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Biomedical subjects

A M Devaux

Publications and source records attributed to A M Devaux.

At least 19 recordsLinked to original sources
PubMed1999

[Recurrence of herpes simplex encephalitis].

UNLABELLED: Herpes simplex encephalitis (HSE) rarely occurs in children, is not easily diagnosed, and has a poor prognosis. CASE REPORT: We report a pediatric case with a relapse on the 29th day despite conventional acyclovir therapy. As the relapse mechanism is not clearly understood, antiviral and immunosuppressive therapy was administered. CONCLUSION: This case underlines the importance of clinical examination and the necessity of accurate testing prior stopping antiviral treatment. A better understanding of the relapse mechanism is required in order to propose more efficient treatment.

Acyclovir↗
PubMed1997

Prognostic value of neonatal electroencephalography in premature newborns less than 33 weeks of gestational age.

In a prospective study of 417 premature neonates born before 33 weeks' gestational age, neonatal tracings were reviewed to evaluate the use of EEG in prognosis of neurological injuries. The population was divided into two groups: Group 1, infants who died before the age of 1, and Group 2, survivors in which two categories of motor development were considered. Category A, were abnormal, and Category B, were always normal. Positive rolandic sharp waves (PRSW), which reflect white matter injury, occurred equally in both groups, indicating a similar incidence of white matter damage in Groups 1 and 2. In Group 2, there was a significant correlation of PRSW with developmental motor sequelae (Category A). A frequency of PRSW above 2/min (suggesting more severe periventricular white matter injury) and seizures were significantly more prevalent in Group 1 than in Group 2 and in Category A of Group 2 than in Category B. Background abnormalities occurred equally in both subgroups of extremely premature infants (< or = 28 weeks' gestation) they were significantly more numerous in the subgroup of very premature infants (between 28 and 33 weeks' gestation) who died, than in the subgroup of very premature infants who survived. This study shows the potential utility of using neonatal EEG in association with transfontanellar ultrasonography in anticipating the neurological development of very (> 28 weeks' gestation) and extremely (< or = 28 weeks' gestation) premature newborns.

Asphyxia↗
PubMed1997

[Esophageal bezoar in a child treated with sucralfate].

BACKGROUND: Sucralfate is widely used in stress bleeding prophylaxis in intensive care units as it causes relatively few side effects. Its use in patients with risk factors may lead to the formation of esophageal bezoar. We describe the first known pediatric case of sucralfate esophageal bezoar. CASE REPORT: A 11-year-old girl presented with severe encephalitis complicated by seizures. She was treated in an intensive care unit by restrictive hydration associated with sucralfate, morphinic compound, phenobarbital and curare. At day 10, enteral feeding through a nasogastric tube was started. Five days later, an esophageal bezoar was diagnosed, which disappeared after discontinuing sucralfate, morphinic compound, curare and enteral feeding. CONCLUSIONS: Risk factors, similar to those reported in adults with esophageal bezoars, were found in this patient ie, plurimedication, dehydration, impaired gastric motility. Caution should be taken when combining enteral feeding and sucralfate whenever any additional risk factor is present.

Anti-Ulcer Agents↗
PubMed1993

[Neonatal septicemia due to Pneumococcus resistant to beta-lactam antibiotics].

BACKGROUND: Neonatal sepsis due to Streptococcus pneumoniae is relatively rare. The increasing risk that this bacterium is resistant to betalactam antibiotics worsens its prognosis. CASE REPORT: A newborn was delivered by cesarean section because of an abnormal fetal heart rate pattern. Despite intubation, respiratory support and correction of acidosis, the baby remained cyanotic and displayed signs of shock. Neutropenia, increased percentage of immature neutrophils, high C-reactive protein levels and an X-ray pattern of pneumonia also indicated an infection. The child was given symptomatic therapy, and amoxicillin, cefotaxime and amikacin. Pneumococci type 9 were isolated from peripheral secretions and from the blood. Deterioration of the respiratory condition required higher doses of amoxicillin and cefotaxime on day 2 pending the results of antibiotic sensitivity testing. This test showed that the strains were resistant to beta-lactam antibiotics. On day 3, the treatment was replaced by a combination of vancomycin, rifampicin, amikacin and cefotaxime. This treatment was pursued for 2 weeks, except for rifampicin which was stopped after 2 days. The follow-up was uneventful. A search for pneumococci in the mother was negative. CONCLUSIONS: Streptococcus pneumoniae should always be considered as a cause of neonatal sepsis. Poor therapeutic control indicates resistance to beta-lactam antibiotics. This patient may be the first reported case of maternal-fetal infection with this resistant strain.

Anti-Bacterial Agents↗
PubMed1992

[Systemic gas embolism in the greater circulation in a ventilated premature infant].

BACKGROUND: Pneumothorax is common complication in newborns; its incidence is increased by intubation, particularly when high pressure ventilation is necessary. Systemic air embolism is a rare and usually fatal form of "displaced air". CASE REPORT: A preterm newborn, 27 weeks of gestational age, weighing 940 g, with respiratory distress syndrome was treated by intubation at 1 min of life and high pressure ventilation (Peak 36 cmH2O, PEP 6 cmH2O, FiO2 = 1). Bilateral pulmonary interstitial emphysema was seen on X-rays at 4 hr of life. Acute cyanosis and bradycardia occurred at 7 hr of life; large amounts of air mixed with blood were withdrawn from the umbilical vein catheter. There was no pneumothorax, pneumomediastinum or subcutaneous emphysema. The newborn died at 9 hr of life. Post mortem injection of contrast fluid into umbilical vein catheter indicated no cardiac perforation: this finding was confirmed by autopsy. CONCLUSION: This is a new case of systemic air embolism that may be due to high pressure ventilation in an extremely underweight newborn. Preventive measures consist of monitoring ventilation, possibly using new techniques, but their efficacy remain to be demonstrated.

