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  • 1
    ISSN: 1432-0428
    Keywords: Congenital diabetes mellitus ; absence of beta cells ; methylmalonic acidaemia ; mutase deficiency
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary We report on a female neonate with diabetes mellitus and methylmalonic acidaemia, who died at age 16 days. Using immunocytochemistry, electron microscopy and in situ hybridisation, we were unable to demonstrate any insulin cells in the pancreatic islets. Methylmalonic acidaemia was caused by a methylmalonyl coenzyme A mutase apoenzyme defect. The metabolic crisis of the methylmalonic acidaemia aggravated the diabetes and may explain the failure of insulin therapy. Our results suggest that the infant suffered from a congenital absence of beta cells associated with a genetically transmitted mutase apoenzyme defect.
    Type of Medium: Electronic Resource
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  • 2
    Electronic Resource
    Electronic Resource
    Springer
    European journal of pediatrics 145 (1986), S. 351-356 
    ISSN: 1432-1076
    Keywords: Sudden Infant Death Syndrome ; Sleep ; Monitoring ; Apnoea
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract We report preliminary results of a prospective study conducted to prevent sudden death in asymptomatic infants. From 1977–1984, 3658 infants were studied polygraphically. There were 923 siblings of SIDS victims and 2735 infants with no personal of family history of SIDS. The infants were studied at 8 weeks of age. Polygraphic “risk factors” were defined by central apnoeas longer than 15s; periodic breathing above 5% sleep time; or obstructive apnoeas above 3s. In 937 infants “risk factors” were seen and a second study was requested 4 weeks later. Out of 891 infants re-studied at 12 weeks, 153 still presented some “risk factors” and were selected for a home monitoring programme; 150 families agreed to monitor their infants at home with a cardiorespiratory monitor with the alarms set at 20s apnoea, and 50 beats per min bradycardia. Repeated alarms were reported for 97/150 (65%) infants; 48/150 (32%) infants were stimulated and 8/150 (5.3%) were resuscitated on at least one occasion. No death occurred during monitoring, which could be interrupted before the end of the first year of life in all infants. In the group of 3459 infants with normal results and not monitored, three siblings (0.35%) and one infant without history (0.04%) died of SIDS. Of the infants with abnormal polygraphic results, one sibling not returned for the second recording, and two out of three infants for whom the parents refused monitoring, died of SIDS. It is concluded that the programme, may prevent the death of some infants, but that the outcome of a child with normal results cannot be foreseen.
    Type of Medium: Electronic Resource
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  • 3
    Electronic Resource
    Electronic Resource
    Springer
    European journal of pediatrics 146 (1987), S. 159-161 
    ISSN: 1432-1076
    Keywords: Home monitoring ; SIDS ; Stress ; Near miss for SIDS
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract As home monitoring has been advocated for the prevention of sudden infant death (SIDS) we investigated the influence of such a monitoring programme on family life. Twenty European middle and lower-class families with a child monitored at home after a near miss for SIDS event were investigated. Some psychological and social findings were compared with a group of 20 matched control families. It appears that home monitoring induces severe stress, mainly in the mothers. Fathers and siblings also manifested significant emotional stress. Poor schooling of the parents and previous marital discord seem to be predictors of bad adaptation to home monitoring.
    Type of Medium: Electronic Resource
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  • 4
    Electronic Resource
    Electronic Resource
    Springer
    European journal of pediatrics 139 (1982), S. 94-100 
    ISSN: 1432-1076
    Keywords: Home monitoring ; Sudden infant death syndrome ; Apnea
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract From 1977 to 1981, 500 infants had been referred to evaluate their risk for the sudden infant death syndrome (SIDS). These included 186 infants who had presented an event (prolonged apnea, hypotonia, pallor or cyanosis) initated while asleep, 133 siblings and 181 “controls”. All-night polygraphic recordings were performed in all infants, and if indicated by the history of the infants, complementary clinical investigations were done. These procedures led to the identification of 50 infants considered at risk for SIDS (10% of all referrals): 30 near-misses for SIDS, 10 siblings and 10 infants with a minor incident during sleep but with abnormal polygraphic recordings. These 50 infants (group I) were monitored at home during sleep with the help of a cardiac and respiratory monitor. Eight infants not considered at risk were monitored similarly at the request of their parents (group II). Forty of the 50 infants in group I presented with repetitive sleep apneas and bradycardias, and required stimulation by their parents to regain normal cardiorespiratory rhythm. Twelve had to be resuscitated at least once for a life-threatening event. None of the infants in group II showed alarms during sleep. Monitoring could be discontinued after a mean length of 7.2 months for the infants in group I, 4.1 months in group II. It is concluded that if identified in time through adequate investigations, some infants may be protected against SIDS through home monitoring. This approach requires expensive and well trained teams, ready, at any time, to cope with the problems that may arise in the homes of the monitored infants.
