P. Gérard

Meningococcal purpura: report of 19 patients treated with heparin.

Nineteen patients with meningococcal purpura were studied. Arterial hypotension, absence of meningeal signs, coma, normal or low white blood cell count, and low cerebrospinal fluid cell count were signs of severe illness. Some degree of consumptive coagulopathy, a low rate of fibrinolysis, and activation of platelets with release of their clotting and antiplasmin factors were documented. Heparin was administered to all patients in a dosage adapted to the platelet count. The mortality rate in this series was 2 of 19; all other patients had a complete recovery.

Mortality in 504 infants weighing less than 1501 g at birth and treated in four neonatal intensive care units of South-Belgium between 1976 and 1980

Mortality was studied in 504 infants weighing less than 1501 g at birth and treated in four neonatal intensive care units of South-Belgium between 1976 and 1980. Two hundred and twenty-one babies died during their stay at the hospital, a mortality rate of 438 per 1000 live births. The neonatal mortality rate (mortality during the first 28 days of life) was 373 per 1000 live-births. Thirty-three infants died after the neonatal period, which is 15% of the total number of deaths. Twothirds of these post-neonatal deaths were related to complications of diseases associated with pre-term delivery. Mortality rates were higher in infants of less than 1001 g than in those of 1001–1250 g or 1251–1500 birth weight. In each birth weight category, patients born in their own obstetrical departments and referred infants had similar mortality rates. Longitudinal analysis showed improving mortality rates between 1976 and 1977 in the total population of VLBW infants, between 1977 and 1978 in infants of <1001 g and in 1980 compared to 1976 in the 1251–1500 g group. There were higher incidences of need for ventilatory assistance, patent ductus arteriosus, necrotising enterocolitis and septicaemia in referred patients of <1001 g than in patients born in their own obstetrical departments with comparable birth weight. Artification ventilation was more often required in referred infants of 1251–1500 g. This study confirms the importance of considering at least the complete hospital stay when analysing mortality in VLBW infants. Infants of <1001 g had high mortality, particularly after the neonatal period. This phenomenon was asscciated with complications of morbid conditions related to extreme prematurity.

Carbohydrate Metabolism in the Newborn Rat

The metabolism of newborns is often studied in experimental animals, including the pig, guinea pig, sheep, and cat. Newborn rats, which have the advantage of large litters and can be handled easily, are not suitable for all methods because of their limited size. Nevertheless, it seemed valuable to determine the metabolic parameters of the newborn rat as a basis for research.

Role of carbohydrates in energy balance of prematurely and term born rats.

Speculation: This study shows that during the early neonatal period the fuel consumption and the energy production is relatively low. This could be related to a slow operating Krebs cycle. This, in turn, could be a protective mechanism of the organs that allows them to get through the hypoxic phase of birth without damage and explains the greater resistance of the newborn to hypoxia.

Incidence of low Apgar score at birth in high risk pregnancies

SummaryOver a 3-year period (1976-1978) 5274 babies were born in our unit, with a perinatal mortality of 13·5/1000 and a neonatal mortality rate in the first 7 days of life of 5·7/1000 live births. Within the total group, 1210 births (22·9 per cent) were to mothers who had risk factors identified. Within this high risk group, the early neonatal mortality was 16·5/1000 live births, compared with 2·6/1000 for the remaining ‘low risk’ population.In the high risk population, birth asphyxia was common. Three hundred and thirty-seven (29 per cent) had a one minute Apgar score of less than 7, and 100 (8·3 per cent) were severely asphyxiated with an Apgar score of less than 3 at one minute. The severely asphyxiated group had a predictably poor prognosis with an early neonatal mortality of 122/1000, rising to 180/1000 if the 5 minute Apgar score was below 8. Males were more commonly asphyxiated than females. Among the factors analysed (maternal age, parity, social class and ethnic origin), poor social class of the...