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Cohen R, Rybak A, Ouldali N, Angoulvant F, Béchet S, Gajdos V, Hau I, Sellam A, El Aouane El Ghomari I, Elmerich F, Batard C, Auvrignon A, Grimprel E, Favier M, Jung C, Levy C. From the original SARS-CoV-2 strain to the Omicron variant: predictors of COVID-19 in ambulatory symptomatic children. Infect Dis Now 2022; 52:432-440. [PMID: 36116761 PMCID: PMC9477611 DOI: 10.1016/j.idnow.2022.09.012] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2022] [Revised: 09/06/2022] [Accepted: 09/12/2022] [Indexed: 11/30/2022]
Abstract
OBJECTIVES To determine the predictors of a positive SARS-CoV-2 test in a pediatric ambulatory setting. PATIENTS AND METHODS We performed a cross-sectional prospective study (November 2020-February 2022) of 93 ambulatory settings in France. We included symptomatic children < 15 years old tested for SARS-CoV-2. For each period corresponding to the spread of the original strain and its variants (period 1: original strain; period 2: Alpha, period 3: Delta; period 4: Omicron), we used a multivariate analysis to estimate adjusted odds ratios (aORs) associated with COVID-19 among age, signs, symptoms or contact, and 95 % confidence intervals (95CIs). RESULTS Of 5,336 children, 13.9 % (95CI 13.0-14.8) had a positive test. During the first three periods, the positivity rate ranged from 5.6 % (95CI 4.6-6.7) to 12.6 % (95CI 10.8-14.6). The main factors associated with a positive test were contact with an infected adult at home or outside the home (aOR 11.5 [95CI 4.9-26.9] to 38.9 [95CI 19.3-78.7]) or an infected household child (aOR 15.0 [95CI 4.8-47.1] to 28.4 [95CI 8.7-92.6]). By contrast, during period 4, aORs for these predictors were substantially lower (2.3 [95CI 1.1-4.5] to 5.5 [95CI 3.2-7.7]), but the positivity rate was 45.7 % (95CI 42.3-49.2). CONCLUSIONS In pediatric ambulatory settings, before the Omicron period, the main predictor of a positive test was contact with an infected person. During the Omicron period, the odds of these predictors were substantially lower while the positivity rate was higher. An accurate diagnostic strategy should only rely on testing and not on age, signs, symptoms or contact.
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Affiliation(s)
- R Cohen
- ACTIV, Association Clinique et Thérapeutique Infantile du Val-de-Marne, Créteil, France; Clinical Research Center (CRC), Centre Hospitalier Intercommunal de Créteil, Créteil, France; Université Paris Est, IMRB-GRC GEMINI, Créteil, France; AFPA, Association Française de Pédiatrie Ambulatoire, Orléans, France; GPIP, Groupe de Pathologie Infectieuse Pédiatrique, Créteil, France
| | - A Rybak
- ACTIV, Association Clinique et Thérapeutique Infantile du Val-de-Marne, Créteil, France; AFPA, Association Française de Pédiatrie Ambulatoire, Orléans, France; Unité d'Épidémiologie Clinique, Assistance Publique-Hôpitaux de Paris, Hôpital Robert Debré, ECEVE INSERM UMR 1123, Paris, France.
| | - N Ouldali
- ACTIV, Association Clinique et Thérapeutique Infantile du Val-de-Marne, Créteil, France; AFPA, Association Française de Pédiatrie Ambulatoire, Orléans, France; GPIP, Groupe de Pathologie Infectieuse Pédiatrique, Créteil, France; Unité d'Épidémiologie Clinique, Assistance Publique-Hôpitaux de Paris, Hôpital Robert Debré, ECEVE INSERM UMR 1123, Paris, France; Assistance Publique - Hôpitaux de Paris, Pediatric Department, Robert Debré Hospital, France
| | - F Angoulvant
- GPIP, Groupe de Pathologie Infectieuse Pédiatrique, Créteil, France; Assistance Publique - Hôpitaux de Paris, Pediatric Department, Robert Debré Hospital, France; INSERM, Centre de Recherche des Cordeliers, UMRS 1138, Sorbonne Université, Université de Paris, Paris, France
| | - S Béchet
- ACTIV, Association Clinique et Thérapeutique Infantile du Val-de-Marne, Créteil, France; Clinical Research Center (CRC), Centre Hospitalier Intercommunal de Créteil, Créteil, France
| | - V Gajdos
- GPIP, Groupe de Pathologie Infectieuse Pédiatrique, Créteil, France; Centre for Research in Epidemiology and Population Health, INSERM UMR1018, Villejuif, France; Assistance Publique-Hôpitaux de Paris, Pediatric Department, Antoine Béclère University Hospital, Université de Paris Saclay, Clamart, France
| | - I Hau
- Université Paris Est, IMRB-GRC GEMINI, Créteil, France; GPIP, Groupe de Pathologie Infectieuse Pédiatrique, Créteil, France; Service de pédiatrie, Centre Hospitalier Intercommunal de Créteil, Créteil, France
| | - A Sellam
- ACTIV, Association Clinique et Thérapeutique Infantile du Val-de-Marne, Créteil, France
| | | | - F Elmerich
- CHU Reims, Urgences Pédiatriques, France
| | - C Batard
- ACTIV, Association Clinique et Thérapeutique Infantile du Val-de-Marne, Créteil, France; AFPA, Association Française de Pédiatrie Ambulatoire, Orléans, France
| | - A Auvrignon
- ACTIV, Association Clinique et Thérapeutique Infantile du Val-de-Marne, Créteil, France; AFPA, Association Française de Pédiatrie Ambulatoire, Orléans, France
| | - E Grimprel
- GPIP, Groupe de Pathologie Infectieuse Pédiatrique, Créteil, France; Service de pédiatrie, Hôpital Trousseau, Paris, France
| | - M Favier
- GPIP, Groupe de Pathologie Infectieuse Pédiatrique, Créteil, France; Urgences Pédiatriques CHU de Bordeaux, Bordeaux, France
| | - C Jung
- Clinical Research Center (CRC), Centre Hospitalier Intercommunal de Créteil, Créteil, France; Université Paris Est, IMRB-GRC GEMINI, Créteil, France
| | - C Levy
- ACTIV, Association Clinique et Thérapeutique Infantile du Val-de-Marne, Créteil, France; Clinical Research Center (CRC), Centre Hospitalier Intercommunal de Créteil, Créteil, France; Université Paris Est, IMRB-GRC GEMINI, Créteil, France; AFPA, Association Française de Pédiatrie Ambulatoire, Orléans, France; GPIP, Groupe de Pathologie Infectieuse Pédiatrique, Créteil, France.
