Search

Copyright of Pan African Medical Journal is the property of Pan African Medical Journal and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Ensuring patients are informed and knowledgeable about their health and disease management has been identified as a key aspect of effective health care. Patient education has been incorporated in treatment guidelines for childhood asthma. The effectiveness of patient education should be evaluated. However, the best tool to evaluate educational interventions on children's knowledge and management of their asthma is unknown and guidelines do not recommend any standard knowledge evaluation tool. The objective was to identify and analyze the asthma knowledge evaluation tools available for children and their caregivers participating in asthma education programs. Methods : The study consisted of two parts: (i) observation of patient education sessions and review of international asthma guidelines to identify essential topics for education and (ii) a literature review to identify existing knowledge evaluation tools and assess how they addressed the essential topics. Results : Six essential topics (physiology of the respiratory system, physiopathology of asthma, trigger factors, asthma treatments, asthma exacerbation management and self-management education) and sixteen knowledge evaluation tools were identified. None of the tools evaluated all the essential topics. Understanding of the respiratory system was the topic most frequently lacking. Eight validated questionnaires were found. However, they did not address all the essential topics nor were designed for children under 9 years old. Conclusions : This study highlighted some gaps in the evaluation methods for asthma education and identified the essential elements of a pediatric asthma knowledge evaluation tool. New knowledge evaluation tools assessing the six essential topics identified and appropriate for children of various ages are needed. [ABSTRACT FROM AUTHOR]

Copyright of Pediatrie pro Praxi is the property of SOLEN sro and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

La connaissance de la physiologie de la vitamine D a progressé de manière considérable, faisant passer sa conception d'une hormone purement phosphocalcique et osseuse à une hormone ayant un rôle sur la santé globale (rôles anti-infectieux, anti-inflammatoire, antitumoral et protecteur cardiovasculaire). En parallèle de cette description d'effets pléiotropes à la fois dans des modèles cellulaires, des modèles animaux et des études cliniques, de plus en plus d'études épidémiologiques ont montré l'importance de la carence en vitamine D dans la population générale, adulte comme pédiatrique. L'objectif de cette mise au point est de rappeler les grands principes de physiologie phosphocalcique et vitaminique D, et d'en proposer une lecture spécifique à l'enfant, de la néonatologie à l'âge de 18 ans, en insistant d'une part sur les recommandations de supplémentation chez l'enfant sain de 0 à 18 ans et, d'autre part, sur les situations d'hypo- et d'hypervitaminose D. [ABSTRACT FROM AUTHOR]

Transfusion in paediatrics requires specific guidelines, because child physiology and pathology differ significantly as compared to adults. Adverse transfusion reactions in transfused children also vary in type and frequency, but there is a better understanding of these reactions in adults than in children. However, for the most frequent adverse transfusion reactions, the overall prevalence is higher in children than in adults, with the exception of post-transfusion red blood cell alloimmunisation, which is lower, excluding patients with haemoglobinopathies. In several studies, allergic reactions were the most frequently reported adverse transfusion reaction in paediatrics, and the platelet concentrate the most frequently implicated blood product. Early diagnosis of certain adverse transfusion reactions such as haemosiderosis, is essential in order to initiate the best therapy and obtain a good clinical outcome. The prevention of adverse transfusion reactions in children is required, but needs further clinical studies in paediatrics. Lastly, changes in technology, policy and clinical practices will improve transfusion safety in children. [ABSTRACT FROM AUTHOR]

Background: The extended spectrum beta-lactamase (ESBL)-producing Escherichia coli strains which have been implicated in septicaemia among hospitalized children is a serious concern due to their high resistance rates to commonly used antimicrobial agents. The objective of this study was to determine the prevalence and antibiotic susceptibility of urinary ESBL-producing E. coli in paediatric patients who had clinical evidence of urinary tract infections (UTI). Methodology: Clean catch specimens of urine collected from 100 eligible paediatric patients with clinical evidence of UTI in St. Patricks' Hospital, Mile Four, Abakaliki, Ebonyi State, were cultured for isolation of E. coli using standard bacteriological techniques. Isolates were confirmed for ESBL production by double disk synergy test (DDST), and antibiotic susceptibility of the ESBL-producing ones was determined by the modified Kirby Bauer disk diffusion method. Results: Twenty one (21%) E. coli were isolated out of which 11 (52 %) were ESBL producers, all of which were totally resistant (100%) to cefotaxime, ticarcillin and sulfamethoxazole-trimethoprim, 85% to aztreonam and 83% to ceftazidime. The multiple antibiotic resistance index (MARI) values ranged from 0.4 to 0.9, which implies high usage of antimicrobials. Conclusion: The high prevalence of multi-drug resistant ESBL-producing E. coli obtained in this study shows that there has been overuse (abuse or misuse) of antibiotics in the study area. There is need for antimicrobial stewardship programme that will ensure prudent use of antimicrobial agents to forestall the emergence and spread of multi-drug resistant bacteria. [ABSTRACT FROM AUTHOR]

