Archives De Pediatrie最新文献

{"title":"Care for newborns and its diverse meanings","authors":"Hélène Kane ,&nbsp;Yannick Jaffré ,&nbsp;Alain Prual","doi":"10.1016/j.arcped.2024.10.002","DOIUrl":"10.1016/j.arcped.2024.10.002","url":null,"abstract":"<div><div>The arrival of a newborn in a family brings with it many worries, together with baby-related tasks to keep family members busy, and sometimes paradoxically withdrawal. Funding from UNICEF enabled us to conduct an original anthropological study in five countries of sub-Saharan Africa (Benin, Burkina Faso, Mali, Mauritania, Togo), studying newborn care from birth to the seventh day of life. We focused on the various kinds of care provided to these babies and on their diverse meanings. We examined how the social status of newborns induced forms of care and of interpretations of particular disorders. This work shows that the conceptions of the newborn: vulnerable beings of uncertain social integration – engendered less investment by health care professionals at birth, but inversely, strong mobilization by members of the extended family. Despite the generalization of hospital births, care during the first days of life remained associated with the domestic household universe and was barely if at all medicalized. The heterogeneous integration of medical recommendations for newborn care in the first days of life can be analyzed as arising from divergent intentions around the birth and the reception of the newborn. This study also examined how changes in neonatal care may generate conflicts of influence and intrafamily power struggles and thus allowed us to explain how the adoption of some recommended neonatal care was compromised and how they need to be adapted locally. It thus showed how some changes in neonatal care helped to bring about the reexamination of family roles. This will lead us to discuss how to define \"respectful care\" for these subjects who cannot speak. Beyond quality of care based on good practice guidelines, it is important to underline how respect in the care relationship is indissociable from the local cultural construction of newborns.</div></div>","PeriodicalId":55477,"journal":{"name":"Archives De Pediatrie","volume":"31 8","pages":"Pages 547-550"},"PeriodicalIF":1.3,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142565391","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":"Implementation of a protocol to prevent hypoglycemia in at-risk neonates born at 35 weeks’ gestational age in a tertiary hospital: Adherence and satisfaction. It's not so easy!","authors":"Marion Suprin ,&nbsp;Nathan Micheletti ,&nbsp;Sylvie-Françoise Caraby ,&nbsp;Cyril Ruello ,&nbsp;Anne Ego ,&nbsp;Thierry Debillon ,&nbsp;Julia Doutau ,&nbsp;Marie Chevallier","doi":"10.1016/j.arcped.2024.07.008","DOIUrl":"10.1016/j.arcped.2024.07.008","url":null,"abstract":"<div><h3>Background</h3><div>The present study assessed adherence and satisfaction regarding a new protocol for preventing hypoglycemia in neonates, with a target of 80 % adherence.</div></div><div><h3>Methods</h3><div>This 6-month prospective observational study was conducted between 2021 and 2022 in a tertiary hospital maternity unit. Neonates with at least one hypoglycemia risk factor were included. Two factors for adherence were evaluated: feeding before 1 h of life and capillary blood glucose assay at 2 h of life.</div></div><div><h3>Results</h3><div>Protocol adherence was 67.6 % overall, with clinically satisfactory protocol application. Neonates small for gestational age were at the greatest risk of hypoglycemia (34.8 %). Non-adherence mainly concerned early feeding (28.9 %). The rate of hypoglycemia with adherence and non-adherence was, respectively, 15.8 % (<em>n</em> = 27/171) and 22.0 % (<em>n</em> = 18/82) (<em>p</em> = 0.23). Teams integrated the new recommendations successfully (satisfaction: 8/10), with some reluctance on the part of childcare assistants due to increased workload.</div></div><div><h3>Conclusion</h3><div>This apparently simple protocol could be supported by a quality improvement program. This study might help other care teams to establish similar protocols and identify areas for improvement.