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Biomedical subjects

P Cochat

Publications and source records attributed to P Cochat.

At least 181 records · Page 10Linked to original sources
PubMed1988

[Metastatic neuroblastoma with secondary hypersecretion of vasoactive intestinal peptide].

A 18-month-old boy with stage 4 neuroblastoma needed intensive care because of prerenal acute renal failure related to an intractable watery diarrhoea syndrome occurring 10 months after the diagnosis of the primary tumor. This diarrhoea was in relation with a late hyperproduction of vasoactive intestinal peptide by the relapsing neuroblastoma itself and stopped with intravenous somatostatin administration.

Diarrhea, Infantile↗
PubMed1988

[Treatment of hypertensive attacks in children with nicardipine].

A prospective study of the hypotensive effects of nicardipine has been performed during 65 administrations of the drug in 6 children with malignant hypertension. We conclude that this calcium channel blocker is useful to treat hypertensive emergency in children owing to its tolerance and its efficacy (mean arterial blood pressure was lowered by 28 to 38% after 90 min). In addition, it ensures the maintenance of cerebral, renal and myocardial blood flow. A posology of 1 mg/kg/dose, 3 or 4 times/day (oral route) seems to be sufficient, as its effects last 6 to 10 h. Nevertheless the control of acute arterial hypertension must always be associated with the introduction or adjustment of long-term antihypertensive therapy.

Acute Disease↗
PubMed1988

[Resuscitation of children in the brain death state from the view of organ procurement for therapeutic purposes].

Thirty-six brain-dead children were managed to allow organ harvesting, which was possible in 21 (7 multi-organ). Optimal ventilation allowed for normal PaO2 and PaCO2 (mean +/- SEM FiO2 = 0.50 +/- 0.05). The management of hemodynamics was quite difficult and cardiac arrest may be due to patient transport, electrolyte disorders and dehydration. Vascular filling was of main importance and required standard solutes (5 or 2.5% glucose, normal saline, Ringer lactate) at a rate of 3.0 +/- 0.5 ml/kg/h, adapted for electrolytes (mainly KCl); sometimes, other solutes may be used: blood (17 patients), human 20% serum albumin (17 patients), plasma (9 patients). This filling was sufficient for 15 patients; the others required inotropic agents: dopamine (17 +/- 8 micrograms/kg/min), dobutamine (42 +/- 18 micrograms/kg/min). Diuresis was more than 3 ml/kg/h in 38% of the patients and desmopressin was used in 3 cases. Hypothermia (minimum 31.2 degrees) had no major consequence. No infection was found. Quality of management of brain-dead patients is of main importance; the possibility of organ harvesting must be evoked in such situations and is the first step in organ transplantations.

Adolescent↗
PubMed1987

[Scriver type autosomal hypophosphatemic rachitis: a family case].

A familial observation of hypophosphatemic rickets with unusual inheritance and evolution, different from that of X linked hypophosphatemia, is reported. The mode of inheritance was autosomal dominant, a father and his son being affected. Severe early signs of rickets and delayed growth were present in both cases. Plasma 1,25 dihydroxyvitamin D and PTH levels were normal. There was no hypercalciuria. Complete cure of rickets and catch-up growth were obtained with the only treatment of vitamin D (40,000 U/day) in the father and of 1 alpha hydroxyvitamin D (1 microgram/day) in the son. This observation is quite similar to the 'autosomal hypophosphatemic bone disease' described by Scriver et al. It illustrates the heterogeneity of familial hypophosphatemia which presently includes 4 different physiopathological entities.

Genes, Dominant↗
PubMed1987

[Carbonic anhydrase II deficiency: osteopetrosis, renal tubular acidosis and intracranial calcifications. Review of the literature and 3 cases].

Three children in two unrelated families are affected by carbonic anhydrase II (CA II) deficiency. This disease has been reported in 27 other patients to date; the study of the pedigrees indicates that it is supported by autosomal recessive inheritance. All the patients have a very high CA I/CA II ratio (greater than 10(4) versus 6 to 10 in controls) and carrier detection is possible in obligate heterozygotes (CA I/CA II = 12 to 17). The clinical presentation consists in renal tubular acidosis, osteopetrosis and cerebral calcifications. The long term follow-up of these patients shows that the prognosis is mainly of neurological and mental expression.

Acidosis, Renal Tubular↗
PubMed1987

[A migrating ear of barley: a curious story of an intrabronchial foreign body].

A case of migrating inhaled ear of barley in a 2 1/2 year old boy is reported with: 1) mild initial symptoms at the time of inhalation followed by a symptomless interval of 8 days; 2) at day 9 fever and dyspnea, right paracardiac infiltrate with pleural reaction on X-rays, normal bronchoscopy; 3) at day 11 extensive right pneumothorax; 4) at day 20, right axillary inflammatory lesion; 5) at day 28 expulsion of an ear of barley from this lesion, followed by complete recovery.

Axilla↗
PubMed1987

[The role of immunosuppressive agents in the treatment of nephrosis in children].

