Pub Date : 2025-11-05DOI: 10.1016/j.arcped.2025.09.006
Christophe Dupont, Sandra Brancato, Rosan Meyer, Martin Chalumeau, Dominique Darmaun, Marie Laure Frelut, Dominique Guimbert, Alexandre Lapillonne, Arnaud de Luca, Sophie Nicklaus, Noel Peretti, Jean-Pierre Chouraqui
Background: The increase in allergic, autoimmune, and metabolic diseases observed in recent decades correlates with increased exposure to new chemicals that can damage the epithelial barrier, regardless of its location, the skin, respiratory, and digestive tract. Infants are often exposed to detergents and disinfectants from birth.
Objectives, methods, and setting: Published data indicate a potentially harmful impact of these chemicals on the epithelial barrier, which could promote allergies. The aim of this article is to review the available data on how these chemicals affect the epithelial barrier.
Results: We depict the likely harmful role of common household products in the development of allergies in children.
Conclusion: We suggest simple changes in everyday life aimed at reducing contact with these products in infants and young children.
{"title":"The potential hidden dangers in household products for infant's immune system: Consequences for childcare.","authors":"Christophe Dupont, Sandra Brancato, Rosan Meyer, Martin Chalumeau, Dominique Darmaun, Marie Laure Frelut, Dominique Guimbert, Alexandre Lapillonne, Arnaud de Luca, Sophie Nicklaus, Noel Peretti, Jean-Pierre Chouraqui","doi":"10.1016/j.arcped.2025.09.006","DOIUrl":"https://doi.org/10.1016/j.arcped.2025.09.006","url":null,"abstract":"<p><strong>Background: </strong>The increase in allergic, autoimmune, and metabolic diseases observed in recent decades correlates with increased exposure to new chemicals that can damage the epithelial barrier, regardless of its location, the skin, respiratory, and digestive tract. Infants are often exposed to detergents and disinfectants from birth.</p><p><strong>Objectives, methods, and setting: </strong>Published data indicate a potentially harmful impact of these chemicals on the epithelial barrier, which could promote allergies. The aim of this article is to review the available data on how these chemicals affect the epithelial barrier.</p><p><strong>Results: </strong>We depict the likely harmful role of common household products in the development of allergies in children.</p><p><strong>Conclusion: </strong>We suggest simple changes in everyday life aimed at reducing contact with these products in infants and young children.</p>","PeriodicalId":55477,"journal":{"name":"Archives De Pediatrie","volume":" ","pages":""},"PeriodicalIF":1.3,"publicationDate":"2025-11-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145460659","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 scoliosis, defined by a major curve exceeding 80°, requires surgical correction and is particularly prone to post-operative mechanical and neurological complications.
Objective
This study aimed to evaluate the corrections and complications obtained by halo-gravity traction (HGT) followed by single posterior approach surgery for severe scoliosis. The secondary objective was to identify any risk factors associated with neurological complications.
Methods
A single-center retrospective review of all patients operated on with severe scoliosis or kyphosis of any cause, by a single posterior approach after a period of HGT. Demographic data including age at surgery, sex, and body mass index were collected. Pre-traction, post-traction, postoperative major curve, and kyphosis angles were reported. Perioperative complications both during the traction period and postoperatively were recorded.
Results
117 patients with a mean age at surgery of 14.0 ± 2.0 years were included. The mean preoperative major curve was 90.7°±22.1° (from 80.1 to 147.2°) and the mean kyphosis was 60.8°± 31.70 (from 3.3 to 150.2°). The mean major curve after traction was 66.1°±15.2° (from 30.2 to 101.5°) and 33.7°±17.0° (from 0.2° to 104.4°) postoperatively, with a total correction of 69 %. During the HGT period, 8 (6.8 %) complications occurred: 3 superficial infections, 4 pin displacement, and 1 case of encopresis. Postoperatively, eight deficits were observed, with two being permanent. No risk factors for postoperative neurological complications were identified.
