Pub Date : 2025-08-01DOI: 10.1016/j.arcped.2025.06.004
Bruno Hoen
{"title":"Recent and important updates to the French meningococcal vaccination strategy","authors":"Bruno Hoen","doi":"10.1016/j.arcped.2025.06.004","DOIUrl":"10.1016/j.arcped.2025.06.004","url":null,"abstract":"","PeriodicalId":55477,"journal":{"name":"Archives De Pediatrie","volume":"32 6","pages":"Pages 361-362"},"PeriodicalIF":1.3,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144849715","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Ovarian hyperstimulation syndrome is characterized by enlarged ovaries, multiple follicular cysts, and fluid leakage into the extravascular space caused by increased vascular permeability. Although controlled ovarian stimulation is often the main cause, spontaneous ovarian hyperstimulation syndrome is rare.
Observation and discussion
We present a seventeen-year-old patient with ovarian hyperstimulation syndrome and primary hypothyroidism due to autoimmune thyroiditis, who presented with galactorrhea and severe abdominal pain. The thyroid-stimulating hormone level was 713 uIU/ml. Ultrasonography and magnetic resonance imaging showed ovarian enlargement and multiple cysts. Our patient, who also had galactorrhea and hyperprolactinemia, was treated with levothyroxine and cabergoline. The ovaries, which were very large and multicystic before treatment, showed significant improvement after treatment.
Conclusion
Spontaneous ovarian hyperstimulation syndrome, although rare in childhood, should be considered in patients with primary hypothyroidism. Abdominal pain is an important symptom for diagnosis.
{"title":"Spontaneous Ovarian Hyperstimulation Syndrome and Hyperprolactinemia due to Primary Hypothyroidism: An Adolescent Case Report","authors":"Emel Hatun Aytaç Kaplan , Nazlı Gülsüm Akyel , Zümrüt Kocabey Sütçü","doi":"10.1016/j.arcped.2025.03.007","DOIUrl":"10.1016/j.arcped.2025.03.007","url":null,"abstract":"<div><h3>Introduction</h3><div>Ovarian hyperstimulation syndrome is characterized by enlarged ovaries, multiple follicular cysts, and fluid leakage into the extravascular space caused by increased vascular permeability. Although controlled ovarian stimulation is often the main cause, spontaneous ovarian hyperstimulation syndrome is rare.</div></div><div><h3>Observation and discussion</h3><div>We present a seventeen-year-old patient with ovarian hyperstimulation syndrome and primary hypothyroidism due to autoimmune thyroiditis, who presented with galactorrhea and severe abdominal pain. The thyroid-stimulating hormone level was 713 uIU/ml. Ultrasonography and magnetic resonance imaging showed ovarian enlargement and multiple cysts. Our patient, who also had galactorrhea and hyperprolactinemia, was treated with levothyroxine and cabergoline. The ovaries, which were very large and multicystic before treatment, showed significant improvement after treatment.</div></div><div><h3>Conclusion</h3><div>Spontaneous ovarian hyperstimulation syndrome, although rare in childhood, should be considered in patients with primary hypothyroidism. Abdominal pain is an important symptom for diagnosis.</div></div>","PeriodicalId":55477,"journal":{"name":"Archives De Pediatrie","volume":"32 6","pages":"Pages 427-431"},"PeriodicalIF":1.3,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144849716","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-08-01DOI: 10.1016/j.arcped.2025.05.004
Victor Sartorius , Ann-Marie Crowe , Alina Marilena Lazarescu , Laurence Labat , Anna Kaminska , Charles Joris Roux , Gilles A Orliaguet , Stéphane Blanot
Background
The determination of brain death (BD) is the primary pathway to organ donation in children. Thiopental is a sedative drug prescribed in critical situations potentially leading to BD and has been identified as a confounder during BD diagnosis. The implications of prior thiopental sedation on the diagnostic process of BD are poorly defined.
Objective
To compare the timeline and process involved in BD diagnosis between patients who received thiopental sedation versus those who did not.
Methods and Setting
Retrospective analysis was carried out on the healthcare records of all children who underwent the process of BD evaluation and diagnosis in our institution, between January 2012 and April 2020.
