Pub Date : 2024-10-28DOI: 10.1016/j.arcped.2024.07.008
Marion Suprin, Nathan Micheletti, Sylvie-Françoise Caraby, Cyril Ruello, Anne Ego, Thierry Debillon, Julia Doutau, Marie Chevallier
Background: The present study assessed adherence and satisfaction regarding a new protocol for preventing hypoglycemia in neonates, with a target of 80 % adherence.
Methods: This 6-month prospective observational study was conducted between 2021 and 2022 in a tertiary hospital maternity unit. Neonates with at least one hypoglycemia risk factor were included. Two factors for adherence were evaluated: feeding before 1 h of life and capillary blood glucose assay at 2 h of life.
Results: Protocol adherence was 67.6 % overall, with clinically satisfactory protocol application. Neonates small for gestational age were at the greatest risk of hypoglycemia (34.8 %). Non-adherence mainly concerned early feeding (28.9 %). The rate of hypoglycemia with adherence and non-adherence was, respectively, 15.8 % (n = 27/171) and 22.0 % (n = 18/82) (p = 0.23). Teams integrated the new recommendations successfully (satisfaction: 8/10), with some reluctance on the part of childcare assistants due to increased workload.
Conclusion: This apparently simple protocol could be supported by a quality improvement program. This study might help other care teams to establish similar protocols and identify areas for improvement.
{"title":"Implementation of a protocol to prevent hypoglycemia in at-risk neonates born at 35 weeks' gestational age in a tertiary hospital: Adherence and satisfaction. It's not so easy!","authors":"Marion Suprin, Nathan Micheletti, Sylvie-Françoise Caraby, Cyril Ruello, Anne Ego, Thierry Debillon, Julia Doutau, Marie Chevallier","doi":"10.1016/j.arcped.2024.07.008","DOIUrl":"https://doi.org/10.1016/j.arcped.2024.07.008","url":null,"abstract":"<p><strong>Background: </strong>The present study assessed adherence and satisfaction regarding a new protocol for preventing hypoglycemia in neonates, with a target of 80 % adherence.</p><p><strong>Methods: </strong>This 6-month prospective observational study was conducted between 2021 and 2022 in a tertiary hospital maternity unit. Neonates with at least one hypoglycemia risk factor were included. Two factors for adherence were evaluated: feeding before 1 h of life and capillary blood glucose assay at 2 h of life.</p><p><strong>Results: </strong>Protocol adherence was 67.6 % overall, with clinically satisfactory protocol application. Neonates small for gestational age were at the greatest risk of hypoglycemia (34.8 %). Non-adherence mainly concerned early feeding (28.9 %). The rate of hypoglycemia with adherence and non-adherence was, respectively, 15.8 % (n = 27/171) and 22.0 % (n = 18/82) (p = 0.23). Teams integrated the new recommendations successfully (satisfaction: 8/10), with some reluctance on the part of childcare assistants due to increased workload.</p><p><strong>Conclusion: </strong>This apparently simple protocol could be supported by a quality improvement program. This study might help other care teams to establish similar protocols and identify areas for improvement.</p>","PeriodicalId":55477,"journal":{"name":"Archives De Pediatrie","volume":" ","pages":""},"PeriodicalIF":1.3,"publicationDate":"2024-10-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142549057","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 : 2024-10-28DOI: 10.1016/j.arcped.2024.07.009
Claire Bouvattier, Lise Duranteau, Tristan Verdelet, Marion Joly, Caroline Le Roux, Laurence Brunet
In 2021, for the first time, a legal framework organizing the care of children with a variation in genital development (VGD), sometimes referred to as "intersex children" or "children with differences in sex development" (DSD), was introduced in France (article L. 2131-6 of the Code of Public Health). It should be immediately apparent that the chosen term, "variation" rather than "anomalies" or "disorders" - which was previously used in the medical world - reflects a political will to renew both the way of thinking and the medical practices in this field. The aim of the new legal framework is to guarantee optimum care for children with VGD by requiring the systematic involvement of expert centers (to establish diagnoses and therapeutic proposals), providing the most comprehensive information possible to their families and seeking the minor's consent. Among the possible medical care options, the law explicitly mentions "therapeutic abstention," reflecting a paradigm shift aimed at curbing the too-frequent recourse to treatments whose sole objective is the conformation of the genitalia. An order was subsequently issued on 15 November 2022 to provide the necessary details for the implementation of the changes introduced by the law.
