Archives De Pediatrie最新文献

{"title":"Impact of early administration of long-acting insulin on ketosis rebound in diabetic ketoacidosis","authors":"Emilie Thibault ,&nbsp;Thomas Loppinet ,&nbsp;Aurélie Portefaix ,&nbsp;Valérie Launay ,&nbsp;Kevin Perge","doi":"10.1016/j.arcped.2024.09.008","DOIUrl":"10.1016/j.arcped.2024.09.008","url":null,"abstract":"<div><h3>Background</h3><div>Diabetic ketoacidosis (DKA) is a potentially life-threatening metabolic disorder that can occur with the onset or during follow-up of type 1 diabetes (T1D). Once DKA has been resolved, discontinuing the intravenous insulin infusion may lead to a rebound of hyperglycemia. Therefore, this study aimed to demonstrate that early administration by an injection of long-acting insulin avoids a ketosis rebound after stopping intravenous insulin.</div></div><div><h3>Methods</h3><div>A retrospective study was conducted in the Femme-Mère-Enfant Hospital. We included patients aged 0 and 18 years, admitted to the intensive care unit and then to pediatric diabetology for DKA between January 2022 and April 2023. We separated patients into two groups depending on the protocol received. For the \"old protocol\" group, intravenous insulin was stopped when the acidosis was resolved, and before the patient was transferred, subcutaneous insulin injections were given in diabetology. For the \"new protocol\" group, subcutaneous injections of long-acting and rapid-acting insulin were administered before discontinuing the intravenous infusion in the intensive care unit before transfer.</div></div><div><h3>Results</h3><div>A total of 58 children were included. 46 patients were managed for inaugural DKA and 12 for DKA decompensating of known T1D. 41 patients received the old protocol, and 17 the new protocol. The incidence of ketosis rebound was lower in the \"new protocol\" group (41.2 % vs. 75.6 %; p 0.027). There is a significant association between the new protocol and reduced risk of ketosis rebound (OR 0.23, p 0.015). Multivariate analysis adjusted for potential confounding factors doesn't modify these results (OR 0.25, p 0.045).</div></div><div><h3>Conclusion</h3><div>Our study is the first pediatric study suggesting that earlier injection of long-acting insulin after resolution of DKA in children reduces the risk of ketosis rebound.</div></div>","PeriodicalId":55477,"journal":{"name":"Archives De Pediatrie","volume":"32 1","pages":"Pages 30-35"},"PeriodicalIF":1.3,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142775198","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}

