EMC - Pédiatrie最新文献

{"title":"Amblyopie chez l'enfant","authors":"P Dureau (Praticien titulaire),&nbsp;G Caputo (Chef de service)","doi":"10.1016/j.emcped.2004.03.001","DOIUrl":"https://doi.org/10.1016/j.emcped.2004.03.001","url":null,"abstract":"<div><p>Amblyopia is the most frequent aetiology of unilateral poor vision in childhood. It is related to abnormal development during the first years of life. Some cases are secondary to a malformation of the globe, but most of the amblyopias are functional, related to a refractive error or strabismus. Early detection is essential to the success of the treatment. This treatment has to be undertaken before the age of seven, and the paediatrician is the first-line actor in the detection of amblyopia. As soon the first months of life, observation of a strabismus, a nystagmus, and some simple examination signs must lead to an ophthalmologic examination in order to exclude any organic disease and to begin a treatment. In older children, vision testing with optotypes is simple and efficient for the detection of amblyopia. Basic of treatment principales are the correction of any refractive trouble by spectacles, patching of the good eye and penalization methods.</p></div>","PeriodicalId":100441,"journal":{"name":"EMC - Pédiatrie","volume":"1 3","pages":"Pages 271-280"},"PeriodicalIF":0.0,"publicationDate":"2004-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.emcped.2004.03.001","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"137089836","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}

{"title":"Psychoses à l'adolescence","authors":"M Botbol (Psychiatre des Hôpitaux, directeur médical) ,&nbsp;Y Barrère (Psychiatre, médecin adjoint) ,&nbsp;M Speranza (Praticien hospitalier)","doi":"10.1016/j.emcped.2004.03.002","DOIUrl":"10.1016/j.emcped.2004.03.002","url":null,"abstract":"<div><p>Psychosis is a major concern for adolescent-specialized psychiatrists who face great difficulties in making diagnosis in case of acute or torpid symptomatology since at this age, such symptoms are not systematically correlated with a specific mental disorder. This symptomatology is relatively frequent as a polymorph expression of psychic suffering due to adolescence process. Adolescence is a period characterized by many deep internal and external changes, and it is also the preferential age period for the onset of most chronic mental disorders. At their beginning, most of these disorders have not yet the typical recognizable form they will have latter on, allowing at that time easier diagnosis. More than at other life periods, the clinician has to go beyond the descriptive symptomatology to find out the underlying psychopathological organisation that may be more informative on the observed disorder in terms of diagnosis and prognosis, with the awareness that schizophrenia begins frequently at this age. Similarly, we should not forget that this age corresponds also with the onset of mood disorders, often associated with psychotic positive symptoms that may lead to misdiagnosis. We should also distinguish, among pre-morbid symptoms, vulnerability factors or prodromal manifestations that induce important consequences in terms of therapeutic strategies.</p></div>","PeriodicalId":100441,"journal":{"name":"EMC - Pédiatrie","volume":"1 3","pages":"Pages 259-270"},"PeriodicalIF":0.0,"publicationDate":"2004-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.emcped.2004.03.002","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"80035299","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}

{"title":"Syndrome infectieux fœtal","authors":"F Jacquemard","doi":"10.1016/j.emcped.2004.02.005","DOIUrl":"10.1016/j.emcped.2004.02.005","url":null,"abstract":"<div><p>Prenatal diagnosis of foetal infections has been greatly improved these last years since new molecular biology techniques became available, allowing to establish rapid and reliable diagnosis using polymerase chain reaction on amniotic fluid. In France, toxoplasmosis is the most frequently observed congenital parasitic infection. Any occurrence of maternal seroconversion (ascertained or very suspected) during pregnancy constitutes an indication for early clinical and biological check-up of the newborn. A chemo-prophylactic combination of chloroquine and proguanil (Savarine^®) should be recommended in a pregnant woman going to endemic areas, in order to prevent the risk of congenital malaria and its clinical consequences. The cytomegalovirus (CMV)- induced infection is the most frequent maternal-foetal infection. It constitutes the first cause of neuro-sensorial handicaps acquired during intrauterine life. CMV-induced primary infection in a pregnant woman is therefore a situation with major pathological risk for the foetus. The foetal contamination is principally due to hematogenous trans-placental transmission, inducing viral proliferation in the foetus. The B19 parvovirus is commonly considered responsible for the megalerythema, or fifth disease. Embryo-foetopathies associated to parvovirus infections are now better understood: the rate of maternal-foetal transmission and the risk of complications are better identified. Rubella which is a benignant infection occurring during early childhood was the first infectious disease identified as responsible for embryo-foetopathies. The Australian ophthalmologist MacAlister Gregg was the first to hypothesise, in 1941, a relationship between the onset of a per gravidic rubella and congenital cataract. The serological screening for rubella which is mandatory on early pregnancy allows to identify the initial serological status of the pregnant woman. Potential embryo-foetopathy should therefore be suspected in case any delayed intrauterine growth associated to a heart abnormality is observed in the foetus. Chickenpox is an uncommon disease in women during pregnancy. For the mother, complications are mainly of pulmonary type (in about 10% of the cases), and potentially life-threatening. Before 24-week amenorrhoea, the fœtal transmission (estimated to approximate 6%) may be responsible for a congenital varicella syndrome in about 2% of cases. Perinatal chickenpox due to peripartum transmission induces in about 25% of the cases a neonatal chickenpox potentially serious and sometimes fatal; this risk is essentially associated to an eruption in the mother, occurring during the period from 5 days before delivery to 2 days after. Bacterial infections remain the major concern for paediatric obstetricians since they always constitute a frequent risk for perinatal morbidity and mortality (3^rd cause of mortality). In all studies on maternal-foetal bacterial infections, the streptococcus B was","PeriodicalId":100441,"journal":{"name":"EMC - Pédiatrie","volume":"1 3","pages":"Pages 296-323"},"PeriodicalIF":0.0,"publicationDate":"2004-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.emcped.2004.02.005","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"76207610","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}

