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Copyright of Orthodontie Française is the property of John Libbey Eurotext Ltd. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Canadian Oncology Nursing Journal is the property of Pappin Communications and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Psycho-Oncologie is the property of Tech Science Press and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Actualités Pharmaceutiques is the property of Elsevier B.V. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Psycho-Oncologie is the property of Tech Science Press and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

This descriptive observational study aims to describe the epidemiological profile of children hospitalized for burnsin Guyana, a French districtwhich does not have a burn treatment centre, and direct prevention towardsthe populations most atrisk. Retrospective analysis of 665 hospitalizations was made thanksto the coding of patients aged 0 to 18, hospitalized for burns between January 2010 and December 2022 at Cayenne Hospital Centre. Univariate and multivariate descriptive analyses were carried out on age, sex, municipality of origin, date of burn, duration of hospitalization, mode of burn, location, percentage and depth of burn. A total 416 children with "burn" coding were hospitalized overthis period and 358 patients were included. Burns were more common in males(58%) and in children under 6 (75%). A majority of patients were townspeople and lived on the coast (70%). 9.5% of patients were transferred to Trousseau Hospital in Paris for more specialized care. 61% of burns were caused by hot water and 16.5% by flames. Duration of hospitalization was on average 8 days and the burnt skin surface was 9.5%. Children under 2 years old living in Cayenne and its suburbs are the most at risk of burns, but the most serious burns requiring a transfer to Paris are found in children over 3 years old living on the Maroni River and playing with flammable products. [ABSTRACT FROM AUTHOR]

Copyright of Psycho-Oncologie is the property of Tech Science Press and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Despite major improvement in the management of sickle cell anemia during the last decades, this pathology remains associated with severe acute complications and early mortality in adults. Many children and most adults develop a chronic debilitating condition due to chronic pain or organ damage. Yet, hydroxyurea the first and only available disease-modifying oral therapy for twenty-five years, was underused, restricted to the most severe patients and mostly introduced after the recurrence of acute vaso-occlusive events. More preventive intervention is needed, and hydroxyurea should be offered earlier to infants, beginning at nine months of age, regardless of clinical severity. Dosing (usually 20 to 35 mg/kg/d) should aim for maximal clinical and biological efficacy, and target an absolute neutrophil count under 2.5 G/L. To observe the benefits of this approach in real-life setting, caregivers and children's long-term compliance to hydroxyurea (once-daily oral dosing) becomes a key issue. Accordingly, health care providers should work on reinforcing adherence to therapy at each medical visit. [ABSTRACT FROM AUTHOR]

Copyright of Psycho-Oncologie is the property of Tech Science Press and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Goal: To assess knowledges and practices on iron prescription in pediatric ward in CHU Gabriel Touré of Bamako, Mali. Tools and methods: It was a prospective and transversal study canied out. We submitted questionnaire and analyzed the case history of to the children aged 1-60 months old who received iron during the study period from 1rstto 30 July 2012.The prescriptators' consent were solicited and obtained at first of all. Results: Fifty prestators were interviewed among them 10 pediatricians (20%), 31 pediatrics' resident (62 %), 2 generalists physicians (4%), 7 medical student (14%). One hundred 100 were analyzed medical records. More than half of the prestators known the need of iron in children. Thirty percent have received iron at 8 to 10mg/kg. The medication duration wasn't indicating in 92% of patients. In our context prestators well know about meaning and the needs of iron in children bout they're limited on iron food sources and iron storage. Conclusion: The well theorical knowledge on indications and prescription roules on iron in children didn't escape from miss practices in its prescription. Moreover works should analyze the reasons of discrepancies. [ABSTRACT FROM AUTHOR]

Food allergy is a growing public health problem. This increase in prevalence has notably led to greater awareness of the burden of living with a food allergy, particularly the emotional, social and financial problems it causes. In the clinic, the speech of patients' parents often revolves around the feeling of loneliness and incomprehension of those around them, the need for control and hypervigilance. Although several studies have recently been published on the impact of food allergy on quality of life, data on the mental health of patients and families remains fragmentary and vague. A qualitative study has been carried out within the Pediatric Pulmonology and Allergology at Robert-Debré Hospital in order to assess the parental psychosocial impact, and anxiety in the case linked to the child's food allergy, in the form of a focus group. These group times allow families to discuss and discuss the impact of this disease, which is often trivialized even though it requires major life adjustments (eviction diet, emergency action plan, potential hospitalizations in intensive care). The objective of this workshop is to present this multidisciplinary research work (hospital practitioner, psychologist, therapeutic education nurse) and to allow us as caregivers to better understand parental difficulties in order to offer ever more qualitative follow-up for these vulnerable families. [ABSTRACT FROM AUTHOR]

