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Biomedical subjects

J Delorme

Publications and source records attributed to J Delorme.

At least 19 recordsLinked to original sources
PubMed2005

Double-blind randomized evaluation of clinical and biological tolerance of polyethylene glycol 4000 versus lactulose in constipated children.

OBJECTIVES: To assess the safety of a polyethylene glycol (PEG) 4000 laxative without additional salts in pediatric patients. STUDY DESIGN: This was a 3-month multicenter, randomized, double-blind, double-dummy, lactulose-controlled, parallel study enrolling 96 ambulatory constipated children aged 6 months to 3 years, treated daily with 4-8 g PEG or 3.33 g-6.66 g lactulose. Total protein, albumin, iron, electrolytes, and vitamins B9 (folates), A and D (25OHD3) were measured in blood before and after treatment (day 84) in a central laboratory. RESULTS: The percentage of children with at least one value out of normal range at day 84 with respect to baseline status (with or without at least one value out of normal range), i.e. the primary endpoint, was 87% and 90% in the PEG and lactulose groups, respectively, without any difference between groups. The whole blood parameters showed no qualitative or quantitative treatment-related changes. Vitamin A values were above normal range in 56% and 41% of children at baseline versus 33% and 36% at day 84 in the PEG and lactulose groups, respectively. Iron values were similarly under normal range in 47% and 51% at baseline versus 42% and 51% at day 84. Clinical tolerance was similar for both treatments except for vomiting and flatulence, which were significantly higher with lactulose. Significantly higher improvements were evidenced with PEG regarding stool consistency, appetite, fecaloma and use of additional laxatives. CONCLUSION: This 3-month study in 96 constipated children aged 6 months to 3 years confirms the long-term tolerance of PEG 4000 in pediatrics and indicates a PEG efficacy similar to or greater than that of lactulose.

Cathartics↗
PubMed2003

[Medico-economic study of percutaneous and surgical closure of ostium secundum type interatrial communications].

The aim of this study was the medico-economic evaluation of the closure of ostium secundum type interatrial communications in 32 patients, treated by cardiac catheterisation (group A: n = 17) or by surgery (group B: n = 15). The success rate was 100% with the 2 techniques. With national cost scale data we evaluated the overall cost of the 2 treatments using the information system medical program, starting from homogenous groups of patients: 150 catheterisation, 169 and 170 surgery. As the value for the homogenous group of 150 patients was much lower than the price of the material used for catheterisation, an adjusted group of 150 patients including the price of this material was created. An evaluation in terms of an artificial index of activity was also performed. The average duration of hospital stay for group A was reduced by 6.1 days compared to group B (p < 0.001). The overall cost was lower in group A than in group B (p < 0.001), using the real and "adjusted" homogenous group of 150 patients, with a respective reduction of 7,582 Euros and 3,731 Euros. Surgery and catheterisation scored 8,167 points (17,756 Euros) and 2,726 points (5,926 Euros) per patient respectively on the artificial activity index. In conclusion, catheterisation reduced the duration of hospital stay and brought an economic benefit for the Assurance Maladie compared to surgery. However, surgery is more profitable for the hospital than catheterisation because of the high cost of the prosthesis, which is not taken into account with a homogenous group of non-specific patients. This could hamper the development of this innovative technique in a hospital subjected to overall budgetary constraints.

Adolescent↗
PubMed2001

EMLA versus nitrous oxide for venous cannulation in children.

We compared EMLA cream with nitrous oxide (N(2)O) for providing pain relief during venous cannulation in children. In a prospective, double-blinded, randomized study, 40 children, 6-11 yr, ASA status I or II, undergoing scheduled surgery received either EMLA cream and inhaled air and oxygen (Group EMLA) or a placebo cream and inhaled 70% N(2)O in oxygen (Group N(2)O) before venous cannulation. Pain was evaluated with a visual analog scale and the Objective Pain Scale. The ease of venous cannulation and the observer's assessment of its efficacy for preventing pain were assessed. Heart rate, blood pressure, respiratory rate, and oxygen saturation were compared before and after venous cannulation. Visual analog scale scores (4.4 +/- 7.5 vs 3.9 +/- 9.3 mm, P = 0.85), Objective Pain Scale scores (median 0 [0-6] vs 0 [0-1], P = 0.61), efficacy (median 0 [0-1] vs 0 [0-1], P = 0.59), and ease of venous cannulation (0 [0-2] vs 0 [0-1], P = 0.84) were not different between EMLA and N(2)O groups, respectively. There was no statistical difference between the groups for the physiologic variables. Minor side effects were significantly more common in the N(2)O group (11 of 20) than in the EMLA group (7 of 20) (P = 0.0248). We conclude that both techniques provided adequate pain relief during venous cannulation, as demonstrated by the low pain scores.

