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B Le Luyer

Publications and source records attributed to B Le Luyer.

At least 19 recordsLinked to original sources
PubMed2001

[Incidence of symptomatic celiac disease in French children].

OBJECTIVE: The study was carried out by the GFHGNP to determine the annual incidence of symptomatic celiac disease in children. PATIENTS AND METHODS: The diagnostic criteria were: symptomatic patients diagnosed under 15 years of age during 1996, villous atrophy and positivity of antigliadin and/or other antibodies. Cases were collected from referral centers, general hospital pediatric departments and private pediatricians with endoscopic practice. RESULTS: The study involved roughly half of the French pediatric population in 41 out of the 95 French districts. In all, 124 patients were collected: 76 girls and 48 boys. By geographical areas, in 30 districts where collection of data was complete which counted 186,285 births, the yearly incidence varied from 1/1731 births to 1/3110. (0.57@1000 to 0.32@1000). On the whole there were 77 cases i.e. an annual incidence of 1/2419 or 0.41@1000 (confidence interval 95%: 0.32 to 0.50@1000). Lower incidences were observed in the district of Paris: 1/4865 (0.21@1000) and Lyon: 1/3310 (0.27@1000). Those lower incidences could be explained by the difficulties of collecting the data in the biggest urban areas. The first signs occurred before one year of age in 73% of the cases, during the second year of life in 20.5% and after 3 in only 6.5%. The diagnosis was made before 2 years of age in 77% of the cases and after 3 in only 13%. In order of frequency symptoms were: failure to thrive (80%), diarrhea (59%), anorexia (59%), abdominal distension (57%), weight under 2 standard deviations (43%), short stature (43%). CONCLUSION: Compared with previous studies in two French districts between 1975 and 1990, the annual incidence of symptomatic celiac disease in children appears to be on the rise. The usual clinical signs continue to be observed.

Adolescent↗
PubMed2000

[Use of interferon in a case of hepatic hemangioma].

UNLABELLED: Hepatic hemangioendothelioma can have a fatal outcome. After failure of classic therapies, and when surgery or arterial embolization are not possible, those benign tumours may benefit from interferon alpha treatment. CASE REPORT: We report a case of a 14-month-old infant who presented with hepatic hemangiomatosis and cardiac failure. The disease can neither be controlled by steroids nor by radiotherapy associated with digitalo-diuretic treatment. Due to the important vascular volume of the tumour, neither surgical care nor arterial embolization were possible. Thus this infant was treated for ten months by interferon alpha. The evolution was favourable: cardiac failure, calcifications and volume of the angiomatosis were regressive. CONCLUSION: Interferon alpha treatment helps to control cardiac failure and the course of hepatic hemangioma in childhood.

Antineoplastic Agents↗
PubMed2000

[Sarcoidosis and goiter. A case report in an adolescent].

UNLABELLED: Sarcoidosis is a systemic granulomatous disease of uncertain etiology which can affect different organs in the body. In this study, we report a case with both lung and thyroid involvement. CASE REPORT: A 12-year-old girl with goiter was referred for dyspnea. Lung CT scan showed diffuse interstitial disease. The diagnosis of sarcoidosis was made following a histological study of lung specimens obtained via video-assisted thoracoscopy. CONCLUSION: Lung biopsy is important in establishing the diagnosis of interstitial lung disease. In this study, the various forms of granulomatous lesions in the thyroid gland and in the lung have been described. However, it should be emphasized that the association of thyroid gland disorder and lung involvement in cases of sarcoidosis is a rare occurrence in children and adolescents. The necessity of establishing a certain diagnosis justifies the use of these invasive procedures.

Biopsy↗
PubMed1998

[Constipation in children].

Constipation in childhood is often unrecognized and diagnosed upon manifestations such as pain and pseudo-diarrhoea reflecting of a fecalith. It is sometimes complicated with urinary infection and can be a factor favouring enuresis. In the absence of deterioration in the general condition, it reflects modification of the propulsive functions of the colon or of the reservoir function of the rectum. In a such context, no further explorations are required. Treatment involves dietary recommendations such as good nutritional balance and sufficient fibre intake as well as mineral-based laxatives (paraffin oil) or nonabsorbable osmotic sugars. Enemas and suppositories should be used in case of stool withholding. Sphincter reeducation by biofeedback is indicated in child over 8 years of age after failure of medical therapy.

Biofeedback, Psychology↗
PubMed1998

Factors associated with glycemic control. A cross-sectional nationwide study in 2,579 French children with type 1 diabetes. The French Pediatric Diabetes Group.