{"title":"Paradigm shift in France in the medical care of children with genital development variations: Medical care for children with genital development variations in France.","authors":"Claire Bouvattier, Lise Duranteau, Tristan Verdelet, Marion Joly, Caroline Le Roux, Laurence Brunet","doi":"10.1016/j.arcped.2024.07.009","DOIUrl":"https://doi.org/10.1016/j.arcped.2024.07.009","url":null,"abstract":"<p><p>In 2021, for the first time, a legal framework organizing the care of children with a variation in genital development (VGD), sometimes referred to as \"intersex children\" or \"children with differences in sex development\" (DSD), was introduced in France (article L. 2131-6 of the Code of Public Health). It should be immediately apparent that the chosen term, \"variation\" rather than \"anomalies\" or \"disorders\" - which was previously used in the medical world - reflects a political will to renew both the way of thinking and the medical practices in this field. The aim of the new legal framework is to guarantee optimum care for children with VGD by requiring the systematic involvement of expert centers (to establish diagnoses and therapeutic proposals), providing the most comprehensive information possible to their families and seeking the minor's consent. Among the possible medical care options, the law explicitly mentions \"therapeutic abstention,\" reflecting a paradigm shift aimed at curbing the too-frequent recourse to treatments whose sole objective is the conformation of the genitalia. An order was subsequently issued on 15 November 2022 to provide the necessary details for the implementation of the changes introduced by the law.</p>","PeriodicalId":55477,"journal":{"name":"Archives De Pediatrie","volume":" ","pages":""},"PeriodicalIF":1.3,"publicationDate":"2024-10-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142549058","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}
Introduction: Identifying and alerting suspected child abuse enables its investigation and management. In France, anyone can report the situation to child services when child abuse is suspected. However, the number of reports of concern received from physicians is low, and lack of knowledge is a frequent obstacle. This study aimed to explore the practices of trained general practitioners (GPs) regarding the identification and management of suspected child abuse.
Method: We led a qualitative study from February to November 2021 based on a grounded theory approach. We conducted semi-structured interviews with GPs working in the south of France who had received training in identifying child abuse. We performed an inductive analysis using NVivo software.
Results: We interviewed 10 GPs (data saturation with seventh GP). Despite the training, obstacles seemed to persist, such as apprehension of the parents' reaction, the technical difficulties of the process, and the lack of feedback after making a report. Being accompanied by a professional who can be directly contacted would facilitate the communication of worrying information. Without direct links to a single referent, doctors would prefer alternative ways of referring their patients to organizations they were familiar with.
Discussion and conclusion: GPs expressed a need for easy access to childcare professionals to support them in the decision to file a report of suspected child abuse. A multidisciplinary approach and a dedicated point of contact seemed to help the process. Nominating a child protection referent doctor per department and creating specific units in hospitals for children at risk would help GPs get effectual contacts for reporting worrying information and better care for children at risk of abuse.
