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de Rougemont A, Kaplon J, Fremy C, Legrand-Guillien MC, Minoui-Tran A, Payan C, Vabret A, Mendes-Martins L, Chouchane M, Maudinas R, Huet F, Dubos F, Hober D, Lazrek M, Bouquignaud C, Decoster A, Alain S, Languepin J, Gillet Y, Lina B, Mekki Y, Morfin-Sherpa F, Guigon A, Guinard J, Foulongne V, Rodiere M, Avettand-Fenoel V, Bonacorsi S, Garbarg-Chenon A, Gendrel D, Lebon P, Lorrot M, Mariani P, Meritet JF, Schnuriger A, Agius G, Beby-Defaux A, Oriot D, Colimon R, Lagathu G, Mory O, Pillet S, Pozzetto B, Stephan JL, Aho S, Pothier P. Clinical severity and molecular characteristics of circulating and emerging rotaviruses in young children attending hospital emergency departments in France. Clin Microbiol Infect 2016; 22:737.e9-737.e15. [PMID: 27287887 DOI: 10.1016/j.cmi.2016.05.025] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2016] [Revised: 05/25/2016] [Accepted: 05/28/2016] [Indexed: 11/18/2022]
Abstract
Group A rotavirus (RVA) is the leading cause of acute gastroenteritis in young children worldwide. A prospective surveillance network has been set up to investigate the virological and clinical features of RVA infections and to detect the emergence of potentially epidemic strains in France. From 2009 to 2014, RVA-positive stool samples were collected from 4800 children <5 years old attending the paediatric emergency units of 16 large hospitals. Rotaviruses were then genotyped by RT-PCR with regard to their outer capsid proteins VP4 and VP7. Genotyping of 4708 RVA showed that G1P[8] strains (62.2%) were predominant. The incidence of G9P[8] (11.5%), G3P[8] (10.4%) and G2P[4] (6.6%) strains varied considerably, whereas G4P[8] (2.7%) strains were circulating mostly locally. Of note, G12P[8] (1.6%) strains emerged during the seasons 2011-12 and 2012-13 with 4.1% and 3.0% prevalence, respectively. Overall, 40 possible zoonotic reassortants, such as G6 (33.3%) and G8 (15.4%) strains, were detected, and were mostly associated with P[6] (67.5%). Analysis of clinical records of 624 hospitalized children and severity scores from 282 of them showed no difference in clinical manifestations or severity in relation to the genotype. The relative stability of RVA genotypes currently co-circulating and the large predominance of P[8] type strains may ensure vaccine effectiveness in France. The surveillance will continue to monitor the emergence of new reassortants that might not respond to current vaccines, all the more so as all genotypes can cause severe infections in infants.
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Affiliation(s)
- A de Rougemont
- Centre National de Référence des virus entériques, Laboratoire de Virologie, CHU de Dijon, France; UFR des Sciences de Santé, Université de Bourgogne, Dijon, France.
| | - J Kaplon
- Centre National de Référence des virus entériques, Laboratoire de Virologie, CHU de Dijon, France
| | - C Fremy
- Centre National de Référence des virus entériques, Laboratoire de Virologie, CHU de Dijon, France
| | | | | | - C Payan
- Centre Hospitalier Universitaire de Brest, France
| | - A Vabret
- Centre Hospitalier Universitaire de Caen, France
| | | | - M Chouchane
- Centre Hospitalier Universitaire de Dijon, France
| | - R Maudinas
- Centre Hospitalier Universitaire de Dijon, France
| | - F Huet
- UFR des Sciences de Santé, Université de Bourgogne, Dijon, France; Centre Hospitalier Universitaire de Dijon, France
| | - F Dubos
- Centre Hospitalier Régional Universitaire de Lille, France
| | - D Hober
- Centre Hospitalier Régional Universitaire de Lille, France
| | - M Lazrek
- Centre Hospitalier Régional Universitaire de Lille, France
| | - C Bouquignaud
- Groupement des Hôpitaux de l'Institut Catholique de Lille, France
| | - A Decoster
- Groupement des Hôpitaux de l'Institut Catholique de Lille, France
| | - S Alain
- Centre Hospitalier Universitaire de Limoges, France
| | - J Languepin
- Centre Hospitalier Universitaire de Limoges, France
| | | | - B Lina
- Hospices Civils de Lyon, France
| | - Y Mekki
- Hospices Civils de Lyon, France
| | | | - A Guigon
- Centre Hospitalier Universitaire d'Orléans, France
| | - J Guinard
- Centre Hospitalier Universitaire d'Orléans, France
| | - V Foulongne
- Centre Hospitalier Universitaire de Montpellier, France
