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Biomedical subjects

M Boule

Publications and source records attributed to M Boule.

34 records · Page 2Linked to original sources
PubMed1985

[Respiratory function during wakefulness and sleep in a 7-year-old child with congenital alveolar hypoventilation of central origin].

Pulmonary function tests were performed in a 7 year-old girl with central alveolar hypoventilation syndrome treated with mechanical ventilation during sleep. Results showed: 1. during wakefulness decrease in residual functional capacity, in dynamic lung compliance and in lung transfer factor for CO; 2. during sleep the characteristics of the syndrome as reported in the neonatal period i.e. central alveolar hypoventilation in stages 2 and 3-4 which justified maintenance of mechanical ventilation when asleep.

Child↗
PubMed1984

Lung mechanics and breathing pattern during wakefulness and sleep in children with enlarged tonsils.

Thirteen children (mean age, 45 months) with nocturnal symptoms of upper airway obstruction, the result of enlarged tonsils, were tested during wakefulness (W) and sleep (S) induced by chloral hydrate (less than or equal to 50 mg/kg). During W, lung mechanics, blood gas, breathing pattern, and airflows during tidal breathing were in the normal range. During S, total lung resistance increased significantly, and dynamic lung compliance and transcutaneous PO2 decreased significantly. During S, the tidal volume (VT) and the mean inspiratory flow, normalized for body weight (BW), decreased whereas the ratio of the inspiratory time (TI) over the total duration of the respiratory cycle (TTOT) rose, indicating a longer contraction time of the respiratory muscles. The time to reach peak inspiratory flow, measured as a percentage of TI (dTI/TI), increased in seven children, with no change in the ratio of the expiratory flow over the inspiratory flow, both measured at 50% of VT (EF50/IF50). In three other patients dTI/TI decreased with an increase in EF50/IF50. We conclude that in children with enlarged tonsils, S modified lung mechanics, gas exchange, and the inspiratory components of the breathing pattern and airflow.

Airway Obstruction↗
PubMed1984

Comparison of transcutaneous and alveolar partial pressure of carbon dioxide during carbon dioxide breathing in healthy children.

In 18 healthy children three to 13 years of age, the transcutaneous partial pressure of carbon dioxide (PtcCO2) (Radiometer electrode) and the alveolar partial pressure of carbon dioxide (PACO2) (Beckman analyzer) were measured simultaneously during the breathing of room air and 5 percent carbon dioxide. The PtcCO2 electrode was placed on the anterior thorax and heated to 42 degrees C. The PACO2 was calculated on the 4/5 part of the carbon dioxide expired trace. Minute ventilation (VE) was measured in 11 cases. There was a significant correlation between PtcCO2 (in millimeters of mercury) and PACO2 (in millimeters of mercury) while breathing room air (PtcCO2 = 0.82 PACO2 + 19.7; r = 0.55; p less than 0.02) and while breathing 5 percent carbon dioxide (PtcCO2 = 0.77 PACO2 + 22.5; r = 0.61; p less than 0.01); however, the ratio of PtcCO2 over PACO2 was significantly lower while breathing 5 percent carbon dioxide (p less than 0.01) than while breathing room air. When considering the relationship between the increase in VE (delta VE while breathing 5 percent carbon dioxide and the changes in PACO2 (delta PACO2) or in PtcCO2 (delta PtcCO2), a significant correlation was found only between delta VE and delta PACO2, ie, delta VE = 0.41 delta PACO2 + 0.44 (r = 0.63; p less than 0.01). These results suggest that breathing carbon dioxide modified the factors acting on PtcCO2, possibly by changes in the vasomotor tone of cutaneous blood vessels. These modifications appeared to be variable from subject to subject. Therefore, we conclude that PtcCO2 does not appear to be an accurate quantitative index to assess ventilatory response to carbon dioxide.

Adolescent↗
PubMed1984

Lung function in children with hypersensitivity pneumonitis.

Pulmonary function tests were performed on 12 children with hypersensitivity pneumonitis (HP) aged from 4-15 years (10 with bird breeder's lung and 2 with farmer's lung). Lung volumes, lung mechanics (lung resistance, dynamic lung compliance (CLdyn], lung transfer factor for CO (TLCO), and blood gases were measured. Eleven children ceased to be exposed to the antigen, and the functional course was studied as a function of time after the cessation of exposure (CE). During the short term (less than 2 months after CE) initial hypoxemia was observed and CLdyn and TLCO were below normal. Two months after CE, blood gases were normal in most of the cases. A persistent hypoxemia appeared to be an unfavorable prognostic factor. CLdyn was normal by the eighth month after CE, while TLCO improved more slowly and remained significantly decreased in one case. In our series the children under 10 years had less functional abnormalities and normalized more rapidly than the older children. The one child without CE, had major functional abnormalities.

