EMC - PédiatriePub Date : 2004-11-01DOI: 10.1016/j.emcped.2004.07.002
S. Viola (Chef de clinique-assistante) , F. Sarrio (Diététicienne)
{"title":"Traitement diététique de l'allergie aux protéines du lait de vache","authors":"S. Viola (Chef de clinique-assistante) , F. Sarrio (Diététicienne)","doi":"10.1016/j.emcped.2004.07.002","DOIUrl":"10.1016/j.emcped.2004.07.002","url":null,"abstract":"<div><p>Prevalence of cow milk allergy is high, affecting 2 to 3% of infants in unselected cohorts. This allergy begins early in life, after the introduction of cow milk in the food of babies, but the affected children often become tolerant for cow milk later on. Prevalence of food allergy (soy, fish, egg, especially) associated with cow milk allergy is increasing. Specific diet is the only treatment; it consists in the exclusion of any cow milk protein from the nutrition until the age of 1 to 2 years which is the period when, usually, immunotolerance is acquired.</p></div>","PeriodicalId":100441,"journal":{"name":"EMC - Pédiatrie","volume":"1 4","pages":"Pages 335-340"},"PeriodicalIF":0.0,"publicationDate":"2004-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.emcped.2004.07.002","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"77560163","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
EMC - PédiatriePub Date : 2004-11-01DOI: 10.1016/j.emcped.2004.07.003
B. Friedli (Professeur)
{"title":"Tétralogie de Fallot","authors":"B. Friedli (Professeur)","doi":"10.1016/j.emcped.2004.07.003","DOIUrl":"10.1016/j.emcped.2004.07.003","url":null,"abstract":"<div><p>The Tetralogy of Fallot refers to the most common cyanotic congenital heart defect. Anatomically, this is essentially a perimembranous subaortic ventricular septal defect, together with a right ventricular outflow obstruction, resulting from an infundibular and often valvular pulmonary stenosis. The pathophysiology is a right to left shunt at ventricular level. Clinical signs include cyanosis, which is often progressive with age, squatting, and often hypoxic spells. The natural history is characterized by progressive cyanosis, erythrocytosis, and complications such as cerebrovascular accidents and brain abscesses. Death occurs in the second decade as a mean. Surgical correction is therefore mandatory and lifesaving. The operation includes closure of the ventricular septal defect with a patch, and relief of pulmonary infundibular and valvular stenosis. This may often require patch enlargement of the right ventricular outflow tract, including the pulmonary valve annulus, leaving the pulmonary orifice partially unguarded. As a consequence, pulmonary valve regurgitation is very often observed. If it is important, it may compromise right ventricular function in the long term. Rhythm disturbances are another common complication in the late follow-up of operated tetralogy of Fallot. For these reasons, medical follow-up is indicated. Despite these possible complications, it is obvious that longevity and quality of life have been considerably improved by surgical repair.</p></div>","PeriodicalId":100441,"journal":{"name":"EMC - Pédiatrie","volume":"1 4","pages":"Pages 365-378"},"PeriodicalIF":0.0,"publicationDate":"2004-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.emcped.2004.07.003","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"77389494","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
EMC - PédiatriePub Date : 2004-11-01DOI: 10.1016/j.emcped.2004.06.001
A. Baculard (Ancienne attachée-consultante des hôpitaux de Paris)
{"title":"Reflux gastro-œsophagien et affections respiratoires chez l'enfant","authors":"A. Baculard (Ancienne attachée-consultante des hôpitaux de Paris)","doi":"10.1016/j.emcped.2004.06.001","DOIUrl":"10.1016/j.emcped.2004.06.001","url":null,"abstract":"<div><p>Gastroesophageal reflux (GER)-associated respiratory disorders are frequent and varied: chronic cough, asthma, bronchitis, pneumonia, laryngitis, sinusitis, otitis, stridor. A cause/ effect relationship between GER and respiratory disorders has never been demonstrated and identifying the exact role of GER in respiratory pathology remains difficult. The \"gold standard\" for the diagnosis is the 24-hour continuous esophageal pH monitoring, but clinical data and pulmonary check-up should be considered for the elimination of other respiratory diseases. Following GER diagnosis, medical therapy including prokinetic and antisecretory agents is recommended since the efficacy of these drugs has been shown; indications for surgery are rare in children.</p></div>","PeriodicalId":100441,"journal":{"name":"EMC - Pédiatrie","volume":"1 4","pages":"Pages 351-364"},"PeriodicalIF":0.0,"publicationDate":"2004-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.emcped.2004.06.001","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"72560944","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
EMC - PédiatriePub Date : 2004-11-01DOI: 10.1016/j.emcped.2004.06.003
P. Brisou (Spécialiste du service de santé des Armées) , J.-M. Chamouilli (Praticien hospitalier, chef de service de pédiatrie) , T. Gaillard (Assistante du service de santé des Armées) , Y. Muzellec (Spécialiste du service de santé des Armées)