Results
74 patients were included; 29 had been treated with thiopental and 45 had received other sedatives or none. Median [IQR] time from reporting of suspected BD patients to apnea test (19.5 [11.5–30.2] vs 11.5 [5.4–21.1] hours, p = 0.015) and to BD confirmatory test (24.2 [7.2–32.6] vs 13.2 [6.2–23.5] hours, p = 0.019) was significantly longer in the thiopental group. Organ allocation was also delayed in the thiopental group. Thiopental plasma level was measured before BD examination in 24 patients, and the median concentration of the last assay was 4.6 [0.8–8.8] mg.L-1. The BD diagnostic process included persistent signs of cerebral blood flow interruption on transcranial Doppler in 89.7 % of patients in the thiopental group vs 68.9 % in the other group (p = 0.049).
Conclusion
Prior administration of thiopental delays the process involved in the evaluation and diagnosis of BD in children in our intensive care unit. The diagnosis of BD after thiopental sedation requires a multimodal evaluation, which should include the monitoring of thiopental plasma levels and could be guided by transcranial Doppler.
{"title":"Brain death diagnostic process in children after thiopental sedation: a comparative retrospective cohort study","authors":"Victor Sartorius , Ann-Marie Crowe , Alina Marilena Lazarescu , Laurence Labat , Anna Kaminska , Charles Joris Roux , Gilles A Orliaguet , Stéphane Blanot","doi":"10.1016/j.arcped.2025.05.004","DOIUrl":"10.1016/j.arcped.2025.05.004","url":null,"abstract":"<div><h3>Background</h3><div>The determination of brain death (BD) is the primary pathway to organ donation in children. Thiopental is a sedative drug prescribed in critical situations potentially leading to BD and has been identified as a confounder during BD diagnosis. The implications of prior thiopental sedation on the diagnostic process of BD are poorly defined.</div></div><div><h3>Objective</h3><div>To compare the timeline and process involved in BD diagnosis between patients who received thiopental sedation versus those who did not.</div></div><div><h3>Methods and Setting</h3><div>Retrospective analysis was carried out on the healthcare records of all children who underwent the process of BD evaluation and diagnosis in our institution, between January 2012 and April 2020.</div></div><div><h3>Results</h3><div>74 patients were included; 29 had been treated with thiopental and 45 had received other sedatives or none. Median [IQR] time from reporting of suspected BD patients to apnea test (19.5 [11.5–30.2] vs 11.5 [5.4–21.1] hours, <em>p</em> = 0.015) and to BD confirmatory test (24.2 [7.2–32.6] vs 13.2 [6.2–23.5] hours, <em>p</em> = 0.019) was significantly longer in the thiopental group. Organ allocation was also delayed in the thiopental group. Thiopental plasma level was measured before BD examination in 24 patients, and the median concentration of the last assay was 4.6 [0.8–8.8] mg.L<sup>-1</sup>. The BD diagnostic process included persistent signs of cerebral blood flow interruption on transcranial Doppler in 89.7 % of patients in the thiopental group vs 68.9 % in the other group (<em>p</em> = 0.049).</div></div><div><h3>Conclusion</h3><div>Prior administration of thiopental delays the process involved in the evaluation and diagnosis of BD in children in our intensive care unit. The diagnosis of BD after thiopental sedation requires a multimodal evaluation, which should include the monitoring of thiopental plasma levels and could be guided by transcranial Doppler.</div></div>","PeriodicalId":55477,"journal":{"name":"Archives De Pediatrie","volume":"32 6","pages":"Pages 383-388"},"PeriodicalIF":1.3,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144838624","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
The exposure of children to situations of danger or risk of danger is a major public health problem. General practitioners (GPs) and pediatricians play an essential role in identification and management of these situations thanks to two procedures: the administrative procedure consists of sending an information of concern (“Information préoccupante” -IP- in French) to the departmental unit of collection, evaluation and processing of information of concern (CRIP in French) for a child at risk of danger; the judicial procedure consists of sending an alert (“signalement” in French) to the public prosecutor for serious and immediate danger. However, hospital and private doctors only perform 5 % of child abuse alerts.
Objective
The main objective was to describe doctors’ practices regarding the care of children in danger or at risk of danger. The secondary objective was to identify areas for improving the efficiency of management.
Methods
We present a descriptive, quantitative, and cross-sectional study using questionnaires to the GPs and pediatricians in private practice in Var (French department) in 2021.
