Search

In this article, the authors present the important steps for the diagnosis of neurologic diseases in children. Simptoms and algorhitmic approach are discussed regarding for age and frequency of the neurological disturbances. The main features are reviewed in the following situations: neonatal neurologic distress and seizures, hypotonia, epileptic seizures and epileptic syndromes, cerebral palsy, abnormal gait, coma, mental retardation, abnormal behavior and communication, cranial nerve palsy, orthopedic abnormalities of neurologic etiology. [ABSTRACT FROM AUTHOR]

Genetic defects of neurotransmitter and related disorders are beginning to be recognized, These disorders cause severe metabolic encephalopathy either before birth, or within the first days of life. In this review are presented: • Disorders of glycine and serine metabolism • Disorders of pteines and other biogenic amines metabolism • Disorders of gamma aminobutyrate metabolism • Other related neurometabolic disorders. [ABSTRACT FROM AUTHOR]

A number of children with inherited metabolic diseases have immunologic problems that result in increased susceptibility to infection. In some, infections are secondary to chronic disease, malnutrition, or poor control of swallowing and the resulting aspiration. In most metabolic defects the immunologic abnormalities are secondary to the metabolism derangement. In the review are presented: - Inherited metabolic diseases associated with T-cell immunodeficiency (purine nucleoside phosphorylase) - PNP-deficiency (lysinuric protein intolerance; Menkes disease; Zellweger syndrome); - Inherited metabolic diseases associated with B-cell immunodeficiency (nucleotide depletion syndrome); - Transcobalamin II deficiency; propionic aciduria; - Inherited metabolic diseases associated with combined T-cell and B-cell immunodeficiency (adenosine deaminase - ADA - deficiency; acrodermatitis enteropathica; biotinidase deficiency; hereditary orotic aciduria; deficiency of intestinal folic acid absorbtion; deficiency of alfa-mannosidase; methylmalonic aciduria); - Inherited metabolic diseases associated with phagocyte immunodeficiency (galactosemia; glycogen storage diseases GSD types Ib and I c; X-linked cardioskeletal myopathy - Barth syndrome; glutathione synthetase deficiency; Pearson syndrome; Smith-Lemli-Opitz syndrome; acrodermatitis enteropathica, methylmalonic aciduria, propionic aciduria, lysinuric protein intolerance, alpha-mannosidosis); - Inherited metabolism diseases associated with NK-cell immunodeficiency (lysinuric protein intolerance, Chediak-Higashi syndrome; Sutor syndrome; Griscelli syndrome; xeroderma pragmentorum). [ABSTRACT FROM AUTHOR]

Gastrointestinal manifestations of metabolic disorders include vomiting, diffuse abdominal pain, pancreatitis, slowed transit time and constipation, maldigestion and malabsorbtion (which may result in diarrhea), and ascites. These symptoms may occur as part of systemic disorder of intermediary metabolism in which other symptoms predominate, or they may be the major or exclusive symptoms. Vomiting is typical of the organic acidurias and hyperammonemic syndromes. Pain and constipation occur in the porphyrias and familial fevers. Pancreatitis occurs with many organic acidurias, lipid and fatty acid disorders, and defects of oxidative phosphorylation. Malabsorbtion and diarrhea can be due to disorders of digestive enzymes, especially disaccharidases, defects of carrier proteins, and mitochondrial dysfunction. Ascites occurs in many lysosomal disorders. [ABSTRACT FROM AUTHOR]

Headaches are relatively common in childhood. Undue irritability in young children may be an indication of recurrent or persistent headaches. Older children may have headaches which are related to increased intracranial pressure from any cause, migraine, tension, trauma, and systemic disease. These painful episodes may precede, follow or be the only manifestation of convulsions. [ABSTRACT FROM AUTHOR]

