Search PubMed⌕ Search

Biomedical subjects

C Ricour

Publications and source records attributed to C Ricour.

At least 109 records · Page 6Linked to original sources
PubMed1990

Recovery of [13C]-bicarbonate as respiratory 13CO2 in parenterally fed infants.

Ten infants on continuous total parenteral nutrition (TPN) were infused with NaH13CO3 for 6 h in order to assess the amount of 13C recovered as breath 13CO2. Protein intake was 2.8 +/- 0.3 g/kg/d and non-protein energy intake 107 +/- 4 kcal/kg/d (447 +/- 18 kJ/kg/d), provided either as glucose alone or as an isoenergetic glucose-lipid mixture. In the five infants receiving glucose as the sole non-protein energy source, total CO2 production (559 +/- 50 mumol/kg/min), natural 13C abundance of breath CO2 (-11.8 +/- 0.6 delta % versus PDB) and basal 13CO2 production (6.1 +/- 0.6 mumol/kg/min) were higher than in the five infants infused the glucose-lipid mixture (465 +/- 30 mumol/kg/min, P less than 0.02; -16.1 +/- 0.5 delta %, P less than 0.01 and 5.0 +/- 0.3 mumol/kg min, P less than 0.02, respectively). There was a good agreement, in the glucose-infused infants, between the net glucose oxidation rate measured by indirect calorimetry (25.6 +/- 2 g/kg/d) and the glucose oxidation rate estimated from the 13C natural abundances of breath CO2 and infused substrates (23.5 +/- 3 g/kg/d). Steady state 13C enrichment of breath CO2 was reached in all infants after 120 min infusion and ranged from 11.0 to 21.5 delta % over baseline. Steady state 13C enrichment was negatively related to total CO2 production (r = -0.72; P less than 0.02). In contrast, steady state 13CO2 production in excess of baseline was only correlated to bicarbonate infusion rate (r = 0.95; P less than 0.001).(ABSTRACT TRUNCATED AT 250 WORDS)

Bicarbonates↗
PubMed1989

Stress-induced disturbances of the gastro-intestinal tract in children.

The gastrointestinal tract is particularly sensitive to stress, especially in children. The specificity of the gastric, intestinal and colonic microcirculation explains the high risk of ischemia during septic and hemorrhagic shock. The consequences of digestive ischemia vary from mucosal ulceration to transmural necrosis. Tissue hypoxia, the production of superoxide radicals and luminal factors explain these lesions. Some drugs are proposed which may limit the extent of these ischemic lesions; however to prevent them the author advises, on anticipating stress and complete hemodynamic monitoring of infants at risk.

Child↗
PubMed1989

Energy substrate utilization in infants receiving total parenteral nutrition with different glucose to fat ratios.

As the fate of glucose and lipids infused during total parenteral nutrition is not well known in infants, we assessed energy substrate oxidation in 36 patients (mean age: 5.8 +/- 3.6 mo) on continuous total parenteral nutrition. The infants received isocaloric feeding regimens with nonprotein energy intakes either based on glucose alone (group 1) or on glucose-lipid mixtures providing 15% (group 2), 35% (group 3), 50% (group 4), or 70% (group 5) energy as fat for at least 6 d before glucose and fat oxidation rates were measured by open-circuit indirect calorimetry. Oxidative glucose disposal reached a maximal rate of 12.6 +/- 1.2 mg/kg.min (17.9 +/- 1.7 g/kg.d) in patients with the higher glucose infusion rates. Glucose infused in excess of maximal oxidative disposal was stored, mainly as fat. The increase in glucose infusion rate was paralleled by an increase in energy expenditure amounting to 16% of the energy value of infused glucose. Net fat oxidation was only observed in group 3 (1.6 +/- 0.7 g/kg.d), 4 (3.4 +/- 0.6 g/kg.d), and 5 (3.9 +/- 0.4 g/kg.d) patients, with glucose infusion rates lower than 18.3 g/kg.d. However, there was no further increase in fat oxidation in group 5 as compared to group 4 patients, despite a further increase in fat intake, which only resulted in increasing fat deposition. Thus, fat infusion aiming at a significant contribution to coverage of energy expenditure requires that glucose oxidation be equal to or lower than maximal oxidative glucose disposal, hence that glucose infusion rates be lower than 18 g/kg.d.(ABSTRACT TRUNCATED AT 250 WORDS)

Dietary Carbohydrates↗
PubMed1989

Primary intestinal myopathy, a cause of chronic idiopathic intestinal pseudoobstruction syndrome (CIPS): clinicopathological studies of seven cases in children.

