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A Bourrillon

Publications and source records attributed to A Bourrillon.

At least 19 recordsLinked to original sources
PubMed2006

[Chronic otitis and hearing loss revealing a disseminated tuberculosis in a child].

UNLABELLED: Ear localization is sometimes the first symptom of tuberculosis. CASE REPORT: We report a case of a teen with a chronic otitis revealing a disseminated tuberculosis. The investigations showed ear, bones and pulmonary localisations. The outcome with treatment showed a persistent hearing loss. CONCLUSION: Middle ear tuberculosis should be suspected in patients with chronic otitis and risk factors of tuberculosis. A disseminated tuberculosis should be investigated and an early treatment is necessary to prevent hearing loss.

Adolescent↗
PubMed2005

[Recurrent respiratory tract infections: how should we investigate and treat?].

Recurrent respiratory tract infections are a common reason for visits to primary care practitioners or hospital physicians. They are placed at the junction of several medical specialities: paediatrics, ENT, pneumology, allergology, immunology, infectiology. The great diversity of the laboratory tests requested and on the other hand the proposed treatments, are the consequences of the diversity of the patients encountered and the paucity of the evidence based-medicine studies in this setting. The dilemma is how to identify the child for which recurrent respiratory tract infections are the witness of underlying condition, without performing repeated medical examinations, laboratory tests and treatments for normal children for which immunologic development occurs normally. The essential tools are the history analysis, physical examination and few laboratory tests. The other questions are how to include, for these patients, influenza and pneumococcal vaccines in the immunization program and how to assess the benefit/risk ratio and the cost of surgical treatments. This paper presents the thought of an expert group trying to define the situations where biological tests or treatments are useful.

Child↗
PubMed2005

[Clinical aspects and outcome of meningococcal disease due to Neisseria meningitidis of serogroup W135 in 5 children].

Meningococcal disease due to Neisseria meningitidis of serogroup W135 (N. meningitidis W135) is increasing in France. Clinical and outcome data concerning these infections in children are scarce. We report five cases of children hospitalized between June 2000 and December 2002 for N. meningitidis W135 infection. Extra-meningeal septic and/or non-septic complications were frequent and a prolonged post meningococcal inflammatory syndrome was reported. In N. meningitidis W135 infections a careful clinical evaluation of potential extra-meningeal complications and a long term follow up of children are needed.

Anti-Bacterial Agents↗
PubMed2004

Self-assessment of immediate post-vaccination pain after two different MMR vaccines administered as a second dose in 4- to 6-year-old children.

The aim of this study was to compare self-reported immediate post-vaccination pain and safety of Priorix versus RORVax in 4- to 6-year-old children receiving their second dose of MMR vaccine, using the Faces Pain Scale-Revised (FPS-R), a validated self-report pain scale recommended by the French National Accreditation Agency and Health Evaluation. A total of 620 children from 28 French pediatricians completed all study procedures. Immediate post-vaccination pain was reported by 17.8% of the subjects in Priorix group (N=309) and by 44.7% of the subjects in RORVax group (N=311) [OR=3.7; P<0.001]. Parents' pain scores correlated significantly with children's scores. The reduction of immediate pain incidence in Priorix group persisted over the 4 post-vaccination days. This study, using a validated self-assessment pain scale, confirmed previous data showing a significantly lower incidence of immediate post-vaccination pain with Priorix as compared to RORVax.

Child↗
PubMed2004

[Outcome evaluation of education in asthmatic children: the Robert-Debré hospital's experience].

