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Biomedical subjects

J C Picaud

Publications and source records attributed to J C Picaud.

33 records · Page 2Linked to original sources
PubMed1996

[New technique of nasal continuous positive pressure in neonatology].

BACKGROUND: Early treatment with nasal continuous positive airway pressure (CPAP) in newborns with respiratory distress syndrome is useful, by recruiting alveoli and restoring the functional residual capacity. POPULATION AND METHODS: Nasal CPAP was supplied by the Infant Flow Driver (Electro Medical Equipment). From 15 June 1994 to 15 December 1994, 42 neonates received nasal CPAP. Their mean birthweight and gestational age were 1511 +/- 411 g and 30.9 +/- 2.5 weeks, respectively. Fifteen infants had been ventilated for hyaline membrane disease and nasal CPAP was applied immediately after extubation. In the other 27 infants, nasal CPAP was given soon after birth (respiratory distress syndrome: 20 neonates; apneic spells: seven neonates). RESULTS: Three infants needed subsequent mechanical ventilation because of the severity of the disease (one had spontaneous pneumothorax); four infants received exogenous surfactant (Curosurf, one single dose) within a brief period of mechanical ventilation (30-45 min). There were no failure of extubation, and no intracranial lesions. Excess of pharyngeal secretion and abdominal distension were common. CONCLUSION: Early treatment with nasal CPAP reduces the need for mechanical ventilation. Furthermore, surfactant therapy required by a moderate to severe disease is possible with a rather short period of artificial ventilation.

Apnea↗
PubMed1996

Evaluation of dual-energy X-ray absorptiometry for body-composition assessment in piglets and term human neonates.

The reproducibility, accuracy, and precision of dual-energy X-ray absorptiometry (DXA) was assessed by scanning 13 piglets (1471-5507 g) in triplicate. In four piglets, fat content was increased with porcine lard around the abdomen; additional measurements were performed on these animals. Reproducibility in DXA measurements from the animals without added fat was 0.09% for body weight, 1.95% for bone mineral content (BMC), and 5.35% for fat content. DXA estimates of body weight, BMC, and fat content were significantly correlated with scale body weight, ash weight, chemical calcium, and chemical fat. Body weight was measured accurately but fat content was overestimated by DXA. Mean BMC estimated by DXA represented 48% of ash weight and 215% of calcium content. The precision of DXA was 0.23% for body weight, 10.99% for ash weight, and 4.44% for calcium content. The precision of DXA for fat content was poor. However, for measurements performed in piglets with > 250 g fat, the precision was 8.85%. Thirty appropriate-forgestational-age term human neonates (birth weight: 3188 +/- 217 g) were scanned once during the first week of life. BMC and fat content were 54 +/- 6 and 470 +/- 92 g, respectively, which corresponded to 26.4 +/- 2.6 g calcium and 427 +/- 82 g fat. These were close to the reference values previously determined by chemical analysis. This study suggests that DXA is accurate and reliable for measurement of calcium and fat contents in human neonates. Further refinements would be beneficial for determining fat content in preterm human infants.

Absorptiometry, Photon↗
PubMed1996

Incidence of ischemic-hemorrhagic cerebral lesions in premature infants of gestational age < or = 28 weeks: a prospective ultrasound study.

While it is well accepted that the incidence of intraventricular hemorrhage (IVH) increases with decreasing gestational age (GA), the majority of studies report their findings on the basis of birthweight (BW) rather than GA. Over a 5-year period, 199 infants born at or below 28 weeks of gestation were entered into a prospective cranial ultrasound study stratified according to GA. One hundred and five (53%) had normal ultrasound findings. The overall incidence of IVH, as expected, rose with decreasing GA but we were unable to show any clear influence of BW or growth retardation on its occurrence. Incidence of grades I, IIa, IIb and III IVH were 8, 10, 16 and 11%, respectively. Leukomalacia, bleeding in the posterior fossa and in the cerebellum occurred in 4, 7 and 2% of the population, respectively.

Birth Weight↗
PubMed1995

Nutritional evaluation of protein hydrolysate formulas.

