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Gradone AM, Champion G, McGregor KM, Nocera JR, Barber SJ, Krishnamurthy LC, Dotson VM. Rostral anterior cingulate connectivity in older adults with subthreshold depressive symptoms: A preliminary study. Aging Brain 2022; 3:100059. [PMID: 36911261 PMCID: PMC9997166 DOI: 10.1016/j.nbas.2022.100059] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2022] [Revised: 12/07/2022] [Accepted: 12/07/2022] [Indexed: 12/23/2022] Open
Abstract
Subthreshold depressive symptoms are highly prevalent among older adults and are associated with numerous health risks including cognitive decline and decreased physical health. One brain region central to neuroanatomical models of depressive disorders is the anterior cingulate cortex (ACC). The rostral portion of the ACC-comprised of the pregenual ACC and subgenual ACC-is implicated in emotion control and reward processing. The goal of the current study was to examine how functional connectivity in subregions of the rostral ACC relate to depressive symptoms, measured by the Beck Depression Inventory-Second Edition, in an ethnically diverse sample of 28 community-dwelling older adults. Based on meta-analyses of previous studies in primarily young adults with clinical depression, we hypothesized that greater depressive symptoms would be associated with primarily increased resting-state functional connectivity from both the subgenual ACC and pregenual ACC to default mode network regions and the dorsolateral PFC. We instead found that higher depressive symptoms were associated with lower functional connectivity of the ACC to the dorsolateral PFC and regions within the default mode network, including from the subgenual ACC to the dorsolateral PFC and anterior cingulate and from the pregenual ACC to the middle cingulate gyrus. This preliminary study highlights brain alterations at subthreshold levels of depressive symptoms in older adults, which could serve as targets for interventions.
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Affiliation(s)
- Andrew M. Gradone
- Department of Psychology, Georgia State University, Atlanta, GA, United States
| | - Gabriell Champion
- Department of Psychology, Georgia State University, Atlanta, GA, United States
- VA Rehabilitation Research & Development Center for Visual and Neurocognitive Rehabilitation, Atlanta VA Health Care System, Decatur, GA, United States
| | - Keith M. McGregor
- VA Rehabilitation Research & Development Center for Visual and Neurocognitive Rehabilitation, Atlanta VA Health Care System, Decatur, GA, United States
- Department of Neurology, Emory University, Atlanta, GA, United States
- Birmingham VA Geriatrics Research Education and Clinical Center, Birmingham, AL, United States
- University of Alabama –Birmingham, School of Health Professions, Department of Clinical and Diagnostic Sciences, Birmingham, United States
| | - Joe R. Nocera
- VA Rehabilitation Research & Development Center for Visual and Neurocognitive Rehabilitation, Atlanta VA Health Care System, Decatur, GA, United States
- Department of Neurology, Emory University, Atlanta, GA, United States
- Division of Physical Therapy, Department of Rehabilitation Medicine, Emory University, Atlanta, GA, United States
| | - Sarah J. Barber
- Department of Psychology, Georgia State University, Atlanta, GA, United States
- Gerontology Institute, Georgia State University, Atlanta, GA, United States
| | - Lisa C. Krishnamurthy
- VA Rehabilitation Research & Development Center for Visual and Neurocognitive Rehabilitation, Atlanta VA Health Care System, Decatur, GA, United States
- Department of Physics & Astronomy, Georgia State University, Atlanta, GA, United States
- Department of Radiology and Imaging Sciences, Emory University, Atlanta, GA, United States
| | - Vonetta M. Dotson
- Department of Psychology, Georgia State University, Atlanta, GA, United States
- Gerontology Institute, Georgia State University, Atlanta, GA, United States
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McGregor K, Nocera J, Novak T, Champion G, Mammino K, Goodwin-Hamel C, Walters C, Krishnamurthy L. Baseline Measures of Cortical Inhibition Predict Motor Performance Changes after Exercise Interventions. Arch Phys Med Rehabil 2022. [DOI: 10.1016/j.apmr.2022.08.779] [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: 12/03/2022]
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McGregor K, Champion G, Mammino K, Bello M, Nocera J, Krishnamurthy L. Changes in Gamma-aminobutyric Acid Concentrations in Sensorimotor Cortical Regions Following a 12-week Exercise Intervention in Older Adults. Arch Phys Med Rehabil 2020. [DOI: 10.1016/j.apmr.2020.09.109] [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: 12/01/2022]
