Search

Résumé: Lorsqu’une pathologie fœtale incurable est découverte, certains couples choisissent de poursuivre la grossesse, ne pouvant se résoudre à une interruption de grossesse pour motif médical. De telles situations apparaissent, depuis quelques années, en médecine néonatale et peuvent déboucher sur une prise en charge palliative néonatale. Devant l’imprécision du diagnostic anténatal et face aux incertitudes pronostiques, l’équipe médicale se doit d’informer le couple des différentes évolutions possibles, étape après étape. La prise en charge palliative de l’enfant à naître doit alors avoir une cohérence d’intention à la fois dans la réflexion qui la porte, le discours qui est livré aux parents et les actions qui sont menées, tout en faisant participer l’ensemble des intervenants d’une équipe de santé. L’un des enjeux est d’explorer comment il est possible de contribuer à la construction de la parentalité dans le contexte d’un projet de naissance en soins palliatifs. [ABSTRACT FROM AUTHOR]

Reference values of red blood cell and with blood cell count are not established at birth in Mali. This study aimed to determine reference values of erythrocyte and leukocyte at birth in Bamako. Cord blood was collected without delay after clamping and studied for complete blood cell count in 481 newborns with a birth weight > 2500 g, Apgar score ≥ 7 at 5 or 10 minutes, without abnormal migration of hemoglobin and whose mothers were willing in Bamako. The medians and mean values, 2.5 and 97.5 percentiles were calculated. The normal reference values of red blood cell, red blood indices and leukocytes were (mean ± 1SD and range): RBC = 4,00 ± 0,46.1012/L (3,13 – 4,89), Hb = 14,12 ± 1,49 g/dL (11,20 – 17,00), Hct = 40,27 ± 4,71% (31,62 – 50,18), MCV = 101 ± 5 fl (91 – 112), MCHC = 35,37 ± 2,16 pg/cellule (30,70 – 39,59), MCH = 35,06 ± 0,93 g/dL (33,40 – 36,90), RDW = 17,79 ± 7,33% (15,50 – 20,39), Réticulocytes (109/L) = 133,081 ± 29,95 (66,62 – 200,86), GB (109/L) = 13,24 ± 7,23 (7,20 – 23,70), PMN (109/L) = 7,16 ± 4,70 (3,07 – 14,22), PME (109/L) = 0,28 ± 0,26 (0 – 0,98), PMB(109/L) = 0,05 ± 0,09 (0 – 0,31), Lymphocytes (109/L) = 4,49 ± 2,45 (1,96 – 9,42), Monocytes (109/L) = 1,06 ± 0,73 (0,21 – 2,54), myelocytes = 1.43 ± 1.51%, erythroblasts = 4.52 ± 7.83%. Male babies had lower Polymorphonuclear count than the female neonates. Taking into account these results in interpretation of whole blood cell count in newborn should avoid misdiagnosis as well as additional investigations in population with low incomes. [ABSTRACT FROM AUTHOR]

Copyright of Archives of Cardiovascular Diseases is the property of Elsevier B.V. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Summary: Neonatal meningococcal meningitis are rare, but serious by their high mortality and squealer of severe psychomotor and sensor neural. We report four cases of meningococcal meningitis collected in neonatology and neonatal resuscitation service CHU Hassan II of Fez, from 1st January 2003 to 31st December 2006. The aim of our work is to reassess the frequency of this pathology and analyze its transmission in the neonatal period. Neonatal meningococcal meningitis accounts for 12% of all neonatal meningitis collected in our service and 0.7% of neonatal infections during the study period. Three patients aged respectively H2, H17 and j2 life so the transmission path is most likely the placenta. The fourth patient is older than 12 days, which suggests the likelihood of exogenous transmission. The clinical picture is variable and atypical disorders tone is found in three patients representing the most constant sign. Direct examination of the CSF has identified the germ in three cases and the fourth by soluble Ag. The third generation cephalosporins were the treatment of choice for our patients. The evolution was favorable and complications are encountered in only one patient. [Copyright &y& Elsevier]

Summary: The objective of our study was to determine the Incidence of nosocomial bacterial infections in a neonatal intensive care unit and to describe and identify the factors associated with their occurrence. Subjects and methods: We led a cohort study concerning newborn infants old from 0 to 28days, were hospitalized 48hours or more in the neonatal intensive care unit, University Hospital Ibn Rochd, Casablanca (Morocco), from December 1st, 2010 until November 30th, 2011. Two distinct populations were defined: group 1 (infected neonates), and group 2 (non-infected neonates). Results: We identified 35 episodes of nosocomial infections. The incidence and the density incidence rates of nosocomial bacterial infections were 7.5% and 7.1 per 1000patient-days, respectively. Two types of infection were found: pneumonias (40%) and bloodstream infections (confirmed and clinical sepsis) represented 31.4%. Bloodstream infections and pneumonias had an incidence rate of 3.1% and 2.4%, respectively. The most frequently isolated pathogens were Gram Negative Bacilli (51.5%), with Klebsiella pneumonia isolates accounting for 37%. These bacteria were isolated throughout the study year. The univariate analysis of risk factors demonstrated that the odds ratio for nosocomial infection was significantly related to umbilical vein catheterization (OR 21.44) .The odd ratio for artificial ventilation was 15.05 (OR 15.05). The isolated risk factors were: an age lower than 33 weeks (OR=12.5); a birth weight less than 1500g (OR=12.06), compared to non-infected childs. The length of hospital stay, was significantly longer in nosocomial infected patients (20±10.79days versus 9.68±5.9days;<0.0001). Mortality associated with nosocomial infection was 28.5% versus 2.5% (P ≤0.001). Conclusion: The nosocomial infections are dominated by pneumonias and bloodstream infections due to Gram Negative Bacilli. Factors associated with infections were identified. [Copyright &y& Elsevier]

