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Biomedical subjects

J Laugier

Publications and source records attributed to J Laugier.

At least 73 records · Page 4Linked to original sources
PubMed1991

[Purulent meningitis due to flavobacterium meningosepticum in Cameroonian children].

Following a number of reports of purulent CSF specimens positive for Flavobacterium meningosepticum in pediatric patients in Yaoundé, a prospective study was carried out in the Department of Pediatrics of the Central Yaoundé Hospital from December 1988 through December 1989. The goals of this study were to determine the incidence of Flavobacterium meningosepticum among infants and children with purulent meningitis, to discover the origin of this pathogen, and to examine its susceptibility to antimicrobial agents. Flavobacterium meningosepticum (18.4% of cases) was second by order of incidence, after pneumococci (50%). Incidences were low for the other pathogens usually described in purulent meningitis (H. influenzae, meningococcus...). All the pneumococcus strains recovered were susceptible to ampicillin. In contrast, 21.43% of strains of Flavobacterium meningosepticum were resistant to both ampicillin and chloramphenicol (the combination currently used as first line therapy in the Department), and 14.25% of strains were resistant to cefotaxime. The origin of the Flavobacterium meningosepticum strains found remains to be discovered. The low incidence of H. influenzae deserves to be reevaluated over the next few years.

Adolescent↗
PubMed1990

Area of lateral ventricles measured on cranial ultrasonography in preterm infants: reference range.

Serial ultrasound imaging of the brain was carried out in 87 preterm infants of 27 to 36 weeks' gestational age while they were in the special care nursery and during their first postnatal year. None had evidence of intracranial disease during the neonatal period and 94% had good neurodevelopmental outcome at 2 years of age. Lateral ventricle area measurements were plotted against independent variables including postnatal age and head circumference at the time of the examination. The measurements increased as age and head circumference increased. During the first six weeks of life the mean (SD) postnatal head circumference growth velocity (rate of growth) was 0.53 (0.13) cm/week and the mean postnatal ventricular area growth velocity was 0.39 (0.19) mm2/week. A reference range for lateral ventricle area values was developed from these serial measurements in infants with documented good short term developmental outcome.

Age Factors↗
PubMed1990

Area of lateral ventricles measured on cranial ultrasonography in preterm infants: association with outcome.

The association between measurements of lateral ventricle area (determined by serial ultrasound scans) and outcome was studied in 70 preterm neonates of 33 weeks' gestation or less. The study group was subdivided into four groups according to cranial ultrasonographic findings at 2 weeks postnatal age: group A (n = 15) had isolated periventricular/intraventricular haemorrhage; group B (n = 20) had periventricular/intraventricular haemorrhage and dilated ventricles; group C (n = 24) had periventricular/intraventricular haemorrhage and periventricular leukomalacia with or without dilated ventricles; and group D (n = 11) had isolated periventricular leukomalacia. Eighty seven preterm infants with no evidence of intracranial disease and good neurodevelopmental outcomes at 2 years formed the control group. A poor outcome was observed in infants in group B, C, and D, particularly in those who had persistent dilated ventricles at 6 weeks postnatal age and extensive periventricular leukomalacia. There was no difference in outcome between group A and controls. During the first six weeks of life ventricular area growth velocities were significantly higher in groups B, C, D, compared with normal controls and group A. We suggest that persistent ventricular dilatation at this early stage carries a bad prognosis, which is the result of atrophy of the brain.

Age Factors↗
PubMed1990

Implantation and in vivo antagonistic effects of antibiotic-susceptible Escherichia coli strains administered to premature newborns.

Two antibiotic-susceptible and non-pathogenic Escherichia coli strains were administered to hospitalized premature infants in order to protect them from intestinal colonization by hospital-acquired antibiotic-resistant enteric organisms (EOs). Three groups of 16 premature newborns received respectively strain ECA, strain EMO and both strains simultaneously. A fourth group was used as a control. Resistant EOs became spontaneously established in the digestive tract of a majority of the unadministered children. Both ECA and EMO were able to colonize the digestive tract of a majority of the subjects, and reached high population numbers (greater than 10(7)/g) in the faeces. Both strains appeared as able to reduce significantly the establishment of antibiotic-resistant EOs. This effect was more prominent with EMO, which also impaired the implantation of ECA when both strains had been administered simultaneously. The use of such innocuous microorganisms could thus constitute an additional means of preventing nosocomial infections of intestinal origin.

Anti-Bacterial Agents↗
PubMed1990

Randomized study of vancomycin pharyngeal instillation as a prophylaxis of bronchopulmonary infection in intubated neonates.

In a randomized prospective trial, we investigated whether vancomycin (chosen for local microbiological reasons) given by instillation into the oropharynx of intubated neonates could reduce the frequency of pharyngeal and tracheal colonization, and then broncho pulmonary infection. Two groups of 20 neonates intubated for an expected ventilation period of more than 7 days were included in the study. There was no statistical difference between the two groups for weight, gestational age and duration of treatment. One group (V+) received 4 drops of a 5% solution of vancomycin every 8 h. The control group (V-) had no local treatment. Oropharyngeal and tracheal aspirates were collected twice weekly for bacterial examination. During ventilation, colonization occurred in the oropharynx of 5 V+ (on day 18 +/- 10) and 18 V- (on day 5 +/- 2.5; p less than 0.001); the colonization occurred in trachea of 5 V+ (on day 19 +/- 11) and 17 V- (on day 6 +/- 3.6; p less than 0.001). The same bacteria were identified on both sides in all infants colonized. This treatment produced no adverse effects and seemed particularly valid for very low birth weight infants.

