Acute disseminated encephalomyelitis (ADEM) ADEM is a well-known and treatable inflammatory pediatric condition with a good prognosis outcome. Atypical forms exist that can lead to misdiagnosis and sometimes inappropriate management.
Observation and discussion
We report two cases with tumor-like lesions, highlighting their clinical and magnetic resonance imaging (MRI) features. Diagnostic keys for prompt recognition are discussed.
Conclusion
Tumefactive demyelinating lesions can mimic brain tumors or abscesses, leading to potential misdiagnosis and inappropriate or delayed treatment. These two clinical cases emphasize the importance of considering this entity in the differential diagnosis of brain tumors in pediatric patients.
{"title":"Acute disseminated encephalomyelitis mimicking brain tumor: about 2 pediatric cases","authors":"Francesca Albertini , Mériam Koob , Stephane Darteyre , Sébastien Lebon","doi":"10.1016/j.arcped.2025.05.009","DOIUrl":"10.1016/j.arcped.2025.05.009","url":null,"abstract":"<div><h3>Introduction</h3><div>Acute disseminated encephalomyelitis (ADEM) ADEM is a well-known and treatable inflammatory pediatric condition with a good prognosis outcome. Atypical forms exist that can lead to misdiagnosis and sometimes inappropriate management.</div></div><div><h3>Observation and discussion</h3><div>We report two cases with tumor-like lesions, highlighting their clinical and magnetic resonance imaging (MRI) features. Diagnostic keys for prompt recognition are discussed.</div></div><div><h3>Conclusion</h3><div>Tumefactive demyelinating lesions can mimic brain tumors or abscesses, leading to potential misdiagnosis and inappropriate or delayed treatment. These two clinical cases emphasize the importance of considering this entity in the differential diagnosis of brain tumors in pediatric patients.</div></div>","PeriodicalId":55477,"journal":{"name":"Archives De Pediatrie","volume":"32 7","pages":"Pages 503-505"},"PeriodicalIF":1.3,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145245916","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 : 2025-10-01DOI: 10.1016/j.arcped.2025.05.010
Agnès Viguier , Bastien Estublier , Anne-Isabelle Bertozzi , Marion Gambart , Annick Sevely , Nicolas Leboucq , Pierre Antherieu , François Rivier , Pierre Meyer , Didier Bessis , Yves Chaix , Eloïse Baudou
Introduction
Focal areas of signal intensity (FASI) in the posterior fossa are common in children with neurofibromatosis type 1 (NF1). These can be difficult to distinguish from tumour processes when they are atypical. This study aimed to describe the initial radiological features of atypical posterior fossa FASI, depending on the clinical and radiological evolution of the lesion.
Methods
We conducted a multicentre retrospective study of NF1 children with atypical FASI in the posterior fossa. The lesions were classified according to their evolution over time: ‘non-neoplastic FASI’ if they regressed, or ‘possible neoplastic FASI’ if they remained stable or progressed.
Results
Forty-two lesions from 31 patients were analyzed. The mean follow-up period between the first and last MRI scans was 7.1 years. Twenty-one atypical FASI were classified as ‘non-neoplastic FASI’ and 21 as ‘possible neoplastic FASI’. Younger age at diagnosis, pontine location, and blurred contours were more indicative of ‘non-neoplastic FASI’ on the initial MRI, whereas symptomatic, cystic or exophytic lesions, the presence of enhancement after gadolinium injection, sharp contours, and clear mass effect were more indicative of a ‘possible neoplastic FASI’. Unexpectedly, abnormal initial spectroscopy and small mass effect could be found in ‘non-neoplastic FASI’, as could the presence of hypointensity on T1-weighted images.
Conclusion
This study is important in specifying which posterior fossa hyperintensities on T2-weighted MRIs require specific clinical and radiological follow-up.