Summary: Neonatal thrombocytopenia are common, they represent 20% of inpatients in neonatal units and intensive care. The causes are multiple; the main consequence of this condition is the risk of bleeding including intracranial hemorrhage. Objective: The objective of our work is to focus on the etiologic profile of thrombocytopenic hemorrhagic syndrome of origin and to emphasize the importance of having an accurate diagnostic approach to avoid late squealer or severe neurosensory deaths. Patients and methods: Our work is a retrospective study of 91 cases of infants with hemorrhagic syndrome of thrombotic origin, during a study period spanning 1st January 2009 to June 30, 2010. Results: During the study period, there were 91 cases of neonatal thrombocytopenic hemorrhagic syndrome, which represents 7.02% of hospitalized neonates. Premature infants had more thrombocytopenic hemorrhagic syndrome (68.13%) than in term newborns. The hypotrophy was encountered in 27 newborns (29.67%) including 17 of them were premature. Biologically, 37 cases or 40.65% had severe thrombocytopenia with a rate less than 13 cases or 30,000/mm3 and 14.28% had levels between 30,000/mm3 and 50,000/mm3. The etiologies of hemorrhagic syndrome of thrombotic origin were dominated by neonatal sepsis (74.72%) and périnatals asphyxia (13.18%). The outcome was favorable in 28 cases corresponding to 30.76% and 63 cases died or 69.23% in an array of severe hemorrhagic syndrome. Conclusion: We emphasize the interest of early treatment to prevent severe neurological squealer and mortality significant. [Copyright &y& Elsevier]

Objectives To review medical devices addressing newborn health in resource-poor settings, and to identify existing and potential barriers to their actual and efficient use in these settings. Methods We searched Pubmed as our principal electronic reference library and dedicated databases such as Maternova and the Maternal and Neonatal Directed Assessment of Technology. We also researched standard public search engines. Studies and grey literature reports describing devices for use in a low- or middle-income country context were eligible for inclusion. Results Few devices are currently described in the peer-reviewed medical or public health literature. The majority of newborn-specific devices were found in the grey literature. Most sources described infant warmers, neonatal resuscitators, and phototherapy devices. Other devices address the diagnosis of infectious diseases, monitoring of oxygen saturation, assisted ventilation, prevention of mother-to-child transmission of HIV, assisted childbirth, weight or temperature assessment, and others. Conclusion Many medical devices designed for newborns in the developing world are under development or in the early stages of production, but the vast majority of them are not available when and where they are needed. Making them available to mothers, newborns, and birth attendants in resource-limited countries at the time and place of birth will require innovative and creative production, distribution, and implementation approaches. [ABSTRACT FROM AUTHOR]

Introduction: La mortalité néonatale demeure un problème majeur de santé publique dans les pays en développement. Notre étude avait pour but de déterminer la morbidité et la mortalité des nouveau-nés à Ouagadougou, Burkina Faso. Méthodes: Une étude rétrospective sur 10 années a permis d'inclure tous les nouveau-nés admis dans l'Unité de Néonatologie de la Clinique El Fateh-Suka. Résultats: Au total, 697 nouveau-nés étaient hospitalisés sur la période d'étude. Les principaux diagnostics étaient les infections néonatales (23.5 %), les anomalies liées à la durée de la gestation et à la croissance du fœtus (17.9 %) et le paludisme congénital (15.1 %). Les 91 (13.1 %) décès étaient dus aux anomalies liées à la durée de la grossesse et à la croissance du fœtus (46.1 %), à l'hypoxie intra-utérine et à l'asphyxie obstétricale (20,9 %) et aux infections néonatales (17.6 %). Ces décès survenaient dans 81.3 % dans les 72 heures, dans 93.4 % des cas dans la première semaine d'hospitalisation. Le facteur de risque associé à ces décès était la voie basse d'accouchement (p = 0.02). Conclusion: Cette étude a identifié des pathologies évitables déjà décrites comme les principales causes d'hospitalisations et de décès néonatals. La voie basse d'accouchement était le facteur de risque associé à ces décès, ce qui n'avait pas encore été rapporté. Les efforts pour améliorer la qualité des services de soins périnatals doivent être intensifiés afin de réduire la mortalité néonatale dans les pays en développement. [ABSTRACT FROM AUTHOR]

