Pub Date : 2024-10-01DOI: 10.1016/j.arcped.2024.07.004
Mathilde Bodolec , Moriamo-Bisi Eniafe-Eveillard , Brice Loddé , Sanna Ouedraogo , Laurence Pougnet , Anne Moal , Richard Pougnet
In France, return to work represents a break in the continuation of breastfeeding, especially for caregivers. The objective of this study was to describe the breastfeeding practices of hospital workers. From 378 respondents, the prevalence of breastfeeding was found to be 69 % when leaving the maternity ward, 36.5 % when returning to work, and 20.1 % at 6 months. The average duration of breastfeeding was 23.3 weeks. In total, 44 % of breastfeeding women said they stopped breastfeeding because of their work: workload, irregular hours, no breastfeeding room, and fatigue.
{"title":"Breastfeeding and return to work at a teaching hospital","authors":"Mathilde Bodolec , Moriamo-Bisi Eniafe-Eveillard , Brice Loddé , Sanna Ouedraogo , Laurence Pougnet , Anne Moal , Richard Pougnet","doi":"10.1016/j.arcped.2024.07.004","DOIUrl":"10.1016/j.arcped.2024.07.004","url":null,"abstract":"<div><div>In France, return to work represents a break in the continuation of breastfeeding, especially for caregivers. The objective of this study was to describe the breastfeeding practices of hospital workers. From 378 respondents, the prevalence of breastfeeding was found to be 69 % when leaving the maternity ward, 36.5 % when returning to work, and 20.1 % at 6 months. The average duration of breastfeeding was 23.3 weeks. In total, 44 % of breastfeeding women said they stopped breastfeeding because of their work: workload, irregular hours, no breastfeeding room, and fatigue.</div></div>","PeriodicalId":55477,"journal":{"name":"Archives De Pediatrie","volume":"31 7","pages":"Pages 467-469"},"PeriodicalIF":1.3,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142333017","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.2024.06.001
Esra Uslu , Hülya Çelik Özdemir , Türkan Peşkirci
Objective
This study was designed to examine the mediator role of resilience in the relationship between chronotype and mental toughness in adolescents.
Methods
The descriptive correlational study was completed with 342 high school students from one school in Türkiye (mean age 17.25±1.11 years). Data were collected with the Morningness–Eveningness Scale for Children, Child and Youth Resilience Measure, and Mental Toughness Scale for Adolescents. Hierarchical regression analyses with PROCESS Model 4 were used to evaluate the mediator effect.
Results
It was observed that the morning chronotype tendency increased resilience (p < 0.001) mental toughness (p < 0.001). Higher resilience led to increased mental toughness. When the mediation effect was examined, resilience was a full mediator in the relationship between chronotype characteristics and mental toughness (β=0.396; p = 0.000).
Conclusions
According to these results, a morning chronotype tendency in adolescents increases their resilience and, therefore, mental toughness. These results suggest that effective methods for enhancing mental toughness in adolescents should be multifaceted. Additionally, it highlights the importance of identifying and regulating chronotype tendencies among adolescents, while also emphasizing the need to increase resilience in this demographic.
{"title":"The relationship between chronotype and mental toughness in adolescents: Is resilience a mediator?","authors":"Esra Uslu , Hülya Çelik Özdemir , Türkan Peşkirci","doi":"10.1016/j.arcped.2024.06.001","DOIUrl":"10.1016/j.arcped.2024.06.001","url":null,"abstract":"<div><h3>Objective</h3><div>This study was designed to examine the mediator role of resilience in the relationship between chronotype and mental toughness in adolescents.</div></div><div><h3>Methods</h3><div>The descriptive correlational study was completed with 342 high school students from one school in Türkiye (mean age 17.25±1.11 years). Data were collected with the Morningness–Eveningness Scale for Children, Child and Youth Resilience Measure, and Mental Toughness Scale for Adolescents. Hierarchical regression analyses with PROCESS Model 4 were used to evaluate the mediator effect.</div></div><div><h3>Results</h3><div>It was observed that the morning chronotype tendency increased resilience (<em>p</em> < 0.001) mental toughness (<em>p</em> < 0.001). Higher resilience led to increased mental toughness. When the mediation effect was examined, resilience was a full mediator in the relationship between chronotype characteristics and mental toughness (β=0.396; <em>p</em> = 0.000).</div></div><div><h3>Conclusions</h3><div>According to these results, a morning chronotype tendency in adolescents increases their resilience and, therefore, mental toughness. These results suggest that effective methods for enhancing mental toughness in adolescents should be multifaceted. Additionally, it highlights the importance of identifying and regulating chronotype tendencies among adolescents, while also emphasizing the need to increase resilience in this demographic.</div></div>","PeriodicalId":55477,"journal":{"name":"Archives De Pediatrie","volume":"31 7","pages":"Pages 446-450"},"PeriodicalIF":1.3,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142301750","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.2024.06.004
Claire Fontaine , Cécile Rochefort-Morel , Gwenaëlle Veyrac , Elisabeth Polard , Lucie-Marie Scailteux , French Pharmacovigilance Network
Background
Immediate allergic reactions to chlorhexidine have been clearly identified in numerous countries, generating governmental warnings worldwide.