Eosinophilic oesophagitis in children is an emerging condition. The diagnosis is pathological, following upper GI endoscopy and staged biopsies of the oesophagus. A personal history of atopy is found in 50 to 60% of cases. Topical corticosteroids are effective in about three quarters of cases. The effectiveness of this first-line treatment is assessed after eight to twelve weeks or earlier if there is no clinical improvement at for weeks. A repeat digestive endoscopy with staged oesophageal biopsies is essential, as clinical improvement is not always associated with endoscopic improvement. This individualised avoidance diet may be offered as a first or second treatment, with or without drug therapy. As eosinophilic oesophagitis is a chronic disease, there is a significant risk of relapse on discontinuation of induction therapy or afterwards. Maintenance therapy should be continued, at best with the minimum effective dosage of the induction therapy. Multidisciplinary follow-up (gastro-paediatrician, allergist, dietician, psychologist, etc.) is necessary in the long term. [ABSTRACT FROM AUTHOR]

Research Framework: In 1999, Montreal’s Sainte-Justine University Hospital created a pediatric palliative care (PPC) service that was gradually deployed in all sectors of the hospital. A retrospective and critical research program aims to understand the evolution of practices and to pinpoint current issues. Objectives: This article presents a portrait of PPC in tertiary care settings in order to fuel reflection on the evolution of practices by identifying research priorities at the clinical, organizational and systemic levels. Methodology: A mixed methods approach is used for this research intervention. An archive database (1999-2021) and workshop proceedings (2021-2022) were subjected to descriptive statistical analysis, conceptual analysis, and collective narration. Results: PPC interventions have increased over the year and then stabilized. The number of requests does not correlate with the number of deaths for a given area. Respondents described 10 central themes for PPC practice, training and research: (1) patient needs at the tertiary hospital setting, (2) pediatric specificities of palliative and end-of-life care, (3) child centredness, (4) pain and suffering or well-being and quality of life, (5) motivations and needs of caregivers, (6) interdisciplinary and interprofessional practices, (7) training and skills, (8) practice norms and indicators, (9) ethical and systemic dimensions of PPC, and (10) hope and high hopes. Conclusion: Conceptual, procedural, and educational tools are essential to improve quality and accessibility of care and PPC services. Contribution: We aim to contribute to the reflection on PPC by describing our perspective and by stimulating interactions among the various hospitals and communities involved.

Research Framework: In serious illness, the proliferation of therapeutic possibilities often delays the moment when death is foreseen and when palliative care, too often associated with the end of life and death, is introduced into patients’ care paths. In this context, pediatric palliative care tries to play an active role in the care relationship, beyond the idea of treatments for recovery. Objectives: Our aim is to better understand the moment when palliative care becomes a possibility in the trajectory of serious illness, and how it is represented. We examine how palliative care fits into the parents’ experience, as well as the way in which their experience of serious illness, and more so the relational dimension of the end of life, is expressed. Methodology: We draw on the testimonies of parents whose children suffered major illness and death. Through individual semi-structured interviews between 2017 and 2019, we collected the stories of 16 Montreal children and adolescents (10 boys and 6 girls aged between a few weeks to 19 years) with a genetic or rare disease, cancer or multiple chronic conditions of migrant and non-migrant background. Results: Not only is the type of illness an important figure in the palliative care trajectory, care and the families’ profiles also shape their perception of a (nonetheless) positive experience of their child’s end of life. Conclusions: Curative/palliative therapeutic perspectives have little bearing on our participants’ satisfaction with care at the end of life, as long as a therapeutic trust bond is present between the family and the health care team. Both positively and negatively, this bond of trust influences the pediatric care relationships and major illness trajectories, as well as the end-of-life experiences of loved ones. Contribution: Through the experiences of children at the end of life as shared (mostly) by mothers, this paper discusses both curative and palliative perspectives as chosen by the parents of children facing a poor prognosis. Beyond the different philosophies that inhabit these approaches, the quality (and continuity) of the relationships established with care providers is a determining factor in the quality of the experiences documented through our study.

