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Biomedical subjects

J Cottalorda

Publications and source records attributed to J Cottalorda.

At least 55 records · Page 3Linked to original sources
PubMed1997

[Muscular lengthening of the triceps by successive casts in children with cerebral palsy].

PURPOSE OF THE STUDY: Twenty children with cerebral palsy who underwent elongation of the triceps surae using successive plaster-casts (28 short triceps) were reviewed. This study was retrospective. MATERIAL AND METHODS: Among the eighteen children, 10 were hemiplegic, 8 were diplegic and 2 were spastic quadriparetic. All of them except one were ambulatory children. The authors describe their elongation technique by plaster-casts and the treatment they lead. The mean age at time of elongation was 4 years and 6 months (range 2 years 4 months to 8 years). The passive dorsiflexion of the foot before elongation was of 0 degree (range -20 degrees to +10 degrees) knee in extension, and of 5 degrees (range -15 degrees to +15 degrees) knee in flexion. RESULTS: The passive dorsiflexion of the foot after elongation was of 23 degrees (range +10 degrees to +30 degrees) knee in extension, and of 27 degrees (range +10 degrees to +35 degrees) knee in flexion. One major complication was noted: the persistence of a varus foot in child after elongation. 24 elongations were reviewed with a mean follow-up of 21 months (range 12 months to 30 months). The passive dorsiflexion of the foot was of 10 degrees (range 0 degree to +20 degrees) knee in extension and of 17 degrees (range -5 degrees to +25 degrees) knee in flexion. DISCUSSION: Compared to different procedures (surgical lengthening, botulinum-A toxin) elongation by successive plaster-casts is a quick, safe, complication-free, and simple technique, whose results are equivalent. Even if recurrence of equinus is probable, a surgical procedure of lengthening could be made on an operative-free tendon. CONCLUSION: Elongation of the triceps surae muscle by successive plaster-casts constitutes a safe alternative technique compared to surgical procedure.

Achilles Tendon↗
PubMed1996

Neonatal characteristics in rapidly progressive perinatally acquired HIV-1 disease. The French Pediatric HIV Infection Study Group.

OBJECTIVE: To identify clinical and laboratory parameters at birth that are associated with the rapidly progressive form of human immunodeficiency virus type 1 (HIV-1) disease in children born to infected mothers. DESIGN: Multicenter, prospective study of infants born to HIV-seropositive mothers. SETTING: A total of 62 obstetric and pediatric centers in France. PARTICIPANTS: Of 1386 children born to HIV-1-seropositive mothers at least 18 months before the cutoff date, 267 were infected. Infection was defined as serological positivity at 18 months or death from HIV disease before the age. MAIN OUTCOME MEASURE: Category C events (including opportunistic infections, recurrent severe bacterial infections, cancers, specific encephalopathy, and wasting syndrome) in the new pediatric Centers for Disease Control and Prevention classification during the first year of life, according to clinical, immunological, and virological findings at birth. RESULTS: The risk of category C manifestations at 12 months was significantly higher when an infected newborn had liver and/or spleen enlargement and/or adenopathies (38.1% vs 15.1%; relative risk [RR], 2.5; 95% confidence interval [CI], 1.4 to 6.0; P<.02) or a low proportion (<30%) of CD4+ cells at birth (45.5% vs 15.0%; RR, 3.0; 95% CI, 1.4 to 6.4; P<.005). Similarly, HIV-1 culture and/or polymerase chain reaction positivity during the first week of life was associated with a higher risk of the early, severe form of HIV infection (26.4% vs 9.3%; RR, 2.8; 95% CI, 1.3 to 6.1; P<.006). In case of positive antigenemia at birth, the risk was 50.0% vs 14.4% (RR, 3.5; 95% CI, 1.9 to 6.2; P<.001). These parameters, determined at birth, were strongly interrelated and could reflect active disease onset in utero in some cases of early, severe HIV-1 disease in childhood. CONCLUSIONS: These prognostic markers, particularly virological parameters, are of value in monitoring children infected by HIV and might serve as a basis for early therapeutic intervention.

