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Biomedical subjects

B Grenier

Publications and source records attributed to B Grenier.

At least 55 records · Page 3Linked to original sources
PubMed1986

Pharmacokinetics of amikacin in cystic fibrosis: a study of bronchial diffusion.

36 pharmacokinetic studies of amikacin were performed to evaluate the bronchial diffusion of amikacin in 9 children with cystic fibrosis, 3 to 15 years old. Amikacin was administered i.v. according to a variable dosage regimen. Four children without cystic fibrosis were enrolled as controls. The mean half life was 1.1, the volume of distribution averaged 0.26 l/kg, and the mean plasma clearance was 131 ml/min/1.73 m2, which no differed from that of the controls. The mean peak plasma concentration was always above the MIC but its level depended on the unit dose: 18.5 mg/l, 25,95 mg/l and 31,46 mg/l for doses of 5, 7.5 and 12.5 mg/kg, respectively. Between consecutive amikacin infusions, the plasma level was above the MIC for 21% and 46% of the time after the 5 and 7.5 mg/kg doses. The maximum concentration in sputum between H1 and H2 was always below the MIC, except after 15 mg/kg. The ratio AUC sputum/AUC plasma was between 0.028 and 0.61, and it increased from the beginning to the end of the course of treatment. No side effects were observed on hearing, or vestibular and renal function. The results are used to suggest more appropriate dosing regimens.

Adolescent↗
PubMed1985

Pertussis immunization of infants using a new combined DTP-polio vaccine.

As part of the evaluation of a new combined Diphtheria-Tetanus-Pertussis-Poliomyelitis (DTP-Polio) inactivated vaccine, the pertussis agglutinin response was studied in 62 infants, two to three months old. Each dose of vaccine combined these antigens in a 0.5 ml volume, and contained at least four International Protective Units of pertussis antigen adsorbed on aluminium hydroxide. Infants were vaccinated with three doses of DTP-Polio vaccine at two month intervals. Pertussis agglutinin determinations showed a satisfactory response after two DTP-Polio vaccine doses. Although higher agglutinin titres were apparent after three doses than after two, no significant difference was observed in the seroconversion rate after two or three doses (88.8% and 96.3% respectively). The DTP-Polio vaccine would thus seem suitable for use in a two-dose primary immunization schedule against pertussis.

Agglutinins↗
PubMed1985

Rotavirus electrophoretypes in infantile gastro-enteritis. An epidemiological study.

From January first 1978 to September 30, 1981, 93 fecal samples from children hospitalized with a rotavirus gastro-enteritis were tested after RNA extraction and polyacrylamide gel electrophoresis. 14 electrophoretypes (TI--T14) were identified by this technique. They were studied in relation with epidemiological as well as clinical symptoms. No electrophoretype correlated well with age or living area. The electrophoretype T3 was found only in male infants and the electrophoretype T7 was 3 times more frequent in boys than in girls. The electrophoretype T4 was prevailing during the winter 1980-1981 and the electrophoretype T5 prevailed during the summer 1981. 19 infants were probably contaminated during their stay in the hospital, 9 of them with the electrophoretype T4 prevailing at that time. The prevalence of associated otitis and rash was significantly higher with the electrophoretype T3. The polyacrylamide gel electrophoresis technique appears to be a simple, and reliable epidemiological tool to evaluate rotavirus infection in communities.

Child, Preschool↗
PubMed1985

[Ceftazidime absorption into bronchial secretions in mucoviscidosis patients].

Penetration of ceftazidime into bronchial secretions was studied in 23 patients, of which 18 had cystic fibrosis. Ceftazidime was used as the single drug for treating exacerbations caused by Pseudomonas aeruginosa. Dosage was 6 g/1.73 m2/day divided into three intravenous injections for 14 to 21 days. Bronchial secretion samples were obtained by fiber-optic bronchoscopy or physical therapy. Serum and bronchial secretion ceftazidime concentrations were assayed using a microbiological method. Ceftazidime concentrations in both media were lower in children than in adults : elimination half-life is shorter (1.7 h against 2.45 h in adults), extravascular distribution is faster, with earlier (1 h against 2 h in adults) achievement of the peak bronchial secretion concentration (2 micrograms/ml). The ratio of bronchial secretion concentration to concomitant serum concentration did not exceed 5% at the time of peak bronchial concentration. These results suggest that in cystic fibrosis patients, the faster and lower bronchial penetration of ceftazidime may be due to faster elimination as compared to adults. Although transient elimination of Pseudomonas aeruginosa was achieved in 12 study patients, our findings support the use of higher dosages or alternative administration modalities designed to increase in situ ceftazidime concentrations.

Adolescent↗
PubMed1985

[True and false agreement relations between 2 qualitative tests].

The respective effectiveness of two qualitative tests is usually compared by their results when applied to a same specimen or subject. The results reported in a fourfold table show coincident numbers of double positive and double negative results. That straight concordance is fallacious, including the chance coincidences. Test Kappa measures the true agreement, without the chance coincidences. Kappa value may be compared to a maximum value of agreement depending on the marginal results of the fourfold table. As a matter of fact, the test Kappa is a non parametric correlation function comparable to the non parametric correlation coefficient Phi computed from the value of the chi square test.

Clinical Laboratory Techniques↗
PubMed1985

[Antipoliomyelitis vaccination of young children with a new inactivated vaccine. Serological results].

