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Characteristics and predictors of outcome in children with severe acute bronchiolitis: A 10-yearexperience 严重急性支气管炎患儿的特征和预后因素:10年的经验。
IF 1.3 4区 医学 Q3 PEDIATRICS Pub Date : 2024-10-01 DOI: 10.1016/j.arcped.2024.06.002
Samia Hamouda , Safa Khatrouch , Aida Borgi , Ahmed Hajji , Hanen Smaoui , Najla Ben Jaballah , Fatma Khalsi , Khadija Boussetta

Background

Severe acute bronchiolitis (SAB) can be life-threatening for infants and may be responsible for the congestion of intensive care units (ICU) during epidemics. We aimed to study the clinical and paraclinical characteristics of patients with SAB requiring a transfer to the ICU in order to examine their outcomes and to identify the predictors of a stay of ≥7 days and/or death.

Methods

This was a cross-sectional retrospective study including infants aged ≤12 months transferred to the ICU for their first episode of SAB between 1 January 2010 and 31 December 2019.

Results

We collected data on 380 patients with a median age of 1.75 months. They had a history of prematurity (20.53 %), low birth weight (18.68 %), parental atopy (12.89 %), and comorbidity (7.37 %, mainly congenital heart disease [5 %]). The leading cause of transfer was hypoxemia and increased oxygen requirements (49.73 %). The patients required mechanical ventilation (MV) in 63.42 % of the cases and noninvasive ventilation (NIV) in 67.63 %. NIV has supplanted MV over the years. Its use has increased from 40.4 % in 2010 to 96 % in 2019 compared with 83.84 % and 42 % for MV. A total of 14 (3.68 %) patients died. The independent predictors of a stay of ≥7 days and/or death were young age ≤2 months (p = 0.002), failure to thrive (p = 0.006), apnea (p = 0.045), dehydration (p = 0.018), the presence of biological inflammatory reaction (p = 0.002), isolation of respiratory syncytial virus (p < 0.001), and bacterial coinfection (p = 0.013).NIV was a protective factor (p < 0.001). A severity score ranging from 0 to 17 was established with an optimal cut-off value of 5 points.

