Archives De Pediatrie最新文献_第3页

Impact of early administration of long-acting insulin on ketosis rebound in diabetic ketoacidosis 早期使用长效胰岛素对糖尿病酮症酸中毒患者酮症反弹的影响。

IF 1.3 4区医学 Q3 PEDIATRICS

Archives De Pediatrie

Pub Date : 2025-01-01 DOI: 10.1016/j.arcped.2024.09.008

Emilie Thibault , Thomas Loppinet , Aurélie Portefaix , Valérie Launay , Kevin Perge

Background

Diabetic ketoacidosis (DKA) is a potentially life-threatening metabolic disorder that can occur with the onset or during follow-up of type 1 diabetes (T1D). Once DKA has been resolved, discontinuing the intravenous insulin infusion may lead to a rebound of hyperglycemia. Therefore, this study aimed to demonstrate that early administration by an injection of long-acting insulin avoids a ketosis rebound after stopping intravenous insulin.

Methods

A retrospective study was conducted in the Femme-Mère-Enfant Hospital. We included patients aged 0 and 18 years, admitted to the intensive care unit and then to pediatric diabetology for DKA between January 2022 and April 2023. We separated patients into two groups depending on the protocol received. For the "old protocol" group, intravenous insulin was stopped when the acidosis was resolved, and before the patient was transferred, subcutaneous insulin injections were given in diabetology. For the "new protocol" group, subcutaneous injections of long-acting and rapid-acting insulin were administered before discontinuing the intravenous infusion in the intensive care unit before transfer.

Results

A total of 58 children were included. 46 patients were managed for inaugural DKA and 12 for DKA decompensating of known T1D. 41 patients received the old protocol, and 17 the new protocol. The incidence of ketosis rebound was lower in the "new protocol" group (41.2 % vs. 75.6 %; p 0.027). There is a significant association between the new protocol and reduced risk of ketosis rebound (OR 0.23, p 0.015). Multivariate analysis adjusted for potential confounding factors doesn't modify these results (OR 0.25, p 0.045).

Conclusion

Our study is the first pediatric study suggesting that earlier injection of long-acting insulin after resolution of DKA in children reduces the risk of ketosis rebound.

背景：糖尿病酮症酸中毒（DKA）是一种潜在的危及生命的代谢紊乱，可发生在1型糖尿病（T1D）发病或随访期间。一旦DKA得到解决，停止静脉注射胰岛素可能导致高血糖的反弹。因此，本研究旨在证明早期注射长效胰岛素可避免停止静脉注射胰岛素后酮症反弹。方法：在妇婴医院进行回顾性研究。我们纳入了在2022年1月至2023年4月期间因DKA入住重症监护病房并随后入住儿科糖尿病的0至18岁患者。我们根据所接受的治疗方案将患者分为两组。“老方案”组酸中毒解决后停止静脉注射胰岛素，糖尿病患者转移前皮下注射胰岛素。对于“新方案”组，在转移前在重症监护病房停止静脉输注之前，皮下注射长效和速效胰岛素。结果：共纳入58例患儿。46例患者接受首次DKA治疗，12例患者接受已知T1D的DKA失代偿治疗。41名患者接受了旧方案，17名接受了新方案。“新方案”组酮症反弹的发生率较低(41.2% vs 75.6%；p 0.027)。新方案与降低酮症复发风险之间存在显著关联（OR 0.23, p 0.015）。校正潜在混杂因素的多变量分析没有改变这些结果（OR 0.25, p 0.045）。结论：我们的研究是第一个儿科研究，表明在DKA解决后早期注射长效胰岛素可以降低酮症反弹的风险。

{"title":"Impact of early administration of long-acting insulin on ketosis rebound in diabetic ketoacidosis","authors":"Emilie Thibault , Thomas Loppinet , Aurélie Portefaix , Valérie Launay , Kevin Perge","doi":"10.1016/j.arcped.2024.09.008","DOIUrl":"10.1016/j.arcped.2024.09.008","url":null,"abstract":"<div><h3>Background</h3><div>Diabetic ketoacidosis (DKA) is a potentially life-threatening metabolic disorder that can occur with the onset or during follow-up of type 1 diabetes (T1D). Once DKA has been resolved, discontinuing the intravenous insulin infusion may lead to a rebound of hyperglycemia. Therefore, this study aimed to demonstrate that early administration by an injection of long-acting insulin avoids a ketosis rebound after stopping intravenous insulin.</div></div><div><h3>Methods</h3><div>A retrospective study was conducted in the Femme-Mère-Enfant Hospital. We included patients aged 0 and 18 years, admitted to the intensive care unit and then to pediatric diabetology for DKA between January 2022 and April 2023. We separated patients into two groups depending on the protocol received. For the \"old protocol\" group, intravenous insulin was stopped when the acidosis was resolved, and before the patient was transferred, subcutaneous insulin injections were given in diabetology. For the \"new protocol\" group, subcutaneous injections of long-acting and rapid-acting insulin were administered before discontinuing the intravenous infusion in the intensive care unit before transfer.</div></div><div><h3>Results</h3><div>A total of 58 children were included. 46 patients were managed for inaugural DKA and 12 for DKA decompensating of known T1D. 41 patients received the old protocol, and 17 the new protocol. The incidence of ketosis rebound was lower in the \"new protocol\" group (41.2 % vs. 75.6 %; p 0.027). There is a significant association between the new protocol and reduced risk of ketosis rebound (OR 0.23, p 0.015). Multivariate analysis adjusted for potential confounding factors doesn't modify these results (OR 0.25, p 0.045).</div></div><div><h3>Conclusion</h3><div>Our study is the first pediatric study suggesting that earlier injection of long-acting insulin after resolution of DKA in children reduces the risk of ketosis rebound.</div></div>","PeriodicalId":55477,"journal":{"name":"Archives De Pediatrie","volume":"32 1","pages":"Pages 30-35"},"PeriodicalIF":1.3,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142775198","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}

