Pub Date : 2026-01-01DOI: 10.1016/j.arcped.2025.10.007
Floriane Le Bricquir , Sophie Gueden , Didier Loisel , Pauline de Cambourg , Patrick Van Bogaert
Objective
This study aimed to describe data of patients included in the in-hospital pediatric stroke alert and compare it to published data.
Methods
This bicentric retrospective study includes all children aged one month to 18 years who underwent an MRI (magnetic resonance imaging) for an acute neurological deficit according to the stroke alert protocol established at Nantes and Angers University Hospitals between January 2017 and July 2021. Demographic characteristics, time from stroke onset to imaging, diagnosis, treatments if any, and outcomes were collected.
Results
Seventy-eight children were included. The stroke alert procedure led to early stroke detection in 16 children (21%). Four of them received acute recanalization therapy. Other diagnoses needing specific management were identified in 12% of cases. Migraine was the most common diagnosis, affecting more than half of the patients.
Conclusions
This stroke alert protocol allowed children presenting with acute neurological deficit to have rapid access to brain MRI, which confirmed the diagnosis of stroke or other acute neurological disorder necessitating specific management in one-third of the cases.
{"title":"Pediatric acute stroke alert in Nantes and Angers hospitals: description of patients included and comparison with published data","authors":"Floriane Le Bricquir , Sophie Gueden , Didier Loisel , Pauline de Cambourg , Patrick Van Bogaert","doi":"10.1016/j.arcped.2025.10.007","DOIUrl":"10.1016/j.arcped.2025.10.007","url":null,"abstract":"<div><h3>Objective</h3><div>This study aimed to describe data of patients included in the in-hospital pediatric stroke alert and compare it to published data.</div></div><div><h3>Methods</h3><div>This bicentric retrospective study includes all children aged one month to 18 years who underwent an MRI (magnetic resonance imaging) for an acute neurological deficit according to the stroke alert protocol established at Nantes and Angers University Hospitals between January 2017 and July 2021. Demographic characteristics, time from stroke onset to imaging, diagnosis, treatments if any, and outcomes were collected.</div></div><div><h3>Results</h3><div>Seventy-eight children were included. The stroke alert procedure led to early stroke detection in 16 children (21%). Four of them received acute recanalization therapy. Other diagnoses needing specific management were identified in 12% of cases. Migraine was the most common diagnosis, affecting more than half of the patients.</div></div><div><h3>Conclusions</h3><div>This stroke alert protocol allowed children presenting with acute neurological deficit to have rapid access to brain MRI, which confirmed the diagnosis of stroke or other acute neurological disorder necessitating specific management in one-third of the cases.</div></div>","PeriodicalId":55477,"journal":{"name":"Archives De Pediatrie","volume":"33 1","pages":"Pages 29-35"},"PeriodicalIF":1.3,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145770067","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 : 2026-01-01DOI: 10.1016/j.arcped.2025.10.008
Pauline Labe , Matthieu Bendavid , Julie Toubiana , Céline Anquetil , Mehdi Oualha , Charlotte Collignon
Background
Acute bronchiolitis is a common viral infection in infants, with severe cases requiring admission to pediatric intensive care units (PICU). While bacterial co-infections are rare, timely diagnosis and management are essential. Updated guidelines from the French-speaking Group of Pediatric Intensive and Emergency Care (GFRUP) aim to standardize the standard of care, reducing unnecessary interventions.
Objectives
This study evaluated the impact of updated bronchiolitis management guidelines on sepsis incidence, diagnostic test use, and antibiotic prescriptions in a single center.
Methods and settings
A retrospective study compared two epidemic periods (2022–2023 and 2023–2024) at the PICU, Necker-Enfants Malades Hospital. Clinical and microbiological data, including sepsis incidence, bacterial co-infections, diagnostic tests, and antibiotic use, were analyzed.
Results
Among 257 infants admitted for bronchiolitis, sepsis incidence remained low (8% vs. 7%). Implementation of the guidelines led to a significant reduction in additional diagnostic tests (65% vs. 49%, p = 0.013). Antibiotic prescription rates were unchanged, but a narrower spectrum of antibiotics was observed, with decreased amoxicillin/clavulanate use and increased amoxicillin prescriptions. Lung infections were the most frequent bacterial co-infections, with no rise in bacterial infection rates.