OBJECTIVE: To determine on a large scale the multiple medical and nonmedical factors that influence glycemic control in the general population of children with diabetes, we performed a nationwide French cross-sectional study. RESEARCH DESIGN AND METHODS: We enrolled 2,579 patients aged 1-19 years with type 1 diabetes of > 1 year's duration. The study was center based: 270 centers were identified, 206 agreed to participate, and 147 included at least 90% of their patients. Questionnaires were completed by physicians interviewing patients and family, and HbA1c measurements were centralized. To identify explanatory variables for HbA1c level and frequency of severe hypoglycemia, we performed multiple regression analysis using all the quantitative variables collected and stepwise logistic regression for the qualitative variables. RESULTS: Mean HbA1c value for the whole population was 8.97 +/- 1.98% (normal 4.7 +/- 0.7% [SD]). Only 19 children (0.7%) had ketoacidosis during the 6 months before the study, whereas 593 severe hypoglycemia events occurred in 338 children (13.8%). Control was better in university-affiliated hospitals and centers following > 50 patients, reflecting the importance of access to experienced diabetologists. Children had a mean of 2.3 injections, allegedly performed 2.8 glucose measurements per day, and were seen an average of 4.6 times per year at the center. In the multiple regression analysis, 94% of the variance of HbA1c was explained by our pool of selected variables, with the highest regression coefficient between HbA1c and age (Rc = 0.43, P < 0.0001), then with daily insulin dosage per kilogram (Rc = 0.28, P < 0.0001), mother's age (Rc = 0.26, P < 0.0001), frequency of glucose measurements (Rc = 0.21, P < 0.0001), and diabetes duration (Rc = 0.14, P < 0.0001). Logistic regression identified quality of family support and dietary compliance, two related qualitative and possibly subjective variables, as additional explanatory determinants of HbA1c. The frequency of severe hypoglycemia was 45 per 100 patient-years and correlated with diabetes duration, but not with HbA1c levels or other variables. CONCLUSIONS: Although overall results remain unsatisfactory, 33% of studied French children with type 1 diabetes had HbA1c < 8%, the value obtained in Diabetes Control and Complications Trial adolescents treated intensively. Diabetes management in specialized centers should be encouraged.

Adolescent↗
PubMed1996

Case report: insulin-dependent diabetes mellitus in childhood associated with scleroderma.

A 14-year-old boy presented with Type I diabetes mellitus and subsequently developed pancreatic exocrine insufficiency and systemic sclerosis (SSc). His diabetes had been diagnosed when he was about 5 years old, after the onset of ketoacidosis. Insulin treatment was provided from then until the time he was treated in our department. Exocrine pancreatic insufficiency, which occurred at age 9, was treated with pancreatic extracts. Cystic fibrosis was excluded after a chloride sweat test. The diagnosis of SSc was confirmed at age 14 on the basis of skin sclerosis, sclerodactyly and oesophageal and pulmonary involvement and then at age 18 by the occurrence of Raynaud's disease. Thus, this patient demonstrated a rare and previously unreported association of Type I diabetes mellitus and systemic scleroderma. Limited joint mobility and skin abnormalities are frequent in childhood diabetes mellitus but should not be misdiagnosed as systemic scleroderma.

Adolescent↗
PubMed1995

[Epidemiology of infantile asthma in the Le Havre region].

BACKGROUND: Prevalence of asthma is influenced by environmental factors which may be different from area to area. POPULATION AND METHODS: A cross-sectional epidemiological survey was carried out among 1,395 children attending primary schools in the city of Le Havre and the canton of Fécamp (Haute-Normandie). Questionnaires including data about the disease, family history, environmental and socio-economic factors were completed by the school physician in presence of the parents. RESULTS: Prevalence rate of asthma calculated from 1,193 questionnaires was 7.8%. The logistic regression curves pointed out four risk factors: family history of asthma (odds ratio: 2.52) or hay fever (OR: 1.98), atopic dermatitis (OR: 3.96), and parental smoking (OR: 1.79). Sex, socioeconomic status of parents, type of housing, presence of pets in the house were not related to prevalence of asthma. Frequency of cough during the day was only significantly different between both areas. CONCLUSIONS: The high level of school absence (21.1%) and frequency of hospitalizations for acute asthma (20.4%) should lead health professionals and educators to improve management of asthma in these areas.

Air Pollution↗
PubMed1993

[Isolated acute peripheral facial paralysis in children. Etiological and prognostic study].

BACKGROUND: As facial nerve palsy is usually of sudden onset and of obscure etiology, a survey of large series may provide new information. PATIENTS AND METHODS: The files of 40 children suffering from acute facial nerve palsy seen in 3 pediatric and 1 otorhinolaryngologic (ORL) departments between 1980 and 1990 were analysed. Patients with congenital palsy and those with paralysis that appeared after injury or in the course of acute or chronic disease (otitis media, tumor) were excluded from the study. The children were 9 months-16 years old (mean: 7 year 1 month). There were 22 left and 18 right facial nerve palsies. The palsy was moderate in 17 children, severe in 15, and total in 5. Etiologic factors (viral serologic studies, CSF examination), ORL studies and electromyogram of the facial nerve were analyzed in the majority of cases. Corticosteroids were used in 30 patients. RESULTS: A viral etiology was suspected and/or confirmed in 13 children; abnormalities were seen in 6 of the patients who underwent lumbar puncture. A familial facial nerve palsy was seen in 1 case and kidney disease in 2 cases. 23 cases appeared to be idiopathic. A moderate permanent residual weakness was seen in only 4 children. The mean time for recovery was 32 days (4-140 days). Corticosteroids did not influence the incidence of complete recovery, but decreased the time for recovery (26 versus 37 days) only in the patients who were treated before the 3rd day of the disease. Patients with idiopathic palsy recovered 23 days before those with viral etiology. CONCLUSIONS: Idiopathic and post-viral facial nerve palsies seem to have an excellent prognosis. Corticosteroids seem to have no effect although there is some evidence of benefit when treatment is begun early.

