Search PubMed⌕ Search

Biomedical subjects

J Just

Publications and source records attributed to J Just.

At least 19 recordsLinked to original sources
PubMed1992

Genetic risk factors for perinatally acquired HIV-1 infection.

This study evaluates genetic influence on susceptibility to perinatal HIV-1 infection among 106 Black infants from New York and San Francisco born to mothers infected with HIV-1. Genes tested by molecular techniques are HLA class II loci DRB1, DPB1 and DQA1; HLA class III loci complement C4A and C4B; alpha and beta interferons; and the constant region of the T-cell receptor beta chain. Of the 106 infants analysed, 54 are infected with HIV and 52 remain uninfected at age 15 months and older. Genotypes in the HLA region appear to influence risk of HIV infection. Specifically, infants with the amino acid sequence -asp-glu-ala-val- at DPB1 positions #84-87 are more likely to be infected (P = 0.001) and infants with the allele DQA1*0102 are less likely to be infected (P = 0.031). Combinations of these two risk factors show a strong dose response (P = 0.0005). HLA DPB1 and DQA1 may play a direct role in immune response associated with HIV-1 infection, or the critical region may be located between these two genes. Characterisation of other class II HLA genes in these infants will allow more precise determination of the role of HLA loci in susceptibility to HIV-1 infection.

Alleles↗
PubMed1992

Detection of Mycoplasma pneumoniae in clinical samples from pediatric patients by polymerase chain reaction.

The polymerase chain reaction (PCR) technique was used to detect Mycoplasma pneumoniae DNA in clinical samples (nasopharyngeal aspirations or bronchoalveolar lavages) obtained from 100 children, 1 month to 16 years old. PCR allowed the detection of M. pneumoniae DNA from 20 out of the 100 patients studied. In 16 cases, PCR positivity was associated with acute respiratory symptomatology. For five PCR-positive patients, a positive culture or a serological response evidenced acute M. pneumoniae infections. A lack of antibody response was observed particularly with immunocompromised children and infants less than 12 months old. The amount of M. pneumoniae DNA in the PCR was estimated in a semiquantitative way by comparison of its hybridization signal with those obtained for 100, 10, and 1 color-changing unit (CCU) of the M. pneumoniae FH strain. Small amounts (less than or equal to 10(2) CCU/ml) of M. pneumoniae were found in samples from asymptomatic patients, while larger amounts (greater than or equal to 10(2) to greater than or equal to 10(4) CCU/ml) were found for 8 out of 10 patients with acute pneumonia.

Adolescent↗
PubMed1992

[Reliability and reproducibility of 3 peak flowmeters determined in a population of primary school children].

Peak-flow measurement increasingly seems to be very useful for routine monitoring of asthma in children. The purpose of this study was to evaluate the reliability and reproductibility of three different peak-flow meters: Miniwright, Vitalograph and Assess. This prospective study was conducted in 100 primary school children aged from 6 to 11 years. In each child, 9 measurements of expiratory peak-flow rate (EPF) were performed with these 3 peak flow meters in a random order. Reproductibility was assessed for each instrument by the greatest divergence observed between the 3 EPF values measured in the same session. Reliability was assessed by comparison between the values obtained with each instrument and theoretical EPF values calculated from a formula which included age, sex and size. Our study validated the reliability and reproductibility of the 3 peak flow meters studied. EPF values were more scattered and less reproductible with Assess, but the difference was not significant.

Asthma↗
PubMed1992

[Role of inhalation therapy in the management of childhood asthma].