On constate des écarts dans les taux de prématurité et de mortalité néonatale au Canada, en partie à cause d'une formation insuffisante en réanimation et en stabilisation néonatales et de même que d'une adhésion inégale aux pratiques exemplaires. Depuis les années 1990, le Programme de réanimation néonatale est la norme dans tous les établissements qui prodiguent des soins périnatals, mais les fournisseurs et les formateurs de soins périnatals ont continué d'observer des lacunes sur le plan des connaissances et des habiletés en matière de stabilisation des nouveau-nés après la réanimation, particulièrement dans les milieux où ces soins sont rarement requis. Le Programme de soins aigus aux nouveau-nés à risque (ACoRN) a été mis sur pied pour corriger ces lacunes. Dans l'ACoRN, une évaluation primaire et des trajectoires pour soigner les divers systèmes organiques (les séquences) priorisent et orientent l'évaluation, les soins essentiels et la prise en charge des nouveau-nés à risque ou malades pendant les premières heures et les premiers jours de vie. Le présent point de pratique fait ressortir les changements aux pratiques et aux recommandations depuis 2012, année de la dernière révision du texte et du fonctionnement de l'ACoRN, qui n'était alors offert qu'en anglais. À l'instar du Programme de réanimation néonatale, l'ACoRN est géré par la Société canadienne de pédiatrie au Canada. Un manuel et un programme d'enseignement révisés, mis à jour, traduits en français et lancés en 2021 standardiseront les soins, accroîtront les compétences et la confiance chez les dispensateurs de soins périnatals et amélioreront les pronostics néonatals au Canada et ailleurs au cours des prochaines années., (© Société canadienne de pédiatrie 2022. Publié par Oxford University Press pour le compte de la Société canadienne de pédiatrie. Tous droits réservés. Pour obtenir une autorisation, écrivez à journals.permissions@oup.com.)

Summary: Introduction: The umbilical venous catheter (UVC) is widely used for venous access emergency in the newborn. The objective of this work is to describe the major complications the UVC in the newborn the Neonatal Intensive Care Unit, Mother-Child hospital, CHU Mohamed VI, Marrakech. Materials and methods: All newborns hospitalized in neonatal intensive care unit from 1st January to June 30, 2010, which required the establishment of an UVC, were included in this study. Statistical analysis was performed by SPSS 11.0 software. Results: One hundred and seventy-three newborn benefited from UVC. Ninety-nine (57.2%) were male. The mean gestational age was 35.6 (±2.5) weeks of gestation, the average duration of use of UVC was 4.3 (±1.9) days. The initial position was central in 27.7% of cases; device in 17.9% of cases, at the right atrium in 27.2% and in intra-hepatic 22.5% of cases. The repositioning of the catheter was performed in 48.6% of cases. The incidence of catheter infection was 38 episodes per 1000 days of use. Thirty-three infectious episodes were reported in the main germs isolated were Klebsiella pneumoniae in 11 cases and Staphylococcus in seven cases. Four episodes of umbilical hemorrhage have been reported. Conclusion: The main complications UVC in our series are the initial wrong position and nosocomial infection. [Copyright &y& Elsevier]

Abstract: Pregnancy denial and neonaticide have recently received media coverage following a series of French cases of neonatal killing. Although it has been known for a long time that some women deny their pregnancy and may kill their newborns, there is still no consensus on the etiopathogenic factors involved in the denial of pregnancy occurrence. Even though neonaticide is often committed by young, poor, unmarried women with little or no prenatal care, it appears that denial of pregnancy is a heterogeneous condition associated with different psychological features. Societies are ambivalent with regard to mothers who killed their children and tend to lay the entire blame on them. Furthermore, there is a widespread lack of understanding among the public on these affairs, when birth control techniques and methods are widely available. The purpose of this article is to describe the different types of pregnancy denial and neonaticide and to review the still debated etiopathogenic hypotheses. The absence of the physical changes of pregnancy at the time of the denial such as cessation of menstruation, abdominal swelling or perception of foetal movements is also discussed. [Copyright &y& Elsevier]

Copyright of Revue Francaise d'Allergologie is the property of Elsevier B.V. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Summary: Congenital Candida infection is a rare disease. Although Candida infection occurs in 10–35% of pregnant women. The infection is generally limited to the skin, however, systemic candidal infection can be fatal. This paper adds an additional case, and it discusses the clinical and laboratory features of congenital cutaneous candidiasis that permit its differentiation from other papular and vesicopustular dermatoses occurring during the first few days of life. A full-term, male infant was born by cesarean section. Since the second days of his life, he presented pustules overlying areas of confluent macular erythema on his trunk and extremities. The palms and soles were also affected. The rest of the physical examination found a fever. Microscopic examination of skin scrapings showed the presence of many yeasts and the culture permitted the identification of a strain of Candida albicans. Precocity and extent of the cutaneous signs attest a congenital cutaneous candidiasis. Congenital cutaneous candidiasis is a rare disease, its diagnosis and treatment should be started early to prevent the systemic candidal infection. [ABSTRACT FROM AUTHOR]

