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Biomedical subjects

R E Begue

Publications and source records attributed to R E Begue.

At least 19 recordsLinked to original sources
PubMed1999

Acute gastroenteritis.

Acute gastroenteritis represents a frequent cause of morbidity and mortality among children in the developing world as well as morbidity in the developed world. Despite the large number of potential etiologic agents, management of gastroenteritis is uniform and aimed to prevent the two major complications, dehydration and malnutrition. Current guidelines emphasize the use of oral rehydration and the early reintroduction of age-appropriate foods. These guidelines are reviewed here, the underlying principles discussed, and practical points provided.

Acute Disease↗
PubMed1999

Helicobacter pylori infection and insulin requirement among children with type 1 diabetes mellitus.

OBJECTIVE: Helicobacter pylori induces gastric inflammation and the the production of cytokines in infected individuals. Theoretically, this increased production of cytokines could be deleterious for the control of the glycemia of patients with diabetes. This study aimed to describe the insulin requirement among patients with type 1 diabetes and H pylori infection compared with uninfected counterparts. METHODS: Cross-sectional design. Demographic information (age, gender, race, annual family income, and number of individuals per room in the household) and clinical information (age at diagnosis of diabetes, duration of illness, weight, height, compliance with clinical appointments, daily insulin units per kilogram of body weight [IU/kg/d], and glycosylated hemoglobin A level) was obtained from children and adolescents with diagnosis of type 1 diabetes mellitus who were seen at Children's Hospital in New Orleans. A total of 2 mL of blood was also collected and sera were tested for H pylori-specific immunoglobulin G antibodies using an enzyme immunoassay. The daily insulin requirement among infected and uninfected children was compared, and the effect of other variables was evaluated with multiple linear regression. RESULTS: Of the 71 subjects who were evaluated (median age: 11 years), 11 (15.5%) were found to be infected. H pylori infection was more frequent among subjects who were older, who had a lower family income, and who were black. Infected children were found to require more insulin (1.2 vs 0.9 IU/Kg/d) and their glycosylated hemoglobin A level was higher (14.9 vs 11.8) than the level found in uninfected subjects. Multiple linear regression analysis identified H pylori infection duration of illness, race (black), body mass index, and gender (female), to be associated independently with increased daily insulin requirement (IU/kg/d). CONCLUSION: n our study population, children with type 1 diabetes and H pylori infection had an increased daily insulin requirement compared with the requirement of their uninfected peers. The reason for this association requires additional investigation.

Adolescent↗
PubMed1998

Serologic responses by immunoblot following natural infection with rotavirus serotypes G1 and G4 in children.

Serologic responses to proteins of rotavirus serotypes G1, P1A[8]; G2, P1B[4]; G3, P1A[8]; and G4, P2A[6] were evaluated by immunoblotting paired sera from 17 children with primary rotavirus infection. Ten children were infected with G1, P1A[8]; five with G4, P1A[8]; and two with G4, P2A[6] viruses. Anti-VP6 and anti-VP2 were seen in most responses. Homotypic anti-VP7 developed following G1 and G4 infections in 8 (80%) and 6 (86%) cases, respectively. Homotypic anti-VP4 developed in 9 (60%) cases following P1A[8] infection and in 0 of 2 cases following P2A[6] infection. Heterotypic anti-VP7 appeared against G4 (20%) and G3 (20%) following the 10 G1 infections, and against G3 (86%) and G1 (57%) following the 7 G4 infections. Heterotypic anti-VP4 occurred in only 3 (18%) children. The data show the antigenic predominance of internal proteins VP6 and VP2. Homotypic antibodies developed against VP7 but not against VP4 in most cases, while heterotypic antibodies were infrequent.

Child, Preschool↗
PubMed1998

Escherichia coli and the hemolytic-uremic syndrome.