{"title":"Distinguishing atypical focal areas of signal intensity from probable low-grade gliomas in the posterior fossa of children with neurofibromatosis type 1","authors":"Agnès Viguier , Bastien Estublier , Anne-Isabelle Bertozzi , Marion Gambart , Annick Sevely , Nicolas Leboucq , Pierre Antherieu , François Rivier , Pierre Meyer , Didier Bessis , Yves Chaix , Eloïse Baudou","doi":"10.1016/j.arcped.2025.05.010","DOIUrl":"10.1016/j.arcped.2025.05.010","url":null,"abstract":"<div><h3>Introduction</h3><div>Focal areas of signal intensity (FASI) in the posterior fossa are common in children with neurofibromatosis type 1 (NF1). These can be difficult to distinguish from tumour processes when they are atypical. This study aimed to describe the initial radiological features of atypical posterior fossa FASI, depending on the clinical and radiological evolution of the lesion.</div></div><div><h3>Methods</h3><div>We conducted a multicentre retrospective study of NF1 children with atypical FASI in the posterior fossa. The lesions were classified according to their evolution over time: ‘non-neoplastic FASI’ if they regressed, or ‘possible neoplastic FASI’ if they remained stable or progressed.</div></div><div><h3>Results</h3><div>Forty-two lesions from 31 patients were analyzed. The mean follow-up period between the first and last MRI scans was 7.1 years. Twenty-one atypical FASI were classified as ‘non-neoplastic FASI’ and 21 as ‘possible neoplastic FASI’. Younger age at diagnosis, pontine location, and blurred contours were more indicative of ‘non-neoplastic FASI’ on the initial MRI, whereas symptomatic, cystic or exophytic lesions, the presence of enhancement after gadolinium injection, sharp contours, and clear mass effect were more indicative of a ‘possible neoplastic FASI’. Unexpectedly, abnormal initial spectroscopy and small mass effect could be found in ‘non-neoplastic FASI’, as could the presence of hypointensity on T1-weighted images.</div></div><div><h3>Conclusion</h3><div>This study is important in specifying which posterior fossa hyperintensities on T2-weighted MRIs require specific clinical and radiological follow-up.</div></div>","PeriodicalId":55477,"journal":{"name":"Archives De Pediatrie","volume":"32 7","pages":"Pages 463-468"},"PeriodicalIF":1.3,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144818367","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 : 2025-10-01DOI: 10.1016/j.arcped.2025.05.008
Karinne Gueniche , Dinane Samara-Boustani , Michel Polak
{"title":"Complementary reflections on the paradigm shift in the care of children with genital development variations","authors":"Karinne Gueniche , Dinane Samara-Boustani , Michel Polak","doi":"10.1016/j.arcped.2025.05.008","DOIUrl":"10.1016/j.arcped.2025.05.008","url":null,"abstract":"","PeriodicalId":55477,"journal":{"name":"Archives De Pediatrie","volume":"32 7","pages":"Pages 506-507"},"PeriodicalIF":1.3,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144857011","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 : 2025-10-01DOI: 10.1016/j.arcped.2025.08.004
Hamdy El-Sayed , Hala Elmarsafawy , Basma Shouman , Mostafa Mansour , Amal Osman
Background
Pediatric pulmonary arterial hypertension (PAH) is a potentially fatal disease. New targeted therapies based on the underlying pathogenesis are still needed.
Objective
This study aims to evaluate the role of leukotriene E4, an inflammatory mediator, in developing pediatric pulmonary arterial hypertension (PAH).
Methods and setting
The study included 21 patients with PAH who belonged to group 1 of the international pH classification. PAH was diagnosed via cardiac catheterization. Most patients had PAH associated with congenital heart disease (PAHCHD). The control group comprised 21 healthy participants of matched age and sex. Urinary leukotriene E4 (LTE4) levels were assessed using an enzyme-linked immunosorbent assay.
Results
Urinary LTE4 levels and urinary LTE4 to urinary creatinine ratio were significantly increased among patients compared to healthy controls (p < 0.05). Further, a high combination of sensitivity and specificity was observed for urinary LTE4 with a cut-off level of 35.4pg/ml for predicting PAH.
Conclusion
The significantly elevated urinary LTE4 levels in pediatric patients with PAH can suggest the role of LTE4 as an inflammatory mediator in the disease pathogenesis.
