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Biomedical subjects

G Dubar

Publications and source records attributed to G Dubar.

4 recordsLinked to original sources

Favorable nutritional outcome after isolated liver transplantation for liver failure in a child with short bowel syndrome.

A patient with short gut syndrome presented with end-stage liver disease. She underwent an isolated liver transplantation at the age of 3.5 years. Parenteral nutrition was discontinued 1.5 years after surgery. At 7 years of age, the patient has maintained normal nutritional indices and growth while on a normal oral diet. This observation suggests that liver transplantation alone can be a valuable alternative to the combined small bowel/liver transplantation in short bowel syndrome when intestinal adaptation is expected and if the ileocecal valve is present and that improvement of gut function can occur after successful liver transplantation.

Child, Preschool↗

Influence of recombinant interferon alpha on nutritional status and growth pattern in children with chronic viral hepatitis.

UNLABELLED: Anorexia and weight loss are frequently reported as adverse effects during recombinant interferon alpha (rIFN-alpha) treatment. The aim of the present study was to assess both nutritional status and growth of children and adolescents treated with rIFN-alpha for chronic viral hepatitis. Eleven patients aged 4-16 years with histologically proven chronic active hepatitis (hepatitis B, n = 9; hepatitis C, n = 2) receiving rIFN-alpha subcutaneously thrice a week for 6 months were studied. Weight and height increments were assessed during the 6 months before starting rIFN-alpha. Weight and height were measured every 3 months (M0, M3, M6) during the 6 months of rIFN-alpha treatment, then every 6 months during the follow up period (6-36 months). Weight decreased in every child during rIFN-alpha treatment (weight loss varies from 0.5 to 2.6 kg after 3 months of treatment). Weight/age Z-score decreased from 0.12 at M0 to -0.69 at M3 (P < 0.01), then increased between M3 and M6 (-0.33) (P < 0.01), but normalized (0.02) only 6 months after completion of treatment. Nutritional status was significantly impaired during treatment (Z-score for weight/height decreased from 0.18 at M0 to -0.74 at M3, P < 0.01) and recovered progressively thereafter. Height and height velocity were not modified by rIFN-alpha treatment. A reduction of the caloric intake observed between M0 and M3 might explain these features. CONCLUSION: Significant but transient abnormalities of the nutritional status are encountered constantly at the beginning of rIFN-alpha therapy without any deleterious effect on growth. Information of the families and nutritional intervention during treatment should be required, in order to limit the importance of weight loss.

Adolescent↗

[Cow's milk proteins intolerance disclosed by ulcero-necrotizing enterocolitis in a full-term infant].

BACKGROUND: Necrotizing enterocolitis associated with milk protein intolerance is rare. CASE REPORT: A girl, born at term, weighing 3,150 g, was fed several different formulas because of persistent vomiting and diarrhea; some of these formulas contained cow's milk proteins. At 5 weeks of age, the patient developed acute abdominal distension and obstructive manifestations. Laparotomy showed intestinal distension and perforation of the distal small bowel, requiring resection with temporary ileostomy. Histological examination of the resected segment of the small bowel showed extensive necrosis of the mucosa and submucosa with involvement of the muscular layers. The patient was given parenteral nutrition for 3 weeks then refed with human milk. Cow's milk was introduced at the age of 2 1/2 months; this was immediately followed by vomiting and an anaphylactic reaction, with increased ileostomy fluid volume and blood and sugars in stools. A jejunal biopsy performed 3 weeks later showed moderate villous atrophy with a dense infiltrate of eosinophils below the epithelium. The RAST test was positive to beta-lactoglobulin and negative to casein and lactalbumin. The patient tolerated cow milk by the age of 18 months. CONCLUSIONS: Cow's milk protein tolerance should be evaluated when necrotizing enterocolitis occurs in the absence of classical risk factors.

Animals↗