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1. Neonatal outcomes for women at risk of preterm delivery given half dose versus full dose of antenatal betamethasone: a randomised, multicentre, double-blind, placebo-controlled, non-inferiority trial

Author

Thomas Schmitz, Muriel Doret-Dion, Loic Sentilhes, Olivier Parant, Olivier Claris, Laurent Renesme, Julie Abbal, Aude Girault, Héloïse Torchin, Marie Houllier, Nolwenn Le Saché, Alexandre J Vivanti, Daniele De Luca, Norbert Winer, Cyril Flamant, Claire Thuillier, Pascal Boileau, Julie Blanc, Véronique Brevaut, Pierre-Emmanuel Bouet, Géraldine Gascoin, Gaël Beucher, Valérie Datin-Dorriere, Stéphane Bounan, Pascal Bolot, Christophe Poncelet, Corinne Alberti, Moreno Ursino, Camille Aupiais, Olivier Baud, Philippe Boize, Charles Garabédian, Florence Flamein, Maela Le Lous, Alain Beuchée, Jean Gondry, Pierre Tourneux, Perrine Coste-Mazeau, Antoine Bedu, Denis Gallot, Karen Coste, Céline Chauleur, Hugues Patural, Gilles Kayem, Delphine Mitanchez, Hélène Heckenroth, Farid Boubred, Jeanne Sibiude, Luc Desfrère, Caroline Bohec, Thierry Mansir, Antoine Koch, Pierre Kuhn, Nadia Tillouche, Fabrice Lapeyre, Franck Perrotin, Géraldine Favrais, Edouard Lecarpentier, Xaxier Durrmeyer, Véronique Equy, Thierry Debillon, Luc Rigonnot, Stéphanie Lefoulgoc, Claudia Brie, Anne-Sophie Pagès, Romy Rayssiguier, Gilles Cambonie, Corinne Cudeville, Doriane Madeleneau, Olivier Morel, Jean-Michel Hascoet, Vincent Letouzey, Massimo Di Maio, Laurent J. Salomon, Alexandre Lapillonne, Hôpital Robert Debré, Hôpital Femme Mère Enfant [CHU - HCL] (HFME), Hospices Civils de Lyon (HCL), CHU Bordeaux [Bordeaux], Centre Hospitalier Universitaire de Toulouse (CHU Toulouse), Centre de recherche Cardio-Thoracique de Bordeaux [Bordeaux] (CRCTB), Université Bordeaux Segalen - Bordeaux 2-CHU Bordeaux [Bordeaux]-Institut National de la Santé et de la Recherche Médicale (INSERM), Maternité Port-Royal [CHU Cochin], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Cochin [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), AP-HP - Hôpital Cochin Broca Hôtel Dieu [Paris], Equipe 1 : EPOPé - Épidémiologie Obstétricale, Périnatale et Pédiatrique (CRESS - U1153), Centre de Recherche Épidémiologie et Statistique Sorbonne Paris Cité (CRESS (U1153 / UMR_A_1125 / UMR_S_1153)), Conservatoire National des Arts et Métiers [CNAM] (CNAM), HESAM Université - Communauté d'universités et d'établissements Hautes écoles Sorbonne Arts et métiers université (HESAM)-HESAM Université - Communauté d'universités et d'établissements Hautes écoles Sorbonne Arts et métiers université (HESAM)-Université Sorbonne Paris Cité (USPC)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Paris Cité (UPCité)-Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement (INRAE)-Conservatoire National des Arts et Métiers [CNAM] (CNAM), HESAM Université - Communauté d'universités et d'établissements Hautes écoles Sorbonne Arts et métiers université (HESAM)-HESAM Université - Communauté d'universités et d'établissements Hautes écoles Sorbonne Arts et métiers université (HESAM)-Université Sorbonne Paris Cité (USPC)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Paris Cité (UPCité)-Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement (INRAE), AP-HP Hôpital Bicêtre (Le Kremlin-Bicêtre), AP-HP - Hôpital Antoine Béclère [Clamart], Service de Pédiatrie et Réanimations néonatales [Béclère], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-AP-HP - Hôpital Antoine Béclère [Clamart], Hypertension pulmonaire : physiopathologie et innovation thérapeutique (HPPIT), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Paris-Saclay, Physiopathologie des Adaptations Nutritionnelles (PhAN), Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement (INRAE)-Nantes Université - UFR de Médecine et des Techniques Médicales (Nantes Univ - UFR MEDECINE), Nantes Université - pôle Santé, Nantes Université (Nantes Univ)-Nantes Université (Nantes Univ)-Nantes Université - pôle Santé, Nantes Université (Nantes Univ)-Nantes Université (Nantes Univ), CHI Poissy-Saint-Germain, Physiologie et physiopathologie endocriniennes (PHYSENDO), École Nationale Supérieure de Formation de l'Enseignement Agricole de Toulouse-Auzeville (ENSFEA), Education, Formation, Travail, Savoirs (EFTS), Université Toulouse - Jean Jaurès (UT2J), Université de Toulouse (UT)-Université de Toulouse (UT)-École Nationale Supérieure de Formation de l'Enseignement Agricole de Toulouse-Auzeville (ENSFEA), Hôpital Nord [CHU - APHM], Centre Hospitalier Universitaire d'Angers (CHU Angers), PRES Université Nantes Angers Le Mans (UNAM), CHU Caen, Normandie Université (NU)-Tumorothèque de Caen Basse-Normandie (TCBN), Centre Hospitalier de Saint-Denis [Ile-de-France], Centre Hospitalier René Dubos [Pontoise], Hôpital Robert Debré Paris, Centre de Recherche des Cordeliers (CRC (UMR_S_1138 / U1138)), École Pratique des Hautes Études (EPHE), Université Paris sciences et lettres (PSL)-Université Paris sciences et lettres (PSL)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Sorbonne Université (SU)-Université Paris Cité (UPCité), Health data- and model- driven Knowledge Acquisition (HeKA), Inria de Paris, Institut National de Recherche en Informatique et en Automatique (Inria)-Institut National de Recherche en Informatique et en Automatique (Inria)-Centre de Recherche des Cordeliers (CRC (UMR_S_1138 / U1138)), Université Paris sciences et lettres (PSL)-Université Paris sciences et lettres (PSL)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Sorbonne Université (SU)-Université Paris Cité (UPCité)-École Pratique des Hautes Études (EPHE), Centre d'Investigation Clinique 1426 (CIC 1426), Institut National de la Santé et de la Recherche Médicale (INSERM)-AP-HP Hôpital universitaire Robert-Debré [Paris], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Epidémiologie Clinique et Evaluation Economique Appliquées aux Populations Vulnérables (ECEVE (U1123 / UMR_S_1123)), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Université Paris Cité (UPCité), Maladies neurodéveloppementales et neurovasculaires (NeuroDiderot (UMR_S_1141 / U1141)), and Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Paris Cité (UPCité)

Subjects
Respiratory Distress Syndrome, Newborn, Double-Blind Method, Pregnancy, [SDV]Life Sciences [q-bio], Infant, Newborn, Humans, Premature Birth, Female, Infant, Premature, Diseases, General Medicine, Betamethasone
Abstract

International audience; BackgroundAntenatal betamethasone is recommended before preterm delivery to accelerate fetal lung maturation. However, reports of growth and neurodevelopmental dose-related side-effects suggest that the current dose (12 mg plus 12 mg, 24 h apart) might be too high. We therefore investigated whether a half dose would be non-inferior to the current full dose for preventing respiratory distress syndrome.MethodsWe designed a randomised, multicentre, double-blind, placebo-controlled, non-inferiority trial in 37 level 3 referral perinatal centres in France. Eligible participants were pregnant women aged 18 years or older with a singleton fetus at risk of preterm delivery and already treated with the first injection of antenatal betamethasone (11·4 mg) before 32 weeks’ gestation. We used a computer-generated code producing permuted blocks of varying sizes to randomly assign (1:1) women to receive either a placebo (half-dose group) or a second 11·4 mg betamethasone injection (full-dose group) 24 h later. Randomisation was stratified by gestational age (before or after 28 weeks). Participants, clinicians, and study staff were masked to the treatment allocation. The primary outcome was the need for exogenous intratracheal surfactant within 48 h after birth. Non-inferiority would be shown if the higher limit of the 95% CI for the between-group difference between the half-dose and full-dose groups in the primary endpoint was less than 4 percentage points (corresponding to a maximum relative risk of 1·20). Four interim analyses monitoring the primary and the secondary safety outcomes were done during the study period, using a sequential data analysis method that provided futility and non-inferiority stopping rules and checked for type I and II errors. Interim analyses were done in the intention-to-treat population. This trial was registered with ClinicalTrials.gov, NCT02897076.FindingsBetween Jan 2, 2017, and Oct 9, 2019, 3244 women were randomly assigned to the half-dose (n=1620 [49·9%]) or the full-dose group (n=1624 [50·1%]); 48 women withdrew consent, 30 fetuses were stillborn, 16 neonates were lost to follow-up, and 9 neonates died before evaluation, so that 3141 neonates remained for analysis. In the intention-to-treat analysis, the primary outcome occurred in 313 (20·0%) of 1567 neonates in the half-dose group and 276 (17·5%) of 1574 neonates in the full-dose group (risk difference 2·4%, 95% CI –0·3 to 5·2); thus non-inferiority was not shown. The per-protocol analysis also did not show non-inferiority (risk difference 2·2%, 95% CI –0·6 to 5·1). No between-group differences appeared in the rates of neonatal death, grade 3–4 intraventricular haemorrhage, stage ≥2 necrotising enterocolitis, severe retinopathy of prematurity, or bronchopulmonary dysplasia.InterpretationBecause non-inferiority of the half-dose compared with the full-dose regimen was not shown, our results do not support practice changes towards antenatal betamethasone dose reduction.

Published
2022
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2. Maternal employment and socio‐economic status of families raising children born very preterm with motor or cognitive impairments: the EPIPAGE cohort study

Author

Marie-Josèphe Saurel-Cubizolles, Jacqueline Matis, Antoine Burguet, Laetitia Marchand-Martin, Catherine Arnaud, Stéphane Marret, Monique Kaminski, Véronique Pierrat, Pierre-Yves Ancel, Gilles Cambonie, Jean-Christophe Rozé, and Jeanne Fresson

Subjects
Employment, Male, Gerontology, 030506 rehabilitation, Developmental Disabilities, Mothers, Gestational Age, Standard of living, Social class, Cohort Studies, 03 medical and health sciences, 0302 clinical medicine, Developmental Neuroscience, Economic Status, Humans, Medicine, Very Preterm Birth, Cognitive Dysfunction, Family, Child, Socioeconomic status, Reference group, business.industry, Cognition, Social Class, Child, Preschool, Pediatrics, Perinatology and Child Health, Cohort, Female, France, Neurology (clinical), 0305 other medical science, business, Infant, Premature, 030217 neurology & neurosurgery, Maternal Age, Cohort study
Abstract

AIM To describe maternal employment and the socio-economic status of the household up to 8 years after the very preterm birth of a child, according to the presence and type of motor or cognitive impairment. METHOD A total of 1885 families from the French EPIPAGE cohort of children who were born very preterm between 1997 and 1998 were included. Motor and cognitive impairments were identified in children between the ages of 2 and 8 years in 770 families and were classified according to type. The 1115 families with children born very preterm without these impairments were considered the reference group. RESULTS Mothers of children with severe motor or cognitive impairments were less often working at 5 years after the birth than the reference mothers (21% and 30% vs 57%; p

Published
2020
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3. Cerebral sinovenous thrombosis associated with head/neck infection in children: Clues for improved management

Author

Lucie Narcy, Sabine Durand, Marion Grimaud, Nicolas Leboucq, David Grevent, Gilles Cambonie, Vincent Couloigner, François Rivier, Pierre Meyer, and Manoelle Kossorotoff

Subjects
Male, Sinus Thrombosis, Intracranial, Developmental Neuroscience, Risk Factors, Pediatrics, Perinatology and Child Health, Infant, Newborn, Humans, Infant, Female, Thrombosis, Neurology (clinical), Child, Retrospective Studies
Abstract

To compare paediatric patients with cerebral sinovenous thrombosis (CSVT) with and without head/neck infection to improve management of the condition.We conducted a bicentric retrospective study of consecutive children (neonates excluded) with radiologically confirmed CSVT, comparing children with a concurrent head/neck infection and children with other causes.A total of 84 consecutive patients (46 males and 38 females) with a median age of 4 years 6 months (range 3 months-17 years 5 months) were included. Associated head/neck infection was identified in 65.4% of cases and represented the main identified CSVT aetiology. Children in the head/neck infection group displayed a milder clinical presentation and less extensive CSVT. Median time to complete recanalization was significantly shorter in this group (89 days [interquartile range 35-101] vs 112.5 days [interquartile range 83-177], p = 0.005). These findings were even more pronounced in the subgroup of patients with otogenic infection and no neurological sign.As CSVT in the setting of an otogenic infection and no neurological sign seems to represent a milder condition with a shorter course, these results suggest adapting current recommendations: consider earlier control imaging in paediatric otogenic CSVT, and shorter anticoagulant treatment if recanalization is obtained.Children with cerebral sinovenous thrombosis related to head/neck infections have a milder clinical presentation. They also have a shorter recanalization time, especially if there is otogenic infection without neurological symptoms.

Published
2022

4. Association Between Early Amino Acid Intake and Full-Scale IQ at Age 5 Years Among Infants Born at Less Than 30 Weeks’ Gestation

Author

Jean-Christophe, Rozé, Baptiste, Morel, Alexandre, Lapillonne, Stéphane, Marret, Isabelle, Guellec, Dominique, Darmaun, Nathalie, Bednarek, Thomas, Moyon, Laetitia, Marchand-Martin, Valérie, Benhammou, Véronique, Pierrat, Cyril, Flamant, Géraldine, Gascoin, Delphine, Mitanchez, Gilles, Cambonie, Laurent, Storme, Bathélémie, Tosello, Valérie, Biran, Olivier, Claris, Jean-Charles, Picaud, Géraldine, Favrais, Alain, Beuchée, Gauthier, Loron, Catherine, Gire, Xavier, Durrmeyer, Pierre, Gressens, Elie, Saliba, Pierre-Yves, Ancel, Catherine, Adamsbaum, Physiopathologie des Adaptations Nutritionnelles (PhAN), Université de Nantes - UFR de Médecine et des Techniques Médicales (UFR MEDECINE), Université de Nantes (UN)-Université de Nantes (UN)-Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement (INRAE), Centre hospitalier universitaire de Nantes (CHU Nantes), Centre d'épidémiologie Clinique [Hôtel-Dieu], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Hôpital Hôtel Dieu, Centre Hospitalier Régional Universitaire de Tours (CHRU Tours), Imagerie et cerveau (iBrain - Inserm U1253 - UNIV Tours ), Université de Tours (UT)-Institut National de la Santé et de la Recherche Médicale (INSERM), CHU Necker - Enfants Malades [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), CHU Rouen, Normandie Université (NU), Service de néonatologie [CHU Trousseau], CHU Trousseau [APHP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), Centre de Recherche en Sciences et Technologies de l'Information et de la Communication - EA 3804 (CRESTIC), Université de Reims Champagne-Ardenne (URCA), Centre Hospitalier Universitaire de Reims (CHU Reims), Equipe 1 : EPOPé - Épidémiologie Obstétricale, Périnatale et Pédiatrique (CRESS - U1153), Centre de Recherche Épidémiologie et Statistique Sorbonne Paris Cité (CRESS (U1153 / UMR_A_1125 / UMR_S_1153)), Conservatoire National des Arts et Métiers [CNAM] (CNAM), HESAM Université - Communauté d'universités et d'établissements Hautes écoles Sorbonne Arts et métiers université (HESAM)-HESAM Université - Communauté d'universités et d'établissements Hautes écoles Sorbonne Arts et métiers université (HESAM)-Université Sorbonne Paris Cité (USPC)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Paris Cité (UPCité)-Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement (INRAE)-Conservatoire National des Arts et Métiers [CNAM] (CNAM), HESAM Université - Communauté d'universités et d'établissements Hautes écoles Sorbonne Arts et métiers université (HESAM)-HESAM Université - Communauté d'universités et d'établissements Hautes écoles Sorbonne Arts et métiers université (HESAM)-Université Sorbonne Paris Cité (USPC)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Paris Cité (UPCité)-Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement (INRAE), CHU Lille, CHU Trousseau [Tours], CHU Montpellier, Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier), Université de Montpellier (UM), CHU Marseille, AP-HP Hôpital universitaire Robert-Debré [Paris], Hospices Civils de Lyon (HCL), CHU Pontchaillou [Rennes], Centre Hospitalier Intercommunal de Créteil (CHIC), CIC - Mère Enfant Necker Cochin Paris Centre (CIC 1419), Hôpital Cochin [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Paris Cité (UPCité), Nutrition EPIPAGE-2 Study Group and the EPIRMEX Study Group: Farid Bourdred, Odile Dicky, Jean-Michel Hascoet, Gerard Thiriez, Luc Desfrere, Clement Chollat, Isabelle Filipiak, Dominique Sirinelli, Alexandre Chadi, Catherine Adamsbaum, HAL-SU, Gestionnaire, Université de Tours-Institut National de la Santé et de la Recherche Médicale (INSERM), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-CHU Trousseau [APHP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), Conservatoire National des Arts et Métiers [CNAM] (CNAM)-Université Sorbonne Paris Cité (USPC)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Paris (UP)-Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement (INRAE)-Conservatoire National des Arts et Métiers [CNAM] (CNAM)-Université Sorbonne Paris Cité (USPC)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Paris (UP)-Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement (INRAE), and Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Paris (UP)

Subjects
Male, [SDV.MHEP] Life Sciences [q-bio]/Human health and pathology, Research, Intelligence, Infant, Newborn, Infant, Gestational Age, Infant, Premature, Diseases, Pediatrics, Cohort Studies, Online Only, Child Development, Treatment Outcome, Child, Preschool, Practice Guidelines as Topic, Humans, Female, France, Prospective Studies, Amino Acids, [SDV.MHEP]Life Sciences [q-bio]/Human health and pathology, Original Investigation
Abstract

Key Points Question Is early amino acid intake among very preterm infants associated with cognitive performance at age 5 years? Findings In this cohort study of 1789 infants born at less than 30 weeks’ gestation, exposure vs nonexposure to amino acid intake between 3.51 and 4.50 g/kg/d at 7 days after birth was significantly and independently associated with a higher likelihood (61% vs 54%, respectively) of surviving with a full-scale IQ score greater than −1 SD at age 5 years. Meaning The results of this study suggest that high early amino acid intake among very preterm infants is safe and significantly associated with improved cognitive outcomes at age 5 years., Importance An international expert committee recently revised its recommendations on amino acid intake for very preterm infants, suggesting that more than 3.50 g/kg/d should be administered only to preterm infants in clinical trials. However, the optimal amino acid intake during the first week after birth in these infants is unknown. Objective To evaluate the association between early amino acid intake and cognitive outcomes at age 5 years. Design, Setting, and Participants Using the EPIPAGE-2 (Epidemiologic Study on Small-for-Gestational-Age Children—Follow-up at Five and a Half Years) cohort, a nationwide prospective population-based cohort study conducted at 63 neonatal intensive care units in France, a propensity score–matched analysis was performed comparing infants born at less than 30 weeks’ gestation who had high amino acid intake (3.51-4.50 g/kg/d) at 7 days after birth with infants who did not. Participants were recruited between April 1 and December 31, 2011, and followed up from September 1, 2016, to December 31, 2017. Full-scale IQ (FSIQ) was assessed at age 5 years. A confirmatory analysis used neonatal intensive care unit preference for high early amino acid intake as an instrumental variable to account for unmeasured confounding. Statistical analysis was performed from January 15 to May 15, 2021. Exposures Amino acid intake at 7 days after birth. Main Outcomes and Measures The primary outcome was an FSIQ score greater than −1 SD (ie, ≥93 points) at age 5 years. A complementary analysis was performed to explore the association between amino acid intake at day 7 as a continuous variable and FSIQ score at age 5 years. Data from cerebral magnetic resonance imaging at term were available for a subgroup of preterm infants who participated in the EPIRMEX (Cerebral Abnormalities Detected by MRI, Realized at the Age of Term and the Emergence of Executive Functions) ancillary study. Results Among 1789 preterm infants (929 boys [51.9%]; mean [SD] gestational age, 27.17 [1.50] weeks) with data available to determine exposure to amino acid intake of 3.51 to 4.50 g/kg/d at 7 days after birth, 938 infants were exposed, and 851 infants were not; 717 infants from each group could be paired. The primary outcome was known in 396 of 646 exposed infants and 379 of 644 nonexposed infants who were alive at age 5 years and was observed more frequently among exposed vs nonexposed infants (243 infants [61.4%] vs 206 infants [54.4%], respectively; odds ratio [OR], 1.33 [95% CI, 1.00-1.71]; absolute risk increase in events [ie, the likelihood of having an FSIQ score >−1 SD at age 5 years] per 100 infants, 7.01 [95% CI, 0.06-13.87]; P = .048). In the matched cohort, correlation was found between amino acid intake per 1.00 g/kg/d at day 7 and FSIQ score at age 5 years (n = 775; β = 2.43 per 1-point increase in FSIQ; 95% CI, 0.27-4.59; P = .03), white matter area (n = 134; β = 144 per mm2; 95% CI, 3-285 per mm2; P = .045), anisotropy of the corpus callosum (n = 50; β = 0.018; 95% CI, 0.016-0.021; P, This cohort study assesses the association between high amino acid intake among very preterm infants at 7 days after birth and cognitive performance at age 5 years.

