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Publisher: Elsevier   (Total: 3177 journals)

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Showing 2001 - 2200 of 3177 Journals sorted alphabetically
J. of the Nigerian Mathematical Society     Open Access   (Followers: 1)
J. of the Saudi Heart Association     Open Access   (Followers: 1, SJR: 0.292, h-index: 5)
J. of the Saudi Society of Agricultural Sciences     Open Access   (Followers: 2)
J. of the Saudi Society of Dermatology & Dermatologic Surgery     Open Access   (Followers: 1)
J. of the Taiwan Institute of Chemical Engineers     Hybrid Journal   (Followers: 2, SJR: 0.736, h-index: 34)
J. of the World Federation of Orthodontists     Full-text available via subscription  
J. of Theoretical & Philosophical Psychology     Full-text available via subscription   (Followers: 2, SJR: 0.385, h-index: 16)
J. of Theoretical Biology     Hybrid Journal   (Followers: 15, SJR: 1.089, h-index: 121)
J. of Thermal Biology     Hybrid Journal   (Followers: 4, SJR: 0.491, h-index: 45)
J. of Thoracic and Cardiovascular Surgery     Hybrid Journal   (Followers: 12, SJR: 2.369, h-index: 161)
J. of Thoracic Oncology     Hybrid Journal   (Followers: 4, SJR: 2.597, h-index: 81)
J. of Tissue Viability     Full-text available via subscription   (Followers: 3, SJR: 0.542, h-index: 20)
J. of Trace Elements in Medicine and Biology     Hybrid Journal   (Followers: 1, SJR: 0.576, h-index: 49)
J. of Traditional and Complementary Medicine     Open Access   (Followers: 1, SJR: 0.486, h-index: 7)
J. of Traditional Chinese Medical Sciences     Open Access   (Followers: 1)
J. of Traditional Chinese Medicine     Open Access   (Followers: 3, SJR: 0.368, h-index: 17)
J. of Traffic and Transportation Engineering (English Edition)     Open Access   (Followers: 5)
J. of Transport & Health     Hybrid Journal   (Followers: 8, SJR: 0.463, h-index: 5)
J. of Transport Geography     Hybrid Journal   (Followers: 24, SJR: 1.734, h-index: 58)
J. of Transportation Systems Engineering and Information Technology     Full-text available via subscription   (Followers: 16, SJR: 0.255, h-index: 13)
J. of Unconventional Oil and Gas Resources     Hybrid Journal   (Followers: 2, SJR: 1.066, h-index: 6)
J. of Urban Economics     Hybrid Journal   (Followers: 16, SJR: 2.434, h-index: 74)
J. of Urban Management     Open Access  
J. of Urology     Full-text available via subscription   (Followers: 52, SJR: 2.259, h-index: 211)
J. of Vascular and Interventional Radiology     Hybrid Journal   (Followers: 10, SJR: 1.21, h-index: 104)
J. of Vascular Nursing     Hybrid Journal   (Followers: 1, SJR: 0.211, h-index: 18)
J. of Vascular Surgery     Hybrid Journal   (Followers: 26, SJR: 2.115, h-index: 154)
J. of Vascular Surgery : Venous and Lymphatic Disorders     Hybrid Journal   (Followers: 3, SJR: 0.54, h-index: 8)
J. of Vascular Surgery Cases and Innovative Techniques     Open Access   (Followers: 1)
J. of Veterinary Behavior: Clinical Applications and Research     Hybrid Journal   (Followers: 4, SJR: 0.658, h-index: 19)
J. of Veterinary Cardiology     Full-text available via subscription   (Followers: 10, SJR: 0.734, h-index: 25)
J. of Virological Methods     Hybrid Journal   (Followers: 7, SJR: 0.866, h-index: 79)
J. of Visceral Surgery     Full-text available via subscription   (Followers: 1, SJR: 0.297, h-index: 12)
J. of Visual Communication and Image Representation     Hybrid Journal   (Followers: 10, SJR: 0.785, h-index: 54)
J. of Visual Languages & Computing     Hybrid Journal   (Followers: 1, SJR: 0.411, h-index: 38)
J. of Vocational Behavior     Hybrid Journal   (Followers: 16, SJR: 1.741, h-index: 101)
J. of Voice     Hybrid Journal   (Followers: 43, SJR: 0.878, h-index: 60)
J. of Volcanology and Geothermal Research     Hybrid Journal   (Followers: 18, SJR: 1.714, h-index: 88)
J. of Water Process Engineering     Full-text available via subscription   (Followers: 4, SJR: 0.633, h-index: 6)
J. of Wind Engineering and Industrial Aerodynamics     Hybrid Journal   (Followers: 7, SJR: 1.097, h-index: 72)
J. of World Business     Hybrid Journal   (Followers: 10, SJR: 1.656, h-index: 67)
JAAD Case Reports     Open Access  
JACC : Basic to Translational Science     Open Access   (Followers: 2)
JACC : Cardiovascular Imaging     Hybrid Journal   (Followers: 10, SJR: 3.591, h-index: 71)
JACC : Cardiovascular Interventions     Hybrid Journal   (Followers: 13, SJR: 5.063, h-index: 76)
JACC : Clinical Electrophysiology     Full-text available via subscription   (Followers: 4)
JACC : Heart Failure     Full-text available via subscription   (Followers: 10, SJR: 4.318, h-index: 18)
Japan and the World Economy     Hybrid Journal   (Followers: 2, SJR: 0.477, h-index: 24)
Japanese Dental Science Review     Open Access   (SJR: 0.215, h-index: 11)
JCC Open : J. de Cas Cliniques     Open Access  
JCRS Online Case Reports     Open Access   (SJR: 0.112, h-index: 1)
Joint Bone Spine     Full-text available via subscription   (Followers: 13, SJR: 0.807, h-index: 57)
Joint Commission J. on Quality and Patient Safety     Hybrid Journal   (Followers: 34, SJR: 0.75, h-index: 59)
Jornal de Pediatria     Open Access   (Followers: 1, SJR: 0.766, h-index: 36)
Jornal de Pediatria (Versão em Português)     Full-text available via subscription  
Joule     Hybrid Journal  
JPRAS Open     Open Access  
Kaohsiung J. of Medical Sciences     Open Access   (SJR: 0.443, h-index: 24)
Karbala Intl. J. of Modern Science     Open Access   (Followers: 3)
Kasetsart J. of Social Sciences     Open Access  
Kidney Intl. Reports     Open Access   (Followers: 1)
Kidney Intl. Supplements     Partially Free   (Followers: 3, SJR: 2.976, h-index: 11)
Kinésithérapie, la Revue     Full-text available via subscription   (Followers: 1, SJR: 0.159, h-index: 3)
King Saud University J. of Dental Sciences     Open Access  
Knowledge-Based Systems     Hybrid Journal   (Followers: 6, SJR: 2.14, h-index: 63)
Komplementäre und Integrative Medizin     Full-text available via subscription  
Kontakt     Full-text available via subscription  
Krankenhaus-Hygiene - Infektionsverhütung     Full-text available via subscription   (SJR: 0.102, h-index: 4)
L'Anthropologie     Full-text available via subscription   (Followers: 10, SJR: 0.384, h-index: 23)
L'Encéphale     Full-text available via subscription   (Followers: 1, SJR: 0.313, h-index: 39)
La Presse Médicale     Full-text available via subscription   (Followers: 3, SJR: 0.246, h-index: 31)
La Revue d'Homéopathie     Full-text available via subscription   (SJR: 0.188, h-index: 2)
La Revue de Medecine Interne     Full-text available via subscription   (Followers: 4, SJR: 0.237, h-index: 30)
La Revue de Médecine Légale     Full-text available via subscription   (SJR: 0.193, h-index: 3)
La Revue Gestion et Organisation     Open Access  
La Revue Sage-Femme     Full-text available via subscription   (SJR: 0.101, h-index: 2)
Laboratory Techniques in Biochemistry and Molecular Biology     Full-text available via subscription   (Followers: 4)
Labour Economics     Hybrid Journal   (Followers: 45, SJR: 1.127, h-index: 50)
Lancet Public Health     Open Access   (Followers: 4)
Land Use Policy     Hybrid Journal   (Followers: 19, SJR: 1.438, h-index: 66)
Landscape and Urban Planning     Hybrid Journal   (Followers: 27, SJR: 1.699, h-index: 102)
Language & Communication     Hybrid Journal   (Followers: 18, SJR: 0.633, h-index: 30)
Language Sciences     Hybrid Journal   (Followers: 4, SJR: 0.377, h-index: 27)
Large Marine Ecosystems     Full-text available via subscription   (Followers: 1)
Le Pharmacien Hospitalier     Full-text available via subscription  
Le Pharmacien Hospitalier et Clinicien     Full-text available via subscription   (Followers: 1, SJR: 0.237, h-index: 6)
Le Praticien en Anesthésie Réanimation     Full-text available via subscription   (Followers: 2, SJR: 0.104, h-index: 3)
Learning and Individual Differences     Hybrid Journal   (Followers: 11, SJR: 1.057, h-index: 47)
Learning and Instruction     Hybrid Journal   (Followers: 29, SJR: 2.851, h-index: 73)
Learning and Motivation     Hybrid Journal   (Followers: 19, SJR: 0.589, h-index: 35)
Learning, Culture and Social Interaction     Hybrid Journal   (Followers: 3)
Legal Medicine     Hybrid Journal   (Followers: 358, SJR: 0.908, h-index: 32)
Les Houches Summer School Proceedings     Full-text available via subscription   (Followers: 1)
Leukemia Research     Hybrid Journal   (Followers: 8, SJR: 1.043, h-index: 70)
Leukemia Research Reports     Open Access   (Followers: 2, SJR: 0.407, h-index: 5)
Library & Information Science Research     Hybrid Journal   (Followers: 1239, SJR: 1.629, h-index: 41)
Life Sciences     Hybrid Journal   (Followers: 6, SJR: 1.056, h-index: 132)
Life Sciences in Space Research     Hybrid Journal   (Followers: 2, SJR: 0.626, h-index: 5)
Limnologica - Ecology and Management of Inland Waters     Hybrid Journal   (Followers: 5, SJR: 0.668, h-index: 32)
Linear Algebra and its Applications     Full-text available via subscription   (Followers: 14, SJR: 0.837, h-index: 65)
Lingua     Hybrid Journal   (Followers: 16, SJR: 0.768, h-index: 37)
Linguistics and Education     Hybrid Journal   (Followers: 15, SJR: 0.669, h-index: 28)
Literatura Mexicana     Open Access  
Lithos     Hybrid Journal   (Followers: 14, SJR: 2.92, h-index: 110)
Livestock Science     Hybrid Journal   (Followers: 6, SJR: 0.837, h-index: 81)
Long Range Planning     Hybrid Journal   (Followers: 13, SJR: 1.958, h-index: 69)
Lung Cancer     Hybrid Journal   (Followers: 14, SJR: 1.923, h-index: 98)
LWT - Food Science and Technology     Hybrid Journal   (Followers: 6, SJR: 1.3, h-index: 84)
Machine Intelligence and Pattern Recognition     Full-text available via subscription   (Followers: 14)
Magister : Revista de Investigación Educativa     Full-text available via subscription  
Magnetic Resonance Imaging     Hybrid Journal   (Followers: 5, SJR: 1.139, h-index: 87)
Magnetic Resonance Imaging Clinics of North America     Full-text available via subscription   (Followers: 5, SJR: 0.746, h-index: 40)
Mammalian Biology - Zeitschrift für Säugetierkunde     Hybrid Journal   (Followers: 4, SJR: 0.863, h-index: 29)
Management Accounting Research     Hybrid Journal   (Followers: 16, SJR: 1.913, h-index: 56)
Manual Therapy     Hybrid Journal   (Followers: 25, SJR: 0.863, h-index: 64)
Manufacturing Letters     Full-text available via subscription   (Followers: 1, SJR: 0.608, h-index: 5)
Manufacturing Research and Technology     Full-text available via subscription   (Followers: 3)
Marine and Petroleum Geology     Hybrid Journal   (Followers: 23, SJR: 1.372, h-index: 75)
Marine Chemistry     Hybrid Journal   (Followers: 8, SJR: 1.389, h-index: 99)
Marine Environmental Research     Hybrid Journal   (Followers: 28, SJR: 1.113, h-index: 69)
Marine Genomics     Hybrid Journal   (Followers: 1, SJR: 0.984, h-index: 17)
Marine Geology     Hybrid Journal   (Followers: 36, SJR: 1.489, h-index: 98)
Marine Micropaleontology     Hybrid Journal   (Followers: 3, SJR: 1.1, h-index: 68)
Marine Policy     Hybrid Journal   (Followers: 59, SJR: 1.567, h-index: 60)
Marine Pollution Bulletin     Hybrid Journal   (Followers: 29, SJR: 1.264, h-index: 113)
Marine Structures     Hybrid Journal   (Followers: 5, SJR: 1.746, h-index: 41)
Materials & Design     Hybrid Journal   (Followers: 43)
Materials Characterization     Hybrid Journal   (Followers: 34, SJR: 1.267, h-index: 61)
Materials Chemistry and Physics     Full-text available via subscription   (Followers: 17, SJR: 0.733, h-index: 104)
Materials Discovery     Full-text available via subscription  
Materials Letters     Hybrid Journal   (Followers: 12, SJR: 0.807, h-index: 99)
Materials Research Bulletin     Hybrid Journal   (Followers: 28, SJR: 0.753, h-index: 79)
Materials Science and Engineering: A     Hybrid Journal   (Followers: 43, SJR: 1.803, h-index: 162)
Materials Science and Engineering: B     Hybrid Journal   (Followers: 21, SJR: 0.723, h-index: 87)
Materials Science and Engineering: C     Hybrid Journal   (Followers: 19, SJR: 1.332, h-index: 80)
Materials Science and Engineering: R: Reports     Hybrid Journal   (Followers: 17, SJR: 7.616, h-index: 107)
Materials Science in Semiconductor Processing     Hybrid Journal   (Followers: 5, SJR: 0.577, h-index: 38)
Materials Science Monographs     Full-text available via subscription   (Followers: 2)
Materials Today     Open Access   (Followers: 15, SJR: 6.876, h-index: 98)
Materials Today : Proceedings     Hybrid Journal   (SJR: 0.529, h-index: 2)
Materials Today Chemistry     Hybrid Journal  
Materials Today Communications     Full-text available via subscription   (Followers: 2, SJR: 0.138, h-index: 2)
Materials Today Energy     Hybrid Journal   (Followers: 1)
Materials Today Physics     Hybrid Journal  
Mathematical and Computer Modelling     Full-text available via subscription   (Followers: 14, SJR: 0.643, h-index: 73)
Mathematical Biosciences     Hybrid Journal   (Followers: 2, SJR: 0.719, h-index: 65)
Mathematical Social Sciences     Hybrid Journal   (Followers: 1, SJR: 0.493, h-index: 27)
Mathematics and Computers in Simulation     Hybrid Journal   (Followers: 5, SJR: 0.677, h-index: 54)
Mathematics in Science and Engineering     Full-text available via subscription  
Matrix Biology     Hybrid Journal   (Followers: 1, SJR: 1.902, h-index: 93)
Matter and Radiation at Extremes     Open Access  
Maturitas     Hybrid Journal   (Followers: 11, SJR: 1.107, h-index: 78)
Measurement     Hybrid Journal   (Followers: 2, SJR: 0.721, h-index: 47)
Meat Science     Hybrid Journal   (Followers: 5, SJR: 1.963, h-index: 113)
Mechanical Systems and Signal Processing     Hybrid Journal   (Followers: 7, SJR: 1.887, h-index: 100)
Mechanics of Materials     Hybrid Journal   (Followers: 23, SJR: 1.311, h-index: 74)
Mechanics Research Communications     Hybrid Journal   (Followers: 2, SJR: 0.937, h-index: 43)
Mechanism and Machine Theory     Hybrid Journal   (Followers: 9, SJR: 1.264, h-index: 72)
Mechanisms of Ageing and Development     Hybrid Journal   (Followers: 4, SJR: 1.737, h-index: 91)
Mechanisms of Development     Hybrid Journal   (Followers: 5, SJR: 1.368, h-index: 124)
Mechatronics     Hybrid Journal   (Followers: 6, SJR: 1.019, h-index: 62)
Médecine & Droit     Full-text available via subscription   (SJR: 0.115, h-index: 5)
Médecine & Longévité     Full-text available via subscription   (Followers: 1, SJR: 0.103, h-index: 3)
Médecine des Maladies Métaboliques     Full-text available via subscription   (Followers: 1, SJR: 0.111, h-index: 6)
Médecine du Sommeil     Full-text available via subscription   (SJR: 0.107, h-index: 4)
Médecine et Maladies Infectieuses     Full-text available via subscription   (SJR: 0.605, h-index: 23)
Médecine Nucléaire     Full-text available via subscription   (Followers: 1, SJR: 0.119, h-index: 7)
Médecine Palliative : Soins de Support - Accompagnement - Éthique     Full-text available via subscription   (Followers: 2, SJR: 0.155, h-index: 8)
Medical Clinics of North America     Full-text available via subscription   (Followers: 4, SJR: 0.796, h-index: 67)
Medical Dosimetry     Hybrid Journal   (Followers: 4, SJR: 0.532, h-index: 30)
Medical Engineering & Physics     Hybrid Journal   (Followers: 9, SJR: 0.784, h-index: 76)
Medical Hypotheses     Hybrid Journal   (Followers: 6, SJR: 0.464, h-index: 65)
Medical Image Analysis     Hybrid Journal   (Followers: 10, SJR: 2.048, h-index: 89)
Medical J. Armed Forces India     Full-text available via subscription  
Medical Mycology Case Reports     Open Access   (SJR: 0.37, h-index: 5)
Medical Photonics     Hybrid Journal   (Followers: 2)
Medicina     Open Access   (Followers: 1, SJR: 0.252, h-index: 24)
Medicina Clínica     Full-text available via subscription   (Followers: 7, SJR: 0.221, h-index: 55)
Medicina Clínica (English Edition)     Hybrid Journal   (Followers: 1)
Medicina General y de Familia     Open Access  
Medicina Intensiva     Open Access   (Followers: 3, SJR: 0.334, h-index: 18)
Medicina Intensiva (English Edition)     Hybrid Journal   (Followers: 1)
Medicina Paliativa     Hybrid Journal  
Medicine     Full-text available via subscription   (Followers: 10, SJR: 0.147, h-index: 22)
Medicine - Programa de Formación Médica Continuada Acreditado     Full-text available via subscription   (Followers: 1, SJR: 0.108, h-index: 3)
Membrane Protein Transport     Full-text available via subscription   (Followers: 2)
Membrane Science and Technology     Full-text available via subscription   (Followers: 4)
Membrane Technology     Full-text available via subscription   (Followers: 5, SJR: 0.135, h-index: 15)
Mendeleev Communications     Full-text available via subscription   (SJR: 0.436, h-index: 29)
Mental Health & Prevention     Hybrid Journal   (Followers: 2, SJR: 0.262, h-index: 3)
Mental Health and Physical Activity     Hybrid Journal   (Followers: 17, SJR: 0.772, h-index: 19)
Meta Gene     Open Access   (SJR: 0.339, h-index: 4)
Metabolic Engineering     Hybrid Journal   (Followers: 14, SJR: 3.655, h-index: 75)
Metabolic Engineering Communications     Open Access   (Followers: 4, SJR: 1.215, h-index: 3)
Metabolism     Hybrid Journal   (Followers: 12, SJR: 1.978, h-index: 105)
Metal Finishing     Full-text available via subscription   (Followers: 20, SJR: 0.148, h-index: 20)
Metal Powder Report     Full-text available via subscription   (Followers: 22, SJR: 0.113, h-index: 14)
Metamaterials     Hybrid Journal   (Followers: 4, SJR: 0.344, h-index: 21)
Methods     Hybrid Journal   (Followers: 12, SJR: 2.377, h-index: 108)
Methods in Cell Biology     Full-text available via subscription   (Followers: 7, SJR: 1.15, h-index: 59)