{"title":"Urinary leukotriene E4 in pediatric pulmonary arterial hypertension: a pilot case control study","authors":"Hamdy El-Sayed , Hala Elmarsafawy , Basma Shouman , Mostafa Mansour , Amal Osman","doi":"10.1016/j.arcped.2025.08.004","DOIUrl":"10.1016/j.arcped.2025.08.004","url":null,"abstract":"<div><h3>Background</h3><div>Pediatric pulmonary arterial hypertension (PAH) is a potentially fatal disease. New targeted therapies based on the underlying pathogenesis are still needed.</div></div><div><h3>Objective</h3><div>This study aims to evaluate the role of leukotriene E4, an inflammatory mediator, in developing pediatric pulmonary arterial hypertension (PAH).</div></div><div><h3>Methods and setting</h3><div>The study included 21 patients with PAH who belonged to group 1 of the international pH classification. PAH was diagnosed via cardiac catheterization. Most patients had PAH associated with congenital heart disease (PAH<img>CHD). The control group comprised 21 healthy participants of matched age and sex. Urinary leukotriene E4 (LTE4) levels were assessed using an enzyme-linked immunosorbent assay.</div></div><div><h3>Results</h3><div>Urinary LTE4 levels and urinary LTE4 to urinary creatinine ratio were significantly increased among patients compared to healthy controls (<em>p</em> < 0.05). Further, a high combination of sensitivity and specificity was observed for urinary LTE4 with a cut-off level of 35.4pg/ml for predicting PAH.</div></div><div><h3>Conclusion</h3><div>The significantly elevated urinary LTE4 levels in pediatric patients with PAH can suggest the role of LTE4 as an inflammatory mediator in the disease pathogenesis.</div></div>","PeriodicalId":55477,"journal":{"name":"Archives De Pediatrie","volume":"32 7","pages":"Pages 475-478"},"PeriodicalIF":1.3,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145245565","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}
Spinal dysraphism is a common condition and may be either open or occult. Occult dysraphism is generally diagnosed in the postnatal period through clinical examination and spinal ultrasonography (USG). Clinical signs of spinal dysraphism are common and not specific. Several spinal USG are required to confirm or exclude this condition. It is crucial to identify the infants at highest risk of dysraphism for rapid USG, and avoid unnecessary screening. The aim of the study was to evaluate the relationship between clinical examination signs and spinal USG examination results to determine which clinical signs are associated with a high risk of dysraphism, to facilitate the prioritization of infants for spinal USG examinations.
Patients and Methods
We performed a retrospective cohort study in a regional neurosurgical and neonatal reference center, from January 2017 to December 2021. All infants undergoing screening for spinal dysraphism by USG during this period based on clinical indicators in the lumbosacral region were included. Infants who underwent spinal USG as part of a systematic assessment were excluded. The primary outcome was the incidence of abnormal USG results. The clinical characteristics of patients with suspected dysraphism were collected and compared between groups.
Results
We included 144 patients, 22.2 % USG results were abnormal suggesting occult dysraphism. USG was performed due to the presence of a simple sacral dimple in 41.7 % infants which was strongly associated with a normal USG result (RR = 0.32 95 %CI [0.14 – 0.70]; p = 0.0029), whereas abnormal USG results were more frequent in patients with gluteal cleft abnormalities (RR = 3.09 95 %CI [1.5 – 5.2]; p = 0.0029).
Conclusion: Clinical signs such as sacral dimple or gluteal cleft abnormality could help prioritizing USG. The use of a diagnostic tree based on a “step-by-step” model would make it possible to avoid some unnecessary USG and would allow comparative international studies.