引用次数: 0

Survey on vitamin D supplementation in children in France: Evaluation of real-life practices following the new 2022 French recommendations 法国儿童维生素 D 补充调查：根据 2022 年法国新建议对现实生活中的做法进行评估。

IF 1.3 4区医学 Q3 PEDIATRICS

Archives De Pediatrie

Pub Date : 2025-01-01 DOI: 10.1016/j.arcped.2024.09.006

Marie Lou Pechabrier , Justine Bacchetta , Patrick Tounian , Sanaa Eddiry , Agnès Linglart , Thomas Edouard

Background and objective

In 2022, recommendations for vitamin D supplementation in children were updated in France. The objective of this study was to assess real-life practices of vitamin D supplementation in children following these recommendations.

Methods

A thirty-three-question questionnaire was distributed to members of the scientific societies of paediatrics and general medicine via an online platform.

Results

There were 966 respondents, of whom 87 % were paediatricians and 13 % were general practitioners. About half of the physicians (47 %) were in private practice, 49 % worked in a hospital centre and 6 % worked in a maternal and child health centre. As recommended and regardless of the professional practice, vitamin D supplementation was almost systematically prescribed in all age groups (over 90 % of respondents), in daily doses up to 2 years of age (97 % of all respondents) and then every 3 months in older children (year-round in 38 % and winter/spring only in 40 %). Contrary to the new recommendations, loading doses of 200,000 units of vitamin D were prescribed by 5 % of respondents and non-pharmaceutical forms of vitamin D (e.g. unlicensed food supplements) were prescribed by 10 % of respondents. Although risk factors such as low sun exposure and dark skin were well known by respondents (75 % and 74 % respectively), obesity and veganism were only reported by half the respondents (40 % and 53 % respectively). Two-thirds (61 %) of respondents reported assessing calcium intakes when following children; however, only 10 % of them use specific questionnaires or calcium equivalence tables. Finally, the calcium content of foods and its bioavailability appeared to be poorly understood by health professionals.

Conclusion

This survey shows that the practice of paediatricians and general practitioners are in accordance with the new recommendations for vitamin D supplementation in very young children. The identification by this survey of knowledge gaps will allow targeted information campaigns.

背景和目的：2022 年，法国更新了儿童补充维生素 D 的建议。本研究旨在评估根据这些建议为儿童补充维生素D的实际做法：方法：通过在线平台向儿科和全科医学科学协会的成员发放了一份包含 33 个问题的调查问卷：共有 966 名受访者，其中 87% 为儿科医生，13% 为全科医生。大约一半的医生（47%）是私人医生，49%在医院中心工作，6%在妇幼保健中心工作。根据建议，无论专业实践如何，几乎所有年龄组（超过 90% 的受访者）都系统地开具了维生素 D 补充剂处方，2 岁以下儿童每天服用一次（占所有受访者的 97%），年龄较大的儿童每 3 个月服用一次（38% 的受访者全年服用，40% 的受访者只在冬春季服用）。与新建议相反，5% 的受访者开出了 20 万单位维生素 D 的负荷剂量处方，10% 的受访者开出了非药物形式的维生素 D 处方（如无证食品补充剂）。尽管受访者对日晒少和皮肤黝黑等风险因素非常了解（分别为 75% 和 74%），但只有半数受访者（分别为 40% 和 53%）报告了肥胖和素食情况。三分之二（61%）的受访者表示在跟踪儿童时会评估钙摄入量；然而，只有 10% 的受访者使用特定的调查问卷或钙当量表。最后，医疗专业人员似乎对食物中的钙含量及其生物利用率知之甚少：这项调查表明，儿科医生和全科医生的做法符合为幼儿补充维生素 D 的新建议。通过此次调查发现的知识差距将有助于开展有针对性的宣传活动。