{"title":"Infections à pneumocoque","authors":"P. Brisou (Spécialiste du service de santé des Armées) , J.-M. Chamouilli (Praticien hospitalier, chef de service de pédiatrie) , T. Gaillard (Assistante du service de santé des Armées) , Y. Muzellec (Spécialiste du service de santé des Armées)","doi":"10.1016/j.emcped.2004.06.003","DOIUrl":"10.1016/j.emcped.2004.06.003","url":null,"abstract":"<div><p>Currently, pneumococcal infections are a public health problem. <em>Streptococcus pneumoniae</em> is a leading cause of community acquired invasive and non invasive bacterial infections in infants and young children, more specifically among those under five years. Pneumococcal invasive infections, in particular meningitis, carry a mortality upper than 8 % and a high risk of sequelae. Atypical clinical expression is frequent in youngest children. Membrane immunochromatography for rapid detection of urinary C-polysaccharide antigen is one of the advances for biological diagnosis, but it remains to be evaluated in children. Due to the increasing prevalence of penicillin-resistant pneumococci, treatment has to be adapted to clinical and epidemiological features. Frequent, serious, antibiotic-resistant characters of pneumococcal infections plea for vaccine. In France, Pneumo 23<sup>®</sup> indications were extended in 1998, and pneumococcal conjugate vaccine Prevenar<sup>®</sup> indications were modified in 2002. Local, national and international surveys are needed to adapt treatment and vaccine strategies.</p></div>","PeriodicalId":100441,"journal":{"name":"EMC - Pédiatrie","volume":"1 4","pages":"Pages 410-431"},"PeriodicalIF":0.0,"publicationDate":"2004-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.emcped.2004.06.003","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"76056918","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
EMC - PédiatriePub Date : 2004-11-01DOI: 10.1016/S1762-6013(04)00051-5
{"title":"Index des mots cles","authors":"","doi":"10.1016/S1762-6013(04)00051-5","DOIUrl":"https://doi.org/10.1016/S1762-6013(04)00051-5","url":null,"abstract":"","PeriodicalId":100441,"journal":{"name":"EMC - Pédiatrie","volume":"1 4","pages":"Pages 433-435"},"PeriodicalIF":0.0,"publicationDate":"2004-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/S1762-6013(04)00051-5","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136715126","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
EMC - PédiatriePub Date : 2004-11-01DOI: 10.1016/j.emcped.2004.06.002
D. Parain
{"title":"Céphalées de l'enfant et de l'adolescent","authors":"D. Parain","doi":"10.1016/j.emcped.2004.06.002","DOIUrl":"10.1016/j.emcped.2004.06.002","url":null,"abstract":"<div><p>Headache is one of the most frequent symptoms in neuropaediatrics. Numerous types and causes of headache exist, and precise diagnosis is sometimes difficult. The primary headache (migraine and tension headache), without brain lesion are the main types. Secondary headaches are less frequent. The classification of the International Headache Society (IHS) is a good tool for the diagnosis, although it is not fully adapted for children. According to the recent epidemiologic surveys, migraines represent 90% of headaches. About 20% of migraines begin by an aura, with visual symptoms in most cases. Non habitual migraines or migraine equivalents (basilar, abdominal, confusional migraines, or migraines with prolonged aura, benign paroxystic vertigo, and visual aura without headache) are more frequent in children than in adults. Tension headaches are far less frequent in children than in adult. These different types of headache may turn to chronic daily headaches, especially in case of prolonged drug abuse. The management of patients with headache, in terms of investigations and therapy, must therefore be based on the diagnosis hypothesis that results from the neurological exam data and, above all, from the patient's questioning which allows to analyse headaches history, context and characteristics. The identification of anatomic structures and mechanisms responsible for headaches and migraines has improved these past decades, but many uncertainties remain. The availability of new drugs, such as the triptans, with a specific activity on those serotoninergic receptors which participate in the migraine process, has improved the therapeutic management of the disease.</p></div>","PeriodicalId":100441,"journal":{"name":"EMC - Pédiatrie","volume":"1 4","pages":"Pages 386-396"},"PeriodicalIF":0.0,"publicationDate":"2004-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.emcped.2004.06.002","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"87027643","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
EMC - PédiatriePub Date : 2004-11-01DOI: 10.1016/j.emcped.2004.07.004
E. Bui Quoc (Interne des hôpitaux de Paris) , M.-A. Espinasse-Berrod (Ancien interne des hôpitaux de Paris, ancien chef de clinique à la Faculté, assistant des hôpitaux de Paris, ophtalmologiste attaché des Hôpitaux)
