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Arnoux A, Bailhache M, Tetard C, Rebouissoux L, Clouzeau H, Lamireau T, Enaud R. Proton pump inhibitors are still overprescribed for hospitalized children. Arch Pediatr 2022; 29:258-262. [PMID: 35304031 DOI: 10.1016/j.arcped.2022.02.004] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [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: 08/23/2021] [Revised: 12/17/2021] [Accepted: 02/20/2022] [Indexed: 12/22/2022]
Abstract
OBJECTIVE The use of proton pump inhibitors has increased exponentially over the past 20 years. Several side effects have been reported and concerns exist about the consequences of long-term proton pump inhibitors on health, leading to limitation of their use. The present study analyzed prescriptions of proton pump inhibitors at inpatient units and assessed their compliance with current recommendations. METHODS This single-center, observational, retrospective study reviewed medical file of patients hospitalized at the pediatric medical departments of the Bordeaux University Hospital between April 1 and September 30, 2019. Patients younger than 18 years, hospitalized in the pediatric hospital units and treated with proton pump inhibitors were included. Prescriptions of proton pump inhibitors were compared with French and international guidelines. RESULTS Proton pump inhibitors were prescribed for 251 of 2237 children (11%), mainly for gastroesophageal reflux disease (47%) and prevention of peptic ulcer disease (32.7%). Proton pump inhibitor prescription complied to recommendations in 34.5% of cases, less often in children aged younger than 1 year (13.5%) than in older children. Compliance to recommendations was lower when proton pump inhibitors were indicated for the prevention of peptic disease (5%) than for gastroesophageal reflux disease (48%). CONCLUSIONS Proton pump inhibitors are frequently prescribed for hospitalized children, and indications comply with recommendations in only 35% of the cases. Efforts in spreading awareness of the recommendations on the use of proton pump inhibitors in children are mandatory among hospital pediatricians.
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Affiliation(s)
- A Arnoux
- Bordeaux University Hospital, Pediatric department, Pediatric Gastroenterology Unit, France
| | - M Bailhache
- Bordeaux University Hospital, Pediatric department, Pediatric Emergency Unit, France
| | - C Tetard
- Bordeaux University Hospital, Pediatric department, Pediatric Gastroenterology Unit, France
| | - L Rebouissoux
- Bordeaux University Hospital, Pediatric department, Pediatric Gastroenterology Unit, France
| | - H Clouzeau
- Bordeaux University Hospital, Pediatric department, Pediatric Gastroenterology Unit, France
| | - T Lamireau
- Bordeaux University Hospital, Pediatric department, Pediatric Gastroenterology Unit, France
| | - R Enaud
- Bordeaux University Hospital, Pediatric department, Pediatric Gastroenterology Unit, France.
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Tetard C, Mittaine M, Beaufils F, Bui S, Clouzeau H, Galodé F, Collet C, Fayon M, Lamireau T, Burgel PR, Delhaes L, Mas E, Enaud R. WS03.4 Lumacaftor/ivacaftor improves the intestinal inflammation in children with cystic fibrosis. J Cyst Fibros 2020. [DOI: 10.1016/s1569-1993(20)30180-6] [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: 10/24/2022]
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3
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Kadi H, Lamireau D, Bouncer H, Madhkour I, Madden I, Enaud R, Renesme L, Lamireau T. Satisfaction of mothers regarding human milk donation. Arch Pediatr 2020; 27:202-205. [PMID: 32278587 DOI: 10.1016/j.arcped.2020.03.005] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [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: 03/13/2018] [Revised: 02/14/2020] [Accepted: 03/28/2020] [Indexed: 11/25/2022]
Abstract
In France, human milk banks are in charge of the collection, analysis, processing, and distribution of human milk to neonatology centers for preterm infants. Knowledge of what motivates mothers to donate their milk could lead to better communication regarding human milk donation. A satisfaction survey was conducted among mothers who were donating their milk to a human milk bank. In total, 214 mothers answered a questionnaire in the presence of the collector during a home visit. The median age of the mothers was 31 years (18-46), mainly high school (19%) or university (65%) graduates, and the median duration of donation was 3 months (0.5-22). At the time of the study, the median age of infants was 3 months (0.5-25), and 88% of infants were exclusively breastfed. About three quarters of mothers were motivated by willingness to help others, a quarter of them being especially sensitive to premature neonatal care; 30% of mothers were motivated by having a high supply of milk. Around 25% of mothers were given information on human milk donation during pregnancy, and two thirds after delivery, mainly by the maternity ward midwives (53.4%) or by collectors during their visit (14.1%). Most mothers (72%) found the human milk donation process easy and most of them (92.5%) were willing to donate their milk again after their next pregnancy. This survey shows that more than 90% of mothers are satisfied with donation to human milk banks. However, efforts should be made to provide information on breastfeeding and human milk donation to the general population and health professionals.
