[Show abstract][Hide abstract] ABSTRACT: Le tétrachlorure de carbone (CCl4) est un hépatotoxique qui provoque une altération massive des hépatocytes. Une intoxication massive des rats en injection intrapéritonéale (IP), avec des doses mortelles, provoque leur mort en 24 heures. Un traitement avec l’extrait aqueux deGomphrena celosioides (EAG), à des doses comprises entre 250 et 750 mg/kg de poids vif (PV), entraîne une baisse de la mortalité. À partir de la dose de 500 mg/kg PV, la mortalité est de 0 % avec une baisse du taux des transaminases. L’étude histologique des foies des rats à cette dose révèle des lésions moindres que celles observées chez les animaux morts et ceux ayant reçu une dose inférieure. La dose de 500 mg d’EAG/kg PV peut être considérée comme la dose efficace de l’EAG sur le foie du rat intoxiqué au CCl
Abstract: Carbon tetrachloride (CCl4) is hepatotoxic and causes massive damage to hepatocytes. Massive intoxication of rats by intraperitoneal injection with lethal doses induced death in 24 h. Treatment with aqueous extract of Gomphrena celosioides (AEG), with doses between 250 and 750 mg/kg of body weight (BW), caused a decrease of mortality. From the dose of 500 mg/kg BW, the observed mortality was 0% with a decrease of transaminase levels. Histological study of the rats’ livers at this dose showed that the survived rats had a liver in a better anatomical structure than the liver of those died and those receiving a lower dose. 500 mg/kg BW of AEG can be considered as the effective dose in rats intoxicated with CCl4
[Show abstract][Hide abstract] ABSTRACT: We determined the type of toxins produced by Staphylococcus aureus strains and the possible source of contamination during an
outbreak of nosocomial pneumonia in a Paediatric service in Benin.Data of 37 patients admitted in themalnourished unitwhowere
diagnosed with pneumonia according to WHO definition and with radiological evidence of a pulmonary infiltrate were collected
within six weeks. Pneumonia was further confirmed by the identification of corresponding pneumonia-related S. aureus. Samples
were also collected from hospital personnel, the environment, and the food fed to the patients. Pulsed field gel electrophoresis
(PFGE) was used to compare the bacterial profile from different sources. Among the 37 patients admitted during this period, 17
developedpneumonia and 10were associatedwithS. aureus strains.Nine patients infectedwith S. aureus PVL-producing strains had
underlying diseases and developed an acute multilobar pneumonia, which was fulminating and rapidly became fatal in all except
the oldest child. Most of the isolates found on sick children were similar to those from special nutrients consumed by children
and on the personnel at the hospital.The highly probable relationships between children contamination and isolate presence in the
special nutrient underline the rapid and disastrous dissemination of some PVL-producing isolates in this paediatric uni
[Show abstract][Hide abstract] ABSTRACT: Background: Infections due to Staphylococcus sciuri in hospitalized patients seem to be emerging in different
countries. Their incidence and clinical impact with inpatients have not been studied in Benin.
Objective: The aim of this study was to estimate the prevalence of Staphylococcus sciuri during bloodstream
infection and to assess the importance of the hospital environment as a possible secondary reservoir of multiresistant
bacteria capable of colonizing or infecting patients.
Patients and methods: Between June and December 2008, clinical information and samples were collected
from patients suspected to have nosocomial bloodstream infections at a tertiary hospital in Benin. The isolates
were identified, tested for antimicrobial susceptibility. Particularly attention was paid to Staphylococcus sciuri and
factors associated with the carriage. Concurrently, swabbing of environment was achieved. MALDI TOF of abundant
proteins was applied to identify and to discriminate Staphylococcus sciuri isolates.
Results: Nosocomial bactereamia incidence rate was 2, 58 cases per 1000 patient-days. The proportion of
Staphylococcus sciuri among coagulase negative staphylococci was 24.5% and represented 15% of the environment
specimens. Catheter was the commonest source of nosocomial bacteremia (41%). The frequency of resistance to
methicillin for Staphylococcus aureus isolates was 36% and 44% for Staphylococcus sciuri isolates. Mass spectra
were specific for five groups of S. sciuri isolates.
Conclusion: Our survey revealed a high level of Staphylococcus sciuri among Coagulase Negative
Staphylococcus isolated from blood specimen. There is a need to institute strict hospital infection control policy and
a regular surveillance of resistance to antimicrobial agents.