Acute Disease↗
PubMed1992

[Multicenter study of sodium alginate in the treatment of regurgitation in infants].

An open multicenter study was performed to assess the efficacy and safety of alginic acid in two different dosages in 76 pediatric patients with gastroesophageal reflux confirmed by pH monitoring. Among the 69 patients in whom endoscopy was carried out before treatment, 18 had erythematous esophagitis and 5 had erosive esophagitis. Irrespective of the dosage used, the frequency of regurgitation and vomiting decreased significantly (p < 0.00001 and p = 0.01, respectively). Clinical and biochemical tolerance were outstanding and no adverse effects were recorded. On the basis of these data, the recommended dosage is 1 to 2 ml/kg/day in divided doses after meals.

Alginates↗
PubMed1992

[Esophageal pH monitoring in children. Methodological aspects and a review of the literature related to indications].

Because it offers high sensitivity and specificity, esophageal pH monitoring has become the reference method for the diagnosis of gastroesophageal reflux. This review was undertaken to evaluate methodologic problems raised by this method, involving selection of the electrode, selection of equipment, and criteria of normality according to the patient's symptoms. In some instances, multiple recordings are needed to detect correlations between clinical symptoms and esophageal pH, cardiac and respiratory tracings and esophageal pH, or oxygen saturation and esophageal pH. These studies allow improved qualitative interpretation of results. Emphasis is put on the value of esophageal pH recordings for the evaluation of medical or surgical therapies.

Child↗
PubMed1991

[A prognostic study of cryptogenic infantile spasms].

The prognosis of infantile spasms is grim when a detectable brain lesion is present. In contrast, cryptogenic infantile spasms, in which there is no identifiable brain lesion, usually run a favorable course under treatment. Few studies have focused on the outcome in children with cryptogenic infantile spasms. Among 111 pediatric patients with a history of infantile spasms hospitalized over 18 consecutive years, 23 (21%) were given a diagnosis of cryptogenic infantile spasms. Follow-up ranged from 4 to 21 years. Outcome was as follows: the IQ was above 80 in 39% of cases and above 100 in 13% of cases; 42% of patients of school age were attending school but half of these had learning disabilities; 30% of patients had severe psychiatric disorders, and 22% had developmental delay and severe epilepsia. Early factors apparently associated with a good prognosis included the mild nature of psychomotor regression, persistence of spindles on EEGs recorded during NREM sleep, and prompt improvement of clinical status and EEG recordings under treatment. Conversely, severe regression, focalized EEG anomalies, failure of development to resume promptly after initiation of therapy, recurrence of spasms and hypsarrhythmia at discontinuation of treatment, and onset before 5 months or after 11 years of age were associated with a poor prognosis.

Adrenocorticotropic Hormone↗
PubMed1991

[Accelerated desensitization to Dermatophagoides pteronyssinus mites in children with asthma. Results of two years of immunotherapy].

16 children with chronic asthma were given a rush immunotherapy with standardized Dermatophagoides Pteronyssinus extracts. For two years, the dose of 10 IR was injected monthly. Before this rush, six children have received a typical immunotherapy ineffective on asthma. Examination of clinical, medication, immuno-allergologic and functional parameters were recorded before and at 6, 12 and 24 months of the follow-up. Rush immunotherapy was well tolerated. Substantial improvement of asthmatic syndrome was seen in 12 children. Skin sensitivity decreased significantly since 6 months (p less than 0.001). Laboratory results were not changed. At 24 months, improvement of CRF Helium was showed (p less than 0.01). This study with two years follow-up shows that specific immunotherapy is efficacy and possible in children with severe asthma. Symptom, medication, functional scores were substantial improvement.

Adolescent↗
PubMed1990

Comparison of two oral rehydration solutions in eutrophic infants with moderate acute diarrhea: results of an interim analysis.

A randomized, multicenter clinical trial comparing two oral rehydration solutions (ORS) with different sugar content and total osmolality was carried out in France. Solution A had 168 mmol/L of sugar and a total osmolarity of 326 mosm/kg; solution D had 90 mmol/L of sugar and a total osmolarity of 240 mosm/kg. Weight gain, stool output, and biologic variables were analyzed. This interim analysis included 49 infants (27 in group A and 22 in group D). Patients in both groups gained weight without any significant difference between the two ORS. Between admission and day 4, the overall number of stools and the number of liquid stools decreased. Laboratory values were within the normal range on admission and remained unchanged. The weight increase during the first 24 hours and the reduced frequency of stools was similar in both groups.

Acute Disease↗