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Brédy S, Campion A, Nguyen S, Martinot A, Pouessel G. Pediatric private practice in the Nord-Pas-de-Calais region: Demographics, organization, and challenges. Arch Pediatr 2023:S0929-693X(23)00085-4. [PMID: 37286424 DOI: 10.1016/j.arcped.2023.04.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2022] [Revised: 01/02/2023] [Accepted: 04/29/2023] [Indexed: 06/09/2023]
Abstract
While the needs for pediatric care are increasing and becoming more diverse, pediatric private practice in France is encountering difficulties linked to a growing medical demographic deficit. The objective of this study was to give an overview of pediatric private practice in the Nord-Pas-de-Calais region and to describe the main challenges encountered. METHODS For this descriptive observational survey, private practice pediatricians in the Nord-Pas-de-Calais region filled out an online questionnaire between April 2019 and October 2020. RESULTS The response rate was 64%. Most respondents practiced in an urban area (87%) and shared the practice with other physicians (59%). A majority (85%) had previously worked in hospital; 65% reported training in a subspecialty. Overall, 48% had other professional activities; 28% worked night shifts and 96% accepted urgent requests for consultations. A total of 33% reported having difficulties contacting specialists for consults, and 46% had difficulties in obtaining written reports of their patients' hospitalizations. All respondents participated in a form of ongoing medical education. The main difficulties were: lack of information about how to found a private practice (68%), lack of personal time (61%), balance between medical and administrative work (59%), and an excess of patients to care for (57%). The main satisfactions were: trusting relationships with patients (98%), freedom in their choice of practice (85%), and the diversity of problems and situations encountered (68%). CONCLUSION Our study underlines that private practice pediatricians are involved in healthcare provision, in particular regarding ongoing medical training, subspecialties, and continuity of care. It also highlights the problems encountered and the possible improvements: developing better communication between private practice and hospitals, reinforcing training during residency, and highlighting the importance and complementarity of private practice in children's healthcare.
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Affiliation(s)
- S Brédy
- Centre Hospitalier de Roubaix, Service de Pédiatrie, 11 Bd Lacordaire, 59100 Roubaix, France
| | - A Campion
- Cabinet de Pédiatrie Libérale, 92 Bd du Général de Gaulle, 59100 Roubaix, France
| | - S Nguyen
- Hôpital Roger Salengro, Service de Neurologie Pédiatrique, Av du Professeur Emile Laine, 59037 Lille, France
| | - A Martinot
- CHRU Lille, Service des Urgences Pédiatriques, Av du Professeur Emile Laine, 59037 Lille, France
| | - G Pouessel
- Centre Hospitalier de Roubaix, Service de Pédiatrie, 11 Bd Lacordaire, 59100 Roubaix, France.
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Bradatan E, Beaudoin E, Beaumont P, Demoly P, Dumond P, Fardeau M, Liabeuf V, Mariotte D, Pouessel G, Tscheiller S, Van der Brempt X, Renaudin J, Ponvert C, Sabouraud-Leclerc D. Le recueil des cofacteurs et comorbidités lors des déclarations d’anaphylaxie : vers une médecine personnalisée adaptée au patient. Revue Française d'Allergologie 2023. [DOI: 10.1016/j.reval.2023.103329] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/27/2023]
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3
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Deschildre A, Pouessel G. Allergies alimentaires, des données nouvelles ouvrant des perspectives innovantes. Revue Française d'Allergologie 2022. [DOI: 10.1016/s1877-0320(22)00482-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
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Pouessel G, Tanno L, Beaudouin E, Chatain C, Corriger J, Demoly P, Flabbée J, Jacquier J, Larroche Y, Neukirch C, Leroy S, Mariotte D, le Mauff B, Mertes P, Thi N, Pouessel G, Tacquard C, Tanno L, Vitte J. Les sapeurs-pompiers en première ligne dans l’anaphylaxie ! Revue Française d'Allergologie 2022. [DOI: 10.1016/j.reval.2022.10.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Pouessel G, Couvreur M, Deschildre A. [Food allergy at school: Personalized healthcare project and adrenaline]. Ann Pharm Fr 2021; 80:239-247. [PMID: 34331936 DOI: 10.1016/j.pharma.2021.07.006] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2021] [Revised: 06/25/2021] [Accepted: 07/20/2021] [Indexed: 11/30/2022]
Abstract
In Europe, the prevalence of food allergy is estimated at 6-8% of children. Ten to 20% of pediatric food-induced anaphylaxis reactions occur at school. Individual healthcare plans (IHP) for food allergy aim at: identifying children at risk of allergic reactions; reducing the risk of allergen exposure; providing emergency kits containing adrenaline auto-injectors (AAI) if needed with emergency action plans and instructions about when and how to use AAI. In France, IHP were introduced into law in 2003 and was updated in 2021. The number of IHP for allergy is increasing since 10 years (50,000 IHP for allergy/year). While the recommendations of the learned societies have resulted in the national harmonization of criteria for the implementation of IHP for allergy and for the prescription of emergency kits with AAI, adrenaline remains underused. In 2019, a national policy stated that all high schools must have a provision of spare AAI in case of anaphylaxis and the promotion of school staff training about food allergy and anaphylaxis was encouraged. These recommendations should be assessed widely and allergy training should be widespread. Pharmacists play an important role to take care of food-allergic children: provision of AAI prescribed for the most at-risk food allergic patients, advice and information on AAI. The pharmacist is therefore a key player in the therapeutic education of the patient to reinforce the key messages on the efficacy and safety of adrenaline used for anaphylaxis.