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Journal Cover Archives de Pédiatrie
  [SJR: 0.198]   [H-I: 32]   [0 followers]  Follow
   Full-text available via subscription Subscription journal
   ISSN (Print) 0929-693X
   Published by Elsevier Homepage  [3177 journals]
  • Les modifications de pratique clinique liées à l’arrivée du
           séquençage haut débit dans le diagnostic génétique des maladies du
    • Authors: L. Demougeot; F. Houdayer; A. Pélissier; F. Mohrez; J. Thevenon; Y. Duffourd; S. Nambot; E. Gautier; C. Binquet; M. Rossi; D. Sanlaville; S. Béjean; C. Peyron; C. Thauvin-Robinet; L. Faivre
      Pages: 77 - 83
      Abstract: Publication date: Available online 12 February 2018
      Source:Archives de Pédiatrie
      Author(s): L. Demougeot, F. Houdayer, A. Pélissier, F. Mohrez, J. Thevenon, Y. Duffourd, S. Nambot, E. Gautier, C. Binquet, M. Rossi, D. Sanlaville, S. Béjean, C. Peyron, C. Thauvin-Robinet, L. Faivre
      Introduction The arrival of high-throughput sequencing (HTS) has led to a sweeping change in the diagnosis of developmental abnormalities (DA) with or without intellectual deficiency (ID). With the prospect of deploying these new technologies, two questions have been raised: the representations of HTS among geneticists and the costs incurred due to these analyses. Methods Geneticists attending a clinical genetics seminar were invited to complete a questionnaire. The statistical analysis was essentially descriptive and an analysis of costs was undertaken. Results Of those responding to the questionnaire, 48% had already prescribed exome analysis and 25% had already had the occasion to disclose the results of such analyses. Ninety-six percent were aware that whole-exome sequencing (WES) had certain limits and 74% expressed misgivings concerning its use in medical practice. In parallel, the evaluation of costs showed that WES was less expensive than conventional procedures. Discussion The survey revealed that geneticists had already come to terms with HTS as early as 2015. Among the major concerns expressed were the complexity of interpreting these tests and the many ethical implications. Geneticists seemed to be aware of the advantages but also the limits of these new technologies. The cost analysis raises questions about the place of HTS and in particular WES in the diagnostic work-up: should it be used early to obtain an etiological diagnosis rather than as the last resort' Conclusion It is essential for future generations of doctors and for the families concerned to learn about the concepts of HTS, which is set to become a major feature of new genomic medicine.

      PubDate: 2018-02-14T22:17:09Z
      DOI: 10.1016/j.arcped.2017.12.006
      Issue No: Vol. 25, No. 2 (2018)
  • Principles of curative antibiotic treatment
    • Authors: R. Cohen; E. Grimprel; I. Hau; F. Madhi; J. Gaudelus; J. Raymond
      Abstract: Publication date: December 2017
      Source:Archives de Pédiatrie, Volume 24, Issue 12, Supplement
      Author(s): R. Cohen, E. Grimprel, I. Hau, F. Madhi, J. Gaudelus, J. Raymond
      Infectious diseases are constantly evolving for many reasons. New infectious agents are regularly discovered, mainly because of the development of identification methods, including the molecular tools and mass spectrometry. Changes in the epidemiology of infectious diseases are not always understood, but several factors undoubtedly play an important role, notably the impact of vaccination implementations, the ecological consequences of antibiotic treatments and their excessive use, and the secular epidemiological trends of pathogenic agents. Antibiotic resistance has been recognized as one of the major challenges for humanity and few new antibiotics with potent activity against resistant Gram-negative rods have been developed in recent years. The rationalization of antibiotic treatments is a key for reducing or limiting antimicrobial resistance. This guide takes into account the latest recommendations, the consensus conferences, and the guidelines of the Pediatric Infectious Diseases Group of the French Society of Pediatric, the French Infectious Diseases Society, and French official agencies. For each clinical situation, the main bacterial target of the antibiotic treatment, the first-choice antibiotic and the alternative treatment, as well as the most important findings for the diagnosis and treatment of the infection are detailed.