Objectives
The aim of our study was to characterize (i) these allergies, which are less reported in pediatric populations, and (ii) the patient-at-risk profile so as to suggest preventive measures.
Methods
In association with the allergy department and the regional pharmacovigilance center in Rennes University Hospital, France, a multicenter retrospective, descriptive, and observational study was conducted using data from the national pharmacovigilance database for the period of January 1, 2010 to June 30, 2020. Immediate allergies to chlorhexidine cases based on a clinical history compatible with an immunoglobulin E (IgE)-mediated reaction, along with positive allergic testing, were analyzed.
Results
Of the 478 cases identified, 17 pediatric cases of immediate allergic reaction to chlorhexidine (13 cases of grades II–IV anaphylaxis) were retained for the analysis. For 58.8 % of these cases, a history of a previous more moderate reaction to the substance was identified. The reactions occurred most frequently in cases of domestic misuse (88.2 %, n = 15/17) of chlorhexidine to dress a wound. Recurrence was reported for two cases, later leading to severe reactions at each new exposure to the allergen, suggesting an aggravation mechanism.
Conclusion
The number of pediatric cases of immediate allergies to chlorhexidine has possibly been underestimated on account of insufficient knowledge of the allergy and in view of its common usage. Information on the method of caring for wounds among children and on the risk of allergic sensitization as well as exploring any unusual reaction to chlorhexidine application could reduce the number of allergic reactions.
{"title":"Immediate allergies to chlorhexidine: A series of pediatric cases from the French pharmacovigilance database","authors":"Claire Fontaine , Cécile Rochefort-Morel , Gwenaëlle Veyrac , Elisabeth Polard , Lucie-Marie Scailteux , French Pharmacovigilance Network","doi":"10.1016/j.arcped.2024.06.004","DOIUrl":"10.1016/j.arcped.2024.06.004","url":null,"abstract":"<div><h3>Background</h3><div>Immediate allergic reactions to chlorhexidine have been clearly identified in numerous countries, generating governmental warnings worldwide.</div></div><div><h3>Objectives</h3><div>The aim of our study was to characterize (i) these allergies, which are less reported in pediatric populations, and (ii) the patient-at-risk profile so as to suggest preventive measures.</div></div><div><h3>Methods</h3><div>In association with the allergy department and the regional pharmacovigilance center in Rennes University Hospital, France, a multicenter retrospective, descriptive, and observational study was conducted using data from the national pharmacovigilance database for the period of January 1, 2010 to June 30, 2020. Immediate allergies to chlorhexidine cases based on a clinical history compatible with an immunoglobulin E (IgE)-mediated reaction, along with positive allergic testing, were analyzed.</div></div><div><h3>Results</h3><div>Of the 478 cases identified, 17 pediatric cases of immediate allergic reaction to chlorhexidine (13 cases of grades II–IV anaphylaxis) were retained for the analysis. For 58.8 % of these cases, a history of a previous more moderate reaction to the substance was identified. The reactions occurred most frequently in cases of domestic misuse (88.2 %, <em>n</em> = 15/17) of chlorhexidine to dress a wound. Recurrence was reported for two cases, later leading to severe reactions at each new exposure to the allergen, suggesting an aggravation mechanism.</div></div><div><h3>Conclusion</h3><div>The number of pediatric cases of immediate allergies to chlorhexidine has possibly been underestimated on account of insufficient knowledge of the allergy and in view of its common usage. Information on the method of caring for wounds among children and on the risk of allergic sensitization as well as exploring any unusual reaction to chlorhexidine application could reduce the number of allergic reactions.</div></div>","PeriodicalId":55477,"journal":{"name":"Archives De Pediatrie","volume":"31 7","pages":"Pages 419-425"},"PeriodicalIF":1.3,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142333019","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.2024.03.010
Fiona Bensoussan , Guillaume Costa , Anne Blanchard , Isabelle Vaugier , Stéphanie Baron , Aben Essid , Blaise Mbieleu , Awa Bakayoko , Nicolas Deconinck , Jean Bergounioux , Justine Zini
Background
Spinal muscular atrophy (SMA) is a hereditary neuromuscular disease that progresses toward restrictive respiratory failure due to muscle paralysis. We observed that SMA patients presented with a specific clinical and laboratory profile, consisting of severe metabolic acidosis following an episode of mild vomiting. This is an unusual, little-known, and life-threatening situation for these patients, as hyperventilation induced by metabolic acidosis can lead to exhaustion and to death by mixed acidosis.
