Pédiatrie
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One of the aspects of prematurity in neonates is the respiratory distress syndrome. Although treatment with mechanical ventilation reduced the mortality rate, bronchopulmonary dysplasia still develops in many neonates. We have attempted to reduce intubation and mechanical ventilation by using, in the delivery room, humidified and warmed gas with fractional inspired oxygen as low as possible to obtain SaO2 between 85 and 95%. ⋯ Seven out of 26 infants (27%) born between 30 and 32 weeks required mechanical ventilation. In contrast, ventilation was necessary for eight out of 16 premature neonates born before the 29th week of gestation. Mortality rate was 6% (4/66) in the latter group (< 29 weeks), and only one neonate developed bronchopulmonary dysplasia.
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A survey carried out by questionnaire was performed among parents accompanying their children to the emergency department of the Lenval's children hospital in order to determine their opinion on the quality of the reception and care. The questionnaire was distributed to 2,382 parents. ⋯ A large majority of the parents (99%) expressed their satisfaction with the care and reception in the emergency department. The necessary improvements following this survey concern the duration of waiting prior to the consultation and the quality of the reception in the radiological and admittance departments; it is hoped that the radiological and admittance areas will be included within the emergency department, in the future.
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In 1988 and 1989, 79 children have been treated for induction of acute leukemia. 68 presented an acute lymphoblastic leukemia (ALL) and 11 an acute non-lymphoblastic leukemia (ANLL). The complete remission rate was 92% (96% in ALL, 73% in ANLL). Fever occurred in 50% of the children, with positive blood cultures in 11 of them. ⋯ Four patients were transferred into the intensive care unit. After 8 days, the treatment of ALL was continued in the outpatient clinic in more than 50% of the cases. The treatment of ANLL is frequently complicated by hemorrhages and sepsis and needs adapted supportive care in a specialized unit.
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In 1988, a cross-sectional study was undertaken in secondary modern schools from the city of Le Havre in order to assess the spread of health education regarding licit and illicit drugs and prepare a pedagogical kit including adolescent opinions on the subject. Through the school system, more than one adolescent out 5 had been taught about tobacco or alcohol, and 11% about illicit drugs. Only 6% had been informed about all 3 subjects, and 70% had not received any information. ⋯ Information related to potential health risk constituted the main source of satisfaction. Lastly, 62% of the adolescents were ready to set up a health promotion program on illicits drugs. This choice was not influenced by age, sex or school performance.
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The increasing aggressivity of the modern technology connected with neonatal resuscitation had led to the recognition by paediatricians of the existence of pain in the newborn, and of the necessity to treat this condition. The neurophysiological development of the neonate is such that it allows pain perceptions even in premature infants; a number of clinical parameters have therefore been described for pain recognition in neonates. An antalgic therapeutic scheme to be used for treatment of pain in the intensive care unit is proposed.