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.2024.04.006
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}
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}
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}