背景：脊柱畸形是一种常见的疾病，可能是开放性的，也可能是隐匿性的。隐匿性发育异常一般在产后通过临床检查和脊柱超声检查（USG）诊断。脊柱发育不良的临床症状是常见的，并不特殊。需要多次脊髓USG来确认或排除这种情况。关键是要确定婴儿的最高风险的异常书写障碍的快速USG，避免不必要的筛选。本研究的目的是评估临床检查体征与脊柱USG检查结果之间的关系，以确定哪些临床体征与异常书写障碍的高风险相关，从而促进婴儿脊柱USG检查的优先级。患者和方法：2017年1月至2021年12月，我们在一家区域性神经外科和新生儿参考中心进行了一项回顾性队列研究。根据腰骶区的临床指标，所有在此期间接受USG筛查脊柱发育异常的婴儿都被纳入其中。将接受脊髓USG作为系统评估的一部分的婴儿排除在外。主要结局是USG结果异常的发生率。收集疑似书写障碍患者的临床特征，并进行组间比较。结果：144例患者中，22.2%的USG结果异常提示有隐匿性异常。41.7%的婴儿由于单纯骶窝的存在而进行USG检查，这与USG结果正常密切相关（RR = 0.32 95% CI [0.14 - 0.70]; p = 0.0029），而臀裂异常患者USG结果异常更为常见（RR = 3.09 95% CI [1.5 - 5.2]; p = 0.0029）。结论：骶窝或臀裂异常等临床症状可帮助确定USG的优先级。使用基于“一步一步”模型的诊断树将有可能避免一些不必要的USG，并允许进行比较国际研究。
{"title":"Spinal dysraphism in newborns: Screening factors for prioritizing rapid spinal ultrasonography from a retrospective cohort study","authors":"Lorena Wagnez , Mélodie-Anne Karnoub , Thameur Rakza , Constance Marié , Pierre Tourneux","doi":"10.1016/j.arcped.2025.07.003","DOIUrl":"10.1016/j.arcped.2025.07.003","url":null,"abstract":"<div><h3>Background</h3><div>Spinal dysraphism is a common condition and may be either open or occult. Occult dysraphism is generally diagnosed in the postnatal period through clinical examination and spinal ultrasonography (USG). Clinical signs of spinal dysraphism are common and not specific. Several spinal USG are required to confirm or exclude this condition. It is crucial to identify the infants at highest risk of dysraphism for rapid USG, and avoid unnecessary screening. The aim of the study was to evaluate the relationship between clinical examination signs and spinal USG examination results to determine which clinical signs are associated with a high risk of dysraphism, to facilitate the prioritization of infants for spinal USG examinations.</div></div><div><h3>Patients and Methods</h3><div>We performed a retrospective cohort study in a regional neurosurgical and neonatal reference center, from January 2017 to December 2021. All infants undergoing screening for spinal dysraphism by USG during this period based on clinical indicators in the lumbosacral region were included. Infants who underwent spinal USG as part of a systematic assessment were excluded. The primary outcome was the incidence of abnormal USG results. The clinical characteristics of patients with suspected dysraphism were collected and compared between groups.</div></div><div><h3>Results</h3><div>We included 144 patients, 22.2 % USG results were abnormal suggesting occult dysraphism. USG was performed due to the presence of a simple sacral dimple in 41.7 % infants which was strongly associated with a normal USG result (RR = 0.32 <sub>95 %</sub>CI [0.14 – 0.70]; <em>p</em> = 0.0029), whereas abnormal USG results were more frequent in patients with gluteal cleft abnormalities (RR = 3.09 <sub>95 %</sub>CI [1.5 – 5.2]; <em>p</em> = 0.0029).</div><div><em>Conclusion</em>: Clinical signs such as sacral dimple or gluteal cleft abnormality could help prioritizing USG. The use of a diagnostic tree based on a “step-by-step” model would make it possible to avoid some unnecessary USG and would allow comparative international studies.</div></div>","PeriodicalId":55477,"journal":{"name":"Archives De Pediatrie","volume":"32 7","pages":"Pages 492-496"},"PeriodicalIF":1.3,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145276639","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 : 2025-10-01DOI: 10.1016/j.arcped.2025.06.005
Eric Moreddu , Audrey Gallucci , Grégoire Pech-Gourg , Julie Mazenq , Richard Nicollas
Introduction
Syndromic faciocraniosynostoses are malformations of the skull and face caused by premature closure of one or more cranial sutures, characterized by hypoplasia of the maxilla, leading to upper airway obstruction.
Objective
The aim is to provide a comprehensive review on the management of upper ventilatory disorders in the context of craniosynostosis.
Methods and results
Initial management should look for upper airway obstruction through questioning, clinical examination with flexible laryngoscopy, and, if in doubt, sleep recording to look for obstructive sleep-disordered breathing. Treatment consists of re-establishing airway patency through non-surgical treatments such as non-invasive ventilation and correcting the obstruction through various surgical procedures: fronto-facial advancement, adenoidectomy, turbinoplasty, septoplasty, etc. A tracheotomy may be necessary during early childhood, pending permeabilization of the upper airways. The age at which surgery is performed varies, depending on the individual patient, and it is not uncommon for patients to require surgery in adulthood, either as part of the initial management or for additional surgeries to improve obstruction.
Conclusion
The multidisciplinary approach is the key for managing craniosynostoses, from diagnosis to treatment, from childhood to adulthood.