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Affiliation(s)
- H Kadi
- Lactarium de Bordeaux et Marmande, CHU de Bordeaux, 3306 Bordeaux cedex, France; Laboratoire alimentation, nutrition et santé, institut de nutrition, d'alimentation et technologies agro-alimentaires, université Frères Mentouri, Constantine, Algeria
| | - D Lamireau
- Lactarium de Bordeaux et Marmande, CHU de Bordeaux, 3306 Bordeaux cedex, France.
| | - H Bouncer
- Faculté des sciences médicales, université Hadj-Lakhdar, Batna, Algeria
| | - I Madhkour
- Laboratoire alimentation, nutrition et santé, institut de nutrition, d'alimentation et technologies agro-alimentaires, université Frères Mentouri, Constantine, Algeria
| | - I Madden
- Unité de gastroentérologie et nutrition pédiatriques, hôpital des Enfants, CHU de Bordeaux, 3306 Bordeaux cedex, France
| | - R Enaud
- Unité de gastroentérologie et nutrition pédiatriques, hôpital des Enfants, CHU de Bordeaux, 3306 Bordeaux cedex, France
| | - L Renesme
- Unité de néonatalogie, maternité Hôpital Pellegrin, CHU de Bordeaux, 3306 Bordeaux cedex, France
| | - T Lamireau
- Unité de gastroentérologie et nutrition pédiatriques, hôpital des Enfants, CHU de Bordeaux, 3306 Bordeaux cedex, France
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Poupon P, Foussard N, Helmer C, Cougnard-Gregoire A, Rajaobelina K, Delcourt C, Lamireau T, Haissaguerre M, Blanco L, Alexandre L, Mohammedi K, Rigalleau V. Serum fructosamine predicts macrosomia in well-controlled hyperglycaemic pregnant women: An observational cross-sectional study. Diabetes Metab 2019; 46:219-222. [PMID: 31325500 DOI: 10.1016/j.diabet.2019.07.003] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/27/2019] [Revised: 06/29/2019] [Accepted: 07/07/2019] [Indexed: 11/18/2022]
Abstract
AIM While serum fructosamine may be a good marker of glucose control in pregnant women with diabetes, its relationship with macrosomia is still uncertain. METHODS In 130 hyperglycaemic women with singleton pregnancies (117 gestational diabetes mellitus, 13 pregestational diabetes), serum fructosamine and HbA1c levels were measured at 25±7 weeks of gestation. Levels in mothers of infants with and without macrosomic newborns (birth weight>4000g and/or large-for-gestational-age birth weight>90th percentile) were compared using logistic regression analysis adjusted for macrosomia risk factors. RESULTS These 130 pregnant women were 33±5 years old; their BMI before pregnancy was 27.7±6.9kg/m2, and they gained 7.5±5.1kg during the first 6 months of gestation. Glucose control was good according to HbA1c levels (5.3±0.3%; 34±2mmol/mol), yet 17/130 (13%) newborns had macrosomia: 3900±227g vs 3057±512g (P<0.001) in the others. These mothers were older and had higher parity, whereas their BMI scores before pregnancy and gestational weight gains did not differ. Fructosamine levels were also higher at 221±40μmol/L vs 192±22μmol/l (P<0.001), respectively, and remained significant even after adjusting for maternal age, BMI, parity, type of diabetes, antecedents of macrosomia and excessive gestational weight gain. By contrast, HbA1c did not differ between the two groups. In fact, nearly two-thirds (64.7%) of the mothers of macrosomic newborns had fructosamine levels>200μmol/l vs 31.9% of mothers with non-macrosomic newborns (P<0.05). CONCLUSION High fructosamine levels are associated with macrosomia in the newborns of well-controlled hyperglycaemic pregnant women.
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Affiliation(s)
- P Poupon
- Nutrition-Diabetology, hôpital Haut-Lévêque, CHU de Bordeaux, 1, avenue de Magellan, F-33600 Pessac, France
| | - N Foussard
- Nutrition-Diabetology, hôpital Haut-Lévêque, CHU de Bordeaux, 1, avenue de Magellan, F-33600 Pessac, France
| | - C Helmer
- Inserm U1219, Bordeaux Population Health Research Centre, F-33000 Bordeaux, France
| | - A Cougnard-Gregoire
- Inserm U1219, Bordeaux Population Health Research Centre, F-33000 Bordeaux, France
| | - K Rajaobelina
- Inserm U1219, Bordeaux Population Health Research Centre, F-33000 Bordeaux, France
| | - C Delcourt
- Inserm U1219, Bordeaux Population Health Research Centre, F-33000 Bordeaux, France
| | - T Lamireau
- Inserm U1219, Bordeaux Population Health Research Centre, F-33000 Bordeaux, France
| | - M Haissaguerre
- Nutrition-Diabetology, hôpital Haut-Lévêque, CHU de Bordeaux, 1, avenue de Magellan, F-33600 Pessac, France
| | - L Blanco
- Nutrition-Diabetology, hôpital Haut-Lévêque, CHU de Bordeaux, 1, avenue de Magellan, F-33600 Pessac, France
| | - L Alexandre
- Nutrition-Diabetology, hôpital Haut-Lévêque, CHU de Bordeaux, 1, avenue de Magellan, F-33600 Pessac, France
| | - K Mohammedi
- Nutrition-Diabetology, hôpital Haut-Lévêque, CHU de Bordeaux, 1, avenue de Magellan, F-33600 Pessac, France; Inserm U1219, Bordeaux Population Health Research Centre, F-33000 Bordeaux, France
| | - V Rigalleau
- Nutrition-Diabetology, hôpital Haut-Lévêque, CHU de Bordeaux, 1, avenue de Magellan, F-33600 Pessac, France; Inserm U1219, Bordeaux Population Health Research Centre, F-33000 Bordeaux, France.
