An epidemic of adenovirus type 1 conjunctivitis.
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Adenoviridae Infections↗
Biomedical subjects
J P Collet
Publications and source records attributed to J P Collet.
[Juvenile insulin-dependent diabetes in Wuhan Province, People's Republic of China. Incidence rate from 1971 to 1985].
The average incidence rate of juvenile diabetes in Wuhan (People's Republic of China) between 1971 and 1985 was 0.6/10(5) in children less than 14 years of age. This incidence rate is close to that observed in Japan but seven times lower than the French rate and much lower than the incidence rate in other occidental countries. This is the second study to show a lower incidence rate of juvenile diabetes among Asian populations as opposed to occidental populations. However, interpretation of the results must be cautious with regard to the method of data collection.
Adolescent↗
[Atresia of the esophagus. Study of a cluster observed in 1984 in the Rhône-Alpes region].
The Rhône-Alpes Auvergne Register allows the monitoring of malformations, in 2 French regions. This monitoring led to the discovery of a cluster of cases of esophageal atresia of the isolated type during the year 1984. Analysis of this cluster showed that it was mainly due to a concentration of cases (7 observed vs 1.78 expected) born in the Ain department, 4 of them being born during the first trimester. Analysis of the cluster was followed by an individual questioning of families. It concerned essentially the environmental conditions of the onset of pregnancy and did not allow to set the hypothesis of a possible risk factor. The authors conclude that either the cluster should be attributed to chance, or the used questionnaire, even if directed towards all directions and seeming quite complete, was not sufficient to allow bringing out an hypothesis.
Abnormalities, Multiple↗
[Modalities of the care of acute non-severe infantile diarrhea as a function of the place of care. Prospective study during a winter epidemic].
Seventeen pediatricians and 34 general practitioners (GP) randomly selected in the closest area around Edouard-Herriot hospital (Lyon, France) were questioned regarding socio-economic status of families of infants who were treated for non severe acute diarrhea (loss of weight less than 10% of the initial body weight, no dehydration), and gave a copy of their prescription. During the same period, information was collected on outpatients as well as hospitalized cases of non severe acute diarrhea. Results show that in 3 months, GPs treated approximately 500 cases of non severe acute diarrhea, pediatricians 230 and the hospital 64. Oral rehydration was prescribed in 16% of diarrhea treated by GPs and 50% of those treated by pediatricians. The socio-economic status of families treated by pediatricians differed widely from those treated by GPs as well as those cared for in hospital. Vomiting as an argument for admission was found in 55% of referrals.
Acute Disease↗
[Care of non-severe acute diarrhea in infants: a socioeconomic approach].
During a period of 3 months, 267 children with non severe acute diarrhea (NSAD) were treated by one of four modalities of care: in the private office of a general practitioner (n = 58), or of a paediatrician (n = 109), in a hospital emergency service (n = 62), or as hospital inpatients (n = 38). The socio-economic status and the cost of treatment for each of these children was subsequently assessed. The children admitted to hospital were mainly referred by hospital out-patient departments (47%) and general practitioners (37%) who, unlike paediatricians, care for more socially disadvantaged patients. The main reason for hospitalization was the presence of diarrhea with vomiting (55%). Several measures are proposed to redefine the role of the hospital and to improve cooperation with doctors in office practice, which would reduce both the number of hospitalizations due to NSAD and the length of hospital stay. Since the cost of treating NSAD hospital is 60 time greater than care at home, these measures are economically important.
Diarrhea, Infantile↗
[Severe, refractory neonatal inflammatory syndrome as the manifestation of a systemic multivisceral and meningeal syndrome].
A neonate presented with an inflammatory syndrome with multisystemic manifestations. There was no remission until age 6 years, despite anti-inflammatory treatments. Neonatal onset and neuromeningeal manifestations identified a peculiar rare inflammatory syndrome, whose relationship with juvenile rheumatoid arthritis is discussed. In the case reported, renal, abdominal, deep lymphatic and cranial involvements were present: these have not been previously reported.
Follow-Up Studies↗
[Growth from birth to 2 years of North African infants born in France].
North African people living in France have low socio-economic standing and high birth rates. Growth in weight and height of 359 North African infants born in France was followed during their first 2 years of life. Comparisons were made with standard growth curves for French infants and with the growth of 143 French infants living in similar conditions. Growth in height was similar in each group but at 6 to 9 months of age North African girls were heavier (p less than 0.05). In order to standardize the data for each infant, cubic polynomial interpolation method was used.