La varicelle est une maladie contagieuse fréquente chez l'enfant, mais rare chez la femme enceinte. La survenue de varicelle pendant la grossesse peut entrainer des complications périnatales dont la pneumonie varicelleuse du nouveau-né. Cette atteinte pulmonaire est accompagnée d'un taux élevé de décès. Nous rapportons un cas de pneumonie varicelleuse grave chez un nouveau-né qui a été contaminé par le virus de la varicelle par voie transplacentaire. Le tableau clinique associait un syndrome infectieux, une détresse respiratoire sévère avec coma, des râles sous-crépitants diffus aux deux champs pulmonaires, et une éruption cutanée disséminée faite de macules, vésicules, croûtes, évocatrice de la varicelle. La radiographie du thorax montrait un syndrome interstitiel diffus aux deux poumons. Un traitement par l'aciclovir injectable associé à l'oxygénothérapie continue a permis une évolution vers la guérison. La pneumonie varicelleuse du nouveau-né est situation associée à une forte mortalité mais dont le traitement par l'aciclovir injectable peut permettre la guérison. La prophylaxie par administration intraveineuse d'aciclovir ou d'immunoglobulines polyvalentes chez le nouveau-né permet de diminuer la sévérité et la mortalité de la varicelle périnatale. [ABSTRACT FROM AUTHOR]

Le Blueberry Muffin Baby est un syndrome cutané rare observé en période néonatale. Il est caractérisé par des papulo-nodules disséminés inflammatoires traduisant des réactions dtiématopoïèse dermique. Plusieurs causes doivent être recherchées, notamment les infections congénitales, une hémolyse sévère et les pathologies tumorales. Nous rapportons l'observation d'un nouveau-né chez qui l'aspect d'un Blueberry muffin baby a conduit au diagnostic d'une leucémie aiguë myéloïde. [ABSTRACT FROM AUTHOR]

Perinatal asphyxia contributes to over one million newborn deaths worldwide annually, and may progress to multiorgan failure. Cardiac dysfunction, of varying severity, is seen in 50%-70% of asphyxiated newborns. Resuscitation is necessary to restore oxygenation to deprived tissues, including the heart. However, reoxygenation of asphyxiated newborns may lead to generation of reactive oxygen species (ROS) and further myocardial damage, termed reperfusion injury. The newborn heart is especially vulnerable to oxidative stress and reperfusion injury due to immature antioxidant defense mechanisms and increased vulnerability to apoptosis. Currently, newborn myocardial protective strategies are aimed at reducing the generation of ROS through controlled reoxygenation, boosting antioxidant defenses, and attenuating cellular injury via mitochondrial stabilization. [ABSTRACT FROM AUTHOR]

Copyright of Revue Francophone des Laboratoires is the property of Elsevier B.V. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Summary: For a child psychiatrist, interactions between mother and child are of major importance to understand human personality and its dysfunction. However, what about perinatal depression and its consequences for the mother, child and their interaction? The aim of this prospective case-control study summary was to assess, in a same cohort, the effect of pre- and post-natal depression on new born and 1-year-old infant characteristics as related to gender, controlling for confounding variables, and on mother-child interaction at two months (PHRC AOM 02082). We evaluated maternal depression as early as during pregnancy and followed its evolution and consequences regarding psychological development in children and interactions. Method: We screened 205 pregnant women for depressive symptoms from April 2004 to November 2006. Inclusion in the prenatal depression group was based on meeting DSMIV criteria for major depressive episode. We excluded postnatal depression from the control group by routine screening at two, six and 12 months. Anxiety and stress were respectively assessed on Stait Trait Anxiety Inventory (STAI) and on Sensations during pregnancy and Life Events Questionnaire ; newborn and 1-year-old infant characteristics were evaluated with the Neonatal Behavioral Assessment Scale (NBAS) and the Infant-Toddler Social and Emotional Assessment (ITSEA) ; early infants responses to non-contingent maternal behaviour were explored by J. Nadel''s double video. Results: Prenatal depression were more frequent than postnatal depression and was highly associated with a feeling of stress and anxiety of pregnancy despite our use of numerous exclusion criteria (at-risk pregnancy, preterm delivery) and had a major impact on child behavioural development, particularly for boys. Post-natal depressions were responsible for interaction synchronism impairment, resulting in difficulties for the newborn in their emotional abilities to react. Conclusion: Our results suggest that there is a continuity between pre- and post-natal depression, but specific risks and consequences for each period. As in animal studies which have shown sex differences in the impact of prenatal maternal stress on the offspring, depression during pregnancy may affect development in a way that is related to gender. Early gender differences observed to be associated with depression, stress and anxiety during pregnancy may be a key to understanding the higher prevalence in males of child psychiatric disorders. [Copyright &y& Elsevier]

Copyright of Revue Francophone des Laboratoires is the property of Elsevier B.V. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

L'éversion congénitale des paupières est une affection rare. Son traitement en première intention est généralement conservateur, constitué de lubrifiant, d'antibiotiques, de manoeuvres d'inversion de la paupière éversée et d'une éducation des parents. Nous présentons le cas d'un nouveauné de huit heures de vie ayant une éversion congénitale bilatérale des paupières avec surinfection bactérienne. La ponction à l'aiguille de la conjonctive oedémateuse associée au traitement topique avec du sérum salé isotonique et des antibiotiques ont accéléré le processus de guérison. Une récidive n'a pas été observée lors des pleurs après trois semaines d'inversion des paupières. [ABSTRACT FROM AUTHOR]