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Oualha M, Bendavid M, Berteloot L, Corsia A, Lesage F, Vedrenne M, Salvador E, Grimaud M, Chareyre J, de Marcellus C, Dupic L, de Saint Blanquat L, Heilbronner C, Drummond D, Castelle M, Berthaud R, Angoulvant F, Toubiana J, Pinhas Y, Frange P, Chéron G, Fourgeaud J, Moulin F, Renolleau S. Severe and fatal forms of COVID-19 in children. Arch Pediatr 2020; 27:235-238. [PMID: 32518045 PMCID: PMC7269941 DOI: 10.1016/j.arcped.2020.05.010] [Citation(s) in RCA: 93] [Impact Index Per Article: 23.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2020] [Accepted: 05/28/2020] [Indexed: 12/11/2022]
Abstract
Objectives The aim of this study was to describe severe forms of novel coronavirus disease 2019 in children, including patient characteristics, clinical, laboratory, and imaging findings, as well as the disease management and outcomes. Methods This was a retrospective, single-center, observational study conducted in a pediatric intensive and high-dependency care unit (PICU, HDU) in an urban hospital in Paris. All patients, aged from 1 month to 18 years, admitted for confirmed or highly suspected SARS-CoV-2 were included. Results We analyzed the data of 27 children. Comorbidities (n = 19, 70%) were mainly neurological (n = 7), respiratory, (n = 4), or sickle cell disease (n = 4). SARS-CoV-2 PCR results were positive in 24 children (nasopharyngeal swabs). The three remaining children had a chest CT scan consistent with COVID-19. Respiratory involvement was observed in 24 patients (89%). Supportive treatments were invasive mechanical ventilation (n = 9), catecholamine (n = 4), erythropheresis (n = 4), renal replacement therapy (n = 1), and extracorporeal membrane oxygenation (n = 1). Five children died, of whom three were without past medical history. Conclusion This study highlighted the large spectrum of clinical presentation and time course of disease progression as well as the non-negligible occurrence of pediatric life-threatening and fatal cases of COVID-19 mostly in patients with comorbidities. Additional laboratory investigations are needed to further analyze the mechanism underlying the variability of SARS-Cov-2 pathogenicity in children.
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Affiliation(s)
- M Oualha
- Pediatric Intensive Care Unit, Necker-Enfants-Malades University Hospital, APHP, Centre-Université de Paris, Paris, France.
| | - M Bendavid
- Pediatric Intensive Care Unit, Necker-Enfants-Malades University Hospital, APHP, Centre-Université de Paris, Paris, France
| | - L Berteloot
- Pediatric Radiology Department, Necker-Enfants-Malades University Hospital, APHP, Centre-Université de Paris, Paris, France; INSERM U1163, Université Paris Descartes-Sorbonne Paris Cité, Institut Imagine, France
| | - A Corsia
- Pediatric Intensive Care Unit, Necker-Enfants-Malades University Hospital, APHP, Centre-Université de Paris, Paris, France
| | - F Lesage
- Pediatric Intensive Care Unit, Necker-Enfants-Malades University Hospital, APHP, Centre-Université de Paris, Paris, France
| | - M Vedrenne
- Pediatric Intensive Care Unit, Necker-Enfants-Malades University Hospital, APHP, Centre-Université de Paris, Paris, France
| | - E Salvador
- Pediatric Intensive Care Unit, Necker-Enfants-Malades University Hospital, APHP, Centre-Université de Paris, Paris, France
| | - M Grimaud
- Pediatric Intensive Care Unit, Necker-Enfants-Malades University Hospital, APHP, Centre-Université de Paris, Paris, France
| | - J Chareyre
- Pediatric Intensive Care Unit, Necker-Enfants-Malades University Hospital, APHP, Centre-Université de Paris, Paris, France
| | - C de Marcellus
- Pediatric Intensive Care Unit, Necker-Enfants-Malades University Hospital, APHP, Centre-Université de Paris, Paris, France
| | - L Dupic
- Pediatric Intensive Care Unit, Necker-Enfants-Malades University Hospital, APHP, Centre-Université de Paris, Paris, France
| | - L de Saint Blanquat
- Pediatric Intensive Care Unit, Necker-Enfants-Malades University Hospital, APHP, Centre-Université de Paris, Paris, France