Results
Our sample consisted of 134 GPs and 28 pediatricians. 75.3 % had already faced children in danger. Only 17.1 % provided efficient management (according to the recommendations of the Haute Autorité de Santé) when faced with a suspicion of a child at risk, 53.4 % for suspicion of child abuse, and 44.5 % for child sexual abuse. Pediatricians were more likely to know the contact details of child protection actors, and 84.6 % of doctors expressed a desire for more exchanges with them. 85.8 % expressed a feeling of being insufficiently trained.
Conclusion
It is essential to enhance the training of doctors and foster more effective collaboration with child protection actors. We propose distributing a document to private doctors in the Var to help them identify and manage cases.
{"title":"Difficulty of caring for children in danger or at risk of danger in Var (a French department) by general practitioners and private pediatricians","authors":"Clemence Desmarets , Julie Berbis , Paul Casha , Violaine Bresson , Emmanuelle Bosdure , Kareen Thibault , Michel Delage , Aurelie Morand , Brigitte Chabrol , Elisabeth Martin-Lebrun , Lindsay Osei","doi":"10.1016/j.arcped.2025.04.006","DOIUrl":"10.1016/j.arcped.2025.04.006","url":null,"abstract":"<div><h3>Background</h3><div>The exposure of children to situations of danger or risk of danger is a major public health problem. General practitioners (GPs) and pediatricians play an essential role in identification and management of these situations thanks to two procedures: the administrative procedure consists of sending an information of concern (“Information préoccupante” -IP- in French) to the departmental unit of collection, evaluation and processing of information of concern (CRIP in French) for a child at risk of danger; the judicial procedure consists of sending an alert (“signalement” in French) to the public prosecutor for serious and immediate danger. However, hospital and private doctors only perform 5 % of child abuse alerts.</div></div><div><h3>Objective</h3><div>The main objective was to describe doctors’ practices regarding the care of children in danger or at risk of danger. The secondary objective was to identify areas for improving the efficiency of management.</div></div><div><h3>Methods</h3><div>We present a descriptive, quantitative, and cross-sectional study using questionnaires to the GPs and pediatricians in private practice in Var (French department) in 2021.</div></div><div><h3>Results</h3><div>Our sample consisted of 134 GPs and 28 pediatricians. 75.3 % had already faced children in danger. Only 17.1 % provided efficient management (according to the recommendations of the Haute Autorité de Santé) when faced with a suspicion of a child at risk, 53.4 % for suspicion of child abuse, and 44.5 % for child sexual abuse. Pediatricians were more likely to know the contact details of child protection actors, and 84.6 % of doctors expressed a desire for more exchanges with them. 85.8 % expressed a feeling of being insufficiently trained.</div></div><div><h3>Conclusion</h3><div>It is essential to enhance the training of doctors and foster more effective collaboration with child protection actors. We propose distributing a document to private doctors in the Var to help them identify and manage cases.</div></div>","PeriodicalId":55477,"journal":{"name":"Archives De Pediatrie","volume":"32 6","pages":"Pages 404-412"},"PeriodicalIF":1.3,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144838653","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-08-01DOI: 10.1016/j.arcped.2025.05.013
Lucy Carriat , Huu Kim An N’Guyen , Marion Honnorat , Franck Plaisant , Marine Butin
Background
The management of gastroschisis involves immediate surgery and post-surgery nutritional management. Ileus is a frequent complication, leading to difficulties in establishing enteral feeding. Parasympathomimetic agents, including neostigmine, are safely used in case of ileus in adults. Neostigmine was used in a single neonatal intensive care unit (NICU) for the management of ileus after gastroschisis repair.
Objective
The aim of this study was to report this experience of neostigmine use to improve digestive motility and its tolerance.
Methods and settings
This is an observational study from electronic health records (EHRs) that included all infants born with gastroschisis and treated with neostigmine in a NICU in Lyon, France, between June 2009 and December 2023. The primary outcome was the time to achieve effective enteral nutrition after the introduction of neostigmine. Secondary outcomes of tolerance and efficacy were also collected from the medical records. This study received approval from an ethics committee.
Results
Among 86 patients with gastroschisis, 16 patients received neostigmine due to either large volumes of gastric residue or absence of transit. They received neostigmine at a median (IQR) of 13.5 (12;17.25) days of life. Effective enteral feeding was achieved after a median of 11 (5.75;13) days of neostigmine treatment. Neostigmine was well tolerated, apart from one case of a serious but quickly resolved adverse event after intravenous administration.
Conclusions
The use of oral neostigmine in neonates with gastroschisis appears to be effective and safe. Larger prospective studies are required to determine its possible place in the management of these newborns.