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5
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Zaghet O, Enaud R, Clouzeau H, Rebouissoux L, Lamireau T. Évaluation de l’état nutritionnel chez l’enfant polyhandicapé (étude Polynut). NUTR CLIN METAB 2019. [DOI: 10.1016/j.nupar.2019.01.317] [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: 11/24/2022]
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6
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Celton G, Flurin V, Renesme L, Lamireau T, Enaud R, Clouzeau H. Devenir des enfants suivis pour trouble de l’oralité : aspects comportementaux et nutritionnels. NUTR CLIN METAB 2018. [DOI: 10.1016/j.nupar.2018.09.176] [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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Léonard M, Caldari D, Mas E, Lambe C, Compte A, Ley D, Peretti N, Borderon C, Marinier E, Coste ME, Lamireau T, Rubio A, Turquet A, Dubern B, Dabadie A, Gautry J, Kyheng M, Guimber D, Gottrand F. Experience of using a semi-elemental formula for home enteral nutrition in children: a french multicenter study. Clin Nutr 2018. [DOI: 10.1016/j.clnu.2018.06.2088] [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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8
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Belleau C, Nacka F, Clouzeau H, Bui S, Enaud R, Fayon M, Lamireau T. Mesure des produits avancés de glycation (AGE) chez l’enfant mucoviscidosique. NUTR CLIN METAB 2017. [DOI: 10.1016/j.nupar.2016.10.015] [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: 11/30/2022]
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Cardey J, Le Gall C, Michaud L, Dabadie A, Talbotec C, Bellaiche M, Lamireau T, Mas E, Lachaux A. La vidéocapsule oesophagienne : une méthode non invasive et fiable pour le diagnostic et la surveillance des varices oesophagiennes chez l’enfant. Arch Pediatr 2016. [DOI: 10.1016/j.arcped.2016.02.037] [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: 12/01/2022]
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Blasquez A, Clouzeau H, Fayon M, Mouton JB, Thambo JB, Enaud R, Lamireau T. Evaluation of nutritional status and support in children with congenital heart disease. Eur J Clin Nutr 2015; 70:528-31. [DOI: 10.1038/ejcn.2015.209] [Citation(s) in RCA: 46] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2014] [Revised: 10/20/2015] [Accepted: 11/01/2015] [Indexed: 11/09/2022]
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11
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Belleau C, Nacka F, Clouzeau H, Bui S, Enaud R, Fayon M, Lamireau T. CO-13 – Mesure des produits avancés de glycation (AGE) chez l'enfant mucoviscidosique. Arch Pediatr 2015. [DOI: 10.1016/s0929-693x(15)30116-0] [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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12
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Gerbaud-Morlaes L, Frison E, Babre F, De Luca A, Didler A, Borde M, Zaghet B, Batoz H, Semjen F, Nouette-Gaulain K, Hankard R, Lamireau T. CO-04 – Dénutrition chez l'enfant en préopératoire: fréquence et facteurs de risque. Arch Pediatr 2015. [DOI: 10.1016/s0929-693x(15)30108-1] [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: 11/26/2022]
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13
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Delteil AL, Sarlangue J, Lamireau T. [Anti-rotavirus vaccination: what impedes its wide prescription]. Arch Pediatr 2014; 21:1200-5. [PMID: 25267194 DOI: 10.1016/j.arcped.2014.08.015] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2014] [Revised: 06/26/2014] [Accepted: 08/06/2014] [Indexed: 10/24/2022]
Abstract
UNLABELLED The aim of this study was to analyze why anti-rotavirus vaccination is rarely used in France, although this infection is frequent and associated with a large number of hospitalizations. METHOD A questionnaire was sent to 732 general practitioners and pediatricians in the Bordeaux area. RESULTS The response rate was 57% (381 GPs and 38 pediatricians). Most of them (71.8%) declared that they received information on the vaccination and more than 80% of them feel that gastroenteritis is a severe disease. However, anti-rotavirus is never prescribed by the majority of them (59.6%) and only 2.6% prescribe it systematically. The reasons are that the patient is not refunded (64.2%), the vaccination timetable is overloaded (53.6%), and there are no recommendations for this vaccination (35.1%). Physicians believe that parents feel gastroenteritis as a benign disease (52.6%) and say that they refuse the vaccination because it is not refunded (77.7%), not mandatory (45.5%), or may have side effects (44.1%). Physicians' prescription of vaccination is correlated to their information on the vaccination and their feeling about the disease's severity. They would modify their practice if the vaccination was recommended and/or refunded. CONCLUSION The main obstacles against anti-rotavirus vaccination are the absence of recommendations and refunding. The recent recommendation for the vaccination and a lower price should lead to its generalization in France.
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Affiliation(s)
- A-L Delteil
- Unité de gastroentérologie et nutrition pédiatriques, hôpital des Enfants, place Amélie-Raba-Léon, 33076 Bordeaux cedex, France
| | - J Sarlangue
- Unité de néonatologie, hôpital des Enfants, place Amélie-Raba-Léon, 33076 Bordeaux cedex, France
| | - T Lamireau
- Unité de gastroentérologie et nutrition pédiatriques, hôpital des Enfants, place Amélie-Raba-Léon, 33076 Bordeaux cedex, France.