{"title":"Management of upper airway obstruction in syndromic craniosynostosis: A lifespan approach from childhood to adulthood","authors":"Eric Moreddu , Audrey Gallucci , Grégoire Pech-Gourg , Julie Mazenq , Richard Nicollas","doi":"10.1016/j.arcped.2025.06.005","DOIUrl":"10.1016/j.arcped.2025.06.005","url":null,"abstract":"<div><h3>Introduction</h3><div>Syndromic faciocraniosynostoses are malformations of the skull and face caused by premature closure of one or more cranial sutures, characterized by hypoplasia of the maxilla, leading to upper airway obstruction.</div></div><div><h3>Objective</h3><div>The aim is to provide a comprehensive review on the management of upper ventilatory disorders in the context of craniosynostosis.</div></div><div><h3>Methods and results</h3><div>Initial management should look for upper airway obstruction through questioning, clinical examination with flexible laryngoscopy, and, if in doubt, sleep recording to look for obstructive sleep-disordered breathing. Treatment consists of re-establishing airway patency through non-surgical treatments such as non-invasive ventilation and correcting the obstruction through various surgical procedures: fronto-facial advancement, adenoidectomy, turbinoplasty, septoplasty, etc. A tracheotomy may be necessary during early childhood, pending permeabilization of the upper airways. The age at which surgery is performed varies, depending on the individual patient, and it is not uncommon for patients to require surgery in adulthood, either as part of the initial management or for additional surgeries to improve obstruction.</div></div><div><h3>Conclusion</h3><div>The multidisciplinary approach is the key for managing craniosynostoses, from diagnosis to treatment, from childhood to adulthood.</div></div>","PeriodicalId":55477,"journal":{"name":"Archives De Pediatrie","volume":"32 7","pages":"Pages 433-436"},"PeriodicalIF":1.3,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145253938","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}
Hypoglycemia can be a major obstacle to obtaining satisfactory metabolic control for patients with type 1 diabetes (T1D) and their parents. It is essential that patients and/or parents with fear of hypoglycemia be identified (FOH), to offer them therapeutic or educational support to reduce this apprehension. To assess fear of hypoglycemia, the most widely used tool is the Hypoglycemia Fear Survey (HFS), and its three pediatric versions (HFS-Child (HFS-C), HFS-Parents (HFS-P), and HFS-Parents Young Children (HFS-PYC)). There are no similar validated questionnaires in French to assess fear of hypoglycemia. Our main objective was to translate and validate the French translation of the three pediatric versions of the HFS.
Between January 2017 and December 2020, we carried out a prospective, non-interventional, multicenter, cross-sectional psychometric study in children with T1D and their parents, the aim of which was to translate and validate the French version of these surveys. The pediatric HFS were translated and adapted to French, using the forward-backward translation method. The psychometric propriety of the resulting questionnaires was then evaluated: internal consistency (Cronbach’s alpha), concurrent validity (correlating a validated survey assessing anxiety about diabetes), and stability (by means of scale scores at inclusion and at 3 months).
The internal consistency of the French version of HFS-C, HFS-P and HFS-PYC was very good, with respective Cronbach coefficients of 0.86, 0.85 and 0.90. There were no differences between the Hypoglycemia Fear Survey at inclusion and at 3 months. Each French version was correlated with the anxiety questionnaire.
With this study, we developed a French translation of the three pediatric versions of the Hypoglycemia Fear Survey, which can be used to assess the fear of hypoglycemia in children with T1D and their parents.