{"title":"Survey on vitamin D supplementation in children in France: Evaluation of real-life practices following the new 2022 French recommendations","authors":"Marie Lou Pechabrier , Justine Bacchetta , Patrick Tounian , Sanaa Eddiry , Agnès Linglart , Thomas Edouard","doi":"10.1016/j.arcped.2024.09.006","DOIUrl":"10.1016/j.arcped.2024.09.006","url":null,"abstract":"<div><h3>Background and objective</h3><div>In 2022, recommendations for vitamin D supplementation in children were updated in France. The objective of this study was to assess real-life practices of vitamin D supplementation in children following these recommendations.</div></div><div><h3>Methods</h3><div>A thirty-three-question questionnaire was distributed to members of the scientific societies of paediatrics and general medicine via an online platform.</div></div><div><h3>Results</h3><div>There were 966 respondents, of whom 87 % were paediatricians and 13 % were general practitioners. About half of the physicians (47 %) were in private practice, 49 % worked in a hospital centre and 6 % worked in a maternal and child health centre. As recommended and regardless of the professional practice, vitamin D supplementation was almost systematically prescribed in all age groups (over 90 % of respondents), in daily doses up to 2 years of age (97 % of all respondents) and then every 3 months in older children (year-round in 38 % and winter/spring only in 40 %). Contrary to the new recommendations, loading doses of 200,000 units of vitamin D were prescribed by 5 % of respondents and non-pharmaceutical forms of vitamin D (<em>e.g.</em> unlicensed food supplements) were prescribed by 10 % of respondents. Although risk factors such as low sun exposure and dark skin were well known by respondents (75 % and 74 % respectively), obesity and veganism were only reported by half the respondents (40 % and 53 % respectively). Two-thirds (61 %) of respondents reported assessing calcium intakes when following children; however, only 10 % of them use specific questionnaires or calcium equivalence tables. Finally, the calcium content of foods and its bioavailability appeared to be poorly understood by health professionals.</div></div><div><h3>Conclusion</h3><div>This survey shows that the practice of paediatricians and general practitioners are in accordance with the new recommendations for vitamin D supplementation in very young children. The identification by this survey of knowledge gaps will allow targeted information campaigns.</div></div>","PeriodicalId":55477,"journal":{"name":"Archives De Pediatrie","volume":"32 1","pages":"Pages 4-11"},"PeriodicalIF":1.3,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142683716","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Prescription practice and yield of chest radiography in the management of children presenting to the French pediatric emergency department with non-traumatic chest pain 法国儿科急诊室在处理因非外伤性胸痛前来就诊的儿童时的处方做法和胸片检查率。

IF 1.3 4区医学 Q3 PEDIATRICS

Archives De Pediatrie

Pub Date : 2025-01-01 DOI: 10.1016/j.arcped.2024.09.002

Faïza Abdallah , Damiano Cerasuolo , David Brossier , Philippe Eckart , Emeline Duroy , Fanny Delehaye , Caroline Faucon

Objectives

Chest pain is a common symptom in pediatric emergency department. The causes are mostly benign without any sign on chest x-ray (CXR). However, CXR is one of the most ordered tests in this situation. Our main objective was to assess the current management of CXR by physicians in this context, according to the algorithm proposed by the French Society of Pediatrics (FSP).

Materials and methods

We conducted a retrospective study in two French pediatric emergency departments. We reviewed the medical records of children who presented with chest pain between 2018, July 1rst to 2021, July 31th. We collected data from history and clinical examination. The prescription of CXR and its interpretation were collected.

Results

Overall, 599 children were enrolled. The algorithm was followed in 57,1 % of cases, and 8,2 % of abnormal CXR were noted. On univariate analysis, medical history with a significant OR greater than 2 included cardiological history (as defined by FSP), neoplasia, pneumonia and sickle cell disease. Right lateralized pain, pain that worsens with respiration, fever and cough were also symptoms significantly associated with an abnormal CXR result. On physical finding, tachycardia, tachypnea, abnormal cardiac and pulmonary clinical examination (as defined by the FSP) were significantly associated with pathological CXR. However, the multivariate logistic regression model could not be carried out due to too many significant variables in univariate analysis, and too few number of abnormal CXR reported.

Conclusion

CXR remains the cornerstone of chest pain management in pediatric emergencies, even though the rate of abnormal CXR appears low. The appropriateness of CXR prescribing can be improved by guidelines focusing on the clinical etiologies of chest pain visible on CXR. A similar prospective study may identify risk factors for pathological CXR and clarify the decision tree for the indication of CXR in chest pain.