Objective
The aim of our study was to describe this paradoxical acidosis after vomiting in SMA patients and to discuss the physiological basis of this condition.
Methods
We conducted a retrospective single-center study reviewing the clinical and laboratory data of SMA patients who were hospitalized in the intensive care unit for severe metabolic acidosis after vomiting.
Results
Our cohort comprised 11 cases. On arrival, the median pH of the patients was 7.23 with a median bicarbonate concentration of 11.7 mmol/L and almost half of them (45 %) had ketone bodies in the blood and/or urine. The median correction time was 24 h for pH and 48 h for bicarbonate concentrations after receiving intravenous hydration with a glucose solution.
Conclusions
We suggest that SMA patients are particularly sensitive to ketoacidosis induced by fasting, even after a few episodes of mild vomiting. Moreover, they have a low buffering capacity due to their severe amyotrophy, which favors metabolic acidosis. They must be quickly hydrated through a glucose-containing solution to avoid exhaustion, mixed acidosis, and death.
{"title":"Paradoxical metabolic acidosis after vomiting in children with spinal muscular atrophy: A report of 9 patients","authors":"Fiona Bensoussan , Guillaume Costa , Anne Blanchard , Isabelle Vaugier , Stéphanie Baron , Aben Essid , Blaise Mbieleu , Awa Bakayoko , Nicolas Deconinck , Jean Bergounioux , Justine Zini","doi":"10.1016/j.arcped.2024.03.010","DOIUrl":"10.1016/j.arcped.2024.03.010","url":null,"abstract":"<div><h3>Background</h3><div>Spinal muscular atrophy (SMA) is a hereditary neuromuscular disease that progresses toward restrictive respiratory failure due to muscle paralysis. We observed that SMA patients presented with a specific clinical and laboratory profile, consisting of severe metabolic acidosis following an episode of mild vomiting. This is an unusual, little-known, and life-threatening situation for these patients, as hyperventilation induced by metabolic acidosis can lead to exhaustion and to death by mixed acidosis.</div></div><div><h3>Objective</h3><div>The aim of our study was to describe this paradoxical acidosis after vomiting in SMA patients and to discuss the physiological basis of this condition.</div></div><div><h3>Methods</h3><div>We conducted a retrospective single-center study reviewing the clinical and laboratory data of SMA patients who were hospitalized in the intensive care unit for severe metabolic acidosis after vomiting.</div></div><div><h3>Results</h3><div>Our cohort comprised 11 cases. On arrival, the median pH of the patients was 7.23 with a median bicarbonate concentration of 11.7 mmol/L and almost half of them (45 %) had ketone bodies in the blood and/or urine. The median correction time was 24 h for pH and 48 h for bicarbonate concentrations after receiving intravenous hydration with a glucose solution.</div></div><div><h3>Conclusions</h3><div>We suggest that SMA patients are particularly sensitive to ketoacidosis induced by fasting, even after a few episodes of mild vomiting. Moreover, they have a low buffering capacity due to their severe amyotrophy, which favors metabolic acidosis. They must be quickly hydrated through a glucose-containing solution to avoid exhaustion, mixed acidosis, and death.</div></div>","PeriodicalId":55477,"journal":{"name":"Archives De Pediatrie","volume":"31 7","pages":"Pages 451-454"},"PeriodicalIF":1.3,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142333020","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.2024.05.003
Stéphanie Fontaine Carbonnel , Ivana Dabaj , Camille de Montferrand , Pascal Rippert , Vincent Laugel , Silvana De Lucia , Claudia Ravelli , Andreea Seferian , Juliette Ropars , Claude Cances
The French Society of Pediatric Neurology and the FILNEMUS network created a working group on corticosteroid therapy in children with Duchenne muscular dystrophy in order to analyze the literature review and current French practices. The aim of this work was to produce guidelines regarding treatment initiation, pre-therapeutic interventions, choice between available compounds, and treatment monitoring (dosage, duration, and discontinuation). The treatment side effects and their management are also detailed: osteoporosis, endocrinological anomaly (growth delay, weight gain, pubertal delay), cataract, arterial hypertension, behavioral disorders, management of immunosuppression and vaccines, and management of gastrointestinal and metabolic complications.