| | - M Rodiere
- Centre Hospitalier Universitaire de Montpellier, France
| | | | - S Bonacorsi
- Assistance Publique Hôpitaux de Paris, France
| | | | - D Gendrel
- Assistance Publique Hôpitaux de Paris, France
| | - P Lebon
- Assistance Publique Hôpitaux de Paris, France
| | - M Lorrot
- Assistance Publique Hôpitaux de Paris, France
| | - P Mariani
- Assistance Publique Hôpitaux de Paris, France
| | - J-F Meritet
- Assistance Publique Hôpitaux de Paris, France
| | | | - G Agius
- Centre Hospitalier Universitaire de Poitiers, France
| | - A Beby-Defaux
- Centre Hospitalier Universitaire de Poitiers, France
| | - D Oriot
- Centre Hospitalier Universitaire de Poitiers, France
| | - R Colimon
- Centre Hospitalier Universitaire de Rennes, France
| | - G Lagathu
- Centre Hospitalier Universitaire de Rennes, France
| | - O Mory
- Centre Hospitalier Universitaire de Saint-Etienne, France
| | - S Pillet
- Centre Hospitalier Universitaire de Saint-Etienne, France
| | - B Pozzetto
- Centre Hospitalier Universitaire de Saint-Etienne, France
| | - J-L Stephan
- Centre Hospitalier Universitaire de Saint-Etienne, France
| | - S Aho
- Service d'Hygiène Hospitalière, Centre Hospitalier Universitaire de Dijon, France
| | - P Pothier
- Centre National de Référence des virus entériques, Laboratoire de Virologie, CHU de Dijon, France; UFR des Sciences de Santé, Université de Bourgogne, Dijon, France
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Lemale J, Salaün JF, Assathiany R, Garcette K, Clouzeau H, Languepin J, Dubern B, Peretti N, Tounian P. CO-11 – Conséquences nutritionnelles de l'utilisation des jus végétaux chez le nourrisson. Arch Pediatr 2015. [DOI: 10.1016/s0929-693x(15)30114-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Languepin J, Munck A, Gros G, Mas E. 194 A French survey on gastro-oesophageal reflux in CF: need for guidance. J Cyst Fibros 2014. [DOI: 10.1016/s1569-1993(14)60329-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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Fourcade L, Pommepuy I, Mons F, Pham Dang A, Compagnon R, Longis B, Grimaudo A, Cros J, Berenguer D, Languepin J. Diagnostic et prise en charge de la maladie de Hirschsprung à la naissance. Arch Pediatr 2012. [DOI: 10.1016/s0929-693x(12)71120-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Dupont-Lucas C, Bellaïche M, Mouterde O, Bernard O, Besnard M, Campeotto F, Languepin J, Mosca A, Goulet O, Vannerom PY, Mougenot JF, Cardey J, Cézard JP, Viala J. [Capsule endoscopy in children: which are the best indications?]. Arch Pediatr 2011; 17:1264-72. [PMID: 20627490 DOI: 10.1016/j.arcped.2010.04.026] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2009] [Revised: 01/18/2010] [Accepted: 04/27/2010] [Indexed: 12/15/2022]
Abstract
BACKGROUND AND STUDY AIMS Capsule endoscopy (CE) is a novel and noninvasive means of investigating the small bowel. In children, the best CE indications have not yet been fully appraised. The aim of this study was to evaluate the diagnostic yield of CE in different pediatric pathologies. PATIENTS AND METHODS We retrospectively reviewed every CE performed in children in two French pediatric hospitals between March 2002 and June 2009. Seventy-nine CEs were performed on 70 children (mean age, 10.6 years; range, 2.2-18.0); 52 boys and 18 girls. The indications were iron deficiency anemia (24%), obscure gastrointestinal bleeding (14%), polyposis syndromes (16%), suspected Crohn disease (15%), unresponsive Crohn disease (10%), graft-versus-host disease (10%), and other (10%). RESULTS Of the 79 CEs, 69 reached the cecum (87%). Only one occlusion occurred in a case of stenosing Crohn disease, requiring surgical removal. In addition, technical difficulties led to an incomplete small bowel study in 12 cases (16%). The CE showed small bowel lesions in 42 cases (53%). The diagnostic yield was 27% in obscure gastrointestinal bleeding, 37% in iron-deficiency anemia, 42% in suspected Crohn disease, 88% in unresponsive Crohn disease, 62% in polyposis syndromes, and 88% in graft-versus-host disease. CONCLUSION In children, CE is well tolerated and can be performed in children as young as 2.2 years of age. Its diagnostic yield is highest in polyposis syndromes, unresponsive Crohn disease, and graft-versus-host disease.