| | - C Heilbronner
- Pediatric Intensive Care Unit, Necker-Enfants-Malades University Hospital, APHP, Centre-Université de Paris, Paris, France
| | - D Drummond
- Department of pediatric pneumology and allergology, Necker-Enfants-Malades University Hospital, APHP, Centre-Université de Paris, Paris, France; INSERM UMR 1138, Université de Paris, Paris, France
| | - M Castelle
- Department of pediatric Immuno-hematology and rhumatology, Necker-Enfants Malades University Hospital, APHP, Centre-Université de Paris, Paris, France
| | - R Berthaud
- Department of Pediatric Nephrology, Necker-Enfants Malades University Hospital, APHP, Centre-Université de Paris, Paris, France
| | - F Angoulvant
- Pediatric Emergency Department, Necker-Enfants-Malades University Hospital, APHP, Centre-Université de Paris, Paris, France; INSERM, Centre de Recherche des Cordeliers, UMRS 1138, Université de Paris, Paris, France
| | - J Toubiana
- Department of General Paediatrics and Paediatric Infectious Diseases, Necker-Enfants-Malades University Hospital, APHP, Centre-Université de Paris, Paris, France
| | - Y Pinhas
- Department of General Paediatrics and Paediatric Infectious Diseases, Necker-Enfants-Malades University Hospital, APHP, Centre-Université de Paris, Paris, France
| | - P Frange
- Clinical microbiology laboratory, Necker-Enfants-Malades University Hospital, APHP, Centre-Université de Paris, Paris, France; EHU 7328 PACT, Imagine institute, Université de Paris, Paris, France
| | - G Chéron
- Pediatric Emergency Department, Necker-Enfants-Malades University Hospital, APHP, Centre-Université de Paris, Paris, France
| | - J Fourgeaud
- Virology laboratory, Necker-Enfants-Malades University Hospital, APHP, Centre-Université de Paris, EHU 7328 PACT, Imagine Institute, University of Paris, Paris, France
| | - F Moulin
- Pediatric Intensive Care Unit, Necker-Enfants-Malades University Hospital, APHP, Centre-Université de Paris, Paris, France
| | - S Renolleau
- Pediatric Intensive Care Unit, Necker-Enfants-Malades University Hospital, APHP, Centre-Université de Paris, Paris, France
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Abstract
Lower respiratory tract infections, i.e., bronchitis, bronchiolitis, and pneumonia, are the second leading cause of antibiotic prescriptions. The vast majority of these infections are due to viruses and are self-limited diseases: most patients recover spontaneously. These two facts explain that antibiotic prescriptions must be limited to some clinical situations for which the diagnosis has to be done early. The first message of this manuscript is to strengthen non-antibiotic prescriptions in many situations such as bronchitis and bronchiolitis. Implementation of pneumococcal conjugate vaccines (PCVs) has reduced the incidence of pneumonia and empyema, and induced a dramatic decrease in the proportion of pneumococcus in these diseases. However, pneumococcus remains probably the leading cause of bacterial pneumonia and empyema and the main target of antibiotic treatment. Furthermore, the implementation of PCVs has reduced resistance to antibiotics including penicillins and macrolides antibiotics, explaining the de-escalation proposed in the last few years, with the reduction of the use if third generation cephalosporins and vancomycin. The therapeutic choices proposed in this article follow the previous official guidelines in France. Serious infections represented by empyema and severe pneumonia remain therapeutic emergencies, most often warranting hospitalization and IV antibiotics.
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Affiliation(s)
- R Cohen
- Université Paris Est, IMRB-GRC GEMINI, 94000 Créteil, France; Unité Court Séjour, Petits Nourrissons, Service de Néonatologie, Centre Hospitalier Intercommunal de Créteil, France; ACTIV, Association Clinique et Thérapeutique Infantile du Val de Marne, Saint-Maur des Fossés, France; Groupe de Pathologie Infectieuse Pédiatrique de la Société Française de Pédiatrie, Saint-Maur des Fossés, France.
