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D Gendrel

Publications and source records attributed to D Gendrel.

At least 109 records · Page 6Linked to original sources
PubMed1995

[Primary tuberculous infection. Current aspects in imaging. Apropos of 14 cases].

Active pulmonary tuberculosis, a source of contamination, is currently undergoing a recrudescence in developed countries, particularly in clinical contexts of immunodepression. The authors report a retrospective series of 14 cases of primary tuberculosis in a paediatric population (7 girls and 7 boys) with a mean age of 3.5 years (range: 4 months-16 years) observed over a 3-year period. After reviewing the current radiological features of patent primary tuberculosis, the authors emphasize the contribution of chest CT scan in latent forms with a normal chest x-ray and a difficult bacteriological diagnosis. Imaging remains an essential tool in early diagnosis, therapeutic management and active surveillance of this form. The authors propose a decisional flow-chart in the case of suspected primary tuberculosis in children.

Adolescent↗
PubMed1994

[Abdominal pain in children caused by lactose intolerance. Prospective use of the hydrogen breath test].

OBJECTIVES: We performed the breath hydrogen test in children consulting for abdominal pain in order to determine the minimal quantity of lactose required to prove malabsorption with least patient incomfort and to evaluate the effect of an adapted diet in children with a positive test. METHODS: The breath hydrogen test after lactose intake was performed in 109 children (51 boys, 58 girls, mean age 8.2 + 3.2 years, range 3 to 15) seen for unexplained abdominal pain. All these children had complained of abdominal pain daily for at least 6 months and no other cause could be identified. Children with acute or chronic diarrhoea or constipation were excluded. Nineteen children had been transferred from the surgery unit and 6 had been followed by the psychiatry unit. All these children drank milk regularly. RESULTS: The diagnosis of lactose intolerance was established in 83 children (76.1%) on the basis of a hydrogen peak in the breath after lactose ingestion. One-fourth of the children were of French origin and the others had at least one grandparent who was of Mediterranean or African origin. A lactose-free diet was proposed and led to the disappearance of abdominal pain in 24% and a clear improvement in 32%. CONCLUSION: The breath hydrogen test is a simple non-invasive test which allows a selection of children who could benefit from a lactose-free diet although it cannot be used to predict the effect of diet.

Abdominal Pain↗
PubMed1994

Eradication of convalescent-phase Salmonella carriage in children with two oral doses of pefloxacin.

Fifteen children (age range 1.5 months to 7.2 years), who were excluded from schools or nurseries due to asymptomatic convalescent-phase non-typhoidal Salmonella carriage, received two oral doses of pefloxacin (12 mg/kg on days 1 and 4) and were examined on days 10, 30, 45 and 60. Definitive eradication was observed in 13 patients, all of whom had initial low Salmonella counts in stools and were culture-negative by day 10. In the two patients who failed to respond, the same treatment was effective when repeated 4 and 6 months later respectively. No side-effects were observed. In six other children, considered as controls, eradication by day 10 was observed in only one case after administration of amoxicillin for eight days. Two oral doses of pefloxacin could be a useful and safe means for eliminating Salmonella carriage in young children.

Administration, Oral↗
PubMed1994

Nontyphoidal salmonellal septicemia in Gabonese children infected with Schistosoma intercalatum.

Relapses of enteric fever induced by Schistosoma intercalatum have been observed to occur in central Africa. In Libreville, Gabon, 70 children (ages, 2.1-15.9 years) who were seronegative for human immunodeficiency virus and were hospitalized for septicemic salmonellosis underwent rectal biopsy for diagnosis of S. intercalatum infection. A nontyphoidal Salmonella species was isolated from 53 of the 70 patients: Salmonella typhimurium in 14 cases; Salmonella enteritidis in 7 cases; Salmonella galiema in 4 cases; Salmonella arizonae in 3 cases; and other species in 25 cases. Schistosomal eggs were present in the rectal mucosa of 48 (90.6%) of these 53 patients, in 11 (64.7%) of 17 patients with septicemia due to Salmonella typhi or Salmonella paratyphi, and in 21 (38.2%; P < .001) of 55 controls. Clinical symptoms were not different among patients coinfected with S. intercalatum and nontyphoidal Salmonella vs. those with enteric fever. Treatment with antibiotics induced apyrexia only after administration of antiparasitic therapy in 30 patients. These data strongly suggest interactions between S. intercalatum and Salmonella in infected children with clinically severe nontyphoidal salmonellal septicemia.

Adolescent↗
PubMed1993

High serum procalcitonin concentrations in patients with sepsis and infection.

High concentrations of calcitonin-like immunoreactivity have been found in the blood of patients with various extrathyroid diseases. By means of a monoclonal immunoradiometric assay for calcitonin precursors, we have measured serum concentrations of procalcitonin in patients with various bacterial and viral infections. 79 children (newborn to age 12 years) in hospital with suspected infections were investigated prospectively. 19 patients with severe bacterial infections had very high serum concentrations of procalcitonin at diagnosis (range 6-53 ng/mL) in comparison with 21 children found to have no signs of infection (baseline concentrations < 0.1 ng/mL). Serum procalcitonin values decreased rapidly during antibiotic therapy. 11 patients with peripheral bacterial colonisation or local infections without invasive sepsis and 18 (86%) of 21 patients with viral infections had concentrations within or slightly above the normal range (0.1-1.5 ng/mL). Among 9 severely burned patients studied in an intensive care unit, the post-traumatic course of procalcitonin concentrations (range 0.1-120 ng/mL) was closely related to infectious complications and acute septic episodes. Concentrations of mature calcitonin were normal in all subjects, whatever procalcitonin concentrations were found. Concentrations of a substance immunologically identical to procalcitonin are raised during septic conditions. Serum concentrations seem to be correlated with the severity of microbial invasion.

