[Endocrine complications of radiotherapy in children].
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Child↗
Biomedical subjects
J M Garnier
Publications and source records attributed to J M Garnier.
[Cefotaxime in childhood infections (author's transl)].
Cefotaxime was administered to 20 patients suffering from severe bacterial infections. Four were newborn babies, seven were infants, and nine were children. The infections treated included 9 bronchopulmonary infections and 6 urinary tract infections. In 9 patients, the infecting organism was identified: E. coli (3), Klebsiella (2), Staphylococcus aureus (3), and Proteus (1). Except in one case, cefotaxime was administered alone at doses of 50 to 100 mg/kg every 12 hours. The route of administration was intramuscular. 4 patients had already received unsuccessful antimicrobial therapy. All patients were clinically cured. In those with pneumonia, the clinical and radiological response was very prompt; in urinary tract infections, the temperature returned to normal in less than 48 hours. The local and general tolerance was always good. It may be concluded from these results that cefotaxime, a new parenteral cephalosporin, is especially useful and should prove particularly effective in severe infectious conditions found in pediatric practice.
Adolescent↗
Duchenne type muscular dystrophy and consanguinity: difficulties in pedigree analysis.
We report the case of a 2-year-old girl who had signs of Duchenne type muscular dystrophy on clinical, electromyographic, laboratory, and pathological examination. The parents of the child are first cousins. A brother and nephew of the mother also had Duchenne type muscular dystrophy. Karyotype analysis in the proband showed both X chromosomes to be morphologically normal. The mother had very high plasma CK levels, equivalent to those observed in carriers of the disease. We discuss different hypothetical mechanisms designed to account for the family pedigree.
Biopsy↗
[Malaria in childhood and G6PD deficiency. Report of three cases].
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Adolescent↗
[Letter: Serum copper-iron imbalance in bronchopulmonary cancers and in severe pulmonary tuberculosis].
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Alpha-Globulins↗
Choice of therapy for imported cases of falciparum malaria in children: a retrospective study of 100 cases seen in Marseilles, France.
We have carried out a retrospective study on 100 children in hospital in Marseilles, France with a diagnosis of Plasmodium falciparum malaria. On admission, the main clinical features were anaemia (90 cases), fever (83 cases, > 40 degrees C in 22 cases), hepatomegaly (44 cases), vomiting (29 cases), neurological signs (22 cases), thrombocytopenia (13 cases), hyperparasitaemia (6 cases), jaundice (4 cases), shock (1 case) and hypoglycaemia (1 case). Severe malaria, as defined by the World Health Organization Malaria Action Programme, was rare in our study (only 2 cases) and the prognosis was good (no death, no sequela). The search for neurological signs such as impaired consciousness, prostration or convulsions is an effective and simple way to diagnose potentially severe cases. In the presence of these signs, intravenous quinine treatment resulted in a shortened duration of fever (30 h instead of 63 h) and thereby avoided patients becoming worse. In children without neurological signs or persistent vomiting, oral therapy may be used even if there is high fever or hyperparasitaemia, but close surveillance is required. Patients treated with halofantrine or mefloquine had a shorter stay in hospital than those treated with chloroquine (mean = 4 d instead of 5.7 d). The resistance of some strains to chloroquine may explain this difference.
Administration, Oral↗
Evidence for autoimmune antibodies directed against embryonic neural cell adhesion molecules (N-CAM) in patients with group B meningitis.
Human brain tissue shares alpha 2-8 linked polymers of neuraminic acid with the carbohydrates expressed on the capsule of group B Neisseria meningitidis bacteria (Finne et al. (1983) Lancet ii, 355-357; Finne (1985) Trends Biochem. Sci. 10, 129-132; Rougon et al. (1986) J. Cell. Biol. 103, 2429-2437). We report that sera from patients suffering from group B meningitis exhibited IgM antibodies directed against the embryonic, but not the adult, form of neural cell adhesion molecules (N-CAM). These sera also stained live ATt20 cells as well as neuron membranes in mouse embryonic brain cultures. We have demonstrated that such antibodies, directed against carbohydrate moieties of bacterial capsula, were able to lyse cells expressing embryonic N-CAM in a complement-dependent cytotoxic assay. These data infer (1) that humans are able to develop anti-MenB humoral responses, (2) that such responses could initiate autoimmune disorders or be potentially detrimental by interfering with processes mediated by N-CAM interactions, (3) that the development of a vaccine against group B meningitidis should be considered with caution.
Antibodies, Bacterial↗
High concentrations of 2-5A, the interferon intracellular mediator, in the blood of children with acute viral infections.