Clinicopathological data on seven instances of primary intestinal myopathy in children are reported. The ages of the patients ranged from eleven months to thirteen years. A persistent intestinal obstruction was the main and constant clinical feature. An ineffective intestinal propulsion was documented on manometric studies. Various urological abnormalities were present in three cases. One patient died and six survive but are dependent on enteral and parenteral nutrition. The morphological findings consisted of degenerative changes involving the muscular layers of the intestinal wall. These changes varied from cytoplasmic vacuolation to definite atrophy and disappearance of the muscular fibers. An extensive interstitial fibrosis underlined these atrophic changes in the late stages of the disease. A familial history was identified in three cases, one consistent with an autosomal dominant transmission.

Child↗
PubMed1989

Decrease of slow-wave sleep in children with prolonged absence of essential lipids intake.

Sleep measures of eight children fed by total parenteral nutrition (TPN) without essential lipids were compared to those of seven children fed by TPN receiving a daily supplementation of essential lipids. Slow wave sleep (SWS) is significantly decreased in the former group, particularly in the second half of the night, thus suggesting that lipids could be involved in sleep regulation.

Adolescent↗
PubMed1989

Testing for course patterns in Crohn's disease using clustering analysis.

Using clustering analysis, we sought to identify groups of patients on the basis of the disease course among a population of 177 patients with Crohn's disease and followed for 3 years or more, starting from the first frank exacerbation of the disease. The first 36 values of a monthly clinical score represented the active variables of the clustering analysis. This method yielded 2 course groups, A and B, of 95 and 82 patients respectively. The unfavorable course in group A was characterized by the persistence of the clinically active disease at 3 years, whereas group B individuals achieved complete clinical remission within 2 years of onset on the average. Among the initially known clinical data which could explain the course, only the incidence of an occlusive syndrome was higher in group B, which showed a more favorable course. Although we applied clustering analysis to a patient sample over a period of only 3 years, our results do suggest the existence or 2 primary course groups within the population of patients with Crohn's disease. It would appear that the disease course cannot be predicted from the clinical parameters present at the time of onset, but rather becomes apparent during the course of the first 2 years.

Adult↗
PubMed1989

[Munchausen's syndrome by proxy and chronic intestinal pseudo-obstruction].

A case of intestinal pseudo-obstruction in a 4 1/2 year-old boy is reported. All etiologic investigations remained negative. Management successively required continuous enteral feeding, ileostomy then total parental nutrition. The proof of a chronic barbiturate intoxication, induced by the mother, was made only after 2 1/2 years of follow-up, when the patient was in a critical condition. Separation of the child from his family led to complete disappearance of symptoms within a few days.

Barbiturates↗
PubMed1988

Lipid tolerance in children receiving long-term parenteral nutrition: a biochemical and immunologic study.

The effect of intravenously administered lipids (intralipid) on immunologic function, complement, and coagulation was prospectively studied over 1 year in 15 children. The mean age of the children was 52.4 +/- 37.9 months; they had received total parenteral nutrition for an average of 3 years. Immunoglobulins (IgA, IgM, IgG), coagulation studies (platelets, prothrombin time (PT), partial thromboplastin time (PTT), fibrinogen, fibrinogen degradation products, factor V) and components of complement (C3, C4, and CH100) were analyzed. Activation of monocytes by opsonized zymosan was measured by chemiluminescence and compared with that of normal control subjects. The clinically stable children had normal monocyte activation and normal complement levels. The PT and PTT values were significantly increased but improved with increased intralipid dose; other coagulation factors were normal. Acutely sick children, however, had decreased fat tolerance with significantly increased serum triglyceride levels and PT and PTT values; their monocyte activation and complement factors remained normal. These data indicate that the dose of intralipid should be lowered during acute illnesses; we suggest close monitoring of PT and PTT values and of serum triglyceride and cholesterol levels to avoid the fat overload syndrome.

