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Biomedical subjects

M Bethenod

Publications and source records attributed to M Bethenod.

At least 19 recordsLinked to original sources
PubMed1989

[Newborn infants of psychotic mothers].

Pregnancy in women with psychotic disorders raises the problems of its advisability in such a psychiatric condition, of its fetal consequences, and of the child's future. The acceptance of pregnancy depends on the disease and the physician. Fetal consequences are mainly related to the use of psychotropic drugs because of their possible teratogenic effects, of neonatal intoxication and of postnatal withdrawal syndrome. The long-term outcome is conditioned by the quality of the mother-to-child relation, which needs frequent controls during the first years of life.

Female↗
PubMed1988

Prevention of neonatal hypoglycaemia by oral lipid supplementation in low birth weight infants.

The effect of oral lipid supplementation (2.9 g/day containing 67% medium chain triglycerides) on the prevention of neonatal hypoglycaemia was evaluated in 28 low birth weight infants (mean +/- 1 SD for gestational age: 36 +/- 1.2 weeks and birth weight: 1778 +/- 230 g) and compared to a control group of 23 infants with similar gestational age, birth weight and sex. The incidence of hypoglycaemic patients with plasma glucose less than 1.72 mmol/l was 8/23 (35%) in the control group versus 2/28 (7%) in the supplemented group: chi 2 = 6.72; P less than 0.01. Determinations of plasma beta-hydroxybutyrate concentrations in 11 infants of the supplemented group did not show values higher than 1.2 mmol/l. This prospective study shows that supplementation with lipids can prevent the occurrence of hypoglycaemia in low birth weight infants.

Female↗
PubMed1988

Arm fat and muscle areas in infancy.

Growth of arm muscle, fat and water areas were evaluated longitudinally in a prospective study in 81 infants from birth to the age of 12 months. The percentage of arm fat area v the cross sectional upper arm area increased at the age of 15 days with a peak peak at the age of 6 months while arm muscle area increased progressively throughout the year. As arm water area represented only 1% of cross sectional upper arm area, calculations of arm fat and muscle areas can be carried out from measurements of mid arm circumference and tricipital skinfold at 15 seconds. Percentiles are presented for the upper arm fat and muscle areas, which can be used as index for the infants' nutritional state.

Adipose Tissue↗
PubMed1987

[High-risk congenital diaphragmatic aplasia and hernia (apropos of 64 cases)].

The prognosis of high risk congenital diaphragmatic hernia and eventration diagnosed in the early neonatal period (before 24 h) is studied based on a series of 64 cases. Eventration has a poor prognosis with 5 deaths out of 7 cases. The replacement of the hemidiaphragm by an abdominal muscular flap seems to be the best surgical procedure (2 recoveries on 4 cases). A high mortality rate remains in the diaphragmatic hernias which are undiagnosed before birth. Out of 54 operated cases with systematic homolateral drainage, there were 35 survivors (65%). Post-operative alveolar-arterial PO2 difference less than 53 kPa appears to be a reliable criterion of good prognosis with a survival rate of 91% in this series. Thus, despite major progresses in post-operative resuscitation, the recovery rate in high risk neonatal congenital diaphragmatic hernia and eventration is only 75%. This seems to be partly related to the existence of lethal forms due to bilateral pulmonary hypoplasia and structural anomalies of the pulmonary arteries.

Blood Gas Analysis↗
PubMed1986

Effects of prematurity and dysmaturity on growth at age 5 years.

Forty-two term and 106 preterm appropriate for gestational age (AGA), and 43 term and 31 preterm small for gestational age (SGA) children were observed from birth to age 5 years. Parents' weight and height were also measured in 193 subjects including 97 couples. The percentage of short children was higher in SGA (17%) than in AGA (3.4%) children (P less than 0.01). This difference was significant in the preterm but not in the term children, suggesting that early failure of growth in utero can result in reduced growth in children. The findings were similar for weight and head circumference, but microcephaly was more frequent in term SGA (30%) than in preterm SGA (6.4%) children (P less than 0.05), suggesting that late impaired growth in utero can result in poor growth of the head. Height at the age of 5 years correlated with the parents' height only in AGA children, and with length at birth in SGA children. Weight of the 5-year-old children correlated with the mother's weight only in AGA children. Multivariate analysis in 66 couples and their children confirmed a greater tendency toward the influence of parental factors in AGA children and a more significant relationship with perinatal factors in SGA children.