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Affiliation(s)
- G Pouessel
- Service de pédiatrie, pavillon médicochirurgical de pédiatrie, 59056 Roubaix, France; Unité de pneumologie et allergologie pédiatriques, CHRU Lille, université Lille2, hôpital Jeanne-de-Flandre, 59037 Lille, France; Groupe de travail « Allergie en milieu scolaire » de la Société française d'allergologie, Paris, France.
| | - M Couvreur
- Pharmacie du Château, 59152 Chéreng, France
| | - A Deschildre
- Unité de pneumologie et allergologie pédiatriques, CHRU Lille, université Lille2, hôpital Jeanne-de-Flandre, 59037 Lille, France
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- Groupe de travail « Allergie en milieu scolaire » de la Société française d'allergologie, Paris, France
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Pouessel G, Chagnon F, Trochu C, Labreuche J, Lejeune S, Recher M, Deschildre A, Leteurtre S. Anaphylaxis admissions to pediatric intensive care units in France. Allergy 2018; 73:1902-1905. [PMID: 29787624 DOI: 10.1111/all.13483] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Affiliation(s)
- G. Pouessel
- Department of Pediatrics; Children's Hospital; Roubaix France
- Pediatric Pulmonology and Allergy Department; Hôpital Jeanne de Flandre; CHU Lille; Lille France
| | - F. Chagnon
- Pediatric Intensive Care Unit; CHU Lille; Lille France
| | - C. Trochu
- Department of Pediatrics; Children's Hospital; Roubaix France
- Pediatric Intensive Care Unit; CHU Lille; Lille France
| | - J. Labreuche
- Department of Biostatistics; CHU Lille; Lille France
- EA 2694 - Santé Publique: épidémiologie et qualité des soins; University of Lille; Lille France
| | - S. Lejeune
- Pediatric Pulmonology and Allergy Department; Hôpital Jeanne de Flandre; CHU Lille; Lille France
| | - M. Recher
- Pediatric Intensive Care Unit; CHU Lille; Lille France
- EA 4489 - Environnement périnatal et croissance; University of Lille Lille; Lille France
| | - A. Deschildre
- Pediatric Pulmonology and Allergy Department; Hôpital Jeanne de Flandre; CHU Lille; Lille France
| | - S. Leteurtre
- Pediatric Intensive Care Unit; CHU Lille; Lille France
- EA 2694 - Santé Publique: épidémiologie et qualité des soins; University of Lille; Lille France
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Gloaguen A, Cesareo E, Vaux J, Valdenaire G, Ganansia O, Renolleau S, Pouessel G, Beaudouin E, Lefort H, Meininger C. Prise en charge de l’anaphylaxie en médecine d’urgence. Recommandations de la Société française de médecine d’urgence (SFMU) en partenariat avec la Société française d’allergologie (SFA) et le Groupe francophone de réanimation et d’urgences pédiatriques (GFRUP), et le soutien de la Société pédiatrique de pneumologie et d’allergologie (SP2A). Revue Française d'Allergologie 2017. [DOI: 10.1016/j.reval.2017.10.004] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
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Pouessel G, Claverie C, Labreuche J, Dorkenoo A, Renaudin JM, Eb M, Lejeune S, Deschildre A, Leteurtre S. Mortalité par anaphylaxie en France métropolitaine : analyse des données nationales de 1979 à 2011. Revue Française d'Allergologie 2017. [DOI: 10.1016/j.reval.2017.06.005] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
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Pouessel G, Galand J, Beaudouin E, Renaudin JM, Labreuche J, Moneret-Vautrin DA, Deschildre A. The gaps in anaphylaxis diagnosis and management by French physicians. Pediatr Allergy Immunol 2017; 28:295-298. [PMID: 28178763 DOI: 10.1111/pai.12703] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Affiliation(s)
- G Pouessel
- Department of Pediatrics, Children's Hospital, Roubaix, France.,Pediatric Pulmonology and Allergy Department, Pôle enfant, Hôpital Jeanne de Flandre, CHRU de Lille, Université Nord de France, Lille, France.,Allergy Vigilance Network, Vandoeuvre les Nancy, France
| | - J Galand
- Department of Pediatrics, Children's Hospital, Roubaix, France.,Pediatric Pulmonology and Allergy Department, Pôle enfant, Hôpital Jeanne de Flandre, CHRU de Lille, Université Nord de France, Lille, France
| | - E Beaudouin
- Allergy Vigilance Network, Vandoeuvre les Nancy, France.,Department of Allergology, Emile Durkheim Hospital, Epinal, France
| | - J M Renaudin
- Allergy Vigilance Network, Vandoeuvre les Nancy, France.,Department of Allergology, Emile Durkheim Hospital, Epinal, France
| | - J Labreuche
- EA 2694 - Santé publique: épidémiologie et qualité des soins, Department of Biostatistics, CHU Lille, Univ. Lille, Lille, France
| | | | - A Deschildre
- Pediatric Pulmonology and Allergy Department, Pôle enfant, Hôpital Jeanne de Flandre, CHRU de Lille, Université Nord de France, Lille, France.,Allergy Vigilance Network, Vandoeuvre les Nancy, France
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Gloaguen A, Cesareo E, Vaux J, Valdenaire G, Ganansia O, Renolleau S, Pouessel G, Beaudouin E, Lefort H, Meininger C. Erratum to: Prise en charge de l’anaphylaxie en médecine d’urgence. Recommandations de la Société française de médecine d’urgence (SFMU) en partenariat avec la Société française d’allergologie (SFA) et le Groupe francophone de réanimation et d’urgences pédiatriques (GFRUP), et le soutien de la Société pédiatrique de pneumologie et d’allergologie (SP2A). Ann Fr Med Urgence 2016. [DOI: 10.1007/s13341-016-0693-1] [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: 11/25/2022]
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Pouessel G, Deschildre A. [Anaphylaxis in children: What pediatricians should know]. Arch Pediatr 2016; 23:1307-1316. [PMID: 27836164 DOI: 10.1016/j.arcped.2016.09.013] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2016] [Revised: 09/02/2016] [Accepted: 09/14/2016] [Indexed: 11/18/2022]
Abstract
Anaphylaxis is a severe potentially life-threatening allergic emergency that has been increasing over the last two decades, especially in young children. Anaphylaxis deaths remain rare, in particular in children, and their frequency is stable during this period. Food is the main anaphylaxis trigger in children, notably to cow's milk, peanuts, and tree nuts. In infants, the recognition of anaphylaxis may be difficult. Vomiting, urticaria, and laryngeal edema are more frequent at this age. Cardiovascular involvement is rare, most often encountered in adolescence. A history of asthma or atopy, allergy to particular foods such as peanuts and tree nuts, and adolescence are some risk factors for anaphylaxis and more severe reactions. First-line treatment is intramuscular adrenaline for all patients experiencing anaphylaxis. There are no absolute contra-indications. Guidelines for the prescription of the adrenaline auto-injector and for establishing a personalized care project in allergic children at school have recently been updated. Recognition of anaphylaxis and treatment should also be improved.