    Type of Medium: Electronic Resource
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  • 5
    Electronic Resource
    Electronic Resource
    Springer
    European journal of pediatrics 146 (1987), S. 458-460 
    ISSN: 1432-1076
    Keywords: Apnoea ; Infancy ; SIDS
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Among 857 infants admitted between 1977 and 1984 for a life-threatening apnoeic event a definite pathologic condition was found in 576 (66%). In 32 (6.5%) of the latter the polysomnogram was abnormal. The major clinical diagnostic categorics were, with decreasing frequency: digestive (n=263), vasovagal (n=95), neurological (n=78), respiratory obstructions (n=33), and respiratory infections (n=27); miscellaneous causes were found in 80 infants. No obvious cause could be traced in the remaining 281 infants. According to those caring for them the episode was severe in 77 (27%) of these infants, 57 (74%) of which had an abnormal polysomnogram, and minor in 204 (73%), 36 (18%) of which had an abnormal sleep study. Home monitoring was performed for 145 patients: all those with an abnormal polysomnogram and the 20 infants with an unexplained severe episode associated with a normal sleep study. We conclude from our experience that when an infant is referred for an acute event suggesting nearmiss sudden infant death syndrome (SIDS), a large array of diagnoses can be found and that an electric monitoring device will ultimately be advocated for only 17% of all infants presented, but for all those with an unexplained severe episode, irrespective of the results of the sleep study.
    Type of Medium: Electronic Resource
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  • 6
    Electronic Resource
    Electronic Resource
    Springer
    European journal of pediatrics 135 (1981), S. 293-296 
    ISSN: 1432-1076
    Keywords: Dehydration ; Hypernatremia ; Seizures
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract This prospective study comprises 40 infants with severe hypernatremic dehydration due to gastroenteritis. During the first 24 h, natremia was closely monitored and infusion rates were adjusted so as to keep the rate of fall in natremia below 0.5 mEq/l/h. This could be achieved by giving a 70 mEq/l Na solution at the rate of 120 ml/kg/24 h. Rehydration was uneventful in all cases, and no convulsions were observed.
    Type of Medium: Electronic Resource
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  • 7
    ISSN: 1432-1076
    Keywords: Sudden Infant Death ; Near-miss for SIDS ; Apnea ; Sleep
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract To determine whether significant historical differences distinguish the near-miss for Sudden Infant Death from the infants who died of SIDS, we analysed the histories and clinical data from two groups of infants seen in our University Hospital and from collaborative research group. The data were obtained with the use of a standardised questionnaire and consultation of all available medical data. Sixty-five infants were identifed as near-miss for SIDS after they had suffered a severe cardiorespiratory incident during sleep for which no cause could be found despite a complet medical examination. After an autopsy had failed to reveal a cause for the unexpected death 95 cases of SIDS were retained in the study. A series of 353 variables were collected from the parents, the gynaecologists, neonatologists and attending physicians. After statistical analysis, only 15 of the 353 items studied significantly differentiated between the two groups. A stepwise discriminant analysis performed on these items led to the identification of six independent variables: the time of the incident; the circumstances leading to the observation of the child; the child's sleep position; previous minor intestinal problems; the size of the family and the mother's coffee consumption. Most variables indicate that the near-miss infants were discovered and rescued earlier than the infants who died. No other historical information appeared significantly to differentiate between the two groups of infants. These data need confirmation from a prospective epidemiological survey.