Summary: Perinatal testicular torsion (PTT) is a rare disease. Two entities have been described: prenatal or postnatal. The aim of this study is to recall the different etiopathogenic and histological features of this disease, to highlight the difficulties of diagnosis and discuss treatment modalities and finally to establish a treatment protocol of PTT. Patients and methods: This is a retrospective study through which we studied 10 patients admitted in the pediatric surgery department of Monastir hospital between 1990 and 2009. Results: Seven newborns had the antenatal testicular torsion form and three had the postnatal form. The main clinical symptom was the scrotal swelling. The controlateral vaginal hydrocele was found in 50% of cases. Doppler ultrasonography was performed in five cases and found a PTT with no blood flow in four of the five cases. The no surgical treatment was opted for a single patient and semi-urgent surgical treatment by scrotal incision has been practiced for the nine other cases. The PTT was extravaginal in all the cases. The surgical procedure consisted of an ipsilateral orchiectomy in 100% of cases and we have realized a contralateral orchiopexy in six of the nine cases operated. Pathological examination found a hemorrhagic infarction in seven cases and testicular necrosis in three cases. The postoperative and subsequent evolution was favorable in all cases. Conclusion: The PTT is a rare disease occurring in utero and during the first month of life. Its pathogenesis is still poorly understood and the therapeutic approach is controversial. [Copyright &y& Elsevier]

Background. Mutations in the SCN5A gene have been linked to Brugada syndrome (BrS), conduction disease, Long QT syndrome (LQT3), atrial fibrillation (AF), and to pre- and neonatal ventricular arrhythmias. Objective. The objective of this study is to characterize a novel mutation in Nav1.5 found in a newborn with fetal chaotic atrial tachycardia, post-partum intraventricular conduction delay, and QT interval prolongation. Methods. Genomic DNA was isolated and all exons and intron borders of 15 ion-channel genes were sequenced, revealing a novel missense mutation (Q270K) in SCN5A. Nav1.5 wild type (WT) and Q270K were expressed in CHO-K1 with and without the Navβ1 subunit. Results. Patch-clamp analysis showed ∼40% reduction in peak sodium channel current ( INa) density for Q270K compared with WT. Fast and slow decay of INa were significantly slower in Q270K. Steady-state activation and inactivation of Q270K channels were shifted to positive potentials, and window current was increased. The tetrodotoxin-sensitive late INa was increased almost 3-fold compared with WT channels. Ranolazine reduced late INa in WT and Q270K channels, while exerting minimal effects on peak INa. Conclusion. The Q270K mutation in SCN5A reduces peak INa while augmenting late INa, and may thus underlie the development of atrial tachycardia, intraventricular conduction delay, and QT interval prolongation in an infant. [ABSTRACT FROM AUTHOR]

Abstract: Objectives: Oxygen hood is largely used to deliver O2 to newborn infants with respiratory failure in the northern region of France. The oxygen flow is set to obtain the target arterial blood oxygen saturation. Thus, O2 flow delivers into the hood may be below the recommended gas flow of 6L/min. However, gas flow below 6L/min exposes to CO2 rebreathing. The aim of this study was to evaluate the effect of various rates of gas flows on the values of partial pressure of CO2 into the hood. Material and methods: We measured CO2 and O2 partial pressure into hoods of two different volumes (4 and 10L) under two experimental bench test conditions. Protocol 1: gas flow was constant at 6L/min, while oxygen fraction varied from 0.21 to 1. Partial pressure of CO2 and O2 were recorded. Protocol 2: while O2 fraction was kept constant, oxygen flow varied from 0.5 to 7L/min (by step of 0.5L/min). Partial pressure of CO2 and O2 were recorded. Results: Partial pressure of CO2 increases proportionally to the decrease in the gas flow delivered into the hood, and reached 14mmHg at gas flow of 0.5L/min. Conclusion: Risk of CO2 rebreathing exists as soon as the gas is delivered into the hood at minimal flow rates below 6L/min. [Copyright &y& Elsevier]

Vein of Galen aneurysmal malformation is a rare congenital anomaly. Diagnosis is rarely made in early pregnancy. We report the case of a full-term neonate with cerebral vascular dilatation seen on antenatal Doppler ultrasound at 30 weeks. There were also signs of cardiac failure. Antenatal diagnosis of vein of Galen malformation was suspected. Fetal MRI could not be performed. Medical termination of pregnancy was suggested but was not accepted by the parents. The infant was delivered vaginally at 41 weeks. He presented with growth restriction and cardiac failure. The infant died a few hours later due to severe cardiac failure. Diagnosis of the malformation was confirmed by autopsy findings. [ABSTRACT FROM AUTHOR]

Summary: Introduction: In Africa, with the technological advances of the last decade, the university hospital pediatric departments have optimized the management of newborns at the cost of a nosocomial risk premium. In Abidjan, in the service of neonatology, the prevalence of germs usually implicated in nosocomial infections was 33% with a predominance of gram negative bacilli (79%). Klebsiella pneumoniae and Enterobacter cloacae were the two most common germs. Nosocomial infection or maternal-fetal distinction was not made. Method: A retrospective cohort study was conducted over a period of seven years in the neonatal unit of university hospital of Yopougon in Abidjan. Purpose: Identify clinical signs suggestive of infection due to Klebsiella pneumoniae and Enterobacter cloacae and propose a clinical score of risk of nosocomial infection. The records of newborns with a positive blood culture for Klebsiella pneumoniae or Enterobacter cloacae were assessed under Center for Disease Control and Prevention suitable for newborns. Fever (31%), digestive signs (27%), respiratory distress (16%) and jaundice (13%) were the main signs identified. A clinical score for risk of nosocomial infection has been proposed based on signs and identified risk factors in our context. [ABSTRACT FROM AUTHOR]