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Affiliation(s)
- G Pouessel
- Service de pédiatrie, pavillon médicochirurgical de pédiatrie, boulevard Lacordaire, 59056 Roubaix, France; Unité de pneumologie et allergologie pédiatriques, université Lille 2, hôpital Jeanne-de-Flandre, CHRU Lille, 2, avenue Oscar-Lambret, 59037 Lille, France.
| | - A Deschildre
- Unité de pneumologie et allergologie pédiatriques, université Lille 2, hôpital Jeanne-de-Flandre, CHRU Lille, 2, avenue Oscar-Lambret, 59037 Lille, France
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Pouessel G, Deschildre A, Beaudouin E, Birnbaum J, Neukirch C, Meininger C, Leroy S. À qui prescrire un dispositif auto-injectable d’adrénaline ? Position des groupes de travail « Anaphylaxie », « Allergie alimentaire », « Insectes piqueurs » sous l’égide de la Société française d’allergologie. Revue Française d'Allergologie 2016. [DOI: 10.1016/j.reval.2016.06.001] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Pouessel G, Deschildre A, Beaudouin E, Birnbaum J, Neukirch C, Meininger C, Leroy S. Conditions d’établissement du projet d’accueil individualisé pour l’enfant allergique : position des groupes de travail « anaphylaxie », « allergie alimentaire » et « insectes piqueurs » sous l’égide de la Société française d’allergologie. Revue Française d'Allergologie 2016. [DOI: 10.1016/j.reval.2016.05.003] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Pouessel G, Beaudouin E, Renaudin JM, Moneret-Vautrin AM, Deschildre A. Adherence to the guidelines for adrenaline auto-injector prescription should be improved. Pediatr Allergy Immunol 2016; 27:430-3. [PMID: 26845628 DOI: 10.1111/pai.12546] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Affiliation(s)
- G Pouessel
- Department of Pediatrics, Children's Hospital, Roubaix, France. .,Allergy Vigilance Network, Vandoeuvre les Nancy, France. .,Pediatric Pulmonology and Allergy Department, Pôle enfant, Hôpital Jeanne de Flandre, CHRU de Lille and Université Nord de France, Lille, France.
| | - E Beaudouin
- Allergy Vigilance Network, Vandoeuvre les Nancy, France.,Department of Allergology, Emile Durkheim Hospital, Epinal, France
| | - J M Renaudin
- Allergy Vigilance Network, Vandoeuvre les Nancy, France.,Department of Allergology, Emile Durkheim Hospital, Epinal, France
| | - A M Moneret-Vautrin
- Allergy Vigilance Network, Vandoeuvre les Nancy, France.,Department of Allergology, Emile Durkheim Hospital, Epinal, France
| | - A Deschildre
- Allergy Vigilance Network, Vandoeuvre les Nancy, France.,Pediatric Pulmonology and Allergy Department, Pôle enfant, Hôpital Jeanne de Flandre, CHRU de Lille and Université Nord de France, Lille, France
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Pouessel G, Dupond M, Combes S, Sabouraud D, Deschildre A. Projet d’accueil individualisé pour enfant allergique : expérience des médecins de l’Éducation nationale du département du Nord. Revue Française d'Allergologie 2016. [DOI: 10.1016/j.reval.2015.10.008] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Pouessel G, Beaudouin E, Renaudin JM, Drumez E, Moneret-Vautrin DA, Deschildre A. Pratiques et adhésion aux recommandations pour la prescription des dispositifs auto-injectables d’adrénaline : enquête auprès des allergologues du réseau allergo-vigilance. Revue Française d'Allergologie 2016. [DOI: 10.1016/j.reval.2015.10.006] [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] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Pouessel G, Gueorguieva I, Bernaczyk Y, Flammarion S, Thumerelle C, Deschildre A. [Inhaled corticosteroids and growth: should we be worried?]. Arch Pediatr 2015; 22:886-91. [PMID: 26142772 DOI: 10.1016/j.arcped.2015.05.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2014] [Revised: 02/13/2015] [Accepted: 05/22/2015] [Indexed: 10/23/2022]
Abstract
Inhaled corticosteroids (ICSs) are the cornerstone and the first stage of asthma treatment. The objective of this study was to synthesize data on the potential effects of ICSs on growth in children. Studies on the short-term impact of ICSs on growth evaluated by knemometry cannot be extrapolated to the medium or long term and therefore have no utility in real life for a given person. In the medium term, the various ICSs given at the usual doses cause a small reduction in growth after 6 months of treatment. This slowdown occurs at the beginning of treatment, especially in younger children, and the growth velocity corrects itself later but without catching up. In the long term, the prolonged use of ICSs seems to induce a small reduction in the final size in adulthood (close to 1cm) occurring in the first 2 years of treatment without worsening over time. The impact of gender, age at onset of treatment, different ICSs, modes of inhalation, and severity of asthma should also be studied further. The benefit of ICSs in asthma treatment is greater than the risk of side effects, including on growth. The majority of the therapeutic effect is obtained for small to moderate doses of ICSs. Regular adjustment of ICS dose for optimal asthma control should also reduce ICS dose and the impact on growth.