      PubDate: 2018-01-03T18:55:27Z
      DOI: 10.1016/s0929-693x(17)30510-9
  • Antibiotic pharmacokinetic and pharmacodynamic parameters in pediatric
           clinical practice
    • Authors: R. Cohen; E. Grimprel
      Abstract: Publication date: December 2017
      Source:Archives de Pédiatrie, Volume 24, Issue 12, Supplement
      Author(s): R. Cohen, E. Grimprel
      Progress in the knowledge of antibiotic mechanisms of action allows to determine the pharmacodynamics/pharmacokinetic (PK/PD) parameters predictive of antibiotic efficacy in bacterial infections. According to the antibiotic compound, the bacterial species implicated, the location of the infection, and the severity of the disease, these parameters may vary. The PK/PD parameters described in this paper, focus only on blood compartments. These PK/PD parameters best predict efficacy in the most frequent infections (e.g., respiratory, bacteremia, skin and soft tissue infections and intra-abdominal infections). Furthermore, they contribute to the determination of doses and number of administrations per day as well as the determination of minimum inhibitory concentration (MIC) breakpoints. The time above the MIC (T> MIC) is the main criterion for β-lactams: free drug serum levels of these drugs should be above the MIC for at least 40%–50% of the dosing interval to produce adequate clinical and microbiological efficacy. Peak/MIC ratio is the major determinant of the activity of aminoglycosides: in general, peak/MIC ratios should exceed 8-10. Area under the MIC curve (AUC/MIC) is considered for quinolones, macrolides, and vancomycin as the best predictor of efficacy.

      PubDate: 2018-01-03T18:55:27Z
      DOI: 10.1016/s0929-693x(17)30511-0
  • Étude du fonctionnement adaptatif d’adultes présentant une déficience
           intellectuelle : rôles des apprentissages réalisés dans l’enfance,
           de l’âge et du quotient intellectuel ; étude préliminaire
           observationnelle de 16 adultes
    • Authors: A. Minguez; M. Milh
      Abstract: Publication date: Available online 16 March 2018
      Source:Archives de Pédiatrie
      Author(s): A. Minguez, M. Milh
      The objective of this study was to investigate the adaptive functioning of adults who had a slight to moderate intellectual deficiency, in regard of age and intellectual quotient (IQ). Cognitive and adaptive functioning were evaluated using the WAIS and VINELAND scales in 16 adults who accepted to participate in this study. We found a correlation between global IQ and each domain of the adaptive score, mostly communication skills. We also found that there was an age effect on socialization skills. Most skills were learned during infancy and adolescence, especially communication skills, which are highly stable at different ages and highly correlated with IQ. However, some abilities are still acquired in adulthood, mostly socialization skills, especially in persons with the lowest IQ. These data are of particular interest for people caring for disabled adults.

      PubDate: 2018-03-19T00:22:54Z
      DOI: 10.1016/j.arcped.2018.02.002
  • First-line treatment using high-flow nasal cannula for children with
           severe bronchiolitis: Applicability and risk factors for failure
    • Authors: C. Guillot; C. Le Reun; H. Behal; J. Labreuche; M. Recher; A. Duhamel; S. Leteurtre
      Abstract: Publication date: Available online 15 March 2018
      Source:Archives de Pédiatrie
      Author(s): C. Guillot, C. Le Reun, H. Behal, J. Labreuche, M. Recher, A. Duhamel, S. Leteurtre
      Background Viral bronchiolitis is the leading cause of hospitalization in children during the first 12 months of life. There is evidence to support the use of noninvasive ventilation in bronchiolitis. A recent respiratory management of bronchiolitis is the use of high-flow nasal cannula (HFNC) therapy. The primary objective of this study was to evaluate the use of HFNC as the first-line treatment for children with severe bronchiolitis and the secondary objective was to identify factors for HFNC therapy failure. Methods Observational prospective study in a pediatric intensive care unit (PICU), during two consecutive seasons (2013–2014 without recommendation and 2014–2015 with a study design suggesting HFNC as first-line treatment). The percentages of children treated with HFNC, nasal continuous or biphasic positive airway pressure (nCPAP/BiPAP) and invasive ventilation were compared. Associations between parameters recorded and HFCN therapy failure were established. Results The percentage of patients treated with HFNC at admission was higher during the second season (90%, n =55/61) than the first season (34%, n =14/41) (p <0.0001). In bivariate analysis, heart rate, pH, and pCO2 were significantly associated with the occurrence of HFNC therapy failure in time-varying Cox regression models using all available values (i.e., admission and repeated measures during the first 5 days of hospitalization). Only pCO2 remained independently associated as a factor of HFNC failure in the multivariate Cox model with a hazard ratio per 5mmHg of 1.37 (95%CI: 1.01–1.87; P =0.046). Conclusion In our PICU, HFNC therapy for children with bronchiolitis can potentially decrease the use of nCPAP. In this study, the factor of failure was higher pCO2. Studies to evaluate PCO2 level to discriminate HFNC versus CPAP indication could be useful.

      PubDate: 2018-03-19T00:22:54Z
      DOI: 10.1016/j.arcped.2018.01.003
  • Troubles en mathématiques : une origine multiple ' L’exemple des
           syndromes de Turner et de l’X Fragile
    • Authors: C. Deffrennes; M. De Clercq; L. Vallée; M.-P. Lemaître
      Abstract: Publication date: Available online 14 March 2018
      Source:Archives de Pédiatrie
      Author(s): C. Deffrennes, M. De Clercq, L. Vallée, M.-P. Lemaître
      Problems in mathematics are a frequent major complaint in neuropediatric departments, for which there are two explanatory theoretical models: the hypothesis of a genetic and modular origin (with a number sense deficit) and a multidetermined origin. The purpose of this paper is to review the mathematical difficulties described in Turner syndrome and Fragile X syndrome, because a specific mathematical disorder is usually reported in these populations, supporting the existence of a number sense. Analysis of the literature reveals highly variable cognitive phenotypes in these populations, especially regarding mathematical abilities. Performance heterogeneity might be related to different factors such as the abilities needed to perform the task, the variability of definitions, the different tests used in the studies and the heterogeneity of the syndromes themselves. A number sense deficit is usually described in these syndromes, but variable cognitive impairments are also observed. The idea of a modular functioning is then debated and we argue for the necessity of a global cognitive evaluation approach.

      PubDate: 2018-03-19T00:22:54Z
      DOI: 10.1016/j.arcped.2018.01.001
  • Hypercholesterolemia in children: Why and how to screen for it'
    • Authors: J.- P. Girardet; A. Bocquet; J.P. Chouraqui; D. Darmaun; F. Feillet; M.-L. Frelut; R. Hankard; J.-C. Rozé; U. Simeoni; D. Turck; A. Briend; C. Dupont
      Abstract: Publication date: Available online 13 March 2018
      Source:Archives de Pédiatrie
      Author(s): J.- P. Girardet, A. Bocquet, J.P. Chouraqui, D. Darmaun, F. Feillet, M.-L. Frelut, R. Hankard, J.-C. Rozé, U. Simeoni, D. Turck, A. Briend, C. Dupont

      PubDate: 2018-03-19T00:22:54Z
      DOI: 10.1016/j.arcped.2018.01.005
  • Tout ce que vous devez connaître sur le méthylphénidate (sans oser le
    • Authors: L. Zimmer; P. Fourneret
      Abstract: Publication date: Available online 12 March 2018
      Source:Archives de Pédiatrie
      Author(s): L. Zimmer, P. Fourneret
      Methylphenidate (MPH) remains the only accessible psychostimulant used in France in the attention and behavior disturbances of attention deficit disorder with or without hyperactivity (ADHD). Its prescription has been extended during the past decade to other neurodevelopmental disorders in children and adolescents, also associated with a deficit of attentional resources or, more broadly, fragility of executive functions. Despite its efficiency, validated by more than 400 randomized controlled and double-blind studies, and the good tolerance of MPH in these indications, this treatment remains limited in France because of many fears and other prejudices on the part of medical practitioners and/or families. This article, resulting from the complementary viewpoints of a psychiatrist and a neuropharmacologist, is not intended to advocate MPH but to present, in a concise and nuanced manner, the approved scientific data justifying and framing this prescription.

      PubDate: 2018-03-19T00:22:54Z
      DOI: 10.1016/j.arcped.2018.01.002
  • Acute hemorrhagic edema of infancy associated with Coxsackie virus
    • Authors: A. Ferrarini; G.P. Milani; M.G. Bianchetti; S.A.G. Lava
      Abstract: Publication date: Available online 12 March 2018
      Source:Archives de Pédiatrie
      Author(s): A. Ferrarini, G.P. Milani, M.G. Bianchetti, S.A.G. Lava

      PubDate: 2018-03-19T00:22:54Z
      DOI: 10.1016/j.arcped.2018.01.006
  • De la pédiatrie à la médecine adulte : transition des patients
           drépanocytaires, une étude monocentrique française
    • Authors: M. Colinart-Thomas; V. Noël; G. Roques; S. Gordes-Grosjean; M. Abely; C. Pluchart
      Abstract: Publication date: Available online 9 March 2018
      Source:Archives de Pédiatrie
      Author(s): M. Colinart-Thomas, V. Noël, G. Roques, S. Gordes-Grosjean, M. Abely, C. Pluchart
      Sickle cell disease, a hemoglobin disorder with autosomal recessive transmission, is one of the most common genetic diseases screened in France. Thanks to early management, 95% of sickle cell patients reach adulthood and require transition from pediatric care to adult care. Through a retrospective study of records from serious sickle cell patients over 17 years old, followed in the hematology-oncology pediatric unit of Reims University Hospital Center in France, we analyzed transition conditions, compared pediatric and adult management, and proposed a plan for transition care. As of 1 January 2016, out of 19 sickle cell patients meeting the inclusion criteria, 12 had made the transition from pediatric care to adult medicine. Among the transition group, the transition was proposed by the pediatrician in 92% of cases. The average age of transition was 19.4 years. The time between receiving the information and the last pediatric visit was 2.4 months. Seven out of the 12 patients were informed of their transition during the last pediatric visit. The age of the first adult visit was 20.3 years. There was no alternate or joint consultation. The treatments prescribed during the last pediatric visit were not modified during the first adult visit. The average number of hospitalizations per patient was 2.7 in pediatric care and 3.4 in adult care with a median value of 2 in both groups. Three out of 12 patients died, the average age of death being 26.7 years. Transition is an important milestone in chronic disease patients. More than age, the maturity of the patient must be taken into account. The transition to the adult structure requires early preparation in the teenage years and investment of the adolescent and his family as well as investment of pediatric and adult caregivers. This study points out the need to establish a transition plan within our hospital in collaboration with adult physicians. Continuity of care is necessary to increase the quality of managing patients and cannot be done without a close relationship between pediatric specialists and adult physicians.

      PubDate: 2018-03-19T00:22:54Z
      DOI: 10.1016/j.arcped.2017.12.012
  • Outcome of children born after pregnancy denial
    • Authors: M. Simermann; S. Rothenburger; B. Auburtin; J.-M. Hascoët
      Abstract: Publication date: Available online 7 March 2018
      Source:Archives de Pédiatrie
      Author(s): M. Simermann, S. Rothenburger, B. Auburtin, J.-M. Hascoët
      Introduction Denial of pregnancy remains a phenomenon little known to healthcare professionals. Yet its repercussions are far from negligible. The aim of this study was to assess whether denial of pregnancy has an impact on the infant's development. Patients and method This prospective study included 51 full-term infants born in Nancy Regional Maternity Hospital between 1 January 2009 and 30 June 2015. In this study, the development of the children was followed longitudinally. We collected data during the neonatal period, at 9months, and at 2years of age from the infants’ file and standardized medical certificates, and current data through a telephone questionnaire. Three fundamental aspects of the infants’ development were analyzed: height and weight growth, psychomotor development, and the existence of pathologies. Given that this was a preliminary study aiming at exploring facts, no statistical tests were carried out. Results The rate of denial of pregnancy was one birth in 300 during the study period. These infants showed proportional intrauterine growth restriction, which leveled out later, with their height and weight growth normal by month 9. The full-term perinatal mortality rate was 5%. The infants showed no sign of increased morbidity; 20% of them presented with delayed psychomotor development at 9months of age, with an increased impact as they grew older. The rate reached 30% after 24months, half of which were language disorders. Conclusion The results of this preliminary study point out the need for thorough monitoring of these infants throughout infancy.