Lysosomal storage disorders comprise a group of over 40 different diseases that are caused by genetic defects of lysosomal enzymes, resulting in the accumulation of incompletely digested substrates within the lysosome, and, consequently, in the increasing impairement of cellular function. As cells become filled with storage material, the whole organ may enlarge. Although different predominances of involvement are characteristic for individual disorders, the three systems primarily affected are the connective tissue, nervous tissue and parenchymatous organs. However, the idea that all lysosomal storage disorders generally cause visceromegaly and characteristic skeletal changes is a misconception. A substantial number affect predominantly, or even exclusively, the central nervous system, causing chronic progressive neurologic and psychiatric dysfunction. Inheritance is autosomal recessive with the exception of mucopolysaccharidosis type II/( Hunter disease) and Fabry disease, a sphingolipidosis in which the affected genes are located on the X-chromosome. [ABSTRACT FROM AUTHOR]

Peroxisomes are indispensable for the synthesis of bile acids, cholesterol and lipids, including plasmalogens and other phospholipids that are present in highest concentrations in the brain, heart and muscle. Impairments of these biosynthetic pathways result in progressive multisystem disease. Peroxisomes are also critical for the oxidation of very-long-chain fatty acids and related substances, such as phytanic acid. In addition, peroxisomes accommodate many oxygen-dependent reactions and peroxisomal catalase protects against H2O2. Peroxisomal disorders can be subclassified as follows: A. Disorders of peroxisom biogenesis and peroxisomal  -oxidation (elevations of very-long-chain faty acids) B. Single peroxisomal disorders with variant phenotypes. C. Defects of plasmalogen synthesis However, this widely used classification is not optimal for a clinical and diagnostic approach to peroxisomal disorders. Symptoms and disease courses in patients with generalized versus specific peroxisomal disorders are often indistinguishable and they may vary tremendously within the same group. Further on the authors present a modified grouping of peroxisomal disorders on the basis of the simple, comprehensive diagnostic approach outlined below. Clinical presentations, routine laboratory investigations and specialized investigations of peroxisomal disorders are discussed in the end. [ABSTRACT FROM AUTHOR]

Abnormalities in one or more components of the hematologic system are present in a variety of inborn errors of metabolism. In some they may serve as signals to alert the clinician to the presence of an undelzing metabolic disease. In others, such as the enzymopathies that produce hemolytic anemia, the abnormal hematologic is the disease. In some, as in hypersplenism of Gaucher disease, they represent an important complication that must be monitored and treated appropriately in a patient whose diagnosis had been made earlier on the basis of other manifestations. In this paper the authors presents the hematologic abnormalities in inborn errors of metabolism: - neutropenia, thrombocytopenia or pancytopenia in severe metabolic disorders (table 1); - megaloblastic anemia in some metabolic disorders (table 2); - hemolitic anemia in some metabolic or molecular disease (table 3); - vacuolated lymphocytes and abnormal storage cells in the bone marrow in lysosomal storage disease, including disorders of complex lipid catabolism and the mucopolysaccharidoses. [ABSTRACT FROM AUTHOR]

Routine screening of newborn infants for metabolic disorders was introduced in 1961 after Bickel established an effective dietary therapy for phenyketonuria (PKU) and Guthrie developed a bacterial inhibition assay to detect elevated concentrations of phenylalanine in dried blood tests. Over time, neonatal screening has been expanded to several other treatable metabolic and endocrine disorders, including galactosemia, biotinidase deficiency, congenital hypothiroidism, congenital adrenal hyperplasia. A major step in recent years has been the development of routine acylcarnitine and aminoacid analysis in Guthrie cards by tandem mass spectroscopy. Researchers at Duke University developed tandem mass spectroscopy of acylcarnitines and aminoacids for expanded newborn screening in the early 1990's. It allows for screening aminoacidopathies, including PKU, organic acidurias and disorders of fatty acids oxidation. A positive result often constitutes a metabolic emergency as infants with many of the disorders diagnosed by the technique can become critically ill in the first days after birth. [ABSTRACT FROM AUTHOR]

