Archives De Pediatrie最新文献_第8页

« 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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引用次数: 0

Investigating risk factors for hypospadias: insights from a study in Eastern Algeria 调查尿道下裂的危险因素：来自阿尔及利亚东部一项研究的见解。

IF 1.3 4区医学 Q3 PEDIATRICS

Archives De Pediatrie

Pub Date : 2025-08-01 DOI: 10.1016/j.arcped.2025.06.001

Laouar Rania , Chellat-Rezgoune Djalila , Atrih Zoubir , Benhizia Yacine , Sifi Karima

Background

Hypospadias is among the most common congenital anomalies of the male genitalia, with a multifactorial cause involving genetic, environmental, and maternal factors. In Algeria, the condition remains under-studied, with limited data on its epidemiology and risk factors.

Objective

To analyze the clinical characteristics, associated anomalies and key risk factors for hypospadias in Eastern Algeria over a 16-year period.

Methods

This retrospective case-control study included 483 hypospadias cases and 503 healthy controls. Cases were identified through medical records from the Pediatric Surgery Department, while controls were recruited via online questionnaires. Statistical analyses, including logistic regression, were performed to identify independent risk factors.

Results

Significant risk factors for hypospadias included low birth weight (<2500 g; OR = 11.86, p < 0.001), intrauterine growth restriction (IUGR) (OR = 2.36, p = 0.027), maternal gestational hypertension (OR = 2.65, p = 0.008), and rural residence (OR = 3.78, p < 0.001). Severe forms of hypospadias were associated with a higher prevalence of anomalies, particularly genitourinary anomalies (81.82 %).

Conclusion

Hypospadias in Eastern Algeria is strongly influenced by perinatal, maternal, and environmental factors. Enhancing prenatal care, enforcing stricter environmental regulations, and improving healthcare access in rural areas are crucial steps in reducing the burden of this condition and its complications.

背景：尿道下裂是男性生殖器最常见的先天性异常之一，其病因多因素，包括遗传、环境和母体因素。在阿尔及利亚，对该病的研究仍不充分，关于其流行病学和危险因素的数据有限。目的：分析16年来阿尔及利亚东部地区尿道下裂的临床特点、相关异常及主要危险因素。方法：回顾性病例对照研究包括483例尿道下裂患者和503名健康对照者。病例是通过儿科外科的医疗记录确定的，而对照组是通过在线问卷调查招募的。进行统计分析，包括逻辑回归，以确定独立的危险因素。结果：低出生体重是尿道下裂的重要危险因素(结论：阿尔及利亚东部地区的尿道下裂受围产期、产妇和环境因素的强烈影响。加强产前护理、执行更严格的环境法规和改善农村地区的医疗保健可及性是减轻这种疾病及其并发症负担的关键步骤。

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引用次数: 0

Successful ECMO rescue for organophosphate poisoning causing refractory acute respiratory distress syndrome: a first pediatric case 成功的ECMO抢救有机磷中毒引起难治性急性呼吸窘迫综合征：第一例儿科病例。

IF 1.3 4区医学 Q3 PEDIATRICS

Archives De Pediatrie

Pub Date : 2025-08-01 DOI: 10.1016/j.arcped.2025.05.001

Charlotte Suermondt , Charles de Marcellus , Dominique Vodovar , Charlotte Roy , Nathanael Shraer , Mehdi Oualha , Noémie de Cacqueray

A 20-month-old girl presented with organophosphate poisoning. Her clinical course was complicated by acute respiratory failure despite oxime administration, requiring mechanical ventilation within 24 h. Due to refractory acute respiratory distress syndrome (ARDS), the patient was placed on veno-venous extracorporeal membrane oxygenation (VV-ECMO) therapy on day 3. Successful rescue and complete recovery were achieved with VV-ECMO. Veno-venous ECMO may be an option for organophosphate poisoning in case of respiratory failure.