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Laliève F, Tellier S, Dunand O, Boyer O, Llanas B, Roussey G, Samaille C, Novo R, Merieau E, Bacchetta J, Cailliez M, Rousset C, Champion G, Delbet J, Zaloszyc A, Taque S, Berard E, Nobili F, Parvex P, Djeddi D, De Parscaud L, Jay N, Ichay L, Lefranc V, Louillet F, Pietrement C, Klifa R, Cousin E, Postil D, Crepin S, Bahans C, Guigonis V. 06Adverse effects of rituximab used in children with idiopathic nephrotic syndrome. A multicentric retrospective study. Arch Pediatr 2017. [DOI: 10.1016/j.arcped.2017.10.010] [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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Coulibaly G, Ouédraogo-Yugbaré SO, Kouéta F, Yao LS, Savadogo H, Dao L, Leboucher B, Champion G, Kam L, Ouédraogo R, Yé D. [Perinatal asphyxia and acute renal insufficiency in Ouagadougou]. Arch Pediatr 2016; 23:249-54. [PMID: 26857645 DOI: 10.1016/j.arcped.2015.12.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [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: 12/28/2014] [Revised: 12/02/2015] [Accepted: 12/04/2015] [Indexed: 11/18/2022]
Abstract
AIM This study aimed to analyze acute renal failure in perinatal asphyxia (PNA) of term newborns in a sub-Saharan urban health center. PATIENTS AND METHODS The study was prospective, conducted from 1st June to 30th November 2013 on term newborns hospitalized at the centre hospitalier universitaire pédiatrique Charles-de-Gaulle for PNA. Renal insufficiency (RI) was defined by a serum creatinine greater than or equal to 90 μmol/L. RESULTS Eighty-five PNA cases were included, or 19.8% of newborns hospitalized in the study period. The sex ratio was 2.1. Thirty-eight newborns (44.7%) had RI. Their creatinine averaged 153.8±96.6 μmol/L. Twenty-six of 38 (68.4%) had brain damage in Sarnat stage 2 and 12 (31.6%) stage 3. Twelve newborns with RI (31.6%) had seizures. Transfontanellar echography revealed an abnormality in 30 cases (78.9%) of RI. Of the 38 newborns with renal failure, albuminuria was found in 21 cases (65.2%) and leukocyturia in 28 cases (73.7%). Renal function improved in 86.1% of cases. Newborns with initially normal serum creatinine had no RI during hospitalization. Six newborns (7.1%) died. CONCLUSION This study showed that acute RI is common during PNA most particularly in newborns with severe neurological impairment. In our context, earlier support for women in labor could help prevent PNA and therefore newborn acute RI.
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Affiliation(s)
- G Coulibaly
- Unité de formation et de recherche en sciences de la santé, Ouagadougou, Burkina Faso; Services de néphrologie et d'hémodialyse, centre hospitalier universitaire Yalgado Ouédraogo, Ouagadougou, Burkina Faso.
| | - S O Ouédraogo-Yugbaré
- Unité de formation et de recherche en sciences de la santé, Ouagadougou, Burkina Faso; Service de pédiatrie médicale, centre hospitalier universitaire pédiatrique Charles-de-Gaulle, Ouagadougou, Burkina Faso
| | - F Kouéta
- Unité de formation et de recherche en sciences de la santé, Ouagadougou, Burkina Faso; Service de pédiatrie médicale, centre hospitalier universitaire pédiatrique Charles-de-Gaulle, Ouagadougou, Burkina Faso
| | - L S Yao
- Service de pédiatrie médicale, centre hospitalier universitaire pédiatrique Charles-de-Gaulle, Ouagadougou, Burkina Faso
| | - H Savadogo
- Service de pédiatrie médicale, centre hospitalier universitaire pédiatrique Charles-de-Gaulle, Ouagadougou, Burkina Faso
| | - L Dao
- Unité de formation et de recherche en sciences de la santé, Ouagadougou, Burkina Faso; Service de pédiatrie médicale, centre hospitalier universitaire pédiatrique Charles-de-Gaulle, Ouagadougou, Burkina Faso
| | - B Leboucher
- Service de néonatalogie, Fédération de pédiatrie, CHU, 49933 Angers cedex 9, France
| | - G Champion
- Service de néphrologie pédiatrique, Fédération de pédiatrie, CHU, 49933 Angers cedex 9, France
| | - L Kam
- Unité de formation et de recherche en sciences de la santé, Ouagadougou, Burkina Faso; Service de pédiatrie, centre hospitalier universitaire Yalgado Ouédraogo, Ouagadougou, Burkina Faso
| | - R Ouédraogo
- Unité de formation et de recherche en sciences de la santé, Ouagadougou, Burkina Faso; Service de pédiatrie médicale, centre hospitalier universitaire pédiatrique Charles-de-Gaulle, Ouagadougou, Burkina Faso
| | - D Yé
- Unité de formation et de recherche en sciences de la santé, Ouagadougou, Burkina Faso; Service de pédiatrie médicale, centre hospitalier universitaire pédiatrique Charles-de-Gaulle, Ouagadougou, Burkina Faso