    Type of Medium: Electronic Resource
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  • 8
    ISSN: 1432-1076
    Keywords: Sudden infant death ; Home monitoring
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract The prevalence of “over-the-counter” monitors, was surveyed in infants referred to five Belgian paediatric centres between September 1987 and March 1988 for evaluation of their risk for sudden infant death (SID). Questionnaires were collected from 1625 families. Of the infants, 8.9% were already being monitored at home. For 78.1% of the infants no medical advice had been solicited, and for 21.9%, a paediatrician or a general practitioner had advised home monitoring without previous evaluation. Forty of 824 infants referred with no history of SID, and no history of apparent life-threatening event (ALTE), were monitored (4.8%). Monitoring was started for 3.8% (5 out of 130) of the infants who had lost a cousin or an uncle to SID, and for 22.2% (69 of 310) of the younger siblings of a SID victim. Of the 341 infants who had presented with an ALTE, monitoring was started in 32 (9.4%). The infants were monitored with respiratory monitors only, and in 86% of the monitors, the alarm delay had been regulated unnecessarily low.
    Type of Medium: Electronic Resource
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  • 9
    Electronic Resource
    Electronic Resource
    Springer
    Hernia 4 (2000), S. 89-93 
    ISSN: 1248-9204
    Keywords: Groin hernia ; Inguinal hernia ; Femoral hernia ; Recurrent hernia
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary In 2390 groin hernias operated on by the same surgeon there were 2327 inguinal hernias (97.4%) and 63 femoral (2.6%); 261 (11.2%) were recurrent hernias. The aim of this study was to define the different features of recurrences in a series of 206 recurrences operated on by an inguinal approach. The median time of recurrence was 3 years (〈 1–58). It was 〈 1 year in 67 cases (40%) and 50% of all recurrences had occurred in 2.4 years. The time of recurrence after operation performed in childhood was 31 years (15–58). All recurrences were located in the area of the myo-pectineal and femoral orifices. There was only one site of recurrence in 125 cases (61%); the recurrence was direct in 73 cases (58%), indirect in 44 cases (35%) and femoral in 8 cases (7%). There were 2 sites of recurrence in 81 cases (39%), 76 mixed (94%) and 6 inguinal associated with a femoral hernia (6%). Altogether there were 288 sites of recurrence. There were 44 direct diverticular recurrences and 26 of these were located near the pubic tubercle. The rate of recurrence in current practice is much higher than that in specialized centers. The long delay of recurrence after simple resection of the sac in childhood constitutes an indirect argument for the Marcy procedure in adolescents and young men with type I or II hernias. The preeminence of direct recurrences and the existence of direct diverticular suprapubic recurrences are arguments for mesh procedures. The fact that all recurrences are located in the area of myo-pectineal and femoral orifices must be considered for the choice of a mesh procedure.
    Type of Medium: Electronic Resource
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  • 10
    Electronic Resource
    Electronic Resource
    Springer
    Hernia 1 (1997), S. 185-189 
    ISSN: 1248-9204
    Keywords: Inguinal hernia ; Tension-free hernioplasty ; Mesh plug ; Local anesthesia
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary The aim of this prospective study was to evaluate the postoperative pain and disability after treatment of inguinal hernia by the plug technique. Postoperative pain, main organic functions, mobility, return to normal activities and absence from work were prospectively assessed in 118 consecutive patients. Only 3 benign postoperative complications (2.5%) occurred. The mean postoperative pain as assessed by visual analogue scale was 20.3 ± 15.1 mm/100. The mean duration of analgesic consumption was 2.7 ± 1.6 days and the mean total number of capsules was 7.1 ± 4.7. The percentages of patients capable of eating lunch the day of operation, passing urine, walking and bending forward without difficulty 6 hours after operation were 97.5,97.4, 97.5 and 85.6 respectively. The mean postoperative hospital stay was 1.2 ± 0.6 days. The mean times of first outdoor walking, return to normal activities and return to work were 1.5 ± 1, 3.6 ± 2.2 and 15.2 ± 8.9 days respectively. These results show that the plug technique provides a low complication rate, a low level of pain, and allows early resumption of full activity.
    Type of Medium: Electronic Resource
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