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Affiliation(s)
- C Dupont-Lucas
- Service de pédiatrie, hôpital Femme-Enfant-Hématologie, CHU de Caen, avenue de la Côte-de-Nacre, 14033 Caen cedex 09, France.
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Dallocchio A, Canioni D, Ruemmele F, Languepin J, Jacques J, Duquesne A, Quartier P, Bader-Meunier B. CL171 - Inflammation digestive et etanercept : série de sept cas pédiatriques. Arch Pediatr 2010. [DOI: 10.1016/s0929-693x(10)70388-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Dallocchio A, Canioni D, Ruemmele F, Duquesne A, Scoazec JY, Bouvier R, Paraf F, Languepin J, Wouters CH, Guillot M, Quartier P, Bader-Meunier B. Occurrence of inflammatory bowel disease during treatment of juvenile idiopathic arthritis with etanercept: a French retrospective study. Rheumatology (Oxford) 2010; 49:1694-8. [DOI: 10.1093/rheumatology/keq136] [Citation(s) in RCA: 42] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023] Open
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Burgel PR, Fajac I, Hubert D, Grenet D, Stremler N, Roussey M, Siret D, Languepin J, Mely L, Fanton A, Labbé A, Domblides P, Vic P, Dagorne M, Reynaud-Gaubert M, Counil F, Varaigne F, Bienvenu T, Bellis G, Dusser D. Non-classic cystic fibrosis associated with D1152H CFTR mutation. Clin Genet 2009; 77:355-64. [PMID: 19843100 DOI: 10.1111/j.1399-0004.2009.01294.x] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
BACKGROUND Limited knowledge exists on phenotypes associated with the D1152H cystic fibrosis transmembrane conductance regulator (CFTR) mutation. METHODS Subjects with a D1152H allele in trans with another CFTR mutation were identified using the French Cystic Fibrosis Registry. Phenotypic characteristics were compared with those of pancreatic insufficient (PI) and pancreatic sufficient (PS) cystic fibrosis (CF) subjects in the Registry (CF cohort). RESULTS Forty-two subjects with D1152H alleles were identified. Features leading to diagnosis included chronic sinopulmonary disease (n = 25), congenital absence of the vas deferens (n = 11), systematic neonatal screening (n = 4), and genetic counseling (n = 2). Median age at diagnosis was 33 [interquartile range (IQR, 24-41)] years in D1152H subjects. Median sweat chloride concentrations were 43.5 (39-63) mmol/l in D1152H subjects and were markedly lower than in PI and PS CF subjects (p < 0.05). Bronchiectasis was present in 67% of D1152H subjects, but Pseudomonas aeruginosa colonization and pancreatic insufficiency were present in <30% of subjects. Estimated rates of decline in forced expiratory volume in 1 s (FEV(1)) were lower in D1152H subjects vs PI CF subjects (p < 0.05). None of the D1152H subjects identified since 1999 had died or required lung transplantation. CONCLUSIONS When present in trans with a CF-causing mutation, D1152H causes significant pulmonary disease, but all subjects had prolonged survival.
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Affiliation(s)
- P-R Burgel
- Hôpital Cochin, APHP, Université Paris Descartes, Paris, France.