Conclusion

Specific caution is needed in patients with these severity predictors. The generalization ofNIV in general pediatrics departments would improve SAB management and reduce transfers to the ICU.
背景:严重急性支气管炎(SAB)可危及婴儿的生命,并可能导致流行病期间重症监护病房(ICU)的拥挤。我们的目的是研究需要转入重症监护室的 SAB 患者的临床和辅助临床特征,以检查他们的预后,并确定住院时间超过 7 天和/或死亡的预测因素:这是一项横断面回顾性研究,研究对象包括2010年1月1日至2019年12月31日期间因首次发作SAB而转入重症监护室的年龄≤12个月的婴儿:我们收集了380名患者的数据,中位年龄为1.75个月。他们有早产史(20.53%)、低出生体重(18.68%)、父母有过敏史(12.89%)和合并症(7.37%,主要是先天性心脏病[5%])。转院的主要原因是低氧血症和氧需求增加(49.73%)。63.42%的患者需要机械通气(MV),67.63%的患者需要无创通气(NIV)。多年来,无创通气已取代了机械通气。其使用率从 2010 年的 40.4% 增加到 2019 年的 96%,而 MV 和 NIV 的使用率分别为 83.84% 和 42%。共有 14 名患者(3.68%)死亡。住院时间≥7天和/或死亡的独立预测因素是年龄小于2个月(p = 0.002)、发育不良(p = 0.006)、呼吸暂停(p = 0.045)、脱水(p = 0.018)、出现生物炎症反应(p = 0.002)、分离出呼吸道合胞病毒(p < 0.001)和细菌合并感染(p = 0.013)。严重程度评分范围为 0 至 17 分,最佳临界值为 5 分:结论:对于具有这些严重程度预测因素的患者,需要特别谨慎。在普通儿科普及 NIV 可以改善 SAB 的管理,减少转入重症监护室的情况。
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引用次数: 0
Interaction of the protective effect of breastfeeding and the aggravating effect of pacifier use in the occurrence of bronchiolitis in children 母乳喂养的保护作用与使用安抚奶嘴的加重作用在儿童支气管炎发病中的相互作用。
IF 1.3 4区 医学 Q3 PEDIATRICS Pub Date : 2024-10-01 DOI: 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.
背景介绍在法国,每年冬季约有 30% 的婴儿患有急性支气管炎。在发展中国家,母乳喂养(BF)对急性下呼吸道感染有保护作用,但在工业化国家却很难证明这种作用。此外,使用安抚奶嘴对支气管炎发生的影响尚未得到明确证实。有鉴于此,本研究旨在调查在法国卢瓦尔河地区五家儿科急救中心就诊的 1 岁以下儿童支气管炎的发生与婴儿肥胖和使用安抚奶嘴之间的关系:2018年至2020年期间,法国卢瓦尔河地区五家医院的儿科急救中心在收治儿童时发放了一份调查问卷,收集了有关饮食、社会人口特征和发病原因的数据。支气管炎患儿被纳入第一组,因其他原因就诊的患儿(胃肠道感染或中耳炎除外)被纳入第二组。 母乳喂养分为纯母乳喂养(EBF)和部分母乳喂养(PBF)。安抚奶嘴的使用分为经常使用、睡眠中使用和不使用:研究包括 671 名 1 岁以下儿童,其中 174 名(25.8%)因支气管炎入院。在单变量分析中,入院时母乳喂养(EBF 和 PBF)的第 1 组儿童明显少于第 2 组儿童:分别为 21.8% 对 32.8%(OR=0.57,95% CI:0.38-0.86,p = 0.006);此外,第 1 组儿童使用安抚奶嘴的频率高于第 2 组儿童:分别为 84.5% 对 75.8%(OR=1.74,95% CI:1.10-2.76,p = 0.017)。在多变量分析中,对年龄进行调整后,9 个月和 12 个月以上的持续婴儿喂养或 EBF 仍是一个保护因素;但是,婴儿喂养的保护作用在使用安抚奶嘴后消失,而使用安抚奶嘴与支气管炎显著相关:结论:婴儿喂养对支气管炎的保护作用不受使用奶嘴的影响。然而,由于使用安抚奶嘴与支气管炎之间存在密切联系,婴儿喂养的效果有所减弱。本文讨论了在婴儿喂养和使用安抚奶嘴方面应向父母提出的建议。
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引用次数: 0
Breastfeeding and return to work at a teaching hospital 教学医院的母乳喂养和重返工作岗位。
IF 1.3 4区 医学 Q3 PEDIATRICS Pub Date : 2024-10-01 DOI: 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.
在法国,重返工作岗位意味着中断母乳喂养,尤其是对护理人员而言。这项研究旨在了解医院工作人员的母乳喂养情况。从 378 名受访者中发现,离开产科病房时母乳喂养率为 69%,重返工作岗位时为 36.5%,6 个月时为 20.1%。母乳喂养的平均持续时间为 23.3 周。总共有 44%的哺乳期妇女表示,她们停止母乳喂养的原因是工作:工作量大、工作时间不固定、没有哺乳室和疲劳。
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引用次数: 0
The relationship between chronotype and mental toughness in adolescents: Is resilience a mediator? 青少年的时间型与心理韧性之间的关系:复原力是中介吗?
IF 1.3 4区 医学 Q3 PEDIATRICS Pub Date : 2024-10-01 DOI: 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.
研究目的本研究旨在探讨抗逆力在青少年时序型与心理韧性之间关系中的中介作用:研究对象为来自土耳其一所学校的 342 名高中生(平均年龄为 17.25±1.11 岁)。数据收集采用了儿童早睡早起量表、儿童和青少年复原力测量以及青少年心理韧性量表。使用 PROCESS 模型 4 进行层次回归分析,以评估中介效应:结果:观察发现,早晨时间型倾向会提高复原力(p < 0.001)和心理韧性(p < 0.001)。复原力越高,心理韧性越强。在对中介效应进行研究时,抗逆力是时序特征与心理韧性之间关系的完全中介(β=0.396;p=0.000):根据这些结果,青少年的晨时型倾向会提高他们的复原力,从而提高心理韧性。这些结果表明,提高青少年心理韧性的有效方法应该是多方面的。此外,它还强调了识别和调节青少年时间型倾向的重要性,同时也强调了提高这一人群复原力的必要性。