[Show abstract][Hide abstract] ABSTRACT: methicillin-sensitive Staphylococcus aureus (one producing
of Panton-Valentine leukocidin (PVL) and the
other not) were isolated from bronchial specimens of
paediatric inpatient unit at the Zou/Collines Departmental
Hospital (CHDZ/C), who had been previously cared
for by the nurses. The source of outbreak was probably
a faulty contamination of specific food consumed by
we aim to determine the source of particular S. aureus
strains and possible relationships with hospital
An investigation was conducted that involved screening
of all inpatients receiving a specific food, hospital environment
sampling and the follow-up of cases until the
end of hospital stay. Isolates were identified, tested for
antimicrobial susceptibility and analysed for PVL,LukE/
LukD, and enterotoxin A production. Pulse Field Gel
Electrophoresis (PFGE) was performed to establish the
clonality of the strains.
[Show abstract][Hide abstract] ABSTRACT: An eight (8) months prospective study was carried out to control an outbreak of nosocomial pneumonia due to a Panton-Valentine Leukocidin (PVL) producing Staphylococcus aureus, in the paediatrics' unit at the Zou/Collines Departmental Hospital (CHDZ/C), (Benin).
Between 1(st) September 2004 and 30(th) May 2005 an investigation was conducted that involved the screening of all patients suspected to have nosocomial pneumonia, hospital environment sampling and the follow-up of cases until the end of hospital admission period. Isolates were identified, tested for antimicrobial susceptibility and analysed for PVL production. The study period was divided into Period I, corresponding to the outbreak period and Period II, after the complete renovation of the Unit along with hand washing promotion.
A total of 453 patients were admitted during the period of the study; (235 during Period I and 218 during Period II) in the malnourished children sector. Twenty eight (28) cases of pneumonia due to S. aureus were discovered and PVL-producing S. aureus constituted 61% (17/28) of identified cases. The mortality rate among the PVL- producing strains was 15/17 (88%) while it was 1/11 (9%) among non PVL-producing strains. Enhanced hygiene measures helped to terminate the outbreak.
This study showed that PVL was strongly linked to nosocomial pneumonia. PVL-producing S aureus can be controlled in the hospital by a combination of the promotion of preventive measures, decontamination of the environment and the early use of the correct antibiotic at the appropriate dose and for an adequate duration.
Full-text · Article · Dec 2012 · Ghana medical journal
[Show abstract][Hide abstract] ABSTRACT: Jatropha multifida L. is a plant widely used in traditional medicine in Benin including some voodoo ritual practices, to stop bleeding. In this study, we investigated in vitro haemostatic properties of the sap of J. multifida L. Morphological observations and determination of some biochemical and hematological parameters were performed on whole blood, plasma and serum before and after addition of sap. Results obtained showed sap contains tannins, flavonoids, saponins, leucoanthocyanes, mucilage and reducing compounds. When added to plasma or serum, proteins precipitated sap and led to (<1 s) their constitution network very quickly. On whole blood, the addition of sap led to an instantiated coagulation. Microscopic observations have revealed that cells have reached (<1 s) the protein network formed which led to the formation of a cell aggregate. Apart from fibrinogen, which was significantly reduced, other coagulation factors are not modified by sap. The sap has a proven hemostatic property and its mechanism of action is different from the cascade reaction of coagulation. INTRODUCTION Jatropha multifida L. is a plant producing abundant sap that is used to stop external bleeding (Klotoé, 2011). The leaves of the plant are also applied to wounds and ulcers to speed healing. The use of the sap of J. multifida L. as local haemostatic is widespread in southern Benin, particularly in certain voodoo rituals (de Souza, 1988; Adjanohoun et al., 1989; Akoègninou et al., 2006). However, the mechanism of action of the hemostatic effect of the sap of J. multifida L. is currently unknown. J. multifida belongs to the family of Euphorbiaceae (Padoue et al., 1999) and is known by the common names, such as, coral, coral-and-gardens and flower-of-blood. It is native to tropical America and is cultivated as an ornamental plant in northern Australia and South East Africa (Nayak and Patel, 2009). This study aims to study the basic mechanisms that underlie the hemostatic effects of the sap of J. multifida L. MATERIALS AND METHODS Plant material Using scalpel, green leaves of J. multifida L. were cut and the sap was directly collected in sterile collection plastic tubes. Samples
[Show abstract][Hide abstract] ABSTRACT: Annona senegalensis (Leaves), Newbouldia laevis (Leaves), Cassytha filiformis (aerial part), Cissampelos mucronata (aerial part) are four species of medicinal plants commonly sold by herbalists in South Benin for treatment of bleeding. Hemostatic tests performed in vitro on hydro alcoholic extracts of these plants revealed that all of them have coagulant properties, with a percentage reduction of plasma re-calcification time which is 31% for C. filiformis and 39% for A. senegalensis. The action of these plant extracts is different from that of the classical pathway of blood coagulation. A. senegalensis extract also showed an astringent power. The phytochemical study of these plants revealed that: C. mucronata contains alkaloids and tannins; A. senegalensis contains tannins, mucilages and reducing compounds; C. filiformis contains alkaloids, tannins (gallic tannins and cathetics) and mucilage; N. leavis contains tannins, triterpenoids, mucilages and reducing compounds. The traditional use of plants as hemostatic is convicted with these results.