Abstract: Objectives: To investigate the determinants of Group B streptococcus (GBS) maternal colonization, as well as factors associated with its vertical transmission. Patients and methods: Case–control study on all singletons pregnancies delivered beyond at least 24weeks of amenorrhoea in Southern Reunion maternities for which GBS screening was known. Multiple logistic regression analysis using 2004–2007 dataset of South Reunion birth registers. Results: Out of 17,430 women delivered between 1st January 2004 and 31st December 2007, 2911 (16.7%) carried GBS. In a model adjusted on antenatal care, risk groups for GBS carriage were the women indigenous from another island of the Indian Ocean than Reunion (OR: 1.29, CI95%: 1.05–1.57) and obese women (body mass index≥30, OR: 1.19, CI95%: 1.03–1.18). Protective factors included birthplace in mainland France (OR: 0.82, CI95%: 0.69–0.97) and underweight (OR: 0.81; CI95%: 0.69–0. 95). In a model controlling for a composite obstetrical variable delineating the protective roles of C-section and antibioprophylaxis as well as the putative role of meconium-stained fluids (thin, thick or fetid), all previously found in our setting, three key factors were independently associated with GBS vertical mother-to-child transmission: obesity (OR: 1.48, CI95%: 1.05–2.09), fetal tachycardia (OR: 4.92, CI95%: 2.79–8.68) and late preterm birth (35 to 36 wks, OR: 2.14, CI95%: 1.32–3.45). Conclusion: These findings strengthen the putative roles of corpulence and ethnicity in GBS acquisition previously found in the United States, while confirming an authentic role of obesity in its vertical transmission, independently of other classical cofactors lighted by our study. [Copyright &y& Elsevier]

Summary: Background: Neonatal malaria is classicaly known to be rare in malaria endemic countries. However, reports increasingly suggest an underestimation of its true frequency. The aim of this study was to determine the prevalence of congenital and neonatal malaria in infants admitted in tertiary reference hospital in Mali using three complementary diagnostic methods. Methods: The study was conducted in neonatalogy unit of the pediatric ward of the teaching hospital Gabriel Toure in Bamako, Mali from October 1st 2006 to March 17th 2008. In-patient infants aged between 0 and 28days and their mothers were included. Malaria was diagnosed on infants and mothers venous blood using a rapid diagnostic test (RDT, OptiMAL IT®), light microscopy of thick smear and polymerase chain reaction (PCR). Results: Overall 267 infants and 146 mothers were included. The mean age and weight of the infants were 2.7days and 2862.4g respectively. Light microscopy of thick smears and PCR amplification of parasite DNA were both negative in the infant population. Mothers had a mean age of 25years. Microscopy of thick smears was negative in all samples collected from these mothers while the RDT detected one case of Plasmodium falciparum and PCR detected seven cases of P. falciparum and two cases of P. ovale. Conclusion: Congenital and neonatal malaria remain of a rare occurrence in in-patients infants admitted in a tertiary reference hospital in Mali. [Copyright &y& Elsevier]

Summary: Newborns and particularly preterm infants are a population at high risk of transfusion. The implementation of strategies to prevent transfusion by reducing blood loss, use of recombinant human erythropoietin, administration of iron and vitamins and delayed umbilical cord clamping have reduced the frequency of transfusions neonatal periods. The emergence of more stringent recommendations on indications for transfusion has been involved in this development. Various transformations and qualifications for red cell concentrates, platelet concentrates and fresh frozen plasma must be known to better adapt the blood products to newborn term and preterm according to their pathologies. Preparing pediatric units from a single donor for repeated transfusions reduces the allo-immune and infectious risks. [Copyright &y& Elsevier]

Copyright of Revue Francaise d'Allergologie is the property of Elsevier B.V. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Ginecología y Obstetricia de México is the property of Federacion Mexicana de Ginecologia y Obstetricia and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

The objective of this article is to question certain discourses regarding the beginnings of the structuring of the subject, in order to next construct hypotheses as to what is involved in the experience of newborn babies in an ICU. For this purpose, we will compare the condition of the biological organism and medical interventions into the functions of speech and language as determinant of what will be constituted as trauma. We will also discuss how to approach the question of time in children's processes of subjectivation. [ABSTRACT FROM AUTHOR]

Summary: Adams-Oliver syndrome is a rare congenital anomaly characterized by aplasia cutis congenita (ACC) and variable degrees of terminal transverse limb defects. We report on a neonatal case with the sporadic form of the disease with minimal expression, illustrating the wide spectrum of clinical expression in Adams-Oliver syndrome. We also review the literature and highlight the different pathogenetic hypotheses of this syndrome. [ABSTRACT FROM AUTHOR]

Summary: Morgagni hernia is a rare malformation (3% of diaphragmatic hernias). This hernia is usually asymptomatic in children. We report on a case revealed by an unusual complication. Severe cyanosis was due to right-to-left atrial shunt through the foramen ovale assessed by 2D echocardiography. Diagnosis of the Morgagni hernia was made with CT scan. The intrathoracic liver compressed the right chambers of the heart causing tamponade. Cardiac compression was reversed after surgery and replacement of the liver in the abdomen. Six months after the surgery, the infant was symptom-free with normal size right chambers of the heart. [ABSTRACT FROM AUTHOR]