{"title":"Efficacy and tolerance of neostigmine to improve digestive motility in neonates after gastroschisis surgery","authors":"Lucy Carriat , Huu Kim An N’Guyen , Marion Honnorat , Franck Plaisant , Marine Butin","doi":"10.1016/j.arcped.2025.05.013","DOIUrl":"10.1016/j.arcped.2025.05.013","url":null,"abstract":"<div><h3>Background</h3><div>The management of gastroschisis involves immediate surgery and post-surgery nutritional management. Ileus is a frequent complication, leading to difficulties in establishing enteral feeding. Parasympathomimetic agents, including neostigmine, are safely used in case of ileus in adults. Neostigmine was used in a single neonatal intensive care unit (NICU) for the management of ileus after gastroschisis repair.</div></div><div><h3>Objective</h3><div>The aim of this study was to report this experience of neostigmine use to improve digestive motility and its tolerance.</div></div><div><h3>Methods and settings</h3><div>This is an observational study from electronic health records (EHRs) that included all infants born with gastroschisis and treated with neostigmine in a NICU in Lyon, France, between June 2009 and December 2023. The primary outcome was the time to achieve effective enteral nutrition after the introduction of neostigmine. Secondary outcomes of tolerance and efficacy were also collected from the medical records. This study received approval from an ethics committee.</div></div><div><h3>Results</h3><div>Among 86 patients with gastroschisis, 16 patients received neostigmine due to either large volumes of gastric residue or absence of transit. They received neostigmine at a median (IQR) of 13.5 (12;17.25) days of life. Effective enteral feeding was achieved after a median of 11 (5.75;13) days of neostigmine treatment. Neostigmine was well tolerated, apart from one case of a serious but quickly resolved adverse event after intravenous administration.</div></div><div><h3>Conclusions</h3><div>The use of oral neostigmine in neonates with gastroschisis appears to be effective and safe. Larger prospective studies are required to determine its possible place in the management of these newborns.</div></div>","PeriodicalId":55477,"journal":{"name":"Archives De Pediatrie","volume":"32 6","pages":"Pages 368-373"},"PeriodicalIF":1.3,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144818368","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Intimate partner violence (IPV) is a major global public health issue, frequently impacting children as secondary victims. However, research on the involvement of general practitioners (GPs) in identifying and managing children exposed to IPV in France is lacking.
Objective
This study aimed to assess GPs' knowledge and practices regarding child protection in IPV cases, shedding light on gaps in their training and practices.
Methods and Settings
An electronic survey was conducted among GPs in Bretagne from May 2020 to May 2022, assessing demographic characteristics, clinical experiences, management practices for children exposed to IPV, and understanding its impact on children and adolescents.
Results
The study involved 91 GPs (sex ratio: 0.34, median: 15 [interquartile: 5.75–23] years of practice experience, and 25 % [18–30] of their practice focused on paediatrics). Results showed that 67 % encountered IPV situations within the past year, 46 % of children were in danger (2[1–2] per practitioner), and 48 % of children lived in a family with IPV (2[1–3] per practitioner). Thirty-five percent of GPs observed children exposed to IPV without recognizing them as endangered. Regarding knowledge of the impact of IPV on children, practitioners rated it at 5 out of 10, expressing discomfort (Likert scale from 0 to 10 (LS0–10): 4[3:5]) and perceiving their training as inadequate (LS0–10: 3[2:4]). They emphasized the need for better stakeholder understanding, favoring in-person training and enhanced access to specialized consultations to enhance their expertise.
Conclusion
These findings highlight the critical role of GPs in identifying and managing children exposed to IPV in France, despite gaps in knowledge and practice. Strengthening GPs’ training, standardizing protocols, improving and developing access to specialized consultations, such as hospital-based Unit for Endangered Children (“Unité d’Accueil Pédiatrique Enfant en Danger”, UAPED), and fostering interprofessional collaboration could enhance child protection efforts in IPV contexts.