| | - F Angoulvant
- Groupe de Pathologie Infectieuse Pédiatrique de la Société Française de Pédiatrie, Saint-Maur des Fossés, France; Service des Urgences Pédiatriques, AP-HP, Hôpital Necker-Enfants Malades & Université Paris Descartes, 149 rue de Sèvres, 75015, Paris, France
| | - S Biscardi
- Université Paris Est, IMRB-GRC GEMINI, 94000 Créteil, France; Groupe de Pathologie Infectieuse Pédiatrique de la Société Française de Pédiatrie, Saint-Maur des Fossés, France; Urgences Pédiatriques, service de Pédiatrie, Centre Hospitalier Intercommunal de Créteil, France
| | - F Madhi
- Université Paris Est, IMRB-GRC GEMINI, 94000 Créteil, France; Groupe de Pathologie Infectieuse Pédiatrique de la Société Française de Pédiatrie, Saint-Maur des Fossés, France; Service de Pédiatrie Générale, Centre Hospitalier Intercommunal de Créteil, France
| | - F Dubos
- Groupe de Pathologie Infectieuse Pédiatrique de la Société Française de Pédiatrie, Saint-Maur des Fossés, France; Urgences de Pédiatrie, Université de Lille, Lille, France
| | - Y Gillet
- Groupe de Pathologie Infectieuse Pédiatrique de la Société Française de Pédiatrie, Saint-Maur des Fossés, France; Urgences de Pédiatrie, HFME Lyon, France
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Benoit J, Grimprel E, Angoulvant F. Évaluation des pratiques professionnelles des pédiatres hospitaliers dans la prise en charge de nourrissons fébriles à bas risque d’infection bactérienne. Arch Pediatr 2017; 24:1049-1051. [DOI: 10.1016/j.arcped.2017.07.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2017] [Revised: 06/27/2017] [Accepted: 07/14/2017] [Indexed: 11/30/2022]
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5
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Boulkedid R, Teixeira M, Rouault A, Prot-Labarthe S, Morin L, Alberti C, Bourdon O, Angoulvant F. Apport de l’anthropologie à l’élaboration et à la validation d’un questionnaire d’évaluation d’un programme d’éducation thérapeutique à la prise en charge de la fièvre de l’enfant. Rev Epidemiol Sante Publique 2017. [DOI: 10.1016/j.respe.2017.03.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022] Open
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Angoulvant F, Claudet I, Dauger S, Dubos F, Gajdos V, Gillet Y, Gras-Le Guen C, Haas H, Minodier P, Portefaix A. [Setting up a pediatric emergency medicine research network]. Arch Pediatr 2016; 24:1-2. [PMID: 27823843 DOI: 10.1016/j.arcped.2016.06.023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2016] [Accepted: 06/24/2016] [Indexed: 10/20/2022]
Affiliation(s)
- F Angoulvant
- Service d'accueil des urgences pédiatriques, hôpital Necker-Enfants-Malades, AP-HP, 75015 Paris, France; ECEVE, Inserm UMR1123, Université Paris Descartes Sorbonne Paris Cité, 75018 Paris, France
| | - I Claudet
- Service d'accueil des urgences pédiatriques, hôpital des Enfants, CHU de Toulouse 31059 Toulouse cedex 9, France; Inserm UMR 1027, université Paul Sabatier, 31000 Toulouse, France
| | - S Dauger
- Service de réanimation et surveillance continue pédiatriques, hôpital Robert-Debré, AP-HP, université Paris Diderot, 75019 Paris 7, France
| | - F Dubos
- Urgences pédiatriques et maladies infectieuses, hôpital R.-Salengro, université Lille, CHU de Lille, 2, avenue Oscar-Lambret, 59000 Lille, France; EA2694, santé publique - épidémiologie et qualité des soins, hôpital R.-Salengro, université Lille, CHU de Lille, 2, avenue Oscar-Lambret, 59000 Lille, France.
| | - V Gajdos
- Service de pédiatrie, hôpital Antoine-Béclère, AP-HP, 92140 Clamart, France; CESP Inserm U1018, centre de recherche en épidémiologie et santé des populations, université Paris-Sud, 94800 Villejuif, France
| | - Y Gillet
- Service d'urgence et de réanimation pédiatrique, hôpital Femme-Mère-Enfant, 69500 Bron, France
| | - C Gras-Le Guen
- Service d'accueil des urgences pédiatriques, CHU de Nantes, 44000 Nantes, France; Centre d'investigation clinique de la femme, l'enfant et l'adolescent, 44000 Nantes, France
| | - H Haas
- Service d'accueil des urgences pédiatriques, CHU Lenval, 06200 Nice, France
| | - P Minodier
- Urgences enfants, CHU Nord, 13015 Marseille, France
| | - A Portefaix
- Service d'urgence et de réanimation pédiatrique, hôpital Femme-Mère-Enfant, 69500 Bron, France
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Prot-Labarthe S, Weil T, Nguyen NPK, Berthe-Aucejo A, Angoulvant F, Boulkedid R, Alberti C, Bourdon O. [Consensus validation of a tool to identify inappropriate prescribing in pediatrics (POPI)]. Arch Pediatr 2016; 23:481-90. [PMID: 27067037 DOI: 10.1016/j.arcped.2016.02.010] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2015] [Revised: 12/21/2015] [Accepted: 02/21/2016] [Indexed: 11/30/2022]
Abstract
OBJECTIVE Medication errors including inappropriate prescriptions and drug omissions are one of the causes of adverse drug events in children. Our aim was to develop a preliminary screening tool to detect omissions and inappropriate prescriptions in pediatrics based on French and international guidelines. MATERIEL AND METHODS Disease classification was based on the prevalence rate of pathology and hospital statistics. The criteria were obtained by reviewing many French and international references. The Delphi consensus technique was used to establish the content validity of POPI. The level of agreement and the proposals of healthcare professionals was noted on a nine-point Likert scale. RESULTS The criteria were categorized according to the main physiological systems (gastroenterology, respiratory infections, pain, neurology, dermatology, and miscellaneous). They were distributed to 16 French pediatric panelists (eight pharmacists, eight pediatricians who were hospital-based [50%] or working in the community [50%]). After two rounds of the Delphi process, 101 of 108 criteria were chosen with strong consensus (76 inappropriate prescriptions and 25 omissions). CONCLUSIONS POPI is the first screening tool to detect inappropriate prescriptions and omissions in pediatrics. It is now necessary to conduct a prospective study to determine inter-rater reliability and the tool's detection capacity.