Conclusions
Implementation of updated guidelines reduced unnecessary diagnostic tests and promoted narrower-spectrum antibiotic use without increasing sepsis incidence. These findings highlight the potential of evidence-based guidelines to optimize care, support antibiotic stewardship, and minimize unnecessary interventions in pediatric critical care.
{"title":"Impact of the francophone pediatric intensive care group bronchiolitis recommendations on diagnostic testing, antibiotic therapy and patient prognosis","authors":"Pauline Labe , Matthieu Bendavid , Julie Toubiana , Céline Anquetil , Mehdi Oualha , Charlotte Collignon","doi":"10.1016/j.arcped.2025.10.008","DOIUrl":"10.1016/j.arcped.2025.10.008","url":null,"abstract":"<div><h3>Background</h3><div>Acute bronchiolitis is a common viral infection in infants, with severe cases requiring admission to pediatric intensive care units (PICU). While bacterial co-infections are rare, timely diagnosis and management are essential. Updated guidelines from the French-speaking Group of Pediatric Intensive and Emergency Care (GFRUP) aim to standardize the standard of care, reducing unnecessary interventions.</div></div><div><h3>Objectives</h3><div>This study evaluated the impact of updated bronchiolitis management guidelines on sepsis incidence, diagnostic test use, and antibiotic prescriptions in a single center.</div></div><div><h3>Methods and settings</h3><div>A retrospective study compared two epidemic periods (2022–2023 and 2023–2024) at the PICU, Necker-Enfants Malades Hospital. Clinical and microbiological data, including sepsis incidence, bacterial co-infections, diagnostic tests, and antibiotic use, were analyzed.</div></div><div><h3>Results</h3><div>Among 257 infants admitted for bronchiolitis, sepsis incidence remained low (8% vs. 7%). Implementation of the guidelines led to a significant reduction in additional diagnostic tests (65% vs. 49%, <em>p</em> = 0.013). Antibiotic prescription rates were unchanged, but a narrower spectrum of antibiotics was observed, with decreased amoxicillin/clavulanate use and increased amoxicillin prescriptions. Lung infections were the most frequent bacterial co-infections, with no rise in bacterial infection rates.</div></div><div><h3>Conclusions</h3><div>Implementation of updated guidelines reduced unnecessary diagnostic tests and promoted narrower-spectrum antibiotic use without increasing sepsis incidence. These findings highlight the potential of evidence-based guidelines to optimize care, support antibiotic stewardship, and minimize unnecessary interventions in pediatric critical care.</div></div>","PeriodicalId":55477,"journal":{"name":"Archives De Pediatrie","volume":"33 1","pages":"Pages 24-28"},"PeriodicalIF":1.3,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145770105","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}
Cancer diagnosis in the child is stressful for the family caregiver and could have a major impact on his/her mental health, including depression and anxiety, especially during the harsh current Lebanese economic crisis. This study aims at evaluating the correlates of depression and anxiety among family caregivers of pediatric cancer patients in Lebanon.
Methods
It is a cross-sectional study, using a convenience sample of 193 caregivers of pediatric patients with cancer. Depression, anxiety, and work fatigue were assessed using the Patient Health Questionnaire-9, Lebanese Anxiety Scale, and 3D-Work Fatigue Inventory respectively.
Results
The results showed that 18.1 % of the participants have moderately severe depression, whereas 22.2 % show severe depression. Moreover, 79.8 % had anxiety. Having a shortage of medications (Beta = 2.38) and more mental work fatigue (Beta = 0.36) were significantly associated with more depression. Higher physical (Beta = 0.32) and mental (Beta = 0.37) work fatigue were significantly associated with more anxiety.
Conclusion
The study results should raise concerns and make physicians in Lebanon aware of the psychological status of the family caregivers and encourage them to provide adequate support. The results underscore the urgent need for advocacy to improve conditions for families and enhance access to care for children with cancer and their families.