Conclusions
A 6-week period of HGT is associated with a low complication rate, and is effective to prepare severe scoliosis surgery, even for curvatures exceeding 120°
{"title":"Surgical management of 117 patients with halo-gravity traction: corrections, complications, and neurological risks","authors":"Lou Richard, Elie Saghbini, Gauthier Eloy, Reda Kabbaj, Clélia Thouement, Raphael Vialle, Mathilde Gaume","doi":"10.1016/j.arcped.2025.07.006","DOIUrl":"10.1016/j.arcped.2025.07.006","url":null,"abstract":"<div><h3>Background</h3><div>Severe scoliosis, defined by a major curve exceeding 80°, requires surgical correction and is particularly prone to post-operative mechanical and neurological complications.</div></div><div><h3>Objective</h3><div>This study aimed to evaluate the corrections and complications obtained by halo-gravity traction (HGT) followed by single posterior approach surgery for severe scoliosis. The secondary objective was to identify any risk factors associated with neurological complications.</div></div><div><h3>Methods</h3><div>A single-center retrospective review of all patients operated on with severe scoliosis or kyphosis of any cause, by a single posterior approach after a period of HGT. Demographic data including age at surgery, sex, and body mass index were collected. Pre-traction, post-traction, postoperative major curve, and kyphosis angles were reported. Perioperative complications both during the traction period and postoperatively were recorded.</div></div><div><h3>Results</h3><div>117 patients with a mean age at surgery of 14.0 ± 2.0 years were included. The mean preoperative major curve was 90.7°±22.1° (from 80.1 to 147.2°) and the mean kyphosis was 60.8°± 31.70 (from 3.3 to 150.2°). The mean major curve after traction was 66.1°±15.2° (from 30.2 to 101.5°) and 33.7°±17.0° (from 0.2° to 104.4°) postoperatively, with a total correction of 69 %. During the HGT period, 8 (6.8 %) complications occurred: 3 superficial infections, 4 pin displacement, and 1 case of encopresis. Postoperatively, eight deficits were observed, with two being permanent. No risk factors for postoperative neurological complications were identified.</div></div><div><h3>Conclusions</h3><div>A 6-week period of HGT is associated with a low complication rate, and is effective to prepare severe scoliosis surgery, even for curvatures exceeding 120°</div></div>","PeriodicalId":55477,"journal":{"name":"Archives De Pediatrie","volume":"32 8","pages":"Pages 552-557"},"PeriodicalIF":1.3,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145245469","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-11-01DOI: 10.1016/j.arcped.2025.07.002
Siyi Gan, Li Xu, Hongmei Liao, Liwen Wu
Background
Duchenne muscular dystrophy (DMD) is caused by mutations in the DMD gene, but comprehensive analyses of mutational patterns and clinical correlations remain limited.
Objective
To characterize the DMD mutational spectrum and its clinical implications in a large Asian cohort.
Methods & Settings
A retrospective genetic analysis of 507 unrelated male DMD/Becker muscular dystrophy patients was conducted at Hunan Children’s Hospital (2018–2021). Multiplex ligation-dependent probe amplification (MLPA) and next-generation sequencing (NGS) were employed for comprehensive variant detection. Variants were classified per ACMG/AMP guidelines.
Results
Exon deletions predominated (64.9%), followed by small mutations (26.0%) and duplications (9.1%). Nonsense mutations were the most frequent small variant (16.0%). Domain analysis revealed mutations clustered in the Central Rod Domain (CRD; exons 45–55). The Carboxy-Terminal Domain (CTD) was associated with the most severe phenotype (earliest loss of ambulation, P < 0.05 vs. Actin-Binding Domain [ABD] or CRD). Exon 53 skipping was applicable in 39.39% of eligible patients. De novo mutations accounted for 7.9% (40/507) of cases. Epilepsy comorbidity occurred in 1.34% (6/448) of DMD patients.
Conclusion
This study delineates the DMD mutational landscape in a Chinese cohort, highlighting domain-specific phenotypic severity (CTD > ABD > CRD) and identifying exon 53 as the primary therapeutic target for exon skipping. These findings enhance prognostic precision and guide targeted therapeutic strategies.
背景:杜氏肌营养不良症(DMD)是由DMD基因突变引起的,但对突变模式和临床相关性的综合分析仍然有限。目的:在一个大型亚洲队列中描述DMD突变谱及其临床意义。方法与背景:对湖南省儿童医院2018-2021年507例无亲缘关系的男性DMD/Becker肌营养不良患者进行回顾性遗传分析。多重连接依赖探针扩增(MLPA)和下一代测序(NGS)用于全面的变异检测。根据ACMG/AMP指南对变异进行分类。结果:外显子缺失居多(64.9%),其次为小突变(26.0%)和重复(9.1%)。无义突变是最常见的小变异(16.0%)。结构域分析显示突变聚集在中央杆结构域(CRD,外显子45-55)。羧基末端结构域(CTD)与最严重的表型相关(与肌动蛋白结合结构域[ABD]或CRD相比,最早丧失活动能力,P < 0.05)。外显子53省略适用于39.39%的符合条件的患者。新生突变占7.9%(40/507)。癫痫合并症发生率为1.34%(6/448)。结论:本研究描绘了中国队列中的DMD突变景观,突出了区域特异性表型严重程度(CTD > ABD > CRD),并确定外显子53是外显子跳变的主要治疗靶点。这些发现提高了预后的准确性,并指导了有针对性的治疗策略。
{"title":"Spectrum of DMD gene mutations in 507 patients: a retrospective genotype-phenotype study using next-generation sequencing","authors":"Siyi Gan, Li Xu, Hongmei Liao, Liwen Wu","doi":"10.1016/j.arcped.2025.07.002","DOIUrl":"10.1016/j.arcped.2025.07.002","url":null,"abstract":"<div><h3>Background</h3><div>Duchenne muscular dystrophy (DMD) is caused by mutations in the DMD gene, but comprehensive analyses of mutational patterns and clinical correlations remain limited.</div></div><div><h3>Objective</h3><div>To characterize the DMD mutational spectrum and its clinical implications in a large Asian cohort.</div></div><div><h3>Methods & Settings</h3><div>A retrospective genetic analysis of 507 unrelated male DMD/Becker muscular dystrophy patients was conducted at Hunan Children’s Hospital (2018–2021). Multiplex ligation-dependent probe amplification (MLPA) and next-generation sequencing (NGS) were employed for comprehensive variant detection. Variants were classified per ACMG/AMP guidelines.</div></div><div><h3>Results</h3><div>Exon deletions predominated (64.9%), followed by small mutations (26.0%) and duplications (9.1%). Nonsense mutations were the most frequent small variant (16.0%). Domain analysis revealed mutations clustered in the Central Rod Domain (CRD; exons 45–55). The Carboxy-Terminal Domain (CTD) was associated with the most severe phenotype (earliest loss of ambulation, <em>P</em> < 0.05 vs. Actin-Binding Domain [ABD] or CRD). Exon 53 skipping was applicable in 39.39% of eligible patients. De novo mutations accounted for 7.9% (40/507) of cases. Epilepsy comorbidity occurred in 1.34% (6/448) of DMD patients.</div></div><div><h3>Conclusion</h3><div>This study delineates the DMD mutational landscape in a Chinese cohort, highlighting domain-specific phenotypic severity (CTD > ABD > CRD) and identifying exon 53 as the primary therapeutic target for exon skipping. These findings enhance prognostic precision and guide targeted therapeutic strategies.</div></div>","PeriodicalId":55477,"journal":{"name":"Archives De Pediatrie","volume":"32 8","pages":"Pages 547-551"},"PeriodicalIF":1.3,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145245283","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 emergence of acute hepatitis of unknown etiology in the spring of 2022 was strikingly reminiscent of how multisystem inflammatory syndrome in children (MIS-C) had appeared two years earlier.
