F Barbé

Publications (7)16.61 Total impact

• Article: QT interval lengthening in premature infants treated with doxapram.

  C Maillard, M J Boutroy, J Fresson, F Barbé, J M Hascoët
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  ABSTRACT: Doxapram, routinely used in premature infants treated for apnea of prematurity unresponsive to methylxanthines, has been related to cardiac conduction disorders. This study was designed to evaluate doxapram cardiac and general tolerance and its relationship to drug plasma concentrations in very premature infants. Forty infants (mean +/- SEM, 28.9 +/- 0.3 weeks of gestation) who were given intravenous doxapram, 0.5 to 1 mg/kg per hour, at 15.9 +/- 2.4 days of life were evaluated prospectively. Electrocardiograms were monitored before and during the first 3 days of treatment. QT interval corrected for heart rate (QTc) longer than 440 ms was regarded as clinically pertinent, given that it is considered a significant risk of conduction disorder leading to torsades de pointes and sudden death. Other side effects were recorded. Toxic plasma concentration of doxapram and ketodoxapram was set at >4 mg/L. A statistically significant but moderate lengthening of QTc interval has been observed from 394 +/- 4 ms before doxapram to 409 +/- 4 ms at 48 and 72 hours of treatment (P =.0065). For 6 patients, QTc interval became longer than 440 ms without any other rhythm or conduction disorder. Digestive disorders were observed in 20 infants but 9 presented with concomitant septicemia. No relationship was found between presence or absence of adverse effects and drug plasma concentrations. Our study enlightened the lengthening effect of doxapram on QTc interval in premature infants with a risk of exceeding the 440 ms threshold that is considered life-threatening. This finding emphasizes the need for electrocardiogram follow-up when using doxapram in neonates.
  Clinical Pharmacology &#38 Therapeutics 12/2001; 70(6):540-5. · 6.04 Impact Factor
• Article: Severe side effects and drug plasma concentrations in preterm infants treated with doxapram.

  F Barbé, C Hansen, Y Badonnel, H Legagneur, P Vert, M J Boutroy
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  ABSTRACT: A high-performance liquid chromatography method has been developed for simultaneous determination of doxapram and its metabolites including ketodoxapram, the main and only active metabolite. The aim of the study was to evaluate this microtechnique and to report the cases involving severe adverse effects to determine toxic plasma levels in neonates. The method was found to be selective, and showed a good baseline separation of doxapram and metabolites. Recovery, linearity, intraday/interday precision, and limit of detection determined in aqueous solutions and in spiked plasma were satisfactory. The assay is simple, rapid, and plasma-sparing, which represents a true advantage in managing neonates. Case analysis was performed in two consecutive periods: 124 preterm infants in the first period and 173 in the second period. Severe toxic effects were observed in 4 cases in the first period, with doxapram plus keto-doxapram levels 9 mg/L. In the second period, only one case was observed. High-range plasma concentrations were significantly less frequent in the second period than in the first one. The authors conclude that measuring doxapram plus keto-doxapram in plasma may be of interest to avoid severe toxic effects in preterm neonates treated with doxapram.
  Therapeutic Drug Monitoring 11/1999; 21(5):547-52. · 2.49 Impact Factor
• Article: [Stability of extemporaneous preparations of doxapram (Dopram) for neonatal use].

  F Barbé, H Legagneur, D Boisseau, Y Badonnel, M J Boutroy
  Archives de Pédiatrie 11/1998; 5(10):1170-1. · 0.30 Impact Factor
• Article: Undetectable luteinizing hormone levels using a monoclonal immunometric assay.

  F Barbé, H Legagneur, V Watrin, M Klein, Y Badonnel
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  ABSTRACT: Previous studies have shown wide discrepancies among the results obtained with different immunometric assays. We present five cases (out of 4000 women) whose plasma luteinizing hormone was not detected using a LH immunometric assay (LH Stratus Baxter) but was recognized by other kits. These cases concerned one 28-year-old woman presenting with infertility and four postmenopausal women. The LH Amerlite kit gave detectable but low results. The results obtained with the other kits were > 7 IU/l. FSH levels were > 7 IU/l. In one case, sera were taken before and after the menopause; differences between the LH results increased. Discrepancies among LH assay kits have been attributed to variation both in standard curve calibration and in epitope specificity of the kit monoclonal antibodies. The Baxter kit might misrecognize some isoforms present in postmenopausal women. The present data illustrate the potential false results with such immunoassays in routine clinical laboratory testing. When undetectable LH results are not clinically explained or when disparities between LH and FSH are observed, we suggest using a second methodology or a bioassay if necessary. Improvement in LH assays and standardization might resolve the problem of discrepancies between the LH results.
  Journal of endocrinological investigation 12/1995; 18(10):806-8. · 1.57 Impact Factor
• Article: Circulating chromogranin A and catecholamines in human fetuses at uneventful birth.