{"title":"Managing child abuse or suspected child abuse in primary care: Results from a qualitative study of general practitioners trained in detecting child abuse: Managing child abuse or suspected child abuse in primary care.","authors":"Maeva Jego, Camille De Lapeyrière, Mohamed Belhachemi, Didier Théry, Aurélie Janczewski","doi":"10.1016/j.arcped.2024.07.006","DOIUrl":"https://doi.org/10.1016/j.arcped.2024.07.006","url":null,"abstract":"<p><strong>Introduction: </strong>Identifying and alerting suspected child abuse enables its investigation and management. In France, anyone can report the situation to child services when child abuse is suspected. However, the number of reports of concern received from physicians is low, and lack of knowledge is a frequent obstacle. This study aimed to explore the practices of trained general practitioners (GPs) regarding the identification and management of suspected child abuse.</p><p><strong>Method: </strong>We led a qualitative study from February to November 2021 based on a grounded theory approach. We conducted semi-structured interviews with GPs working in the south of France who had received training in identifying child abuse. We performed an inductive analysis using NVivo software.</p><p><strong>Results: </strong>We interviewed 10 GPs (data saturation with seventh GP). Despite the training, obstacles seemed to persist, such as apprehension of the parents' reaction, the technical difficulties of the process, and the lack of feedback after making a report. Being accompanied by a professional who can be directly contacted would facilitate the communication of worrying information. Without direct links to a single referent, doctors would prefer alternative ways of referring their patients to organizations they were familiar with.</p><p><strong>Discussion and conclusion: </strong>GPs expressed a need for easy access to childcare professionals to support them in the decision to file a report of suspected child abuse. A multidisciplinary approach and a dedicated point of contact seemed to help the process. Nominating a child protection referent doctor per department and creating specific units in hospitals for children at risk would help GPs get effectual contacts for reporting worrying information and better care for children at risk of abuse.</p>","PeriodicalId":55477,"journal":{"name":"Archives De Pediatrie","volume":" ","pages":""},"PeriodicalIF":1.3,"publicationDate":"2024-10-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142523743","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 : 2024-10-08DOI: 10.1016/j.arcped.2024.05.001
Khadijeh Rezvani, Mohammad Hossein Kaveh, Leila Ghahramani, Abdolrahim Asadollahi
Background Empowering adolescents in the field of puberty health is one of the important goals of public health programs. The present study was carried out with the aim of determining the effect of peer-led training on puberty-related behavior and its determinants using social cognitive theory.
Methods: A total of 245 teenage girls were randomly divided into two groups: the intervention group and the comparison group. The questionnaire measuring puberty-related behavior and its determinants was self-administered and completed before and 2 months after training in the two groups. One session for parents, four sessions for peer educators, and four sessions for participants were conducted for 1 month.
Results: In the intervention group, unlike the comparison group, the mean scores of knowledge, outcome expectations, self-efficacy, self-control, social support, and behavior increased significantly after training (p <0.05). Based on regression analysis, outcome expectations and social support were the main determinants of puberty-related behavior (adjusted R2 = 0.464).
Conclusion: The findings of this study support the effectiveness of the peer-led educational intervention based on social cognitive theory in the improvement of puberty-related behavior and its determinants, which can be used in the design of puberty-related health promotion programs. Further research to assess the longer-term outcomes and to examine other theories of behavior change are suggested.
{"title":"Investigating the effect of peer-led educational intervention on behaviors related to pubertal health and its determinants in high school girls of Genaveh, Iran: Application of social cognitive theory.","authors":"Khadijeh Rezvani, Mohammad Hossein Kaveh, Leila Ghahramani, Abdolrahim Asadollahi","doi":"10.1016/j.arcped.2024.05.001","DOIUrl":"https://doi.org/10.1016/j.arcped.2024.05.001","url":null,"abstract":"<p><p>Background Empowering adolescents in the field of puberty health is one of the important goals of public health programs. The present study was carried out with the aim of determining the effect of peer-led training on puberty-related behavior and its determinants using social cognitive theory.</p><p><strong>Methods: </strong>A total of 245 teenage girls were randomly divided into two groups: the intervention group and the comparison group. The questionnaire measuring puberty-related behavior and its determinants was self-administered and completed before and 2 months after training in the two groups. One session for parents, four sessions for peer educators, and four sessions for participants were conducted for 1 month.</p><p><strong>Results: </strong>In the intervention group, unlike the comparison group, the mean scores of knowledge, outcome expectations, self-efficacy, self-control, social support, and behavior increased significantly after training (p <0.05). Based on regression analysis, outcome expectations and social support were the main determinants of puberty-related behavior (adjusted R<sup>2</sup> = 0.464).</p><p><strong>Conclusion: </strong>The findings of this study support the effectiveness of the peer-led educational intervention based on social cognitive theory in the improvement of puberty-related behavior and its determinants, which can be used in the design of puberty-related health promotion programs. Further research to assess the longer-term outcomes and to examine other theories of behavior change are suggested.</p>","PeriodicalId":55477,"journal":{"name":"Archives De Pediatrie","volume":" ","pages":""},"PeriodicalIF":1.3,"publicationDate":"2024-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142395452","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}
Congenital central hypoventilation syndrome (CCHS) is a rare genetic disorder of the autonomic nervous system resulting in decreased brain sensitivity to hypercapnia and hypoxia characterized by a genetic abnormality in the pair-like homeobox 2B (PHOX2B) gene. Most patients have a heterozygous expansion of the polyalanine repeat in exon 3 (PARM), while 10 % of patients have non-PARM (NPARM) mutations that can span the entire gene. The majority of pathogenic variants are de novo, but variants with incomplete penetrance can be identified in the heterozygous state. In the present report, CCHS was diagnosed in a symptomatic 3-month-old infant with neonatal respiratory distress. Genetic analysis revealed a new mutation in exon 1 of the PHOX2B gene – p.Ser28* (c.83C>G) – which was further identified in two family members, one minimally symptomatic and one asymptomatic. The identification of this new mutation supports the importance of sequencing the entire gene even when the classic PARM mutation is not found and highlights the phenotypic variability of CCHS.
