Dominique Haumont

Centre Hospitalier Universitaire Saint-Pierre | CHU Saint-Pierre · Service d'Néonatologie

Residual insulin secretion in juvenile diabetes. Relationships with duration of diabetes, metabolic control and retinopathy Summary. This study concerned 74 diabetic children and adolescents, ages ranging from 3 to 21 years. Duration of the disease ranged from 1 month to 15 years. Blood samples were taken during a 12 month period of observation. 2...

Au cours d'une colonie de vacances de 4 semaines, nous nous sommes proposés de déterminer la.fréquence des malaises hypoglycémiques chez 24 adolescents diabétiques, âgés de I I ans 1/2 à l5 ans, qui atteignent un degré de contrôle optimal tout en pratiquant de nombreux sports et de mesurer, par le Dextrostix @ lu à l'œil [1] les glycémies auxquelle...

It is well known that during an intravenous glucose tolerance test (IVTT), muscular exercise enhances the coefficient of glucose assimilation (K) both in normal and in diabetic men (Franckson and Conard, 1958). K values are linked to the intensity of the exercise and the level of circulating insulin (Loeb et al., 1963; Dorchy et al., 1976a; Dorchy...

Les buts de notre travail sont : 1. Mesurer Ie peptide C de nouveau-nés normaux, dans le sang cordonnal et au 5" jour de vie. 2. Corréler glycémie, insulinémie et C-peptidémie. 3. Déterminer une éventuelle relation entre poids de naissance et peptide C. 4. Comparer les enfants nourris au sein ou artificiellement.

Background: The pregnancies of Rh D negative mothers are considered high risk as they can complicate maternal fetal alloim-munization and lead to hemolytic disease of the fetus and newborn. This pathology is grafted with a high morbidity, in its severe form we find anemia, jaundice and sometimes an anasarca. This is the most well-documented, best-k...

The inefficiency of recording data repeatedly limits the number of studies conducted. Here we illustrate the wider use of data captured as part of the European eNewborn benchmarking programme. We extracted data on 39,529 live-births from 22 weeks 0 days to 31 weeks 6 days gestational age (GA) or ≤1500 g birth weight. We explored relationships betwe...

Healthcare of newborn babies is a major issue for families and societies, as care in infancy affects health for life. The strongest tools for incremental improvement are to involve parents so that they are partners in care, promote research so that healthcare is informed by evidence, and evaluate health outcomes. Crucial to each of these aims is hi...

Among preterm infants, 1-2% are born before 32 weeks of gestation or have a birth weight below 1,500 g. They contribute disproportionately to the burden of mortality and morbidity related to preterm birth, whether in the neonatal period or later in life. They are the target population studied in neonatal networks. Improving neonatal care and later...

Preterm infants are exposed in the neonatal intensive care unit (NICU) to an environment of important and often chaotic neurosensory stimulation. There is substantial scientific evidence to support the negative effects of pain and stress, prolonged periods of intense light and noise, sleep disturbances, and difficulties of parenting. It is against...

Résumé Les naissances « à la limite de la viabilité » sont souvent considérées comme des situations extrêmes dans le champ médical et comme des situations emblématiques dans le débat sur l’excès thérapeutique, l’« obstination déraisonnable » mentionnée dans la loi française sur la fin de vie. Le contexte de ces situations est certainement spécifiqu...

Perinatal mortality in very low birth weight infants has dramatically decreased during the last decades. However, 15-25% of these infants will show neurodevelopmental impairment later on. The aim of implementing early developmental care (EDC), emerged as a new field in neonatology, is to create an intervention program designed to provide support fo...

Dans les années soixante, les unités de néonatologie étaient des nurseries où l’on réchauffait (couvait) des enfants de petit poids de naissance. Un tampon de ouate était placé sur la cage thoracique du bébé pour surveiller son rythme respiratoire ; en cas d’apnée l’infirmière lui mettait un peu d’ammoniaque sous le nez pour stimuler sa respiration...

Overtreatment in extreme prematurity, is an ongoing debate and often translated as 'what are the limits of viability?' The concerns stemming from this issue are the risks of long-term morbidity and mortality. Although many medical specialties are concerned with overtreatment, in neonatology and especially in extreme prematurity, the paradox of the...

Recognition of the potential vulnerability of children and newborns and protection of their health is essential, especially regarding to genotoxic compounds. Benzo(a)pyrene B(a)P a commonly found carcinogen, and its metabolite BPDE, are known to cross the placenta. To investigate how well newborns are able to cope with BPDE-induced DNA damage, a re...