Growth parameters, biochemical indice of protein metabolism and plasma Amino acid (AA) concentrations were investigated during the first month of life in term infants (n = 61) fed various protein hydrolysate formulas (whey (WHF, n = 3), soy collagen (SCHF, n = 1) and whey-casein hydrolysate formulas (WCHF, n = 1)). In addition, metabolic balance studies were performed in 10 infants fed WHF and in 5 fed WCHF. Comparatively to breast fed infants, growth reduction and decrease in plasma protein concentrations were observed with the use of one of the WHF and in a lesser extent with the SCHF and the WCHF. Plasma amino acid pattern reflected the AA content of the formulas. Whey hydrolysate formulas induced mainly an increase in threonine and a decrease in tyrosine concentrations. Soy-collagen hydrolysate formula led to an increase of non-essential amino acids, such as glycine and hydroxyproline and a decrease in plasma lysine and cystine. Whey-casein hydrolysate formula induced a plasma amino acid pattern close to the profile observed in breast fed infant. Metabolic balance studies showed a relative reduction in nitrogen absorption and utilisation in the infants fed the WHF and the WCHF. In addition a drastic reduction in fat, calcium and phosphorus absorption was also observed with the use of the WCHF. In preterm infants (n = 19) fed whey predominant hydrolysed preterm formulas (n = 3), metabolic balance studies an plasma AA concentration were evaluated at the end of the first month of life at 34 weeks of gestation age. Comparatively to similar preterm infants fed conventional preterm formulas, a relative reduction in nitrogen absorption (83% vs 90%) and retention (64 vs 70%) as well as in phosphorus absorption (78 vs 89%) was observed. Calcium retention was similar (48 vs 45 mg/kg/d) but calcium intake was significantly higher in infants fed hydrolysate formulas 120 vs 91 mg/kg/d. Plasma amino acid concentrations were related to amino acid composition of the formulas. Compared with the standard preterm formulas, all three protein hydrolysate formulas led to a significant increase in plasma threonine and a decrease in tyrosine and phenylalanine concentrations. In addition, there was a reduction in plasma histidine, valine, leucine, cystine, methionine and/or tryptophane with some of the hydrolysate formulas used. In conclusion, these studies provide evidence that protein hydrolysed formulas are not equivalent to whole protein formulas in terms of nutritional efficiency for preterm and term infants. Therefore further extensive nutritional studies on growth, biochemical indices of protein metabolism and metabolic balance, including minerals and trace elements, appear to be necessary before maintaining and promoting the use of such formulas for teh potential benefits on atopic disease in preterm and in full-term newborn infants.

Breast Feeding↗
PubMed1994

Metabolic and energy balance in small- and appropriate-for-gestational-age, very low-birth-weight infants.

This study compared nutrient utilization and postnatal weight gain composition in eight appropriate for gestational age (AGA: birth weight 1293 +/- 107 g; gestational age 28.8 +/- 1.4 weeks) and eight symmetrically growth-retarded (SGA: birth weight 1110 +/- 230 g; gestational age 32.7 +/- 1.9 weeks), very low-birth-weight (VLBW) infants. There was no significant difference in protein, mineral and energy intake between AGA and SGA infants. Nitrogen absorption (84 +/- 3 and 83 +/- 4%) and nitrogen retention (356 +/- 48 and 352 +/- 43 mg/kg/day) were similar in both groups. Fat absorption tended to be lower in AGA (78 +/- 15%) than in SGA (87 +/- 4%) infants. Calcium, phosphorus and magnesium absorptions were similar in AGA and SGA infants. Metabolizable energy utilization was similar in both groups; about 55% was expended and 45% stored in new tissues. Energy expenditure was 58 +/- 4 kcal/kg/day in SGA infants and 61 +/- 9 kcal/kg/day in AGA infants. Weight gain and its composition were similar in both groups. We conclude that nutrient and energy utilization are similar in AGA and symmetrically growth-retarded, VLBW infants.

Energy Metabolism↗
PubMed1993

Pharmacokinetics of cyclosporin A in 16 newborn infants of renal or cardiac transplant mothers.