{"title":"General practitioners' knowledge and management of children co-victimized by intimate partner violence","authors":"Justine Launey , Bernard Brau , Mathieu Kuchenbuch , Martine Balençon","doi":"10.1016/j.arcped.2025.04.004","DOIUrl":"10.1016/j.arcped.2025.04.004","url":null,"abstract":"<div><h3>Background</h3><div>Intimate partner violence (IPV) is a major global public health issue, frequently impacting children as secondary victims. However, research on the involvement of general practitioners (GPs) in identifying and managing children exposed to IPV in France is lacking.</div></div><div><h3>Objective</h3><div>This study aimed to assess GPs' knowledge and practices regarding child protection in IPV cases, shedding light on gaps in their training and practices.</div></div><div><h3>Methods and Settings</h3><div>An electronic survey was conducted among GPs in Bretagne from May 2020 to May 2022, assessing demographic characteristics, clinical experiences, management practices for children exposed to IPV, and understanding its impact on children and adolescents.</div></div><div><h3>Results</h3><div>The study involved 91 GPs (sex ratio: 0.34, median: 15 [interquartile: 5.75–23] years of practice experience, and 25 % [18–30] of their practice focused on paediatrics). Results showed that 67 % encountered IPV situations within the past year, 46 % of children were in danger (2[1–2] per practitioner), and 48 % of children lived in a family with IPV (2[1–3] per practitioner). Thirty-five percent of GPs observed children exposed to IPV without recognizing them as endangered. Regarding knowledge of the impact of IPV on children, practitioners rated it at 5 out of 10, expressing discomfort (Likert scale from 0 to 10 (LS<sub>0–10</sub>): 4[3:5]) and perceiving their training as inadequate (LS<sub>0–10</sub>: 3[2:4]). They emphasized the need for better stakeholder understanding, favoring in-person training and enhanced access to specialized consultations to enhance their expertise.</div></div><div><h3>Conclusion</h3><div>These findings highlight the critical role of GPs in identifying and managing children exposed to IPV in France, despite gaps in knowledge and practice. Strengthening GPs’ training, standardizing protocols, improving and developing access to specialized consultations, such as hospital-based Unit for Endangered Children (“Unité d’Accueil Pédiatrique Enfant en Danger”, UAPED), and fostering interprofessional collaboration could enhance child protection efforts in IPV contexts.</div></div>","PeriodicalId":55477,"journal":{"name":"Archives De Pediatrie","volume":"32 6","pages":"Pages 413-419"},"PeriodicalIF":1.3,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144818369","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-08-01DOI: 10.1016/j.arcped.2025.06.003
Yuan Zhou , Beilei Zeng , Yinyin Huang , Panwang Huang , Ye Li , Zhuangjian Xu , Yaping Ma
Background
There is still no consensus on simple methods to monitor the effectiveness of gonadotropin-releasing hormone analogs in girls with precocious or early puberty.
Objective
To evaluate the value of urinary luteinizing hormone (LH) and follicle-stimulating hormone (FSH) before and after triptorelin stimulation test detected by immunochemiluminometric assay (ICMA) to monitor the efficacy of triptorelin depot in girls with precocious or early puberty.
Methods
A total of 128 girls with precocious or early puberty were included, of whom 81 received triptorelin depot treatment (3.75 mg). Triptorelin (100 μg) stimulation tests were performed before and after 3 months treatment. The time of triptorelin stimulation test was designated as 0 h. Timed 12 h urine with recorded urine volume was collected before and after the test, defined as diurnal spontaneous (-24 h to -12 h), nocturnal spontaneous (-12 h to 0 h), diurnal stimulated (0 h to 12 h), and nocturnal stimulated urine (12 h to 24 h), respectively. LH and FSH were assayed by ICMA.
Results
After 3 months of treatment, 67 girls completed sample collections, with 2 out of 67 girls experiencing inadequate efficacy. Serum and urinary gonadotropin levels decreased significantly after 3 months of treatment. The area under curve (AUC) of nocturnal spontaneous, diurnal stimulated, and nocturnal stimulated urinary FSH (UFSH) concentrations in determining efficacy were 0.962, 0.985, and 0.954. The three AUCs were all greater than serum peak LH (PLH, 0.746) or peak FSH (PFSH, 0.931). When nocturnal spontaneous, diurnal stimulated, and nocturnal stimulated UFSH concentrations were ≤ 5.24 IU/L, 6.94 IU/L, and 5.78 IU/L, the sensitivity was 93.8 %, 96.9 % and 95.4 %, and the specificity was all 100.0 %.
Conclusion
UFSH measured by ICMA from diurnal and nocturnal stimulated 12-hour urine samples can be used to assess the effectiveness of triptorelin depot in girls with precocious or early puberty. For a non-invasive and cost-effective option, spontaneous nocturnal urine may also be a suitable choice.