{"title":"Choice of compound, dosage, and management of side effects for long-term corticosteroid treatment in Duchenne muscular dystrophy: Guidelines from the Neuromuscular Commission of the French Society of Pediatric Neurology","authors":"Stéphanie Fontaine Carbonnel , Ivana Dabaj , Camille de Montferrand , Pascal Rippert , Vincent Laugel , Silvana De Lucia , Claudia Ravelli , Andreea Seferian , Juliette Ropars , Claude Cances","doi":"10.1016/j.arcped.2024.05.003","DOIUrl":"10.1016/j.arcped.2024.05.003","url":null,"abstract":"<div><div>The French Society of Pediatric Neurology and the FILNEMUS network created a working group on corticosteroid therapy in children with Duchenne muscular dystrophy in order to analyze the literature review and current French practices. The aim of this work was to produce guidelines regarding treatment initiation, pre-therapeutic interventions, choice between available compounds, and treatment monitoring (dosage, duration, and discontinuation). The treatment side effects and their management are also detailed: osteoporosis, endocrinological anomaly (growth delay, weight gain, pubertal delay), cataract, arterial hypertension, behavioral disorders, management of immunosuppression and vaccines, and management of gastrointestinal and metabolic complications.</div></div>","PeriodicalId":55477,"journal":{"name":"Archives De Pediatrie","volume":"31 7","pages":"Pages 410-418"},"PeriodicalIF":1.3,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142333018","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
The aim of this study was to describe the quality of life (QoL) of children with a chronic illness treated in a tertiary multidisciplinary pediatric department in comparison with the general population.
Study design
A cross-sectional study was conducted in the tertiary multidisciplinary (nephrology, hepatogastroenterology, endocrinology, diabetology, transplantation) pediatric department of Timone Hospital in Marseille, France. Patients 8–17 years of age with a chronic disease were included during regular follow-up appointments. Medical and sociodemographic variables were obtained from medical records. Self-reported QoL was assessed using the VSPA (Vécu et Santé Perçu de l'Adolescent) questionnaire and parent-reported QoL was assessed using the VSPA questionnaire for parents.
Results
A total of 244 patients were included. Overall QoL did not differ significantly from that of the general population. Adolescent patients’ self-reported QoL scores were lower than those of the general population in the domains of physical health and leisure, and parents reported QoL scores for adolescent patients lower than those of the general population for self-esteem and physical health. Adolescents’ self-reported QoL scores were higher than in the general population for relationships with parents, healthcare professionals, and teachers as well as for school achievement. Parents also reported higher QoL scores in these areas for their children.
Conclusion
Children and adolescents with a variety of chronic diseases had similar overall QoL scores to the general population but with different QoL profiles; their scores in some domains were higher than those of the general population.