  A Moftaquir-Handaj, F Barbé, P Barbarino-Monnier, D Aunis, M J Boutroy
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  ABSTRACT: Chromogranin A (CGA), a large acidic 48-kD protein, costored and coreleased by exocytosis with catecholamines, has been shown to be a precursor of peptides that exert feedback regulatory control on catecholamine secretion. In plasma, CGA levels increase in response to a large-amplitude physical stimulation in adult subjects and may be related to catecholamine levels. Any skin information is not yet available when the sympathoadrenal system is highly active during birth. This activation is strongly related to parturition circumstances such as the mode of delivery. The aim of our study was to determine CGA plasma levels in infants delivered vaginally or by elective cesarean section and to investigate the possible correlation between CGA and catecholamine concentrations. Plasma levels of catecholamines (norepinephrine and epinephrine) and CGA were assessed by HPLC with electrochemical detection and immunoenzymology, respectively. CGA and norepinephrine concentrations were significantly higher (p < 0.0002 and p < 0.02) in infants vaginally born than in the group delivered by elective cesarean section. A significant relationship (p < 0.04) was found between CGA and norepinephrine levels. However, for epinephrine, no significant difference was found between both groups. These results demonstrate the fetus' ability to corelease CGA and norepinephrine massively in response to stress of birth.
  Pediatric Research 01/1995; 37(1):101-5. · 2.70 Impact Factor
• Article: Inhibin as a marker for hydatidiform mole: a comparative study with the determinations of intact human chorionic gonadotrophin and its free beta-subunit.

  Y Badonnel, F Barbé, H Legagneur, E Poncelet, M Schweitzer
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  ABSTRACT: The purpose of the study was to evaluate plasma inhibin as a marker of hydatidiform mole and to compare the results with intact human chorionic gonadotrophin (hCG) and its free beta-subunit. Serial determinations of the plasma concentrations of inhibin, intact human chorionic gonadotrophin and its free beta-subunit in cases of hydatidiform mole over an average period of 140 days. Five cases of hydatidiform mole, including patients with spontaneous remission after evacuation or persistent trophoblastic disease. Immunoreactive inhibin, hCG and free hCG beta-subunit were measured using standard enzyme immunoassays. Inhibin and free hCG beta-subunit levels were greater than in normal pregnant women at the same gestational age. Only intact hCG could detect the persistence of trophoblastic tissue. Our data suggest that inhibin, intact human chorionic gonadotrophin and free beta-subunit might be useful as diagnostic markers of molar pregnancies. However, the original method of intact hCG determination is still superior for follow-up.
  Clinical Endocrinology 09/1994; 41(2):155-62. · 3.17 Impact Factor
• Article: Early detection of antibodies to human immunodeficiency virus 1 by a third-generation enzyme immunoassay. A comparative study with the results of second-generation immunoassays and western blot.

  F Barbé, M Klein, Y Badonnel
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  ABSTRACT: The aim of the study was to examine the sensitivity and the specificity of a HIV-1/HIV-2 third-generation enzyme immunoassay, the Abbott recombinant HIV-1/HIV-2 third-generation enzyme immunoassay, which is reported to detect simultaneously IgG and IgM. Sensitivity was evaluated with sera from seropositive subjects and a series of samples from eight HIV-1 seroconverting subjects. Results were compared with Western blot, second-generation immunoassays (including Vidas HIV-1 + 2) and an HIV-1 antigen assay. Specificity was studied with sera collected from a low-risk population and sera with false-reactive enzyme immunoassays results. In seven cases, the third-generation immunoassay detected HIV-antibodies several days earlier (range 4 to > or = 9 days) than the Western blot test according to the criteria proposed by the Association of State and Territorial Public Health Laboratory Directors, ie, positive with two of the three bands-gp160 or gp120, gp41, and p24. In the last case detection occurred at the same time as Western blot. The second-generation tests generally detected HIV-antibodies at the same time as Western blot. Antigaenemia was positive in the first samples tested in most cases, prior to or simultaneously with the Abbott third-generation test first reactivity, before the second generation tests and the Western blot test. In most cases, the disappearance of detectable HIV antigen was observed, and was concurrent with the development of the antibodies immune response. For our low-risk population, the current third-generation EIA test obtained a false-reactive rate of 0.26%. Our data indicate that the Abbott third-generation immunoassay is more sensitive than the Western blot test and the second-generation tests. The addition of a third-generation assay to the strategy for HIV-antibody screening may indeed be of interest and could make it possible to decrease the number of false-negative results.
  Annales de biologie clinique 02/1994; 52(5):341-5. · 0.34 Impact Factor