Africa, Northern↗
[Cutaneous manifestations of periodic disease].
The authors report the case of an 8 year-old girl admitted for an erysipelas-like rash of the lower limbs and an episode of Henoch-Schönlein purpura. These manifestations were subsequently attributed to familial mediterranean fever. This case report illustrates the polymorphism of cutaneous manifestations in this disease.
Child↗
[Spina ventosa, a historic disease].
We report a case of tuberculous dactylitis--spina ventosa--in a 5 year-old girl from a French upper class family. Being today an unusual affection, the diagnosis of spina ventosa can be missed. Symptoms and means of diagnosis are reviewed.
Antitubercular Agents↗
[Medium chain acyl-CoA dehydrogenase deficiency. Apropos of a case with demonstration of this enzyme deficiency].
The medium chain acyl-CoA deshydrogenase defect: a new inherited metabolic disorder. This enzymatic defect blocks the catabolism of non esterified fatty acids during fasting. Thus, this disease is revealed by a coma due to hypoglycemia in a young child; the presence of dicarboxylic aciduria in such a situation is the main evidence for this diagnosis. Finally, the enzymatic studies performed on skin fibroblasts show a defect in medium chain acyl-CoA deshydrogenase. When a child is investigated away from a coma episode, the ketotic diet induces dicarboxylic aciduria but must be performed in an intensive care unit for its dangers.
Acyl-CoA Dehydrogenase↗
Dicarboxylic aciduria due to medium chain acyl CoA dehydrogenase defect. A cause of hypoglycemia in childhood.
Dicarboxylic aciduria was found during hypoglycemic episode in a 14 months old girl. Her brother had died at the age of 4 years during febrile illness. A ketogenic diet induced in this patient a severe hypoglycemia. Urinary organic acid profile exhibited abnormal excretion of the C6-C10 dicarboxylic acids (adipic-suberic-sebacic) and related metabolites (5 hydroxyhexanoic, hexanoylglycine, suberyl glycine). This pattern suggested a defect in fatty acids beta oxidation. Plasma carnitine values was within control limits. Similar clinical findings and urinary organic acids excretion have been described in 6 patients since the initial case of Gregersen. Enzymatic studies on cultivated fibroblasts from our patient showed a defect in medium chain CoA dehydrogenase. The treatment of this disease consists of glucose infusion during attacks and prevention of fasting. This rare disease must be considered in a child with non ketotic hypoglycemia or Reye's syndrome.
Acyl-CoA Dehydrogenases↗
[Coffin-Siris syndrome. Critical study of the literature apropos of a case].
The authors report a case of the Coffin Siris syndrome which associates a ungueo-digital syndrome (special by the bilateral aplasia or severe hypoplasia of nails and third phalanx of fifth toes and fingers) to other anomalies: facies with thinly fine hairs contrasting with bushy and dense eyebrows and body hypertrichosis, hypotonia and mental retardation. The connections of the Coffin Siris syndrome with the trisomy 9 p+ syndrome and the fetal hydantoïn syndrome are discussed.
Abnormalities, Multiple↗
[What is your diagnosis? Acute pneumopathy with a pseudotumoral spherical radiologic image].
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Acute Disease↗
Promotion of Breastfeeding Intervention Trial (PROBIT): a randomized trial in the Republic of Belarus.