Bacterial Infections↗
PubMed1993

[Bilharziasis caused by Schistosoma intercalatum, a recent and forgotten form of schistosomiasis].

Schistosoma intercalatum schistosomiasis is confined to the western regions of equatorial Africa. It is often asymptomatic but it produces microscopic lesions in the intestine (mainly the rectum), the liver and the genital organs of both men and women, the latter lesions being more insidious and insufficiently explored. Its treatment, like that of other schistosomiases, consists of one course of praziquantel. Naturally, S. intercalatum may be hybridized with S. haematobium in Gabon and Cameroun which are the two countries where the two parasites coexist.

Animals↗
PubMed1993

[Salmonella-Schistosoma interactions].

Prolonged or recurrent typhoid fever and mainly salmonella septicaemia usually regarded as minor, or even episodes of salmonelluria are not uncommon in patients infested with Schistosoma spp. In such cases the salmonella infection is often apparently resistant to antibiotic therapy. Schistosoma-salmonella interactions have been described with all species of schistosoma, notably S. haematobium, S. mansoni, S. intercalatum and S. japonicum. The adult worms of schistosoma live in the mesenteric venous plexuses and, in some particular sites, salmonellas are electively stuck onto the outer wall of adult schistosomas. As a result of this, salmonella septicaemia is facilitated and sustained by the schistosomal infestation, and several varieties of salmonella may be involved. These salmonella infections cannot be cured without treatment of the associated schistosomiasis.

Adolescent↗
PubMed1993

Use of pefloxacin after failure of initial antibiotic treatment in children with severe salmonellosis.

Sixteen children (7 males, 9 females) aged 0.1 to 9.5 years (mean 3.6 years) who were hospitalized for severe salmonella infection were treated with conventional antibiotics. In nine children disappearance of fever and bloody diarrhea was obtained 2 to 4 days after the beginning of antibiotic therapy. Although the antibiotic administered was active against the pathogen, after 4 to 8 days the seven other children experienced clinical failure of the initial therapy, with a temperature of over 39 degrees C, bloody diarrhea and positive stool culture in all cases. The seven Salmonella strains isolated (1 S. typhi, 1 S. paratyphi B, 2 S. enteritidis, 3 S. typhimurium) were all sensitive to ampicillin, cotrimoxazole and pefloxacin. These seven children were then given 12 mg/kg/day of pefloxacin orally for 7 days. Apyrexia and complete resolution of diarrhea were obtained within 1 to 3 days in all cases without side effects. Trials are needed to determine the safety and toxicity of quinolones in children, however short-term therapy with pefloxacin could be useful in children with severe invasive salmonellosis after failure of conventional antibiotic therapy.

4-Quinolones↗
PubMed1992

[Parasitemia in Plasmodium falciparum malarial attacks in children].

In order to evaluate the predictive value of parasitaemia, this parameter was measured on admission in 69 Gabonese children aged from 3 to 13 years hospitalized for Plasmodium falciparum malarial attacks. Fourteen of these children had cerebral malaria, 5 had isolated convulsions and 50 had uncomplicated attacks. The parasitaemia values measured were compared with those found in asymptomatic children of the same age range carrying trophozoites. There were no significant differences in mean parasitaemia count between the 3 types of malarial attack, and only the asymptomatic carriers had significantly lower counts. However, the wide scattering of individual values within each group indicated that simple measurement of parasitaemia is not discriminative enough to predict the course of malarial attacks in children living in endemic regions. In particular, malarial attacks with very low or very high parasitaemia value are possible, but similar values are found in asymptomatic carriers.

Adolescent↗
PubMed1992

[Malaria and hemoglobin S: interactions in African children].

Among 300 cases of Plasmodium falciparum malaria attacks explored in Gabon, the proportion of homozygous (SS) or heterozygous (AS) sickle-cell patients was 6.2 percent in 206 ordinary attacks and 3.2 percent in 94 cerebral malaria attacks, and 23.2 percent in the general population. On the other hand, asymptomatic carriage, as detected in 98 children by thin blood films in school screening, was as frequent in the SS or AS infantile population as in the general population. These data show that haemoglobin S protects effectively, although not entirely, against severe attacks of P. falciparum malaria. The incidence of anaemia and vaso-obstructive crisis in malaria-infested sickle-cell patients suggests that subclinical carriage of haematozoa may worsen the course of sickle-cell disease, and this must be taken into account when planning treatment.

Adolescent↗
PubMed1992

Underestimation of the incidence of measles in a population of French children.

Data on titres of specific antibodies against measles virus and information given by families and physicians were analysed in 133 vaccinated and 117 unvaccinated children. Only 2 of the 133 vaccinated children reported a history of measles, while 131 had detectable levels of antibodies. Measles antibodies were detected in 102 (87.2%) of the unvaccinated children, but a history of measles diagnosed clinically by a physician was reported in only 42 of them. These findings suggest that subclinical cases of measles are possible and contribute to the high circulation of the measles virus in the child population in France.

Adolescent↗