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Champion G, Belin R, Palancher H, Iltis X, Rouquette H, Pasturel M, Demange V, Castany P, Dorcet V, Tougait O. Development of characterisation methods on U(Mo) powders for material testing reactors (MTRs). POWDER TECHNOL 2014. [DOI: 10.1016/j.powtec.2013.10.048] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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Allard L, Giniès JL, Champion G, Chevailler A, Subra JF. Auto-anticorps anticytoplasme des polynucléaires neutrophiles en pédiatrie : caractéristiques cliniques. Arch Pediatr 2013; 20:232-40. [DOI: 10.1016/j.arcped.2012.12.020] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2012] [Revised: 10/19/2012] [Accepted: 12/11/2012] [Indexed: 11/30/2022]
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Champion G, Darviot E, Gatelais F, Duverger P, Rouget Maillard C. P336 - La multidisciplinarité, soutien efficace lors d’auditions d’enfants victimes d’abus sexuels. Arch Pediatr 2010. [DOI: 10.1016/s0929-693x(10)70732-6] [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: 11/16/2022]
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Affiliation(s)
- P Duverger
- Service de pédopsychiatrie, CHU d'Angers, 49933 Angers cedex 09, France
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Champion G. Frozen shoulder. Ann Rheum Dis 2005; 64:795-6; author reply 796. [PMID: 15834069 PMCID: PMC1755494] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/02/2023]
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Schlierf U, Champion G, Sproule GI, Moisa S, Fraser JW, Graham MJ, Schmuki P. Selective porosification of n-InP(100) after focused ion beam implantation of Si. ACTA ACUST UNITED AC 2003. [DOI: 10.1002/pssa.200306496] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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Burguet A, Abraham-Lerat L, Cholley F, Champion G, Bouissou F, André JL. [Terminal and pre-terminal chronic renal insufficiency in newborns in French neonatal intensive care units: survey of the French pediatric nephrologic society of resuscitation and emergency]. Arch Pediatr 2002; 9:489-94. [PMID: 12053542 DOI: 10.1016/s0929-693x(01)00830-2] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Abstract
OBJECTIVES The aim of this study was to describe the intensive care unit neonatologists' attitudes about a neonate with terminal or pre-terminal renal failure. METHODS A questionnaire was sent to all French neonatal intensive care units. Physicians were asked to describe their attitude about neonatal chronic renal failure (Would you agree with dialysis and graft for these children?). Physicians were also presented with two clinical observations involving neonates with varying degrees of renal insufficiency and a complicating comorbidity, including neurological abnormality or socioeconomic circumstances. RESULTS Responses were obtained from 92% of the university neonatal care units. The will to take care of a neonate with end-stage renal failure till the renal graft, varied greatly from a centre to another one. Three (9%) university-teams said they had a strong will to bring the baby from the neonatal period to the time of renal graft. Eleven other centres (32%) did not have any will for accompanying the baby till the renal graft. Eight centres (24%) would be rather favourable to the idea of dialysis and graft, and 12 others (35%) would be rather unfavourable. CONCLUSION The results of this study show great differences between French neonatologists when they are faced to newborns with end stage renal failure. Ethical, medical and organisational difficulties are matters of controversy. The epidemiological impact of the perinatal discussion could be a 20% variation of all the renal grafts in children.
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Affiliation(s)
- A Burguet
- Service de pédiatrie 2, CHU Saint-Jacques, 25030 Besançon, France.
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Champion G, Escax V, Cartier Dit Moulin C, Bleuzen A, Villain F, Baudelet F, Dartyge E, Verdaguer M. Photoinduced ferrimagnetic systems in Prussian blue analogues C(I)xCo4[Fe(CN)6]y (C(I) = alkali cation). 4. Characterization of the ferrimagnetism of the photoinduced metastable state in Rb1.8Co4[Fe(CN)6]3.3-13H2O by K edges X-ray magnetic circular dichroism. J Am Chem Soc 2001; 123:12544-6. [PMID: 11741418 DOI: 10.1021/ja011297j] [Citation(s) in RCA: 104] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
In Part 2 of this work, the electronic and local structure of the photoinduced metastable magnetic state of the Prussian blue analogue Rb1.8Co4[Fe(CN)6]3.3-13H2O were characterized. To determine directly the relative orientation of the magnetic moments of Co(II) and Fe(III) ions in the metastable state, and the nature of the exchange interaction between them, we performed X-ray magnetic circular dichroism (XMCD) experiments at the cobalt and iron K edges. We present the first direct experimental evidence of the antiferromagnetic interaction between the cobalt and the iron ions, leading to the ferrimagnetism of the photoinduced metastable state.