[Show abstract][Hide abstract] ABSTRACT: An attempt has been made to carry out a screening on the antibacterial activity of leaves of Crateva religiosa Forst used in Benin traditional veterinary medicine against bacterial infection of Thryonomys swinderianus (class of Mammalia, family of Thryonomyidae) commonly called agouti or kholan. The aim of this study was to select the most active extracts and fractions which may be useful to combat these bacterial infections. Seven extracts from C. religiosa were screened for their antibacterial. The antibacterial activity was evaluated by both microtest method using p-iodonitrotetrazolium and bioautography against five microorganisms obtained from T. swinderianus (Escherichia coli, Shigella sonei, Staphylococcus aureus, Pasteurela pestis and Yersinia enterocolitica). The minimum inhibitory concentration (MIC) and the total activity (TA) were determined. All extracts were effective against tested microorganisms at different levels (0.31 ≤ MIC ≤ 10 mg/ml). The screening experiment revealed that ethyl acetate extract was more potent than other extracts with the MIC values of 0.62 mg/ml against E. coli and 0.31 mg/ml against S. aureus, S. sonei, P. pestis and Y. enterocolitica. The results provide an evidence for the traditional use of C. religiosa for the treatment of infective diseases of T. swinderianus Temminck.
Full-text · Article · Aug 2011 · AFRICAN JOURNAL OF BIOTECHNOLOGY
[Show abstract][Hide abstract] ABSTRACT: Promotion of environmental hygiene and sanitation in school districts contributes to community health. The purpose of the present study using physicochemical and biological parameters was to show the impact of these hygiene and sanitation measures on the health of schoolchildren in Collines Departement of Benin.
This prospective study was carried out in three selected primary schools from 28 September to 30 December 2007. A group of 210 children (100 boys and 110 girls) was obtained by careful identification of schoolchildren who benefited from the program and simple random selection. Physicochemical and bacteriologic analysis of water distributed in schools, assessment of the clinical condition of schoolchildren and screening of their hands for pathogenic bacteria allowed us to evaluate the level of hygiene in schools. Existing sanitary equipment was evaluated by on-site visual inspection.
Hand screening identified the presence of pathogenic microorganisms on the hands of 74% of schoolchildren. Diarrhea was observed in 30% of pupils, osteomyelitis in 15% and tooth dystrophy in 25%. Water quality analysis showed fluorine and nitrate concentrations of 3.5 mg/L and 15 mg/L respectively and demonstrated contamination by fecal bacteria, especially during storage.
The present study revealed a high level of pathogenic organisms on hands and confirmed their presence in water. Training teaching staff about educating and monitoring pupils regarding sanitary standards and protocols is needed to improve the level of competency and of compliance with hygiene measures.