Objective: To compare, in a large representative sample of European neonatal intensive care units, the policies and practices regarding parental involvement and holding babies in the kangaroo care position as well as differences in the tasks mothers and fathers are allowed to carry out. Design: Prospective multicenter survey. Setting: Neonatal...

Newborns have to cope with hypoxia during delivery and a sudden increase in oxygen at birth. Oxygen will partly be released as reactive oxygen species having the potential to cause damage to DNA and proteins. In utero, increase of most (non)-enzymatic antioxidants occurs during last weeks of gestation, making preterm neonates probably more sensitiv...

The spectacular development of neonatal intensive care since the 1960s has allowed a drop in neonatal mortality of very-low-birth-weight (VLBW) infants from 50% to less than 15% in the last decade [1]. However 15 to 25% of the VLBW infants will present neurodevelopment impairment in the following fields: motor function, vision, auditory function, c...

To describe the use of heel blood sampling and non-pharmacological analgesia in a large representative sample of neonatal intensive care units (NICUs) in eight European countries, and compare their self-reported practices with evidence-based recommendations. Information on use of heel blood sampling and associated procedures (oral sweet solutions,...

The birth of neonates at the limits of viability, or periviability, poses numerous challenges to health care providers and to systems of care, and the care of these pregnancies and neonates is fraught with ethical controversies. This statement summarizes the ethical principles involved in the care of periviable pregnancies and neonates, and provide...

The objective of the present study was to develop a cellular phenotype assay for nucleotide excision repair (NER), using benzo[a]pyrene diol epoxide (BPDE) as model mutagen. Since in vitro exposure to BPDE may lead to DNA strand breaks resulting from both direct interaction with DNA and incisions introduced by the repair enzymes, we aimed to discri...

To describe policies towards family visiting in Neonatal Intensive Care Units (NICU) and compare findings with those of a survey carried out 10 years earlier. A questionnaire on early developmental care practices was mailed to 362 units in eight European countries (Sweden, Denmark, the UK, the Netherlands, Belgium, France, Spain and Italy). Of them...

Aim: A new technique allowing placement of umbilical silicone venous catheters (USVC) is described and compared with percutaneous silicone venous catheters (PSVC). Methods: Data were retrospectively recorded for 198 infants with USVC and 141 infants with PSVC. Results: Overall rate of complications was low and comparable in both groups: thrombosis...

This Preface introduces the 23rd Annual International Workshop on Surfactant Replacement and the 11th Nils Svenningsen Memorial Lecture given by Dr Barbara Schmidt on effectiveness of evidence-based treatments for bronchopulmonary dysplasia. The meeting was held in Brugge, Belgium from 5th to 7th June 2008. Other talks included those on ventilation...

A central question in risk assessment is whether newborns' susceptibility to mutagens is different from that of adults. Therefore we investigated whether genotype and/or the DNA strand break repair phenotype in combination with the MN assay would allow estimation of the relative sensitivity of a newborn as compared to his mother for oxidative DNA d...

Unlabelled: The aim of the aborted trial was to determine whether the short early dexamethasone (DX) given after the birth improves the early outcome. We also reviewed the evidence (meta-analysis) to determine whether the duration of early DX treatment influences the early outcome, particularly in terms of bronchopulmonary dysplasia (BPD). The par...

The active treatment of fetuses or neonates at the limits of viability is an ongoing debate for perinatal physicians. Although initiating intensive care at 26 weeks is generally accepted, the gray zone of gestational ages at which aggressive perinatal care should be offered is less clear and ranges from 22 to 25 weeks. The gray zone has remained ra...

L’étude EPIBEL s’est penchée sur toutes les naissances “inborn” d’âge gestationnel de 22 à 26 semaines d’enfants nés en Belgique durant les années 1999 et 2000. Nous vous proposons un aperçu des résultats les plus importants.

De gegevens van 525 extreem premature kinderen (< 2§ weken zwangerschap) werden verzameld in 1999 en 2000 in de 19 Belgische centra voor neonatologie om de morbiditeit en de mortaliteit te bestuderen bij het verlaten van het ziekenhuis.

To assess the extent of nosocomial transmission of tuberculosis among infants, family members, and healthcare workers (HCWs) who were exposed to a 29-week-old premature infant with congenital tuberculosis, diagnosed at 102 days of age. A prospective exposure investigation using tuberculin skin test (IST conversion was conducted. Contacts underwent...

To determine mortality and morbidity at discharge from the hospital of a large population-based cohort of infants who were born at <or=26 weeks' gestation. Perinatal data were collected on extremely preterm infants who were alive at the onset of labor and born between January 1, 1999, and December 31, 2000, in all 19 Belgian perinatal centers. A to...