Research framework: In Belgium, euthanasia was made available to minors in February 2014. The request to die must be expressed by the minor and receive parental consent. It is regulated by an interdisciplinary process and support for situations of constant, unbearable and unappeasable physical suffering presenting no other reasonable solution in the context of an incurable condition. Objectives: Share reflections and recommendations on support for children, their families and teams in the context of euthanasia requests. They aim to point out the elements that this support has in common with any care process, but also those that characterize it specifically. Methodology: Since 2014, the pediatric palliative care mobile team of the Queen Fabiola University Children's Hospital (HUDERF) of the Brussels University Hospital (HUB) of the Université Libre de Bruxelles (ULB) has met regularly on an interdisciplinary basis to examine and discuss the various aspects of the law. Results: The outcome of this dialogue opens up a field of reflection and guidelines for ensuring appropriate, regulated care. Its aim is to support all those involved in the emergence of a request for euthanasia. The aim is not to define a strict framework, but to propose generalizable benchmarks capable of ensuring dynamic, non-linear, collaborative and comprehensive care. Conclusions: Euthanasia is a process of care and accompaniment that follows the multiple rhythms of the people for whom it is responsible. A human and interdisciplinary constellation is needed to guide this process. Contribution: Euthanasia of minors in Belgium is a rare practice, little studied but never trivial. This article examines the exceptional singularity of this care process and the interdisciplinary resources needed to support it.

Copyright of Actualités Pharmaceutiques is the property of Elsevier B.V. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Introduction: When their child presents a complex chronic health condition, parents take on a new role as caregivers. The dual identity of parent and caregiver exposes them to a risk of exhaustion. Objectives: We developed and assessed workshops for parent caregivers. These workshops aimed to help parents become aware of their needs and identify their helpful resources. Methods: We opted for an action-research methodology conducted in a participatory, iterative and evaluative approach, supported by a steering committee (professionals, parents and researchers). Three groups of parents (N = 18) participated in four support workshops. The data collected was processed through thematic analysis. Results: The workshops made it possible for parents to take time for themselves, to become aware of their own experiences, to support among parents, and to consider changes in their daily life. These benefits were supported by an online program, supervised by health professionals, offering support workshops to parents regardless of the characteristics of their family and their child. Discussion and conclusions: These workshops are an opportunity of encounters that preserves a personal and family balance. They could participate in preventing parental burnout. [ABSTRACT FROM AUTHOR]

Esophageal atresia is a congenital malformation incompatible with life. Its management in our context is difficult. The purpose of this study was to determine the clinical, therapeutic and epidemiological profile of esophageal atresia at the Mother and Child University Hospital of the Jeanne Ebori Foundation from 2019 to 2020. We conducted a retrospective study in the Neonatal Medicine and Pediatric Surgery Department of Mother and Child University Hospital of the Jeanne Ebori Foundation over a 2-year period from January 1, 2019 to December 31, 2020. We collected data from the medical records of 10 newborns diagnosed with esophageal atresia. The prevalence of neonatal surgical emergencies was 11% (n=10/89). Mean gestational age of patients was 37 WA+2, ranging from 34WA+2 days to 40WA+2 days; mean life span was 3.7 days with extremes of D0 and D7. Sex ratio was 1. The average birth weight was 2636 grams, ranging from 1460 g to 3425g; mean time between symptom onset and diagnosis was 4 days. Type III accounted for 70% of anatomical shapes. Mean waiting time for surgery was 0.8 days, ranging from D0 to D3. The average length of stay in hospital was 9.3 days, ranging from 1 to 38 days. Nine out of 10 patients underwent surgery. Only 2 patients survived, with a follow-up period of at least one year without sequelae. The management of esophageal atresia is still precarious in our context. Diagnostic delay is the main challenge. Improvement in prognosis involves improvement in anesthetic, surgical and neonatal technical equipment. [ABSTRACT FROM AUTHOR]

Copyright of Enfances, Familles, Generations is the property of Enfances, Familles, Generations and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Enfances, Familles, Generations is the property of Enfances, Familles, Generations and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Enfances, Familles, Generations is the property of Enfances, Familles, Generations and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

FRANCE'S FIRST "PESTICIDES AND PEDIATRIC PATHOLOGIES" CONSULTATION. The "Pesticides and Pediatric Pathologies" department of the Regional Center for Occupational and Environmental Diseases of Hauts-de-France (CHU Amiens-Picardie, France) was set up on October 1 2023, to support children (and their families) suffering from leukemia, brain tumors, hypospadias or cleft lip and palate whose parents have been professionally exposed to pesticides. This support includes assistance in dealing with the Fonds d'indemnisation des victimes de pesticides (Pesticide Victims Compensation Fund)., Competing Interests: Les auteurs déclarent n’avoir aucun lien d’intérêt.

