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Biomedical subjects

A Bourrillon

Publications and source records attributed to A Bourrillon.

At least 37 records · Page 2Linked to original sources
PubMed1999

[Bacterial concentration in the cerebrospinal fluid in childhood meningitis].

OBJECTIVES: The aim of this study was to analyze the epidemiological evolution of causal germs in meningitis in children aged 1 day to 15 years and determine the relationship between pretreatment concentrations of bacteria in cerebral spinal fluid (CSF), patient age, bacterial species and bacteriological eradication. PATIENTS AND METHODS: A quantitative analysis of germs was performed in 212 children with bacterial meningitis (mean age 19.8 months). RESULTS: Bacterial counts ranged from 2.10(1) to 4.10(9) CFU/ml in CSF. Among the 212 patients, 52 (24.5%) had counts 10(7)/ml. Infants had significantly higher counts than the other age groups. Mean counts for Hoemophilus influenzoe serotype B were not different from those for Streptococcus pneumoniae but were significantly higher than for Neisseria meningitidis. Compared with initial germ counts, 98.5% of the CSF specimens were sterile at 24 and 48 hours and 100% at 72 hours. CONCLUSION: Germ counts were higher in infants.

Adolescent↗
PubMed1999

[Idiopathic juvenile osteoporosis: a new observation].

UNLABELLED: Idiopathic juvenile osteoporosis is a rare form of bone demineralization which occurs during childhood. The mechanism of disease remains unknown. We report a new case which illustrates the main difficulties of diagnosis and treatment. CASE REPORT: A 7 year old girl was admitted because of painful disability of her lower limbs. Diagnosis was based on radiological signs, total bone density and bone histologic pattern. Plasma levels of calcium, phosphorus, alkaline phosphatases, 25-OH D3 and parathormone were within the normal range value. Other diseases associated with bone demineralization, such as enteric malabsorption, endocrine or tumoral diseases, were excluded. Recovery occurred after some months of treatment with calcium, vitamin D and rehabilitation, but we could not establish a clear causal relationship. CONCLUSION: The relative role of increased bone resorption or defective osteoblast function remain to be discussed. Recovery often occurs with or without treatment, but sequelae can lead to disability.

Alkaline Phosphatase↗
PubMed1999

[Management of prolonged fever in infants].

Prolonged fever is defined as an unexplained fever of more than 5 days duration. In infancy and early childhood, it is most often of infectious origin, viral infections being the most frequent. Mycoplasma pneumoniae infections, urinary tract infection and otitis media are also commonly involved. Kawasaki disease is the main inflammatory etiology, juvenile rhumatoïd arthritis in its systemic form (Still's disease) being much rarer. In most cases the etiological diagnosis can be made with a limited number of laboratory and/or imaging investigations based upon a careful clinical evaluation and an oriented chronological strategy.

Diagnosis, Differential↗
PubMed1998

[Epidemiologic survey of infants hospitalized for bronchiolitis. Survey conducted by the ERBUS medical network].

BACKGROUND: Acute infant bronchiolitis is a frequent seasonal disease which peaks in December. It often requires hospital care in Paris and in its surroundings. The exceptional bronchiolitis epidemic of December 1991 brought about a temporary saturation of hospital bed space at the Assistance Publique-Hôpitaux de Paris (AP-HP). Hereafter, in order to organize care more efficiently, an epidemiological observation network called ERBUS was set up. METHODS: Thanks to daily reports of emergency pediatric admissions through the Minitel network, it has been possible to get real time information on the course of the past five epidemics in each of the 11 AP-HP hospitals with pediatric emergency units. RESULTS: Globally the results point to a similar situation every year: approximately 60% boys, 35% babies under 6 months; the ratio of very young patients who are admitted to hospital is multiplied by 1.5 at the mid-point of and at the end of the epidemic compared with the beginning; 70% of the babies under 3 months are admitted to hospital. The ratio of patients who come and are admitted to hospital has been on the decrease every year since 1991: globally from 36.8% down to 28.6% in five years (from 75.1% down to 65.3% among babies under 3 months). The rhythm and intensity of the epidemic have risen sharply: in five years, the number of patients has increased by 119% and that of patients admitted to hospital by 69%, while the epidemic peaks are earlier and higher. CONCLUSION: These statistics have actually been used to allocate additional resources in AP-HP hospitals during the epidemics. To avoid the saturation of bed space in the future, ambulatory care of patients not admitted to hospital should be favored.

Bronchiolitis↗
PubMed1997

Another look at emergency room overcrowding: accessibility of the health services and quality of care.

PURPOSE: To describe both the social characteristics and the health needs of the medical users of a pediatric hospital Emergency Room with special emphasis on frequent use. STUDY SELECTION: Observational study on health services utilization and health care needs of young children consulting at a teaching hospital's Emergency Room. DATA SOURCES: Mother interview and medical record review. RESULTS OF DATA SYNTHESIS: Children from underprivileged strata are more often high Emergency Room users. Their preventive needs are satisfied but adequate follow-up of their medical problems is more often lacking. CONCLUSION: To understand why some achievable benefits are not achieved it is necessary to evaluate the varying performance of health services according to the social origin of the users.

Child, Preschool↗
PubMed1997

Bactericidal activity against intermediately cephalosporin-resistant Streptococcus pneumoniae in cerebrospinal fluid of children with bacterial meningitis treated with high doses of cefotaxime and vancomycin.

Cerebrospinal fluid (CSF) was taken from 19 children with bacterial meningitis treated with cefotaxime (300 mg/kg of body weight/day) and vancomycin (60 mg/kg/day). Median levels of drugs in CSF were smaller than expected, as follows: 4.4 microg/ml for cefotaxime, 3.2 microg/ml for desacetylcefotaxime, and 1.7 microg/ml for vancomycin. The median CSF bactericidal titer against an intermediately cefotaxime-resistant pneumococcus was 1:4. Our data suggest at least an additive interaction between the drugs used in this study.

Adolescent↗