Anesthesia, Inhalation↗
PubMed2001

Variability in hemoglobin levels: clinical implications. Case study of the anemic patient.

A historical, prospective, multicenter, observational study was conducted on data from October 1996 to December 1997 to determine the impact of hemoglobin (Hb) variability on the interpretation of maintenance anemia management outcomes in hemodialysis patients. Trends in mean Hb levels were retrospectively analyzed to determine whether there were any differences between 1-month Hb averages versus 3- or 6-month rolling averages. Results showed that: (a) Hb measurements exhibit wide variability between patients and within patients, regardless of the assessment method used, and (b) it is difficult to maintain patients within the 1 g/dL Hb spread recommended by NKF-K/DOQI. The largest variations in Hb readings were observed in 1-month readings, while 6-month rolling averages exhibited the least variability. These data illustrate the importance of assessing long-term trends in laboratory data before making incremental or decremental modifications in the anemia prescription.

Anemia, Iron-Deficiency↗
PubMed1999

Group A Streptococcus carriage among close contacts of patients with invasive infections.

During the past few years, the incidence of invasive group A Streptococcus (GAS) infection has been increasing. However, there are presently no clear recommendations regarding antibiotic prophylaxis for close contacts of index patients. The aims of this study were 1) to determine the prevalence of carriage of the same GAS strain as the patient's among contacts of patients with invasive infections and 2) to assess the importance of exposure duration. From March 1995 to March 1996, the authors prospectively included in the study all patients with invasive GAS infection, as defined by the Working Group on Severe Streptococcal Infections, who came to Hôpital Maisonneuve-Rosemont in Montreal, Quebec, Canada. An epidemiologic investigation was systematically carried out for each index case. Contacts were divided into two groups: those who had spent 24 hours or more with the index patient during the week preceding the beginning of his or her illness and those who had spent 12-24 hours with the index patient during that week. Strains of GAS were examined by serotyping (proteins M and T and the presence or absence of the serum opacity factor) and by characterization of streptococcal pyrogenic exotoxins (exotoxins A, B, and C). One hundred and two contacts of 17 index cases with invasive GAS infection were systematically screened. Contacts were considered positive if they carried the same strain of the bacterium and the same streptococcal pyrogenic exotoxin as the index case. Among the contacts who had spent at least 24 hours per week with their respective index cases, 13 out of 48 (27%) were found to be harboring the same serotype of GAS as the index patient (95% confidence interval 14.5-39.5). By comparison, only one of the 54 contacts in the 12- to 24-hour group (1.8%) was found to be carrying the same strain of the bacterium (95% confidence interval 0-5.3). This difference between the two groups was statistically significant (p<0.001). The median age of the positive carriers (10 years) was significantly lower than the median age of the noncarriers (39 years) (p< or =0.0005). This study showed that close contacts who had spent 12-24 hours with the index patient were rarely colonized with GAS. If antibiotic prophylaxis against GAS is recommended, it should probably target contacts who spent at least 24 hours with an infected patient during the week preceding illness onset.

Adolescent↗
PubMed1998

Trends in antibiotic resistance of staphylococci over an eight-year period: differences in the emergence of resistance between coagulase positive and coagulase-negative staphylococci.

The antimicrobial susceptibilities of 1058 Staphylococcus aureus and 2,163 coagulase-negative staphylococci (CNS) isolates obtained from clinical specimen between 1988 and 1995, were determined against 13 anti-staphylococcal antibiotics. During the study period the resistance of Staphylococcus aureus to ciprofloxacin, ceftazidime, and norfloxacin increased significantly by 7%, 4%, and 6%, respectively (p < or = 0.001). By comparison, the antibiotic resistance of CNS to ceftazidime, oxacillin, norfloxacin, ciprofloxacin, fusidic acid, and cefoxitin increased by 20%, 17%, 15%, 14%, 12% and 10%, respectively (p < or = 0.001). Invasive and noninvasive S. aureus had similar antibiotic resistance, whereas CNS invasive isolates were more resistant than noninvasive isolates to every antibiotics, except vancomycin and fusidic acid. These differences were significant (p < 0.001) for oxacillin, cefoxitin, and clindamycin. Our observations confirm that staphylococci and particularly CNS isolates show an important rate of increased resistance to the standard antimicrobials used for therapy, and that the rate of emergence of resistance differ considerably between coagulase-positive and coagulase-negative staphylococci.

Anti-Bacterial Agents↗
PubMed1997

[Clinical pilot study on repeated use of heparin, vancomycin, colimycine locked flush solution for central intravenous implanted catheter in oncology].

