ABSTRACT. The effect of two doses of Phosphorus (P) supplementation to pooled breast milk (BM): 0.48 and 0.800 mmol/kg/24 h given during the second month of life was evaluated in 22 very low birthweight infants. The concentration of calcium and phosphorus in serum and urine, the serum concentration of immunoreactive parathyroid hormon (iPTH) and the plasma 1,25‐dihydroxy‐vitamin D concentration (1,25‐OH‐D) were compared to the values in 19 control infants. The mean ± SD concentrations in control infants and adults are 63 ±18 ulEq/ml for serum iPTH and 85±pmol/l for plasma 1,25‐OH‐D. With 0.48 P supplementation, urinary Ca (UCa) excretion (median and range) 0.238 mmol/kg/24 h (0.105‐0.520) was lower than in the control group 0.288 (0.205‐0.679) (p<0.05); the reduction of UCa was larger with 0.8 P supplementation: 0.047 (0.023‐0.163) (p<0.01). P supplementation induced no change in serum Ca concentration but a slight and significant increase in serum iPTH was observed only with the 0.8 P supplementation: 55 μl Eq/ml (<25‐80) (p<0.05). With 0.8 P supplementation there was no significant change of plasma 1,25‐OH‐D concentration: 173 μmol/l (106‐271) vs. 255 (132‐293) in the control group. These data show that with 0.8 P supplementation, the hypercalciuria in BM‐fed infant disappears without secondary hyperparathyroidism, but without any change in plasma 1,25‐OH‐D concentration.
Le but de l'etude est de determiner la place de l'appareil de chromatographie liquide Remedi (Biorad) par rapport aux methodes traditionnelles colorimetriques et immunologiques pour le diagnostic des intoxications medicamenteuses volontaires. Le travail porte sur l'analyse de 469 prelevements sanguins et 95 liquides de lavage gastrique recus au laboratoire en 1995. Le bilan toxicologique habituel comprend les recherches systematiques des salicyles, des benzodiazepines, des antidepresseurs tricycliques et des barbituriques, les dosages d'alcool, de meprobamate, de paracetamol n'etant realises qu'a la demande du medecin. L'utilisation du systeme Remedi permet d'etablir un screening toxicologique correspondant a la base de donnees de l'appareil (500 molecules neutres ou basiques), mais ne peut se substituer aux methodes habituelles puisque seules trois classes pharmacologiques peuvent a priori etre mises en evidence a la fois par les methodes immunologiques et par le systeme Remedi (benzodiazepines, antidepresseurs tricycliques et barbituriques). Si le systeme Remedi apparait beaucoup moins sensible que la methode immunologique pour la recherche des benzodiazepines et qu'il ne permet pas toujours la mise en evidence des barbituriques, il identifie souvent un psychotrope n'appartenant pas aux trois categories precedentes ou des molecules non psychotropes comme les betabloquants ou les anti-arythmiques susceptibles de modifier la symptomatologie liee aux psychotropes habituels. Dans tous les cas, il permet une estimation semi-quantitative de la concentration sanguine du toxique identifie. Il se revele etre un excellent complement, utilisable en garde et en urgence, en particulier lorsque les signes cliniques ne correspondent pas aux toxiques suspectes apres les interrogatoires du patient et de son entourage.
SFBC work group on uric acid propose a method for evaluation in blood serum which is modeled on the one defined by American Association for Clinical Chemistry. Serum is deproteinized by trichoracetic acid and the supernatant, buffered to pH 8.5, is submitted to uricase action. The disappearing of the strong band of uric acid in UV is measured by derivative spectrophotometry; this procedure vanished the effect of trouble which remains in the supernatant. This spectrophotometric technic permit to reach, in multiple sites, a variation coefficient near of 1 p. cent.
A retrospective study of the occurrence of hyponatremia (i.e. less than 135 mmol/l) was carried out in 17 control preterm neonates and 25 infants treated with theophylline. These infants had a birthweight lower than 1,301 g and a gestational age less than 36 weeks. Despite a similar sodium and water intake in both groups, hyponatremia was detected at the age of 7-8 days in 37% infants treated with theophylline and none of the control infants. Their mean weight loss was 11% with theophylline and 5% in the controls. These data suggest that theophylline may play a role in the occurrence of hyponatremia of very low birthweight infants.
The aim of this study was to evaluate and to validate an enzyme immunoassay in homogeneous phase for netilmicin and amikacin, adapted on the Dimension RXL HM (Dade Behring) machine. The results were compared with those obtained with automated polarization of fluorescence immunoassay using TDx FLx (Abbott). The protocol of the study and the analytical criteria were inspired by the protocol Valtec version 2002 recommended by the French Society of Clinical Biology (SFBC). The validation of this technique as adapted to the Dimension RXL HM has allowed its use for routine dosage adjustment of amikacin and netilmicin. The practicability is however the weak point of the adaptation of these techniques, even limiting as for their implementation.
The authors report the results of the immunonephelometric determination of 9 proteins in the serum of 74 newborns: CRP, orosomucoid, haptoglobin, alpha-1-antitrypsin, C3, C4, transferrin, prealbumin and apo B have been studied. The influence of gestational and postnatal ages are shown. Results are compared with those of the literature. The respective role of the transfer of plasma proteins from mother to foetus and of foetal synthesis in the concentration of a protein in the serum of a neonate is discussed.