An inactivated trivalent poliovirus vaccine, prepared on simian line-cells (Vero cells), has been injected in 3 doses one month apart in 36 infants, 2 to 11 months old (30 of whom were 2 to 6 months old) to determine its tolerance and antigenic efficacy. Each dose contained 40, 8 and 32 antigenic D units for the 3 types respectively. DPT vaccine was injected simultaneously in another part of the body. Before beginning the immunization program, 20 infants had significant titers of antibodies against the 3 types of poliovirus; Only 6 were triple negative. One month after the second dose of vaccine, all the infants had significant titers of antibodies against the 3 types; these titers have not been significantly enhanced one month after the third dose. Two doses of the inactivated vaccine one month apart induced a satisfactory serologic response in spite of the presence of serum maternally transmitted antibodies. There were no adverse reactions.

Antibodies, Viral↗
PubMed1984

[Azlocillin treatment of Pseudomonas aeruginosa bronchopulmonary infections in children with cystic fibrosis].

From April, 1980 to December, 1981 ten children aged from 2 to 14 years presenting with cystic fibrosis were admitted to hospital for exacerbation of their chronic bronchial infection. Mucous Pseudomonas aeruginosa was present in sputum. Seven of the 10 strains isolated were susceptible to azlocillin and 3 were classified as intermediate. Eight children were treated with azlocillin alone in doses of 200-300 mg/kg/day and two with combined azlocillin 300 mg/kg/day and amikacin 16 and 23 mg/kg/day respectively. In both groups the antibiotics were administered 8-hourly by short (30 min) intravenous infusions and the duration of treatment ranged from 8 to 21 days (mean 14 days). Both drugs were well tolerated. Antibacterial activity was assessed as "cure" when Pseudomonas could not be isolated in sputum for at least 2 weeks after the end of the treatment, as "relapse" when that organism reappeared in sputum within the same period of time, and as "failure" when it persisted in sputum. On this account, among the 8 children treated with azlocillin alone 3 were cured, one relapsed and 4 failed. One of the two children treated with the azlocillin-amikacin association was cured, the other failed. Clinical results correlated roughly with antibacterial activity. Five distinct improvements were observed: 2 were associated with bacteriological cure, 2 with transient eradication followed by relapse and 1 occurred although the responsible organism persisted in bronchial secretions. Two children showed poor clinical results; 2 with failure and 1 with bacteriological cure. In two other children treatment was ineffective both clinically and bacteriologically. This study confirms that high parenteral doses of azlocillin have a beneficial effect on exacerbations with Ps. aeruginosa of chronic bronchial infection in cystic fibrosis. Clinical improvement usually correlates with antibacterial activity when the organism is eliminated, even temporarily, from bronchial secretions. The synergistic azlocillin-aminoglycoside association should probably be recommended, at least to reduce the risk of emergence of resistant strains.

Adolescent↗
PubMed1984

[C-reactive protein of the cerebrospinal fluid in children. A new evaluation of its diagnostic value].

The presence of C-reactive protein in the cerebrospinal fluid (CSF) has been proposed as an early indicator of bacterial meningitis in children. A commercial latex agglutination test (CR-test, Hyland) was performed in CSF obtained at first lumbar puncture in 114 children (26 neonates and 88 children aged from 1 month to 15 years) presenting with meningitis-like episodes. The CSF was regarded as normal in 41 cases; 50 had non-bacterial meningitis, and bacterial infection was diagnosed in 14 and suspected in 9. The latex agglutination test was positive in the first CSF sample from 2 neonates with bacterial meningitis, but its specificity was low (= 0.58). In older infants and children the test was positive in 18/21 cases of bacterial meningitis (sensitivity = 0.86) and negative in the 18 cases with normal CSF, as well as in 47/49 cases of non-bacterial meningitis (specificity = 0.97). The presence of C-reactive protein in CSF obtained at first lumbar puncture therefore is unreliable to distinguish between bacterial and aseptic meningitis.

Adolescent↗
PubMed1982

Vaccine against hepatitis B in children: prevention of hepatitis in a pediatric hemodialysis unit.

In a pediatric hemodialysis unit, 10 children (aged 1 to 14 years) with chronic renal failure were immunized against hepatitis B infection (HB) by means of a vaccine. The vaccine was prepared by purification of Hepatitis B surface antigen (HGs Ag) from human sera and was formalin inactivated. Seven children were undergoing periodic hemodialysis and three were still managed with conservative treatment. There HBs Ag chronic carriers children were also dialysed in the unit and therefore represented a permanent high risk of HB for the whole unit. All the vaccinated children sero-converted for antibody to HBs Ag (anti-HBs) after vaccination. A follow-up from 16 to 33 months did not evidence clinical, biological and serological sign of hepatitis B in the vaccinated children. Presence of anti-HGs and absence of appearance of hepatitis B following immunization suggest that hepatitis B vaccine has represented for these children an effective means of prevention against hepatitis B infection.

Adolescent↗
PubMed1981

[Cefotaxime in the treatment of purulent meningitis in children (author's transl)].

Five meningitis due to Haemophilus influenzae and 6 meningitis due to Enterobacteria were treated with cefotaxime. The antibiotic was administered at a dose of 150 to 200 mg/kg/day in four 1 hour infusions. The pathogens were eradicated in all patients. Cefotaxime activity was efficient either against resistant pathogens (Haemophilus, Enterobacter) or against organism susceptible to ampicillin. Because cefotaxime is active at low concentration and has a good diffusion in the CSF, it provides a particularly effective treatment in Gram-negative meningitis in children. The initial use of cefotaxime should result in rapid eradication of the pathogen, with consequent improvement in the prognosis.

Cefotaxime↗