No preview · Article · Jun 2011 · Médecine tropicale: revue du Corps de santé colonial
[Show abstract][Hide abstract] ABSTRACT: Gestational diabetes frequently results in macrosomia and fetal obesity. The aim of this review is to shed a light on the actual knowledge on the implication of the new concept of ‘‘metabolic memory’’ created during gestational diabetes on the onset of metabolic diseases in adulthood in macrosomic offspring. Several studies have shown that the abnormalities in carbohydrate and lipid metabolism in macrosomic newborns of diabetic mothers are due to maternal hyperglycemia, which leads to fetal hyperinsulinemia. We have developed a rat model of macrosomic offspring and assessed the onset of obesity in these animals. The macrosomic newborns of diabetic mothers are prone to develop glucose intolerance, insulin resistance and obesity as a function of age. Besides, T cells isolated from gestational diabetic rats and their macrosomic offspring seem to present a defect in immunity signal transduction. Finally, it seems that in utero programming during diabetic pregnancy generates a “metabolic memory” which could be responsible for the development of obesity in macrosomic offspring and the onset of metabolic diseases in adulthood.
No preview · Article · Oct 2010 · Médecine des Maladies Métaboliques
[Show abstract][Hide abstract] ABSTRACT: The present study was conducted on CD4+ T cells, isolated from wild type (WT) and PPARαnull mice, in order to assess the mechanism of action of docosahexaenoic acid (DHA), an n-3 fatty acid, in the modulation of two transcription factors, i.e., T-bet and GATA-3, implicated in T-cell differentiation towards, respectively, TH1 and TH2 phenotype. The T-cells from PPARαnull mice secreted higher IFN-γ and lower IL-4 concentrations than WT T-cells. Furthermore, the deletion of PPARα gene in T-cells resulted in the upregulation of T-bet and downregulation of GATA-3 both at mRNA and protein levels. DHA exerted not only an inhibitory effect on T-cell proliferation, but also diminished IFN-γ and stimulated IL-4 secretions in both cell types. DHA also downregulated T-bet and upregulated GATA-3 both at transcription and protein levels. Though the T-cells from PPARαnull mice expressed higher p38 phosphorylation than WT T-cells, DHA diminished the MAP kinase phosphorylation (p38 and ERK1/2) in both the cell types. The pharmacological inhibitors of MAP kinases also downregulated T-bet and upregulated GATA-3 in T-cells. Altogether, these results demonstrate that DHA, via its action on MAP kinases, modulates the expression of transcription factors. These results also explain the mechanism of action of this fatty acid on T-cell differentiation in disease and health.
[Show abstract][Hide abstract] ABSTRACT: Feed intake and preference were examined in the breeding of the edible giant snail Achatina achatina (Linné). The fodder or flour was fed by pairs to the snails in a dietary preference experiment. The results indicated that: 1) this mollusc consumed a wide array of comestible feeds such as green fodder, flour of roots or cereals and mature fruits; 2) the feed intake and preference seem to vary with the body size and feed palatability; 3) the feed which was well consumed did not necessarily offer the best feed conversion ratio. Then it is necessary to balance the diets in order to master efficient snail breeding
[Show abstract][Hide abstract] ABSTRACT: We have recently reported that PPAR alpha deficiency leads to hypoglycaemia and hypoinsulinemia in mice (Yessoufou et al. Endocrinology 147:4410-4418, 2006). Besides, these mice exhibited high adiposity with an inflammatory state. We, therefore, assessed, in this study, the effects of PPAR alpha deficiency on the expression of mRNA encoding for the insulin gene transcription factors in pancreatic beta-cells along with those implicated in inflammation in adipose tissues. On fasting, the adult PPAR alpha-null mice were hypoglycemic. Serum insulin concentrations and its pancreatic mRNA transcripts were downregulated in PPAR alpha-null mice, suggesting that PPAR alpha gene deletion contributes to low insulin gene transcription. The PPAR alpha gene deletion downregulates the mRNA expression of insulin gene transcription factors, i.e., Pdx-1, Nkx6.1, and MafA. Besides, the pancreatic function was diminished by PPAR alpha deficiency as PPAR alpha-null mice expressed low pancreatic Glut2 and glucokinase mRNA. PPAR alpha-null mice also expressed high adiponectin and leptin mRNA levels compared to wild type animals. Adipose tissues of PPAR alpha-null mice exhibited upregulation of CD14 and CD68 mRNA, generally expressed by macrophages. PPAR alpha gene deletion downregulates the adipocyte mRNA of certain pro-inflammatory agents, like MCP-1, TNF-alpha, IL-1 beta, IL-6, and RANTES, though pro-inflammatory TLR-2 and TLR-4 mRNAs were upregulated in the adipose tissues. Our results suggest that PPAR alpha deficiency, in mice, is implicated in the modulation of insulin gene transcription and inflammatory status in adipose tissues.