Adolescent↗
PubMed1984

Lung functional follow-up in children after severe viral infection.

Pulmonary function tests (PFT) were performed in 12 children after viral infection (VI) due to an adenovirus in 9 cases and occurring before the age of 4 in 10. Functional residual capacity (FRC), thoracic gas volume (TGV), total lung resistance (R1), dynamic lung compliance (C1dyn), expiratory flows and blood gases were measured during three periods after VI: from 3 to 12 months (n = 10), from 1 yr 6 months to 3 yr 8 months (n = 8), and from 4 yr 7 months to 8 yr (n = 6). In the short term period one child had normal PFT, while in the remaining cases there was increased R1, decreased C1dyn and hypoxemia. R1, C1dyn and blood gases did not significantly change between short and mid term periods. In the long term period the children had overinflation with trapped gases, airways obstruction and hypoxemia. These functional sequelae may be related to structural lesions due to VI and abnormal postnatal lung growth.

Adolescent↗
PubMed1983

[Sustained-action oral theophylline in the asthmatic child. Clinical, pharmacokinetic and respiratory function studies].

Twenty children aged between 5 and 16 suffering from severe asthma were treated with long acting oral theophylline. The minimum duration of treatment was three months and the maximum 12 months. Clinical, pharmacokinetic and pulmonary function studies were made. With a mean dose of 8.75 mg/kg, morning and evening, the theophylline blood levels on the 4th day of treatment (4 hours after the morning dose) were 12.3 +/- 4.36 mg/l. Those taken 4 hours after the evening dose 9.41 +/- 3.75 mg/l, suggesting a circadian rhythm for theophylline blood levels. The importance if fever is stressed in relationship to blood levels, which were increased by 67-100% with fevers of 38.5-39 degrees C. Treatment was very beneficial in 53% of cases. Respiratory function studies were performed in 13 children. After 4 days of treatment there was a significant decrease in airflow obstruction and hypoxemia However, despite carefully adjusted treatment, functional disturbances persisted, in particular hyperinflation.

Administration, Oral↗
PubMed1982

Control of breathing in children with interstitial lung disease.

Control of breathing at rest was studied in 14 children (4-16 years old) with interstitial lung disease (ILD). Four of them were tested several times. Breathing pattern and the mouth occlusion pressure (P0.1) were measured. Results in ILD children were compared to values in healthy children previously reported. Respiratory frequency and minute ventilation were increased (P less than 0.02). Inspiratory time (TI) was shortened (P less than 0.001), the shortening in TI being significantly related to the increase in lung elastance (EL). The ratio of TI to the total duration of the respiratory cycle (TI/TTOT) was lowered (P less than 0.01). Tidal volume (VT) both in ml and normalized for body weight (BW) was normal. P0.1 was higher than predicted. The increase in P0.1 was significantly related to change in arterial O2 pressure (PaO2) which was reduced in 10 cases. There was a significant relationship between the increase in P0.1 and in EL. The increase in mean inspiratory flow (VTBW/TI) was related to the increase in EL. But VTBW/TI was not increased as much as P0.1. Consequently the effective inspiratory impedance was enhanced. This high effective inspiratory impedance was related to the increased lung elastance.

Adolescent↗
PubMed1981

[Successive courses of intensive therapy in cystic fibrosis (author's transl)].

Twenty-four patients aged from 3 to 30 years and suffering from advanced cystic fibrosis received several courses of intensive antibiotic therapy combined with prolonged respiratory physiotherapy with postural drainage. Antibiotics included carbenicillin 500 mg/kg/day and aminoglycosides in high dosage (6 mg/kg/day). These treatments were administered to prevent aggravation of chronic bronchitis and to suppress acute exacerbations. Tolerance was satisfactory, and all patients felt better, at least during the first courses. Improvement was also observed in the main respiratory function parameters. In a total of 95 courses only two side-effects (severe dizziness and giant urticaria) were recorded. Intensive courses of combined antibiotic therapy associated with physiotherapy constitute a new way of treating severe, progressive cystic fibrosis. The patients are made comfortable, and their survival time is increased by several years.

