Archives De Pediatrie最新文献_第8页

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

Efficacy and tolerance of neostigmine to improve digestive motility in neonates after gastroschisis surgery 新斯的明改善胃裂术后新生儿消化功能的疗效和耐受性：新斯的明改善新生儿消化功能的疗效和耐受性。

IF 1.3 4区医学 Q3 PEDIATRICS

Archives De Pediatrie

Pub Date : 2025-08-01 DOI: 10.1016/j.arcped.2025.05.013

Lucy Carriat , Huu Kim An N’Guyen , Marion Honnorat , Franck Plaisant , Marine Butin

Background

The management of gastroschisis involves immediate surgery and post-surgery nutritional management. Ileus is a frequent complication, leading to difficulties in establishing enteral feeding. Parasympathomimetic agents, including neostigmine, are safely used in case of ileus in adults. Neostigmine was used in a single neonatal intensive care unit (NICU) for the management of ileus after gastroschisis repair.

Objective

The aim of this study was to report this experience of neostigmine use to improve digestive motility and its tolerance.

Methods and settings

This is an observational study from electronic health records (EHRs) that included all infants born with gastroschisis and treated with neostigmine in a NICU in Lyon, France, between June 2009 and December 2023. The primary outcome was the time to achieve effective enteral nutrition after the introduction of neostigmine. Secondary outcomes of tolerance and efficacy were also collected from the medical records. This study received approval from an ethics committee.

Results

Among 86 patients with gastroschisis, 16 patients received neostigmine due to either large volumes of gastric residue or absence of transit. They received neostigmine at a median (IQR) of 13.5 (12;17.25) days of life. Effective enteral feeding was achieved after a median of 11 (5.75;13) days of neostigmine treatment. Neostigmine was well tolerated, apart from one case of a serious but quickly resolved adverse event after intravenous administration.

Conclusions

The use of oral neostigmine in neonates with gastroschisis appears to be effective and safe. Larger prospective studies are required to determine its possible place in the management of these newborns.

背景：胃裂的治疗包括立即手术和术后营养管理。肠梗阻是一种常见的并发症，导致肠内喂养困难。拟副交感神经药物，包括新斯的明，可安全用于成人肠梗阻。新斯的明用于单一新生儿重症监护病房（NICU）胃裂修复后肠梗阻的管理。目的：本研究的目的是报告新斯的明用于改善消化运动及其耐受性的经验。方法和背景：这是一项来自电子健康记录（EHRs）的观察性研究，该研究包括2009年6月至2023年12月期间在法国里昂NICU出生并接受新斯的明治疗的所有胃裂患儿。主要观察指标是引入新斯的明后获得有效肠内营养的时间。从医疗记录中也收集了耐受性和疗效的次要结局。这项研究得到了伦理委员会的批准。结果：86例胃裂患者中，有16例患者因胃残量大或胃未经过而接受新斯的明治疗。他们在平均寿命（IQR）为13.5（12;17.25）天时接受新斯的明治疗。新斯的明治疗中位数为11（5.75;13）天，肠内喂养有效。新斯的明耐受性良好，除了一例静脉给药后严重但迅速解决的不良事件。结论：口服新斯的明治疗新生儿胃裂是安全有效的。需要更大的前瞻性研究来确定其在这些新生儿管理中的可能位置。

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引用次数: 0

General practitioners' knowledge and management of children co-victimized by intimate partner violence 全科医生对共同遭受亲密伴侣暴力的儿童的了解和管理。

IF 1.3 4区医学 Q3 PEDIATRICS

Archives De Pediatrie

Pub Date : 2025-08-01 DOI: 10.1016/j.arcped.2025.04.004

Justine Launey , Bernard Brau , Mathieu Kuchenbuch , Martine Balençon

Background

Intimate partner violence (IPV) is a major global public health issue, frequently impacting children as secondary victims. However, research on the involvement of general practitioners (GPs) in identifying and managing children exposed to IPV in France is lacking.

