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Biomedical subjects

P Reinert

Publications and source records attributed to P Reinert.

At least 109 records · Page 6Linked to original sources
PubMed1987

[Autoimmune neutropenia disclosing AIDS in a child].

A 15 month old child with a history of multiple infectious diseases was admitted to hospital for investigation of pyrexia and general ill health. She was anaemic with a persistent neutropaenia associated with hypergamma globulinemia, indicating intense autoimmune activity: cellular immunity was abnormal with a normal total lymphocyte count but a very low T4/T8 ratio. HIV serology was positive; the virus was isolated from a lymph node biopsy specimen. The parents for the child were HIV positive and the father went on to develop full blown AIDS. The neutropaenia was constant over the two years of follow-up and granulo-immunofluorescence studies suggested an autoimmune origin. In contrast to autoimmune thrombocytopaenia and haemolytic anaemia, autoimmune neutropaenia is a rare condition. A few cases have been reported in adult AIDS. Our case is of additional interest as it illustrates the vertical mode of transmission of AIDS.

Acquired Immunodeficiency Syndrome↗
PubMed1987

[The role of IgE in recurrent ORL infections in children].

The high incidence of bacterial super-infection in atopic individuals has long been known, especially in asthma and atopic dermatitis. In recurrent ENT infections in children, increased IgE levels are found in half the cases; this increase results from two main mechanisms: a predisposition to allergy (often with positive RASTs), and certain viral infections: respiratory syncytial virus, para-influenzae, and measles, that trigger production of partly non-specific serum IgEs. In the latter situation, the increased IgE levels are both a cause and a consequence of recurrent infections. More recently, in some forms of atopic dermatitis (infant and Buckley syndrome), attention has been drawn to the severity of viral superinfections (herpes, chickenpox, vaccine), which is directly correlated with the IgE levels. The mechanism of such infections is unclear: the local increase in IgE levels is responsible for degranulation of mastocytes which in turn results in edema, fissures of mucosae and congestion; an effect on the lymphocytic response is possible, with inhibition of the production of certain lymphokines, especially interleukins.

Air Pollutants↗
PubMed1987

[The practitioner and vaccination (results of a sample survey)].

A sample survey was performed in 1986 among a sample of physicians in liberal practice with the aim of analyzing their attitude towards vaccination. This sample survey was geographically limited to one "département" in the vicinity of Paris, the "Val-de-Marne" (comprising 1.2 million inhabitants). Eighty-five per cent of the random sample answered the questionnaire, which was aimed at determining opinions and practices in immunizations. The study shows that general practitioners and pediatricians respect the compulsory principle of vaccinations as applied in France, but that 47% would like this principle to be extended to measles and 46% to rubella. Pediatricians perform vaccinations on a more systematic basis than generalists for measles, rubella and mumps. There were 16% of the physicians practising homeopathy, and they tended to vaccinate less than their colleagues against whooping cough, measles, and rubella. The experience of complications of infectious disease is a good incitement to vaccination. The absence of obligation regarding the vaccination against measles, mumps and rubella leads to a large disparity of practices and strategies that could have, at a long range term, unexpected consequences.

Attitude of Health Personnel↗
PubMed1987

Critical risk/benefit analysis of pefloxacine use in children under 15 years--the problem of arthralgias.

Pefloxacine belongs to a group of new quinolone antibiotics with more general indications than the urinary quinolones marketed about twenty years ago. The contraindication of the quinolones in children under 15 years of age limits their usage exclusively to adults. In this paper, the adverse arthralgic effects of these quinolones, which have largely motivated the contraindication, have been analyzed from an experimental, clinical and pathophysiological point of view. It is concluded that the pediatric benefits associated with the marked antibacterial activity of pefloxacine, particularly in pseudomonas and enterobacteriae infections, should be balanced against the risks associated with arthralgia whenever the condition of the patient is grave and decisions vital to a favorable prognosis for the sick child are necessary.

Acidosis↗
PubMed1986

Timentin (ticarcillin and clavulanic acid) in combination with aminoglycosides in the treatment of febrile episodes in neutropenic children.

Timentin (ticarcillin + clavulanic acid) combined with an aminoglycoside usually netilmicin, was given to 33 children with neutropenic haematological malignancies. The combination of Timentin and aminoglycoside was effective treatment in 27 (87%) of 31 febrile episodes. There were four failures and three results which could not be interpreted. Bacteriological investigations were positive in 13 patients, three strains were resistant to ticarcillin but all were sensitive to Timentin. Clinical success, based upon reduction of fever within 48 h of treatment, was identical whether an organism was isolated or not. The combination of Timentin plus aminoglycoside was very successful and represents one of the best combinations available for empirical treatment for febrile neutropenic children.

Adolescent↗
PubMed1986

Coincidence of familial systemic lupus erythematosus and the fragile X syndrome.

The coincidence of fragile X syndrome (fra(X] and systemic lupus erythematosus (SLE) in the same family is reported here for the first time. A 16-year-old boy with typical fra(X) had a severe SLE with multiple organ involvement. His 12-year-old sister of normal intelligence had circulating antinuclear antibodies and proliferative glomerulonephritis. The fra(X) was not found in her karyotype. Except for abnormalities due to immunosuppressive treatment during pregnancy, the association of SLE and chromosome abnormalities has been only reported in Klinefelter's syndrome. The possible pathogenic role of sex hormonal abnormalities due to an extra X chromosome has been suggested in the occurrence of SLE.

Fragile X Syndrome↗
PubMed1985

[Idiopathic nephrotic syndrome and the HLA allele. Prevalence of age-related DR7].