{"title":"Urinary follicle-stimulating hormone during triptorelin stimulation test can monitor the efficacy of triptorelin depot in girls with precocious or early puberty","authors":"Yuan Zhou , Beilei Zeng , Yinyin Huang , Panwang Huang , Ye Li , Zhuangjian Xu , Yaping Ma","doi":"10.1016/j.arcped.2025.06.003","DOIUrl":"10.1016/j.arcped.2025.06.003","url":null,"abstract":"<div><h3>Background</h3><div>There is still no consensus on simple methods to monitor the effectiveness of gonadotropin-releasing hormone analogs in girls with precocious or early puberty.</div></div><div><h3>Objective</h3><div>To evaluate the value of urinary luteinizing hormone (LH) and follicle-stimulating hormone (FSH) before and after triptorelin stimulation test detected by immunochemiluminometric assay (ICMA) to monitor the efficacy of triptorelin depot in girls with precocious or early puberty.</div></div><div><h3>Methods</h3><div>A total of 128 girls with precocious or early puberty were included, of whom 81 received triptorelin depot treatment (3.75 mg). Triptorelin (100 μg) stimulation tests were performed before and after 3 months treatment. The time of triptorelin stimulation test was designated as 0 h. Timed 12 h urine with recorded urine volume was collected before and after the test, defined as diurnal spontaneous (-24 h to -12 h), nocturnal spontaneous (-12 h to 0 h), diurnal stimulated (0 h to 12 h), and nocturnal stimulated urine (12 h to 24 h), respectively. LH and FSH were assayed by ICMA.</div></div><div><h3>Results</h3><div>After 3 months of treatment, 67 girls completed sample collections, with 2 out of 67 girls experiencing inadequate efficacy. Serum and urinary gonadotropin levels decreased significantly after 3 months of treatment. The area under curve (AUC) of nocturnal spontaneous, diurnal stimulated, and nocturnal stimulated urinary FSH (UFSH) concentrations in determining efficacy were 0.962, 0.985, and 0.954. The three AUCs were all greater than serum peak LH (PLH, 0.746) or peak FSH (PFSH, 0.931). When nocturnal spontaneous, diurnal stimulated, and nocturnal stimulated UFSH concentrations were ≤ 5.24 IU/L, 6.94 IU/L, and 5.78 IU/L, the sensitivity was 93.8 %, 96.9 % and 95.4 %, and the specificity was all 100.0 %.</div></div><div><h3>Conclusion</h3><div>UFSH measured by ICMA from diurnal and nocturnal stimulated 12-hour urine samples can be used to assess the effectiveness of triptorelin depot in girls with precocious or early puberty. For a non-invasive and cost-effective option, spontaneous nocturnal urine may also be a suitable choice.</div></div>","PeriodicalId":55477,"journal":{"name":"Archives De Pediatrie","volume":"32 6","pages":"Pages 395-403"},"PeriodicalIF":1.3,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144857012","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-07-01DOI: 10.1016/j.arcped.2025.03.005
Philippe Reix , Camille Audousset , Emmanuelle Girodon , Isabelle Sermet Gaudelus , Sophie Gautier
The number of pregnancies in women with cystic fibrosis (CF) has significantly increased in recent years, leading to a corresponding rise in the number of healthy infants exposed to cystic fibrosis transmembrane conductance regulator modulator (CFTRm) such as elexacaftor-tezacaftor-ivacaftor (ETI) or Kaftrio/Kalydeco® (K/K) triple therapy. Currently, data on the immediate outcomes for these children is reassuring; however, some cases of abnormal liver tests and cataracts have been reported in a few newborns indirectly exposed to ETI in utero or postnatally. Long-term neurodevelopment remains a concern that requires further investigation.
A working group from the Société Française de la Mucoviscidose has developed recommendations for monitoring these children during the first two years and beyond. Given the increasing number of infants born to mothers taking CFTR modulators, as well as questions regarding their immediate care during the maternity stay and the feasibility of breastfeeding, it is crucial for pediatricians to be aware of these recommendations, which are based on a comprehensive review of the literature.
