Archives de pédiatrie : organe officiel de la Sociéte française de pédiatrie
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Case Reports
[Focalized multiple beam radiotherapy: an alternative in the treatment of deep cerebral arteriovenous malformations].
Cerebral arteriovenous malformations are usually treated by excision or selective embolization. Some untreatable malformations may be presently cured by radiosurgery. ⋯ Gamma-Unit treatment can be successfully proposed for treating those malformations that are inaccessible to surgery or embolization.
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Acute respiratory distress syndrome (ARDS) is a frequent condition in pediatric intensive care units. The mortality remains high despite advances in conventional mechanical ventilation and aetiological treatment. ⋯ Nevertheless the usefulness of extrapulmonary gas exchange remains much debated. New ventilatory strategies have been developed in order to reduce ventilator-induced lung injury and to improve systemic oxygenation but multicentric randomized clinical trials are needed before these strategies can be validated.
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Cardiovascular disorders associated with neural crest tumors are congenital malformations rather than cardiomyopathies. ⋯ The cardiomyopathy presented by this patient is possibly catecholamine-induced even though catecholamines usually results in myocardial hypertrophy rather than dilated cardiomyopathy. The reason why such a cardiomyopathy has never been reported in patients with neuroblastoma remains unclear.
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Wilms tumor is associated in 7 to 10% of patients with congenital abnormalities. Among those, aniridia is the most constant feature of the WAGR syndrome that includes, in one third of cases. Wilms tumor. We report two cases of aniridia associated with fetal rhabdomyomatous nephroblastoma. ⋯ Both cases of fetal rhabdomyomatous nephroblastoma, a histological variant of Wilms tumor, seem to be the first reported in the WAGR syndrome.
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Insufflation pressures were measured during manual ventilation using a neonatal rebreathing bag (Ambu on a manikin. Maximal insufflation pressures were greater than that published or given by the manufacturer, theoretically limited to 30 cm of water at open valve, and that whatever the number of fingers used for the compression of the bag. These results indicate that Ambu ventilation, often mandatory for newborn resuscitation, does not simply rely upon the finger-touch of the operator and that it always has a risk of baro and/or volotraumatism.