Objective

This study aimed to assess GPs' knowledge and practices regarding child protection in IPV cases, shedding light on gaps in their training and practices.

Methods and Settings

An electronic survey was conducted among GPs in Bretagne from May 2020 to May 2022, assessing demographic characteristics, clinical experiences, management practices for children exposed to IPV, and understanding its impact on children and adolescents.

Results

The study involved 91 GPs (sex ratio: 0.34, median: 15 [interquartile: 5.75–23] years of practice experience, and 25 % [18–30] of their practice focused on paediatrics). Results showed that 67 % encountered IPV situations within the past year, 46 % of children were in danger (2[1–2] per practitioner), and 48 % of children lived in a family with IPV (2[1–3] per practitioner). Thirty-five percent of GPs observed children exposed to IPV without recognizing them as endangered. Regarding knowledge of the impact of IPV on children, practitioners rated it at 5 out of 10, expressing discomfort (Likert scale from 0 to 10 (LS_0–10): 4[3:5]) and perceiving their training as inadequate (LS_0–10: 3[2:4]). They emphasized the need for better stakeholder understanding, favoring in-person training and enhanced access to specialized consultations to enhance their expertise.

Conclusion

These findings highlight the critical role of GPs in identifying and managing children exposed to IPV in France, despite gaps in knowledge and practice. Strengthening GPs’ training, standardizing protocols, improving and developing access to specialized consultations, such as hospital-based Unit for Endangered Children (“Unité d’Accueil Pédiatrique Enfant en Danger”, UAPED), and fostering interprofessional collaboration could enhance child protection efforts in IPV contexts.

背景：亲密伴侣暴力（IPV）是一个重大的全球公共卫生问题，儿童经常作为次要受害者受到影响。然而，关于全科医生（gp）参与识别和管理暴露于IPV的儿童在法国的研究是缺乏的。目的：本研究旨在评估全科医生在IPV案件中关于儿童保护的知识和实践，揭示他们在培训和实践中的差距。方法和环境：于2020年5月至2022年5月对布列塔尼全科医生进行电子调查，评估暴露于IPV儿童的人口统计学特征、临床经验、管理实践，并了解其对儿童和青少年的影响。结果：该研究涉及91名全科医生（性别比：0.34，中位数：15[四分位数间：5.75-23]年的执业经验，25%[18-30]的执业集中在儿科）。结果显示，67%的儿童在过去一年内遇到IPV情况，46%的儿童处于危险之中（每名从业人员2例[1-2]），48%的儿童生活在有IPV的家庭（每名从业人员2例[1-3]）。35%的全科医生观察到暴露于IPV的儿童，但没有意识到他们处于危险之中。关于IPV对儿童影响的知识，从业人员将其评为5分（满分为10分），表示不适（李克特量表从0到10 (LS0-10): 4[3:5]），并认为他们的培训不足（LS0-10: 3[2:4]）。他们强调需要增进利益攸关方的了解，支持面对面培训和增加获得专门咨询的机会，以提高他们的专业知识。结论：尽管在知识和实践方面存在差距，但这些发现突出了全科医生在识别和管理法国暴露于IPV的儿童方面的关键作用。加强全科医生的培训，使协议标准化，改善和发展获得专门咨询的机会，例如医院的濒危儿童救助单位，以及促进专业间的合作，可以加强在IPV情况下的儿童保护工作。