对于1型糖尿病（T1D）患者及其父母来说，低血糖可能是获得满意代谢控制的主要障碍。确定有低血糖恐惧的患者和/或家长（FOH），为他们提供治疗或教育支持以减少这种恐惧是至关重要的。为了评估对低血糖的恐惧，最广泛使用的工具是低血糖恐惧调查（HFS），以及它的三个儿科版本(HFS- child （HFS- c), HFS- parents （HFS- p）和HFS- parents Young Children (HFS- pyc)）。法国没有类似的有效问卷来评估对低血糖的恐惧。我们的主要目标是翻译和验证三个儿科版本的HFS的法语翻译。在2017年1月至2020年12月期间，我们对T1D儿童及其父母进行了一项前瞻性、非干预性、多中心、横断面心理测量研究，目的是翻译和验证这些调查的法语版本。将儿童HFS翻译并改编为法语，采用前向向后翻译方法。然后评估结果问卷的心理测量性：内部一致性（Cronbach's alpha），并发效度（与评估糖尿病焦虑的有效调查相关）和稳定性（通过纳入和3个月时的量表得分）。法国版HFS-C、HFS-P和HFS-PYC的内部一致性很好，Cronbach系数分别为0.86、0.85和0.90。低血糖恐惧调查在入组时和3个月时没有差异。每个法语版本都与焦虑问卷相关。在这项研究中，我们开发了三个儿科版本的低血糖恐惧调查的法语翻译，可用于评估T1D儿童及其父母对低血糖的恐惧。
{"title":"Validation of French versions of scales for evaluating the fear of hypoglycemia in children with type 1 diabetes and their parents","authors":"Lénaig Coustans , Solène Collay , Chantal Metz , Loïc de Parscau , Elise Bismuth , Luc Ollivier , Raphael Teissier , AJD (Aide aux Jeunes Diabétiques)","doi":"10.1016/j.arcped.2025.03.008","DOIUrl":"10.1016/j.arcped.2025.03.008","url":null,"abstract":"<div><div>Hypoglycemia can be a major obstacle to obtaining satisfactory metabolic control for patients with type 1 diabetes (T1D) and their parents. It is essential that patients and/or parents with fear of hypoglycemia be identified (FOH), to offer them therapeutic or educational support to reduce this apprehension. To assess fear of hypoglycemia, the most widely used tool is the Hypoglycemia Fear Survey (HFS), and its three pediatric versions (HFS-Child (HFS-C), HFS-Parents (HFS-P), and HFS-Parents Young Children (HFS-PYC)). There are no similar validated questionnaires in French to assess fear of hypoglycemia. Our main objective was to translate and validate the French translation of the three pediatric versions of the HFS.</div><div>Between January 2017 and December 2020, we carried out a prospective, non-interventional, multicenter, cross-sectional psychometric study in children with T1D and their parents, the aim of which was to translate and validate the French version of these surveys. The pediatric HFS were translated and adapted to French, using the forward-backward translation method. The psychometric propriety of the resulting questionnaires was then evaluated: internal consistency (Cronbach’s alpha), concurrent validity (correlating a validated survey assessing anxiety about diabetes), and stability (by means of scale scores at inclusion and at 3 months).</div><div>The internal consistency of the French version of HFS-C, HFS-P and HFS-PYC was very good, with respective Cronbach coefficients of 0.86, 0.85 and 0.90. There were no differences between the Hypoglycemia Fear Survey at inclusion and at 3 months. Each French version was correlated with the anxiety questionnaire.</div><div>With this study, we developed a French translation of the three pediatric versions of the Hypoglycemia Fear Survey, which can be used to assess the fear of hypoglycemia in children with T1D and their parents.</div></div>","PeriodicalId":55477,"journal":{"name":"Archives De Pediatrie","volume":"32 7","pages":"Pages 450-455"},"PeriodicalIF":1.3,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145253987","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 : 2025-10-01DOI: 10.1016/j.arcped.2025.05.011
Marina Vincent , Laure Ponthier , Thierry Chianea , Céline Menetrey , Chahrazed El Hamel , Vincent Guigonis
Background
Numerous studies have reported an atopic background in patients with idiopathic nephrotic syndrome. Proteinuria has also been reported in allergic patients, but in a limited number of studies, and most of them with a low level of evidence. If confirmed, the presence of proteinuria in allergic children could be a clue to approach the pathophysiology of idiopathic nephrotic syndrome.
Objective
We therefore performed a prospective study to compare the urine protein levels in allergic and non-allergic children.
Methods and setting
Urine samples were collected from 190 children suspected of having allergies. Total urinary protein, albumin, and creatinine levels were measured. After completing the allergological analysis, patients were divided into allergic and non-allergic groups.
Results
In the allergic group (n = 97), four children (4.1 %) were proteinuric compared to five (5.4 %) in the non-allergic patients (n = 93). Eleven children (11.3 %) were albuminuric versus eight (8.6 %), in the allergic and non-allergic groups respectively. Therefore, no significant differences were observed in proteinuria or albuminuria between allergic and non-allergic children.