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Murris M, Boniface S, Brémont F, Bui S, Chiron R, De Lumley L, Fayon M, Gautry P, Heraud M, Languepin J, Mely L, Moreau L, Petit I, Stremler N, Maitre M, Têtu L, Dubus J. 58 Couverture vaccinale contre la grippe des soignants en 2005-2006 dans 9 CRCM du Grand Sud. Rev Mal Respir 2007. [DOI: 10.1016/s0761-8425(07)72433-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Dupont C, Leluyer B, Maamri N, Morali A, Joye JP, Fiorini JM, Abdelatif A, Baranes C, Benoît S, Benssoussan A, Boussioux JL, Boyer P, Brunet E, Delorme J, François-Cecchin S, Gottrand F, Grassart M, Hadji S, Kalidjian A, Languepin J, Leissler C, Lejay D, Livon D, Lopez JP, Mougenot JF, Risse JC, Rizk C, Roumaneix D, Schirrer J, Thoron B, Kalach N. Double-blind randomized evaluation of clinical and biological tolerance of polyethylene glycol 4000 versus lactulose in constipated children. J Pediatr Gastroenterol Nutr 2005; 41:625-33. [PMID: 16254521 DOI: 10.1097/01.mpg.0000181188.01887.78] [Citation(s) in RCA: 81] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/10/2022]
Abstract
OBJECTIVES To assess the safety of a polyethylene glycol (PEG) 4000 laxative without additional salts in pediatric patients. STUDY DESIGN This was a 3-month multicenter, randomized, double-blind, double-dummy, lactulose-controlled, parallel study enrolling 96 ambulatory constipated children aged 6 months to 3 years, treated daily with 4-8 g PEG or 3.33 g-6.66 g lactulose. Total protein, albumin, iron, electrolytes, and vitamins B9 (folates), A and D (25OHD3) were measured in blood before and after treatment (day 84) in a central laboratory. RESULTS The percentage of children with at least one value out of normal range at day 84 with respect to baseline status (with or without at least one value out of normal range), i.e. the primary endpoint, was 87% and 90% in the PEG and lactulose groups, respectively, without any difference between groups. The whole blood parameters showed no qualitative or quantitative treatment-related changes. Vitamin A values were above normal range in 56% and 41% of children at baseline versus 33% and 36% at day 84 in the PEG and lactulose groups, respectively. Iron values were similarly under normal range in 47% and 51% at baseline versus 42% and 51% at day 84. Clinical tolerance was similar for both treatments except for vomiting and flatulence, which were significantly higher with lactulose. Significantly higher improvements were evidenced with PEG regarding stool consistency, appetite, fecaloma and use of additional laxatives. CONCLUSION This 3-month study in 96 constipated children aged 6 months to 3 years confirms the long-term tolerance of PEG 4000 in pediatrics and indicates a PEG efficacy similar to or greater than that of lactulose.
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Affiliation(s)
- Christophe Dupont
- Hôpital Saint-Vincent-de-Paul, Service de Néonatologie, Paris, France.
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Berrebi D, Languepin J, Ferkdadji L, Foussat A, De Lagausie P, Paris R, Emilie D, Mougenot JF, Cezard JP, Navarro J, Peuchmaur M. Cytokines, chemokine receptors, and homing molecule distribution in the rectum and stomach of pediatric patients with ulcerative colitis. J Pediatr Gastroenterol Nutr 2003; 37:300-8. [PMID: 12960653 DOI: 10.1097/00005176-200309000-00018] [Citation(s) in RCA: 34] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
BACKGROUND Cytokines appear to play a significant role in the pathogenesis of inflammatory bowel disease (IBD) with a predominant Th2 pattern in colonic mucosa of patients with ulcerative colitis (UC). Chemokines and their receptors also regulate the migration of Th1 or Th2 lymphocytes to inflammatory tissues during the immune response. Although adult UC is usually confined to the colon, pediatric UC not uncommonly affects the stomach. AIMS The aim of this study was to compare expression of cytokines, chemokine receptors, and homing molecules in the rectal and the histologically characterized gastric mucosa of pediatric patients with UC. SUBJECTS Sixteen patients (11 girls and 5 boys; median age, 9 years) having all the features of UC were included in the study. METHODS Rectal and gastric mucosa obtained from UC cases were immunostained with antibodies against L-selectin, beta 7 integrin, CXCR3, CCR3, and CCR5. IL-4 and IL-12 p40 transcript expression was studied by in situ hybridization. RESULTS Chronic gastritis was found in 93.7% of cases and Helicobacter pylori (Hp) was found in 2 (13.3%) cases. In the rectal and gastric mucosa, CXCR3 was found in perivascular lymphocytes and CCR5 in a subset of CXCR3+ cells in the lamina propria. CCR3+ lymphocytes and IL-4-positive cells were always found, but there was no evidence of IL-12 production. Most of the lymphocytes infiltrating the gastric mucosa expressed beta 7 but not CD62L. In contrast, beta 7-positive cells were randomly dispersed in the rectal lamina propria, and the fraction of CD3+beta 7+ was low. CONCLUSIONS The authors conclude that gastritis is common in pediatric UC. The presence of CCR3+ lymphocytes, IL-4 transcript expression, without IL-12 p40 production in the stomach and in the rectum suggests a Th2 immune response. The presence of CCR3+, CD62L- activated Th2 cells may suggest that these gastric cells are recruited from colorectal primary lesions.