{"title":"Survey on vitamin D supplementation in children in France: Evaluation of real-life practices following the new 2022 French recommendations","authors":"Marie Lou Pechabrier ,&nbsp;Justine Bacchetta ,&nbsp;Patrick Tounian ,&nbsp;Sanaa Eddiry ,&nbsp;Agnès Linglart ,&nbsp;Thomas Edouard","doi":"10.1016/j.arcped.2024.09.006","DOIUrl":"10.1016/j.arcped.2024.09.006","url":null,"abstract":"<div><h3>Background and objective</h3><div>In 2022, recommendations for vitamin D supplementation in children were updated in France. The objective of this study was to assess real-life practices of vitamin D supplementation in children following these recommendations.</div></div><div><h3>Methods</h3><div>A thirty-three-question questionnaire was distributed to members of the scientific societies of paediatrics and general medicine via an online platform.</div></div><div><h3>Results</h3><div>There were 966 respondents, of whom 87 % were paediatricians and 13 % were general practitioners. About half of the physicians (47 %) were in private practice, 49 % worked in a hospital centre and 6 % worked in a maternal and child health centre. As recommended and regardless of the professional practice, vitamin D supplementation was almost systematically prescribed in all age groups (over 90 % of respondents), in daily doses up to 2 years of age (97 % of all respondents) and then every 3 months in older children (year-round in 38 % and winter/spring only in 40 %). Contrary to the new recommendations, loading doses of 200,000 units of vitamin D were prescribed by 5 % of respondents and non-pharmaceutical forms of vitamin D (<em>e.g.</em> unlicensed food supplements) were prescribed by 10 % of respondents. Although risk factors such as low sun exposure and dark skin were well known by respondents (75 % and 74 % respectively), obesity and veganism were only reported by half the respondents (40 % and 53 % respectively). Two-thirds (61 %) of respondents reported assessing calcium intakes when following children; however, only 10 % of them use specific questionnaires or calcium equivalence tables. Finally, the calcium content of foods and its bioavailability appeared to be poorly understood by health professionals.</div></div><div><h3>Conclusion</h3><div>This survey shows that the practice of paediatricians and general practitioners are in accordance with the new recommendations for vitamin D supplementation in very young children. The identification by this survey of knowledge gaps will allow targeted information campaigns.</div></div>","PeriodicalId":55477,"journal":{"name":"Archives De Pediatrie","volume":"32 1","pages":"Pages 4-11"},"PeriodicalIF":1.3,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142683716","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prescription practice and yield of chest radiography in the management of children presenting to the French pediatric emergency department with non-traumatic chest pain","authors":"Faïza Abdallah ,&nbsp;Damiano Cerasuolo ,&nbsp;David Brossier ,&nbsp;Philippe Eckart ,&nbsp;Emeline Duroy ,&nbsp;Fanny Delehaye ,&nbsp;Caroline Faucon","doi":"10.1016/j.arcped.2024.09.002","DOIUrl":"10.1016/j.arcped.2024.09.002","url":null,"abstract":"<div><h3>Objectives</h3><div>Chest pain is a common symptom in pediatric emergency department. The causes are mostly benign without any sign on chest x-ray (CXR). However, CXR is one of the most ordered tests in this situation. Our main objective was to assess the current management of CXR by physicians in this context, according to the algorithm proposed by the French Society of Pediatrics (FSP).</div></div><div><h3>Materials and methods</h3><div>We conducted a retrospective study in two French pediatric emergency departments. We reviewed the medical records of children who presented with chest pain between 2018, July 1rst to 2021, July 31th. We collected data from history and clinical examination. The prescription of CXR and its interpretation were collected.</div></div><div><h3>Results</h3><div>Overall, 599 children were enrolled. The algorithm was followed in 57,1 % of cases, and 8,2 % of abnormal CXR were noted. On univariate analysis, medical history with a significant OR greater than 2 included cardiological history (as defined by FSP), neoplasia, pneumonia and sickle cell disease. Right lateralized pain, pain that worsens with respiration, fever and cough were also symptoms significantly associated with an abnormal CXR result. On physical finding, tachycardia, tachypnea, abnormal cardiac and pulmonary clinical examination (as defined by the FSP) were significantly associated with pathological CXR. However, the multivariate logistic regression model could not be carried out due to too many significant variables in univariate analysis, and too few number of abnormal CXR reported.</div></div><div><h3>Conclusion</h3><div>CXR remains the cornerstone of chest pain management in pediatric emergencies, even though the rate of abnormal CXR appears low. The appropriateness of CXR prescribing can be improved by guidelines focusing on the clinical etiologies of chest pain visible on CXR. A similar prospective study may identify risk factors for pathological CXR and clarify the decision tree for the indication of CXR in chest pain.</div></div>","PeriodicalId":55477,"journal":{"name":"Archives De Pediatrie","volume":"32 1","pages":"Pages 41-47"},"PeriodicalIF":1.3,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142693928","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}

{"title":"Impact of the first COVID-19 lockdown on domestic accidents in children in France","authors":"Marie-Prisca Chaffard Luçon ,&nbsp;Nathalie Beltzer ,&nbsp;Annabel Rigou ,&nbsp;Isabelle Claudet","doi":"10.1016/j.arcped.2024.09.007","DOIUrl":"10.1016/j.arcped.2024.09.007","url":null,"abstract":"<div><h3>Background</h3><div>In March 2020, several countries, including France, implemented a total lockdown policy to combat the spread of the COVID-19 epidemic, involving the closure of schools. This measure required children to stay at home for an extended period of time. Several studies have shown an increase in the number or proportion and severity of domestic accidents in children during this period. Santé Publique France and the paediatric emergency department of Toulouse University Hospital conducted a study on the impact of the first lockdown on the use of the emergency department due to domestic accidents in children under 15 years of age in France.</div></div><div><h3>Methods</h3><div>The study was conducted using data from nine French emergency departments participating in the <em>Enquête permanente sur les accidents de la vie courante</em> [Permanent Survey on Home and leisure injuries] (EPAC), which involves the exhaustive collection of data on emergency admissions following home and leisure injuries. The frequencies and characteristics of emergency department admissions due to domestic accidents were analysed over the period from 17 March to 11 May 2020, and compared to those over the same period in 2016–2019.</div></div><div><h3>Results</h3><div>During the lockdown period, an increase in the proportion of emergency department admissions due to domestic accidents is observed in boys and children aged [2–5[years. This study showed an increase in the proportion of hospital admissions during this period. These accidents were mainly falls in outside living spaces (balcony, patio, garden, etc.). The results showed an increase in admissions for fractures and upper limb injuries.</div></div><div><h3>Conclusion</h3><div>This study shows that health policies must take into account the collateral effects of certain measures put in place to manage an epidemic. Prevention messages for parents of young children need to be strengthened and their attention drawn to the risk of certain kinds of accidents, such as falls.</div></div>","PeriodicalId":55477,"journal":{"name":"Archives De Pediatrie","volume":"32 1","pages":"Pages 52-57"},"PeriodicalIF":1.3,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142689789","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}

