Search PubMed⌕ Search

Biomedical subjects

A P Jonville-Bera

Publications and source records attributed to A P Jonville-Bera.

At least 19 recordsLinked to original sources

[Treatment of febrile convulsions].

Information and reassurance of parents are essential before considering therapeutic measures following a first febrile seizure. It must be emphasized that, although impressive, febrile convulsions are essentially benign, and that in the majority of cases there will be no recurrence. Apart from that, therapeutic measures are of limited efficacy in order to prevent reocurrence. The correct use of antipyretic treatment during febrile episodes must be specified. Due to its several inconveniences, oral diazepam as an intermittent prophylaxis should be only considered in case of multiple reoccurrences. There is little place for continuous anticonvulsant treatment.

Age Factors↗

[Prolonged neuromuscular blockade with mivacurium in a newborn].

Mivacurium is a short acting non-depolarising neuromuscular blocking agent. Short duration of action is due to a rapid hydrolysis by plasma cholinesterase (CHe). The duration of neuromuscular blockade can be prolonged by an abnormal variant of CHe. We report a case of a newborn with neuromuscular blockade for a duration of 8 hours following mivacurium 0.2 mg.kg-1. CHe activity values were not contributive for the diagnosis. The diagnosis was obtained with molecular study showing the new-born homozygocity. The whole family was heterozygous. This case emphasises the lack of precision of CHe activity measurement during the first 6 months of life.

Cholinesterases↗

[Eruption after the 1st dose of standard antitubercular chemotherapy. Thoughts on pyrazinamide].

UNLABELLED: We report 3 cases of rash after the first dose of antituberculosis polytherapy, thus raising questions concerning the procedures to be followed. CASE REPORT: Three patients developed a pruritic rash 1 hour after the first dose of isoniazide, rifampicine, pyrazinamide and ethambutol given simultaneously. The eruption did not recur after readministration of isoniazide and rifampicine successively. Pyrazinamide, which was readministered last (at the full dose in one case and at progressive doses in the two others), induced a recurrence in two of them. Pyrazinamide was definitively withdrawn in one patient with recurrence and slower pyrazinamide readministration allowed continuation of treatment in the other two patients. CONCLUSION: Since pyrazinamide appeared to be responsible for rash following the first administration of antituberculosis polytherapy, a protocol for readministration of the 4 drugs is suggested. If the responsibility of pyrazinamide is confirmed it should be readministered very slowly.

Aged↗

Study of the use of vitamin K in neonates in France.

OBJECTIVE: Because of the risk of haemorrhagic disease of the newborn as a result of a deficit in vitamin K, it is generally agreed that newborns should receive vitamin K. However, there is no consensus concerning the route of administration, dose, number of doses, or dose frequency. METHODS: We studied patterns of vitamin K administration in all maternity hospitals in France in order to establish the range of practices and policies. Six hundred and forty questionnaires were analysed. Vitamin K was given systematically to all neonates in 619 maternity hospitals (96.7%), not given to any neonates in 2 (0.3%), and only to certain newborns in 19 (3%). A similar protocol was used for all newborns in 299 (47%) of the maternity hospitals, and the treatment protocol differed according to the neonatal clinical picture in 336 maternity hospitals (53%). RESULTS: The route of administration agreed with the recommendation that healthy newborns receive formula milk. In contrast, infants receiving breast milk were given IM vitamin K in only 19% of the maternity hospitals studied and regular weekly doses were prescribed in only 56%. In premature infants, IM doses were prescribed in only 46% of cases and repeat weekly doses in 34%. The dose generally prescribed (5 mg p.o. or IM) was not the recommended dose.

Administration, Oral↗

[Syncope with long QT interval in a 39 day-old infant treated with cisapride].

UNLABELLED: Cardiotoxicity of cisapride may increase when this drug is associated with ranitidine. CASE REPORT: A 37-day old term infant, treated with cisapride (1.2 mg/kg/d) and ranitidine for regurgitations, was hospitalized for malaise. A prolonged QT interval (with isolate ventricular extrasystoles), noted at admission, disappeared rapidly after cisapride withdrawal. Linkage to cisapride was probable, promoted by high dosage and cisapride metabolism inhibition by ranitidine, but its plasma concentration was not measured. CONCLUSION: This case report stresses the problem of cisapride dosage in infants and the question of an interaction between cisapride and ranitidine.

