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Biomedical subjects

A Poujol

Publications and source records attributed to A Poujol.

12 recordsLinked to original sources
PubMed2001

Efficacy and tolerability of racecadotril in acute diarrhea in children.

BACKGROUND & AIMS: Oral rehydration therapy is the only treatment recommended by the World Health Organization in acute diarrhea in children. Antisecretory drugs available could not be used because of their side effects, except for racecadotril, which is efficient in acute diarrhea in adults. METHODS: The efficacy and tolerability of racecadotril (1.5 mg/kg administered orally 3 times daily) as adjuvant therapy to oral rehydration were compared with those of placebo in 172 infants aged 3 months to 4 years (mean age, 12.8 months) who had acute diarrhea. The treatment groups were comparable in terms of age, duration of diarrhea, number of stools, and causative microorganism at inclusion. RESULTS: During the first 48 hours of treatment, patients receiving racecadotril had a significantly lower stool output (grams per hour) than those receiving placebo. The 95% confidence interval was 43%-88% for the full data set (n = 166; P = 0.009) and 33%-75% for the per-protocol population (n = 116; P = 0.001). There was no difference between treatments depending on rotavirus status. Significant differences between treatment groups were also found after 24 hours of treatment: full data set (n = 167; P = 0.026) and per-protocol population (n = 121; P = 0.015). Tolerability was good in both groups of patients. CONCLUSIONS: This study demonstrates the efficacy (up to 50% reduction in stool output) and tolerability of racecadotril as adjuvant therapy to oral rehydration solution in the treatment of severe diarrhea in infants and children.

Acute Disease↗
PubMed1999

[Pediatric medical emergencies: clinical classification on basis of severity of illness, distribution between work days and non-working days].

OBJECTIVES: Assess one year of activity in a pediatric medical emergency unit of a non-university hospital to detail the degree of gravity of patients admitted to pediatric wards and the distribution of non-programmed activity between and work days and non-work days. METHODS: Prospective classification into 5 degrees of emergency of all admitted children and count of non-programmed medical and surgical activity. RESULTS: A significantly growing number of consultations for minor problems was observed during non-work days. Most hospitalizations were for problems of a rather relative emergency nature. CONCLUSION: The creation of a "day-hospital" would allow evaluation and/or treatment of a large number of pediatric patients without requiring hospitalization. The problem of controlling the flow of consultations to the hospital remains a difficult problem. The many reasons leading to hospital consultation are poorly assessed. It appears indispensable to promote population "education" and development of closer physician's office-hospital collaboration.

Adolescent↗
PubMed1999

[Subphrenic abscess due to ectopic appendicitis].

BACKGROUND: Idiopathic subphrenic abscesses are uncommon in children. Standard chest X-rays may provide the suspicion of this diagnosis. Initial percutaneous drainage of the collection is usually performed. Surgery is required when the underlying cause remains unknown. CASE REPORT: A 12-year-old boy presented signs of pulmonary abscess. Chest X-rays, ultrasonography and computed tomography established the diagnosis of a right subphrenic abscess, which was percutaneously drained. Surgery disclosed an ectopic appendiceal perforation. CONCLUSION: In children, appendicitis is the main etiology of primary or postoperative subphrenic suppurations. Ectopic appendicitis is an important predisposing factor to this complication.

Appendectomy↗
PubMed1998

[Recurrent osteitis and Coxiella burnetii: the relation to chronic recurrent multifocal osteomyelitis].

UNLABELLED: Chronic recurrent multifocal osteomyelitis (CRMO) is a disorder of suspected--but unproved-infectious etiology. OBSERVATION: A girl presented with a typical CRMO involving successively the left fibula, radius, humerus and the right carpus. A Coxiella burnetii infection was indicated during the first attack. Two recurrences occurred in spite of suitable antibiotic treatment and with negative infectious investigation. Two months after stopping antibiotic treatment, a new recurrence associated with antibodies increase and positive bone culture occurred. CONCLUSION: Coxiella burnetii can initiate a CRMO. The mechanism involved is probably a delayed hypersensitivity. CRMO would therefore be the first type of reactive osteitis.

Anti-Bacterial Agents↗
PubMed1995

Osteoarticular infection due to Coxiella burnetii in children.

We report three cases of chronic osteoarticular infections associated with Q fever in children. In two of them, serologic diagnosis was confirmed by direct immunofluorescence of Coxiella burnetii in the synovial and bone biopsy specimen. We suspect that bone infections due to Coxiella burnetii could be underdiagnosed because this etiology is not frequently seen.

