Subject(s)
Aortic Dissection/complications , Multiple Organ Failure/etiology , Abscess/etiology , Aged, 80 and over , Biliary Fistula/etiology , Celiac Artery , Cholecystitis/etiology , Disseminated Intravascular Coagulation/etiology , Gallbladder/pathology , Gangrene , Humans , Ischemia/etiology , Liver Abscess/etiology , Male , Pancreatitis/etiology , Shock, Septic/etiology , Splenic Diseases/etiologyABSTRACT
Hip fracture is a major health burden due to both its frequency and its deep impact on patient's outcome. The key issue of this poor outcome seems to be cardiac complications. The onset of these cardiac complications seems to appear early in the clinical course in the form of perioperative myocardial ischemia that are both preventable and treatable. Their clinical and electrocardiographic pattern is very poor and they can be thoroughly detected by only either a systematic electrocardiographic 12 lead monitoring or troponin dosage.
Subject(s)
Heart Diseases/etiology , Hip Fractures/surgery , Orthopedic Procedures/adverse effects , Postoperative Complications/etiology , Electrocardiography , Heart Diseases/epidemiology , Heart Diseases/prevention & control , Heart Diseases/therapy , Hip Fractures/epidemiology , Humans , Monitoring, Intraoperative , Postoperative Complications/epidemiology , Postoperative Complications/prevention & control , Postoperative Complications/therapy , Treatment OutcomeABSTRACT
UNLABELLED: Enterovirus infections in neonates are difficult to diagnose. Diphasic pattern and possibly fatal myocarditis must be anticipated. CASE REPORT: A 14-day-old girl had presented a heart failure after an initial episode of gastroenteritis and supraventricular tachycardia. Investigation demonstrated global myocardial dysfunction. Diagnosis of neonatal enterovirus myocarditis was made by polymerase chain reaction detection of viral genome. Heart failure was controlled with medical treatment. CONCLUSION: Enterovirus myocarditis is typically a biphasic illness. Rapid diagnosis of enteroviral infection in neonatal period may be made by polymerase chain reaction detection of viral genome. There is anecdoctal evidence that immunoglobulin infusions may improve outcome.
Subject(s)
Enterovirus B, Human/isolation & purification , Enterovirus Infections , Myocarditis/virology , Female , Humans , Infant, Newborn , Polymerase Chain Reaction/methods , Sensitivity and SpecificityABSTRACT
BACKGROUND: The survival and outcome of infants with bronchopulmonary dysplasia (BD) depend on the patient's maturity, the severity of the BD and nutritional problems. This study evaluates the specific role of chronic pulmonary failure in the growth and development of infants recovering from BD. POPULATION AND METHODS: 88 infants admitted for BD from January 1984 to December 1988, having gestational age from 25 to 41 weeks 5 days (mean: 29) and birth weight from 680 to 3,400 g (mean: 1,195) were studied. All infants were given respiratory support for 6 to 914 days (mean 84) and oxygen therapy for 28 to 1,232 days (mean: 119). 29 infants were given corticosteroids for more than 1 month. The outcome of the 80 infants with gestational ages of less than 33 weeks was compared to that of 272 infants with the same gestational age but not suffering from BD on their 28th day. The infants in both groups were examined at 2 years of age and classified as: a) handicapped (neurologic deficit, IQ < 80, hearing loss, blindness, convulsions); b) doubtful (transitory neurology dysfunction); c) normal. RESULTS: Of the 88 infants still living at the age of 28 days, 19 died before the age of 2 years: 16 of the 64 surviving infants who could be followed until the age of 2 years were classified as handicapped, 13 were considered doubtful and 35 were normal. The more significant risk factors for neurodevelopmental impairment were: a) the presence of porencephaly and/or ventricular dilatation on brain ultrasonography; b) head circumference < -2 SD at the end of hospital stay; c) oxygen therapy and hospitalization > 5-6 months. The group of infants with BD had a higher death rate (24% vs. 3.7 in the group without BD) and more frequent neurodevelopmental impairment at gestational ages of > 31-32 weeks. CONCLUSIONS: BD is an extra risk for the survival and neurodevelopment of infants with gestational age > 31 weeks.
Subject(s)
Bronchopulmonary Dysplasia/physiopathology , Psychomotor Disorders/etiology , Bronchopulmonary Dysplasia/complications , Bronchopulmonary Dysplasia/mortality , Child, Preschool , Developmental Disabilities/etiology , Female , Follow-Up Studies , Gestational Age , Humans , Infant , Infant, Newborn , Male , Nervous System Diseases/etiology , Prognosis , Respiratory Insufficiency/complications , Risk Factors , Time FactorsABSTRACT
A retrospective study of 2 125 preterm infants, who were ventilated at the Institut de Puériculture in Paris over 9 years (1974-1982) for respiratory distress at birth, showed that 45 (2%) developed clinical and radiological bronchopulmonary dysplasia (BPD): 8 minimal forms, 23 moderate forms and 14 severe forms, 30 of these patients survived (66%). The pathogenesis of this chronic respiratory disease is multifactorial: oxygen + pressure + duration + endotracheal intubation. Efforts should be made to limit the damaging effect of each of these factors, which should be kept down to the minimum values compatible with adequate oxygenation. The presence of emphysema and of a patent ductus arteriosus has also been incriminated, but they may reflect the severity of the initial lung lesion. Rickets, whose incidence was found to be 27%, majors respiratory distress. In the ensuing months, babies with BPD are susceptible to recurrent viral or bacterial respiratory tract infection, failure to thrive and cor pulmonale. The presence of the mother and the care of a psychomotor development specialist are needed for these infants who will be confined for months in conditions which are unsuited to their sensory, physical, emotional and cognitive development.
