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Biomedical subjects

G Putet

Publications and source records attributed to G Putet.

At least 19 recordsLinked to original sources
PubMed1992

Net calcium absorption in premature infants: results of 103 metabolic balance studies.

Net calcium absorption was evaluated in 103 low-birth-weight preterm infants by a 72-h balance technique. At birth the infants had a mean (+/- SE) gestational age of 30.9 +/- 0.2 wk and weighed 1.43 +/- 0.03 kg. When tested 3 wk later, their net calcium absorption averaged 58 +/- 1% with an intake of 80 +/- 2 mg Ca.kg body wt-1.d-1. Of the 103 infants, 58 had been fed low-birth-weight formulas supplemented with vitamin D. The remainder received banked human milk, of whom 34 were supplemented with vitamin D and calcium; 11 infants received no supplementation. Calcium absorption in the four subgroups did not differ significantly, with neither vitamin D supplementation nor supplementation with vitamin D and calcium affecting percent absorption significantly. Net calcium absorption was a linear function of intake (40-130 mg Ca.kg body wt-1.d-1) with a zero intercept. Because vitamin D supplementation did not increase net calcium absorption, it is concluded that in preterm low-birth-weight infants calcium absorption proceeds by a nonsaturable route, with the transcellular, vitamin D-regulated mechanism not yet expressed.

Calcium↗
PubMed1992

Leucine kinetics in fed low-birth-weight infants: importance of splanchnic tissues.

Whole body Leu kinetics were determined in fed low-birth-weight (LBW) infants. To assess the importance of first-pass splanchnic extraction of ingested amino acids, two tracers were simultaneously infused by intravenous (L-[1-13C]Leu) and intragastric (L-[5,5,5-2H3]Leu) routes in 13 LBW infants [1,742 +/- 169 (SE) g] fed with protein-enriched human milk (protein intake 3.23 +/- 0.97 g.kg-1.day-1). Splanchnic extraction estimated from plasma [2H3]Leu appearance was 48.2 +/- 15.6% of Leu intake. Total Leu flux, endogenous Leu flux (index of protein catabolism), and nonoxidative Leu disposal (NOLD, index of protein synthesis) were 3.45 +/- 0.57, 1.90 +/- 0.74, and 2.54 +/- 0.62 mumol.kg-1.min-1, respectively. Higher estimates were obtained when using alpha-ketoisocaproate as a precursor pool. There was a wide individual variation of protein intake due to the use of human milk, and, over this range, Leu intake was correlated negatively with endogenous Leu flux (r = 0.88, P less than 0.01) whereas NOLD remained fairly constant. Thus, in LBW infants, 1) splanchnic extraction is two times as high as in adults and might reflect an elevated splanchnic protein turnover and 2) increasing protein intake probably promotes protein gain mainly by inhibiting protein catabolism.

Animals↗
PubMed1991

[Antibiotherapy of maternal-fetal infections].

The initial antibiotic therapy of neonatal infections must be aimed at Streptococcus B, E. coli and Listeria which are the most frequent responsible pathogens. It must be initiated promptly and be effective against a possible meningeal infection. The first-line therapy with amoxicillin, amikacin and cefotaxime, which in theory should cover all the micro-organisms involved, must be short and rapidly replaced by an antibiotic proved to be active against the isolated pathogen. If aminoglycosides are administered for a long time, serum level assays are recommended for optimal safety.

Anti-Bacterial Agents↗
PubMed1991

Oxygen consumption during sleep in children under continuous and cyclic nutrition.

The present study investigated the effects of two modalities of parenteral nutrition (continuous nutrition over the 24-hour period vs. cyclic nutrition, i.e., administered only during the night) on O2 consumption during sleep in children affected by severe gastrointestinal diseases. In both feeding modalities O2 consumption was always highest in REM sleep, intermediate in stage 2 and lowest in SWS. The trends during the night of O2 consumption (an increase from the second to the third part of the night) for different sleep stages were comparable in both feeding modalities. These results suggest that O2 consumption is not affected by the feeding modalities investigated, but is dependent on both sleep stages and time of night.

Cerebral Cortex↗
PubMed1991

[Neonatal mortality and morbidity of low birth weight premature infants (less than or equal to 1500 g)].

