showed no statistical difference between 1997 and 2002. Respiratory disease was the first reason of rehospitalization. Several factors were correlated with an increase risk of rehospitalization: birth weight less than 1000 g, chronic lung disease and gestational age less than 28 weeks at birth (only in 2002 cohort). CONCLUSION: Rehospitalization rate remained stable between 1997 and 2002 whereas during this period of time, the gravity of these preterm infants had increased. The use of specific hospital discharge procedure represents a real benefit for premature infants. It must be continued after the discharge with the establishment of a strong network with the implication of parents, infants, hospital and city health workers. It may contribute to limit the very premature babies' rehospitalization rate.

Cohort Studies↗

PubMed2004

[Attachment and prematurity].

The path leading from the desire for a child, his or her birth to the very meeting with the newborn is pregnant with psychic experiences. Among the different experiences punctuating the way is found the process of attachment, that which is necessary to the establishing and structuring the link between the newborn, his or her mother, father and family. Prematurity, and along with it the receiving the premature babies in intensive care or neonatology units, modify the conditions of this meeting, in other word this getting to know one's baby. We will try and understand how and why the nature of the bond that is being created may then be altered. We will mention the characteristic troubles of attachment as reported in the literature. We will also discuss the possible ways of prevention or restoration to be set up. The evaluation of attachment, its follow-up, as well as the possibility of early care surrounding the mother-child bond should be encouraged nowadays for all premature babies and their parents.

Female↗

PubMed2002

Minimal effective dose of indomethacin for the treatment of patent ductus arteriosus in preterm infants.

The aim of this study was to determine if it was possible to decrease the number of boluses of indomethacin for the treatment of patent ductus arteriosus. This retrospective study included 46 preterm neonates (<34 weeks' GA) who had had an ultrasound diagnosis predictive of subsequent symptomatic patent ductus arteriosus. All patients had received a daily intravenous doses of indomethacin, 0.1 mg/kg. Mean age at initiation of treatment was 4.5 +/- 3.1 days. Patency of the ductus arteriosus was controlled echocardiographically each day and treatment was discontinued as soon as the ductus arteriosus was closed. The initial success rate was 84.7%, of which 6.5% reopened. The mean cumulative dose of indomethacin was 0.35 mg/kg. There was no correlation between gestational age or birth weight and total cumulative dose. Overall tolerance was satisfactory with only one case of transient acute renal failure. A weak correlation between the cumulative dose of indomethacin and natremia (r = -0.43) or weight gain (r = 0.35) was noted, and none with serum creatinine or blood urea nitrogen levels. We confirm that lower indomethacin treatment of patent ductus arteriosus in premature neonates are as effective as standard protocols.

Cardiovascular Agents↗

PubMed2001

[Respiratory emergencies in infants].

Respiratory distress in childhood is a frequent cause of admission to the emergency department. The initial management requires a rapid clinical evaluation in order to initiate appropriate interventions, which will improve respiratory status, and avoid cardiac arrest and hypoxic encephalopathy. There are many possible etiologies but in the vast majority of cases the following conditions are observed: nasal obstruction before 3 months and laryngitis after 6 months. Moreover, during winter acute viral bronchiolitis is the most common disease of the respiratory tract during the first year of life, and occurs in annual epidemics. The diagnostic of an inhaled foreign body must always be suspected. Prevention is based upon information given to families, as well as the medical community, which often minimises the seriousness of inhalation hazards.

Bronchiolitis↗

PubMed2001

[Intrapleural fibrinolytic treatment and infectious pleuresies: three pediatric cases].

UNLABELLED: Intrapleural instillation of fibrinolytic agents has been proposed for the treatment of loculated pleural effusions, or whenever the biochemical characteristics of the pleural fluid (pH, glucose level, LDH) indicate the risk of a complicated outcome due to a pleural effusion with complications and the possible development of empyema. At present, there is no consensus regarding the use of intrapleural fibrinolytic agents in children. CASE REPORTS: In this study, the successful treatment by fibrinolytic agents and standard drainage are successfully performed in three children with a pleural effusion due to an infection. CONCLUSION: The clinical utility, in terms of the reduction of the duration of hospitalization and additional surgical treatment, should be assessed in prospective studies.

Anti-Bacterial Agents↗

PubMed2001

[Neonatal nonbacterial thrombotic endocarditis].

UNLABELLED: Nonbacterial thrombotic endocarditis is not widely known in neonates. CASE REPORTS: We report three new cases which illustrate some specific aspects of this pathology. Respiratory distress with severe pulmonary hypertension, systemic hypotension and disseminated intravascular coagulopathy in a full-term newborn were characteristic findings. CONCLUSION: An early echocardiography should lead to accurate diagnosis. Hypoxemia and genetic factors could be determining factors in its pathogenesis.

Diagnosis, Differential↗

PubMed1999

[Neonatal staphylococcal epidermolysis due to maternal-fetal transmission].

INTRODUCTION: The staphylococcal scalded skin syndrome (SSSS) is due to exfoliative toxins A or B excreted by some strains of Staphylococcus aureus. This syndrome is exceptional in the first hours of life. We report a case of SSSS due to materno-fetal infection. CASE REPORT: At 31 weeks of pregnancy a 40-year-old mother was febrile (39 degrees C) and a premature rupture of the amniotic sac occurred the following day. SSSS was diagnosed at 6 hours of life in the newborn, a 1760 g female. Staphylococcus aureus grew on the blood and vaginal bacterial cultures of the mother, as well as, from cultures of skin, nose, throat, and umbilical catheter in the newborn. The strains of Staphylococcus aureus isolated in the mother and the child had identical characteristic antibiotype and genotype by Random-PCR. The genes for both exfoliations A and B were present. Epidermization was rapidly obtained and no septicemia or septic complication was noted. DISCUSSION: Staphylococcus aureus is usually responsible for nosocomial infections which occur in the early newborn period. In most cases, the infection is transmitted by a carrier who manipulates the child (family, visitors, nurse or medical staff). In our case, onset of SSSS early after birth suggested a perinatal transmission, due to lower genital tract infection in the mother. The presence of SSSS in the child and not in the mother may be explained by a massive perinatal infection and low elimination of the toxin in the newborn resulting in higher concentrations of exfoliative toxins in the blood.

Adult↗