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Biomedical subjects

P Reinert

Publications and source records attributed to P Reinert.

At least 19 recordsLinked to original sources
PubMed1998

Role of bilirubin in the regulation of the total peroxyl radical trapping antioxidant activity of plasma in sickle cell disease.

Alpha-tocopherol and bilirubin antioxidant properties were evaluated in sickle cell disease. The total peroxyl radical trapping antioxidant activity of plasma (TRAP) was measured with a polarographic method using hemin as oxidative stress initiator. The TRAP was not correlated with plasma alpha-tocopherol concentration. The TRAP was correlated with plasma total bilirubin concentration [TRAP = 8.1 (total bilirubin) +363.7 (r = 0.67)] and the correlation was even better with the sum (alpha-tocopherol + total bilirubin) plasma concentration [TRAP = 9.1(alpha-tocopherol + total bilirubin)+ 170.5(r = 0.77)]. The alpha-tocopherol contribution in the antioxidant capacity of plasma was significant but bilirubin level acted as the limiting factor of plasma antioxidant capacity in sickle cell anemia. This result can be explained by the antioxidant property of bilirubin but also by coantioxidant activity towards oxidized alpha-tocopherol.

Anemia, Sickle Cell↗
PubMed1998

[Immunization schedule in the European Union].

All nations that are part of the European Union share the same aim for the control and eradication of vaccine-preventable diseases. However, there are differences in child immunization strategies and schedules between nations, depending upon health care systems, immunization habits and epidemiology of infectious diseases. All nations immunize children against diphtheria, tetanus, poliomyelitis, measles, rubella and mumps. Immunization against pertussis, Haemophilus influenzae, hepatitis B and tuberculosis are not systematically applied.

Adolescent↗
PubMed1998

[Plea for an evaluation of beta hemolytic streptococcal tonsillitis: from diagnosis to treatment].

There is no justification to maintain a systematic antibiotic treatment of all tonsillitis as currently practiced in France. Indeed, it is today possible to exclude the streptococcal origin of tonsillitis with a fair probability using a rapid diagnosis test. It is therefore mandatory that these tests are made available to the French practitioner. Additionally, alternatives to the classical 10-day penicillin V treatment of streptococcal tonsillitis must be seriously considered: shorter duration treatment with oral cephalosporins, macrolides or amoxicillin have proved to be as efficient and of lower cost; they are also probably safer due to a better compliance related to the shorter duration.

Child↗
PubMed1998

[Exploration of 112 children suspected of amoxicillin allergy. Indications and efficacy of oral provocation test].

BACKGROUND: One to 10% of treatments using betalactams, particularly synthetic penicillin, are complicated by allergic reactions, usually cutaneous, and not easily imputable to immunologic sensitization in children. PATIENTS AND METHODS: The aim of this study was to identify, using cutaneous and biological tests, those from a group of 112 children suspected of amoxicillin allergy (evidenced by rash) who were actually sensitized, and to confirm the absence of allergy in others by an oral provocation test (OPT) associated to a long-term survey. The cutaneous tests were made by prick test and intra-dermo reaction (IDR) with Allergopen and with amoxicillin or amoxicillin + clavulanic acid. The biological tests included examination for penicillin and amoxicillin antibodies by using various techniques including enzyme-linked immunosorbent assay (ELISA) immunoglobulin G (IgG) and IgE, FARR, radioallergo sorbent test (RAST) and a histaminoliberation. When these tests were negative, an OPT with the suspected antibiotic was subsequently performed. RESULTS: Thirty-nine children (36.4%) confidently presented at least one positive cutaneous test (38 Allergopen, ten amoxicillin); 25 biological tests were positive (16 ELISA IgE, one ELISA IgG and eight histaminolibarations), seven times with negative cutaneous test. Forty-five children were judged to be sensitized to amoxicillin, with only one who subsequently took amoxicillin again. Among the 67 others, 52 received an OPT, six of them with moderate cutaneous reactions. Fifty-one (45.5%) children were allergic and 46 (41%) were allowed to take amoxicillin again; 17 did, one of them with a benign cutaneous reaction. CONCLUSION: Efficacy and safety of this type of investigation seems clear; it will have to be confirmed by other studies.

Adolescent↗
PubMed1997

Incidence of primary ciliary dyskinesia in children with recurrent respiratory diseases.

The goal of the study was to evaluate the incidence of primary ciliary dyskinesia (PCD) in children suffering from recurrent respiratory tract infections (RRIs) by means of noninvasive method. Respiratory ciliated cells were collected by nasal brushing in 118 children (4.6 +/- 2.5 years) with RRIs. The ciliary beat frequency (CBF) was measured with a stroboscopic method, and when the CBF was abnormal, the ciliary ultrastructure was analyzed by a quantitative method. The CBF could be measured in 106 patients (90%) and was abnormal in 15 patients. The ciliary ultrastructure was found to be abnormal in 11 of 15 patients: PCD was diagnosed in 6 cases, and acquired ciliary defects were observed in the remaining 5 patients. Our conclusion, that PCD is rare but net exceptional (5.6%) in children with RRIs, justifies the systematic investigation of ciliated cells in such patients. For this purpose, nasal brushing can be used to sample ciliated cells even in young children.