Conclusion
The lack of increased prevalence of proteinuria in allergic patients does not support a strong pathophysiological hypothesis linking allergy to idiopathic nephrotic syndrome through the presence of asymptomatic pathological proteinuria in allergic patients. Other hypotheses still need to be explored to analyze the possible association between idiopathic nephrotic syndrome and allergy.
{"title":"Proteinuria and albuminuria prevalence in allergic children","authors":"Marina Vincent , Laure Ponthier , Thierry Chianea , Céline Menetrey , Chahrazed El Hamel , Vincent Guigonis","doi":"10.1016/j.arcped.2025.05.011","DOIUrl":"10.1016/j.arcped.2025.05.011","url":null,"abstract":"<div><h3>Background</h3><div>Numerous studies have reported an atopic background in patients with idiopathic nephrotic syndrome. Proteinuria has also been reported in allergic patients, but in a limited number of studies, and most of them with a low level of evidence. If confirmed, the presence of proteinuria in allergic children could be a clue to approach the pathophysiology of idiopathic nephrotic syndrome.</div></div><div><h3>Objective</h3><div>We therefore performed a prospective study to compare the urine protein levels in allergic and non-allergic children.</div></div><div><h3>Methods and setting</h3><div>Urine samples were collected from 190 children suspected of having allergies. Total urinary protein, albumin, and creatinine levels were measured. After completing the allergological analysis, patients were divided into allergic and non-allergic groups.</div></div><div><h3>Results</h3><div>In the allergic group (<em>n</em> = 97), four children (4.1 %) were proteinuric compared to five (5.4 %) in the non-allergic patients (<em>n</em> = 93). Eleven children (11.3 %) were albuminuric versus eight (8.6 %), in the allergic and non-allergic groups respectively. Therefore, no significant differences were observed in proteinuria or albuminuria between allergic and non-allergic children.</div></div><div><h3>Conclusion</h3><div>The lack of increased prevalence of proteinuria in allergic patients does not support a strong pathophysiological hypothesis linking allergy to idiopathic nephrotic syndrome through the presence of asymptomatic pathological proteinuria in allergic patients. Other hypotheses still need to be explored to analyze the possible association between idiopathic nephrotic syndrome and allergy.</div></div>","PeriodicalId":55477,"journal":{"name":"Archives De Pediatrie","volume":"32 7","pages":"Pages 469-474"},"PeriodicalIF":1.3,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144838657","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 : 2025-10-01DOI: 10.1016/j.arcped.2025.06.007
Chloé Andres , Lukas Widmann
Introduction
Scuba diving is becoming increasingly popular worldwide, including among children and adolescents. This activity carries risks and potential accidents. Differences in anatomy, psychology, and human physiology between adults and children must be considered, leading to specific recommendations for scuba diving for young people.
Methods and results
Contra-indications should be known by the dive physician and in this article we compare recommendations of different countries, leading diving organizations (PADI (Professional Association of Diving Instructors) and SSI (Scuba Schools International)) to the French recommendations. The lack of homogeneous international recommendations and limited evidence-based data result in significantly different recommendations.
Conclusion
It seems necessary to inform general practitioners and pediatricians, mostly without experience in diving medicine, about the key physiological effects of scuba diving and the main differences in physiology between adults and children or teenagers. This is essential to ensure proper medical examinations and certification.
{"title":"Scuba diving of children: A global review","authors":"Chloé Andres , Lukas Widmann","doi":"10.1016/j.arcped.2025.06.007","DOIUrl":"10.1016/j.arcped.2025.06.007","url":null,"abstract":"<div><h3>Introduction</h3><div>Scuba diving is becoming increasingly popular worldwide, including among children and adolescents. This activity carries risks and potential accidents. Differences in anatomy, psychology, and human physiology between adults and children must be considered, leading to specific recommendations for scuba diving for young people.</div></div><div><h3>Methods and results</h3><div>Contra-indications should be known by the dive physician and in this article we compare recommendations of different countries, leading diving organizations (PADI (Professional Association of Diving Instructors) and SSI (Scuba Schools International)) to the French recommendations. The lack of homogeneous international recommendations and limited evidence-based data result in significantly different recommendations.</div></div><div><h3>Conclusion</h3><div>It seems necessary to inform general practitioners and pediatricians, mostly without experience in diving medicine, about the key physiological effects of scuba diving and the main differences in physiology between adults and children or teenagers. This is essential to ensure proper medical examinations and certification.</div></div>","PeriodicalId":55477,"journal":{"name":"Archives De Pediatrie","volume":"32 7","pages":"Pages 437-443"},"PeriodicalIF":1.3,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145245348","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 : 2025-10-01DOI: 10.1016/j.arcped.2025.05.012
Katarzyna Rakoczy , Justyna Kaczor , Adam Sołtyk , Iga Mastalska , Małgorzata Saczko , Julita Kulbacka
Background
Even though society wants to eradicate the pandemic of SARS-CoV-2, people are distrustful of the vaccination program, especially regarding children. Moreover, parents are becoming increasingly skeptical about vaccinating their children.