CONTEXT: Current evidence that breastfeeding is beneficial for infant and child health is based exclusively on observational studies. Potential sources of bias in such studies have led to doubts about the magnitude of these health benefits in industrialized countries. OBJECTIVE: To assess the effects of breastfeeding promotion on breastfeeding duration and exclusivity and gastrointestinal and respiratory infection and atopic eczema among infants. DESIGN: The Promotion of Breastfeeding Intervention Trial (PROBIT), a cluster-randomized trial conducted June 1996-December 1997 with a 1-year follow-up. SETTING: Thirty-one maternity hospitals and polyclinics in the Republic of Belarus. PARTICIPANTS: A total of 17 046 mother-infant pairs consisting of full-term singleton infants weighing at least 2500 g and their healthy mothers who intended to breastfeed, 16491 (96.7%) of which completed the entire 12 months of follow-up. INTERVENTIONS: Sites were randomly assigned to receive an experimental intervention (n = 16) modeled on the Baby-Friendly Hospital Initiative of the World Health Organization and United Nations Children's Fund, which emphasizes health care worker assistance with initiating and maintaining breastfeeding and lactation and postnatal breastfeeding support, or a control intervention (n = 15) of continuing usual infant feeding practices and policies. MAIN OUTCOME MEASURES: Duration of any breastfeeding, prevalence of predominant and exclusive breastfeeding at 3 and 6 months of life and occurrence of 1 or more episodes of gastrointestinal tract infection, 2 or more episodes of respiratory tract infection, and atopic eczema during the first 12 months of life, compared between the intervention and control groups. RESULTS: Infants from the intervention sites were significantly more likely than control infants to be breastfed to any degree at 12 months (19.7% vs 11.4%; adjusted odds ratio [OR], 0.47; 95% confidence interval [CI], 0.32-0.69), were more likely to be exclusively breastfed at 3 months (43.3% vs 6.4%; P<.001) and at 6 months (7.9% vs 0.6%; P =.01), and had a significant reduction in the risk of 1 or more gastrointestinal tract infections (9.1% vs 13.2%; adjusted OR, 0.60; 95% CI, 0.40-0.91) and of atopic eczema (3.3% vs 6.3%; adjusted OR, 0.54; 95% CI, 0.31-0.95), but no significant reduction in respiratory tract infection (intervention group, 39.2%; control group, 39.4%; adjusted OR, 0.87; 95% CI, 0.59-1.28). CONCLUSIONS: Our experimental intervention increased the duration and degree (exclusivity) of breastfeeding and decreased the risk of gastrointestinal tract infection and atopic eczema in the first year of life. These results provide a solid scientific underpinning for future interventions to promote breastfeeding.
Adult↗
[Antithrombotic therapy in the acute phase of unstable angina].
Low molecular weight heparins appear to be a better choice in patients with unstable angina than unfractionated heparin. In addition, the excellent predictable dose-response makes them suitable to prevent ischemic complications of percutaneous coronary intervention. Although direct comparisons between LMWH and UH are limited, substantial evidence exists that patients receiving LMWH can be safely brought to cardiac catheterization. Therefore, previous concern regarding transitioning such therapy from the medical service to the cardiac catheterization laboratory should not impede the upstream use of thèse agents. Although UH remains an option in conjunction with GP IIB/IIIa inhibitors, there is substantial evidence that LMWH and GP IIb/IIIa inhibitor therapy can be used safely in combination. Although GP IIb/IIIa inhibitors are very potent to prevent ischemic events after percutaneous coronary interventions, their benefit in the medical management of unstable angina is much more modest. ADP receptor antagonists reduce major ischemic events in combination with aspirin in the medical management of unstable angina patients but also when PCI is planned. Their combination with GP IIB/IIIa receptor antagonist does not impair the benefit of GP IIb/IIIa antagonists. The development of biologic tools to monitor these antithrombotic regimen is highly warranted especially in high risk patients (chronic renal failure, elderly).
Acute Disease↗
Myocardial infarction after aspirin cessation in stable coronary artery disease patients.
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Adult↗
Acute myocarditis presenting as acute myocardial infarction and sudden death with complete atrioventricular block: value of antimyosin scintigraphy.
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Acute Disease↗
Economic impact of using an immunostimulating agent to prevent severe acute exacerbations in patients with chronic obstructive pulmonary disease.
RATIONALE: OM-85 BV, an immunostimulant made from bacterial extracts, has been shown to reduce the risk of hospitalization for acute exacerbation in patients with chronic obstructive pulmonary disease, as well as to reduce the length of stay for all hospitalizations. METHODS: In conjunction with a placebo controlled, randomized clinical trial, a cost effectiveness analysis was carried out to assess the economic impact of using OM-85 BV. In the analysis, effectiveness was defined as the difference in the number of severe acute exacerbations, assessed by the number of hospitalizations for a respiratory problem, between the placebo and OM-85 BV-treated groups. RESULTS: The median cost to prevent one day of hospitalization for a respiratory condition was CDN$45, with a 95% CI of CDN$18 to CDN$210. Bootstrap of the study population and sensitivity analyses showed that the results were robust and not likely due to random fluctuation; 98.8% of the cost effectiveness and 96.8% of the cost-benefit ratios favoured the use of OM-85 BV. Indirect costs, defined as a need for help, were reduced by 36% in the group treated with OM-85 BV: 779 h of help compared with 1212 h in the placebo group. This trend, while not significant, is consistent with other results and suggests a decrease in the severity of exacerbations in the OM-85 BV-treated group. CONCLUSION: Given the high prevalence of chronic obstructive pulmonary disease worldwide and the high cost of acute exacerbations, immunostimulants may become a key element in the improved control of this condition.
Adjuvants, Immunologic↗