一名20个月大的女婴出现有机磷中毒。尽管给予肟治疗，患者的临床过程仍出现急性呼吸衰竭，需要在24小时内进行机械通气。由于难治性急性呼吸窘迫综合征（ARDS），患者于第3天接受静脉-静脉体外膜氧合（VV-ECMO）治疗。VV-ECMO手术成功抢救，患者完全恢复。在呼吸衰竭的情况下，静脉ECMO可能是有机磷中毒的一种选择。

引用次数: 0

Familial vitamin K metabolism deficiency responsible for a congenital binder phenotype 家族性维生素K代谢缺乏导致先天性结合物表型。

IF 1.3 4区医学 Q3 PEDIATRICS

Archives De Pediatrie

Pub Date : 2025-08-01 DOI: 10.1016/j.arcped.2025.05.003

Konstantinos Grammatopoulos , Annie Harroche , Cristina Peduto , Nancy Vegas , Alix Mathonnet , Genevieve Baujat , Veronique Abadie , Alix Flamant

A 4-month-old male born with a Binder Phenotype was admitted for the evacuation of a large subdural hematoma. The blood analysis revealed a prolonged prothrombin time due to vitamin K-dependent coagulation factor deficiency. Vitamin K participates in the embryonic development of the nasal cartilage. The genetic analysis of our patient revealed a rare genetic cause, responsible for the congenital Binder phenotype associated with a defect in the vitamin K metabolism, a pathogenic variant in the GGCX gene that has not been previously reported in the literature. All neonates presenting a Binder Phenotype would benefit from coagulation screening, an easy-access exam, in order to prevent severe and potentially dreadful hemorrhagic events.

一个4个月大的男性出生与粘合剂型被承认为一个大硬膜下血肿的疏散。血液分析显示，由于维生素k依赖性凝血因子缺乏，凝血酶原时间延长。维生素K参与鼻软骨的胚胎发育。我们患者的遗传分析揭示了一种罕见的遗传原因，导致先天性Binder表型与维生素K代谢缺陷相关，这是一种以前未在文献中报道的GGCX基因的致病性变异。所有呈现Binder表型的新生儿都将受益于凝血筛查，这是一种易于进行的检查，以防止严重和潜在可怕的出血事件。

引用次数: 0

Recent and important updates to the French meningococcal vaccination strategy 法国脑膜炎球菌疫苗接种战略的最新重要更新。

IF 1.3 4区医学 Q3 PEDIATRICS

Archives De Pediatrie

Pub Date : 2025-08-01 DOI: 10.1016/j.arcped.2025.06.004

Bruno Hoen

引用次数: 0

Spontaneous Ovarian Hyperstimulation Syndrome and Hyperprolactinemia due to Primary Hypothyroidism: An Adolescent Case Report 原发性甲状腺功能减退所致自发性卵巢过度刺激综合征和高催乳素血症：一例青少年病例报告。

IF 1.3 4区医学 Q3 PEDIATRICS

Archives De Pediatrie

Pub Date : 2025-08-01 DOI: 10.1016/j.arcped.2025.03.007

Emel Hatun Aytaç Kaplan , Nazlı Gülsüm Akyel , Zümrüt Kocabey Sütçü

Introduction

Ovarian hyperstimulation syndrome is characterized by enlarged ovaries, multiple follicular cysts, and fluid leakage into the extravascular space caused by increased vascular permeability. Although controlled ovarian stimulation is often the main cause, spontaneous ovarian hyperstimulation syndrome is rare.

Observation and discussion

We present a seventeen-year-old patient with ovarian hyperstimulation syndrome and primary hypothyroidism due to autoimmune thyroiditis, who presented with galactorrhea and severe abdominal pain. The thyroid-stimulating hormone level was 713 uIU/ml. Ultrasonography and magnetic resonance imaging showed ovarian enlargement and multiple cysts. Our patient, who also had galactorrhea and hyperprolactinemia, was treated with levothyroxine and cabergoline. The ovaries, which were very large and multicystic before treatment, showed significant improvement after treatment.

Conclusion

Spontaneous ovarian hyperstimulation syndrome, although rare in childhood, should be considered in patients with primary hypothyroidism. Abdominal pain is an important symptom for diagnosis.

