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Biomedical subjects

J F Duhamel

Publications and source records attributed to J F Duhamel.

At least 19 recordsLinked to original sources
PubMed1994

[Virological diagnosis and treatment of respiratory syncytial virus infections].

Respiratory syncytial virus infections occur frequently in children, often localized in the upper respiratory tract. Outcome is usually quite satisfactory, but in nearly one half of the infants lower tract involvement may cause severe respiratory insufficiency leading to hospitalization in about 1% of the cases. Its frequency has been estimated at 20 to 30% of the viral infections in hospitalized infants, 10 times the frequency of the other respiratory virus. Respiratory syncytial epidemias last about 4 to 5 months with a seasonal peak in december and january. The direct detection of respiratory syncytial antigens in nasal specimens by immunofluorescence or enzymatic immunoassay is the key to rapid diagnosis. They appear as performant and more convenient than specific IgM antibodies or nucleic acid detections, and than virus isolation on cell culture, which is justified to evaluate strain sensitivity to ribavirin. Immunofluorescence has also been used to identify the subgroups A and B from 1981 to 1993, and respiratory syncytial subgroup A seems to signify more severe disease. Symptomatic assistance may require hydratation, oxygenotherapy and respiratory physical therapy. Antibiotics should not be given as a routine treatment since bacterial superinfection is infrequent, but may be indicated in cases with associated signs of complications. Indications for bronchodilators and corticosteroids are still under debate. Significant results have been obtained with ribavirin and specific anti respiratory syncytial immunoglobulins but further evaluations are still required to precise their use in clinical practice.

Antibodies, Viral↗
PubMed1993

Chromium and parenteral nutrition in children.

Chromium (Cr) dosage was assayed in i.v. nutrition, serum, and losses of five children on total parenteral nutrition for > or = 4 weeks. The Cr supply (4.7 +/- 1.2 micrograms/kg/day) was above recommended levels (0.5 microgram/kg/day). Serum (18.2 +/- 1.8 micrograms/L) and urine (37.4 +/- 10.5 micrograms/L) were also higher than control values (0.7-0.9 microgram/L and 0.2-0.8 microgram/L, respectively). Serum and urine Cr concentrations displayed a positive correlation. Serum Cr and Fe showed a negative correlation. These results confirm the potential toxicity of Cr previously reported in animals. Cr levels of i.v. nutrition solutes should be checked thoroughly.

Child↗
PubMed1993

Pharmacokinetics of fusidic acid after a single dose of a new paediatric suspension.

The pharmacokinetics of fusidic acid (Fucidine, Leo Laboratories) were studied in 10 children after single oral dosing with 20 mg/kg of a new banana-flavoured paediatric suspension (titrating at 50 mg/ml). Nine blood samples were drawn from each child at 0, 1, 2, 3, 6, 8, 12, 24 and 48 h following dosing with the antibiotic. Serum fusidic acid levels were measured by high-performance liquid chromatography (HPLC). A model-independent method was used for the pharmacokinetic analysis. Results were compared with those obtained after dosing eight healthy adult volunteers with 500 mg of sodium fusidate by parenteral administration (infusion) then per os. The acceptability of the single dose was good. The terminal elimination half-life t1/2 (h) and the mean residence time (MRT, h) of fusidate were similar to those determined in healthy adults after oral dosing, i.e. 16.0 +/- 14.5 versus 16.0 +/- 3.5 and 17.7 +/- 12.1 versus 17.7 +/- 2.5, respectively. In contrast, the oral bioavailability of the suspension (Fapprox., %) was relatively low: of the order of 22.5 versus 91.0% for tablets in the healthy adult, which justifies the use of a relatively higher dose in the child. This led to the calculation of an estimated total clearance (Clest., ml/min) significantly less than that in the healthy adults, while the estimated apparent volume of distribution (Vd, litre/kg) was significantly increased (10.4 +/- 9.1 versus 21.8 +/- 2.1 and 0.73 +/- 0.53 versus 0.30 +/- 0.04, respectively). Fusidic acid is normally excreted in metabolized form (98%). The decrease in clearance could be attributed to the almost immediate saturation of liver enzymes in immature infants.(ABSTRACT TRUNCATED AT 250 WORDS)

Administration, Oral↗
PubMed1993

[Prevalence and clinical aspects of A and B subgroups of respiratory syncytial virus infection. Observation of 8 consecutive epidemics between 1982 and 1990].