{"title":"Neuroendocrine tumor discovered in a teenager following asthma misdiagnosis","authors":"Sophie Denamur ,&nbsp;Erik Hervieux ,&nbsp;Elora Peulier-Maitre ,&nbsp;Francois Chalard ,&nbsp;Aurore Coulomb ,&nbsp;Nadia Nathan ,&nbsp;Harriet Corvol","doi":"10.1016/j.arcped.2024.11.002","DOIUrl":"10.1016/j.arcped.2024.11.002","url":null,"abstract":"<div><div>Although relatively rare, neuroendocrine tumors (NETs) represent the most common type of endobronchial tumors in pediatric patients. Their clinical presentation lacks specificity, often leading to delayed diagnosis due to limited clinical suspicion. Mainly classified as low-grade malignant tumors (grade 1), they typically demonstrate favorable outcomes following surgical removal. However, local recurrence and/or metastases may occur in both low- and high-grade NET. We present the case of a 17-year-old girl initially misdiagnosed with asthma, later found to have a low-grade NET obstructing the left main bronchus. Surgical resection enabled complete tumor removal, and subsequent follow-up confirmed the postsurgical recovery. This case emphasizes the importance of familiarizing pediatricians and GP with the need for chest X-rays in all initial asthma diagnosis in order to eliminate differential diagnoses such as bronchial NET. This underscores the importance of a prompt diagnosis and follow-up care in similar cases.</div></div>","PeriodicalId":55477,"journal":{"name":"Archives De Pediatrie","volume":"32 1","pages":"Pages 72-76"},"PeriodicalIF":1.3,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142883729","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"School-entry age and academic difficulties at 7 years of age in children born very preterm: A call for age-corrected schooling","authors":"Jean-Christophe Roze ,&nbsp;Geraldine Apprioual ,&nbsp;Andrei Scott Morgan ,&nbsp;Jean-Baptiste Muller ,&nbsp;Stephane Marret ,&nbsp;Valerie Rouger ,&nbsp;Ghislain Leduc ,&nbsp;Nail Benallegue ,&nbsp;Mickael Dinonais ,&nbsp;Charlote Bouvard ,&nbsp;Pierre-Yves Ancel ,&nbsp;Cyril Flamant","doi":"10.1016/j.arcped.2024.10.007","DOIUrl":"10.1016/j.arcped.2024.10.007","url":null,"abstract":"<div><h3>Background</h3><div>Very preterm children are at greater risk of academic difficulties (AD). Some of them start school a year earlier than anticipated during pregnancy due to being born preterm. The aim of this study was to analyze the relationship between neurodevelopment, school-entry age, and AD at age seven.</div></div><div><h3>Method</h3><div>AD were assessed at age seven in children born before 33 weeks of gestation between January 1st, 2007 and December 31, 2014 and enrolled in LIFT cohort. To analyze the relationship between school-entry age and AD, we used generalized equations with adjustment for perinatal, socio-economic factors, and neurodevelopment assessed by Age Stages Questionnaire (ASQ) at 5 years. Moreover, we used Global Scholar Adaptation (GSA) score to evaluate the school adaptation.</div></div><div><h3>Results</h3><div>2599 children were in routine schooling. Entering school a year earlier was observed in 597 (23.0 %). AD was known for 1943/2599 (74.8 %). Starting school a year earlier was associated with an increased rate of AD: 35.4 % in the exposed group versus 20.2 % in the non-exposed group, with a relative risk of 1.76 (95 % CI: 1.48; 2.08). Both starting school a year earlier and ASQ at 5 years old were independently associated with the GSA score at age 7: standardized β = -0.15 (95 % CI:-0.10;-0.20) and 0.40 (95 % CI: 0.35; 0.45) respectively.</div></div><div><h3>Conclusion</h3><div>Starting school a year earlier than anticipated during pregnancy was associated with an increased rate of AD at age 7 in children born very preterm, independently of their neurodevelopment at age 5 assessed by ASQ. Basing school entry age on corrected age seems appropriate to mitigate this risk.</div></div>","PeriodicalId":55477,"journal":{"name":"Archives De Pediatrie","volume":"32 1","pages":"Pages 66-71"},"PeriodicalIF":1.3,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142883732","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Acknowledging our reviewers","authors":"","doi":"10.1016/j.arcped.2024.12.002","DOIUrl":"10.1016/j.arcped.2024.12.002","url":null,"abstract":"","PeriodicalId":55477,"journal":{"name":"Archives De Pediatrie","volume":"32 1","pages":"Page 1"},"PeriodicalIF":1.3,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143104021","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}

