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P Boutte

Publications and source records attributed to P Boutte.

At least 19 recordsLinked to original sources
PubMed2004

Successful use of recombinant factor VIIa for management of severe menorrhagia in an adolescent with an acquired inhibitor of human thrombin.

UNLABELLED: Antibodies directed against human thrombin are exceedingly rare, having only been reported in adult patients with underlying diseases. Consensus on the most appropriate management has not yet been reached. A 12-y-old girl presented with intractable menorrhagia several days after an acute infectious episode. Laboratory tests revealed disturbed clotting tests: prothrombin index 17%, activated partial thromboplastin time >150 s, thrombin time >120 s, and failure to achieve correction with a normal pooled plasma. Further studies demonstrated the presence of an antibody directed against human thrombin. Viral serology revealed a 1/128 titre for adenovirus. Massive haemorrhage was unresponsive to standard treatments, but intravenous administration of recombinant factor VIIa resulted in a successful outcome. CONCLUSION: This is the first report of an anti-human thrombin antibody associated with severe bleeding in a child. Recombinant factor VIIa could represent a novel therapeutic approach for such patients.

Child↗
PubMed2002

[HIV exposure accidents in children. Experience at the emergency admission services of the CHU of Nice].

UNLABELLED: Accidental exposure to human immunodeficiency virus (HIV), either by injury with a discarded syringe or after sexual abuse, increases among the children population. PATIENTS AND METHODS: The entire period of the study was seven-year. Twenty-eight children (14 males, 14 females) underwent three visits after an accidental exposure at Day 0, Day 30th and Day 90th. During each visit, a physical examination, liver enzymes, Ag P24, PCR-RNA HIV, B, C hepatitis serologies were performed. An antiretroviral prophylaxis was proposed when a high risk of HIV transmission was recognized. Anti hepatitis B globulins were administrated when no previous immunization had been made. RESULTS: The median age was 9.3 years (range: 1.5 to 16.7 years). 93% of the children consulted within 48 hours after exposure. Five of them consulted after a sexual aggression with penetration, two after a mucosus exposition and two after deep needle injuries. The source of the contamination was known in five cases. Nine patients were given an antiretroviral treatment for four weeks (seven bitherapy, two tritherapy), with no major side effects. Eighteen and 11 children were seen at the second and third visits, respectively. No case of HIV or HCV infection was observed. CONCLUSION: No case of infection after injury with a discarded syringe was found in our study. This situation differs from what is observed in health care workers, where the higher risk factor is observed. Even if no contamination was found after sexual aggression in our population, the risk of HIV is actual. This is why we propose an antiretroviral prophylaxis against HIV in only one indication, corresponding to sexual penetration.

Adolescent↗
PubMed2002

[Juvenile dermatomyositis in the Nice area: a retrospective study 1991-2001].

INTRODUCTION: Juvenile dermatomyositis is a rare disease. We conducted a retrospective chart review on patients with juvenile dermatomyositis diagnosed in the Nice area from 1991 to 2001. Our purpose was to review diagnosis criteria and treatment strategies. PATIENTS AND METHODS: The cases of juvenile dermatomyositis were identified by phone investigation of physicians of the departments of paediatrics, dermatology, rheumatology and internal medicine. RESULTS: Seven cases of juvenile dermatomyositis (sex ratio M/W: 0.75, medium age: 7.7 years) were identified. Myalgia and/or weakness were the main reasons for initial consultation. Cutaneous lesions were present in all patients on initial presentation. Muscular enzymes were abnormal in 4 cases out of 7. Muscular biopsy was conducted in 6 patients. In one case, MRI revealed an inflammatory involvement although no clinical or biological sign existed. Systemic corticosteroids was the initial treatment, associated with monthly intravenous immunoglobulins in 5 cases, allowing initial control of the disease in all cases. The other therapies were: methotrexate (3 cases), ciclosporin A (1 case), and chloroquine (2 cases). The evolution was monocyclic in three cases, polycyclic in four cases. With a median follow-up of two years, all the patients are alive: five under treatment, three still in first flare. COMMENT: The diagnosis strategy seems relevant because at least 3 criteria of Peter and Bohan were found in 6/7 patients. Muscular biopsy appears fundamental in the diagnosis strategy. MRI was useful when it was conducted but its use has to be assessed. Therapies were those of previous published studies, except for the use of intravenous immunoglobulins as first-line treatment, associated with corticosteroids. This strategy may be justified for corticosteroid-sparing purposes. CONCLUSION: Working on a real, well-codified strategy of diagnosis and treatment would enhance the uniform management of these patients.

Adolescent↗
PubMed1992

Lethal junctional epidermolysis bullosa with normal expression of BM 600 and antro-pyloric atresia: a new variant of junctional epidermolysis bullosa?

A newborn girl is described with a lethal junctional epidermolysis bullosa (Herlitz form) (JEB) associated with a congenital localized absence of skin, and a pyloric atresia (PA). The post-mortem examination of the digestive tract showed a widespread cleavage between the epithelium and the chorion. Immunohistological and electron microscopical examination showed a cleavage occurring through the lamina lucida of the digestive basement membrane, as for the skin blisters. Despite the lethal character of this form of JEB, the BM 600 glycoprotein was normally recognized at the dermo-epidermal junction by the monoclonal antibody GB3. This rare association of lethal JEB-PA-localized absence of skin, with a quite unusual GB3 positive immunophenotype could correspond to a new variant of JEB.

Antibodies, Monoclonal↗
PubMed1991

[The variability of arterial pressure measured by oscillometric methods in premature newborn infants].