{"title":"Diététique et néphropathies de l'enfant","authors":"M. Broyer ,&nbsp;D. Folio ,&nbsp;F. Mosser","doi":"10.1016/j.emcped.2004.04.002","DOIUrl":"https://doi.org/10.1016/j.emcped.2004.04.002","url":null,"abstract":"<div><p>Dietary recommendations constitute a major intervention in children with renal diseases. A sodium-limited diet is prescribed in potential or overt sodium retention states, such as nephritic syndromes and, generally speaking, in glomerulo-nephritis. Practical modalities of this prescription are explained taking into account the sodium content of the different foods. Diet plays a major role in the treatment of the infant with renal failure, because related anorexia and gastrointestinal disorders frequently result in naso-gastric or gastrostomy nutrition in order to provide sufficient energy. The principles of diet in patients with chronic renal impairment have evolved these last years. The previously recommended severe protein restriction is no longer recommended. Nevertheless, according to age and degree of renal impairment, recommendations for protein intakes are proposed on the basis of standard occidental alimentary habits, generally largely above the minimum amounts as estimated by experts taking into account the age. Limited protein intakes is useful for limiting phosphorus and acid loads, but its interest in slowing the renal function degradation remains questionable. Other recommendations concern the child with renal failure, especially potassium limitation when GFR decreases to below 20 mL/mn; water and sodium intakes must also be adjusted. Examples of dietary regimens together with practical indications are provided. Diet in nephrogenic diabetes insipidus and in some metabolic lithiasis is also considered.</p></div>","PeriodicalId":100441,"journal":{"name":"EMC - Pédiatrie","volume":"1 3","pages":"Pages 281-295"},"PeriodicalIF":0.0,"publicationDate":"2004-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.emcped.2004.04.002","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"137089689","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}

{"title":"Néphrocalcinose de l’enfant","authors":"M.-F Gagnadoux (Praticien hospitalier)","doi":"10.1016/j.emcped.2004.01.001","DOIUrl":"10.1016/j.emcped.2004.01.001","url":null,"abstract":"<div><p>Nephrocalcinosis, the diagnosis of which is now made easier by ultrasonography, is not exceptional in children and even infants. Its etiologies are multiple, but almost all of them involve a metabolic disorder, most often of genetic or iatrogenic origin, increasing the urinary excretion of calcium or oxalate. The most frequent causes vary according to age. Nephrocalcinosis in newborn and infants suggests three main causes : “prematurity-associated hypercalciuria”, the origin of which, multifactorial, is mostly iatrogenic, early-onset tubulopathies (distal tubular acidosis, Bartter's syndrome), and infantile-onset primary hyperoxaluria, which is fortunately very rare. In older children, the main causes are : distal tubular acidosis, primary hyperoxaluria, and hypercalciurias from known genetic origin (Dent's disease, familial hypomagnesemia-hypercalciuria) or still “idiopathic”. The prognosis depends upon the extension of calcic deposit and, above all, on the feasibility, by treating the causal disease, of preventing the calcification process.</p></div>","PeriodicalId":100441,"journal":{"name":"EMC - Pédiatrie","volume":"1 2","pages":"Pages 198-202"},"PeriodicalIF":0.0,"publicationDate":"2004-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.emcped.2004.01.001","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"74502743","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}