Les réactions anaphylactiques connaissent une augmentation inquiétante, notamment chez l'enfant. L'anaphylaxie est une réaction allergique brutale, sévère, potentiellement létale, pouvant toucher les systèmes cutanéomuqueux, gastro-intestinal, respiratoire et cardiovasculaire. Des critères diagnostiques précis ont été définis. Bien que les symptômes d'une anaphylaxie soient variables en fonction de l'âge de l'enfant et de l'allergène déclencheur, ces critères diagnostiques sont fiables chez le nourrisson, l'enfant et l'adolescent. Les allergènes responsables les plus fréquents sont les aliments, suivis du venin d'insectes puis des médicaments. Le traitement de première intention est l'adrénaline. Elle doit être injectée par voie intramusculaire le plus tôt possible. Même en cas d'évolution favorable, une surveillance prolongée de 24 h est recommandée en raison de l'existence de réactions biphasiques retardées. En cas d'évolution défavorable, l'administration d'adrénaline doit être renouvelée. À distance de l'anaphylaxie l'enquête et le suivi allergologiques sont indispensables. Ils guident la mise en place des mesures préventives et thérapeutiques, notamment la prescription d'adrénaline auto-injectable et/ou d'un plan d'accueil individualisé. The prevalence of anaphylaxis has increased for two decades, especially among children. Anaphylaxis is an acute severe reaction involving the skin, gastrointestinal and respiratory tracts, and cardiovascular system. Clinical criteria for diagnosing anaphylaxis were defined to help physician. Even if the clinical manifestations of anaphylaxis depend on age and allergen, the diagnostic criteria are reliable in infants, children and teenagers. The first-line treatment is epinephrine, regardless of age. It must be injected intramuscularly as soon as possible. Because biphasic reactions can occur after initial resolution, a advisable length of time for observation of an anaphylactic patient is 24 h. Some patients with persistent symptoms may require repeat doses of epinephrine. The mainstays of long-term management include specialist assessment, avoidance measures, the provision of an epinephrine auto-injector and an individualized anaphylaxis action plan. [ABSTRACT FROM AUTHOR]

Objective: To understand the importance of authorship and authorship position, and gauge perceptions of inappropriate authorship assignment, among authors publishing paediatric research conducted in low- and middle-income countries (LMICs).Methods: We conducted a cross-sectional, mixed-methods study using an online survey of both corresponding and randomly selected, non-corresponding authors who published research conducted in LMICs from 2006 to 2015 in the top four paediatric journals by Eigenfactor score. We used chi-square tests to compare responses by authors living in LMICs to authors living in high-income countries (HICs). We analysed qualitative responses using thematic analysis.Results: Of 1420 potential respondents, 19.6% (n = 279) completed the survey. 57% (n = 159) lived in LMICs and 43% (n = 120) in HICs. LMIC authors more commonly perceived first authorship as most important for their academic advancement than HIC authors (74.2% vs. 60.8%, P = 0.017), while HIC authors reported last authorship as most important (25.1% vs. 38.3%, P = 0.018). 65% (n = 181) of respondents believed that their collaborators had been inappropriately assigned authorship positions (no difference in LMIC and HIC responses) and 32.6% (n = 91) reported personally accepting inappropriate authorship positions (more common in HIC respondents, P = 0.005). In qualitative data, respondents questioned the applicability of standard authorship guidelines for collaborative research conducted in LMICs.Conclusions: LMIC and HIC authors held different perceptions about the importance of authorship position. Reported inappropriate authorship assignment was common among both LMIC and HIC respondents. Alternatives to standard authorship criteria for research conducted in LMICs merit further studies. [ABSTRACT FROM AUTHOR]

Copyright of Canadian Journal of Community Mental Health is the property of Canadian Periodical for Community Studies Inc. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Revue Universitaire des Sciences Humaines et Sociales is the property of University of Kasdi Merbah Ouargla and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Annales Françaises de Médecine d'Urgence is the property of John Libbey Eurotext Ltd. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Physiotherapy Canada is the property of University of Toronto Press and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