BACKGROUND: The hemolytic-uremic syndrome (HUS) comprises hemolytic anemia, acute renal failure, and thrombocytopenia. It is the most frequent cause of acute renal failure in children. METHODS: This review is based on an extensive overview of the literature dealing with the HUS in children. RESULTS: HUS is the most common cause of acute renal failure in infants and young children and follows a diarrheal prodrome approximately 90% of the time. Nearly all postdiarrheal cases are caused by enterohemorrhagic E coli infections, in particular serotype O157:H7. Mortality is around 5%, and approximately 50% of survivors manifest some types of sequelae. CONCLUSION: Surveillance and contact investigation are important to control outbreaks, as well as early and aggressive treatment of symptomatic subjects to prevent mortality and severe complications, such as chronic renal disease.

Child↗
PubMed1998

Dietary risk factors associated with the transmission of Helicobacter pylori in Lima, Peru.

The factors influencing the risk of acquisition of Helicobacter pylori infection are not well established. One hundred four children (0-17 years of age) requiring an endoscopy for the evaluation of gastrointestinal symptoms had demographic and dietary data collected and biopsy specimens of the gastric antrum stained for the identification of H. pylori. The 52 (50%) infected subjects were significantly older than the uninfected ones with no difference in gender, crowding, source of drinking water, or exposure to domestic animals. Increased prevalence of infection was associated with increased consumption of food from street vendors, and decreased consumption of fruits in the subgroup that denied consuming food from street vendors. No association was found with consumption of fish, chicken, beef, beans, vegetables, rice, cheese, milk, and unboiled water. These findings support the role of food prepared under unhygienic conditions as a probable mechanism of transmission of H. pylori in developing countries.

Adolescent↗
PubMed1998

HIV seronegativity in an infant with the acquired immunodeficiency syndrome.

We report the case of an infant with progressive human immunodeficiency virus (HIV) infection and persistent seronegativity. The child had Pneumocystis carinii pneumonia at 4 months of age and was documented to be HIV-infected by HIV-1 deoxyribonucleic acid (DNA) polymerase chain reaction (PCR), but enzyme-linked immunosorbent assay (ELISA) and Western blot tests for HIV-1 and HIV-2 specific antibodies remained negative until the infant was 10 months old. This case should increase awareness about the possibility of seronegative HIV infection in infants and stress the fact that in questionable cases, even if the screening serology is negative, additional methods of diagnosis (ie, PCR, viral culture, and p24 antigen) should be considered.

AIDS-Related Opportunistic Infections↗
PubMed1997

Helicobacter pylori infection in children with abdominal ailments in a developing country.

Helicobacter pylori commonly infects children in developing countries. To determine the frequency of this infection and its potential role in specific gastrointestinal entities, all patients requiring upper gastrointestinal endoscopy for the evaluation of abdominal ailments in a gastroenterology practice in Lima, Peru, were evaluated during a 1-year period. Gastric biopsies were obtained for each child and were stained with hematoxylin-eosin and Warthin-Starry stains. Of the 107 evaluable patients (mean age 7.4 years, 58% boys), 52 (49%) were infected. The infection rate increased with older patients (P = 0.004). Children with recurrent abdominal pain (P = 0.04), an endoscopic finding of nodular gastritis (P = 0.007), and a histologic finding of chronic active gastritis (P < 0.0001) were infected more commonly.

Abdominal Pain↗
PubMed1997

Epidemiology of sharp object injuries in a children's hospital.

BACKGROUND: Limited data exist on the frequency, circumstances and management of sharp object injuries (SOIs) in pediatric facilities. METHOD: SOIs reported at a large children's hospital during a 2-year period were reviewed. RESULTS: One hundred thirteen SOIs were reported for an average of 6 injuries per 100 employees per year. The greatest number of injuries occurred among nurses (46%) and physicians (23%), but phlebotomists experienced the highest rate (25.5 injuries per 100 full time equivalent employees per year). Most common locations were the patient room (27%), operating room (25%) and intensive care units (17%). Needles accounted for 71% of injuries and procedural devices accounted for 22%. Forty-eight percent of injuries occurred during use of the item, 42% after use or during disposal and 7% after disposal. Twenty percent were associated with loose sharps and 15% with inadvertent patient movement. Only 2 injuries were associated with recapping. Eighty-eight percent of the objects were contaminated with blood or body fluid. Of 88 known source patients 1 tested positive for hepatitis B surface antigen, 2 for hepatitis C virus and none for HIV. One hundred four employees sought treatment: 36 received tetanus vaccine; 14 received hepatitis B vaccine; 9 received hepatitis B immunoglobulin; and 12 received zidovudine. No employee subsequently tested positive for HIV, hepatitis B virus, or hepatitis C virus. CONCLUSIONS: SOIs represent a frequent occurrence among pediatric health care workers. Minimizing the use of sharps, appropriately restraining patients during procedures and promptly disposing of sharp items after use might decrease the frequency of SOIs.