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Affiliation(s)
- G Champion
- Laboratoire de Chimie Inorganique et Matériaux Moléculaires, Unité CNRS 7071, Case 42, Université Pierre et Marie Curie, 4 place Jussieu, 75252 Paris Cedex 05, France
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Zhang Z, Jin L, Champion G, Seydel KB, Stanley SL. Shigella infection in a SCID mouse-human intestinal xenograft model: role for neutrophils in containing bacterial dissemination in human intestine. Infect Immun 2001; 69:3240-7. [PMID: 11292746 PMCID: PMC98282 DOI: 10.1128/iai.69.5.3240-3247.2001] [Citation(s) in RCA: 56] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Shigellae infect human intestine and cause intense inflammation and destruction of colonic and rectal mucosa. To model the interactions of shigella with human intestine in vivo, we have studied shigella infection in human intestinal xenografts in severe combined immunodeficient mice (SCID-HU-INT mice). Inoculation of shigella into human intestinal xenografts caused severe inflammation and mucosal damage, which was apparent as soon as 4 h following infection. Shigella infection was associated with human intestinal production of interleukin-1B (IL-1B) and IL-8 and a marked neutrophil influx into the graft. Depletion of neutrophils from SCID-HU-INT mice reduced inflammation in the human intestinal xenograft in response to shigella infection but failed to significantly alter tissue damage. However, the number of intracellular bacteria was more than 20-fold higher in the human intestinal xenografts from neutrophil-depleted SCID-HU-INT mice. Infection of human intestinal xenografts with an attenuated vaccine strain of shigella (CVD1203) induced lower levels of IL-1B and IL-8 than wild-type shigella and caused only moderate damage to the intestinal permeability barrier. Our studies establish the SCID-HU-INT mouse as a viable model for studying the interactions between shigella and human intestine and indicate that neutrophils are important for controlling the invasion of human intestine by shigella.
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Affiliation(s)
- Z Zhang
- Department of Medicine, Washington University School of Medicine, St. Louis, Missouri 63110, USA
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Caldari D, Pellier I, Anglade E, Reboul P, Champion G, Duverne C. Pyelonephrite xanthogranulomateuse: 1 cas d'evolution favorable sous traitement medical. Arch Pediatr 1999. [DOI: 10.1016/s0929-693x(99)81779-5] [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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Duverger P, Champion G, Malka J. Les Urgences Pedopsychiatriques A L'urgence Pediatrique: Donnees Recentes. Arch Pediatr 1999. [DOI: 10.1016/s0929-693x(99)81596-6] [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: 10/25/2022]
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Rischmueller M, Lester S, Chen Z, Champion G, Van Den Berg R, Beer R, Coates T, McCluskey J, Gordon T. HLA class II phenotype controls diversification of the autoantibody response in primary Sjögren's syndrome (pSS). Clin Exp Immunol 1998; 111:365-71. [PMID: 9486405 PMCID: PMC1904917 DOI: 10.1046/j.1365-2249.1998.00504.x] [Citation(s) in RCA: 62] [Impact Index Per Article: 2.4] [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] [Accepted: 10/21/1997] [Indexed: 02/06/2023] Open
Abstract
The coexistence of anti-La (SS-B) and anti-Ro (SS-A) autoantibodies in pSS is probably explained by intermolecular spreading of autoimmunity toward different components of the La/Ro ribonucleoprotein (RNP). In order to evaluate the role of the HLA class II phenotype in controlling diversification of this autoantibody response, 80 patients with pSS were typed by polymerase chain reaction sequence-specific oligonucleotide (PCR-SSO) at the HLA class II loci DRB1, DQA1 and DQB1. Serum samples were examined for anti-La and anti-Ro by counterimmunoelectrophoresis and by ELISA using purified recombinant La and 60-kD Ro proteins. Patient sera were classified according to the extent of diversification of the anti-La, anti-Ro response including the presence or absence of precipitating anti-La antibodies. Immunogenic characteristics of these stratified groups were then studied. All patients with pSS, with or without autoantibodies to Ro and La, were found to have at least one of the HLA-DRB1 types DR2, DR3 or DR5. The HLA DR3-DQA1*0501-DQB1*02 (DR3-DQ2) haplotype was primarily associated with a diversified La/Ro RNP response containing precipitating autoantibodies to La (P<0.001); whereas the haplotype HLA DR2-DQA1*0102-DQB1*0602 (DR2-DQ1) was associated with a less diversified La/Ro RNP response containing non-precipitating (restricted epitope) anti-La autoantibodies (P<0.001). Anti-La-positive patients lacking both HLA-DR2 and HLA-DR3 all expressed the HLA-DQA1*0501 allele, which was present at increasing frequency with greater diversification of the anti-La/Ro autoantibody response. The association of distinct HLA haplotypes with different degrees of autoantibody diversification in patients with pSS suggests a model of HLA-restricted presentation of La/Ro peptide determinants to autoreactive helper T cells. We propose that non-precipitating anti-La responses are driven by limited intermolecular help from DR2-DQ1-restricted T helper cells recognizing Ro determinants. On the other hand, we speculate that the more diversified, precipitating anti-La responses obtain more efficient cognate T help from DR3-DQ2-restricted T helper cells recognizing La determinants, where HLA-DQA1*0501 may be a critical determinant for antigen presentation.
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Affiliation(s)
- M Rischmueller
- Department of Immunology, Allergy and Arthritis, Flinders Medical Centre and Flinders University of South Australia
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Abstract
Mutations in the CLCN5 gene, mapped in Xp11.22, have been recently reported to be associated with X-linked nephrolithiasis, X-linked recessive hypophosphataemic rickets and Dent's disease. We report a missense mutation in exon 6 of the CLCN5 gene. The mutation in this pedigree is S244L, the same mutation as has previously been described in an Italian family showing a similar pathology. However, in the family reported here, affected males have developed neither nephrolithiasis nor nephrocalcinosis. The question arises whether we are dealing with a milder phenotype or whether a more severe pathology will develop with ageing.