La prescription hors autorisation de mise sur le marché (AMM) est une pratique peu médiatisée, mais d'usage courant dans de nombreux pays, notamment en pédiatrie. L'objectif de cette étude était de quantifier et de caractériser la prescription hors AMM en pédiatrie à l'hôpital militaire d'instruction Mohammed V de Rabat. Méthodes. Un enregistrement prospectif des prescriptions médicales du service pédiatrique a été effectué pendant six mois, du 1er juin à 31 décembre 2017, dans le pôle pharmacie de l'établissement. Les données concernaient les patients (sexe, âge et poids) et les prescriptions médicamenteuses (dénomination commune internationale [DCI], dose, fréquence d'administration, voie d'administration et indication). Les médecins y spécifiaient l'indication de chaque prescription. Chaque prescription a été analysée a posteriori pour vérifier son adéquation avec l'AMM. Résultats. Au total, 120 enfants, 41,7 % de garçons et 58,3 % de filles sont inclus dans notre étude. Leur âge variait entre 4 jours et 18 ans (moyenne 5,4 ans ± 3,5). Sur les 120 patients étudiés, soixante-dix-sept (64,17 %) ont reçu au moins un médicament, comprenant un total de 127 médicaments prescrits et cinquante-quatre principes actifs différents. Dans notre étude, il y avait une prévalence de 23,6 % des prescriptions hors AMM. Sur les 127 médicaments prescrits, 23,6 % (trente) étaient hors AMM. La raison principale de la prescription de médicaments hors AMM était le dosage utilisé (33 %), l'âge du patient (27 %), l'indication thérapeutique (23 %) et la fréquence de l'utilisation des médicaments (17 %). Dans 7 % des cas, il n'y avait pas d'information disponible sur le dosage et la fréquence prescrite. Selon la classification anatomique, thérapeutique et chimique, les prescriptions médicamenteuses hors AMM comprenaient principalement (27 %) des médicaments appartenant à la classe des anti-infectieux à usage systémique, 3 % de médicaments de système respiratoire, 10 % de médicaments de système nerveux et 7 % de médicaments agissant sur le système musculosquelettique. Sur les 127 substances actives prescrites, 23 % ont été utilisés hors AMM à un moment donné. Les cinq substances actives les plus fréquemment prescrites étaient aussi les plus prescrit fréquemment hors AMM : amoxicilline (7 %) seul ou en combinaison avec de l'acide clavulanique (20 %), le salbutamol (27 %), le paracétamol (10 %) et le diclofénac (7 %). Conclusion. Il est important de fournir aux médecins plus de données sur le rapport bénéfice-risque de la prescription hors AMM et sur les indications approuvées dans le résumé des caractéristiques du produit pour les médicaments les plus utilisés de cette façon. [ABSTRACT FROM AUTHOR]

Children and adolescents with acute leukemia have certainly a high chance of recovery, and much higher than adults, from the first line of treatment with conventional chemotherapy, but if a relapse occurs, subsequent survival remains poor, whether in lymphoblastic or myeloblastic subtypes. The accumulation of treatments is responsible for severe acute toxicities, long-term sequelae and a significant risk of secondary cancer. The exponential growth of new targeted therapies with small molecules, monoclonal antibodies and adoptive immunotherapy gives great hope for the most serious diseases. The large number of these new drugs raises the question of their respective place in new therapeutic strategies in the face of conventional chemotherapy and hematopoietic stem cell transplantation procedures, including in economic terms. [ABSTRACT FROM AUTHOR]

Pediatric cancers and acute leukaemias are rare diseases, associated with specific oncogenic mechanisms justifying dedicated research. Immunotherapy has led to spectacular advances in the field of pediatric acute lymphoblastic leukemia, but major efforts still need to improve the outcome of patients with pediatric acute myeloid leukemia (AML). The consolidation of clinical, biological and translational research, led by an ambitious policy conducted by the National Institute for Cancer (INCa), SFCE and patient associations, offers significant progress levers for pediatric oncology in France. The CONECT-AML project on pediatric AML is one example of this policy. Several European (ITCC) and international (ACCELERATE) projects aim to promote access to new drugs and to strengthen international collaborations. [ABSTRACT FROM AUTHOR]

Management of childhood acute lymphoblastic leukemia, the most common cancer in childhood, is based on specialized oncology treatment teams, included in well-structured regional network. As soon as the diagnosis is established, the patient is hospitalized in a referral centre for childhood cancer, which works in close collaboration with community hospitals and has partnerships with other health care facilities to enable continuous and integrated care for patients and their families. The quality of patients cares rely heavily on the coordinated implementation of health professionals: medical doctors, dieticians, physiotherapists, psychologists, oncology nurse coordinators, and also social workers. [ABSTRACT FROM AUTHOR]

Allogeneic hematopoietic stem cell transplantation (HSCT) is a combination of replacement medicine (rather than surgery) and immunotherapy. Whatever the transplanted stem cell source (i.e. bone marrow, peripheral blood stem cells or cord blood stem cells), the graft provide both new hematopoiesis (erythrocyte, white blood cell and platelet-production) and new "immunopoiesis". This new infused immunologic system is able to participate in the underlying malignant disease control in association with previous chemotherapy and/or radiotherapy by providing graft-versus-leukelia effect. The main steps of HSCT are 1. Administration of a conditioning regimen, mainly myelo-ablative and then toxic in the frame of acute leukemia in children and adolescents; 2. Management of prolonged and severe neutropenia and of chemotherapy-related toxicities; 3. Management of possible immunological conflict between competent T-cells from the graft and recipient tissues (namely graft versus host disease); 4. Relapse occurrence monitoring and management; 5. Management of HSCT related late-effects and sequelae. [ABSTRACT FROM AUTHOR]

