Archives de pédiatrie : organe officiel de la Sociéte française de pédiatrie
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The aim of this study was to investigate the use of psychotropic medications for both labeled and off-labeled indications in a French paediatric teaching hospital. ⋯ The high rates of off-label prescription documented here and elsewhere highlight the need for further controlled clinical trials to evaluate the risks and benefits of psychotropic medication in children and adolescents.
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Provide a descriptive analysis of children admitted to a tertiary care pediatric emergency department (PED) for a nasal foreign body (NFB) and describe the current knowledge and management of such accidents. ⋯ Often benign, this frequent accident can be serious in case of batteries or neodymium magnet insertion: the extraction becomes an emergency because of risks of nasal mucosa necrosis and/or nasal septum perforation. In other cases, positive pressure techniques (the parent's kiss or its variants) could be tried first in the emergency department or at home at the time of a call to emergency services before a medical visit.
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Even though ventilatory support for preterm infants has improved over the past few decades, about 30% of intubated preterm infants fail an extubation attempt. There are still no simple standards to determine the optimal extubation time for those infants. ⋯ As previously described, a low gestational age is a major factor predicting the extubation failure. However, our data suggests that ventilator settings and blood gas should also be considered when attempting extubation, following written guidelines.
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The newborn's energy expenditure is used in order of priority for: (i) basic metabolism; (ii) body temperature regulation and (iii) body growth. Thermal regulation is an important part of energy expenditure, especially for low birth-weight infants or preterm newborns. The heat exchanges with the environment are greater in the infant than in the adult, explaining the increased risk of body hypo- or hyperthermia. ⋯ Further developments are expected to improve the infant's thermal environment, with assessment of the various heat exchange mechanisms by conduction, convection, radiation and evaporation. The quantification of the respective parts of these exchanges would improve nursing care through clinical procedures or equipment used to ensure the control of the optimal thermohygrometric conditions in incubators, especially when the likelihood of excessive body cooling is high. The present review focuses on the various body heat exchange mechanisms, the thermoregulation processes of the newborn, and their implications in clinical usage and limitations in the neonatal intensive care unit.
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Is it reasonable to care for children born under 26 gestational weeks (GW)? To answer this question, we compared outcome at 5 years of 2 groups of children:less or equal to 25 GW+6 days (group 1) and 26-27 GW+6 days (group 2). ⋯ The progression of under 26-GW preterm babies is more often unfavorable than the progression of babies born 26-27 GW+6 days. However, given the low number of patients, no significant difference was made concerning the prognosis at 5 years between the survivors of the 2 groups.