Blood Chemical Analysis↗
PubMed1988

In vitro quantitative model of catheter infection during simulated parenteral nutrition.

We developed a quantitative in vitro model of catheter infection. Colonization was initiated by inoculating the catheter lumen with a small number of bacteria (approximately 5 x 10(3) viable organisms). Then the inoculated catheters were used for simulated total parenteral nutrition therapy consisting of infusions for 9 h a day, and bacteria were counted in the effluent fluid against time, enabling us to monitor catheter colonization quantitatively. Bacterial colonization of prosthetic devices is a progressive process, as evidenced by the slow day-to-day increase of bacterial release seen here. On the other hand, bacterial strains of various representative species exhibited significant differences in their ability to infect catheters. These results suggest that the in vitro model presented here is a reliable tool for monitoring the degree of catheter colonization under standardized conditions and could be used for further studying the main factors of catheter-related sepsis or the treatment of this information.

Bacteria↗
PubMed1988

[Intestinal transplantation in children].

A long period of experimental work has allowed to study successively hypothermic preservation of the small bowel, autotransplantation and finally allotransplantation. After this initial phase of experimental surgery, a certain number of intestinal transplantations in humans could be attempted as cyclosporine became available. Following a brief of report of 3 intestinal transplantations recently performed by the group of the hôpital des Enfants-Malades in Paris, indications for intestinal transplantation are provided. Subtotal resections of the small bowel in children or adolescents and extensive resections in neonates account for most of the indications. Despite significant progress, further advances in intestinal transplantation need to be made, because the small bowel poses unique problems in that it seems to represent a compendium of all the particularities and difficulties of other organ transplantations.

Animals↗
PubMed1988

[Hepatobiliary changes during exclusive parenteral feeding in infants with severe diarrhea].

In order to specify the factors responsible for the hepatic changes occurring during total parenteral nutrition (TPN) and to propose a preventive treatment, 30 infants treated for severe protracted diarrhea were prospectively distributed into 4 groups: I (n = 10): controls; II (n = 7): oral administration of human milk since the 15th day of TPN; III (n = 5): oral metronidazole since the 15th day; IV (n = 8): parenteral antibiotic therapy for septicemia since the 1st day. Contrary to group IV, the first 3 groups were randomly constituted on the 15th day. Liver function tests, bile and serum biliary acids, duodenal flora, hepato-biliary ultrasonography and, in 12 cases, liver histology were sequentially studied. Liver function changes were observed on the 15th day in all groups. An improvement occurred 15 days later in the infants treated, when the control group worsened (p less than 0.02). A significant increase of bile chenodeoxycholic acid levels was observed in the control group only (p less than 0.01), without change in lithocholic acid levels. These results lead the authors to recommend the preventive use of metronidazole or human milk during prolonged TPN in infants.

Bile Acids and Salts↗
PubMed1988

[Digestive hemorrhage and bacterial overgrowth in children].

Two cases of gastrointestinal bleeding due to bacterial overgrowth syndrome are presented. The microbial contamination was confirmed by quantitative studies of the intestinal microflora and by therapeutic test; the association colistin-metronidazole could stop the digestive hemorrhage.

Bacterial Infections↗
PubMed1987

[Severe epithelio-exfoliative colitis in infants. I. Clinical data].

Two cases of colitis with neonatal onset are reported. They were characterized by their severity which made early exclusive parenteral nutrition necessary, by the lack of ulcerations visible at endoscopy and of biological inflammatory signs and by an associated neural deafness. In spite of prolonged digestive and corticosteroid treatment, a colectomy had to be performed in both cases. The specificity of the histologic abnormalities of the colon individualizes this severe colitis in infancy.

Colitis↗