Abscess↗
PubMed1993

[Dwarfism, arterial hypertension and hyperkalemic acidosis corrected with thiazides. A case of type II pseudohypoaldosteronism].

BACKGROUND: Type II pseudohypoaldosteronism is a rare tubulopathy defined by abnormal renal potassium excretion. CASE REPORT: A 12 1/2 year-old girl, was admitted for dwarfism. Her parents were not consanguineous and her 5 living sibs were normal. At admission, she had moderate hypertension: systolic 130-150 mmHg; diastolic 80-100 mmHg and no pubertal development. LABORATORY DATA: pH (arterial): 7.34; bicarbonates: 18-20 mEq/l; chloride: 112-120 mEq/l; potassium: 5.6-7 mEq/l; aldosterone: 200-700 pg/ml (N < 60); plasma renin activity: 0.4 ng/ml/hr (N 2.2 +/- 0.2). The bone maturation was 8 1/2 years. All the other renal function tests were normal. The titratable acidity was 22 mEq/day (N 20-40) and the ammonia excretion 15.2 mEq/l (N 44-61). The fractional excretion of potassium was 6.5% (N 11.8 +/- 1.9). This girl was given polystyrene sulfonate resin followed by hydrochlorothiazide (1 to 3 mg/kg/day). There was a subsequent improvement in all data, a growth spurt and pubertal development. CONCLUSION: This is the fifth case of type II pseudohypoaldosteronism reported in childhood and the first one with hypertension. The beneficial effect of hydrochlorothiazide is underlined.

Acidosis, Renal Tubular↗
PubMed1993

[Study of risk factors for recurrence in severe life-threatening conditions in infants].

In a prospective study, 180 infants, mean age 2-6 months, hospitalized for apparent life threatening events between October 1985 and September 1988 (for 7,261 infants admitted into the pediatric unit during the same period), were submitted to the following investigations: careful anamnesis, complete clinical examination, systematic paraclinical investigations (standard biological studies, infectious and metabolic tests, investigations for gastro esophageal reflux (GER) and vagal hyper-reflectivity (VHR), polysomnography) or adapted to the clinical situation (toxic tests, brain computed scan, laryngoscopy, etc). Pathologies were mainly functional with neuro-vegetative immaturity (67.5%): gastro esophageal reflux (49%), vagal hyper-reflectivity (8.5%) or both (10%). An incidental pathological factor (breath holding spell, convulsion, intoxication, infection) was found in 18.5% of the infants, and 14% had normal results. Diphemanil 10 mg/kg/24h corrected the VHR and Metoclopramide 1 mg/kg/24h controlled 52% of the GER. The recurrence rate of illness in the GER and VHR groups was statistically lower with efficient therapy (12% vs 48%); no recurrence occurred in other groups.

Cranial Nerve Diseases↗
PubMed1992

[Prevention advice for families].

SIDS is in most cases unforeseeable and unavoidable. However, present progress in knowledge about this syndrome allows practitioners to give preventive advice, for two types of infant: for all neonates--simple advice of infant care and hygiene--for some at risk babies (siblings of SIDS cases, ALTE, premature), advice on tests, or treatment or more specific medical care.

Humans↗
PubMed1989

[Apropos of 100 cases of malaise in infants].

Among 4,411 children hospitalized from May 1985 through April 1987, 100 infants (mean age three months) had exhibited an apparently life-threatening event. Management included careful history taking by interviewing parents, a thorough physical evaluation, routine laboratory tests, and cardiorespiratory monitoring. A variety of further investigations were usually performed to look for gastroesophageal reflux (GER), vagal hyperreflectivity, or sleep-related cardiorespiratory disorders. Leading causes, that often occurred in combination, included GER (66 per cent of cases), and vagal hyperreflectivity (13%). Atypical breath-holding spells, ENT causes, and neurological causes were documented in 8%, 6% and 5% of cases respectively. Medical treatment of the GER proved effective in 90% of cases. Metoclopramide (Primperan, 10 drops/kg/d) was effective in 62% of infants with GER and was well tolerated. Diphemanil methylsulfate (Prantal, 10 mg/kg/d) satisfactorily controlled vagal hyperreflectivity. Monitoring was prescribed in 43% of cases.

Apnea↗