研究目的本研究旨在描述在三级多学科儿科接受治疗的慢性病患儿的生活质量（QoL），并与普通人群进行比较：这项横断面研究在法国马赛 Timone 医院的三级多学科儿科（肾病学、肝胃肠病学、内分泌学、糖尿病学、移植学）进行。8至17岁的慢性病患者在定期复诊时被纳入其中。医疗和社会人口变量均来自医疗记录。自我报告的 QoL 采用 VSPA（Vécu et Santé Perçu de l'Adolescent）问卷进行评估，家长报告的 QoL 采用 VSPA 问卷进行评估：结果：共纳入 244 名患者。总体 QoL 与普通人群无显著差异。在身体健康和休闲方面，青少年患者自我报告的 QoL 分数低于普通人群，而在自尊和身体健康方面，家长报告的青少年患者 QoL 分数低于普通人群。在与父母、医护人员和教师的关系以及学习成绩方面，青少年自我报告的 QoL 分数高于普通人群。父母也报告说，他们的孩子在这些方面的 QoL 分数更高：结论：患有各种慢性疾病的儿童和青少年的总体 QoL 分数与普通人群相似，但 QoL 特征不同；他们在某些领域的分数高于普通人群。
{"title":"Quality of life of chronically ill children and adolescents: a cross-sectional study","authors":"Pauline Perreard , Sarah Castets , Karine Aouchiche , Delphine Bernoux , Daniele Bruno , Mathilde Cailliez , Stéphanie Clave , Marie-Edith. Coste , Cécile De Leusse , Pauline Duvant , Florentine Garaix , Laetitia Gauche , Emeline Marquant , Céline Roman , Bertrand Roquelaure , Caroline Rousset Rouvière , Julia Vergier , Michel Tsimaratos , Julie Berbis , Alexandre Fabre , Rachel Reynaud","doi":"10.1016/j.arcped.2024.04.007","DOIUrl":"10.1016/j.arcped.2024.04.007","url":null,"abstract":"<div><h3>Objective</h3><div>The aim of this study was to describe the quality of life (QoL) of children with a chronic illness treated in a tertiary multidisciplinary pediatric department in comparison with the general population.</div></div><div><h3>Study design</h3><div>A cross-sectional study was conducted in the tertiary multidisciplinary (nephrology, hepatogastroenterology, endocrinology, diabetology, transplantation) pediatric department of Timone Hospital in Marseille, France. Patients 8–17 years of age with a chronic disease were included during regular follow-up appointments. Medical and sociodemographic variables were obtained from medical records. Self-reported QoL was assessed using the VSPA (<em>Vécu et Santé Perçu de l'Adolescent</em>) questionnaire and parent-reported QoL was assessed using the VSPA questionnaire for parents.</div></div><div><h3>Results</h3><div>A total of 244 patients were included. Overall QoL did not differ significantly from that of the general population. Adolescent patients’ self-reported QoL scores were lower than those of the general population in the domains of physical health and leisure, and parents reported QoL scores for adolescent patients lower than those of the general population for self-esteem and physical health. Adolescents’ self-reported QoL scores were higher than in the general population for relationships with parents, healthcare professionals, and teachers as well as for school achievement. Parents also reported higher QoL scores in these areas for their children.</div></div><div><h3>Conclusion</h3><div>Children and adolescents with a variety of chronic diseases had similar overall QoL scores to the general population but with different QoL profiles; their scores in some domains were higher than those of the general population.</div></div>","PeriodicalId":55477,"journal":{"name":"Archives De Pediatrie","volume":"31 7","pages":"Pages 439-445"},"PeriodicalIF":1.3,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142301749","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.2024.05.002
Anne Laure Blanquart , Fabien Garnier , Thomas Lauvray , Perrine Coste Mazeau , Sophie Martinez , Cyrille Catalan , Vincent Guigonis , Antoine Bedu , Fabienne Mons , Laure Ponthier
Background
Early-onset neonatal sepsis represents a diagnostic challenge, as it is a cause of neonatal mortality and morbidity. Guidelines for the prevention of group B streptococcus (GBS) infection recommend that all pregnant women must be screened for GBS carriage at the end of pregnancy, with intrapartum antibiotic prophylaxis being provided for GBS carriers. If vaginal culture is not available, GBS polymerase chain reaction (GBS-PCR) is an alternative option for this type of screening. In our unit, GBS-PCR is performed when pregnant women present to the delivery room with ongoing labor and with no results of culture GBS screening available. The main objective of this study was to evaluate the impact of the results of GBS-PCR on monitoring modifications in newborns of mothers with unknown GBS status. The secondary objectives were to confirm the feasibility of a GBS-PCR-based screening method in everyday practice and to evaluate the impact of GBS-PCR results on the modification of intrapartum antibiotic therapy in pregnant women.