No preview · Article · Dec 2008 · Molecular and Cellular Biochemistry
[Show abstract][Hide abstract] ABSTRACT: Diabetes is a worldwide public health problem and is progressively increasing in Third World countries, particularly in African continent and Southern Asia due to low socio-economic standards. Since malnutrition and undernutrition with cassava consumption and cyanide intoxication have been thought to be the major cause of diabetes in tropical countries, WHO Expert Committee on Diabetes suggested, in its report, that the relationship between Malnutrition-Modulated Diabetes Mellitus (MMDM) and high cassava consumption should be clarified. Be that as it may, many recent studies have failed to establish a link between tropical diabetes and cassava malnutrition. In this paper, we shed light on MMDM in order to reach a consensus on its clinical, physiological and pathogenic features.
No preview · Article · Jul 2008 · International Journal of Biological and Chemical Sciences
[Show abstract][Hide abstract] ABSTRACT: ATP-sensitive potassium (K(ATP)) channels and nitric oxide (NO) have been suggested to contribute in mediating active hyperemia in diaphragm. However, no data is available in the current literature concerning their comparative contributions to arteriolar dilation during muscle contraction. The aim of this study was therefore to examine, by video microscopy in rats, the effects of superfusing the muscle with Krebs solution alone (group C), or Krebs solution containing either glybenclamide (3mdeltaM, a blocker of K(ATP), group GLY), or Nwdelta-nitro-L-arginine (300 mdeltaM, a NO synthase inhibitor, group NNA), or mefenamic acid (50 mdeltaM, a prostaglandin synthesis inhibitor, group MA) on second and third order of diaphragm (A2 and A3 respectively) arteriolar dilation elicited by 3 min muscle stimulation (40 Hz, train duration: 300 milliseconds, 90 cycles per min). In group C, A2 diameters increased by 67.5 +/- 1.9% referring to baseline at the end of the stimulation. This increase was significantly reduced in groups GLY and NNA (16.7 +/- 2.5% and 47.3 +/- 2.2% respectively, p < 0.001 as compared to group C) and was more important in group GLY than in group NNA (p < 0.001). By contrast, no difference in post-contraction diameter was observed between groups C and MA. Similar results were observed in A3 vessels. These results indicate that K(ATP) are more important mediators of functional diaphragm arteriolar dilation in rat than NO, whereas prostaglandins are not involved in this phenomenon.
No preview · Article · Jan 2008 · Bulletin de la Société médicale d'Afrique noire de langue française
[Show abstract][Hide abstract] ABSTRACT: Over a 6-month period, extended-spectrum betalactamase (ESBL)-producing isolates of Escherichia coli (EC) were collected from in-patients and their environment at the Zou-Collines Hospital Centre (CHDZ/C) in Benin. The aim of this study was to determine the incidence of ESBL and to describe their phenotypic susceptibility to antibiotics in a secondary hospital (500 beds) in Benin.
From 15 May to 15 November 2005, clinical informations and samples were collected from patients suspected to have nosocomial infections. The isolates were identified, tested for antimicrobial susceptibility and analysed for the presence of ESBL genes blaTEM and blaSHV by PCR.
One hundred ninety-seven enterobacteria were isolated from the clinical samples of 342 patients, these isolates included 143 EC and 32/143 (22%) of these isolates produced ESBL. Forty-six EC were isolated from the environment and 7 (15%) of them produced ESBL. Except for Imipenem for which the difference was not significant, the isolates producing ESBL were more resistant to the other antibiotics (especially to third generation cephalosporins: Ceftriaxone, Cefotaxime, Ceftazidime (P<0.00001)) than non-ESBL producing isolates. Both ESBL genes blaSHV and blaTEM were identified in the EC ESBL strains from patient and from the environment.
This study shows the presence of ESBL genes among EC in various wards of the CHDZ/C hospital proving that there is a need to implement a strict hospital infection control program and a regular surveillance of resistance to antimicrobial agents.