{"title":"Correlates of depression and anxiety among family caregivers of pediatric patients with cancer in Lebanon","authors":"Jhony Baissary , Souheil Hallit , Melyssa Assaf , Feten Fekih-Romdhane , Mohamad Farhat , Peter Noun","doi":"10.1016/j.arcped.2025.10.006","DOIUrl":"10.1016/j.arcped.2025.10.006","url":null,"abstract":"<div><h3>Background</h3><div>Cancer diagnosis in the child is stressful for the family caregiver and could have a major impact on his/her mental health, including depression and anxiety, especially during the harsh current Lebanese economic crisis. This study aims at evaluating the correlates of depression and anxiety among family caregivers of pediatric cancer patients in Lebanon.</div></div><div><h3>Methods</h3><div>It is a cross-sectional study, using a convenience sample of 193 caregivers of pediatric patients with cancer. Depression, anxiety, and work fatigue were assessed using the Patient Health Questionnaire-9, Lebanese Anxiety Scale, and 3D-Work Fatigue Inventory respectively.</div></div><div><h3>Results</h3><div>The results showed that 18.1 % of the participants have moderately severe depression, whereas 22.2 % show severe depression. Moreover, 79.8 % had anxiety. Having a shortage of medications (Beta = 2.38) and more mental work fatigue (Beta = 0.36) were significantly associated with more depression. Higher physical (Beta = 0.32) and mental (Beta = 0.37) work fatigue were significantly associated with more anxiety.</div></div><div><h3>Conclusion</h3><div>The study results should raise concerns and make physicians in Lebanon aware of the psychological status of the family caregivers and encourage them to provide adequate support. The results underscore the urgent need for advocacy to improve conditions for families and enhance access to care for children with cancer and their families.</div></div>","PeriodicalId":55477,"journal":{"name":"Archives De Pediatrie","volume":"33 1","pages":"Pages 43-49"},"PeriodicalIF":1.3,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145607539","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}
Annular skin lesions are ring-shaped manifestations characterized by an erythematous margin and a preserved or atrophic center. Their pathophysiology involves mechanisms such as peripheral inflammatory mediator expansion or immune tolerance at the center of the lesions.
Methods
This article reviews some of the most common annular lesions observed in pediatric populations within our setting.
Results
We included urticarial vasculitis, childhood cutaneous lupus erythematous, Still’s disease, annular granuloma, centriphugal annular erythema, pigmentary dermatoses, erythema migrans, multiform urticaria, acute hemorrhagic edema of the infancy, infectious dermatoses such as dermatophyte infections, and blistering conditions like linear IgA dermatosis, highlighting their clinical presentations, diagnostic approaches, and treatment options, emphasizing the importance of clinical correlation, biopsy findings, and appropriate therapeutic strategies.
Conclusion
This review will assist clinicians in diagnosing diseases associated with annular skin lesions.
{"title":"Annular lesions in childhood: A narrative review","authors":"Sergio Castillo-Pinto , Margarita Gomez , Monica Novoa-Candia","doi":"10.1016/j.arcped.2025.10.004","DOIUrl":"10.1016/j.arcped.2025.10.004","url":null,"abstract":"<div><h3>Backgound</h3><div>Annular skin lesions are ring-shaped manifestations characterized by an erythematous margin and a preserved or atrophic center. Their pathophysiology involves mechanisms such as peripheral inflammatory mediator expansion or immune tolerance at the center of the lesions.</div></div><div><h3>Methods</h3><div>This article reviews some of the most common annular lesions observed in pediatric populations within our setting.</div></div><div><h3>Results</h3><div>We included urticarial vasculitis, childhood cutaneous lupus erythematous, Still’s disease, annular granuloma, centriphugal annular erythema, pigmentary dermatoses, erythema migrans, multiform urticaria, acute hemorrhagic edema of the infancy, infectious dermatoses such as dermatophyte infections, and blistering conditions like linear IgA dermatosis, highlighting their clinical presentations, diagnostic approaches, and treatment options, emphasizing the importance of clinical correlation, biopsy findings, and appropriate therapeutic strategies.</div></div><div><h3>Conclusion</h3><div>This review will assist clinicians in diagnosing diseases associated with annular skin lesions.</div></div>","PeriodicalId":55477,"journal":{"name":"Archives De Pediatrie","volume":"33 1","pages":"Pages 2-7"},"PeriodicalIF":1.3,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145598461","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 : 2026-01-01DOI: 10.1016/j.arcped.2025.10.003
Ünal Akça , Emre Sanrı , Gülfer Akça
Objective
To identify clinical, chronobiological, and electroencephalographic (EEG) predictors of seizure freedom in pediatric patients with juvenile myoclonic epilepsy (JME), and to evaluate the prognostic utility of both classic and novel markers in a real-world setting.