Method
A retrospective, single-center, observational study was conducted for 1 year. For dyads with GBS-PCR performed, changes concerning intrapartum antibiotic therapy and the newborn's monitoring were recorded. The feasibility of the method was evaluated by the delay between the GBS-PCR realization and the availability of the result; in addition, the number of GBS-PCR tests that could not be realized were collected.
Results
Overall, 60 GBS-PCR samples were tested for 60 pregnant women. Results were obtained for all samples, and the median duration to obtaining the GBS-PCR results was 70 min (60.8–87.2). These results were positive for 11 (18.3 %) women and led to monitoring modifications for two infants. In total, 27 pregnant women (45 %) had modifications in their antibiotic therapy due to the GBS-PCR results.
Conclusion
GBS-PCR was quickly available and the results led to changes in maternal antibiotic prophylaxis and in the monitoring level of the newborns.
{"title":"Vaginal screening for group B streptococcus using PCR in pregnant women with unknown colonization status: Impact on newborn monitoring for early-onset sepsis","authors":"Anne Laure Blanquart , Fabien Garnier , Thomas Lauvray , Perrine Coste Mazeau , Sophie Martinez , Cyrille Catalan , Vincent Guigonis , Antoine Bedu , Fabienne Mons , Laure Ponthier","doi":"10.1016/j.arcped.2024.05.002","DOIUrl":"10.1016/j.arcped.2024.05.002","url":null,"abstract":"<div><h3>Background</h3><div>Early-onset neonatal sepsis represents a diagnostic challenge, as it is a cause of neonatal mortality and morbidity. Guidelines for the prevention of group B streptococcus (GBS) infection recommend that all pregnant women must be screened for GBS carriage at the end of pregnancy, with intrapartum antibiotic prophylaxis being provided for GBS carriers. If vaginal culture is not available, GBS polymerase chain reaction (GBS-PCR) is an alternative option for this type of screening. In our unit, GBS-PCR is performed when pregnant women present to the delivery room with ongoing labor and with no results of culture GBS screening available. The main objective of this study was to evaluate the impact of the results of GBS-PCR on monitoring modifications in newborns of mothers with unknown GBS status. The secondary objectives were to confirm the feasibility of a GBS-PCR-based screening method in everyday practice and to evaluate the impact of GBS-PCR results on the modification of intrapartum antibiotic therapy in pregnant women.</div></div><div><h3>Method</h3><div>A retrospective, single-center, observational study was conducted for 1 year. For dyads with GBS-PCR performed, changes concerning intrapartum antibiotic therapy and the newborn's monitoring were recorded. The feasibility of the method was evaluated by the delay between the GBS-PCR realization and the availability of the result; in addition, the number of GBS-PCR tests that could not be realized were collected.</div></div><div><h3>Results</h3><div>Overall, 60 GBS-PCR samples were tested for 60 pregnant women. Results were obtained for all samples, and the median duration to obtaining the GBS-PCR results was 70 min (60.8–87.2). These results were positive for 11 (18.3 %) women and led to monitoring modifications for two infants. In total, 27 pregnant women (45 %) had modifications in their antibiotic therapy due to the GBS-PCR results.</div></div><div><h3>Conclusion</h3><div>GBS-PCR was quickly available and the results led to changes in maternal antibiotic prophylaxis and in the monitoring level of the newborns.</div></div>","PeriodicalId":55477,"journal":{"name":"Archives De Pediatrie","volume":"31 7","pages":"Pages 461-466"},"PeriodicalIF":1.3,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142301751","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}
Pub Date : 2024-09-10DOI: 10.1016/j.arcped.2024.07.003
Gitte Lee Mortensen, Marie-Laure Charkaluk
Background and aim: Respiratory syncytial virus (RSV) is a leading cause of hospitalization of infants with respiratory infections. A new immunization using monoclonal antibodies (mAbs) may offer protection against RSV infections. A study was conducted across eight countries to gain insight into parental awareness of RSV, their sources of child health information, and attitudes toward infant immunization against RSV using mAbs. This paper presents the findings from France.