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Affiliation(s)
- G Pouessel
- Service de pédiatrie, centre hospitalier de Roubaix, pavillon de pédiatrie médico-chirurgicale, 11-17, boulevard Lacordaire, BP 359, 59056 Lille, France; Unité de pneumologie et allergologie, clinique de pédiatrie, hôpital Jeanne-de-Flandre, CHRU de Lille, 2, avenue Oscar-Lambret, 59037 Lille cedex, France.
| | - I Gueorguieva
- Unité d'endocrinologie pédiatrique, clinique de pédiatrie, hôpital Jeanne-de-Flandre, CHRU de Lille, 2, avenue Oscar-Lambret, 59037 Lille cedex, France
| | - Y Bernaczyk
- Service de pédiatrie, centre hospitalier de Roubaix, pavillon de pédiatrie médico-chirurgicale, 11-17, boulevard Lacordaire, BP 359, 59056 Lille, France
| | - S Flammarion
- Unité de pneumologie et allergologie, clinique de pédiatrie, hôpital Jeanne-de-Flandre, CHRU de Lille, 2, avenue Oscar-Lambret, 59037 Lille cedex, France
| | - C Thumerelle
- Unité de pneumologie et allergologie, clinique de pédiatrie, hôpital Jeanne-de-Flandre, CHRU de Lille, 2, avenue Oscar-Lambret, 59037 Lille cedex, France
| | - A Deschildre
- Unité de pneumologie et allergologie, clinique de pédiatrie, hôpital Jeanne-de-Flandre, CHRU de Lille, 2, avenue Oscar-Lambret, 59037 Lille cedex, France
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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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Pouessel G, Thumerelle C, Nève V, Santangelo T, Flammarion S, Pruvot I, Tillie-Leblond I, Deschildre A. [Lung is also involved in juvenile dermatomyositis]. Rev Med Interne 2014; 35:461-5. [PMID: 24856457 DOI: 10.1016/j.revmed.2014.04.005] [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] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2013] [Revised: 02/24/2014] [Accepted: 04/14/2014] [Indexed: 12/18/2022]
Abstract
Juvenile dermatomyositis is the leading cause of chronic idiopathic inflammatory myopathy of auto-immune origin in children. Lung involvement in inflammatory myopathies is well described in adults, involving mostly interstitial lung disease, aspiration pneumonia and alveolar hypoventilation. We propose to describe its specificities in children. Pulmonary involvement may be asymptomatic and therefore must be systematically screened for. In case of clinical or functional respiratory abnormality, a chest computed tomographic (CT) scan is necessary. In children, a decrease of respiratory muscle strength seems common and should be systematically and specifically searched for by non-invasive and reproducible tests (sniff test). Interstitial lung disease usually associates restrictive functional defect, impairment of carbon monoxide diffusion and interstitial lung disease on CT scan. As in adults, the first-line treatment of juvenile dermatomyositis is based on corticosteroids. Corticosteroid resistant forms require corticosteroid bolus or adjuvant immunosuppressive drugs (methotrexate or cyclosporine). There is no consensus in pediatrics for the treatment of diffuse interstitial lung disease. Complications of treatment, including prolonged steroid therapy, are frequent and therefore a careful assessment of the treatments risk-benefit ratio is necessary, especially in growing children.
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Affiliation(s)
- G Pouessel
- Unité de pneumologie et allergologie pédiatriques, pôle enfant, hôpital Jeanne-de-Flandre, CHRU de Lille, avenue Avinée, 59037 Lille, France; Service de pédiatrie, hôpital Victor-Provo, 59100 Roubaix, France
| | - C Thumerelle
- Unité de pneumologie et allergologie pédiatriques, pôle enfant, hôpital Jeanne-de-Flandre, CHRU de Lille, avenue Avinée, 59037 Lille, France
| | - V Nève
- Unité d'exploration fonctionnelle respiratoire pédiatrique, hôpital Jeanne-de-Flandre, CHRU de Lille, avenue Avinée, 59037 Lille, France
| | - T Santangelo
- Service d'imagerie thoracique, hôpital Calmette, CHRU, 59037 Lille cedex, France
| | - S Flammarion
- Unité de pneumologie et allergologie pédiatriques, pôle enfant, hôpital Jeanne-de-Flandre, CHRU de Lille, avenue Avinée, 59037 Lille, France; Service de pédiatrie, hôpital Victor-Provo, 59100 Roubaix, France
| | - I Pruvot
- Unité de rhumatologie pédiatrique, pôle enfant, hôpital Jeanne-de-Flandre, CHRU de Lille, avenue Avinée, 59037 Lille cedex, France
| | - I Tillie-Leblond
- Service de pneumologie et d'immuno-allergologie, hôpital Calmette, CHRU, 59037 Lille cedex, France
| | - A Deschildre
- Unité de pneumologie et allergologie pédiatriques, pôle enfant, hôpital Jeanne-de-Flandre, CHRU de Lille, avenue Avinée, 59037 Lille, France.