Methods
We conducted a retrospective cohort study of 71 pediatric JME patients (mean age at diagnosis 16.1 ± 1.05 years; 76.1 % female) diagnosed at a single tertiary center between January 2023 and January 2025. Data collected included demographic variables, seizure characteristics, academic performance, comorbidities, antiseizure medication use, and detailed EEG findings. Classic (e.g., seizure type, academic achievement) and novel predictors (e.g., chronodependency) were assessed for their association with seizure outcome. Chronodependency was defined as a pattern of seizures predominantly occurring after awakening or during specific circadian periods. Multivariate logistic regression and receiver operating characteristic (ROC) analyses were performed.
Results
At last follow-up, 63.4 % (n = 45) of patients achieved seizure freedom. High academic performance (OR=42.00, p < 0.001) and initial myoclonic seizure type (OR=6.96, p < 0.001) were strongly associated with seizure freedom, whereas high initial frequency of generalized tonic-clonic seizures (OR=0.05, p < 0.001) and failure of at least two appropriate antiseizure medications (OR=0.07, p < 0.001) predicted poor outcomes. Among novel predictors, chronodependency (OR=0.29, p = 0.025), major focal EEG abnormalities (OR=0.30, p = 0.038), and EEG hyperventilation response (OR=0.35, p = 0.025) were independent negative prognostic factors. The full multivariate model, integrating classic and novel predictors, demonstrated excellent discriminative performance (AUC=0.96). Levetiracetam was the most frequently prescribed monotherapy, reflecting the predominance of adolescent and female patients; multidrug regimens were linked to poor seizure control.
Conclusion
Seizure outcome in pediatric JME is influenced by a complex interplay of cognitive, chronobiological, and electrographic factors. Integrating academic performance, seizure type, chronodependency, and advanced EEG findings enhances prognostication and supports a personalized, multidimensional approach to management. Early identification of at-risk patients may inform tailored interventions and improve long-term outcomes.
目的：确定小儿幼年肌阵挛性癫痫（JME）患者癫痫发作自由的临床、时间生物学和脑电图（EEG）预测因素，并评估经典和新型标志物在现实世界中的预后效用。方法：我们对2023年1月至2025年1月在单一三级中心诊断的71例小儿JME患者（诊断时平均年龄16.1±1.05岁，76.1%为女性）进行了回顾性队列研究。收集的数据包括人口统计学变量、癫痫发作特征、学业表现、合并症、抗癫痫药物使用和详细的脑电图结果。经典的（例如，癫痫发作类型，学习成绩）和新颖的预测因子（例如，时间依赖性）被评估与癫痫发作结果的关系。时间依赖性被定义为一种癫痫发作模式，主要发生在醒来后或特定的昼夜节律期间。进行多因素logistic回归和受试者工作特征（ROC）分析。结果：最后一次随访，63.4% （n = 45）患者癫痫发作自由。高学习成绩（OR=42.00, p < 0.001）和初始肌阵挛性发作类型（OR=6.96, p < 0.001）与癫痫发作自由密切相关，而高初始全身性强直-阵挛性发作频率（OR=0.05, p < 0.001）和至少两种合适的抗癫痫药物失败（OR=0.07, p < 0.001）预测不良预后。在新的预测因素中，时间依赖性（OR=0.29, p = 0.025）、主要局灶性脑电图异常（OR=0.30, p = 0.038）和脑电图过度通气反应（OR=0.35, p = 0.025）是独立的负面预后因素。完整的多元模型，整合了经典和新颖的预测因子，表现出良好的判别性能（AUC=0.96）。左乙拉西坦是最常用的单药治疗，反映了青少年和女性患者的优势；多药治疗方案与癫痫控制不佳有关。结论：小儿JME发作结局受认知、时间生物学和电图因素复杂的相互作用影响。综合学习成绩、发作类型、时间依赖性和先进的脑电图结果可以增强预测，并支持个性化、多维的治疗方法。早期识别有风险的患者可以为量身定制的干预措施提供信息，并改善长期结果。
{"title":"Seizure freedom in pediatric juvenile myoclonic epilepsy: The roles of cognition, chronodependency, and EEG","authors":"Ünal Akça , Emre Sanrı , Gülfer Akça","doi":"10.1016/j.arcped.2025.10.003","DOIUrl":"10.1016/j.arcped.2025.10.003","url":null,"abstract":"<div><h3>Objective</h3><div>To identify clinical, chronobiological, and electroencephalographic (EEG) predictors of seizure freedom in pediatric patients with juvenile myoclonic epilepsy (JME), and to evaluate the prognostic utility of both classic and novel markers in a real-world setting.</div></div><div><h3>Methods</h3><div>We conducted a retrospective cohort study of 71 pediatric JME patients (mean age at diagnosis 16.1 ± 1.05 years; 76.1 % female) diagnosed at a single tertiary center between January 2023 and January 2025. Data collected included demographic variables, seizure characteristics, academic performance, comorbidities, antiseizure medication use, and detailed EEG findings. Classic (e.g., seizure type, academic achievement) and novel predictors (e.g., chronodependency) were assessed for their association with seizure outcome. Chronodependency was defined as a pattern of seizures predominantly occurring after awakening or during specific circadian periods. Multivariate logistic regression and receiver operating characteristic (ROC) analyses were performed.