目的：胸痛是儿科急诊的常见症状。其原因多为良性，胸部 X 光片（CXR）上无任何征象。但在这种情况下，CXR 是最常被要求进行的检查之一。我们的主要目的是根据法国儿科学会（FSP）提出的算法，评估目前医生在这种情况下对 CXR 的处理：我们在法国两家儿科急诊室开展了一项回顾性研究。我们查阅了 2018 年 7 月 1 日至 2021 年 7 月 31 日期间因胸痛就诊儿童的病历。我们收集了病史和临床检查数据。我们还收集了胸透处方及其解释：共有 599 名儿童入选。57.1%的病例遵循了该算法，8.2%的病例发现了异常气管造影。单变量分析显示，心脏病史（根据 FSP 定义）、肿瘤、肺炎和镰状细胞病等病史的 OR 值大于 2。右侧疼痛、呼吸时疼痛加剧、发热和咳嗽也是与 CXR 结果异常显著相关的症状。在体格检查中，心动过速、呼吸过速、心肺临床检查异常（根据 FSP 定义）与病理 CXR 显著相关。然而，由于单变量分析中的显著变量过多，以及报告的异常 CXR 数量过少，多变量逻辑回归模型无法进行：结论：尽管 CXR 异常率似乎较低，但 CXR 仍是儿科急诊胸痛处理的基石。可以通过关注 CXR 可见胸痛的临床病因的指南来提高 CXR 处方的适当性。类似的前瞻性研究可确定病理性 CXR 的风险因素，并明确胸痛时 CXR 适应症的决策树。

{"title":"Prescription practice and yield of chest radiography in the management of children presenting to the French pediatric emergency department with non-traumatic chest pain","authors":"Faïza Abdallah , Damiano Cerasuolo , David Brossier , Philippe Eckart , Emeline Duroy , Fanny Delehaye , Caroline Faucon","doi":"10.1016/j.arcped.2024.09.002","DOIUrl":"10.1016/j.arcped.2024.09.002","url":null,"abstract":"<div><h3>Objectives</h3><div>Chest pain is a common symptom in pediatric emergency department. The causes are mostly benign without any sign on chest x-ray (CXR). However, CXR is one of the most ordered tests in this situation. Our main objective was to assess the current management of CXR by physicians in this context, according to the algorithm proposed by the French Society of Pediatrics (FSP).</div></div><div><h3>Materials and methods</h3><div>We conducted a retrospective study in two French pediatric emergency departments. We reviewed the medical records of children who presented with chest pain between 2018, July 1rst to 2021, July 31th. We collected data from history and clinical examination. The prescription of CXR and its interpretation were collected.</div></div><div><h3>Results</h3><div>Overall, 599 children were enrolled. The algorithm was followed in 57,1 % of cases, and 8,2 % of abnormal CXR were noted. On univariate analysis, medical history with a significant OR greater than 2 included cardiological history (as defined by FSP), neoplasia, pneumonia and sickle cell disease. Right lateralized pain, pain that worsens with respiration, fever and cough were also symptoms significantly associated with an abnormal CXR result. On physical finding, tachycardia, tachypnea, abnormal cardiac and pulmonary clinical examination (as defined by the FSP) were significantly associated with pathological CXR. However, the multivariate logistic regression model could not be carried out due to too many significant variables in univariate analysis, and too few number of abnormal CXR reported.</div></div><div><h3>Conclusion</h3><div>CXR remains the cornerstone of chest pain management in pediatric emergencies, even though the rate of abnormal CXR appears low. The appropriateness of CXR prescribing can be improved by guidelines focusing on the clinical etiologies of chest pain visible on CXR. A similar prospective study may identify risk factors for pathological CXR and clarify the decision tree for the indication of CXR in chest pain.</div></div>","PeriodicalId":55477,"journal":{"name":"Archives De Pediatrie","volume":"32 1","pages":"Pages 41-47"},"PeriodicalIF":1.3,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142693928","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}

引用次数: 0

Impact of the first COVID-19 lockdown on domestic accidents in children in France 第一次 COVID-19 封锁对法国儿童家庭事故的影响：第一次 COVID-19 封锁与法国儿童家庭事故。

IF 1.3 4区医学 Q3 PEDIATRICS

Archives De Pediatrie

Pub Date : 2025-01-01 DOI: 10.1016/j.arcped.2024.09.007

Marie-Prisca Chaffard Luçon , Nathalie Beltzer , Annabel Rigou , Isabelle Claudet

Background

In March 2020, several countries, including France, implemented a total lockdown policy to combat the spread of the COVID-19 epidemic, involving the closure of schools. This measure required children to stay at home for an extended period of time. Several studies have shown an increase in the number or proportion and severity of domestic accidents in children during this period. Santé Publique France and the paediatric emergency department of Toulouse University Hospital conducted a study on the impact of the first lockdown on the use of the emergency department due to domestic accidents in children under 15 years of age in France.

Methods

The study was conducted using data from nine French emergency departments participating in the Enquête permanente sur les accidents de la vie courante [Permanent Survey on Home and leisure injuries] (EPAC), which involves the exhaustive collection of data on emergency admissions following home and leisure injuries. The frequencies and characteristics of emergency department admissions due to domestic accidents were analysed over the period from 17 March to 11 May 2020, and compared to those over the same period in 2016–2019.

Results

During the lockdown period, an increase in the proportion of emergency department admissions due to domestic accidents is observed in boys and children aged [2–5[years. This study showed an increase in the proportion of hospital admissions during this period. These accidents were mainly falls in outside living spaces (balcony, patio, garden, etc.). The results showed an increase in admissions for fractures and upper limb injuries.