Published
2021
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5. Near-Infrared Spectroscopy: A Tool for Diagnosing Necrotizing Enterocolitis at Onset of Symptoms in Preterm Neonates with Acute Gastrointestinal Symptoms?

Author

Julia le Bouhellec, Thibault Mura, Gilles Cambonie, Lucie Gamon, Aurélien Jacquot, Olivier Prodhomme, Clémentine Combes, Sabine Durand, Anne Filleron, Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier), Département d'Information Médicale [CHRU Montpellier], Département Pédiatrie [CHRU Montpellier], Pôle Femme Mère Enfant [CHRU Montpellier], Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier)-Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier), and Centre Hospitalier Universitaire de Nîmes (CHU Nîmes)

Subjects
Male, medicine.medical_specialty, Gastrointestinal Diseases, Birth weight, Gastroenterology, 03 medical and health sciences, 0302 clinical medicine, Near-infrared spectroscopy, Enterocolitis, Necrotizing, Necrotizing enterocolitis, Internal medicine, Abdomen, medicine, [INFO.INFO-IM]Computer Science [cs]/Medical Imaging, Humans, Tissue oxygen, In patient, Prospective Studies, [SDV.MHEP.PED]Life Sciences [q-bio]/Human health and pathology/Pediatrics, Spectroscopy, Near-Infrared, 030219 obstetrics & reproductive medicine, Diagnostic techniques, business.industry, Infant, Newborn, Obstetrics and Gynecology, Bayes Theorem, Oxygenation, Abdominal distension, medicine.disease, Premature neonate, digestive system diseases, 3. Good health, Oxygen, Oxygen Saturation, Pediatrics, Perinatology and Child Health, Gestation, Female, medicine.symptom, business, Infant, Premature, Feeding Intolerance
Abstract

Objective In premature neonates, bloody stools and/or abdominal distension with feeding intolerance may be inaugural signs of necrotizing enterocolitis (NEC). We assessed the ability of near-infrared spectroscopy (NIRS) to distinguish those neonates with NEC soon after the occurrence of these symptoms. Study Design We prospectively collected NIRS measurements of abdominal and cerebral regional tissue oxygen saturation (r-SO2), with values masked by an opaque cover. Two physicians, blinded to the NIRS data, determined whether the gastrointestinal symptoms were related to NEC 10 days after symptom onset. Results Forty-five neonates with mean (standard deviation [SD]) gestational, birth weight and postnatal ages of 31 (3.9) weeks, 1,486 (794) g, and 18 (14) days were enrolled over 30 months. Gastrointestinal symptoms were related to NEC in 23 patients and associated with other causes in 22. Analysis of the 48 hours of monitoring revealed comparable abdominal r-SO2 and splanchnic-cerebral oxygenation ratio (SCOR) in patients with and without NEC (r-SO2: 47.3 [20.4] vs. 50.4 [17.8], p = 0.59, SCOR: 0.64 [0.26] vs. 0.69 [0.24], p = 0.51). Results were unchanged after NIRS analysis in 6-hour periods, and restriction of the analysis to severe NEC (i.e., grade 2 and 3, 57% of the NEC cases). Conclusion In this study, NIRS monitoring was unable to individualize NEC in premature infants with acute gastrointestinal symptoms.

Published
2021
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6. Premedication with ketamine or propofol for less invasive surfactant administration (LISA): observational study in the delivery room

Author

Gilles Cambonie, M. Badr, Camille Brotelande, Christophe Milési, Sabine Durand, and Clémentine Combes

Subjects
medicine.medical_treatment, Sedation, Premedication, 03 medical and health sciences, Surface-Active Agents, 0302 clinical medicine, Pregnancy, 030225 pediatrics, Intensive care, medicine, Intubation, Humans, Ketamine, 030212 general & internal medicine, Continuous positive airway pressure, Prospective Studies, Propofol, business.industry, Delivery Rooms, Infant, Newborn, Gestational age, Anesthesia, Pediatrics, Perinatology and Child Health, Female, medicine.symptom, business, medicine.drug
Abstract

Less invasive surfactant administration (LISA) has become increasingly popular in neonatal intensive care units (NICUs), but there are currently no guidelines for the premedication prior to this procedure. The aim of this observational study was to compare the efficacy and tolerance of intravenous administrations of ketamine and propofol before LISA in neonates born before 30 weeks of gestational age (GA). The primary outcome was requirement of intubation within 2 h of the procedure. One hundred and fourteen infants, with respective GA and birthweight of 27.6 (26.4, 28.7) weeks and 940 (805, 1140) g, were prospectively included from January 2016 to December 2019. Drug doses were 1 (0.5, 1) mg/kg for ketamine and 1 (1, 1.9) mg/kg for propofol, providing comparable comfort during LISA (p = 0.61). Rates of intubation within 2 h were 5/52 after ketamine, and 5/62 after propofol [aOR 0.54 (0.11-2.68)]. No difference was observed for rates of intubation at 24 h and 72 h following LISA, mortality, or severe morbidity.Conclusion: Pending results from prospective trials, these findings suggest that ketamine or propofol can be used for premedication before LISA, as they show comparable efficacy and tolerance.Trial registration: This study was recorded on the National Library of Medicine registry (https:// clinicaltrials.gov / Identifier: NCT03705468). What is Known? • Less invasive surfactant administration (LISA) is increasingly used in spontaneously breathing premature infants supported with continuous positive airway pressure, but few data are available to guide adequate premedication for this procedure. What is New? • This observational study of 114 neonates, all less than 30-week gestational age and requiring surfactant without endotracheal tube in the delivery room, suggested that ketamine or propofol can be used for premedication before LISA with comparable efficacy and tolerance.

Published
2021

7. Assessment of Peak Inspiratory Flow in Young Infants with Acute Viral Bronchiolitis: Physiological Basis for Initial Flow Setting in Patients Supported with High-Flow Nasal Cannula

Author

Julien Baleine, Erika Nogue, Martí Pons-Òdena, Anne Requirand, Pascal Amedro, Aymeric Douillard, Christophe Milési, Gilles Cambonie, S. Matecki, Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier), Physiologie & médecine expérimentale du Cœur et des Muscles [U 1046] (PhyMedExp), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Montpellier (UM)-Centre National de la Recherche Scientifique (CNRS), Hospital Sant Joan de Déu [Barcelona], University of Barcelona, Pathogénèse et contrôle des infections chroniques (PCCI), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Montpellier (UM)-Centre Hospitalier Universitaire de Montpellier (CHU Montpellier ), and MORNET, Dominique

Subjects
Adult, Male, Spirometry, [SDV]Life Sciences [q-bio], medicine.disease_cause, Young Adult, 03 medical and health sciences, 0302 clinical medicine, 030225 pediatrics, Clinical endpoint, Bronchiolitis, Viral, Cannula, Humans, Medicine, Respiratory function, Prospective Studies, 030212 general & internal medicine, Prospective cohort study, Peak flow meter, ComputingMilieux_MISCELLANEOUS, Aged, measurement_unit, Pediatric intensive care unit, Respiratory distress, medicine.diagnostic_test, business.industry, Oxygen Inhalation Therapy, Middle Aged, 3. Good health, [SDV] Life Sciences [q-bio], Anesthesia, Acute Disease, Pediatrics, Perinatology and Child Health, measurement_unit.measuring_instrument, Female, Pulmonary Ventilation, business, Nasal cannula
Abstract

Objective To assess the inspiratory demand in young infants with acute viral bronchiolitis to provide a physiological basis for initial flow setting for patients supported with high flow nasal cannula. Study design Prospective study in 44 infants up to 6 months old with acute viral bronchiolitis, admitted to a pediatric intensive care unit from November 2017 to March 2019. Airflow measurements were performed using spirometry. The primary endpoint was the inspiratory demand as measured by peak tidal inspiratory flow (PTIF). The secondary endpoints were the relationships determined between PTIF, patient weight, and disease severity. Results Median (Q25-Q75) age and weight of the patients were 37 (20-67) days and 4.3 (3.5-5.0) kg, respectively. Mean PTIF was 7.45 (95% CI 6.51-8.39, min-max: 2.40-16.00) L/minute. PTIF indexed to weight was 1.68 (95% CI 1.51-1.85, min-max: 0.67-3.00) L/kg/minute. PTIF was Conclusions High flow nasal cannula therapy is used commonly to support infants with acute viral bronchiolitis. The efficiency of the device is optimal if the flow setting matches the patient's inspiratory demand. According to our results, a flow rate of

Published
2020
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8. New Modalities for the Administration of Inhaled Nitric Oxide in Intensive Care Units After Cardiac Surgery or for Neonatal Indications

Author

Pierre Damas, Mimoun M'rini, Pierre Louis Leger, Gauthier Loron, Gilles Cambonie, Philippe Gaudard, Ziad Assaf, Julien Amour, Philippe Pouard, Claudio Barbanti, Claude Girard, Bertrand Rozec, Jean Michel Liet, Laurent Lecourt, and Philippe Mauriat

Subjects
Male, Hypertension, Pulmonary, Vasodilator Agents, medicine.medical_treatment, Population, 030204 cardiovascular system & hematology, Nitric Oxide, Persistent Fetal Circulation Syndrome, law.invention, 03 medical and health sciences, 0302 clinical medicine, Belgium, law, Intensive Care Units, Neonatal, Intensive care, Administration, Inhalation, medicine, Humans, Prospective Studies, Cardiac Surgical Procedures, Adverse effect, education, Prospective cohort study, Aged, Mechanical ventilation, education.field_of_study, Ventilators, Mechanical, business.industry, Coronary Care Units, Infant, Newborn, Infant, Equipment Design, Middle Aged, medicine.disease, Respiration, Artificial, Pulmonary hypertension, Intensive care unit, 3. Good health, Treatment Outcome, Anesthesiology and Pain Medicine, 030228 respiratory system, Child, Preschool, Anesthesia, Concomitant, Female, France, business
Abstract

Background Nitric oxide (NO) has a well-known efficacy in pulmonary hypertension (PH), with wide use for 20 years in many countries. The objective of this study was to describe the current use of NO in real life and the gap with the guidelines. Methods This is a multicenter, prospective, observational study on inhaled NO administered through an integrated delivery and monitoring device and indicated for PH according to the market authorizations. The characteristics of NO therapy and ventilation modes were observed. Concomitant pulmonary vasodilator treatments, safety data, and outcome were also collected. Quantitative data are expressed as median (25th, 75th percentile). Results Over 1 year, 236 patients were included from 14 equipped and trained centers: 117 adults and 81 children with PH associated with cardiac surgery and 38 neonates with persistent PH of the newborn. Inhaled NO was initiated before intensive care unit (ICU) admission in 57%, 12.7%, and 38.9% with an initial dose of 10 (10, 15) ppm, 20 (18, 20) ppm, and 17 (11, 20) ppm, and a median duration of administration of 3.9 (1.9, 6.1) days, 3.8 (1.8, 6.8) days, and 3.1 (1.0, 5.7) days, respectively, for the adult population, pediatric cardiac group, and newborns. The treatment was performed using administration synchronized to the mechanical ventilation. The dose was gradually decreased before withdrawal in 86% of the cases according to the usual procedure of each center. Adverse events included rebound effect for 3.4% (95% confidence interval [CI], 0.9%-8.5%) of adults, 1.2% (95% CI, 0.0%-6.7%) of children, and 2.6% (95% CI, 0.1%-13.8%) of neonates and methemoglobinemia exceeded 2.5% for 5 of 62 monitored patients. Other pulmonary vasodilators were associated with NO in 23% of adults, 95% of children, and 23.7% of neonates. ICU stay was respectively 10 (6, 22) days, 7.5 (5.5, 15) days, and 9 (8, 15) days and ICU mortality was 22.2%, 6.2%, and 7.9% for adults, children, and neonates, respectively. Conclusions This study confirms the safety of NO therapy in the 3 populations with a low rate of rebound effect. Gradual withdrawal of NO combined with pulmonary vasodilators are current practices in this population. The use of last-generation NO devices allowed good compliance with recommendations.

Published
2018
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9. 15‐Year trends in respiratory care of extremely preterm infants: Contributing factors and consequences on health and growth during hospitalization

Author

Renaud Mesnage, Sabine Durand, Clémentine Combes, Arthur Gavotto, Gilles Cambonie, Jean-Charles Picaud, Christophe Milési, Flora Habas, Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier), Physiologie & médecine expérimentale du Cœur et des Muscles [U 1046] (PhyMedExp), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Montpellier (UM)-Centre National de la Recherche Scientifique (CNRS), Department of Neonatal Medicine, Croix-Rousse Hospital, Lyon University Hospital Center, Lyon, and MORNET, Dominique

Subjects
Male, Pulmonary and Respiratory Medicine, Respiratory Therapy, medicine.medical_specialty, Time Factors, medicine.medical_treatment, [SDV]Life Sciences [q-bio], Gestational Age, medicine.disease_cause, 03 medical and health sciences, 0302 clinical medicine, 030225 pediatrics, Internal medicine, medicine, Humans, Respiratory system, ComputingMilieux_MISCELLANEOUS, Bronchopulmonary Dysplasia, Retrospective Studies, Mechanical ventilation, business.industry, Infant, Newborn, Retrospective cohort study, medicine.disease, Infant mortality, 3. Good health, Hospitalization, [SDV] Life Sciences [q-bio], 030228 respiratory system, Bronchopulmonary dysplasia, Infant, Extremely Premature, Pediatrics, Perinatology and Child Health, Gestation, Female, business, Nasal cannula, Respiratory care
Abstract

OBJECTIVES To review 15-year trends in respiratory care of extremely preterm infants managed in a tertiary perinatal center; to identify the factors contributing to their evolution; and to determine whether these changes had an impact on infant mortality, severe morbidity, and growth. METHODS Retrospective cohort study of infants born at 23 to 26 weeks' gestation between 2003 and 2017. Changes in respiratory care were assessed in three 5-year periods. Logistic regression was used to examine the factors associated with prolonged duration (ie, greater than the median) of invasive mechanical ventilation (IMV), noninvasive ventilation (NIV), and overall respiratory support (ORS), and those associated with adequate weight and head circumference growth. RESULTS Of the 396 actively treated neonates, 268 (68%) survived to discharge. Between the first and third periods, IMV duration decreased from 22 (6-37) to 4 (1-14.0) days (P

Published
2020
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10. KMT2B-related disorders: expansion of the phenotypic spectrum and long-term efficacy of deep brain stimulation

Author

Nihr BioResource, F. Lucy Raymond, Shekeeb S. Mohammad, TD Graves, Susan J. Hayflick, Bert B.A. de Vries, Katy Barwick, Conor Fearon, Dora Steel, Mark Hallett, Asif Doja, Emilie Chan Seng, Camilo Toro, Fiona Stewart, Diane Demailly, Suh Young Jeong, Claudio M. de Gusmao, Frédérique Pavillard, Nutan Sharma, Fabienne Cyprien, Juan C Pallais, Brent L. Fogel, David R. FitzPatrick, Lucia Abela, Russell C. Dale, Bettina Balint, Natalie Trump, Michel Tchan, Sony Malhotra, Swasti Pal, Maya Topf, Manju A. Kurian, Michelle Sahagian, Julia Rankin, Laila Selim, Jeff L. Waugh, Sidney Krystal, Gustavo Polo, Caleb Rogers, Michel Mondain, Kailash P. Bhatia, Ishwar C. Verma, Marisela Dy-Hollins, Kelly A. Mills, Derek Wong, Laura Cif, William A. Gahl, Meredith W Allain, Sanaz Attaripour Isfahani, Agathe Roubertie, Jenny L. Wilson, Allison Gregory, Victoria Gonzalez, Carolyn D. Applegate, Nathalie Dorison, Jennifer A. Bassetti, Catherine Blanchet, Ada Hamosh, Deciphering Developmental Disorders Study, Hane Lee, Julien Baleine, Emma L. Baple, Gaetan Lesca, Anna Znaczko, Thomas Roujeau, Mario Sa, Laurence Lion François, Neil Mahant, Diane Doummar, Sandra Jansen, Marie Hully, Christine Coubes, Eva B. Forman, Victor S.C. Fung, Gaëtan Poulen, Raghda Zaitoun, Serena Galosi, Timothy Lynch, Xavier Vasques, Elise Schaefer, Richard Selway, Adeline Ngoh, Tuula Rinne, Philippe Coubes, Elizabeth L. Fieg, Rachel Fox, Jennifer Friedman, Andrea K. Petersen, Hugo Morales-Briceño, Rebecca Signer, Luis Rohena, Sandra Chantot Bastaraud, Chloé Laurencin, Kishore R. Kumar, Julian A. Martinez-Agosto, Ellyn Farrelly, Kathleen M. Gorman, Esther Meyer, Joel B. Krier, Ariane Soldatos, Lydie Burglen, Jean-Pierre Lin, Pierre-François Perrigault, Dolly Zhen, Harutomo Hasegawa, Mary D. King, Alba Sanchis-Juan, David A. Stevenson, Gilles Cambonie, Wui K. Chong, Christophe Milési, Vincent d'Hardemare, John R. Østergaard, Laboratoire de Recherche en Neurosciences Cliniques, IBM Systems Group, Service de Neurochirurgie [Montpellier], Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier)-CHU Gui de Chauliac [Montpellier], Evelina London Children's Hospital, Institute of Child Health [London], University College of London [London] (UCL), Birkbeck College [University of London], Great Ormond Street Hospital for Children [London] (GOSH), Cambridge University Hospitals - NHS (CUH), University of Cambridge [UK] (CAM), Royal Devon and Exeter NHS Foundation Trust [UK], and Stanford University