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Schneider A, Gottrand F, Bellaiche M, Becmeur F, Lachaux A, Michel J, Dabadie A, Faure C, Philippe P, Vandenplas Y, Breton A, Dupont C, Gaudin J, Lamireau T, Muyshont L, Podevin G, Viola S, Bertrand V, Caldari D, Colinet S, Sokal E, Leteurtre E, Michaud L. SFCP CO-18 - Prévalence de l’œsophage de Barrett dans l’atrésie de l’œsophage. Arch Pediatr 2014. [DOI: 10.1016/s0929-693x(14)71656-2] [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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15
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Kadi H, Lamireau D, Lamireau T. SFP P-084 – Enquête sur la motivation des mères donneuses de lait maternel. Arch Pediatr 2014. [DOI: 10.1016/s0929-693x(14)72054-8] [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: 11/30/2022]
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16
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Gallineau A, Dousseau A, Gobet A, Elleau C, Rigalleau V, Lamireau T. SFP PC-13 - Mesure des produits avancés de glycation (AGE) cutanés par autofluorescence chez le nouveau-né. Arch Pediatr 2014. [DOI: 10.1016/s0929-693x(14)72163-3] [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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Kadi H, Lamireau D, Lamireau T. P046 Enquête sur la motivation des mères donneuses de lait maternel. NUTR CLIN METAB 2013. [DOI: 10.1016/s0985-0562(13)70378-9] [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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Menet D, Lamireau T. [A survey of milk reintroduction in children with cow milk protein allergy in pediatric departments of French hospitals]. Arch Pediatr 2013; 20:1206-1211. [PMID: 24080040 DOI: 10.1016/j.arcped.2013.08.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2013] [Revised: 07/03/2013] [Accepted: 08/22/2013] [Indexed: 11/16/2022]
Abstract
The outcome of cow milk allergy (CMA) usually progresses to acquisition of tolerance, allowing a normal diet. This study conducted in France aimed to survey practices of milk reintroduction after an exclusion diet. A questionnaire was sent to 278 pediatric centers, exploring the reintroduction procedure in the 3 main types of CMA and in patients with persistent allergy. The response rate was 27%, 53% for tertiary centers and 23% for secondary centers. Cow's milk is reintroduced at a median age of 12months, and after 6months of exclusion diet whatever the type of allergy. In about half the centers, Prick-Tests and specific IgE are tested before milk reintroduction, but the procedure in case of a positive test differs between centers. Procedures are similar regarding the type of milk, the quantity, the place (home or hospital), the presence of an intravenous line, and the time before a second reintroduction. A desensitization procedure is proposed in 43% of centers in case of persistent allergy, after 2 reintroduction failures, and at a median age of 2.5years. Milk reintroduction procedures are similar to those for oral challenge for the diagnosis of CMA but with differences between centers.
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Affiliation(s)
- D Menet
- Gastro-entérologie et nutrition pédiatriques, hôpital des Enfants, CHU de Bordeaux, place Amélie-Raba-Léon, 33076 Bordeaux cedex, France
| | - T Lamireau
- Gastro-entérologie et nutrition pédiatriques, hôpital des Enfants, CHU de Bordeaux, place Amélie-Raba-Léon, 33076 Bordeaux cedex, France; Inserm U897 ISPED, unité d'épidémiologie de la nutrition, université Bordeaux 2, 33077 Bordeaux, France.
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Clouzeau H, de Lédinghen V, Bui S, Fayon M, Foucher J, Lamireau T. Suivi longitudinal de la mesure d’élasticité hépatique par Fibroscan® chez les enfants atteints de mucoviscidose. Arch Pediatr 2013. [DOI: 10.1016/j.arcped.2013.02.044] [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: 10/26/2022]
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Missmahl C, Salinier C, Maurice-Tison S, Lamireau T. P045 Impact de l’Initiative Hôpital Ami des Bébés sur l’allaitement maternel : comparaison de trois maternités. NUTR CLIN METAB 2011. [DOI: 10.1016/s0985-0562(11)70112-1] [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: 11/29/2022]
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21
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Lamireau T. [Celiac disease.]. Pathol Biol (Paris) 2011:S0369-8114(11)00088-5. [PMID: 21733641 DOI: 10.1016/j.patbio.2011.05.005] [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] [Subscribe] [Scholar Register] [Received: 05/02/2011] [Accepted: 05/25/2011] [Indexed: 05/31/2023]
Affiliation(s)
- T Lamireau
- Unité de gastroentérologie pédiatrique, hôpital des Enfants, place Amélie-Raba-Léon, 33076 Bordeaux, cedex, France.
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22
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Abstract
Celiac disease is an autoimmune disorder induced by gluten in genetically susceptible individuals. Patients may present with typical symptoms of enteropathy with diarrhoea and failure to thrive, but atypical symptoms, or even silent forms are more often recognized since serologic markers are available. This progress led to the increase of the incidence of the celiac disease during the last 30 years, which reflect probably the improvement in diagnosing atypical forms of the disease. The prevalence is comparable from a country to another, around 0,7 to 2%. There is a progression with time from latent to silent form, and then to the active disease. The exclusion of the gluten from the diet leads to the regression from the active to the latent form of the disease.