The transition of young type 1 diabetic patients from pediatrics to adult diabetes services is a delicate stage, with the risk of a break in the care pathway. These adolescents are apprehensive about leaving the pediatric sector, and often experience the change as an abandonment. It is therefore vital to prepare them and support them during and after the transfer, in order to improve their experience., (Copyright © 2024 Elsevier Masson SAS. All rights reserved.)

In this article, the authors wish to offer the product of their reflections on the concept of coercive control, and share various findings from their day-to-day practice. The text should be read as an invitation to clinical reflection on the conceptualization of a specific form of abuse. Reflection on this approach, initially ignored by the authors, has enriched clinical thinking on certain care situations., (Copyright © 2024 Elsevier Masson SAS. All rights reserved.)

Purpose: Myasthenia is a rare disease in children, with an estimated incidence of 1 to 5 per million children. However, the potential severity of its consequences and the existence of specific treatments require prompt diagnosis by pediatric ophthalmologists., Methods: Retrospective review of patient records. Patients were identified from a rare disease database. Patients under the age of 18 years with confirmed diagnosis of myasthenia and ocular symptoms seen in a specialized clinic between 2005 and 2021 were included., Results: Twenty-six (16 girls) with confirmed myasthenia and ocular symptoms were included. Ten patients had definite autoimmune myasthenia gravis (AIMG); 6 had suspected AIMG with negative antibody testing. Six patients had definite congenital myasthenic syndrome (CMS); 4 had suspected CMS with no evidence of mutation. Mean age at diagnosis of myasthenia was 5 years-3 years and 5 months for CMS and 6 years and 3 months for AIMG. Male to female (M:F) ratio was 6/10 for autoimmune myasthenia gravis and 4/6 for CMS. Ptosis was present in all cases; strabismus in 21 patients (68%). The clinical forms of myasthenia were ocular myasthenia in 12 patients (10 AIMG and 2 CMS), generalized in 12 patients (7 CMS and 5 AIMG) and secondary generalization of ocular myasthenia in 2 patients (2 AIMG)., Discussion: These results are based on only 26 cases, which can be explained by the rarity of this diagnosis in children. As in adults, the first signs are often ophthalmologic - ptosis alone or associated with strabismus. Diagnosis is difficult because of the absence of clinical signs, laboratory tests or electrophysiological signs with high sensitivity. Thus, the work-up may remain completely negative in secondarily proven forms. In addition, electroneuromyograms and oculomotor recordings in small children are more difficult to perform than in adults. For these reasons, the clinical examination is essential. In the case of strong suspicion, all additional medical examinations are carried out in a day unit, in order to reach a positive diagnosis of myasthenia. The so-called "congenital" forms, which are genetic, are proportionately higher than in adults, and diagnosis and treatment are often more difficult than in the classic autoimmune forms., Conclusion: Myasthenia can affect children from a very young age and can present as ptosis, initially isolated or associated with strabismus. Diagnosis and treatment may be difficult and should be organized in specialized centers., (Copyright © 2024 Elsevier Masson SAS. All rights reserved.)

In paediatrics, the pulmonary function test (PFT) is most often performed to support the diagnosis or in follow-up of asthma patients. Whatever the pathology responsible for respiratory symptoms and/or functional impairment, repeated PFTs make it possible to establish a prognosis (pulmonary function trajectories…) and to orient preventive interventions. PFT can be performed routinely from the age of three years, provided that the following requirements are met: suitable techniques and equipment, staff trained to apply the techniques and to receive young children, reference values for each technique indicating the limits of normal values and of between-test significant variation. From the age of three, children can be subjected to tidal breathing measurement of: resistance of the respiratory system (oscillometry, Rrs; airflow interruption, Rint) or of airways specific resistance (sRaw) and functional residual capacity (by applying a dilution technique). With maturity, the child will become capable of mobilizing his or her slow vital capacity to measure total lung capacity (TLC), once again by applying a dilution technique, then later by breathing against a closed shutter (plethysmography TLC and Raw). Finally, the child will be able to carry out forced expiration (forced spirometry) along with all of the other PFTs. It is important to take into account the paediatric adaptations specified in the international recommendations regarding the performance, reproducibility and quality of PFTs targeting this population., (Copyright © 2024 SPLF. Published by Elsevier Masson SAS. All rights reserved.)