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Affiliation(s)
- S Prot-Labarthe
- Département de pharmacie, hôpital Robert-Debré, AP-HP, 75019 Paris, France; Inserm ECEVE unité 1123, 75019 Paris, France; Groupe pédiatrie de la Société française de pharmacie clinique, France.
| | - T Weil
- Département de pharmacie, hôpital Robert-Debré, AP-HP, 75019 Paris, France
| | - N P K Nguyen
- Département de pharmacie, hôpital Robert-Debré, AP-HP, 75019 Paris, France
| | - A Berthe-Aucejo
- Département de pharmacie, hôpital Robert-Debré, AP-HP, 75019 Paris, France
| | - F Angoulvant
- Service d'accueil des urgences, hôpital Necker, AP-HP, 75015 Paris, France
| | - R Boulkedid
- Unité d'épidémiologie clinique, hôpital Robert-Debré, AP-HP, 75019 Paris, France
| | - C Alberti
- Inserm ECEVE unité 1123, 75019 Paris, France; Unité d'épidémiologie clinique, hôpital Robert-Debré, AP-HP, 75019 Paris, France
| | - O Bourdon
- Département de pharmacie, hôpital Robert-Debré, AP-HP, 75019 Paris, France; Groupe pédiatrie de la Société française de pharmacie clinique, France; Pharmacie clinique, université Paris Descartes, Sorbonne Paris Cité, 75006 Paris, France; EA3412, laboratoire éducations et pratiques de santé, université Paris XIII, 93017 Bobigny, France
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8
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Dauger S, Lachaussée N, Angoulvant F, Julliand S, Prot-Labarthe S. [Management of acute asthma]. Arch Pediatr 2016; 22:161-2. [PMID: 26112571 DOI: 10.1016/s0929-693x(15)30080-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Affiliation(s)
- S Dauger
- Service de Réanimation et Surveillance Continue Pédiatriques, Hôpital Robert-Debré, AP-HP, Université Paris Diderot, Paris 7, France.
| | - N Lachaussée
- Service de Réanimation et Surveillance Continue Pédiatriques, Hôpital Robert-Debré, AP-HP, Université Paris Diderot, Paris 7, France
| | - F Angoulvant
- Service des Urgences Pédiatriques Médico-chirurgicales, Hôpital Necker-Enfants Malades, AP-HP, Université René Descartes, Paris 5, France
| | - S Julliand
- Service de Réanimation et Surveillance Continue Pédiatriques, Hôpital Robert-Debré, AP-HP, Université Paris Diderot, Paris 7, France
| | - S Prot-Labarthe
- Service de Pharmacie, Hôpital Robert-Debré, AP-HP, INSERM U1123, ECEVE, France
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Bocquet N, Angoulvant F, Chéron G. Comment identifier une urgence néphrologique aux urgences? Arch Pediatr 2015; 22:30-1. [DOI: 10.1016/s0929-693x(15)30016-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Lachaussée N, Angoulvant F, Tissières P, Léger P, Hubert P, Javouhey E, Leteurtre S, Dauger S. P-162 – Place actuelle de la VNI dans l'AAG en réanimation pédiatrique. Arch Pediatr 2015. [DOI: 10.1016/s0929-693x(15)30344-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Guedj R, Chappuy H, Titomanlio L, Trieu T, Bisacrdi S, Nissak G, Pellegrino B, Charara O, Angoulvant F, De Villemeur TB, Levy C, Cohen R, Denis J, Carbajal R. CO-54 – Crise convulsive complexe et risque d'infection neurologique grave. Arch Pediatr 2015. [DOI: 10.1016/s0929-693x(15)30155-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Cheron G, Angoulvant F. Triage aux urgences pédiatriques : où en sommes-nous ? Ann Fr Med Urgence 2015. [DOI: 10.1007/s13341-014-0497-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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Houdouin V, Pouessel G, Angoulvant F, Brouard J, Derelle J, Fayon M, Ferroni A, Gangneux JP, Hau I, Le Bourgeois M, Lorrot M, Menotti J, Nathan N, Vabret A, Wallet F, Bonacorsi S, Cohen R, de Blic J, Deschildre A, Gandemer V, Pin I, Labbe A, Le Roux P, Martinot A, Rammaert B, Dubus JC, Delacourt C, Marguet C. Erratum à l’article « Recommandations sur l’utilisation des nouveaux outils diagnostiques étiologiques des infections respiratoires basses de l’enfant de plus de trois mois » [Arch. Pediatr. 21(4) (2014) 418–423]. Arch Pediatr 2014. [DOI: 10.1016/j.arcped.2014.05.022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Angoulvant F, Levy C, Varon E, Doit C, Thollot F, Cohen R. AFPA CO-03 - Résistance du pneumocoque dans la flore rhinopharyngée avant/après le PCV13. Arch Pediatr 2014. [DOI: 10.1016/s0929-693x(14)71595-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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Lanneaux J, Naudin J, Pham L, Gillet Y, Bosdure E, Chéron G, Morin L, Carbajal R, Dubos F, Vialet R, Dauger S, Angoulvant F. SFP PC-80 – Critères de gravité du paludisme d’importation pédiatrique en France. Arch Pediatr 2014. [DOI: 10.1016/s0929-693x(14)72229-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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Desmarest M, Mariani P, Galli Gibertini G, Mercier J, Bonacorsi S, Angoulvant F. SFP PC-54 - Infections urinaires à BLSE aux urgences pédiatriques en 2012. Arch Pediatr 2014. [DOI: 10.1016/s0929-693x(14)72204-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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Guedj R, Billette De Villemeur T, Angoulvant F, Trieu T, Biscardi S, Titomanlio L, Nissack Obiketeki G, Pellegrino B, Oussama C, Carbajal R. SFP CO-72 - Méningite bactérienne et crise convulsive fébrile simple avant 12 mois. Arch Pediatr 2014. [DOI: 10.1016/s0929-693x(14)71910-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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18