INTRODUCTION: Asthma, the most frequent chronic disease in childhood, is often treated by a continuous preventive treatment associated to the treatment of attacks. This therapeutic scheme fits well with educative skills. The Robert Debré's asthma school has been created in December 1999. Two nurses specialized in child asthma education are working in the school, helped by the pediatric pulmonologists. Children 6-year-old or more, that are treated in the hospital for asthma may be sent to the asthma school for education. They receive individual or collective education for cognitive, psycho-affective and sensory-motor targets related to asthma. AIM OF THE STUDY: To evaluate the outcome of educative action in childhood asthma and to study hospitalizations costs. METHODS SUBJECTS: children who received education for the first time in the year 2000 or 2001 and in whom exhaustive computerized data were available were eligible for the study. METHODS: retrospective and comparative study one-year-before/one-year-after the first educational intervention, assessed by comparison of the numbers of scheduled medical consultations and hospitalizations (and their cost). RESULTS: Sixty-six children were studied. We registered a significant increase of scheduled medical consultations (177 vs. 223; P < 0.03), and a very significant decrease of hospitalizations for asthma attacks (32 vs. 11; P < 0.001) without influence of the number of educational interventions and with a 52% decrease in costs (84,788 vs. 40,073 euros; P < 0.03). CONCLUSION: Asthmatic children education is a useful tool to improve medical follow-up and to decrease hospitalizations number. In a two-year survey, the decrease of cost in a group of 66 children is 44,715 euros.

Asthma↗
PubMed2004

[Middle ear tuberculosis extended to the skull base in a teenager: a case report].

Tuberculosis of the middle ear and mastoid is a rare disease in our countries. Nevertheless, it still occurs and the diagnosis must be considered in the differential diagnosis, especially in particular populations, of acute or chronic ear drainage. Diagnosis is not always easy, as in this case report, where the disease is disseminated, involving the skull and the lung. The discussion highlights the difficulty of diagnosis, and the different actual aspects of treatment.

Adolescent↗
PubMed2002

[Childhood fatigue].

Explore the source record for details and available documents.

Activities of Daily Living↗
PubMed2001

[Bacterial meningitis and purpura fulminans in the child].

Antimicrobial therapy must start promptly. Antimicrobial regimen is adapted to the data of epidemiological trends. Bacterial meningitis of children are a matter of therapeutical urgency. Diagnosis must be easily considered according to the clinical analysis. Fulminant meningococcal sepsis is the most alarming clinical presentation of the meningococcal diseases.

Anti-Bacterial Agents↗
PubMed2001

[Treatment of acute group A beta-hemolytic streptococcal tonsillitis in children with a 5-day course of josamycin].

MATERIAL AND METHODS: In this randomized open study, 325 children aged two to 15 years with acute tonsillitis and a positive test of GA beta H streptococcal antigen were treated with josamycin 50 mg.kg-1.day-1 b.i.d for 5 days, or penicillin 50,000 to 100,000 IU/day t.i.d for 10 days. Clinical assessments and throat cultures for GA beta HS isolation were performed at the inclusion visit (V1), at the end of treatment visit (V2: day 12 for all patients) and at the follow-up visit (V3: day 30). In case of positive GA beta HS culture, the bacterial DNA by RFLP was performed to differentiate between the persistence (presence of original strain at V2), relapse (eradication at V2 and acquisition of same strain at V3) and reinfection (eradication at V2 and acquisition of different strain at V3). RESULTS: Two hundred and twenty-three patients were included in the bacteriological and clinical criteria per protocol analysis. At V2, eradication rates were comparable: 82% in josamycin and 80% in penicillin patients; clinical cure rates were 90% and 89%. At V3, relapse of GAS assessed only on clinically and bacteriologically cured patients at V2 occurred in 12% of josamycin patients and 12.8% of penicillin patients. Tolerance was good; 14% and 10% of josamycin and penicillin patients respectively experienced an adverse event. CONCLUSION: In this non-inferiority study, the efficacy of a 5-day course of josamycin is comparable to reference treatment in GA beta HS tonsillitis in children.

Acute Disease↗
PubMed2001

[Severe cutaneous Streptococcus pyogenes infections in the child: results of a multicenter survey].