Aims: To determine the epidemiological profile of newborn dermatitis and to describe the different clinical aspects of the observed neonatal dermatitis. Procedure: The study took place at the University Hospital of Cocody (Abidjan). The study was cross-sectional, descriptive and analytical, carried out on the basis of prospective recruitment. The study included newborns who were seen in outpatient or inpatient settings by 4 april 2018 to 23 August 2018 and in whom the pediatrician had observed cutaneous and/or mucosal lesions. The diagnosis was made with the collaboration of a dermatologist. Results: During the study period, 116 newborns were identified. The age of the patients seen in pediatrics with dermatitis varied from 1 to 28 days, with a mean of 16.86 ± 8.4 days. The median age was 19 days. The most representative age range (32.8%) was 24-28 days. The sex ratio (M/F) was 1. In almost 2/3 of the cases, the children were born at term, 29.3% were premature and 5.2% were born after term. In almost 2/3 of the cases (63.8%), the newborns had a birth weight of more than 2500 g. Only 3.4% of newborns seen in pediatric consultations were referred for a dermatitis. The age of the lesions at the time of consultation varied from 1 to 26 days, with a mean of 06.19 days ± 5.13. In more than half (53.5%) of the cases, the lesions had evolved for less than 5 days. Transient dermatitis was more frequent (51.7%), followed by infectious dermatitis (32.8%). Transient dermatitis of the newborn was dominated by sweaty miliaria (40%). Infectious dermatitis were mainly represented by mycotic (68.4%) and bacterial (31.9%) infections. Bacterial dermatitis were composed of neonatal impetigo (83.3%) and folliculitis (16.7%). In almost half of the cases (46.1%) the mycotic dermatitis were represented by candidosis intertrigo and in 38.5% of the cases there was oral candidiasis. The other neonatal dermatitis observed were dominated by diaper rash (64.3%) (Photo 2) and congenital nevi (21.5%). More than half (57.1%) of the cases of toxic erythema neonatorum occurred between days 6 and 10 of life. Nearly half (41.6%) of the cases of sudoral miliaria occurred between birth and day 5 of life. More than half (57.1%) of the cases of sebaceous hyperplasia occurred before the 5th day of life. All cases of neonatal scaling and mongoloid spots were already present between birth and day 5 of life. The mean age of patients with transient dermatitis was 14.31 days compared with 19.41 days for those with the other dermatitis. The difference in age was statistically significant (p < 0.05). The transient dermatitis predominated in male neonates while the other dermatitis predominated in females, however the difference observed at the level of sex was not statistically significant (p > 0.05). Conclusion: The diagnosis of neonatal dermatitis is not always obvious, especially on black skin where few publications have been published. [ABSTRACT FROM AUTHOR]

Adolescence is a time of transition from childhood to adulthood. For a teenager who has T1D, there is also a transition for medical follow-up. This medical transition is the passage from carring by a pediatric team with the participation of the parents, towards a team which takes care of the adults and gradually dispenses with the intervention of the parents. It is part of an ordinary emancipation process specific to all adolescents. The prospect of the transition must be announced from the beginning of adolescence; it is organized with the pediatric team. It includes three phases: preparation, transfer and follow-up. [ABSTRACT FROM AUTHOR]

The transition from pediatrics to the adult service in the management of patients with congenital adrenal hyperplasia is a key step that must not be overlooked to ensure the future quality of life of the developing adult. [ABSTRACT FROM AUTHOR]

The transition from pediatrics to adult medicine is an essential step for adolescents and young adults living with a chronic disease. It involves a significant risk of disruption of the care pathway with deleterious consequences for health in the short and long term. The challenge of this transition is to ensure continuity of care while successfully completing adolescence and its developmental tasks, in particular autonomy. The success of this transition therefore requires an organized and structured preparation, tailored for each patient and his/her parents, and over a period of transition, from several years before transfer until a regular follow-up in an adult service is established. [ABSTRACT FROM AUTHOR]