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Affiliation(s)
- T Lamireau
- Unité de gastroentérologie pédiatrique, hôpital des Enfants, place Amélie-Raba-Léon, 33076 Bordeaux cedex, France.
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Lapeyre D, Gottrand F, Debray D, Bridoux L, Lachaux A, Morali A, Lamireau T. CL141 - Traitement de la maladie de Wilson par le zinc. Arch Pediatr 2010. [DOI: 10.1016/s0929-693x(10)70362-6] [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: 11/17/2022]
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Lavrand F, Notz A, Bouty A, Bessou P, Rullier A, Lamireau T. P249 - Fetus in Fetu : une étiologie rare de tumeur chez l’enfant. Arch Pediatr 2010. [DOI: 10.1016/s0929-693x(10)70647-3] [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: 11/15/2022]
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Affiliation(s)
- L Harper
- CHU Bordeaux, Department of Pediatric Surgery, Place Amélie Raba-Léon, Bordeaux, France.
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26
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Kalach N, Bontems P, Koletzko S, Mourad-Baars P, Shcherbakov P, Celinska-Cedro D, Iwanczak B, Gottrand F, Martinez-Gómez M, Pehlivanoglu E, Oderda G, Urruzuno P, Casswall T, Lamireau T, Sykora J, Roma E, Veres G, Wewer V, Charkaluk M, Mégraud F, Cadranel S. SFP-11 – Hépatologie, gastro-entérologie et nutrition – Etude prospective multicentrique européenne pilote sur l’ulcère peptique ou les érosions gastroduodénales chez l’enfant. Arch Pediatr 2008. [DOI: 10.1016/s0929-693x(08)72079-7] [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: 10/21/2022]
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Englender M, Lavrand F, Rebouissoux L, Clouzeau H, Le Bail B, Lamireau T. SFP-P159 – Hépatologie, gastro-entérologie et nutrition – Résultats de la chirurgie transanale dans la maladie de Hirschsprung. Arch Pediatr 2008. [DOI: 10.1016/s0929-693x(08)72289-9] [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: 11/27/2022]
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Firah N, Aladjidi N, Elleau C, Lamireau T, Flurin V, Gavilan I, Lafon M, Pietrera P, Picard C, Senechal B, Grangeot-Keros L, Perel Y. SFP-P177 – Pathologie infectieuse – A propos d’une observation de rubéole congénitale : évolution clinique et immuno-virologique sur 3 ans. Arch Pediatr 2008. [DOI: 10.1016/s0929-693x(08)72306-6] [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: 11/30/2022]
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Masse G, Choukroun M, Fayon M, Rebouissoux L, Bui S, Clouzeau H, Lamireau T. SFP-P158 – Hépatologie, gastro-entérologie et nutrition – Diffusion membranaire et volume capillaire pulmonaire dans la maladie de Crohn. Arch Pediatr 2008. [DOI: 10.1016/s0929-693x(08)72288-7] [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: 10/21/2022]
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Olives JP, Tounian P, Lamireau T. La vaccination rotavirus en France : position du groupe francophone d'hépatologie, gastroentérologie et nutrition pédiatriques. Arch Pediatr 2007; 14 Suppl 3:S194-6. [DOI: 10.1016/s0929-693x(07)80027-3] [Citation(s) in RCA: 5] [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] [Indexed: 11/25/2022]
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Lamireau T, Martin S, Lallier M, Marcotte JE, Alvarez F. Liver transplantation for cirrhosis in cystic fibrosis. Canadian Journal of Gastroenterology 2006; 20:475-8. [PMID: 16858500 PMCID: PMC2659915 DOI: 10.1155/2006/539345] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/24/2023]
Abstract
BACKGROUND Liver disease is the third most common cause of death in children with cystic fibrosis (CF). Liver transplantation is an effective treatment in children with hepatic failure. AIMS The objective of the present study was to review the indications and postoperative course of hepatic transplantation in a cystic fibrosis population. PATIENTS Five children with CF, at a mean age of 16.5 years, underwent liver transplantation. RESULTS All patients showed cirrhosis, portal hypertension and hepatic failure. The main postoperative complication was ascites refractory to treatment in two patients. No significant deterioration of the pulmonary function was noted. Two patients died, one of Hodgkin lymphoma and the other of progressive pulmonary failure. CONCLUSION Liver transplantation was indicated in children with CF when hepatic failure and/or severe portal hypertension was present with well-preserved pulmonary function.