{"title":"General practitioners' knowledge and management of children co-victimized by intimate partner violence","authors":"Justine Launey , Bernard Brau , Mathieu Kuchenbuch , Martine Balençon","doi":"10.1016/j.arcped.2025.04.004","DOIUrl":"10.1016/j.arcped.2025.04.004","url":null,"abstract":"<div><h3>Background</h3><div>Intimate partner violence (IPV) is a major global public health issue, frequently impacting children as secondary victims. However, research on the involvement of general practitioners (GPs) in identifying and managing children exposed to IPV in France is lacking.</div></div><div><h3>Objective</h3><div>This study aimed to assess GPs' knowledge and practices regarding child protection in IPV cases, shedding light on gaps in their training and practices.</div></div><div><h3>Methods and Settings</h3><div>An electronic survey was conducted among GPs in Bretagne from May 2020 to May 2022, assessing demographic characteristics, clinical experiences, management practices for children exposed to IPV, and understanding its impact on children and adolescents.</div></div><div><h3>Results</h3><div>The study involved 91 GPs (sex ratio: 0.34, median: 15 [interquartile: 5.75–23] years of practice experience, and 25 % [18–30] of their practice focused on paediatrics). Results showed that 67 % encountered IPV situations within the past year, 46 % of children were in danger (2[1–2] per practitioner), and 48 % of children lived in a family with IPV (2[1–3] per practitioner). Thirty-five percent of GPs observed children exposed to IPV without recognizing them as endangered. Regarding knowledge of the impact of IPV on children, practitioners rated it at 5 out of 10, expressing discomfort (Likert scale from 0 to 10 (LS<sub>0–10</sub>): 4[3:5]) and perceiving their training as inadequate (LS<sub>0–10</sub>: 3[2:4]). They emphasized the need for better stakeholder understanding, favoring in-person training and enhanced access to specialized consultations to enhance their expertise.</div></div><div><h3>Conclusion</h3><div>These findings highlight the critical role of GPs in identifying and managing children exposed to IPV in France, despite gaps in knowledge and practice. Strengthening GPs’ training, standardizing protocols, improving and developing access to specialized consultations, such as hospital-based Unit for Endangered Children (“Unité d’Accueil Pédiatrique Enfant en Danger”, UAPED), and fostering interprofessional collaboration could enhance child protection efforts in IPV contexts.</div></div>","PeriodicalId":55477,"journal":{"name":"Archives De Pediatrie","volume":"32 6","pages":"Pages 413-419"},"PeriodicalIF":1.3,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144818369","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

Urinary follicle-stimulating hormone during triptorelin stimulation test can monitor the efficacy of triptorelin depot in girls with precocious or early puberty 雷普多雷林刺激试验期间的尿卵泡刺激素可监测雷普多雷林库在性早熟或性早熟女孩中的疗效。

IF 1.3 4区医学 Q3 PEDIATRICS

Archives De Pediatrie

Pub Date : 2025-08-01 DOI: 10.1016/j.arcped.2025.06.003

Yuan Zhou , Beilei Zeng , Yinyin Huang , Panwang Huang , Ye Li , Zhuangjian Xu , Yaping Ma

Background

There is still no consensus on simple methods to monitor the effectiveness of gonadotropin-releasing hormone analogs in girls with precocious or early puberty.

Objective

To evaluate the value of urinary luteinizing hormone (LH) and follicle-stimulating hormone (FSH) before and after triptorelin stimulation test detected by immunochemiluminometric assay (ICMA) to monitor the efficacy of triptorelin depot in girls with precocious or early puberty.

Methods

A total of 128 girls with precocious or early puberty were included, of whom 81 received triptorelin depot treatment (3.75 mg). Triptorelin (100 μg) stimulation tests were performed before and after 3 months treatment. The time of triptorelin stimulation test was designated as 0 h. Timed 12 h urine with recorded urine volume was collected before and after the test, defined as diurnal spontaneous (-24 h to -12 h), nocturnal spontaneous (-12 h to 0 h), diurnal stimulated (0 h to 12 h), and nocturnal stimulated urine (12 h to 24 h), respectively. LH and FSH were assayed by ICMA.

