[Organization of patient management in level II centers in the Paris area: a prospective survey]. / Organisation de la prise en charge dans les centres de niveau II en région parisienne: enquête prospective.

Perinatal asphyxia is a common emergency for both obstetricians and pediatricians. A prospective study was conducted in 14 maternity hospitals (type II centres) in the Paris suburbs in order to assess pediatric activity and neonatal morbidity associated with supposed perinatal asphyxia in term newborns. Pediatricians were called in at birth very frequently: 1/20 deliveries. Intubation and/or resuscitation procedures were needed in 20% of cases and 20% of infants were referred to a neonatal unit for birth asphyxia or associated pathology. Moderate encephalopathy was observed in 1.5% of all term newborns who needed medical intervention for supposed birth asphyxia.

[Spontaneous neonatal arterial thrombosis treated with tissue plasminogen activator]. / Thrombose artérielle néonatale spontanée traitée par activateur tissulaire du plasminogène.

BACKGROUND: Spontaneous neonatal arterial thrombosis is a rare entity with serious and potentially fatal complications. A wide spectrum of management has been proposed. CASE REPORT: Ophélie was born after premature delivery at 33 weeks. She was referred soon after birth in the neonatal intensive care unit for respiratory distress syndrome. Spontaneous acute ischemia of the right lower limb was noted soon after admission. Iliac thrombosis was confirmed by ultrasonography and colour coded doppler. Thrombolysis was achieved with systemic infusion of recombinant tissue plasminogen activator (rtPA). Full recovery was obtained within 12 hours of treatment without any complication. No rethrombosis occurred with heparin prophylaxis. No predisposing disorder to thrombosis was found. CONCLUSION: Systemic rtPA is an alternative to thrombectomy and urokinase in critically ill neonates. This treatment should be considered if no major risk of bleeding is found during the pretherapeutic screening.

[Juvenile and familial amyotrophic lateral sclerosis. 2 case reports (author's transl)]. / La sclérose latérale amyotrophique juvénile et familiale. Place nosologique, á propos de deux observations.

The case report of two brothers who evidenced neurological disorders with peripheral nerve syndrome, pyramidal deficit and bulbar symptoms is described. The diagnosis of amyotrophic lateral sclerosis was assumed upon the association of these clinical features. Seven and nine years respectively after the beginning of the disease, an increase of the clinical features was noticed in the 2 children, more pronounced in the second one. The possibility of true juvenile and familial amyotrophic lateral sclerosis is discussed in this study; different aspects of this disease are described. A final classification of these 2 cases will not be possible until histological features are available.

["Serratia marcescens" in neonatology: epidemiology of a hazard (author's transl)]. / "Serratia marcescens" en médecine néo-natale. Epidémiologie d'un risque (à propos d'une méningite à 6 jours).

A case of meningitis, caused by Serratia marcescens in a 6-day old newborn triggered a search for Serratia in the Neonatology ward. Fifteen out of 38 newborns were found fecal carriers of S. marcescens. The source of S. marcescens was found in flasks containing almond oil with 1% cetyltrimethylammonium bromide used for skin care. All strain of S. marcescens belonged to pigmented biotype A6a and serotype 014 : H10. The spread of S. marcescens was controlled by heat sterilizing and renewing twice a week the almond oil flasks. Means of control of contamination sources are discussed.