Described by Erik Adolf von Willebrand in 1926, it is a constitutional hemorrhagic disease, inherited in the autosomal mode. Considered initially as a thrombopathic disease, then as a prologation of the bleeding time associated to a deficit in the factor VIII, today it is defined as an absence, diminuation or a modification of the von Willebrand factor, a glycoprotein sintetized by the endotheklial cell and the megariocyte. The incidence of the disease is around 2%, being the first constitutionally hemorrhagic deficit, in front of the hemophilias. In this article we present: phisiopathologic mechanisms of the disease, clinical signs, biologic diagnosis, classification of von Willebrand disease, the differential diagnosis and treatment. [ABSTRACT FROM AUTHOR]

Thrombosis is a rare situation in pediatric practice. That makes it impossible to have homogenous series and therefore treatment regimens are difficult to be well defined. In this article the authors present: - neonatal thrombosis (arterial and venous), thrombosis in infants and older children; - treatment regimens (indications regarding the etiology) in neonates, infants, children; - thrombolitic treatment (dosage, duration of treatment, precautions and biologic follow-up); - conclusions. [ABSTRACT FROM AUTHOR]

An anomaly of Central Nervous System (CNS) can occur as an isolated defect or as a part of a syndrome. This syndrome can be the result of single genes, a chromosome aberration, or environmentally induced conditions (Bergsna D, 1979; Smith DW, 1982). The authors present: - Anomalies of the head: microcephaly; macrocephaly; hydrocephaly; - Central Nervous System (CNS) closure defects (Open neural tube defects); Spinal dysraphism; spina bifida occulta; - Epilepsy; - Huntington's disease; - Alzheimer disease; - Cerebellar ataxias. [ABSTRACT FROM AUTHOR]

This article presents genetic disorders that appear with increased frequency in certain ethnic groups: - Ashkenazi jews: Tay-Sachs disease, adult Gaucher's disease - type I, Niemann-Pick disease, mucolipidosis (type IV), pentosuria, Bloom syndrome, disautonomia (Riley-Day syndrome), plasma thromboplastin antecedent (PTA) or Factor XI deficiency, spongy degeneration of the central nervous system, dystonia musculorum deformans (torsion dystonia); - Black: sickle cell disease (HbSS), hemoglobin C disease (HbSC), essential hypertension; - Caucasians: cystic fibrosis: - Mediteraneans: beta-thalasemia (Cooley or mediteranean anemia): - Orientals: alpha-thalasemia; - Polynesians: club foot; - Irish: central nervous system (CNS) defects. [ABSTRACT FROM AUTHOR]

This article presents advances in the field of fetal echocardigraphy and the significant impact of these within the fields of pediatric cardiology, perinatology and neonatology. A prenatal diagnosis of congenital heart disease allows improved counseling of the parents, guides the timing and optimal location of delivery, and allows appropriate planning and consultation between the cardiologist and neonatologist. It also facilitates accurate diagnosis and management of fetal arrhytmias, identifies potential candidates for in utero cardiac intervention and serves as the imaging guidance technique for these procedures. The goals, indications, advantages, limitations and spectrum of congenital heart disease that can be diagnosed are reviewed. [ABSTRACT FROM AUTHOR]

Another reproductive option that is now available is prenatal diagnosis. By utilizing increasingly sophisticated technology, many congenital malformations and genetic defects can now be diagnosed prior to twenty weeks of pregnancy. The authors present: 1. Couples at risk. 2. Techniques used for prenatal diagnosis: X-rays, amniography, fetoscopy, echography, amniocentesis, chorionic willi sampling (CVS). 3. Conditions amenable to prenatal diagnosis (chromosome abnormalities, CNS closure defects, metabolic diseases, X-linked recessive diseases, hemoglobinopathies, miscelaneous). 4. Prerequisites for prenatal diagnosis. 5. Reaction of couple to prenatal diagnosis. [ABSTRACT FROM AUTHOR]

