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Biomedical subjects

D Semama

Publications and source records attributed to D Semama.

10 recordsLinked to original sources
PubMed1997

Vitamin A deficiency and nocturnal vision in teenagers with cystic fibrosis.

UNLABELLED: The aim of this study was to document plasma retinol status and nocturnal vision in ten eutrophic adolescents with cystic fibrosis (CF) receiving daily retinol supplementation. Plasma retinol, alpha and beta carotenes and retinol binding protein were measured in ten clinically stable CF patients (mean age: 14.3 years; Shwachman score: 80-100). Nocturnal vision evaluation was performed with a Beyne optometer. Plasma retinol (mean 0.42 +/- 0.16 mg/l), alpha carotene and beta carotene levels were below the lower limit of normal in all but one patient. Five out of ten patients with normal standard opthalmological examination presented a poor (n = 3 patients) or a pathological (n = 2) dark adaptation test. These two patients showed a dramatic increase in nocturnal vision after 1 year of adapted retinol supplementation. CONCLUSION: Low vitamin A levels occur frequently in clinically stable, eutrophic and retinol supplemented CF adolescents. Since vitamin A deficiency is associated with poor nocturnal vision and since this pattern can be reversed by adapted retinol supplementation, we recommend monitoring plasma vitamin A levels in CF patients and evaluation of dark adaptation in retinol deficient patients.

Adaptation, Physiological↗
PubMed1996

Removal of branched-chain amino acids and alpha-ketoisocaproate by haemofiltration and haemodiafiltration.

Venovenous haemofiltration (VVHF) and haemodiafiltration (VVHDF) were performed with a neonatal haemo(dia)filter (Miniflow 10, Hospal) on 8 anaesthetized rabbits infused with branched-chain amino acids (leucine, isoleucine and valine) and alpha-ketoisocaproate. The branched-chain amino acids (BCAA) and alpha-ketoisocaproate blood levels were close to those previously observed in neonates with maple syrup urine disease when extracorporeal blood purification was required. VVHF and VVHDF performances were assessed with two different blood flows (Qb = 8.3 and 16.6 ml/min). VVHDF was performed with four dialysate flow rates (Qd = 0.5, 1.0, 2.0 and 3.0 L/h). Within each period, clearances of the three BCAA were strictly similar. BCAA clearances obtained by VVHF were similar to ultrafiltration rates (respectively, 0.78 +/- 0.14 and 1.79 +/- 0.28 ml/min at high and low Qb; p < 0.05). The alpha-ketoisocaproate clearances obtained by VVHF were 0.39 +/- 0.17 and 0.92 +/- 0.43 ml/min at low and high Qb (not significantly different). Whatever the Qd value, the VVHDF procedures always allowed higher BCAA and alpha-ketoisocaproate clearances as compared with the corresponding VVHF period with similar Qb. BCAA clearances obtained by VVHDF with a 0.5 L/h dialysate flow were 4.1 +/- 0.5 and 5.4 +/- 0.5 mL/min at low and high Qb, respectively. The concurrent alpha-ketoisocaproate clearances were 2.5 +/- 0.8 and 2.9 +/- 1.0 ml/min.

Amino Acids, Branched-Chain↗
PubMed1996

[Survey on the practice of extrarenal hemofiltration in pediatrics].

BACKGROUND: Several methods of dialysis are currently available. The choice of whether to use one of them is determined by multiple factors that are analyzed in this study. PATIENTS AND METHODS: One hundred and twenty-six children (mean age: 48 +/- 6 months) were treated in 29 French intensive care units and/or departments of nephrology during 1991. The underlying diseases were: hemolytic-uremic syndrome (HUS) in 28% of patients, other renal diseases in 6%, metabolic diseases in 8%, septic shock in 8%, cardiogenic shock in 9%, hypovolemic shock in 10%, multiple organ failure in 7%, acute liver disease in 9% and other diseases in 15%. RESULTS: Peritoneal dialysis (PD) was the favorite method in patients less than 10 years: intermittent hemodialysis (IHD), continuous hemofiltration and hemodiafiltration, (HF, HDF) were preferentially used above this age. PD was used in 85% of HUS, 58% of shocks and 50% of metabolic diseases. Sixty percent of acute renal diseases other than HUS were treated by IHD. HF and HDF were used in 66% of acute liver diseases and 42% of shocks. Overall mortality was 40% but no death could be directly ascribed to the different methods of dialysis. CONCLUSION: The choice of method depends on the type of underlying disease, age of the patient but also the equipment of centers. Progress in evaluating indications and results of the different methods of dialysis are necessary.

Adolescent↗
PubMed1995

Effects of theophylline on renal insufficiency in neonates with respiratory distress syndrome.