简介：卵巢过度刺激综合征以卵巢增大、多发卵泡囊肿、血管通透性增高引起的液体渗漏到血管外间隙为特征。虽然控制卵巢刺激往往是主要原因，自发性卵巢过度刺激综合征是罕见的。观察和讨论：我们报告了一位17岁的卵巢过度刺激综合征和原发性甲状腺功能减退症患者，该患者由自身免疫性甲状腺炎引起，其表现为乳溢和严重的腹痛。促甲状腺激素水平为713 uIU/ml。超声及磁共振示卵巢肿大及多发囊肿。我们的病人，谁也有溢乳和高催乳素血症，治疗左甲状腺素和卡麦角林。治疗前卵巢大而多囊，治疗后明显改善。结论：自发性卵巢过度刺激综合征虽然在儿童期罕见，但在原发性甲状腺功能减退患者中应予以考虑。腹痛是诊断的重要症状。

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引用次数: 0

Brain death diagnostic process in children after thiopental sedation: a comparative retrospective cohort study 硫喷妥钠镇静后儿童脑死亡诊断过程：一项比较回顾性队列研究。

IF 1.3 4区医学 Q3 PEDIATRICS

Archives De Pediatrie

Pub Date : 2025-08-01 DOI: 10.1016/j.arcped.2025.05.004

Victor Sartorius , Ann-Marie Crowe , Alina Marilena Lazarescu , Laurence Labat , Anna Kaminska , Charles Joris Roux , Gilles A Orliaguet , Stéphane Blanot

Background

The determination of brain death (BD) is the primary pathway to organ donation in children. Thiopental is a sedative drug prescribed in critical situations potentially leading to BD and has been identified as a confounder during BD diagnosis. The implications of prior thiopental sedation on the diagnostic process of BD are poorly defined.

Objective

To compare the timeline and process involved in BD diagnosis between patients who received thiopental sedation versus those who did not.

Methods and Setting

Retrospective analysis was carried out on the healthcare records of all children who underwent the process of BD evaluation and diagnosis in our institution, between January 2012 and April 2020.

Results

74 patients were included; 29 had been treated with thiopental and 45 had received other sedatives or none. Median [IQR] time from reporting of suspected BD patients to apnea test (19.5 [11.5–30.2] vs 11.5 [5.4–21.1] hours, p = 0.015) and to BD confirmatory test (24.2 [7.2–32.6] vs 13.2 [6.2–23.5] hours, p = 0.019) was significantly longer in the thiopental group. Organ allocation was also delayed in the thiopental group. Thiopental plasma level was measured before BD examination in 24 patients, and the median concentration of the last assay was 4.6 [0.8–8.8] mg.L^-1. The BD diagnostic process included persistent signs of cerebral blood flow interruption on transcranial Doppler in 89.7 % of patients in the thiopental group vs 68.9 % in the other group (p = 0.049).

Conclusion

Prior administration of thiopental delays the process involved in the evaluation and diagnosis of BD in children in our intensive care unit. The diagnosis of BD after thiopental sedation requires a multimodal evaluation, which should include the monitoring of thiopental plasma levels and could be guided by transcranial Doppler.

背景：确定脑死亡（BD）是儿童器官捐献的主要途径。硫喷妥是一种镇静药，在可能导致双相障碍的危急情况下使用，在双相障碍诊断中被认为是一种混杂因素。既往硫喷妥镇静对双相障碍诊断过程的影响尚不明确。目的：比较接受硫喷妥钠镇静和未接受硫喷妥钠镇静的患者在BD诊断中的时间和过程。方法和背景：回顾性分析2012年1月至2020年4月在我院接受双相障碍评估和诊断的所有儿童的医疗记录。结果：纳入74例患者；29例使用硫喷妥钠治疗，45例使用或未使用其他镇静剂。硫喷妥钠组从报告疑似双相障碍患者到呼吸暂停测试（19.5[11.5-30.2]对11.5[5.4-21.1]小时，p = 0.015）和BD确诊测试（24.2[7.2-32.6]对13.2[6.2-23.5]小时，p = 0.019）的中位数[IQR]时间明显更长。硫喷妥钠组器官分配也延迟。24例患者在BD检查前测定硫喷妥钠血浆水平，末次测定中位浓度为4.6 [0.8-8.8]mg.L-1。双相障碍的诊断过程包括经颅多普勒显示持续的脑血流中断迹象，硫喷妥钠组为89.7%，另一组为68.9% （p = 0.049）。结论：事先使用硫喷妥会延迟我们重症监护室儿童双相障碍的评估和诊断。硫喷妥钠镇静后BD的诊断需要多模式评估，包括监测硫喷妥钠血浆水平，并可经颅多普勒指导。