Résumé La peau du nouveau-né à terme est très semblable à celle de l'adulte, cependant l'adaptation de la peau à la vie extra-utérine peut être responsable de dermatoses « physiologiques » et transitoires qu'il convient de connaître pour éviter les traitements et explorations inutiles. Les particularités de la peau du nouveau-né doivent également être connues pour éviter toute iatrogénicité due à une utilisation inappropriée de topiques. Ce chapitre abordera les principales affections dermatologiques dites « physiologiques » autorésolutives, puis les dermatoses les plus fréquemment rencontrées au cours du premier mois de vie, en privilégiant une approche par lésion élémentaire ou dont l'aspect clinique est facilement identifiable et doit entraîner une prise en charge spécifique. [ABSTRACT FROM AUTHOR]

Copyright of Archives of Cardiovascular Diseases is the property of Elsevier B.V. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Physiotherapy Canada is the property of University of Toronto Press and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Minitablets are multiparticulate dosage forms that have been developed in the last decades to overcome certain disadvantages of monolithic dosage forms (tablets, capsules) and of pellets. Minitablets can be manufactured using conventional methods and equipment, with tooling adapted to their small size; their advantages rely also in the uniform passing through the gastrointestinal tract, with a minimum interindividual variability, reducing the risk of dose dumping effect. Minitablets can be administered to pediatric patients even at very small ages, in these field being also studied the orodispersible types. Bioadhesive minitablets have been formulated for various administration routes (oral, buccal, vaginal) and in cardiovascular fixed dose combination therapy; usually, three different drugs are combined, compressed into three to six minitablets (units) and then encapsulated in hard capsules. [ABSTRACT FROM AUTHOR]

Objectif : Ce travail visait à étudier la morbidité et la mortalité chez les enfants âgés de 01 à 59 mois hospitalisés dans le service de pédiatrie générale du CHU Gabriel Touré. Matériels et Méthodes : Il s’agissait d’une étude rétrospective, descriptive, sur une période de 12 mois allant du 1er janvier au 31 décembre 2013. Résultats : Nous avons inclus 1625 enfants âgés de 01 à 59 mois soit 58% des patients hospitalisés. Le tiers des patients avait moins d’un an. Les garçons représentaient 57 % de notre échantillon avec un sex ratio de 1,33. La majorité des patients (83%) était issu de milieu social défavorisé. Les principaux diagnostics retrouvés étaient le paludisme (45%), les infections respiratoires aiguës (20,30%), et la malnutrition aiguë sévère (20,06%). Les patients guéris représentaient 82,3% et le taux de mortalité était estimé à 3,3%. La majorité des patients décédés était des filles (51%). Les décès étaient plus fréquents en juillet et aout. Les trois principales causes de décès étaient la malnutrition (47%), le paludisme (32%) et les infections respiratoires aigües (19%). Nous avons enregistré 48 sorties contre avis médical (3%) et 81 cas d’évasion (5%). Conclusion : La morbidité et la mortalité en pédiatrie restent préoccupantes dans notre pratique. Elles sont liées à des affections pour la plupart évitables par l’information, l’éducation et la communication.

Înţelegerea schimbărilor de patologie din ultimele decade a devenit posibilă datorită achiziţiilor epigenetice. Această ramură a geneticii explică cum influenţează mediul funcţionarea dinamică a genelor. Variaţiile epigenetice sunt determinate de nutriţie, infecţii, noxe chimice, stres. Programarea metabolică iniţiată din viaţa fetală este determinantă pentru patologia cronică a vârstei adulte. Infecţiile, bolile alergice, afecţiunile maligne, prezintă o semnificativă dimensiune epigenetică. Medicul pediatru, acţionând la începutul ciclului de viaţă, poate interveni în derularea acestor procese prin abordarea profilactică şi prin terapia epigenetică, ultima fiind în curs de cristalizare.

Introduction : Les détresses respiratoires sont une cause majeure de morbidité et de mortalité en pédiatrie ; l’objectif de notre étude était d’étudier les aspects épidemiocliniques des détresses respiratoires chez les enfants âgés de 1 à 59 mois dans le service de pédiatrie de CHU. Gabriel Toure. Méthodologie : Il s’agit d’une étude transversale descriptive sur douze mois du 1er au 31 décembre 2012 au service de pédiatrie du CHU Gabriel Touré Bamako Mali. Tous les enfants de 1 à 59 mois présentant une détresse respiratoire ont été inclus. Résultats : Ainsi 678 dossiers d’enfants en détresse respiratoire sur un total de 2241 hospitalisés en pédiatrie ont été analysés soit un taux d’admission de 30,25%. 64,75% des enfants avaient un âge compris entre 1 et 11 mois. Le sex-ratio était de 1,38 en faveur des garçons; les signes de lutte respiratoire (battement des ailes du nez, tirage intercostal et le geignement) étaient présents dans 96,22%. La pathologie pulmonaire la plus fréquente était la pneumonie (68,36%) celle extra-pulmonaire était le paludisme grave (11,80%). Le taux de mortalité était de 20,65%. Conclusion : les détresses respiratoires restent une importante cause de mortalité du nourrisson dans notre contexte avec des problèmes majeurs de prise en charge