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Affiliation(s)
- C Oudet
- Institut de Génétique et de Biologie Moléculaire et Cellulaire, CNRS/INSERM/ULP, Illkirch, France
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Grimal I, Giniès J, Champion G, Limal J, Audran M. Mineralisation osseuse de l'enfant diabetique. etude par absorptiometrie biphotonique a rayon x. Arch Pediatr 1997. [DOI: 10.1016/s0929-693x(97)86594-3] [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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Radet C, Champion G, Grimal I, Duverne C, Coupris L, Ginies JL, Limal JM. [Urinary tract abnormalities with prenatal diagnosis: neonatal management and outcome of 100 children born 1988-1990 at the Angers CHU (University Hospital)]. Arch Pediatr 1996; 3:1069-78. [PMID: 8952769 DOI: 10.1016/s0929-693x(96)89511-x] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
UNLABELLED Malformative uropathies diagnosed in utero are increasing in number. This work describes the decision strategy adopted in Angers concerning the neonatal handling of those abnormalities. PATIENTS AND METHODS One hundred children born between 1988 and 1990, with prenatally suspected fetal uropathy, were included in the study and followed for a period of 3 years. In every case, an ultrasound scan was performed at birth. In cases with persistent abnormality, a voiding cystourethrography was done in the first week of life. An intravenous urograph and/or a nuclear renography were performed during the second month of life. RESULTS Twenty-nine children were normal. Seventy-one were affected by 126 isolated or related uropathies; the most frequent ones were the ureteropelvic junction obstruction syndrome (48), ureterovesical junction obstruction (18) and multicystic kidneys (13). A vesicoureteral reflux was associated in 22% of cases. The diagnosis was perfectly correlated with the prenatal diagnosis in 50% of cases. Fourteen of the normal children had a later ultrasound scan control, between 2 and 9 months; later on, three of them showed a moderate ureteropelvic junction obstruction syndrome. Amongst the 48 ureteropelvic junction obstruction syndromes, 22% have been operated on. The others obstructive uropathies remained stable or spontaneously improved. DISCUSSION These results require us to discuss as matter of priority the large number of spontaneously regressive prenatal hydronephrosis and the necessity to establish a consensus for the pre and postnatal pathological thresholds of the anteroposterior pelvic diameter, the interest in carrying out a voiding cystography after the birth when dilatation is confirmed, the interest of nuclear renography for the diagnosis and follow-up of obstructive uropathies and the absence of urgency for surgery. CONCLUSION We propose a decision tree specifying the action to take when facing the diagnosis of a prenatal hydronephrosis. It could be a part of the reflection for the medical teams handling these uropathies is the aim of a consensual attitude which is now essential.
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Affiliation(s)
- C Radet
- Département de pédiatrie B, centre Robert-Debré, CHU, Angers, France
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Giniès JL, François H, Joseph MG, Champion G, Coupris L, Limal JM. A curable cause of chronic idiopathic intestinal pseudo-obstruction in children: idiopathic myositis of the small intestine. J Pediatr Gastroenterol Nutr 1996; 23:426-9. [PMID: 8956181 DOI: 10.1097/00005176-199611000-00012] [Citation(s) in RCA: 19] [Impact Index Per Article: 0.7] [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: 02/03/2023]
Abstract
We report an intestinal pseudo-obstruction syndrome occurring in a 6-month-old infant girl suffering from acquired major and persistent abdominal distension, which 2 months later required ileostomy. Histologic examination of samples of the small intestine showed considerable inflammatory reaction in the muscular layers of the intestinal wall. Steroid therapy, begun as soon as the histologic results were known, resulted in recovery. In a similar case, reported previously, steroid therapy used after the lesions had already caused fibrosis and atrophy of the intestinal wall, proved ineffective. This particular form of pseudo-obstruction is classified as "idiopathic myositis of the small intestine." It is important to identify the condition because an early course of steroid therapy, before the appearance of fibrotic lesions, could improve the prognosis.
