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Biomedical subjects

A Barois

Publications and source records attributed to A Barois.

At least 55 records · Page 3Linked to original sources
PubMed1987

[Diffusion of vancomycin in the cerebrospinal fluid, in the dog, in the absence of meningeal inflammation].

The diffusion of vancomycin into the cerebro-spinal fluid was studied in 5 healthy dogs. Its appears that vancomycin does diffuse across the blood-brain barrier. Though the concentrations reached in the CSF are low, they are of the same order of magnitude as the minimal inhibitory concentrations of this antibiotic towards the germs usually treated. The usual pharmacokinetic parameters were determined.

Animals↗
PubMed1987

[Myasthenia in children: long-term course].

Twenty three children with myasthenia were followed up in our Department for 10 years. There were no familial forms of the disease; there were no patients with the pure ophthalmic form but 61 p. 100 of patients had serious respiratory disease. Steroid therapy was possible in 10 cases: in 4 patients under 15 years of age, short courses of steroids were ineffective; in 6 patients over the age of 15, long term steroid therapy resulted in some improvement but cortico-dependence developed in 4 cases. One child responded to treatment with veinoglobulin (R). Sixteen children underwent thymectomy; the symptoms in the 7 non-thymectomized patients were equivalent. The myasthenic syndrome was stable or worsened in 75 p. 100 of cases after thymectomy; only 56 p. 100 of children improved 2 years after surgery. The incidence of complete remission was the same in the children undergoing thymectomy and in those not treated surgically at 7 years after thymectomy. Our attitude is therefore not to refer myasthenic children for routine thymectomy and to avoid steroid therapy whenever possible.

Adolescent↗
PubMed1987

[Endocarditis of the ventricular septum. Echocardiographic diagnosis].

A 5 year-old child presented with prolonged fever, severe impairment of general condition and a pleuro-pericardium effusion. Echocardiography revealed a "bell-clapper-like tumor" in each ventricle, developed from the ventricular septum. Presence of a staphylococcal sepsis and early disappearance of the echocardiographic signs after antibiotic treatment allowed for diagnosis of bacterial endocarditis with abscess of the ventricular septum. Sinusitis and IgA deficiency were later found to be also present.

Child, Preschool↗
PubMed1986

[Ventricular staphylococcal infections. Treatment with vancomycin by continuous venous infusion].

Thirteen cases of meningeal and/or ventricular infection and 1 case of septicaemia, all caused by staphylococci, were treated with continuous intravenous infusions of vancomycin. Repeated measurements of vancomycin plasma and CSF levels by microbiological assay or by high performance liquid chromatography showed that the antibiotic entered the CSF after 48 hours of treatment and that its concentrations in CSF remained stable at 1 to 4 micrograms/ml (mean: 2 micrograms/ml) throughout the 3 weeks' treatment period. After treatment was discontinued, vancomycin became undetectable in CSF within less than 24 hours. All the children were cured.

Cerebral Ventricles↗
PubMed1986

[The Landry-Guillain-Barré syndrome. Study of prognostic factors in 223 cases].

A retrospective study of 223 patients (111 men, 112 women, mean age 40.6 years) with the Landry-Guillain-Barre syndrome investigated vital or functional prognostic factors. Patients were first seen between 1963 and 1981, when 192 were noted to have cranial nerve disorders. Assisted ventilation was required in 152 cases, and 23 patients died, including 5 from cardiocirculatory dysautonomy. Plasma exchange was not used. Patients were divided into 3 groups as a function of the degree of maximum paralysis: group 1 (n = 63) patients had incomplete quadriplegia without assisted ventilation, group 2 (n = 93) incomplete quadriplegia with assisted ventilation, group 3 (n = 62) quadriplegia with or without assisted ventilation. Vital prognosis was related to the severity of neurologic disorders. Frequency of intercurrent complications, dysautonomic disorders and mortality increased with maximal severity of motor deficit. The 3 groups did not differ as a function of previous history, mode of onset of polyradiculoneuritis, duration of extension phase of paralysis, or CSF protein content at the first examination during the extension phase of the paralyses. It is therefore impossible at an early stage of the disease to predict future motor deficit. The cumulative percentage of patients who recovered a normal muscular force in limbs and cranial territories was 48 p. 100 after one year and 60 p. 100 after two years (actuarial values). The functional prognosis depends upon the degree of motor deficit at maximum paralysis and duration of the plateau phase. Probability of full muscular strength recovery was lower in group 3 and in those patients with a plateau phase duration longer than 2 weeks. Independently of groups, motility recovery rate was markedly higher in patients with a plateau phase duration of less than one week. Motility recuperation was independent of age, sex, duration of extension phase, CSF protein levels during the acute phase, and presence of autonomic nervous system disorders.

Adolescent↗
PubMed1985

[Immunologic thrombopenic purpura in children: therapeutic trial with high dose of intravenous gamma globulins].

Fifteen children with immunological thrombocytopenic purpura were treated by first intention with high dose intravenous gammaglobulins (Venoglobulins and Sandoglobulins). Nine children recovered after the first injection with platelet counts greater than 50,000/mm3 after 2 days' treatment, so countering the risk of haemorrhage. One child required a second course of treatment and was then cured. Three children had temporary rises in their platelet counts and then relapsed; two children did not react at all to the treatment. The most interesting feature of this new therapeutic approach is the possibility of preventing serious haemorrhagic complications in cases of severe thrombocytopaenia (less than 10,000/mm3) by inducing a rapid rise in the platelet count.