Inhaled drugs became of great interest in the treatment of childhood asthma. They must be adapted now to age and each form of the disease. The primarily interest of an organ therapy is to lead to a maximal efficacy by bringing locally an optimal quantity of drug without or with very few side effects. The choice of the device depends upon age which determines drug tolerance and quality of the inhalation technique. In infants and young children the use of nebulizers appears to be the most suitable technique; preschool children are capable to use metered-dose inhalers (MDI) with spacers; in older children the use of MDI, without spacers, or dry powder inhalers is allowed. During attacks of asthma, inhaled therapy appears to be effective in most cases using either B2 agonists alone in moderate forms, or B2 agonists associated with oral or parenteral corticoids in more severe forms. For the preventive treatment of asthma, in order to prevent attacks, some inhaled drugs also belong to a first line therapy against either allergy or on specific bronchial hyperreactivity: cromolyn or nedocromil are often used in mild to moderate forms (in association with oral anti-histamine drugs in some cases); in more severe forms we can start with a bronchodilator B2 agonist long-term treatment (associated with sustain-released theophylline in some cases), except in infants before twelve or eighteen months of age; in the most severe forms of chronic asthma an anti-inflammatory long-term treatment with inhaled corticosteroids may be prescribed even in young children.

Administration, Inhalation↗
PubMed1992

[Treatment understanding and compliance in asthma of children. Results of a prospective survey].

Compliance with treatment is a crucial factor in the management of asthmatic children which depends on the understanding of the disease and its treatment. The understanding of, and compliance with treatment were evaluated by means of a questionnaire in 50 parents of asthmatic children. 50% of these parents used anti-histamines as maintenance treatment and 30% also used these drugs during attacks. Half the parents knew about the bronchodilator effects of theophylline and B2-agonists. 42% and 30% respectively of the parents thought that the side-effects of theophylline or corticosteroids were few or inexistent; 86% claimed regular attendance to out-patient clinics, but 30% confessed that they had forgotten such drugs as theophylline and antihistamines. 50% took the appropriate therapeutic measures when confronted with a moderate or severe attack of asthma. Each child received 2.3 drugs on average for his or her asthma. This study shows that parents have an insufficient knowledge of asthma treatments, and this may partially explain the poor compliance with therapy as well as the morbidity and mortality associated with childhood asthma.

Adolescent↗
PubMed1992

[Asthma in infants. Clinical and functional aspects].

BACKGROUND: The incidence of asthma in infancy is rising but its clinical and physiological components remain unclear. METHODS: A total of 24 infants, aged less than 48 months, in whom the first wheezing episode (WE) appeared before the age of 30 months (mean age: 9 months) underwent clinical examination and pulmonary function tests at least 2 weeks after the last WE. RESULTS: The mean WE frequency was 1.1 per month and the mean number of admissions for WE was 1.8. 63% of patients showed symptoms between WE and 50% had an allergic profile. There was no evidence of thoracic distension. Bronchial obstruction (BO) occurred in 71% of patients; among these, BO was distal or generalized in 59% and medium or severe in 47%. 12.5% of patients were hypoxemic at testing. BO was less severe in patients treated with theophylline; it was more frequent (87%) in those with symptoms between WE and/or several admissions, and/or admission to the intensive care unit. CONCLUSION: This study provides additional evidence that infants presenting with asthma at an early age have severe clinical and physiological profiles.

Age Factors↗
PubMed1992

[Value of accelerated hyposensitization with mixed allergens in severe childhood asthma].

The value (in terms of decreased numbers of attacks and of hospitalizations for attacks, decreased need for asthma medications, and improved tolerance to allergens) of rush immunotherapy to a mixture of allergens was studied in children with multiple sensitizations and severe asthma (as evaluated on the number of attacks, number of hospitalizations, and dependence on corticosteroids) already receiving optimal medical therapy. Because syndromic reactions are common, rush immunotherapy should be performed in the hospital and premedication with corticosteroids may be warranted in the most severe cases.

Adolescent↗
PubMed1991

[Vaccination against the hepatitis B virus in alcoholics].

