Search PubMed⌕ Search

Biomedical subjects

D de Boissieu

Publications and source records attributed to D de Boissieu.

34 records · Page 2Linked to original sources
PubMed1996

Small-bowel bacterial overgrowth in children with chronic diarrhea, abdominal pain, or both.

OBJECTIVE: To evaluate the frequency of small-bowel bacterial overgrowth (SBBO) as a cause of chronic digestive symptoms in a large cohort of children, using the glucose breath hydrogen test (BHT). DESIGN: Patients were 53 children (aged 2 months to 12 years) with chronic diarrhea, abdominal pain, or both. Diagnosis of SBBO was defined with a BHT by a change in H2 concentration of 10 ppm H2 or more in expired air after an oral glucose load. Patients with a positive BHT result were included in group 1 and treated with a combination of colistin and metronidazole for 10 days; a second BHT was performed 1 month later. Group 2 comprised patients with a negative BHT result. Group 3 (n = 15) was a control group of healthy subjects, and group 4 (n = 6) a comparison group of subjects with bacteriologically documented SBBO. RESULTS: Eighteen patients (34%) had a positive BHT result and 35 a negative result. The BHT results were comparable in groups 1 and 4 and in groups 2 and 3, respectively. Fasting H2 levels were higher in group 1 than in groups 2 (p < 0.001) and 3 (p < 0.01). In group 1, children were younger than in group 2 (1 +/- 1 year vs 3.9 +/- 3 years; p < 0.001) and diarrhea was frequent (83%), but 17% of patients had abdominal pain alone. Fetid stools (p < 0.01), mucus in stools (p < 0.01), and flatulence (p < 0.05) were more frequent in group 1 than in group 2. Antibiotic treatment of children in group 1 led to a rapid disappearance of symptoms and normalization of BHT results. CONCLUSION: SBBO appears to be a frequent cause of chronic digestive symptoms in children, especially before the age of 2 years. The BHT provides a simple and noninvasive method of detecting it. The recognition of SBBO in children leads to effective treatment.

Abdominal Pain↗
PubMed1995

Ketone body turnover at term and in premature newborns in the first 2 weeks after birth.

Using the infusion of D-(-)-3-hydroxy-[1,2,3,4,-13C4]butyrate at tracer doses, we measured total ketone body turnover in 13 premature and 10 at term infants in the first 2 weeks after birth. The premature infants received parenteral and/or oral feeding. The normal newborns were either recently fed or briefly fasting. The premature and the fed at term infants had comparable concentrations of ketone body (476 +/- 86 and 406 +/- 78 mumol/l) and free fatty acids (FFA) (309 +/- 47 and 325 +/- 75 mumol/l). In the premature newborns, ketone body turnover rates (3.2 +/- 0.2 mumol kg-1 min-1) were 74% that of fed newborns at term (4.3 +/- 0.3 mumol kg-1 min-1, p < 0.05), and 18% that of normal newborns during a brief fast (17.3 +/- 1.3 mumol kg-1 min-1, p < 0.01). Ketone body production rates correlated with plasma FFA concentrations in both groups (r = 0.62 and 0.69, p < 0.05). However, for a similar plasma FFA content, ketone production was 2- to 3-fold lower in the premature, indicating an immature hepatic capacity to convert FFA into ketones. Our study therefore shows that ketogenesis is already active in infants born 10 weeks before normal term and continuously fed, but that daily ketone production is lower than at term.

Fasting↗
PubMed1994

Distinct features of upper gastrointestinal endoscopy in the newborn.

Between January 1987 and December 1990, 293 upper GI endoscopic procedures were performed in 219 neonates < 1 month of age. No lesion was found in 57 cases (26%; group 1), whereas esophagitis was present in 158 cases, alone in 45 cases (20.6%; group 2) and associated with gastritis in 113 cases (51.8%; group 3). The association of esophagitis with gastritis seems to be a specific feature of neonates and not older children. The presence of gastritis with esophagitis suggests that a primary peptic mechanism is unlikely to explain all endoscopic findings, although the presence of such a mechanism secondary to esophagitis could contribute to the esophageal lesions. Acute fetal distress was more frequent in group 3 than in the other groups. Symptoms associated with endoscopic lesions in groups 2 and 3 were, respectively, malaise (38 and 42%), hematemesis (4 and 35%), frequent regurgitation (45 and 26%), and difficult feeding and/or failure to thrive (26 and 24%). In Group 3, minor symptoms often led to the diagnosis of severe mucosal lesions, and antireflux therapy elicited prompt relief of clinical symptoms. The causes of neonatal esophagogastritis remain unknown. Wide use of endoscopy in the presence of discrete clinical abnormalities is likely to considerably improve the clinical condition of some children in their first days of life.

Endoscopy, Gastrointestinal↗
PubMed1994

Allergy to nondairy proteins in mother's milk as assessed by intestinal permeability tests.

The intestinal permeability test is a noninvasive method which, when done during a food provocation procedure, can detect the deleterious effect of food on the intestinal mucosa in allergic children. We report on a 1-month-old breast-fed boy with a history of regurgitation, diarrhea, difficult feeding, and malaise suggesting food allergy. Intestinal permeability tests were done with the mother's milk and showed breast-milk-induced alterations of intestinal permeability. No improvement occurred in the child's clinical symptoms or in the results of the intestinal permeability test when the mother withdrew dairy products from her diet. Disappearance of the child's symptoms and normalization of intestinal permeability during provocation with the milk were obtained after elimination of egg and pork from the mother's diet. This observation suggests that dietary proteins different from cow's milk antigens may be transferred to breast milk and induce adverse reactions in hypersensitive infants.