Adolescent↗
PubMed1984

[Aeromonas hydrophila septicemia: 3 cases, 1 with mediastinitis].

Three cases of Aeromonas hydrophila septicaemia are reported. The first case concerned a 51 years old patient suffering from drowning who had previously been in good health and who died after a few days of refractory hypoxaemia. The second case was an 8 years old child with trisomy 21 operated for a congenital cardiac defect. The portal of entry was a catheter and the septicaemia was complicated by A. hydrophila mediastinitis, a complication which has not been described previously. The third case was a 75 years old man with no previous medical history, whose hobby was gardening. He developed septicaemia after a flu-like illness. A. hydrophila is a mobile Gram negative bacillus whose natural habitat is water. It appears to be an exceptional and temporary contaminant of the human G I tract. Clinical infection is rare and usually focal: gastroenteritis, infection of soft tissues after trauma in aquatic surroundings. In 60 out of 82 cases there was a documented deficiency in the patient's immune defenses. A digestive portal of entry was suspected in 63 cases but only rarely proved. In one of our cases the portal of entry was septic thrombophlebitis induced by an indwelling catheter; this complication has not previously been reported. The clinical picture of A. hydrophila septicaemia is characterised by the relative high incidence of Echtyma gangrenosum. The lethal outcome in 50 p. 100 of cases is often related to the patient's general condition. The sensitivity of the three cultures isolated was tested against third generation cephalosporins: they were effective in each occasion.

Aeromonas↗
PubMed1983

[Fungal osteoarthritis of the knee with joint destruction treated with ketoconazole].

The authors report a case of acute fungal arthritis following traumatic inoculation (bramble prick) in a 9 year-old boy. The implicated fungus was an highly pathogenic atypical strain of Scedosporium (monosporium) apiospermum. Two surgical operations (synovectomy and arthrodesis) and antifungal treatment with ketoconazole led to recovery. The pathogenic role of this fungus and especially the importance of toxic phenomena are discussed. This case is compared with other in the literature. The part of ketoconazole in the recovery of this patient is emphasized.

Antifungal Agents↗
PubMed1982

[Staphylococcus, the most frequent agent of serious complications of acute sinusitis in children. 5 cases].

The high incidence of staphylococcal infection in severe forms of orbital cellulitis is reviewed with 4 case reports of children with complications of acute sinusitis due to staphylococcal infection. Three cases of thrombosis of the sinus cavernosus due to ethmoidal extension were observed, complicated in one case by fatal purulent meningitis. In one case, the sinusitis was a mixed staphylococcal and anerobic infection with orbital cellulitis and subcutaneous gas gangrene. No organism was isolated in the fifth child who had exophtalmos due to retroorbital cellulitis, but a rapid recovery was obtained with anti staphylococcal antibiotics after failure of inappropriate antibiotics. In conclusion, all periorbital cellulitis complicating sinusitis should be prescribed active anti staphylococcal antibiotics. In addition low dose anti coagulant therapy and prophylactic treatment against cerebral aedema are recommanded because of the risk of extension of the infection by thrombophlebitis of the sinus cavernosus and of intracranial propagation of the periorbital aedema.

Adolescent↗
PubMed1978

Treatment of mediastinitis in children after cardiac surgery. A study of 20 cases.

Twenty-three cases of mediastinitis after cardiac surgery in children were treated by us between 1973 and 1976. Three patients died within 6 hours of admission. Treatment used in the tweny other cases are discussed. The mean age of the patients was three years and three months. The mediastinitis was evident an average of twelve days after extracoporeal circulation. A staphylococus was always responsible for the infection. Treatment was a combination of surgery, antibiotics and respiratory and nutritional supplies. The surgical treatment consisted of a careful mediastinal cleansing with resection of the sternal edges. In fifteen patients the thorax was closed after surgery, and an irrigation system installed using a solution of 4% Dakin in physiologic saline. Recovery was simple in 5 patients. In the 10 other patients of this group the thorax had to be reopened; one patient died after 90 days from Serratia marcescens endocarditis. The thorax was left open initially in five patients: one patient of this group died from candida endocarditis. All patients needed endotracheal ventilation through a nasotracheal tube (7 to 90 days of ventilation). Treatment with bactericidal antibiotics was pursued for three months and a monotherapy was kept for nine months. After reviewing the observed complications, our methods and results are compared with others in the literature.

Child↗
PubMed1978

Membrane oxygenators for acute respiratory insufficiency. Clinical use in 11 patients.

Extracorporeal circulation with a membrane oxygenator (ECMO) was used in 11 patients with acute respiratory insufficiency who did not respond to conventional treatment. By pass was veno-arterial in every case, seven times with femoral artery return, three times with axillary artery return, and once with both femoral and axillary return. Five patients died on ECMO. Six patients were taken off ECMO and two of them are long-term survivors. In nine cases ECMO allowed short-term control of respiratory failure. The respective roles of oxygen supply from ECMO and the haemodynamic changes incurred by its use are discussed. Although use of ECMO for long periods seems less hazardous now, present results are restricted by the lack of therapy for the underlying pulmonary lesions.

Acute Disease↗