BACKGROUND: Infants suffering from respiratory syncytial virus (RSV) infection can have severe responses that require intensive care. This study compares the epidemiologic patterns and the severity of respiratory diseases produced by RSV strain subtypes A and B. POPULATION AND METHODS: The prevalence of RSV subgroups was studied over 8 consecutive outbreaks from 1982 to 1990. The files of 73 infants aged from 1 to 24 months admitted because of RSV infection between October 1987 and March 1990 were studied. The criteria of severity were tachypnea and/or the use of the accessory muscles for respiration, apnea and/or cyanosis, hospitalization for > 8 days, hypercapnia and/or acidosis, oxygen therapy, use of corticosteroids and/or bronchodilators, nutritional difficulties. RESULTS: A total of 374 RSV strains were isolated: 142 were group A and were 232 group B. Subtype A predominated during the winter 1987-1988 and subtype B during 1983-1984, 1984-1985 and 1989-1990. Some indicators of severity, such as degree of respiratory distress, duration of hospitalization and levels of oxygen saturation, were correlated with A subgroup infections, but the difference in the severity index for the two subtypes was not statistically significant. CONCLUSIONS: The results are not consistent with other previous reports, perhaps because different indicators of severity were used in this study and infants less than one month old or having other underlying diseases were excluded.

Acute Disease↗
PubMed1993

[Antipyretic effect of tiaprofenic acid in children. Comparative study with paracetamol].

The authors report the results of a randomised, multi-centric study comparing the antipyretic activity of tiaprofenic acid to that of acetaminophen. Seventy nine children of both sexes, aged 8 months to 9 years, having an average temperature at inclusion of 38.5 degrees C (+/- 0.5 degree C), received as a single dose 50 mg of tiaprofenic acid (3.7 +/- 0.9 mg/kg) (40 children) or 100 mg of acetaminophen (7.7 +/- 1.7 mg/kg) (39 children) for upper respiratory tract infection. The rectal temperature was taken regularly over a 6-hour period. Whatever the criteria considered (gradient between the initial temperature and the lowest temperature observed, difference of temperature at the different time points between the two groups), tiaprofenic acid appeared as effective an antipyretic as acetaminophen. Tolerance was good in both groups. Tiaprofenic acid appears as an interesting alternative to acetaminophen in the treatment of fever in upper respiratory tract infections in children.

Acetaminophen↗
PubMed1993

[Nutrition of children and adolescents engaged in high-level sports activities].

Young high-level athletes are frequently exposed to deficiencies, the most frequent origin of which is dietary. Supervision must be clinical, biological and dietary. Recommendations should be made individually, based on the nature and intensity of the exercise, and are calculated from the recommended supplements for the paediatric population. Protein, glucid and lipid supplements must represent approximately 12, 60 and 28% of the daily energetic intake respectively, the glucid ratio reaching 70% under certain conditions of prolonged exercise. Liquids must be controlled when exercise takes place in a warm atmosphere because young athletes are rapidly exposed to dehydration, the osmolarity of the selected drink being below 250 mosm/l. Mineral and vitamin supplementations are recommended. For minerals, perspiration losses may be associated with dietary deficiency. Possible vitamin deficiencies concern B1, B2, B6, B9, B12, C and D vitamins. The daily mineral supplements are estimated at 10 mg for iron, 5 mg for zinc and 1 mg for copper, and have to be prescribed in regular treatment after biological control.

Adolescent↗
PubMed1992

[Influenza A infection in children. Clinical spectrum and comparison with respiratory syncytial virus infection during the winter 1989-1990].

BACKGROUND: Respiratory syncytial viral (RSV) infection can be rapidly differentiated from influenza viral infection by immunofluorescence techniques. These tests were used to identify some epidemiological and clinical characteristics of both infections. METHODS AND PATIENTS: 77 RSV and 22 influenza viral infections were detected during an outbreak (November 1989 to March 1990) in 210 children less than 6 years admitted for lower respiration tract infections. The fluorescent antibody assay was performed on nasal aspirates. RESULTS: The RSV outbreak ran from November to March, while the influenza outbreak was shorter, during December and January. The patients infected with RSV were younger (mean age: 6.7 months) than those infected with influenza virus (mean age: 20.9 months) (p < 0.001). Those with influenza virus infection presented with higher temperatures, more often had initial seizures (p < 0.05) and displayed fewer clinical or X-ray respiratory symptoms (p < 0.001). Mean durations of hospitalization were 9.9 days for RSV infection and 7.7 days for influenza virus infection. The therapeutic use of bronchial dilators, oxygen and steroids was correlated with the degree and duration of respiratory manifestations. A 3 month follow-up was insufficient to show any difference between recurrences or complications in the two groups. CONCLUSION: The clinical and radiological differences in these two groups of patients viral-infected are similar to those described in the literature. Variability from one outbreak to another precludes any extrapolation to other populations and justifies the systematic use of the fluorescent antibody assay, especially when a specific antiviral therapy is considered.