</div></div>","PeriodicalId":55477,"journal":{"name":"Archives De Pediatrie","volume":"31 8","pages":"Pages 540-546"},"PeriodicalIF":1.3,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142549057","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":"A decisive step in supporting transgender youth in France.","authors":"Sylvie Rossignol, Agnès Linglart","doi":"10.1016/j.arcped.2024.09.001","DOIUrl":"https://doi.org/10.1016/j.arcped.2024.09.001","url":null,"abstract":"","PeriodicalId":55477,"journal":{"name":"Archives De Pediatrie","volume":" ","pages":""},"PeriodicalIF":1.3,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142565382","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":"Paradigm shift in France in the medical care of children with genital development variations","authors":"Claire Bouvattier ,&nbsp;Lise Duranteau ,&nbsp;Tristan Verdelet ,&nbsp;Marion Joly ,&nbsp;Caroline Le Roux ,&nbsp;Laurence Brunet","doi":"10.1016/j.arcped.2024.07.009","DOIUrl":"10.1016/j.arcped.2024.07.009","url":null,"abstract":"<div><div>In 2021, for the first time, a legal framework organizing the care of children with a variation in genital development (VGD), sometimes referred to as “intersex children” or “children with differences in sex development” (DSD), was introduced in France (article L. 2131–6 of the Code of Public Health). It should be immediately apparent that the chosen term, “variation” rather than “anomalies” or “disorders” – which was previously used in the medical world – reflects a political will to renew both the way of thinking and the medical practices in this field. The aim of the new legal framework is to guarantee optimum care for children with VGD by requiring the systematic involvement of expert centers (to establish diagnoses and therapeutic proposals), providing the most comprehensive information possible to their families and seeking the minor's consent. Among the possible medical care options, the law explicitly mentions “therapeutic abstention,” reflecting a paradigm shift aimed at curbing the too-frequent recourse to treatments whose sole objective is the conformation of the genitalia. An order was subsequently issued on 15 November 2022 to provide the necessary details for the implementation of the changes introduced by the law.</div></div>","PeriodicalId":55477,"journal":{"name":"Archives De Pediatrie","volume":"31 8","pages":"Pages 551-553"},"PeriodicalIF":1.3,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142549058","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":"Predictors of emotional eating behaviors in adolescents with overweight and obesity","authors":"Makbule ESEN ÖKSÜZOĞLU ,&nbsp;Devrim AKDEMİR ,&nbsp;Sinem AKGÜL ,&nbsp;Pınar ÖZDEMİR","doi":"10.1016/j.arcped.2024.07.007","DOIUrl":"10.1016/j.arcped.2024.07.007","url":null,"abstract":"<div><h3>Purpose</h3><div>Mood symptoms and disordered eating behaviors are common in adolescents with overweight and obesity. This study aimed to investigate the relationships between mood symptoms, difficulties in emotion regulation, and emotional eating behaviors in adolescents with overweight and obesity.</div></div><div><h3>Methods</h3><div>In this cross-sectional study, adolescents with normal weight (<em>N</em> = 45), overweight (<em>N</em> = 45), or obesity (<em>N</em> = 55) were assessed using semi-structured clinical interviews and self-report scales. Path analysis was used to examine factors contributing to emotional eating behaviors, considering psychiatric comorbidities, mood symptoms, emotional/binge/restrictive eating behaviors, difficulties in emotion regulation, and self-esteem.</div></div><div><h3>Results</h3><div>Adolescents with overweight and obesity exhibited more depressive, anxiety, and anger symptoms; restrictive, emotional, and external eating behaviors; and psychopathologies such as mood disorders, anxiety disorders, and attention-deficit/hyperactivity disorder (ADHD) compared with normal-weight adolescents. ADHD diagnosis, difficulties in emotion regulation, hypomanic/manic symptoms, and anger symptoms directly predicted emotional eating behavior, while self-esteem was an indirect predictor.</div></div><div><h3>Conclusion</h3><div>Adolescents with overweight and obesity tend to exhibit similar psychological characteristics, including increased mood symptoms and maladaptive eating behaviors associated with higher rates of anxiety and mood disorders, compared with their normal-weight peers. The most significant predictors of emotional eating behaviors were ADHD and difficulties in emotion regulation. Given the frequency of psychological comorbidities in obesity, their detection and management should be encouraged.</div></div>","PeriodicalId":55477,"journal":{"name":"Archives De Pediatrie","volume":"31 8","pages":"Pages 527-532"},"PeriodicalIF":1.3,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142549060","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":"A new nonsense pathogenic variant in exon 1 of PHOX2B leads to the diagnosis of congenital central hypoventilation syndrome with intra-familial variability","authors":"Morgane Pelleter ,&nbsp;Charlène Desaintjean ,&nbsp;Romane Gyapay ,&nbsp;Bruno Massenavette ,&nbsp;Florent Baudin ,&nbsp;Nathalie Couque ,&nbsp;Renaud Tamisier ,&nbsp;Benjamin Dudoignon ,&nbsp;Patricia Franco ,&nbsp;Antoine Mougenel-Chantereau ,&nbsp;Laurianne Coutier","doi":"10.1016/j.arcped.2024.06.003","DOIUrl":"10.1016/j.arcped.2024.06.003","url":null,"abstract":"<div><div>Congenital central hypoventilation syndrome (CCHS) is a rare genetic disorder of the autonomic nervous system resulting in decreased brain sensitivity to hypercapnia