      PubDate: 2018-03-19T00:22:54Z
      DOI: 10.1016/j.arcped.2018.01.004
  • L’anémie, un nouveau facteur de sévérité de la bronchiolite aiguë
           du nourrisson '
    • Authors: G. Tourniaire; C. Milési; J. Baleine; J. Crozier; C. Lapeyre; C. Combes; N. Nagot; G. Cambonie
      Abstract: Publication date: Available online 7 March 2018
      Source:Archives de Pédiatrie
      Author(s): G. Tourniaire, C. Milési, J. Baleine, J. Crozier, C. Lapeyre, C. Combes, N. Nagot, G. Cambonie
      Introduction The role of anemia is raised as a risk of low respiratory infection of the child, but there are no data on anemia as a severity factor in acute viral bronchiolitis (AVB) in infants. Methods All infants less than 16 weeks old admitted to Montpellier University Hospital from 2015/10/01 to 2016/04/01 for AVB were included in a retrospective observational study. The primary objective was to determine whether the hemoglobin (Hb) concentration on admission was an independent factor of clinical severity, judged by the modified Wood's clinical asthma score (m-WCAS). The secondary objective was to assess the impact of Hb level on the characteristics of hospitalization, including the type and duration of respiratory support. Results The m-WCAS was used at least once during hospitalization in 180 out of 220 patients (82%), making it possible to distinguish patients with mild AVB (maximum m-WCAS<2, n =81) from patients with severe AVB (maximum m-WCAS>2, n =99). A logistic regression model indicated that the Hb concentration, for every 1g/dL decrement, was an independent factor of AVB severity (OR 1.16 [1.03–1.29], P =0.026). A level under 10g/dL on admission was associated with a higher use of continuous positive airway pressure (P <0.001), as well as a longer duration of respiratory support (P =0.01). Conclusion This study suggested that anemia may influence the clinical expression of AVB in young infants.

      PubDate: 2018-03-19T00:22:54Z
      DOI: 10.1016/j.arcped.2018.02.001
  • Préparation et administration des médicaments dans les services de
           pédiatrie. Évaluation des pratiques des soignants
    • Authors: S. Ménétré; M. Weber; M. Socha; S. Le Tacon; I. May; C. Schweitzer; B. Demoré
      Abstract: Publication date: Available online 2 February 2018
      Source:Archives de Pédiatrie
      Author(s): S. Ménétré, M. Weber, M. Socha, S. Le Tacon, I. May, C. Schweitzer, B. Demoré
      In hospitals, the nursing staff is often confronted with the problem of the preparation and administration of drugs for their pediatric patients because of the lack of indication, pediatric dosage, and appropriate galenic form. The goal of this study was to give an overview of the nurses’ preparation habits in pediatric units and highlight their daily problems. This single-center prospective study was conducted through an observation of the nursing staff during the drug preparation process in medicine, surgery and intensive care units. We included 91 patients (55 boys and 36 girls), with an average age of 6.3 years (youngest child, 10 days old; oldest child, 18 years old). We observed a mean 2.16 drug preparations per patient [1–5]. We collected 197 observation reports regarding 66 injectable drugs and 131 oral drugs (71 liquid forms and 60 solid forms). The majority of these reports concerned central nervous system drugs (63/197), metabolism and digestive system drugs (50/197), and anti-infective drugs (46/197). The study highlights the nurses’ difficulties: modification of the solid galenic forms, lack of knowledge on oral liquid form preservation or reconstitution methods, withdrawal of small volumes, and vague and noncompliant labeling. This study led to the creation of a specific working group for pediatrics. This multidisciplinary team meets on a regular basis to work toward improving the current habits to both simplify and secure drug administration to hospitalized children.

      PubDate: 2018-02-04T21:46:52Z
      DOI: 10.1016/j.arcped.2017.12.002
  • Children and screens: Groupe de Pédiatrie Générale (Société
           française de pédiatrie) guidelines for pediatricians and families
    • Authors: G. Picherot; J. Cheymol; R. Assathiany; M.-S. Barthet-Derrien; M. Bidet-Emeriau; S. Blocquaux; R. Carbajal; F.-M. Caron; O. Gerard; M. Hinterman; O. Houde; C. Jollivet; M.-F. Le Heuzey; A. Mielle; M. Ogrizek; B. Rocher; B. Samson; V. Ronziere; P. Foucaud
      Abstract: Publication date: Available online 1 February 2018
      Source:Archives de Pédiatrie
      Author(s): G. Picherot, J. Cheymol, R. Assathiany, M.-S. Barthet-Derrien, M. Bidet-Emeriau, S. Blocquaux, R. Carbajal, F.-M. Caron, O. Gerard, M. Hinterman, O. Houde, C. Jollivet, M.-F. Le Heuzey, A. Mielle, M. Ogrizek, B. Rocher, B. Samson, V. Ronziere, P. Foucaud
      The Groupe de Pédiatrie Générale (General Pediatrics Group), a member of the Société française de pédiatrie (French Pediatrics Society), has proposed guidelines for families and doctors regarding children's use of digital screens. A number of guidelines have already been published, in particular by the French Academy of Sciences in 2013 and the American Academy of Pediatrics in 2016. These new guidelines were preceded by an investigation into the location of digital screen use by young children in France, a survey of medical concerns on the misuse of digital devices, and a review of their documented benefits. The Conseil Supérieur de l’Audiovisuel (Higher Council on Audiovisual Technology) and the Union Nationale de Associations Familiales (National Union of Family Associations) have taken part in the preparation of this document. Five simple messages are proposed: understanding without demonizing; screen use in common living areas, but not in bedrooms; preserve time with no digital devices (morning, meals, sleep, etc.); provide parental guidance for screen use; and prevent social isolation.

      PubDate: 2018-02-04T21:46:52Z
      DOI: 10.1016/j.arcped.2017.12.014
  • Hemodynamic support of a 15-year-old waiting for a heart transplant: Is
           there a role for levosimendan in pediatric heart failure'
    • Authors: I. Goyer; D. Brossier; B. Toledano
      Abstract: Publication date: Available online 1 February 2018
      Source:Archives de Pédiatrie
      Author(s): I. Goyer, D. Brossier, B. Toledano
      Decompensated heart failure in children requires rapid and aggressive support. In refractory cases, invasive supportive care is essential to ensure cardiac output. This results in lengthy pediatric intensive care unit (PICU) stays, secondary morbidity, and high cost. Levosimendan may help palliate the pitfalls encountered with the usual treatment. It has been shown to improve hemodynamics and decrease morbidity and mortality from heart failure in adult trials and pediatric cohorts. We report the case of a 15-year-old boy with dilated cardiomyopathy and refractory ventricular dysfunction who was weaned from continuous inotropes and discharged from the PICU with levosimendan while waiting for heart transplantation.

      PubDate: 2018-02-04T21:46:52Z
      DOI: 10.1016/j.arcped.2017.12.003
  • Sudden unexpected infant death: Time for integrative national registries
    • Authors: K. Levieux; H. Patural; I. Harrewijn; E. Briand Huchet; B. Kugener; O. Pidoux; S. de Visme; C. Adjaoud; C. Gras Le Guen; M. Hanf
      Abstract: Publication date: Available online 1 February 2018
      Source:Archives de Pédiatrie
      Author(s): K. Levieux, H. Patural, I. Harrewijn, E. Briand Huchet, B. Kugener, O. Pidoux, S. de Visme, C. Adjaoud, C. Gras Le Guen, M. Hanf

      PubDate: 2018-02-04T21:46:52Z
      DOI: 10.1016/j.arcped.2017.12.008
  • HIV infection in children as an example of chronic disease management in
           French-speaking Africa
    • Authors: M. Sylla; C.T. Tall; S. Blanche
      Abstract: Publication date: Available online 1 February 2018
      Source:Archives de Pédiatrie
      Author(s): M. Sylla, C.T. Tall, S. Blanche

      PubDate: 2018-02-04T21:46:52Z
      DOI: 10.1016/j.arcped.2017.12.007
  • Exploration d’une avance staturale chez l’enfant : conduite à tenir
           pratique, principales étiologies à évoquer
    • Authors: J. Vergier; E. Marquant; T. Busa; R. Reynaud
      Abstract: Publication date: Available online 1 February 2018
      Source:Archives de Pédiatrie
      Author(s): J. Vergier, E. Marquant, T. Busa, R. Reynaud
      Tall stature is not a common motive for medical consultation, even though by definition 2.5 % of children in the general population are concerned. It is usually defined as height greater than+2 standard deviations (SD) using the appropriate growth chart for age and gender, or a difference greater than +2 SD between actual height and target height. With a patient presenting tall stature, the physician has to determine whether it is a benign feature or a disease. Indeed, making the diagnosis is essential for hormonal disease or genetic overgrowth syndromes. The past medical history including parents’ height, prenatal and birth data, physical examination along with anthropometry (height, weight, head circumference, body mass index), and growth chart evaluation with the detailed growth pattern are generally sufficient to make the diagnosis such as familial tall stature, obesity, or early puberty. Bone age estimation may be helpful for some specific etiologies and is also necessary to help predict final adult height. After exclusion of common causes, further investigation is required. Sudden growth acceleration often reveals endocrine pathology such as early puberty, hyperthyroidism, or acrogigantism. Tall stature accompanied by dysmorphic features, congenital malformations, developmental delay, or a family medical history may be related to genetic disorders such as Marfan, Sotos, or Wiedemann-Beckwith syndromes. We relate here the most frequent etiologies of overgrowth syndromes.

      PubDate: 2018-02-04T21:46:52Z
      DOI: 10.1016/j.arcped.2017.12.010
  • Bowel obstruction due to ingestion of a water-absorbing bead
    • Authors: M. Fuger; C. Desmoulins; N. Khen Dunlop; F. Gobbo; P. Blakime; G. Chéron
      Abstract: Publication date: Available online 1 February 2018
      Source:Archives de Pédiatrie
      Author(s): M. Fuger, C. Desmoulins, N. Khen Dunlop, F. Gobbo, P. Blakime, G. Chéron
      Foreign body ingestion is a common pediatric complaint. Most foreign bodies pass spontaneously through the gastrointestinal tract, but bowel obstruction is a rare complication that can occur. We report a case of a 14-month-old infant with complete bowel obstruction due to ingestion of a polymer bead used for botanical arrangements. A laparotomy was performed to remove the object, resolving the symptoms. Polymer beads are brightly coloured and are of a size that is easy to swallow by very young children, increasing the risk of accidental ingestion. They increase in size over a short period of time during their passage through the gastrointestinal tract, causing significant morbidity.