High prevalence of HLA DR7 was well documented in idiopathic nephrotic syndrome (INS) of childhood. Our data in 43 INS, child and adult patients, did not show any significant difference from control group, specially for HLA DR7. Moreover a significant difference occurred when the data was compared in child and adult INS patients. HLA DR7 was more frequent when the nephrotic syndrome appeared before 15 years old. There was no correlation between the presence of HLA DR7 and those of allergy history or increased serum IgE level, on the opposite with previous data. The presence of DR7 would favor its onset at an earlier age. Alternatively, the difference in DR7 prevalence could be an additional argument for considering that the corticosensitivity and negative histological criteria might collect, under the same name, different glomerulopathies.

Adolescent↗
PubMed1985

Eczema herpeticum of the child. An unusual manifestation of herpes simplex virus infection.

Two children aged 7 months with eczema herpeticum received treatment consisting of intravenous acyclovir and human plasma with a high titer of herpes simplex virus antibodies. One recovered following two recurrences, but the other died rapidly, suffering both septicemia due to Pseudomonas aeruginosa and herpetic encephalitis. In both cases, the virus involved was a herpes simplex virus type 1 (HSV 1). The various isolates obtained before, during and after treatment remained equally sensitive to acyclovir. These observations highlight three points: the unpredictable and sometimes dramatic development of eczema herpeticum in the young child; the urgency of early diagnosis and treatment; the role of environment in viral contamination.

Acyclovir↗
PubMed1985

[Herpes].

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Adolescent↗
PubMed1985

[Opportunistic Toxoplasma gondii infections].

In children with cellular immune deficiency, toxoplasmosis may result in severe infection, chiefly because of cerebral impairment presenting as meningo-encephalitis or as a pseudo-tumoral syndrome. Allogenic bone marrow transplantation or AIDS are high risk situations. Most often it is a reviviscence of former foci toxoplasma cysts. Diagnosis is difficult because serology is not contributive. Isolation of trophozoites in the cerebrospinal fluid is rare. CAT scan and sometimes cerebral biopsy allow unquestionable diagnosis. Early treatment (pyrimethamine, sulfadiazine, spiramycine) may lead to complete recovery.

Acquired Immunodeficiency Syndrome↗
PubMed1985

[Zona].

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Herpes Zoster↗
PubMed1985

[Varicella].

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Adult↗
PubMed1985

[Juvenile chronic arthritis. Double-blind study of the efficacy and tolerance of D-penicillamine].

Seventy-four children with juvenile chronic arthritis were admitted to a 6-month multicentric double blind comparative study of the efficiency of D-Penicillamine or placebo. The results evaluated in 55 patients who completed the study, indicated an improvement in the total number of stiff joints and in the total index of severity measuring joint pain and inflammation. A significant reduction of the concurrent use of non steroidal antiinflammatory drugs was also observed. The tolerance was good except in two patients. Some children in the placebo group exhibited a definite improvement.

Arthritis, Juvenile↗
PubMed1985

[Haemophilus influenzae infections in infants and macrolides. Importance of the choice of an effective antibiotic and compliance with its administration schedule].

Five cases of meningitis due to Haemophilus influenzae type b are reported. In four, the same pathogen was recovered from blood. In every case, meningitis developed despite administration of macrolides for ENT infections (4 cases) or pneumonia (1 case). These five observations are conclusive evidence that macrolides failed to prevent meningeal diffusion of Haemophilus influenzae presumptively responsible for the initial focal infection. In vitro activity of macrolides against Haemophilus influenzae is poor. For the treatment of ENT infections in pediatric patients aged 2 months to 5 years, the age group most susceptible to infection by Haemophilus influenzae, we recommend amoxicillin which is more active and bactericidal. An adequate dosage should be used (50 to 100 mg/kg/24 h) divided into four oral doses given at six hour intervals. This therapeutic attitude may need to be revised if the prevalence of beta-lactamase-producing H. influenzae strains (5 to 10% as of now) were to increase. In this case, use of an amoxicillin-clavulanic acid combination under the same conditions as outlined above may prove satisfactory. Correct administration of judiciously chosen antibiotics in ENT infections in infants and children is the most effective means of preventing meningitis due to H. influenzae.

Amoxicillin↗
PubMed1984

[Stroboscopic study of the respiratory mucosal ciliary beat frequency].

Abnormalities of the ciliary function have been found as an important factor in chronic respiratory diseases. For the study of the ciliary beat frequency, we developed a stroboscopic method using a stroboscopic illuminator ( Strobo Hertz) substituted to the normal light of an inverted optic microscope (Leitz). The ciliated cells obtained either by nasal scraping or tracheobronchial brushing were maintained in a culture medium (IP 199) at 37 degrees C. The ciliary beat frequency was measured at various times, at least one hour after the sampling. Nasal scraping, was performed with a curette in 17 children from 10 months to 16 years who complained of chronic respiratory diseases. Ciliated cells were obtained in 14 samples. In one of them 5 years old with a situs inversus, although the ciliated cells were numerous, the cilia appeared immotile. In the 13 others, the frequency was from 7 to 11.5 Hz with a mean of 10.8 Hz. These results were compared to those obtained by tracheobronchial brushings performed in 7 patients from 4 months to 46 years who underwent an endoscopic investigation. The ciliary frequency was 7 to 10 Hz with a mean of 8.5 Hz. The study of the ciliary beat frequency obtained by nasal scraping seems to be a reliable method for the detection of abnormal ciliary function. Nasal scraping is a non invasive method. Moreover, the stroboscopic method is a non expensive tool.

Adolescent↗