Archives françaises de pédiatrie
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A 6 years experience of the use of a CPAP nasal cannula is reported. In children over 1,500 g and Silverman's index less than or equal to 6, the indications for this technique were neonatal idiopathic respiratory distress (excluding stage 4), transitory respiratory distress, cesarean lungs and amniotic inhalation of clear fluid after aspiration and physiotherapy. ⋯ The innocuousness of the method makes it a routine technique in all cases at the onset of respiratory distress, reducing the need for intubations. It was found to be an efficient complement for the relay after mechanical ventilation.
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The authors report a case of acute fungal arthritis following traumatic inoculation (bramble prick) in a 9 year-old boy. The implicated fungus was an highly pathogenic atypical strain of Scedosporium (monosporium) apiospermum. ⋯ This case is compared with other in the literature. The part of ketoconazole in the recovery of this patient is emphasized.
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Cerebral edema complicating treatment of diabetic ketoacidosis does not seen to be very rare. This neurologic complication, which was observed in 3 cases, presents similarly in all patients, occurs mainly in children and adolescents and is usually lethal. ⋯ Various etiologic factors have been considered; sodium depletion, rapid infusion of hypotonic solutions and rapid fall of plasma glucose level might have a deleterious effect. On the basis of these data, some preventive therapeutic measures are proposed.
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Case Reports
[Study of the renin-angiotensin system in 2 cases of Wilm's tumor with severe arterial hypertension].
Two children who presented with Wilm's tumour and severe hypertension are described. The hypertension, which was secondary to excessive renin secretion, regressed after unilateral nephrectomy. In one child the total quantity of renin in the tumour was high and the peripheral plasma renin was also increased. ⋯ No renin was detected in the tumour. In this child the inappropriate secretion of renin was probably due to renal parenchyma close to the tumour causing reno-vascular hypertension. The anti-hypertensive effect of propranolol given pre-operatively was excellent.