Subjects
0301 basic medicine, Male, Pediatrics, medicine.medical_treatment, [SDV]Life Sciences [q-bio], Deep Brain Stimulation, DYT1 DYSTONIA, GENERALIZED DYSTONIA, VARIANTS, Cohort Studies, 0302 clinical medicine, genetics, [MATH]Mathematics [math], Deep brain stimulation (DBS), Child, Laryngeal dystonia, ComputingMilieux_MISCELLANEOUS, Dystonia, Fetal Growth Retardation, neurodevelopment, Parkinsonism, KMT2B, 3. Good health, INSIGHTS, Phenotype, Treatment Outcome, Dystonic Disorders, Child, Preschool, Cohort, Disease Progression, deep brain stimulation (DBS), dystonia, Female, Chromosome Deletion, Adult, medicine.medical_specialty, Deep brain stimulation, Adolescent, DATABASE, Mutation, Missense, Endocrine System Diseases, Laryngeal Diseases, 03 medical and health sciences, Young Adult, All institutes and research themes of the Radboud University Medical Center, medicine, Genetics, Humans, Computer Simulation, Gait Disorders, Neurologic, Neurodevelopmental disorders Donders Center for Medical Neuroscience [Radboudumc 7], business.industry, MUTATIONS, Histone-Lysine N-Methyltransferase, Original Articles, medicine.disease, Status dystonicus, 030104 developmental biology, Disease Presentation, Brain stimulation, Mutation, Quality of Life, Neurology (clinical), business, FOLLOW-UP, GAIT, 030217 neurology & neurosurgery, SYSTEM
Abstract

Heterozygous mutations in KMT2B are associated with an early-onset, progressive and often complex dystonia (DYT28). Key characteristics of typical disease include focal motor features at disease presentation, evolving through a caudocranial pattern into generalized dystonia, with prominent oromandibular, laryngeal and cervical involvement. Although KMT2B-related disease is emerging as one of the most common causes of early-onset genetic dystonia, much remains to be understood about the full spectrum of the disease. We describe a cohort of 53 patients with KMT2B mutations, with detailed delineation of their clinical phenotype and molecular genetic features. We report new disease presentations, including atypical patterns of dystonia evolution and a subgroup of patients with a non-dystonic neurodevelopmental phenotype. In addition to the previously reported systemic features, our study has identified co-morbidities, including the risk of status dystonicus, intrauterine growth retardation, and endocrinopathies. Analysis of this study cohort (n = 53) in tandem with published cases (n = 80) revealed that patients with chromosomal deletions and protein truncating variants had a significantly higher burden of systemic disease (with earlier onset of dystonia) than those with missense variants. Eighteen individuals had detailed longitudinal data available after insertion of deep brain stimulation for medically refractory dystonia. Median age at deep brain stimulation was 11.5 years (range: 4.5–37.0 years). Follow-up after deep brain stimulation ranged from 0.25 to 22 years. Significant improvement of motor function and disability (as assessed by the Burke Fahn Marsden’s Dystonia Rating Scales, BFMDRS-M and BFMDRS-D) was evident at 6 months, 1 year and last follow-up (motor, P = 0.001, P = 0.004, and P = 0.012; disability, P = 0.009, P = 0.002 and P = 0.012). At 1 year post-deep brain stimulation, >50% of subjects showed BFMDRS-M and BFMDRS-D improvements of >30%. In the long-term deep brain stimulation cohort (deep brain stimulation inserted for >5 years, n = 8), improvement of >30% was maintained in 5/8 and 3/8 subjects for the BFMDRS-M and BFMDRS-D, respectively. The greatest BFMDRS-M improvements were observed for trunk (53.2%) and cervical (50.5%) dystonia, with less clinical impact on laryngeal dystonia. Improvements in gait dystonia decreased from 20.9% at 1 year to 16.2% at last assessment; no patient maintained a fully independent gait. Reduction of BFMDRS-D was maintained for swallowing (52.9%). Five patients developed mild parkinsonism following deep brain stimulation. KMT2B-related disease comprises an expanding continuum from infancy to adulthood, with early evidence of genotype-phenotype correlations. Except for laryngeal dysphonia, deep brain stimulation provides a significant improvement in quality of life and function with sustained clinical benefit depending on symptoms distribution.

Published
2020
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11. Implementation of an organizational infrastructure paediatric plan adapted to bronchiolitis epidemics

Author

Guillaume Du Chaffaut, Myriam Guiraud, Christophe Milési, Eric Jeziorski, David Lavilledieu, Arthur Gavotto, Gilles Cambonie, Gregoire Mercier, Pascal Amedro, Hamouda Abassi, Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier), Aix Marseille Université (AMU), CHU Montpellier, Université des Antilles et de la Guyane - UFR des sciences médicales (UAG UFR SM), Université des Antilles et de la Guyane (UAG), Département Pédiatrie [CHRU Montpellier], Pôle Femme Mère Enfant [CHRU Montpellier], Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier)-Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier), Physiologie & médecine expérimentale du Cœur et des Muscles [U 1046] (PhyMedExp), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Montpellier (UM)-Centre National de la Recherche Scientifique (CNRS), and MORNET, Dominique

Subjects
Male, 0301 basic medicine, Epidemiology, Respiratory syncytial virus, Tertiary care, 0302 clinical medicine, [SDV.MHEP.MI]Life Sciences [q-bio]/Human health and pathology/Infectious diseases, Health care, 030212 general & internal medicine, lcsh:Public aspects of medicine, General Medicine, University hospital, International health, Respiratory Syncytial Viruses, 3. Good health, Hospitalization, Infectious Diseases, [SDV.MHEP.MI] Life Sciences [q-bio]/Human health and pathology/Infectious diseases, Bronchiolitis, Female, France, Seasons, medicine.medical_specialty, 030106 microbiology, Respiratory Syncytial Virus Infections, Infections, lcsh:Infectious and parasitic diseases, 03 medical and health sciences, [SDV.MHEP.PED] Life Sciences [q-bio]/Human health and pathology/Pediatrics, medicine, Humans, Revenue, lcsh:RC109-216, Epidemics, Quality of Health Care, Retrospective Studies, [SDV.MHEP.PED]Life Sciences [q-bio]/Human health and pathology/Pediatrics, business.industry, Public health, Infant, Newborn, Public Health, Environmental and Occupational Health, Infant, lcsh:RA1-1270, Length of Stay, medicine.disease, [SDV.SPEE] Life Sciences [q-bio]/Santé publique et épidémiologie, Peadiatrics, Emergency medicine, [SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie, business
Abstract

Introduction: Acute bronchiolitis epidemics are known to destabilize healthcare structures and stand as a major public health issue. Our tertiary care regional university hospital designed an organizational infrastructure paediatric plan (OIPP) to adapt to bronchiolitis epidemics. This study aimed to assess the impact of the OIPP on the length of stay and quality of care of children hospitalized for bronchiolitis. Methods: This epidemiological study analyzed data from 2 epidemic seasons before and after the OIPP implementation. The OIPP used a standardized algorithm of patient orientation and a 4-level stratification of care. Results: A total of 1636 children were included in the study, with 718 children before and 918 children after the OIPP implementation. The length of stay significantly decreased after the OIPP implementation, from 5.1 ± 6.8 days to 3.9 ± 3 days (P

Published
2020
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12. Respiratory syncytial virus-associated mortality in a healthy 3-year-old child: a case report

Author

A. Ousselin, J. L. Pasquié, C. Rambaud, Pascal Amedro, Arthur Gavotto, P. Cathala, Gilles Cambonie, Odile Pidoux, V. Costes-Martineau, B. Rivière, Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier), Université de Montpellier (UM), Physiologie & médecine expérimentale du Cœur et des Muscles [U 1046] (PhyMedExp), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Montpellier (UM)-Centre National de la Recherche Scientifique (CNRS), Laboratoire Interdisciplinaire de Physique [Saint Martin d’Hères] (LIPhy), Centre National de la Recherche Scientifique (CNRS)-Université Grenoble Alpes [2016-2019] (UGA [2016-2019]), Department of Pathology and Forensic Medicine, Raymond Poincaré Hospital, Garches University Hospital, Garches, and MORNET, Dominique

Subjects
medicine.medical_specialty, Resuscitation, Myosin Light Chains, viruses, [SDV]Life Sciences [q-bio], Cardioneuropathy, Case Report, Context (language use), Respiratory Syncytial Virus Infections, 030204 cardiovascular system & hematology, Respiratory syncytial virus, Polymerase Chain Reaction, Pericardial effusion, Sudden death, Pericardial Effusion, 03 medical and health sciences, Fatal Outcome, 0302 clinical medicine, 030225 pediatrics, Internal medicine, medicine, Humans, Pediatric intensive care unit, Myosin light chain 2, business.industry, Myocardium, lcsh:RJ1-570, Hypertrophic cardiomyopathy, Arrhythmias, Cardiac, lcsh:Pediatrics, medicine.disease, Comorbidity, Heart Arrest, 3. Good health, Arrhythmogenic right ventricular dysplasia, [SDV] Life Sciences [q-bio], Myocarditis, Death, Sudden, Cardiac, Child, Preschool, Respiratory Syncytial Virus, Human, Mutation, Pediatrics, Perinatology and Child Health, Female, Autopsy, Sudden unexpected death in childhood, business, Myoepicarditis, Cardiac Myosins
Abstract

Background Respiratory syncytial virus (RSV) is the most frequently identified pathogen in children with acute lower respiratory tract infection. Fatal cases have mainly been reported during the first 6 months of life or in the presence of comorbidity. Case presentation A 47-month-old girl was admitted to the pediatric intensive care unit following sudden cardiopulmonary arrest occurring at home. The electrocardiogram showed cardiac asystole, which was refractory to prolonged resuscitation efforts. Postmortem analyses detected RSV by polymerase chain reaction in an abundant, exudative pericardial effusion. Histopathological examination was consistent with viral myoepicarditis, including an inflammatory process affecting cardiac nerves and ganglia. Molecular analysis of sudden unexplained death genes identified a heterozygous mutation in myosin light chain 2, which was also found in two other healthy members of the family. Additional expert interpretation of the cardiac histology confirmed the absence of arrhythmogenic right ventricular dysplasia or hypertrophic cardiomyopathy. Conclusions RSV-related sudden death in a normally developing child of this age is exceptional. This case highlights the risk of extrapulmonary manifestations associated with this infection, particularly arrhythmia induced by inflammatory phenomena affecting the cardiac autonomic nervous system. The role of the mutation in this context is uncertain, and it is therefore necessary to continue to assess how this pathogenic variant contributes to unexpected sudden death in childhood.

Published
2019
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13. Specific cognitive correlates of the quality of life of extremely preterm school-aged children without major neurodevelopmental disability

Author

Catherine, Gire, Barthélémy, Tosello, Stéphane, Marret, Gilles, Cambonie, Isabelle, Souksi-Medioni, Jean-Baptiste, Müller, Patricia, Garcia, Julie, Berbis, Pascal, Auquier, Véronique, Brévaut-Malaty, Noémie, Resseguier, and M A, Einaudi

Subjects
Male, Parents, Psychometrics, Developmental Disabilities, Age Factors, Infant, Newborn, Gestational Age, Child Behavior Disorders, Executive Function, Cognition, Cross-Sectional Studies, Infant, Extremely Premature, Surveys and Questionnaires, Body Image, Linear Models, Quality of Life, Humans, Female, Child
Abstract

We examined how specific cognitive behavioral impairments impacted quality of life (QoL) within a large multicenter cohort of 7-10 year olds surviving extremely preterm (EPT) without major neurodevelopmental disability.Between 7 and 10 years of age, two generic, self-proxy, and parental evaluations were obtained. QoL measurement questionnaires (Kidscreen-10/VSPA (Vécu et Santé Perçue de l'Enfant et de l'Adolescent)) were used and compared to a reference population. The general and specific cognitive functions, such as executive functions, behavior and anxiety, and clinical neurologic examination, were also assessed.We analyzed 211 school-aged EPT children. The mean gestational age was 26.2 (±0.8) weeks, birth weight was 879 g (±181) and the mean age was 8.4 years (±0.87). Children with a Full-Scale Index Quotient ≥89, who were considered as normal, had a lower QoL. Specific cognitive impairments: comprehensive language delay, visuo-spatial integration defect, and dysexecutive disorders) were the QoL correlates in the domains of school performance and body image.School and health care professionals need to increase their focus on EPT children's lower so as to recognize the preterm behavioral/cognitive phenotype and their potential need for supportive measures. Research on preventive interventions is warranted to investigate if these long-term effects of an EPT birth can be attenuated in neonatal period and after.

Published
2019

14. Extended spectrum beta-lactamase-producing Klebsiella pneumoniae outbreak reveals incubators as pathogen reservoir in neonatal care center

Author

Estelle Jumas-Bilak, Sara Romano-Bertrand, Gilles Cambonie, Lucile Cadot, Sylvie Parer, Marie-Noelle Didelot, Gaëlle de Barry, Hélène Bruguière, Agnès Masnou, Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier), Hydrosciences Montpellier (HSM), and Institut national des sciences de l'Univers (INSU - CNRS)-Institut de Recherche pour le Développement (IRD)-Université Montpellier 2 - Sciences et Techniques (UM2)-Université de Montpellier (UM)-Centre National de la Recherche Scientifique (CNRS)

Subjects
Male, medicine.medical_specialty, Incubators, Infant, Neonatal intensive care unit, [SDV]Life Sciences [q-bio], Context (language use), Drug resistance, Beds, Molecular typing, beta-Lactam Resistance, beta-Lactamases, Disease Outbreaks, Multi-drug-resistant bacteria, 03 medical and health sciences, 0302 clinical medicine, 030225 pediatrics, Intensive care, Intensive Care Units, Neonatal, medicine, Infection control, Humans, 030212 general & internal medicine, [SDU.STU.HY]Sciences of the Universe [physics]/Earth Sciences/Hydrology, Steam-cleaner, Cross Infection, Infection Control, business.industry, Infant, Newborn, Outbreak, Incubator, Infant, medicine.disease, Drug Resistance, Multiple, 3. Good health, Klebsiella Infections, Incubator mattress, Klebsiella pneumoniae, Pediatrics, Perinatology and Child Health, Emergency medicine, Female, Klebsiella pneumonia, business
Abstract

International audience; In the context of a 3-month extended-spectrum beta-lactamase-producing Klebsiella pneumonia (ESBL-KP) outbreak in a neonatal care center (NCC), hygiene practices and hospital environment were investigated. ESBL-KP strains isolated from patients and environment were compared by molecular typing. The density of incidence of multi-drug-resistant bacteria (MDRB) was calculated from January 2014 to September 2016. The 3-month ESBL-KP outbreak involved 19 patients. Clinical strains from the 19 patients displayed the same molecular profile between them, and with a strain isolated from an incubator after cleaning. Furthermore, 52.4% of incubator mattresses were positive for diverse pathogens. Hygiene practices were acceptable except for external practitioners and parents. In addition to classical infection control (IC) measures, the replacement of mattresses and the improvement of incubators disinfection stopped the outbreak. The protocol of disinfection was revised and microbiological control was implemented. A significant decrease of MDRB incidence was concomitant (p value = 0.03219) but 3 months later, MDRB incidence increased again.Conclusion: This investigation highlighted incubators and mattresses as critical materials associated to infectious risk in NCC. NCC and IC teams should implement efficient protocol for incubators disinfection and monitoring. What is Known: • Environment in neonatal intensive care units is often suspected as reservoir for Enterobacteriaceae outbreaks but is scarcely investigated. • Incubators and mattresses offer wet and warm conditions suitable for pathogens multiplication, but microbiological survey is not performed routinely for assessing bacterial contamination. What is New: • Incubators and mattresses serve as reservoir for pathogens and relay in outbreak. • An infection control protocol associating efficient disinfection and microbiology analysis is proposed.

Published
2019
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15. Perceived maternal information on premature infant's pain during hospitalization: the French EPIPAGE-2 national cohort study

Author

Mélanie Durox, Pierre-Yves Ancel, Ricardo Carbajal, Monique Kaminski, Pierre Kuhn, Logayani Vasante, Antoine Burguet, Gilles Cambonie, Xavier Durrmeyer, Valérie Datin-Dorrière, Véronique Pierrat, Laetitia Marchand-Martin, Centre de Recherche Épidémiologie et Statistique Sorbonne Paris Cité (CRESS (U1153 / UMR_A_1125 / UMR_S_1153)), Conservatoire National des Arts et Métiers [CNAM] (CNAM)-Université Sorbonne Paris Cité (USPC)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Paris (UP)-Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement (INRAE), Sorbonne Universités (COMUE), Department of Neonatal Medicine, University Hospital, Department of Neonatal Pediatrics, Centre Hospitalier Universitaire de Grenoble, Centre Hospitalier Universitaire de Strasbourg (CHU de Strasbourg ), CHU Caen, Normandie Université (NU)-Tumorothèque de Caen Basse-Normandie (TCBN), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Physiopathologie des Adaptations Nutritionnelles (PhAN), Université de Nantes - UFR de Médecine et des Techniques Médicales (UFR MEDECINE), Université de Nantes (UN)-Université de Nantes (UN)-Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement (INRAE), ProdInra, Migration, Conservatoire National des Arts et Métiers [CNAM] (CNAM), HESAM Université - Communauté d'universités et d'établissements Hautes écoles Sorbonne Arts et métiers université (HESAM)-HESAM Université - Communauté d'universités et d'établissements Hautes écoles Sorbonne Arts et métiers université (HESAM)-Université Sorbonne Paris Cité (USPC)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Paris Cité (UPCité)-Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement (INRAE), and Centre Hospitalier Universitaire [Grenoble] (CHU)

Subjects
Male, Pediatrics, medicine.medical_specialty, Health Knowledge, Attitudes, Practice, MEDLINE, Mothers, Gestational Age, National cohort, Access to Information, 03 medical and health sciences, 0302 clinical medicine, [SDV.MHEP.PED] Life Sciences [q-bio]/Human health and pathology/Pediatrics, Pain assessment, 030225 pediatrics, Surveys and Questionnaires, Developmental care, Pediatric surgery, Medicine, Humans, Pain Management, Maternal Behavior, Pain Measurement, [SDV.MHEP.PED]Life Sciences [q-bio]/Human health and pathology/Pediatrics, business.industry, Infant, Newborn, Gestational age, parents, Pain management, neonates, Maternal education, Hospitalization, maternal, Pediatrics, Perinatology and Child Health, Female, business, 030217 neurology & neurosurgery, Infant, Premature
Abstract

International audience; Background Parents of preterm neonates wish greater involvement in pain management; little is known about factors associated with this involvement. We aim to describe perceived maternal information on infants’ pain during hospitalization (PMIP), to study associations between PMIP and mothers’ attitudes during painful procedures, and to identify individual and contextual factors associated with PMIP. Methods Analyses of questionnaires from the French national cohort study of preterm neonates, EPIPAGE-2. PMIP was derived from mothers’ answers to questions about information perceived on both pain assessment and management. Results Among 3056 eligible neonates born before 32 weeks, 1974, with available maternal reports, were included in the study. PMIP was classified as “sufficient,” “little, not sufficient,” or “insufficient, or none” for 22.7, 45.9, and 31.3% of neonates, respectively. Mothers reporting PMIP as “sufficient” were more frequently present and more likely comforting their child during painful procedures. Factors independently associated with “sufficient” PMIP were high maternal education, gestational age

Published
2019
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16. Facilitated tucking during early neonatologist-performed echocardiography in very preterm neonates

Author

Gilles Cambonie, Emilie Jourdes, Clémentine Combes, Julien De Jonckheere, Sabine Durand, Laurène Gautheyrou, Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier), Environnement périnatal et croissance - EA 4489 (EPS), Université de Lille-Centre Hospitalier Régional Universitaire [Lille] (CHRU Lille), Centre d'Investigation Clinique - Innovation Technologique de Lille - CIC 1403 - CIC 9301 (CIC Lille), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Lille-Centre Hospitalier Régional Universitaire [Lille] (CHRU Lille), and Université de Montpellier (UM)

Subjects
Male, medicine.medical_specialty, Hemodynamics, Facilitated tucking, 03 medical and health sciences, 0302 clinical medicine, Neonatologists, Heart Rate, 030225 pediatrics, Internal medicine, medicine.artery, Heart rate, medicine, Humans, Heart rate variability, Oximetry, 030212 general & internal medicine, Neonatology, [SDV.MHEP.PED]Life Sciences [q-bio]/Human health and pathology/Pediatrics, Cross-Over Studies, business.industry, Infant, Newborn, Gestational age, General Medicine, Premature neonate, 3. Good health, Very preterm, Postnatal age, Echocardiography, Infant, Extremely Premature, Pediatrics, Perinatology and Child Health, Pulmonary artery, Cardiology, Female, business, Discomfort
Abstract

International audience; AIM:To assess the effect of facilitated tucking (FT), a nonpharmacologic nursing intervention, on echocardiographic parameters and infant comfort collected prospectively during neonatologist-performed echocardiography.METHODS:Echocardiography was performed twice, in standard conditions and with FT; the order was randomised by computer. Echocardiography provided data on pulmonary artery flow and pressure, right and left ventricular function, and persistent ductus arteriosus. Comfort was assessed by a behavioural scale of pain, variations in heart rate (HR) and SpO2 , and a newborn infant parasympathetic evaluation index based on the high-frequency variability in HR.RESULTS:Fifty newborns, with mean gestational age of 28 [26.6-29.0] weeks and mean birthweight of 950 [780-1190] g, were studied at a postnatal age of 13 [9-27] hours. FT was associated with longer acceleration time/right ventricular ejection time in the main pulmonary artery (p = 0.006), reduced averaged HR variations (p = 0.03) and lower pain scores (p < 0.001). The other haemodynamic parameters and the parasympathetic index were not influenced by FT.CONCLUSION:Echocardiography performed soon after birth in very premature neonates may generate mild discomfort. FT during echocardiography is associated with lower pulmonary artery pressures and improves infant's comfort during this examination.