      PubDate: 2018-02-04T21:46:52Z
      DOI: 10.1016/j.arcped.2017.12.004
  • Postdiarrheal hemolytic and uremic syndrome with severe multiorgan
           involvement and associated early risk factors
    • Authors: M. Oualha; S. Pierrepont; P. Krug; C. Gitiaux; P. Hubert; F. Lesage; R. Salomon
      Abstract: Publication date: Available online 1 February 2018
      Source:Archives de Pédiatrie
      Author(s): M. Oualha, S. Pierrepont, P. Krug, C. Gitiaux, P. Hubert, F. Lesage, R. Salomon
      Aim Identifying early clinical and biological factors associated with severe forms of postdiarrheal hemolytic uremic syndrome (D+HUS) that may help practitioners determine appropriate treatment. Methods This retrospective study was conducted in 49 children with D+HUS between 2001 and 2011. Severe forms were defined as occurrence of one of the following conditions: death, major neurological involvement, cardiovascular involvement, and/or the presence of sequelae (neurological, cardiovascular, pancreatic, or renal). Results During the acute phase, 35 children exhibited at least one type of extrarenal involvement including 13 severe forms with a median delayed occurrence after admission of 4.5 days (range: 1–8) for comatose children and 5 days (range: 2–6) for cardiovascular involvement; 32 children required dialysis and three died. In multivariate analysis, (i) major neurological involvement (n =13), (ii) dialysis (n =32), and (iii) sequelae (n =12) were associated with (i) fever during the prodromal phase requiring dialysis at admission, (ii) C-reactive protein level (CRP) >22mg/L at admission, and (iii) major neurological involvement and a white blood cell count (WBC)>20×103/mm3 during the acute stage, respectively. Conclusions D+HUS is a multiorgan disease with a delayed occurrence of life-threatening extrarenal organ involvement. Severe forms appear to be associated with early biological and clinical inflammatory parameters.

      PubDate: 2018-02-04T21:46:52Z
      DOI: 10.1016/j.arcped.2017.12.005
  • Newborn follow-up after discharge from the maternity unit: Compliance with
           national guidelines
    • Authors: J. Roisné; M. Delattre; S. Rousseau; A. Bourlet; M.-L. Charkaluk
      Abstract: Publication date: Available online 1 February 2018
      Source:Archives de Pédiatrie
      Author(s): J. Roisné, M. Delattre, S. Rousseau, A. Bourlet, M.-L. Charkaluk
      Background In the context of shorter hospital stays in maternity units, in 2014 the French health authorities issued guidelines for newborn follow-up after discharge from maternity units. A medical visit is recommended between the 6th and 10th day of life, as are home visits from midwives. This study was designed to evaluate compliance with these guidelines. Methods The study was observational, prospective, multicenter, and was conducted in March and April 2015 in three maternity units in northern France that participate in the Baby Friendly Hospital Initiative (BFHI). Follow-up practices (medical visit between the 6th and 10th day, home visits from a midwife) and demographic, social, and medical data were recorded during the stay in the maternity unit, and through a phone interview 1 month later, in singleton term-born infants. Results The study population included 108 mother–infant pairs. The recommended medical visit was effectively performed by a physician between the 6th and 10th day of life for 20 newborns (19%) (95% CI: [11; 26]). During the 1st month, at least one home visit from a midwife was recorded for 96 mother–infant pairs (89%). The only factor positively correlated with a medical visit between the 6th and 10th day was the mother's choice, made early during the hospital stay and independently of the real length of stay, for early discharge from the maternity unit. Conclusion Compliance with national guidelines was poor for the recommended medical visit between the 6th and 10th day of life. Information needs to be improved.

      PubDate: 2018-02-04T21:46:52Z
      DOI: 10.1016/j.arcped.2017.12.011
  • Peau et fièvres récurrentes auto-inflammatoires
    • Authors: A. Escudier; F.-X. Mauvais; P. Bastard; C. Boussard; A. Jaoui; V. Koskas; E. Lecoq; A. Michel; M.-C. Orcel; P.-E. Truelle; D. Wohrer; M. Piram
      Abstract: Publication date: Available online 1 February 2018
      Source:Archives de Pédiatrie
      Author(s): A. Escudier, F.-X. Mauvais, P. Bastard, C. Boussard, A. Jaoui, V. Koskas, E. Lecoq, A. Michel, M.-C. Orcel, P.-E. Truelle, D. Wohrer, M. Piram
      Auto-inflammatory diseases are characterized by unexplained and recurrent attacks of systemic inflammation often involving the skin, joints, or serosal membranes. They are due to a dysfunction or dysregulation of the innate immunity, which is the first line of defense against pathogens. Early recognition of these diseases by the clinician, especially by pediatricians encountering such pathologies in pediatric patients, is primordial to avoid complications. Skin manifestations, common in most auto-inflammatory diseases, are helpful for prompt diagnosis. After a brief physiopathological review, we will describe auto-inflammatory recurrent fevers by their main dermatological presentations: urticarial lesions, neutrophilic dermatoses, panniculitis, other maculopapular eruptions, dyskeratosis, skin vasculitis, and oral aphthous. We finally suggest a decision tree to help clinicians better target genetic exams in patients with recurrent fevers and dermatological manifestations.

      PubDate: 2018-02-04T21:46:52Z
      DOI: 10.1016/j.arcped.2017.12.001
  • Palivizumab administration in preterm infants in France: EPIPAGE-2 cohort
    • Authors: H. Torchin; J. Rousseau; L. Marchand-Martin; P. Truffert; P.-H. Jarreau; P.-Y. Ancel
      Abstract: Publication date: Available online 1 February 2018
      Source:Archives de Pédiatrie
      Author(s): H. Torchin, J. Rousseau, L. Marchand-Martin, P. Truffert, P.-H. Jarreau, P.-Y. Ancel
      Background Several countries, including France, have restricted the indications for monoclonal antibodies directed against respiratory syncytial virus (RSV) compared to the marketing authorization (MA). No new data concerning use of palivizumab on a national scale have been published since the 2007 update of the national guidelines. Objectives To describe palivizumab administration for RSV prophylaxis during the first RSV season in infants born prematurely in France in 2011. Methods Infants from the national population-based cohort EPIPAGE-2 born at≤34 weeks’ gestation, discharged home before 31 March 2012 and followed-up at 1year were included. The RSV season ran from 1 October 2011 to 31 March 2012. Prophylaxis was deemed “initiated” if the infant had received at least one dose of palivizumab during this period and “complete” if it had received at least five doses or as many doses as the number of exposed months. The reference documents were the MA and French Transparency Committee guidelines (TC). Results Prophylaxis was indicated in 3586 of 3608 infants (99.7%) according to the MA and 1315 of 3608 (16.7%) according to the TC. A total of 1906 infants (26.6%) received at least one dose of palivizumab. The overall rate of conformity with TC indications was 85%, but was lower for infants born at 27–32 weeks’ gestation. The rate of complete prophylaxis was 77.2%. The factors associated with prophylaxis initiation were low gestational age, low birthweight, high maternal educational level, type of neonatal unit, and date at discharge. Factors associated with complete prophylaxis were respiratory impairment, high educational level, and characteristics related to living conditions (absence of siblings at home, type of childcare). Conclusions Palivizumab administration in France generally conformed with TC guidelines, but could be further improved for infants born at 27–32 weeks’ gestation without bronchopulmonary dysplasia.

      PubDate: 2018-02-04T21:46:52Z
      DOI: 10.1016/j.arcped.2017.12.009
  • 2018, a turning point for the Archives de Pédiatrie
    • Authors: Chabrol
      Abstract: Publication date: January 2018
      Source:Archives de Pédiatrie, Volume 25, Issue 1
      Author(s): B. Chabrol

      PubDate: 2018-01-25T21:14:35Z
  • La maladie thrombo-embolique veineuse en oncologie pédiatrique
    • Authors: A. Theron; C. Biron-Andreani; S. Haouy; L. Saumet; M. Saguintah; E. Jeziorski; N. Sirvent
      Abstract: Publication date: Available online 8 January 2018
      Source:Archives de Pédiatrie
      Author(s): A. Theron, C. Biron-Andreani, S. Haouy, L. Saumet, M. Saguintah, E. Jeziorski, N. Sirvent
      The survival rate of children with cancer is now close to 80 %, as a result of continuous improvement in diagnostic and treatment procedures. Prevention and treatment of treatment-associated complications is now a major challenge. Thromboembolic venous disease, due to multifactorial pathogenesis, is a frequent complication (up to 40 % asymptomatic thrombosis in children with cancer), responsible for significant morbidity. Predominantly in children with acute lymphoblastic leukemia, lymphoma, or sarcoma, thromboembolic disease justifies primary prophylaxis in certain populations at risk, whether genetic or environmental. The curative treatment, well codified, is based on the administration of low-molecular-weight heparin. In the absence of robust pediatric prospective studies, this article proposes a concise decision tree summarizing the preventive and curative strategy.

      PubDate: 2018-01-09T19:12:23Z
      DOI: 10.1016/j.arcped.2017.10.029
  • Soins sub-optimaux et infections bactériennes sévères communautaires
           aux Antilles françaises
    • Authors: E. Goisque; E. Launay; B. Vrignaud; E. Jolivet; F. Henaff; C. Gras-Leguen
      Abstract: Publication date: Available online 28 December 2017
      Source:Archives de Pédiatrie
      Author(s): E. Goisque, E. Launay, B. Vrignaud, E. Jolivet, F. Henaff, C. Gras-Leguen
      Objectifs Étudier la fréquence et les types de soins sub-optimaux dans la prise en charge initiale des infections bactériennes sévères (IBS) de l’enfant dans une région française où l’épidémiologie des IBS en pédiatrie est mal connue. Méthode Étude rétrospective monocentrique, sur une période de 6 ans. Les enfants âgés de 3 mois à 15 ans décédés ou survivants admis en réanimation pédiatrique au CHU de Martinique pour une IBS communautaire ont été inclus. L’optimalité de la prise en charge avant l’admission en réanimation était évaluée par 2 experts indépendants et à l’aveugle de l’issue. Résultats Sur les 30 enfants atteints d’IBS, 29 ont pu être analysés. L’âge médian était de 3,7 ans (EIQ 1,7–10,4) et la mortalité de 14 % (IC95 % : 1–27 %). Les infections les plus fréquentes étaient pulmonaires avec 48 % (IC95 % : 29–67 %) suivis des chocs septiques avec 44 % (IC95 % : 25–63 %). Le bilan bactériologique était positif dans 55 % (IC95 % : 36–74 %) (n =16) des cas dont 5 avec du pneumocoque et 4 avec du streptocoque A. Parmi les 29 enfants inclus, 72 % (IC95 % : 55–89 %) (n =21) ont reçu au moins un soin sub-optimal avec un retard au diagnostic (identification des signes de gravité) dans 65 % (IC95 % : 47–83 %) des cas, un délai parental de recours aux soins trop long dans 41 % (IC95 % : 22–60 %) des cas et un retard; à l’initiation des traitements antibiotiques et hémodynamiques dans respectivement 45 % (IC95 % : 26–64 %) et 38 % (IC95 % : 20–56 %) des cas. Conclusion Les prises en charge étaient souvent sub-optimales avec une fréquence élevée du retard à la consultation et de la non reconnaissance des signes précoces d’IBS par les médecins. Des actions d’information auprès du grand-public, une réflexion sur l’amélioration de l’accessibilité aux soins et une meilleure formation des médecins à la reconnaissance des signes précoces d’IBS pourraient permettre d’optimiser les prises en charge. Objective To study the frequency and types of suboptimal care in initial management of children suffering from a severe bacterial infection (SBI), in a French region where little is known about pediatric SBI epidemiology. Method Retrospective single-center study over a 6-year period. Children between 3 months and 15 years of age, deceased or surviving and admitted to the pediatric intensive care unit of the university-affiliated hospital of Martinique for a community-onset SBI were included in this study. The optimality of the medical care before admission to the pediatric intensive care unit was assessed in a blinded fashion by two independent experts. Results Twenty-nine of the 30 children suffering from SBI could be analyzed. The median age was 3.7 years (IQR: 1.7–10.4); the mortality rate was 14 % (95 % CI: 1–27 %). Most frequently infections were pulmonary infections (48 %; 95 % CI: 29–67 %), followed by septic shock (44 %; 95 % CI: 25–63 %). Microbiol...
      PubDate: 2018-01-03T18:55:27Z
      DOI: 10.1016/j.arcped.2017.11.002
  • Introduction of new food textures during complementary feeding:
           Observations in France
    • Authors: A. Marduel Boulanger; M. Vernet
      Abstract: Publication date: Available online 20 December 2017
      Source:Archives de Pédiatrie
      Author(s): A. Marduel Boulanger, M. Vernet
      Introduction Complementary feeding plays a crucial role in the development of infants and toddlers and studies suggest benefits specific to the introduction of food textures. Objectives Evaluate the recommendations given to parents, their practices, and their attitudes towards the introduction of food textures during complementary feeding in France. Methods This was a cross-sectional pilot study conducted in 2013. One hundred and eighty-one parents with at least one child aged 6–36 months living in France completed an ad hoc questionnaire. Results Eighty-eight percent of the parents surveyed received oral information on complementary feeding, but only 46% received such information on the introduction of food textures. Pediatricians were the most frequently listed source of oral information on complementary feeding. More than half the parents also looked for additional information in books and on the internet. While oral recommendations matched parents’ practices, they seemed to occur at a later age compared to infants’ physiological ability to handle new textures. The quality of information on food texture advice available in paper and electronic formats evaluated using a 4-point scale was found to be limited. Introducing new food texture was spontaneously reported as the most common difficulty in complementary feeding (16%). Fear of choking when first introducing food pieces was reported by 54% of the parents. Conclusions The parents’ lack of information on the introduction of food textures, as well as their fear that their child may choke, should encourage providing new recommendations in France.

