Search PubMed⌕ Search

Biomedical subjects

P Reinert

Publications and source records attributed to P Reinert.

At least 91 records · Page 5Linked to original sources
PubMed1991

[An open randomized trial, Pediazole versus cefaclor in the treatment of acute otitis media in children].

The combination of erythromycin ethylsuccinate and acetyl sulfafuroxazole (Pediazole = ES) is effective against Hemophilus influenzae, including beta-lactamase-producing strains, and against Streptococcus pneumoniae, including macrolide-resistant strains. In this study, mean daily dosage was 40-50 mg/kg for cefaclor and 50 mg/kg ES + 150 mg/kg sulfamide for Pediazole. Both products were given in three divided doses per day for ten days. Tolerance was evaluable in 106 children and effectiveness in 103 children including 52 in the ES group and 51 in the cefaclor group. Mean age was 23.5 months and both groups were comparable as concerns age, weight, previous ENT disease, and severity of the otitis media. Tolerance was satisfactory in both groups. Clinical results were as follows: failures before or at completion of the course, 5/52 in the ES group versus 13/51 in the cefaclor for the treatment of children with acute otitis media.

Acute Disease↗
PubMed1990

[Accelerated statural growth in children. 26 cases].

From the present study devoted to the follow-up of 26 children (20 girls and 6 boys) having a tall stature, three major points have emerged: (1) an excessive acceleration of the speed of growth is characteristic of abnormal heights; (2) an endocrine disorder is responsible for the accelerated growth in 50 percent of the cases, and (3) when the cause cannot be determined or suspected by clinical examination, measurement of bone age is the first parameter to be requested.

Adolescent↗
PubMed1990

[Osteomyelitis in patient with sickle cell disease].

From 1977 to 1989, 23 children with sickle cell disease were identified as having 21 episodes of acute and 3 episodes of chronic osteomyelitis, respectively. The responsible organisms were found in 17 cases: Salmonella (12 cases), coagulase-negative Staphylococcus (3 cases). Haemophilus influenzae (1 case), Escherichia coli (1 case). The mean age was 7 7/12 years. In 15 patients, osteomyelitis occurred in 1 bone; osteomyelitis of more than one bone was recorded in 9 cases. The most commonly affected bone was the femur (7 episodes); 5 episodes of hand-foot syndrome with osteomyelitis occurred in children in the first 2 years of life (mean age 16 months). Two patients had a Salmonella vertebral osteomyelitis. Incision and drainage were performed in 5 cases and bone aspiration in 9 cases. Etiologic agents were obtained with these two procedures in respectively 5 and 3 cases. Radionuclide scans were used in 7 episodes: uptake on bone scan was increased in 5 cases and normal in 2. In all cases, the outcome was satisfactory. Differentiation from acute bone infarcts in difficult. An extensive workup is required to confirm the diagnosis of infection: early scintigraphy, bone aspiration or surgical biopsy in patients with negative blood cultures should be performed. Until the results of cultures, the antimicrobial regimen chosen for initial therapy should be broad enough to treat the likely etiologic agents including Salmonella.

Acute Disease↗
PubMed1990

[Kawasaki's disease with thrombocytopenia].

A thrombocytopenia has been observed at the initial stage of a mucocutaneous lymph node syndrome in a 8 year-old patient; it appeared at the 5th day of the disease in another 11 year-old patient. This unusual and unexplained transitory thrombocytopenia led to delayed administration of intravenous gammaglobulins.

Child↗
PubMed1990

[Delayed acute measles encephalitis].

Delayed acute encephalitis is a rare complication of measles that may occur either in immunodepressed patients or in patients without overt immunodepression. In the present series of 8 cases, diagnosis was made on CSF/serum measles antibody titre and/or intranuclear paramyxovirus nucleocapsides identified by electron microscopy in the central nervous system cells. The disease is characterized by the association of focal defects (monoparesis, hemiparesis, aphasia, a.s.o.) with periodic myoclonic jerks without major impairment of consciousness. The encephalitis lasted 2 to 4 weeks and 3 patients died. With the exception of 1 case, all the patients had severe sequelae after a follow-up of 1 to 9 years. The EEG showed diffuse polymorphous delta waves, with a predominance on the side opposite to the myoclonias and pseudoperiodic complexes in all cases. CT scan was abnormal in 4 of 6 cases, showing hypodense areas. Antiviral or immunogenic therapeutic trials were administered to 5 patients without clear improvement. Sensitive methods of antibody dosage seem to be useful for the early diagnosis of the disease.

Acute Disease↗
PubMed1989

[Macrophage activation syndrome linked to Epstein-Barr virus].

