Browsing by Autor "Philippe Chevalier"

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["CLAPSEN", a global approach to the rehabilitation of severe childhood malnutrition in Bolivia].
(National Institutes of Health, 2000) Ricardo Sevilla; Edgar Sejas; Lourdes Zalles; Guadalupe Belmonte; Philippe Chevalier; Geneviève J. Parent; Hilderbrand Katherine; Patrick Kolsteren
The "CLAPSEN" approach was developed at the Hospital Materno Infantil German Urquidi in Cochabamba, to provide a global response for the study and treatment of childhood malnutrition. "CLAPSEN" is short for Clinical, Laboratory, Anthropometry, Psychology, Sociology, Nursing (Enfermera in Spanish) and Nutritional care. Most of the malnourished children admitted to Cochabamba Hospital are from poor families, more than three quarters of whom have only recently arrived in the city. Acute malnutrition is just one of the manifestations of a generally unfavorable environment. Malnutrition should not be considered as a simple deficiency in energy, protein or micronutrients, but rather as a multi-deficiency syndrome, also involving a lack of basic health and social care. This study demonstrates that malnourished children display a considerable degree of psychological retardation and of immune system depression. After five weeks of rehabilitation, the children were considered to have recuperated physically, as assessed by anthropometry, but not psychologically, as assessed by the adapted Dewer Score, or immunologically, as shown by the size of the thymus or the extent of maturation of lymphocytes. This strategy was not designed as a long-term approach for treating malnutrition, but rather as a research project to characterize the children arriving at the hospital, to determine the reasons for their malnutrition and to identify strategies that could be implemented earlier by health centers of social services, to prevent deterioration in the condition of these children to severe malnutrition requiring hospital admission. We believe that, in this Latin American context, in which the rate of acute malnutrition is low, the hospital should continue to be involved in the treatment of severely malnourished children with associated diseases. The child's stay in hospital should be short and once the child has recovered clinically, he should be sent home. In light of the observed levels of social deprivation, psychosocial and immune deficits, there appears to be a need for continued support for the family, to ensure the full recovery of the child and to prevent relapses.
Effect of zinc supplementation on nutritional immune deficiency
(Elsevier BV, 1996) Philippe Chevalier; Ricardo Sevilla; Lourdes Zalles; Edgar Sejas; Guadalupe Belmonte
Estrategia multidimensional comunitaria integral en desnutrición crónica
(2020) Sevilla Paz Soldán Ricardo; Zalles Cueto Lourdes; Philippe Chevalier; Gérard Parent; Carlos Erostegui Revilla; Elvira Serrano Caballero
Objetivo: evaluar la estrategia multidimensional CLAPSEN a nivel biológico, cognitivo, social y del entorno ambiental en niños con desnutrición crónica.  Métodos: estudio descriptivo y de seguimiento longitudinal en 53 niños con retardo en crecimiento leve, moderado y severo. Ingresaron al modelo multidimensional de intervención comunitaria: Clínica, Laboratorio, Antropometría, Psicología, Educación y Nutrición (CLAPSEN). Se determinó el peso, talla, perímetro cefálico, perímetro braquial, pliegue cutáneo tricipital de la población en estudio, y ecografía del timo al inicio y final de la intervención. Luego de desparasitación de la población seleccionada, se realizó el seguimiento por ocho meses con la estrategia CLAPSEN.  Resultados: los niños recuperaron las condiciones biológicas y nutricionales siguientes, teniendo como resultados: el crecimiento de -2,11±0,7 a 0,6±0,3 (p?0,001), anemia de 10,4 ±3,3 g/L a 12,5± 1,21 g/L(p?0,001) las proteínas nutricionales mejoraron, las proteínas inflamatorias descendieron, la respuesta inmunitaria mejoró, reflejándose en la superficie del timo de 391,3±91 mm2 a 909,4±140,9 mm2(p?0,001).  Conclusiones: la estrategia CLAPSEN, desde una visión multidimensional, fue útil para recuperar el retardo en crecimiento y desarrollo, para el control de posibles enfermedades crónicas y mejorar del entorno en el que vive el niño en forma relevante por el tiempo que duró el estudio.
In vitro lymphocyte-differentiating effects of thymulin (Zn-FTS) on lymphocyte subpopulations of severely malnourished children
(Elsevier BV, 1994) Geneviève J. Parent; Philippe Chevalier; Lourdes Zalles; Ricardo Sevilla; Matilde Bustos; JM Dhenin; Bernard Jambón