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引用次数: 0
Immediate allergies to chlorhexidine: A series of pediatric cases from the French pharmacovigilance database 对洗必泰的直接过敏:法国药物警戒数据库中的一系列儿科病例:对洗必泰立即过敏:来自法国药物警戒数据库的一系列儿科病例。
IF 1.3 4区 医学 Q3 PEDIATRICS Pub Date : 2024-10-01 DOI: 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.
背景:洗必泰的直接过敏反应已在许多国家被明确发现,并引发了全球范围内的政府警告:我们的研究旨在了解(i)这些过敏反应的特征(在儿科人群中报告较少)和(ii)高危患者的特征,从而提出预防措施:与法国雷恩大学医院过敏科和地区药物警戒中心合作,利用国家药物警戒数据库中 2010 年 1 月 1 日至 2020 年 6 月 30 日期间的数据,开展了一项多中心回顾性、描述性和观察性研究。研究分析了根据与免疫球蛋白E(IgE)介导的反应相符的临床病史和阳性过敏试验得出的洗必泰过敏病例:在已确定的 478 个病例中,有 17 个氯已定立即过敏反应的儿科病例(13 个 II-IV 级过敏性休克病例)被保留下来进行分析。在这些病例中,58.8%的病例曾对该物质产生过中度反应。这些反应最常发生在家庭滥用洗必泰包扎伤口的病例中(88.2%,n = 15/17)。据报告,有两例病例出现复发,后来每次接触过敏原都会导致严重反应,这表明存在加重机制:结论:由于对洗必泰过敏的认识不足以及洗必泰的普遍使用,对洗必泰直接过敏的儿童病例数可能被低估了。了解儿童伤口护理方法、过敏致敏风险以及探索使用洗必泰后的任何异常反应,可以减少过敏反应的发生。
{"title":"Immediate allergies to chlorhexidine: A series of pediatric cases from the French pharmacovigilance database","authors":"Claire Fontaine ,&nbsp;Cécile Rochefort-Morel ,&nbsp;Gwenaëlle Veyrac ,&nbsp;Elisabeth Polard ,&nbsp;Lucie-Marie Scailteux ,&nbsp;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}
引用次数: 0
Paradoxical metabolic acidosis after vomiting in children with spinal muscular atrophy: A report of 9 patients 脊髓性肌肉萎缩症患儿呕吐后出现的反常代谢性酸中毒:9例患者的报告。
IF 1.3 4区 医学 Q3 PEDIATRICS Pub Date : 2024-10-01 DOI: 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.
背景:脊髓性肌萎缩症(SMA)是一种遗传性神经肌肉疾病:脊髓性肌萎缩症(SMA)是一种遗传性神经肌肉疾病,会因肌肉瘫痪而导致限制性呼吸衰竭。我们观察到,SMA 患者具有特殊的临床和实验室特征,即在轻度呕吐后出现严重的代谢性酸中毒。对于这些患者来说,这是一种不寻常、鲜为人知且危及生命的情况,因为代谢性酸中毒引起的过度换气会导致患者衰竭,并因混合性酸中毒而死亡:我们的研究旨在描述 SMA 患者呕吐后出现的矛盾性酸中毒,并探讨这种情况的生理基础:我们进行了一项回顾性单中心研究,回顾了因呕吐后严重代谢性酸中毒而在重症监护室住院的SMA患者的临床和实验室数据:我们的研究组共有11例患者。入院时,患者的 pH 中位数为 7.23,碳酸氢盐浓度中位数为 11.7 mmol/L,近一半患者(45%)的血液和/或尿液中含有酮体。接受葡萄糖溶液静脉补液后,pH 值的中位纠正时间为 24 小时,碳酸氢盐浓度的中位纠正时间为 48 小时:我们认为,SMA 患者对禁食引起的酮症酸中毒特别敏感,即使在几次轻微呕吐后也是如此。此外,由于严重肌萎缩,他们的缓冲能力很低,这有利于代谢性酸中毒的发生。他们必须通过含葡萄糖的溶液迅速补充水分,以避免衰竭、混合性酸中毒和死亡。
{"title":"Paradoxical metabolic acidosis after vomiting in children with spinal muscular atrophy: A report of 9 patients","authors":"Fiona Bensoussan ,&nbsp;Guillaume Costa ,&nbsp;Anne Blanchard ,&nbsp;Isabelle Vaugier ,&nbsp;Stéphanie Baron ,&nbsp;Aben Essid ,&nbsp;Blaise Mbieleu ,&nbsp;Awa Bakayoko ,&nbsp;Nicolas Deconinck ,&nbsp;Jean Bergounioux ,&nbsp;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}
引用次数: 0
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 杜氏肌营养不良症长期皮质类固醇治疗的化合物选择、剂量和副作用管理:法国儿科神经病学协会神经肌肉委员会指南》。
IF 1.3 4区 医学 Q3 PEDIATRICS Pub Date : 2024-10-01 DOI: 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.
法国儿科神经病学会和 FILNEMUS 网络成立了一个工作组,负责杜氏肌营养不良症患儿的皮质类固醇治疗,以分析文献综述和法国的现行做法。这项工作的目的是制定有关治疗启动、治疗前干预、可用化合物选择和治疗监测(剂量、持续时间和停药)的指南。此外,还详细介绍了治疗的副作用及其处理方法:骨质疏松症、内分泌异常(生长迟缓、体重增加、青春期延迟)、白内障、动脉高血压、行为紊乱、免疫抑制和疫苗的处理方法,以及胃肠道和代谢并发症的处理方法。
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引用次数: 0
Quality of life of chronically ill children and adolescents: a cross-sectional study 慢性病儿童和青少年的生活质量:一项横断面研究。
IF 1.3 4区 医学 Q3 PEDIATRICS Pub Date : 2024-10-01 DOI: 10.1016/j.arcped.2024.04.007
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