The authors present: 1. What patients ought to be transferred in an intensive care unit 2. Parenteral feeding 3. Daily needs (per weight and in 24 hours) 4. Treatment of cerebral edema 5. General principles of hypothermia treatment 6. Prescribing dangerous drugs in an infant 7. Diet of an infant with acute renal failure 8. Osmotic diuresis 9. Ventilation 10. External cardiac massage 11. Cardiac puncture 12. Measuring the cardio-thoracic proportion 13. Endovenous perfusisons 14. Antibiotics used in neonates. [ABSTRACT FROM AUTHOR]

Rett syndrome, a neurodegenerative disorder, occurs almost exclusively in female children and has an incidence of 1/15.000. Development proceeds normally until 1 year of age when regression of language and motor milestones and acquired microcephaly become apparent. An ataxic gait or fine tremor of hand movements is an early neurologic finding. Most children develop peculiar sighing respirations with intermittent periods of apnea that may be associated with cyanosis. The hallmark of Rett syndrome is repetitive hand-wringing movements and a loss of purposeful and spontaneous use of the hands which may not appear until 2-3 years of age. Autistic behavior is a typical findings in all patients. Generalized tonic-clonic convulsions occur in the majority and are usually well controlled by anticonvulsivants. Feeding disorders and poor weight gain are common. Several studies have shown elevated CSF levels of endorphins in Rett syndrome. Trials of opiate receptorblocking agents (e.g., naltrexone) have improved the apnea and behavior abnormalities in some patients. After the initial period of neurologic regression, the disease process appears to plateau, with a persistence of the autistic behavior. [ABSTRACT FROM AUTHOR]

After presenting the main characteristics of tics, the authors are evaluating the etiopatogeny, considering their psychogenic or somatogenic nature. Tics may not be considered exclusively nevrotic and for each case we must establish how much of the clinical signs can be determined by the psychogenic factors. Finally the authors are discussing about preventing and treatment of tics. [ABSTRACT FROM AUTHOR]

The paper presents one of the most important signs/symptoms - cutaneous erythema - which is often met in pediatric practice. The author presents: definition; characteristic elements of erythema isolated or associated with a group of clinical entities; identification of erythema's cause; various clinical aspects; scarlatiniform erythema; macular erythemas: allergy, from congenital early syphilis, viral infections, toxoplasmosis, toxidermic erythemas, erythemas from systemic lupus erythematosus, recidivant macular erythemas; erythemas with different shapes (ring-shape, incomplete ring shape, “target lesion” appearance, map shape). [ABSTRACT FROM AUTHOR]

Central nervous system (CNS) tumors comprise 15% to 20% of all malignancies occuring in childhood and adolescence. Symptoms and signs depend on the growth rate of the tumor, its location in the central nervous system (CNS) and the age of the child. This article describes the presentation, diagnosis and the management of these tumors. [ABSTRACT FROM AUTHOR]

Crohn's disease is a chronic inflammatory condition that may affect any part of the gastrointestinal system and multiple extraintestinal organs. Although its exact pathogenesis remains unknown, increasing evidence suggest an abnormality in the control of ‟pathologic„ inflammation caused by bacterial and other antigens. Diagnosis starts with a careful history and physical examination, and confirmation rests with radiologic and histologic studies. Newer treatments are more specifically targeting the cascade of cytokine-mediated that perpetuate inflammation. The indications for surgery in Crohn's disease are: failure of medical therapy; obstruction - acute or chronic (gastroduodenal, small bowel, large bowel); hemorrhage; perforation; fistula; growth retardation; carcinoma; obstructive uropathy. Within 10 to 15 years of diagnosis, approximately 50% to 70% of children with Crohn's disease require surgery. With appropiate management, death from Crohn's disease is extremely rare in the pediatric population. [ABSTRACT FROM AUTHOR]

The article reviews the clinical presentation, treatment, and mechanism of hypertension associated with the various cardiovascular abnormalities associated with the development of hypertension in childhood. Special emphasis is given to coarctation of the aorta because it is the major cardiovascular cause of secondary hypertension in childhood. [ABSTRACT FROM AUTHOR]