Conclusion

This study shows that health policies must take into account the collateral effects of certain measures put in place to manage an epidemic. Prevention messages for parents of young children need to be strengthened and their attention drawn to the risk of certain kinds of accidents, such as falls.

背景：2020 年 3 月，包括法国在内的一些国家实施了全面封锁政策，以遏制 COVID-19 疫情的蔓延，包括关闭学校。这项措施要求儿童长时间呆在家中。多项研究表明，在此期间，儿童家庭事故的数量、比例和严重程度都有所增加。法国公共卫生部和图卢兹大学医院儿科急诊部开展了一项研究，探讨第一次封锁对法国 15 岁以下儿童因家庭事故而使用急诊室的影响：这项研究使用了参与 "家庭和休闲伤害长期调查"（EPAC）的九个法国急诊科的数据。我们分析了2020年3月17日至5月11日期间因家庭意外事故而被急诊入院的频率和特征，并与2016-2019年同期进行了比较：在封锁期间，观察到男孩和[2-5]岁儿童因家庭意外事故而入院的急诊比例增加。这项研究显示，在此期间入院比例有所增加。这些事故主要是在室外生活空间（阳台、庭院、花园等）摔倒。结果显示，骨折和上肢受伤的入院人数有所增加：这项研究表明，卫生政策必须考虑到为控制疫情而采取的某些措施的附带影响。需要加强对幼儿家长的预防宣传，并提请他们注意某些类型事故的风险，如跌倒。

{"title":"Impact of the first COVID-19 lockdown on domestic accidents in children in France","authors":"Marie-Prisca Chaffard Luçon , Nathalie Beltzer , Annabel Rigou , Isabelle Claudet","doi":"10.1016/j.arcped.2024.09.007","DOIUrl":"10.1016/j.arcped.2024.09.007","url":null,"abstract":"<div><h3>Background</h3><div>In March 2020, several countries, including France, implemented a total lockdown policy to combat the spread of the COVID-19 epidemic, involving the closure of schools. This measure required children to stay at home for an extended period of time. Several studies have shown an increase in the number or proportion and severity of domestic accidents in children during this period. Santé Publique France and the paediatric emergency department of Toulouse University Hospital conducted a study on the impact of the first lockdown on the use of the emergency department due to domestic accidents in children under 15 years of age in France.</div></div><div><h3>Methods</h3><div>The study was conducted using data from nine French emergency departments participating in the <em>Enquête permanente sur les accidents de la vie courante</em> [Permanent Survey on Home and leisure injuries] (EPAC), which involves the exhaustive collection of data on emergency admissions following home and leisure injuries. The frequencies and characteristics of emergency department admissions due to domestic accidents were analysed over the period from 17 March to 11 May 2020, and compared to those over the same period in 2016–2019.</div></div><div><h3>Results</h3><div>During the lockdown period, an increase in the proportion of emergency department admissions due to domestic accidents is observed in boys and children aged [2–5[years. This study showed an increase in the proportion of hospital admissions during this period. These accidents were mainly falls in outside living spaces (balcony, patio, garden, etc.). The results showed an increase in admissions for fractures and upper limb injuries.</div></div><div><h3>Conclusion</h3><div>This study shows that health policies must take into account the collateral effects of certain measures put in place to manage an epidemic. Prevention messages for parents of young children need to be strengthened and their attention drawn to the risk of certain kinds of accidents, such as falls.</div></div>","PeriodicalId":55477,"journal":{"name":"Archives De Pediatrie","volume":"32 1","pages":"Pages 52-57"},"PeriodicalIF":1.3,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142689789","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}

引用次数: 0

Neuroendocrine tumor discovered in a teenager following asthma misdiagnosis 青少年哮喘误诊后发现神经内分泌肿瘤。

IF 1.3 4区医学 Q3 PEDIATRICS

Archives De Pediatrie

Pub Date : 2025-01-01 DOI: 10.1016/j.arcped.2024.11.002

Sophie Denamur , Erik Hervieux , Elora Peulier-Maitre , Francois Chalard , Aurore Coulomb , Nadia Nathan , Harriet Corvol

Although relatively rare, neuroendocrine tumors (NETs) represent the most common type of endobronchial tumors in pediatric patients. Their clinical presentation lacks specificity, often leading to delayed diagnosis due to limited clinical suspicion. Mainly classified as low-grade malignant tumors (grade 1), they typically demonstrate favorable outcomes following surgical removal. However, local recurrence and/or metastases may occur in both low- and high-grade NET. We present the case of a 17-year-old girl initially misdiagnosed with asthma, later found to have a low-grade NET obstructing the left main bronchus. Surgical resection enabled complete tumor removal, and subsequent follow-up confirmed the postsurgical recovery. This case emphasizes the importance of familiarizing pediatricians and GP with the need for chest X-rays in all initial asthma diagnosis in order to eliminate differential diagnoses such as bronchial NET. This underscores the importance of a prompt diagnosis and follow-up care in similar cases.