UNLABELLED: To assess pediatric cases of severe cutaneous infections due to Streptococcus pyogenes. Since the beginning of 1980, the incidence of cellulitis and necrotizing fasciitis due to S. pyogenes has increased in adults. Serotyping of obtained isolates are in most cases M1, M3 or M5 protein. PATIENTS AND METHOD: A retrospective (1990-2000) survey was carried out in pediatric hospital centers. RESULTS: Three cases of necrotizing fasciitis and 15 of cellulitis were observed. In 30% of the cases, vancella lesions were associated; in the other cases, minor wounds were the site of the infection. Bacteriologic diagnosis was made by local samples in 14 cases; blood cultures were positive in four cases. In 11 cases, initial intravenous treatment consisted of third generation cephalosporin, in six cases of penicillin M or G and in one case of fusidic acid. In the second time, penicillin M was perfused in the majority of the cases. Mean duration of intravenous antibiotics perfusion was 15 days. There were no sequelae or death in this survey. CONCLUSIONS: Despite this study had limited epidemiological characteristics, it confirms that these two infections are rare. The frequency is probably underestimated, due to the difficulty in performing a diagnosis. The major site of infection was the varicella lesion. These two infections are so similar that it is frequent to mistake one infection for the other. Nonsteroidal anti-inflammatory drugs and site of infections did not influence prognosis. The treatment of cellulitis is penicillinotherapy whereas in necrotizing fasciitis early major surgery is often correlated with the rate of survival.

Cellulitis↗
PubMed2000

[Buruli ulcer: an exported pathology].

CASE REPORT: A nine-year-old boy from the Ivory Coast was admitted to hospital because of extremely serious Buruli ulcers. CONCLUSION: Surgery is the only treatment available. Moreover, the surgical excision has to be wide; both open and closed wounds have to be removed to give significant improvements.

Child↗
PubMed2000

[Pathology of Haemophilus infections: current situation in pediatrics].

Haemophilus influenzae is the main pathogen in community-acquired infections in children. Prior to the introduction of H. influenzae type b immunization (Hib), capsular type b H. influenzae was the most invasive type of H. influenzae, and was the major cause of meningitis in children in France and many developing countries. The introduction of a Hib vaccine program results in rapid and dramatic decline in the incidence of Hib infections in children. The resistance rate to beta-lactam antibiotics is slowly increasing with beta-lactamase production. Third generation cephalosporins are used for the treatment of invasive infection (meningitis etc.). The empiric treatment of otitis and respiratory tract infections in children is the combination of clavulanic acid and amoxicillin or third generation cephalosporins.

Anti-Bacterial Agents↗
PubMed2000

Analysis of circulating immune complexes (CICs) in childhood tuberculosis: levels of specific antibodies to glycolipid antigens and relationship with serum antibodies.

BACKGROUND: The presence of specific antiglycolipid antibodies in serum and circulating immune complexes (CIC) in children with tuberculosis was detected in order to evaluate their contribution to the value of serodiagnosis of tuberculosis, as has already been shown in adults. METHODS: ELISAs using the three glycolipids LOS, DAT and PGLTb1 were performed in whole serum and immune complexes from 20 children with tuberculous disease or infection, in seven child contacts, and in 26 children with non-tuberculous disease. The contribution of complexed IgG antibody to the diagnostic values was established for each group. RESULTS: The antibody levels in free serum were higher (P < 0.01) in children with tuberculous disease or infection and in contacts than in controls. By contrast, except for PGLTb1, the IgG antibody levels were higher (P < 0.02) in children with tuberculous disease than in the other groups. The highest contribution of IgG antibody against LOS to the predictive values was shown in children with pulmonary tuberculosis (positive predictive value 1,000, negative predictive value 1,000). In paucibacillary tuberculosis (extra-pulmonary and tuberculous infection) and in contacts, the IgG antibody did not contribute to the sensitivity of the serodiagnosis, where the combination of antigens tested in serum increased the diagnostic yield. The very low levels of IgG antibody in these settings may indicate a different B cell response. CONCLUSION: The detection of immune complexes and IgG antibodies against the three glycolipid antigens is useful as a complementary technique for the serodiagnosis of children with a high probability of pulmonary tuberculosis.

Adolescent↗