Beside several malformations, especially cerebral (neurulation disorders, agenesia of the corpus callosum, neuronal migration disorders, etc.), the main neonatal causes of neurological sequelar handicaps are: hipoxya, intracerebral hemorrhage, nuclear icterus, hypoglycemia, CNS infections, and iatrogenic pathology. [ABSTRACT FROM AUTHOR]

The increasing temperatures, changing precipitation patterns and more extreme weather events occurring because of climate change have begun to increase morbidity and mortality from climate-sensitive health determinants and outcomes. This review first presents the key issues related to climate change, then presents climate-sensitive health determination and outcomes (extreme weather and heat events; infectious disease; air pollutants and aeroallergens; global assessments to UV radiation) and finishes with a discussion of intergenerational equity and opportunities for reducing current and future vulnerabilities to climate change. [ABSTRACT FROM AUTHOR]

This article focuses on the few disorders that produce chronic cholestasis in infants. The author presents: definition and pathophysiology of cholestasis; the consequences of cholestasis; an approach to diagnosis of cholestasis in infancy and childhood; the differential diagnosis of chronic cholestasis in infancy (chronic obstructive cholestasis; chronic cholestasis in association with ductal paucity; chronic hepatocellular cholestasis). [ABSTRACT FROM AUTHOR]

In this article the authors present: - what are IEMs? - what are the different types of IEMs? - what is the relative frequency of these IEMs? - what is the inheritance pattern of these IEMs? - how can these IEMs be diagnosed in a timely manner? - what is the role of newborn screening (NS) programe in early diagnosis and prevention of morbidity and mortality? - what are the treatment and management options for these IEMs? - what is the long-term prognosis for patients with IEMs? [ABSTRACT FROM AUTHOR]

Chronic nonspecific ulcerative colitis remaine a disease of unkown etiology, although much new information continues to be gleaned from basic research and clinical trials. In most instances, ulcerative colitis respond to medical therapy. Selecting appropriate drug therapy for a specific child dependends on the extent and severity of colitis. This article summarized the clinical information, diagnostic studies and approaches to management that should be considered when evaluating a child for ulcerative colitis. [ABSTRACT FROM AUTHOR]

This article provides overviews of the hepatobiliary diseases associated with cystic fibrosis (CF). Liver disease in infancy and childhood is often asymptomatic, but serious complications arising from advanced disease, including cirrhosis with portal hypertension, occure more frequent, in the adolescent and adult population. The author presents: - specific hepatic disorders: incidency, specific hepatic disorders: fatty cirrhosis; neonatal cholestasis; evaluation of liver disease; management of liver disease (cholestasis, portal hypertension, hepatic failure); - biliary tract disease: nonvisualization of the gallbladder and microgallbladder; cholelitiasis; distal common duct stricture. [ABSTRACT FROM AUTHOR]

Group B Streptococcus (Streptococcus agalactiae). Infections colonizes the maternal urethra, vaginal tract and rectum; it is sexually transmitted but colonization is usually asymptomatic. In the mother, group B Streptococcus can cause puerperal sepsis, endometritis and preterm delivery. The biggest risk, however, is to the newborn. The risk of infection appears enhanced in twins. The most devastating form of infection is early-onset bacteremia with shock, pneumonia and, occasionally, meningitis. All three serotypes (I, II, III) can cause early-onset infection although type III is most common in infections that are seen after the first week of age. All three serotypes (I, II, III) can cause early-onset infection although type III is most common in infections that are seen after the first week of age (see table 1). The author presents: morphopathology (pneumonia, especially in early onset group B Streptococcus infections; meningitis, meningoencephalitis in late onset group B Streptococcus infections); clinical manifestations; diagnosis (positive, differential); evolution and treatment; prevention and prognosis. [ABSTRACT FROM AUTHOR]

