Archives de pédiatrie : organe officiel de la Sociéte française de pédiatrie
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Observational Study
[Memory boxes in the neonatal period: caregivers' opinions after 1 year of practice].
Perinatal death is a profound experience for childbearing families and mementoes are key to providing essential records of the baby's life and death. The aim of this observational study was to evaluate the caregiver's feelings on 1 year of using memory boxes in the neonatal and pediatric intensive care unit of a tertiary care center. ⋯ This is the first study describing caregivers' opinions about the memory box practices. Memory boxes are considered helpful for bereaved parents, especially in the neonatal period, but are of little help to the caregivers.
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Brain development is a complex phenomenon in which several stages of production, maturation, and organization of neural cells in a network succeed each other. Various environmental factors can disrupt these stages. During the last decade, numerous in vitro and in vivo experimental studies in newborn animal models have established the neurotoxic effects of most anesthetic and sedative drugs used in pediatrics. ⋯ These numerous experimental data must be interpreted with caution with regard to their validity in humans, mainly because of interspecies differences as well as differences between experimental conditions and clinical practice. Today, these data are insufficient to change our practices, taking into account the indisputable benefits of the use of anesthetics and sedative drugs. However, progress in experimental research will help us identify the safest therapeutic strategies and neuroprotective treatments.
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The main objective of this study was to evaluate the rate of breastfeeding at NICU discharge in a population of very preterm infants. The secondary objective was to identify maternal, gestational, and neonatal factors associated with successful breastfeeding at NICU discharge. ⋯ The rate of breastfeeding of very preterm infants at hospital discharge is lower than the rates reported in the literature. The mother's marital status significantly influences the decision to breastfeed very preterm infants at discharge.
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The timing of umbilical cord clamping remains controversial. Although most maternity wards use the early clamping (5-15s), randomized studies and meta-analyses have demonstrated the benefit of delayed clamping for term and preterm newborn infants over the past 10 years. ⋯ For preterm newborns, placental transfusion for 45 s or milking the cord for 15 s improves cardiovascular adaptation, with better hemodynamic stability, as well as decreased intraventricular hemorrhages, need for transfusion, and late-onset sepsis. A new look at this symbolic act is needed and professionals need to be persuaded of the importance of the "wait a minute" policy for a better physiological delivery.
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Case Reports
[Analgesic efficacy of topical lidocaine for vaso-occlusive crisis in children with sickle cell disease].
Pain associated with vaso-occlusive crisis is the main cause of hospitalization in children with sickle cell disease. Recent studies have suggested that pain might have a neuropathic component. ⋯ This study reports the efficacy and safety of such treatment in 6 patients with sickle cell disease, aged 6-18 years, who had been hospitalized for vaso-occlusive crisis after failure of the standard analgesic treatment. These data have led to setting up a confirmatory phase II trial, which is currently underway.