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Houdouin V, Pouessel G, Angoulvant F, Brouard J, Derelle J, Fayon M, Ferroni A, Gangneux JP, Hau I, Le Bourgeois M, Lorrot M, Menotti J, Nathan N, Vabret A, Wallet F, Bonacorsi S, Cohen R, de Blic J, Deschildre A, Gandemer V, Pin I, Labbe A, Le Roux P, Martinot A, Rammaert B, Dubus JC, Delacourt C, Marguet C. Recommandations sur l’utilisation des nouveaux outils diagnostiques étiologiques des infections respiratoires basses de l’enfant de plus de trois mois. Arch Pediatr 2014; 21:418-23. [DOI: 10.1016/j.arcped.2014.01.004] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2013] [Revised: 11/16/2013] [Accepted: 01/23/2014] [Indexed: 10/25/2022]
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19
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Sviestina I, Aston J, Lorrot M, Prot-Labarthe S, Angoulvant F, Doit C, Mozgis D. DI-100 Comparison of antibiotic prescribing for paediatric lower respiratory tract infections in three paediatric hospitals in the UK, France and Latvia. Eur J Hosp Pharm 2014. [DOI: 10.1136/ejhpharm-2013-000436.271] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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Levy C, Pereira M, Guedj R, Abt-Nord C, Gelbert NB, Cohen R, Alberti C, Gajdos V, Angoulvant F. Impact of 2011 French guidelines on antibiotic prescription for acute otitis media in infants. Med Mal Infect 2014; 44:102-6. [PMID: 24630597 DOI: 10.1016/j.medmal.2014.01.005] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2013] [Revised: 12/08/2013] [Accepted: 01/15/2014] [Indexed: 11/20/2022]
Abstract
OBJECTIVE In 2011, new guidelines on antibiotic prescription for acute otitis media (AOM) were published in France to decrease the use of third generation cephalosporins that promote the carriage of extended-spectrum beta-lactamase producing Escherichia coli. Our objective was to assess the impact of the 2011 French recommendations on the type of antibiotics prescribed for AOM. METHODS Fourteen thousand six hundred and sixty-one children, 6 to 24 months of age, presenting with AOM were included in 2 studies, between November 1, 2009 and October 31, 2012. The first one was conducted with the support of 62 private practice pediatricians; the second one was conducted in 7 pediatric emergency departments. Three periods of 1 year each were defined. RESULTS Antibiotics were prescribed in 12,471 (85.1%) of cases of AOM during the study period. Amoxicillin prescriptions was multiplied by 25, between the first year (2.6%) and the last year (66.1%). Conversely, prescriptions of cefpodoxime proxetil and amoxicillin-clavulanic acid decreased from 33.6% and 62.0% in the first year to 5.2% and 27.7% in the last year, respectively. This trend was observed in both private practices and in the pediatric emergency departments. CONCLUSION Amoxicillin became the most frequently prescribed antibiotic for AOM in 2012, complying with the 2011 French guidelines, while the proportion of prescribed broad-spectrum antibiotics decreased. Our study highlights the importance of guidelines to decrease the prescription of broad-spectrum antibiotics, a crucial factor in the prevention of antibiotic resistance.
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Affiliation(s)
- C Levy
- Association clinique et thérapeutique infantile du Val-de-Marne (ACTIV), 27, rue Inkermann, 94100 Saint-Maur-des-Fossés, France; CRC, centre hospitalier intercommunal de Créteil, 94000 Créteil, France
| | - M Pereira
- Service d'accueil des urgences pédiatriques, université Paris-Diderot, hôpital Robert-Debré, AP-HP, 48, boulevard Sérurier, 75019 Paris, France
| | - R Guedj
- Service des urgences pédiatriques, université Pierre-et-Marie-Curie, hôpital Armand-Trousseau, AP-HP, 75012 Paris, France
| | - C Abt-Nord
- Association française de pédiatrie ambulatoire (AFPA), 30400 Villeneuve-les-Avignons, France
| | - N Baudino Gelbert
- Association française de pédiatrie ambulatoire (AFPA), 30400 Villeneuve-les-Avignons, France
| | - R Cohen
- Association clinique et thérapeutique infantile du Val-de-Marne (ACTIV), 27, rue Inkermann, 94100 Saint-Maur-des-Fossés, France; CRC, centre hospitalier intercommunal de Créteil, 94000 Créteil, France
| | - C Alberti
- Unité d'épidémiologie clinique Inserm CIE 5, université Paris-Diderot, hôpital Robert-Debré, AP-HP, 75019 Paris, France
| | - V Gajdos
- Service de pédiatrie, université Paris-Sud, hôpital Antoine-Béclère, AP-HP, 92140 Clamart, France; Inserm, U1018, équipe reproduction et développement de l'enfant, centre de recherche en épidémiologie et santé des populations (CESP), 94807 Villejuif, France
| | - F Angoulvant
- Service d'accueil des urgences pédiatriques, université Paris-Diderot, hôpital Robert-Debré, AP-HP, 48, boulevard Sérurier, 75019 Paris, France; Inserm, U1018, équipe reproduction et développement de l'enfant, centre de recherche en épidémiologie et santé des populations (CESP), 94807 Villejuif, France.