and hypoxia characterized by a genetic abnormality in the pair-like homeobox 2B (<em>PHOX2B</em>) gene. Most patients have a heterozygous expansion of the polyalanine repeat in exon 3 (PARM), while 10 % of patients have non-PARM (NPARM) mutations that can span the entire gene. The majority of pathogenic variants are de novo, but variants with incomplete penetrance can be identified in the heterozygous state. In the present report, CCHS was diagnosed in a symptomatic 3-month-old infant with neonatal respiratory distress. Genetic analysis revealed a new mutation in exon 1 of the <em>PHOX2B</em> gene – <em>p.Ser28* (c.83C&gt;G) –</em> which was further identified in two family members, one minimally symptomatic and one asymptomatic. The identification of this new mutation supports the importance of sequencing the entire gene even when the classic PARM mutation is not found and highlights the phenotypic variability of CCHS.</div></div>","PeriodicalId":55477,"journal":{"name":"Archives De Pediatrie","volume":"31 7","pages":"Pages 470-472"},"PeriodicalIF":1.3,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142301745","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":"Neonatal screening: A public health success and the ethical dilemmas it can pose","authors":"Brigitte Chabrol","doi":"10.1016/j.arcped.2024.07.002","DOIUrl":"10.1016/j.arcped.2024.07.002","url":null,"abstract":"","PeriodicalId":55477,"journal":{"name":"Archives De Pediatrie","volume":"31 7","pages":"Pages 407-409"},"PeriodicalIF":1.3,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142301747","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":"Disordered eating behaviors and associated factors in children and adolescents with type 1 diabetes","authors":"Ebru Barsal Çetiner ,&nbsp;Zeynep Donbaloğlu ,&nbsp;Aynur İnan Yüksel ,&nbsp;Berna Singin ,&nbsp;Bilge Aydın Behram ,&nbsp;Aynur Bedel ,&nbsp;Mesut Parlak ,&nbsp;Hale Tuhan","doi":"10.1016/j.arcped.2024.04.006","DOIUrl":"10.1016/j.arcped.2024.04.006","url":null,"abstract":"<div><h3>Object</h3><div>As part of their treatment, patients with type 1 diabetes mellitus (DM) have to be very careful with what they eat and with their insulin doses. Therefore, the risk of eating disorders increases in this patient group. In this study, we aimed to determine the disordered eating behaviors of patients with type 1 DM and to evaluate the sociodemographic characteristics, diabetes care behaviors, and quality-of-life scale results that these behaviors may be related to.</div></div><div><h3>Method</h3><div>The sociodemographic characteristics and diabetes treatment data of 191 patients aged 9–18 years with type 1 DM were analyzed. The Pediatric Quality of Life Inventory (PedsQL), the PedsQL 3.0 Diabetes Module, and the Diabetes Eating Problem Survey-Revised (DEPS-R) were applied.</div></div><div><h3>Results</h3><div>The median DEPS-R score of the patients was 18 (19.00), and 44.5 % had a DEPS-R score above 20. A significant correlation was found between age, duration of diabetes, frequency of blood glucose measurement, hemoglobin A_1c (HbA_1c) level, body mass index standard deviation score (BMI-SDS), and DEPS-R score. There was no significant difference between girls and boys. Patients with a high DEPS-R score had low scores on the PedsQL and on the PedsQL 3.0 Diabetes Module.</div></div><div><h3>Conclusion</h3><div>The DEPS-R scale is a diabetes-specific, easy-to-use, and effective method for screening patients with type 1 DM for disordered eating behaviors. It can help prevent the progression of disordered eating behaviors to clinical eating disorders in patients with type 1 DM. It would be beneficial to use this scale as a routine screening, especially in clinics where access to a psychologist is not possible.</div></div>","PeriodicalId":55477,"journal":{"name":"Archives De Pediatrie","volume":"31 7","pages":"Pages 455-460"},"PeriodicalIF":1.3,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142115169","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":"Characteristics and predictors of outcome in children with severe acute bronchiolitis: A 10-yearexperience","authors":"Samia Hamouda ,&nbsp;Safa Khatrouch ,&nbsp;Aida Borgi ,&nbsp;Ahmed Hajji ,&nbsp;Hanen Smaoui ,&nbsp;Najla Ben Jaballah ,&nbsp;Fatma Khalsi ,&nbsp;Khadija Boussetta","doi":"10.1016/j.arcped.2024.06.002","DOIUrl":"10.1016/j.arcped.2024.06.002","url":null,"abstract":"<div><h3>Background</h3><div>Severe acute bronchiolitis (SAB) can be life-threatening for infants and may be responsible for the congestion of intensive care units (ICU) during epidemics. We aimed to study the clinical and paraclinical characteristics of patients with SAB requiring a transfer to the ICU in order to examine their outcomes and to identify the predictors of a stay of ≥7 days and/or death.