Randomised trial of analgesic effects of sucrose, glucose, and pacifiers in term neonates.

Objectives: To assess and compare the analgesic effects of orally administered glucose and sucrose and pacifiers. To determine the synergistic analgesic effect of sucrose and pacifiers.

Design: Randomised prospective study with validated behavioural acute pain rating scale.

[Post-lumbar puncture headache in children. Treatment with epidural autologous blood (blood patch)].

Unlabelled: Post-lumbar puncture headaches (PLPH) are uncommon in children, but when they occur treatment is challenging. PLPH in adults have been successfully treated by the use of the epidural blood patch. This treatment has been very rarely reported in children.

[APN: evaluation behavioral scale of acute pain in newborn infants].

Aim: This study was designed to validate a behavioral acute pain rating scale for term and preterm neonates (APN).

Methods: From January through June 1996, neonates requiring a heel lance or a venous puncture for blood sampling at the intensive care unit and the nursery of Poissy Hospital were recruited into the study. After a pilot study, a pain rating scale was developed.

[Telephonic advice by an emergency department given in a simulated pediatric case].

Background: Emergency departments (ED) are requested everyday to dispense medical telephone advice for children. To evaluate the quality of telephone management, a mock scenario simulating a febrile 4 month-old-girl with signs compatible with septicemia was used.

Methods: One hundred randomly selected French emergency departments were called on.

[Evaluation of pediatric advise asked by telephone in emergency units].

Background: Telephone calls for advice are common in pediatric emergency departments. This study was conducted to determine the nature of these calls and the answers provided.

Methods: From 24 April through 24 July 1994, all telephone calls requesting pediatric advice in the emergency department of the Poissy Hospital were independently analysed by two pediatricians from forms prospectively filled in for each call by the resident or the attending people who answered the call.

[Inaugural acute cholestasis of Kawasaki disease].

Background: Hepatic dysfunction with mild obstructive jaundice occurs occasionally in Kawasaki disease. Acute episode of cholestasis as a presenting symptom has never been reported.

Case Report: A 14 year-old-boy was admitted with fever and cholestasis.

[Water intoxication following preparation for barium enema].

Background: Induction of water intoxication from tap water enemas was reported a few years ago. Its treatment is still debated.

Case Report: A 4 1/2 year-old boy was admitted because he suffered from coma grade I.

[Intraosseous infusion in children].

Background: Intravenous access in critically ill patients may be very difficult to obtain. The intraosseous route is an alternate way to administer fluids and drugs.

Case Report: A five month old infant was brought to the emergency department in profound hypovolemia requiring immediate tracheal intubation.

[An unusual etiology of hydramnios: prenatal cerebral vascular accident. Five cases].

Neurological anomalies of the fetus are classically reported as causes of hydramnios, but cerebral vascular events occurring in utero in the fetus are rarely mentioned. We observed five newborns with neurological complications during the neonatal period in which anomalies of cerebral vascularization were identified antenatally. The mothers had hydramnios during pregnancy.

[Prenatal prevention of infant respiratory distress syndrome. 2nd part: clinical applications and indications].

Two types of sometimes complementary therapeutic strategies can be developed to prevent infant respiratory distress syndrome antenatally. The first is to administer a treatment aimed at accelerating the maturation process of fetal lung tissue in women at risk of premature birth. This is the only strategy with a goal of antenatal treatment.

[Prenatal prevention of infant respiratory distress syndrome. 1st part: experimental data and pharmacological treatment].

Pulmonary maturation and growth are two time-related interdependent phenomena. The main regulatory mechanisms of pulmonary maturation are complex and the role of epithelial-mesenchymal interrelationship appear to be determinant in the phenomena leading to morphological growth of the lung and in cellular differentiation of the epithelium during development. At an early stage of morphological development of the fetal lung, endogenous hormones do not directly affect epithelial differentiation but modulate the expression of genes coding for surfactant.

[Pneumothorax revealing pneumoblastoma in an infant].

Background: Pulmonary blastoma is a tumor with bad prognosis that is exceptionally seen before the age of 2 years.

Case Report: A 3 1/2 month-old infant was admitted because she suffered from tachypnea. A left pneumothorax with shift of the mediastinum was recognized that required insertion of a chest tube followed by ventilation and pleural drainage.

[Deficiency in medium chain acyl coA dehydrogenase manifested as febrile coma].

A 21-month-old infant developed coma with hypotonia during a viral infection. Acyl CoA dehydrogenase deficiency was diagnosed on the basis of results of the chromatographic study of organic acids performed on a urine specimen collected during the acute episode. However, other disorders of mitochondrial and fatty acid oxygenation can generate similar symptoms.

[Cerebral embolism revealing aneurysm of the interauricular septum].

Background: Aneurysm of the interatrial septum is a potential cause of systemic embolism, but it is rarely responsible for a cerebral embolism in childhood.

Case Report: A girl, aged 14 years, presented with a sudden right hemiplegia. The coagulation factors were normal, as was the CSF.

[The fate of very early premature babies. Mortality, morbidity and 2-year follow-up in a population of 96 very early premature babies].

The neonatal fate, and outcome at 2 years in a population of 96 premature babies born after no more than 28 weeks of amenorrhea is described. Mortality was directly influenced by the gestational age (< 26 WA = 52% vs. > or = 26 WA = 21.

[Thrombosis of the right atrium after umbilical venous catheterization. Favourable outcome after early thrombectomy].

A case of right atrial thrombosis after venous umbilical catheterization in a 21 day-old premature newborn is reported. The initiating factors of such an accident and its clinical signs are evocated. The authors emphasize the value of a systematic ultrasonographic supervision of newborns with central catheters for a long period of time and the value of surgical thrombectomy.