RESUMO
OBJECTIVE: To study perinatal and neonatal mortality of very preterm infants and to assess the association with birth weight and multiple births. METHODS: Infants enrolled in the Epipage study born between 22 and 32 weeks gestational age in 9 French regions in 1997 were included in this study. The main outcome measure was stillbirth and death before discharge from hospital. RESULTS: During the study period, 4397 births and therapeutic abortions meeting the inclusion criteria were recorded (including 16% therapeutic abortions and 18% stillbirths). Survival rate for babies born between 22 and 32 weeks was 67% of all births (stillborn + liveborn) and 85% among livebirths. Survival rose with increasing gestational age: survival (livebirths) was 50% at 25 weeks gestation, 78% at 28 weeks and 97% at 32 weeks. Survival was lower for infants with a birthweight below the 10th percentile and for multiple-pregnancy infants. The different stages of the follow-up planned up to 5 years are presented together with the response rate to the postal follow-up questionnaire. CONCLUSION: This cohort provides mortality data on very premature infants during pregnancy, at birth, during hospitalization before discharge. Survival of liveborn infants was stratified by gestational age and was consistent with other geographically based studies of very preterm infants born in the 1990s.
Assuntos
Mortalidade Infantil , Recém-Nascido Prematuro , Peso ao Nascer , Estudos de Coortes , Feminino , Seguimentos , França/epidemiologia , Idade Gestacional , Humanos , Recém-Nascido , Gravidez , Gravidez Múltipla , Inquéritos e QuestionáriosAssuntos
Anormalidades Múltiplas/genética , Ossos Faciais/anormalidades , Deficiência Intelectual/genética , Obstrução Intestinal/genética , Instabilidade Articular/genética , Megacolo/genética , Doenças do Colo Sigmoide/genética , Crânio/anormalidades , Anormalidades Múltiplas/diagnóstico , Adulto , Diagnóstico Diferencial , Humanos , Deficiência Intelectual/diagnóstico , Obstrução Intestinal/diagnóstico , Instabilidade Articular/diagnóstico , Masculino , Megacolo/diagnóstico , Doenças do Colo Sigmoide/diagnóstico , SíndromeRESUMO
The early occurrence of peritoneal signs and hyperamylasemia in a 14-year-old boy, who had fallen off his horse, urged us to perform a sonographic and computed tomographic study of the upper abdomen. Both examinations showed a complete pancreatic rupture. Distal pancreatectomy led to a rapid and uneventful recovery.
Assuntos
Pâncreas/lesões , Tomografia Computadorizada por Raios X , Ultrassonografia , Adolescente , Traumatismos em Atletas/diagnóstico , Humanos , Masculino , Pâncreas/diagnóstico por imagem , Ruptura , Ferimentos não Penetrantes/diagnósticoRESUMO
The effects of cisapride, a nondopaminolytic motility-enhancing agent, were studied in 56 patients with chronic functional dyspepsia; all had symptoms suggestive of delayed gastric emptying. The patients received 4 mg or 8 mg of cisapride or placebo orally three times daily for two successive three-week periods according to a randomized, double-blind, crossover study design. Although there was a high placebo response (55% showed good or excellent results), the global response to treatment was significantly (P = 0.024) in favor of cisapride (75% had good or excellent results). The drug was particularly superior to placebo (P = 0.03) in the improvement of a cluster of symptoms typical of postprandial discomfort, including early satiety and nausea. Side effects were minimal.