Background: Clinical practices regarding duration of antibiotics used for Community Acquired Pneumonia (CAP) in children vary between settings. This could contribute to adverse drug reactions, treatment failure and antimicrobial resistance. Methods: The following search tools were used for the review: PubMed, TRIP, and Medline/Ovid. Keywords included were "pneumonia", "pediatric", "treatment", "duration", "child", "days", "community acquired pneumonia", "short", "non-severe", "amoxicillin dose", and "pneumonia children" and the selection of articles was limited to the last 10 years from 2011 to 2021. Results: We found 15 studies that assessed short (3 or 5 days) versus longer (7 or 10 days) duration of antibiotic treatment in pediatric outpatient CAP. Of these we selected 8 studies: 5 completed Randomized Controlled Trials (RCTs), 2 ongoing RCTs, and 1 retrospective cohort study. Discussion: Our review shows that short-course antimicrobial therapy for outpatient pediatric CAP is a promising option for maximizing efficacy, while also minimizing adverse effects, non-adherence, and antimicrobial resistance. Half of RCTs showed that a short-course treatment with oral amoxicillin, the antibiotic of reference, had a comparable efficacy to longer course treatment. However, in these studies bacterial CAP was not easily established, and there was considerable variability in the diagnosis and interpretation of radiological findings. Conclusion: The results from the studies included in this narrative review are informative and add to our understanding of outpatient pediatric CAP. They highlight the importance of maintaining an effective balance, where a clinician can aim to minimize antimicrobial overuse and risk of resistance while maximizing efficacy. Although these studies look promising, future research is required in pediatric patients with CAP, and these studies must be capable of addressing the limitations listed in this paper. [ABSTRACT FROM AUTHOR]

Chemotherapy-induced neutropenia (FN) is the most common infectious complication in pediatric oncology. To our knowledge, no pediatric research has been published in Tunisia. The purpose of our study was to describe the features of FN among Tunisian children and to investigate factors correlated with FN. We conducted a prospective study of children with chemotherapy-induced FN at the Department of Pediatric Medicine A of the Tunis Children's Hospital from July 2019 to December 2019. We recorded 50 episodes of FN in 32 patients whose mean age was 5.3 years (3 months-16 years). We included 26 patients with solid tumors (81%) and six patients with hemopathies (18.7%). The mean time between last treatment and fever onset was 10.67 days. Bacteriological investigation was contributory in 18% of cases and mainly showed gram positive cocci. Therapeutic protocol including 1st line empirical antibiotic therapy (3rd generation cephalosporin with aminoglycoside) was effective in 62% of cases. Mortality rate of patients with FN was 2%. The statistical study did not reveal any factor of correlation with late-onset neutropenia. In conclusion, our results are consistent with literature data on bacteriological documentation and mortality. Our 1st line treatment option based on 3rd generation cephalosporin associated with aminoglycoside was effective in 2/3 of the cases. In the future, oral antibiotics may be considered in patients at low risk for infection. [ABSTRACT FROM AUTHOR]

The interviews of children who are victims of violence carried out by doctors are never filmed. The children can in certain situations be auditioned by detectives or by policemen, at the police station but also in structures like pediatric child at risk units, hospital facilities. The law requires that auditions must be filmed for sexual facts/sexual assault. But it is recommended that these filmed auditions must be extended to the most serious cases. [ABSTRACT FROM AUTHOR]

Post-burn retractile contractures of the foot are considered serious given their potentially significant functional and aesthetic repercussions. We report a 13-year-old paediatric case with retractile contractures in both feet neglected for 10 years and responsible for a very significant deformity with marked misalignment of the toes. The patient suffered from a severe limitation of activities and an inability to put on shoes. The surgical release of the contractures by several Z-plasties associated with the realignment of the dislocated toes allowed a good result to be obtained with a return to almost normal function. The prevention of retractable contractures and their early management remains the best way to avoid serious deformities and their consequences in a growing patient. [ABSTRACT FROM AUTHOR]

Copyright of Annales Françaises de Médecine d'Urgence is the property of John Libbey Eurotext Ltd. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Background Painful experiences are common among hospitalized children. Long-term negative biopsychosocial consequences of undertreated pain are recognized. Aims The study benchmarks pain prevalence, assessment, and treatment as first steps to improve pain care in a Canadian tertiary hospital. Methods Single-day audits were undertaken on the pediatric ward (PW), pediatric emergency department (ED), and maternal services (MS). Participants (child or caregiver proxy) reported hospital pain experiences in the preceding 24 h; medical records were reviewed for assessment and treatment. Results Among 84 participants, pain prevalence ranged from 75% to 88%; mean pain intensity ranged from 5.7 to 6.5/10. Prevalence of moderate to severe pain was 78% on PW, 65% in ED, and 55% on MS; needle pokes were the most frequent cause of worst pain. Documentation of pain assessment varied by setting (PW, 93%; ED, 13%; MS, 0%). Documented maximum pain scores were significantly lower compared to participant report (mean difference 4.5/10, SD 3.1, P