Methods: In 2021, a survey was conducted in eight countries among expecting and current parents with children younger than 24 months of age. Eligible respondents included parents who were open to childhood immunizations, i.e., they had given or planned to give their children "all," "most," or "some" immunizations.
Results: In France, the survey respondents had high adoption rates for childhood immunizations. Key drivers behind these high rates were the desire to protect their children from severe diseases and adherence to mandatory immunizations, whereas concerns about safety were the main barriers. While general practitioners and pediatricians were key sources of advice on child health, many parents also requested information about immunizations from health authorities and nurses. Sources of advice varied with parental age, gender, educational level, and income. The majority of parents had no knowledge about mAbs or passive immunization, and the overall awareness of RSV was low. When informed about RSV and mAbs, most parents held neutral to positive attitudes toward nirsevimab for their infants if recommended by a healthcare professional and/or included in the immunization program. These findings were further confirmed by the 60 %-80 % uptake rates of nirsevimab following the introduction in September 2023.
{"title":"Parental knowledge about respiratory syncytial virus and attitudes toward infant immunization with monoclonal antibodies in France.","authors":"Gitte Lee Mortensen, Marie-Laure Charkaluk","doi":"10.1016/j.arcped.2024.07.003","DOIUrl":"https://doi.org/10.1016/j.arcped.2024.07.003","url":null,"abstract":"<p><strong>Background and aim: </strong>Respiratory syncytial virus (RSV) is a leading cause of hospitalization of infants with respiratory infections. A new immunization using monoclonal antibodies (mAbs) may offer protection against RSV infections. A study was conducted across eight countries to gain insight into parental awareness of RSV, their sources of child health information, and attitudes toward infant immunization against RSV using mAbs. This paper presents the findings from France.</p><p><strong>Methods: </strong>In 2021, a survey was conducted in eight countries among expecting and current parents with children younger than 24 months of age. Eligible respondents included parents who were open to childhood immunizations, i.e., they had given or planned to give their children \"all,\" \"most,\" or \"some\" immunizations.</p><p><strong>Results: </strong>In France, the survey respondents had high adoption rates for childhood immunizations. Key drivers behind these high rates were the desire to protect their children from severe diseases and adherence to mandatory immunizations, whereas concerns about safety were the main barriers. While general practitioners and pediatricians were key sources of advice on child health, many parents also requested information about immunizations from health authorities and nurses. Sources of advice varied with parental age, gender, educational level, and income. The majority of parents had no knowledge about mAbs or passive immunization, and the overall awareness of RSV was low. When informed about RSV and mAbs, most parents held neutral to positive attitudes toward nirsevimab for their infants if recommended by a healthcare professional and/or included in the immunization program. These findings were further confirmed by the 60 %-80 % uptake rates of nirsevimab following the introduction in September 2023.</p>","PeriodicalId":55477,"journal":{"name":"Archives De Pediatrie","volume":" ","pages":""},"PeriodicalIF":1.3,"publicationDate":"2024-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142301748","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 : 2024-09-01DOI: 10.1016/S0929-693X(24)00153-2
Geneviève Baujat , Alix Besançon
Generalized arterial calcification of infancy (GACI) is an ultra-rare autosomal recessive disorder associated with pathogenic variants in ENPP1, the major gene involved in this condition, and in ABCC6, which is involved in a small fraction of affected individuals. Loss-of-function pathogenic variants of ENPP1 and ABCC6 lead to perturbations in the PPi/Pi ratio, thereby promoting hydroxyapatite mineralization in peripheral tissues. GACI is initially characterized by an abnormal ectopic mineralization process in arteries and soft tissue. Nearly half of the patients die within the first 6 months of life from cardiovascular complications, hence the poor prognosis associated with an early diagnosis. In recent years, progress has been made in our understanding of the long-term natural history of GACI, the intricate symptoms due to vascular calcifications, the overmineralization of soft tissues, of hypophosphatemia designated as ARHR2, and of the consequences such as undermineralization of the skeleton, but also of the features possibly seen in pseudoxanthoma elasticum (PXE). Indeed, GACI, PXE, and ARHR2 share common pathophysiological pathways and clinical features beyond the vascular calcifications. Treatment options for severe forms of GACI are mostly based on symptomatic management, including the option of starting bisphosphonates early after birth, such as etidronate and pamidronate, analogues of PPi. Follow-up within an expert and coordinated multidisciplinary team includes treatment of arterial hypertension, calcitriol and phosphorus adjustments, hearing aids, and early detection of possible angioid streaks. It is hoped that ongoing basic and clinical research will lead to the development of effective therapies that specifically target the abnormal PPi regulation and the other mechanisms involved in this disorder.
