Archives De Pediatrie最新文献_第7页

Spinal dysraphism in newborns: Screening factors for prioritizing rapid spinal ultrasonography from a retrospective cohort study 新生儿脊柱发育异常：从回顾性队列研究中筛选优先进行快速脊柱超声检查的因素。

IF 1.3 4区医学 Q3 PEDIATRICS

Archives De Pediatrie

Pub Date : 2025-10-01 DOI: 10.1016/j.arcped.2025.07.003

Lorena Wagnez , Mélodie-Anne Karnoub , Thameur Rakza , Constance Marié , Pierre Tourneux

Background

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。

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引用次数: 0

Management of upper airway obstruction in syndromic craniosynostosis: A lifespan approach from childhood to adulthood 综合征性颅缝闭闭患者上气道阻塞的处理：从儿童期到成年期的终身方法。

IF 1.3 4区医学 Q3 PEDIATRICS

Archives De Pediatrie

Pub Date : 2025-10-01 DOI: 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.

简介：综合征型面颅缝闭是由于一条或多条颅缝过早闭合而引起的颅骨和面部畸形，其特征是上颌骨发育不全，导致上气道阻塞。目的：对颅缝闭合症的上呼吸系统疾病的治疗进行综述。方法和结果：早期治疗应通过询问寻找上呼吸道阻塞，在柔性喉镜下进行临床检查，如有疑问，记录睡眠以寻找阻塞性睡眠呼吸障碍。治疗包括通过无创通气等非手术治疗重建气道通畅，以及通过各种外科手术纠正梗阻：额面推进、腺样体切除术、鼻甲成形术、鼻中隔成形术等。在儿童早期可能需要气管切开术，等待上呼吸道的通透性。进行手术的年龄因患者个体而异，并且患者在成年期需要手术的情况并不罕见，无论是作为初始治疗的一部分，还是为了改善梗阻而进行的额外手术。结论：从诊断到治疗，从儿童期到成年期，多学科结合是治疗颅缝闭锁的关键。

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引用次数: 0

Validation of French versions of scales for evaluating the fear of hypoglycemia in children with type 1 diabetes and their parents 评估1型糖尿病儿童及其父母对低血糖恐惧的法语版本量表的验证

IF 1.3 4区医学 Q3 PEDIATRICS

Archives De Pediatrie

Pub Date : 2025-10-01 DOI: 10.1016/j.arcped.2025.03.008

Lénaig Coustans , Solène Collay , Chantal Metz , Loïc de Parscau , Elise Bismuth , Luc Ollivier , Raphael Teissier , AJD (Aide aux Jeunes Diabétiques)

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。

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引用次数: 0

Proteinuria and albuminuria prevalence in allergic children 过敏性儿童蛋白尿和白蛋白尿患病率。

IF 1.3 4区医学 Q3 PEDIATRICS

Archives De Pediatrie

Pub Date : 2025-10-01 DOI: 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.

背景：大量研究报道了特发性肾病综合征患者的特应性背景。过敏患者中也有蛋白尿的报道，但研究数量有限，而且大多数研究的证据水平很低。如果得到证实，过敏性儿童蛋白尿的存在可能是探讨特发性肾病综合征病理生理学的线索。目的：因此，我们进行了一项前瞻性研究，比较过敏和非过敏儿童的尿蛋白水平。方法和背景：收集了190例疑似过敏患儿的尿液样本。测定尿总蛋白、白蛋白和肌酐水平。完成过敏分析后，将患者分为过敏组和非过敏组。结果：过敏组（n = 97） 4例（4.1%）出现蛋白尿，非过敏组（n = 93） 5例（5.4%）出现蛋白尿。过敏组和非过敏组分别有11例（11.3%）和8例（8.6%）出现蛋白尿。因此，过敏儿童和非过敏儿童在蛋白尿和白蛋白尿方面没有显著差异。结论：在过敏患者中蛋白尿的患病率没有增加，这并不支持一个强有力的病理生理学假说，即通过在过敏患者中无症状的病理性蛋白尿，将过敏与特发性肾病综合征联系起来。特发性肾病综合征与过敏之间可能存在的关联尚需进一步探讨。

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引用次数: 0

Scuba diving of children: A global review 儿童水肺潜水：全球综述。

IF 1.3 4区医学 Q3 PEDIATRICS

Archives De Pediatrie

Pub Date : 2025-10-01 DOI: 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.

