[Neonatal hyperbilirubinemia]

Hyperbilirubinemia is frequently encountered in neonatology. This disorder causes mucocutaneous jaundice, often transient and mild. It is due to the physiological characteristics of the newborn as hepatic immaturity and fragile red blood cells with polycythemia. Sometimes it reaches levels to much high that exceed the control capacity of the organism and thus causes kernicterus with severe neurological sequelae. This is an exhaustive retrospective study on a series of cases of newborn infants with hyperbilirubinemia and registered in the service of biochemistry. We have profiled the types, etiology and assessment of risk of kernicterus in order to better situate the ideal model that ensures optimal management of neonatal jaundice. The neonatal hyperbilirubinemia were all with unconjugated bilirubin. The majority of them were due to physiological origin, but the maternal-fetal blood incompatibility and neonatal infection are not negligible. All are likely to expose to serious neurological complications. Newborns, especially premature babies with jaundice of the integument must be screened for potentially severe jaundice. The prevention of alarming levels of bilirubin not bound to albumin must be realized through a monitoring including total bilirubin and albumin, or failing that, the serum protein. The best adaptation of albumin to bilirubin becomes possible by the prompt initiation of therapy, minimally invasive, such as phototherapy or the infusion of albumin. It is imperative to integrate this action in a global screening and to implement an algorithm taking into account all risk factors

[Hemolysis interference on the determination of the clinical biochemistry parameters]

Introduction: is to determine the prevalence of the hemolysed samples and to study the interference of hemoloysis on the determination of 17 current biochemical parameters: 3 electrolytes [K[+], Ca[2][+], PO[4] [2]]; 8 substrates [cholesterol, triglycerides, total bilirubin, direct bilirubin, glucose, uric acid, rate of protids, creatinin], 6 enzymes [LDH, ASAT, GGT, CK, ALAT, ALP]

Material and method: The study, concerning 34 patients performed blood samples for each patient on dry tubes without freezing, on one of these 2 samples we carried out a hemolysis by agitation [mechanical manner], after centrifugation of the two tubes we made the biochemical parameters assay. The study of the prevalence of the hemolysis samples was carried out by counting the number of hemolysed samples among the whole of samples received at the laboratory during six weeks

Results: Potassium; cholesterol, tiglycerides, total bilirubin, direct bilirubin; uric acid, LDH, ASAT; ALAT, CK and ALP were positively influenced by hemolysis, whereas the influence was negative for glucose, and creatinin. calcium, phoshorus, rate of protids, and GGT did not show significant variations. The prevalence of the hemolysed samples in the clinical biochemistry laboratory was 4,8%

Conclusion: The most common biochemical parameters are influenced by hemolysis, which conducts us to insist on control of the pre-analytical phase of sampling

Les dysphonies de l'enfant

Dysphonia is a modification of the timbre of the voice which becomes deep. It is more frequent in the child than in the adult. When it is acute, its etiological diagnosis is easy; but when it is chronic, it requires a complete otolaryngologic check-up to set up a diagnosis, and institute the appropriate treatment. There are many etiologies, and they are either organic or functional. The vocal unconfortableness is always present. The congenital malformations must be looked for, because they can entail organic lesions such as nodules. The treatment requires the cooperation of the child, and orthophonic therapy is essential to complete the treatment

pport des explorations otologiques dans le diagnostic des tumeurs de l'angle ponto-cerebelleux [A.P.C.]

The otologic explorations in pontocerebellar angle tumors are non invasive, not very expensive and constitute a means of patients detection and selection for neuroradiological examinations [CT scan and Magnetic Resonance Imaging]. When the affection is diagnosed, they are useful to discuss the surgical management according the audition level and the controlateral ear state