In order to evaluate a new indicator of the foeto-maternal bacterial infection, we have measured the level of procalcitonine (PCT) by an ultrasensitive immunoluminometric method in a group of 202 non-infected women, aged from 20 to 40. Twenty-four patients with a CRP > 1 have been excluded; the others were divided into two groups: Group I: pregnant...

We present an algorithm to generate a cell-and-portal decomposition of general indoor scenes. The method is an adaptation of the 3D watershed transform, computed on a distance-to-geometry sampled field. The watershed is processed using a flooding analogy in the distance field space. Flooding originates from local minima, each minimum producing a re...

Unlabelled: Belgium used to be affected by mild iodine deficiency. Improvement in iodine nutrition has been recently documented in schoolchildren in Belgium in spite of the absence of any systematic programme of iodine supplementation. The question arises as to whether this 'silent iodine prophylaxis' affected also the neonates. A total of 185 ran...

Background: Inhaled nitric oxide improves oxygenation in severely hypoxaemic term neonates, which lessens the need for extracorporeal-membrane oxygenation. Improvement in other relevant outcomes remains unknown, and safety of inhaled nitric oxide is uncertain in preterm neonates. We did a randomised controlled trial to assess use of inhaled nitric...

We report on newborn monozygotic twins with a Noonan-like phenotype, and multiple congenital anomalies due to a monocentric recombinant chromosome 18. The mother carried a paracentric inversion of the long arm of chromosome 18, inv(18)(q21.1q22.3). Cytogenetic, fluorescent in situ hybridization, comparative genomic hybridization and DNA marker anal...

We report on newborn monozygotic twins with a Noonan-like phenotype, and multiple congenital anomalies due to a monocentric recombinant chromosome 18. The mother carried a paracentric inversion of the long arm of chromosome 18, inv(18)(q21.1q22.3). Cytogenetic, fluorescent in situ hybridization, comparative genomic hybridization and DNA marker anal...

We realised this study in order to determine the frequency of abnormal haemoglobins and to appreciate the need for a neonatal screening for haemoglobinopathies in Brussels. Over a two year-period, 9575 cord blood samples were systematically screened. The study disclosed following results : 40% of newborns were from regions at risk for haemoglobinop...

Unlabelled: We describe a neonate born of drug dependent parents. This observation documents the variability of expression in the neonatal abstinence syndrome and the interaction with an additional disease. Conclusion: The neonatal abstinence syndrome was masked by congenital hypothyroidism until thyroxine treatment had normalised cellular metab...

The number of pregnant women uncovered by medical insurance is increasing in the maternity of Saint-Pierre Hospital (44% increase over a 3 year period). During the academic year 92-93, this situation was present in 9.8% of the mothers; 98% of these patients were foreigners. The majority of pregnancies were not or poorly followed. Admissions occurre...

In infants who have experienced prenatal or perinatal injury, it is often difficult, on the basis of clinical examination and conventional investigations (electroencephalogram, cranial ultrasound scan), to diagnose those with brain damage and to predict the type and the severity of subsequent neurological handicaps. We investigated the predictive v...

We studied the effects of phospholipid liposomes present in intravenously administered lipid emulsions on plasma lipid levels in preterm infants given 10% and 20% lipid emulsions. Twenty premature infants (birth weight 1454 +/- 54 gm) on a parenteral nutrition regimen received up to 4 gm triglycerides per kilogram per day in a 20% lipid emulsion fo...

Neonatal respiratory distress syndrome (RDS) is characterized by an immature surfactant phospholipid pattern. We aimed to study the evolution of surfactant phospholipids over a 6-day period, before and after surfactant replacement therapy with Curosurf, and to investigate possible interactions with exogenous phospholipids administered during total...

A case of type IIa glycogenosis presenting in early neonatal period is described. An unusual bradycardia and slow recovery from acute fetal distress were the leading signs. It is suggested to include metabolic myocardiopathies in the differential diagnosis of bradycardia in the newborn.

The application of regional cerebral blood flow (rCBF) study by means of lipophilic radiotracers and single photon emission computed (SPECT) devices in very young infants is hampered by the considerable changes of rCBF pattern as a result of the cerebral maturation process. In an attempt to determine the normal evolution of [123I]IMP SPECT pattern...

Because 10% and 20% intravenously administered lipid emulsions (intralipid preparations) differ in their phospholipid/triglyceride ratio (0.12 and 0.06, respectively), 28 low birth weight infants requiring parenteral nutrition for at least 1 week were selected at random to receive either emulsion to determine the effects on plasma lipids and lipopr...

