Archives de pédiatrie : organe officiel de la Sociéte française de pédiatrie
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Review Comparative Study
[Antiseptics in neonatology: the inheritance of the past in the daylight].
The antiseptics are antimicrobial substances that are applied to living tissue to reduce the growth of microorganisms. The physiological particularities of newborns, and especially premature, reduce the list of used antiseptic in neonatology. The choice of antiseptic in neonates depends on its activity, its presentation and its tolerance. ⋯ Using eosin for umbilical cord care is not recommended because it doesn't have any antiseptic activity and causes neonatal infections. Through this article, the authors review the principal aspects of antiseptic and report the properties and advantages-disadvantages of each antiseptic. The goal is to facilitate the choice of antiseptic used in neonatology.
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Comparative Study
[Difficulties of TB diagnosis in children: QuantiFERON TB Gold In-Tube as useful tool].
Diagnosis of childhood tuberculosis (TB), active TB or latent tuberculosis infection (LTBI), is complicated by uncommon clinical, radiological and bacteriological features. The tuberculin skin test (TST) is imperfect: difficulty of the intradermal injection for the child, lack of sensibility and specificity. The stop of the systematic inoculation by the BCG since July 2007, in France, could lead to an increase of the incidence of the childhood TB. ⋯ This allowed us to confirm interest of QFT-IT; however, surprisingly, very discordant QFT-IT and TST results were obtained (only five children were QFT-IT+/TST+). A high number (14%) of indeterminate QFT-IT occurred, without explanation by pre-analytical or clinical parameters. Further studies are needed to demonstrate the usefulness of this assay in diagnosing LTBI and particularly active TB in children.
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Accidental drownings are severe and sometimes mortal events in children. Our study aims to better clarify the epidemiology and the respiratory complications of these accidents in our hospital. We led a retrospective study over 10 years concerning the children hospitalized for accidental drowning in our hospital centre. ⋯ Accidental drowning causes important consequences in children. The long-term respiratory outcomes have not been properly studied. Prevention of such accidents is based on parental vigilance during their child's bathe.
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Vesicoureteric reflux (VUR) is found in about 30 % of children with pyelonephritis (PN). It has been identified as a risk factor for the development of urinary tract infections, renal scars, hypertension and chronic renal failure but this risk is considerably smaller than previously assumed. Currently the therapeutic option was to use an antibiotic prophylaxis in order to keep the urinary tract sterile in order to prevent pyelonephritis and new renal scars. The review of the available data has shown that the antibiotic prophylaxis therapy is subject to discussion. The aim of this study was to evaluate the follow up of children with low-grade reflux before and after stopping the urinary antibiotic prophylaxis as soon as they became toilet-trained. ⋯ By stopping the urinary antibiotic prophylaxis in children with mild/moderate grade VUR when they became toilet-trained, there is no increase of the incidence of UTI, pyelonephritis. This study does not support the role for urinary antibiotic prophylaxis in preventing the recurrence of pyelonephritis.
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Tracheomalacia (TM) or bronchomalacia (BM) refers to softness or weakness of the trachea or the bronchi. Its management is not evidenced-based. Conservative therapy is preferred in milder cases, since the outcome is usually favourable within the first 2 years of life. ⋯ Airway surgery should be avoided, and non-invasive ventilation may be proposed as a temporary measure. In case of very severe cases, aortopexy, trachostomy or stent placement are the preferred treatments. Regular respiratory monitoring until remission is mandatory.