水肺潜水在世界范围内越来越受欢迎，包括儿童和青少年。这种活动有风险和潜在的事故。必须考虑到成人和儿童在解剖学、心理学和人体生理学上的差异，因此对年轻人的水肺潜水提出了具体的建议。方法和结果：潜水医生应该知道禁忌症，在这篇文章中，我们比较了不同国家的建议，主要的潜水组织（PADI（专业潜水教练协会）和SSI（国际水肺学校））和法国的建议。缺乏同质的国际建议和有限的基于证据的数据导致了显著不同的建议。结论：有必要告知全科医生和儿科医生，他们大多没有潜水医学经验，了解水肺潜水的主要生理作用以及成人与儿童或青少年在生理上的主要差异。这对确保适当的医疗检查和证明至关重要。

引用次数: 0

Vaccinating children against SARS-CoV-2 - parents' attitude 为儿童接种SARS-CoV-2疫苗——家长的态度。

IF 1.3 4区医学 Q3 PEDIATRICS

Archives De Pediatrie

Pub Date : 2025-10-01 DOI: 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.

背景：尽管社会希望根除SARS-CoV-2大流行，但人们对疫苗接种计划，特别是对儿童的疫苗接种计划持怀疑态度。此外，父母对给孩子接种疫苗越来越持怀疑态度。目的：本研究旨在确定这种不信任的原因，从而发现新的方法来提高社会对疫苗接种重要性的认识。方法和背景：该研究基于作者准备并在波兰进行的在线问卷调查的结果。调查对象是5-11岁儿童的父母。结果：本研究共招募了1263名5-11岁儿童的家长，他们正确填写了问卷。其中34.28%的人确认已经或计划为子女接种疫苗。超过一半的应答者是父母，他们宣称他们没有给孩子接种疫苗，将来也不会这样做（52.02%），而13.7%的父母尚未决定是否给孩子接种疫苗。那些声称自己的孩子没有接种过SARS-CoV-2疫苗的父母通常对疫苗接种持高度负面态度，这否定了疫苗接种的安全性和有效性。未接种疫苗的家长中，大多数（73.93%）认为疫苗危害儿童健康和生命。还有一些人担心严重的不良反应（33.84%），并表示最好让孩子克服疾病进行免疫接种（28.05%）。结论：对儿童接种SARS-CoV-2疫苗的负面看法源于对免疫系统机制和接种目的的误解。因此，有关COVID-19疫苗和一般疫苗的安全性和价值的信息应更广泛地宣传。

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引用次数: 0

How to start prophylaxis in untreated children with severe and moderate haemophilia in 2025, opinion of paediatricians from the French Society of Thrombosis and Haemostasis 法国血栓和止血学会儿科医生的意见：2025年，如何在未治疗的重度和中度血友病患儿中开始预防。

IF 1.3 4区医学 Q3 PEDIATRICS

Archives De Pediatrie

Pub Date : 2025-10-01 DOI: 10.1016/j.arcped.2025.08.002

Alexandre Theron , Olivia Pineau , Sophie Bayart , Caroline Oudot , Sandrine Meunier , pediatric group of French Society of Thrombosis and Haemostasis

Hemophilia is the most prevalent constitutional bleeding disorder. Management of severe and moderate hemophilia has completely evolved in recent years due to major therapeutic innovations, such as antihemophilic factors with a prolonged half-life and non-substituted treatments, particularly emicizumab. Initial treatment takes place as early as possible in infancy to limit bleeding incidents and their consequences. In light of recent therapeutic changes, the pediatricians of the French Society of Thrombosis and Hemostasis have therefore carried out a national practice survey. Based on the survey results and a literature review, this article proposes suggestions for the initial management, prophylaxis, and monitoring of children with severe or moderate hemophilia. We recommend establishing early and long-term prophylaxis for all patients with severe or moderate hemophilia and a severe phenotype who have not been previously treated. The choice of treatment and prophylaxis regimen should be made through a shared decision-making process with the family. Close monitoring is recommended after prophylactic treatment initiation.

