Late thalamic atrophy in infarction of the middle cerebral artery territory in neonates. A prospective clinical and radiological study in four children.

We report four cases of progressive thalamic atrophy following ipsilateral cerebral infarction in the territory of the middle cerebral artery in neonates, with prospective radiological and clinical follow-up. This type of atrophy appears within 6 months after the onset of cerebral infarction. In the short term, this atrophy has no action on sensory and memory function and/or on sensory evoked potentials. This atrophy is not the result of secondary ischemic neuronal damage. Judging from several other experimental studies, thalamic atrophy may primarily result from retrograde degeneration. It would be interesting to observe the consequences of this atrophy on sensory and memory function over a long period.

Accuracy of urine output measurement with regular disposable nappies.

Evaporation of urine from four types of disposable absorbent infant nappies (A, B, C, D) was assessed under a radiant warmer or in an incubator, with or without phototherapy. Each nappy was weighed dry and then 5, 10, 15 or 30 ml of urine were added. The nappy was immediately reweighed, placed in its study environment and then weighed 5, 15, 30, 60 and 120 min later. Under all conditions, the percentage evaporation from each type of nappy increased during the 120 min and was inversely correlated with urine volume. Without phototherapy, the maximum evaporation at 120 min with a 5-ml urine sample was 15.9% +/- 6.1% for nappy B in the incubator and 20.8% +/- 4.0% for nappy A in the radiant warmer. Phototherapy was associated with slight but significant changes in evaporation in the incubator and the radiant warmer. Nappy D allowed the lowest percentage evaporation in the incubator with or without phototherapy and in the radiant warmer with phototherapy (8.8% +/- 4.4%, 2.4% +/- 1.8% and 16.0% +/- 10%, respectively for a 5-ml urine sample).

Smectite reduces gastroesophageal reflux in newborn infants.

We assessed the efficacy of a natural clay (smectite) on the frequency and the duration of acid (pH less than 4) and very acid (pH less than 3) gastroesophageal reflux (GER) measured by 24-hour continuous pH recording (CPR). Twenty newborn infants were enrolled in this double-blind controlled study owing to pathological CPR in supine position. After inclusion, all the patients were maintained in the 30-degree elevated prone position and received either smectite (3 g/day; n = 10) or placebo (n = 10) for 7 days. On the 8th day, a second 24-hour CPR was performed in supine position. The postural therapy alone (placebo group) was followed by a significant decrease in the numbers of acid GER (p less than 0.05) during the second CPR. The combination of postural therapy and smectite treatment was followed by a decrease in the number of acid (p less than 0.05) and very acid GER (p = 0.01), the percentages of time spent at pH below 4 (p less than 0.05) and 3 (p less than 0.01) and the maximal duration of acid GER (p less than 0.05).