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Biomedical subjects

O Kremp

Publications and source records attributed to O Kremp.

At least 19 recordsLinked to original sources
PubMed2005

[Familial use of ibuprofen in febrile children: a prospective study in the emergency room of an hospital in Lille].

AIM OF THE STUDY: To assess the place of ibuprofen in the treatment of fever in children. PATIENTS AND METHODS: An anonymous self-questionnaire was submitted to the parents of 156 children aged less than 15 years and 3 months consulting for a fever in a pediatric emergency care unit. Questions related antipyretic drugs availability at home and their administration modality to the febrile child. RESULTS: Acetaminophen (liquid or rectal) was the first drug owned by families (N = 149, 96%). Ibuprofen was owned by 79 families (51%). The antipyretic drug administered as a first intention treatment was acetaminophen in 131 children (77%), ibuprofen in 27 (17%) and aspirin in 6 children (4%). An antipyretic bi-therapy was received by 58 children (35%), nearly always acetaminophen and ibuprofen (N = 48, 87%). The use of a bi-therapy was more frequent when ibuprofen was the first drug used. Children who received an antipyretic bi-therapy as compared to those who received a monotherapy exhibited significantly a higher fever level and long lasting fever period. Antipyretic drugs given to the sick children were prescribed by a physician in more than 90% of cases. CONCLUSION: Ibuprofen was largely used in febrile children. This drug has almost always been prescribed by a physician. However, due to its side effects, ibuprofen should be used only in high and badly tolerated fever that is not altered by a well conducted acetaminophen monotherapy.

Acetaminophen↗
PubMed1996

[Evolution of the result of respiratory function studies in children with bronchopulmonary dysplasia].

BACKGROUND: Reports of short- and medium-term evolution of Lung Function Tests (LFT) in infants with bronchopulmonary dysplasia (BPD) are still scarce. POPULATION AND METHODS: The results of the first (before 3 months of corrected age) and the second (between 3 and 9 months of corrected age) LFT in 22 premature infants with BPD (gestational age 31 +/- 2.5 weeks; birth weight: 1570 +/- 440 g; duration of mechanical ventilation: 46 +/- 24 days, total duration of oxygen therapy: 88 +/- 47 days) were compared to those obtained in 27 normal infants for the first LEF and 10 normal infants for the second LFT, similar to the patients for birth weight and corporeal index (CI). RESULTS: In the first LFT, major abnormalities were an increased thoracic gaz volume (TGV) (16.5 +/- 42 vs 122 +/- 24 mL; P < 0.001) and TGV CI ratio (1.25 +/- 0.31 vs 0.89 +/- 0.17 ml/kg/m2; P < 0.0001) a decreased pulmonary compliance (2.49 +/- 1.46 vs 11.60 +/- 4.50 mL/cmH2O; P < 0.0001) and specific pulmonary compliance (0.015 +/- 0.10 vs 0.100 +/- 0.042 mL/cmH2O/mL de TGV; P < 0.0001), an increased total pulmonary resistance (20.4 +/- 12.1 vs 10.5 +/- 5.3 cmH2O/L/s; P < 0.001). In the second LFT, an increased TGV (235 +/- 62 vs 166 +/- 28 mL; P < 0.01) and TGV CI ratio (1.64 +/- 0.65 vs 0.98 +/- 0.11 ml/kg/m2; P < 0.05), a decreased pulmonary compliance (2.68 +/- 2.0 vs 15.2 +/- 5.7 mL/cmH2O; P < 0.0001) and specific pulmonary compliance (0.013 +/- 0.010 vs 0.106 +/- 0.050 mL/cmH2O/mL de TGV; P < 0.0001), an increased total pulmonary resistance (17.1 +/- 9.6 vs 8.6 +/- 4.9 cmH2O/L/s; P < 0.05) were noted when compared with the control group results. Major abnormalities of the blood gases were hypoxemia (63 +/- 10 vs 85 +/- 20 mmHg; P < 0.05), hypercapnia (38.5 vs 31 +/- 4 mmHg; P < 0.0001) during the first LFT. Hypoxemia (77 +/- 14 vs 90 +/- 14 mmHg and hypercapnia (37 +/- 4 vs 29 +/- 5 mmHg) continued in the second LFT. Thoracic distention and total pulmonary resistances in infants with BPD did not improve but their pulmonary compliance (P < 0.0001) and PaO2 (P < 0.01) between the first and second LFT did it. Infants who had been ventilated for a hyaline membrane disease (HMD) were more hypoxic on the second LFT (P < 0.05) than those who had been ventilated for other causes. Statistically significant relationships were found between thoracic distention and duration of positive inspiratory pressure (P < 0.05; r = 0.43), duration of positive expiratory pressure (P < 0.05, r = 0.45) total oxygen therapy duration; between total pulmonary resistance and duration of mechanical ventilation with high frequency (P < 0.05; r = 0.52); between hypoxemia and duration of oxygen therapy with FiO2 > or = 60% (P < 0.05; r = 0.54). CONCLUSIONS: This study shows prolonged clinical and functional abnormalities of the respiratory functions requiring longer follow-up.