AIDS Serodiagnosis↗
PubMed1996

Fracture of the occipital condyle.

We report the case of a patient with occipital condyle fracture who was neurologically intact. The patient was treated conservatively with a neck collar, and the symptoms resolved in 3 months. This diagnosis can be suspected in high-velocity road traffic accidents, in a patient with neck pain, disproportionate torticollis, or lower cranial nerve symptoms. Skull radiography and cervical spine films can be normal. The diagnosis is best made by high-resolution computed tomographic (CT) scanning with sagittal and coronal reconstruction.

Adolescent↗
PubMed1995

Autoantibodies directed against CD43 molecules with an altered glycosylation status on human immunodeficiency virus type 1 (HIV-1)-infected CEM cells are found in all HIV-1+ individuals.

Autoantibodies to lymphocytes have been detected in sera from human immunodeficiency virus type 1 (HIV-1)-infected individuals, and several autoantigens have been described. Among them, hyposialylated CD43 has been shown to be a target for autoantibodies in up to 47% of HIV+ individuals. However, the corresponding autoantigen (ie, the incompletely sialylated CD43) has not been isolated from blood cells of HIV-1-infected individuals. Recently, we have observed in vitro that HIV-1 productively or latently infected CEM cells (CEMLAI/NP) express CD43 molecules with modified glycosylation (mogly CD43). Using CEMLAI/NP cells, which do not express any structural viral antigen, we show now that all of the tested HIV+ sera from asymptomatic individuals, and up to 86% of those from subjects at the acquired immunodeficiency syndrome stage contain antibodies (mainly IgM and, to a lesser degree, IgG) that recognize the surface of CEMLAI/NP cells, and precipitate mogly CD43 molecules from the cells lysates. Taken together with our previous demonstration of altered glycosylation of CD43 from HIV-1-infected CEM cells in vitro, the constant antimogly CD43 autoimmune response observed from asymptomatic HIV-1+ subjects is likely to illustrate the occurrence of an altered glycosylation in vivo of the major lymphocyte surface CD43 glycoprotein, associated with HIV-1 infection.

Acquired Immunodeficiency Syndrome↗
PubMed1995

Osteoarticular infection due to Coxiella burnetii in children.

We report three cases of chronic osteoarticular infections associated with Q fever in children. In two of them, serologic diagnosis was confirmed by direct immunofluorescence of Coxiella burnetii in the synovial and bone biopsy specimen. We suspect that bone infections due to Coxiella burnetii could be underdiagnosed because this etiology is not frequently seen.

Abscess↗
PubMed1995

[Munchmeyer's disease in children].

The clinical features of two children with myositis ossificans progressiva are described. Skeletal malformations can be observed in many sites: hand, femur, tibia and spine. Phalangeal abnormalities (shortened hallux, hallux valgus) are essential to the diagnosis. We recommend systematic roentgenographic examination to search for other skeletal malformations for congenital hallux valgus in young children because it can be the first sign of myositis ossificans progressiva. Progression of disability does not seem to be influenced by any form of medical treatment. Surgical removal of ectopic bone is thought to be followed inevitably by rapid recalcification at the original site.

Abnormalities, Multiple↗
PubMed1993

[Fibrous dysplasia in children].

The authors report a series of 19 children (ten boys and nine girls) presenting fibrous dysplasia with an average follow-up of 7 years 10 months. Twenty five bones were involved. The average age at diagnosis was 9 years (range 3 years to 14 years). Fatigue fractures and pains were the main reasons for consultation. The most frequent anatomic sites were the femur, the tibia and the humerus. In six cases it was decided to simply watch the children without any treatment. The clinical results were good for 18 children. In two cases the initial radiological lytic aspect remained at the longest follow-up. Nine complications (among which two iterative fractures and three recurrences) occurred. None of the cases developed malignant transformation. The authors discuss the different possibilities of treatment with a review of the literature.

Adolescent↗
PubMed1993

[Aneurysmal cyst of the bones in children].

