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Biomedical subjects

C Dupont

Publications and source records attributed to C Dupont.

At least 235 records · Page 13Linked to original sources

[Intestinal permeability disorders in children].

The intestinal mucosa has a certain degree of "porosity", which allows some molecules and macromolecules that are not subject to active transport, to cross the intestinal wall and enter the blood circulation. This permeability of the intestinal mucosa, which depends mostly on the size of the molecule and the state of the mucosa, can be studied with the assistance of protein macromolecules in an allergy-immunological investigation, or with inert markers, so permitting evaluation of the state of integrity of the small intestine. The markers used are polyethylene glycols (PEG) of various molecular weights, Cr EDTA, the monosaccharide sugars mannitol or rhamnose and the disaccharide sugars lactulose or cellobiose. Study of the intestinal permeability to inert markers allows detection of coeliac or Crohn's disease. It can be repeated, especially at the time of food provocation tests needed in the diagnosis of food intolerances in pediatrics in the enteropathology to cows milk proteins, atopic dermatitis and irritable colon in children.

Antigens↗

[Use of a fermented powdered milk in malnourished or lactose intolerant children].

Lactase deficient subjects, who form the bulk of the world population, absorb yogurt lactose because the bacteria used for fermentation produce beta-galactosidase. From a milk fermented by these bacteria and dried by a temperature-controlled process a power could be obtained which possess residual lactase activity but, unlike yogurt, does not need storage at low temperature. The lactose of this fermented powdered milk is perfectly absorbed, as proved by hydrogen respiratory tests performed in 35 lactose intolerant African subjects living in isolated villages. In 25 malnourished children under 3 years of age, this milk allowed renutrition without inducing diarrhoea--a result which could not have been obtained with ordinary milk in two-thirds of the cases. This type of food is potentially valuable to feed the large population of the third world.

Adolescent↗

Effect of xamoterol on haemodynamics and plasma catecholamines in chronic heart failure.

The effects of xamoterol on haemodynamics and plasma catecholamines were studied at rest and after exercise in patients with mild to moderate heart failure, using a symptom-limited exercise test. Exercise duration and myocardial efficiency were significantly increased, and heart rate on maximal exercise was reduced despite increased catecholamine levels.

Adrenergic beta-Agonists↗

Feeding lactose-intolerant children with a powdered fermented milk.

Fresh yogurt has been proposed as a milk substitute for lactase-deficient patients. We investigated the possibility that a dried, low-fat milk fermented by yogurt microorganisms would be effective. Processing of a fermented milk by spray-drying led to a powder with persistence of lactase activity (11.7 units/g) without storage at 4 degrees C and stable at room temperature (20-23 degrees C). The tolerance and absorption of 10.5 g of lactose in a volume of 150 ml was studied in 25 Gabonese lactase-deficient children aged 5-14 years in the form of a standard humanized milk formula followed 1 week later by the powdered fermented milk formula. Results of the breath hydrogen test showed that in 24 of 25 cases, lactose absorption was normal with a maximal rise of hydrogen over baseline of under 13 ppm after ingestion of the powdered fermented milk. The rise was above 20 ppm in the 25 children with the same load of lactose in the form of the standard formula and one-third had symptoms of lactose intolerance. This powdered fermented milk preparation should be considered as a valid approach in programs of nutritional support targeted to countries with a high prevalence of lactase deficiency.

Adolescent↗

Alterations of intestinal permeability to sugars in infants following neonatal surgery.

The 12-h urinary elimination of orally ingested mannitol and lactulose was studied in 29 infants aged 3 days-20 months admitted in an intensive care unit of gastrointestinal surgery, and in 24 age-matched healthy controls. In patients with short bowel syndrome, there was a significant fourfold reduction in urinary mannitol elimination compared with controls. The lactulose/mannitol urinary ratio was significantly increased in patients with necrotizing enterocolitis (p less than 0.01) and in patients with disorders of intestinal propulsion during episodes of diarrhea with a monomorphic fecal flora (p less than 0.01). The urinary recovery of mannitol and lactulose after oral loads is a good marker of intestinal mucosal damage in infants with surgical disorders of the digestive tract.

Dietary Carbohydrates↗

Modifications of intestinal permeability during food provocation procedures in pediatric irritable bowel syndrome.

An intestinal permeability test analyzing the differential urinary elimination of lactulose and mannitol orally ingested at the same dosage was carried out first in fasting condition, then combined with specific food ingestion, in 17 children with clinical symptoms of irritable bowel syndrome (IBS). Foods were selected based on a suggestive clinical history or on a positive radioallergosorbent or prick test. Comparison of the results with those of a control population reported in a previous study showed that in nine IBS patients, specific food ingestion was associated with a modification of intestinal permeability. The nine children all had a personal and/or familial history of allergy and/or raised total IgE. The symptoms disappeared in the nine patients after food exclusion either alone (seven patients) or together with further treatment by cromolyn (two patients). We conclude that, at least in some children, symptoms of IBS may be related to food hypersensitivity.

Adolescent↗

[Intestinal parasites and lactose malabsorption].

