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Biomedical subjects

J Senterre

Publications and source records attributed to J Senterre.

At least 19 recordsLinked to original sources

[Medico-surgical management of childhood cardiopathy: results of the Liège experience].

OBJECTIVE: Evaluation of the results obtained in the management of congenital heart diseases in Liège. MATERIAL AND METHODS: We evaluated the results, the mortality and the morbidity of diagnostic and interventional cardiac catheterization, and of the cardiac surgery in the 123 cardiac children who were referred to us during the three first years of operation of our medico-surgical team. RESULTS: 89 children underwent a catheterization, including 12 therapeutic interventions, whereas 68 were operated. In the two domains, the results are completely comparable with those of the established centers. CONCLUSIONS: The widening of the activity of paediatric cardiology and the creation of an activity of pediatric cardiac surgery in Liège appeared important to us for the quality of management of the cardiac children. This goal could be reached only if our results were comparable with those of the literature. The bet seems to be held. The ultimate objective is to contribute by an adequate policy of management to the quality of life and the health of the cardiac children.

Adolescent

[Drug clinics. Drug of the month. A new measles-rubella-mumps vaccine (Priorix)].

A novel measles-mumps-rubella vaccine (Priorix) has been marketed by SmithKline Beecham. It contains live attenuated virus with measles and mumps strains slightly different from those present in MMR VAX (Pasteur Merieux MSD). The indications and contraindications are similar for both vaccines. Immunogenicity is also equivalent as well as general reactogenicity. By contrast local symptoms were reported significantly less frequently after Priorix.

Adjuvants, Immunologic

[Pompe disease or type 2 glycogenosis].

We report the case of a rapidly progressing respiratory failure of a three-month old infant, who shows a cardiomyopathy with left ventricule hypertrophy leading to a Pompe's disease diagnosis. This type 2 glycogenosis will be confirmed by the enzymatic study of the hepatocytes. It is a genetic pathology associated with a deficient activity of the acid maltase resulting in a intralysosomial accumulation of glycogen. The most generally responsible mutations are: delta 18 et delta 525. Prognosis is quite bad with a progressive deterioration of the heart, brain and muscular functions causing death at around 4 to 8 months. Type 2 glycogenosis may be diagnosed before birth through enzymatic study of a material collected through an amniocentesis or a biopsy on chorionic villi, and through DNA analysis. Curative treatment is still under study, but two main research orientations are being developed: genic therapy using viral vector and the correction of the enzymatic deficiency thanks to the synthesis of alpha glucosidase modified to specially get affixed to the heart and muscular cells. Both techniques have already show some encouraging results even though the clinical applications are not presently valid yet.

Female

[Cat-scratch disease].

Cat-scratch disease is a subacute, regional lymphadenitis syndrome that occurs mainly in children. The causative agent is Bartonella henselae. After an incubation period ranging usually between 1 and 2 weeks, red papules develop at the site of cutaneous inoculation and persist until the development of lymphadenopathy with some malaise. Cases with complications have been observed including Parinaud oculoglandular syndrome, encephalopathy, a variety of exanthems and granumatous hepatitis. Diagnosis is based on serologic tests and, when necessary, antimicrobial treatment can be considered. Incision and drainage should not be done.

Amoxicillin-Potassium Clavulanate Combination

Evaluation of dual-energy X-ray absorptiometry for body-composition assessment in piglets and term human neonates.

The reproducibility, accuracy, and precision of dual-energy X-ray absorptiometry (DXA) was assessed by scanning 13 piglets (1471-5507 g) in triplicate. In four piglets, fat content was increased with porcine lard around the abdomen; additional measurements were performed on these animals. Reproducibility in DXA measurements from the animals without added fat was 0.09% for body weight, 1.95% for bone mineral content (BMC), and 5.35% for fat content. DXA estimates of body weight, BMC, and fat content were significantly correlated with scale body weight, ash weight, chemical calcium, and chemical fat. Body weight was measured accurately but fat content was overestimated by DXA. Mean BMC estimated by DXA represented 48% of ash weight and 215% of calcium content. The precision of DXA was 0.23% for body weight, 10.99% for ash weight, and 4.44% for calcium content. The precision of DXA for fat content was poor. However, for measurements performed in piglets with > 250 g fat, the precision was 8.85%. Thirty appropriate-forgestational-age term human neonates (birth weight: 3188 +/- 217 g) were scanned once during the first week of life. BMC and fat content were 54 +/- 6 and 470 +/- 92 g, respectively, which corresponded to 26.4 +/- 2.6 g calcium and 427 +/- 82 g fat. These were close to the reference values previously determined by chemical analysis. This study suggests that DXA is accurate and reliable for measurement of calcium and fat contents in human neonates. Further refinements would be beneficial for determining fat content in preterm human infants.