The variability of blood pressure measured by oscillometry and the validity of this technique were studied in premature infants. Thirty premature babies whose postnatal age was six days or more had their blood pressure measured 11 times over a twenty-minute period for three consecutive days. Movements were found to have a very substantial influence on results that could not be reliably compared with values obtained invasively. No consistent pattern of variations of oscillometric results obtained during the eleven measurements of use for recommending a specific measurement time was found. Diastolic blood pressure fell gradually over the three-day study period. The most reliable of the eleven daily values was the lowest value for which good correlations were found between the three study days; this lowest value was not influenced by neonatal or postnatal factors.

Analysis of Variance↗
PubMed1990

[Fetal macrosomia in a diabetic mother].

Foetal macrosomia is arbitrarily defined as an excessive weight for the gestational age, was found to be present in 36 p. 100 of 43 diabetic pregnancies. This finding may indicate incomplete normalization of maternal metabolic control despite the use of new forms of insulin delivery systems, such as insulin pumps. However, in our series the macrosomia was usually moderate and without consequences on the foetal outcome. The levels of insulin, but not those of the insulin-like growth factor (IgF1), were increased in the umbilical cord blood of macrosomic newborns of diabetic mothers. Cardiac septum hypertrophy correlated with maternal glycosylated haemoglobin levels better than with macrosomia. We therefore suggest that in all diabetic pregnancies the cardiac septum thickness should be measured in utero by sonocardiography.

Adult↗
PubMed1989

Variation in peak expiratory flow of normal and asymptomatic asthmatic children.

Peak expiratory flow (PEF) variation was measured in 18 healthy children (Group I) aged 9.25 to 13.3 years (mean, 11 years) and in 17 asymptomatic asthmatic children (Group II) aged 8.75 to 14.25 years (mean, 11.9 years) receiving no bronchodilators. PEF was measured four times a day for a period of 10-14 days. There were no differences between Group I and Group II regarding age, height, weight, sex, duration of the study, and overall mean PEF values. Mean daily PEF variation amplitude (difference between the highest and the lowest daily values as a percent of the mean) was significantly higher in Group II than in Group I subjects (15.2 vs. 9.9%), and so was cosinor amplitude (9.6 vs. 5.9%). Significant circadian rhythm in PEF was detected by cosinor analysis in nine subjects of Group I and in eight subjects of Group II. Mean PEF bathyphase calculated by cosinor analysis (trough time in a 24 h scale) was similar in the two groups (0503 h, in Group I and 0434 h in Group II). The results of this study show that the amplitude of circadian variation in PEF tends to be higher in asymptomatic asthmatic children than in normal children, but there is too much overlap to use PEF monitoring to identify an individual asymptomatic asthmatic child. Therefore, diurnal variation of PEF is not suitable for diagnosing mild asthmatics.

Adolescent↗
PubMed1989

[Variability of blood pressure measured using an oscillometric method in children 4 to 48 months of age].

The usual method of measuring arterial blood pressure cannot be used in children less than 4 years of age because of lack of cooperation. We investigated variations of blood pressure measured during 20 minutes by an oscillometric method (Dinamap) in 100 children aged 4 to 48 months and tried to come up with some recommendations for measuring and interpreting blood pressure. Serial blood pressure recordings showed poor reproducibility due to movements which are impossible to avoid and which account for wide variations. Because of this variability, a single measurement is inadequate and must be repeated. The average of repeated recordings does not seem to be a reliable parameter. We suggest that the lower measured value (minima) as the only parameter allowing us to track the progressive increase in blood pressure with age. The data probably explain the large discrepancies between published studies taking into account the use of different methods.

Age Factors↗
PubMed1987

[Atypical mycobacterial pulmonary infections. Apropos of a case in a newborn infant].

The authors report the case of an 8 month-old infant presenting with mycobacterium avium-intracellulare pulmonary infection. The etiological diagnosis relies upon isolation of the organism. The cutaneous reactions to avian tuberculin are only a guiding factor. Evolution was favorable in spite of the resistance of the bacteria to antituberculous chemotherapy. The epidemiological research carried out in a neighbouring chicken-run was negative.

Humans↗
PubMed1985

[Congenital tracheal stenosis associated with aberrant left pulmonary artery. Apropos of a severe form with neonatal disclosure].

The case report is presented of a newborn infant afflicted with extensive congenital tracheal stenosis associated with anomalous left pulmonary artery, proving rapidly fatal. The possibility of tracheal anomaly must be envisaged in the face of any neonatal respiratory distress unexplained by pulmonary parenchymatous pathology. Diagnosis of this complex malformation relies on endoscopy and oesophagogram and tracheo-bronchogram contrasts.

Abnormalities, Multiple↗
PubMed1985

[Supraventricular tachycardia and fetal edema. Apropos of 2 cases].

Two cases of supraventricular tachycardia responsible for hydrops fetalis emphasize the interest of an antenatal echocardiography. The systematic use of this technique will increase the frequency of diagnosis of this etiology in other cases where the prognosis is less favorable. The in utero treatment of this rhythmic disorder consists in administering Digoxin to the mother and the newborn child must receive excellent care from the moment of the birth.

Digoxin↗
PubMed1984

[Longterm pH measurement in the diagnosis of gastroesophageal reflux in children. Apropos of 20 cases].

Long duration continuous recording of esophageal pH was performed in 20 children suspected of having gastroesophageal reflux. Six pH monitoring parameters were analysed and their values compared with normal standards found in the literature. The results of pH monitoring were compared with those of upper gastrointestinal series and with oesophagoscopy, performed in all patients but one. The diagnostic utility of long duration pH monitoring is discussed, according to data in the literature.

Child↗