Algorithms↗
PubMed1997

[Endoscopic endonasal ethmoidectomy in severe sinusitis of cystic fibrosis. Mid-term results in 12 patients].

UNLABELLED: Sinusitis, with sometimes severe symptoms, are frequent in cystic fibrosis (CF). The aim of this mild-term retrospective study was to evaluate the functional and anatomical results of functional endoscopic ethmoidectomy (FEE) in 12 patients with CF. Nasal polyposis (9 cases) and medialization of the nasomaxillary wall (3 cases) were detected during endoscopic examination. Bilateral and multifocal opacities of the paranasal sinuses were present on the CT-scan images in all cases. A FEE was performed in 11 cases and in 1 case, only the anterior ethmoid was opened. Symptoms improved or disappeared in 9/12 cases between 1 and 3 years of follow-up and in 5/7 cases after 3 years of follow-up. A good or mild anatomical result was recorded in 6/12 cases between 1 and 3 years of follow-up and in 5/7 cases after 3 years of follow-up. During follow-up, a new surgical procedure (limited in 8 patients and complete in 3 patients) was often necessary. CONCLUSION: It is reasonable to propose FEE in CF patients with chronic sinusitis presenting severe symptoms with the aim of a substantial functional but not anatomical improvement.

Adolescent↗
PubMed1996

Cost-effectiveness evaluation of vaccination against Haemophilus influenzae invasive diseases in France.

A cost-effectiveness analysis of a vaccination program against Haemophilus influenzae type b (Hib) was conducted using French epidemiological data. The vaccine would be added as a fifth valence to the tetravalent vaccines (DTCP) widely used in France. The permanent sequelae of the Hib invasive diseases which might be avoided by vaccination were weighted to determine Quality Adjusted Life Years gained. In a stable French population of 3,746,000 children aged < 5 years old (1990), and for a followup period of ten years, the cost-effectiveness ratio of such a program for the French national health insurance system would equal 54,084 FF per year of life added or 34,050 FF per QALY. The net cost of the program during that period would be 1.02 billion FF for the French national health insurance system and 920 million FF for patients' families. Comparison of these projections with available information supports, a posteriori, the decision of the French government to authorize the licensing of the pentavalent vaccine.

Child, Preschool↗
PubMed1996

[Trial of prevention of severe Haemophilus influenzae type b infections and trial of tolerance, after PRP-T vaccination, in the Val-de-Marne region].

BACKGROUND: Protein-polysaccharide conjugate H influenzae vaccine is now routinely recommended for infants. To assess the vaccine's protective efficacy against invasive H influenzae infections and its safety, we conducted a study in the Val-de-Marne area of France. METHODS: From April 1991 to April 1993, 22,443 children less than 5 years of age were given PRP-T vaccine. Infants less than 6 months were given three doses whereas those between 6 and 12 months received only two doses, and children over 1 year of age received one dose. According to the infant's DTP-IPV vaccination status, PRP-T was administered alone or reconstituted extemporaneously with DTP-IPV. The immunogenicity of the conjugate vaccine was assessed after three doses in 100 infants under the age of 6 months. RESULTS: The PRP-T vaccine administered alone was safe. The reactions were more frequent when PRP-T vaccine was combined with DTP-IPV vaccine but they were comparable in frequency and severity to those observed after DTP-IPV vaccination. Before 1992, 18 Hib infections were reported each year in the Val-de-Marne region. During the study, only three Hib infections were reported each year. CONCLUSIONS: The fall in incidence of Hib infections, greater than expected, suggests a widespread immune effect of the vaccine, possibly due to a decrease in Hib nasopharyngeal carriage. The antibody titres to each component of vaccine were comparable to those observed in previous clinical infant studies.

Antibodies, Viral↗
PubMed1996

[Sickle cell anemia: study of the pediatric mortality in Ile de France from 1985 to 1992].

BACKGROUND: Sickle cell anemia is now relatively frequent in France. Its clinical course is punctuated by acute episodes that threaten the life, specially during the first year of life. POPULATION AND METHODS: The files of 26 children (14 boys, 12 girls) dead from sickle cell disease between 1985 and 1992 were retrospectively studied. These files concerned patients from the Ile-de-France area. RESULTS: Their mean age at time of diagnosis was 13.7 months (0 to 3 years 4 months); mean age was 5.5 years at time of death. Infection was the cause of death in 15 patients (S pneumoniae in eight patients despite prophylactic penicillin and pneumococcal vaccine in the majority of them). Splenic sequestration crisis was the cause of death in three patients less than 5 years of age; vasocclusive crisis resulting in cerebral infarction was the cause in three patients aged 7.5 to 13 years. Mortality calculated from those patients followed since 1987 (total: 2,063 years) was 0.29% person/year. CONCLUSION: Comfort of patients and risk of permanent disability become the main factors of choice for new treatments such as chemotherapy or bone marrow transplantation.