Intrauterine Listeria monocytogenes infection may result in abortion early in gestation and stillbirth later on or congenital infection with early neonatal death. Newborn acquiring Listeria late in pregnancy or during birth manifest diverse clinical signs ranging from septicemia to focal skin lesions. Two clinical syndromes: •the first with early onset presents in the first two days of life and is characterized by septicemia and high mortality rate; •the second form (late onset) presents after the fifth day of life and represents infection acquired during delivery or postnatally - with meningitis or meningoencephalitis. The diagnosis of listeriosis is suggested by the clinical picture and gram stain vizualization of listeria, a grampositive bacteria. Treatment of listeriosis is most often initiated with a combination of ampicillin and an aminoglycoside - gentamicin. The outcome is favorable in most cases, the exception being the cases with fulminant sepsis and meningoencephalitis often complicated by disseminated intravascular coagulation and bleeding. [ABSTRACT FROM AUTHOR]

L'électroencéphalograhie (l'ÉEG) dans la pratique pédiatrique: l'aspect normal (chez le premature, noveau-née a terme apréè la période néinatale); l'aspect pathologique dans les principales maladies de SNC chez l'enfant. L' ÉEG ermet de recueillie et d'étudier par l'intermédiaire d'électrodes, en nombres et disposition variable (mais généralement standardizes, placées à la surface de cuir chevelu), l'activité bioélectrique spontanée emises par le cortex cerebral. Permettant d'évoqué, d'orienter ou de préciser un diagnostique, fournissant un element pronostique souvent important, reflétant dans nombre de cas l'efficacité d'une thérapeutique, l' ÉEG présente dans la pratique pédiatrique un très grand intérê. L'auteur present: L'aspect normal de L' ÉEG chey le premature, noveau-né a terme, après la période néonatale. L'aspect pathologique: etudes analytique, l'apport de l'ÉEG dans les principales affections du SNC (crise convulsives - occasionnelles, les crises convulsives avec lesions cérébrales certaines, les infirmities motrices cérébrales, les crises convulsives de l'épilepsie infantile (grand mal, le petit mal de type absences, le petit mal myoclonique, l'épilepsie psycho-motrice, le spasms en flexion, Lenox-Gastaut syndrome, autres affections neurologique (meningitis, méningo-encéfaphalites et encephalitis et encephalitis, la leucoencéphalite sclérosante subaiguë de Van Bogaert, les tumeurs cérébrales, les hydrocéphalies, les traumatisms crânienés, les abcès du cerveau, les hématomes sous-duraux, trombophlébites cérébrales, migraine, myxoedème, affections congénitales diverses genératrices d'encéphalopathie diverses etc. [ABSTRACT FROM AUTHOR]

L'auteur presents la valeur pronostique de l'ÉEG chez le nouveau-né à terme (connue depuis les travaux de C. Dreyfus-Brisac et. N. Monod (1964)] et les divers aspects d'EEG chez le nouveau-né à terme: Certains trace ÉEG: trace inactif; trace „bas voltage+théta“; tracé paroxystique; tracé hyperactif (avec anomalies surajouté); anomalies focales; l'energistrement de l'ÉEG (qui perment en effet d'infirmer) le caractère épileptique de manifestations paroxystiques; L'enregistrement de l'ÉEG (qui permet en effet d'affirmer (ou d'infirmer) le caractère épileptique de manifestations paroxystiques. ÉEG dans l'épilepsies focales symptomatiques (dans les lesions dysplasiques anténatales, hémimégalencéphalie-corespondant à une désordre de la migration neuronale). ÉEG dans les syndromes épileptique néonataux d'evolution favorable-crise néonatales familiales bénignes. [ABSTRACT FROM AUTHOR]

This report presents updated recommendations for the optimal management of acute gastroenteritis in childhood, according to fundamental therapeutical principles recommended by ESPGHAN ( European Society of Paediatric Gastroenterology, Hepatology and Nutrition). The authors underline the importance of the correct estimation of dehydration therapy considered as the „cornerstone“ of therapeutical success. Finally the therapeutic and adverse effects of the main antidiarrhoeal drugs are presented, which played an adjuvant role in most cases. The authors emphasize the advantages of a newer generation drug-racecadotril, a selective and powerful intestinal antisecretory agent, considered a safe and efficient component of the management of acute diarrhoea in addition to oral rehydration therapy. [ABSTRACT FROM AUTHOR]