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Affiliation(s)
- T Lamireau
- Division of Pediatric Gastroenterology, Hôpital Sainte-Justine, Montreal, Quebec
| | - S Martin
- Division of Pediatric Gastroenterology, Hôpital Sainte-Justine, Montreal, Quebec
| | - M Lallier
- Division of Pulmonology, Hôpital Sainte-Justine, Montreal, Quebec
| | - JE Marcotte
- Division of Surgery, Hôpital Sainte-Justine, Montreal, Quebec
| | - F Alvarez
- Division of Pediatric Gastroenterology, Hôpital Sainte-Justine, Montreal, Quebec
- Correspondence: Dr Fernando Alvarez, Division of Pediatric Gastroenterology, Hôpital Sainte-Justine, 3175 chemin de la Côte Sainte-Catherine, Montreal, Quebec H3T 1C5. Telephone 514-345-4931, fax 514-345-4999, e-mail
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Le Bail B, De Lédinghen V, Bioulac-Sage P, Lamireau T. Évaluation de la fibrose hépatique chez l’enfant : la biopsie sera t-elle supplantée ? Ann Pathol 2006. [DOI: 10.1016/s0242-6498(06)78425-5] [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: 10/22/2022]
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Lamireau T, Le Bail B, Rebouissoux L, Foucher J, Castéra L, Darriet M, De Lédinghen V. CA12 - Le fibroscan® permet le diagnostic non-invasif de la fibrose hépatique chez l’enfant : comparaison prospective avec le fibrotest et la ponction-biopsie hépatique. ACTA ACUST UNITED AC 2005. [DOI: 10.1016/s0399-8320(05)86409-7] [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] [Indexed: 10/22/2022]
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David-Henriau L, Bui S, Molinari I, Montaudon D, Lamireau T. [Fecal elastase-1: a useful test in pediatric practice]. Arch Pediatr 2005; 12:1221-5. [PMID: 16051075 DOI: 10.1016/j.arcped.2005.02.016] [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] [Received: 10/18/2004] [Accepted: 02/11/2005] [Indexed: 11/30/2022]
Abstract
AIM To study fecal elastase-1 (E1F) and chymotrypsin (ChT) in stools for the diagnosis of pancreatic insufficiency in pediatric practice. MATERIALS AND METHODS E1F and ChT were measured in stools of 198 children divided in 3 groups: 49 children without any digestive disease (group A), 71 children with pancreatic diseases (group B), and 78 children with non-pancreatic digestive diseases (group C). RESULTS In group B, E1F values were very low in 64 children and normal in 7 children without pancreatic insufficiency (6 children with cystic fibrosis and 1 with chronic pancreatitis). ChT values were normal in children without pancreatic insufficiency but also in half of children treated with pancreatic enzymes. Decreased E1F values were seen in 2 children (4%) in the group A and 22 children (28%) in the group C, especially those with acute gastroenteritis or celiac disease. CONCLUSION E1F is a simple, non-invasive, useful tool for the diagnosis of pancreatic insufficiency in children with growth failure or chronic diarrhea, and those with cystic fibrosis. Nevertheless, low values may be found in diseases with villous atrophy or very liquid stools.
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Affiliation(s)
- L David-Henriau
- Unité de gastroentérologie pédiatrique, département de pédiatrie, centre hospitalier Pellegrin, CHU de Bordeaux, place Amélie-Raba-Léon, 33076, Bordeaux cedex, France
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Rebouissoux L, Ramirez del Villar S, Brun M, Fayon M, Lamireau T. Intra-rachidian disorders: two unusual cases of recurrent abdominal pain in children. Acta Paediatr 2003; 92:395-7. [PMID: 12725559 DOI: 10.1080/08035250310009365] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/02/2023]
Abstract
UNLABELLED Recurrent abdominal pain (RAP) is generally thought to be of psychological origin but organic aetiologies are increasingly being identified. The cases of two children with vertebral disorders revealed by recurrent abdominal pain are reported. A 14-y-old girl presented with RAP associated with scoliosis, due to a T8-T9 intra-dural extra-medullary tumour. A 7-y-old girl who suffered from nocturnal RAP located in the right iliac fossa for 1 y had decreased muscular strength, pyramidal signs, and a 10 degree Lassègue sign in the right lower limb, revealing a vascular malformation extending from T12 to L2. CONCLUSION Atypical pain and associated neurological signs or scoliosis must raise the possibility of intra-rachidian disorders. Magnetic resonance examination will then precisely state the location and nature of the pathological process, avoiding excessive delay in therapeutic management.
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Affiliation(s)
- L Rebouissoux
- Unité de Gastroentérologie Pédiatrique, Hôpital Pellegrin-Enfants, Bordeaux, France
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Tourneux P, Morales P, Lamouliatte H, Le Mahn C, Lamireau T. [Radiological quiz of the month: intramural pseudodiverticulosis of the esophagus in a child presenting with dysphagia]. Arch Pediatr 2003; 10:545-7. [PMID: 12915021 DOI: 10.1016/s0929-693x(03)00172-6] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Affiliation(s)
- P Tourneux
- Département de pédiatrie médicale, hôpital des enfants, place Amélie-Raba-Léon, 33076 Bordeaux cedex, France
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Lamireau T, Monnereau S, Martin S, Marcotte J, Alvarez F. CO26 Pédiatrie générale et spécialisée Epidemiologie de l'atteinte hepatique au cours de la mucoviscidose: Etude longitudinale. Arch Pediatr 2003. [DOI: 10.1016/s0929-693x(03)90492-1] [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: 11/29/2022]
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Abstract
UNLABELLED Crohn's disease may exceptionally be revealed by recurrent pancreatitis. CASE REPORT A 12-year-old boy presented with recurrent pancreatitis without recognized etiology. At the fourth episode, abdominal pain and abscess of the anus led to the diagnostic of Crohn's disease. Corticotherapy was successful on pancreatic and intestinal manifestations. CONCLUSION Recurrent pancreatitis may reveal Crohn's disease. Endoscopic examination of the duodenum and the colon is recommended in patients with recurrent pancreatitis and negative etiologic investigations.