Birth Weight↗
PubMed1986

[Neonatal bilateral interstitial emphysema. Surgical treatment. Apropos of 1 case].

The authors report a case of respiratory distress secondary to inhalation of meconial amniotic fluid treated by mechanical ventilation, which was complicated by severe interstitial emphysema. Treatment by pleurotomy allowed a favorable evolution. The various therapies of interstitial emphysema of the neonate, in particular surgical technics are described.

Humans↗
PubMed1985

Effect of phosphate supplementation to breast fed very low birthweight infants on urinary calcium excretion, serum immunoreactive parathyroid hormone and plasma 1,25-dihydroxy-vitamin D concentration.

The effect of two doses of Phosphorus (P) supplementation to pooled breast milk (BM): 0.48 and 0.800 mmol/kg/24 h given during the second month of life was evaluated in 22 very low birthweight infants. The concentration of calcium and phosphorus in serum and urine, the serum concentration of immunoreactive parathyroid hormone (iPTH) and the plasma 1,25-dihydroxy-vitamin D concentration (1,25-OH-D) were compared to the values in 19 control infants. The mean +/- SD concentrations in control infants and adults are 63 +/- 18 microliters Eq/ml for serum iPTH and 85 +/- pmol/l for plasma 1,25-OH-D. With 0.48 P supplementation, urinary Ca (UCa) excretion (median and range) 0.238 mmol/kg/24 h (0.105-0.520) was lower than in the control group 0.288 (0.205-0.679) (p less than 0.05); the reduction of UCa was larger with 0.8 P supplementation: 0.047 (0.023-0.163) (p less than 0.01). P supplementation induced no change in serum Ca concentration but a slight and significant increase in serum iPTH was observed only with the 0.8 P supplementation: 55 microliters Eq/ml (less than 25-80) (p less than 0.05). With 0.8 P supplementation there was no significant change of plasma 1,25-OH-D concentration: 173 pmol/l (106-271) vs. 255 (132-293) in the control group. These data show that with 0.8 P supplementation, the hypercalciuria in BM-fed infant disappears without secondary hyperparathyroidism, but without any change in plasma 1,25-OH-D concentration.

Breast Feeding↗
PubMed1985

Pharmacokinetics of vitamin K1 in low-birth-weight neonates.

The pharmacokinetics of vitamin K1 was studied in 21 newborn infants. 11 neonates had received no parenteral loading dose prior to the study (group I), while 10 had been injected 5-10 mg vitamin K1 at birth (group II). At postnatal age 2-9 h, 1 mg of vitamin K1 was injected intravenously, and small samples of blood (less than or equal to 500 microliter) were collected at different times during 6 h. Serum vitamin K1 and its epoxide were assayed by high-performance liquid chromatography (HPLC). In both groups, the disappearance curve showed two exponential components: a fast distribution component during the 1st h and a slower elimination component during the next 5 h. In group I, the plasma half-life of the first component was between 18 and 52 min (median 23 min), and the half-life of the second was between 67 and 179 min (median 109 min). Both half-lives were significantly higher in group II. The volumes of distribution were suggestive of distribution into plasma during the first phase and roughly into the extracellular water for the second component. Epoxide was detected in most patients 15 min after vitamin K1 injection, and after 3 h its concentration was higher than the concentration of vitamin K1. These data suggest that the kinetics of vitamin K1 in neonates is not very different from that in adults. The newborn infant is able to oxidize vitamin K1, a phenomenon in keeping with the gamma carboxylation of glutamic acid.

Adult↗
PubMed1985

Neonatal hypercalcemia in preterm infants fed with human milk.

Hypercalcemia (serum Ca greater than or equal to 2.83 mmol/l) was detected in 10 premature infants (gestational age: 31-37 weeks and birthweight: 1100-1950 g). All were fed with pooled human breast milk. Urinary Ca excretion was high (greater than 0.200 mmol/kg/24 h) in all but one infant while serum phosphorus (P) concentration and urinary P excretion were low. Serum immunoreactive parathyroid hormone and plasma 25-hydroxyvitamin-D concentrations were normal. A significant positive correlation was found between serum Ca concentration and urinary Ca excretion, and a negative correlation between serum Ca concentration and serum P concentration or urinary P excretion. Hypercalcemia disappeared spontaneously in two patients, was corrected by a humanized milk in three patients and by P supplementation in five patients. These data suggest that neonatal hypercalcemia is related to P depletion induced by human breast milk in premature infants.