Blood Gas Analysis↗
PubMed1995

[Retrospective analysis of 1331 samples of cerebrospinal fluid in newborn infants with suspected infection].

BACKGROUND: Definitive diagnosis of a neonatal infection usually requires recovery of an etiologic agent from body fluids or tissues such as spinal fluid, blood and urine. Routine lumbar puncture (LP) may raise some problems in interpreting results. POPULATION AND METHODS: A retrospective analysis of 1331 samples of CSF was made. LP had been performed on 1041 neonates including 569 prematures (54.6%) as a part of the evaluation for suspected bacterial infection. RESULTS: In 50.7% of the cases, the CSF was haemorrhagic. The frequency of traumatic taps increased with the degree of prematurity, low birth weight, precocity of LP, association with respiratory distress and disorders of coagulating factors. In addition, haemorragic taps modified biochemical and cytologic characteristics of CSF. One hundred and six (8%) CSF samples contained organisms but the diagnosis of meningitis was certain in only 23 cases (2.2%). In the other 83 cases, CSF was thought to be contaminated, mostly by coagulase-negative staphylococci. Since both blood and CSF cultures were positive for the same bacterial organism in 18 cases, it was concluded that the LP had been useful in identifying the pathogens in only five cases. The high frequency of contaminated CSF led to overestimation of the incidence of true bacterial meningitis (0.57% in our study). CONCLUSIONS: The low incidence of meningitis in neonates, the risk of having an haemorragic tap associated with the possibility of clinical aggravation during LP and the fact that the same pathogen is frequently (78.2% of cases) identified in blood cultures suggest that the immediate and routine LP is of less value than expected in infants suspected to be infected. LP could be postponed when the neonate presents with a respiratory distress syndrome and/or a precarious haemodynamic state.

Bacterial Infections↗
PubMed1995

Selective abortion: a new moral order? Consensus and debate in the medical community.

The authors discuss the results of a survey of the attitudes of Canadian and French (Picardie, Nord-Pas de Calais) physicians toward selective abortion of fetal anomalies detected by ultrasound, amniocentesis, or chorionic villus sampling. The study documents the threshold of acceptability of abortion of fetuses with selected anomalies, as well as the physicians' own perceptions of their role in the decision to abort. While there was no consensus among all Canadian physicians regarding the acceptability of abortion, more than 55 percent from France and Quebec would accept selective abortion of a fetus affected with trisomy 21, Duchenne muscular dystrophy, cystic fibrosis, Huntington's chorea, or spina bifida. In the province of Quebec, Anglophone physicians showed a greater acceptance of abortion than did their French-speaking colleagues. In reference to the physician's role in the decision to abort, French physicians are more directive than North American physicians. Cultural predispositions may explain these differences in attitudes.

Abortion, Eugenic↗
PubMed1994

Regulation of sleep and body temperature in response to exposure to cool and warm environments in neonates.