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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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Aubertin G, Marguet C, Delacourt C, Houdouin V, Leclainche L, Lubrano M, Marteletti O, Pin I, Pouessel G, Rittié JL, Saulnier JP, Schweitzer C, Stremler N, Thumerelle C, Toutain-Rigolet A, Beydon N. Recommandations pour l’oxygénothérapie chez l’enfant en situations aiguës et chroniques : évaluation du besoin, critères de mise en route, modalités de prescriptions et de surveillance. Rev Mal Respir 2013; 30:903-11. [DOI: 10.1016/j.rmr.2013.03.002] [Citation(s) in RCA: 4] [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] [Indexed: 10/26/2022]
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Nuytten A, Rocca A, Lagrée M, Flammarion S, Wambre A, Ythier H, Pouessel G. Une angine compliquée. Arch Pediatr 2013; 20:507-8, 533-5. [DOI: 10.1016/j.arcped.2013.01.057] [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: 09/28/2012] [Revised: 11/23/2012] [Accepted: 01/22/2013] [Indexed: 11/25/2022]
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Nuytten A, Rocca A, Lagrée M, Flammarion S, Wambre A, Ythier H, Pouessel G. Syndrome de Lemierre. Arch Pediatr 2013. [DOI: 10.1016/j.arcped.2013.01.056] [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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Bécourt C, Pouessel G, Catteau B, Martin Delasalle E, Ythier H, Carpentier O. Pemphigoïde bulleuse cortico-résistante du nourrisson : efficacité des immunoglobulines. Ann Dermatol Venereol 2012. [DOI: 10.1016/j.annder.2012.10.172] [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: 10/27/2022]
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Aubertin G, Marguet C, Delacourt C, Houdouin V, Leclainche L, Lubrano M, Marteletti O, Pin I, Pouessel G, Rittié JL, Saulnier JP, Schweitzer C, Stremler N, Thumerelle C, Toutain-Rigolet A, Beydon N. Recommandations pour l’oxygénothérapie chez l’enfant en situations aiguës et chroniques : évaluation du besoin, critères de mise en route, modalités de prescription et de surveillance. Arch Pediatr 2012; 19:528-36. [DOI: 10.1016/j.arcped.2012.02.016] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2012] [Accepted: 02/26/2012] [Indexed: 10/28/2022]
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Lefevre C, Mars A, Doan C, Liesse A, Bonnevalle M, Ganga-Zandzou S, Ythier H, Pouessel G. [An atypical case of asthma]. Arch Pediatr 2011; 18:1327-8, 1336-8. [PMID: 22047771 DOI: 10.1016/j.arcped.2011.09.004] [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] [Received: 03/08/2011] [Revised: 04/18/2011] [Accepted: 09/19/2011] [Indexed: 11/30/2022]
Affiliation(s)
- C Lefevre
- Service de pédiatrie, pavillon médico-chirurgical de pédiatrie, centre hospitalier de Roubaix, France
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Deschildre A, Béghin L, Salleron J, Iliescu C, Thumerelle C, Santos C, Hoorelbeke A, Scalbert M, Pouessel G, Gnansounou M, Edmé JL, Matran R. Home telemonitoring (forced expiratory volume in 1 s) in children with severe asthma does not reduce exacerbations. Eur Respir J 2011; 39:290-6. [PMID: 21852334 DOI: 10.1183/09031936.00185310] [Citation(s) in RCA: 38] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Some children with severe asthma develop frequent exacerbations despite intensive treatment. We sought to assess the outcome (severe exacerbations and healthcare use, lung function, quality of life and maintenance treatment) of a strategy based on daily home spirometry with teletransmission to an expert medical centre and whether it differs from that of a conventional strategy. 50 children with severe uncontrolled asthma were enrolled in a 12-month prospective study and were randomised into two groups: 1) treatment managed with daily home spirometry and medical feedback (HM) and 2) conventional treatment (CT). The children's mean age was 10.9 yrs (95% confidence interval 10.2-11.6). 44 children completed the study (21 in the HM group and 23 in the CT group). The median number of severe exacerbations per patient was 2.0 (interquartile range 1.0-4.0) in the HM group and 3.0 (1.0-4.0) in the CT group (p=0.38 with adjustment for age). There were no significant differences between the two groups for unscheduled visits (HM 5.0 (3.0-7.0), CT 3.0 (2.0-7.0); p=0.30), lung function (pre-β(2)-agonist forced expiratory volume in 1 s (FEV(1)) p=0.13), Paediatric Asthma Quality of Life Questionnaire scores (p=0.61) and median daily dose of inhaled corticosteroids (p=0.86). A treatment strategy based on daily FEV(1) monitoring with medical feedback did not reduce severe asthma exacerbations.
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Affiliation(s)
- A Deschildre
- Unité de Pneumologie-Allergologie Pédiatrique, Clinique de Pédiatrie Jeanne de Flandre, CHRU, 59037 Lille cedex, France.
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Levaillant C, Doan C, Giard H, Liesse A, Collet B, Ganga-Zandzou P, Pierre MH, Ythier H, Pouessel G. Une oligoarthrite atypique. Arch Pediatr 2011. [DOI: 10.1016/j.arcped.2011.03.009] [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: 11/25/2022]
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Levaillant C, Doan C, Giard H, Liesse A, Collet B, Ganga-Zandzou P, Pierre MH, Ythier H, Pouessel G. Une oligoarthrite atypique. Arch Pediatr 2011; 18:678, 707-8. [DOI: 10.1016/j.arcped.2011.03.008] [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: 09/24/2010] [Accepted: 03/06/2011] [Indexed: 11/28/2022]
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Ganga-Zandzou PS, Bourgois B, Mars A, Pouessel G, Flammarion S, Cixous E, Ythier H. Nutrition entérale à domicile par gastrostomie per-endoscopique. Expérience chez l’enfant à Roubaix. Arch Pediatr 2011; 18:459-60. [DOI: 10.1016/j.arcped.2011.01.019] [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: 11/16/2010] [Revised: 12/20/2010] [Accepted: 01/21/2011] [Indexed: 10/18/2022]
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Azarnoush S, Carpentier O, Thumerelle C, Flammarion S, Lambilliotte A, Botte A, Ythier H, Pouessel G. Histiocytose langerhansienne néonatale. Arch Pediatr 2010. [DOI: 10.1016/j.arcped.2010.08.028] [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: 11/16/2022]
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Azarnoush S, Carpentier O, Thumerelle C, Flammarion S, Lambilliotte A, Botte A, Ythier H, Pouessel G. [Cutaneous eruption associated with respiratory distress in an infant. Neonatal Langerhans cell histiocytosis]. Arch Pediatr 2010; 17:1571-2, 1583-5. [PMID: 20884184 DOI: 10.1016/j.arcped.2010.08.027] [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: 12/17/2009] [Revised: 04/13/2010] [Accepted: 08/08/2010] [Indexed: 11/15/2022]
Affiliation(s)
- S Azarnoush
- Service de pédiatrie, pavillon de pédiatrie médicochirurgicale, centre hospitalier de Roubaix, 11-17, boulevard Lacordaire, BP 359, 59056 Roubaix, France
