RESUMO
Idiopathic thrombocytopenic purpura [ITP] represented the most frequent cause of children's thrombocytopenia. Until our days universal management of ITP does not exist. We performed retrospective and then prospective study of 61 children admitted for ITP during 15 years. The aim of the study was to precise the epidemiological, clinical and therapeutic profiles and propose management algorithm. The incidence of ITP was 0.34 per cent. The mean age was 6 years with male predominance. Initial thrombocytopenia was inferior than 10.000/mm3 in 44,2 per cent of cases. Spontaneous recovering was noted in 17 cases. Oral prednisone therapy with 2mg/kg/day during 21 to 35 days and 4mg/kg/day during 4 days was performed respectively in 21 and 19 cases. Intravenous immunoglobulin and methylprednisolone pulse therapy was performed respectively in 17 and 5 cases. Splenectomy was successfully performed in 3 cases. Chronic ITP was noted in 13 cases. Acute ITP without hemorrhagic syndrome should be treated in first stage with oral prednisone at 4mg/kg/day during 4 days. In case of failure, a second cure may be prescribed. If not we return to intravenous immunoglobulin
RESUMO
Epilepsy is known to have a higher association with cerebral Palsy and it's often severe. This retrospective study described 42 children with cerebral Palsy and epilepsy between 1985 and 1998 in Pediatric Department of Monastir. The mean age of patients was 6 years. The first seizure occurred during the first year of life in 47.6%. Generalized epilepsy was the predominant form [61%], followed by partial epilepsy [34.1%] and west syndrome [4.9%]. Polytherapy was required for 46.4% of patients and seizures control was achieved
RESUMO
Jaundice is the common clinical sign in neonatal medicine. Its causes were dominated by ABO incompatibility. The aim of the study was to compare the effectiveness of ordinary phototherapy [OP] versus intensive phototherapy [IP] in the treatment of hyperbilirubinemia due to ABO incompatibility. A total of 104 newborns infants with haemolytic hyperbilirubinemia were evaluated. Group I [G I], 52 infants treated with OP or OP and exchange transfusion and group II [G II], 52 infants treated with IP or IP and OP. Our study demonstrated that the overall percentage decline rate of unconjugated serum bilirubin was 0.31 %/h in G I and 0.7 %/h in G II. Median duration of phototherapy was shorter in G II [16h vs 47.3h]. The use of continue OP was reduced in G II [7 vs 31 cases]. Exchange transfusion was no longer used in G I. Also we found significant decrease of the mean duration of hospitalisation in G II [4.54 vs 5.15 days] This study showed that in G II of jaundiced babies treated with IP, kernicterus was totally eliminated also the need of exchange transfusion. The use of IP reduced mother-baby separation
RESUMO
The authors report their experiences in the treatment and survival of antiphospholipid antibody syndrom in pregnant women. Four patients. The diagnosis was performed by both the of coagulation study and titration of antiphospholipid antibodies [ELISA assay]. We excluded cases with systemic lupus erythematosus. Patients were treated by aspirine, dipyridamole, prednisone and low-molecular weight heparin. The circulant anticoagulant rate, measured by the thromboplastin diluted test, showed a dramatic decrease with the introduction of differents drugs. Deliveries were performed by cesarian section about 34-35 weeks of amenorrhea. Excluding prematury, no neonatal complications were recorded. Our data indicate that a quadruple therapy with aspirin, dipyridamole, prednisone and low-molecular-weight heparin could be efficient in the improvement of fetal prognosis in primitive antiphospholipid syndrome in pregnant women