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Biomedical subjects

Y Aujard

Publications and source records attributed to Y Aujard.

123 records · Page 7Linked to original sources
PubMed1980

[Hemodynamic and echocardiographic investigations in children with severe meningococcosis (author's transl)].

In eight children presenting with severe meningococcosis, hemodynamic investigations were performed at various stages of the disease (thermodilution technique and echocardiography). Surveillance of hypovolemia and myocardial incompetence associated with sceptic shock allows a better adaptation of symptomatic treatment and a better prognosis in these severe cases. It seems that invasive hemodynamic methods (thermodilution) cannot be replaced presently by echocardiography alone.

Child↗
PubMed1978

[Severe hyperthermia in children].

In some children severe hyperthermia may be the result of fever that causes cellular damage. This can be seen histologically as cell necrosis. When hyperthermia occurs with collapse or with neurological symptoms it should lead to a search for other lesions (renal, hepatic and/or coagulation disorders). Treatment of these conditions may, in some cases, lead to improvement. Simple prophylactic measures and close supervision of febrile children should prevent this serious syndrome.

Blood Coagulation Disorders↗
PubMedDate not supplied

Early synergistic killing activity at concentrations attainable in CSF of amoxicillin or cefotaxime and aminoglycosides against Haemophilus influenzae.

Rapid eradication of bacteria from the CSF is critical for the outcome of Haemophilus influenzae meningitis in children. In 15 patients studied, the mean H. influenzae colony counts in CSF were 10(5) CFU/ml (range: 10(2) to 10(9) CFU/ml). Time-kill curves were determined for amoxicillin and cefotaxime alone and in combination with gentamicin or amikacin, against 60 clinical isolates of H. influenzae at concentrations equivalent to those found in CSF following systemic administration. Against beta-lactamase-negative strains (n = 44) a bactericidal effect was observed at 18 h for amoxicillin alone, at 5 h for amoxicillin plus aminoglycosides and at 2.5 h for cefotaxime with or without aminoglycosides. Against beta-lactamase-positive strains a bactericidal effect was observed at 18 h for cefotaxime, at 5 h for amoxicillin plus aminoglycosides and at 2.5 h for cefotaxime plus aminoglycosides. It appears that despite low concentrations of gentamicin or amikacin in the CSF, the accelerated killing of H. influenzae provides a rationale for the initial use of the combination of cefotaxime and aminoglycosides in the initial treatment of H. influenzae meningitis.

Aminoglycosides↗
PubMedDate not supplied

Pharmacokinetics of cefotaxime and desacetylcefotaxime in the newborn.

A study of the pharmacokinetic parameters of cefotaxime (CTX) and desacetylcefotaxime (dCTX) in newborns was conducted; the former is commonly used for neonatal infections. The elimination half life of CTX correlated with gestational age (GA) and postnatal age (PNA). Elimination of dCTX was longer permitting a synergistic or additive effect with CTX against Gram-negative bacteria. CTX is indicated in the treatment of neonatal sepsis because of the increasing resistance of Escherichia coli to ampicillin and its good efficacy against group B streptococcus.

Cefotaxime↗
PubMedDate not supplied

[Low serum thyroxin and thyroxin-binding globulin in neonatal respiratory distress (author's transl)].

Measurements of thyroxin (T4), thyroxin-binding globulin (TBG) and TSH were carried out in 34 full-term newborns, 21 prematures and 11 neonates with respiratory distress (6 with hyaline membrane disease) at 5 days of age. In cases with neonatal respiratory distress and to a lesser extent in prematures, low T4 due to a decrease of TBG was found, TSH being identical in all groups. The positive correlation between TBG and transferrin suggests a disturbance in hepatic synthesis. The authors conclude that, in cases with neonatal respiratory distress, low T4 does not mean hypothyroidism and does not require a treatment, provided TSH remains within normal limits.

Humans↗
PubMedDate not supplied

[Infections in pediatrics].

PROBABILITY-BASED ANTIBIOTIC THERAPY: In children, the risk of an unfavorable course of bacterial infections requires careful selection of the initial antibiotic prescription based on the disease state, bacterial epidemiology and the child's age. ACUTE COMMUNITY ACQUIRED PNEUMONIA: Before the age of 5 years, antibiotics active against Haemophilus influenzae such as amoxicillin or clavulanic acid can be given orally. In children over 5, amoxicillin or a macrolide are effective. SEVERE EAR, NOSE AND THROAT INFECTIONS: For sore throats, clinical and bacterial results of a 4-day antibiotic regimen using a second generation cephalosporin are equivalent (with better compliance) to a 10-day regimen of penicillin V. For acute middle ear infections, a combination of amoxicillin-clavulanic acid is usually prescribed as initial treatment. COMMUNITY ACQUIRED BACTERIAL MENINGITIS: The most recent consensus established the indication for cefotaxime or ceftriaxone. The increasing number of peni-R pneumococci and the major drop in the frequency of Haemophilus infections have led to new therapeutic propositions currently under investigation. ACUTE SKIN INFECTIONS: For impetigo, general antibiotics-oxacillin or a derivative-are required due to the risk of contagion. BONE AND JOINT INFECTIONS: For these urgent situations, in vitro sensitivity and antibiotic penetration into the infected tissue are the determining factors. BACTERIAL DIARRHEA: Antibiotics are not required in case of acute diaarhea with little or no fever. Antibiotics could be discussed for cholera-like diarrhea and are required in case of invasive bacterial diarrhea, shigelosis, cholera, and Clostridium difficile as well as diarrhea with fever and blood loss in infants or salmonella-induced diarrhea with signs of extradigestive complications. URINARY TRACT INFECTIONS: The choice of the antibiotic and the duration of treatment depend on the clinical presentation: lower tract infection, acute pyeloephritis, or prophylaxis. The causal germ must be identified for adapted antibiotic treatment.

Acute Disease↗