Pédiatrie
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During 1989, a nosocomial infection rate of 3.15% was observed among the 412 neonates hospitalised for more than 2 days in the paediatric intensive care unit and a special care baby unit in the medical centre of Nice. Certain factors only partially explain the above, and it is probable that the non-invasive methods of monitoring and care and the experienced nursing staff contribute to a great extent to this low frequency of infection.
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Lissencephaly is a rare brain anomaly characterized by a lack of cerebral sulci and gyri. We report 2 cases of lissencephaly syndrome with infantile spasms diagnosed by CT-Scan. We discuss the relationship between lissencephaly and infantile spasms, and attempt to estimate the frequency of infantile spasms in lissencephaly and the frequency of this cerebral abnormality among other etiologies of infantile spasms. The prognosis of infantile spasms is indeed variable, according to the presence of underlying cerebral abnormality.
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Recent advances in neurophysiology and neurochemical management of pain has lead to a new concept in pain relief in the post-operative period. After a review of the pain perception mechanism and of the effects of antinociceptive drugs, the authors present simplified protocols for the management of post operative pain in pediatric surgery.
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Case Reports
[Delayed appearance of left Bochdalek hernia disclosed by intrathoracic gastric perforation].
Late onset congenital diaphragmatic hernia is a rare condition that is difficult to diagnose. Complications such as intestinal obstruction and digestive perforation may occur. A previously healthy three year-old girl was admitted to hospital with dehydration, shock, and ketoacidosis. ⋯ Hexabrix introduced through a nasogastric tube showed opacification of the left hemithorax attributed to an intrathoracic gastric perforation. She recovered after surgery. Gastrointestinal complications of delayed congenital diaphragmatic hernia must be promptly recognized since surgery should not be delayed.