{"title":"Gastroesophageal reflux within first year of life: What new recommendations from French National Authority for Health (HAS) tell us","authors":"Camille Jung ,&nbsp;Haude Clouzeau ,&nbsp;Karim Bouziane Nedjadi ,&nbsp;Noël Peretti ,&nbsp;Arnaud Lalanne ,&nbsp;Stéphanie Coopman ,&nbsp;Marc Bellaiche ,&nbsp;Hugues Piloquet ,&nbsp;Alexandre Fabre ,&nbsp;Delphine Ley ,&nbsp;French-speaking Pediatric Hepatology, Gastroenterology and Nutrition Group (GFHGNP)","doi":"10.1016/j.arcped.2024.08.008","DOIUrl":"10.1016/j.arcped.2024.08.008","url":null,"abstract":"","PeriodicalId":55477,"journal":{"name":"Archives De Pediatrie","volume":"32 1","pages":"Pages 2-3"},"PeriodicalIF":1.3,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142683710","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}

{"title":"Scurvy in an 18-month-old child mimicking a clinical presentation of rickets.","authors":"Ai Tien Nguyen, Sibylle Jalon, Albane Simon, Maurine Jouret, Justin Le Lorier, Véronique Hentgen, Marie-Aliette Dommergues","doi":"10.1016/j.arcped.2024.10.006","DOIUrl":"https://doi.org/10.1016/j.arcped.2024.10.006","url":null,"abstract":"<p><p>Scurvy is now considered to be a rare disease in European countries, even among children, but it still exists. We report the case of an 18-month-old boy who was initially hospitalized for a walking disorder and ultimately diagnosed with scurvy. Radiographs were compatible with rickets, but biological analysis ruled out this diagnosis. The vitamin C deficiency was due to an inadequate diet of a young child without any underlying conditions. This child was exclusively breastfed until the age of 17 months and his mother was also likely vitamin C deficient, as she had a diet lacking in fruits and vegetables. Practitioners should become familiar with symptoms of scurvy to prevent the ordering of unnecessary tests and delays in diagnoses.</p>","PeriodicalId":55477,"journal":{"name":"Archives De Pediatrie","volume":" ","pages":""},"PeriodicalIF":1.3,"publicationDate":"2024-12-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142900676","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}

{"title":"Comparison of sedation using pentobarbital or chlorpromazine in pediatric non-invasive imaging procedures: A before and after study.: Comparison of sedation using pentobarbital or chlorpromazine in non-invasive imaging procedures.","authors":"Elodie Morin, Eric Xu, Elise Sacaze, Olivier Legeas, Juliette Ropars","doi":"10.1016/j.arcped.2024.11.001","DOIUrl":"https://doi.org/10.1016/j.arcped.2024.11.001","url":null,"abstract":"<p><strong>Background: </strong>Sedation is often required for pediatric medical imaging procedures to ensure compliance and image quality. Recommendations for pediatric sedation exist, but there are currently no guidelines for the choice of the sedative drug.</p><p><strong>Objective: </strong>To compare the efficacy and adverse events of per os pentobarbital with intravenous chlorpromazine in children undergoing diagnostic imaging procedures. We hypothesized that the efficacy of per os pentobarbital would not be inferior to that of intravenous chlorpromazine, that safety would be similar, and that patient acceptance would be higher.</p><p><strong>Material and methods: </strong>A pilot study (before and after study methodology) was performed. The sedation of 247 children with intravenous chlorpromazine or oral pentobarbital was evaluated for 6 months successively (independently by two radiologists, both blinded to the sedation technique). The primary outcome was sedation success as defined by an acceptable image quality. Secondary outcomes were induction time, length of hospital stay, adverse events, parental satisfaction and potential factors associated with failure of pentobarbital sedation.</p><p><strong>Results: </strong>The sedation success rate of per os pentobarbital was found to be not inferior to that of intravenous chlorpromazine (83 % vs 90 %, p < 0.01). Mean length of hospital stay was shorter with per os pentobarbital. Despite the higher incidence of agitation during recovery with per os pentobarbital, parents expressed a preference for it. Per os pentobarbital failed more often in children older than 5 years.</p><p><strong>Conclusion: </strong>Per os pentobarbital may be an effective alternative to intravenous chlorpromazine, especially in children under 5 years of age.</p>","PeriodicalId":55477,"journal":{"name":"Archives De Pediatrie","volume":" ","pages":""},"PeriodicalIF":1.3,"publicationDate":"2024-12-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142883726","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}