Published
2018
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17. Deep brain stimulation is effective in pediatric patients with GNAO1 associated severe hyperkinesia

Author

Philippe Coubes, Friederike Körber, Laura Cif, Victoria Gonzalez, Claude Cances, Caroline Nava, Julien Baleine, Pierre-François Perrigault, Nathalie Dorison, Agathe Roubertie, Thomas Roujeau, Frédéric Greco, Sebahattin Cirak, Diane Doummar, Christophe Béroud, Cyril Mignot, Christophe Milési, Gilles Cambonie, Stephan Waltz, Mohammad Maarouf, Anne Koy, Burkhard Stüve, Kerstin Becker, Alain Boularan, CHU Montpellier, Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier), Marseille medical genetics - Centre de génétique médicale de Marseille (MMG), Aix Marseille Université (AMU)-Institut National de la Santé et de la Recherche Médicale (INSERM), Département de génétique médicale [Hôpital de la Timone - APHM], Institut National de la Santé et de la Recherche Médicale (INSERM)- Hôpital de la Timone [CHU - APHM] (TIMONE)-Assistance Publique - Hôpitaux de Marseille (APHM)-Aix Marseille Université (AMU), Institut de Génomique Fonctionnelle (IGF), Université de Montpellier (UM)-Université Montpellier 1 (UM1)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Montpellier 2 - Sciences et Techniques (UM2)-Centre National de la Recherche Scientifique (CNRS), Aix Marseille Université (AMU)-Assistance Publique - Hôpitaux de Marseille (APHM)- Hôpital de la Timone [CHU - APHM] (TIMONE)-Institut National de la Santé et de la Recherche Médicale (INSERM), and Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Montpellier (UM)-Centre National de la Recherche Scientifique (CNRS)

Subjects
Male, 0301 basic medicine, Pediatrics, medicine.medical_specialty, Deep brain stimulation, Movement disorders, Hyperkinetic movement disorder, medicine.medical_treatment, Choreoathetosis, GTP-Binding Protein alpha Subunits, Gi-Go, Hyperkinesis, Globus Pallidus, GNAO1, 03 medical and health sciences, 0302 clinical medicine, medicine, Humans, Missense mutation, Child, Children, Dystonia, Splice site mutation, business.industry, Infant, medicine.disease, 3. Good health, Treatment Outcome, 030104 developmental biology, Neurology, [SDV.GEN.GH]Life Sciences [q-bio]/Genetics/Human genetics, Child, Preschool, Mutation, Female, Neurology (clinical), medicine.symptom, Hyperkinesia, business, 030217 neurology & neurosurgery
Abstract

International audience; Background: Exacerbation of hyperkinesia is a life-threatening complication of dyskinetic movement disorders, which can lead to multi-organ failure and even to death. GNAO1 has been recently identified to be involved in the pathogenesis of early infantile epileptic encephalopathy and movement disorders. Patients with GNAO1 mutations can present with a severe, progressive hyperkinetic movement disorder with prolonged life-threatening exacerbations, which are refractory to most anti-dystonic medication. Objective: The objective was to investigate the evolution of symptoms and the response to deep brain stimulation of the globus pallidus internus (GPi-DBS) in patients with different GNAO1 mutations. Methods: We report six patients presenting with global motor retardation, reduced muscle tone and recurrent episodes of severe, life-threatening hyperkinesia with dystonia, choreoathetosis, and ballism since early childhood. Five of them underwent GPi-DBS. Results: The genetic workup revealed mutations in GNAO1 for all six patients. These encompass a new splice site mutation (c.723 + 1G > T) in patient 1, a new missense mutation (c.610G > C; p.Gly204Arg) in patient 2, a heterozygous mutation (c.625 > T; p.Arg209Cys) in patients 3 and 4, and a heterozygous mutation (c.709G > A; p.Glu237Lys) in patients 5 and 6. By intervention with GPi-DBS the severe paroxysmal hyperkinetic exacerbations could be stopped in five patients. One patient is still under evaluation for neuromodulation. Conclusion In complex movement disorders of unsolved etiology clinical WES can rapidly streamline pathogenic genes. We identified two novel GNAO1 mutations. GPi-DBS can be an effective and life-saving treatment option for patients with GNAO1 mutations and has to be considered early.

Published
2018
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18. Supraclavicular catheterization of the brachiocephalic vein: a way to prevent or reduce catheter maintenance-related complications in children

Author

Sara Romano-Bertrand, Julien Baleine, Clémentine Combes, Flora Habas, Delphine Grau, Marie-Noelle Didelot, Christophe Milési, Gilles Cambonie, Sylvie Parer, Catherine Baud, Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier), Pathogénèse et contrôle des infections chroniques (PCCI), Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre Hospitalier Universitaire de Montpellier (CHU Montpellier )-Université de Montpellier (UM), Hydrosciences Montpellier (HSM), Institut national des sciences de l'Univers (INSU - CNRS)-Institut de Recherche pour le Développement (IRD)-Université Montpellier 2 - Sciences et Techniques (UM2)-Université de Montpellier (UM)-Centre National de la Recherche Scientifique (CNRS), and Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Montpellier (UM)-Centre Hospitalier Universitaire de Montpellier (CHU Montpellier )

Subjects
Male, Brachiocephalic vein, Catheterization, Central Venous, medicine.medical_specialty, Adolescent, Supraclavicular approach, medicine.medical_treatment, Ultrasound guidance, 03 medical and health sciences, 0302 clinical medicine, 030225 pediatrics, medicine, Catheter-associated bloodstream infection, Humans, 030212 general & internal medicine, Child, Children, Ultrasonography, Interventional, Brachiocephalic Veins, Retrospective Studies, Venous Thrombosis, Pediatric intensive care unit, business.industry, Catheter-associated deep-vein thrombosis, Incidence, Incidence (epidemiology), Infant, Retrospective cohort study, medicine.disease, Thrombosis, 3. Good health, Surgery, Catheter, Venous thrombosis, Logistic Models, Treatment Outcome, Catheter-Related Infections, Child, Preschool, Pediatrics, Perinatology and Child Health, Female, business, Central venous catheter, [SDV.MHEP]Life Sciences [q-bio]/Human health and pathology
Abstract

International audience; Placement of a central venous catheter (CVC) in the brachiocephalic vein (BCV) via the ultrasound (US)-guided supraclavicular approach was recently described in children. We aimed to determine the CVC maintenance-related complications at this site compared to the others (i.e., the femoral, the subclavian, and the jugular). We performed a retrospective data collection of prospectively registered data on CVC in young children hospitalized in a pediatric intensive care unit (PICU) during a 4-year period (May 2011 to May 2015). The primary outcome was a composite of central line-associated bloodstream infection (CLABSI) and deep-vein thrombosis (CLAT) according to the CVC site. Two hundred and twenty-five children, with respective age and weight of 7.1 (1.3-40.1) months and 7.7 (3.6-16) kg, required 257 CVCs, including 147 (57.2%) inserted in the BCV. The risk of the primary outcome was lower in the BCV than in the other sites (5.4 vs 16.4%; OR: 0.29; 95% CI: 0.12-0.70; p = 0.006). CLABSI incidence density rate (2.8 vs 8.96 per 1000 catheter days, p

Published
2018
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19. Quality of life of extremely preterm school-age children without major handicap: a cross-sectional observational study

Author

Catherine, Gire, Noémie, Resseguier, Véronique, Brévaut-Malaty, Stéphane, Marret, Gilles, Cambonie, Isabelle, Souksi-Medioni, Jean-Baptiste, Müller, Patricia, Garcia, Julie, Berbis, Barthélémy, Tosello, Pascal, Auquier, M A, Einaudi, Centre d'études et de recherche sur les services de santé et la qualité de vie (CEReSS), Aix Marseille Université (AMU), Service de Néonatologie, Assistance Publique - Hôpitaux de Marseille (APHM)- Hôpital Nord [CHU - APHM], Génomique et Médecine Personnalisée du Cancer et des Maladies Neuropsychiatriques (GPMCND), Université de Rouen Normandie (UNIROUEN), Normandie Université (NU)-Normandie Université (NU)-Institut National de la Santé et de la Recherche Médicale (INSERM), Team 4 'NeoVasc' - INSERM U1245, Normandie Université (NU)-Normandie Université (NU)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Rouen Normandie (UNIROUEN), Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier), Centre Hospitalier Universitaire de Nîmes (CHU Nîmes), Anthropologie bio-culturelle, Droit, Ethique et Santé (ADES), Aix Marseille Université (AMU)-EFS ALPES MEDITERRANEE-Centre National de la Recherche Scientifique (CNRS), Hôpital Nord [CHU - APHM], Microbiology Laboratory, Clinical Laboratory Department, School of Medicine, Pontificia Universidad Católica de Chile (UC), and Team 4 NeoVasc - Region Team ERI 28 INSERM (Neovasc)

Subjects
Gerontology, Male, Birth weight, [SDV]Life Sciences [q-bio], education, Physical examination, Vitality, 03 medical and health sciences, 0302 clinical medicine, Quality of life, 030225 pediatrics, Medicine, Humans, Child, ComputingMilieux_MISCELLANEOUS, medicine.diagnostic_test, business.industry, Cognitive flexibility, Gestational age, Cognition, extremely preterm, Disabled Children, Cross-Sectional Studies, Socioeconomic Factors, Child, Preschool, Infant, Extremely Premature, Pediatrics, Perinatology and Child Health, school age, Quality of Life, Observational study, Female, France, business
Abstract

ObjectiveTo determine the quality of life (QoL) of school-aged children who were born +0weeks of gestation and who have no resultant major disabilities.Design, setting and patientsA cross-sectional multicentre study of extremely preterm (EPT) infants born +0weeks, discharged alive and free from severe impairments (cerebral palsy, autism, major cognitive disabilities). Two generic, self-evaluation and hetero-evaluation (by parent) QoL measurement questionnaires (Kidscreen 10/VSP-A) were used and then compared with French population reference.Main outcome measuresClinical examination, an assessment of cognitive functions and QoL between 7 and 10 years of age.Results40 (7.5%) severely disabled children were excluded. Among those 471 eligible, the lost to follow-up group (169 (36%)) paralleled those 302 (64%) included in the study. The mean gestational age was 26.2 (±0.8), birth weight was 879 (±181) g and the mean age was 8.4 (±0.87) years. 48% of participants had minor or moderate cognitive disabilities based on their Full-Scale Index Quotient. Working memory, attention and mental flexibility scored as low-average. Except for family relationships, the EPT QoL VSP-A and Kidscreen 10 assessment were significantly lower based on the children’s and parent’s perspectives. Children reported the most significant QoL decline as (1) friends’ relationships, (2) self-esteem and (3) leisure, while parents indicated (1) psychological well-being, (2) schoolwork and (3) vitality.ConclusionThe QoL of a school-age EPT child without severe impairment was lower relative to a reference population from both the parents’ and child’s points of view. This evaluation should help to better understand the long-term outcomes and to provide better support for them and their families.Trial registration numberNCT01675726, pre-results.

Published
2018
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20. Nasal midazolam vs ketamine for neonatal intubation in the delivery room: a randomised trial

Author

Pierre Thevenot, Christophe Milési, Clémentine Combes, Gilles Cambonie, Ricardo Carbajal, Gérard Thiriez, Félicie Ferragu, Thibault Mura, Julien Baleine, Fernando Benito-Castro, Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier), Centre Hospitalier Universitaire de Nîmes (CHU Nîmes), Service Pédiatrie, Hôpital Saint-Jacques-Université de Franche-Comté (UFC), Université Bourgogne Franche-Comté [COMUE] (UBFC)-Université Bourgogne Franche-Comté [COMUE] (UBFC), CHU Trousseau [APHP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), Service de pédiatrie [CHRU Besançon], Centre Hospitalier Régional Universitaire de Besançon (CHRU Besançon), and Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)

Subjects
Male, medicine.medical_specialty, nasal mucosa, ketamine, medicine.medical_treatment, Sedation, Birth weight, [SDV]Life Sciences [q-bio], intubation, 03 medical and health sciences, 0302 clinical medicine, Bolus (medicine), Double-Blind Method, newborn, 030225 pediatrics, Intubation, Intratracheal, medicine, Humans, Intubation, Ketamine, Prospective Studies, 030212 general & internal medicine, Administration, Intranasal, Anesthetics, Respiratory Distress Syndrome, Newborn, Respiratory distress, business.industry, Delivery Rooms, Infant, Newborn, Obstetrics and Gynecology, Gestational age, Pulmonary Surfactants, General Medicine, 3. Good health, Surgery, Treatment Outcome, midazolam, Anesthesia, Pediatrics, Perinatology and Child Health, Midazolam, Female, France, medicine.symptom, business, Infant, Premature, medicine.drug
Abstract

ObjectiveTo compare the effectiveness of sedation by intranasal administration of midazolam (nMDZ) or ketamine (nKTM) for neonatal intubation.DesignA multicentre, prospective, randomised, double-blind study.SettingDelivery rooms at four tertiary perinatal centres in France.PatientsPreterm neonates with respiratory distress requiring non-emergent endotracheal intubation for surfactant instillation.InterventionsTreatment was randomly allocated, with each neonate receiving a bolus of 0.1 mL/kg in each nostril, corresponding to 0.2 mg/kg for nMDZ and 2 mg/kg for nKTM. The drug was repeated once 7 min later at the same dose if adequate sedation was not obtained.Main outcome measuresSuccess was defined by adequate sedation before intubation and adequate comfort during the procedure. Intubation features, respiratory and cardiovascular events were recorded.ResultsSixty newborns, with mean (SD) gestational age and birth weight of 28 (3) weeks and 1100 (350) g, were included within the first 20 min of life. nMDZ was associated with a higher success rate (89% vs 58%; RR: 1.54, 95% CI 1.12 to 2.12, pNumber of attempts, time to intubation, mean arterial blood pressure measures over the first 12 hours after birth and length of invasive ventilation were not different.ConclusionsnMDZ was more efficient than nKTM to adequately sedate neonates requiring intubation in the delivery room. The haemodynamic and respiratory effects of both drugs were comparable.Clinical trialThis clinical trial was recorded on the National Library of Medicine registry (NCT01517828).

Published
2017
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21. Effects of Maternal Supplementation With Omega-3 Precursors on Human Milk Composition

Author

Jean-Charles Picaud, Virginie Rigourd, Fabienne Nacka, Claude Billeaud, Paul Perez, Gilles Cambonie, Rémi Sitta, Evelyne Mazurier, Wafae Belcadi, Rachel Buffin, Leslie Couëdelo, Delphine Lamireau, Carole Vaysse, Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier), CHU Necker - Enfants Malades [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), CHU Bordeaux [Bordeaux], Hôpital de la Croix-Rousse [CHU - HCL], Hospices Civils de Lyon (HCL), Université de Bordeaux (UB), Centre d'Investigation Clinique - Epidemiologie Clinique / Essais Cliniques Bordeaux, Institut National de la Santé et de la Recherche Médicale (INSERM), Hôpital Pellegrin, and CHU Bordeaux [Bordeaux]-Groupe hospitalier Pellegrin

Subjects
Adult, 0301 basic medicine, Rapeseed, Breastfeeding, Mothers, [SDV.MHEP.GEO]Life Sciences [q-bio]/Human health and pathology/Gynecology and obstetrics, Washout period, 03 medical and health sciences, Fatty Acids, Omega-3, Humans, Lactation, Medicine, Food science, Milk Banks, Maternal Behavior, ComputingMilieux_MISCELLANEOUS, 2. Zero hunger, chemistry.chemical_classification, [SDV.MHEP.PED]Life Sciences [q-bio]/Human health and pathology/Pediatrics, 030109 nutrition & dietetics, Milk, Human, business.industry, alpha-Linolenic Acid, Obstetrics and Gynecology, Fatty acid, Feeding Behavior, Breast Feeding, chemistry, Dietary Supplements, Female, Composition (visual arts), France, business, Polyunsaturated fatty acid, Olive oil
Abstract

Background:Long-chain polyunsaturated fatty acids (LC-PUFAs) are important for newborn neurosensory development. Supplementation of breastfeeding mothers’ diets with omega-3 PUFAs, such as alpha-linolenic acid (ALA), may increase their concentration in human milk.Research aim:This study aimed to assess human milk composition after 15-day supplementation regimens containing either omega-3 PUFAs or olive oil, which does not provide ALA.Methods:A multicenter factorial randomized trial was conducted with four groups of breastfeeding women, with each group containing 19 to 22 women. After a 15-day ALA washout period, three groups received supplementation with omega-3 precursors for 15 days: an enriched margarine (M), a rapeseed oil (R), and a margarine and rapeseed oil (MR). The fourth was unexposed to omega-3 precursors (olive oil control diet, O). After 15 days, blind determination of human milk fatty acid (FA) composition was assessed by gas chromatography, and the FA composition was compared among groups using variance analyses.Results:Alpha-linolenic acid content, expressed as the mean (standard deviation) total human milk FA percentage, was significantly higher after diet supplementation with omega-3 PUFAs, with values of 2.2% (0.7%) (MR), 1.3% (0.5%) (R), 1.1% (0.4%) (M), and 0.8% (0.3%) (O at D30) ( p < .003 for each comparison). The lowest LA–ALA ratio (5.5) was found in the MR group ( p < .001). Docosahexaenoic acid and trans FA concentrations did not differ among groups.Conclusion:In lactating women, omega-3 supplementation via the combination of enriched margarine and rapeseed oil increased the ALA content of human milk and generated the most favorable LA–ALA ratio for LC-PUFA synthesis.