Objective
To carry out a bibliometric analysis of the early literature on acute hepatitis of unknown aetiology, and another coincident but non-pediatric disease, Mpox, in comparison with our previous findings on the early coverage of MIS-C.
Methods and Settings
A review of the literature was conducted in the MEDLINE database, on preprint servers, and among Reuters news articles. Articles were included if they had been published in 2022 and were specifically about acute hepatitis of unknown aetiology or Mpox.
Results
The first newspaper/non-academic journal article on acute hepatitis of unknown aetiology was published in week 14 and the weekly number rapidly peaked in week 16 before decreasing gradually down to zero in week 22. The first peer-reviewed article was published in week 15 and remained between 3 and 7 from weeks 17 to 23. Just under a quarter (23.5 %) of references in these articles were to health agency publications on acute hepatitis of unknown aetiology. Over 7-week periods beginning just before the corresponding health agency alerts, 25 articles were published on MIS-C (21 peer-reviewed and 4 preprints), 20 articles were published on acute hepatitis of unknown aetiology (18 peer-reviewed and 4 preprints), and 74 on Mpox (48 peer-reviewed and 26 preprints). The proportion of preprints was significantly associated with disease type (p = 0.03), as was the proportion of clinical studies, with values of 52 %, 10 %, and 18 %, respectively (p = 0.002). Many more non-academic articles were published on Mpox (N = 180) than on acute hepatitis of unknown aetiology (17) or MIS-C (24).
Conclusion
Although Mpox attracted more overall attention, the medical community responded similarly rapidly to acute hepatitis of unknown aetiology and to MIS-C. The fact that a major source of early information on these diseases was health agency reports suggests that these should be included in bibliographic databases for ease of access.
{"title":"Hepatitis in the time of pandemics: A comparative bibliometric analysis of early publications on MIS-C, acute hepatitis of unknown aetiology and Mpox","authors":"Alexandre Fabre MD, PhD , Paul Guerry PhD , Aurélie Morand MD, PhD","doi":"10.1016/j.arcped.2025.09.003","DOIUrl":"10.1016/j.arcped.2025.09.003","url":null,"abstract":"<div><h3>Background</h3><div>The emergence of acute hepatitis of unknown etiology in the spring of 2022 was strikingly reminiscent of how multisystem inflammatory syndrome in children (MIS-C) had appeared two years earlier.</div></div><div><h3>Objective</h3><div>To carry out a bibliometric analysis of the early literature on acute hepatitis of unknown aetiology, and another coincident but non-pediatric disease, Mpox, in comparison with our previous findings on the early coverage of MIS-C.</div></div><div><h3>Methods and Settings</h3><div>A review of the literature was conducted in the MEDLINE database, on preprint servers, and among Reuters news articles. Articles were included if they had been published in 2022 and were specifically about acute hepatitis of unknown aetiology or Mpox.</div></div><div><h3>Results</h3><div>The first newspaper/non-academic journal article on acute hepatitis of unknown aetiology was published in week 14 and the weekly number rapidly peaked in week 16 before decreasing gradually down to zero in week 22. The first peer-reviewed article was published in week 15 and remained between 3 and 7 from weeks 17 to 23. Just under a quarter (23.5 %) of references in these articles were to health agency publications on acute hepatitis of unknown aetiology. Over 7-week periods beginning just before the corresponding health agency alerts, 25 articles were published on MIS-C (21 peer-reviewed and 4 preprints), 20 articles were published on acute hepatitis of unknown aetiology (18 peer-reviewed and 4 preprints), and 74 on Mpox (48 peer-reviewed and 26 preprints). The proportion of preprints was significantly associated with disease type (<em>p</em> = 0.03), as was the proportion of clinical studies, with values of 52 %, 10 %, and 18 %, respectively (<em>p</em> = 0.002). Many more non-academic articles were published on Mpox (<em>N</em> = 180) than on acute hepatitis of unknown aetiology (17) or MIS-C (24).</div></div><div><h3>Conclusion</h3><div>Although Mpox attracted more overall attention, the medical community responded similarly rapidly to acute hepatitis of unknown aetiology and to MIS-C. The fact that a major source of early information on these diseases was health agency reports suggests that these should be included in bibliographic databases for ease of access.</div></div>","PeriodicalId":55477,"journal":{"name":"Archives De Pediatrie","volume":"32 8","pages":"Pages 527-531"},"PeriodicalIF":1.3,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145454221","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-11-01DOI: 10.1016/j.arcped.2025.09.001
Ana Claudia Lopes , Tatiana Pereira , Marisa Lousada
Background
Breastfeeding interventions among refugee, migrant, and asylum seeker populations hold significant promise for improving maternal, infant, and community health.