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Pouessel G, Flammarion S, Romero D, Giard H, Liesse A, Ganga-Zandzou P, Ythier H, Santos C. Détresse respiratoire aiguë après un accident de la voie publique. Arch Pediatr 2010; 17:1183-4. [DOI: 10.1016/j.arcped.2010.05.012] [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: 09/26/2009] [Revised: 12/17/2009] [Accepted: 05/24/2010] [Indexed: 10/19/2022]
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Ganga-Zandzou PS, Pouessel G, Pierre MH, Bourgois B, Cixous E, Ythier H. [Study of the factors related to Helicobacter pylori infection in children]. Arch Pediatr 2009; 16:1595-7. [PMID: 19796923 DOI: 10.1016/j.arcped.2009.09.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2009] [Revised: 02/23/2009] [Accepted: 09/01/2009] [Indexed: 12/01/2022]
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35
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Pouessel G, Damie R, Soudan B, Weill J, Gottrand F, Turck D. Statut en iode chez des enfants de moins de 1 an : conséquences sur la fonction thyroïdienne. Arch Pediatr 2008; 15:1276-82. [DOI: 10.1016/j.arcped.2008.04.011] [Citation(s) in RCA: 3] [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: 07/21/2007] [Revised: 02/28/2008] [Accepted: 04/13/2008] [Indexed: 10/21/2022]
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Pouessel G, Dos Remedios J, Cixous E, Ganga-Zandzou S, Ythier H. [Quad-bikes, mini-motorbikes... toys for kids?]. Arch Pediatr 2007; 14:1461-2. [PMID: 17935954 DOI: 10.1016/j.arcped.2007.08.021] [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: 07/04/2007] [Accepted: 08/29/2007] [Indexed: 10/22/2022]
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Mercier A, Pouessel G, Dos Remedios J, Dewatre F, Ganga-Zandzou S, Ythier H. Abcès de la fesse et toux chronique chez une adolescente. Arch Pediatr 2007; 14:43-4, 73-6. [PMID: 17011757 DOI: 10.1016/j.arcped.2006.08.011] [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] [Subscribe] [Scholar Register] [Received: 06/10/2006] [Accepted: 08/08/2006] [Indexed: 11/24/2022]
Affiliation(s)
- A Mercier
- Service de pédiatrie, pavillon de pédiatrie médicochirurgical, centre hospitalier Victor-Provo, 59056 Roubaix cedex 01, France
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Pouessel G, Deschildre A, Castelain C, Sardet A, Sagot-Bevenot S, de Sauve-Boeuf A, Thumerelle C, Santos C. Parental knowledge and use of epinephrine auto-injector for children with food allergy. Pediatr Allergy Immunol 2006; 17:221-6. [PMID: 16672011 DOI: 10.1111/j.1399-3038.2006.00391.x] [Citation(s) in RCA: 53] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Epinephrine should be prescribed for patients at risk of anaphylaxis. Our purpose was to determine the use of Anapen prescribed for food-allergic children, to assess parental knowledge regarding Anapen, and to evaluate the arrangements for emergency kits and personalized care projects in everyday life. A prospective study was performed with a questionnaire sent to families with a food-allergic child previously prescribed Anapen. One hundred and fifty two families were contacted and finally 111 children included (median age 6.5 yrs). Main food allergens were peanuts (n = 89), egg (n = 39) and cow's milk (n = 10). The use of Anapen had been demonstrated to 90% of parents (by prescribing physician, 69%; pharmacist, 25%; general practitioner, 5%; nurse 1%), with a training device (76%) and/or written instructions (49%). When asked to list symptoms requiring injection, 48% of parents cited more than one response: breathing difficulties only (23%), or with angio-edema (41%), collapse or faintness (38%), anaphylactic shock (48%). Of 107 children attending school, 54% had a personalized care project, 72% an Anapen device, and 60% a complete emergency kit (epinephrine, inhaled beta-agonist, corticosteroid, anti-H1 drug). Beta-agonists were forgotten at school by 34 children (13 asthmatics). Anapen was used in one child for angio-edema and dyspnea after inadvertent ingestion of egg at home. In our population, epinephrine auto-injectors and emergency kits were insufficiently available at schools and in daily life. The use of auto-injectors was not adequately demonstrated. The prescription of epinephrine for food-allergic children at risk of anaphylaxis requires accurate diagnosis, educational programs, information, and follow up.
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Affiliation(s)
- G Pouessel
- Unité de pneumologie-allergologie pédiatrique, Clinique de Pédiatrie, Hôpital Jeanne de Flandre, CHRU de Lille, France
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Pouessel G, Morillon S, Bonnel C, Neve V, Robin S, Santos C, Thumerelle C, Matran R, Deschildre A. Tests de marche : une avancée dans l'évaluation fonctionnelle cardiorespiratoire. Arch Pediatr 2006; 13:277-83. [PMID: 16324830 DOI: 10.1016/j.arcped.2005.10.008] [Citation(s) in RCA: 10] [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: 07/01/2005] [Accepted: 10/03/2005] [Indexed: 11/24/2022]
Abstract
Exercise testing provides information on physical capacity during exercise in addition to spirometric measures of lung function or assessment on treadmills or ergonomic cycle. The "gold standard" assessment of exercise tolerance is measured in the laboratory using treadmills or ergonomic cycle but the necessary equipment is expensive and may not be readily accessible; such tests require people used to work with children. Walking tests are field tests providing a valid and easily accessible method of measuring function-limited exercise tolerance in patients with respiratory or cardiac chronic diseases. These walking tests are non-threatening, inexpensive, easy to perform and to understand for children. Walking tests performed in daily practice are the following: "time-based" tests (2-, 6- or 12-min walking test), 3-min step test (on a step) and the shuttle walking test. It may be a useful measure to assess therapeutic intervention and provide information on the prognosis. They are simple and safe methods to evaluate quality of life in these patients.
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Affiliation(s)
- G Pouessel
- Unité de Pneumologie et Allergologie, Clinique de Pédiatrie, Hôpital Jeanne-de-Flandre, 2, avenue Oscar-Lambret, 59037 Lille cedex, France
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Thumerelle C, Pouessel G, Errera S, Penel-Capelle D, Morillon S, Santos C, Robert Y, Deschildre A. [Radiologic manifestations of pulmonary tuberculosis]. Arch Pediatr 2005; 12 Suppl 2:S132-6. [PMID: 16129325 DOI: 10.1016/s0929-693x(05)80029-6] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Pulmonary tuberculosis is an endemic infection. Chest radiography is the mainstay in the evaluation of pulmonary tuberculosis. High resolution CT is required to detect fine lesions overlooked on chest radiographs, to define equivocal lesions, to determine disease activity in some cases and to evaluate complications or sequels. We review indications of chest radiograph and CT, the radiologic features of primary and post-primary tuberculosis, and outcome of tuberculous lesions.