Objectives
This study aims to identify the reasons for this distrust and thus discover novel ways to raise societal awareness of the importance of vaccination.
Methods and setting
The study was based on the results of an online questionnaire survey prepared by the authors and conducted in Poland. The survey was addressed to parents of children aged 5–11.
Results
The study recruited 1263 parents of children aged 5–11 who completed the questionnaire correctly. Among those, 34.28 % confirmed that they did or planned to vaccinate their children. More than half of the responders were parents who declared that they had not vaccinated their children and would not do that in the future (52.02 %), whereas 13.7 % of parents had not yet decided whether they would vaccinate their children. Parents who declared their children were not vaccinated against SARS-CoV-2 exhibited a predisposition to highly negative attitudes towards vaccination in general, which negated their safety and efficacy. The majority (73.93 %) of those non-vaccinating parents believed that vaccines endanger the health and life of children. Some also feared severe adverse reactions (33.84 %) and expressed that it would be better for children to be immunized by getting over the disease (28.05 %).
Conclusions
Negative opinions about vaccinating children against SARS-CoV-2 derive from misunderstanding the immune system mechanisms and the vaccination purpose. For this reason, information regarding the safety and value of the COVID-19 vaccine and vaccines in general should be more widely publicized.
{"title":"Vaccinating children against SARS-CoV-2 - parents' attitude","authors":"Katarzyna Rakoczy , Justyna Kaczor , Adam Sołtyk , Iga Mastalska , Małgorzata Saczko , Julita Kulbacka","doi":"10.1016/j.arcped.2025.05.012","DOIUrl":"10.1016/j.arcped.2025.05.012","url":null,"abstract":"<div><h3>Background</h3><div>Even though society wants to eradicate the pandemic of SARS-CoV-2, people are distrustful of the vaccination program, especially regarding children. Moreover, parents are becoming increasingly skeptical about vaccinating their children.</div></div><div><h3>Objectives</h3><div>This study aims to identify the reasons for this distrust and thus discover novel ways to raise societal awareness of the importance of vaccination.</div></div><div><h3>Methods and setting</h3><div>The study was based on the results of an online questionnaire survey prepared by the authors and conducted in Poland. The survey was addressed to parents of children aged 5–11.</div></div><div><h3>Results</h3><div>The study recruited 1263 parents of children aged 5–11 who completed the questionnaire correctly. Among those, 34.28 % confirmed that they did or planned to vaccinate their children. More than half of the responders were parents who declared that they had not vaccinated their children and would not do that in the future (52.02 %), whereas 13.7 % of parents had not yet decided whether they would vaccinate their children. Parents who declared their children were not vaccinated against SARS-CoV-2 exhibited a predisposition to highly negative attitudes towards vaccination in general, which negated their safety and efficacy. The majority (73.93 %) of those non-vaccinating parents believed that vaccines endanger the health and life of children. Some also feared severe adverse reactions (33.84 %) and expressed that it would be better for children to be immunized by getting over the disease (28.05 %).</div></div><div><h3>Conclusions</h3><div>Negative opinions about vaccinating children against SARS-CoV-2 derive from misunderstanding the immune system mechanisms and the vaccination purpose. For this reason, information regarding the safety and value of the COVID-19 vaccine and vaccines in general should be more widely publicized.</div></div>","PeriodicalId":55477,"journal":{"name":"Archives De Pediatrie","volume":"32 7","pages":"Pages 479-486"},"PeriodicalIF":1.3,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145260076","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
扫码关注我们
求助内容：
应助结果提醒方式：
京公网安备 11010802042870号