[Preliminary study on transplacental transfer of fluoride. Apropos of 41 mother-infant couples]. / Etude préliminaire sur le passage transplacentaire du fluor. A propos de 41 couples mère-enfant.

Comparing the levels of ionised fluoride in the serum of maternal blood at the time of delivery and cord blood shows that there is a good correlation between the two levels (r = 0.66). This makes it possible to say that fluoride is transferred easily across the placenta. The transfer is not influenced by the parity of the age of the mother nor by epidural anaesthesia, nor by the Apgar score. It does, however, correlate with the duration of the pregnancy.

[In utero treatment of fetal tachycardias with a digitalis-beta blocker combination. Apropos of 2 cases]. / Traitement in utero des tachycardies foetales par l'association digitalique-bêta-bloquant. A propos de deux cas.

The authors report two cases of fetal tachycardia treated in utero by digitalis (Digoxin) and a beta-blocker (Sotalol). The first case did well on treatment but the second case gave rise to difficulties in treatment both before and after delivery. A study of the literature and an analysis of our findings makes it possible for us to point out the following: echotomography is valuable in screening for fetal cardiac rhythm troubles and echocardiography is useful to work out the cause and to follow the progress of the case, this condition can be treated in utero and Sotalol, a beta-blocker, is valuable in overcoming the troubles of the rhythm, it is difficult to follow up the treatment by relying on maternal blood levels of the drugs used, finally the cause of the abnormal rhythm possibly alters the expectation of success from the treatment.

Neonatal polycythemia in low birthweight infant.

74 low birthweight infants haematologic findings were studied during the first 24 hours and at the 8th day of life. By statistical methods derived from the multivariate analysis: stepwise multiple regression analysis and factor analysis, correlations were investigated between haemogram data (red cells count, haemoglobin and haematocrit levels and 18 others parameters. Most of the infants with polycythemia have toxaemic mothers and were born after a long gestation: they are affected by intra-uterine growth retardation, have a low glycaemia level but a normal calcaemia level, a large skull perimeter and a small thymus volume. But no correlation was observed between polycythemia and the following data: heart volume, neonatal icterus intensity, reticulocytes and erythroblasts counts.

Duodenal ulcer in the new-born (author's transl). / Ulcère duodénal chez un nouveau-né.

A new-born baby was found to have a duodenal ulcer after developing a severe hematemesis 24 hours after birth. The diagnosis was established by fibroscopic examination, which was also used to follow progress in this case, in which operation for a secondary hypertrophic stenosis of the pylorus led to a favourable outcome. The role of "stress" and, more particularly, gastric hyperacidity in the neonatal period are discussed. Once the critical period is passed, during which hemorrhage and perforation are the cause of the high mortality, recovery is complete.

Maternal-fetal transfer of fluoride in pregnant women.

Gas chromatography was used to measure the maternal and fetal plasma inorganic fluoride values at term in 91 women. They were assigned to one of four groups: group A were untreated controls; group B received a single daily dose of 1.5 mg of fluoride (as calcium fluoride) during the final trimester of pregnancy; group C was given a single dose of 1.5 mg of fluoride (as sodium fluoride) and group D was given 2 daily doses of fluoride (as sodium fluoride) totaling 1.5 mg. There was a significant difference between the cord plasma fluoride levels of the newborns in the untreated group (mean: 27.8 micrograms/l) and that of the combined supplemented groups B, C and D (mean: 58.3 micrograms/l). There was no difference between the average fluoride levels in the three supplemented groups. There was no significant effect of maternal age, infant birth weight, gestation or diet during pregnancy on the cord plasma fluoride level. These results indicate that fluoride supplementation during the final trimester of pregnancy will significantly elevate cord plasma fluoride concentrations.

[Double blind study of vitamin E compared to placebo in the prevention of anemia in the low birth weight infant during the 7th week of life: therapeutic study]. / Comparaison en double aveugle de la vitamine e au placebo dans la prévention de l'anémie de l'enfant de faible poids de naissance a la 7e semaine de vie: essai thérapeutique

alpha-tocopherol and placebo were compared by a double-blind trial to study their preventive effect on secondary anemia in a sample of low birth weight (less than or equal 2,500 g) infants. In the 7th week of life, hematological data from each of the two groups of infants (receiving vitamin E or placebo) were compared either by covariance analysis or by the t test of comparison of means. The infants who were given vitamin E have a higher serum level of vitamin E, a lower hemolysis, a higher erythrocyte count and a higher hemoglobin level than infants given the placebo. No significant difference was observed with respect to hematocrit or reticulocyte count. Thus, it appears that vitamin E has an effect on some of the factors in the anemia of infants of low birth weight.

[The effect of human albumin in association with intensive phototherapy in the management of neonatal jaundice]. / Etude de l'action de l'albumine humaine sur l'ictère néonatal en association avec la photothérapie intensive.

BACKGROUND: The effectiveness of phototherapy in lowering serum bilirubin levels in neonates varies inversely with the rate and degree of hemolysis. Combining this therapy with albumin perfusion could enhance its effectiveness. This study examines total, unconjugated and unbound fractions of bilirubin in infants treated by phototherapy alone or by phototherapy plus albumin. PATIENTS AND METHODS: The files of 211 neonates treated from January 1990 to March 1991 for severe neonatal jaundice were analysed. Jaundice was due to ABO incompatibility in 113 cases and hereditary hemolytic anemia in 6 cases; its cause was unknown in 92 patients. Other causes of jaundice such as Rh incompatibility, premature delivery before 34 gestational weeks and neonatal infections were excluded from the study. All 211 neonates were given phototherapy from admission with similar light energy. 114 babies (group I) received only phototherapy, while the 97 others (group II) were also given human albumin, (1.5 g/kg), during the first 2 hours of phototherapy. RESULTS: The decrease in serum unconjugated and unbound bilirubin after 4 hours of phototherapy was 34% in group I and 45% in group II (p < 0.0005). There was no difference between both groups after 24 hours of phototherapy. Other factors such as the initial concentration of serum unconjugated and unbound bilirubin, age at the onset of therapy, and ethnic skin color also influenced the decrease in bilirubin after 4 and 24 hours of phototherapy, in addition to albumin perfusion. CONCLUSIONS: Albumin perfusion plus phototherapy appears to induce a rapid and early decrease in unconjugated, unbound bilirubin, the fraction that is potentially neurotoxic, while phototherapy alone acts over a longer period.

The Bjornstad syndrome (sensorineural hearing loss and pili torti) disease gene maps to chromosome 2q34-36.

We report that the Bjornstad syndrome gene maps to chromosome 2q34-36. The clinical association of sensorineural hearing loss with pili torti (broken, twisted hairs) was described >30 years ago by Bjornstad; subsequently, several small families have been studied. We evaluated a large kindred with Bjornstad syndrome in which eight members inherited pili torti and prelingual sensorineural hearing loss as autosomal recessive traits. A genomewide search using polymorphic loci demonstrated linkage between the disease gene segregating in this kindred and D2S434 (maximum two-point LOD score = 4.98 at theta = 0). Haplotype analysis of recombination events located the disease gene in a 3-cM region between loci D2S1371 and D2S163. We speculate that intermediate filament and intermediate filament-associated proteins are good candidate genes for causing Bjornstad syndrome.