      PubDate: 2018-01-03T18:55:27Z
      DOI: 10.1016/j.arcped.2017.10.025
  • La douleur chez l’enfant en situation de handicap neurologique : mise
           au point de la Commission « déficience intellectuelle et handicap »
           de la Société française de neurologie pédiatrique
    • Authors: J. Avez-Couturier; S. Joriot; S. Peudenier; D. Juzeau
      Abstract: Publication date: Available online 19 December 2017
      Source:Archives de Pédiatrie
      Author(s): J. Avez-Couturier, S. Joriot, S. Peudenier, D. Juzeau
      Management of pain is one of the major expectations of children with neurological impairment and their families. The medical literature is poor on this topic accounting for approximately 0.15 % of the publications on pain in general. The objective of the French Pediatric Neurology Society was to review the current knowledge on this topic. Bibliographic research was conducted with PubMed and RefDoc for publications between 1994 and 2014 in French or English. A total of 925 articles were retrieved and 92 were selected for review. Pain is common in this population: a 2-week survey indicated that pain occurs in 50–75 % of children. Pain negatively impacts the quality of life of children and their parents. Children with neurological impairment express their pain with pain expression patterns and specific patterns common to children (change of tone, abnormal movements, spasticity, paradoxical reactions, such as laughter, self-injury or vasomotor dysfunction). Some children with neurological impairment are able to use self-report pain scales. If not, observational measures should be used. Behavioral rating scales specifically designed for this population are more sensitive than others. Scales must be selected according to children's communication skills, type of pain, and the context. Sometimes behavioral changes are the only expression of pain: any change in sleep, tone, feeding, or mood must suggest pain in this population. Management of pain remains difficult. There are no specific guidelines. Procedural pain management guidelines and the usual analgesic drugs can be used in children with neurological impairment with specific concerns regarding tolerance and side effects. These children are particularly at risk for neuropathic pain. A multidisciplinary approach is helpful, involving physicians, nurses, physiotherapists, psychologists and parents.

      PubDate: 2018-01-03T18:55:27Z
      DOI: 10.1016/j.arcped.2017.11.012
  • Apport de la télédermatologie dans un service de pédiatrie
    • Authors: S. Nathanson; M.-A. Dommergues; V. Hentgen; F. Arditty; A. Greder Belan; B. Carton; C. Wozniak; J. Parigot; P. Foucaud; E. Mahé
      Abstract: Publication date: Available online 14 December 2017
      Source:Archives de Pédiatrie
      Author(s): S. Nathanson, M.-A. Dommergues, V. Hentgen, F. Arditty, A. Greder Belan, B. Carton, C. Wozniak, J. Parigot, P. Foucaud, E. Mahé
      The hospital of Versailles no longer has a dermatologist; consequently the pediatrics department suggested assess to the system put in place in 2015 based on the telemedicine software platform WebDCR developed throughout the hospital. The acceptability of this was based on its implementation as well as speed and ease of use. Methods In 2015, 47 reviews were submitted. Results No patient refusal was noted. The answer was obtained in 100 % of cases on the day the requests were made, during the week. A diagnosis was made in 36 % of cases and one or more hypotheses were formulated in the 64 % of the remaining cases. The review resulted in a further consultation in 28 % of cases, and in one case to transfer to the dermatology department. The quality of the data collected was considered good or excellent in 96 % of cases. Discussion This first teledermatology experiment seems to show its utility in terms of the services provided. Given the successful deployment of the system, it was extended to the pediatric emergency department. The response time was reduced to 1h. Conclusion This first teledermatology experiment seems to show its real value in terms of services rendered. However, it is necessary to have more experience to confirm the contribution of this tool, and to reassess the sustainability and economic relevance of the device.

      PubDate: 2018-01-03T18:55:27Z
      DOI: 10.1016/j.arcped.2017.10.027
  • Les nourrissons vivant auprès de leur mère incarcérée au centre
           pénitentiaire des femmes de Rennes entre 1998 et 2013. Constats et
    • Authors: A. Blanchard; L. Bébin; S. Leroux; M. Roussey; M.-A. Horel; M. Desforges; I. Page; Y. Bidet; M. Balençon
      Abstract: Publication date: Available online 14 December 2017
      Source:Archives de Pédiatrie
      Author(s): A. Blanchard, L. Bébin, S. Leroux, M. Roussey, M.-A. Horel, M. Desforges, I. Page, Y. Bidet, M. Balençon
      Every year in France, nearly 50 infants live in a prison nursery with their mother. According to French law, infants can live with their mother in the prison nursery until they reach 18 months of age. The international community is concerned about the lack of validated social, medical and legal data on these infants living in prison. This was a retrospective and descriptive study. Medical and paramedical files of the General Council of Île-et-Vilaine, France, were studied. Every infant born between 1998 and 2013 while their mother was in prison were included. Fifty-four files were collected. The average length of stay was 6.2 months (n =54). The type of the mother's prison sentence was property damage in 40 % of cases, personal injury in 51.1 % of cases and both in 8.9 % of cases (n =45). The length of the mother's imprisonment was on average 45 months, ranging from 3 to 216 months (n =34). After prison, 42.9 % of the infants were placed in foster care and 57.1 % resided with their family (n =42). This child–mother incarceration could be an opportunity for positive intergenerational paramedical, medical and social services. The lack of data and problems collecting data restrict our knowledge of these families. This should motivate a national follow-up for these children.

      PubDate: 2018-01-03T18:55:27Z
      DOI: 10.1016/j.arcped.2017.11.016
  • Évaluation des connaissances et des pratiques des pédiatres de Bretagne
           concernant la protection de l’enfance
    • Authors: C. Ayou; E. Gauducheau; A. Arrieta; M. Roussey; M. Marichal; N. Vabres; M. Balençon
      Abstract: Publication date: Available online 13 December 2017
      Source:Archives de Pédiatrie
      Author(s): C. Ayou, E. Gauducheau, A. Arrieta, M. Roussey, M. Marichal, N. Vabres, M. Balençon
      Background and aims On 5 March 2007, the law concerning the child protection system was reformed. Since then, child protection services have been responsible for the management of child abuse and neglect. Reporting and asking for child protection is now easier for every physician by submitting a “preoccupying information” form. A study conducted in 2014 in the general practitioners (GP) in the Ille-et-Vilaine department showed that they were quite unfamiliar with the child protection updates and that they needed special training. We wished to study the knowledge and practices of the pediatricians in Brittany and compare these results to the previous study. Methods An anonymous postal investigation was conducted between May and July 2014. The questionnaire was referred to the previous study so the results would be comparable. Results A total of 134 pediatricians (including 99 women) of the 316 pediatricians of Brittany answered our questionnaire regarding their activity and their knowledge about child abuse and neglect. These results were analyzed and compared to the data of GPs in Ille-et-Vilaine. Only 4.4 % of the pediatricians obtained more than 80 % correct answers and 12 % of the pediatricians obtained fewer than 50 % correct answers. Among the pediatricians, 41 % of them had not reported a single time since 2007. The pediatricians who obtained better results (P <0.001) had more training and were more often in contact with child abuse and neglect than the GPs. The most common reasons that clinicians gave for not reporting were lack of a return from social services after a report, lack of training and the fear of making a misdiagnosis. Indeed only 9 % had received feedback from social services. To make reporting easier, 92 % of the pediatricians would like training and 97 % found a simple practice guide on child abuse useful. Conclusion Child protection is a neglected subject, including by pediatricians. To fight against professional denial and isolation, a substantial effort is still needed concerning caregivers’ training as well as pediatric care organization.

      PubDate: 2018-01-03T18:55:27Z
      DOI: 10.1016/j.arcped.2017.11.003
  • Un score échographique pulmonaire simple peut-il prédire la durée de
           ventilation des nourrissons atteints de bronchiolite aiguë
           sévère '
    • Authors: M. Taveira; N. Yousef; J. Miatello; C. Roy; C. Claude; B. Boutillier; C. Dubois; A.-F. Pierre; P. Tissières; P. Durand
      Abstract: Publication date: Available online 13 December 2017
      Source:Archives de Pédiatrie
      Author(s): M. Taveira, N. Yousef, J. Miatello, C. Roy, C. Claude, B. Boutillier, C. Dubois, A.-F. Pierre, P. Tissières, P. Durand
      Background Lung ultrasound (LU) is a bedside point-of-care technique in critical care and emergency medicine. LU is quick and non-irradiating, and provides accurate diagnostic information when compared with chest radiographs. Specific LU signs have been described for bronchiolitis. This study aimed to evaluate the correlation between severity of LU-diagnosed lung lesions, using a quantitative LU score, and the length of non-invasive ventilation (LOV) for infants diagnosed with severe viral bronchiolitis. Methods This was a prospective observational single-center study conducted at a level 3 pediatric intensive care unit. A LU score was calculated for 47 infants under 6 months of age with severe acute viral bronchiolitis during the 2015–2016 epidemic, and the number of intercostal spaces with consolidation or interstitial syndrome was counted for each lung. The LU score is based on the presence of A lines or B-line artifacts and consolidation (0–2 points). The modified Wood score (mWCAS) was used to define clinical severity. Other parameters such as gestational age at birth, age, supplemental oxygen (LOS), and length of stay were recorded. All LU scans were later reviewed by two trained ultrasonographers to assess the score's inter-rater reproducibility. Results The LU score on admission (3.5±2.6) did not correlate with LOV (69±68.6), mWCAS score (4±1.6), LOS (3±3.4), or length of stay (4±3.4). However, there was a significant correlation between the number of affected intercostal spaces on the right and LOS (Spearman's Rho 0.318; P =0.037). Conclusion This is the first study to evaluate the use of LU in infants needing PICU admission for severe acute bronchiolitis. The LU score does not correlate with LOV, mWCAS, LOS, or length of stay, but the number of pathological intercostal spaces on the right side correlates significantly with LOS. Although LU scores have been validated for the newborn and the adult, this has been in the setting of restrictive lung diseases. Bronchiolitis is a predominantly obstructive lung disease and this may explain the lack of performance observed.

      PubDate: 2018-01-03T18:55:27Z
      DOI: 10.1016/j.arcped.2017.11.005
  • Training program for pain assessment in the newborn
    • Authors: E. Carpentier; F. Moreau; S. Soriot-Thomas; P. Tourneux
      Abstract: Publication date: Available online 23 December 2017
      Source:Archives de Pédiatrie
      Author(s): E. Carpentier, F. Moreau, S. Soriot-Thomas, P. Tourneux
      Aim Pain management is correlated with pain assessment in the newborn infant. The aim of this study was to assess the impact of a 2-week training program composed of short (20min), repeated training sessions conducted in the unit. Methods Pain assessment was studied by means of audits. Each audit included data recorded from the newborn infant's medical charts on the day the infant was admitted to the unit and 3 days before the audit. An audit was performed before the training program and then repeated every month for 12 months. Results Eighty-eight (53.7%) members of the neonatology staff were trained during the 2-week training program. After the training program, pain assessment “at least once a day” increased by 39.0% and pain assessment “at least once a shift” increased by 21.5% compared to baseline (P <0.05). The effects of the training program were maintained after 12 months (P <0.05). Conclusion A training program with short, repeated sessions conducted in the unit trained 53.7% of the neonatology staff and increased the frequency of pain assessment.