虽然相对罕见，但神经内分泌肿瘤（NETs）是儿科患者中最常见的支气管内肿瘤类型。他们的临床表现缺乏特异性，往往导致延误诊断由于有限的临床怀疑。它们主要被归类为低级别恶性肿瘤（1级），通常在手术切除后表现出良好的预后。然而，局部复发和/或转移可能发生在低级别和高级别NET。我们报告一个17岁的女孩最初被误诊为哮喘，后来发现有一个低级别NET阻塞左主支气管。手术切除使肿瘤完全切除，随后的随访证实了术后恢复。本病例强调了儿科医生和全科医生在所有哮喘初始诊断中熟悉胸部x光片的重要性，以消除支气管NET等鉴别诊断。这强调了在类似病例中及时诊断和随访护理的重要性。

引用次数: 0

School-entry age and academic difficulties at 7 years of age in children born very preterm: A call for age-corrected schooling 早产儿7岁时入学年龄和学业困难：对年龄矫正教育的呼吁：早产儿7岁时入学年龄和学业困难。

IF 1.3 4区医学 Q3 PEDIATRICS

Archives De Pediatrie

Pub Date : 2025-01-01 DOI: 10.1016/j.arcped.2024.10.007

Jean-Christophe Roze , Geraldine Apprioual , Andrei Scott Morgan , Jean-Baptiste Muller , Stephane Marret , Valerie Rouger , Ghislain Leduc , Nail Benallegue , Mickael Dinonais , Charlote Bouvard , Pierre-Yves Ancel , Cyril Flamant

Background

Very preterm children are at greater risk of academic difficulties (AD). Some of them start school a year earlier than anticipated during pregnancy due to being born preterm. The aim of this study was to analyze the relationship between neurodevelopment, school-entry age, and AD at age seven.

Method

AD were assessed at age seven in children born before 33 weeks of gestation between January 1st, 2007 and December 31, 2014 and enrolled in LIFT cohort. To analyze the relationship between school-entry age and AD, we used generalized equations with adjustment for perinatal, socio-economic factors, and neurodevelopment assessed by Age Stages Questionnaire (ASQ) at 5 years. Moreover, we used Global Scholar Adaptation (GSA) score to evaluate the school adaptation.

Results

2599 children were in routine schooling. Entering school a year earlier was observed in 597 (23.0 %). AD was known for 1943/2599 (74.8 %). Starting school a year earlier was associated with an increased rate of AD: 35.4 % in the exposed group versus 20.2 % in the non-exposed group, with a relative risk of 1.76 (95 % CI: 1.48; 2.08). Both starting school a year earlier and ASQ at 5 years old were independently associated with the GSA score at age 7: standardized β = -0.15 (95 % CI:-0.10;-0.20) and 0.40 (95 % CI: 0.35; 0.45) respectively.

Conclusion

Starting school a year earlier than anticipated during pregnancy was associated with an increased rate of AD at age 7 in children born very preterm, independently of their neurodevelopment at age 5 assessed by ASQ. Basing school entry age on corrected age seems appropriate to mitigate this risk.

背景：非常早产的儿童有更大的学习困难（AD）风险。由于早产，他们中的一些人在怀孕期间比预期提前一年开始上学。本研究的目的是分析7岁时神经发育、入学年龄和AD之间的关系。方法：对2007年1月1日至2014年12月31日期间出生在33周前的7岁儿童进行AD评估，并纳入LIFT队列。为了分析入学年龄与AD之间的关系，我们使用了广义方程，并调整了围产期、社会经济因素和5岁时通过年龄阶段问卷（ASQ）评估的神经发育。此外，我们使用全球学者适应（GSA）评分来评估学校适应。结果：2599名儿童正常上学。597例（23.0%）提前一年入学。公元1943/2599年（74.8%）。提前一年上学与AD发病率增加有关：暴露组为35.4%，未暴露组为20.2%，相对危险度为1.76 (95% CI: 1.48；2.08)。提前一年入学和5岁时的ASQ与7岁时的GSA得分独立相关：标准化β = -0.15 （95% CI:-0.10;-0.20）和0.40 (95% CI: 0.35；分别为0.45)。结论：怀孕期间比预期早一年上学与早产儿7岁时阿尔茨海默病的发病率增加有关，这与ASQ评估的5岁时的神经发育情况无关。以矫正年龄为入学年龄似乎可以减轻这种风险。