Embolism, Air↗
PubMed1989

[Contribution of the EEG and evoked potentials in the prognosis of post-anoxic comas in children].

Six children with post-anoxic coma were studied and there was evidence of preserved brainstem function together with the presence of electrocerebral activity on EEG. There is no definite prognosis with slow EEG; patients can either die, survive, but with major neurological damage, or recover completely. In that case, evoked potentials have a good prognostic value. Normal BAEP indicate that patients will survive. However, absence of the cortical component of SEP indicates major cerebral damage. Evolution towards a vegetative state can therefore be predicted.

Adolescent↗
PubMed1986

[Intermediate neurological development of 60 neonates weighing 1500 grams or less at birth. Predictive value of initial findings (clinical aspects, electroencephalograms and brain imaging)].

60 low birthweight (less than or equal to 1,500 g) are distributed according to existence or not, and intensity of brain disturbances, during the neonatal period; appreciated by neurological examinations, early EEG and brain imaging during the second month of life. At 18 months, at least, neurological outcome is normal for 46 children (but 6 had transient neuromotor anomalies), 14 have sequelae (7 mild, 7 major). All children with clinical neurological examination carried out during the neonatal period are normal at follow up. It is true also for the children without EEG anomaly and normal brain imaging. The early prediction of neurological outcome can be made easily with consideration of these three data. Standardised test are proposed, during the neonatal period, for these low birth weight infants.

Brain↗
PubMed1984

[Circulating calcitonin in fulminating purpura in children].

Hypocalcaemia may complicate the treatment of fulminating meningococcaemia in children. In an attempt to elucidate the pathophysiology of the hypocalcaemia, we have measured accompanying changes in blood levels of calcitonin (BW-336-6 antiserum) and parathyroid hormone (C-terminal antiserum IRE). Ten children aged 1-11 years with fulminating meningococcaemia are studied. The high PTH levels may be a response to the hypocalcaemia, but the hypercalcitoninaemia seems inappropriate. Provided the immunoreactivity of the calcitonin detected corresponds to calcitonin 1-32, the origin of this hypercalcitoninaemia remains to be explained.

Calcitonin↗
PubMed1983

[Acute neurological deficit in treated malignant hemopathies].

Neurological complications are frequent in the course of malignant hematological diseases. Five cases occurring in children are reported here: 4 presented with acute lymphoblastic leukemia and 1 with lymphoma. The clinical pattern was remarkably acute, with fever, seizures and a neurological deficit. Brain CT scan showed a limited hypodensity sometimes with a contrast uptake in the involved area in the first days or weeks. Seroconversion for measles virus occurred in 3 cases, associated with the presence of helix-like bodies in the cerebrospinal fluid and/or cerebral tissue. These case reports are discussed with respect to the neurological complications already reported in patients with hematologic malignancies. The hypothesis of measles-virus related encephalitis seems likely.

Adolescent↗
PubMed1983

[Polyradiculoneuritis as a manifestation of childhood sarcoidosis].

A case of juvenile sarcoidosis presenting initially as Guillain-Barré syndrome is reported. Biochemical and radiologic data (bilateral hilar lymphadenopathies) led to suspect the diagnosis which was assessed by bronchial biopsy. Evolution was marked by spontaneous neurologic recovery, while the evolution of the pulmonary disease needed corticosteroid treatment. After a 3 year follow-up, chest X-rays are considered normal and the only pathologic findings are minimal changes in functional respiratory investigations.

Biopsy↗
PubMed1980

[Obstruction of the abdominal aorta and cyanotic heart disease in a 1 year old child (author's transl)].

In a 1 year old child, cyanotic congenital heart disease was complicated by a severe obstruction of the abdominal aorta between the renal arteries and the bifurcation. The surgical treatment consisted of relief of the obstruction in the aorta and a Blalock-Taussig shunt. The general progress was good but there was a ischemia of the left leg for which amputation of the forefoot was required.

Aorta, Abdominal↗
PubMed1978

Neonatal parathyroid secretion and renal receptor maturation in premature infants.

16 premature infants with normal trophicity were studied during the 1st week of life using serum parathormone (IPTH) dosage and evaluation of renal tubule maturation by the effect of exogenous parathormone (PTE) on urinary elimination of 3':5'-cyclic adenosine monophosphate (cAMP). As of the 1st day, IPTH levels reached or surpassed those in the adult. Prematurity thus does not appear to influence parathormone response. Given the specificity of the dosage antiserum, it appears reasonable that the PTH detected is biologically active. After PTE, urinary elimination of cAMP does not appreciably increase until the 6th day, while still remaining much lower than adult levels. The lower the weight of the premature infant, the less intense the response of the kidney. It thus seems possible that the later development of renal parathormone receptor in the premature infant may be a factor responsible for neonatal hypocalcemia with hyperphosphatemia.

Body Weight↗