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Biomedical subjects

Y Aujard

Publications and source records attributed to Y Aujard.

At least 55 records · Page 3Linked to original sources
PubMed1997

Prolongation of hospital stay and extra costs due to hospital-acquired infection in a neonatal unit.

A case-control study to evaluate the mean extra stay and corresponding cost of neonates acquiring a hospital-acquired infection (HAI) was performed on all patients admitted to a neonatology unit and discharged alive in 1994. Cases were identified from medical records. Controls were matched to cases for birthweight, gestational age, mode of admission to the unit, previous stay in an intensive care unit and presence of a central venous catheter. Costs were taken as those of the extra days attributable to HAI, i.e. the mean difference in the length of stay between cases and controls. Among a cohort of 616 neonates, 34 (5.5%) had one or more HAIs (average = 1.1). The mean extra cost per infected case was 52,192 FF (US$10,440), corresponding to 5.2 extra days in hospital.

Birth Weight↗
PubMed1997

[Long QT syndrome under cisapride in neonates and infants].

BACKGROUND: Cisapride is frequently used in the newborn and infant for treatment of gastroesophageal reflux. Twisting-spikes have been reported in adults due to overdosage or therapeutic interaction. We report seven cases of QT prolongation in infants treated with cisapride. PATIENTS AND METHODS: Seven children (one full-term, two mature preterms, four preterm babies), aged (mean, range) 41.8 +/- 21 days (14-79) weighing 2.1 +/- 1.1 kg (1.2-4), free from any cardiac abnormality, except one patent ductus arteriosus, have been studied by ECG and Holter monitoring. They received cisapride at a mean dose of 1.31 +/- 0.2 mg/kg/d (between 1 and 1.7 mg/kg/d). RESULTS: The corrected QT (QTc: N < 450 ms) was increased to 486 ms (450-540) with a notched T-wave pattern. No arrhythmia was detected. In five cases, cisapride was stopped and changed to metoclopramide. Cisapride dosage was reduced to 0.8 mg/kg/d in the two others. No other therapeutic modification was done. A control ECG performed 48 hours after therapeutic changes showed a QTc shortening of 74 +/- 18 ms (45-90) and the disappearance of the notches independent of any heart rate changes, leading to normal QTc values: 413 +/- 21 ms (390-440). CONCLUSION: High cisapride dosage in preterm, newborns and infants seems to favor QT prolongation which is reversible when dosage is reduced or drug is stopped. The use of cisapride in combination with other drugs known to increase QT should be done with extreme caution.

Anti-Ulcer Agents↗
PubMed1996

[Sleeping position, prevention of sudden death syndrome and gastroesophageal reflux].

Based on results of epidemiological studies, dorsal or lateral sleeping positions are now recommanded in the prevention of sudden infant death syndrome (SIDS). This raises an ethical question about the attitude towards the ventral positioning therapy for gastroesophageal reflux (GOR). The consensus conference considers that the ventral position should only be recommanded in GOR when the benefit appears to outweigh the risk of SIDS that it induces. The conference proposes that for infants with simple uncomplicated reflux, sleeping in the prone position should not be introduced in the first line treatment. Prone positioning should be restricted to complicated cases resistant to dietary and medical measures.

Gastroesophageal Reflux↗
PubMed1995

[Opposable medical references in pediatrics].

Recommended guidelines for medical practice are instituted in France as a contribution to a reduction of health care expenses. The methodology, applications, and implications in pediatrics, are presented.

Child↗
PubMed1995

Comparative efficacy and safety of four-day cefuroxime axetil and ten-day penicillin treatment of group A beta-hemolytic streptococcal pharyngitis in children.

In a prospective randomized multicenter study, 308 children, ages 2 to 15 years, were randomized to receive either cefuroxime axetil suspension (N = 152; 20 mg/kg/day twice daily) for 4 days, penicillin suspension (N = 156; 45 mg/kg/day divided three times daily) for 10 days, of whom 97 and 103, respectively, had culture-proved group A beta-hemolytic Streptococcus infection. Two to 4 days after completion of the treatment, group A beta-hemolytic Streptococcus were eradicated from 85 of 97 (87.6%) children taking cefuroxime and from 90 of 103 (87.4%) taking penicillin; respective clinical cure rates were 94.8% and 96.1%. Clinical signs and symptoms resolved significantly more rapidly with cefuroxime (P < 0.05). At 28 to 32 days posttreatment the eradication of the primary isolate was confirmed in 94.4 and 91.9% of cefuroxime axetil and penicillin-treated patients, respectively. Drug-related adverse events (mainly gastrointestinal and cutaneous reactions) were reported in 2.1 and 2.7% of the cefuroxime- and penicillin-treated patients, respectively. Results indicated that a 4-day treatment with cefuroxime axetil was as effective and well-tolerated as the conventional 10-day treatment with penicillin in children with acute group A beta-hemolytic Streptococcus pharyngitis.

Adolescent↗
PubMed1995

Use of molecular analysis in pathophysiological investigation of late-onset neonatal Escherichia coli meningitis.

We describe one case of late-onset neonatal Escherichia coli meningitis associated with urinary tract infection. Two genotypic methods revealed that the E. coli isolates obtained from blood, feces, and cerebrospinal fluid shared the same pattern, which was different from the unique pattern obtained for the isolates recovered from the urine and the tracheal aspirate. Our study supports passage of bacteria through the gastrointestinal mucosa to the bloodstream as the initial event, with subsequent meningeal localization.

Bacterial Typing Techniques↗
PubMed1994

[Treatment of bacterial meningitis in newborn infants and children].

Third generation cephalosporin as cefotaxime or ceftriaxone is the best first line treatment. Duration of treatment is 7 to 10 days in uncomplicated disease. Dexamethasone used very early--before or at the same time of the antibiotic injection--seems to decrease sensorial sequelae. Amikacin by IV route, decreases short term complications. For bacterial meningitis due to intermediate penicillin pneumococci, an increase in daily dose of beta-lactamin is recommended; for resistant pneumococci, vancomycin by continuous infusion and with large doses is used. Chemoprophylaxis by rifampicine is effective for both Meningococcus and Haemophilus. Haemophilus influenzae b vaccination will decrease systemic infection due to this pathogen. In newborns, morbidity is higher, due in part to brain abscesses. Therapeutic choice is not the same for materno-foetal and postnatal infection. Antibiotherapy duration is, at least, 15 days and 21 days for gram-negative bacteria.

Age Factors↗