Child↗
PubMed1991

Molybdenum in the premature infant.

The molybdenum (Mo) levels in the plasma and urine of 30 premature and 15 full-term infants have been compared with the Mo intakes and urine uric acid excretion (uric acid/creatinine ratio) produced by the Mo enzyme xanthine oxidase. The Mo intakes of full-term infants were 41 +/- 14 nmol/kg/day (mean +/- SEM). In the premature group breast milk supplied significantly less Mo (4.3 +/- 0.4 nmol/kg/day) than infant formulas (101 +/- 31 nmol/kg/day) or premature formula (255 +/- 13 nmol/kg/day). When fed breast milk, the preterm infants displayed similar or higher plasma and urine Mo and urine uric acid levels than formula-fed infants. For the whole preterm group a significant correlation was determined for urine Mo levels and Mo intakes as well as for plasma Mo and uric acid excretion. The bioavailability of breast milk Mo seems to be higher than formula Mo according to the Mo levels and to their statistical link with uric acid excretion which could be proposed as a functional index of Mo status. These parameters displayed similar values in breast milk-fed prematures and control full-term infants. The Mo needs of formula-fed premature newborns remain to be defined using complete balance trials.

Creatinine↗
PubMed1990

[Vitamin A status in full-term and premature infants].

Vitamin A status has been assessed by studying plasma vitamin A and retinol binding protein (RBP) levels in premature infants receiving 7,500 IU vitamin A/d (RDA 660-3,300 IU/d) and in control term babies during the 3 first months of life. Sampling was performed within the first week (D0-D7), between the 8th and the 30th day (D8-D30) and during the 2nd and the 3rd month of life (M2-M3). At D0-D7, vitamin A levels of the PTI group (28-32 weeks gestational age), PTII (33-36 weeks GA) and AT (control term newborn) were 242.1 +/- 20.5 (X +/- SEM), 176.1 +/- 12.3 and 213.1 +/- 17.1 micrograms/l respectively (P = 0.005). At D8-D30, these values were 264.2 +/- 26.0, 270.4 +/- 21.6 and 242.6 +/- 24.5 micrograms/l respectively (NS), and at M2-M3 234.2 +/- 21.6, 282.1 +/- 18.5 and 292.1 +/- 31.5 micrograms/l (NS). A significant difference was found between the values of the different dosage periods for PTII and AT groups; no difference in RBP levels was found either between groups or between dosage periods. At birth, our results show that the RBP synthesis is not closely linked to gestational age. The plasma vitamin A levels which rely on foetal stores and therefore on transplacental passage and on peripheral tissue requirements are low at 33-36 weeks gestational age. With a 7,500 IU daily supplement, excessively high vitamin A levels were not observed in premature infants; vitamin A and RBP levels in premature infants receiving supplement are not different from controls despite the 8-12-week term high vitamin A supply.

Follow-Up Studies↗
PubMed1990

[Selenium and vitamin E in patients with progressive muscular dystrophy].

Serum levels of selenium and vitamin E were prospectively studied in children with Duchenne de Boulogne muscular dystrophy of variable age and muscular status. In contrast with previous studies, we found no differences with controls. However, we believe that selenium and vitamin E, two natural antioxydants, may contribute to the pathophysiology of pseudohypertrophic muscular dystrophy. A study of the effects of supplementation is on-going.

Adolescent↗
PubMed1989

[Neutralizing activity against herpes simplex in maternal milk].

Human milk could play a role in the protection of the newborn from Herpes simplex virus 2 contamination. Neutralizing activity against Herpes simplex virus 2 was measured in 94 human milk samples and in 31 sera from healthy women. A weak neutralizing activity was detected in 48 milk samples. They were neither correlated to anti-Herpes simplex virus antibodies found in milk, nor to the neutralizing activity in sera. The origin and non immunologic nature of this activity are discussed.

Antibodies, Viral↗