Animals↗
PubMed1992

Impairment of lung diffusion capacity in Schönlein-Henoch purpura.

Twenty-nine children with typical Schönlein-Henoch purpura (SHP) were tested at the initial phase of the disease for respiratory function. Of the 29 patients, 28 had a decrease of lung transfer for carbon monoxide (TLCO) as measured by a steady-state method. Lung volumes and blood gas values were normal; slight radiologic signs of interstitial lung involvement were observed in 18 of 26 patients. There was a decrease in TLCO to 56.8% of normal values for height and gender and to 58.5% when normal values were volume-adjusted to functional residual capacity. In 19 of 25 patients, TLCO measurements were performed at 3-month intervals during follow-up. In all cases, normalization of TLCO values was observed only after complete clinical recovery from SHP. All children with persisting symptoms, even limited to microscopic hematuria or slight proteinuria, had low TLCO values. In one patient low TLCO during follow-up preceded a late relapse of SHP in the form of acute nephritic disease with characteristic IgA deposits on renal biopsy. We conclude that low TLCO in SHP is probably related to alteration of the alveolar-capillary membrane by circulating immune complexes. This noninvasive technique may be useful in diagnosis, and during the follow-up of the disease as an early indicator of reactivation.

Carbon Monoxide↗
PubMed1992

Absence of intrathecal synthesis of some interferon-alpha subtypes in bacterial meningitis.

Sixty-five cerebrospinal fluid (CSF) samples from 54 infants and children with bacterial meningitis were analyzed for the presence of interferon (IFN)-alpha with a biologic assay. Of the 65 samples, 3 were positive (2-4 IU/mL) and only 1 of 56 collected early was at 4 IU/mL. These results suggest that some subtypes of IFN-alpha already reported as present in viral infections of the central nervous system are not detected in bacterial meningitis by our IFN assay. This difference may be helpful in differentiating bacterial from viral infections and also in evaluating the quality of the virologic investigation; moreover, the rarity of IFN-gamma in CSF in bacterial meningitis needs further investigation to understand its role in the pathogenesis of the disease.

Child↗
PubMed1991

[Perinatal hemochromatosis].

Neonatal hemochromatosis is responsible for death in utero or severe hepatic insufficiency in the newborn, generally with rapid progression to death. Recurrence in sibships is frequent. Necropsy findings are characterized by siderosis in the liver, pancreas, heart, thyroid, but not in the reticuloendothelial system. Urinary cytology, serum iron concentration, iron-binding capacity, ferritin, and magnetic resonance imaging allow a diagnosis to be made before death. Liver transplantation probably offers the best chance of survival. The pathophysiology is unknown; there may be a variety of etiologies.

Female↗
PubMed1991

[Superficial pseudophlebitis in a HIV seropositive child].

A case of "hyperalgesic pseudothrombophlebitis" in an hemophilic child with acquired immune deficiency syndrome (AIDS) is reported. Known causes such as associated blood clotting defect, collagen vascular disease, infection and homocystinuria were ruled out. Five similar cases were reported in 1985, in homosexual American adult males with AIDS, in whom venography did not show evidence of venous occlusion. Recovery occurred spontaneously and progressively, while the patients were given an anticoagulant therapy. Despite our hemophilic patient did not receive any anticoagulant treatment, a similar favorable course was observed. This AIDS related syndrome has not been reported in children yet, and its pathogenesis remains unknown.

Child↗
PubMed1990

[Perinatal hemochromatosis].

Perinatal hemochromatosis (PHC) is a rare disorder presumably autosomal recessive, responsible for foetal death or severe liver failure during the neonatal period. It is fatal in nearly all cases. Diagnosis relies on histologic examination, generally post mortem, which shows numerous iron deposits in the liver as well as other organs (pancreas, heart, thyroid...). The study of iron and of its ligands may have a diagnostic interest. The authors report 2 cases of PHC in one family, of whom one concerned child presented with biological signs evoking PHC on foetal blood at 31 weeks of pregnancy.

Female↗
PubMed1990

[Familial forms of gastro-esophageal reflux].

Gastroesophageal reflux is a common disorder that can be responsible for respiratory disease and is not considered as an inherited condition. We report five families with several affected members. Other familial cases have been published and some authors have suggested that transmission occurs on an autosomal dominant basis. Only prospective studies could determine whether GER is an inherited disorder, but at present their feasibility is limited since currently available diagnostic investigations are not suitable for screening.

Child↗
PubMed1989

[Esophagogastroduodenitis in the newborn. Apropos of 32 cases].

Inflammatory lesions involving esophagus, stomach and duodenum are frequent in neonates and run a benign course. Thirty-two cases of esophagogastritis associated with duodenitis in 28% of cases were studied. Presenting symptoms included nonspecific symptoms such as feeding difficulties (15 cases), G-I bleeding (14 cases), regurgitation (14 cases) and/or impaired weight gain (4 cases). No precipitating factor could be identified. The diagnosis was established by endoscopy. Gastro-esophageal reflux, which seemed to be secondary to the mucosal lesions, required an anti-reflux treatment, which led to a rapid clinical recovery. Repeat endoscopy invariably showed an improvement or complete recovery of the mucosal lesions which did not seem to be influenced by antacid treatment. The etiology and pathogenesis of neonatal esophagogastroduodenitis remain undetermined.

Adult↗
PubMedDate not supplied

[Delayed cortical hyperostosis in children].

A case of recurrent infantile cortical hyperostosis in a 3 1/2 year-old girl is reported. Nine other late cases have been previously described. When compared with Caffey's disease, this delayed form of the illness constitutes a distinct homogeneous syndrome of unknown etiology.

Child, Preschool↗