May-Thurner syndrome refers to compression of the left common iliac vein, between the right common iliac artery and the vertebral body. It carries risks of venous hyperplasia and thrombosis. This entity is extremely rare in the pediatric patients. We report the case of a 24-month-old child in whom left lower extremity swelling, led to the diagnosis of May-Thurner syndrome. We present a literature reviewof therapeutic strategies for this infrequent condition. [ABSTRACT FROM AUTHOR]

Tuberculoza este una din cele mai frecvente patologii infecţioase, reprezând o problemă majoră de sănătate publică globală, cu incidenţă crescută la vârsta pediatrică. Prezentăm cazul unui pacient în vârstă de 15 ani, care a fost internat în clinica noastră pentru febră, stare de rău, vărsături, tuse productivă, ameţeli şi dureri toracice. Antecedentele personale patologice au subliniat faptul că pacientul a mai prezentat dureri toracice în urmă cu aproximativ 6 luni, care au fost interpretate ca nevralgie intercostală. Analizele de laborator au evidenţiat: leucocitoză, neutrofilie, monocitoză, probe inflamatorii crescute şi hiponatremie. Ecocardiografia a evidenţiat pericardită lichidiană. În ciuda tratamentului antibiotic cu spectru larg, cantitatea de lichid pericardic a crescut, astfel că s-a efectuat puncţie pericardică. Datorită evoluţiei lent favorabile şi a rezultatelor testelor uzuale negative din lichidul de puncţie, am efectuat de asemenea teste bazate pe reacţia în lanţ a polimerazei, care au identificat ADN-ul bacterian în lichid stabilind astfel diagnosticul de pericardită tuberculoasă. Particularitatea cazului constă în diagnosticarea unei pericardite TBC la un adolescent de sex masculin, în vârstă de 15 ani, care a mai prezentat dureri toracice în antecedentele personale recente, doar pe baza identificării ADN-ului M. tuberculosis din lichidul pericardic, în lipsa altor teste pozitive pentru această infecţie

La pycnodysostose est une maladie osseuse génétique très rare associant une ostéocondensation, un syndrome dysmorphique et un retard de croissance. Rappeler les anomalies phénotypiques, les signes radiologiques, la prise en charge thérapeutiques et évolutifs de la Pycnodysostose chez un enfant de 11 ans. Enfant de 11 ans, a été réferé par son dentiste pour évaluation de son état clinique. Il est de parents consanguin de premier degré, qui présentait depuis l'âge de 3 ans des fractures spontanées à répétition. L'examen trouvait un syndrome dysmorphique fait de bosse frontale, fontanelle antérieure persistante, micrognathie, malformations des doigts, malposition dentaire, ongles incurvées, thorax asymétrique, attitude scoliotique du rachis dorsal, avec retard statural important (-4DS). Les radiographies du squelette montraient une densification des os de la base du crâne, une persistance de la fontanelle antérieure, une malposition dentaire, une densification diaphysaire et métaphysaire des os longs prédominants au niveau des membres inférieurs avec présence des cals vicieux et des phalanges grêles des mains. L'ostéodensitométrie était normale. Devant les signes cliniques et les manifestations radiologiques, le diagnostic retenu est une pycnodysostose. Un conseil génétique a été proposé pour la famille ainsi qu'une prise en charge dentaire et orthopédiques. La pycnodysostose est une entité rare de diagnostic parfois difficile et tardif, elle pose un problème du diagnostic avec l'ostéoporose. Le traitement est essentiellement préventif des fractures et des caries dentaires.

Copyright of Pediatrie pro Praxi is the property of SOLEN sro and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Profesorul Mihail Manicatide este unul dintre corifeii medicinei româneşti, a cărui contribuţie la dezvoltarea ştiinţelor medicale din ţara noastră îl aşază în rândul marilor personalităţi, creatori de şcoală cum ar fi: Nicolae C. Paulescu, Victor Babeş, Ion Cantacuzino, Gheorghe Marinescu etc. Fondator al şcolii de pediatrie româneşti prin crearea şcolilor de pediatrie de la Iaşi şi Bucureşti, întemeietorul pediatriei ştiinţifice ca metodă de abordare a patologiei infantile, în care cercetarea clinică şi de laborator constituie o îmbinare firească, autorul primelor tratate de pediatrie şi terapeutică infantilă, va reuşi în 1929 să fondeze Societatea Română de Pediatrie ca for ştiinţific în care să se regăsească întreaga gândire şi practică pediatrică. Elev şi discipol al marelui savant Victor Babeş, bun cunoscător al şcolii franceze şi germane de pediatrie prin marile personalităţi ale acestora, Mihail Manicatide va aplica cu rigurozitate în întreaga sa activitate pincipiile onestităţii, devotamentului şi dăruirii totale misiunii pe care şi-a asumat-o. Adept convins al medicinei preventive, a reuşit să imprime orientarea către latura socială a practicii pediatrice, fără de care nu se poate face o medicină de calitate, de aici şi numeroasele sale iniţiative sub aspectul protecţiei copilului. Din nefericire, posteritatea rareori îl evocă la adevărata sa valoare şi importanţă; de aceea, ne facem o datorie de onoare în a-l prezenta la nivelul adevăratei sale dimensiuni.

