[Caries: a contagious infection?].
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Child↗
Biomedical subjects
D Breton
Publications and source records attributed to D Breton.
The incidence of male genital tumors: a cellular model for the age dependence.
Most human tumors, including most male genital tumors, exhibit an exponential increase in incidence with advancing age of the host. This exponential age-incidence pattern can be explained by the accumulation of mutations in the stem cells of the tissues of tumor origin. The age-incidence pattern for testicular tumors, however, is unique with a large linear increase in incidence from age 14 to 30 and a linear decline in incidence from age 30 to 60. After age 60, the incidence of testicular tumors remains low and constant. The probability of testicular tumorigenesis is determined by the susceptibility of male germ cells to neoplastic mutation and/or the neoplastic mutagenicity of the male germ cell environment. Since there is no evidence for an environmental mutagen which is specific for male germ cells, and since male germ cells are unusually susceptible to mutation, we interpret the variation in testicular tumor incidence with age as a reflection of the susceptibility of male germ cells to neoplastic mutation. Cell are most susceptible to mutation during genome replication and we propose a model for testicular tumorigenesis which is consistent with the available data on male germ cell proliferation and with the data on testicular tumor incidence.
Adolescent↗
[Transient neonatal hyperthyroidism caused by transplacental transport of pituitary TSH receptor antibodies].
BACKGROUND: Neonatal hyperthyroidism is a relatively rare condition. It can be severe and difficult to treat when the maternal hyperthyroidism has recently been recognized. CASE REPORT: A baby was born at 37 weeks of gestational age to a mother whose hyperthyroidism was only suspected at the 34th week. The mother was not given propylthiouracil until the day before delivery. At birth, the newborn presented with meconial fluid; it weighed 2,380 grams, was 46 cm long and had a head circumference of 32 cm. Clinical examination showed exophthalmos, tachycardia, hepatosplenomegaly, restlessness, moderate goiter and premature craniosynostosis. Laboratory data showed elevated serum free T4 (76 pmol/l), unmeasurable TSH, and the presence of thyroid-stimulating immunoglobulins. The infant was given propranolol (10 mg/day), and carbimazol (3.75 mg/day) from day 13. Clinical and biological improvement allowed the carbimazol to be stopped at 1 month. A relapse was treated with carbimazol plus L-thyroxine. Both drugs were discontinued at the age of 4 months. At 12 months, the baby is perfectly well and has developed normally. CONCLUSION: This transient thyrotoxicosis was due to the transplacental passage of TSH receptor antibodies. Its management was difficult because the mother was treated late during her pregnancy.
Antibodies↗
[Growth retardation and obstructive sleep apnea in infants].
BACKGROUND: Obstructive sleep apnea can induce growth retardation, with cardiac and/or neurologic manifestations. Tonsillectomy and adenoidectomy may improve failure to thrive. CASE REPORTS: Case n. 1: A 11 1/2-month-old boy was admitted because of feeding problems plus chronic nasopharyngeal secretions (eventually purulent) since the first months of life. He showed a low rate of weight gain since the age of 7 months and had been treated treated for gastroesophageal reflux for a few weeks. On admission, his weight was 6,220 g and his height was 70.5 cm. The tonsils were enlarged and the uvula was long. He displayed tachycardia (150/min). Polygraphic recordings during sleep showed numerous episodes of obstructive apnea. Arterial oxygen saturation (SaO2) during the night was low, frequently below 80%. Tonsillectomy and adenoidectomy immediately improved the quality of sleep. Nocturnal SaO2 and cardiac rythm improved one week later; there was a catch-up weight one month after surgery. Case n. 2: A 7-month-old boy, was admitted because chronic manifestations similar to those of case n. 1. His weight was 5,900 g and his height was 67.5 cm. He also had enlarged tonsils. He suffered from episodes of snoring and obstructive sleep apnea followed by waking and sweating. PaO2 was 70 mmHg and PaCO2 was 48 mmHg. Nocturnal SaO2 was frequently below 60%. Tonsillectomy and adenoidectomy resulted in a net improvement in sleep and weight, despite persistent episodes of nocturnal hypoxemia. CONCLUSIONS: Chronic hypertrophic tonsils and adenoids can interfere with weight gain. Growth retardation may dramatically improve after surgery, even if the tonsils and adenoids do not completely obstruct the nasopharynx.
Adenoidectomy↗