Apnea↗
PubMed1990

[Technique of cardiac output measurement by pulsed Doppler coupled to echocardiography in newborn infants and infants: value of the subcostal route].

The authors describe the measurement of cardiac output by Doppler echocardiography in neonates and infants. After reviewing theoretical considerations, the authors review the various practical aspects of the method. They emphasize the need for an excellent technique so that possible errors are avoided. In their experience, the most appropriate measurement site is at the sinotubular junction of the aorta, as the velocity signal is obtained by subcostal and the diameter measured by parasternal long axis view.

Cardiac Output↗
PubMed1990

[Bacterial infection in the newborn by maternal-fetal contamination: oral antibiotic treatment of the colonized newborn. Prospective study at a maternity unit].

It is not yet known how important bacterial colonisation of the newborn is but in most maternity units this, when it occurs, is treated by parenteral antibiotic therapy. We have, in a prospective study, given antibiotics orally (amoxycillin or clavulanic acid-amoxycillin) in neonates who were colonised by bacteria, and have studied their clinical progress in the first month of life, using a questionnaire to be filled in by the parents. There were 119 neonates treated in 19 months and of these 87.4% of the parents replied to the questionnaires. The children did well in every case. A pharmacokinetic study showed that 76% of the amoxycillin given by mouth was absorbed. It seems, therefore, to us to be useful to give antibiotic treatment by mouth in these neonates.

Administration, Oral↗
PubMed1990

[Is the qualitative research of benzodiazepines by the EMIT method and diazocopulation in accidental poisoning in children relevant?].

A retrospective study was undertaken to evaluate the relevance of benzodiazepine detection in 42 children with accidental poisoning. Immunoenzymatic assay for benzodiazepine in serum and colorimetric method in urines were positive respectively in 3 and 4 patients only. Several reasons could explain these results: the high detection threshold, the different drug reactivity according to the molecular structure and the great delay between intoxication and toxicology analysis. An advised physician should not prescribe a toxicological analysis after a small quantity of benzodiazepine ingestion.

Benzodiazepines↗
PubMed1990

[Organ procurement in pediatrics. General and ethic aspects].

The progress in organ transplantation is leading an increase in the demand for organs. Any non-harvested organs from a dead child mean at least a delay or even the loss of hope for life. All brain dead children do not undergo organ harvesting because there are still obstacles. The definition of brain death must be clear and include the destruction of all the brain system. Intensive care units must be motivated by improved contacts with transplantation teams. The number of parents who refuse could decrease with better public information, good contacts with medical teams and the quality of discussion with parents when a child dies. Energy should be concentrated on improving the collective consciousness about this new aspect of medicine.

Attitude↗
PubMed1990

[Conditions of low birth weight newborn infants at home after prolonged neonatal hospitalization; prospective study of 50 cases].

The hospitalisation of low birth weight neonates has an effect on the parent-child relationship. A prospective study on the effects of returning home and on home conditions was conducted in the neonatal unit over a 6-month period. Fifty infants were included in the study. The results showed that difficulties in the parent-child relationship took place after the infant returned home in 11 cases (22%). Examination of the possible role of factors prior to or during the hospital stay indicated the significance of the following: premature delivery, disturbances during the childhood one of the parent's, and the infant's stay in neonatal intensive care unit.

Child, Hospitalized↗
PubMed1990

[Effect of ceftriaxone on aerobic fecal flora in children].

Counts of aerobic faecal flora were done using serial dilutions of stools cultured on selective media in order to estimate the ecological effects of ceftriaxone. Twenty children were studied (24 courses of treatment), 17 of them with post-chemotherapy agranulocytosis. Enterobacteriaceae disappeared in all cases. After treatment, they rose again, unless another antibiotic was administered. No Pseudomonas could be found, due to the protective isolation. Streptococci D disappeared in 6 children. Staphylococcus aureus was present transiently at a low level in one case. Candida persisted in two cases at the same level in spite of antifungal therapy.

Adolescent↗
PubMed1990

[Pharyngeal and tracheal flora in intubated neonates: interrelations and role of streptococci].

Fourteen neonates intubated within 48 hours of birth were studied for a mean period of two weeks. None were candidates for antimicrobial therapy. Microorganism loads were evaluated twice a week, quantitatively in the pharynx and semiquantitatively in the trachea. Most microorganisms recovered were Gram-positive cocci. All species acquired reached 10(7) CFU/g by the time of the second sampling. All species recovered from the pharynx were recovered from the trachea within 0.25 weeks. The presence of alpha-hemolytic streptococci did not modify the other populations. A colonization pattern similar to that seen in the digestive tract but with specific features due to countercurrent colonization is suggested.