</div></div><div><h3>Results</h3><div>At last follow-up, 63.4 % (<em>n</em> = 45) of patients achieved seizure freedom. High academic performance (OR=42.00, <em>p</em> < 0.001) and initial myoclonic seizure type (OR=6.96, <em>p</em> < 0.001) were strongly associated with seizure freedom, whereas high initial frequency of generalized tonic-clonic seizures (OR=0.05, <em>p</em> < 0.001) and failure of at least two appropriate antiseizure medications (OR=0.07, <em>p</em> < 0.001) predicted poor outcomes. Among novel predictors, chronodependency (OR=0.29, <em>p</em> = 0.025), major focal EEG abnormalities (OR=0.30, <em>p</em> = 0.038), and EEG hyperventilation response (OR=0.35, <em>p</em> = 0.025) were independent negative prognostic factors. The full multivariate model, integrating classic and novel predictors, demonstrated excellent discriminative performance (AUC=0.96). Levetiracetam was the most frequently prescribed monotherapy, reflecting the predominance of adolescent and female patients; multidrug regimens were linked to poor seizure control.</div></div><div><h3>Conclusion</h3><div>Seizure outcome in pediatric JME is influenced by a complex interplay of cognitive, chronobiological, and electrographic factors. Integrating academic performance, seizure type, chronodependency, and advanced EEG findings enhances prognostication and supports a personalized, multidimensional approach to management. Early identification of at-risk patients may inform tailored interventions and improve long-term outcomes.</div></div>","PeriodicalId":55477,"journal":{"name":"Archives De Pediatrie","volume":"33 1","pages":"Pages 36-42"},"PeriodicalIF":1.3,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145607552","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 : 2026-01-01DOI: 10.1016/j.arcped.2025.10.009
Chantal Stheneur , Sirine Sandli , Solène Sirieys , Alexandra Loisel , Marie Rose Moro , Rahmethnissah Radjack , Anne Li
Background
Dangerous games are playful activities engaged in by children and adolescents, posing significant risks to their health. Various types exist, aggressive games, challenge games, and asphyxiation games, with the ‘Choking game’ (where individuals attempt strangulation) being the most well-known. The prevalence of dangerous games among adolescents is increasing, yet it remains a little-known and studied societal issue among healthcare professionals.
Objective
To assess physicians’ role in the prevention and management of dangerous games.
Methods and Settings
Qualitative semi-structured interviews with general practitioners, pediatricians, and psychiatrists were performed. All data were transcribed verbatim and analyzed using a content analysis approach.
Results
We interviewed 6 general practitioners, 6 psychiatrists, and 5 pediatricians practicing in the Paris region. Three main themes emerged from the data: 1) physicians' lack of knowledge about the topic due to insufficient training, 2) players’ profiles characterized by psychological vulnerability, influence of peer pressure and social media, with no clear suicidal intent, and 3) the need to primarily focus on screening, prevention, and management at the school level.
Conclusion
This study highlights a critical public health issue. Physicians' roles are essential for identifying psychological vulnerabilities and raising awareness among youth of the associated risks. However, prevention requires close collaboration between the educational sector and healthcare professionals, who could benefit from targeted training and regular interventions within educational institutions.