BACKGROUND AND OBJECTIVE: Thermoregulation is impaired during desynchronized sleep in animals and in adults. This can lead to a conflict between homeothermy and sleep in nonthermoneutral conditions. This study aimed to analyze thermoregulation during sleep, especially during desynchronized sleep (active sleep, AS) and to determine whether the conflict between thermoregulation and sleep might exist in the newborn sleeping in warm or cool conditions. METHODS: Esophageal and skin (cheek and abdomen) temperatures, local sweating rate (ventilated sweat collection capsule stuck on the abdomen), metabolism (indirect respiratory calorimetry), and sleep variables were recorded in 10 newborns exposed, in an incubator, to thermoneutral, warm, and cool environments. Body movements and apneas were also considered. Exposures were performed after a first habituation condition. RESULTS: Sleep structure was not modified by the first exposure nor by the warm environment. Exposure to cool temperatures increased AS duration (+13% of total sleep time) and the quantity of body movements during AS (+11.3% of AS duration), whereas these parameters were not modified during quiet sleep. The thermoregulatory response to warm and cool environments was not impaired during AS. During exposure to mild thermal load, analyses revealed large interindividual differences in the strategy for thermoregulation during AS. Depending on the newborn, the thermoregulatory response to cool temperatures could be described by an increase either in nonshivering thermogenesis or in frequency of body movement. In warm conditions, most newborns exhibited an increased sweating rate. The interindividual differences (lack of increase sweating in three newborns) seemed to be linked to changes in the sensitivity of the sweating response. CONCLUSION: Because thermoregulation is not impaired during AS, this sleep stage seems to be a well-protected one from a thermoregulatory point of view. This difference from adults and animals may be due to the important role of AS in newborn's nervous maturation.

Body Temperature Regulation↗
PubMed1993

Is selective abortion for a genetic disease an issue for the medical profession? A comparative study of Quebec and France.

This article discusses the results of a study of the stand and attitudes of physicians from the Picardie, Nord-Pas-de-Calais region in France and the province of Quebec (Canada) regarding abortion following the diagnosis of a fetal anomaly by ultrasound, amniocentesis, or chorionic villus sampling. The study examined the degree of acceptability of abortion for several specific conditions as well as the physicians' perceptions of their role in the women's decision to abort. The study shows a consensus (over 75 per cent of the physicians surveyed) for aborting a fetus with trisomy 21. There is a similar consensus, except among Francophones in Quebec, for muscular dystrophy, cystic fibrosis, and Huntington disease. Conversely, there is no consensus (below 60 per cent) for several anomalies. In these cases, Quebec Anglophone physicians find abortion more acceptable than Quebec Francophone or French physicians. Concerning the role of the practitioners in the decision to abort, physicians in France tend to be much more directive than their overseas colleagues. Several hypotheses are suggested to explain the difference between the three groups surveyed.

Abortion, Therapeutic↗
PubMed1992

[Home cardio-respiratory monitoring with alarm record system in infants at risk of life-threatening events].

In few infants, home monitoring is useful to prevent recurrent apparently life-threatening events. Some devices have an alarm record system. We report our experience of home monitoring with such a device in 22 infants. 43.3% of the recorded events were considered as false alarms and 56.7% as true alarms. Among the alarms relative to abnormal respiratory events (38%), more than half occurred after two min of very low impedance thoracic signal. Among the true alarms relative to cardiac abnormalities (18.7%) more than half occurred during high amplitude fluctuations of the thoracic impedance signal and were relative to obstructive apnea or hypertonic vagal reactivity. Three infants presented an apparent life threatening event during an alarm, and two of them were hospitalized. These results indicate that it is important to define precisely the significance of the alarms during the survey of home monitoring of infants at risk for sudden infant death.

Apnea↗
PubMed1992

[A case report of Russel's diencephalic cachexia].

The case of an infant admitted for evaluation of severe emaciation with intermittent ocular anomalies including strabismus and nystagmus is reported. This case demonstrates the value of magnetic resonance imaging and transfontanellar ultrasonography for the diagnosis of diencephalic syndrome of infancy. The prognosis of this condition is usually grim, in particular because of the severe emaciation which is disproportionate with the tumour spread. Pathophysiologic hypotheses put forward to explain this cachexia are reviewed. Although cytokines such as TNF alpha are currently incriminated in the pathophysiology of cachexia induced by a number of conditions, they have not yet been studied in diencephalic syndrome of infancy. TNF alpha is a potent lipolytic agent. Excessive production of TNF alpha may be involved in the genesis of the emaciation characteristic of diencephalic syndrome. Inappropriate production of TNF alpha may respond to the administration of specific anti-TNF monoclonal antibodies. This approach may be considered as a means for treating emaciation in patients with diencephalic syndrome of infancy.

Astrocytoma↗