{"title":"A new nonsense pathogenic variant in exon 1 of PHOX2B leads to the diagnosis of congenital central hypoventilation syndrome with intra-familial variability","authors":"Morgane Pelleter , Charlène Desaintjean , Romane Gyapay , Bruno Massenavette , Florent Baudin , Nathalie Couque , Renaud Tamisier , Benjamin Dudoignon , Patricia Franco , Antoine Mougenel-Chantereau , Laurianne Coutier","doi":"10.1016/j.arcped.2024.06.003","DOIUrl":"10.1016/j.arcped.2024.06.003","url":null,"abstract":"<div><div>Congenital central hypoventilation syndrome (CCHS) is a rare genetic disorder of the autonomic nervous system resulting in decreased brain sensitivity to hypercapnia and hypoxia characterized by a genetic abnormality in the pair-like homeobox 2B (<em>PHOX2B</em>) gene. Most patients have a heterozygous expansion of the polyalanine repeat in exon 3 (PARM), while 10 % of patients have non-PARM (NPARM) mutations that can span the entire gene. The majority of pathogenic variants are de novo, but variants with incomplete penetrance can be identified in the heterozygous state. In the present report, CCHS was diagnosed in a symptomatic 3-month-old infant with neonatal respiratory distress. Genetic analysis revealed a new mutation in exon 1 of the <em>PHOX2B</em> gene – <em>p.Ser28* (c.83C>G) –</em> which was further identified in two family members, one minimally symptomatic and one asymptomatic. The identification of this new mutation supports the importance of sequencing the entire gene even when the classic PARM mutation is not found and highlights the phenotypic variability of CCHS.</div></div>","PeriodicalId":55477,"journal":{"name":"Archives De Pediatrie","volume":"31 7","pages":"Pages 470-472"},"PeriodicalIF":1.3,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142301745","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 : 2024-10-01DOI: 10.1016/j.arcped.2024.07.002
Brigitte Chabrol
{"title":"Neonatal screening: A public health success and the ethical dilemmas it can pose","authors":"Brigitte Chabrol","doi":"10.1016/j.arcped.2024.07.002","DOIUrl":"10.1016/j.arcped.2024.07.002","url":null,"abstract":"","PeriodicalId":55477,"journal":{"name":"Archives De Pediatrie","volume":"31 7","pages":"Pages 407-409"},"PeriodicalIF":1.3,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142301747","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 : 2024-10-01DOI: 10.1016/j.arcped.2024.04.008
Betül Orhan Kılıç, Serhat Kılıç, Betul Ulukol
Background: This study examined the correlation between social media usage, sharenting practices (sharing parenting-related content on social media), and psychological well-being among 130 mothers whose children visited Baskent University Hospital between April 2020 and January 2021.
Methods: The participants completed an online questionnaire that assessed their social media usage, sharenting practices on Instagram, as well as their levels of depression, life satisfaction, and psychological resilience. Additionally, the researchers created an Instagram account and followed the mothers' social media activities.
