Archives de pédiatrie : organe officiel de la Sociéte française de pédiatrie
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Observational Study
Neonatal pain assessment practices in the maternity ward (delivery room and postpartum ward): We can improve!
Almost 20% of neonates experience pain during delivery or the period following birth. ⋯ This first regional study on pain assessment in the maternity ward showed that nearly two thirds of centers assessed pain. This rate may be overestimated because of the reporting method used. The EDIN scale is the most widely used tool but seems unsuitable especially for the delivery room setting. Studies should be conducted to test other tools for assessing neonatal pain in the delivery room.
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Chronic granulomatous disease (CGD) is associated with multiple and recurrent infections. In patients with CGD, invasive pulmonary infection with aspergillus species remains the greatest cause of mortality. ⋯ We describe the case of an 11-year-old boy, with late initial presentation of CGD, which was revealed by fulminant aspergillus pneumonia. He was successfully treated with an association of high doses of steroids and voriconazole.
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Observational Study
First-line treatment using high-flow nasal cannula for children with severe bronchiolitis: Applicability and risk factors for failure.
Viral bronchiolitis is the leading cause of hospitalization in children during the first 12 months of life. There is evidence to support the use of noninvasive ventilation in bronchiolitis. A recent respiratory management of bronchiolitis is the use of high-flow nasal cannula (HFNC) therapy. The primary objective of this study was to evaluate the use of HFNC as the first-line treatment for children with severe bronchiolitis and the secondary objective was to identify factors for HFNC therapy failure. ⋯ In our PICU, HFNC therapy for children with bronchiolitis can potentially decrease the use of nCPAP. In this study, the factor of failure was higher pCO2. Studies to evaluate PCO2 level to discriminate HFNC versus CPAP indication could be useful.
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On 5 March 2007, the law concerning the child protection system was reformed. Since then, child protection services have been responsible for the management of child abuse and neglect. Reporting and asking for child protection is now easier for every physician by submitting a "preoccupying information" form. A study conducted in 2014 in the general practitioners (GP) in the Ille-et-Vilaine department showed that they were quite unfamiliar with the child protection updates and that they needed special training. We wished to study the knowledge and practices of the pediatricians in Brittany and compare these results to the previous study. ⋯ Child protection is a neglected subject, including by pediatricians. To fight against professional denial and isolation, a substantial effort is still needed concerning caregivers' training as well as pediatric care organization.