Pédiatrie
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The authors report on a case of cardiocirculatory arrest in a 4-month old infant, related to severe vitamin D deficiency rickets with hypocalcemia. Despite medical follow-up, this infant, who was breast-fed during the first 3 weeks of life, did not receive any vitamin D prophylaxis. This observation shows the potential severity of vitamin D deficiency rickets. Thus, systematic prophylaxis should be applied as soon as the infant is born, even in breast-fed children.
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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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[Search for early indications for reintubation after mechanical ventilation weaning of the newborn].
Early predictive factors for successful extubation were investigated, in order to determine the best moment for respiratory weaning of the newborn, and the risk of subsequent reintubation. PaO2/FiO2 ratio, PCO2 and respiratory rate were measured 2 h after extubation in 100 newborn infants. There was no statistically significant difference for the PaO2/FiO2 ratio and PCO2 between infants who were successfully extubated (group 1) and those who required subsequent reintubation (group 2). By contrast, the respiratory rate 2 h after extubation was significantly higher in group 2, and a respiratory rate greater than 70/min appears to be the earliest ventilatory modification predictive of the need for further mechanical ventilation before the occurrence of hypoxemia and respiratory acidosis.
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Lissencephaly is a rare brain anomaly characterized by a lack of cerebral sulci and gyri. We report 2 cases of lissencephaly syndrome with infantile spasms diagnosed by CT-Scan. We discuss the relationship between lissencephaly and infantile spasms, and attempt to estimate the frequency of infantile spasms in lissencephaly and the frequency of this cerebral abnormality among other etiologies of infantile spasms. The prognosis of infantile spasms is indeed variable, according to the presence of underlying cerebral abnormality.
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Recent advances in neurophysiology and neurochemical management of pain has lead to a new concept in pain relief in the post-operative period. After a review of the pain perception mechanism and of the effects of antinociceptive drugs, the authors present simplified protocols for the management of post operative pain in pediatric surgery.