Results: The findings revealed that Instagram was the most commonly used social media platform, with mothers using it an average of 5.8 times per day and spending an average of 75 min per day on the platform. Sharing privacy-violating photos of their children was positively correlated with the mothers' own depressive symptoms (r = 0.285, p < 0.01) and negatively correlated with their life satisfaction (r=-0.274, p < 0.01). Similarly, sharing children's photos containing identifiable information was positively correlated with mothers' depressive symptoms (r = 0.373, p < 0.01) and negatively correlated with their life satisfaction (r=-0.282, p = 0.001).
Conclusion: These findings indicate a significant relationship between social media usage, sharenting practices, and the psychological well-being of mothers. The study underscores the importance of raising awareness about the potential risks associated with social media use, particularly among mothers who engage in sharenting practices.
{"title":"Exploring the relationship between social media use, sharenting practices, and maternal psychological well-being.","authors":"Betül Orhan Kılıç, Serhat Kılıç, Betul Ulukol","doi":"10.1016/j.arcped.2024.04.008","DOIUrl":"https://doi.org/10.1016/j.arcped.2024.04.008","url":null,"abstract":"<p><strong>Background: </strong>This study examined the correlation between social media usage, sharenting practices (sharing parenting-related content on social media), and psychological well-being among 130 mothers whose children visited Baskent University Hospital between April 2020 and January 2021.</p><p><strong>Methods: </strong>The participants completed an online questionnaire that assessed their social media usage, sharenting practices on Instagram, as well as their levels of depression, life satisfaction, and psychological resilience. Additionally, the researchers created an Instagram account and followed the mothers' social media activities.</p><p><strong>Results: </strong>The findings revealed that Instagram was the most commonly used social media platform, with mothers using it an average of 5.8 times per day and spending an average of 75 min per day on the platform. Sharing privacy-violating photos of their children was positively correlated with the mothers' own depressive symptoms (r = 0.285, p < 0.01) and negatively correlated with their life satisfaction (r=-0.274, p < 0.01). Similarly, sharing children's photos containing identifiable information was positively correlated with mothers' depressive symptoms (r = 0.373, p < 0.01) and negatively correlated with their life satisfaction (r=-0.282, p = 0.001).</p><p><strong>Conclusion: </strong>These findings indicate a significant relationship between social media usage, sharenting practices, and the psychological well-being of mothers. The study underscores the importance of raising awareness about the potential risks associated with social media use, particularly among mothers who engage in sharenting practices.</p>","PeriodicalId":55477,"journal":{"name":"Archives De Pediatrie","volume":" ","pages":""},"PeriodicalIF":1.3,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142367636","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 : 2024-10-01DOI: 10.1016/j.arcped.2024.04.006
Ebru Barsal Çetiner , Zeynep Donbaloğlu , Aynur İnan Yüksel , Berna Singin , Bilge Aydın Behram , Aynur Bedel , Mesut Parlak , Hale Tuhan
Object
As part of their treatment, patients with type 1 diabetes mellitus (DM) have to be very careful with what they eat and with their insulin doses. Therefore, the risk of eating disorders increases in this patient group. In this study, we aimed to determine the disordered eating behaviors of patients with type 1 DM and to evaluate the sociodemographic characteristics, diabetes care behaviors, and quality-of-life scale results that these behaviors may be related to.
Method
The sociodemographic characteristics and diabetes treatment data of 191 patients aged 9–18 years with type 1 DM were analyzed. The Pediatric Quality of Life Inventory (PedsQL), the PedsQL 3.0 Diabetes Module, and the Diabetes Eating Problem Survey-Revised (DEPS-R) were applied.
Results
The median DEPS-R score of the patients was 18 (19.00), and 44.5 % had a DEPS-R score above 20. A significant correlation was found between age, duration of diabetes, frequency of blood glucose measurement, hemoglobin A1c (HbA1c) level, body mass index standard deviation score (BMI-SDS), and DEPS-R score. There was no significant difference between girls and boys. Patients with a high DEPS-R score had low scores on the PedsQL and on the PedsQL 3.0 Diabetes Module.