Published
2017
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22. Subclinical mastitis occurs frequently in association with dramatic changes in inflammatory/anti-inflammatory breast milk components

Author

Pierre-Alain Rubbo, Gilles Cambonie, Johanes Viljoen, Philippe Van de Perre, Nicolas Nagot, Stéphanie Badiou, Marie-Louise Newell, Edouard Tuaillon, Pierre Dujols, Ruth M Bland, Pathogénèse et contrôle des infections chroniques (PCCI), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Montpellier (UM)-Centre Hospitalier Universitaire de Montpellier (CHU Montpellier ), Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier), University of KwaZulu-Natal (UKZN), Physiologie & médecine expérimentale du Cœur et des Muscles [U 1046] (PhyMedExp), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Montpellier (UM)-Centre National de la Recherche Scientifique (CNRS), University of Southampton, Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre Hospitalier Universitaire de Montpellier (CHU Montpellier )-Université de Montpellier (UM), and Université de Montpellier (UM)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS)

Subjects
0301 basic medicine, Adult, Lipopolysaccharides, Adolescent, medicine.drug_class, [SDV]Life Sciences [q-bio], Mastitis, Breast milk, Sensitivity and Specificity, Anti-inflammatory, Cohort Studies, 03 medical and health sciences, Young Adult, Th2 Cells, medicine, Humans, Lactation, Subclinical mastitis, skin and connective tissue diseases, ComputingMilieux_MISCELLANEOUS, Inflammation, Mucous Membrane, Milk, Human, business.industry, Pediatric research, Sodium, food and beverages, Th1 Cells, 030104 developmental biology, Breast Feeding, Pediatrics, Perinatology and Child Health, Immunology, Potassium, Cytokines, Female, sense organs, business
Abstract

Subclinical mastitis (SCM) is a frequent, but poorly characterized entity that may influence immune development of breastfed infants. Mechanisms driving the emergence of SCM and changes in immunological content of human milk during SCM remain to be explored. In this study, the breast milk environment was to describe during SCM.One hundred and ten samples of mature breast milk were collected from 44 healthy, HIV-negative mothers, included in a large infant feeding intervention cohort (ANRS 1271/Vertical Transmission Study). Immune markers related to inflammatory/anti-inflammatory balances and secreted in response to bacterial exposure were explored in SCM breast milk samples (Na/K ratio1) and compared to non-SCM controls.SCM was observed in 23% of women (95% confidence interval (CI): 21-24) and associated with higher levels of inflammatory markers (β2 microgobulin, PS100A9, TNF-α, IL-6, IL-8, IL-17, and RANTES) and Th1-related cytokines (IL-2R, IL-12p40/70, IFN-α, IFN-γ, CXCL-9, andIP-10). High levels of factors secreted in response to bacteria and lipopolysaccharide (LPS) exposure were observed in SCM breast milk samples (MIP-1α, MIP-1β, LPS binding protein, α-defensins, and antileukoproteinase 1).SCM is associated with important changes in breast milk microenvironment, with a proinflammatory/Th1-cytokine predominant profile. During SCM, cytokine imbalances in breast milk may have a notable influence on mucosal immune system of the infant early in life.

Published
2017
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23. Intubation in the delivery room: Experience with nasal midazolam

Author

Gilles Cambonie, Christophe Milési, Aline Rideau Batista Novais, Sabine Durand, Julien Baleine, Clémentine Combes, and Renaud Mesnage

Subjects
Male, medicine.medical_specialty, Midazolam, Sedation, medicine.medical_treatment, Hemodynamics, Intubation, Intratracheal, medicine, Humans, Hypnotics and Sedatives, Intubation, Continuous positive airway pressure, Administration, Intranasal, Respiratory Distress Syndrome, Newborn, Respiratory distress, business.industry, Delivery Rooms, Infant, Newborn, Obstetrics and Gynecology, Apnea, Surgery, Blood pressure, Anesthesia, Pediatrics, Perinatology and Child Health, Female, medicine.symptom, business, medicine.drug
Abstract

Background Neonates are often intubated in the delivery room (DR) without anesthesia because vascular access is impossible. Aims To assess neonatal comfort and adverse events after use of nasal midazolam (nMDZ) for intubation in the DR. Study design Prospective data collection over 6 months on the intubation of neonates with respiratory distress requiring tracheal instillation of surfactant. Subjects Twenty-seven neonates with median (Q25–75) gestational age and birthweight of, respectively, 29 (27–33) weeks and 1270 (817–1942) g received a 0.1 mg/kg dose of nMDZ, and intubation was performed at the onset of tonus resolution or apnea. Outcome measures Comfort was assessed with a scale of hetero-pain assessment and electrical skin conductance monitoring. Continuous pulse oximetry was recorded in the first postnatal hour, with oscillometric blood pressure measurement every 10 min. Results Seventy percent of the patients required a single dose, with intubation performed 4.8 (3–9) min after administration. Combined electro-clinical assessment found adequate comfort during the procedure in 68% of neonates. Mean blood pressure decreased from 39 (34–44) mm Hg before to 31 (25–33) mm Hg 1 h following nMDZ (p = 0.011). Conclusion nMDZ provided rapid and effective sedation to intubate neonates in the DR but potentially exposed them to hypotension, thus requiring close hemodynamic monitoring.

Published
2014
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24. Group Bstreptococciin milk and late neonatal infections: an analysis of cases in the literature

Author

Estelle Jumas-Bilak, Hélène Marchandin, Fanny Lombard, Michel Rodière, Anne Filleron, Gilles Cambonie, and Aurélien Jacquot

Subjects
medicine.medical_specialty, Gastrointestinal Diseases, Caesarean delivery, Reproductive medicine, Breast milk, medicine.disease_cause, Group B, Streptococcus agalactiae, Streptococcal Infections, Internal medicine, Prevalence, medicine, Humans, Milk, Human, business.industry, Transmission (medicine), Streptococcus, Infant, Newborn, Obstetrics and Gynecology, General Medicine, Infectious Disease Transmission, Vertical, 3. Good health, Neonatal infection, Pediatrics, Perinatology and Child Health, Immunology, Female, business
Abstract

Background The source for late-onset neonatal infections (LONI) due to group B Streptococcus (GBS) has not been fully explored. We reviewed GBS LONI cases associated with contaminated breast milk to determine whether breast milk was a possible route for neonatal infection. Data sources A PubMed search from January 1977 to March 2013 was performed with MeSH words “ Stre ptococcus agalactiae ”, “group B Streptococcus ”, “infection”, “milk”, “human”, “late-onset infection” and/or “neonate”; relevant cross references were also reviewed. Results Forty-eight documented cases of GBS LONI matched our search criteria and were retrieved from the literature. When performed, molecular typing identified clonal isolates in the neonate and milk samples taken after LONI in all cases, with the hypervirulent sequence type 17 (ST-17) clone identified in two of these cases. Caesarean delivery combined with the absence of GBS recovery from maternal samples other than milk was noted for four cases. The rate of recurrent infections was high (35%) and, together with the data reviewed, points to a potential role of breast milk in GBS LONI. Conclusions The cases reviewed here, together with the evidence of breast milk transmission for other pathogens, suggest that breast milk, which would account for repeated GBS transmission to the neonate, may favour gut translocation and subsequent LONI. Further investigations are nevertheless needed to study the relative importance of this contamination route compared with persistent postnatal gut colonisation and the dynamics of milk and neonatal gut colonisation.

Published
2013
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25. Is treatment with a high flow nasal cannula effective in acute viral bronchiolitis? A physiologic study

Author

Christophe, Milési, Julien, Baleine, Stefan, Matecki, Sabine, Durand, Clémentine, Combes, Aline Rideau Batista, Novais, Gilles, Cambonie, Gilles, Combonie, Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier), Physiologie & médecine expérimentale du Cœur et des Muscles [U 1046] (PhyMedExp), and Université de Montpellier (UM)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS)

Subjects
Male, Respiratory rate, Respiratory Syncytial Virus Infections, Critical Care and Intensive Care Medicine, medicine.disease_cause, Hospitals, University, 03 medical and health sciences, 0302 clinical medicine, 030225 pediatrics, Positive airway pressure, [SDV.MHEP.PHY]Life Sciences [q-bio]/Human health and pathology/Tissues and Organs [q-bio.TO], Bronchiolitis, Viral, Humans, Medicine, Prospective Studies, 030212 general & internal medicine, Respiratory system, Prospective cohort study, Pediatric intensive care unit, Continuous Positive Airway Pressure, Respiratory distress, business.industry, Infant, Newborn, Infant, medicine.disease, 3. Good health, High flow nasal cannula, Treatment Outcome, Bronchiolitis, Anesthesia, Female, business, Nasal cannula, Acute viral bronchiolitis
Abstract

International audience; Purpose: The high flow nasal cannula (HFNC) has recently been proposed to support infants with respiratory syncytial virus (RSV)-related respiratory distress. However, in this disease, no physiologic data are currently available on the effects of this device. We assessed the capacity of HFNC to generate positive airway pressure, as well as the resulting effects on breathing pattern and respiratory effort. Methods: Twenty-one infants less than 6 months old with acute RSV bron-chiolitis were studied prospectively in the pediatric intensive care unit of a university hospital. Pharyngeal pressure (PP) and esophageal pressure (Pes) were measured simultaneously at four increasing flows of 1, 4, 6 and 7 L/min delivered through HFNC. Results: The PP was correlated with flow rate (r = 0.65, p B 0.0001), reaching mean and end-expiratory values of, respectively, 4 (95% CI 3-5) cmH 2 O and 6.5 (95% CI 5-8) cmH 2 O at 7 L/min. A flow C2 L/kg/min was associated with the generation of a mean pha-ryngeal pressure C4 cmH 2 O with a sensitivity of 67 %, a specificity of 96 %, a positive predictive value of 75 %, and a negative predictive value of 94.5%. Only flows C6 L/min provided positive PP throughout the respiratory cycle. From baseline to maximal flow rate, breathing frequency (p \ 0.01), T i /T tot (p \ 0.05), Pes swing (p \ 0.05) and PTPes insp / min (p \ 0.01), an index of respiratory effort, were reduced. Conclusions: HFNC with a flow rate equal to or above 2 L/kg/min generated a clinically relevant PP, with improved breathing pattern and rapid unloading of respiratory muscles , in young infants with acute RSV bronchiolitis.

Published
2013
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26. Mother-infant interaction assessment at discharge and at 6 months in a French cohort of infants born very preterm: The OLIMPE study

Author

Gilles Cambonie, Jean-Baptiste Muller, Virginie Ehlinger, Joël Roy, Antoine Guédeney, Cécile Lebeaux, Monique Kaminski, Corine Alberge, Sophie Denizot, Pierre-Yves Ancel, Catherine Arnaud, OLIMPE study writing group, KARLI, Mélanie, Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier), Centre hospitalier universitaire de Nantes (CHU Nantes), Epidémiologie et analyses en santé publique : risques, maladies chroniques et handicaps (LEASP), Université Toulouse III - Paul Sabatier (UT3), Université Fédérale Toulouse Midi-Pyrénées-Université Fédérale Toulouse Midi-Pyrénées-Institut National de la Santé et de la Recherche Médicale (INSERM), Centre Hospitalier Universitaire de Nîmes (CHU Nîmes), AP-HP - Hôpital Bichat - Claude Bernard [Paris], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Equipe 1 : EPOPé - Épidémiologie Obstétricale, Périnatale et Pédiatrique (CRESS - U1153), Université Paris Descartes - Paris 5 (UPD5)-Centre de Recherche Épidémiologie et Statistique Sorbonne Paris Cité (CRESS (U1153 / UMR_A_1125 / UMR_S_1153)), Institut National de la Recherche Agronomique (INRA)-Université Paris Diderot - Paris 7 (UPD7)-Université Paris Descartes - Paris 5 (UPD5)-Université Sorbonne Paris Cité (USPC)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Institut National de la Recherche Agronomique (INRA)-Université Paris Diderot - Paris 7 (UPD7)-Université Sorbonne Paris Cité (USPC)-Institut National de la Santé et de la Recherche Médicale (INSERM), Centre Hospitalier Universitaire de Toulouse (CHU Toulouse), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Toulouse III - Paul Sabatier (UT3), Université Fédérale Toulouse Midi-Pyrénées-Université Fédérale Toulouse Midi-Pyrénées, Hôpital des Enfants, CHU Toulouse [Toulouse], Centre Hospitalier Régional Universitaire de Nîmes (CHRU Nîmes), Centre de Recherche Épidémiologie et Statistique Sorbonne Paris Cité (CRESS (U1153 / UMR_A_1125 / UMR_S_1153)), and Université Paris Diderot - Paris 7 (UPD7)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Institut National de la Recherche Agronomique (INRA)-Université Paris Descartes - Paris 5 (UPD5)-Université Sorbonne Paris Cité (USPC)-Université Paris Diderot - Paris 7 (UPD7)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Institut National de la Recherche Agronomique (INRA)-Université Paris Descartes - Paris 5 (UPD5)-Université Sorbonne Paris Cité (USPC)

Subjects
Maternal Health, lcsh:Medicine, Cohort Studies, Families, 0302 clinical medicine, Pregnancy, Medicine and Health Sciences, lcsh:Science, Children, Depression (differential diagnoses), education.field_of_study, Multidisciplinary, Depression, 05 social sciences, Obstetrics and Gynecology, Mother-Child Relations, Distress, Premature birth, Cohort, Anxiety, Female, France, medicine.symptom, Infants, Infant, Premature, 050104 developmental & child psychology, Cohort study, Research Article, Adult, Population, Parenting Behavior, Mothers, [SDV.MHEP.GEO]Life Sciences [q-bio]/Human health and pathology/Gynecology and obstetrics, Preterm Birth, 03 medical and health sciences, [SDV.MHEP.PED] Life Sciences [q-bio]/Human health and pathology/Pediatrics, 030225 pediatrics, Mental Health and Psychiatry, medicine, Humans, 0501 psychology and cognitive sciences, Family, education, [SDV.MHEP.PED]Life Sciences [q-bio]/Human health and pathology/Pediatrics, Behavior, Behavioral Disorders, business.industry, Mood Disorders, lcsh:R, Infant, Newborn, Reproducibility of Results, Biology and Life Sciences, Neonates, medicine.disease, Mental health, Pregnancy Complications, [SDV.MHEP.GEO] Life Sciences [q-bio]/Human health and pathology/Gynecology and obstetrics, [SDV.SPEE] Life Sciences [q-bio]/Santé publique et épidémiologie, Age Groups, People and Places, Birth, Women's Health, [SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie, lcsh:Q, Population Groupings, business, Demography, Developmental Biology
Abstract

International audience; Objectives : The principal aim was to investigate the feasibility of assessing mother-infant interactions at discharge and at 6 months infant corrected age in singletons born before 32 weeks of gestation. The secondary aims were to describe these interactions and their disorders, explore the association between maternal emotional state and the interactions, and assess the relationship between disordered interactions and infant social withdrawal behaviour.Methods : OLIMPE is an ancillary study of the population-based study EPIPAGE 2, which recruited preterm neonates in France in 2011. 163 dyads participated at discharge and 148 at 6 months. Interactions were observed with the Attachment During Stress (ADS) scale, which includes two behavioural subscales, for the mother (m-ADS) and her infant (i-ADS). Two professionals independently completed the ADS scales for one third of the observations. Maternal emotional state was assessed using self-administered questionnaires of depression, anxiety, and stress. Infant’s social withdrawal behaviour at 6 months was measured by the Alarm Distress Baby scale.Results : At discharge, 15.3% of the m-ADS scales and 43.3% of the i-ADS scales had at least one unobserved component. At 6 months, all items on both scales were noticeable in >90% of the dyads. Reliability, estimated by the kappa coefficient, ranged between 0.39 and 0.76 at discharge, and between 0.21 and 0.69 at 6 months. Disordered interactions were indicated on 48.6% of the m-ADS scales and 36.5% of the i-ADS scales at discharge. At 6 months, these rates were 32.6% and 26.0%. Disordered interactions at 6 months were associated with identified disorder at discharge. Insecure infant attachment was not influenced by maternal mental health but was strongly associated with infant social withdrawal behaviour.Conclusions : The ADS scale can be used to screen for early interaction disorders after premature birth and may help to target dyads that would most benefit from early intervention.

Published
2017
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27. Perfusion index and its dynamic changes in preterm neonates with patent ductus arteriosus

Author

Magalie Vidal, Sabine Durand, Félicie Ferragu, Julien Baleine, Aline Rideau Batista-Novais, and Gilles Cambonie

Subjects
Male, medicine.medical_specialty, Perfusion index, Pulsatile flow, Ductus arteriosus, Internal medicine, Respiration, medicine, Humans, Plethysmograph, Oximetry, Ductus Arteriosus, Patent, Ultrasonography, Chi-Square Distribution, medicine.diagnostic_test, business.industry, Infant, Newborn, Gestational age, General Medicine, Respiration Disorders, medicine.disease, Respiration, Artificial, Pulmonary hypertension, Perfusion, Plethysmography, Pulse oximetry, medicine.anatomical_structure, Anesthesia, Pediatrics, Perinatology and Child Health, Cardiology, Female, business, Infant, Premature
Abstract

Aim The perfusion index (PI) and its dynamic change during respiration, and supressed the plethysmographic variability index (PVI), are calculated from pulse oximetry, and these indexes were recently proposed for continuous and noninvasive assessment of peripheral perfusion in neonates. We aimed to assess the effect of patent ductus arteriosus (PDA) on PI and PVI, according to ductal Doppler flow pattern. Methods Forty-five neonates with median (Q25-75) gestational age (GA) and birthweight of 27 (25–28) weeks and 857 (750–1080) grams, respectively, were assessed prospectively using serial echocardiography and pulse oximetry during the first postnatal week. Results Perfusion index increased from 0.70 (0.50–1.05) at day 1 to 1.50 (1.0–2.00) at day 7 (p

Published
2013
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28. Abstention or intervention for isolated hypotension in the first 3 days of life in extremely preterm infants: association with short-term outcomes in the EPIPAGE 2 cohort study

Author

Xavier, Durrmeyer, Laetitia, Marchand-Martin, Raphaël, Porcher, Geraldine, Gascoin, Jean-Christophe, Roze, Laurent, Storme, Geraldine, Favrais, Pierre-Yves, Ancel, Gilles, Cambonie, Patrick, Pladys, CHI Créteil, Equipe 1 : EPOPé - Épidémiologie Obstétricale, Périnatale et Pédiatrique (CRESS - U1153), Centre de Recherche Épidémiologie et Statistique Sorbonne Paris Cité (CRESS (U1153 / UMR_A_1125 / UMR_S_1153)), Université Paris Diderot - Paris 7 (UPD7)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Institut National de la Recherche Agronomique (INRA)-Université Paris Descartes - Paris 5 (UPD5)-Université Sorbonne Paris Cité (USPC)-Université Paris Diderot - Paris 7 (UPD7)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Institut National de la Recherche Agronomique (INRA)-Université Paris Descartes - Paris 5 (UPD5)-Université Sorbonne Paris Cité (USPC), Equipe 5 : METHODS - Méthodes de l’évaluation thérapeutique des maladies chroniques (CRESS - U1153), Université Paris Descartes - Paris 5 (UPD5)-Centre de Recherche Épidémiologie et Statistique Sorbonne Paris Cité (CRESS (U1153 / UMR_A_1125 / UMR_S_1153)), Université Paris Diderot - Paris 7 (UPD7)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Institut National de la Recherche Agronomique (INRA)-Université Paris Descartes - Paris 5 (UPD5)-Université Sorbonne Paris Cité (USPC)-Université Paris Diderot - Paris 7 (UPD7)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Institut National de la Recherche Agronomique (INRA)-Université Sorbonne Paris Cité (USPC), Centre Hospitalier Universitaire d'Angers (CHU Angers), PRES Université Nantes Angers Le Mans (UNAM), Centre hospitalier universitaire de Nantes (CHU Nantes), Centre Hospitalier Régional Universitaire [Lille] (CHRU Lille), Centre Hospitalier Régional Universitaire de Tours (CHRU TOURS), Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier), Institut National de la Recherche Agronomique (INRA)-Université Paris Diderot - Paris 7 (UPD7)-Université Paris Descartes - Paris 5 (UPD5)-Université Sorbonne Paris Cité (USPC)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Institut National de la Recherche Agronomique (INRA)-Université Paris Diderot - Paris 7 (UPD7)-Université Sorbonne Paris Cité (USPC)-Institut National de la Santé et de la Recherche Médicale (INSERM), Institut National de la Recherche Agronomique (INRA)-Université Paris Diderot - Paris 7 (UPD7)-Université Paris Descartes - Paris 5 (UPD5)-Université Sorbonne Paris Cité (USPC)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Institut National de la Recherche Agronomique (INRA)-Université Paris Diderot - Paris 7 (UPD7)-Université Paris Descartes - Paris 5 (UPD5)-Université Sorbonne Paris Cité (USPC)-Institut National de la Santé et de la Recherche Médicale (INSERM), and Centre Hospitalier Régional Universitaire de Tours (CHRU Tours)

Subjects
Male, medicine.medical_specialty, Pediatrics, Cardiotonic Agents, Epidemiology, Population, Blood Pressure, Infant, Premature, Diseases, Cohort Studies, 03 medical and health sciences, 0302 clinical medicine, 030225 pediatrics, Intensive care, Intensive Care Units, Neonatal, Infant Mortality, medicine, Humans, 030212 general & internal medicine, Neonatology, Prospective Studies, education, Propensity Score, Glucocorticoids, education.field_of_study, [SDV.MHEP.PED]Life Sciences [q-bio]/Human health and pathology/Pediatrics, business.industry, Intensive Care, Infant, Newborn, Obstetrics and Gynecology, Gestational age, Disease Management, Infant, Retinopathy of prematurity, General Medicine, medicine.disease, 3. Good health, Survival Rate, Blood pressure, Treatment Outcome, Infant, Extremely Premature, Pediatrics, Perinatology and Child Health, Fluid Therapy, Female, Hypotension, business, Circulatory, Cohort study
Abstract

To compare outcomes at hospital discharge for preterm infants born before 29 weeks of gestation who had at least one episode of isolated hypotension during their first 72 hours of life for which they did or did not receive antihypotensive treatment.Etude Epidémiologique sur les Petits Ages Gestationnels 2 (EPIPAGE 2) French national prospective population-based cohort study in 2011.60 neonatal intensive care units.All infants with a minimum mean arterial blood pressure less than gestational age (in weeks) (minMAPGA) within 72 hours of birth. Infants whose reason for receiving antihypotensive treatments was isolated hypotension only were compared with untreated hypotensive infants by propensity score matching.Fluid bolus and/or inotropes and/or corticosteroids.The primary outcome was survival at hospital discharge without major morbidity, defined as any of necrotising enterocolitis, severe cerebral abnormalities, severe bronchopulmonary dysplasia or severe retinopathy of prematurity.Among the 1532 infants with available data, 662 had a minMAPGA; 206 were treated for unknown or other reasons than isolated hypotension, 131 were treated for isolated hypotension only and 325 were untreated; 119 infants from each of these last two groups were matched. Treated infants had a significantly higher survival rate without major morbidity (61.3% vs 48.7%; OR, 1.67, 95% CI 1.00 to 2.78, p=0.049) and a lower rate of severe cerebral abnormalities (10.1% vs 26.5%, p=0.002).In this population, antihypotensive treatment was associated with improved short-term outcomes. Therapeutic abstention should be cautiously considered for early isolated hypotension in extremely premature infants.