{"title":"The role of primary care physicians in preventing and managing dangerous games among adolescents: A qualitative study","authors":"Chantal Stheneur , Sirine Sandli , Solène Sirieys , Alexandra Loisel , Marie Rose Moro , Rahmethnissah Radjack , Anne Li","doi":"10.1016/j.arcped.2025.10.009","DOIUrl":"10.1016/j.arcped.2025.10.009","url":null,"abstract":"<div><h3>Background</h3><div>Dangerous games are playful activities engaged in by children and adolescents, posing significant risks to their health. Various types exist, aggressive games, challenge games, and asphyxiation games, with the <em>‘Choking game’</em> (where individuals attempt strangulation) being the most well-known. The prevalence of dangerous games among adolescents is increasing, yet it remains a little-known and studied societal issue among healthcare professionals.</div></div><div><h3>Objective</h3><div>To assess physicians’ role in the prevention and management of dangerous games.</div></div><div><h3>Methods and Settings</h3><div>Qualitative semi-structured interviews with general practitioners, pediatricians, and psychiatrists were performed. All data were transcribed verbatim and analyzed using a content analysis approach.</div></div><div><h3>Results</h3><div>We interviewed 6 general practitioners, 6 psychiatrists, and 5 pediatricians practicing in the Paris region. Three main themes emerged from the data: 1) physicians' lack of knowledge about the topic due to insufficient training, 2) players’ profiles characterized by psychological vulnerability, influence of peer pressure and social media, with no clear suicidal intent, and 3) the need to primarily focus on screening, prevention, and management at the school level.</div></div><div><h3>Conclusion</h3><div>This study highlights a critical public health issue. Physicians' roles are essential for identifying psychological vulnerabilities and raising awareness among youth of the associated risks. However, prevention requires close collaboration between the educational sector and healthcare professionals, who could benefit from targeted training and regular interventions within educational institutions.</div></div>","PeriodicalId":55477,"journal":{"name":"Archives De Pediatrie","volume":"33 1","pages":"Pages 69-74"},"PeriodicalIF":1.3,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145770025","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 : 2026-01-01DOI: 10.1016/j.arcped.2025.11.002
Mathilde Letouzey , Elisabeth Outtier , Tiphaine Biaggi , Anne Rousseau , Pascal Boileau , Laurence Foix-L’Hélias
Background
Accurately targeting newborns suspected of early-onset bacterial neonatal infection (EONI) and optimizing the administration of antibiotics is challenging. French clinical guidelines (HAS/SFN) on the management of newborns over 34 weeks at risk of EONI were deployed in September 2017.
Objective
Our objective was to assess their implementation 3 years later in the Paris area, representing approximately 180,000 births.
Methods and Settings
We conducted an observational study in all maternity units of the Ile-de-France region from July 2020 to January 2021. We sent a self-administered questionnaire on the application of the new guidelines by email addressed to a pediatrician in each maternity unit.
Results
Out of the 80 maternity units in the Ile-de-France region, 78 participated. Among the participating units, 40 (51 %) reported applying the new clinical guidelines fully, 28 (36 %) partially, while 10 (13 %) reported not applying them. Among participants, 45 (66 %) maternity units found the implementation of the clinical guidelines feasible, and nearly 80 % of them observed that applying them resulted in fewer additional tests, such as blood samples or peripheral bacteriological tests. Only 35 % of maternity units no longer collect gastric fluid sample, even though this practice is no longer recommended. Among the difficulties identified by the 10 centers that reported not implementing the guidelines were a lack of equipment, insufficient numbers of competent personnel, and insufficient time to train relevant professionals.
Conclusion
Three years after the publication of the French clinical guidelines (HAS/SFN) on the management of newborns over 34 weeks at risk of EONI, this study showed that over 85 % of responding maternity units in the Ile-de-France region reported have implemented the guidelines either fully or partially.
