Archives de pédiatrie : organe officiel de la Sociéte française de pédiatrie
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Perinatal asphyxia complicated by hypoxic ischemic brain injury remains a source of neurological lesions. A major aim of neonatologists is to evaluate the severity of neonatal encephalopathy (NE) and to evaluate prognosis. The purpose of this study was to determine the contribution of brain MRI compared to electroencephalogram (EEG) and clinical data in assessing patients' prognosis. ⋯ This study confirms the usefulness of brain MRI as a diagnostic tool in hypoxic ischemic encephalopathy in association with clinical data and EEG tracings.
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Donohue syndrome or leprechaunism is a severe congenital insulin-resistance syndrome. It is characterized by intra-uterine and neonatal growth retardation, typical dysmorphic features, and metabolic abnormalities with hyperinsulinism and hyperandrogenism. ⋯ This patient had hypertrophic cardiomyopathy with heart failure and bronchial compression leading to clinical deterioration over 5 days and subsequently death. A treatment with recombinant IGF-1 was tried without efficacy.
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Observational Study
[Palliative care for newborns: practices in a level-III unit during a 5-year period].
The "Patients' rights and end-of-life care" act known as "Leonetti's Law" promulgated in 2005 has promoted the use of palliative care to avoid unreasonable obstinacy when life-sustaining treatment appears disproportionate. Very little is known about this new practice for newborns in French neonatal units. ⋯ A significant number of newborns affected by various pathologies undergo neonatal palliative care. Despite their recent introduction in neonatal medicine, palliative care practices have changed significantly. These practices are mostly in compliance with the "patients' rights and end-of-life care" act promulgated in France in 2005.
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Telephone counseling is a daily occurrence in the pediatric emergency department (ED). It is difficult and has no legal framework. In 2010, we created a new protocol aimed at improving the telephone counseling given by the admission nurse at our pediatric emergency department: an index card is created for every call, color-coded according to severity with a list of clinical items, allowing for simple and reproducible advice. ⋯ These innovative color-coded cards make it possible to dispense reliable and harmonized advice. They ease the process of an otherwise difficult exercise.
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Practice Guideline
[Update on the management of acute viral bronchiolitis: proposed guidelines of Grand Ouest University Hospitals].
While our European and North American colleagues have recently updated their recommendations, the 2000 Consensus Conference remains the main guideline on management of acute viral bronchiolitis in France. We aimed to establish an updated inter-regional protocol on management of acute viral bronchiolitis in infants. ⋯ This work has provided new proposals for management of acute viral bronchiolitis and helped standardize practices within the Grand Ouest University Hospitals. This local organization could lay the keystone for working toward guidelines initiated by learned societies at the national level.