Purpose: We report a case of unilateral Terrien's marginal degeneration in a 14-year-old girl., Clinical Case: Slit-lamp examination of the affected eye revealed 360° circumferential lipid deposits with 6mm of superior limbal distension, superficial neovascularization, a zone of corneal thinning from 3:00 to 9:00 with a zone of corneomalacia at 11:00. The remainder of the cornea was clear, without fluorescein staining or anterior chamber reaction., Discussion: Terrien's marginal degeneration (TMD) is typically known to occur bilaterally in men over the age of 40. Terrien's degeneration must be differentiated from other causes of peripheral corneal thinning; the primary differential diagnosis is Fuchs' marginal keratitis. Other causes of corneal thinning must be ruled out, including Mooren's ulcer. In Terrien's degeneration, there is no central mined edge in the thinning sulcus, the epithelium remains intact, and affected patients do not present with pain. Other differential diagnoses include pellucid marginal degeneration and sulcus degeneration, which are characterized by the absence of lipid infiltrates associated with the central region of the thinning zone, thus distinguishing them from TMD., Conclusion: It is important to keep in mind that Terrien's marginal degeneration can occur in children., (Copyright © 2023 Elsevier Masson SAS. All rights reserved.)

Copyright of Pediatrie pro Praxi is the property of SOLEN sro and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

The incidental finding of a proteinuria is a common cause of consultation in pediatric nephrology. Although it is transient in most cases, it may also be indicative of a kidney disease. For this reason, a moderate proteinuria in children should not be overlooked. Moreover, as well as in adults, proteinuria is an essential marker in the monitoring of chronic renal disease in pediatric patients. We propose to review the physiopathology of proteinuria, the screening modalities and how to deal with proteinuria in pediatric. [ABSTRACT FROM AUTHOR]

Autism spectrum disorders (ASD) are among the most severe disorders of mental health in children and their prevalence in the society is increasing. The fundamental symptoms of ASD are defi cits in communication and social behavior, restricted interests or difficulties in the adaptation to the unknown environment. Th e daily routine activities in the life of families with children with ASD thus become challenging in many aspects. Visits to the doctor’s office can be exceptionally stressful for children with ASD, but also for their parents and the medical stuff . Our article summarizes the trends in providing the healthcare to children with ASD in the Czech Republic and abroad. These trends served as the basis for conducting a quantitative research with 474 participating parents. Our major fi ndings are that parents with children with ASD visit doctors more oft en than other parents, they are less satisfi ed with the provided care and, in general, they are more stressed by all kind of visits to the doctor’s office. [ABSTRACT FROM AUTHOR]

This narrative review summarizes the current literature on early sport specialization and changes that occur in the musculoskeletal system throughout growth and maturation. It discusses the impact of development on the motor and sensory systems and how this contributes to movement and coordination in the young athlete. With the increasing number of youth athletes in organized sport and the popularization of early sport specialization, the purpose of this paper is to educate those involved with the youth and adolescent athlete to important changes that are occurring at this time in development and the implications they have on movement, performance and injury. It is important for coaches, parents and athletes to understand and acknowledge the changes that are occurring, and to expect some difficulty in adaptation, which may be evident as either a plateau or deterioration in performance, or typical overuse injuries that are seen in the adolescent athlete. [ABSTRACT FROM AUTHOR]

Résumé Introduction Malgré l'augmentation de la prévalence de l'allergie aux anacardiacées, l'indication d'un test de provocation orale (TPO) à la noix de cajou est plus rarement portée que celle d'un TPO à l'arachide. Malgré une histoire naturelle habituelle de non-guérison, cette étude montre qu'une allergie à la noix de cajou même sévère peut évoluer vers une acquisition de tolérance spontanée. Matériels et méthodes Étude rétrospective, monocentrique de 36 enfants ayant bénéficié d'un TPO à la noix de cajou au sein des hôpitaux pédiatiques de Nice CHU-Lenval. Résultats Vingt-cinq enfants ont atteint la dose cumulée maximale de 4441 mg dont 15 sont considérés comme des TPO négatifs. Vingt et un TPO ont été positifs pour une dose cumulée réactive moyenne de 2881 mg de noix de cajou avec 13 réactions anaphylactiques. Six de ces enfants toujours allergiques ont bénéficié d'une immunothérapie alimentaire et 15 enfants ont poursuivi un régime d'éviction strict. Discussion Chez un tiers de nos patients, une tolérance spontanée a été acquise. Seulement 15 enfants ont bénéficié du dosage d'IgE récemment disponible pour rAna o 3, composant allergénique de la noix de cajou, considéré comme un facteur prédictif majeur de réactivité et de sévérité. La présence d'IgE contre Ana o 3 confirme, chez nos patients cette valeur prédictive sans que l'on puisse en dégager une valeur seuil. Abstract Introduction Despite the increased prevalence of allergy to anacardiaceae, oral food challenge tests (OFC) to cashews are more rarely carried out than peanut OFC. Despite a natural history of normal non-healing, this study shows that an allergy to cashews, even severe, can progress towards acquisition of spontaneous tolerance. Materials and methods A retrospective, single-center study of 36 children who underwent cashew OFC at the pediatric hospitals of Nice CHU-Lenval. Results Twenty-five children reached the maximum cumulative dose of 4441 mg, with 15 OFC being considered negative. 21 OFC were positive for a mean reactive cumulative dose of 2881 mg of cashew, with 13 anaphylactic reactions. 6 of these still-allergic children received food immunotherapy and 15 children continued on a strict avoidance diet. Discussion In one-third of our patients, spontaneous tolerance was achieved. Only 15 children underwent the recently available IgE assay for rAna o 3, an allergenic component of cashews, considered a major predictor of reactivity and severity. The presence of IgE directed against Ana o 3 confirmed the predictive value of this test in our patients, although we could not derive a threshold value. [ABSTRACT FROM AUTHOR]