Objectives
This systematic review aims to comprehensively synthesize existing interventions and assess their effectiveness within these vulnerable demographics.
Methods and Setting
Following the PRISMA framework, a thorough literature search was conducted across four electronic databases—PubMed, Cochrane Library, Web of Science, and Scopus—from February 2014 to February 2024, focusing on studies involving refugees, migrants, and asylum seekers who received breastfeeding interventions. Methodological quality appraisal was executed utilizing the Effective Public Health Practice Project Quality Assessment Tool for Quantitative Studies.
Results
Of the scrutinized studies, nine met the stringent eligibility criteria and were subsequently included in this review. Two independent researchers meticulously performed data extraction and analysis. The synthesized findings revealed a spectrum of breastfeeding interventions tailored to migrant populations, comprising both individualized and group-based approaches. Significant outcomes included elevated breastfeeding initiation rates and positive indicators, such as sustained exclusive breastfeeding for up to six months, increased maternal self-efficacy, enhanced dietary diversity, and the adoption of healthier dietary practices.
Conclusion
The collated evidence underscores the potential of breastfeeding interventions to profoundly influence maternal and child health outcomes within migrant communities. Nonetheless, the interpretation of results warrants caution due to the scarcity of high-quality studies and inherent methodological limitations. This review underscores the imperative for further rigorous research to elucidate the nuanced impacts of breastfeeding interventions in migrant populations and to inform evidence-based practices for optimizing maternal and infant health outcomes globally.
背景:在难民、移民和寻求庇护者人群中进行母乳喂养干预,对改善孕产妇、婴儿和社区健康具有重大希望。目的:本系统综述旨在全面综合现有干预措施并评估其在这些脆弱人口统计中的有效性。方法和背景:遵循PRISMA框架,从2014年2月到2024年2月,在pubmed、Cochrane图书馆、Web of Science和scopus四个电子数据库中进行了全面的文献检索,重点研究涉及接受母乳喂养干预的难民、移民和寻求庇护者的研究。采用定量研究的有效公共卫生实践项目质量评估工具进行方法学质量评估。结果:在审查的研究中,有9项符合严格的资格标准,随后纳入本综述。两名独立研究人员细致地进行了数据提取和分析。综合研究结果揭示了针对流动人口量身定制的一系列母乳喂养干预措施,包括个性化和基于群体的方法。显著的结果包括提高母乳喂养开始率和积极指标,如持续纯母乳喂养长达6个月,提高产妇自我效能,增强饮食多样性,以及采用更健康的饮食习惯。结论:整理的证据强调了母乳喂养干预措施对移民社区孕产妇和儿童健康结果产生深远影响的潜力。尽管如此,由于缺乏高质量的研究和固有的方法局限性,对结果的解释需要谨慎。这篇综述强调了进一步严格研究的必要性,以阐明母乳喂养干预措施对移民人群的细微影响,并为全球优化母婴健康结果的循证实践提供信息。
{"title":"Enhancing maternal and infant health: A systematic review of breastfeeding interventions among refugee, migrant, and asylum seeker populations","authors":"Ana Claudia Lopes , Tatiana Pereira , Marisa Lousada","doi":"10.1016/j.arcped.2025.09.001","DOIUrl":"10.1016/j.arcped.2025.09.001","url":null,"abstract":"<div><h3>Background</h3><div>Breastfeeding interventions among refugee, migrant, and asylum seeker populations hold significant promise for improving maternal, infant, and community health.</div></div><div><h3>Objectives</h3><div>This systematic review aims to comprehensively synthesize existing interventions and assess their effectiveness within these vulnerable demographics.</div></div><div><h3>Methods and Setting</h3><div>Following the PRISMA framework, a thorough literature search was conducted across four electronic databases—PubMed, Cochrane Library, Web of Science, and Scopus—from February 2014 to February 2024, focusing on studies involving refugees, migrants, and asylum seekers who received breastfeeding interventions. Methodological quality appraisal was executed utilizing the Effective Public Health Practice Project Quality Assessment Tool for Quantitative Studies.</div></div><div><h3>Results</h3><div>Of the scrutinized studies, nine met the stringent eligibility criteria and were subsequently included in this review. Two independent researchers meticulously performed data extraction and analysis. The synthesized findings revealed a spectrum of breastfeeding interventions tailored to migrant populations, comprising both individualized and group-based approaches. Significant outcomes included elevated breastfeeding initiation rates and positive indicators, such as sustained exclusive breastfeeding for up to six months, increased maternal self-efficacy, enhanced dietary diversity, and the adoption of healthier dietary practices.</div></div><div><h3>Conclusion</h3><div>The collated evidence underscores the potential of breastfeeding interventions to profoundly influence maternal and child health outcomes within migrant communities. Nonetheless, the interpretation of results warrants caution due to the scarcity of high-quality studies and inherent methodological limitations. This review underscores the imperative for further rigorous research to elucidate the nuanced impacts of breastfeeding interventions in migrant populations and to inform evidence-based practices for optimizing maternal and infant health outcomes globally.</div></div>","PeriodicalId":55477,"journal":{"name":"Archives De Pediatrie","volume":"32 8","pages":"Pages 517-526"},"PeriodicalIF":1.3,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145454140","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-11-01DOI: 10.1016/j.arcped.2025.09.004
Mathilde Gaume , Lisa Viallard , Pascal Rippert , Martin Bail , Raphael Vialle , Isabelle Desguerres , Capucine de Lattre , Vincent Cunin , Carole Vuillerot
Background
Spinal muscular atrophy (SMA) affects the motor neurons of the anterior spinal cord, causing progressive muscle weakness and atrophy. SMN restoring therapies have led to the emergence of new phenotypes in spinal muscular atrophy (SMA), including early-onset scoliosis. Guidelines regarding the optimal treatment for scoliosis and its consequences are lacking.