BACKGROUND: The risk of hepatitis B virus infections is high among alcohol abusers, and vaccination has been evaluated in previous studies. However, the response has been low with the usual doses and schedules. METHODS: In the present controlled trail a group of 14 alcohol abusers was vaccinated following a rapid schedule with a dose twice the usual one. Their response was compared to that of a second group of 16 alcohol abusers vaccinated in the usual way. Both groups were compared to a third one consisting of 30 healthy individuals. RESULTS: At the end of the program 83% of the healthy controls responded, with a mean anti-HBs titer of 1130.3 mU/ml. The anti-HBs titer achieved in both groups of alcohol abusers was lower that in healthy individuals (p less than 0.05). 56% of the alcohol abusers vaccinated with the usual program responded (with a mean titer of 80.1 mU/ml), and so did 66% of those vaccinated with high doses (mean titer 63.3 mU/ml). CONCLUSIONS: These results indicate that the poor response of alcohol abusers to HBV vaccine does not improve with increased doses and a rapid schedule.

Adult↗
PubMed1991

[Intralobar pulmonary sequestration manifested by neonatal cardiac insufficiency].

The authors report the case of an intralobar pulmonary sequestration in a newborn presenting congestive heart failure. The clinical symptoms mimicked a persistent ductus arteriosus. Clinical, radiographic and echographic data suggested the diagnosis which was confirmed by the angiography. A surgical treatment was realised at seven weeks consisting in the ligation of the abnormal artery and a right lower lobectomy. This is the 9th case found in the literature. A congestive heart failure in a neonate with normal intracardiac anatomy may suggest a pulmonary sequestration.

Bronchopulmonary Sequestration↗
PubMed1990

[Cystic fibrosis in infants revealed by severe respiratory distress. Mid-term course].

We report the follow-up of 13 infants aged 2.5 to 24 months in whom cystic fibrosis disease presented as respiratory distress. All infants received an intensive treatment. Mean clinical, radiological and microbiological follow-up was 3.1 years. Ten children aged 1.5 to 8.5 years are still alive. One of them presents with serious respiratory failure, with a Shwachman score of 50. The Shwachman score is between 85 and 70 for 8 of 13 and 65 for one. The prognosis of this group did not differ from the one usually observed in the disease. It depends partially on early intensive care management and is not altered by mechanical ventilation.

Child, Preschool↗
PubMed1990

Cutaneous acquired immunodeficiency syndrome-associated Kaposi's sarcoma in pediatric patients.

Kaposi's sarcoma has only rarely been reported in children with acquired immunodeficiency syndrome. In contrast to adult patients, in whom the disease is predominantly cutaneous, among pediatric patients with acquired immunodeficiency syndrome, Kaposi's sarcoma is primarily limited to the lymphadenopathic form. We describe two children with the acquired immunodeficiency syndrome who developed diffuse nodular skin lesions of Kaposi's sarcoma.

Acquired Immunodeficiency Syndrome↗
PubMed1989

Success of mutant Drosophila at different sex ratios.

Relative courtship success of mutant Drosophila melanogaster males was found to vary with sex ratio. Males with one of three recessive mutants: White, vermilion, or vestigial, competed with wild type males for females. Female-biased sex ratios were associated with increased success of all three different mutant phenotypes relative to wild-type as compared to an unbiased sex ratio. There was no difference in the success of mutant males in the first or second half of the observation periods, which spanned one hour.

Animals↗
PubMed1989

[Familial pulmonary hemorrhage and lupus syndrome with C4 deficiency].

A six year old girl developed severe pulmonary hemorrhage following appendectomy. Clinical findings and results of immunfluorescence studies of skin, lung and renal biopsy specimens were consistent with systemic lupus erythematosus (SLE). A sister also had hemoptyses and a lupus syndrome. Both girls, but none of the other siblings or parents, were shown to have a partial C4 deficiency. A review of the literature disclosed 13 pediatric cases of SLE with pulmonary hemorrhages. In none of these cases was congenital C4 deficiency reported (although C4 deficiency is known to induce autoimmune diseases, including lupus). Our two patients are therefore the first reported cases of SLE with pulmonary hemorrhage and a partial congenital C4 deficiency.

Biopsy↗