Colony Count, Microbial↗
PubMed1989

[Conventional mechanical ventilation in the premature infant and the full-term newborn].

Convention mechanical ventilation (MV) is installed after nasotracheal intubation by means of a volume generator or pressure reducer. Careful monitoring of the child's respiratory status is indispensable; sedatives and/or muscle relaxants may facilitate MV. The method is indicated in case of oxygen-resistant hypoxaemia or of global alveolar hypoventilation, or to cope with a severe general or neurological stress. While MV is being applied, there main and dangerous complications may occur: respiratory obstruction, pneumothorax and lower respiratory tract superinfection. Weaning must be progressive. As regards the practical handing of MV, the best way to adjust the respirator constants is to evaluate the time constant according to the nature of the lung disease and to the stage it has reached in its course. In the most severe situations, and particularly in case of hyaline membrane disease, one must try to obtain the best possible adequation between severity of the disease and ventilatory stress, without preestablished arbitrary limits.

Humans↗
PubMed1989

[Early administration of antibiotic susceptible strain of Escherichia coli in the intestine of the premature infant].

An antibiotic-susceptible, innocuous Escherichia coli strain of human origin was administered to premature infants in order to protect them from nosocomial colonization by antibiotic-resistant enteric organisms. The strain was given to 16 untreated patients in the first six hours of life, and to 11 patients treated with antibiotics in the first six hours after cessation of treatment. The strain was able to colonize the intestinal tracts of all treated infants and 14/16 untreated infants. Colonization of these patients by antibiotic-resistant enteric organisms was compared with results obtained in a control group of 15 unadministered and untreated infants. A significant difference was recorded in the first ten days after administration. Our results show that previous antibiotic treatments did not impair intestinal colonization by an antibiotic-susceptible strain, and demonstrate the in vivo antagonistic abilities of the administered strain. Such antagonistic strains might thus be used for control of nosocomial infections of intestinal origin due to antibiotic-resistant enteric organisms.

Cross Infection↗
PubMed1989

Is monitoring plasma levels of netilmicin necessary in neonates?

Thirty-two neonates were treated with netilmicin 3 mg/kg every 12 h by IV infusion for 30 min for suspected infections, colonization, or proven infections. Pharmacokinetic studies were performed in order to define the situations in which monitoring of plasma levels would be appropriate. Mean plasma levels were within the therapeutic range and did not differ in fullterms and preterms. In the 4 children who had 2 successive pharmacokinetic studies, plasma levels were increased between H1 and H5 at the second evaluation due to netilmicin accumulation. Plasma half-life was longer in proven infections and seemed to decrease in preterms with increased gestational age. These results suggest that the dosage schedule should be left inchanged, but that administration time should be reduced from 30 to 20 min and that peak and trough plasma levels should be measured only in proven infections, in very premature babies (gestational age less than 33 wk), and during netilmicin treatment longer than 5 d.

Female↗
PubMed1989

Effect of caffeine on cerebral blood flow velocity in preterm infants.

A continuous-wave form Doppler monitor was used to examine the effect of caffeine on cerebral blood flow velocity (CBFV) in 7 clinically stable preterm neonates suffering from apnea. Caffeine, in the form of caffeine citrate, or saline were given intravenously at loading doses of 20 mg/kg. Every subject was his own control. Placebo (saline) was systematically injected prior to caffeine citrate. Simultaneous recording of heart rate, arterial blood pressure, respiratory rate, TcPO2, TcPCO2 were made before, then at the end of the injection, and 30, 60 and 120 min after the end of each administration of either placebo or caffeine. Compared with placebo, caffeine injection was not associated with significant changes in CBFV. An increase was found in both heart-rate and respiratory rate (p less than 0.05). Mean arterial blood pressure, TcPCO2 and TcPO2 did not change significantly. Our data suggest that a caffeine citrate loading dose of 20 mg/kg as currently used at the beginning of treatment of apnea in preterm neonates has no effect on CBFV.

Blood Flow Velocity↗
PubMed1989

Caffeine and cerebral blood flow velocity in preterm infants.

Continuous wave Doppler monitor was used to examine the effect on cerebral blood flow velocity (CBFV) of caffeine in 7 clinically stable preterm neonates suffering from apnea. Caffeine, as caffeine citrate at a loading dose of 20 mg.kg-1 BW, or saline were given intravenously. Every subject was his own control. Placebo (saline) was systematically injected prior to caffeine citrate. Simultaneous recording of heart rate, arterial blood pressure, respiratory rate, Tc PO2, and Tc PCO2 were made before, at the end of the injection, and 30, 60 and 120 min after the end of each administration of either placebo or caffeine. Compared with placebo, caffeine injection was not associated with significant changes in CBFV. An increase was found in both heart rate and respiratory rate (p less than 0.05). Mean arterial blood pressure, Tc PCO2 and Tc PO2 did not change significantly. Our data suggest that a caffeine citrate loading dose of 20 mg.kg-1 BW as currently used at the beginning of treatment of apnea in preterm neonates has no effect on CBFV.

Blood Pressure↗