Objective
To provide guidelines to help clinical decision-making and to standardise the management of neuromuscular scoliosis (NMS) in children with SMA.
Methods
We conducted a Delphi study with 31 experts between July 2023 and February 2024. Three rounds were conducted using anonymous electronic questionnaires to determine consensus on items grouped into 5 main domains: Respiratory monitoring (7 items), Trunk orthoses (4 items), Surgical approaches (13 items), Preoperative care (17), post-operative care (10 items). Experts were asked to rate their agreement with each item on a scale from 1 (strongly disagree) to 9 (strongly agree). Consensus was considered to have been achieved if the median value of the responses was ≥ 7. Items that did not reach consensus in one round were reformulated in the following round using comments provided by the experts.
Results
The experts included 12 orthopaedic surgeons, 9 physical medicine and rehabilitation physicians and 10 paediatricians/child neurologists. Fourty-seven items achieved consensus. In the first round, consensus was achieved for 33 of the 51 items. The second round included 15 items, and a consensus was achieved for 11 items. In the third round, 3 of the 4 items included achieved consensus and the fourth item was dropped due to a lack of agreement.
Conclusions
The recommendations generated from the questionnaire provide a relevant consensus-based guidance for the multidisciplinary management of spinal deformities in children with SMA.
{"title":"French-Belgian consensus statement to managing spinal deformities in children with spinal muscular atrophy treated with SMN restoring therapies","authors":"Mathilde Gaume , Lisa Viallard , Pascal Rippert , Martin Bail , Raphael Vialle , Isabelle Desguerres , Capucine de Lattre , Vincent Cunin , Carole Vuillerot","doi":"10.1016/j.arcped.2025.09.004","DOIUrl":"10.1016/j.arcped.2025.09.004","url":null,"abstract":"<div><h3>Background</h3><div>Spinal muscular atrophy (SMA) affects the motor neurons of the anterior spinal cord, causing progressive muscle weakness and atrophy. SMN restoring therapies have led to the emergence of new phenotypes in spinal muscular atrophy (SMA), including early-onset scoliosis. Guidelines regarding the optimal treatment for scoliosis and its consequences are lacking.</div></div><div><h3>Objective</h3><div>To provide guidelines to help clinical decision-making and to standardise the management of neuromuscular scoliosis (NMS) in children with SMA.</div></div><div><h3>Methods</h3><div>We conducted a Delphi study with 31 experts between July 2023 and February 2024. Three rounds were conducted using anonymous electronic questionnaires to determine consensus on items grouped into 5 main domains: Respiratory monitoring (7 items), Trunk orthoses (4 items), Surgical approaches (13 items), Preoperative care (17), post-operative care (10 items). Experts were asked to rate their agreement with each item on a scale from 1 (strongly disagree) to 9 (strongly agree). Consensus was considered to have been achieved if the median value of the responses was ≥ 7. Items that did not reach consensus in one round were reformulated in the following round using comments provided by the experts.</div></div><div><h3>Results</h3><div>The experts included 12 orthopaedic surgeons, 9 physical medicine and rehabilitation physicians and 10 paediatricians/child neurologists. Fourty-seven items achieved consensus. In the first round, consensus was achieved for 33 of the 51 items. The second round included 15 items, and a consensus was achieved for 11 items. In the third round, 3 of the 4 items included achieved consensus and the fourth item was dropped due to a lack of agreement.</div></div><div><h3>Conclusions</h3><div>The recommendations generated from the questionnaire provide a relevant consensus-based guidance for the multidisciplinary management of spinal deformities in children with SMA.</div></div>","PeriodicalId":55477,"journal":{"name":"Archives De Pediatrie","volume":"32 8","pages":"Pages 538-546"},"PeriodicalIF":1.3,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145460661","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-11-01DOI: 10.1016/j.arcped.2025.07.001
Alexia Morel , Julien Baleine , Christophe Milesi , Maliha Badr , Arthur Gaudaire , Alexandra Deveze , Sylvain Paulhac , Charline Andrieu , Marion Palpacuer , Gilles Cambonie , Arthur Gavotto
Background
Neonatal respiratory distress (NRD) requiring continuous positive airway pressure (CPAP) is a common indication for inter-hospital transfer of late preterm and term neonates. The optimal composition of the inter-hospital team transfer - involving an advanced neonatal nurse and an ambulance driver or a complete team, which also includes a paediatrician - remains uncertain. Particularly when clinical interventions are required.