Objective

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。
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引用次数: 0
Vaginal screening for group B streptococcus using PCR in pregnant women with unknown colonization status: Impact on newborn monitoring for early-onset sepsis 使用 PCR 对定植状况不明的孕妇进行 B 群链球菌阴道筛查:对新生儿早期败血症监测的影响。
IF 1.3 4区 医学 Q3 PEDIATRICS Pub Date : 2024-10-01 DOI: 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.
背景:早发型新生儿败血症是诊断方面的一项挑战,因为它是新生儿死亡和发病的原因之一。预防 B 组链球菌(GBS)感染的指南建议,所有孕妇必须在妊娠末期接受 GBS 携带者筛查,并为 GBS 携带者提供产前抗生素预防。如果无法进行阴道培养,GBS 聚合酶链反应(GBS-PCR)是此类筛查的另一种选择。在我们科室,当孕妇在分娩过程中进入产房,但没有获得 GBS 培养筛查结果时,就会进行 GBS-PCR 筛查。本研究的主要目的是评估 GBS-PCR 结果对 GBS 状态不明的母亲所生新生儿监测模式的影响。次要目标是确认基于 GBS-PCR 的筛查方法在日常实践中的可行性,并评估 GBS-PCR 结果对孕妇产前抗生素治疗调整的影响:方法:进行为期一年的回顾性单中心观察研究。对于进行了 GBS-PCR 检测的夫妇,记录了产前抗生素治疗和新生儿监护方面的变化。该方法的可行性通过 GBS-PCR 检测与结果获得之间的延迟时间进行评估;此外,还收集了无法进行 GBS-PCR 检测的数量:总共对 60 名孕妇的 60 份 GBS-PCR 样本进行了检测。所有样本都获得了结果,获得 GBS-PCR 结果的中位时间为 70 分钟(60.8-87.2 分钟)。有 11 名孕妇(18.3%)的检测结果呈阳性,并因此对两名婴儿的监测结果进行了调整。共有 27 名孕妇(45%)因 GBS-PCR 结果而调整了抗生素治疗:结论:GBS-PCR 可快速获得,其结果导致孕妇抗生素预防措施和新生儿监测水平的改变。
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Title Page 标题页
IF 1.3 4区 医学 Q3 PEDIATRICS Pub Date : 2024-09-01 DOI: 10.1016/S0929-693X(24)00147-7
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引用次数: 0
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Archives De Pediatrie
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