The authors have analysed a series of aneurysmal bone cysts (A.B.C.) in children and adolescents which were reviewed at an average follow-up of 4 years 2 months (6 months-15 years). The average age at diagnosis was 8 years (3-19 years). Pathological fractures were the main reason for consultation, probably due to the predominance of central lesions. If conventional radiology remains indispensable to diagnosis, magnetic resonance imaging is nevertheless the most important examination in determining the extent of the affection. The diagnosis remains anatomopathological, even if this may be difficult due to associated lesions (A.B.C. illness and A.B.C. symptoms). In long bones lesions, we observed recurrence after curettage in 3 out of 7 cases. For this reason the recommend simple resection or reconstructive resection rather than curettage whenever possible. 5 lesions in contact with growth plate were observed. In such cases we recommend its conservation by careful curettage, especially in young children. We feel that subsequent recurrence is easier to treat than an epiphysiodesis bridge. The surgical techniques employed to conserve the plate are described along with methods of bone reconstruction after surgery.

Age Factors↗
PubMed1993

[Closed spinal dysraphism].

This retrospective review included 133 patients with one or several of the following defects: diastematomyelia, neurenteric cyst, dermal sinus or cyst, meningeal malformation, sacral agenesis, tethering of the spinal cord, and lumbosacral lipoma. Physical evaluation readily identified most lumbosacral lipomas, as well as most cases of diastematomyelia since hypertrichosis over the defect was common. Some patients developed life-threatening clinical manifestations, e.g., meningitis due to a dermal sinus. On the basis of this retrospective review and a review of the literature, the clinical and therapeutic aspects of each defect are discussed.

Adolescent↗
PubMed1992

The skin as the possible reservoir for Candida albicans in the oculocutaneous candidiasis of heroin addicts.

We describe 2 patients who injected themselves with the same brown heroin a few days before hospitalization. The first patient presented with characteristic oculo-cutaneous candidiasis. Blood samples remained sterile during the so-called 'septicemic syndrome' which represents the first phase of this syndrome and were positive for Candida albicans only when cutaneous nodules developed. The second patient was hospitalized for a stomach perforation and had no cutaneous or ocular candida involvement. Both patients were unusually colonized by C. albicans on their skin (particularly on hairy zones). These observations support the hypothesis that the skin may constitute the reservoir for C. albicans in oculo-cutaneous candidiasis.

Adult↗
PubMed1992

[Surgical treatment of ruptures of the achilles tendon in athletes. 31 cases operated on with an average follow up of 4 years].

The authors analyze a series of 31 tendo achillis ruptures occurring after sport accident. All were treated surgically. The actual follow up being of 4 years (1 to 12 years). In nearly one third of the cases, either a change in the training methods or intensive activity was noted. 80% of cases showed an causal violent trauma. Tendinopathy preceded the rupture in 20% of the cases, without being an important prognosis factor. In 70% of cases, diagnosis was made within the 24 following hours, and later (more than 8 days after) in one patient out of ten. Type of the surgical procedure does not seem to make any change in the long term prognosis. Each time a severe post op. complication occurred, the final result was bad. In one third of cases pre op. and post op. tendon lengths were not identical, this detail not seeming to bother the patients. In 60% of cases, same sport level was reached. In 80% of cases the final results were good or excellent.

Achilles Tendon↗
PubMed1992

[Sequelae of osteoarthritis of the hip in growing children. Apropos of 72 cases].

The authors reviewed a series of 72 hips in 60 children with sequelae of septic arthritis of the hip to evaluate the long term evolution. The average follow up was 7 years 8 months (Range 1Y-17Y). 40 hips were operated and 32 were not. The results were analysed according to clinical and radiological criterions in an attempt to propose a guide for treatment. Sequelae might also occur after both initial treatment with open drainage or aspiration. The study of sequelae according to the factors of severity (organism, age when infected) showed that the evolution of these cases of arthritis cannot be forecast. The authors noticed that very severe roentgenographic lesions could be well tolerated clinically, at least on a medium term basis. They advise great care before operating on dislocated hips when they are clinically well tolerated. Finally the authors insist on 2 little known lesions: caput valgum and caput antetorsum.

Adolescent↗