Conclusion
The DEPS-R scale is a diabetes-specific, easy-to-use, and effective method for screening patients with type 1 DM for disordered eating behaviors. It can help prevent the progression of disordered eating behaviors to clinical eating disorders in patients with type 1 DM. It would be beneficial to use this scale as a routine screening, especially in clinics where access to a psychologist is not possible.
{"title":"Disordered eating behaviors and associated factors in children and adolescents with type 1 diabetes","authors":"Ebru Barsal Çetiner , Zeynep Donbaloğlu , Aynur İnan Yüksel , Berna Singin , Bilge Aydın Behram , Aynur Bedel , Mesut Parlak , Hale Tuhan","doi":"10.1016/j.arcped.2024.04.006","DOIUrl":"10.1016/j.arcped.2024.04.006","url":null,"abstract":"<div><h3>Object</h3><div>As part of their treatment, patients with type 1 diabetes mellitus (DM) have to be very careful with what they eat and with their insulin doses. Therefore, the risk of eating disorders increases in this patient group. In this study, we aimed to determine the disordered eating behaviors of patients with type 1 DM and to evaluate the sociodemographic characteristics, diabetes care behaviors, and quality-of-life scale results that these behaviors may be related to.</div></div><div><h3>Method</h3><div>The sociodemographic characteristics and diabetes treatment data of 191 patients aged 9–18 years with type 1 DM were analyzed. The Pediatric Quality of Life Inventory (PedsQL), the PedsQL 3.0 Diabetes Module, and the Diabetes Eating Problem Survey-Revised (DEPS-R) were applied.</div></div><div><h3>Results</h3><div>The median DEPS-R score of the patients was 18 (19.00), and 44.5 % had a DEPS-R score above 20. A significant correlation was found between age, duration of diabetes, frequency of blood glucose measurement, hemoglobin A<sub>1c</sub> (HbA<sub>1c</sub>) level, body mass index standard deviation score (BMI-SDS), and DEPS-R score. There was no significant difference between girls and boys. Patients with a high DEPS-R score had low scores on the PedsQL and on the PedsQL 3.0 Diabetes Module.</div></div><div><h3>Conclusion</h3><div>The DEPS-R scale is a diabetes-specific, easy-to-use, and effective method for screening patients with type 1 DM for disordered eating behaviors. It can help prevent the progression of disordered eating behaviors to clinical eating disorders in patients with type 1 DM. It would be beneficial to use this scale as a routine screening, especially in clinics where access to a psychologist is not possible.</div></div>","PeriodicalId":55477,"journal":{"name":"Archives De Pediatrie","volume":"31 7","pages":"Pages 455-460"},"PeriodicalIF":1.3,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142115169","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}
Severe acute bronchiolitis (SAB) can be life-threatening for infants and may be responsible for the congestion of intensive care units (ICU) during epidemics. We aimed to study the clinical and paraclinical characteristics of patients with SAB requiring a transfer to the ICU in order to examine their outcomes and to identify the predictors of a stay of ≥7 days and/or death.
Methods
This was a cross-sectional retrospective study including infants aged ≤12 months transferred to the ICU for their first episode of SAB between 1 January 2010 and 31 December 2019.
Results
We collected data on 380 patients with a median age of 1.75 months. They had a history of prematurity (20.53 %), low birth weight (18.68 %), parental atopy (12.89 %), and comorbidity (7.37 %, mainly congenital heart disease [5 %]). The leading cause of transfer was hypoxemia and increased oxygen requirements (49.73 %). The patients required mechanical ventilation (MV) in 63.42 % of the cases and noninvasive ventilation (NIV) in 67.63 %. NIV has supplanted MV over the years. Its use has increased from 40.4 % in 2010 to 96 % in 2019 compared with 83.84 % and 42 % for MV. A total of 14 (3.68 %) patients died. The independent predictors of a stay of ≥7 days and/or death were young age ≤2 months (p = 0.002), failure to thrive (p = 0.006), apnea (p = 0.045), dehydration (p = 0.018), the presence of biological inflammatory reaction (p = 0.002), isolation of respiratory syncytial virus (p < 0.001), and bacterial coinfection (p = 0.013).NIV was a protective factor (p < 0.001). A severity score ranging from 0 to 17 was established with an optimal cut-off value of 5 points.