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Bouvier M, Landreau D, Pelle B, Souhard M, Champion G. [Training protocol for nurses in a hemodialysis unit]. Rev Infirm 1996:12-7. [PMID: 8850703] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
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Abstract
BACKGROUND/AIMS Several reports suggest that duodenogastroesophageal reflux may produce esophagitis, Barrett's esophagus, and esophageal adenocarcinoma. The purpose of this study was to understand better the relationship of pH (< 4 and > 7), duodenogastroesophageal reflux, and fasting bile acid concentrations in producing esophageal damage. METHODS Using a spectrophotometric technique to measure bile reflux, four groups were studied: healthy subjects, reflux patients, patients with Barrett's esophagus, and patients with esophageal symptoms after partial gastrectomy. RESULTS Simultaneous 24-hour pH and bile monitoring of distal esophagus found close association between total percent of time pH < 4 and duodenogastroesophageal reflux (r = 0.78; P < 0.001) but a poor relationship (r = -0.06) with total percent of time pH > 7, suggesting that the term alkaline reflux is a misnomer. Duodenogastroesophageal reflux increased significantly with the severity of reflux disease, being greatest in patients with Barrett's esophagus and comparable with that in patients with partial gastrectomy. Fasting bile acid concentrations did not distinguish patients with Barrett's esophagus from those with reflux. Rather, increased quantity of acid reflux was the single factor most characterizing patients with Barrett's esophagus. Omeprazole (20 mg twice daily) normalized acid reflux parameters (13.8% +/- 1.6% to 0.8% +/- 0.6%) and significantly (P < 0.001) decreased duodenogastroesophageal reflux (32.8% +/- 6.9% to 4.7% +/- 1.7%). CONCLUSIONS Acid reflux is the primary factor in the development of Barrett's esophagus. Bile reflux parallels acid reflux and, at best, may have a synergistic role. Aggressive acid suppression with omeprazole markedly decreases both.
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Affiliation(s)
- G Champion
- Division of Gastroenterology, University of Alabama at Birmingham
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26
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Abid S, Champion G, Richter JE, McElvein R, Slaughter RL, Koehler RE. Treatment of achalasia: the best of both worlds. Am J Gastroenterol 1994; 89:979-85. [PMID: 8017394] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
OBJECTIVE To conduct a retrospective analysis of one center's experience with treating achalasia over 4 yr with skilled gastroenterologists using primarily the Rigiflex balloon dilator and with a senior surgeon performing Heller myotomies. METHODS Newly diagnosed cases of achalasia were identified by a computer search of hospital records. Charts were reviewed for the presence/severity of dysphagia, regurgitation, heartburn, and chest pain. Weight loss was also recorded. Esophageal manometries and barium swallows were reviewed. Choice of treatment was made freely by patients. With an a priori definition of success, follow-up was conducted by telephone interviews. RESULTS A total of 45 achalasia patients (mean age, 46 yr; 32 females, 13 males) were identified with a symptoms-frequency as follows: dysphagia, 100%; regurgitation, 78%; heartburn, 50%; and chest pain, 42%. Mean weight loss was 17.5 pounds. Primary treatment was pneumatic dilation in 36 patients and surgery in nine patients. In a total of 45 pneumatic dilations, three (6.6%) were complicated by perforation. Five (14%) patients required repeat dilation. Mean duration of follow-up for pneumatic dilation and surgery was 27 months and 20.8 months, respectively. The overall excellent-good success rates were: pneumatic dilation 88% and surgery 89%. In comparing the efficacy of pneumatic dilation versus surgery, all symptoms were improved significantly (p < 0.01) in both groups, except heartburn, which increased postmyotomy. CONCLUSIONS If both procedures are available by skilled operators, pneumatic dilation and surgery are equally effective in the treatment of achalasia.
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Affiliation(s)
- S Abid
- Division of Gastroenterology, University of Alabama at Birmingham
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Marks RD, Richter JE, Rizzo J, Koehler RE, Spenney JG, Mills TP, Champion G. Omeprazole versus H2-receptor antagonists in treating patients with peptic stricture and esophagitis. Gastroenterology 1994; 106:907-15. [PMID: 7848395 DOI: 10.1016/0016-5085(94)90749-8] [Citation(s) in RCA: 152] [Impact Index Per Article: 5.1] [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: 01/27/2023]
Abstract
BACKGROUND/AIMS Although dysphagia in patients with peptic stricture is attributed to a decreased luminal diameter, coexistent esophagitis may be an equally important cause. The goals of this study were to determine whether medical healing of esophagitis in patients with stricture improves dysphagia and decreases dilatation need and to compare the efficacy and cost-effectiveness of omeprazole versus H2-receptor antagonists (H2RA). METHODS Thirty-four dysphagic patients with peptic stricture and erosive esophagitis were dilated and randomized to omeprazole 20 mg every day versus H2RA (ranitidine 150 mg twice daily or famotidine 20 mg twice daily). Patients received further dilatations only if dysphagia frequency was greater than or equal to once per week. At 3 and 6 months, patients were assessed for esophagitis healing, dysphagia relief, and bougienage requirements. Cost-effectiveness of omeprazole and H2RA was determined. RESULTS Patients with healed esophagitis at 3 and 6 months were more likely to dysphagia-free and to require fewer dilatations than patients with persistent esophagitis. At 6 months, omeprazole produced a significantly (P < 0.01) higher rate of esophagitis healing, dysphagia relief, and fewer dilatations compared with H2RA. Omeprazole was also 40%-50% more cost-effective. CONCLUSIONS Esophagitis healing improves dysphagia and decreases dilatation need in patients with peptic stricture. Omeprazole heals esophagitis and relieves dysphagia more efficaciously than H2RA while decreasing costs to patients.