Pathogenetic mechanisms in neonatal infections The author reviewed the pathogenetic mecanisms of ante- intra and postnatal infections of the newborn. They also discussed the results of the antenatal infections on embrion and foetus, and the clinical variants of intra- and postnatal infections. The attention is focussed on the relationship between pathogenetic mechanisms and the relevant clinical and paraclinical alteration for the diagnosis of the most frequent encountered infections of the newborn. [ABSTRACT FROM AUTHOR]

Infections are a frecvent and important cause of morbidity and mortality in the newborn period. Infections in the newborn infant may be required in utero (congenital), at the terme/or birth (perinatal), or after birth and during the neonatal period (postnatal). The transplacental route is the most common means by which microorganisms reaches the fetus in utero. Some viruses: Toxoplasma gondii, Treponema pallidum, and occasionally other bacteria are transmitted by this route. Infection acquired in utero may result in resorption of the embryo, absorbtion, stillbirth, congenital malformations, intrauterine growth retardation, premature birth, acute diseases in the immediate neonatal, prenatal, or on asymptomatic, but persistent infection that cause neurologic sequelae later in life. Further on the author presents: Viral infections: rubella virus, cytomegalovirus, - herpes virus hominis, hepatitis B, Coksackie, HIV, measles virus, mumps virus, Varicella-zoster virus; - bacterial infections; - rickettiene infections; - infections with mycoplasme and chlamydia; - mycotic infections; - protozoar infections (toxoplasma, malaria, leishmaniasis - Kala - Azar, trypanosomiasis); - parasitic infections (echinococosis, schistosomiasis, ankilostomiasis). [ABSTRACT FROM AUTHOR]

The neonate with abdominal mass Abdominal masses in neonates reflect a wide spectrum of disease from lesions that can cause significant morbidity and mortality, to conditions readily corrected surgically, to entities wich may be safely observed. It is incumbent upon the infant's physician to determine the nature of the mass in a timely, safe, and cost/effective manner. [ABSTRACT FROM AUTHOR]

Bilirubin-induced neurologic dysfunction can occur in term and near-term healty babies. The term babies who are unwell, the preterm neonates, and the infants who have multiple comorbidities constitute a group vulnerable to bilirubin neurotxicity. The current resurces for clinical interventions that can drastically and efficiently reduce the increased bilirubin-load-intensive phototherapy and exchange transfusions - are available for use in those infants who have excessive hyperbilirubinemia (as judged by their postnatal age, wellenss and gestation); howerver these interventions have a very narrow margin of safety for babies who have rapid or unrecognized increases in their bilirubin load. Because most babies are discharged before the hyperbilirubinemia reaches its peak during the first week of life, preventive and system-based strategies offer a safer, kinder and gentler means to prevent BIND, including kernicterus. [ABSTRACT FROM AUTHOR]

Nouveau-né a haut risque Les principales situations responsables pour le nouveau-nè à haut risque sont: - pathologie sous la dépendence de l'âge gestationnel ou de poids de naissance; - situations gestationnelles pouvant affecter le foetus; - maladies chroniques maternelles pouvant entraîner une pathologie foeale; - traumatismes de la naissance (consequences de difficultés mécaniques, complications cérébrales exclues); - variations pathologiques de certaines particularités physiologiques du nouveau - né. [ABSTRACT FROM AUTHOR]

Although the term ‟congenital„ is inaccurate it is so widely accepted that it is used interchangeably with ‟prenatal„ as signyfing syphilis acquired in utero or at birth. Prenatal (congenital) syphilis, reported among infants under a year of age, is estimates with a incidence in growing during the past decade, result from environmental factors of climate and culture and, possibly also, genetic differences in parasit or host, or both (Finberg L. 2000). The author presents: etiology; transmission of prenatal syphilis; pathogenesis and clinical manifestation in early congenital (prenatal) syphilis; in late congenital syphilis; diagnosis; treatment and prophylaxy. [ABSTRACT FROM AUTHOR]