Conclusion
Specific caution is needed in patients with these severity predictors. The generalization ofNIV in general pediatrics departments would improve SAB management and reduce transfers to the ICU.
{"title":"Characteristics and predictors of outcome in children with severe acute bronchiolitis: A 10-yearexperience","authors":"Samia Hamouda , Safa Khatrouch , Aida Borgi , Ahmed Hajji , Hanen Smaoui , Najla Ben Jaballah , Fatma Khalsi , Khadija Boussetta","doi":"10.1016/j.arcped.2024.06.002","DOIUrl":"10.1016/j.arcped.2024.06.002","url":null,"abstract":"<div><h3>Background</h3><div>Severe acute bronchiolitis (SAB) can be life-threatening for infants and may be responsible for the congestion of intensive care units (ICU) during epidemics. We aimed to study the clinical and paraclinical characteristics of patients with SAB requiring a transfer to the ICU in order to examine their outcomes and to identify the predictors of a stay of ≥7 days and/or death.</div></div><div><h3>Methods</h3><div>This was a cross-sectional retrospective study including infants aged ≤12 months transferred to the ICU for their first episode of SAB between 1 January 2010 and 31 December 2019.</div></div><div><h3>Results</h3><div>We collected data on 380 patients with a median age of 1.75 months. They had a history of prematurity (20.53 %), low birth weight (18.68 %), parental atopy (12.89 %), and comorbidity (7.37 %, mainly congenital heart disease [5 %]). The leading cause of transfer was hypoxemia and increased oxygen requirements (49.73 %). The patients required mechanical ventilation (MV) in 63.42 % of the cases and noninvasive ventilation (NIV) in 67.63 %. NIV has supplanted MV over the years. Its use has increased from 40.4 % in 2010 to 96 % in 2019 compared with 83.84 % and 42 % for MV. A total of 14 (3.68 %) patients died. The independent predictors of a stay of ≥7 days and/or death were young age ≤2 months (<em>p</em> = 0.002), failure to thrive (<em>p</em> = 0.006), apnea (<em>p</em> = 0.045), dehydration (<em>p</em> = 0.018), the presence of biological inflammatory reaction (<em>p</em> = 0.002), isolation of respiratory syncytial virus (<em>p</em> < 0.001), and bacterial coinfection (<em>p</em> = 0.013).NIV was a protective factor (<em>p</em> < 0.001). A severity score ranging from 0 to 17 was established with an optimal cut-off value of 5 points.</div></div><div><h3>Conclusion</h3><div>Specific caution is needed in patients with these severity predictors. The generalization ofNIV in general pediatrics departments would improve SAB management and reduce transfers to the ICU.</div></div>","PeriodicalId":55477,"journal":{"name":"Archives De Pediatrie","volume":"31 7","pages":"Pages 433-438"},"PeriodicalIF":1.3,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142301746","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 : 2024-10-01DOI: 10.1016/j.arcped.2024.05.004
Laureen Martin , Amaïa Bainier , Estelle Darviot , Aude Forgeron , Laurent Sarthou , Anne-Claire Wagner , Thomas Blanchais , Thomas Brigly , Françoise Troussier , Bernard Branger
Background
Acute bronchiolitis affects around 30 % of infants each winter in France. Breastfeeding (BF) is described as being protective against acute lower respiratory infections in developing countries, but this effect is more difficult to demonstrate in industrialized countries. Moreover, the effect of using a pacifier in the occurrence of bronchiolitis is not clearly established. In this context, the aim of the study was to investigate the link between BF and the use of a pacifier in the occurrence of bronchiolitis in children under 1 year of age who presented to five pediatric emergency centers in Pays de la Loire, France.
Method
A questionnaire collecting data on diet, sociodemographic characteristics, and the reason for presentation was provided at the admission to pediatric emergency centers in five hospitals in Pays de Loire, France, between 2018 and 2020. Children with bronchiolitis were included in group 1, and children consulting for other reasons (except gastrointestinal infections or otitis) were included in group 2. Breastfeeding was classified as exclusive breastfeeding (EBF) and partial breastfeeding (PBF). Pacifier use was classified as frequent and during sleep or not used.