血友病是最常见的体质出血性疾病。近年来，由于主要的治疗创新，如半衰期延长的抗血友病因子和非替代治疗，特别是emicizumab，严重和中度血友病的管理已经完全发展。在婴儿期尽早进行初步治疗，以限制出血事件及其后果。鉴于最近的治疗变化，法国血栓和止血学会的儿科医生因此开展了一项全国实践调查。根据调查结果和文献综述，本文提出了对重度或中度血友病患儿的初步管理、预防和监测建议。我们建议对以前未接受过治疗的所有严重或中度血友病和严重表型患者建立早期和长期预防措施。治疗和预防方案的选择应与家庭共同决策。建议在开始预防性治疗后密切监测。

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引用次数: 0

« Certain » and « probable » shaken baby syndrome according to the HAS diagnostic criteria: a different neurological prognosis? 根据HAS诊断标准的“一定”和“可能”摇晃婴儿综合征：不同的神经预后？

IF 1.3 4区医学 Q3 PEDIATRICS

Archives De Pediatrie

Pub Date : 2025-10-01 DOI: 10.1016/j.arcped.2025.07.005

Auréliane Dantin , Sofia Guernouche , Sylvie Lorthois-Ninou , Vincent Des Portes , Etienne Javouhey , Carmine Mottolese , Laurence Lion-François , Federico Di Rocco

Objectives

The diagnosis of shaken baby syndrome (SBS) is difficult; the French High Authority for Health called “Haute Autorité de Santé” (HAS) introduced clinical and radiological criteria in 2017 to classify the diagnosis as “certain" or “probable." The aim of this study is to compare the clinical evolution of children with “certain" and “probable” diagnosis criteria of SBS.

Methods

Records of patients with a diagnosis of SBS according to HAS criteria, aged 1 to 16 months, admitted to a University Hospital between January 1st, 2008, and March 31st, 2018, were retrospectively analysed. Medical follow-up data were collected until December 31st, 2019. The primary endpoint was the Glasgow Outcome Scale (GOS) score at the end of hospitalization: the evolution was “favourable" if the GOS was equal to 5, and “unfavourable" if the GOS was lower than 5.

Results

107 children were included. The mortality rate was 10 %. There was no significant difference in the GOS score at the end of hospitalization between children with “certain" diagnosis and those with “probable" diagnosis (p = 0.75). There was no significant difference at last follow-up between these two groups. Among the children with an “unfavourable" outcome, 68 % had psychomotor developmental delay, 57 % had motor sequelae, 38 % had visual impairments and 36 % had epilepsy. Among those with a “favourable" outcome, 31 % had language disorders and 13 % had learning disorders. The GOS score at the end of follow-up was identical to the GOS at the end of hospitalization for 76 % of patients. It had improved for 14 % of the patients and had deteriorated for 10 % of the patients.

Conclusions

The “certain" or “probable" diagnosis of SBS according to HAS criteria does not modify the risk of sequelae during follow-up. Mortality and morbidity remain significant. Multidisciplinary management and specialized medical long-term follow-up are essential in both conditions.

目的：摇晃婴儿综合征（SBS）诊断困难；2017年，法国卫生高级管理局（Haute autorit de sant， HAS）引入了临床和放射学标准，将诊断分为“确定”或“可能”。本研究的目的是比较具有SBS“确定”和“可能”诊断标准的儿童的临床演变。方法：回顾性分析2008年1月1日至2018年3月31日在某大学医院收治的符合HAS标准的1 ~ 16个月SBS患者的记录。医学随访数据收集至2019年12月31日。主要终点是住院结束时的格拉斯哥结局量表（GOS）评分：如果GOS等于5，则演变为“有利”，如果GOS低于5，则为“不利”。结果：共纳入107例患儿。死亡率为10%。“确定”诊断患儿与“可能”诊断患儿住院结束时GOS评分差异无统计学意义（p = 0.75）。两组在最后随访时无显著差异。在“不良”结果的儿童中，68%有精神运动发育迟缓，57%有运动后遗症，38%有视力障碍，36%有癫痫。在结果“良好”的患者中，31%有语言障碍，13%有学习障碍。随访结束时的GOS评分与76%患者住院结束时的GOS评分相同。14%的患者病情好转，10%的患者病情恶化。结论：根据HAS标准对SBS的“确定”或“可能”诊断并不能改变随访期间发生后遗症的风险。死亡率和发病率仍然很高。在这两种情况下，多学科管理和专门的医疗长期随访是必不可少的。

