Archives de pédiatrie : organe officiel de la Sociéte française de pédiatrie
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Case Reports
[Severe tetanus complicated with rhabdomyolysis and acute renal failure: a pediatric case report].
Renal failure is a rare complication of tetanus in children. It occurs following poorly controlled muscle spasms and rigidity. We describe a severe case of tetanus complicated with rhabdomyolysis and acute renal failure in a child.
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For painful procedures in children, national recommendations are now available in France. When sedation-analgesia with nitrous oxide/oxygen mixture fails, in order to perform a painful procedure under good conditions, low dose ketamine (IV bolus titration 0.5 mg/kg but not more than 2 mg/kg) is the only drug potentially used by a trained physician, without the presence of an anaesthesiologist (Grade A). ⋯ The optimal management is performed by an anesthesiologist, it is necessary to facilitate access to the operating room for children undergoing this type of procedure (Professional consensus). Mainly IV ketamine can be used by pediatric intensive care and emergency physicians who currently have medical skills to detect and treat side effects.
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Vitamin B(12), or cobalamin, deficiency is often unrecognized because the clinical manifestations are subtle; they are also potentially serious. We report a case of pseudothrombotic microangiopathy related to cobalamin deficiency. Vitamin B(12) deficiency, which is more commonly recognized in the context of malnutrition, should be considered in the context of microangiopathy.
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Inhalation of foreign body in children is a serious accident that may compromise the vital prognosis of the child. The diagnostic was difficult in the absence of a recognizable penetration syndrome. Bronchoscopy is still recommended as the appropriate diagnostic and treatment of foreign bodies. The purpose of this study was to analyze the diagnostic and the treatment result of bronchoscopy and discuss its indications. ⋯ The diagnosis of laryngotracheobronchial foreign body recures an array of arguments. It is suspected on the clinical interview specially penetration syndrome and on the clinical and radiological presentation. Any suspicion should lead to a bronchoscopy.
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Practice Guideline
[Recommendations for pediatric oxygen therapy in acute and chronic settings: needs assessment, implementation criteria, prescription practices and follow-up].
Recommendations for acute and long-term oxygen therapy (needs assessment, implementation criteria, prescription practices, and follow-up) in children were produced by the Groupe de Recherche sur les Avancées en Pneumo-Pédiatrie (GRAPP) under the auspices of the French Paediatric Pulmonology and Allergology Society (SP2A). The Haute Autorité de Santé (HAS) methodology, based on the Formalized Consensus, was used. A first panel of experts analyzed the English and French literature to provide a second panel of experts with recommendations to validate. Only the recommendations are presented here, but the full text (arguments+recommendations) is available at the website of the French Paediatric Society: www.sfpediatrie.com.