Results
The study included 671 children under 1 year of age, including 174 (25.8 %) who were admitted with bronchiolitis. In univariate analysis, a significantly smaller number of children in group 1 s were breastfed (EBF and PBF) at admission compared with children in group 2:21.8 % versus 32.8 %, respectively, (OR=0.57, 95 % CI: 0.38–0.86, p = 0.006); furthermore, children in group 1 used a pacifier more often than those in group 2: 84.5 % versus 75.8 % (OR=1.74, 95 % CI: 1.10–2.76, p = 0.017). In multivariate analysis, after adjusting for age, ongoing BF or EBF beyond 9 and 12 months of age remained a protective factor; however, the protective effect of BF disappeared with the introduction of a pacifier, and pacifier use was significantly associated with bronchiolitis.
Conclusion
The protective effect of BF against bronchiolitis was demonstrated independently of pacifier use. However, due to the strong association between pacifier use and bronchiolitis, the effect of BF weakened. The advice to be given to parents for BF and pacifier use is discussed.
{"title":"Interaction of the protective effect of breastfeeding and the aggravating effect of pacifier use in the occurrence of bronchiolitis in children","authors":"Laureen Martin , Amaïa Bainier , Estelle Darviot , Aude Forgeron , Laurent Sarthou , Anne-Claire Wagner , Thomas Blanchais , Thomas Brigly , Françoise Troussier , Bernard Branger","doi":"10.1016/j.arcped.2024.05.004","DOIUrl":"10.1016/j.arcped.2024.05.004","url":null,"abstract":"<div><h3>Background</h3><div>Acute bronchiolitis affects around 30 % of infants each winter in France. Breastfeeding (BF) is described as being protective against acute lower respiratory infections in developing countries, but this effect is more difficult to demonstrate in industrialized countries. Moreover, the effect of using a pacifier in the occurrence of bronchiolitis is not clearly established. In this context, the aim of the study was to investigate the link between BF and the use of a pacifier in the occurrence of bronchiolitis in children under 1 year of age who presented to five pediatric emergency centers in Pays de la Loire, France.</div></div><div><h3>Method</h3><div>A questionnaire collecting data on diet, sociodemographic characteristics, and the reason for presentation was provided at the admission to pediatric emergency centers in five hospitals in Pays de Loire, France, between 2018 and 2020. Children with bronchiolitis were included in group 1, and children consulting for other reasons (except gastrointestinal infections or otitis) were included in group 2. Breastfeeding was classified as exclusive breastfeeding (EBF) and partial breastfeeding (PBF). Pacifier use was classified as frequent and during sleep or not used.</div></div><div><h3>Results</h3><div>The study included 671 children under 1 year of age, including 174 (25.8 %) who were admitted with bronchiolitis. In univariate analysis, a significantly smaller number of children in group 1 s were breastfed (EBF and PBF) at admission compared with children in group 2:21.8 % versus 32.8 %, respectively, (OR=0.57, 95 % CI: 0.38–0.86, <em>p</em> = 0.006); furthermore, children in group 1 used a pacifier more often than those in group 2: 84.5 % versus 75.8 % (OR=1.74, 95 % CI: 1.10–2.76, <em>p</em> = 0.017). In multivariate analysis, after adjusting for age, ongoing BF or EBF beyond 9 and 12 months of age remained a protective factor; however, the protective effect of BF disappeared with the introduction of a pacifier, and pacifier use was significantly associated with bronchiolitis.</div></div><div><h3>Conclusion</h3><div>The protective effect of BF against bronchiolitis was demonstrated independently of pacifier use. However, due to the strong association between pacifier use and bronchiolitis, the effect of BF weakened. The advice to be given to parents for BF and pacifier use is discussed.</div></div>","PeriodicalId":55477,"journal":{"name":"Archives De Pediatrie","volume":"31 7","pages":"Pages 426-432"},"PeriodicalIF":1.3,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142367637","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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