{"title":"Preliminary proposals for the follow-up of infants born to mothers with cystic fibrosis treated with CFTR modulators during the first two years of life","authors":"Philippe Reix , Camille Audousset , Emmanuelle Girodon , Isabelle Sermet Gaudelus , Sophie Gautier","doi":"10.1016/j.arcped.2025.03.005","DOIUrl":"10.1016/j.arcped.2025.03.005","url":null,"abstract":"<div><div>The number of pregnancies in women with cystic fibrosis (CF) has significantly increased in recent years, leading to a corresponding rise in the number of healthy infants exposed to cystic fibrosis transmembrane conductance regulator modulator (CFTRm) such as elexacaftor-tezacaftor-ivacaftor (ETI) or Kaftrio/Kalydeco® (K/K) triple therapy. Currently, data on the immediate outcomes for these children is reassuring; however, some cases of abnormal liver tests and cataracts have been reported in a few newborns indirectly exposed to ETI in utero or postnatally. Long-term neurodevelopment remains a concern that requires further investigation.</div><div>A working group from the Société Française de la Mucoviscidose has developed recommendations for monitoring these children during the first two years and beyond. Given the increasing number of infants born to mothers taking CFTR modulators, as well as questions regarding their immediate care during the maternity stay and the feasibility of breastfeeding, it is crucial for pediatricians to be aware of these recommendations, which are based on a comprehensive review of the literature.</div></div>","PeriodicalId":55477,"journal":{"name":"Archives De Pediatrie","volume":"32 5","pages":"Pages 344-350"},"PeriodicalIF":1.3,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144295438","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-07-01DOI: 10.1016/j.arcped.2025.05.006
Daniela Laux , Alexandre J. Vivanti
{"title":"Much ado about … the fetal heart examination during the first trimester.What to expect from the new French obstetrical imaging guidelines?","authors":"Daniela Laux , Alexandre J. Vivanti","doi":"10.1016/j.arcped.2025.05.006","DOIUrl":"10.1016/j.arcped.2025.05.006","url":null,"abstract":"","PeriodicalId":55477,"journal":{"name":"Archives De Pediatrie","volume":"32 5","pages":"Pages 285-287"},"PeriodicalIF":1.3,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144509558","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-07-01DOI: 10.1016/j.arcped.2025.05.007
Clémence Rascle , Pauline Connan , Corentin Tanné
Objective
To develop recommendations for mountain travel and altitude acclimation for children under 3 years old by convening a committee of experts.
Methods
Using the DELPHI method, we collected proposals via email from professionals specializing in altitude and related pathologies. Experts were asked about the maximum suggested altitude and specific recommendations.
Results
Sixteen experts participated in the study. The main recommendations included a maximum altitude of 2000 meters for children under 1 year old and 2500 meters for children under 3 years old, a gradual ascent with stops every 500 meters, and careful monitoring of the child's reactions. Absolute contraindications were noted for cable car ascents in children under 1 year old, with relative contraindications for those under 3 years old. It was also recommended to consult a doctor before traveling to high altitudes if the child has a risk-related pathology and to limit winter outdoor activities to short durations with appropriate clothing.
Conclusion
This survey revealed a consensus on the recommended maximum travel altitude for children and provided various guidelines to mitigate the effects of altitude.
{"title":"Recommendations for mountain travel and altitude acclimation in pediatric populations: a French Delphi study","authors":"Clémence Rascle , Pauline Connan , Corentin Tanné","doi":"10.1016/j.arcped.2025.05.007","DOIUrl":"10.1016/j.arcped.2025.05.007","url":null,"abstract":"<div><h3>Objective</h3><div>To develop recommendations for mountain travel and altitude acclimation for children under 3 years old by convening a committee of experts.</div></div><div><h3>Methods</h3><div>Using the DELPHI method, we collected proposals via email from professionals specializing in altitude and related pathologies. Experts were asked about the maximum suggested altitude and specific recommendations.</div></div><div><h3>Results</h3><div>Sixteen experts participated in the study. The main recommendations included a maximum altitude of 2000 meters for children under 1 year old and 2500 meters for children under 3 years old, a gradual ascent with stops every 500 meters, and careful monitoring of the child's reactions. Absolute contraindications were noted for cable car ascents in children under 1 year old, with relative contraindications for those under 3 years old. It was also recommended to consult a doctor before traveling to high altitudes if the child has a risk-related pathology and to limit winter outdoor activities to short durations with appropriate clothing.</div></div><div><h3>Conclusion</h3><div>This survey revealed a consensus on the recommended maximum travel altitude for children and provided various guidelines to mitigate the effects of altitude.</div></div>","PeriodicalId":55477,"journal":{"name":"Archives De Pediatrie","volume":"32 5","pages":"Pages 288-294"},"PeriodicalIF":1.3,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144499470","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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