Anti-Ulcer Agents↗

Aseptic meningitis following mumps vaccine. A retrospective survey by the French Regional Pharmacovigilance centres and by Pasteur-Mérieux Sérums & Vaccins.

Since 1989 many case series and observational studies of aseptic meningitis (AM) associated with the use of live attenuated mumps vaccines containing the Urabe AM9 strain have been reported worldwide. The aim of this retrospective reported AM in France following mumps vaccination with monovalent or multivalent vaccines containing the Urabe strain. Fifty-four cases of AM were reported to the Regional Pharmacovigilance centres or to the manufacturer from the time each vaccine was launched up until June 1992. Twenty cases were temporally associated with the administration of a monovalent mumps vaccine and 34 with a trivalent measles, mumps and rubella vaccine (MMR). A mumps virus was isolated in four cases in the cerebrospinal fluid and an Urabe-like strain was characterized twice by polymerase chain reaction (PCR). A probable mumps origin was assumed in 17 other cases where the patients presented with other clinical or biological signs of mumps infection. The clinical outcome of AM, known in 87% of the population, was always favourable. The global incidence of mumps vaccine-associated AM was 0.82/100,000 doses, which is significantly lower than the incidence in the unvaccinated population. Even considering that the actual incidence of AM is much higher when assessed by active surveillance studies, the risk/benefit ratio of mumps vaccine remains in favour of vaccination.

Journal Article↗

[Modality of use of vitamin K in France in newborn infants].

BACKGROUND: Because of the risk of hemorrhagic disease of the neonate secondary to vitamin K deficiency, it is generally agreed that neonates should be given vitamin K. There is however, no consensus concerning the route of administration, dose, number of doses, or dose frequency. It was therefore necessary to determine patterns of vitamin K administration in France. POPULATION AND METHODS: Routine vitamin K administration was studied in 1993 by questionnaires sent to all maternity units in France. RESULTS: Six hundred and forty of the 1,086 questionnaires could be analysed. Vitamin K was never prescribed in 0.3% of maternity units and was given only to high risk neonates in 3%. In healthy neonates receiving milk formulas, the route of administration (oral or IM) agreed with the recommendations of the French Committee of Pediatric Nutrition. In contrast, breast-fed infants were given IM vitamin K in only 19% of the maternité units whereas regular weekly doses were prescribed in only 56%. In premature infants, IM doses were prescribed in only 46% of cases and repeated weekly doses in 34%. The dose generally prescribed (5 mg orally or IM) was not the recommended dose. Among the available products, oral or parenteral vitamin K Roche was the most frequently prescribed. CONCLUSION: New recommendations for the use of vitamin K in the perinatal period in France are necessary.

Administration, Oral↗

Sudden infant death syndrome and diphtheria-tetanus-pertussis-poliomyelitis vaccination status.

Because diphtheria, tetanus, pertussis and poliomyelitis vaccine is routinely given during the period of highest incidence of sudden infant death syndrome (SIDS), we carried out a retrospective case-control study to assess whether such vaccination increased the risk of SIDS. The vaccination status of 118 SIDS and 332 control children, matched for sex, date of birth and age of the victims at death, was compared: the victims of SIDS were not significantly more often vaccinated than control children, the odds ratio was estimated at 1.9 with a 95% confidence interval from 0.9 to 3.9. There was a statistical difference between vaccination status of SIDS cases and controls aged less than three months. Nine percent of SIDS cases under 3 months had been vaccinated whereas the matched controls had not. In our study DTCP vaccination was not a risk factor for SIDS; although more of the SIDS infants less than 3 months of age had been vaccinated. This result however, concerns only one subgroup of the population studied and needs to be confirmed with another study of only SIDS infants less than 3 months of age, because DTCP vaccination was not a risk factor for SIDS when considering the total sample of the study.

Case-Control Studies↗