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引用次数: 0

Esophageal atresia in three overseas departments compared with metropolitan France 国外三个科室食管闭锁与法国大都市比较。

IF 1.3 4区医学 Q3 PEDIATRICS

Archives De Pediatrie

Pub Date : 2025-08-01 DOI: 10.1016/j.arcped.2025.03.004

M. Battini , R. Maximilien-François , A. Paygambar , C. Laplace , M-E. Gatibelza , C. Trabanino , H. Coridon , C. Tolg , P. Grall , P. Guemaleu , A. Sika , R. Sfeir , F. Gottrand

Background

Esophageal atresia (EA) is a rare defect in esophageal continuity, frequently associated with tracheoesophageal fistula. Data on EA in children from French Guiana and the French West Indies are lacking. Objectives: The objective of this study was to compare characteristics and outcomes between patients with EA in three French Departments in the Americas (DFAs) and a cohort from metropolitan France.

Methods and settings

This was a retrospective, multicenter descriptive study of all children born with EA in French Guiana, Martinique, or Guadeloupe between 2008 and early 2021. Data were extracted from the French register (from 38 French medical centers), which records characteristics and outcomes from the prenatal period through 1 year of age (with two questionnaires centralized by the National Reference Center for Esophageal Anomalies through an exhaustive search using several methods, with double-checking and verification). The characteristics of infants from the three DFAs were compared with those from metropolitan France.

Results

Overall, 39 children from the DFAs were included, among whom 36 had surgery at a median age of 3 days postnatally (0–81 days). At 1 year of age, eight children (21 %) had died and seven were lost to follow-up. There were no differences among the DFAs regarding mortality (p = 0.318) or morbidity, apart from a greater rate of loss to follow-up in French Guiana than in Guadeloupe (p < 0.01). Compared with metropolitan France (total of 2205 children; 1960 children with an anastomosis, 97 children died at 1 year of age), children from the DFAs had higher rates of complications (36 % vs. 24 % in metropolitan France, p = 0.04), higher mortality (21 % vs. 4 % in metropolitan France, p < 0.01), and fewer rehospitalizations per child (1 vs. 2 in metropolitan France, p < 0.01).

Conclusion

The three overseas groups have similar characteristics and outcomes but significantly higher morbidity and mortality rates compared with metropolitan France.

背景：食管闭锁（EA）是一种罕见的食管连续性缺陷，常伴有气管食管瘘。关于法属圭亚那和法属西印度群岛儿童EA的数据缺乏。目的：本研究的目的是比较美洲三个法国部门（dfa）和来自法国大都市的队列的EA患者的特征和结局。方法和背景：这是一项回顾性、多中心描述性研究，纳入2008年至2021年初在法属圭亚那、马提尼克岛或瓜德罗普岛出生的所有EA患儿。数据提取自法国登记册（来自38个法国医疗中心），记录了从产前到1岁的特征和结果（其中两份问卷由国家食管异常参考中心集中，通过多种方法进行了详尽的搜索，并进行了双重检查和验证）。将三个地区的婴儿特征与法国大城市的婴儿特征进行比较。结果：总的来说，39名来自dfa的儿童被纳入，其中36名在出生后3天（0-81天）的中位年龄进行了手术。在1岁时，8名儿童（21%）死亡，7名儿童失去随访。dfa在死亡率（p = 0.318）或发病率方面没有差异，除了法属圭亚那的随访失失率高于瓜德罗普岛（p < 0.01）。与法国大都市相比(总共2205名儿童；吻合口的儿童1960例，97例1岁死亡)，dfa儿童的并发症发生率较高（36%对24%，法国大城市，p = 0.04），死亡率较高（21%对4%，p < 0.01），每名儿童再住院率较低（1对2，法国大城市，p < 0.01）。结论：与法国本土患者相比，海外三组患者的特点和结局相似，但发病率和死亡率明显高于法国本土患者。