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Affiliation(s)
- C Thumerelle
- Unité de pneumologie et allergologie pédiatriques, hôpital Jeanne-de-Flandre, CHRU de Lille, 59037 Lille cedex, France.
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Thumerelle C, Santos C, Morillon S, Bott L, Pouessel G, Deschildre A. Facteurs de risque de survenue des pleuropneumopathies bactériennes en pédiatrie. Arch Pediatr 2005; 12:827-9. [PMID: 15904818 DOI: 10.1016/j.arcped.2005.04.042] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Affiliation(s)
- C Thumerelle
- Unité de pneumologie, allergologie pédiatriques, hôpital Jeanne-de-Flandre, CHRU de Lille, Lille, France
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Pouessel G, Thumerelle C, Santos C, Copin MC, Deschildre A, Robert Y. Hamartochondrome pulmonaire : une cause rare de nodule pulmonaire solitaire en pédiatrie. ACTA ACUST UNITED AC 2005; 86:79-82. [PMID: 15785421 DOI: 10.1016/s0221-0363(05)81326-5] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
Solitary pulmonary nodules are rare in children. We report an eleven year-old girl evaluated for recurrent respiratory symptoms diagnosed with an intraparenchymal pulmonary hamartochondroma. Spiral computed tomography showed a pulmonary nodule in the middle lobe, 17 mm in diameter, without any specific features. In asymptomatic adult patients, guidelines for the management of solitary pulmonary nodules have been described. The management of solitary pulmonary nodules in pediatric patients is discussed.
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Affiliation(s)
- G Pouessel
- Unité de pneumologie et allergologie, clinique de pédiatrie, Hôpital Jeanne de Flandre, France
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Pouessel G, Lahoche A, Copin MC, Ythier H, Mazingue F, Foulard M. [Verocytotoxin positive haemolytic uremic syndrome and HIV-associated nephropathy]. Nephrologie 2004; 25:141-4. [PMID: 15291142] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 04/30/2023]
Abstract
UNLABELLED Haemolytic uremic syndrome (HUS) and HIV-associated nephropathy (HIVAN) are common renal diseases in the course of HIV-infected patients. CASE REPORT We report the case of a 13-month-old Caucasian boy hospitalised for a verocytotoxin positive HUS associated with HIV infection. After the acute phase of HUS the creatinine level returned to normal values. Because of progressive renal failure with severe overload hypertension and glomerular proteinuria despite antiretroviral therapy and angiotensine converting enzyme inhibitor, the child required peritoneal dialysis 12 months later. Clinical and biological course together with pathological findings were consistent with both typical HUS and HIVAN. CONCLUSION This is the first paediatric case of typical HUS revealing a HIVAN. The association of HUS and HIVAN may explain the progression to end-stage renal failure despite antiretroviral therapy associated with angiotensine converting enzyme inhibitor and a good control of HIV replication. HIVAN is rare in children and may occur in the early phase of HIV infection even not only in black patients.
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Affiliation(s)
- G Pouessel
- Unité de néphrologie pédiatrique, clinique de pédiatrie, Hôpital Jeanne de Flandre, Lille
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Pouessel G, Santos C, Thumerelle C, Neve V, Sardet A, Wizla N, Michaud L, Loeuille GA, Beghin L, Gottrand F, Matran R, Turck D, Deschildre A. [Reproducibility of the shuttle walk test in children with cystic fibrosis]. Rev Mal Respir 2003; 20:711-8. [PMID: 14631250] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/27/2023]
Abstract
INTRODUCTION Exercise testing is useful in the respiratory evaluation of patients with cystic fibrosis. The shuttle walk test (SWT) is a progressive, externally paced, exercise test requiring the subject to walk/run back and forth between two fixed points. The aim is to assess the reproductibility of the SWT in paediatric patients with cystic fibrosis. METHODS This prospective study recruited 31 children with stable disease. The patients performed two SWT one day (SWT 1 and 2) and two others (SWT 3 and 4) within 15 days. Only SWT 2 and 4 were assessed for reproducibility. RESULTS 61% were boys, median age (range): 12.9 (7-18.9) years, median Shwachman score (range): 80 (65-100), median values for FEV1 and FVC (range): 92 (55-154) and 92 (64-140)% predicted, respectively. Median distance for SWT 2-4 (range): 910 (580-1020) and 925 (540-1020) metres. Reproducibility for SWT distance and physical activity measured by an accelerometer is very good (intra-class correlation coefficient=0.90 and 0.92, respectively). SWT distance correlated with physical activity (p=3.10(-4)) and weight (p=0.03). SWT distance was independent of the following parameters: height, weight-for-age Z-score, FEV1, FVC, Shwachman score, colonisation with Pseudomonas aeruginosa. CONCLUSIONS The SWT is reproducible in paediatric patients with cystic fibrosis and provides assessment of respiratory performance that complements spirometric measures of lung function.