      PubDate: 2017-12-26T18:34:59Z
      DOI: 10.1016/j.arcped.2017.11.014
  • Intrapericardial neurofibromatosis with coronary involvement: A case
    • Authors: E.A. Moghadam; M.A. Navabi Shirazi; M.R. Mirzaaghayan; M. Nikoufar; A. Ghamari
      Abstract: Publication date: Available online 21 December 2017
      Source:Archives de Pédiatrie
      Author(s): E.A. Moghadam, M.A. Navabi Shirazi, M.R. Mirzaaghayan, M. Nikoufar, A. Ghamari
      Neurocutaneous syndromes are heterogenous diseases that are diagnosed in the presence of skin and central nervous system disorders. Neurofibromatosis (NF) is one of these disorders, with autosomal dominant inheritance, that causes tumors that grow on nerves as well as other abnormalities such as skin changes and bone deformities. The most common form of NF is type I. A 6-year-old Iranian boy with neurofibromatosis was referred to the pediatric cardiology clinic due to a soft holosystolic murmur discovered on routine examination. The echocardiographic findings included a large intrapericardial, encapsulated echodense homogenous mass located in the posterior part of the pericardium, attached to the posterior aspect of the left atrium and left ventricle. The mass measured about 6.3×6.5×5.5cm and exerted a compressive effect on the left-side chambers, with mild mitral regurgitation and mild pericardial effusion. Magnetic resonance imaging confirmed these findings showing encasement of the left circumflex artery, while the open biopsy through a midsternotomy procedure showed a mildly cellular mesenchymal tumor composed of spindle cells suggestive of neurofibroma. Further resection of the mass was not performed because of the risk of coronary injury and the stable situation of the patient. Visceral involvement of neurofibroma is uncommon and rarely involves the heart. As shown in this case, besides the chance for involving the pericardium, despite its benign nature, this tumor sometimes shows unusual involvement of structures such as the coronary arteries.

      PubDate: 2017-12-23T18:27:11Z
      DOI: 10.1016/j.arcped.2017.11.009
  • Les jeux vidéo sérieux en pédiatrie
    • Authors: Drummond Hadchouel
      Abstract: Publication date: Available online 19 December 2017
      Source:Archives de Pédiatrie
      Author(s): D. Drummond, A. Tesnière, A. Hadchouel
      Les jeux vidéo ont été beaucoup étudiés pour leurs risques en pédiatrie. Cependant, associés à une intention sérieuse, ils peuvent représenter des outils efficaces et ne doivent pas être négligés par la communauté pédiatrique. En matière de santé publique, les jeux vidéo sérieux sont un moyen de réduire les consommations de drogue ou les comportements sexuels à risque chez les adolescents. Au sein des établissements scolaires, ils peuvent permettre de changer le regard d’une classe sur la maladie de l’un de ses élèves ou être utilisés pour former aux premiers secours. Ils trouvent également leur utilité auprès des patients, que ce soit pour distraire l’enfant pendant un soin anxiogène ou douloureux, renforcer la compliance aux traitements ou participer à une rééducation. Enfin les jeux vidéo sérieux à destination des professionnels de santé de la petite enfance sont amenés à se développer rapidement avec l’apparition de simulations virtuelles permettant de s’entraîner à prendre en charge des situations urgentes ou graves sans aucun risque pour le patient. Cette revue présente pour chacun de ces domaines d’application le rationnel ayant conduit à choisir les jeux vidéo comme outil, suivi d’exemples concrets et des résultats de leurs évaluations scientifiques. Playing video games has been associated with several negative effects in children. However, serious games, which are video games designed for a primary purpose other than pure entertainment, should not be neglected by pediatricians. In the field of public health, some serious games are a means to decrease drug consumption and improve sexual health behavior in adolescents. In schools, serious games can be used to change students’ perception of the disease of one of their classmates, or to train students on basic life support. Serious games are also used with patients: they can distract them from a painful procedure, increase their compliance to treatments, or participate in their rehabilitation. Finally, serious games allow healthcare professionals to train on the management of various medical situations without risk. For every field of application, this review presents the rationale of the use of video games, followed by concrete examples of video games and the results of their scientific evaluation.

      PubDate: 2017-12-23T18:27:11Z
  • Amélioration de la santé orale des enfants avec autisme : les outils à
           notre disposition
    • Authors: A. Rouches; G. Lefer; S. Dajean-Trutaud; S. Lopez-Cazaux
      Abstract: Publication date: Available online 18 December 2017
      Source:Archives de Pédiatrie
      Author(s): A. Rouches, G. Lefer, S. Dajean-Trutaud, S. Lopez-Cazaux
      Autism spectrum disorder (ASD) is a life-long heterogeneous psychiatric disorder, characterized by impaired social interaction and communication, and the presence of repetitive and stereotyped behaviors as well as restricted interests. These features have an impact on the oral health of these individuals: high risk of dental caries, poorer periodontal status, and bruxism are often described. Children with ASD often provide limited collaboration with medical procedures, particularly those considered invasive such as dental care. Children with ASD are prone to agitation, self-injury, and emotional dysregulation; they can also present hypersensitivity to sensory input. These features make it difficult for professionals to examine and treat children with ASD; they interfere with dental care and constitute a barrier to it. Most of them are treated under general anesthesia or sedation. Therefore, children with ASD present a challenge for the dental community. Adapted and specific strategies are required to allow individuals with ASD to go beyond the barriers of dental care. Different tools and techniques of evidence-based practice can be considered: visual pedagogy, behavioral approaches, and numeric devices can be used. Pediatricians have a key role in the oral care of children with autism. The aim of this article is to present the oral health associated with ASD, to set out the possible ways to improve oral health, to enable the practitioner to detect problems, to raise awareness, and to help patients and their families in their care pathway.

      PubDate: 2017-12-23T18:27:11Z
      DOI: 10.1016/j.arcped.2017.11.013
  • Vasculopathie cérébrale de l’enfant drépanocytaire : points clés et
    • Authors: V. Corvest; S. Blais; B. Dahmani; M. De Tersant; A.-C. Etienney; A. Maroni; C. Ormières; A. Roussel; C. Pondarré
      Abstract: Publication date: Available online 16 December 2017
      Source:Archives de Pédiatrie
      Author(s): V. Corvest, S. Blais, B. Dahmani, M. De Tersant, A.-C. Etienney, A. Maroni, C. Ormières, A. Roussel, C. Pondarré
      Cerebral vasculopathy is a common and severe complication of sickle cell disease in children. The pathophysiology consists of progressive damage to the basal intracranial arteries and cerebral microcirculation, while chronic anemia worsens exposure to cerebral hypoxia. It results in stroke and subclinical or poorly symptomatic ischemic lesions. Many clinical, biological, and radiological risk factors have been identified. The prevention strategy through systematic transcranial Doppler screening of large-vessel vasculopathy has revolutionized the management of this disease and has greatly decreased the risk of developing stroke. MRI-MRA is a complementary diagnostic tool for anatomical analysis of parenchymal and vascular lesions, which is used for chronic disease monitoring or in the context of an acute neurological event. New exploration opportunities are offered by submandibular Doppler sonography and indirect evaluation methods of cerebral oxygenation and perfusion. If chronic blood transfusion therapy is used to prevent the occurrence and recurrence of cerebral complications of sickle cell disease, only allogeneic hematopoietic stem cell transplantation can safely and definitively stop the transfusion program. It should therefore be proposed early, before irreversible cerebral or vascular lesions occur. Hydroxycarbamide treatment has recently emerged as a potential substitute for chronic transfusions for the maintenance of transcranial Doppler velocities, but only after an initial treatment by transfusions and provided there is close follow-up. In the long run, cerebral vascular damage can cause progressive cognitive impairment and disability, even in children without radiologically identified lesions, indicating the importance of systematic and repeated neuropsychological testing.

      PubDate: 2017-12-23T18:27:11Z
      DOI: 10.1016/j.arcped.2017.11.015
  • Le vécu par le pédiatre de l’annonce d’une « mauvaise nouvelle »
           à l’enfant et à l’adolescent
    • Authors: Crosnier-Schoedel Carbajal; Leverger
      Abstract: Publication date: Available online 16 December 2017
      Source:Archives de Pédiatrie
      Author(s): C. Crosnier-Schoedel, N. Trocmé, R. Carbajal, G. Leverger
      Les études portant sur le vécu du pédiatre de l’annonce d’une mauvaise nouvelle à l’enfant et à l’adolescent sont quasi inexistantes. Cette annonce qui est pourtant le socle de toute prise en charge médicale est d’autant plus complexe qu’elle est plurielle, devant nécessairement passer par l’annonce faite aux parents. Nous avons proposé à 20 pédiatres hospitaliers un questionnaire de 30 questions sur le vécu de leur propre annonce d’une « Mauvaise Nouvelle » à un enfant ou un adolescent. Les obstacles auxquels ils se confrontent, malgré leur âge et le temps respectif de leur exercice de la médecine, sont multiples et sont dus à différents facteurs provenant autant des enfants, des adolescents, et de leurs familles que d’eux-mêmes. Les difficultés répertoriées par les pédiatres concernaient surtout, la notion temporelle de l’annonce, la place et le choix des mots utilisés pour la faire, et la mauvaise compréhension des enfants et de leurs familles qu’elle soit d’origine intellectuelle, culturelle ou psychique. Ensuite, ils questionnent leurs propres capacités à le faire, parfois dans l’incertitude que les choses aient été réellement comprises. Ils expriment le fait qu’eux-mêmes sont éprouvés psychiquement. Ils développent et mettent en place des stratégies pour défier l’instabilité émotionnelle que provoque l’annonce de cette « Mauvaise Nouvelle » chez la plupart d’entre eux. Pourtant, beaucoup se sentent démunis et fragilisés, jusqu’à parler d’un profond sentiment de solitude et de culpabilité. Few studies are available on pediatricians’ experience with announcing bad news. Announcing bad news is an important component of medical practice and is even more complex in pediatrics because parents must be associated. We had 20 hospital pediatricians complete a questionnaire containing 30 questions about their own experience announcing bad news to a child or a teenager. In spite of their experience and the time they have spent practicing medicine, there are many limitations stemming from different factors concerning children, teenagers, their families, and themselves. The difficulties encountered by pediatricians are mainly related to the timing of the announcement, the location, the choice of the words used, and the poor understanding of children and families, due to intellectual, cultural, or psychological limitations. Pediatricians question their own capacity to make such an announcement, wondering if the information has actually been well understood. They indicate that they are themselves affected. Most of them develop and implement strategies to refute the emotional instability caused by the announcement of bad news. Yet many of them feel weak, even talking about a deep sense of loneliness and guilt.

      PubDate: 2017-12-23T18:27:11Z
  • Staphylococcal scalded skin syndrome: An uncommon symptomatology revealing
           an immune deficiency
    • Authors: H. Ajmi; N. Jemmali; S. Mabrouk; S. Hassayoun; M. Ben-Ali; M.-R. Barbouche; M. Mokni; S. Abroug
      Abstract: Publication date: Available online 14 December 2017
      Source:Archives de Pédiatrie
      Author(s): H. Ajmi, N. Jemmali, S. Mabrouk, S. Hassayoun, M. Ben-Ali, M.-R. Barbouche, M. Mokni, S. Abroug
      Primary immune deficiencies associated with hyper-IgE syndrome are rare diseases with clinical features dominated by recurring cutaneous and visceral bacterial infections, particularly infections due to Staphylococcus species. Most of these infections are associated with milder inflammation compared to normal. We report a primary immune deficiency associated with a hyper-IgE syndrome revealed by a staphylococcal scalded skin syndrome in a 5-year-old girl. The patient presented with a severe staphylococcal infection with extensive skin lesions and disseminated intravascular coagulation. She received intravenous fluids to compensate for fluid losses and anti-staphylococcal antibiotics. Coagulopathy was also corrected. However, the progression was rapidly fatal.