This study was designed to rate the clinical value of [123I]iodoamphetamine (IMP) or [99mTc] hexamethyl propylene amine oxyme (HM-PAO) brain single photon emission computed tomography (SPECT) in neonates, especially in those likely to develop cerebral palsy. The results showed that SPECT abnormalities were congruent in most cases with structural le...

Fat emulsions are essentially composed of triglycerides and phospholipids. Their elimination from the plasma--which is generally rapid--is influenced by the amount and the composition of both these components. During their short stay in the vascular compartment, exogenous particles undergo major compositional changes. They acquire various apolipopr...

Fat emulsions are essentially composed of triglycerides and phos-pholipids. Their elimination from the plasma – which is generally rapid is influenced by the amount and the composition of both these components. During their short stay in the vascular compartment, exogenous particles undergo major compositional changes. They acquire various apolipop...

Heat inactivation of serum may interfere with LAV/HTLV-III antibodies with some commercial reagents.

We conducted several studies to determine the influence of some clinical and biological findings on the occurrence of diabetic retinopathy in children and adolescents, as detected by retinal fluorescein angiography. In our experience this method doubles the frequency of diagnosis of incipient retinopathy, showing fluorescein leakage that may occur...

Two female siblings with the oral-facial-digital type II syndrome, or Mohr syndrome, presented an associated brain malformation: the Dandy-Walker syndrome. Up till now, patients with the Mohr syndrome have been considered to be free of mental deficits and/or brain defects. After reviewing the literature and considering the current criteria for OFD...

The measurement of HbA1 gives an "objective" estimate of the degree of metabolic control of diabetes during the erythrocyte lifespan. 333 assays in 85 young diabetics aged three to twenty-three years showed a mean HbA1 of 10.9 +/- 2.6% (controls: 7.4 +/- 1.4%). HbA1 levels parallel the clinical evaluation of the degree of control. HbA1 concentratio...

Coexistence of polydactyly and ectrodactyly in a sibship of four children is reported. One boy and one male twin presented polydactyly, the male monozygotic cotwin had a lobster claw deformity of the right foot and the last child, a girl, had absence of the phalanges of the right hand. Embryological explanation of these apparently totally opposed m...

The study included 75 young diabetics, having a mean age of 13.7 (+/- 3.4) years, and whose diabetes duration was 5.0 (+/- 3.1) years. All of the subjects were insulin dependent, and none had developed insulin resistance. Injections of either conventional or purified insulin were used. The subjects' diets were "spontaneously balanced", and their ph...

This study concerned 74 diabetic children and adolescents, ages ranging from 3 to 21 years. Duration of the disease ranged from 1 month to 15 years. Blood samples were taken during a 12 month period of observation. 292 immunoreactive C-peptide (CPR) evaluations showed a residual endogeneous secretion of insulin in 57% of cases. CPR and duration of...

The reproductive history of a woman diagnosed as having a thalidomide syndrome clearly shows that she is affected by the Holt Oram syndrome (autosomal dominant inheritance). The problem of considering a phenocopy in genetic counselling is discussed. A study of the family illustrates the wide range of clinical manifestations of the Holt Oram syndrom...

Histologic study of the ocular globe of a neonate with Marfan's syndrome revealed iridocorneal-angle anomalies from total absence or slowing of iris, trabeculum, and ciliary-body development between the 5th and 6th intrauterine month, associated with ocular globe ectasia probably resulting from a collagen anomaly.

The studv included 75 young diabetics. having a mean age of 13.7 (+3.4) years, and whose diabetes duration was 5.0 (+3.1) years. All of the subjects were insulin dependent, and none had developed insulin resistance. Injections of either conventional or purified insulin were used. The subjects' diets were "spontaneously balanced". and their physical...

In eight adolescent diabetic patients, receiving their usual daily insulin dose, the influence of muscular effort, equal to 50% of the V̇ 2 max, on the glucose disappearance rate, was evaluated. During an intravenous glucose tolerance test the coefficient of glucose disappearance was, during physical activity, 2.56 ± 0.51 and, 30 minutes after the...

The effect of diabetic control upon EEG has seldom been studied. In the present investigation, a significant positive correlation between EEG abnormalities and degree of diabetic control was found, but no definite increase was noted in relation to the duration of diabetes. Eighty per cent of our patients having more than 5 severe hypoglycemic attac...

Serum C-peptide levels reflect insulin secretion and provide a measure of pancreatic β-cell function applicable to subjects treated with insulin, despite the presence of insulin antibodies. In order to obtain reference values in children, fasting C-peptide immunoreactivity was determined in 102 normal children by a commercially available radioimmun...