Suivre les nouveau-nés à risque. Pourquoi ? Comment ? Pour une action médico-psychosociale dès l’hospitalisation néonatale

The usual follow-up of high-risk children concentrates on screening for sequelae of perinatal pathology, required by emergency pediatricians and neonatologists to assess their practices. The objective is to manage pathologies by intervening as early as possible. However, is this classical medical model, i.e., the diagnosis of something pathological and a schedule of consultations planned at specific dates, adapted to the needs of high-risk children and their parents? Beyond screening, the child development consultation at the Rozanoff Early Medico-Social Action Center, set up at the A. Trousseau Hospital in 1985, proposes a consultation in which a neuropediatrician, a physical therapist, a pediatric psychiatrist-psychoanalyst, and a social worker closely collaborate. The care begun during neonatal hospitalization concentrates on the needs of the child and parents, with a primary objective of lending support to child–parent interaction. The observation of a child born at 26 GW presenting gaze avoidance concurrent with symptoms of depression in the mother exemplifies the importance of this visit. Why are there still so few of this type of consultation taking into account the medical, psychological, and social risks in a single visit? Why is the attention given to neurologic problems, for which there is currently no cure, so disproportionate to the lack of awareness of the psychological and social risks for which effective prevention and treatment possibilities do exist?     

HIV/AIDS in the Southern USA: A disproportionate epidemic

This research synthesis examined HIV/AIDS surveillance and health care financing data and reviewed relevant research literature to describe HIV epidemiology, outcomes, funding, and contributing factors to the HIV epidemic in the Southern USA with particular focus on a group of Southern states with similar demographic and disease characteristics and comparable HIV epidemics (Alabama, Georgia, Florida, Los Angeles, Mississippi, North Carolina, South Carolina, Tennessee, and Texas). These states are hereafter referred to as “targeted Southern states.” Eight of the 10 states with the highest HIV diagnosis rates in 2011 were in the Southern USA; six were targeted states. Forty-nine percent of HIV diagnoses were in the South in 2011, which contains only 37% of the US population. The targeted states region had the highest HIV diagnosis rate than any other US region in 2011. The South was also found to have the highest HIV-related mortality and morbidity rates in the USA. The high levels of poverty, HIV-related stigma, and STDs found in the South, particularly in the targeted Southern states, likely contribute to greater HIV incidence and mortality. The disproportionate impact of HIV in the South, particularly among targeted states, demonstrates a critical need to improve HIV prevention and care and address factors that contribute to HIV disease in this region.     

Alcohol and rhythm disorders

Cardiovascular disease is the main cause of mortality in chronic alcoholics. There is a clear association between excessive alcohol consumption and the risk of sudden cardiac death. The pro-arrhythmogenic effect of ethanol could be responsible for some of these cases of arrhythmia and sudden death in subjects with an alcoholic cardiomyopathy and also in those with an apparently normal heart. In any case of supraventricular or ventricular arrhythmia in a chronic alcoholic or in an occasional heavy drinker, the potential role of alcohol consumption in the initiation of these disorders should be considered. In all cases, patient management consists of detoxification and abstaining from alcohol consumption, but the withdrawal period is particularly critical as regards the risk of ventricular arrhythmias.     

Cerebral magnetic resonance imaging in the neonatal period. Initial results

The place of neonatal cerebral MRI and its specific contribution compared with conventional imaging techniques were evaluated in 36 patients. The difficulties specific to the patient population studied met during this preliminary period are described, with their local solutions. A preliminary evaluation of the diagnostic and prognostic value of MRI according to the disease state and gestational age is presented. The specific contribution of MRI compared with transfontanellar ultrasonography and CT scan is discussed.     

Reconsidering a Paradigm: The Spread of Supraglottic Carcinoma to the Glottis

This study was performed to evaluate the spread of supraglottic carcinoma to the glottic level. Whole organ sections of total laryngectomy specimens from 37 patients with previously untreated supraglottic carcinomas were reviewed retrospectively. Of the 37 specimens, 20 (54%) were noted to have extension of cancer to the glottic level. A significant relationship was noted between glottic extension and abnormal cord motion (P= .0002). A statistically significant trend was noted for the relationship between inferior extension along the supraglottic mucosa and glottic level extension (P< .0001). Contrary to the prevailing model of the spread of supraglottic carcinoma, in which there is a distinct barrier to spread at the ventricle, this analysis of selected supraglottic carcinomas revealed a continuum of spread from the supraglottis to the glottis.     

Biomarkers of oxidative stress: an analytical approach

Oxidative stress is implicated in many pathological processes and results from a disruption of the prooxidant/antioxidant balance. This review will focus on noninvasive biomarkers of radical-induced damage in biological fluids and particularly in blood. Special attention will be addressed to new analytical methods for the measurement of radical-mediated alterations in the integrity of lipids, proteins and DNA.     

Nanocapsule technology: a review

Nanocapsules are submicroscopic colloidal drug carrier systems composed of an oily or an aqueous core surrounded by a thin polymer membrane. Two technologies can be used to obtain such nanocapsules: the interfacial polymerization of a monomer or the interfacial nanodeposition of a preformed polymer. This article is an extended review of these nanocapsule technologies and their applications for the treatment of various diseases (including cancer and infections).