{"title":"Strabisme chez l'enfant","authors":"E. Bui Quoc (Interne des hôpitaux de Paris) , M.-A. Espinasse-Berrod (Ancien interne des hôpitaux de Paris, ancien chef de clinique à la Faculté, assistant des hôpitaux de Paris, ophtalmologiste attaché des Hôpitaux)","doi":"10.1016/j.emcped.2004.07.004","DOIUrl":"https://doi.org/10.1016/j.emcped.2004.07.004","url":null,"abstract":"<div><p>Strabismus is a highly plural and many-sided pathology. The classification of such diseases is very difficult due to the intricacy of clinical signs and pathophysiological mechanisms. The prognosis of strabismus is correlated to the age of onset, due to the influence of visual experience on the development of vision. Examination by an ophthalmologist is mandatory in case of strabismus evidence or strabismus suspicion. Strabismus may reveal an organic ocular disease, such as in the rare but fearsome case of retinoblastoma. By impairing vision, any strabismus can lead to an amblyopia, which can itself be responsible for strabismus in some cases. In early strabismus, monocular amblyopia can be cured, but binocular vision remains impaired; in late strabismus, the treatment must restore both monocular vision of each eye and binocular vision. Priorities must be defined in the treatment of strabismus; satisfactory visual function must be restored first. Optical correction is always essential, and in case of amblyopia, occlusion and optical or pharmacological penalizations may be considered. Most of the time, surgery for ocular deviation is considered only secondarily, after restoration of satisfactory sensorial status. Specialized management as early as possible is necessary in all cases, to improve functional results of the treatment.</p></div>","PeriodicalId":100441,"journal":{"name":"EMC - Pédiatrie","volume":"1 4","pages":"Pages 397-409"},"PeriodicalIF":0.0,"publicationDate":"2004-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.emcped.2004.07.004","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136714562","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
EMC - PédiatriePub Date : 2004-11-01DOI: 10.1016/j.emcped.2004.08.001
P. Niaudet (Professeur)
{"title":"Syndrome hémolytique et urémique chez l’enfant","authors":"P. Niaudet (Professeur)","doi":"10.1016/j.emcped.2004.08.001","DOIUrl":"10.1016/j.emcped.2004.08.001","url":null,"abstract":"<div><p>The haemolytic and uremic syndrome is caracterized by the association of hemolytic anemia with schizocytes, thrombopenia and renal involvement secondary to thrombotic microangiopathy. The typical form is the most frequent in children occuring after an episode of diarrhea caused by <em>Escherichia coli</em>. Other germs may be responsible for HUS such as <em>Shigella dysenteriae</em> or <em>Streptococcus pneumoniae</em>. Acute renal failure is reversible in most cases, but long term renal sequelae are seen in one third of patients when anuria at onset of disease has lasted more than one week. Treatment of typical HUS is only supportive (blood transfusion, treatment of acute renal failure). Atypical HUS is less frequent but of poorer prognosis. Atypical HUS may be associated with factor H gene mutations, von Willebrand factor-cleaving protease deficiency, congenital intracellular defects of vitamine B12 metabolism or may be of unknown origin. Familial forms are frequent. Recurrence of HUS following renal transplantation is exceptional in typical forms but is frequent in atypical HUS.</p></div>","PeriodicalId":100441,"journal":{"name":"EMC - Pédiatrie","volume":"1 4","pages":"Pages 379-385"},"PeriodicalIF":0.0,"publicationDate":"2004-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.emcped.2004.08.001","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"89686838","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
EMC - PédiatriePub Date : 2004-08-01DOI: 10.1016/j.emcped.2004.02.003
P Diallo, F Jacquemard, F Kieffer, V Mirlesse, S Romand, P Thulliez
{"title":"Pathologie urinaire fœtale","authors":"P Diallo, F Jacquemard, F Kieffer, V Mirlesse, S Romand, P Thulliez","doi":"10.1016/j.emcped.2004.02.003","DOIUrl":"10.1016/j.emcped.2004.02.003","url":null,"abstract":"<div><p>Renal agenesia refers to the lack of one or the two kidneys, arising from an agenesis of the metanephros blastema. Paediatric renal or hepato-renal polycystoma is an autosomic recessive hereditary disease concerning 1% of renal or hepato-renal malformative uropathies. It is characterized by a micro-polycystic ectasy of collecting tubules. Polycystic dysplasia is due to abnormal metanephros embryonic development, and represents about 1% of congenital malformative uropathies. Most of the time, such abnormality is unilateral and is defined by an abnormally increased renal volume. Pyelectasia refers to abnormal dilatation of the renal pelvis. Hydronephrosis is the most frequent urinary tract disorder, with an occurrence rate of 30 to 50% among congenital malformations of the kidney and the urinary tract. It is characterized by the dilatation of renal pelvis and calyxes. Megalo-ureter refers to abnormally dilated ureter. In the mega bladder disease, the bladder capacity may vary from an examination to another, or during a single examination, depending on the urinary pathology. Main aetiologies are the posterior ureter abnormalities, and the Prune- Belly syndrome.</p></div>","PeriodicalId":100441,"journal":{"name":"EMC - Pédiatrie","volume":"1 3","pages":"Pages 324-333"},"PeriodicalIF":0.0,"publicationDate":"2004-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.emcped.2004.02.003","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"72978899","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}