Results

After 3 months of treatment, 67 girls completed sample collections, with 2 out of 67 girls experiencing inadequate efficacy. Serum and urinary gonadotropin levels decreased significantly after 3 months of treatment. The area under curve (AUC) of nocturnal spontaneous, diurnal stimulated, and nocturnal stimulated urinary FSH (UFSH) concentrations in determining efficacy were 0.962, 0.985, and 0.954. The three AUCs were all greater than serum peak LH (PLH, 0.746) or peak FSH (PFSH, 0.931). When nocturnal spontaneous, diurnal stimulated, and nocturnal stimulated UFSH concentrations were ≤ 5.24 IU/L, 6.94 IU/L, and 5.78 IU/L, the sensitivity was 93.8 %, 96.9 % and 95.4 %, and the specificity was all 100.0 %.

Conclusion

UFSH measured by ICMA from diurnal and nocturnal stimulated 12-hour urine samples can be used to assess the effectiveness of triptorelin depot in girls with precocious or early puberty. For a non-invasive and cost-effective option, spontaneous nocturnal urine may also be a suitable choice.

背景：对于监测促性腺激素释放激素类似物在性早熟或性早熟女孩中的有效性的简单方法仍未达成共识。目的：评价免疫化学发光法（ICMA）检测雷普雷林刺激试验前后的促黄体生成素（LH）和促卵泡激素（FSH）对监测雷普雷林治疗在性早熟或性早熟女孩中的疗效的价值。方法：纳入128例性早熟或性早熟女童，其中81例接受雷普妥林储备治疗（3.75 mg）。治疗3个月前后分别进行雷普妥林（100 μg）刺激试验。雷喜素刺激试验时间为0 h，试验前后收集记录尿量的定时12 h尿，分别定义为昼自发尿（-24 h至-12 h）、夜自发尿（-12 h至0 h）、昼刺激尿（0 h至12 h）、夜刺激尿（12 h至24 h）。采用ICMA法测定LH和FSH。结果：治疗3个月后，67名女孩完成了样本采集，67名女孩中有2名疗效不足。治疗3个月后血清和尿促性腺激素水平明显下降。夜间自发尿促卵泡刺激素、夜间刺激尿促卵泡刺激素和夜间刺激尿促卵泡刺激素测定疗效的曲线下面积（AUC）分别为0.962、0.985和0.954。3个auc均大于血清LH峰（PLH, 0.746）或FSH峰（PFSH, 0.931）。当夜间自发、日间刺激和夜间刺激UFSH浓度≤5.24 IU/L、6.94 IU/L和5.78 IU/L时，敏感性分别为93.8%、96.9%和95.4%，特异性均为100.0%。结论：用ICMA法测定每日和夜间刺激12小时尿液样本的UFSH可用于评价雷普妥林储库治疗性早熟或性早熟女孩的有效性。作为一种非侵入性和成本效益的选择，自发夜间尿也可能是合适的选择。

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引用次数: 0

Preliminary proposals for the follow-up of infants born to mothers with cystic fibrosis treated with CFTR modulators during the first two years of life 对囊性纤维化母亲在出生后两年内接受CFTR调节剂治疗的婴儿进行随访的初步建议

IF 1.3 4区医学 Q3 PEDIATRICS

Archives De Pediatrie

Pub Date : 2025-07-01 DOI: 10.1016/j.arcped.2025.03.005

Philippe Reix , Camille Audousset , Emmanuelle Girodon , Isabelle Sermet Gaudelus , Sophie Gautier

The number of pregnancies in women with cystic fibrosis (CF) has significantly increased in recent years, leading to a corresponding rise in the number of healthy infants exposed to cystic fibrosis transmembrane conductance regulator modulator (CFTRm) such as elexacaftor-tezacaftor-ivacaftor (ETI) or Kaftrio/Kalydeco® (K/K) triple therapy. Currently, data on the immediate outcomes for these children is reassuring; however, some cases of abnormal liver tests and cataracts have been reported in a few newborns indirectly exposed to ETI in utero or postnatally. Long-term neurodevelopment remains a concern that requires further investigation.