Objectives
To assess the occurrence of clinical interventions necessitating a complete transport team during the inter-hospital transfer of neonates with NRD on CPAP. A secondary objective was to evaluate whether data provided to the transfer regulation centre predicted such interventions.
Methods and Setting
This retrospective observational study was conducted at the Paediatric Emergency Transport Service (PETS) of a level 3 maternity hospital between 2021 and 2023. A total of 110 infants ≥34 weeks’ gestational age were included, all transported for NRD with CPAP (mean gestational age 37.6 ± 2.2 weeks, mean birth weight 3042±615 g). Clinical interventions recorded included intubation, surfactant administration, inhaled nitric oxide (iNO) administration, needle aspiration for pneumothorax, and prostaglandin E1 infusion. Complete team transport involved a paediatrician, an advanced neonatal nurse, and an ambulance driver.
Results
Clinical interventions occurred in 11 cases (10%). Factors associated with the need for intervention included higher FiO₂ (71.4 ± 18.5% vs 28.3 ± 8.0%, p < 0.01), presence of pneumothorax (p < 0.01), and transfer from higher-level maternity hospitals (p < 0.01). The ROC curve for FiO₂ predicting intervention had an area of 0.99 (95% CI 0.97–1.01, p = 0.001), with a cut-off of >40% yielding 91% sensitivity, 98% specificity, 83% positive predictive value, and 99% negative predictive value.
Conclusions
High oxygen dependency and the presence of pneumothorax are key indicators for mobilizing a complete transport team during the transfer of late preterm and term neonates with NRD on CPAP. Early identification of these factors could enhance team allocation and resource utilization.
背景:需要持续气道正压通气(CPAP)的新生儿呼吸窘迫(NRD)是晚期早产儿和足月新生儿院间转院的常见指征。医院间转诊团队的最佳组成——包括一名高级新生儿护士和一名救护车司机,还是包括一名儿科医生的完整团队——仍不确定。特别是当需要临床干预时。目的:评估在医院间转移NRD新生儿进行CPAP时需要一个完整的转运小组的临床干预的发生情况。第二个目标是评估提供给转移监管中心的数据是否可以预测这些干预措施。方法和环境:这项回顾性观察性研究于2021年至2023年在一家三级妇产医院的儿科急诊转运服务(PETS)进行。共纳入110例≥34周胎龄的新生儿,均采用CPAP进行NRD转运(平均胎龄37.6±2.2周,平均出生体重3042±615 g)。记录的临床干预措施包括插管、表面活性剂给药、吸入性一氧化氮(iNO)给药、气胸针吸、前列腺素E1输注。完整的团队运输包括一名儿科医生,一名高级新生儿护士和一名救护车司机。结果:临床干预11例(10%)。与干预需求相关的因素包括较高的FiO₂(71.4±18.5% vs 28.3±8.0%,p < 0.01)、是否存在气胸(p < 0.01)、是否从上级妇产医院转院(p < 0.01)。FiO 2预测干预的ROC曲线面积为0.99 (95% CI 0.97-1.01, p = 0.001),截断值为bb0 40%,敏感性为91%,特异性为98%,阳性预测值为83%,阴性预测值为99%。结论:高氧依赖和气胸的存在是CPAP转移NRD晚期早产儿和足月新生儿时动员完整转运团队的关键指标。尽早识别这些因素可以提高团队分配和资源利用。
{"title":"Occurrence and prediction of clinical interventions during transfer of near-term and term infants with respiratory distress on CPAP. An observational study","authors":"Alexia Morel , Julien Baleine , Christophe Milesi , Maliha Badr , Arthur Gaudaire , Alexandra Deveze , Sylvain Paulhac , Charline Andrieu , Marion Palpacuer , Gilles Cambonie , Arthur Gavotto","doi":"10.1016/j.arcped.2025.07.001","DOIUrl":"10.1016/j.arcped.2025.07.001","url":null,"abstract":"<div><h3>Background</h3><div>Neonatal respiratory distress (NRD) requiring continuous positive airway pressure (CPAP) is a common indication for inter-hospital transfer of late preterm and term neonates. The optimal composition of the inter-hospital team transfer - involving an advanced neonatal nurse and an ambulance driver or a complete team, which also includes a paediatrician - remains uncertain. Particularly when clinical interventions are required.</div></div><div><h3>Objectives</h3><div>To assess the occurrence of clinical interventions necessitating a complete transport team during the inter-hospital transfer of neonates with NRD on CPAP. A secondary objective was to evaluate whether data provided to the transfer regulation centre predicted such interventions.</div></div><div><h3>Methods and Setting</h3><div>This retrospective observational study was conducted at the Paediatric Emergency Transport Service (PETS) of a level 3 maternity hospital between 2021 and 2023. A total of 110 infants ≥34 weeks’ gestational age were included, all transported for NRD with CPAP (mean gestational age 37.6 ± 2.2 weeks, mean birth weight 3042±615 g). Clinical interventions recorded included intubation, surfactant administration, inhaled nitric oxide (iNO) administration, needle aspiration for pneumothorax, and prostaglandin E1 infusion. Complete team transport involved a paediatrician, an advanced neonatal nurse, and an ambulance driver.