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Biomedical subjects

N Bednarek

Publications and source records attributed to N Bednarek.

14 recordsLinked to original sources
PubMed2003

Acquired aqueductal stenosis in preterm infants: an indication for neuroendoscopic third ventriculostomy.

OBJECT: The object of this study is to demonstrate the delayed occurrence of aqueductal stenosis in preterm infants who have suffered from intraventricular hemorrhage (IVH) and to try to explain the mechanisms of this stenosis. METHOD: From January 1996 to June 2002, 1,046 premature infants were admitted to our institution. Thirty-six neonates suffered from grade 3 or 4 intraventricular hemorrhage (Papile grading), of whom 16 died. Twenty patients survived and a ventriculoperitoneal shunt was inserted in 7 infants. Four patients underwent a neuroendoscopic third ventriculostomy. Follow-up was carried out, twice a month during the first 2 months and subsequently twice a year. CONCLUSION: In 2 children NTV was an effective treatment for hydrocephalus with an average follow-up of 29 months. The specific pattern concerning these patients is the long delay before obstructive hydrocephalus and the visualization of de novo obstruction with MRI. The biological explanation must be investigated.

Cerebral Aqueduct↗
PubMed2003

[Cutaneous aplasia, non compaction of the left ventricle and severe cardiac arrhythmia: a new case of MLS syndrome (microphtalmia with linear skin defects)].

A female neonate presented with cutaneous aplasia located to the face and the neck associated with a non compaction of the left ventricle leading to the diagnosis of MLS syndrome (microphtalmia with linear skin defects). The follow-up was complicated by life-threatening cardiac arrhythmia underlying prevention by an early diagnosis and adequate care. MLS syndrome and non compaction of myocardium are both located on X chromosome.

Arrhythmias, Cardiac↗
PubMed2003

[Retinopathy of prematurity screening and follow-up with Retcam120: expertise of a team of neonatologists concerning 145 patients].

OBJECTIVES: The high incidence of retinopathy in very premature infants requires strict evaluation and follow-up in neonatal intensive care. The strict organization required in each center, under the responsibility of ophthalmologists, is sometimes puzzling. Therefore, we tested the hypothesis that the introduction of the Retcam allows the neonatologist under the control of ophthalmologist to diagnose retinopathy of prematurity then preventing sequelae, by comparison of pictures interpretations between neonatologists and ophthalmologists. METHODS: The Retcam gives a 120 degrees picture of the retina which is captured digitally. Then, the interpretation of the neonatologist can be reviewed by the ophthalmologist. We screened premature babies less than 32 weeks of gestation and less than 1500 g, during 1 year, including learning experience. We compared pictures interpretation by neonatologists and ophthalmologists of Retcam recordings. RESULTS: One hundred and forty-five patients were included. Eight cases of retinopathy were diagnosed with an exact correlation : 3 grade III in zone 2 form plus disease, 1 stage III zone 2 unilateral, 1 stage II in zone 3, 2 stage II en zone 2, 1 grade I zone 3 on at least 5 h contiguous. We had neither false positive, nor false negative. Five infants were treated without significant sequelae. CONCLUSIONS: Retcam 120 allows an easy diagnosis and follow-up for the retinopathy of prematurity by the neonatologist. We advocate to spread Retcam to the wards where the screening of retinopathy is difficult for the ophthalmology department. As every case requiring therapy is diagnosed, prevention of severe visual handicap is completed. The cost of this apparatus is equivalent to the cost of the care for a congenital blindness.

Female↗
PubMed2001

[Posterior fossa hemorrhage in newborns following vaccum extractor delivery].

AIM: To emphasize the risk of posterior fossa hemorrhage in newborns following vacuum extraction. PATIENTS AND METHODS: Over a period of 26 months (September 1996-December 1998), seven patients who underwent delivery with the vacuum extractor had symptoms of brain stem compression, related to posterior fossa hemorrhage. They were referred to the neonatal intensive care unit. Some parameters had been analyzed: gestational period, delivery circumstances, gestational age, parameters of newborn, indications of vacuum extraction and other paraclinical investigations (biological and radiological). RESULTS: Ultrasound scan revealed intracranial hemorrhage in five cases of seven; mean time of diagnosis was 10 hours of age. All patients presented symptoms of brain stem compression. Mean period of follow-up was 22 months: six of seven patients had a normal neurodevelopment. One patient had a cerebellar ataxia, another one a palsy of the IIIrd cranial nerve. CONCLUSION: Analyses of posterior fossa by ultrasound scan should be made for newborns delivered by vacuum extractor, especially if they had symptoms of brain stem compression.