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Affiliation(s)
- G Pouessel
- Centre de Ressources et de Compétences pour la Mucoviscidose, Clinique de Pédiatrie, Hôpital Jeanne-de-Flandre, Lille, France
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Pouessel G, Bouarfa K, Soudan B, Sauvage J, Gottrand F, Turck D. [Iodine nutritional status and risk factors for iodine deficiency in infants and children of the french North department]. Arch Pediatr 2003; 10:96-101. [PMID: 12829349 DOI: 10.1016/s0929-693x(03)00304-x] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
INTRODUCTION Iodine deficiency is responsible for a higher mortality and morbidity in neonates and infants. It has not yet disappeared in European countries, especially in Southern and Eastern Europe. OBJECTIVES The present study aimed at evaluating the status of iodine nutrition of infants living in the North department (France) and at studying risk factors for iodine deficiency. METHODS The study was conducted in primary health care centres in 160 healthy infants aged ten days to six years (mean +/- SD: 17.7 +/- 2.5 months). Data included: familial thyroid disease history, type of feeding at inclusion, timing of introduction of complementary foods, nutritional status (weight, height, head and arm circumference), as well as maternal education level and family socio-economical status. Iodine status was assessed by urinary iodine excretion. RESULTS Urinary iodine concentration ranged from 4 to 1042 microg/l (median +/- SD: 195,5 +/- 21,6 microg/l). Thirty-eight (24%) of 160 children were iodine deficient (urinary iodine < 100 microg/l): mild iodine deficiency (50-99 microg/l: 17%), moderate iodine deficiency (20-49 microg/l: 5%), severe iodine deficiency (<20 microg/l: 2%). No relationship was found between iodine status and age, sex, geographic origin of the children, as well as social and occupational group of the parents. Breast-feeding did not prevent from iodine deficiency. Iodine status did not differ between the cow's milk fed group and the group that was not fed cow's milk. Formula feeding was associated with iodine deficiency (p = 0,02). CONCLUSIONS Prevalence of severe iodine deficiency was very low in this population. However, iodine status was not optimal.
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Affiliation(s)
- G Pouessel
- Unité de gastro-entérologie, hépatologie et nutrition, clinique de pédiatrie, hôpital Jeanne-de-Flandre, 2, avenue Oscar-Lambret, 59037 Lille cedex, France
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Noizet O, Leclerc F, Leteurtre S, Brichet A, Pouessel G, Dorkenoo A, Fourier C, Cremer R. Plastic bronchitis mimicking foreign body aspiration that needs a specific diagnostic procedure. Intensive Care Med 2003; 29:329-31. [PMID: 12594596 DOI: 10.1007/s00134-002-1610-1] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.1] [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: 01/22/2002] [Accepted: 11/13/2002] [Indexed: 10/22/2022]
Abstract
OBJECTIVE To report two children admitted to our emergency department with respiratory failure, one for status asthmaticus with pneumomediastinum and requiring mechanical ventilation and the other for high suspicion of foreign body aspiration. INTERVENTIONS Bronchoscopy revealed obstructive plugs and permitted their extraction and their identification as bronchial casts after the immersion in normal saline. Allergy was suspected in the first one, and Hemophilus influenzae infection was present in the second. The outcome was favorable. CONCLUSIONS Plastic bronchitis is an infrequent cause of acute life-threatening respiratory failure that can mimic foreign body aspiration or status asthmaticus. Bronchoscopic extraction must be performed urgently in the case of severe obstruction. This entity is probably underestimated as the casts with their specific ramifications are difficult to recognize. We recommend the immersion in normal saline of all plugs discovered in children with predisposing diseases mainly represented by infections, allergy, acute chest syndrome, and congenital cardiopathies.
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Affiliation(s)
- O Noizet
- Pediatric Intensive Care Unit, University Hospital of Lille, 59037 Lille, France
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Thumerelle C, Santos C, Penel-Capelle D, Pouessel G, Deschildre A. [Inhaled corticosteroids in asthma in infants and young children]. Arch Pediatr 2002; 9 Suppl 3:390s-395s. [PMID: 12205814 DOI: 10.1016/s0929-693x(02)00149-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
Inhaled corticosteroids have become the mainstain in the treatment of asthmatic children and adults. Asthma in infancy and early childhood is a heterogeneous condition, with different disease phenotypes and outcome. However, rationale data justifying the use of inhaled corticosteroids in toddlers and preschool children are now available. We recall the results of controlled trials studying the efficacy of inhaled corticosteroids, their potential side-effects, and their actual indications and modalities of prescription.
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Affiliation(s)
- C Thumerelle
- Unité de pneumologie pédiatrique, hôpital Jeanne de Flandre, CHRU de Lille, 59037 Lille, France
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Fitzgerald JP, Troncone R, Pouessel G, Michaud L, Guimber D, Turck D. Clinical quiz. Prepyloric heterotopic pancreas. J Pediatr Gastroenterol Nutr 2001; 33:476, 487. [PMID: 11930872 DOI: 10.1097/00005176-200110000-00011] [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: 12/10/2022]
Affiliation(s)
- J P Fitzgerald
- Division of Gastroenterology, Hepatology and Nutrition, Department of Pediatrics, Lille University Children's Hospital, France
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Pouessel G, Michaud L, Pierre MH, Guimber D, Sfeir R, Robert Y, Gottrand F, Turck D. [Endoscopic diagnosis of a gastric heterotopic pancreas and esophageal atresia: an incidental association?]. Arch Pediatr 2001; 8:181-5. [PMID: 11232460 DOI: 10.1016/s0929-693x(00)00182-2] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
UNLABELLED Heterotopic or aberrant pancreas is a rare congenital anomaly, usually asymptomatic. The preoperative diagnosis is difficult but most cases of gastric ectopic pancreas have a unique appearance that often makes possible a diagnosis in the absence of histologic confirmation. A well-delineated submucosal, firm mass with central umbilication is characteristic of gastric ectopic pancreas. To the best of our knowledge, the association of esophageal atresia and gastric heterotopic pancreas has never been reported previously. CASE REPORTS We report two cases of heterotropic pancreas associated with esophageal atresia. Both diagnoses were incidental findings and concerned children operated on at birth for esophageal atresia. Although a definitive diagnosis is histologic, the endoscopic appearance made it possible to maintain this diagnosis. CONCLUSION Some symptoms have been attributed to ectopic pancreas, and malignant degeneration has been reported in adults. Management continues to be debated: some authors recommend surgical resection while others, as we do, prefer initial therapeutic abstention.
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Affiliation(s)
- G Pouessel
- Unité de gastroentérologie, hépatologie et nutrition, clinique de pédiatrie, hôpital Jeanne-de-Flandre, 2, avenue Oscar-Lambret, 59037 Lille, France
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