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Angoulvant F, Jumel S, Prot-Labarthe S, Bellettre X, Kahil M, Smail A, Morin L, Alberti C. Multiple health care visits related to a pediatric emergency visit for young children with common illnesses. Eur J Pediatr 2013; 172:797-802. [PMID: 23404734 DOI: 10.1007/s00431-013-1968-9] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/01/2012] [Revised: 01/17/2013] [Accepted: 01/31/2013] [Indexed: 10/27/2022]
Abstract
UNLABELLED We aim to describe the number of health care visits before and after pediatric emergency department (PED) visits for common illnesses in a French tertiary pediatric hospital. This was a prospective cohort study with 501 children under 6 years of age who were evaluated and discharged from a tertiary care PED. Enrollment occurred on eight randomly selected study days between November 2010 and June 2011. The caregivers were then contacted via telephone 8 days later to obtain follow-up data, including information about return visits to health care facilities. Multiple visits were made by 206 (41 %) children, previous visits had occurred for 139 (28 %) children, and return visits had occurred for 94 (19 %) children. Previous and return visits were made at the PED as well as in general practitioners' offices and private pediatric offices. The median age of the subjects was 18 months. Fever was the most common complaint and was associated with more frequent multiple heath care visits. CONCLUSION Multiple heath care visits for the same illness are frequent, especially for febrile children. Interestingly, this phenomenon concerns every type of health care facility, including the PED, general practitioners' offices, and private pediatric offices. Further studies should be performed to achieve a better understanding of this phenomenon and to test specific interventions, such as parental education and improvement of the information system.
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Affiliation(s)
- F Angoulvant
- Service d'Accueil des Urgences Pédiatriques, AP-HP, Hôpital Robert Debré, 48 Boulevard Sérurier, 75019 Paris, France.
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22
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Perry A, Angoulvant F, Chadelat K, De Lauzanne A, Houdouin V, Kheniche A, Lorrot M, Mesples B, Nouyrigat V, Aujard Y, Gaudelus J, Grimprel E, Faye A. Contage tuberculeux néonatal en maternité : dépistage et évolution d’une cohorte de nourrissons exposés. Arch Pediatr 2012; 19:396-403. [DOI: 10.1016/j.arcped.2012.01.017] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2011] [Revised: 11/15/2011] [Accepted: 01/25/2012] [Indexed: 10/28/2022]
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Angoulvant F, Redant S, Holvoet L, Millet B, Ferster A, Andreu-Gallien J. Prise en charge de la douleur des enfants drépanocytaires aux urgences : recommandations et état des lieux dans le Réseau Mère-Enfant de la francophonie. Réanimation 2011. [DOI: 10.1007/s13546-011-0309-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
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Seror E, Blondé R, Naudin J, Armoogum P, Angoulvant F, De Lauzanne A, Lorrot M, Pull L, Mercier JC, Bourrillon A, Alberti C, Faye A. [Evaluation of pre-travel prevention, except vaccination, in children returning from Africa with fever]. Arch Pediatr 2011; 18:1271-7. [PMID: 21963378 DOI: 10.1016/j.arcped.2011.08.027] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2011] [Revised: 08/05/2011] [Accepted: 08/24/2011] [Indexed: 11/30/2022]
Abstract
OBJECTIVES Evaluating the frequency and modalities of transmissible infection prevention counseling in children before a stay in tropical or subtropical areas. METHODS Description of the frequency and modalities of transmissible infection prevention counseling (except specific vaccination) given prior to travel in children attending a tertiary care center in Paris, France, for fever occurring within 3 months following a return from Africa. Data were collected retrospectively from medical observations and telephone interviews with parents. RESULTS A total of 173 children were included; 98 and 75 returned from sub-Saharan Africa and North Africa, respectively. Forty-one percent were less than 2 years old. Eighty-one percent of the children had consulted before leaving. Among children who returned from North Africa, the proportion of children who had a specific preventive consultation before travel was lower than among children who returned from sub-Saharan Africa (respectively, 72.1% versus 94.7%; p<0.001). In children having consulted before traveling, specific hygiene and diet advice had been given in 72% of cases but less frequently in children who traveled in North Africa compared to children who traveled to sub-Saharan Africa (respectively, 57.8% vs. 92.2%; p<0.001). Among children who returned from North Africa, those who had no preventive consultation before travel had febrile gastrointestinal infection more frequently than those who had a consultation before traveling (p=0.003). CONCLUSION Although in this study the majority of children traveling to Africa receive transmissible infection prevention counseling before the travel, prevention could be improved, particularly before a stay in North Africa.
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Affiliation(s)
- E Seror
- Service d'hématologie pédiatrique, hôpital Robert-Debré, université Denis-Diderot Paris, Assistance publique-Hôpitaux de Paris, France.