{"title":"School-entry age and academic difficulties at 7 years of age in children born very preterm: A call for age-corrected schooling","authors":"Jean-Christophe Roze , Geraldine Apprioual , Andrei Scott Morgan , Jean-Baptiste Muller , Stephane Marret , Valerie Rouger , Ghislain Leduc , Nail Benallegue , Mickael Dinonais , Charlote Bouvard , Pierre-Yves Ancel , Cyril Flamant","doi":"10.1016/j.arcped.2024.10.007","DOIUrl":"10.1016/j.arcped.2024.10.007","url":null,"abstract":"<div><h3>Background</h3><div>Very preterm children are at greater risk of academic difficulties (AD). Some of them start school a year earlier than anticipated during pregnancy due to being born preterm. The aim of this study was to analyze the relationship between neurodevelopment, school-entry age, and AD at age seven.</div></div><div><h3>Method</h3><div>AD were assessed at age seven in children born before 33 weeks of gestation between January 1st, 2007 and December 31, 2014 and enrolled in LIFT cohort. To analyze the relationship between school-entry age and AD, we used generalized equations with adjustment for perinatal, socio-economic factors, and neurodevelopment assessed by Age Stages Questionnaire (ASQ) at 5 years. Moreover, we used Global Scholar Adaptation (GSA) score to evaluate the school adaptation.</div></div><div><h3>Results</h3><div>2599 children were in routine schooling. Entering school a year earlier was observed in 597 (23.0 %). AD was known for 1943/2599 (74.8 %). Starting school a year earlier was associated with an increased rate of AD: 35.4 % in the exposed group versus 20.2 % in the non-exposed group, with a relative risk of 1.76 (95 % CI: 1.48; 2.08). Both starting school a year earlier and ASQ at 5 years old were independently associated with the GSA score at age 7: standardized β = -0.15 (95 % CI:-0.10;-0.20) and 0.40 (95 % CI: 0.35; 0.45) respectively.</div></div><div><h3>Conclusion</h3><div>Starting school a year earlier than anticipated during pregnancy was associated with an increased rate of AD at age 7 in children born very preterm, independently of their neurodevelopment at age 5 assessed by ASQ. Basing school entry age on corrected age seems appropriate to mitigate this risk.</div></div>","PeriodicalId":55477,"journal":{"name":"Archives De Pediatrie","volume":"32 1","pages":"Pages 66-71"},"PeriodicalIF":1.3,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142883732","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Acknowledging our reviewers

IF 1.3 4区医学 Q3 PEDIATRICS

Archives De Pediatrie

Pub Date : 2025-01-01 DOI: 10.1016/j.arcped.2024.12.002

引用次数: 0

Gastroesophageal reflux within first year of life: What new recommendations from French National Authority for Health (HAS) tell us 出生后第一年内的胃食管反流：法国国家卫生局（HAS）的新建议告诉我们什么？

IF 1.3 4区医学 Q3 PEDIATRICS

Archives De Pediatrie

Pub Date : 2025-01-01 DOI: 10.1016/j.arcped.2024.08.008

Camille Jung , Haude Clouzeau , Karim Bouziane Nedjadi , Noël Peretti , Arnaud Lalanne , Stéphanie Coopman , Marc Bellaiche , Hugues Piloquet , Alexandre Fabre , Delphine Ley , French-speaking Pediatric Hepatology, Gastroenterology and Nutrition Group (GFHGNP)

引用次数: 0

Scurvy in an 18-month-old child mimicking a clinical presentation of rickets. 一个18个月大的孩子的坏血病，模仿佝偻病的临床表现。

IF 1.3 4区医学 Q3 PEDIATRICS

Archives De Pediatrie

Pub Date : 2024-12-27 DOI: 10.1016/j.arcped.2024.10.006

Ai Tien Nguyen, Sibylle Jalon, Albane Simon, Maurine Jouret, Justin Le Lorier, Véronique Hentgen, Marie-Aliette Dommergues

Scurvy is now considered to be a rare disease in European countries, even among children, but it still exists. We report the case of an 18-month-old boy who was initially hospitalized for a walking disorder and ultimately diagnosed with scurvy. Radiographs were compatible with rickets, but biological analysis ruled out this diagnosis. The vitamin C deficiency was due to an inadequate diet of a young child without any underlying conditions. This child was exclusively breastfed until the age of 17 months and his mother was also likely vitamin C deficient, as she had a diet lacking in fruits and vegetables. Practitioners should become familiar with symptoms of scurvy to prevent the ordering of unnecessary tests and delays in diagnoses.

坏血病现在在欧洲国家被认为是一种罕见的疾病，即使在儿童中也是如此，但它仍然存在。我们报告的情况下，一个18个月大的男孩谁最初住院的行走障碍，最终诊断为坏血病。x线片与佝偻病相符，但生物学分析排除了这种诊断。缺乏维生素C是由于没有任何潜在疾病的幼儿饮食不足。这个孩子在17个月大之前都是纯母乳喂养的，他的母亲也可能缺乏维生素C，因为她的饮食中缺乏水果和蔬菜。从业者应该熟悉坏血病的症状，以防止订购不必要的测试和延误诊断。

引用次数: 0

Comparison of sedation using pentobarbital or chlorpromazine in pediatric non-invasive imaging procedures: A before and after study.: Comparison of sedation using pentobarbital or chlorpromazine in non-invasive imaging procedures. 戊巴比妥或氯丙嗪在儿童无创成像手术中的镇静效果比较：前后研究。：戊巴比妥与氯丙嗪在无创成像过程中的镇静效果比较。

IF 1.3 4区医学 Q3 PEDIATRICS

Archives De Pediatrie

Pub Date : 2024-12-22 DOI: 10.1016/j.arcped.2024.11.001

Elodie Morin, Eric Xu, Elise Sacaze, Olivier Legeas, Juliette Ropars

Background: Sedation is often required for pediatric medical imaging procedures to ensure compliance and image quality. Recommendations for pediatric sedation exist, but there are currently no guidelines for the choice of the sedative drug.