We report here 6 cases of critically ill newborn infants with both RDS and acute renal insufficiency, unresponsive to conventional treatment (furosemide, dopamine). Theophylline, an adenosine antagonist, has been shown to prevent hypoxemia-induced renal insufficiency in rabbits and our patients thus received compassionately a low-dose of theophylline (1 mg . kg-1 i.v.). Urinary water excretion and creatinine clearances increased significantly in 5 out of 6 neonates, thus suggesting a beneficial role of theophylline in neonatal prerenal failure.

Acute Kidney Injury↗
PubMed1995

Protection from hypoxemic renal dysfunction by verapamil and manganese in the rabbit.

The ability of calcium channel blockers to prevent and/or to reverse the hypoxemia-induced renal dysfunction was studied in anesthetized and mechanically-ventilated rabbits. Renal blood flow (RBF) and glomerular filtration rate (GFR) were determined by para-aminohippuric acid and inulin clearance, respectively. Each animal was considered as its own control. In 9 rabbits (group 1), verapamil infusion, 1 microgram.kg-1.min-1, did not change basal renal hemodynamics. In a second group (n = 9), hypoxemia induced marked significant decreases in GFR, RBF and urine flow rate (-22 +/- 5%, -18 +/- 6% and -34 +/- 7% respectively). The administration of verapamil partially reversed the hypoxemia-induced renal dysfunction. Likewise, hypoxemia did not induce any change in renal function in verapamil pretreated rabbits (n = 8). This study shows that verapamil is able to prevent and to partially reverse the adverse effects of hypoxemia on renal hemodynamics. The intrarenal infusion of manganese chloride, another calcium channel blocker, was also effective in blunting the hypoxemia-induced changes in the left infused kidney, but not in the contralateral kidney. The overall results demonstrate that a significant protection from hypoxemic renal dysfunction can be achieved by inhibitors of calcium ion transport.

Animals↗
PubMed1992

[Simultaneous recording of pH in the distal and proximal esophagus].

A 24 hour esophageal pH recording was performed in 46 infants (age: 10 +/- 12 months). Two probes were placed in the proximal and distal esophageal sites respectively. A significant correlation was shown between the upper and lower part of the esophagus for the numbers of acid (pH fall below 4 for at least 15 s) and weakly acid (fall in pH of more than one unit, irrespective of whether or not the pH fell below 4) gastroesophageal reflux (GER), the reflux index and the number of acid GER longer than 5 min. The number of acid GER and the time spent at pH less than 4 at the proximal esophagus were significantly greated in group 1 (reflux index greater than 5% in the distal esophagus, n = 10), than in group 2 (reflux index less than 5% in the distal esophagus, n = 36). The proportion of distal acid and weakly acid reflux reaching the upper esophagus presented with marked variation coefficients. These findings indicate that data obtained in the distal esophagus are poorly predictive of the results in the proximal esophagus, even if infants present high reflux index at the lower esophagus. Weakly acid GER reached the upper esophagus more frequently than acid GER.

Child, Preschool↗
PubMed1990

Hemiballismus revealing multiple sclerosis in an infant.

The authors report a case of a 15-month-old infant who presented a left hemiballismus associated with left Marcus-Gunn pupil, and retrobulbar optic neuritis, which disappeared spontaneously in 7 days. Six weeks later, the infant experienced a mild paraparesis with a palsy of the left sixth cranial nerve, which disappeared following steroid therapy. Evoked visual potentials elicited abnormal latencies; cerebrospinal fluid (CSF) showed a rise in white cells and oligoclonal bands. According to the usual classification, this case corresponds to definite multiple sclerosis. The fact that hemiballismus was the initial clinical feature in an infant makes this observation very interesting. In the literature, eight cases of hemiballismus in patients with multiple sclerosis are reported; however, only two cases of multiple sclerosis in infancy have been published, making our case report of particular interest.

Evoked Potentials, Visual↗
PubMed1990

[Nosocomial Staphylococcus epidermidis and Staphylococcus aureus septicemias in neonates].

Sixteen neonates developed staphylococcal septicemia (S. epidermidis in 10 cases and S. aureus in six). Two infections were due to maternofetal contamination and four to contaminated foreign material. Clinical symptoms included non-specific evidence of neonatal bacterial infection and, in S. aureus infections, suggestive skin or bone localizations. Fifteen patients recovered without sequelae and one died as a result of S. aureus septicopyemia. In view of the patterns of resistance to antimicrobial agents exhibited by S. aureus and S. epidermidis, the vancomycin-amikacin combination seems the most appropriate treatment in neonatal staphylococcal septicemias. However, the fosfomycin-cefotaxim combination can be proposed for the treatment of staphylococcal infections with osteoarticular or meningeal involvement.

Anti-Bacterial Agents↗