With an anti-infectious and an antithrombotic prophylaxis aims, a locked flush solution including heparin and vancomycin, was used systematically for implantable venous access system for each patient, from january to april 1995. Since the 6th of april 1995, in order to widen the antibiotic spectrum on Gram negative bacteriae, we added colimycin at the flush solution. In 1995, 342 hospitalised patients held this type of venous access and received chemotherapy and/or radiochemotherapy for cancer. Two thousand six hundred thirty three manipulations were done, 575 with the first flush solution, 2058 with the second. During the year, 15 implantable access system (4.4%) were considered as infected, only 3 (0.9%) were removed, in the first period. THe infectious rate seemed to be stable, but the bacterial assessment to be modified between the two periods. The Gram negative bacterial infections seemed to decrease with colimycin addition (33% versus 50%). These results must be confirmed by a long term and/or randomized study.

Anti-Bacterial Agents↗
PubMed1994

[Profile of microbiological analyses needed for hospitalized clients at the Maisonneuve-Rosemont hospital].

During five consecutive administrative periods, a computer data bank was set up from informations written on laboratory forms requesting tests in microbiology. A total of 13,260 forms were received and 11,591 were included in our study. 7,010 tests (60%) were requested from medical specialties; 40% of these tests were from patients admitted on hematology and on pediatrics wards. Of the 4,581 remaining tests, 36% were ordered for patients admitted on general surgery and on ophthalmology wards. Medical patients had three times as much blood cultures requested than surgical patients. The numbers of urine cultures done for medical and surgical patients were however similar (1,832 and 1,699 respectively). The average cost for microbiology cultures was twice as much in medical than in surgical patients. Such analysis of prescribing profile for laboratory tests provides useful information for the diagnosis related groups (DRG) system and can allow for a more efficient distribution of hospital resources.

Databases, Factual↗
PubMed1984

Age-dependent responses of the serum non-esterified fatty acids to adrenalectomy and ovariectomy in developing rats.

We report detailed gas chromatography analyses of the non-esterified fatty acids in the sera of female rats during post-natal maturation. A marked age-dependent decrease of concentration is demonstrated for all classes of compounds. Total levels fall from about 0.8 mM at birth to about 0.25 mM, 60 days later. The decrease is most pronounced for the polyunsaturated acids, which represent 27 +/- 9% of total fatty acids at birth and 13 +/- 3% 60 days later. The effects of ovariectomy and adrenalectomy on the free fatty acid levels as a function of age are strikingly different before and after maturation. When ovariectomy is performed at 5, 9 and 15 days, the fatty acid levels respond by a significant (30-40%) decrease; when adrenalectomy is carried out at the same ages, a dramatic 3-5-fold increase of all classes of fatty acids is observed. By contrast, in older animals, both responses have virtually disappeared. Possible mechanisms underlying the age-dependent patterns and behaviour of the serum free fatty acids are briefly discussed.

Adrenalectomy↗
PubMed1983

Early nutritional experiments: effects on the humoral and cellular immune responses in mice.

Studies were carried out to determine the effect of varying intake during the suckling period on the immune responses of mice. Female mice were bred in litters of 4, 9 or 20 pups. Litters of nine pups were considered control groups. Overfeeding (litters of 4) during this period did not change the serum protein profile nor the humoral and cellular immunity of the weanling mice, as judged by their plaque-forming cell responses to SRBC and lymphocyte stimulation in vitro by Con A or LPS. Conversely, mice bred in large litters showed, at weaning, decreased serum levels of albumin and alpha-globulins but did not exhibit marked alterations of their immune responses, although they were in a severe state of protein-energy deficiency. After weaning, feeding a normal diet ad libitum normalized all the altered parameters tested in the malnourished mice. However, when malnutrition was followed by intermittent feeding, the studied immunological functions were significantly affected: the humoral, as well as the cell-mediated immune responses were depressed. These observed alterations were not related to changes in the levels of serum corticosterone or zinc. Our findings suggested that differences in the length of dietary deficiency rather than its severity may explain some of the conflicts in reports on functional immune tests in protein-energy malnutrition.

Aging↗
PubMed1983

The role of nonesterified fatty acids and of alpha 1-fetoprotein in estrogen-dependent endocrine systems.

We discuss the various experimental findings to date that indicate that AFP may be considered as a positive or negative modulator of estrogenic action. Moreover, we show that this protein, even when nonestrogenophilic, is able to bind other hydrophobic ligands, in particular nonesterified fatty acids. These fatty acids inhibit the binding of estrogens to murine AFP as well as to the cytosolic estrogen receptors. Thus, the AFPs of all species--whether or not estrogenophilic--might play an endocrinologic role through the intermediary of the unsaturated fatty acids to which they associate with high affinity.

Animals↗