{"title":"Pathologie neurologique malformative fœtale","authors":"M.L Moutard,&nbsp;C Fallet-Blanco","doi":"10.1016/j.emcped.2004.02.006","DOIUrl":"10.1016/j.emcped.2004.02.006","url":null,"abstract":"<div><p>« Congenital malformation » refers to any structural abnormality of the central nervous system (CNS), present at birth, and due to interrupted or modified CNS development during intrauterine life, whatever the aetiology. The frequency of CNS malformations has been estimated to 5-10/ 1,000 births, found in 5-10% of stillborn infants, or early deceased neonates. “Neural tube defect” (NTD) refers to a large set of malformations resulting from a neural tube closure that may be defective to a variable extent, or abnormal covering tissues induced by the axis mesoderm (posterior dura mater, axis skeleton, hypoderm) and the ectoderm.</p></div>","PeriodicalId":100441,"journal":{"name":"EMC - Pédiatrie","volume":"1 2","pages":"Pages 210-231"},"PeriodicalIF":0.0,"publicationDate":"2004-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.emcped.2004.02.006","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"77467271","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}

{"title":"Détresses respiratoires du nouveau-né (en dehors des malformations et des maladies génétiques ou constitutionnelles)","authors":"S Lorotte-Namouni (Chef de clinique-assistante des hôpitaux de Paris) ,&nbsp;C Clamadieu (Praticien hospitalier) ,&nbsp;P.-H Jarreau (Professeur des Universités, praticien hospitalier)","doi":"10.1016/j.emcped.2004.02.002","DOIUrl":"10.1016/j.emcped.2004.02.002","url":null,"abstract":"<div><p>Respiratory disorders are one of the main cause of neonatal morbidity and mortality. Their aetiology is predominantly linked to an inappropriate cardio-respiratory adaptation at birth and to infections. Recent improvements in the management of these disorders diminished dramatically the mortality. These improvements are due to a better perinatal care organization, and to substantial advances in obstetrics and paediatrics, among which a wide use of antenatal steroids, exogenous surfactants and improvements in mechanical ventilation. Nevertheless, bronchopulmonary dysplasia remains a major problem in the outcome of the most preterm infants. A better knowledge of its physiopathology may open new therapeutic advances.</p></div>","PeriodicalId":100441,"journal":{"name":"EMC - Pédiatrie","volume":"1 2","pages":"Pages 152-170"},"PeriodicalIF":0.0,"publicationDate":"2004-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.emcped.2004.02.002","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"79148275","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}

{"title":"Erratum à l'article : « Insuffisance rénale aiguë chez l’enfant » [EMC-Pédiatrie 2004;1:73–88]","authors":"M.-A Macher","doi":"10.1016/j.emcped.2004.04.001","DOIUrl":"https://doi.org/10.1016/j.emcped.2004.04.001","url":null,"abstract":"","PeriodicalId":100441,"journal":{"name":"EMC - Pédiatrie","volume":"1 2","pages":"Page 258"},"PeriodicalIF":0.0,"publicationDate":"2004-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.emcped.2004.04.001","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"91632184","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Pathologie génitale fœtale","authors":"V Mirlesse ,&nbsp;C Nihoul-Fekete ,&nbsp;J Mac Aleese","doi":"10.1016/j.emcped.2004.02.004","DOIUrl":"10.1016/j.emcped.2004.02.004","url":null,"abstract":"<div><p>An abnormality of genital organs may occur during pregnancy in 0.1 to 0.3% of the cases. This event always constitute a real tragedy. Sexuality and reproduction appear to be the first concern, even before potential associate abnormalities or a clear urinary-genital prognostic are considered.</p></div>","PeriodicalId":100441,"journal":{"name":"EMC - Pédiatrie","volume":"1 2","pages":"Pages 203-209"},"PeriodicalIF":0.0,"publicationDate":"2004-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.emcped.2004.02.004","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"90833754","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}

{"title":"Rein et médicaments","authors":"P. Cochat (Professeur des Universités, praticien hospitalier) ,&nbsp;L. Dubourg (Maître de conférence des universités, praticien hospitalier)","doi":"10.1016/j.emcped.2004.01.003","DOIUrl":"10.1016/j.emcped.2004.01.003","url":null,"abstract":"<div><p>The interaction between drugs and the kidney can be considered at different levels: normal drug clearance, influence of the renal function on their elimination, expression of the drug nephrotoxicity, and their elimination in case of overdosing. In the child, available information often consists in extrapolated observations from adult subjects, and sometimes from animal experiments. It is therefore important to clearly identify the paediatric features of the drugs-kidney relationship, insofar as they considerably vary from the foetal period towards adolescence.</p></div>","PeriodicalId":100441,"journal":{"name":"EMC - Pédiatrie","volume":"1 2","pages":"Pages 171-185"},"PeriodicalIF":0.0,"publicationDate":"2004-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.emcped.2004.01.003","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"89588120","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}