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Biomedical subjects

J Lavaud

Publications and source records attributed to J Lavaud.

At least 55 records · Page 3Linked to original sources
PubMed1979

[Neonatal cardiac tumour: diagnostic and therapeutic problems. One case (author's transl)].

We report a case of cardiac tumour, presenting as cardiac failure during the first hours of life and refractory hypoxia. The diagnosis was made with difficulty by angiography which revealed a filling defect in the right atrium, whilst echocardiography had shown only a localised pericarditis. The tumour (which extended into the pericardium) was found to fill the right atrium and appeared to extend towards the venae cavae and the left atrium, contraindicating any attempt at excision. The newborn infant died on D7 of a strictly intra-atrial well-limited fibromyoma.

Heart Atria↗
PubMed1979

[Emergency treatment of inborn amino errors of amino acid metabolism detected in the neonatal period].

The indications and effects of exchange transfusion, peritoneal dialysis, osmotic diuresis and early feeding have been studied in 28 children with inborn errors of aminoacid metabolism presenting in the neonatal period. Exchange-transfusion has only a transitory and incomplete effect but it is simple and quick. Peritoneal dialysis has a remarkable and often life-saving effect because the blood levels of toxic metabolites are reduced very effectively in organic acidaemias. However the rate of removal may decline if plasma concentrations fall below a critical level (1.2 mmol/L foor leucine). If the dialysis is prolonged for more than 36 hours it may cause hypoprotidaemia. Osmotic diuresis increases the 45 ml/min. However it is of little elimination of methylmalonic acid because the renal clearance is between 15 and 45 ml/min. However it is of little value in maple syrup urine disease, propionic acidaemia or isovaleric acidaemia because the renal clearance of the toxic metabolites is so low. The early re-introduction of low protein high calorie of a low protein and high calorie diet by continuous intragastric feeding is very important. The authors propose a protocol for the treatment of babies presenting inborn errors of aminoacid metabolism in the neonatal period. Peritoneal dialysis should be started as soon as the diagnosis is considered and continued for 24 to 36 hours. An exchange of transfusion shold be undertaken before and after the dialysis, together with an osmotic diuresis if appropriate. Continuous enteral feeding should be given, the quantity being adjusted to the baby's requirements.

Amino Acid Metabolism, Inborn Errors↗
PubMed1979

[De novo monosomy 4q32.1 leads to 4qter in a newborn with multiple malformations (author's transl)].

In a newborn with multiple malformations, deletion 4q32.1 leads to 4qter was observed after BrdU incorporation and staining with acridine orange. The patient's phenotype and that of five children monosomic for 4qter reported in the literature define a syndrome with a high rate of mortality due to major respiratory difficulties, laryngeal hypotonia and oedema, and complex congenital heart malformations.

Abnormalities, Multiple↗
PubMed1979

[Pneumocystis carinii pneumonia in chronically immunosuppressed patients. Apropos of 33 cases].

The availability of drugs that are active against Pneumocystis carinii has renewed interest in and underlined the difficulties of the early diagnosis pneumocystis pneumonia. A retrospective study of 33 cases was undertaken to define the optimal management. It is necessary to take into consideration the high mortality of the untreated condition and the risks of investigation and of treatment. Pneumocystis pneumonia affects only those patients who are immunologicaly incompetent, particularly those with defects of cellular immunity. Early symptoms are common but they are insidious. Indirect immunofluorescent tests were positive in 75% of our cases and were useful as screening tests. However it is necessary to identify the parasite (in our cases it was detected in 29 patients) and this requires invasive techniques such as lung puncture, lung biopsy or bronchial brushing. The best method for the rapid diagnosis of pneumocystis is endobronchial brushing, because it is simple, effect and has few complications.

Adult↗
PubMed1979

[Pulmonary hypertension and fetal circulation after severe congenital diaphragmatic hernia (author's transl)].

The authors present four new born with severe anoxemia after congenital diaphragmatic hernia repair. In three babies' hypoxemia was present from birth. Cardiac catheterization revealed pulmonary hypertension, resulting in a state of fetal circulation. Tolazoline produced an improvement in oxygenation, but became secondary ineffective. In one case ductus arteriosus was occluded during cardiac catheterization, after which immediate improvement in peripheral oxygenation was seen. Ligation of the patient ductus arteriosus was proposed in that case. In the fourth infant, hypoxemia developed secondary and was successfully treated with tolazoline. It is suggested that ligation of the patient ductus arteriosus and administration of pulmonary vasodilatators are both effective in improving oxygenation, in patients who may die an anoxic death after repair of a severe congenital diaphragmatic hernia.

Ductus Arteriosus, Patent↗
PubMed1979

[Hemineurine: an always present hazard in children].

Chlormethiazole, a hypnotic and sedative drug that selectively inhibits the cerebral cortex is occasionally used in status epilepticus in children. A child aged 18 months is described who developed toxic side effects. This drug, given as an alcoholic solution is highly toxic if used inappropriately.

Alcoholic Intoxication↗
PubMed1979

[Severity factors of poisoning in children admitted to intensive care units].

From 1964 to 1976, 854 children were admitted with poisoning to three intensive care units in Paris. The severity of the condition has been assessed in terms of the patients received: 1. observation only (67%). 2. routine intensive care (27%). 3. very seriously ill (6%). At the time of discharge, 92% of children were normal, 3% had minor sequelae, 3% had major sequelae; 2% died. The outcome was closely related to the severity of the illness. The main factors affecting the severity were: 1. The nature of the ingested substance. Poisoning with Amanita phalloides was the most serious with a high mortality. Poisoning with domestic agricultural and industrial products were more often responsible for major sequelae, particularly affecting the oesophagus, than drugs. 2. The type of poisoning. This was related to the age of the child. Iatrogenic poisoning of infants and self poisoning by adolescents were more serious than accidental poisoning in toddlers. 3. The toxicity of the ingested dose. 4. The interval between ingestion and effective treatment. Although all the factors are interrelated, each factor has its own prognostic value.

Adolescent↗
PubMed1979

[An assessment of caustic oesophageal burns in the child (author's transl)].

68 patients who might have had a caustic oesophageal burn were observed in the E.N.T. department of Enfants Malades Hospital between 1973 and 1977. We describe the causes, the age, the character of the burns analysed after systematic oesophagoscopy, and treatment. The results are studied taking into account the depth of the burn, the nature of the toxic agent and the therapeutic possibilities.

Adolescent↗
PubMed1979

[Results of bronchial scrapings in interstitial pulmonary diseases in immunodeficient children (author's transl)].

Endobronchial scraping was used in 53 immunodeficient children, aged 4 months to 15 years, and divided into three categories (37 receiving immunosuppression treatment, 8 with marasmus, and 8 with immunodeficiency), in order to determine the etiology of their interstitial pneumopathy. The examination was made under blind conditions in 21 cases using an intubation tube (under assisted ventilation), and with bronchoscopy under general anesthesia in the other 32 cases. Three scrapings were required for cytological, bacteriological, and virological and mycological examinations. In 32 cases (60%), the etiology of the interstitial pneumopathy was discovered; in 18 patients it was due to pneumocystis carinii, in 10 cases to bacterial infection, in 7 cases a viral infection, and in 3 others a fungal infection. An association of infective agents was reported in 6 cases. The major incident observed was a pneumothorax in 17% of the cases, more especially in 45% of the children under 20 months of age. Bronchial scraping is a valid examination the results and complications of which compare well with other non-vascular methods of diagnostic evaluation of such lesions.

Adolescent↗