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Affiliation(s)
- R D Marks
- Division of Gastroenterology, University of Alabama at Birmingham
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Champion G, Richter JE, Singh S, Schan C, Nellans H. Effects of oral erythromycin on esophageal pH and pressure profiles in patients with gastroesophageal reflux disease. Dig Dis Sci 1994; 39:129-37. [PMID: 8281847 DOI: 10.1007/bf02090072] [Citation(s) in RCA: 22] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
Abstract
Erythromycin, a possible motilin agonist, is a potent gastrokinetic agent that may increase the lower esophageal sphincter pressure. Therefore, we assessed the effects of erythromycin in two dosages (250 and 500 mg per os four times a day) on esophageal pH and pressure profiles in reflux patients using prolonged ambulatory monitoring systems. Studies were blinded, placebo-controlled with randomized crossover design. Patients took each drug for three days prior to studies, with erythromycin serum levels obtained the day of esophageal studies. Erythromycin 250 mg four times a day had no effect on esophageal contraction pressures or peristalsis during the day or meal periods. In the supine position, however, erythromycin significantly (P = 0.012) decreased esophageal contraction velocity and showed a strong trend (P = 0.059) towards increasing the percentage of peristaltic waves. Despite these potentially beneficial effects on esophageal clearance, no significant difference in acid exposure times during 24-hr pH studies were observed between placebo and low-dose erythromycin. High-dose erythromycin (500 mg four times a day) was associated with drug levels in the typical antibiotic efficacy range (normal 1-3 micrograms/ml; patients 1.7-7.0 micrograms/ml), but, here again, there was no significant difference in all acid reflux parameters between placebo and erythromycin phases. Therefore, "standard" doses of erythromycin have no important clinical effects on esophageal pressures or acid reflux parameters.
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Affiliation(s)
- G Champion
- Division of Gastroenterology, University of Alabama at Birmingham 35294
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29
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Joseph MG, Jouanny AC, Chomienne F, Champion G, Giniès JL, Limal JM. [Hypothalamic syndromes. Review of clinical and endocrinal semiology]. Ann Pediatr (Paris) 1993; 40:475-9. [PMID: 8239400] [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: 01/29/2023]
Abstract
A case of hypothalamic dysfunction in a girl with a twelve-year follow-up is reported. Onset occurred at the age of three with severe obesity, hypothermia, hypersomnia, and lethargy. Somatotropic, gonadotropic, and thyrotropic hormones were low, whereas prolactin was increased. Imaging techniques failed to disclose any lesion of the hypothalamus or pituitary. Clomipramine improved the vegetative disorders. The literature on clinical and hormonal disorders of hypothalamic dysfunction is reviewed.
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Affiliation(s)
- M G Joseph
- Service de Pédiatrie B, Centre Robert Debré, CHU, Angers
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30
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Wong CS, Champion G, Smith MD, Soden M, Wetherall M, Geddes RA, Hill WR, Ahern MJ, Roberts-Thomson PJ. Does steroid pulsing influence the efficacy and toxicity of chrysotherapy? A double blind, placebo controlled study. Ann Rheum Dis 1990; 49:370-2. [PMID: 2116773 PMCID: PMC1004102 DOI: 10.1136/ard.49.6.370] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
To test the hypothesis that early steroid pulsing augments the efficacy and decreases the toxicity of chrysotherapy 40 patients with rheumatoid arthritis were studied in a double blind, placebo controlled study. During the first three months of gold treatment group 1 received monthly intravenous methylprednisolone pulsing (steroid group) while group 2 received placebo (placebo group). All patients were assessed clinically and serologically over a 24 week period. Twelve patients were withdrawn before completion of the study and all but one of the remaining 28 patients reported clinical and serological improvements. Two patients in the steroid group were withdrawn owing to gold induced side effects while four were withdrawn in the placebo group. These small numbers were not significantly different. Minor side effects occurred more commonly in the placebo group. The clinical response was clearly better in the steroid group with statistical significance almost being achieved. In an endeavour to obtain a significant conclusion further patients will now be entered into this study.
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Affiliation(s)
- C S Wong
- Department of Clinical Immunology, Flinders Medical Centre, Bedford Park, South Australia
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31
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Ginies JL, Goulet O, Champion G, Larchet M, Granry JC, Coupris L, Fékété C, Ricour C, Limal JM. [Munchausen's syndrome by proxy and chronic intestinal pseudo-obstruction]. Arch Fr Pediatr 1989; 46:267-9. [PMID: 2751396] [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: 01/02/2023]
Abstract
A case of intestinal pseudo-obstruction in a 4 1/2 year-old boy is reported. All etiologic investigations remained negative. Management successively required continuous enteral feeding, ileostomy then total parental nutrition. The proof of a chronic barbiturate intoxication, induced by the mother, was made only after 2 1/2 years of follow-up, when the patient was in a critical condition. Separation of the child from his family led to complete disappearance of symptoms within a few days.