Health Personnel↗
PubMed1997

A double-blind taste comparison of pediatric antibiotic suspensions.

This study examined the palatability of 22 antimicrobial suspensions by using five independent categories for scoring: appearance, smell, texture, taste, and aftertaste. The likely overall influence on patient compliance was also evaluated. Drugs were compared within their respective classes. The only antibiotics judged to be so unpalatable as to potentially jeopardize compliance were dicloxacillin, oxacillin, erythromycin/sulfisoxazole, and cefpodoxime. Among the penicillins, amoxicillin and ampicillin were preferred. Azithromycin was slightly superior to erythromycin and clarithromycin within the macrolide class. Many cephalosporins were ranked quite high, the best being loracarbef, cefadroxyl, cefprozil, and cefixime.

Adult↗
PubMed1996

Treatment of cutaneous sporotrichosis with one daily dose of potassium iodide.

BACKGROUND: Recommended treatment for cutaneous sporotrichosis consists of a saturated solution of potassium iodide (SSKI) administered in three daily doses (tid). Because compliance with this regimen has been a problem in our previous experience, we evaluated the use of one daily (qd) full dose of SSKI. METHODS: Patients with culture-confirmed cutaneous sporotrichosis were entered in a randomized, nonblinded study to compare the safety and efficacy of qd vs. tid dosage of SSKI. RESULTS: Fifty-seven patients were enrolled to receive either qd (29) or tid (28) SSKI. Three (1 in the qd and 2 in the tid group) were not compliant with the assigned regimen. Side effects were common but mild in both treatment groups (61% in the qd and 42% in the tid group, P = 0.17); treatment had to be discontinued because of side effects in 3 cases (2 in the qd and 1 in the tid group). Overall 26 (89.6%) and 25 (89.2%) of the individuals initially assigned to the qd and tid dosing schedule, respectively, were cured by the treatment. No relapse was detected after 45 days of follow-up. CONCLUSION: These findings suggest that a single daily full dose of SSKI appears to be appropriate therapy for cutaneous sporotrichosis; further studies with larger numbers of patients are required.

Adolescent↗
PubMed1995

Community-based assessment of safety and immunogenicity of the whole cell plus recombinant B subunit (WC/rBS) oral cholera vaccine in Peru.

Every year since its introduction in 1991, there have been epidemics of cholera in Lima, Peru. Vaccination is one approach to the control of cholera. A pilot study was conducted to assess the safety and immunogenicity of a whole cell plus recombinant B subunit (WC/rBS) cholrea vaccine in Lima, Peru. Five hundred and forty-one volunteers aged 2-65 years received two doses two weeks apart of WC/rBS vaccine or Escherichia coli K12 placebo administered in bicarbonate buffered water. Symptoms were monitored on all subjects and blood was collected from 102 persons before the first dose and two weeks after the second dose. Mild post-vaccination gastrointestinal symptoms were reported with equal frequency for both the vaccine and placebo recipients. Among 51 vaccines, 49% had a twofold or greater increase in serum vibriocidal titers (GMT = 78; range < 1:10 to 1:5120); and 92% and 82% developed a twofold or greater serum anti-cholera toxin IgG and IgA response, respectively. Persons with elevated prevaccination vibriocidal titers had a decreased response to the WC/rBS. Age and blood group did not affect the immune response. The WC/rBS vaccine was safe and immunogenic in a group of native Peruvians.

Administration, Oral↗