Urinary tract infections in hospital pediatrics: many previous antibiotherapy and antibiotics resistance, including fluoroquinolones.

Objective: We studied antibiotic resistance in pediatric UTIs and we evaluated the impact of antibiotic exposure in the previous 12 months, very little French data being available for this population.

Methods: We conducted a multicenter prospective study including children consulting for, or admitted in 2 hospitals. Prior antibiotic exposure was documented from their health record.

[Benefit of seasonal use of a rapid diagnosis of influenza virus in a paediatric emergency unit].

Influenza virus infections are current in viral infections of childhood. The quick test is now available and we want to assess its clinical and economical benefit through an unicentric study and during two seasons of influenza pandemic. An hospitalization avoided due to a quick test is equivalent to 20 to 30 general practitioner fixes fees.

[Neurosurgical embryology. Part 8: Post-natal angiogenesis and remodeling].

Post-natal angiogenesis (microvascular proliferation) and remodeling (modifications of diameter and wall thickness) occur in various physiological circumstances including adaptation to exercise or wound healing. The formation of a new vessel is submitted to the combinative action of growth factors. New endothelial cells migrate, proliferate, differentiate and attract pericytes and future smooth muscle cells to create the new vessel.

Adaptive common carotid arteries remodeling after unilateral internal carotid artery occlusion in adult patients.

Objective: This study was undertaken in human adults to examine modifications in common carotid internal diameter (ID), intima-media thickness (IMT), cross-sectional area (CSA) and wall shear stress (WSS) occurring both on the ipsilateral side of an internal carotid artery (ICA) occlusion and on the non-occluded contralateral side.

Methods: Seventeen patients with unilateral ICA occlusion had repeated echo-Doppler examinations during 1 year and were compared to 12 volunteers with control non-occluded common carotid arteries (CCA).

Results: The cause of ICA occlusion was atherosclerosis in nine patients, dissection in five, and undetermined in three.

[Familial Romano-Ward syndrome. Apropos of 2 new observations].

Background: Congenital long QT syndrome is rare, usually revealed by bouts of syncopal attacks secondary to effort or strong emotions, and more rarely by atypical epileptic crisis.

Case Reports: We report a family history of two boys whose mother and grandmother both died suddenly a few days after delivery. The oldest child was 10 years old when admitted to hospital for recurrent loss of consciousness.

Influence of posture on middle cerebral artery mean flow velocity in humans.

We determined middle cerebral artery, common carotid artery and temporal superficial artery Doppler derived flow velocities in ten subjects for 10 min after change in posture. Maximal changes were observed after about 3 min. The 10 degrees head-down tilt position increased blood velocities in the common carotid artery by 13% (SD 4)% (P < 0.

[QT prolongation and circulatory arrest after an injection of erythromycin in a newborn infant].

A 8 day-old full-term newborn showed severe cardiac disturbances after intravenous injection of erythromycin. The neonate, suspected of having Chlamydia pneumonitis because of tachypnea and rhinitis, had been given 5 injections of erythromycin without clinical effect. Pallor, vomiting and bradycardia developed a few minutes after the 6th injection, and ECG showed ventricular arrhythmia, prolonged QT interval and an atrioventricular block.

[Perinatal hemochromatosis].

Perinatal hemochromatosis (PHC) is a rare disorder presumably autosomal recessive, responsible for foetal death or severe liver failure during the neonatal period. It is fatal in nearly all cases. Diagnosis relies on histologic examination, generally post mortem, which shows numerous iron deposits in the liver as well as other organs (pancreas, heart, thyroid.

[Bilateral thalamic hemorrhage following severe asphyxia in a 9-month-old infant].

We report a case of post-asphyxic bilateral thalamic hemorrhage in a 9 month-old infant, consecutive to a hemophilus hypopharyngitis. The neuropathologic study revealed that it was in fact a hemorrhagic necrosis associated to diffuse necrosis of the hemispheres. This case is compared to the other reported cases of thalamic hemorrhage and the physiopathologic mechanism is discussed.

Sonographic hepatic arterialisation in newborns receiving parenteral nutrition.

Two cases of severe liver disease with portal hypertension in the newborn are reported. Such complications occurred after necrotizing enterocolitis requiring total parenteral nutrition and digestive exclusion for a long time. Ultrasonography showed an hepatic arterialisation with portal hypertension.

[Triosephosphate isomerase deficiency. Familial survey and prenatal detection].

Triose phosphate isomerase catalyses dihydroxyacetone phosphate to glyceraldehyde 3 phosphate isomerism. Its deficiency associates hemolytic anemia, neurologic abnormalities, relapsing infections and results in encephalopathy or early death. On the occasion of 2 new cases, we report one of the most important familial surveys as 93 subjects were studied, confirming the autosomal recessive transmission of the deficiency and the first results of antenatal diagnosis which could be performed in one of the families.

Presence of an acid-labile alpha-interferon in sera from fetuses and children with congenital rubella.

In congenital rubella an acid-labile alpha-interferon was present in sera collected from fetuses between weeks 21 and 29 of gestation and from children with active congenital rubella. This interferon was different from the interferon detected in normal amniotic fluid and was not found in sera from uninfected fetuses or from children with postnatally acquired rubella. The fetal interferon is of interest as a complementary marker to confirm the virus contamination of the fetuses during maternal rubella.

[Status epilepticus in the infant. Semeiologic, etiologic and prognostic aspects].

During a 4 year period, 79 infants aged from 1 month to 2 years suffered a status epilepticus (SE). The seizures were most often either generalized of tonic-clonic or clonic type, or unilateral clonic; they lasted or were repeated with persistent unconsciousness between the seizures for periods ranging from 30 min to several days. All the cases of SE lasting over 6 h resulted from a recognizable acute brain injury, whereas 11 of 14 cases lasting 1 h or less were cryptogenic.

[Intracranial hypertension in pneumococcal meningitis. Reality, risks, treatment].

The authors report the results of intracranial pressure measurements in 3 cases with pneumococcal meningitis. Severe intracranial hypertension should be quickly investigated and treated in cases rapidly leading to coma.

[Diaphragmatic paralysis and eventration].

Paralysis of the diaphragm normally heals in a matter of weeks, provided that it does not result from permanent damage to the phrenic nerve. The most frequent cause is traumatic, a consequence of birth or a postoperative complication, especially after cardiovascular surgery. The vital prognosis may involve respiratory insufficiency and consequent ventilation problems.

[Perioperative management of 98 cases of type C esophageal atresia (1970-1980) ].

We report our experience about 98 cases of type C esophageal atresia admitted to our unit from 1970 to 1980. 78.6% underwent successful anastomosis; 65.

Neonatal glutaric aciduria type II: an X-linked recessive inherited disorder.

A new case of neonatal glutaric aciduria type II is reported. Neonatal acidosis, hypoglycemia, and hyperammonemia were characteristic. The baby died at four days of age.