Published
2016
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29. Clinical features and prognostic factors of listeriosis: the MONALISA national prospective cohort study

Author

Odile Fremin-Batteux, Juliette Clarissou-Philippe, Benoît Jauhlac, Severine Guyetand, Jacques Gasnault, Corinne Haioun, Liamine Aissaoui, Marie-Christine Pages, Marie-Pierre Fos, Christian Rose, Didier Hubert, Marie-Rose Rothe, N. Bouziges, Benoît Huc, François Devianne, Sabine Bidart, Anne Forest, Kevin Bertrand, Mohamed Eldeghedy, Annick Verhaeghe, Caroline Malderet, Anne Bertrou, Bernard Guerquin, Catherine Duche, Muriel Archambaud, Rabea Cotteret, Olivier Toullalan, Yves Devaux, Smail Bergheul, Valérie Sivadon-Tardy, Pierre-Gilles Merville, Geneviève Blanchard-Marche, Didier Raoult, Bernard Hory, Florence Richardin, Evelyne Belle, Mohamed Menouar, K Guitteaud, Mohamad Mohty, Ambroise Montcriol, Max Laurin, Aurélia Picard, Jean-Paul Mira, Marie-Charlotte Chopin, Richard Bonnet, Michel Wolff, Sébastien Maillez, Jeanne Maugein, Véronique Leblond, Nicola Walid, Bernard Gauche, Mathieu Evillard, Hassen Jeddi, Anne Bourlet, Isabelle Grawey, Thierry Jault, Sandrine Hiret, Valerie Gaborieau, Véronique Boin-Gay, An Kim, Thierry Constans, Jean-François Gaide, Martine Giraud, Eric Meaudre Desgouttes, Alain Fur, Abdallah Maakaroun, Olivier Matray, Bertrand Maubert, Frédérique Péchinot, Aurelie Garbi, Claire Delbrouck, Benoît Grandclerc, Vincent Cadiergue, Hervé Lécuyer, Bernadette Grignon, Thierry Bensaid, Nicole Constantin, Yannick Chevalier, Hassène Rahmani, Thierry Levent, Joelle Desliers, Florence Van de Velde, Xavier Adhoute, Clara Andriau, Christophe Charasse, Rémi Vatan, Benoît Martha, Alain Lecis, Didier Albert, Romain Jacobs, Hélène Lefranc, Christian Martin, Nasseur Rezgui, Bertrand Pigeon, Catherine Le Henaff, Dominique Cassignard, Françoise Cotes, Eric Pujade Lauraine, Jean-François Gattault, Nicole Ferreira-Maident, Noémie Jourde-Chiche, Hélène Garrec, Olivier Darchen, Carole Schwebel, Marie-Christine Bezian, Patrick Daoud, Tsouria Becaid, Simone Laluque, David Broche, Christine Boisselier, Pascale Martres, Sarah Hammami, Brigitte Olivier, Jean-Marie Nkunzimana, Eric Monlun, Isabelle Marterl-Lafay, Marion Carboni, Marie-Françoise Mattei, Sandrine Castelin, Isabelle Barillot, Marie-Noelle Cufi, Thomas Kaiser, Catherine Herry, Pascal Hutin, Jean-Pierre Bronowicki, Bernard Branger, Pierre Thomas, Elie Zagdoun, Anne Goquelin, Ziad Assaf, Ingrid Croquet, Bruno Pozzetto, Thomas Similowski, Anne-Isabelle Briere, Marie-Thérèse Albertini, Mariam Blaka, Christelle Tassot, Anne Gaschet, Jean-Philippe Lavigne, Antoine Pujol, Philippe Colombat, Edouard Devaud, Hana Talabani-Boizot, François Barière, Anne-Marie Cordier, Philippe Gueudet, Georges Simon, Anne-Sophie Lipovac, Françoise Bandaly, Anne Beauplet-Lepage, Sylvie Prince, Charlotte Jouzel, Jean-Luc Deboutin, Patrick Zavadil, Louis Puybasset, Marie-Cécile Petit, Loïc Guillevin, Kamel Touati, Christophe Ntalu Nkato, Sylvie Carette, Jacques Vaucel, Chantal Delasalle, Marine Gross Goupil, Laurent Gutmann, Christiane Payen, Annick Barboteau, Firouzé Bani-Sadr, Christophe Legendre, Philippe Roulier, Elie Azria, Ibrahim Farah, Isabelle Rouquette-Vincent, Anne-Sophie Erena-Penet, Philippe Labadie, Eric Josien, Aicha Derragui, Mathieu Legrand, Odile Beyne-Rauzy, Jean-Marc Nabholtz, Marie-Joelle Demarcq, Olivier Garosi, Michel Deiber, Fabrice Chaix, Bertrand Souweine, Anne Collignon, Gisèle Renard, Mickael Jego, Gilles Bernardin, Anne Allart, Jocelyn Barrier, Marc Vasse, Philippe Ménager, Marc Wurmser, Abderkader Ouazir, Olivier Gontieron, Yvon Berland, Sébastien Trouiller, David Leysenne, Christophe Ozanon, Fanny Autret, Tahar Saghi, Loïc Dopeux, Sophie Benoit-Coustou, T. Fraisse, Christine Maillard, Karine Nikodijevic, Georges Kaltenbach, Angéline Jamet, Philippe Aucher, Julie Bottero, Marie-Claude Piffaut, Marianne Besnard, Florence Courillon, Marie Bonfils, Christine Ghevaert, Marie Destors, Eliette Jeanmaire, Franck Zerbib, Manuel-Luis Gameiro, T Prazuck, Laurent Mandin, Olivier Guisset, Marguerite Fines, Toufik Feddal, Agnès Jouffret, Louis Mesnard, Thomas Bourrée, Hasinrina Razafimahefa, Sylvestre Tigaud, Vincent Estève, Philippe Malherbe, Jean-Michel Salord, Pascal Adam, Bertrand Rozec, Michel Fuillet, Olivier Lemenand, Denis Quinsat, Ana Danalaché, Véronique Vialette, François Brosset, Patrick Messner Pellenc, Nicolas Heisel, Edouard Girard, Régine Martin, Olivier Garesslin, Catherine Mille, Alexandre Gascon, Marc Nicolino, Laurence Mouly, Claire Fabre, Bénédicte Ponceau, Marie-Etiennette Emeriau, Pascal Cathebras, Bérangère Bernardaud, Michèle Pérouse de Montclos, O. Arsene, Karine Grenet, Yazdan Yazdanpanah, Sten De Witte, Anne Scemla, Laurence Bouillet, Christophe Burucoa, Vincent Loffeier, Séverine Visentin, Luc Desfrere, Miloud Arabi, Frédérique Costa, Sylvie Lechat, Ali Chekroun, Raymond Ruimy, Marie, Jérôme Bizet, Xavier Nassif, Baihas Dib, Patrick Bert-Marcaz, Laurent Martin Lefèvre, Nicholas Sedillot, Blandine Cattier, Emilie Boidin, Daniel Sondag, Aude Bourrouillou, Alain Noirot, Franck Desemerie, Fréderic Heluwaert, Catherine Tamalet, Marc G. Berger, Jean-Daniel Lelièvre, Dominique Perotin, Abdelkader Bemrah, Alain Lozniewski, Bernard Borstein, Hanna Eid, Diana Suatean, Virginie Mignaut, Jean-Claude N'guyen, Valérie Le Goff, Laurent Teillet, Christophe Rolland, Gwenaël Alfonsi, Florence Lachenal, Philippe Bossi, Yves Botreau, Florence Doucet Populaire, Henry Jardel, Nicolas Gallo, Elias Jabre-Sikias, Michel Dupon, Hélène Brihier, Isabelle Patry, Alexandre Leclercq, Bernadette Tourrand, Christophe Roussel, Jean-Emmanuel Kurtz, Bénédicte Paindaveine, Simon Elhadad, Richard Sanchez, Eric Sgro, Pierre Berger, Valérie Murbach, Anne Holstein, Florence Martin, Taoufik Merabet, Amélie Benbara, Milagros Ferreyra, Laure Esposito, Pierre Delobel, Antoine Andremont, Marc Bourlière, Carole-Anne Boudy, Jean-Baptiste Gaulthier, Laurent Tacchini, Olivier Marpeau, Sonia Tesseydre, Marie-Pierre Coulhon, Nathalie Hodee, Marie-Chrsitine Conroy, Pierre Weinbreck, Roland Leclercq, Laurent Souply, Christian Bidault, Annie Elbez, Marie-Annick Lebreton, Patrick Brisou, Agnès Ferroni, Jean-Louis Pourriat, Nadia Anguel, Christian Noel, Philippe Jouvencel, Eric Pichard, Xavier Martin, Mathieu Coste, Pierre Zuber, Catherine Neuwirth, Jean-Pierre Hacot, Paul Aye, Jérôme Guinard, Yves Pean, Jean-Christophe Dengo, Fabrice Petassou, Didier Viole, Thierry Messiaen, Jean Beytout, Philippe Petitjean, Ferdinand Savare, Patrice Cuvillier, Sophie Coignard, Hélène Anglaret, Nassim Kamar, Elisabeth Chachaty, Karine Guimard, Louis Braem, Hacene Fezoui, Pierre Martin, Jean-Paul Viard, Claire Larroche, Nicolai Claudiu-Plesa, Thierry Benoit-Cattin, Olivier Moquet, Thierry Pasdeloup, David Rosay, Rodolphe Jean, Jean-Bernard Mariette, Marc Debouverie, Hervé Peltier, Mustapha Terki, Jacques Daleas, Valérie Dattin-Dorrière, Michel Vergnaud, Emmanuel Grimprel, Sylvène Rosselli, Jean-Marc Didier, Pierre Faurie, Luc Frimat, Aziza Mandjee, Sabine Etchemendy, Pierre Tissières, Jean Nakhleh, Sylvie Mariette, Christian Perronne, Bruno Carbonne, Nathalie Houssiaux-Maisonneuve, Tristan Ferry, S Beague, Anthony Sebban, Marie-Thérèse Hili, Jean-Michel De Kermadec, Lucien Brasme, Gilles Blaison, Caroline Garandeau, Jean-Pierre Sollet, Laurent Tronchon, Thierry Samson, Julien Gesquière, Nicolas Ettahar, Alain Créange, Etienne Laurens, Véronique Equy, Fréderic Bart, Bernard Bouffandeau, Christine Vaillant, Valerie Pesque, Jean-Marc Lalot, Marc Levy, Michel Kaidomar, Mihaela Saplacan, Sterenn Yvenou, Marie-Isabelle Steibach, Emmanuelle Cambau, Agnès Riche, François Fourrier, François Raffi, Mélissa Lalu, Henri Bérard, Danielle Clave, Jean-Claude Mouries, Martine Porcheron, Jean Cabalion, Richard Lamarca, Nathalie Canu, Jean-Baptiste Roseau, Annabelle Stoclin, Luca Luminitan Elena Lupean, Rémi Gebeile, Celia Salanoubat, Carole Marmouset, Pierre Bigot, Anne-Laure Breton, Pierre Kalfon, Colette Vincent, Sophie Marty, Olivier Tandonnet, Alexis Redor, Xavier Valette, Ourida Aoudia, Jacques-Arnaud Seyrig, Bertrand Beaune, Hugues Aumaitre, Georges Pinon, Yann Leveneur, Sylvie Charachon, Raoul Herbrecht, Henriette de Valk, Gary David, Julien Pouyanne, Marc Dommergues, Majed Al Chaar, Véronique Blanc-Amrane, Pascale Guillarmé Grossmann, Bruno Abraham, Yves Morel, Philippe Suel, Denis Sautereau, Olivier Guilloy, Tu Anh Tran, Frédéric Laurent, Zahir Amoura, Jacques-Olivier Bay, Zoubida Elharie-Heraux, Joyce Sibony-Prat, Bernard Guillois, Dominique Rohmer-Heitz, Audrey Barrelet, Jérémie Courouble, Jean-Paul Herry, Daniel Vittecoq, Annie Vermesch-Langlin, Jean Auroux, Claude Aubert, Thierry Harvey, Ghislaine Lamoine-Gimet, J. 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Bernard, Vincent Cailleaux Pierre-Etienne Cailleux, Jordi Miatello, Pierre-Yves le Berruyer, Sylvain Kouaho, Michel Briaud, Hélène Delaby, Patrick Herbecq, Christine Segonds, Véronique Jault, Pascale Brunel, Christine Dussopt, Jean Thore, Jean-Marc Thouret, Jean-Marc Kerleau, François Le Baron, Slavius Matica, Sophie Leautez-Nainville, Matthieu Pecquet, Laurent Bret, Yacine Sedjelmaci, Pierre Metton, Habiboulaye Diallo, Jany Rey Zermati, Arnaud Delahaye, Hélène Chaussade, Laurent Mandelbrot, Emilie Bessede, Olivier Casanovas, Paul Pierrot, Annick Legras, Dominique Lauque, Hélène Gatti, Jean Catineau, Ebutu Likose, Gilles Capellier, Eric Kibbrecht, Freddy Thibaut, Patrick Valadier, Chantal Lemble, Joël Gaudelus, Joelle Mellier, Joëlle Brochen, Emmanuel Gascou, Stéphane Bonacorsi, Stéphanie Bannier, Bruno Fantin, Didier Raffenot, Valérie Revel, Hakim Amroun, Huguette Negrery, Anne-Laure Fauchais, Paul Mercury, Michel Chuzeville, Christian Zumbo, Nicolas Després, Pascal Roblot, Jérôme Pasche, Jean Claude Boufetteau, Jocelyne Caillon, Julien Boileau, V. Rabier, Benjamin Manéglier, Emilie Jourdes, Franck Ceppa, Christine Recule, Nicolas Degand, Benoît Henry, Thierry Baranger, Dominique Pateron, Agnès Pélaquier, Gérard Bouchet, Hélène Fiette, Ozel Guiden, Dana Ranta, Etienne Ruppé, Nabil Chiouk, Jacques Breuil, Dominique Leduc, Véronique Loustaud, Hervé Métenier, Michel Durand, Isabelle Mahé, Leila Karaoui, Marie-José Collus, Mehran Monchi, Olivier Belmonte, Romain Blondet, Jacques Thierry, Karine Humbert, Gilles Salama, Marie-Noelle Heurtaux, Cécile Goujard, Bruno Sivery, Martial Boisseau, Redouane Dahoumane, Pierre Delour, Christian Niels Meyer, Anne Faudon-Gibelin, Gérard Poulain, Roger-Charles Luciani, J.-C. Souquet, Olivier Grossi, François Vandenesch, Sylvain Mermont, Jacques Bronner, Sonia Dahan, Paul Marzouk, Pascal Pouedras, Noureddine Djafari, François-Xavier Caroli-Bosc, Jean-François Dessin, Brigitte Gruffat, Armelle Morin-Fatome, Sylvie Thoinet, Bano Konate, Jean-Winoc Decousser, Claire Poyart, Patrick Plessis, Olivier Millet, Vincent Cattoir, Françoise Geffroy, Manica Vasseur, Pierre Carli, Isabelle Citony, Christian Richard, Nicolas Sigur, Patrick Marthelet, Luwawu Mbimba, Pierre Feugier, Philippe Sauder, Hama Djerad, Evelyne Bourgerette, Hanen Chahtour, Adrien Lemaignen, Dominique Bechade, Patrick Ochocki, Antoine Vieillard Baron, Dominique Astruc, Marie-Pierre Moiton, Nicolas Dubois, Sylvie Ledru, Corinne Seknazi, Hélène Poupet, Jean-Philippe Brieux, Gérard Barthélémy, Aihem Yehia, Louis-Jean Couderc, Ahmed, Françoise Rigaux, Yohann N'guyen, Philippe Bethery, Damien Corberand, Etienne Auvray, Paul-Louis Woerther, Christian Combe, Sophie Delesalle, Jean-Marie Piala, Faraj Al 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Francis Schneider, Richard Monarchi, Adeline Schendel, Paramasiven Mootien, Ghislaine Gardes, Pierre-François Westeel, Jean-François Magny, François Caron, Jocelyn Michon, Didier Eyer, Isabelle Ronda, Pierre-Yves Robillard, Frédéric Renou, Anna Faucher, Jean-Robert Harlé, Anne Debernardi, Grégory Akerman, Benoît Fontenel, Pierre Hourdebaigt-Larrusse, Marie-Noëlle Adam, Aude Lessene, Abdelkader Hrichi, François Blot, Athéna Le Pierres, Romain Lemarie, Françoise Granier, Véronique Tardy, Marc Gatfosse, Pierre-Marie Roger, François Goupil, Saïd Aberrane, Franck Bernardi, Isabelle Plantier, Nathalie Funakoshi, Jean-Gilles Delecalle, Patricia Barbut, Jacques Reynes, Christophe Roy, Sophie Perreve, Michel Garre, David Ribes, Cyrille Ede, Jean-Claude Dausset, Francis Duchene, Jean Caussin, Michelle Becker-Schneider, Gilles Berthelot, Damien Dupont, Jean-Michel Gillot, Aurélie Messager, Jean-Marie Pannecouck, Jean-Christian Roussel, Alain Reynaud, Sylvie Cariou, Anne Dao, François Guillemot, 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Costa, Chandrah Goburdhun, Bernard Gressier, Alban Michaud-herbst, Franck Charlier, Moussa Hecham, Luc Boulain, Hélène Corneloup, Alix Greder Belan, Nicolas Boussekey, Claire-Antoinette Dupuy, Yannick Rouquet, Benoit Renard, Benifla Jl, Etienne Javouhey, Michèle Granier, Marie-Christine Jaffarbandjee, Emilie Piet, Benoît Bergues, Claire Malbrunot, Catherine Tiry, Philippe Mérigot, Mouna Ben Soltana, Chantal Roure Sobas, Florian Radenac, Yves Thomas, Agathe Blaise, Sylvie De Martino, Laurence Legout, Gabriel Choukroun, Jean-François Muir, Peggy Dupretz, Patrick Dupont, François Guichart, Julie Jean, Jean-Michel Descamps, Bernard Kittschke, Anne Gruson, Gerard Viquesnel, Marie Keller, Pascal Chavanet, Françis Vallet, Yvan Vaschalde, Jean-Luc Hanouz, Gerard Lina, Françoise Loison, Simon Vincent, Jean-Paul Thellier, Moncef Afi, Dominique Zagozda, Hélène Sokeng-Affoule, Marc Le Bideau, Jean-François Loriferne, Alain Gravet, Sophie Deprecq, Tarik Naceur, Severine Mielczarek, René-Jean Bensadoun, Bernard Karkous, Yves Bléher, Jocelyne Poulain, Véronique Goulet, Laurence Nicolet, Sophie Arista, Antônio Lúcio Teixeira, Jean-François Schved, Laurent Nicolet, Claire Lecomte, Faiza Benddif-Fin, Michel Aumersier, Laurence Burc-Struxiano, Maxime Thouvenin, Samia Harbi, Mathieu Detave, Catherine Rebeyrotte, Jean-Paul Kisterman, Bruno Berdin, Pascal Vincent, Laurent Argaud, Elisabeth Parisi-Duchene, Geneviève Julienne, Fernanda Farto-Bensasson, Georges-Fabrice Blum, Sad Gaizi, Tali-Anne Szwebel, Raphaël Lepeule, Marie-Thérèse Climas, Anne-Françoise Dillies, Amar Boudhane, Umberto Simeoni, Pierre-François Dequin, Gérard Oliviero, Alain Gourlaouen, Caroline Piau, Marie-France Lutz-Murphy, Benoît Claude, Jean-Paul Aubry, Nadine Dubosc-Marchenay, Kamilla Chraibi, Emmanuelle Heusse, Sylvain Le Chevallier, Nathalie Brieu, Farid Sifaoui, Lorraine Letranchant, Hélène Durox, Jean-Pierre Lagasse, Adel Ghedira, Xavier Roubert, Fatma Magdoud, Hélène Jean-Pierre, Etienne Carbonelle, Olivier Dereeper, Lionel Carbillon, Christophe Billy, Mélanie Roblin, Marie-José Kodzin, Philippe Niel, Solène Makdessi, Matteo Vassallo, Maryse Archambaud, Fabian Haccourt, Didier Blaise, Stéphane Bourgeois, Elena Marcu, Charles Kubiak, Brisse Castel, François Guinet, Marie Pouzoullic, Frédérique Nathan-Bonnet, Vincent Gendrin, Céline Becherrawy, Aline Secher, Pierre Abgueguen, Clarence Eloy, Jean-Marc Tourani, Frédéric Klapczynski, Bernard Montmasson, Philippe Real, Joanna Pofelski, Yves Welker, Karim Krechiem, Eric Caumes, Martine Elena-Daumas, Christophe Saigne, Gilles Hittinger, Chantal Delesalle, Jonathan Messika, Fabrice Lesage, Daniela Pop, Daniel Coetmeur, Renato Colamarino, Chetaou Mahaza, Patrick Plésiat, Isabelle Fredenucci, Mylène Baret, Guy Mager, Pascale Chavel, Isabelle Labourdette, Anne-Claude Menguy, Nicolas Fortineau, Ludovic Le Sec, Valérie Gauduchon, Francis Barraud, Nicolas Letellier, Didier Vincent, Janine Frey, Philippe Riegel, Michel Pavic, Jean-Luc Fabre, Jean-Pierre Fauchart, Alain Goudeau, Stéphanie Husson-Wetzel, Philippe Eymerit, Mohamed Camara, Nathalie Seta, Elisabeth Carole Ngo Bell, Philippe Repellin, Laurent Alric, Vincent Leroy, Françoise Delisle Mizon, Jean-Philippe Emond, Marie-Françoise Borie, Lise Crémet, Wladimir Chelle, Elisabeth Brottier-Mancini, Bernard Garrigues, Claire Letellier, Loïc Geffray, Frédéric Méchaï, Julien Bador, Benoit Guery, Alain-Charles Fouilhoux, Corinne Dagada, Pierre Duhaut, Julien Goustille, Arnaud Sément, Francis Carcenac, Isabelle Girard-Buttaz, Claire Chapuzet, Fabienne Jouatte, Bruno Riou, Fabrice Hayoun, Chloé Di Meglio, Youssef Ali, Michel Leneveu, Nathalie Montagne, Yves Garcera, Audrey Moustache, Pierre-Eric Danin, Geneviève Le Lay, Dominique Courouge-Dorcier, Isabelle Worcel, Emmanuel Morelon, Vincent Pestre, Jean-Pierre Vilque, Jean-Christophe Paquet, Lucien Bodson, Anne-Marie Forest, Fabrice Pierre, Christian Pommier, Fabien Dutasta, Pierre Fournel, Stéphanie Courtois, Elodie Dubois, Serge Vanden Einjden, Patrick Honderlick, Pascal Richette, Fabienne Tamion, Véronique Chassy, Richard Megbemado, Anne-Marie Le Reste, Bernard Simian, Henri Osman, Anthony Texier, Badih Ayach, François Simon, Jean-Michel Filloux, Béatrice Dubourdieu, Jean-Claude Semet, Sarah Kubab, Tawfiq Henni, Patrick Dudeffant, Delphine Hequet, Olivier Mimoz, Marc Auburtin, Amélie Chabrol, Mickael Bonnan, Caroline Léonnet, Claire Wintenberger, Serge Ilunga, Patrice Lanba, Sophie Rosello, Alexandre Damage, Flore Bouche, Michel Thibault, Frederic Faibis, Chantal Dhennain, Jean-Philippe Talarmin, Armelle Lamour, Remi Boussier, Fabien Garnier, Marie-Laure Brival, Nourredine Hedjem, Philippe Vande-perre, Raphaël Coint, Jean-Claude Reveil, Eva Weinbronn, Emmanuelle Lavalard, Alexandra Fille, Françoise Le Turdu, Lionel Leroux, Jean-Yves Lefrant, Jean Berthet, Radia Bouaziz, Alain Ravaud, Sylvaine Rousseau, Yacine Merrouche, Alain Le Coustumier, Bertrand Guider, Gisèle Dewulf, Jean-Marc Faucheux, Jacques Piquet, Franck Leibinger, Charles Cerf, Robin Stephan, Jean-Philippe Redonnet, Jean-Paul Stahl, Ella Dzeing, Simona Pavel, Guy Vernet, Ghada Hatem, Samer Kayal, Jacques Deschamps, Dominique Descamps, Marion Levast, Marc Bouiller, Sylvie Dargere, Claire Dingremont, Stéphane Gaudry, François Maillot, Sylvie Odent, Nathalie Cervantes, Hélène Zanaldi, Laurence Gachassin, Olivier Ruyer, David Patin, Benoît Cazenave, Pascal Jacquier, Michelle Boyer, Béatrice Berteaux, Virginie Zarrouk, Jacques Bor, Isabelle Legoff, Hélène Albinet, Florence Rousseau, Gilles Pialoux, Guenaelle Salaun-Beretta, Alexandra Moura, Véronique Vernet Garnier, Didier Lepelletier, Pierre-Alexandre Hauss, Joëlle Belaisch-Amart, Didier Lepeletier, Jacob Xavier, Aline Nare, Annie Motard-Picheloup, Alain Améri, Bertrand Lioger, Jean-Valère Malfuson, Centre d'infectiologie Necker-Pasteur [CHU Necker], Institut Pasteur [Paris] (IP)-CHU Necker - Enfants Malades [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Centre National de Référence Listeria - National Reference Center Listeria (CNRL), Institut Pasteur [Paris] (IP)-Institut National de la Santé et de la Recherche Médicale (INSERM), Centre collaborateur de l'OMS Listeria / WHO Collaborating Centre Listeria (CC-OMS / WHO-CC), Institut Pasteur [Paris] (IP)-Organisation Mondiale de la Santé / World Health Organization Office (OMS / WHO), CHU Pitié-Salpêtrière [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), Université Pierre et Marie Curie - Paris 6 - UFR de Médecine Pierre et Marie Curie (UPMC), Université Pierre et Marie Curie - Paris 6 (UPMC), Département de Médecine interne [Lariboisière], Hôpital Lariboisière-Fernand-Widal [APHP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Université Paris Diderot - Paris 7 (UPD7), Biologie des Infections - Biology of Infection, Service de Gynécologie et Obstétrique [Cochin], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Cochin [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Investigation Clinique et d’Accès aux Ressources Biologiques (Plate-forme) - Clinical Investigation and Access to BioResources (ICAReB), Institut Pasteur [Paris] (IP), Infectious Disease Department [Saint Maurice], Agence Nationale de la Santé Publique [Saint-Maurice] (ANSP), Centre de Recherche Épidémiologie et Statistique Sorbonne Paris Cité (CRESS (U1153 / UMR_A_1125 / UMR_S_1153)), Institut National de la Recherche Agronomique (INRA)-Université Paris Diderot - Paris 7 (UPD7)-Université Paris Descartes - Paris 5 (UPD5)-Université Sorbonne Paris Cité (USPC)-Institut National de la Santé et de la Recherche Médicale (INSERM), Université Paris Descartes - Paris 5 (UPD5), CHU Amiens-Picardie, Mécanismes physiopathologiques et conséquences des calcifications vasculaires - UR UPJV 7517 (MP3CV), Université de Picardie Jules Verne (UPJV)-CHU Amiens-Picardie, MONALISA study group, Programme Hospitalier Recherche Clinique, Institut Pasteur, Inserm, French Public Health Agency., ROZIER, marie-Claire, CHU Necker - Enfants Malades [AP-HP], Centre National de Référence Listeria - Biologie des Infections (CNRL), Institut Pasteur [Paris]-Institut National de la Santé et de la Recherche Médicale (INSERM), Centre collaborateur de l'OMS Listeria - Biologie des Infections (CCOMS), CHU Pitié-Salpêtrière [APHP], Hôpital Lariboisière-Université Paris Diderot - Paris 7 (UPD7), Assistance publique - Hôpitaux de Paris (AP-HP) (APHP)-CHU Cochin [AP-HP], Institut Pasteur [Paris], Assistance publique - Hôpitaux de Paris (AP-HP) (APHP), Assistance publique - Hôpitaux de Paris (AP-HP)-CHU Necker - Enfants Malades [AP-HP], Centre National de Référence Listeria - Biologie des Infections ( CNRL ), Institut Pasteur [Paris]-Institut National de la Santé et de la Recherche Médicale ( INSERM ), Centre collaborateur de l'OMS (CCOMS) des Listeria ( CCOMS ), Centre de Recherche Épidémiologie et Statistique Sorbonne Paris Cité ( CRESS (U1153 / UMR_A 1125) ), Institut National de la Recherche Agronomique ( INRA ) -Université Sorbonne Paris Cité ( USPC ) -Institut National de la Santé et de la Recherche Médicale ( INSERM ), Université Pierre et Marie Curie - Paris 6 - UFR de Médecine Pierre et Marie Curie ( UPMC ), Université Pierre et Marie Curie - Paris 6 ( UPMC ), Université Paris Diderot - Paris 7 ( UPD7 ) -Hôpital Lariboisière, Biologie des Infections, Institut Pasteur [Paris]-Université Paris Descartes - Paris 5 ( UPD5 ) -Institut National de la Santé et de la Recherche Médicale ( INSERM ), Investigation Clinique et d’Accès aux Ressources Biologiques (Plate-forme) - Clinical Investigation and Access to BioResources ( ICAReB ), Agence Nationale de la Santé Publique [Saint-Maurice] ( ANSP ), Assistance Publique - Hôpitaux de Paris, Assistance publique - Hôpitaux de Paris (AP-HP), Université Paris Descartes - Paris 5 ( UPD5 ), Institut Pasteur [Paris]-CHU Necker - Enfants Malades [AP-HP], Institut Pasteur [Paris]-Organisation Mondiale de la Santé / World Health Organization Office (OMS / WHO), Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), and Université Paris Diderot - Paris 7 (UPD7)-Université Sorbonne Paris Cité (USPC)-Université Paris Descartes - Paris 5 (UPD5)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Institut National de la Recherche Agronomique (INRA)