A working group from the Société Française de la Mucoviscidose has developed recommendations for monitoring these children during the first two years and beyond. Given the increasing number of infants born to mothers taking CFTR modulators, as well as questions regarding their immediate care during the maternity stay and the feasibility of breastfeeding, it is crucial for pediatricians to be aware of these recommendations, which are based on a comprehensive review of the literature.

近年来，囊性纤维化（CF）妇女的怀孕数量显著增加，导致健康婴儿接受囊性纤维化跨膜传导调节剂（CFTRm）如elexacaftor-tezacaftor-ivacaftor （ETI）或Kaftrio/Kalydeco®（K/K）三联治疗的数量相应增加。目前，关于这些儿童的直接结果的数据令人放心；然而，据报道，一些在子宫内或出生后间接暴露于ETI的新生儿出现肝脏检查异常和白内障的病例。长期的神经发育仍然是一个需要进一步研究的问题。法国社会卫生组织的一个工作组已经制定了在头两年及以后监测这些儿童的建议。考虑到服用CFTR调节剂的母亲所生婴儿数量的增加，以及有关产妇住院期间的即时护理和母乳喂养可行性的问题，儿科医生了解这些基于文献综合综述的建议至关重要。

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引用次数: 0

Much ado about … the fetal heart examination during the first trimester.What to expect from the new French obstetrical imaging guidelines? 孕早期的胎儿心脏检查太麻烦了。我们对新的法国产科影像指南有什么期待？

IF 1.3 4区医学 Q3 PEDIATRICS

Archives De Pediatrie

Pub Date : 2025-07-01 DOI: 10.1016/j.arcped.2025.05.006

Daniela Laux , Alexandre J. Vivanti

引用次数: 0

Recommendations for mountain travel and altitude acclimation in pediatric populations: a French Delphi study 儿童山区旅行和高原适应的建议：法国德尔菲研究。

IF 1.3 4区医学 Q3 PEDIATRICS

Archives De Pediatrie

Pub Date : 2025-07-01 DOI: 10.1016/j.arcped.2025.05.007

Clémence Rascle , Pauline Connan , Corentin Tanné

Objective

To develop recommendations for mountain travel and altitude acclimation for children under 3 years old by convening a committee of experts.

Methods

Using the DELPHI method, we collected proposals via email from professionals specializing in altitude and related pathologies. Experts were asked about the maximum suggested altitude and specific recommendations.

Results

Sixteen experts participated in the study. The main recommendations included a maximum altitude of 2000 meters for children under 1 year old and 2500 meters for children under 3 years old, a gradual ascent with stops every 500 meters, and careful monitoring of the child's reactions. Absolute contraindications were noted for cable car ascents in children under 1 year old, with relative contraindications for those under 3 years old. It was also recommended to consult a doctor before traveling to high altitudes if the child has a risk-related pathology and to limit winter outdoor activities to short durations with appropriate clothing.

Conclusion

This survey revealed a consensus on the recommended maximum travel altitude for children and provided various guidelines to mitigate the effects of altitude.

目的：召开专家委员会，为3岁以下儿童制定山地旅行和高原适应建议。方法：采用德尔菲法，通过电子邮件收集高原及相关病理专家的建议。专家们被问及建议的最大海拔高度和具体建议。结果：16位专家参与研究。主要建议包括1岁以下儿童的最大海拔高度为2000米，3岁以下儿童的最大海拔高度为2500米，每500米停止一次逐渐上升，并仔细监测儿童的反应。1岁以下儿童缆车攀登的绝对禁忌症，3岁以下儿童缆车攀登的相对禁忌症。如果孩子有风险相关的病理，建议在去高海拔地区旅行前咨询医生，并建议冬季户外活动限制在短时间内，穿适当的衣服。结论：本调查对儿童的推荐最大旅行高度达成了共识，并提供了减轻海拔影响的各种指导方针。

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引用次数: 0

Non-compliance with post-discharge vitamin D intake guidelines: an observational study in an overseas French maternity ward 不遵守出院后维生素D摄入指南：一项法国海外产科病房的观察性研究。

IF 1.3 4区医学 Q3 PEDIATRICS

Archives De Pediatrie

Pub Date : 2025-07-01 DOI: 10.1016/j.arcped.2025.04.005

Mathis Thia , Simon Lorrain , Magali Richard , Alexandre Lapillonne , Silvia Iacobelli

Background

Studies in tropical countries revealed a high prevalence of vitamin D insufficiency. The French recommendations did not differentiate between overseas and mainland areas in terms of vitamin D intake. However, the prevalence of vitamin D supplementation in infants in the French overseas territories is unknown.

