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Biomedical subjects

F Alexandre

Publications and source records attributed to F Alexandre.

At least 19 recordsLinked to original sources

Risk factors for asthma among children in Maputo (Mozambique).

BACKGROUND: Few studies have looked at risk factors for asthma in African children. We aimed to identify the risk factors associated with childhood asthma in Maputo (Mozambique). METHODS: This case-control study included 199 age-matched children (100 asthmatic and 99 nonasthmatic) who attended Maputo Central Hospital between January 1999 and July 2000. We collected information concerning their familial history of atopy, birth weight, environment and breast-feeding. Detailed information about morbidity and treatment was obtained for each asthmatic child. RESULTS: The children were aged between 18 months and 8 years; 60% were male. The asthmatic children were hospitalized more frequently than the nonasthmatic children (P < 0.0001). Most of the asthmatic children lived in the urban area of Maputo [odd ratio (OR) = 6.73, CI = 3.1-14.0, P < 0.0001], had a parental history of asthma (OR = 26.8, CI = 10.8-68.2, P < 0.0001) or rhinitis (OR = 4, CI = 1.2-13.3, P = 0.005), had at least parent who smoked and were weaned earlier than the nonasthmatic children (OR = 2.4, CI = 1.3-4.4, P < 0.001). CONCLUSION: Childhood asthma was strongly associated with a family history of asthma and rhinitis, the place of residence, having smokers as parents and early weaning from maternal breast milk. These results highlight the need to reassess the management of asthmatic children in Maputo.

Asthma↗

Knowledge, attitudes, and behavior of the parents of asthmatic children in Maputo.

Asthma is increasing in frequency worldwide. The education of affected children and their parents is fundamental for the management of the disease. The aim of our study was to describe the knowledge, attitudes, and behavior of the parents of asthmatic children. We studied 152 adults accompanying asthmatic children to consultations in the pediatrics department of Maputo Central Hospital (Mozambique). In general, knowledge about asthma was poor: 11% of the adults thought that asthma was contagious and transmitted from person to person, and 4% thought that it was transmitted by contaminated food. More than half the parents thought that the child could not lead a normal life even during the periods between attacks. A large proportion of the parents thought that asthma could be cured by medical treatment in 7% of cases and by alternative treatment in 43% of cases. The precipitating factors were well identified by the adults, but they had an inaccurate perception of the symptoms of an asthma attack. The actions of the various classes of drugs used were poorly understood. Education programs for both the children and their parents should be developed to improve the management of asthmatic children. Surveys of this type facilitate the targeting of such programs.

Adult↗

Laparoscopic procedures for stress incontinence and prolapse.

Laparoscopic treatment of urinary stress incontinence and urogenital prolapse is a recent development. We describe the progress of the ideas and techniques, in this field. However, the literature lacks prospective randomized studies with sufficient follow up. So there is a need for these techniques, which seem attractive at first glance, to be fully assessed before they can be adopted as standard practice.

Female↗

School achievement in children with hypothyroidism detected at birth and search for predictive factors.

Neonatal screening of hypothyroidism started in 1975, and now sufficient hindsight is gained to assess school results in children with hypothyroidism and compare them to IQ tests. From the 85 cases of hypothyroidism detected in the Midi-Pyrénées area, 40 have enrolled in or finished primary school and 18 started secondary school. School achievement was assessed by school test results in French and mathematics using specific grids for each class and by retention rates. These results were compared to control groups. The hypothyroid group obtained identical results in French to those of the control groups but scored lower in mathematics. Grade retention rated higher in hypothyroid children (20%) than in the control groups (12.5%), especially in the first primary school grade. The search for predictive severity factors revealed significant differences between the grade repeater group and the nonrepeater group: more cases of athyrosis (75 vs. 25% for ectopia), lower T4 levels at birth, lower bone surface, lower IQ at 4 and 7 years, neurological troubles of fine motricity and coordination, and lower socioeconomic level. These results should shortly be taken into consideration in order to isolate a group at risk and undertake specialized care to improve school results in this group.

Child↗

[The cortical column, a new processing unit for cortex-like networks].

We propose in this paper a new connectionnist model which is the result of a collaboration between computer science and neurobiology researchers. This model is based upon a cortical-like network close to cortical function simulation. We present its functional and architectural characteristics together with the very encouraging results obtained for the first simulations on the visual and auditory cortical functions in speech and character recognition.

Auditory Cortex↗

[Functional neurosurgery of cerebral palsy].

In 1983, approximately 40 000 patients in France and 5 760 patients in Switzerland suffered from cerebral palsy, representing more than 0.1% of their respective populations. The functional disability of these patients is particularly impressive and emphasizes the medical, social and economic importance of this problem. The term cerebral palsy is restricted to non-progressive disorders of motor function, already observed at an early age and due to cerebral lesions. These motor disorders can be of paretic, dystonic and dyskinetic nature. Their epidemiology, classification, etiology, pathology, early diagnosis and evolution are extensively reviewed by Th. Deonna. The difficulty in evaluation of treatment is the absence of a generally accepted rating scale. G. Broggi has proposed one on the basis of a large experience which could serve in the future for more objective evaluation. This monograph is devoted to the functional neurosurgical treatment of cerebral palsy. Physiotherapy and rehabilitation are part of the basic treatment of cerebral palsy, and must be continued after any neurosurgical treatment. Various conservative methods of treatment and their neurophysiological rationale are mentioned by P. Claverie. Some technical devices which improve the neurological deficits and facilitate rehabilitation are presented. Radiculotomies and neurotomies are probably the oldest neurosurgical operations for the treatment of spasticity. The neurophysiological and neuroanatomical basis of this therapeutic approach are treated in the review of the material from the neurosurgical department of Montpellier. Sixty cases were collected and the results analysed according to the type of operation (posterior radiculotomy, anterior radiculotomy, mixed) performed. Stereotactic thalamotomies and subthalamotomies are believed to be the best neurosurgical method to treat the tremor and improve other dyskinesias and hyperkinesias. The technique and a personal review of 49 cases of cerebral palsy are presented. The long-term follow-up in this study demonstrates that this type of operation markedly improves the functional disability of patients with moderate hyperkinesias, moderately improves patients severely affected, but also demonstrates that possible side effects cannot be ignored. Review of the literature indicates the difficulty in interpretation of results due to a lack of objective evaluation. Nevertheless, stereotactic thalamotomy can still be recommended when tremor and rigidity are the most prominent symptoms. Stereotactic dentatotomies in the treatment of spasticity were very popular 20 years ago, but have been largely forgotten for nearly a decade.(ABSTRACT TRUNCATED AT 400 WORDS)

Adolescent↗