Archives de pédiatrie : organe officiel de la Sociéte française de pédiatrie
-
Review Comparative Study
[Neuroprotection with hypothermia for hypoxic ischemic encephalopathy in term newborn: review of the learning].
The hypothermia treatment for neonatal hypoxic ischemic encephalopathy is a concept revisited for more than 10 years. With this strategy, animal studies have shown an 80% reduction of brain damage. Conditions for the practice of hypothermia, to obtain neuroprotection, have been described in these studies: rapidity of the onset of cooling after the hypoxic ischemic event, prolonged duration during several hours, ability to obtain neuroprotection with two methods of cooling, selective head cooling or whole body hypothermia. ⋯ Only with the strategy of whole body cooling, the incidence of poor outcome at 18 months (death or severe disability) was statistically decreased (44% versus 66% in the control group). This reduction seems especially significant in the sub group of intermediate severity (48% versus 66%), whereas severe forms (Grade III in the Sarnat and Sarnat classification) were probably not ameliorated with this treatment. Now, the major problem is to determine the best indications for hypothermia with an early and precise assessment of the grade of the encephalopathy.
-
Review Comparative Study
[Coping scales for children with a chronic disease: a review of the literature].
The review of the international literature presented here aimed to determine the measuring instruments of the coping of children chronic disease currently available. This research task was carried out starting from the numerical databases Psychinfo, Medline and Science Direct with various key words such as coping, child, chronic illness, assessment. It was related to the years 1985-2006. ⋯ All these instruments aim to evaluate the way in which the children manage to overcome the negative effects of their disease. Two types of evaluation were, however, distinguished: (1) concise evaluations of the adaptive strategies to a whole of stressors related to the chronic disease (pains, hospitalization...); (2) detailed evaluations of the answers of coping to the painful procedures related to the chronic disease. The discussion of this analysis of the literature relates to the need for developing and for using in the clinical practices the measuring instruments of the coping to the chronic disease during the child.
-
d-lactic acidosis is a rare and severe complication of short bowel syndrome in children that may result from important ileal bacterial overgrowth by lactobacilli. Intestinal flora (Lactobacilli) is responsible for the production of d-lactic acid after fermentation of food carbohydrates. ⋯ d-lactic acidosis should be suspected when neurological symptoms occur in a child with short bowel syndrome. They can be prevented by treating intestinal bacterial overgrowth.