[Show abstract][Hide abstract] ABSTRACT: Fetuses from mothers with gestational diabetes are at increased risk of developing neonatal macrosomia and oxidative stress. We investigated the modulation of antioxidant status and circulating lipids in gestational diabetic mothers and their macrosomic babies and in healthy age-matched pregnant women and their newborns. The serum antioxidant status was assessed by employing anti-radical resistance kit (KRL; Kirial International SA, Couternon, France) and determining levels of vitamin A, C, and E and the activity of superoxide dismutase (SOD). Circulating serum lipids were quantified, and lipid peroxidation was measured as the concentrations of serum thiobarbituric acid-reactive substances (TBARS). As compared with non-diabetic mothers, gestational diabetic women exhibited decreased levels of vitamin E and enhanced concentrations of vitamin C without any changes in vitamin A. Vitamin A and C levels did not change in macrosomic babies except vitamin E whose levels were lower in these infants than in the newborns of non-diabetic mothers. Gestational diabetes mellitus (GDM) and macrosomia were also associated with impaired SOD activities and enhanced TBARS levels. Globally, total serum antioxidant defense status in diabetic mothers and their macrosomic babies was diminished as compared with control subjects. Triglyceride and cholesterol concentrations did not differ significantly between gestational diabetic and control mothers; however, macrosomia was associated with enhanced plasma cholesterol and triglyceride levels. These results suggest that human GDM and macrosomia are associated with downregulation of antioxidant status, and macrosomic infants also exhibit altered lipid metabolism.
Full-text · Article · Oct 2007 · Translational Research
[Show abstract][Hide abstract] ABSTRACT: Chronic intake of cassava has been thought to play a role in the pathogenesis of diabetes. We investigated the effects of dietary cassava (Manihot esculenta), which naturally contains cyanogenic glycosides, in the progression of diabetes mellitus in rats. Diabetes was induced by five mild doses of streptozotocin, in male Wistar rats which were fed a standard or cyanide-free cassava (CFC) diet containing or not containing exogenous cyanide with or without methionine. Methionine was employed to counterbalance the toxic effects of cyanide. During diabetes progression, we determined glycaemia and antioxidant status, by measuring vitamin C levels and activities of superoxide dismutase (SOD), glutathione peroxidase (GSH-Px) and glutathione reductase (GSSG-Red). Feeding CFC diet did not induce diabetes in control rats; rather this diet, in diabetic animals, aggravated hyperglycaemia the severity of which was increased in these animals fed CFC diet, supplemented with cyanide. Addition of methionine curtailed the toxic effects of cyanide supplementation in CFC diet-fed diabetic animals. In standard diet-fed animals, the activities of SOD, GSH-Px and GSSG-Red were lower in diabetic rats than control rats. Interestingly, all of the CFC diets with or without cyanide or methionine, increased vitamin C levels and antioxidant enzyme activities in both control and diabetic animals. However, supplementing cyanide to CFC diet (without methionine) curtailed SOD and GSH-Px activities in diabetic rats. Our study shows that cassava diet containing cyanide is 'diabetes-aggravating'.
No preview · Article · Jan 2007 · Fundamental and Clinical Pharmacology
[Show abstract][Hide abstract] ABSTRACT: Meticillin resistant Staphylococcus aureus (MRSA) is among the most important causes of nosocomial infections. It possesses a particular ability to spread in hospitals worldwide.
To analyze the proportion of MRSA among S. aureus isolated from specimen taken for diagnosis purposes. To make the medical staff aware of the problem of MRSA infections and to take a better care of patients.
During 3 months, a prospective study was carried out in the neonatal unit of centre hospitalier départemental du Zou et Collines in Benin. We identified newborn carriers of SA, particularly MRSA and factors associated with the carriage. Two hundred and ninety patients were admitted in the 3 divisions of the neonatal unit. From 195 specimens examined for diagnosis purposes 48 h after hospitalization, 112 patients were detected by nose swabbing. Concurrently, swabbing of environment was achieved.
Among patients'specimens, 141 isolations of S. aureus were observed. The proportion of MRSA was 36% amongst diagnostic specimens. MRSA represented 39% of the environment specimens. None of the isolated MRSA produces Panton Valentine leukocidin.
Our survey revealed a high level of MRSA among S. aureus isolated from diagnostic specimens. Consecutive to such findings and for decreasing nosocomial infection, an appropriate prevention program was installed, including intensive promotion of hands hygiene, correct sterilization and disinfection of materials and patients.
Full-text · Article · Dec 2006 · Archives de Pédiatrie