Archives de pédiatrie : organe officiel de la Sociéte française de pédiatrie
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Thiamine deficiency is recognized in varied parts of the world. In Asia, it remains an important public health problem where highly polished rice is the major staple food and where other primary dietary sources of thiamine are in short supply. Beriberi, or clinically apparent thiamine deficiency, may present a variety of syndromes including myocardial dysfunction or wet beriberi, dry beriberi with neurological symptoms, and the more severe form Shoshin beriberi with cardiac failure and lactic acidosis. ⋯ We report the case of a 10-week-old girl, admitted with diarrhea, vomiting, acidosis, and cardiac failure. After excluding other etiologies of cardiomyopathy, biochemical thiamine deficiency confirmed the diagnosis of beriberi in an infant of a thiamine-deficient mother from Reunion Island, a French island where recently, with Mayotte Island, epidemic cases of beriberi have been described. This case is important to highlight the manifestations in young infants and to alert physicians to the possibility of thiamine deficiency in developed countries.
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The Script Concordance Test (SCT) is a tool used to evaluate clinical reasoning in complex medical situations. Our aim was to create the first SCT in pediatric gastroenterology in order to objectively assess medical students. We elaborated a SCT including 31 items divided into ten clinical cases. ⋯ This was the first time the students had taken a SCT, but they considered that this tool was appropriate and in concordance with the objectives. Although the SCT is a useful method, its elaboration can be difficult. It seems important to create a group of teachers to validate the process and eliminate the wide variability.