</div></div><div><h3>Methods</h3><div>This was a cross-sectional retrospective study including infants aged ≤12 months transferred to the ICU for their first episode of SAB between 1 January 2010 and 31 December 2019.</div></div><div><h3>Results</h3><div>We collected data on 380 patients with a median age of 1.75 months. They had a history of prematurity (20.53 %), low birth weight (18.68 %), parental atopy (12.89 %), and comorbidity (7.37 %, mainly congenital heart disease [5 %]). The leading cause of transfer was hypoxemia and increased oxygen requirements (49.73 %). The patients required mechanical ventilation (MV) in 63.42 % of the cases and noninvasive ventilation (NIV) in 67.63 %. NIV has supplanted MV over the years. Its use has increased from 40.4 % in 2010 to 96 % in 2019 compared with 83.84 % and 42 % for MV. A total of 14 (3.68 %) patients died. The independent predictors of a stay of ≥7 days and/or death were young age ≤2 months (<em>p</em> = 0.002), failure to thrive (<em>p</em> = 0.006), apnea (<em>p</em> = 0.045), dehydration (<em>p</em> = 0.018), the presence of biological inflammatory reaction (<em>p</em> = 0.002), isolation of respiratory syncytial virus (<em>p</em> &lt; 0.001), and bacterial coinfection (<em>p</em> = 0.013).NIV was a protective factor (<em>p</em> &lt; 0.001). A severity score ranging from 0 to 17 was established with an optimal cut-off value of 5 points.</div></div><div><h3>Conclusion</h3><div>Specific caution is needed in patients with these severity predictors. The generalization ofNIV in general pediatrics departments would improve SAB management and reduce transfers to the ICU.</div></div>","PeriodicalId":55477,"journal":{"name":"Archives De Pediatrie","volume":"31 7","pages":"Pages 433-438"},"PeriodicalIF":1.3,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142301746","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":"Interaction of the protective effect of breastfeeding and the aggravating effect of pacifier use in the occurrence of bronchiolitis in children","authors":"Laureen Martin ,&nbsp;Amaïa Bainier ,&nbsp;Estelle Darviot ,&nbsp;Aude Forgeron ,&nbsp;Laurent Sarthou ,&nbsp;Anne-Claire Wagner ,&nbsp;Thomas Blanchais ,&nbsp;Thomas Brigly ,&nbsp;Françoise Troussier ,&nbsp;Bernard Branger","doi":"10.1016/j.arcped.2024.05.004","DOIUrl":"10.1016/j.arcped.2024.05.004","url":null,"abstract":"<div><h3>Background</h3><div>Acute bronchiolitis affects around 30 % of infants each winter in France. Breastfeeding (BF) is described as being protective against acute lower respiratory infections in developing countries, but this effect is more difficult to demonstrate in industrialized countries. Moreover, the effect of using a pacifier in the occurrence of bronchiolitis is not clearly established. In this context, the aim of the study was to investigate the link between BF and the use of a pacifier in the occurrence of bronchiolitis in children under 1 year of age who presented to five pediatric emergency centers in Pays de la Loire, France.</div></div><div><h3>Method</h3><div>A questionnaire collecting data on diet, sociodemographic characteristics, and the reason for presentation was provided at the admission to pediatric emergency centers in five hospitals in Pays de Loire, France, between 2018 and 2020. Children with bronchiolitis were included in group 1, and children consulting for other reasons (except gastrointestinal infections or otitis) were included in group 2. Breastfeeding was classified as exclusive breastfeeding (EBF) and partial breastfeeding (PBF). Pacifier use was classified as frequent and during sleep or not used.</div></div><div><h3>Results</h3><div>The study included 671 children under 1 year of age, including 174 (25.8 %) who were admitted with bronchiolitis. In univariate analysis, a significantly smaller number of children in group 1 s were breastfed (EBF and PBF) at admission compared with children in group 2:21.8 % versus 32.8 %, respectively, (OR=0.57, 95 % CI: 0.38–0.86, <em>p</em> = 0.006); furthermore, children in group 1 used a pacifier more often than those in group 2: 84.5 % versus 75.8 % (OR=1.74, 95 % CI: 1.10–2.76, <em>p</em> = 0.017). In multivariate analysis, after adjusting for age, ongoing BF or EBF beyond 9 and 12 months of age remained a protective factor; however, the protective effect of BF disappeared with the introduction of a pacifier, and pacifier use was significantly associated with bronchiolitis.</div></div><div><h3>Conclusion</h3><div>The protective effect of BF against bronchiolitis was demonstrated independently of pacifier use. However, due to the strong association between pacifier use and bronchiolitis, the effect of BF weakened. The advice to be given to parents for BF and pacifier use is discussed.</div></div>","PeriodicalId":55477,"journal":{"name":"Archives De Pediatrie","volume":"31 7","pages":"Pages 426-432"},"PeriodicalIF":1.3,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142367637","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}