Subjects
Bacteremia/epidemiology/mortality, 0301 basic medicine, Male, Pediatrics, bacteraemia, Infectious Disease Transmission, [SDV]Life Sciences [q-bio], Bacteremia, France/epidemiology, Infant, Newborn, Diseases, Foodborne Diseases, Meningoencephalitis, Pregnancy, Risk Factors, Vertical, Medicine, Listeriosis, Prospective Studies, Pregnancy Complications, Infectious, Prospective cohort study, ddc:618, diabetes, alcoholism, Hazard ratio, Foodborne Diseases/microbiology, immuno suppressive therapies, Prognosis, 3. Good health, [SDV] Life Sciences [q-bio], Hospitalization, Infectious Diseases, isolates, Population Surveillance, Female, France, Listeria monocytogenes/classification/isolation & purification, Cohort study, Adult, medicine.medical_specialty, 030106 microbiology, Notifiable disease, Listeriosis/diagnosis/epidemiology/microbiology, Context (language use), macromolecular substances, 03 medical and health sciences, Humans, study, Aged, [ SDV ] Life Sciences [q-bio], business.industry, Public health, cirrhosis, Infant, Newborn, Infant, Diseases/epidemiology/microbiology, HIV, Mandatory Reporting, Newborn, medicine.disease, Listeria monocytogenes, infection, Infectious Disease Transmission, Vertical, Pregnancy Complications, Infectious/epidemiology/microbiology, Meningoencephalitis/epidemiology/microbiology/mortality, Observational study, business, prognostic, mellitus
Abstract

International audience; Evidence before this study We searched PubMed on June 30, 2016, for English-language cohort studies published since Jan 1, 1980, of patients with invasive listeriosis worldwide with the keywords " listeria " , " listeriosis " , " maternal " , and " neurolisteriosis ". Studies had to include epidemiological or clinical data on listeriosis. All clinical forms of infection were included (bacteraemia, neurolisteriosis, and maternal–neonatal infection). Host risk factors for listeriosis have been well identified, but the clinical features and prognostic factors of the disease are based on retrospective studies compiling heterogeneous data or random collected cases. Furthermore, no clinical trial has ever been done and medical management is not evidence based. Added value of the study Our study is the first prospective clinical study focusing on all forms of invasive listeriosis. The study is based on a national mandatory system that allowed the nearly complete capture of microbiologically proven cases. The study shows a higher burden of listeriosis than reported before: more than 80% of infected mothers experienced major fetal or neonatal complications (fetal loss, very high prematurity, early or late onset disease); only 39% of patients with neurolisteriosis survived and fully recovered. The study provides important new data to improve management and predict outcome in listeriosis, such as determination of the time window for fetal losses (

Published
2016
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30. Probiotics and growth in preterm infants: A randomized controlled trial, PREMAPRO study

Author

Hélène Gauthier, Estelle Jumas-Bilak, Olivier Claris, Anne Beissel, Jean-Charles Picaud, Evelyne Decullier, Aurélien Jacquot, Gilles Cambonie, Christian Kempf, Odile Pidoux, G Putet, L. Beck, Stéphane Haÿs, E. Lachambre, Hôpital de la Croix-Rousse [CHU - HCL], Hospices Civils de Lyon (HCL), Centre de Recherche en Nutrition Humaine Rhône-Alpes (CRNH-RA), Université Grenoble Alpes [2016-2019] (UGA [2016-2019])-Université Claude Bernard Lyon 1 (UCBL), Université de Lyon-Université de Lyon-Institut National de la Recherche Agronomique (INRA)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Jean Monnet [Saint-Étienne] (UJM)-CHU Saint-Etienne-Hospices Civils de Lyon (HCL)-CHU Grenoble, Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier), Hôpital Femme Mère Enfant [CHU - HCL] (HFME), Ecologie des systèmes marins côtiers (Ecosym), Université Montpellier 1 (UM1)-Université Montpellier 2 - Sciences et Techniques (UM2)-Institut Français de Recherche pour l'Exploitation de la Mer (IFREMER)-Centre National de la Recherche Scientifique (CNRS), Nestlé France, Université de Montpellier (UM), Université Claude Bernard Lyon 1 (UCBL), Université de Lyon, Centre de Recherche en Nutrition Humaine Rhône-Alpes (CRNH-RH), and Université de Lyon-Université de Lyon-Institut National de la Recherche Agronomique (INRA)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Jean Monnet [Saint-Étienne] (UJM)-CHU Saint-Etienne-Hospices Civils de Lyon (HCL)-CHU Grenoble-Université Joseph Fourier - Grenoble 1 (UJF)

Subjects
Male, Pediatrics, Critical Care and Intensive Care Medicine, law.invention, Probiotic, Feces, 0302 clinical medicine, Randomized controlled trial, law, Necrotizing enterocolitis, Birth Weight, Infant, Very Low Birth Weight, 030212 general & internal medicine, Prospective Studies, Infant Nutritional Physiological Phenomena, Bifidobacterium, Nutrition and Dietetics, biology, Incidence, Gestational age, 3. Good health, Treatment Outcome, Body Composition, Female, Dietary Proteins, Safety, Prematurity, Infant, Premature, medicine.medical_specialty, Birth weight, Gestational Age, Placebo, 03 medical and health sciences, Bifidobacterium animalis, Double-Blind Method, Enterocolitis, Necrotizing, 030225 pediatrics, Internal medicine, Sepsis, medicine, Humans, Gut microflora, Intention-to-treat analysis, Milk, Human, business.industry, Probiotics, Infant, medicine.disease, biology.organism_classification, Bifidobacterium longum, Diet, business, [SDV.AEN]Life Sciences [q-bio]/Food and Nutrition
Abstract

Summary Background & aims Recent studies have suggested that the gut microflora has metabolic effects. We aimed to evaluate postnatal growth in preterm infants who received different probiotic supplements, and to assess the safety of probiotic administration. Methods This prospective, randomized, double-blind, controlled trial was performed at three tertiary care neonatal units. Preterm infants were randomly assigned to receive daily supplementation over 4–6 weeks with placebo (group C) or probiotics (group P). Group P comprised three subgroups: P1 received Bifidobacterium lactis , P2 received Bifidobacterium longum , and P3 received B. lactis and B. longum . We assessed postnatal growth during the supplementation period and up to a corrected gestational age (GA) of 41 weeks when body composition was assessed using whole-body dual-energy X-ray absorptiometry. Aerobic and anaerobic blood cultures were performed on suspicion of late-onset sepsis. Results The study comprised 199 preterm infants with a mean GA of 29.1 ± 1.4 weeks and a mean birth weight of 1173 ± 210 g, who received a placebo (group C, n = 52) or probiotics (group P, n = 147) from the first week of life. At the end of the supplementation period, no statistically significant differences were seen between the groups in relation to the mean body weight (group C = 1906 ± 23 g, group P = 1875 ± 14 g, p = 0.25), length, or head circumference. The incidence rates of necrotizing enterocolitis and late-onset sepsis were similar in the two groups. At the corrected GA of 41 weeks, there were no differences between the groups with respect to anthropometric measurements or body composition analysis. Conclusions Preterm infants receiving Bifidobacterium supplements did not exhibit better postnatal growth compared with those who received placebo treatment. No adverse effects were associated with probiotic administration. Registered under ClinicalTrials.gov Identifier no. NCT01379417.