</div></div><div><h3>Results</h3><div>Clinical interventions occurred in 11 cases (10%). Factors associated with the need for intervention included higher FiO₂ (71.4 ± 18.5% vs 28.3 ± 8.0%, <em>p</em> < 0.01), presence of pneumothorax (<em>p</em> < 0.01), and transfer from higher-level maternity hospitals (<em>p</em> < 0.01). The ROC curve for FiO₂ predicting intervention had an area of 0.99 (95% CI 0.97–1.01, <em>p</em> = 0.001), with a cut-off of >40% yielding 91% sensitivity, 98% specificity, 83% positive predictive value, and 99% negative predictive value.</div></div><div><h3>Conclusions</h3><div>High oxygen dependency and the presence of pneumothorax are key indicators for mobilizing a complete transport team during the transfer of late preterm and term neonates with NRD on CPAP. Early identification of these factors could enhance team allocation and resource utilization.</div></div>","PeriodicalId":55477,"journal":{"name":"Archives De Pediatrie","volume":"32 8","pages":"Pages 575-579"},"PeriodicalIF":1.3,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145245882","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-11-01DOI: 10.1016/j.arcped.2025.08.003
Berkay Yalçınkaya, Ahmet Furkan Çolak, Murat Kara
{"title":"Optimizing vitamin D supplementation: the role of physician awareness and patient adherence","authors":"Berkay Yalçınkaya, Ahmet Furkan Çolak, Murat Kara","doi":"10.1016/j.arcped.2025.08.003","DOIUrl":"10.1016/j.arcped.2025.08.003","url":null,"abstract":"","PeriodicalId":55477,"journal":{"name":"Archives De Pediatrie","volume":"32 8","pages":"Pages 599-600"},"PeriodicalIF":1.3,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145260032","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}
Given the frequency of dermatological diseases in children and the difficulties in accessing specialist care in Africa, teledermatology services, such as store-and-forward (SAF), could be used an alternative approach for improving patient care. The dermatology department of the Argenteuil hospital in France developed a SAF network with paediatricians from seven French-speaking African countries. This study assessed the value of this Franco-African SAF collaboration by identifying the advantages and challenges associated with the first 100 uses of the SAF system.
Methods
Paediatricians belonging to medical societies in French-speaking African countries were provided with information on how to register for the SAF service. The first 100 SAF requests were evaluated. Information about the paediatricians who used the service, and patient demographic, clinical and management data were systematically collected.
Results
Twenty-five (10.2%) paediatricians, out of 244 who registered, submitted cases to the SAF network. In 95 cases, a response was sent within 24 h of submission. In 24 cases, additional information was needed (clinical data, n = 17; photos, n = 6; a histological report, n = 1; identity details, n = 1). The mean age of the children was 5.8 ± 5.0 years, with a predominance of girls (n = 61). Most patients had chronic pathologies (≥ 1 month) (n = 56) belonging to three main groups: chronic inflammatory diseases (n = 42), infectious diseases (n = 23), and genetic diseases (n = 11). As a result of the SAF requests, further examinations were proposed in 39 cases, treatment in 82 cases, and hospitalisation in 11 cases.
Conclusion
The SAF approach is an effective solution for improving access to dermatological care in Africa, providing an alternative method for expert consultation when resources are limited, without diminishing the role of local dermatologists. For dermatologists, this solution provides access to expertise on unusual pathologies and allows solutions to be offered that are tailored to the resources available in the field.
