Archives de pédiatrie : organe officiel de la Sociéte française de pédiatrie
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The newborn's energy expenditure is used in order of priority for: (i) basic metabolism; (ii) body temperature regulation and (iii) body growth. Thermal regulation is an important part of energy expenditure, especially for low birth-weight infants or preterm newborns. The heat exchanges with the environment are greater in the infant than in the adult, explaining the increased risk of body hypo- or hyperthermia. ⋯ Further developments are expected to improve the infant's thermal environment, with assessment of the various heat exchange mechanisms by conduction, convection, radiation and evaporation. The quantification of the respective parts of these exchanges would improve nursing care through clinical procedures or equipment used to ensure the control of the optimal thermohygrometric conditions in incubators, especially when the likelihood of excessive body cooling is high. The present review focuses on the various body heat exchange mechanisms, the thermoregulation processes of the newborn, and their implications in clinical usage and limitations in the neonatal intensive care unit.
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Is it reasonable to care for children born under 26 gestational weeks (GW)? To answer this question, we compared outcome at 5 years of 2 groups of children:less or equal to 25 GW+6 days (group 1) and 26-27 GW+6 days (group 2). ⋯ The progression of under 26-GW preterm babies is more often unfavorable than the progression of babies born 26-27 GW+6 days. However, given the low number of patients, no significant difference was made concerning the prognosis at 5 years between the survivors of the 2 groups.
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Whooping cough (pertussis) is a contagious disease caused by Bordetella pertussis that can be prevented by vaccination. The disease is particularly severe in infants who are less than 3 months old, who are not protected against the disease and are often contaminated by their parents. Atypical presentations are frequent and neonatal pertussis is rare. ⋯ In Africa, where complementary investigations such as PCR are seldom accessible, a careful clinical study and the analysis of the absolute rate of lymphocytes could be an alternative for the diagnosis of whooping cough. Vaccination of teenagers and adults is also problematic in poor countries. High-performance new vaccine candidates may contribute to a better control of whooping cough.