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Affiliation(s)
- G Barba
- Unité de gastroentérologie pédiatrique, hôpital des Enfants, place Amélie-Raba-Léon, 33076 Bordeaux, France
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Abstract
Hepatic fibrosis is a scaring process leading to cirrhosis, a major complication of numerous chronic liver diseases. Hepatic stellate cells play a central role in the fibrotic process. After parenchymal or biliary injury, cytokines and growth factors allow the recruitment, proliferation, and activation, of stellate cells toward myofibroblasts, which secrete the extracellular matrix. Fibrosis, resulting from the failure of the balance between synthesis and degradation of extracellular matrix, is an evolutive and potentially reversible process. Histological examination is the main investigation to quantify fibrosis. Serological tests are warranted to allow a non invasive follow up of patients. Development of antifibrotic therapies should soon permit to slow down the evolution toward cirrhosis, limiting the needs for hepatic transplantation.
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Affiliation(s)
- T Lamireau
- Groupe de recherches pour l'étude du foie, Inserm E9917, université Victor-Segalen, département de pédiatrie, hôpital Pellegrin, Bordeaux, France.
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Lamireau T, Llanas B, Kennedy A, Fayon M, Penouil F, Favarell-Garrigues JC, Demarquez JL. Epidemiology of poisoning in children: a 7-year survey in a paediatric emergency care unit. Eur J Emerg Med 2002; 9:9-14. [PMID: 11989508 DOI: 10.1097/00063110-200203000-00004] [Citation(s) in RCA: 66] [Impact Index Per Article: 3.0] [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: 11/26/2022]
Abstract
Acute poisoning in children is still a major public health problem, and represents a frequent cause of admission in emergency departments. We carried out an epidemiological study of poisonings leading to admission to a paediatric emergency care unit (PECU). We analysed data from 2988 children who were admitted to the PECU of Bordeaux, France with acute poisoning from 1989 through 1995. During the 7-year period, the poison exposure numbers decreased slightly from 490 to 382 (6% vs. 3% of total medical emergencies). This represented a mean annual incidence of 1.4 poison exposures per 1000 children younger than 18 years of age and living in Bordeaux and its surroundings. Characteristics of the study population, circumstances of poisoning and substances involved were similar to those previously described. Eighty per cent of children were younger than 5 years of age, presented with a benign course. Forty per cent were not treated and 75% were discharged home either immediately or within 24 hours of admission. Only 1.5% of cases, mainly adolescent girls who attempted suicide, were admitted to a paediatric intensive care unit. Overall mortality rate was 0.33/1000. In children, most cases of acute poisoning are accidental, benign, and mainly attributed to the ingestion of a non-toxic substance. This points to the need for better information of the population on availability of poison control centre calling facilities, in order to decrease the number of admissions to the PECU. Patients suspected of having ingested a potentially dangerous substance can be managed in short-stay observation units, thus avoiding unnecessarily prolonged hospitalization. Acute poisoning in children remains a frequent problem, highlighting the need to develop an education programme on primary prevention in our region.
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Affiliation(s)
- T Lamireau
- Paediatric Emergency Care Unit, Children's Hospital, Bordeaux, France
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Bahuau M, Pelet A, Vidaud D, Lamireau T, LeBail B, Munnich A, Vidaud M, Lyonnet S, Lacombe D. GDNF as a candidate modifier in a type 1 neurofibromatosis (NF1) enteric phenotype. J Med Genet 2001; 38:638-43. [PMID: 11565554 PMCID: PMC1734932 DOI: 10.1136/jmg.38.9.638] [Citation(s) in RCA: 17] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Abstract
BACKGROUND Patients who have experienced severe caustic injury to the gastrointestinal tract are at high risk of esophageal strictures. Early endoscopy is usually recommended systematically in children after caustic ingestion to assess the severity of the initial digestive lesions. The aim of this study was to determine the predictive value of clinical symptoms and ingested-substance types as markers of severe esophagogastric lesions and to define indications for endoscopy. METHODS Ingested-product types, clinical symptoms, endoscopic data and outcome were prospectively recorded in 85 children admitted after accidental caustic ingestion. RESULTS Forty-eight children (57%) had no symptoms; the others presented with vomiting, hematemesis, drooling, respiratory distress, and/or oropharyngeal lesions. Endoscopy showed no or minimal lesions in 63 cases (74%). None of the children developed digestive sequelae. Severe esophagogastric lesions were present in 22 cases (26%), mostly caused by lye ingestion (14 of 22) but also by strong acids (4 of 22); 9 of the 22 children (41%) developed esophageal stenosis. Vomiting, drooling, and oropharyngeal lesions did not predict severe endoscopic lesions. Hematemesis, respiratory distress, or presence of at least three of the symptoms was associated with severe lesions (positive predictive value = 1). The absence of symptoms was always associated with no or minimal lesions (negative predictive value = 1). CONCLUSIONS In conclusion, endoscopy is not recommended for children living in developed countries who are asymptomatic after accidental caustic ingestion.
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Affiliation(s)
- T Lamireau
- Pediatric Emergency Care Unit, Department of Pediatric Gastroenterology, Children's Hospital, Place Amelie Raba Leon, 33077 Bordeaux Cedex, France.