Applying two theories to complex contexts results in a more well-rounded case analysis. This case, involving a Latinx family within pediatrics, requires a multi-faceted approach to better evaluate the culturally specific needs of the patient and the family system. A Mujerista theological approach highlights the subjective nature of family values and lived wisdom. This Mujerista approach adds another dimension, along with a Family Interest Model, for medical decision making

Langerhans cell histiocytosis (LH) is a rare condition, more common in children, of unknown etiology characterized by an infiltration of one or more organs, by Langerhans type dendritic cells, most often organized into granulomas. HL has an extremely polymorphic clinical presentation, ranging from indolent chronic skin lesions to systemic and sometimes fatal attacks. All organs can be affected but the disease essentially affects the bone, the skin, the pituitary gland. There is no therapeutic trial in adults, so the treatment is largely based on the pediatric experience. We report the case of HL in its chronic disseminated form revealed by isolated perineal ulceration. [ABSTRACT FROM AUTHOR]

The authors report a rare probable case of Larsen syndrome found in a 3-day-old male neonate in the paediatric surgery unit of the Yaounde Gynaeco-Obstetric and paediatric hospital. They highlight the diagnostic and therapeutic challenges in a resource limited setting, and express their preference for the orthopedic treatment as the first line treatment. [ABSTRACT FROM AUTHOR]

Kawasaki disease is the leading cause of childhood acquired heart disease. It occurs in the majority of cases between 6 months and 5 years. We carried out a retrospective and descriptive study of cases of Kawasaki disease diagnosed in the pediatric department of the Leon Binet hospital in Provins between January 2007 and February 2019. Eighteen children were identified. The average age of the children at diagnosis was 36 months. The sex ratio was in favor of boys (2:1). Kawasaki disease was incomplete in 30% of cases. One third of the children had intractable Kawasaki disease. The cardiac ultrasound was abnormal 1 in 2 times. Early administration of intravenous immunoglobulins and aspirin was effective in all children. No death were deplored. [ABSTRACT FROM AUTHOR]

Hematopoietic stem cells transplant (HSCT) remains, for hematologic malignancies and some non malignant hematologic diseases, the last therapeutic recourse for adult and paediatric patients. Probability to find a histocompatible donor is 1 for 1 million in international registers. In the family, this probability for a genoidentical donor is 33%. Haploidentical HCST is being increasingly used and allows appeal to intra family donor, from parent to child but also from child to parent. Access of blood/marrow gift by a minor donor is covered by law with a derogatory procedure. Child's protection depends of a Living Donor Committee Experts (LDCE), depending of Biomedicine Agency, who receives and questions the child - alone if more than 7 years old and, after, with his parents, before giving official authorization. According to a recent law - August 2021 - a child can give HCSC to his father or mother. Every year, 90 children are presented to the LCDE for a possible donation. To approach ethical problems concerning HCST by children, a clinical case of an autistic child donation for his sister and the role of LCDE are presented. Despite law regulation and LCDE role are in place, some suggestions for possible improvement are suggested. [ABSTRACT FROM AUTHOR]

Since 2005, performing acts or administering treatmentswhen they appear to be useless, disproportionate or having no other effect than the artificial prolongation of life, defining the unreasonableness of a curative treatment, is prohibited by the French law. In the case of nonemancipated underage patients, the physician in charge is required to respect a collegial procedure before deciding to withhold or withdraw treatments. A preformatted sheet, to be filled during the deliberation, makes it possible, to recall the legal elements that the procedure must include, and the medical and non-medical arguments that must be considered to guarantee the quality of the discussion before the physician makes his or her decision. It thus ensures the tracing of the justification of this medical decision, and establishes a framework for the information given to holders of parental authority. Through formalization it, it constitutes an undeniable educational tool for the ethical and palliative acculturation of caregivers who are less experienced in this process. Finally, it can facilitate research work by providing easier access to systematized data. The institutionalization of such a sheet, authorizing all caregivers in the same hospital to share the same document, facilitates the appropriation of the tool by everyone. The computerization of the sheet, within the shared medical file, should allow the optimization of the sharing of the information to all the caregivers who require it, and the essential updating of the decision, after a maximum period of three months. [ABSTRACT FROM AUTHOR]