Summary: Acute osteomyelitis, although a rare complication in neonates, is a diagnostic and therapeutic challenge. Successful treatment to avoid functional sequelae depends on early recognition of infection and rapid initiation of therapy. Although Staphylococcus aureus is the most common causative agent, coagulase-negative Staphylococcus (CONS), well known for bloodstream infection, can be involved in neonatal osteomyelitis. Risk factors of osteomyelitis include prematurity and invasive procedures, such as long-term central venous catheterization. We report on 3 cases of acute CONS osteomyelitis in preterm infants presenting with prolonged CONS bacteremia. Bacteremia persisted despite antibiotic treatment in accordance with antibiograms and despite removal of the intravascular device. All catheter cultures were negative and osteomyelitis was not located on the limb where the central catheter had been inserted in all cases. Osteomyelitis diagnosis may be difficult in neonates because of the paucity of clinical signs. In our observations, 99mTc scintigraphy was the key investigation for diagnosis and detection of multiple sites of bone infection. The place of this investigation is discussed in relation to other imaging techniques. These observations suggest that in the context of persisting CONS bacteremia, a secondary bone infection should be considered. Scintigraphy is a discriminating diagnostic tool. [ABSTRACT FROM AUTHOR]

Summary: Objective: To evaluate prospectively the benefit of posterior liver mobilization during umbilical venous catheterization to place the umbilical venous catheter (UVC) in the central position (inferior vena cava). Patients and methods: Sixty-five successive newborn infants admitted in 3 neonatal intensive care units who required a UVC were enrolled over a 4-month period. UVC positions were assessed by X-ray. UVCs were placed either in an adequate position (at the right atrial–inferior vena cava junction, indicating success) or inserted within the portal system (failure). In this case, the UVC was drawn back to the 3cm mark and then, an additional attempt to insert the UVC was made during lateroposterior liver mobilization by the operator''s hand. The success and failure rates at 1st and 2nd attempts were evaluated and compared. Characteristics of the population and possible catheter-related complications were recorded. Results: A total of 31 of 65 (55%) UVC insertions failed at the 1st attempt. Among these UVCs, 16 (52%) were correctly repositioned in the central position by hepatic mobilization. The success rate increased by 50% (p <0.05). No life-threatening complications were observed during the procedure. Conclusion: Hand liver mobilization during umbilical venous catheterization improves the rate of adequate insertion of the UVC into the inferior vena cava. It is a simple, quick, and safe procedure. [Copyright &y& Elsevier]

Objectives This study aimed to collect data on thermal care practices in rural Ghana to inform the design of a community newborn intervention. Methods All 635 women who delivered in six districts in Ghana in the first 2 weeks of December 2006 were interviewed about immediate newborn care. Qualitative data on thermal care practices and barriers and facilitators to behaviour change were collected from recently delivered/pregnant women, birth attendants/grandmothers, and husband through birth narratives, in-depth interviews and focus group discussion. Results Respondents knew that keeping the baby warm was essential for health but 71% of babies born at home had delayed drying, 79% delayed wrapping, 93% early bathing and 10% were placed skin-to-skin. Birth attendants were usually in charge of mother and baby immediately after birth. Delays in drying/wrapping were linked to leaving the baby unattended until the placenta was delivered. Early bathing was linked to reducing body odour in later life, shaping the baby’s head, and helping the baby sleep and feel clean. Respondents thought that changing bathing behaviours would be difficult, especially as babies are bathed early in facilities. The concept of skin-to-skin care was easily understood and most women said they would try it if it was good for the baby. Conclusion Thermal care is a key component of community newborn interventions, the design of which should be based on an understanding of current behaviours and beliefs. Formative research can help select focus behaviours, decide who to include in interventions, ensure consistent messages and determine what messages and approaches are needed to overcome behaviour change barriers. [ABSTRACT FROM AUTHOR]

Abstract: Objective: Regional guideline for immediate tracheal suctioning (ITS) in vigorous and non-vigorous infants born through meconium-stained amniotic fluid (MSAF) has been established in 2003. The objective of this study was to evaluate guideline application. Study design: Prospective cohort. Patients and methods: The first part of the study was a short survey about ITS practices in maternity hospitals then, management and early evolution of babies born through particulate MSAF was evaluated by questionnaire. Results: Among 6761 neonates, 199 (3%) were born with MSAF. Early clinical evaluation showed 52 (26%) non-vigorous neonates; 22 of them (42%) have had an ITS. One hundred and forty-seven neonates were vigorous (74%); 27 of them (18%) have had an ITS. Implementation of recommendations in non-vigorous babies was better in maternities of level III, while they were lower in maternities of level IIA for vigorous babies. Among 52 non-vigorous children, eight had a meconium aspiration syndrome (MAS), including five who had an ITS. One MAS occurred in vigorous babies but infection could not be excluded. Conclusion: Recommendations for ITS were implemented in 70% of cases but only in 42% of cases in non-vigorous babies. We have to improve formation and circulation of new recommendations. [Copyright &y& Elsevier]