      PubDate: 2017-12-23T18:27:11Z
      DOI: 10.1016/j.arcped.2017.11.008
  • Impact of structured programs on breastfeeding initiation rates in preterm
           neonates in a socioeconomically deprived area in France: A 10-year
           population-based study
    • Authors: M.-L. Charkaluk; H. Bomy; S. Delguste; M. Courdent; S. Rousseau; C. Zaoui-Grattepanche; V. Pierrat
      Abstract: Publication date: Available online 14 December 2017
      Source:Archives de Pédiatrie
      Author(s): M.-L. Charkaluk, H. Bomy, S. Delguste, M. Courdent, S. Rousseau, C. Zaoui-Grattepanche, V. Pierrat
      Structured programs have a positive impact on breastfeeding (BF) but have rarely been evaluated for preterm neonates, frequently combining prematurity and socioeconomic deprivation as risk factors of a low BF rate. We aimed to assess BF initiation rates in very preterm (<33 weeks’ gestational age), moderately preterm (33–36 weeks), and term neonates from 2002 to 2011 in a French administrative district characterized by socioeconomic deprivation. Structured activities to promote and support BF have been implemented in this area since 2002; they all started in neonatal units. This retrospective population-based study analyzed 302,102 first health certificates. Overall, the BF initiation rate significantly increased, from 52.9% [95% CI: (52.3; 53.4)] in 2002 to 61.0% [95% CI: (60.4; 61.6)] in 2011. In 2002, BF initiation rates did not differ between groups, but in 2011, it was higher for very preterm than for term and moderately preterm neonates [74.7% (69.7; 79.6)] vs. 60.9% (60.3; 61.5) and 59.9% (57.6; 62.2), respectively, both P <0.001. In 2011, however, no difference was observed between moderately preterm children and term-born children (P =0.40). The 2.2% yearly increase observed in very preterm neonates significantly differed from the 0.9% yearly increase in the French general population (P <0.001). Conclusion Structured BF programs initiated in neonatal care units may have a positive impact on BF initiation rates in very preterm neonates, but not in moderately preterm neonates, whose specific needs should be further evaluated.

      PubDate: 2017-12-23T18:27:11Z
      DOI: 10.1016/j.arcped.2017.10.026
  • Impact of obesity on biomarkers of iron and vitamin D status in children
           and adolescents: The risk of misinterpretation
    • Authors: M.-L. Frelut; J.-P. Girardet; A. Bocquet; A. Briend; J.-P. Chouraqui; D. Darmaun; C. Dupont; F. Feillet; R. Hankard; J.-C. Rozé; U. Simeoni
      Abstract: Publication date: Available online 14 December 2017
      Source:Archives de Pédiatrie
      Author(s): M.-L. Frelut, J.-P. Girardet, A. Bocquet, A. Briend, J.-P. Chouraqui, D. Darmaun, C. Dupont, F. Feillet, R. Hankard, J.-C. Rozé, U. Simeoni

      PubDate: 2017-12-23T18:27:11Z
      DOI: 10.1016/j.arcped.2017.11.011
  • Lethal form of spinocerebellar ataxia type 7 with early onset in childhood
    • Authors: G. Gousse; H. Patural; R. Touraine; S. Chabrier; E. Rolland; J.-C. Antoine; L. Perrin
      Abstract: Publication date: Available online 13 December 2017
      Source:Archives de Pédiatrie
      Author(s): G. Gousse, H. Patural, R. Touraine, S. Chabrier, E. Rolland, J.-C. Antoine, L. Perrin
      Progressive cerebellar ataxias are well-known hereditary neurological disorders. Among them, spinocerebellar ataxia type 7 (SCA7) is inherited as an autosomal dominant trait and is ascribed to the expansion of a CAG trinucleotide repeat within the ATXN7 gene. An anticipation phenomenon can occur during paternal transmission and sometimes is responsible for a severe infantile form. The specificity of SCA7 is the retinal involvement with retinitis pigmentosa and cone rod dystrophy. We describe a familial form with two siblings who died of a severe infantile form. Diagnosis was made in their father, who had a recent history of macular atrophy and presented with gait disturbance thereafter. Retrospectively, substantial triplet repeat expansion was confirmed in the two affected infants. These infantile forms are rare and difficult to diagnose in the absence of suggestive family symptoms.

      PubDate: 2017-12-23T18:27:11Z
      DOI: 10.1016/j.arcped.2017.09.029
  • Spontaneous pneumothorax: Diagnosis may be a click away
    • Authors: S. Cabasson; M.Q. Do; A. Giraudon; T. Mansir
      Abstract: Publication date: Available online 13 December 2017
      Source:Archives de Pédiatrie
      Author(s): S. Cabasson, M.Q. Do, A. Giraudon, T. Mansir
      We report the case of a 14-year-old boy presenting to our unit because of a spontaneous left pneumothorax. Over the 3 preceding weeks, he described a rhythmic precordial click and the sensation of bubbles floating inside his chest. This noise, audible to the patient and his family without a medical device, proved to be the Hamman sign, a rare although typical sound formerly related to pneumomediastinum that can be exceptionally encountered in isolated left pneumothorax. Its pathophysiology remains unclear. Small pockets of air close to the heart may be pushed inside pleura and amplified by the chest wall, hence provoking a recurrent rhythmic sound. A small left pneumothorax must be suspected whenever the Hamman sign is elicited in the absence of pneumomediastinum. Chest tomography must be precociously considered if plain x-rays are not contributive.

      PubDate: 2017-12-23T18:27:11Z
      DOI: 10.1016/j.arcped.2017.11.007
  • Évaluation des connaissances et pratiques sur le dépistage de
           l’hypercholestérolémie familiale hétérozygote chez l’enfant
    • Authors: A. Jeangeorges; A. Rubio
      Abstract: Publication date: Available online 13 December 2017
      Source:Archives de Pédiatrie
      Author(s): A. Jeangeorges, A. Rubio
      Introduction Dominant heterozygous familial hypercholesterolemia (FH) is frequent (prevalence, 1/500 to 1/250) and leads to severe and premature cardiovascular complications. It is easily detected, and its treatment is effective. However, recommendations for screening are not followed worldwide. Objectives The aim of this study was to evaluate the knowledge and practices of doctors in the Isère department, France, regarding screening and treatment of FH in children. Methods A questionnaire was distributed by email or during training sessions to general practitioners, doctors working in Infant and Mother Protection (IMP) services, and pediatricians in private practice in Isère. Results Fifty-nine doctors completed the questionnaire (overall response rate, 61%). Respondents were general practitioners (36%), IMP doctors (36%), and pediatricians in private practice (28%). Generalized screening for all children was done by only 8% of the respondents, while cascade screening, in case of familial cardiovascular medical history, was done by only 36%, of which 5% were general practitioners while 53% were doctors with a clinical practice focused on children. The most recent French recommendations by the Société française de pédiatrie and the Nouvelle Société française d’athérosclérose, which were published in 2010, had been read by only nine doctors (15%). Having read them led to a better policy of generalized screening, either generalized to all children (OR=12.0 [2.3–64.0], P =0.004) or in cascade (OR=22.8 [4.2–123.2], P <0.001). Discussion The number of questionnaires collected was small, with possible selection and declaration bias, but the different types of pediatric practice were equally represented. Conclusion Screening of FH in children is not very well organized and recommendations are not followed by doctors in Isère, France. Children with FH are probably underdiagnosed and undertreated.

      PubDate: 2017-12-23T18:27:11Z
      DOI: 10.1016/j.arcped.2017.11.004
  • Children and screens: A survey by French pediatricians
    • Authors: R. Assathiany; E. Guery; F.M. Caron; J. Cheymol; G. Picherot; P. Foucaud; N. Gelbert
      Abstract: Publication date: Available online 12 December 2017
      Source:Archives de Pédiatrie
      Author(s): R. Assathiany, E. Guery, F.M. Caron, J. Cheymol, G. Picherot, P. Foucaud, N. Gelbert
      Introduction Screens are increasingly prevalent within families. The excessive use of screens by children has negative consequences. To measure the use of screens, we undertook an investigation among children being followed by pediatricians. Methods An invitation to participate was sent electronically to 1460 private practice pediatricians. They were asked to complete the questionnaire on screen use by children under 12 years of age during a consultation, according to statements made by parents. Results One hundred and forty-four pediatricians submitted completed questionnaires involving 428 children. Among the 197 children under 3 years of age, 92 had played with an interactive screen for a median duration of 30min during the preceding week; 29% of the children were alone at the time. One hundred and thirty-nine children had watched television for a median weekly duration of 75min. Of the 231 children 3–11 years of age, 108 had played with an interactive screen for a median time of 30min the day before the consultation, and 50% of them were alone at the time. One hundred and seventy-two children watched television for a median daily duration of 45min. There was a correlation between these children's screen time and their mother's (r =0.36). The television was on during meals and continuously in 35% and 21% of the families, respectively. Conclusions Children start looking at screens early, too often watching unsuitable programs, and too often without a parent's present. Regardless of the child's age, pediatricians must ask parents how much time their children are viewing screens, advise them accordingly, and warn them of the consequences of excessive use.

      PubDate: 2017-12-13T06:24:53Z
      DOI: 10.1016/j.arcped.2017.11.001
  • Rapid differential diagnosis of diabetes insipidus in a 7-month-old
           infant: The copeptin approach
    • Authors: J. Vergier; J. Fromonot; A. Alvares De Azevedo Macedo; A. Godefroy; E. Marquant; R. Guieu; M. Tsimaratos; R. Reynaud
      Abstract: Publication date: Available online 11 December 2017
      Source:Archives de Pédiatrie
      Author(s): J. Vergier, J. Fromonot, A. Alvares De Azevedo Macedo, A. Godefroy, E. Marquant, R. Guieu, M. Tsimaratos, R. Reynaud
      Introduction Diabetes insipidus is characterized by hypoosmotic polyuria related to deficiency of arginine–vasopressin (AVP) secretion (central diabetes insipidus, CDI) or renal insensitivity to AVP (nephrogenic diabetes insipidus, NDI). The water deprivation test with assessment of AVP activity is currently the gold standard for differential diagnosis in patients presenting polyuria–polydipsia syndrome. Nevertheless, it can be dangerous without proper surveillance and its interpretation may be challenging. Other markers have been suggested. Direct quantification of circulating AVP is not sufficient for diagnosis: vasopressin is unstable, analysis is complex. AVP comes from prohormone preprovasopressin with concomitant release of copeptin (C-terminal moiety) in the equimolar ratio. Copeptin is stable in vitro, with easy and rapid measurement (<4h). Past studies have shown greater sensitivity and specificity of copeptin versus AVP to discriminate etiologies of polyuria in adults, but its value has not been demonstrated in infants yet. Observation A 7-month-old infant presented polyuria–polydipsia syndrome with poor weight gain. Laboratory tests pointed out hypernatremia (170mmol/L) and blood hyperosmolarity (330mOsm/L) with inappropriate urinary hypoosmolarity (168mOsm/L). Plasmatic copeptin measurement was found at a very high level, 303pmol/L (1–14pmol/L). DdAVP administration did not improve the polyuria, confirming the final diagnosis of NDI. Hyperhydration with a hypoosmolar diet normalized the hydration status and circulating levels of copeptin within 1 week. Conclusion Copeptin, a stable peptide reflecting AVP secretion, could be a safer and faster biomarker for etiological diagnosis of polyuria–polydipsia syndrome in children. Before regularization of hydration status, a single baseline measurement may be enough to discriminate NDI from other etiologies without the water deprivation test.

      PubDate: 2017-12-13T06:24:53Z
      DOI: 10.1016/j.arcped.2017.11.010
  • Vers un new journal
    • Authors: Sarles
      Abstract: Publication date: Available online 15 November 2017
      Source:Archives de Pédiatrie
      Author(s): J. Sarles

      PubDate: 2017-11-27T05:47:24Z
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