La rédaction d'une observation imposée: un recueil d'informations complet, precis et objectif; un examen clinique systématique et bien conduit; une synthèse des données sémiologiques cliniques, permettant la discussion du diagnostic, la demande éventuelle d'examens complémentaires, une prescription thérapeutique et s'il y a bien des informations préventives. [ABSTRACT FROM AUTHOR]

The author presents some surgical abdominal problems in children: • Acute appendicitis • Acute intussusception • Hernia (inguinal, ovary or ovary and fallopian tube) • Torsion of the testis and of the appendages. [ABSTRACT FROM AUTHOR]

Neonatal sepsis (in utero), perinatal and afterbirth - postnatal is a disease with low incidence, but with high risk. Although incidence of the most common etiology - group B Streptococus - has been reduced by prophylactic treatment with penicillin - neonatal sepsis has not been eradicated, and vigilance must remain high. The author presents: etiology; pathogeny; clinical manifestations; diagnosis (positiv, differential, etiological); management with a plan of treatment with antimicrobial agents and supportive care; evolution, complication and prognosis in neonatal sepsis. [ABSTRACT FROM AUTHOR]

A generic group of parasitic (toxoplasmosis), viral pathogens [rubella, cytomegalovirus (CMV) and herpes simplex] and ‟other„ agents responsible for fetal infections, such as varicella zoster, parvovirus, human immunodeficiency virus (HIV), hepatitis B virus and Borrelia burgdorferi that produce congenital or perinatally acquired infections represents the acronym ‟TORCH„. Many of the clinical manifestations of TORCH infections are similar and include intrauterine growth retardation, nonimmune hydrops, anemia, thrombocytopenia, jaundice, hepatosplenomegaly, chorioretinitis and congenital malformations. In this article the author presents toxoplasmosis, rubella, cytomegalovirus infection and herpes simplex infection. [ABSTRACT FROM AUTHOR]

In the article there are presented: prevalence; pathophysiology; diagnosis; treatment (conventional therapy and complementary and alternative medicine - CAM); integrative therapy. [ABSTRACT FROM AUTHOR]

Dans cet article l'auteur présente la séméiologie respiratoire clinique chez l'enfant: • La toux, symptôme extrémement commun dans la pathologie respiratoire de l'enfant; • L'expectoration, peu courante chez l'enfant, qui le plus souvent ne parvient pas a cracher; • Le stridor, bruit rythmé par la respiration, retrouvé le plus souvent chez le nourisson, isolé ou associé à une dyspnée; • La cyanose, toujours un élément de gravité au cours d'une maladie respiratoire; • La dyspnée qui se présente sous plusieurs aspects: les dyspnées inspiratoires (d'origine laryngée ou trachéale) et les dyspnées expiratoires (d'origine bronchique ou bronchiolaire) par spasme, edème ou encombrement bronchique; • L'apnée, qui se complique, en quelques instants, de brachycardie et d'arrêt cardiaque. [ABSTRACT FROM AUTHOR]

L'auteur présente les aspects hématologiques dans la pathologie pédiatrique. La valeur diagnostque ou prognostique des anomalies hématologiques observées en pathologie pédiatrique est de signification variable; elles sont envisagées successivement en tenant compte des facteurs exogenes responsables d'agression (infections, parasitoses, intoxications) et des differents appareils et systemes intéressées par la maladie. [ABSTRACT FROM AUTHOR]

The author presents staphylococcus infections in children with first accent about staphylococcal pneumonia (epidemiology, - pathogenicity and pathology; clinical manifestations; laboratory and roentgenographic findings; diagnosis and differential diagnosis; complications; prognosis and treatment) after which there are discussed other diseases due to staphylococcus: scalded-skinstaphylokoken (SSSS)(Ritter disease, Lyell syndrome, staphylococcal scarlet fever, bullous impetigo), staphylococcal osteomyelitis, staphylococcal enterocolitis, staphylococcal food poisoning, staphylococcal endocarditis, staphylococcal tracheitis, toxic shock syndrome (TSS). [ABSTRACT FROM AUTHOR]