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Prot-Labarthe S, Vercheval C, Angoulvant F, Brion F, Bourdon O. [POPI: a tool to identify potentially inappropriate prescribing practices for children]. Arch Pediatr 2011; 18:1231-2. [PMID: 21963375 DOI: 10.1016/j.arcped.2011.08.019] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2011] [Revised: 07/26/2011] [Accepted: 08/22/2011] [Indexed: 10/17/2022]
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26
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Angoulvant F, Bellettre X, Houhou N, Dexpert JB, Morin L, Siriez JY, Soole F, de Lauzanne A, Cohen R, Brun-Vezinet F, Alberti C, Mercier JC. Sensitivity and specificity of a rapid influenza diagnostic test in children and clinical utility during influenza A (H1N1) 2009 outbreak. Emerg Med J 2010; 28:924-6. [PMID: 20943835 DOI: 10.1136/emj.2010.098533] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
INTRODUCTION The influenza A (H1N1) 2009 outbreak caused death and a disruption of public health services. Rapid influenza diagnostic tests (RIDT) could be helpful to ease the triage of patients and prevent an overload of emergency and laboratory facilities. OBJECTIVES To compare the sensitivity and specificity of the Clearview Exact Influenza A&B test and real-time reverse transcription(RT)-PCR to detect influenza A (H1N1) 2009 in a paediatric emergency department of a paediatric teaching hospital in Paris, France. METHODS 76 children with an influenza-like illness and either severe symptoms or an underlying medical condition were prospectively recruited between July 2009 and October 2009. RIDT and RT-PCR were simultaneously performed and compared. RESULTS Among 39 influenza A (H1N1) 2009 RT-PCR-positive children (median age 5 years), 23 Clearview Exact Influenza A&B tests were positive. Sensitivity was 59% (95% CI 42.2 to 74) and specificity was 94.6% (95% CI 80.5 to 99.1). CONCLUSIONS This study shows a sensitivity of RIDT of 59%, in agreement with other prospective studies, which could be useful in clinical practice for diagnosis influenza A (H1N1) 2009 in children. In outbreaks of a high prevalence, such as the 2009 outbreak, this test can help to prevent an overload of public health services.
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Affiliation(s)
- F Angoulvant
- AP-HP, Hôpital Robert Debré, Pôle de Pèdiatrie Aiguë et Mèdecine Interne, Serviced’Accueil des Urgences Pèdiatriques, Universitè Diderot-Paris 7, Paris, France.
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Henriet S, Kaguelidou F, Bidet P, Lorrot M, Lauzanne A, Dauger S, Angoulvant F, Mercier JC, Alberti C, Bingen E, Faye A. Invasive group A streptococcal infection in children: clinical manifestations and molecular characterization in a French pediatric tertiary care center. Eur J Clin Microbiol Infect Dis 2010; 29:341-6. [DOI: 10.1007/s10096-009-0854-x] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2009] [Accepted: 12/05/2009] [Indexed: 11/28/2022]
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Dauger S, Holvoet L, Pinto-Da-Costa N, Michot C, Aizenfisz S, Angoulvant F. A teaching programme to improve compliance with guidelines about management of hypovolaemia in the emergency department. Acta Paediatr 2008; 97:1746-8. [PMID: 18945277 DOI: 10.1111/j.1651-2227.2008.01068.x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Affiliation(s)
- S Dauger
- Paediatric Intensive Care Unit, Robert-Debré University Hospital, AP-HP and University Paris Diderot-Paris 7, Paris, France.
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Blondé R, Naudin J, Bigirimana Z, Holvoet L, Fenneteau O, Vitoux C, Bourdon O, Angoulvant F, Lorrot M, D’Ortenzio E, Bourrillon A, Le Bras J, Matheron S, Faye A. Tolérance et efficacité de l’atovaquone-proguanil dans le traitement du paludisme d’importation à Plasmodium falciparum de l’enfant en France métropolitaine : expérience d’un centre hospitalier parisien. Arch Pediatr 2008; 15:245-52. [DOI: 10.1016/j.arcped.2007.10.018] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2007] [Revised: 09/23/2007] [Accepted: 10/14/2007] [Indexed: 11/24/2022]
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Weil-Olivier C, Angoulvant F, Chevallier B, De Montalembert M, Gaudelus J, Quinet B, Labrune P, Duclos A, Dunais B, Maitre M. Couverture vaccinale vis-à-vis de la grippe chez les enfants de la région parisienne atteints d'une affection de longue durée. Arch Pediatr 2006; 13:1287-93. [DOI: 10.1016/j.arcped.2006.07.001] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2006] [Accepted: 07/04/2006] [Indexed: 10/24/2022]
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See H, Aubertin G, Angoulvant F, Baculard F, Soussan V, Bourrillon A, Faye A. [Chronic otitis and hearing loss revealing a disseminated tuberculosis in a child]. Arch Pediatr 2006; 13:1233-5. [PMID: 16829062 DOI: 10.1016/j.arcped.2006.05.014] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2005] [Accepted: 05/22/2006] [Indexed: 10/24/2022]
Abstract
UNLABELLED Ear localization is sometimes the first symptom of tuberculosis. CASE REPORT We report a case of a teen with a chronic otitis revealing a disseminated tuberculosis. The investigations showed ear, bones and pulmonary localisations. The outcome with treatment showed a persistent hearing loss. CONCLUSION Middle ear tuberculosis should be suspected in patients with chronic otitis and risk factors of tuberculosis. A disseminated tuberculosis should be investigated and an early treatment is necessary to prevent hearing loss.
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Affiliation(s)
- H See
- Pédiatrie générale, Assistance publique-Hôpitaux de Paris, hôpital Robert-Debré, 48, boulevard Sérurier, 75019 Paris, France
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