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引用次数: 0

Difficulty of caring for children in danger or at risk of danger in Var (a French department) by general practitioners and private pediatricians 在Var（法国的一个科室），全科医生和私人儿科医生难以照顾处于危险或有危险风险的儿童。

IF 1.3 4区医学 Q3 PEDIATRICS

Archives De Pediatrie

Pub Date : 2025-08-01 DOI: 10.1016/j.arcped.2025.04.006

Clemence Desmarets , Julie Berbis , Paul Casha , Violaine Bresson , Emmanuelle Bosdure , Kareen Thibault , Michel Delage , Aurelie Morand , Brigitte Chabrol , Elisabeth Martin-Lebrun , Lindsay Osei

Background

The exposure of children to situations of danger or risk of danger is a major public health problem. General practitioners (GPs) and pediatricians play an essential role in identification and management of these situations thanks to two procedures: the administrative procedure consists of sending an information of concern (“Information préoccupante” -IP- in French) to the departmental unit of collection, evaluation and processing of information of concern (CRIP in French) for a child at risk of danger; the judicial procedure consists of sending an alert (“signalement” in French) to the public prosecutor for serious and immediate danger. However, hospital and private doctors only perform 5 % of child abuse alerts.

Objective

The main objective was to describe doctors’ practices regarding the care of children in danger or at risk of danger. The secondary objective was to identify areas for improving the efficiency of management.

Methods

We present a descriptive, quantitative, and cross-sectional study using questionnaires to the GPs and pediatricians in private practice in Var (French department) in 2021.

Results

Our sample consisted of 134 GPs and 28 pediatricians. 75.3 % had already faced children in danger. Only 17.1 % provided efficient management (according to the recommendations of the Haute Autorité de Santé) when faced with a suspicion of a child at risk, 53.4 % for suspicion of child abuse, and 44.5 % for child sexual abuse. Pediatricians were more likely to know the contact details of child protection actors, and 84.6 % of doctors expressed a desire for more exchanges with them. 85.8 % expressed a feeling of being insufficiently trained.

Conclusion

It is essential to enhance the training of doctors and foster more effective collaboration with child protection actors. We propose distributing a document to private doctors in the Var to help them identify and manage cases.

背景：儿童暴露于危险环境或危险风险是一个重大的公共卫生问题。全科医生和儿科医生在识别和管理这些情况方面发挥着至关重要的作用，这要感谢两个程序：行政程序包括向部门收集、评估和处理有危险儿童的关注信息单位（法语为CRIP）发送一份关注信息（法语为“information pr occupante”- ip）；司法程序包括向公诉人发出严重和紧迫危险的警报（法语“信号”）。然而，医院和私人医生只执行了5%的儿童虐待警报。目的：主要目的是描述医生在照顾处于危险或处于危险危险中的儿童方面的做法。第二个目标是确定可以提高管理效率的领域。方法：我们对2021年Var（法语科）私人执业的全科医生和儿科医生进行了一项描述性、定量和横断面研究。结果：我们的样本包括134名全科医生和28名儿科医生。75.3%的人已经面对过处于危险中的儿童。只有17.1%的学校（根据高等教育委员会的建议）在怀疑有儿童面临危险时提供了有效的管理，53.4%的学校涉嫌虐待儿童，44.5%的学校涉嫌性虐待儿童。儿科医生更有可能知道儿童保护工作者的联系方式，84.6%的医生表示希望与他们进行更多的交流。85.8%的人表示培训不足。结论：必须加强对医生的培训，促进与儿童保护行动者的更有效合作。我们建议向Var的私人医生分发一份文件，以帮助他们识别和管理病例。

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引用次数: 0