Neonatal mortality and morbidity were reported over a 4-yr period from 1986-1989 in premature infants weighing less than 1,500 g, 278 of whom were born in the same obstetrico-neonatal unit. Total mortality was 15%, and was higher in premature infants weighing less than 1,000 g (38%) and lower if the gestational age was greater than 27 wk. Mortality was lower in small for gestational age (SGA) infants than in appropriate for gestational age (AGA) infants (5% vs 19%, P less than 0.001), and lower in inborn babies than in outborn (12% vs 19%, P less than 0.02) but only in neonates weighing less than 1,000 g. Neonatal morbidity was mainly due to hyaline membrane disease and cerebral haemorrhage. The incidence of broncho-pulmonary dysplasia was low (4%). These results indicate that gestational age, birth weight and place of delivery play a role in mortality and morbidity in very low birth weight premature infants.

France↗
PubMed1991

[Infants born to kidney transplant recipients].

Over a period of 24 years, 23 women who had undergone renal transplantation gave birth to 26 children whose gestational ages were above 28 weeks. The average duration of stable kidney function tests before the onset of pregnancy was 34.5 months (6 to 109 months). Immunosuppressive treatment consisted mostly of azathioprine and steroids (20/26), steroids and cyclosporin A (CyA) in one case, and azathioprine, steroids and CyA in 5 cases. Average gestational age at birth was 35.2 weeks (30-40 weeks), average birth weight was 2,330 g (1,160-3,700 g). Caesarean section was performed in 73% of cases. The most frequent neonatal pathological condition was the occurrence of respiratory distress, most often related to prematurity and the mode of delivery. No child presented with any lethal congenital malformation. Children born to mothers who were given CyA did not present with more congenital malformations or renal function impairment.

Adult↗
PubMed1990

Estimating resting energy expenditure by simple lean-body-mass indicators in children on total parenteral nutrition.

The aim of this study was to determine simple predictive factors of the resting energy expenditure (REE) in children. Two groups, A (n = 14) and B (n = 23), were defined by their weight-for-height index, less than 90% and greater than 90%, respectively. Anthropometrically assessed lean body mass (LBM), 24-h urinary creatinine, and REE were measured. From multiple-regression analysis, the best-fitting equation for calculating REE (REE = 54.4 LBM (kg) + 0.095 creatinine (mmol/kg) + 4.7) was highly significant (r = 0.987, p less than 0.0001). Although the regressions of REE on weight were significantly different between the two groups, the equations using LBM or 24-h urinary creatinine did not discriminate between them. These findings suggest that an equation based on LBM or 24-h urinary creatinine excretion could be a more accurate estimate of REE than are conventional methods based on weight or height, and it may be applicable to diverse nutritional states.

Basal Metabolism↗
PubMed1990

Whole body protein turnover measured with 13C-leucine and energy expenditure in preterm infants.

Our study was undertaken in preterm infants to examine the relationship of whole body protein kinetics with protein intake and energy expenditure. Leucine kinetics were determined in seven low birth wt preterm infants fed human milk or human milk enriched with protein (2.5 to 4.3 g protein/kg.d). The infants received a short (4-h) constant infusion of L-[1-13C]leucine and leucine turnover and oxidation were calculated from 13C-plasma leucine and expired 13CO2 enrichments measured by mass spectrometry. Energy expenditure was measured by indirect calorimetry. Nonoxidative leucine disposal (an estimate of protein synthesis) and leucine derived from protein (an estimate of protein breakdown) were, respectively, 2.98 +/- 0.82 and 2.06 +/- 0.74 mumol/kg.min. Whole body protein turnover and deposition, derived from leucine kinetics, were 8.22 +/- 2.31 and 2.17 +/- 0.50 g/kg.d, whereas energy expenditure was 56.3 kcal/kg.day. Protein turnover was correlated with protein intake but not with protein deposition. Energy expenditure was correlated with protein turnover, synthesis, and breakdown but not with protein deposition. These data are in agreement with the fact that protein deposition depends upon protein intake, but they also suggest that an elevated protein deposition is not necessarily the result of a rapid protein turnover or associated with an elevated energy expenditure.

Carbon Isotopes↗
PubMed1990

[Premature infants weighing less than 1000 grams: mortality, morbidity and short-term neurologic outcome].

The outcome of 60 premature infants weighing less than 1,000 g at birth and consecutively born during the years 1986 to 1988 is reported. Forty-two (70%) of them were inborn. The overall mortality rate was 42%, but only 26% in the inborn group instead of 78% in the outborn group (P less than 0.001). The mortality rate was higher for the appropriate for gestational age infants (56%) than for the growth retarded infants (14%, P less than 0.01). The main neonatal problems were the following: hyaline membrane disease (63%), patent ductus arteriosus (7%), bronchopulmonary dysplasia (8%), necrotizing enterocolitis (15%), intraventricular hemorrhages (45%) and periventricular leukomalacia (12%). Twenty percent (7/35) of the surviving infants showed abnormal neurodevelopmental outcome, with only one (3%) having major handicap. No correlation was found between gestational age and neuro-developmental outcome.

