Effect of positioning on the incidence of abnormalities of muscle tone in low-risk, preterm infants.

UNLABELLED: BACKGROUND. The preterm infant is subject to the force of gravity: when its body lies pressed against the mattress on which it is placed. AIMS: The purpose of this study was to investigate short-term effects of varied post-natal lying positions in order to prevent neuromuscular and postural abnormalities. METHODS: 60 low risk preterm infants of 31-36 weeks gestational age were enrolled for this randomised clinical trial. Initially each child underwent neurological and psychomotor assessments which included tonus and reflex protocols as well as behavioral, sensory motor and postural examinations. The lying positions of the treated group were varied (back, prone, and side) using a specially designed moldable mattress that maintained the functional position of the infant's body. The control group was placed on their stomachs, (the standard lying position used in 1994) with a standard orthopaedic bolster support under their hips. All infants underwent a second round of examinations upon discharge to assess any changes in neurological and psychomotor outcomes. RESULTS: The sensory-motor skills examinations showed significant abnormalities in the control group: (1) dominance of the extensor muscles due to muscle shortening, (2) hyper abduction and flexion of the arms, and (3) global neuromuscular rigidity. Psychomotor and neurological exams of the control and treatment groups showed delayed developmental muscular acquisitions for infants in the control group. CONCLUSION: Regular changes in posture, while retaining correct functional positions, allowed maintenance of normal neuromuscular and osteo-articular function and permitted the development of spontaneous and functional motor activity in low-risk perterm infants.

[ABO incompatibility and newborn haemolytic disease: two cases with major erythroblastosis]. / Incompatibilité foeto-maternelle ABO et maladie hémolytique du nouveau-né: à propos de deux observations avec érythroblastose majeure.

Two cases of newborn haemolytic disease because of ABO incompatibility are reported. In both cases, blood erythroblastosis exceeded 300 per 100 leukocytes at birth. Both newborns developed early jaundice and one presented with anaemia. Intensive phototherapy begun soon after birth was an effective treatment. The diagnosis of newborn jaundice and the patho-physiological basis of haemolytic disease because of ABO incompatibility are discussed.

[Bronchiectasis in hemorrhagic rectocolitis. Apropos of a case]. / Les bronchectasies au cours de la rectocolite hémorragique. A propos d'une observation.

Bronchectasis is a rare complication of haemorrhagic rectocolitis, 28 case have been reported in the literature. We report a case in a 40-year-old patient who presented respiratory signs 13 years after the onset of haemorrhagic rectocolitis. The diagnosis was confirmed on the bronchogram showing involvement of the lower lobes on the right and the left. Local corticosteroids given by inhalation decreased the volume of the expectorations and improved bronchial obstruction. Abundant bronchorrhoea is characteristic of bronchectasia in haemorrhagic rectocolitis as in primary bronchectasia. Response to inhaled or systemic corticosteroids is good.

[Prognosis and treatment of chronic cor pulmonale]. / Pronostic et traitement du coeur pulmonaire chronique.

We have report one hundred cases of chronic pulmonary heart observed between 1982 and 1991. Mean age was 63 years, 61% were men. COPD was the most frequent etiology of CP (84%) before restrictive (14%) and thromboembolic diseases (2%). Diuretics were used in all patients, nifedipine in 32% and digitalis in 16%. Eleven patients died during their first admission, and six died later. Only 31 patients are still regularly.

Maternal-fetal hemorrhage: a reappraisal.

PURPOSE: To determine the frequency of maternal-fetal hemorrhage at or above 1 microliter of maternal whole blood. METHODS: Seventy-three mothers whose red blood cells bore an Rh antigen (Rh D, Rh c, Rh E) that was absent on red blood cells of their newborns were identified and a new cytological method, the Kleihauerimmunogold-silver-staining technique, was applied on the blood of their neonates to detect and quantify maternal red blood cells. Stringent precautions were taken to avoid contaminations of neonatal blood samples by adult red blood cells. RESULTS: Maternal red blood cells were present in 3 newborns, a frequency of 4% (95% Cl: 1-11%), and the estimated volumes of hemorrhage were 0.8, 1.5, and 101 microliters of maternal whole blood. No obstetric factor was clearly associated in this limited study with the occurrence of maternal-fetal hemorrhage. CONCLUSIONS: Mother-to-fetus microtransfusion greater than 1 microliter is infrequent at or near delivery, and it may be observed after an uncomplicated pregnancy and vaginal delivery.