Pédiatrie
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Medulloblastoma is a frequent brain tumor in childhood. Recent advances in histogenesis, management of early and late side-effects, and prognosis are discussed in this review.
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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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[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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During 1989, a nosocomial infection rate of 3.15% was observed among the 412 neonates hospitalised for more than 2 days in the paediatric intensive care unit and a special care baby unit in the medical centre of Nice. Certain factors only partially explain the above, and it is probable that the non-invasive methods of monitoring and care and the experienced nursing staff contribute to a great extent to this low frequency of infection.
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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.