Aims

The primary objective of the study was to assess the prevalence of vitamin D supplementation in infants aged 4 to 9 months in a tropical overseas region. Secondary objectives were to assess compliance, adherence and factors influencing vitamin D supplementation.

Material and methods

We conducted a cross-sectional study of infants born in La Réunion, a French overseas department in Indian Ocean. We interviewed the parents of all newborns born at term during a three-month period in 2022.

Results

Among the 323 term infants included, the prevalence of vitamin D supplementation at 4 to 9 months of age was 52 %. Compliance to guidelines was 44.3 %. Factors that were significantly and positively associated with vitamin D use at 4 to 9 months of age were: information about vitamin D supplementation by caregivers before leaving the maternity ward, subscription to a supplementary health insurance, and follow-up by a pediatrician. Infants whose parents reported colic and the use of supplements were significantly more likely to discontinue vitamin D supplementation

Conclusion

Vitamin D supplementation in these infants born in an overseas territory was not in line with current national recommendations.

背景：热带国家的研究表明，维生素D缺乏的患病率很高。法国的建议在维生素D摄入量方面没有区分海外和大陆地区。然而，在法国海外领地的婴儿中维生素D补充剂的普及程度尚不清楚。目的：该研究的主要目的是评估热带海外地区4至9个月婴儿补充维生素D的流行程度。次要目的是评估依从性、依从性和影响维生素D补充的因素。材料和方法：我们对在印度洋的法国海外科La r出生的婴儿进行了横断面研究。我们采访了2022年三个月期间所有足月新生儿的父母。结果：在323名足月婴儿中，在4至9个月大时补充维生素D的患病率为52%。对指导方针的依从性为44.3%。与4到9个月大的婴儿使用维生素D有显著正相关的因素是：在离开产科病房前护理人员提供的维生素D补充信息、补充健康保险的订阅以及儿科医生的随访。父母报告有肠绞痛和服用补充剂的婴儿明显更有可能停止补充维生素D结论：在海外出生的这些婴儿补充维生素D不符合目前的国家建议。

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引用次数: 0

Clinical features, treatment and outcomes of acute ethmoiditis: A case series of 20 hospitalized children 急性筛炎的临床特点、治疗和预后：20例住院儿童的病例分析。

IF 1.3 4区医学 Q3 PEDIATRICS

Archives De Pediatrie

Pub Date : 2025-07-01 DOI: 10.1016/j.arcped.2025.04.002

Sarah Salameh , Noémie Lachaume , Alexandra Bisca , Manon Beauvais , Adrien Chaud , Marie Cotillon , Laure Cohen , Romain Basmaci

We described 20 children hospitalized with acute ethmoiditis between 2017 and 2022 in our center. Median age was 3.5 years, fifteen were Chandler’s group II and three were group III. Despite adequate antibiotic therapy regarding national antibiotic treatment guidelines, six (30 %) patients experienced poor outcomes; five of them required surgical drainage, reinforcing the need of close surveillance of these children.

我们描述了2017年至2022年在我们中心因急性筛炎住院的20名儿童。中位年龄为3.5岁，15例为钱德勒组，3例为第三组。尽管根据国家抗生素治疗指南进行了充分的抗生素治疗，但6名（30%）患者的预后不佳；其中5例需要手术引流，加强了对这些儿童密切监测的必要性。

引用次数: 0