Adolescent↗
PubMed1981

Occlusion pressure and breathing pattern in healthy children.

The breathing pattern was investigated in 62 children aged 4 to 16 years together with the mouth pressure generated 0.1 s after an occlusion at the endexpiratory level (P0.1). A group of 20 adults (18 to 32 years old) were tested in a similar way. The values of P0.1 obtained during room air breathing at rest in the children decreased with age as a power function P0.1 = 8.51 A-0.62 (where A is age in years), r = -0.74. Adult values of P0.1 were achieved at about 13 years. After O2 inhalation P0.1 decreased in children, but the changes in P0.1 were independent of age. Respiratory frequency decreased with age while inspiratory time (TI) increased, both reaching adult values at about 13 years. The ratio of TI over the total respiratory cycle duration did not change significantly with age in the entire population. The absolute value of tidal volume (VT) increased with age, but not when normalized for body weight (BW). The mean inspiratory flow (VT/TI) normalized for BW decreased with age in children as did P0.1. There was a significant relationship between P0.1 and VT/TI normalized for body weight (r = 0.63).

Adolescent↗
PubMed1979

Lung function in children with recurrent bronchitis.

Lung function was studied in 29 children suffering from recurrent bronchitis (average number of bronchitis attacks per year: 4.2 +/- 0.5). Most of them (73%) were 1--7 years old. The date of exploration in relation to the last acute bronchitis was on average 6 weeks. Lung mechanics, residual functional capacity, blood gases and regional lung function were measured. Most of the children were suffering from some kind of functional disorder; alteration of lung mechanics -- increase of lung resistance (22/29) decrease of dynamic compliance (15/23); increase of functional residual capacity (6/10), non specific bronchial hypersensitivity (12/17); regional ventilatory and perfusion malfunction. These functional disorders could be the first evidence of the bronchial lesions which cause chronic obstructive bronchitis in adults.

Bronchitis↗
PubMedDate not supplied

Pulmonary function at 1 year of age in survivors of neonatal respiratory distress: a multivariate analysis of factors associated with sequelae.

We studied pulmonary function 1 year after neonatal respiratory distress (RD) in 54 infants who had been treated at birth in the same neonatal intensive care unit. RD was related to hyaline membrane disease in 36 cases (group I) and to other causes in 18 cases (group II). Compared with predicted values, dynamic lung compliance (CL) was lower (less than -2 SD) and total pulmonary resistance (RL) was higher (+2 SD) in 18 (33%) and 12 (22%) infants, respectively. The relationships between these functional abnormalities at 1 year of age and the characteristics of the neonatal respiratory disease were assessed using a multifactorial analysis (multiple correspondences analysis). We found that elevated RL (greater than +2 SD) at 1 year of age was very significantly related with hyaline membrane disease, involving both high rate of positive pressure ventilation and prolonged intubation, and with the presence of both tachypnea and abnormal chest X rays at the time of discharge. Compared with elevated RL, the relationships between low CL (less than -2 SD) and the same neonatal characteristics were less significant; in particular, there was no strong link between low CL and hyaline membrane disease. Finally, birth before 30 weeks gestation was an index of severity.

Bronchopulmonary Dysplasia↗
PubMedDate not supplied

[Respiratory form mof myasthenia gravis].

BACKGROUND: Extraocular, facial, bulbar and intercostal muscles are frequently affected in juvenile myasthenia gravis, especially during exacerbations. Acetylcholine receptor antibodies are often present in the blood in this type of myasthenic syndrome. CASE REPORT: A girl presented with an exertional dyspnea at the age of 13 years, that improved after rest. All investigations were negative, except for lung function tests that showed a restrictive pattern. The diagnosis of juvenile myasthenia gravis was finally made at the age of 15 years because of the recurrence of sudden exertional dyspnea and a history of subtle weakness on repetitive movement leading to poor suckling, together with vocal and occasional swallowing difficulties. Dyspnea immediately improved after intravenous injection of 1 mg neostigmine, but the response was transient. No acetylcholine receptor antibody was found and a search for thymoma proved negative. Ambenonium chloride (Mytelase) was effective on clinical exacerbations, but the only improved test after 9 months of treatment was the functional residual capacity. CONCLUSION: Anticholinesterase drugs must be tried in patients who present exertional dyspnea without bronchopulmonary or cardiac disease on the presumption of myasthenia gravis even when ocular or bulbar manifestations are absent.

Adolescent↗