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引用次数: 0

Traveling children: Current situation and compliance with hepatitis A vaccination recommendations 旅行儿童：现状和对甲型肝炎疫苗接种建议的遵守情况。

IF 1.3 4区医学 Q3 PEDIATRICS

Archives De Pediatrie

Pub Date : 2025-08-01 DOI: 10.1016/j.arcped.2025.05.002

Cassandra Varoqui , Franck Thollot

Context

Vaccination of traveling children does not seem to be the primary concern for families when preparing for a trip abroad. Few data concerning the hepatitis A vaccine are available in minors traveling outside France.

Objectives

The present study aimed to assess whether the vaccination recommendation against hepatitis A was followed in the population of children traveling outside of France. The secondary objectives were to explore the reasons for non-compliance with vaccination recommendations and assess the frequency of minors travelling abroad in the study settings.

Population and methods

This was a monocentric observational study conducted within a pediatric practice located in the Nancy metropolitan area through the distribution of a questionnaire upon arrival in the waiting room. Inclusion criteria were: age between 1 and 18 years, regular pediatric follow-up within the practice, and absence of language barriers.

Results

477 questionnaires were included, evaluating the proportion of traveling children (outside of France) at 59 % of our population (n = 282). The leading destination remained Western Europe (36 %), but 64 % of children have already traveled to an area where vaccination against hepatitis A before departure is recommended. However, only 10.5 % of patients had received one dose of vaccination before traveling, and only 2.2 % had completed vaccination. The reasons for non-vaccination were a lack of information or a lack of anticipation before departure. After distributing the questionnaire, 101 prescriptions were issued at the parents' request.

Conclusion

The vaccination recommendations against hepatitis A are not followed in our population of travelling children, with only 10 % of them vaccinated, while 50 % have been travelling to a high-risk country. The reasons for non-vaccination may be multifactorial, but this study also highlights the importance of a preventive period to improve the population's knowledge and help them anticipate their travel plans. Although time-consuming, this prevention was profitable since 101 vaccine doses were prescribed out of 477 questionnaires collected. A display could be put up in the waiting room to draw families' attention to the need to anticipate travel.

背景：在准备出国旅行时，为旅行儿童接种疫苗似乎并不是家庭的主要关注点。很少有关于在法国境外旅行的未成年人接种甲型肝炎疫苗的数据。目的：本研究旨在评估在法国境外旅行的儿童是否遵循了甲型肝炎疫苗接种建议。次要目的是探讨不遵守疫苗接种建议的原因，并评估在研究环境中未成年人出国旅行的频率。人群和方法：这是一项单中心观察性研究，在南希市区的一家儿科诊所进行，通过在到达候诊室时分发问卷。纳入标准为：年龄在1至18岁之间，定期儿科随访，无语言障碍。结果：纳入了477份问卷，评估了旅行儿童（法国境外）的比例，占我国人口的59% （n = 282）。主要目的地仍然是西欧（36%），但64%的儿童已前往建议出发前接种甲型肝炎疫苗的地区。然而，只有10.5%的患者在旅行前接种了一剂疫苗，只有2.2%的患者完成了疫苗接种。未接种疫苗的原因是在出发前缺乏信息或缺乏预期。发放问卷后，应家长要求发放处方101张。结论：我们的旅行儿童人群没有遵循针对甲型肝炎的疫苗接种建议，只有10%的儿童接种了疫苗，而50%的儿童曾前往高风险国家。不接种疫苗的原因可能是多方面的，但这项研究也强调了预防期对提高人们的知识和帮助他们预测旅行计划的重要性。虽然耗时，但这种预防是有益的，因为在收集的477份问卷中开出了101剂疫苗。可以在候诊室里放一个显示器，提醒家属注意提前出行的必要性。

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