Objective: To compare the efficacy and adverse events of per os pentobarbital with intravenous chlorpromazine in children undergoing diagnostic imaging procedures. We hypothesized that the efficacy of per os pentobarbital would not be inferior to that of intravenous chlorpromazine, that safety would be similar, and that patient acceptance would be higher.

Material and methods: A pilot study (before and after study methodology) was performed. The sedation of 247 children with intravenous chlorpromazine or oral pentobarbital was evaluated for 6 months successively (independently by two radiologists, both blinded to the sedation technique). The primary outcome was sedation success as defined by an acceptable image quality. Secondary outcomes were induction time, length of hospital stay, adverse events, parental satisfaction and potential factors associated with failure of pentobarbital sedation.

Results: The sedation success rate of per os pentobarbital was found to be not inferior to that of intravenous chlorpromazine (83 % vs 90 %, p < 0.01). Mean length of hospital stay was shorter with per os pentobarbital. Despite the higher incidence of agitation during recovery with per os pentobarbital, parents expressed a preference for it. Per os pentobarbital failed more often in children older than 5 years.

Conclusion: Per os pentobarbital may be an effective alternative to intravenous chlorpromazine, especially in children under 5 years of age.

背景：镇静通常需要儿科医学成像程序，以确保依从性和图像质量。对于小儿镇静的建议是存在的，但是目前还没有关于镇静药物选择的指南。目的：比较戊巴比妥与氯丙嗪在儿童影像学诊断中的疗效和不良事件。我们假设戊巴比妥的有效性不会低于静脉氯丙嗪，安全性相似，患者接受度更高。材料和方法：进行了一项初步研究（研究方法前后）。对247例儿童连续6个月静脉氯丙嗪或口服戊巴比妥的镇静效果进行评估（由两名独立的放射科医师，均对镇静技术不知情）。主要结果是通过可接受的图像质量来定义镇静成功。次要结局是诱导时间、住院时间、不良事件、父母满意度和与戊巴比妥镇静失败相关的潜在因素。结果：戊巴比妥的镇静成功率不低于氯丙嗪的镇静成功率（83% vs 90%, p < 0.01）。戊巴比妥组平均住院时间较短。尽管在使用戊巴比妥的恢复期，躁动的发生率较高，但家长表示更喜欢使用戊巴比妥。戊巴比妥在5岁以上儿童中更常失效。结论：戊巴比妥可有效替代氯丙嗪静脉注射，尤其适用于5岁以下儿童。

{"title":"Comparison of sedation using pentobarbital or chlorpromazine in pediatric non-invasive imaging procedures: A before and after study.: Comparison of sedation using pentobarbital or chlorpromazine in non-invasive imaging procedures.","authors":"Elodie Morin, Eric Xu, Elise Sacaze, Olivier Legeas, Juliette Ropars","doi":"10.1016/j.arcped.2024.11.001","DOIUrl":"https://doi.org/10.1016/j.arcped.2024.11.001","url":null,"abstract":"<p><strong>Background: </strong>Sedation is often required for pediatric medical imaging procedures to ensure compliance and image quality. Recommendations for pediatric sedation exist, but there are currently no guidelines for the choice of the sedative drug.</p><p><strong>Objective: </strong>To compare the efficacy and adverse events of per os pentobarbital with intravenous chlorpromazine in children undergoing diagnostic imaging procedures. We hypothesized that the efficacy of per os pentobarbital would not be inferior to that of intravenous chlorpromazine, that safety would be similar, and that patient acceptance would be higher.</p><p><strong>Material and methods: </strong>A pilot study (before and after study methodology) was performed. The sedation of 247 children with intravenous chlorpromazine or oral pentobarbital was evaluated for 6 months successively (independently by two radiologists, both blinded to the sedation technique). The primary outcome was sedation success as defined by an acceptable image quality. Secondary outcomes were induction time, length of hospital stay, adverse events, parental satisfaction and potential factors associated with failure of pentobarbital sedation.</p><p><strong>Results: </strong>The sedation success rate of per os pentobarbital was found to be not inferior to that of intravenous chlorpromazine (83 % vs 90 %, p < 0.01). Mean length of hospital stay was shorter with per os pentobarbital. Despite the higher incidence of agitation during recovery with per os pentobarbital, parents expressed a preference for it. Per os pentobarbital failed more often in children older than 5 years.</p><p><strong>Conclusion: </strong>Per os pentobarbital may be an effective alternative to intravenous chlorpromazine, especially in children under 5 years of age.</p>","PeriodicalId":55477,"journal":{"name":"Archives De Pediatrie","volume":" ","pages":""},"PeriodicalIF":1.3,"publicationDate":"2024-12-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142883726","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}

引用次数: 0