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Affiliation(s)
- D Berrebi
- Service d'Anatomie et de Cytologie Pathologiques and EA 3102, Université Paris VII, Paris, France.
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Bonnard A, de Lagausie P, Leclair MD, Marwan K, Languepin J, Bruneau B, Berribi D, Aigrain Y. Definitive treatment of extended Hirschsprung's disease or total colonic form. Surg Endosc 2001; 15:1301-4. [PMID: 11727138 DOI: 10.1007/s004640090092] [Citation(s) in RCA: 35] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2000] [Accepted: 02/22/2001] [Indexed: 12/15/2022]
Abstract
BACKGROUND Between December 1990 and March 1999, five laparoscopic Duhamel pull-through procedures for extended or total aganglionosis were performed in our department, one of which had a rectosigmoid form with a short bowel and a colonic resection due to a volvulus. METHODS The aim of this study was to show that even when the extended form of Hirschprung's disease or anatomic difficulties such as a short bowel and anterior colonic resection are encountered, the laparoscopic approach is possible and total colectomy is feasible. The procedure has been described previously. We used one camera port and three working ports. The sigmoid, transverse, and right colon up to the last ileal cove were mobilized laparoscopically. A standard posterior ileo-anal anastomosis was performed, and an endo-GIA stapler was used for the anterior anastomosis. RESULTS A total of five patients underwent laparoscopic surgery for Hirschprung's disease. There were three total colonic forms, one rectosigmoid form with a short bowel and colon resection attributed to a volvulus, and one transverse variant that required a Deloyers' maneuver for the pull-through. Three of the infants required total parenteral nutrition (TPN) for an average of 49 days (range, 28-60) from diversion until the time of the definitive procedure. Only one patient did not receive TPN. Postoperatively, there were two complications-one wound infection and one hectic fever. The clinical results were good, with no soiling or stool incontinence and no constipation. CONCLUSION The laparoscopic procedure for total aganglionosis or the extended form of Hirschprung's disease is safe, feasible, and reproducible.
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Affiliation(s)
- A Bonnard
- Department of Pediatric Surgery, Hôpital Robert Debré, 48 boulevard Sérurier, 75019 Paris, France
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Languepin J, Doit C, Cézard JP, Bingen E, Navarro J. [Pediatric nosocomial diarrhea]. Pathol Biol (Paris) 2000; 48:764-9. [PMID: 11244605] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 04/16/2023]
Abstract
Nosocomial diarrhea are an important cause of childhood morbidity and mortality. Rotavirus has been recognized as the most important cause of nosocomial gastroenteritidis particularly in infants during winter months. Nosocomial diarrhea are also, caused by bacterial pathogen like Clostridium difficile, Salmonella, Shigella, Campylobacter. Clostridium difficile toxin assay should be considered for patients who are receiving antibiotics. Modifications of hygiene procedures and preventive measures are necessary in order to reduce nosocomial infection.