Adolescent↗
PubMed1996

Interstrain variations in the cytomegalovirus (CMV) glycoprotein B gene sequence among CMV-infected children attending six day care centers.

Using the shell vial assay and sequence analysis of a variable region of the glycoprotein B (gB) gene, cytomegalovirus (CMV) excretion rates in urine and virus transmission were studied among 93 children from six day care centers (DCCs). During a 6-month period, excretion rates differed significantly between DCCs (P < .001). The 6 gB gene sequences, obtained from 24 CMV-infected children, were classified in four previously defined groups. In five DCCs, 2 or 3 strains cocirculated, and none was dominant. Infection could have been acquired outside the DCC for 2 children and inside it for 9. Two children from the same DCC had mixed infections. No differences in hygiene, child care practices, or experience and level of qualification of the staff could explain this wide variety of excretion rates between DCCs. The distribution of gB gene patterns observed does not suggest that 1 type was dominant or more efficiently transmitted.

Base Sequence↗
PubMed1996

Interaction of macrolides with alpha dornase during DNA hydrolysis.

Since patients with cystic fibrosis are often treated with alpha dornase to reduce sputum viscosity, and because of preliminary reports of efficacy of long-term low-dose erythromycin therapy in chronic airway diseases, it is likely that alpha dornase and macrolides might be given together in such patients. A possible interaction between these drugs was therefore investigated. Using hyperchromic effect to quantify alpha dornase activity, a time- and dose-dependent inhibitory effect on human DNA hydrolysis has been observed for erythromycin, roxithromycin and azithromycin. Inhibitory doses 50% for alpha dornase were graphically determined. Azithromycin exhibited the strongest inhibitory effect.

Azithromycin↗
PubMed1995

[Polysaccharide subunit vaccines].

The polysaccharide capsules of many germs (pneumococcus, meningococcus, Haemophilus b, salmonella, etc.) can induce synthesis of protective antibodies in man. The development of many vaccines has been based on this phenomenon. Unfortunately, the polysaccharide antigens cannot trigger an immune response before the age of 2 years. In addition, they do not induce an anamnestic response, as do protein antigens. Great progress has been made by conjugating these polysaccharide antigens with protein antigens (tetanus and diphtheria antigens in particular). The resulting novel antigen induces a thymus-dependent response in man, leading to immunogenicity from the first weeks of life, and to a higher and more durable antibody response. On subsequent administration, such conjugated vaccines provoke a booster effect. In practice, the anti-Haemophilus b conjugated vaccine has obtained spectacular results in prevention of meningitis, with an effectiveness close to 100%. Results of the first trials of conjugated anti-pneumococcal vaccines suggest that they may constitute an effective new means of combating the emerging pneumococcal strains resistant to penicillin.

Bacterial Vaccines↗
PubMed1995

Successful engraftment after autologous transplantation of 10-day cultured bone marrow activated by interleukin 2 in patients with acute lymphoblastic leukemia.

Disease recurrence remains the major problem in autologous bone marrow transplantation (BMT) for hematologic malignancies. To improve the therapeutic efficiency of autologous BMT, we investigated the use of autologous marrow activated in vitro with interleukin 2 (IL-2) to generate killer cells for in vivo purging. A feasibility trial was initiated in 5 patients with poor prognosis acute lymphoblastic leukemia, who were transplanted, after marrow ablative therapy, with autologous marrow cultured for 10 days with 10(3) units of IL-2/ml. A highly significant increase in NK activity and an induction of LAK activity were observed after incubation. Patients received 0.64 to 1.56 X 10(8) cultured BM cells/kg and 1.87 to 44.8 x 10(4) CFU-GM/kg. Four patients engrafted and achieved granulocyte counts > 0.5 x 10(9)/l on days 35, 24, 36 and 22 after transplant. Three of these patients showed platelet recovery to > 50 x10(9)/l on days 25, 42 and 40 after transplant. One patient remained thrombocytopenic until relapse. One patient died on day 12 after transplant. This study demonstrates that cultured BM activated with IL-2 can be used successfully for hematological rescue in the clinical setting.

Bone Marrow↗
PubMed1995

[Effects of azithromycin on the virulence of Pseudomonas aeruginosa].

Pseudomonas aeruginosa is a saprophyte opportunistic bacteria which frequently colonizes the respiratory tract of patients presenting a severe chronic bronchitis pathology. Secreting a number of exotoxins and enzymes inducing an inflammation and necrosing of the surrounding tissues, it provokes irreversible pulmonary lesions. Different experimental in vitro works evidenced macrolides activity on the production and/or secretion of these factors, with a diminution of elastase, protease, lecithinase and D-nase synthesis. Among the macrolides, azithromycin seems to have the most pronounced activity. In vivo, some patients suffering from bronchiolitis or cystic fibrosis have been clinically improved with a treatment using erythromycin, or clarithromycin or azithromycin. These very preliminary results demand to be confirmed but the macrolides could allow a decrease of Pseudomonas aeruginosa pathogenicity and thus stop the deterioration of pulmonary functions.

Anti-Bacterial Agents↗