{"title":"Implementation in the Ile-de-France region of French clinical guidelines for the management of newborns at risk of early-onset neonatal infection","authors":"Mathilde Letouzey , Elisabeth Outtier , Tiphaine Biaggi , Anne Rousseau , Pascal Boileau , Laurence Foix-L’Hélias","doi":"10.1016/j.arcped.2025.11.002","DOIUrl":"10.1016/j.arcped.2025.11.002","url":null,"abstract":"<div><h3>Background</h3><div>Accurately targeting newborns suspected of early-onset bacterial neonatal infection (EONI) and optimizing the administration of antibiotics is challenging. French clinical guidelines (HAS/SFN) on the management of newborns over 34 weeks at risk of EONI were deployed in September 2017.</div></div><div><h3>Objective</h3><div>Our objective was to assess their implementation 3 years later in the Paris area, representing approximately 180,000 births.</div></div><div><h3>Methods and Settings</h3><div>We conducted an observational study in all maternity units of the Ile-de-France region from July 2020 to January 2021. We sent a self-administered questionnaire on the application of the new guidelines by email addressed to a pediatrician in each maternity unit.</div></div><div><h3>Results</h3><div>Out of the 80 maternity units in the Ile-de-France region, 78 participated. Among the participating units, 40 (51 %) reported applying the new clinical guidelines fully, 28 (36 %) partially, while 10 (13 %) reported not applying them. Among participants, 45 (66 %) maternity units found the implementation of the clinical guidelines feasible, and nearly 80 % of them observed that applying them resulted in fewer additional tests, such as blood samples or peripheral bacteriological tests. Only 35 % of maternity units no longer collect gastric fluid sample, even though this practice is no longer recommended. Among the difficulties identified by the 10 centers that reported not implementing the guidelines were a lack of equipment, insufficient numbers of competent personnel, and insufficient time to train relevant professionals.</div></div><div><h3>Conclusion</h3><div>Three years after the publication of the French clinical guidelines (HAS/SFN) on the management of newborns over 34 weeks at risk of EONI, this study showed that over 85 % of responding maternity units in the Ile-de-France region reported have implemented the guidelines either fully or partially.</div></div>","PeriodicalId":55477,"journal":{"name":"Archives De Pediatrie","volume":"33 1","pages":"Pages 50-54"},"PeriodicalIF":1.3,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145770057","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 : 2025-12-01DOI: 10.1016/S0929-693X(25)00250-7
Hélène Prigent
Respiratory complications are amajor cause of morbidity and mortality in Duchenne muscular dystrophy (DMD). Progressive weakness of inspiratory and expiratory muscles leads to ineffective cough, mucus retention, sleep-disordered breathing, nocturnal hypoventilation, and ultimately chronic respiratory failure. Before the advent of mechanical ventilation, respiratory failure was the leading cause of early death. Advances in multidisciplinary care, including noninvasive ventilation (NIV), airway clearance techniques, corticosteroid therapy, scoliosis management, and cardioprotective treatments, have markedly improved survival and quality of life. Respiratory decline typically follows loss of ambulation, reflecting the progressive loss of muscle strength. Hypoventilation first appears during REM sleep and evolves into daytime hypercapnia. Regular monitoring—annually before and biannually after loss of ambulation—is essential. Key respiratory monitoring parameters include decreased vital capacity, maximal inspiratory and expiratory pressures, and peak cough flow. Sleep studies are critical for early detection of nocturnal hypoventilation and sleep-disordered breathing. NIV remains the cornerstone of therapy, improving gas exchange, sleep quality, and life expectancy. As weakness increases, patients may become ventilator dependent; invasive ventilation is reserved for NIV failure. Adjunctive strategies such as lung volume recruitment and mechanical insufflation–exsufflation enhance cough efficacy and secretion clearance. Long-term corticosteroid therapy delays respiratory decline, while scoliosis correction and infection prevention further optimize outcomes. Nutritional management also supports respiratory health. Overall, early detection, individualized ventilatory management, and comprehensive multidisciplinary care are critical to improving survival and quality of life in patients with DMD.