Objectives To investigate causes of and contributors to newborn deaths in eastern Uganda using a three delays audit approach. Methods Data collected on 64 neonatal deaths from a demographic surveillance site were coded for causes of deaths using a hierarchical model and analysed using a modified three delays model to determine contributing delays. A survey was conducted in 16 health facilities to determine capacity for newborn care. Results Of the newborn babies, 33% died in a hospital/health centre, 13% in a private clinic and 54% died away from a health facility. 47% of the deaths occurred on the day of birth and 78% in the first week. Major contributing delays to newborn death were caretaker delay in problem recognition or in deciding to seek care (50%, 32/64); delay to receive quality care at a health facility (30%; 19/64); and transport delay (20%; 13/64). The median time to seeking care outside the home was 3 days from onset of illness (IQR 1–6). The leading causes of death were sepsis or pneumonia (31%), birth asphyxia (30%) and preterm birth (25%). Health facilities did not have capacity for newborn care, and health workers had correct knowledge on only 31% of the survey questions related to newborn care. Conclusions Household and health facility-related delays were the major contributors to newborn deaths, and efforts to improve newborn survival need to address both concurrently. Understanding why newborn babies die can be improved by using the three delays model, originally developed for understanding maternal death. [ABSTRACT FROM AUTHOR]

Palliative care appeared recently in perinatal medicine in France. Three main situations have been recognized to open the possibility for palliative care in newborns: newborns who were resuscitated and who present with severe neurologic complications, some premature babies born alive (22–25 weeks), babies born with severe malformations diagnosed when in the uterus and whose mothers did not wish to choose termination of pregnancy. Decision making as well as practical organisation and psychological consequences are reviewed. [ABSTRACT FROM AUTHOR]

Abstract: Objective: To expose the current knowledge about the anaesthetic effects on the developing brain. Data sources: Publications (original articles and reviews) in English and in French language from 1980 were obtained from the Medline database using alone or in combination following keywords: anaesthetics, developing brain, neurodevelopment, neurogenesis, synaptogenesis, neurotoxicity, apoptosis. Data synthesis: Several lines of evidence resulting from animal experiments conducted in rodents and non-human primates have suggested that exposing the developing brain to anaesthetic drugs may elicit an increase a physiological programmed neuronal death (i.e. apoptosis). This neuronal death is not only seen at the cellular level but also results in alterations in some behavioural abilities in the adult animal. However, the vast majority of experiments reported have been conducted in animals not exposed to any surgical or painful stimulation. Moreover, the literature raises contradictory results, some authors not confirming this neurotoxic effect of anaesthetic drugs. Last, available clinical data are scarce and do not allow to claim that exposure to general anaesthesia definitely alters the cognitive development of children. Conclusion: This review raises the question of the innocuity of anaesthetic agents on the developing brain; further clinical trials are required in order to test this effect on human babies. [ABSTRACT FROM AUTHOR]

Copyright of Journal of Medical Mycology / Journal de Mycologie Médicale is the property of Elsevier B.V. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Abstract: A case of ischemic gangrene of the right upper limb and hemiface noticed at birth is reported. It was a male baby born at term vaginally from a non diabetic mother. He was allowed in the surgical emergencies, 24hours after the birth. The injuries were irreversible and required an arm amputation and a debridement of necrotic areas of the hemiface. The authors discuss the aetiology, the clinical features and the management of this rare condition. [Copyright &y& Elsevier]

Summary: An echogenic tumor (22×22mm) isolated from the anterior part of the left leg at 27 WA of pregnancy suggested an angiomatous structure. This mass appeared to be well vascularized on Doppler examination. Three-dimensional imaging showed connections with adjacent tissues. The limbs were mobile. Delivery of a 3990-g-boy occurred normally. On the anterior part of the left leg, there was a plate-shaped mass with a pink hole at the superior part. Excision under general anesthesia was performed at the first month because of the risk of rupture and bleeding. The dissection was easy with the deep plane. Healing was complete 10 days after the surgical procedure and the aesthetic aspect was good 1 year later. Histological findings of the suspect mass emphasize the vascular aspect of the tumor. A hemangioma capillary with venous structures in the dermal hypodermic area was found. [Copyright &y& Elsevier]

Copyright of Psychologie Française is the property of Elsevier B.V. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

To test the hypothesis that vasodilatory prostaglandins buffer the renal vasoconstrictor effects of endothelin-1 (ET-1) early in life, renal haemodynamic responses to ET-1 were measured in 2 groups of conscious, chronically instrumented lambs at 1-2 weeks of age (group I, n = 11) and 6 weeks of age (group II, n = 10). Lambs were pretreated with vehicle or 1 mg·kg-1 indomethacin, a nonselective cyclooxygenase inhibitor, and renal haemodynamic effects were measured continuously for 1 min before (control) and 5 min after intra-arterial injection of 250 ng·kg-1 ET-1. In group II lambs, there was a marked decrease in renal blood flow (RBF) and renal vascular conductance (RVC) elicited by ET-1 administration, as we have previously described. This response was not altered by vehicle or indomethacin pretreatment. In group I lambs, there was an initial increase but no decrease in RBF and RVC elicited by ET-1 administration, as we have previously described, and this response was also not altered by either vehicle or indomethacin. These results suggest that endogenously produced prostaglandins do not appear to modulate the renal haemodynamic effects of ET-1 in conscious lambs during postnatal maturation. [ABSTRACT FROM AUTHOR]