Fourteen renal transplant and one heart transplant mothers receiving cyclosporin (mean dosage: 273 +/- 19 mg/day) underwent a Caesarean section at a mean gestational age of 34.1 +/- 1.9 weeks. Circulating cyclosporin was assayed by HPLC. The mean blood levels in the mothers before the Caesarean section were 210 +/- 16 ng/ml, in cord blood 62 +/- 16 ng/ml (14 infants) and in the peripheral blood within 6 h of birth 31 +/- 12 ng/ml (15 infants); there was no correlation between maternal and cord levels, nor between peripheral blood levels at 2 h and cord blood levels. Cyclosporin levels were undetectable at day 3 in 12 infants, but low levels were found in 1 infant up to day 12. There was no toxic effect on the fetus or neonate.

Adult↗
PubMed1992

Tracheal rupture in a newborn during a complicated delivery. Diagnosis and surgical repair.

Rupture of the trachea is an exceptional obstetrical lesion. The infant reported in this paper, at 1 hour of age, developed respiratory distress with pneumomediastinum, bilateral pneumothorax and subcutaneous emphysema. This resulted from the fact that the trachea had ruptured, within 1 cm of the carina, during the difficult delivery. When the child was 23 days old, operation proved necessary because extubation was not feasible. The stenotic portion of the trachea was resected and continuity restored by end-to-end anastomosis. The tracheal lumen at the site of the anastomosis proved normal by bronchoscopic examination 4 months after the operation. There is only one similar case in the literature. The etiology of this rupture is discussed.

Birth Injuries↗
PubMed1991

Acute renal failure in a child after chewing of match heads.

A few days after ingestion of 40 match heads, a 3-year-old boy was admitted to hospital with oliguric acute renal failure (ARF) requiring peritoneal dialysis during 9 days. A renal biopsy showed acute tubulointerstitial nephritis; the outcome was rapidly favorable and the child recovered normal GFR. It seems to be the first published case of ARF after match poisoning, probably because of the presence of potassium bichromate.

Acute Kidney Injury↗
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

[Treatment of autoimmune neonatal thrombocytopenia with high-dose intravenous immunoglobulins].

During the neonatal period, 6 infants born to mothers with auto-immune thrombocytopenia purpura were diagnosed as having severe thrombopenia (platelet counts below 30 X 10(9)/l). High doses of intravenous immunoglobulins (IVIG) (0.4 g/kg/injection for 2 infants and 1 g/kg/injection for 4 infants) were administered as of the first week of life. Short-term efficacy was good in all cases (platelet counts over 50 X 10(9)/l, 2-10 days after the first injection). During the second week of life, 5 newborns had relapses which were rapidly reversed by one or several IVIG injections. The thrombopenia was cured between days 19 (shortest) and 41 (longest) and, more over, no side effects were observed. High doses of IVIG seem to be an effective and well-tolerated treatment for neonatal auto-immune thrombopenia, and they can be recommended over classical treatments (corticotherapy, exchange transfusion, platelet transfusion) as a first line of attack.

Adult↗
PubMed1989

[Nephrocalcinosis and pancreatic calcification after ablation of adrenal adenoma: the role of hypercortisolism?].

Renal and pancreatic calcifications were observed in an infant who had been surgically treated for Cushing's syndrome associated with an adrenal adenoma. On examination of the relation between this secondary complication and Cushing's syndrome, was carried out and the possible role of the post-operative substitutive treatment is discussed. Close echographic surveillance is advocated in these cases.

Adenoma↗
PubMed1986

[Treatment of 2 newborn infants with autoimmune thrombocytopenia by high-dose intravenous gamma globulins].

We report 2 cases of neonatal auto-immune thrombocytopenia treated with high-dose intravenous gamma-globulins. Efficacy of treatment was immediate, inducing an increase in platelet levels which was transitory during the first 2 weeks but stabilized in the third week. Tolerance was excellent. Injections of 400 mg/kg/day repeated for 4 to 5 days should be preferred to a single dose of 1 to 2 g/kg.

Adult↗