Child Development↗
PubMed1990

[Do any indications remain for vaginal delivery in breech presentation?].

The choice of the mode of delivery in breech presentations is still controversed, particularly in the primipara and in premature delivery. From the study of 277 cases of single pregnancy with a live baby in podalic position the authors analyze the indications for the mode of delivery as well as the foetal results. After 37 complete weeks of amenorrhea, labour was induced in 126 patients out of 248. 96 had a vaginal delivery. The labour comprises a certain number of risks, but gives the same results as the caesarian section. The primiparity does not seem to be a risk factor. Before 37 complete weeks of amenorrhoea, 7 babies were born by vaginal delivery and 22 by caesarian section. In case of foetal distress, the caesarian section decided too late does not avoid an unfavourable evolution, particularly in the very premature baby. Therefore, the indications for caesarian sections must be extremely large and decided without delay particularly before 32 complete weeks of amenorrhea.

Breech Presentation↗
PubMed1990

[The hazards of forceps: the viewpoint of the pediatrician and the obstetrician].

Neonatal and maternal complications observed after 410 forceps deliveries were retrospectively compared to those occurring after spontaneous vaginal delivery. Mild scalp and facial lesions as well as facial palsy were significantly increased in the forceps group. No severe maternal complications were observed. A short literature review was done, and other instrumental extractions were discussed.

Birth Injuries↗
PubMed1990

[Hospital infection in the maternity department. 3 years of surveillance in 9,204 deliveries of which 1,333 were cesarean sections].

Hospital or nosocomial infection, or infection acquired in hospitals, is a health problem in all hospital departments and particularly in the maternity department. We report on a prospective survey of surveillance of hospital-acquired infections both from the mother and the baby's point of view after delivery vaginally or with caesarean carried out at the obstetrical clinic of the Edouard Herriot Hospital in Lyon (France) over three successive years with a series of 9,204 deliveries. The incidence of infection in women who were delivered without caesarean section was 1.37% when urinary tract infections had been excluded but 13% in women who had caesarean sections. Endometritis, skin infections and urinary tract infections were the leading causes. As far as the newborn were concerned, hospital infection ran at about 2.60% and this in the main was due to staphylococcal pustules in the skin. These figures are still too high and prevention should be based on more information given and more care taken by the whole staff of such a hospital.

Cesarean Section↗
PubMed1989

Placental taurine and low birth weight infants.

In order to determine whether the decrease in taurine concentration in the placenta during pregnancy could affect fetal development, as has been observed in animals, we measured the concentration of taurine in placentas obtained after vaginal expulsion. 31 placentas from women with normal pregnancies of over 37 weeks who have given birth to infants of normal weight (3,200 +/- 310 g) were included in the study. In addition, 26 placentas of infants considered to be hypotrophic were also included (gestation over 37 weeks, birth weight: 2,260 +/- 230 g). The taurine was assayed using gaz-liquid chromatography. The concentration of taurine in the placenta was 2.80 +/- 0.56 mumol/g for the placentas of normal birth weight infants and 2.40 +/- 0.64 mumol/g for the placentas of hypotrophic infants (p less than 0.02). There is no significant correlation in normal and hypotrophic newborns between the gestation period, the weight and height at birth, the weight of the placenta, and the taurine concentration in the placenta. The taurine concentration in placentas of hypotrophic born infants is significantly reduced compared to the placentas from normal infants.

Female↗
PubMed1989

Taurine in developing brain, liver and muscle in infants.

In order to evaluate tissue taurine storage during pregnancy, we determined the taurine concentration of a skeletal muscle (abdominal wall), the brain (left parietal lobe), and the liver (right lobe) in 41 children aged 1-10 days, born after 24-41 weeks gestation. Samples were obtained during autopsy. Taurine dosage was carried out by gas chromatography. Muscle and liver taurine concentrations decreased with the duration of gestation. For a given duration of pregnancy, there was no correlation between birth weight and these three tissue concentrations. From these results, we estimate that the fetus accumulates 35-40 mumol/24 h of taurine during the last 3 months of gestation.

Anthropometry↗
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↗