Absorptiometry, Photon

Effect of a fermented infant formula containing viable bifidobacteria on the fecal flora composition and pH of healthy full-term infants.

We assessed the growth, tolerance, and acceptability as well as fecal flora composition and stool pH of 20 healthy full-term infants fed with a fermented whey-adapted infant formula containing viable bifidobacteria (10(6)/g of powder) during the first 2 months of life. This fermented infant formula, first biologically acidified by Streptococcus thermophilus and Lactobacillus helveticus, was compared to a whey-adapted, nonacidified, low-phosphate infant formula in a double-blind, randomized controlled study. The results were compared to a control group (n = 14) of fully breast-fed infants. The fermented whey-adapted formula containing viable bifidobacteria induced a prevalence of colonization with bifidobacteria at 1 month of age similar to that of breast-fed infants (12/20 versus 8/14) but significantly higher than in the group fed the standard infant formula (4/20). The mean bacterial count of bifidobacteria was similar in all colonized infants; however, fecal pH was significantly lower in the breast-fed infants than in the nonacidified bottle-fed infants. This kind of infant formula was well tolerated and promoted a normal growth during the first 2 months.

Bifidobacterium

Nutritional evaluation of protein hydrolysate formulas.

Growth parameters, biochemical indice of protein metabolism and plasma Amino acid (AA) concentrations were investigated during the first month of life in term infants (n = 61) fed various protein hydrolysate formulas (whey (WHF, n = 3), soy collagen (SCHF, n = 1) and whey-casein hydrolysate formulas (WCHF, n = 1)). In addition, metabolic balance studies were performed in 10 infants fed WHF and in 5 fed WCHF. Comparatively to breast fed infants, growth reduction and decrease in plasma protein concentrations were observed with the use of one of the WHF and in a lesser extent with the SCHF and the WCHF. Plasma amino acid pattern reflected the AA content of the formulas. Whey hydrolysate formulas induced mainly an increase in threonine and a decrease in tyrosine concentrations. Soy-collagen hydrolysate formula led to an increase of non-essential amino acids, such as glycine and hydroxyproline and a decrease in plasma lysine and cystine. Whey-casein hydrolysate formula induced a plasma amino acid pattern close to the profile observed in breast fed infant. Metabolic balance studies showed a relative reduction in nitrogen absorption and utilisation in the infants fed the WHF and the WCHF. In addition a drastic reduction in fat, calcium and phosphorus absorption was also observed with the use of the WCHF. In preterm infants (n = 19) fed whey predominant hydrolysed preterm formulas (n = 3), metabolic balance studies an plasma AA concentration were evaluated at the end of the first month of life at 34 weeks of gestation age. Comparatively to similar preterm infants fed conventional preterm formulas, a relative reduction in nitrogen absorption (83% vs 90%) and retention (64 vs 70%) as well as in phosphorus absorption (78 vs 89%) was observed. Calcium retention was similar (48 vs 45 mg/kg/d) but calcium intake was significantly higher in infants fed hydrolysate formulas 120 vs 91 mg/kg/d. Plasma amino acid concentrations were related to amino acid composition of the formulas. Compared with the standard preterm formulas, all three protein hydrolysate formulas led to a significant increase in plasma threonine and a decrease in tyrosine and phenylalanine concentrations. In addition, there was a reduction in plasma histidine, valine, leucine, cystine, methionine and/or tryptophane with some of the hydrolysate formulas used. In conclusion, these studies provide evidence that protein hydrolysed formulas are not equivalent to whole protein formulas in terms of nutritional efficiency for preterm and term infants. Therefore further extensive nutritional studies on growth, biochemical indices of protein metabolism and metabolic balance, including minerals and trace elements, appear to be necessary before maintaining and promoting the use of such formulas for teh potential benefits on atopic disease in preterm and in full-term newborn infants.

Breast Feeding

Plasma amino acid and protein concentrations in infants fed human milk or a whey protein hydrolysate formula during the first month of life.