Epstein-Barr virus infection is one of the etiologies that should be discussed in patients with macrophage activation syndrome. We report a case that is consistent with this diagnosis. The role of the Epstein-Barr virus in the etiologic diagnosis of VAHS (virus-associated hemophagocytic syndrome) is specified. In pediatric patients with VAHS, the other causes of macrophage activation should also be discussed.

Child, Preschool↗
PubMed1989

[Imaging and the first urinary infection in children. Respective role of each test during the initial evaluation apropos of 122 cases].

122 pediatric patients with a first urinary tract infection underwent renal ultrasonography (US) and voiding cystourethrography (VCUG) to evaluate the usefulness of this association. The US was always the first examination undertaken, its sensitivity seems to be very good in detecting renal abnormalities. The major finding on the VCUG was the vesico-ureteral reflux: 25% of cases. When the sonogram and the VCUG are normal, 60% of cases, excretory urography is not considered necessary.

Child↗
PubMed1989

[Tolerance and immunogenicity of the capsular polyoside vaccine against Haemophilus influenzae type b. A study of 325 children 15 to 71 months of age].

The antigenic properties of the capsule polyoside (PRP) from Haemophilus influenzae type b (Hib) are adequate to form the basis for immunization designed to prevent the severe infections caused by this organism. The tolerance and immunogenicity of a vaccine containing either 12.5 or 25 micrograms PRP were studied in 325 healthy children aged 15 to 71 months after informed consent had been obtained from the parents. Each child was given one subcutaneous injection of 0.5 ml vaccine. Antibodies against Hib were assayed before and one month after the injection. Clinical tolerance was outstanding both locally (moderate and transient pain in 13% of cases) and systematically, with only eight (2.6%) febrile reactions in excess of 38.5 degrees C within 24 hours after the injection. A very significant rise in antibody titers was seen in all age groups, but a mean titer of 1 microgram/ml was achieved only in children aged 24 months or more. No significant difference was found between the two dosages. Individual analysis showed that following immunization antibody titers reached 0.15 micrograms/ml or more in 65% of infants aged 15 to 17 months, 71% of infants aged 18 to 23 months, 80% of infants aged 24 to 30 months and 95% of children older than 30 months. Despite the inadequate immune response evidenced in the younger age groups, our results confirm that Hib infections are preventable from the age of 2 years. Our results are consistent with those recorded with a similar vaccine in Finland.

Antibody Formation↗
PubMed1989

[Epidemiology of Haemophilus influenzae type b meningitis in 2 French departments].

Meningitis represents a frequent and severe expression of Haemophilus influenzae type b disease. The results of a 7 year-epidemiologic study (Jan 1980 to Dec 1986) undertaken in 2 French departments are reported herein. One hundred and twenty-three cases of meningitis were detected, representing a yearly rate of 15 cases for 100,000 children aged 0 to 4 years. The real incidence is probably higher and has been estimated as 17/100,000 which corresponds to 572 annual cases for the entire country. The death rate was 3.3% and severe sequelae were documented in 1.6%. To these should be added less severe neurologic (9%) and hearing (2.4%) deficits. These results show that the incidence of meningitis is comparable to the rate observed in Northern Europe but lower than the one reported in the United States. However, the rates of mortality and of neurologic deficit published in recent studies are comparable to those in the present report. Hearing sequelae are probably underestimated and would need systematic screening during the immediate follow-up period.

Child, Preschool↗
PubMed1989

[Epidemiology of Haemophilus influenzae type b infections (excluding meningitis) in 2 French departments].

The spectrum of severe Haemophilus influenzae type b disease exclusive of meningitis includes: epiglottitis, pneumonia, arthritis, septicemia, cellulitis and pericarditis. The results of a 7 year-epidemiologic study (Jan 1980 to Dec 1986) performed in 2 French departments are reported. Sixty-nine cases were detected, representing a yearly rate of 9/100,000 children aged 0 to 4 years. The real incidence is probably higher and was estimated as 11/100,000. In all of France, it corresponds to 382 annual cases and, more specifically to 60 to 70 annual cases of epiglottitis. No deaths were recorded and only 2 cases with minor sequelae were documented in this series. These results, as compared with those of previous studies, show that the incidence is lower than that in other countries, especially with regard to epiglottitis which is more frequent in North America and in Scandinavian countries.

Child, Preschool↗
PubMed1989

[A cry of alarm from non-university hospital pediatric departments. What future?].

A survey by questionnaire was carried out among pediatricians of the departments of pediatrics of the non university hospitals in France in order to know the activity and the conditions of work of these departments. Responses were obtained from 84 of the 140 departments of pediatrics. The results emphasized the important activity of these departments contrasting with frequent insufficiencies of the medical staff and equipment. Solutions are proposed in order to avoid an aggravation of the actual situation.

