[Subcutaneous fat necrosis in the newborn: a risk for severe hypercalcemia]. / Cytostéatonécrose néonatale: attention à l'hypercalcémie sévère.

Hypercalcemia associated with subcutaneous fat necrosis (SCN) is a well known but rare event in the newborn. A newborn infant with a history of SCN was admitted because of anorexia, adynamia, polyuria and polydipsia at 6 weeks of age. Serum calcium was markedly increased on admission, while it was normal on the first day of life. Evolution was favourable after treatment including isotonic saline solution, furosemide, corticosteroids, calcitonin and a low calcium and vitamin D diet. Hypercalcemia was severe enough to potentially induces fatal complications in this case. Neonates who develop skin lesions consistent with SCN should be followed-up for possible onset of hypercalcemia and treated in due time. The treatment of hypercalcemia in SCN is reviewed.

[Ruptured mycotic aneurysm with hemoperitoneum: an unusual septic complication of umbilical arterial catheter]. / Anévrisme mycotique rompu avec hémopéritoine: complication septique inhabituelle d'un cathéter artériel ombilical.

Arterial aneurysms are rare in infants and are usually associated with cardiovascular malformations or connective tissue disorders. Mycotic aneurysms of the aorta or its major branches have been described in newborn infants with septicemia originating from an indwelling umbilical artery catheter. We report a case of a newborn infant with a mycotic aneurysm complicated by massive hemoperitoneum. Surgical treatment allowed a complete recovery. Newborn infants with Staphylococcus aureus bacteremia in the context of a current or recent umbilical artery catheterisation should be followed up closely to detect arterial aneurysms.

[Septic shock due to congenital disseminated toxoplasmosis?]. / Toxoplasmose congénitale disséminée responsable d'un choc septique?

Congenital toxoplasmosis secondary to maternal primary infection acquired late during pregnancy is generally asymptomatic at birth. We report a case of a newborn infant whose mother had been infected between the 27th and the 33rd week of gestation. No treatment had been given during gestation. The infant had a disseminated form of toxoplasmosis with hepatosplenomegaly, pneumonitis, purpura, hepatitis. On the third day of life, he developed shock. The patient died early despite therapy. Septic shock is unusual in congenital toxoplasmosis, although it has been described in immunocompromised patients, notably in patients infected with the human immunodeficiency virus.

[Value of a rapid screening technique for vaginal carriage of group B Streptococcus during hig-risk pregnancies]. / Intérêt d'une technique rapide de dépistage vaginal du portage de streptocoque du groupe B au cours des grossesses à risque.

Vaginal colonization by Group B streptococci (GBS) during pregnancy is associated with lige-threatening neonatal infections acquired during passage through the birth canal. Factors associated with an increased risk of GBS transmission to the neonate include prematurity, premature spontaneous rupture of the membranes before 37 weeks of gestational age, prolonged (> 12 h) rupture of the membranes at full term, fever in the mother, multiple pregnancy, and a history of GBS infection. A study was conducted to evaluate the performance characteristics of a rapid GBS screening test comparatively with conventional microbiological cultures. The 113 high-risk women admitted for delivery to the obstetrics department of the Charleville-Mézières Hospital from January to May 1998 were included in the study. Vaginal specimens were examined by both the Strep B OIA test (International Microbio) and by conventional culturing. Comparison of the results of these two methods showed that sensitivity and specificity of the Strep B OIA test were satisfactory. The Strep B OIA test is a rapid test suitable for use in emergency situations. A positive result should lead to intrapartum prophylactic antimicrobial therapy.

Development and preliminary evaluation of two speech communication aids.

In this paper two projects on speech communication aids for the speech-impaired are discussed. Since the group of speech-impaired people is very diverse, the two projects differ in target group, in the speech technology used and consequently in the complexity of input of the aids. In both projects (Pocketstem and Tiepstem) experimental models have been developed, and in the case of Pocketstem prototypes have been developed and evaluated by potential users. This paper describes the aids, their evaluation, the evaluation results and some conclusions and future plans.