Objectives: To evaluate a paediatric treatment-support intervention for home-based treatment of HIV infection or tuberculous meningitis (TBM).Methods: A randomised-controlled study comparing local standard care (controls) with standard care plus intervention (combining adherence education, reinforcement and monitoring) in children aged 0-14 years. We recorded adherence measures (self-report, pill-count, drug-assays for isoniazid and rifampicin in urine and pyrazinamide in saliva), difficulties administering medication and PedsQL™questionnaires for health-related quality-of-life (HRQoL) and family impact.Results: In the HIV group (6-months follow-up, n = 195), more children had above-median HRQoL-scores in the intervention group than in the control group (P = 0.009). Problems reported administering medication declined between baseline and follow-up for controls (P = 0.043). Disclosure of HIV status to the child increased between baseline and follow-up in both groups (intervention P < 0.001; control P = 0.031). In the TBM group (3-months follow-up, n = 43), all adherence measures remained high for both intervention and controls, except for rifampicin which declined between baseline and follow-up in the intervention group (P = 0.031). The intervention group maintained above median HRQoL-scores between baseline and follow-up, when the number of children with above-median HRQoL-scores decreased in the controls (P = 0.063). More children in the intervention group had above-median family impact-scores than controls (P = 0.040).Conclusions: The low-cost, culturally friendly treatment-support intervention had beneficial effects on health-related quality of life, family impact, caregiver disclosure of HIV status to the child, increased caregiver reporting of medication non-adherence and caregiver reporting of difficulties administering medication. Treatment adherence was not significantly affected in either HIV or TBM group. [ABSTRACT FROM AUTHOR]

Copyright of Pediatrie pro Praxi is the property of SOLEN sro and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Résumé But/objectifs L'administration de la nutrition parentérale (NP) est une pratique à risque. Suite à l'instruction de la direction générale de l'offre de soins (DGOS) du 20 mars 2015, un audit observationnel et une autoévaluation des pratiques d'administration de la NP pédiatrique étaient réalisés. L'objectif de ce travail était de mesurer les écarts entre la pratique observée ou déclarée et celle attendue au regard des référentiels existants. Matériel et méthodes Un audit observationnel, selon une grille composée de 19 critères issus des recommandations de l'inspection générale des affaires sociales (IGAS), de la haute autorité de santé (HAS) et de la DGOS, puis un questionnaire d'autoévaluation destiné aux infirmières de pédiatrie étaient réalisés. Résultats Lors du branchement de la poche, une friction hydro-alcoolique des mains était réalisée dans plus de 90 % des cas. Les contrôles préalables à l'administration étaient globalement respectés (> 80 %). Concernant l'administration, la pose d'un filtre sur la ligne de perfusion était effective dans 41 % des cas (60 % pour l'autoévaluation). Trois changements de ligne de perfusion étaient non conformes (8,6 %). Seulement 6 % des infirmières diplômées d'état déclaraient avoir reçu une formation spécifique. Conclusion Cette étude permettait de dresser un état des lieux des connaissances et des pratiques professionnelles relatives à l'administration de la NP pédiatrique, quel que soit le type de poches. Si certains critères spécifiés par l'instruction de la DGOS étaient respectés, les connaissances et les pratiques des IDE étaient hétérogènes sur d'autres points, nécessitant la mise en place d'actions d'amélioration. Abstract Purpose/objective The administration of parenteral nutrition is a high-risk practice. Following the French instruction (direction générale de l'offre de soins [DGOS]) of March 20, 2015, an observational audit and a self-evaluation of pediatric parenteral nutrition administration practices were performed. The objective of this study was to compare the observed or declared practices with present recommendations. Material and methods An observational audit was performed, with a grid composed of 19 criteria according to the French recommendations (inspection générale des affaires sociales [IGAS], Haute Autorité de santé [HAS] and the DGOS), then with a questionnaire of self-evaluation for nurses in pediatric unit. Results When connecting the bag, a hydro-alcoholic friction of the hands was achieved in more than 90% of cases. Controls before administration were respected (more than 80%). Regarding administration, the positioning of a filter on the line was effective in 41% of cases (60% for self evaluation). Three administration line changes were observed as non-compliant (8.6%). Only 6% of nurses reported having received specific training. Conclusion This survey showed the knowledge and professional practices concerning the administration of pediatric parenteral nutrition, whatever the kind of bag. If some criteria specified by the DGOS instruction were respected, the nurse's knowledge and practices were heterogeneous on other points, requiring the implementation of improvement measures. [ABSTRACT FROM AUTHOR]