婴儿期全身动脉钙化（GACI）是一种超罕见的常染色体隐性遗传疾病，与ENPP1和ABCC6中的致病变体有关，ENPP1是导致这种疾病的主要基因，而ABCC6则涉及一小部分受影响的个体。ENPP1和ABCC6的功能缺失致病变体会导致PPi/Pi比例失调，从而促进外周组织中羟磷灰石的矿化。GACI 最初的特征是动脉和软组织的异常异位矿化过程。近一半的患者在出生后 6 个月内死于心血管并发症，因此早期诊断预后较差。近年来，我们对 GACI 的长期自然病史、血管钙化引起的复杂症状、软组织过度矿化、被称为 ARHR2 的低磷血症、骨骼矿化不足等后果以及假性黄疽弹性瘤（PXE）可能出现的特征的了解取得了进展。事实上，除血管钙化外，GACI、PXE 和 ARHR2 还具有共同的病理生理途径和临床特征。重度 GACI 的治疗方案大多以对症处理为主，包括在婴儿出生后早期开始使用双膦酸盐，如 PPi 的类似物依替膦酸盐和帕米膦酸盐。专家和协调的多学科团队的随访包括动脉高血压的治疗、降钙素三醇和磷的调整、助听器以及可能出现的血管样条纹的早期检测。希望正在进行的基础和临床研究能够开发出有效的疗法，专门针对 PPi 调节异常和这种疾病所涉及的其他机制。
{"title":"Generalized Arterial Calcification of Infancy (GACI)","authors":"Geneviève Baujat , Alix Besançon","doi":"10.1016/S0929-693X(24)00153-2","DOIUrl":"10.1016/S0929-693X(24)00153-2","url":null,"abstract":"<div><div>Generalized arterial calcification of infancy (GACI) is an ultra-rare autosomal recessive disorder associated with pathogenic variants in ENPP1, the major gene involved in this condition, and in ABCC6, which is involved in a small fraction of affected individuals. Loss-of-function pathogenic variants of <em>ENPP1</em> and <em>ABCC6</em> lead to perturbations in the PPi/Pi ratio, thereby promoting hydroxyapatite mineralization in peripheral tissues. GACI is initially characterized by an abnormal ectopic mineralization process in arteries and soft tissue. Nearly half of the patients die within the first 6 months of life from cardiovascular complications, hence the poor prognosis associated with an early diagnosis. In recent years, progress has been made in our understanding of the long-term natural history of GACI, the intricate symptoms due to vascular calcifications, the overmineralization of soft tissues, of hypophosphatemia designated as ARHR2, and of the consequences such as undermineralization of the skeleton, but also of the features possibly seen in pseudoxanthoma elasticum (PXE). Indeed, GACI, PXE, and ARHR2 share common pathophysiological pathways and clinical features beyond the vascular calcifications. Treatment options for severe forms of GACI are mostly based on symptomatic management, including the option of starting bisphosphonates early after birth, such as etidronate and pamidronate, analogues of PPi. Follow-up within an expert and coordinated multidisciplinary team includes treatment of arterial hypertension, calcitriol and phosphorus adjustments, hearing aids, and early detection of possible angioid streaks. It is hoped that ongoing basic and clinical research will lead to the development of effective therapies that specifically target the abnormal PPi regulation and the other mechanisms involved in this disorder.</div></div>","PeriodicalId":55477,"journal":{"name":"Archives De Pediatrie","volume":"31 4","pages":"Pages 4S21-4S26"},"PeriodicalIF":1.3,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142327137","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}
扫码关注我们
求助内容：
应助结果提醒方式：
京公网安备 11010802042870号