Good clinical results are well known with the use of immunosuppressive therapy in children with idiopathic nephrotic syndrome; more recently, biological data have enhanced immunological anomalies, concerning mainly T helper lymphocytes. The need for steroids may decrease when relapsing nephrotic syndrome is associated with steroid intoxication and is absent when corticoresistance occurs. In these cases, the use of immunosuppressive agents is justified, but limited by side effects and toxicity. In patients treated with alkylating agents and now cyclosporine, good responses are often seen in frequently relapsing children whereas the course of steroid-resistant nephrotic syndrome is not significantly modified. However, the definite appreciation of such therapeutic results has to be further precised by both histological data and multicentric studies concerning new protocols.

Adrenal Cortex Hormones↗
PubMed1987

[Value of blood creatinine in children].

Non-standardized values of serum creatinine are studied in 205 children aged 3 months to 12 years. Data are collected from paediatric patients hospitalised for mild illness without previous renal impairment; these values are quite comparable to those related in the literature based or standardised methods. The normal age-dependent serum creatinine values (mean +/- 2 SD) are shown in a graphic curve, which confirms that serum creatinine increases with age and that it is a faithful parameter to estimate the glomerular filtration rate in children.

Aging↗
PubMed1987

[Urinary sediment in acute renal failure].

Over a one-year period, 31 episodes of acute renal failure in children have been studied for urine sediment by contrast phase microscopy (maintained diuresis: 15, oligoanuria: 16, dialysed patients: 9). The etiologies of acute renal failure were: sepsis = 8; nephrotoxicity = 7; hemolytic uremic syndrome = 5; acute nephritic syndrome = 3; hemodynamical changes = 4; obstructive renal failure = 2; others = 3; acute rejections after renal allograft were excluded. The first urine sediment examination was performed 5 days after the onset of renal failure, and has been controlled in 11 children. In 28 cases (90%), there was a good correlation between clinical, biological, ultrasonographic and pathological (4 cases) data. The mechanism of renal failure has been determined by urine sediment examination in most cases, sometimes allowing to rectify a previous diagnosis. The value of this examination seems to be more of anatomoclinical than of prognostic interest, mainly for definite (hemolytic uremic syndrome) or polyfactorial (oncohematological diseases) renal dysfunctions.

Acute Kidney Injury↗
PubMed1987

Cyclosporine A nephrotoxicity: evidence for mesangial foam-cells in dogs.

Nephrotoxicity of cyclosporine A was studied in dog after 3 weeks' administration of the drug at high doses (20 mg/kg/day). Cyclosporine A concentrations measured in different organs revealed a high ratio between renal tissue and plasma. Renal histopathology showed non-specific tubular lesions and glomerular modifications. There were lipids in the mesangial cells which took on a foamy aspect. Ultrastructural study and lipid staining confirmed these findings, and non-specific esterase reaction revealed no macrophagic infiltration. Using anti-CSA antibodies it was not possible to demonstrate CSA in the mesangial cells. This alteration has never been described before in CSA therapy and its meaning is not clear; however, it does suggest that there occur modifications in the lipid metabolism or in the phagocytic function of the mesangial cells when cyclosporine A is administered over long periods.

Animals↗
PubMed1987

[Urinary tract infections in children. Status in a pediatric hospital and sensitivity of bacterial strains to amoxycillin-clavulanic acid combination].

Three hundred bacterial strains from positive urine cultures were isolated over a 10 months period in paediatric hospitalized and out-patients. In addition to commonly used antibiotics, each strain was tested for amoxycillin-clavulanic acid (Augmentin, Beecham) susceptibility. This antibiotic, which is a potent inhibitor of bacterial beta lactamases, may be of interest in the treatment of urinary tract infections because of its pharmacokinetics and activity. The antibacterial activity of amoxycillin and Augmentin against Enterobacteriaceae with special reference to Escherichia coli was compared. The resistance phenotype of Enterobacteriaceae to amoxycillin, carbenicillin and cephalothin allows to anticipate the nature of the beta-lactamase produced by a particular strain, and infer the activity of Augmentin. The overall activity of Augmentin should be interpreted taking into account the resistance phenotypes. In our study, Augmentin was active against 90% of E. coli strains, almost all Proteus mirabilis and vulgaris strains but 9 out of 24 Klebsiella strains were resistant. Augmentin had no activity against nosocomial Enterobacteriaceae, nor against Pseudomonas aeruginosa. On the other hand, its activity was of interest against penicillinase producing Staphylococcus. Our results confirm the interest of Augmentin as a preferential treatment of urinary tract infections in children.

Amoxicillin↗
PubMed1986

Cerebral atrophy and nephropathic cystinosis.

The management of end stage renal failure in cystinotic children is correlated with a longer survival, sometimes complicated with neurological abnormalities. Cranial computed tomography was performed in 10 patients and showed a significant atrophy; the pathogenesis of this damage remains unclear.

Adolescent↗
PubMed1986

[Acute parvovirus B 19-induced erythroblastopenia and hereditary spherocytosis. Apropos of 1 pediatric case and review of the literature].

Authors report a new case of acute erythroblastopenia linked to a parvovirus B 19 infection by a 10 years old boy suffering from an hereditary spherocytosis. Aurillac antigen or parvovirus B 19 is one of the smallest virus to be known. It has been well demonstrated in vitro that the virus inhibits especially erythropoiesis but mechanism remains unclear. Systematic vaccination of all children at risk with congenital or acquired chronic haemolytic anaemia should be in the near future the best prophylaxis of parvovirus B 19 infections.

Acute Disease↗