{"title":"Franco-African paediatric teledermatology: a store-and-forward network","authors":"Asmaa Lahrougui , Dalila Benlahcene , Saïd Afif , Emmanuel Mahé","doi":"10.1016/j.arcped.2025.09.007","DOIUrl":"10.1016/j.arcped.2025.09.007","url":null,"abstract":"<div><h3>Background</h3><div>Given the frequency of dermatological diseases in children and the difficulties in accessing specialist care in Africa, teledermatology services, such as store-and-forward (SAF), could be used an alternative approach for improving patient care. The dermatology department of the Argenteuil hospital in France developed a SAF network with paediatricians from seven French-speaking African countries. This study assessed the value of this Franco-African SAF collaboration by identifying the advantages and challenges associated with the first 100 uses of the SAF system.</div></div><div><h3>Methods</h3><div>Paediatricians belonging to medical societies in French-speaking African countries were provided with information on how to register for the SAF service. The first 100 SAF requests were evaluated. Information about the paediatricians who used the service, and patient demographic, clinical and management data were systematically collected.</div></div><div><h3>Results</h3><div>Twenty-five (10.2%) paediatricians, out of 244 who registered, submitted cases to the SAF network. In 95 cases, a response was sent within 24 h of submission. In 24 cases, additional information was needed (clinical data, <em>n</em> = 17; photos, <em>n</em> = 6; a histological report, <em>n</em> = 1; identity details, <em>n</em> = 1). The mean age of the children was 5.8 ± 5.0 years, with a predominance of girls (<em>n</em> = 61). Most patients had chronic pathologies (≥ 1 month) (<em>n</em> = 56) belonging to three main groups: chronic inflammatory diseases (<em>n</em> = 42), infectious diseases (<em>n</em> = 23), and genetic diseases (<em>n</em> = 11). As a result of the SAF requests, further examinations were proposed in 39 cases, treatment in 82 cases, and hospitalisation in 11 cases.</div></div><div><h3>Conclusion</h3><div>The SAF approach is an effective solution for improving access to dermatological care in Africa, providing an alternative method for expert consultation when resources are limited, without diminishing the role of local dermatologists. For dermatologists, this solution provides access to expertise on unusual pathologies and allows solutions to be offered that are tailored to the resources available in the field.</div></div>","PeriodicalId":55477,"journal":{"name":"Archives De Pediatrie","volume":"32 8","pages":"Pages 592-598"},"PeriodicalIF":1.3,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145454299","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}
Couplet Care ensures zero separation between mother and baby from birth, fostering attachment, particularly for hospitalized premature or full-term infants. Implementation of mother-child paired care was initiated in 2017 at our center. This study aimed to quantify parental presence during hospitalization and identify its determinants.
Method
This retrospective study analyzed data from September to December 2023, recorded by healthcare staff. We included in the study preterm and full-term infants admitted to our level II neonatal unit during this period. Parental involvement was confirmed by at least one of three factors between 0 and 6 am: breastfeeding, parental care, or skin-to-skin contact. Continuous parental presence was defined as 100 % of nights with parental involvement.
Results
Of the 110 children admitted during this period, 37 were excluded, primarily due to admission from home. Among 73 included newborns, 46 (63 %) had parental presence every night. These infants (Permanent Parental Presence—PPP group) had a higher mean gestational age at birth than those with Discontinuous Parental Presence (DPP) (36.3 vs. 31.3 weeks, p < 0.0001). More PPP infants were inborn (80.4 % vs. 51.9 %, p = 0.01). Their hospital stay was shorter (15.9 vs. 45.6 days, p < 0.0001). Breastfeeding rate at admission and at discharge was significantly higher in the PPP group (respectively 91 % vs 74 %, p = 0.05 and 84.7 % vs. 51.8 %, p = 0.002). Distance between home and the neonatal unit was smaller in the PPP group (6.5 km vs 8.8 km, p = 0.03). Multiparity showed no impact on parental presence.
Conclusion
Couplet Care and single-room accommodations encourage continuous parental presence in neonatology. Different ways to support parents’ continuous presence in order to promote parent-child closeness should be promoted.
{"title":"Evaluation of permanent parental presence and its determinants in a French neonatal intensive care unit practicing couplet care","authors":"Sylvaine Rousseau , Lorna Ramelin , Patrick Truffert , Cerise Levaillant","doi":"10.1016/j.arcped.2025.07.007","DOIUrl":"10.1016/j.arcped.2025.07.007","url":null,"abstract":"<div><div>Couplet Care ensures zero separation between mother and baby from birth, fostering attachment, particularly for hospitalized premature or full-term infants. Implementation of mother-child paired care was initiated in 2017 at our center. This study aimed to quantify parental presence during hospitalization and identify its determinants.</div></div><div><h3>Method</h3><div>This retrospective study analyzed data from September to December 2023, recorded by healthcare staff. We included in the study preterm and full-term infants admitted to our level II neonatal unit during this period. Parental involvement was confirmed by at least one of three factors between 0 and 6 am: breastfeeding, parental care, or skin-to-skin contact. Continuous parental presence was defined as 100 % of nights with parental involvement.</div></div><div><h3>Results</h3><div>Of the 110 children admitted during this period, 37 were excluded, primarily due to admission from home. Among 73 included newborns, 46 (63 %) had parental presence every night. These infants (Permanent Parental Presence—PPP group) had a higher mean gestational age at birth than those with Discontinuous Parental Presence (DPP) (36.3 vs. 31.3 weeks, <em>p</em> < 0.0001). More PPP infants were inborn (80.4 % vs. 51.9 %, <em>p</em> = 0.01). Their hospital stay was shorter (15.9 vs. 45.6 days, <em>p</em> < 0.0001). Breastfeeding rate at admission and at discharge was significantly higher in the PPP group (respectively 91 % vs 74 %, <em>p</em> = 0.05 and 84.7 % vs. 51.8 %, <em>p</em> = 0.002). Distance between home and the neonatal unit was smaller in the PPP group (6.5 km vs 8.8 km, <em>p</em> = 0.03). Multiparity showed no impact on parental presence.</div></div><div><h3>Conclusion</h3><div>Couplet Care and single-room accommodations encourage continuous parental presence in neonatology. Different ways to support parents’ continuous presence in order to promote parent-child closeness should be promoted.</div></div>","PeriodicalId":55477,"journal":{"name":"Archives De Pediatrie","volume":"32 8","pages":"Pages 558-563"},"PeriodicalIF":1.3,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145446632","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}