Résumé Objectif La transition entre les milieux pédiatrique et adulte est souvent source de difficultés pour les jeunes patients atteints d’une maladie sévère. L’objectif de cette étude qualitative était d’obtenir une définition et caractériser la transition en interrogeant des psychologues en pédiatrie. Méthode Dix psychologues ont répondu à un entretien de recherche semi-structuré qui a été audio-enregistré. Résultats L’analyse thématique des verbatims a permis de dégager des thèmes communs aux participants quant à la représentation de la transition, aux facilitateurs et obstacles rencontrés dans leur travail. Discussion Cette recherche a permis de mettre en évidence des nouveaux éléments dans le travail des psychologues par rapport à la transition tels que le jugement clinique, les aspects relationnels et les liens d’attachement. Objective Transition between the paediatric and adult environments is often a challenge for young patients with severe diseases. The objective of this qualitative study was to define and identify descriptive characteristics of the transition by interviewing paediatric psychologists. Method Ten psychologists responded to a semi-structured research interview that was audiotaped. Results The thematic analysis of the verbatim revealed common themes among participants regarding the representation of the transition as well as the facilitators and obstacles encountered in their work. Discussion This research has highlighted new elements in the work of psychologists with regards to the transition process such as clinical judgment, interpersonal aspects and therapeutic alliance. [ABSTRACT FROM AUTHOR]

Copyright of Pan African Medical Journal is the property of Pan African Medical Journal and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Objective: Vitamin D has pleiotropic actions, including a role in the development of the immune response. A link was suggested between vitamin D deficiency and the development of asthma in children. The aim of the present study was to investigate the role of serum 25(OH) vitamin D level as a predictor of recurrent wheezing and asthma exacerbations in children. Material and method: We investigated the parameters of 52 children aged 0.8 to 16.3 years, diagnosed with recurrent wheezing or asthma who were admitted to a children's hospital during a 24 months period either for recurrence or during clinically stable state. Results: Of the investigated parameters, eosinophil count and eosinophil/lymphocyte ratio were significantly associated (p<0.05) with serum 25(OH)D levels. Clinical state (stable/recurrence) was suggestively associated (p≤0.1) with several individual parameters: serum 25(OH) D level, age, neutrophil and eosinophil counts and their ratios (eosinophil/neutrophil and neutrophil/lymphocyte ratio). However, in binomial regression analysis serum 25(OH) D level was the only significant (p<0.05) independent predictor of the clinical state. Conclusion: Serum vitamin D level was found to be related to clinical state (stable/ recurrence) in children with recurrent wheezing or asthma. [ABSTRACT FROM AUTHOR]

Introduction: In April 2010, tenofovir and abacavir replaced stavudine in public sector first-line antiretroviral therapy (ART) for children under 20 years old in South Africa. The association of both abacavir and tenofovir with fewer side effects and toxicities compared to stavudine could translate to increased durability of tenofovir or abacavir-based regimens. We evaluated changes over time in regimen durability for paediatric patients 3-19 years of age at eight public sector clinics in Johannesburg, South Africa.Methods: Cohort analysis of treatment-naïve, non-pregnant paediatric patients from 3 to 19 years old initiated on ART between April 2004 and December 2013. First-line ART regimens before April 2010 consisted of stavudine or zidovudine with lamivudine and either efavirenz or nevirapine. Tenofovir and/or abacavir was substituted for stavudine after April 2010 in first-line ART. We evaluated the frequency and type of single-drug substitutions, treatment interruptions and switches to second-line therapy. Fine and Gray competing risk regression models were used to evaluate the association of antiretroviral drug type with single-drug substitutions, treatment interruptions and second-line switches in the first 24 months on treatment.Results: Three hundred and ninety-eight (15.3%) single-drug substitutions, 187 (7.2%) treatment interruptions and 86 (3.3%) switches to second-line therapy occurred among 2602 paediatric patients over 24-months on ART. Overall, the rate of single-drug substitutions started to increase in 2009, peaked in 2011 at 25% and then declined to 10% in 2013, well after the integration of tenofovir into paediatric regimens; no patients over the age of 3 were initiated on abacavir for first-line therapy. Competing risk regression models showed patients on zidovudine or stavudine had upwards of a fivefold increase in single-drug substitution vs. patients initiated on tenofovir in the first 24 months on ART. Older adolescents also had a two- to threefold increase in treatment interruptions and switches to second-line therapy compared to younger patients in the first 24 months on ART.Conclusions: The decline in single-drug substitutions is associated with the introduction of tenofovir. Tenofovir use could improve regimen durability and treatment outcomes in resource-limited settings. [ABSTRACT FROM AUTHOR]