We measured the concentration of 2-5A (2',5'-oligoadenylate), an intracellular mediator of the antiviral action of interferon, in the blood of children with acute viral and bacterial infectious diseases. 2-5A concentration was found to be elevated in several children with viral diseases. This elevation seemed transient and was not specific for viral infections. We provide arguments for the use of 2-5A as a marker of the evolution of diagnosed viral diseases.
Acute Disease↗
Keratitis, ichthyosis, and deafness (KID) syndrome in half sibs.
The keratitis, ichthyosis, and deafness (KID) syndrome is a rare congenital disorder of the ectoderm characterized by diffuse hyperkeratotic erythroderma, keratitis with neovascularization of the cornea, and severe neurosensory hearing loss. A familial occurrence of this syndrome has been mentioned in four reports including three of vertical transmission and one of two affected sisters born from consanguineous, unaffected parents. We report for the first time a familial case of KID syndrome in two half siblings born to the same unaffected mother. This new observation allows us to propose various hypotheses about its mode of inheritance.
Child, Preschool↗
Visits to the emergency room for asthma attacks and short-term variations in air pollution. A case-crossover study.
BACKGROUND: The 'case-crossover' design is a strategy fitted to studying transient effects of intermittent exposure on acute-onset disease occurring shortly after exposure. It has the important advantage of eliminating most confounding variables, allowing a stronger causality inference. OBJECTIVES: The objective of the study was to evaluate the relationships between emergency room (ER) visits for asthma attacks and gaseous air pollution changes. METHODS: The study included 549 individuals, 3-49 years old, visiting the ER during 1 year. Exposure to gaseous air pollutants (SO2, NO2, O3) on the same day and up to 4 days before was computed according to the patient's address. The statistical analysis included meteorological data as potential confounding variables. RESULTS: No association could be shown between ER visits and SO2 or NO2 levels. In contrast, there was a statistically significant association between ER visits and mean O3 levels, on the day of admission and also on D -2 and D -3. For an increase of 10 microg/m3, the risk of requiring an ER admission increased by 6-10%. CONCLUSIONS: Using this new strategy, we confirmed that ozone changes lead to a moderate increase in risk of requiring an ER admission in asthmatic subjects.
Adolescent↗
Epileptic nystagmus: electroclinical study of a case.
Epileptic nystagmus (EN) is a rare form of nystagmus that occurs only during epileptic seizures. We report a case in which EN was first noted in an 8 year-old boy. Neuro-imaging was normal. Sharp waves from the left occipital lobe characterised the interictal EEG. Ictal video-EEG showed the aspects of electric seizures during clinical manifestations e.g. nystagmus. Ambulatory EEG displayed numerous diurnal and nocturnal seizures, but exclusively in REM sleep. After two weeks of sodium valproate treatment, the seizures, EEG focus spikes and nystagmus, as well as the squint, disappeared. During a two-year follow-up the child had no further seizures, EEG was normal and the school performance was unaffected. This case has the main features of benign epilepsy, although there are unusual features such as epileptic nystagmus, permanent squint, reduction of EEG paroxysmal abnormalities during NREM, and the presence of seizures during REM sleep. The observation and the significance of EN are discussed with reference to the literature.
Anticonvulsants↗
[Purpuras fulminans: development over a 15-year period].
Eighty one children were admitted in ICU between 1969 and 1983. 35% of them died. There happened in the meantime an improvement in the results (12 deaths out of 30 children admitted in hospital from 1969 to 1974, 15 deaths out of 51 children from 1975 to 1983). The improvement was obvious in the tiniest children and the less severe cases; this is mostly owing to technical progress (hemodynamic control, sedation, artificial ventilation). Corticoids and heparin were not used, or exceptionally used since 1975. Mortality in severe cases did not change. It is important to point out the fact that the four children presenting a purpura fulminans secondary to an infection with Hemophilus Influenzae died.
Child↗
[Upper extremity abnormalities, thrombopenia and thrombopathy. 3 cases].
Three cases of congenital radial aplasia and amegakaryocytic thrombopenia are discussed from clinical, genetic and hematological viewpoints. Electron microscope studies of the megakaryocytes in the first two patients revealed the presence of microcytic, immature and hypogranular cells. Platelet aggregability studies in the first patient demonstrated the presence of pathological intra-platelet nucleotide release as well as membrane abnormalities of the Willebrand factor binding site. The second case presented an isolated deficiency in platelet factor 3.
Abnormalities, Multiple↗
[Duodenal tuberculosis associated with lymph node tuberculosis (apropos of a surgical case)].
The authors report a case of duodenum tuberculosis associated to a lymph gland tuberculosis. Diagnosis has been made possible only with an exploratory laparotomy justified by an almost total duodenum stenosis. They review the different aspects (pathogenic, anatomopathologic, clinical, radiological, therapeutic) of a disease non frequent but not exceptional, especially in the african countries.
Adult↗