{"title":"Respiratory care in Duchenne muscular dystrophy","authors":"Hélène Prigent","doi":"10.1016/S0929-693X(25)00250-7","DOIUrl":"10.1016/S0929-693X(25)00250-7","url":null,"abstract":"<div><div>Respiratory complications are amajor cause of morbidity and mortality in Duchenne muscular dystrophy (DMD). Progressive weakness of inspiratory and expiratory muscles leads to ineffective cough, mucus retention, sleep-disordered breathing, nocturnal hypoventilation, and ultimately chronic respiratory failure. Before the advent of mechanical ventilation, respiratory failure was the leading cause of early death. Advances in multidisciplinary care, including noninvasive ventilation (NIV), airway clearance techniques, corticosteroid therapy, scoliosis management, and cardioprotective treatments, have markedly improved survival and quality of life. Respiratory decline typically follows loss of ambulation, reflecting the progressive loss of muscle strength. Hypoventilation first appears during REM sleep and evolves into daytime hypercapnia. Regular monitoring—annually before and biannually after loss of ambulation—is essential. Key respiratory monitoring parameters include decreased vital capacity, maximal inspiratory and expiratory pressures, and peak cough flow. Sleep studies are critical for early detection of nocturnal hypoventilation and sleep-disordered breathing. NIV remains the cornerstone of therapy, improving gas exchange, sleep quality, and life expectancy. As weakness increases, patients may become ventilator dependent; invasive ventilation is reserved for NIV failure. Adjunctive strategies such as lung volume recruitment and mechanical insufflation–exsufflation enhance cough efficacy and secretion clearance. Long-term corticosteroid therapy delays respiratory decline, while scoliosis correction and infection prevention further optimize outcomes. Nutritional management also supports respiratory health. Overall, early detection, individualized ventilatory management, and comprehensive multidisciplinary care are critical to improving survival and quality of life in patients with DMD.</div></div>","PeriodicalId":55477,"journal":{"name":"Archives De Pediatrie","volume":"32 7","pages":"Pages 7S25-7S31"},"PeriodicalIF":1.3,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145739241","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 : 2025-12-01DOI: 10.1016/S0929-693X(25)00253-2
Stéphanie Fontaine-Carbonnel
Duchenne muscular dystrophy (DMD) is a severe degenerative disease that remains incurable. Its prognosis has been transformed by multidisciplinary care, which has significantly improved the life expectancy of patients. Corticosteroids have been used for over 20 years and have modified the care of young boys with DMD: They delay the loss of ambulation, support the gradual introduction of technical mobility aids, and reduce the frequency of scoliosis surgery. Corticoids are started and maintained at the theoretical dose of 0.75 mg/kg/day of prednisone/prednisolone or 0.9 mg/kg/day of deflazacort, adjusting the dose to weight if the benefit–risk ratio favors treatment. If introduced early enough, when muscle degeneration is not too advanced, they prolong the ability to climb stairs, rise from the floor, walk, and bring the hands to the mouth. They have been suggested to contribute to delaying the onset of respiratory failure and cardiomyopathy. The well-known side effects of corticosteroids require specific management (to prevent obesity and osteoporosis) and/or adjustment of their dosage. The only reasons to discontinue treatment when the patient and family are adhering to it are the uncontrolled side effects. Thus, in many countries including France, as of late 2025, the only routinely prescribed symptomatic treatment for DMD remains conventional corticosteroids, which will be discussed in this article, followed by a description of vamorolone, a dissociative steroidal compound, and givinostat, a histone deacetylase inhibitor.
{"title":"Corticosteroid treatment in Duchenne muscular dystrophy","authors":"Stéphanie Fontaine-Carbonnel","doi":"10.1016/S0929-693X(25)00253-2","DOIUrl":"10.1016/S0929-693X(25)00253-2","url":null,"abstract":"<div><div>Duchenne muscular dystrophy (DMD) is a severe degenerative disease that remains incurable. Its prognosis has been transformed by multidisciplinary care, which has significantly improved the life expectancy of patients. Corticosteroids have been used for over 20 years and have modified the care of young boys with DMD: They delay the loss of ambulation, support the gradual introduction of technical mobility aids, and reduce the frequency of scoliosis surgery. Corticoids are started and maintained at the theoretical dose of 0.75 mg/kg/day of prednisone/prednisolone or 0.9 mg/kg/day of deflazacort, adjusting the dose to weight if the benefit–risk ratio favors treatment. If introduced early enough, when muscle degeneration is not too advanced, they prolong the ability to climb stairs, rise from the floor, walk, and bring the hands to the mouth. They have been suggested to contribute to delaying the onset of respiratory failure and cardiomyopathy. The well-known side effects of corticosteroids require specific management (to prevent obesity and osteoporosis) and/or adjustment of their dosage. The only reasons to discontinue treatment when the patient and family are adhering to it are the uncontrolled side effects. Thus, in many countries including France, as of late 2025, the only routinely prescribed symptomatic treatment for DMD remains conventional corticosteroids, which will be discussed in this article, followed by a description of vamorolone, a dissociative steroidal compound, and givinostat, a histone deacetylase inhibitor.</div></div>","PeriodicalId":55477,"journal":{"name":"Archives De Pediatrie","volume":"32 7","pages":"Pages 7S45-7S51"},"PeriodicalIF":1.3,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145738828","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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