Calcifediol↗
PubMed1985

[Role of a hypertonic theophylline solution and blood transfusion in necrotizing colitis].

The aim of this study was to evaluate the influence of an hyperosmolar solution of theophylline and of blood transfusion in the occurrence of necrotizing enterocolitis (NEC). By the end of 1982, theophylline previously given in alcoholic solution (osmolality greater than 4000 mosm/kg) was given in a preparation of sodium benzoate isoosmotic to the plasma; in addition, blood was irradiated for 20 minutes by X-Rays (5000 rads) before every transfusion. In the same unit of premature infants, the incidence of NEC was 6.7% in 1981-82; it decreased to 2.7% in 1983-84 (p less than 0.02). In the same periods of time, the incidence of NEC in very low birth weight infants (less than 1500 g) decreased from 18% to 4.7% (p less than 0.001) while the number of these very low birth weight infants had increased significantly. The incidence of blood transfusion prior to NEC was found in 67% of the patients. These data suggest a beneficial role of reducing the osmolality of theophylline and of X-Rays irradiation of blood before transfusion as a prophylaxis of NEC in premature infants.

Blood↗
PubMed1985

[Quantitative study of aerobic and anaerobic fecal flora in necrotizing enterocolitis of the newborn infant].

A quantitative study of the fecal flora was carried out in 21 neonates with necrotizing enterocolitis (NEC), (4 infants being born at term) and 57 control infants (30 born at term and 27 born before term). In the population as a whole Klebsiella was detected more frequently in NEC than in the controls. This was especially true in premature infants where Klebsiella was found in 65% of the affected infants versus 33% of the controls (p less than 0,05), while no Klebsiella was detected in the 4 term infants with NEC and in 87% of the term controls. These data suggest that Klebsiella could play a role in the pathogenesis of NEC, especially in the premature infant. Therefore, it seems required to avoid the artificial selection of Klebsiella in the neonate.

Bacteria, Aerobic↗
PubMed1984

Evolution of serum prealbumin, C-reactive protein, and orosomucoid in neonates with bacterial infection.

The simultaneous changes in serum prealbumin, orosomucoid (alpha-acidglycoprotein, AGP), and C-reactive protein (CRP) were evaluated in 36 newborn infants with septicemia (n = 20), meningitis (n = 10), arthritis (n = 5), and peritonitis (n = 1). In 29 patients with a favorable outcome the values for serum prealbumin and CRP showed a rapid return toward normal: in 2 to 3 days serum prealbumin increased by 84% from the basal value and remained at (mean +/- 1 SD) 0.11 +/- 0.02 gm/L. Serum CRP decreased from 85 +/- 75 mg/L (range 0.15 to 206 mg/L) to 49 +/- 64 mg/L (2 to 210 mg/L) at 3 to 4 days of evolution and to normal values at day 13 to 16. The changes in serum orosomucoid values were slower, from 1.33 +/- 0.75 gm/L to 1.16 +/- 0.75 gm/L at day 13 to 16, with normalization after 20 to 30 days. Serum orosomucoid values returned to the normal range with the clinical improvement. In some patients the orosomucoid/prealbumin ratio decreased earlier than the serum orosomucoid concentration. Seven patients died, and in four of these in whom at least three values could be determined serum CRP and orosomucoid remained very high, whereas serum prealbumin did not increase or subsequently decreased. These data show an inverse change in serum CRP and prealbumin concentrations in infected neonates. The immediate decrease in CRP reflects the effect of treatment, whereas the later decrease in serum AGP parallels the clinical course of the infection. Thus the determination of these proteins can help to guide the treatment of infection in newborn infants.

Acute-Phase Proteins↗
PubMed1984

[Fever during labor].

The authors have studied the progress of labour and the neonatal consequences for 100 patients who started labour with a high temperature. A control group consisted of 100 patients with normal temperature and the comparison showed that there was a raised risk of dystocia and of fetal distress during labour. The maternal and neonatal complications were studied in relationship to the aetiology, which was most frequently premature rupture of the membranes. The authors suggest the way these cases should be managed to lessen the maternal and neonatal risk which is associated with pyrexia in labour. These are: culturing blood, urine and a vaginal or, better still, endocervical swab; giving penicillin with gentamycin and metronidazole throughout the labour and in the first few days after delivery. Very careful monitoring should also be carried out.

Bacterial Infections↗