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Abstract
The authors describe the endoscopic aspect of esophageal lesions in five children with Stevens-Johnson syndrome. Lesions involve the entire esophagus, with blistering of the epithelium leading to large ulcerations of the mucosae. Esophageal involvement is probably underestimated in Stevens-Johnson syndrome and may worsen dysphagia caused by oral lesions, leading to malnutrition. Enteral nutrition can be helpful to provide feeding, limit weight loss, and support skin healing. No strictures were diagnosed during the follow-up period of these patients.
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Affiliation(s)
- T Lamireau
- Division of Pediatric Gastroenterology, Children 's Hospital, Bordeaux, France.
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Affiliation(s)
- D Denis
- Unité de gastroentérologie et de pneumologie pédiatriques, hôpital des Enfants, place Amélie-Raba-Léon, 33076 Bordeaux, France
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Cézard JP, Duhamel JF, Meyer M, Pharaon I, Bellaiche M, Maurage C, Ginies JL, Vaillant JM, Girardet JP, Lamireau T, Poujol A, Morali A, Sarles J, Olives JP, Whately-Smith C, Audrain S, Lecomte JM. Efficacy and tolerability of racecadotril in acute diarrhea in children. Gastroenterology 2001; 120:799-805. [PMID: 11231932 DOI: 10.1053/gast.2001.22544] [Citation(s) in RCA: 82] [Impact Index Per Article: 3.6] [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: 12/02/2022]
Abstract
BACKGROUND & AIMS Oral rehydration therapy is the only treatment recommended by the World Health Organization in acute diarrhea in children. Antisecretory drugs available could not be used because of their side effects, except for racecadotril, which is efficient in acute diarrhea in adults. METHODS The efficacy and tolerability of racecadotril (1.5 mg/kg administered orally 3 times daily) as adjuvant therapy to oral rehydration were compared with those of placebo in 172 infants aged 3 months to 4 years (mean age, 12.8 months) who had acute diarrhea. The treatment groups were comparable in terms of age, duration of diarrhea, number of stools, and causative microorganism at inclusion. RESULTS During the first 48 hours of treatment, patients receiving racecadotril had a significantly lower stool output (grams per hour) than those receiving placebo. The 95% confidence interval was 43%-88% for the full data set (n = 166; P = 0.009) and 33%-75% for the per-protocol population (n = 116; P = 0.001). There was no difference between treatments depending on rotavirus status. Significant differences between treatment groups were also found after 24 hours of treatment: full data set (n = 167; P = 0.026) and per-protocol population (n = 121; P = 0.015). Tolerability was good in both groups of patients. CONCLUSIONS This study demonstrates the efficacy (up to 50% reduction in stool output) and tolerability of racecadotril as adjuvant therapy to oral rehydration solution in the treatment of severe diarrhea in infants and children.
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Affiliation(s)
- J P Cézard
- Pediatric Gastroenterology Unit, Paris, France.
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Trouilloud C, Pedespan L, Demarquez JL, Lamireau T, Fayon M. [Intrapleural fibrinolytic treatment and infectious pleuresies: three pediatric cases]. Arch Pediatr 2001; 8:294-8. [PMID: 11270255 DOI: 10.1016/s0929-693x(00)00198-6] [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: 11/26/2022]
Abstract
UNLABELLED Intrapleural instillation of fibrinolytic agents has been proposed for the treatment of loculated pleural effusions, or whenever the biochemical characteristics of the pleural fluid (pH, glucose level, LDH) indicate the risk of a complicated outcome due to a pleural effusion with complications and the possible development of empyema. At present, there is no consensus regarding the use of intrapleural fibrinolytic agents in children. CASE REPORTS In this study, the successful treatment by fibrinolytic agents and standard drainage are successfully performed in three children with a pleural effusion due to an infection. CONCLUSION The clinical utility, in terms of the reduction of the duration of hospitalization and additional surgical treatment, should be assessed in prospective studies.
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Affiliation(s)
- C Trouilloud
- Service de soins intensifs pédiatriques, hôpital Pellegrin-Enfants, 33076 Bordeaux, France
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Abstract
The aim of this study was to evaluate the influence of a short-stay observation unit (SSOU) on the hospitalization rate, the authors have analysed the activity of a SSOU opened in 1992 in a paediatric emergency department (PED) and the number of children hospitalized between 1987 and 1996. Among 2321 patients admitted to the SSOU in 1996, 644 medical patients have been analysed, showing a young population (55% under 3 years old), living in the town or surroundings (70%) and usually have not been referred by a general practitioner (64%). Twenty per cent were admitted for accurate diagnosis (group A), 49% for treatment and observation of a recognized acute pathology before decision of discharge (group B), and 31% waiting for a bed in a paediatric ward (group C). Sixty-eight per cent of children spent less than 6 hours in the SSOU, and 79% of those from groups A and B were thereafter discharged home. Between 1987 and 1991, the number of children hospitalized increased 5% per year on average. After the opening of the SSOU in 1992, this increase has been stopped although the number of medical referrals to PED was still going up. The SSOU in a PED can provide comprehensive care to young children requiring short-term treatment or observation, and is effective in limiting unappropriate hospitalizations.
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Affiliation(s)
- T Lamireau
- Paediatric Emergency Care Unit, Children's Hospital, Bordeaux, France
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