The aim of the study was to compare growth parameters, biochemical indices of protein metabolism and plasma amino acid concentrations in infants fed either human milk (n = 12) or a whey protein hydrolysate formula (n = 13) during the first month of life. Growth and gain in skin fold thickness were similar in both groups whereas serum protein concentration was significantly decreased (57.4 +/- 3.9 versus 61.2 +/- 2.9 g/l) in the infants fed the whey hydrolysate formula. The discrepancies between the plasma amino acid pattern of the whey hydrolysate formula group and that of the human milk group lessened during the first month. Nevertheless, at a mean age of 33 days the plasma threonine concentration remained twice as high and the plasma tyrosine, phenylalanine and proline concentrations were significantly lower in the whey hydrolysate formula group than in the human milk group. Thus, compared with breast-fed infants, growth and most of the biological indices of protein metabolism were satisfactory in infants fed during the first month of life on a whey protein hydrolysate formula. Nevertheless, the decrease in total plasma protein concentration needs to be confirmed in a larger cohort of infants. In addition, further research is necessary to investigate the possible ways of reducing the hyperthreoninemia and preventing other plasma amino acid disturbances since it would be desirable to obtain plasma amino acid levels similar to those of breast-fed infants.

Amino Acids

Nutritional evaluation of various protein hydrolysate formulae in term infants during the first month of life.

The aim of the study was to compare, during the first month of life, growth parameters, biochemical indices of protein metabolism and plasma amino acid concentrations in newborn infants fed either human milk (n = 23), three different whey hydrolysate formulae (WHF 1, n = 13; WHF 2, n = 10; WHF 3, n = 13), a soy-collagen hydrolysate formula (SCHF n = 18) or a whey-casein hydrolysate formula (WCHF, n = 20). Growth parameters and the various protein concentrations determined in the infants fed WHF 1 and WHF 2 were similar to the values observed with human milk. With WHF 3, growth in weight, length and head circumference and serum total protein concentrations were reduced significantly whereas blood urea nitrogen was increased. With SCHF, growth in weight and length as well as serum total protein and transferrin concentration were decreased significantly, whereas serum IgG concentration was increased. With WCHF growth in length and serum transferrin concentration were decreased compared to the human milk group. In the various groups, the plasma amino acid pattern reflected the amino acid content of the formula. Whey hydrolysate formula induced mainly an increase in threonine and a decrease in tyrosine concentrations. Soy-collagen hydrolysate formula led to an increase of non-essential amino acids, such as glycine and hydroxyproline, and a decrease in plasma lysine and cystine. Whey-casein hydrolysate formula induced a plasma amino acid pattern close to the profile observed with human milk. Nevertheless, the plasma concentrations of most of the various amino acids were higher.(ABSTRACT TRUNCATED AT 250 WORDS)

Amino Acids

Metabolic and energy balance in small- and appropriate-for-gestational-age, very low-birth-weight infants.

This study compared nutrient utilization and postnatal weight gain composition in eight appropriate for gestational age (AGA: birth weight 1293 +/- 107 g; gestational age 28.8 +/- 1.4 weeks) and eight symmetrically growth-retarded (SGA: birth weight 1110 +/- 230 g; gestational age 32.7 +/- 1.9 weeks), very low-birth-weight (VLBW) infants. There was no significant difference in protein, mineral and energy intake between AGA and SGA infants. Nitrogen absorption (84 +/- 3 and 83 +/- 4%) and nitrogen retention (356 +/- 48 and 352 +/- 43 mg/kg/day) were similar in both groups. Fat absorption tended to be lower in AGA (78 +/- 15%) than in SGA (87 +/- 4%) infants. Calcium, phosphorus and magnesium absorptions were similar in AGA and SGA infants. Metabolizable energy utilization was similar in both groups; about 55% was expended and 45% stored in new tissues. Energy expenditure was 58 +/- 4 kcal/kg/day in SGA infants and 61 +/- 9 kcal/kg/day in AGA infants. Weight gain and its composition were similar in both groups. We conclude that nutrient and energy utilization are similar in AGA and symmetrically growth-retarded, VLBW infants.

Energy Metabolism

Metabolic balance studies and plasma amino acid concentrations in preterm infants fed experimental protein hydrolysate preterm formulas.