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Affiliation(s)
- J L Ginies
- l'Hôpital d'Enfants, Centre Robert-Debré, CHU, Angers
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Abstract
The clinical features of six women with spinal cord meningioma are presented. These cases comprise the neurosurgical experience of one of the authors (B.B.) over approximately a 3-year period. Median age was 76 years with a range of 65-89 years. Previous reports of this disorder have not emphasized the occurrence of this tumour in the later decades. A notable feature was delay in diagnosis. Only one patient had a correct diagnosis of spinal cord compression prior to admission. Incorrect diagnoses included diabetes mellitus, osteoarthritis, degenerative spinal disease, gait disturbance secondary to fall and a thalamic cerebrovascular accident. Gait disorders at presentation included paraparesis, wide-based gait and unclassified disability. All patients had pyramidal tract signs and five had a truncal sensory level. Plain radiographs of the spine were unhelpful and can dissuade the physician from the diagnosis. All tumours were in the thoracic region. Surgery resulted in cure in all patients and diverted one patient from planned institutional care. Spinal cord meningioma should be considered in elderly patients presenting with gait disorder.
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Affiliation(s)
- G Champion
- Flinders Medical Centre, Bedford Park, Australia
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Giniès JL, Duverne C, Champion G, Limal JM, Coupris L. [Mediastinal pseudocyst in hereditary pancreatitis]. Arch Fr Pediatr 1986; 43:709-10. [PMID: 3813801] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
A 6 year-old child was hospitalized for thoracoabdominal pain. There was a clinical and radiological right pleural effusion. Ultrasonography showed a pseudocyst of the head of the pancreas. CAT scan and operative opacification showed a mediastinal extension of the pseudocyst, with no communication with the pleural effusion. This pseudocyst illustrates an unusual variation of a known complication of this disease. Recovery was obtained via fistulization into the jejunum.
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Champion G, Nivet H. [End-stage renal insufficiency in children less than 4 months old. Survey of the French Pediatric Nephrology Club]. Arch Fr Pediatr 1986; 43:481-6. [PMID: 3541829] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
One hundred and eleven cases of children with end-stage renal failure prior to 4 years of age were collected from a survey of the French Pediatric Nephrology Club. Clinical and epidemiological data stress the importance of certain etiologies such as 40 cases of renal hypoplasia. The necessity of planning extracorporeal dialysis from the first year of life in 37% of patients demonstrates the importance of difficulties to be overcome. The treatments used for the 82 treated children show the interest of conservative management. However, peritoneal dialysis remains the first treatment of choice (52 times). Besides the problems of hemodialysis vascular approach, related to the small caliber of vessels, the complications of the clearance techniques did not appear to be more frequent than in older children. Use of transplantation is not negligible as 25% of transplanted patients were under 4 years of age; however none was under one year or weighted less than 8 kg. Transplantation remains ultimate treatment, even more so as the actuarial survival at 5 years is clearly worse for children submitted to hemodialysis (68%) than to transplantation (91%) (p less than 0.05).
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Ginies JL, Champion G, Duverne C. [Exclusive parenteral nutrition using a central catheter in children]. Soins Gynecol Obstet Pueric Pediatr 1985:7-11. [PMID: 3925579] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
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de Rasilly A, Champion G. [Substitutes for cow's milk]. Soins Gynecol Obstet Pueric Pediatr 1985:33-5. [PMID: 3848165] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
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Champion G, Ginies JL, Lintanf G, Breugnot F. [Constant flow enteral feeding in pediatrics]. Soins Gynecol Obstet Pueric Pediatr 1985:21-6. [PMID: 3925577] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
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Broyer M, Niaudet P, Champion G, Jean G, Chopin N, Czernichow P. Nutritional and metabolic studies in children on continuous ambulatory peritoneal dialysis. Kidney Int Suppl 1983; 15:S106-10. [PMID: 6368945] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Abstract
A study was done of 15 children and adolescents, aged 2.5 to 17.5 years, who were treated by continuous ambulatory peritoneal dialysis (CAPD) for 6 to 24 months. Plasma albumin concentration decreased from 34.4 +/- 4.8 g/liter at the onset of therapy to 31.3 +/- 5.3 g/liter after 19 to 24 months. Children less than 6 years old had lower albumin levels (29.4 +/- 1.7 g/liter) than did the older group (36.3 +/- 4.2 g/liter). The lower plasma albumin was related to peritoneal protein loss but not to protein intake. Plasma free amino acid concentrations were not significantly modified. No changes occurred in the oral glucose tolerance test during the course of CAPD. Plasma cholesterol and triglycerides were abnormally high for age, with a correlation seen between cholesterolemia and peritoneal protein loss.
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Houssin A, Champion G, Hurez D. [Performance of reused plasma separating filters]. Pathol Biol (Paris) 1982; 30:737-40. [PMID: 6760075] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
Abstract
The performances of reused plasma separators are studied with the coefficient of filtration of IgG and IgM through the membrane and the extraction of the same immunoglobulins from the patient's plasma. 10 filters are used for 32 plasma exchanges in 6 patients. At the second use, the filter retains 78% of the initial performances. There is no more loss of the performances with the next uses. Biologic efficiency appreciated by extraction of IgG don't decrease significantly with the reuses. Those findings let us suggest the reuse of the plasma separators.
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