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Biomedical subjects

J B Cotton

Publications and source records attributed to J B Cotton.

At least 19 recordsLinked to original sources
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↗
PubMed1995

[Tuberculous dacryocystitis].

BACKGROUND: Acute infection and inflammation of the nasolacrimal sac may complicate congenital obstruction of the nasolacrimal duct. Acute dacryocystitis is uncommon later and tuberculosis is exceptionally responsible for it. CASE REPORT: A 4 1/2 year-old boy was admitted because he suffered from acute left dacryocystitis with fever and cervical adenitis. Involvement of both lacrymal gland and lymph node persisted despite antibiotic and corticosteroid therapy. Needle biopsy of the lymph node showed presence of Mycobacterium tuberculosis and excision revealed caseating granulomas. The tuberculin skin test was positive while pulmonary tuberculosis was discovered in the patient's father. The patient was successfully given izoniazid, rifampin for 9 months and pyrazinamide for 2. Drainage of the sac area was necessary after 1 month of treatment followed by dacryocystorhinostomy. CONCLUSION: This rare case of tuberculous dacryocystitis permits to delineate the difficulties of ophthalmologic therapy.

Acute Disease↗
PubMed1994

[Exophthalmos in children caused by vascular orbital neoformation].

BACKGROUND--Exophthalmos or proptosis may be a result of several causes; when unilateral, it leads to search a variety of orbital tumors. CASE 1--A 2 month-old baby presented with a right exophthalmos which developed within a few days. Computed tomography showed infiltration of the orbit by a mass. Surgical biopsy showed capillary hemangioma. The patient was given prednisone 2 mg/kg/day for 2 months; exophthalmos disappeared within 10 days and the child was normal 7 years later. CASE 2--A 13 year-old boy was examined because he had developed left exophthalmos within 2-3 weeks. Ultrasonography and computed tomography showed an orbital tumor compressing the eye and the optic nerve. This tumor was excised and histological examination showed that it was a thrombotic arterial aneurysm. CONCLUSIONS--Vascular lesions can be responsible for a rapidly developing orbital tumor. Their diagnosis can be difficult and must be made in order to avoid aggressive surgery.

Adolescent↗
PubMed1992

[Diffuse alveolar pertussis with major hyperleukocytosis with "pseudocentrocytic" contingent].

A 21 month-old unvaccinated boy was admitted for an acute respiratory distress episode associated with major leukocytosis (maximum = 146 G/l). Transient heart failure and pneumomediastinum occurred but the outcome was favourable. Coughing attacks then occurred and the diagnosis of pertussis was serologically confirmed. This case report is reminiscent of the possible severity of pertussis pneumoniae, the mechanisms of haematologic abnormalities, and stresses to the benefit of pertussis vaccination.

Humans↗
PubMed1991

[Rheumatoid purpura and Berger's disease in the same patient. 2 cases].

The two patients reported experienced initially typical Henoch Schönlein purpura, and Berger disease some years later. Same cases are described in the literature pleading for the relationship between the two entities; Berger disease may be considered as a symptomatic form of anaphylactoïd purpura.

Child↗
PubMed1991

[Congenital mega-urethra. A case].

Congenital megalo-urethra is a malformation of the male urethra with a major dilatation of its penile part without obstruction downwards. It is either due to hypoplasia or agenesia of spongy tissue. Two types are described, scaphoid and fusiform types, according to the presence or the absence of erectile tissue. Megalo-urethra is a rare condition, and 56 cases were previously reported until 1987. A new case of this severe anomaly is reported and management discussed.

Humans↗
PubMed1989

[Congenital mega-urethra. Comments apropos of a case report].

Congenital megalourethra is a malformation of the male urethra with a major dilatation of its penile part without obstruction downwards. It is either due to hypoplasia ore agenesia of spongy tissue. Two types are described, scaphoide and fusiform types, according to the presence or the absence of erectile tissue. Megalourethra is a rare condition, and 55 cases were previously reported until 1987. A new case of this severe anomaly is reported and management discussed.

Humans↗
PubMed1988

[Familial intrauterine nanism with constrictive pericarditis, the MuLiBrEy syndrome].

The authors report the case of two siblings with a MU.LI.BR.EY syndrome. This acronym standing for a singular type of recessive autosomal intra-uterine dwarfism, insufficiently points to the role of pericardial constriction. The main symptoms and the prognosis of the disease are related to pericardial damages. The relevance of the diagnosis lies in the possibilities offered by pericardectomy.

Dwarfism↗
PubMed1986

[Epstein-Barr virus cerebellitis in an 11-year-old girl].

The authors report an eleven year old girl who manifested predominantly an acute cerebellar syndrome secondary to infection by Epstein Barr Virus. This complication is unusual and males are predominantly affected. The diagnostic and common physiopathological hypothesis are discussed.

Acute Disease↗
PubMed1975

[Nephroepithelioma of children manifested by isolated recurrent hematuria. Diagnostic problems apropos of 3 cases].

In children, nephroepithelioma represent less than 10% of the malignant tumors of the kidney. Reporting 3 cases, the authors emphasize that the clinical expression of nephroepithelioma, often made only of recurrent hematuria occuring over years, may mislead adequate diagnostic approach. Thus, a kidney arteriogram should be included in the investigations of nephroepithelioma. Earlier diagnosis may improve the rate of recovery from nephroepithelioma which, in children, is about 30%.

Adenocarcinoma↗
PubMed1975

[A form of late propionic acidemia].

Report of 3 cases of propionic acidemia which concern one boy (O.M.) in whom a formed diagnosis of hyperglycemia with ketosis had been established, and two sisters (C.V. and K.V.) of another family. The activities of propionyl-CoA carboxylase in O.M. and C.V. fibroblasts were reduced to 4.5 and 2.5% of control. After two severe metabolic crisis, at 6 and 44 months of age, O.M. has at the present time (11yrs) a normal psychical development, and very few neurological disorders. Propionic acidemia was manifested only at 34 months of age in C.V. with a very severe crisis of acidoketosis with hypoglycemia, leading to neurological sequellae which are still important at 56 months of age. The disease was entirely latent in K.V. at 26 months, when the diagnosis was proven; it remains latent at 40 months. These case reports represent a special form of propionic acidemia with late clinical expression. Biological evolution does not seem to be affected by prolonged administration of biotine.

Acidosis↗
PubMed1975

Partial 4q trisomy. Apropos of 3 cases.

Three observations of partial trisomy 4q are reported: the first due to a familial translocation the second to a de nove translocation, the third to a "mirror" duplication. The very characteristic phenotype is compared to that of 4 other patients already reported in the literature. The most evocatory symptoms include: absent or poorly indicated nose bridge; pursed lips; shortness of the philtrum; and constant existence of a fold on the antitragus continuing the anthelix reachinghe insertion of the pinna.

Abnormalities, Multiple↗