Brain Stem↗
PubMed2001

[Video-EEG monitoring in neonates: indications].

In neonates with paroxysmal events, video-EEG monitoring proves to be a powerful tool for diagnosis. It allows differentiation of epileptic seizures from other paroxysmal phenomena; a more precise analysis of clinical semiology of seizures; it may help in the localization of a seizure focus; it provides more comprehensive data for the evaluation of the interictal state.

Diagnosis, Differential↗
PubMed1999

[Treatment and followup of epilepsy in children].

The decision to treat and the choice of the right antiepileptic drug depend on frequency, severity, type of seizures, epileptic syndrome, familial and school life, impact of seizures. On the other hand it is important to know the pediatric characteristics of pharmacology, tolerance, possible side effects and efficacy of each antiepileptic drug. Some antiepileptic drugs could also worsen some types of seizures. Other therapies can be efficient in refractory epilepsies: steroids, vague nerve stimulation, ketogenic diet and surgery. Clinical informations are essential to appreciate drugs efficacy and safety. Physician could be very important for the social and school insertion of epileptic children.

Anticonvulsants↗
PubMed1999

[Benign infantile convulsions. French collaborative study].

BACKGROUND: Benign infantile non febrile seizures are not well known, leading us to study their clinical and EEG characteristics. METHODS: Between 1981 and 1994, we assembled 34 patients with the following inclusion criteria: non febrile seizures between 1 month and 2 years of age, normal personal history, no abnormality on clinical, biological and radiological investigations, normal developmental outcome with at least 1 year follow-up. RESULTS: These 34 patients were recognized as 14 familial cases (identical seizures affecting parents) and 11 non familial cases. The other nine cases had different or undefined epilepsy in the family. The clinical and EEG characteristics were the same: at the mean age of 6 months, brief partial seizures (often secondarily or apparently generalized) occurring in a cluster of two to 12 episodes a day for a mean duration of 2.5 days, with ictal EEG showing focal discharge, often slow waves or focal spikes on post-ictal tracing and normal interictal EEG. CONCLUSION: The clinical and EEG characteristics are important in order to recognize this type of infantile convulsions (familial or not familial), which have a good prognosis and need no aggressive treatment.

Age of Onset↗
PubMed1998

[Vancomycin and cardiac arrest in the infant].

BACKGROUND: Different adverse effects induced by vancomycin bolus infusion are described, but cardiac arrest seems rare, in children as in adults. CASE REPORT: Two infants, 5 and 12 months old, were admitted after cardiac arrest, following vancomycin bolus infusion in excessive dose. They recovered after prompt resuscitation and their short term follow-up was normal. CONCLUSION: Two mechanisms are invoked: anaphylactic shock and direct cardiovascular toxicity. Both are dose- and infusion rate-dependent, and probably intersubject dependent. Usually, cardiac arrest is promptly reversed by adequate resuscitation. The rules of prescription are: adequate dilution and slow rate of infusion. If any adverse effect occurred, preventive antihistaminic drug therapy should be advised.

Anaphylaxis↗
PubMed1998

Evidence of late-onset infantile spasms.

PURPOSE: To underline the unusual but possible occurrence of epileptic spasms (ES) in children >1 year of age. METHODS: Cases in whom onset of spasms occurred after 1 year of age were identified through a retrospective review of the records of all patients referred for ES to the Saint-Vincent de Paul Hôpital (Paris) and American Memorial Hospital (Reims) between 1974 and 1994. RESULTS: Eighteen cases were identified among the 734 children referred for ES, 18 cases were identified where spasm onset time ranged from 12 to 38 months of age. In 1/3 of the cases, the diagnosis was suspected from the onset of clinical manifestations; in the remaining 2/3, diagnosis was delayed by a mean 6 months (range, 2-25 months). Neurobehavioral regression affected two-thirds of the patients. Modified hypsarrhythmia was present in 11 patients; all but one exhibited major and diffuse spike- and slow-wave activity. EEG abnormalities were detected in the frontal areas in 11 patients. Spasms were cryptogenic in 9 patients. Steroids were administered to 13 patients; these controlled the spasms in 6 patients. Outcome was favorable for both seizures; cognition favorable in only 2 of the 18 patients. CONCLUSIONS: Beginning after the first year of life, ES, or late-onset infantile spasms, are distinct from early Lennox-Gastaut syndrome, although etiology, prognosis and treatment are similar to that for the classical infantile spasms.

Age of Onset↗