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Affiliation(s)
- J Languepin
- Service de gastro-entérologie, hôpital Robert-Debré, 48, boulevard Sérurier, 75019 Paris, France
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Abstract
Expectoration of bronchial casts, a condition also called plastic bronchitis, is very rare in children. Bronchial casts may be associated with bronchopulmonary diseases associated with mucus hypersecretion, bronchopulmonary bacterial infections, congenital and acquired cardiopathies, or pulmonary lymphatic abnormalities. A classification based on anatomy and pathology has been proposed which identifies an "acellular" group associated with congenital cardiopathies and palliative surgery. We report on 3 cases with bronchial casts associated with cardiopathy. Observations suggest that the formation of bronchial casts may result from lymphatic leakage into the bronchi. The 3 cases on which we report were immunodeficient and had pulmonary lymphatic abnormalities. The bronchial casts contained lymphocytes and lipids, as determined by histologic examination. In the absence of congenital pulmonary or diffuse lymphatic dysplasia associated with cardiopathy, the principal factors resulting in the formation of bronchial casts appear to be surgical trauma to the lymphatic channels surrounding the bronchi, pleural adhesions, and high systemic venous blood pressure. The prognosis for these patients is poor, and possibilities for treatment are limited.
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Affiliation(s)
- J Languepin
- Department of Pediatric Pulmonology, Hôpital Necker Enfants Malades, Paris, France
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Abstract
For the past ten years or so, proton pump inhibitors (PPI) such as omeprazole, lansoprazole, or pantoprazole, have become the reference treatment for peptic disorders in adults. PPIs have recently begun to be used in pediatrics, and this use is likely to expand. They act on the final step of gastric acid secretion by completely inhibiting the ATPase (proton pump) at the surface of the gastric parietal cells, thus yielding long term inhibition which is not correlated with the plasma concentration of the drug, in contrast to the effects of H2-blocker drugs. Our knowledge of this new class of treatment in pediatrics is still fragmentary, but the reported pharmacokinetic and clinical data indicate that they are suitable for use in children. While the short-term risk of complications appears to be minimal, the tolerance of these drugs in chronic use requires careful monitoring because of the potential consequences of prolonged inhibition of acid secretion.
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Affiliation(s)
- C Faure
- Service de gastroentérologie pédiatrique, hôpital Robert-Debré, Paris, France
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de Lagausie P, Aubert F, Hankard GF, Languepin J, Aigrain Y. [Management of Hirschsprung's disease during the neonatal period]. Ann Chir 1999; 52:1028-32. [PMID: 9951105] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/10/2023]
Abstract
Hirschsprung's disease is one of the common est causes of neonatal intestinal obstruction. Despite progress in the identification of genetic mutations, the pathogenesis of Hirschsprug's disease is not completely resolved. The management consists of septic complications of treatment, and a variable "pull-through" procedure, immediately or at a later date. Long-term follow-up is an important component of patient care.
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Affiliation(s)
- P de Lagausie
- Service de Chirurgie Infantile, Hôpital Robert-Debré, Paris
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Languepin J, Daoud P, Desguerre I. [Cervical intraspinal enterogenous cyst: a rare cause of neonatal syncope]. Arch Pediatr 1994; 1:54-6. [PMID: 8087222] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Abstract
BACKGROUND Enterogenous cysts are benign embryogenic tumors that developed close to the central nervous system. They are rarely symptomatic in neonates. This report describes such a cyst in a young infant that was discovered because of the discomfort it produced. CASE REPORT A 16 day-old boy suffered from discomfort during bathing followed by deviation of the eyes. He was given diazepam rectally. At admission, he had generalized hypotonia and hyperreflexia. CSF examination showed 1.7 g/l protein. A prolonged apnea with cyanosis and bradycardia required his admission to the intensive care unit, where a spastic quadriparesis with bilateral phrenic nerve paralysis was found. EEG and brain ultrasonography were normal. MR imaging showed an intraspinal cyst, locating from C1 to C3, that was compressing the spinal cord. The cyst was rapidly excised and histological examination confirmed that it was an enterogenous cyst. CONCLUSION This cyst was not associated with vertebral abnormalities but did produce early symptoms. It was diagnosed by MR imaging.
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Affiliation(s)
- J Languepin
- Unité de réanimation médicale, hôpital Saint-Vincent-de-Paul, Paris, France
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