Archives de pédiatrie : organe officiel de la Sociéte française de pédiatrie
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The clinical aspects of neonatal cerebral venous thrombosis are polymorphic in their mode of onset, making diagnosis difficult. Transfontanellar ultrasound allows for the morphological and vascular exploration of intracranial contents. ⋯ Transfontanellar ultrasound has a variable sensitivity for the detection of thrombus, but it remains the first-line examination before any additional secondary exploration. The early diagnosis of neonatal cerebral venous thrombosis with transfontanellar ultrasound requires the implementation of emergency treatment.
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Perinatal asphyxia complicated by hypoxic ischemic brain injury remains a source of neurological lesions. A major aim of neonatologists is to evaluate the severity of neonatal encephalopathy (NE) and to evaluate prognosis. The purpose of this study was to determine the contribution of brain MRI compared to electroencephalogram (EEG) and clinical data in assessing patients' prognosis. ⋯ This study confirms the usefulness of brain MRI as a diagnostic tool in hypoxic ischemic encephalopathy in association with clinical data and EEG tracings.
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Donohue syndrome or leprechaunism is a severe congenital insulin-resistance syndrome. It is characterized by intra-uterine and neonatal growth retardation, typical dysmorphic features, and metabolic abnormalities with hyperinsulinism and hyperandrogenism. ⋯ This patient had hypertrophic cardiomyopathy with heart failure and bronchial compression leading to clinical deterioration over 5 days and subsequently death. A treatment with recombinant IGF-1 was tried without efficacy.
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Observational Study
[Palliative care for newborns: practices in a level-III unit during a 5-year period].
The "Patients' rights and end-of-life care" act known as "Leonetti's Law" promulgated in 2005 has promoted the use of palliative care to avoid unreasonable obstinacy when life-sustaining treatment appears disproportionate. Very little is known about this new practice for newborns in French neonatal units. ⋯ A significant number of newborns affected by various pathologies undergo neonatal palliative care. Despite their recent introduction in neonatal medicine, palliative care practices have changed significantly. These practices are mostly in compliance with the "patients' rights and end-of-life care" act promulgated in France in 2005.