Background Studies have been conducted describing the potential for using virtual care software during disasters and public health emergencies. However, limited data exist on ways in which the Canadian health care system utilizes virtual care during disasters or public health emergencies. Aims Due to the need for social distancing and reduction of nonessential ambulatory services during the COVID-19 pandemic, the SickKids Chronic Pain Clinic sought to transition care delivery from in person to virtual. The virtual clinic aimed to reduce risks associated with physical contact and environmental exposure without reducing access to care itself. Methods Harnessing of various digital tools including Ontario Telemedicine Network Guestlink, Zoom, and Microsoft Teams. The Chronic Pain Clinic Team worked together to communicate with patients and families, schedule virtual visits, establish remote access to clinical data collection tools, digitize the after-visit summary, and add resources on pain self-management to the clinic’s website. Results The Chronic Pain Clinic successfully transitioned all clinic appointments (multidisciplinary and individual; 77 appointments) over a 2-week period to virtual care. Virtual clinics did not surpass the usual time taken pre-COVID-19, suggesting that the clinic workflow was readily adaptable to virtual care. Conclusions Access to quality virtual care is essential to prevent chronic pain from taking a toll on the lives of patients and families. Rapid establishment of a virtual clinic without gaps in service delivery to patients is possible given institutional support and a team culture centered around collaboration and flexibility.

Résumé: Le pseudo-anévrisme est une entité vasculaire très rare en pédiatrie, souvent liée à une rupture localisée de la paroi vasculaire après un traumatisme direct. L'atteinte de l'artère temporale superficielle représente 1 % et peut prêter à confusion avec d'autres formations kystiques ou tumeurs de cette région. L'interrogatoire prend une importance dans le diagnostic et permet de chercher le traumatisme initial, qui est le plus souvent méconnu. Nous rapportons le cas clinique d'un adolescent qui présente un faux anévrisme de l'artère superficielle dix jours après le traumatisme. Pseudoaneurysm is a rare entity in paediatrics, usually associated with a vascular wall discontinuation following direct trauma. Superficial temporal artery involvement represents one per cent and might be confused with other cystic or neoplastic formations in this region. Anamnesis is a keystone to diagnosis as allows to look for the initial trauma, most often unrecognized. We report the case of a teenager who presents a superficial temporal artery pseudoaneurysm ten days after the initial trauma. [ABSTRACT FROM AUTHOR]

Introduction: Cancer is defined as a chronic disease, in view of the length of treatment and its repercussions on the life of the child. Therapeutic education could be an essential tool to improve the quality of life of sick children. Objectives: Identify the conceptions of caregivers in pediatric oncohaematology institutions and services on educational actions and the implementation of patient therapeutic education programs. Method: Cross-sectional, multicentre qualitative study based on four semi-structured individual interviews and a focus group. Results: Conceptions of the carers in paediatric oncohaematology establishments and services are based on major themes: conceptions of education linked to care, conceptions of the patient therapeutic education session, conceptions of the specificities linked to paediatrics, conceptions of the resources for setting up a patient therapeutic education programme and conceptions of patient therapeutic education linked to the institution. Discussion: Larger study in order to obtain interviews with all the centres de lutte contre le cancer (CLCC) to better understand the obstacles to the implementation of patient therapeutic education programmes and the actions already in place in order to propose a national strategy to formalise and enhance the actions of the CLCCs. [ABSTRACT FROM AUTHOR]

Résumé: Dans un précédent article, après avoir exposé une situation de maltraitance infantile en cabinet de pédiatrie libéral, nous avons fait un point sur les modalités de signalement et d'information préoccupante (IP) en cas de suspicion de maltraitance infantile. Cependant, malgré ces procédures facilitées et modifiées pour encourager les médecins à signaler au moindre doute, les médecins généralistes y ont rarement recours. Pourquoi sont-ils réticents au signalement et quelles peuvent être les conséquences pour eux lorsqu'ils sont face à ces situations difficiles ? In a previous article, after exposing a situation of child abuse in a private pediatric practice, we reviewed the procedures for reporting and worrying information (PI) in the event of suspected child abuse. However, despite these procedures being facilitated and modified to encourage physicians to report any doubt, general practitioners rarely resort to them. Why are they reluctant to report and what might be the consequences for them when faced with these difficult situations? [ABSTRACT FROM AUTHOR]