Breath-test was performed for diagnosis of lactose malabsorption in 50 Gabonese children of normal nutritional status, aged 5 to 15 years, with parasites in stools, but without diarrhoea or digestive symptoms. Control group was unparasitized and consisted of 17 children and 18 young adults living in the same area. Parasites discovered by stool examination were Ascaris lumbricoides in 76% of parasitized children, Trichuris trichiura in 58%, Giardia in 24%, Entamoeba histolytica in 20%, Schistosoma intercalatum in 16% and Necator Americanus in 14%. Children were given a 10 g lactose load and adults 20 g. Lactose malabsorption was discovered in 64% of parasitized patients and in 63% of unparasitized. Ten of 12 (83.3%) of Giardia infected children had a lactose malabsorption (no significant difference). These data show that decrease of lactase activity in African children is not related to the presence or to the importance of intestinal parasitism, except for Giardia infestation, if nutritional status is normal.

Adolescent↗

Gastroesophageal reflux and upper airway diseases.

GER can have important impacts on the upper airway passages, and in turn, upper airway obstruction can certainly aggravate reflux. This relationship should be considered in the newborn or young infant, faced with a sudden life-threatening event, and in the older child or adult presenting with chronic head and neck complaints, either unexplained or unresponsive to adequate medical therapy. A causal relationship may be difficult to establish, based first on clinical expertise as a guideline, on laboratory tests, among which pharyngeal pH monitoring could be promising, and on response to medical antireflux therapy. A better understanding of the significance of high levels of reflux and defective acid clearance, as well as a more precise knowledge of the maturation and functioning of upper airway protective mechanisms, would open the way to more accurate diagnostic procedures, to a more reliable definition of the abnormal, and to greater efficiency in the management of these patients.

Gastroesophageal Reflux↗

[Benign hypertrophic gastritis associated with cytomegalovirus infection].

A new case of benign hypertrophic gastritis associated with cytomegalovirus infection in a 7 year-old boy is reported. The main symptoms were complete digestive intolerance and protein loss, resulting in major hypoalbuminemia and anasarca. The alpha-1-antitrypsin clearance was very increased. Diagnosis was established by upper gastrointestinal x-rays which displayed important thickening of the gastric rugae, and by endoscopic examination with biopsy. A cytomegalovirus infection attested by seroconversion and viruria probably played a role in its origin. Symptomatic treatment and albumin infusions led to recovery within one month. In the last 25 years, 31 cases of benign hypertrophic gastritis have been reported. Vomiting is the main symptom with abdominal pain and G-I bleeding. The protein loss is constant, often severe. In most cases, the disease recedes within a few weeks, unlike the adults' Ménétrier disease which proves to be chronic and severe. The cause remains unknown. In 11 cases, a cytomegalovirus infection was reported and, so, is probably not fortuitous.

Child↗

[Pharmacologic efficacy of sodium alginate suspension on gastro-esophageal reflux in infants and children].

Eighty-three children presenting with symptomatic gastro-esophageal reflux (GER) (48 males, 35 females, aged 15 days to 57 months (mean = 7 months) were assessed by pH monitoring. All showed acid pathological GER on the 3 hours post-prandial esophageal pH measurement (% of time at pH less than 4 greater than 4.2) and all had a second pH measurement within the following 3 hours after intake of a single (5 ml) dose of sodium alginate (AGS). AGS administration was followed by a highly significant reduction (p less than 0.00001) of all pH measurement variables: a) Percentage of time spent at pH less than 4 returned to normal with a mean 11.7% to 4.8%; that is a 52.5% improvement (median); b) Total number of reflux reduced on average from 8.9 to 5.0: that is a 35% improvement (median); c) Mean duration of reflux reduced on average for 4 to 2 min; that is a 60% improvement (median). In 76 patients hourly monitoring of % of time spent at pH less than 4 shows that hourly improvement persists.

Alginates↗

Duodenogastric reflux in children: measurement of phospholipids and trypsin in gastric content.

The duodenogastric reflux (DGR) is a suspected cause in some esogastric pathologies in adults: esophagitis, peptic gastric ulcers, stress ulcers, ulcers secondary to drugs, gastric cancer, and gastritis. The toxic substances of the reflux are essentially bile acids, lysolecithin, and trypsin. A number of diagnostic methods have been proposed in the adult. This study suggests a diagnosis technique for DGR in the child. Fasting gastric juice was collected by gastric intubation during 1 h and three substances were measured: phospholipids as markers of biliary reflux, trypsin as a marker of pancreatic reflux, and sialic acid as a marker of the degradation of gastric mucus. The sialic acid enabled us to evaluate some of the toxicity of DGR on the stomach. The study of 49 child subjects permitted us to show the existence, in the normal child, of biliopancreatic markers in the stomach under fasting conditions through a physiological DGR; to define the norms in the child, varying according to three age groups: 0-2 months, 2-12 months, and 1-4 years (the maximum values for an age above 4 years seemed to correspond to those in the adult); and to suggest the existence of a pathological DGR in children with antral gastritis or ulcers.

Age Factors↗

A program for storage and retrieval of demographic, sample, clinical laboratory, and restriction endonuclease map data.

A program, written in dBASE, is described that manages demographic, sample, clinical laboratory, and restriction endonuclease map data. The program exports migration distances of DNA fragments resulting from specified endonuclease digests to a commercially available, but modified, curve fitting program (CURVE-FITTER) where the fragment sizes in base pairs are calculated. The calculated values are imported back into dBASE files for report generation or later analysis. The program will produce hard copy reports for single or multiple individuals.

Clinical Laboratory Information Systems↗