The aim of this study was to investigate absorption and retention of nitrogen, fat, calcium, phosphorus and magnesium, as well as plasma amino acid concentrations in 19 preterm infants fed three experimental protein hydrolysate preterm formulas (PTHF): seven received a preterm formula based on 100% whey hydrolysate protein (PTHF1), seven other infants were fed a preterm formula based on a mixture of 78% whey and 22% casein hydrolysed protein (PTHF2) and a third group of five infants were fed the same type of protein hydrolysate (78/22) enriched with histidine (PTHF3). Metabolic balances (n = 39) and plasma amino acid concentrations (n = 12) in preterm infants fed a standard preterm formula (whey/casein: 60/40) were included as a control group. Amino acid composition of the formulas was determined after complete hydrolysis with 12 N HCl. Compared with the standard preterm formula, the use of protein hydrolysate formulas led to a decrease in nitrogen and phosphorus absorption without modification of retention. Net absorption of calcium and magnesium was not significantly different in the four groups but calcium intake necessary to obtain calcium retention similar to the standard preterm formula was higher in the infants fed the hydrolysate formulas. Plasma amino acid concentrations were related to the amino acid composition of the formulas. Compared with the standard preterm formula, all three protein hydrolysate formulas led to a significant increase in plasma threonine, and a decrease in tyrosine and phenylalanine concentrations. In addition, there was an important reduction in plasma histidine concentrations with PTHF1.(ABSTRACT TRUNCATED AT 250 WORDS)

Amino Acids

Mineral balance and whole body bone mineral content in very low-birth-weight infants.

Fat and mineral metabolic balance studies were performed in 25 normal very low-birth-weight infants (< or = 1500 g at birth) fed either pooled pasteurized human milk supplemented with calcium, phosphorus and magnesium, or a preterm formula. Calcium, phosphorus and magnesium intake were similar in both groups and averaged 100 mg/kg/day, 72 mg/kg/day and 8 mg/kg/day, respectively. Calcium and phosphorus retention was higher in the subjects fed fortified human milk than in those receiving a preterm formula (65 +/- 14 and 62 +/- 9 mg/kg/day versus 55 +/- 12 and 47 +/- 7 mg/kg/day respectively). The difference was only significant for phosphorus. Magnesium retention was similar in the two groups and averaged 3 mg/kg/day. Fat intake and absorption was significantly higher in the preterm formula fed group than in the one fed fortified human milk (5.5 +/- 0.4 g/kg/day and 88 +/- 4% versus 4.2 +/- 1 g/kg/day, 79 +/- 6% respectively). Assessment of the whole body bone mineral content by dual energy X-ray absorptiometry was performed at 3 and 6 months of age in another group of 25 low-birth-weight infants fed either fortified human milk or a preterm formula. Whole body bone mineral content (BMCt) was low (43.3 +/- 30.8 g of hydroxyapatite) at 3 months of age (theoretical term) compared to normal full-term newborns at birth. There was no significant influence of the diet. At 6 months of age, BMCt reached 168.6 +/- 36.6 g, a value similar to that of full-term newborns, with no significant difference between the two regimen groups.(ABSTRACT TRUNCATED AT 250 WORDS)

Bone Density

[Results of high frequency ventilation in the very low birth weight premature infant].

High frequency ventilation (HFV) has been used by the authors for about 5 years in low-weight premature neonates with severe hyaline membrane disease. This retrospective study concerns principally three classes of results: 1) early results of HFV vs conventional ventilation; 2) middle term results, HFV having been used in most severe cases; 3) long term outcome: HFV might prevent efficiently delayed complications such as bronchotracheal dysplasia. Recent therapy developments (surfactant, new ventilators) require controlled prospective studies to assess the real benefits of HFV compared with conventional methods.

Carbon Dioxide

Net calcium absorption in premature infants: results of 103 metabolic balance studies.

Net calcium absorption was evaluated in 103 low-birth-weight preterm infants by a 72-h balance technique. At birth the infants had a mean (+/- SE) gestational age of 30.9 +/- 0.2 wk and weighed 1.43 +/- 0.03 kg. When tested 3 wk later, their net calcium absorption averaged 58 +/- 1% with an intake of 80 +/- 2 mg Ca.kg body wt-1.d-1. Of the 103 infants, 58 had been fed low-birth-weight formulas supplemented with vitamin D. The remainder received banked human milk, of whom 34 were supplemented with vitamin D and calcium; 11 infants received no supplementation. Calcium absorption in the four subgroups did not differ significantly, with neither vitamin D supplementation nor supplementation with vitamin D and calcium affecting percent absorption significantly. Net calcium absorption was a linear function of intake (40-130 mg Ca.kg body wt-1.d-1) with a zero intercept. Because vitamin D supplementation did not increase net calcium absorption, it is concluded that in preterm low-birth-weight infants calcium absorption proceeds by a nonsaturable route, with the transcellular, vitamin D-regulated mechanism not yet expressed.

Calcium