Forecasting↗
PubMed1988

Teicoplanin in combination therapy for febrile episodes in neutropenic and non-neutropenic paediatric patients.

The aim of this study was to assess the efficacy and safety of teicoplanin in combination with other antimicrobial agents for therapy of severe suspected or proven Gram-positive infection in children and also to determine a dosage regimen for paediatric patients. Twenty children were given 23 courses of teicoplanin therapy for 11 septicaemias, one erysipelas, one cellulitis and 11 cases of fever of unknown origin. Eighteen of the 20 patients had severe underlying disease: one solid tumour, 15 acute lymphoblastic leukaemias, two acute myeloblastic leukaemias; 15 were neutropenic; 19 had a central line. Thirteen Gram-positive bacteria were isolated from the blood cultures in eleven patients. There were eight coagulase-negative staphylococci (CNS), (five methicillin-resistant) and four Staphylococcus aureus isolates. Teicoplanin was given as a 30 min infusion twice on the first day then once a day. The mean unit dose was 6 mg/kg for first eight patients. One clinical failure and lower serum concentrations than expected led us to increase the dosage to 10 mg/kg daily for the remaining patients. Tolerability remained excellent. It is concluded that antistaphylococcal treatment for febrile episodes in neutropenic patients can be satisfactorily provided by teicoplanin 10 mg/kg iv daily with a second loading dose on the first day. One injection a day is a convenient schedule in paediatrics.

Adolescent↗
PubMed1988

[Value of cyclosporin A in dermatomyositis in a child].

Cyclosporin A was used in a 3 1/2 year-old child with dermatomyositis exhibiting severe junctional impairment and intolerance to steroids. After a few weeks, marked clinical improvement was observed allowing a reduction of the doses of steroids. After 9 months, the clinical status was satisfactory: the calcifications had lost their inflammatory characteristics. No side effect of cyclosporin A was observed at the dose used (4.4 mg/kg/d) which maintained effective blood concentrations between 80 and 220 ng/ml.

Child, Preschool↗
PubMed1987

IgG (Gm) allotypes in acute measles encephalomyelitis and subacute sclerosing panencephalitis.

Gm phenotype or haplotype frequencies are known to be increased in some neurological diseases involving dysregulation(s) of the immune system. Therefore, possible associations between acute measles encephalitis (AME) or subacute sclerosing panencephalitis (SSPE) and alleles of the Gm system were investigated by comparison of children (41 AME subjects and 62 SSPE subjects) with 378 ethnically and geographically matched controls. Although the Gm3;..;11 haplotype displayed a very low frequency among SSPE children, no statistically significant departure in the distribution of Gm phenotypes could be evidenced between AME or SSPE, and controls. A further appraisal of combined Gm and HLA phenotypes may be warranted in both diseases since Gm/HLA interactions have been demonstrated in other immunopathological conditions.

Adolescent↗
PubMed1987

[Treatment of febrile episodes in neutropenic children by ceftazidime combined with netilmicin. Results of a multicenter study apropos of 88 cases].

Infection is the most important cause of mortality in leucopenic patients. A broad spectrum antibiotic therapy is imperative in febrile and neutropenic patients. In a multicentric study we have used ceftazidime (100 mg/kg/d) and netilmicin (6 mg/kg/d) in 88 children (fever greater than or equal to 38.5 degrees C, neutropenia less than 500/mm3) treated for acute leukemias (59), non Hodgkin lymphomas (13) or solid tumors (16). Median age was 7 years (2 months-16 years). In patients who continued to remain febrile, vancomycin (40 mg/kg/d) was added after 48 hours. The effective treatment was continued until a neutrophil count greater than 1,000/mm3. The first combination (ceftazidime + netilmicin) was effective in 64 children (73%) and the second combination (ceftazidime + netilmicin + vancomycin) in 11 patients. Bacteria were isolated in 39 children: Escherichia coli: 9, Staphylococcus epidermidis: 9, Staphylococcus aureus: 8, Streptococcus: 6, Pseudomonas aeruginosa: 3, Streptococcus pneumoniae: 1, Haemophilus: 1, Klebsiella pneumoniae: 1, Proteus: 1, Serratia: 1, Flavobacterium: 1. In these 39 patients, 30 became apyretic with ceftazidime and netilmicin and 6 after vancomycin. All blood culture were negative after the first combination. The median duration of antibiotic therapy was 14 days (5-9 days: 28, 10-20 days: 43, greater than 20 days: 17). There were no death, no superinfection. Tolerance was good without kidney or liver or biological perturbation. We conclude that the combination ceftazidime and netilmicin is effective in neutropenic children.

Adolescent↗