Published
2016
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31. Effect of Intra- and Extrauterine Growth on Long-Term Neurologic Outcomes of Very Preterm Infants

Author

Isabelle Guellec, Alexandre Lapillonne, Stephane Marret, Jean-Charles Picaud, Delphine Mitanchez, Marie-Laure Charkaluk, Jeanne Fresson, Catherine Arnaud, Cyril Flamand, Gilles Cambonie, Monique Kaminski, Jean-Christophe Roze, Pierre-Yves Ancel, B. Larroque, P.Y. Ancel, B. Blondel, G. Bréart, M. Dehan, M. Garel, M. Kaminski, F. Maillard, C. du Mazaubrun, P. Missy, F. Sehili, K. Supernant, L. Marchand, M. Durand, J. Matis, J. Messer, A. Treisser, A. Burguet, L. Abraham-Lerat, A. Menget, P. Roth, J.-P. Schaal, G. Thiriez, C. Leveque, S. Marret, L. Marpeau, P. Boulot, G. Cambonie, J.-C. Picaud, A.M. Donadio, B. Ledesert, M. André, J. Fresson, J.M. Hascoët, C. Arnaud, H. Grandjean, M. Rolland, A. Fily, A. Ego, M.L. Outtier, V. Pierrat, D. Subtil, P. Truffert, G. Boog, V. Rouger-Bureau, J.-C. Rozé, V. Zupan-Simunek, M. Vodovar, M. Voyer, Equipe 1 : EPOPé - Épidémiologie Obstétricale, Périnatale et Pédiatrique (CRESS - U1153), Centre de Recherche Épidémiologie et Statistique Sorbonne Paris Cité (CRESS (U1153 / UMR_A_1125 / UMR_S_1153)), Université Paris Diderot - Paris 7 (UPD7)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Institut National de la Recherche Agronomique (INRA)-Université Paris Descartes - Paris 5 (UPD5)-Université Sorbonne Paris Cité (USPC)-Université Paris Diderot - Paris 7 (UPD7)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Institut National de la Recherche Agronomique (INRA)-Université Paris Descartes - Paris 5 (UPD5)-Université Sorbonne Paris Cité (USPC), CHU Necker - Enfants Malades [AP-HP], Service de pédiatrie néonatale et réanimation - neuropédiatrie [Rouen], Hôpital Charles Nicolle [Rouen]-CHU Rouen, Normandie Université (NU)-Normandie Université (NU)-Université de Rouen Normandie (UNIROUEN), Normandie Université (NU), Institut Fédératif de Recherches Multidisciplinaires sur les Peptides (IFRMP 23), CHU Rouen, Normandie Université (NU)-Normandie Université (NU)-Université Le Havre Normandie (ULH), Normandie Université (NU)-Université de Rouen Normandie (UNIROUEN), Normandie Université (NU)-CRLCC Henri Becquerel-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS), Hôpital Edouard Herriot [CHU - HCL], Hospices Civils de Lyon (HCL), Centre de Recherche en Nutrition Humaine Rhône-Alpes (CRNH-RH), Université Claude Bernard Lyon 1 (UCBL), Université de Lyon-Université de Lyon-Institut National de la Recherche Agronomique (INRA)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Jean Monnet [Saint-Étienne] (UJM)-CHU Saint-Etienne-Hospices Civils de Lyon (HCL)-CHU Grenoble-Université Joseph Fourier - Grenoble 1 (UJF), Service de Néonatalogie [CHU Tousseau], Assistance publique - Hôpitaux de Paris (AP-HP) (APHP)-CHU Trousseau [APHP], Service d'Epidémiologie et Evaluations Cliniques [CHRU Nancy] (Pôle S2R), Centre Hospitalier Régional Universitaire de Nancy (CHRU Nancy), Université Toulouse III - Paul Sabatier (UT3), Université Fédérale Toulouse Midi-Pyrénées, Centre hospitalier universitaire de Nantes (CHU Nantes), Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier), Université Paris Descartes - Paris 5 (UPD5)-Centre de Recherche Épidémiologie et Statistique Sorbonne Paris Cité (CRESS (U1153 / UMR_A_1125 / UMR_S_1153)), Institut National de la Recherche Agronomique (INRA)-Université Paris Diderot - Paris 7 (UPD7)-Université Paris Descartes - Paris 5 (UPD5)-Université Sorbonne Paris Cité (USPC)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Institut National de la Recherche Agronomique (INRA)-Université Paris Diderot - Paris 7 (UPD7)-Université Sorbonne Paris Cité (USPC)-Institut National de la Santé et de la Recherche Médicale (INSERM), Normandie Université (NU)-Hôpital Charles Nicolle [Rouen], Institut National de la Santé et de la Recherche Médicale (INSERM)-CRLCC Henri Becquerel-Université de Rouen Normandie (UNIROUEN), Normandie Université (NU)-CHU Rouen, Normandie Université (NU)-Centre National de la Recherche Scientifique (CNRS), Fédération pour la recherche en explorations et thérapeutiques innovantes in utéro (FETUS - EA 7328), Université Paris Descartes - Paris 5 (UPD5), Université Pierre et Marie Curie - Paris 6 (UPMC), Recherche Epidémiologique en Santé Périnatale et Santé des Femmes et des Enfants (UMR_S 953), Université Paris-Sud - Paris 11 (UP11)-Université Pierre et Marie Curie - Paris 6 (UPMC)-Université Paris Descartes - Paris 5 (UPD5)-Institut National de la Santé et de la Recherche Médicale (INSERM), Laboratoire de Biométrie et Biologie Evolutive - UMR 5558 (LBBE), Université de Lyon-Université de Lyon-Institut National de Recherche en Informatique et en Automatique (Inria)-VetAgro Sup - Institut national d'enseignement supérieur et de recherche en alimentation, santé animale, sciences agronomiques et de l'environnement (VAS)-Centre National de la Recherche Scientifique (CNRS), Centre Hospitalier Universitaire de Dijon - Hôpital François Mitterrand (CHU Dijon), Centre Hospitalier Régional Universitaire [Besançon] (CHRU Besançon), Team 4 'NeoVasc' - INSERM U1245, Génomique et Médecine Personnalisée du Cancer et des Maladies Neuropsychiatriques (GPMCND), Université de Rouen Normandie (UNIROUEN), Normandie Université (NU)-Normandie Université (NU)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Rouen Normandie (UNIROUEN), Normandie Université (NU)-Normandie Université (NU)-Institut National de la Santé et de la Recherche Médicale (INSERM), Service de Gynécologie-Obstétrique et Médecine de la Reproduction [CHU Caen], Université de Caen Normandie (UNICAEN), Normandie Université (NU)-Normandie Université (NU)-CHU Caen, Normandie Université (NU)-Tumorothèque de Caen Basse-Normandie (TCBN)-Tumorothèque de Caen Basse-Normandie (TCBN), Service de Néonatalogie [Croix-Rousse - Lyon], Hôpital de la Croix-Rousse [CHU - HCL], Hospices Civils de Lyon (HCL)-Hospices Civils de Lyon (HCL), Université de Cergy Pontoise (UCP), Université Paris-Seine, CHU UCL Namur, Comité consultatif sur le traitement de l'information en matière de recherche dans le domaine de la santé, CCTIRS, INSERM, U1027, Toulouse, France., DGA Tech. Navales, DGA Tech.Navales, Institut Européen des membranes (IEM), Université de Montpellier (UM)-Université Montpellier 2 - Sciences et Techniques (UM2)-Ecole Nationale Supérieure de Chimie de Montpellier (ENSCM)-Centre National de la Recherche Scientifique (CNRS), Service de Médecine Néonatale, Hôpital Jeanne de Flandre [Lille], Département d'obstétrique[Lille], Hôpital Jeanne de Flandre [Lille]-Centre Hospitalier Régional Universitaire [Lille] (CHRU Lille), CIC Plurithématique de Nantes, Institut National de la Santé et de la Recherche Médicale (INSERM)-Ministère des Affaires sociales et de la Santé-Direction générale de l'offre de soins (DGOS)-Centre hospitalier universitaire de Nantes (CHU Nantes), Unité de recherche clinique intersectorielle du Centre Hospitalier Henri Laborit, Centre Hospitalier Henri Laborit (CHL), Centre Hospitalier Régional Universitaire de Besançon (CHRU Besançon), Team 4 NeoVasc - Region Team ERI 28 INSERM (Neovasc), Service de Néonatalogie [Lyon], Epidémiologie et analyses en santé publique : risques, maladies chroniques et handicaps (LEASP), Université de Toulouse (UT)-Université de Toulouse (UT)-Institut National de la Santé et de la Recherche Médicale (INSERM), Ecole Nationale Supérieure de Chimie de Montpellier (ENSCM)-Institut de Chimie du CNRS (INC)-Université de Montpellier (UM)-Centre National de la Recherche Scientifique (CNRS), Université Paris Diderot - Paris 7 (UPD7)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Institut National de la Recherche Agronomique (INRA)-Université Paris Descartes - Paris 5 (UPD5)-Université Sorbonne Paris Cité (USPC)-Université Paris Diderot - Paris 7 (UPD7)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Institut National de la Recherche Agronomique (INRA)-Université Sorbonne Paris Cité (USPC), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-CHU Trousseau [APHP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université-Sorbonne Université, Université Paris Diderot - Paris 7 (UPD7)-Université Sorbonne Paris Cité (USPC)-Université Paris Descartes - Paris 5 (UPD5)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Institut National de la Recherche Agronomique (INRA)-Université Paris Diderot - Paris 7 (UPD7)-Université Sorbonne Paris Cité (USPC)-Université Paris Descartes - Paris 5 (UPD5)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Institut National de la Recherche Agronomique (INRA), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Paris Descartes - Paris 5 (UPD5)-Université Pierre et Marie Curie - Paris 6 (UPMC)-Université Paris-Sud - Paris 11 (UP11), and Centre National de la Recherche Scientifique (CNRS)-Ecole Nationale Supérieure de Chimie de Montpellier (ENSCM)-Université Montpellier 2 - Sciences et Techniques (UM2)-Institut de Chimie du CNRS (INC)-Université de Montpellier (UM)

Subjects
Male, Pediatrics, medicine.medical_specialty, Birth weight, [SDV]Life Sciences [q-bio], Neuropsychological Tests, Weight Gain, Fetal Development, 03 medical and health sciences, 0302 clinical medicine, Weight loss, 030225 pediatrics, medicine, Humans, 030212 general & internal medicine, small-for-gestational age, Child, neurological outcome, ComputingMilieux_MISCELLANEOUS, reproductive and urinary physiology, [SDV.MHEP.PED]Life Sciences [q-bio]/Human health and pathology/Pediatrics, Learning Disabilities, business.industry, Cerebral Palsy, Weight change, Infant, Newborn, Infant, Gestational age, medicine.disease, female genital diseases and pregnancy complications, Attention Deficit Disorder with Hyperactivity, extrauterine growth restriction, Child, Preschool, Infant, Small for Gestational Age, Pediatrics, Perinatology and Child Health, Cohort, Gestation, Small for gestational age, Female, medicine.symptom, Cognition Disorders, business, preterm, Weight gain, Infant, Premature, Follow-Up Studies
Abstract

International audience; OBJECTIVE:To determine whether extrauterine growth is associated with neurologic outcomes and if this association varies by prenatal growth profile.STUDY DESIGN:For 1493 preterms from the EPIPAGE (Étude Épidémiologique sur les Petits Âges Gestationnels [Epidemiological Study on Small Gestational Ages]) cohort, appropriate for gestational-age (AGA) was defined by birth weight >-2 SD and small for gestational-age (SGA) by birth weight ≤-2 SD. Extra-uterine growth was defined by weight gain or loss between birth and 6 months by z-score change. Growth following-the-curve (FTC) was defined as weight change -1 to +1 SD, catch-down-growth (CD) as weight loss ≥1 SD, and catch-up-growth (CU) as weight gain ≥1 SD. At 5 years, a complete medical examination (n = 1305) and cognitive evaluation with the Kauffman Assessment Battery for Children (n = 1130) were performed. Behavioral difficulties at 5 years and school performance at 8 years were assessed (n = 1095).RESULTS:Overall, 42.5% of preterms were AGA-FTC, 20.2% AGA-CD, 17.1% AGA-CU, 5.6% SGA-FTC, and 14.5% SGA-CU. Outcomes did not differ between CU and FTC preterm AGA infants. Risk of cerebral palsy was greater for AGA-CD compared with AGA-FTC (aOR 2.26 [95% CI 1.37-3.72]). As compared with children with SGA-CU, SGA-FTC children showed no significant increased risk of cognitive deficiency (aOR 1.41[0.94-2.12]) or school difficulties (aOR 1.60 [0.84-3.03]). Compared with AGA-FTC, SGA showed increased risk of cognitive deficiency (SGA-FTC aOR 2.19 [1.25-3.84]) and inattention-hyperactivity (SGA-CU aOR 1.65 [1.05-2.60]).CONCLUSION:Deficient postnatal growth was associated with poor neurologic outcome for AGA and SGA preterm infants. CU growth does not add additional benefits. Regardless of type of postnatal growth, SGA infants showed behavioral problems and cognitive deficiency.

Published
2016
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32. Organ volume measurements: comparison between MRI and autopsy findings in infants following sudden unexpected death

Author

Olivier Prodhomme, Fabienne Seguret, Laurent Martrille, Gilles Cambonie, Caroline Rouleau, Alain Couture, and Odile Pidoux

Subjects
Male, Autopsy, Spleen, Sudden death, Unexpected death, Image Processing, Computer-Assisted, Humans, Medicine, Prospective Studies, Prospective cohort study, Organ Volume, medicine.diagnostic_test, business.industry, Infant, Newborn, Infant, Obstetrics and Gynecology, Magnetic resonance imaging, Organ Size, General Medicine, Anatomy, Magnetic Resonance Imaging, medicine.anatomical_structure, Pediatrics, Perinatology and Child Health, Female, business, Nuclear medicine, Sudden Infant Death
Abstract

Objective To assess the accuracy of a semiautomated 3D volume reconstruction method for organ volume measurement by postmortem MRI. Methods This prospective study was approved by the institutional review board and the infants9 parents gave their consent. Postmortem MRI was performed in 16 infants (1 month to 1 year of age) at 1.5 T within 48 h of their sudden death. Virtual organ volumes were estimated using the Myrian software. Real volumes were recorded at autopsy by water displacement. The agreement between virtual and real volumes was quantified following the Bland and Altman9s method. Results There was a good agreement between virtual and real volumes for brain (mean difference: −0.03% (−13.6 to +7.1)), liver (+8.3% (−9.6 to +26.2)) and lungs (+5.5% (−26.6 to +37.6)). For kidneys, spleen and thymus, the MRI/autopsy volume ratio was close to 1 (kidney: 0.87±0.1; spleen: 0.99±0.17; thymus: 0.94±0.25), but with a less good agreement. For heart, the MRI/real volume ratio was 1.29±0.76, possibly due to the presence of residual blood within the heart. The virtual volumes of adrenal glands were significantly underestimated (p=0.04), possibly due to their very small size during the first year of life. The percentage of interobserver and intraobserver variation was lower or equal to 10%, but for thymus (15.9% and 12.6%, respectively) and adrenal glands (69% and 25.9%). Conclusions Virtual volumetry may provide significant information concerning the macroscopic features of the main organs and help pathologists in sampling organs that are more likely to yield histological findings.

Published
2012
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33. Intravenous Immunoglobulins for Neonatal Alloimmune Neutropenia Refractory to Recombinant Human Granulocyte Colony-Stimulating Factor

Author

Marie Rimbert, Jean Yves Muller, Gilles Cambonie, Michel Rodière, Jacques Taïb, Eric Jeziorski, O. Plan, and Aurélie Desenfants

Subjects
Adult, Male, Isoantigens, Neutropenia, Neutrophils, Granulocyte, Immunoglobulin G, Antigen, Granulocyte Colony-Stimulating Factor, Humans, Medicine, Escherichia coli Infections, biology, business.industry, Infant, Newborn, Immunoglobulins, Intravenous, Obstetrics and Gynecology, Transplacental, medicine.disease, Recombinant Proteins, Granulocyte colony-stimulating factor, medicine.anatomical_structure, Pediatrics, Perinatology and Child Health, Immunology, biology.protein, Female, Bone marrow, Antibody, business
Abstract

Neonatal alloimmune neutropenia (NAN) results from neutrophil destruction by transplacental maternal neutrophil-specific immunoglobulin G (IgG) antibodies directed against the antigen inherited from the father. Treatment is usually based on recombinant human granulocyte colony-stimulating factor (G-CSF) and prevention or treatment of infection. We report the case of neutropenia in a newborn discovered because of fetomaternal infection. The bone marrow biopsy showed normal cellularity. Granulocyte typing, granulocyte cross-matching, and serum assays showed anti-neutrophil antibodies specific for human neutrophil antigen-1c, an antigen rarely involved in this disease. This NAN was refractory to G-CSF but responded to intravenous immunoglobulin (IVIG). IVIG should be considered as a second-line treatment in NAN refractory to G-CSF. Clinical trials, however, are required to define the optimal management of NAN, a rare but probably underestimated life-threatening situation for newborns.

Published
2010
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34. Early postpartum discharge and breastfeeding: An observational study from France

Author

Sébastien Fournier-Favre, Thierry-Pascal Baum, Jean-Charles Picaud, Pierre Boulot, Sophie Sabarros, Valérie Rey, Gilles Cambonie, and Evelyne Mazurier

Subjects
Adult, medicine.medical_specialty, Time Factors, Multivariate analysis, Obstetrics, business.industry, Postpartum Period, Breastfeeding, Length of Stay, Planned Duration, Patient Discharge, Breast Feeding, Pediatrics, Perinatology and Child Health, medicine, Humans, Female, Observational study, France, business, Breast feeding, Early discharge, Postpartum period, Early postpartum
Abstract

Background: Early postpartum discharge is a recent practice in France, but the influence of a shortened hospital stay on subsequent breastfeeding is unknown. The objective of the present study was to compare the breastfeeding mode after early discharge (ED) and conventional discharge (CD) from a hospital maternity unit. Methods: An observational study was conducted in a French university hospital among 135 breastfeeding mothers, who delivered between 1 January and 31 July 2006. Forty-five ED mothers were matched with 90 CD mothers on 13 criteria. A structured questionnaire was used to collect data regarding feeding practices at 10 weeks postpartum, the period corresponding to paid maternity leave. Results: Exclusive breast-, mixed, and bottle feedings were reported by, respectively, 35 (77.8%), three (6.7%) and seven (15.5%) ED mothers and 64 (71.1%), 12 (13.3%) and 14 (15.6%) CD mothers (no significant differences). Satisfaction with support for breastfeeding and reasons for switching to mixed or bottle feeding were comparable in the two groups. Multivariate analysis indicated that only the planned duration of breastfeeding and the mother's dissatisfaction with help significantly influenced breastfeeding prevalence. Conclusions: Early postpartum hospital discharge organized by skilled professionals is compatible with a satisfactory rate of exclusive breastfeeding up to the return to work. Formalized programs of instruction for perinatal professionals would help to reduce early abandonment.

Published
2010
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35. Betamethasone Impairs Cerebral Blood Flow Velocities in Very Premature Infants with Severe Chronic Lung Disease

Author

Christophe Milési, Odile Pidoux, Renaud Mesnage, Corinne Veyrac, Gilles Cambonie, and Jean-Charles Picaud

Subjects
Lung Diseases, Male, Anterior Cerebral Artery, Hemodynamics, Gestational Age, Infant, Premature, Diseases, Mean airway pressure, Betamethasone, Blood Circulation Time, Pregnancy, medicine.artery, Laser-Doppler Flowmetry, medicine, Anterior cerebral artery, Humans, business.industry, Infant, Newborn, Gestational age, Blood pressure, Cerebral blood flow, Cerebrovascular Circulation, Anesthesia, Chronic Disease, Pediatrics, Perinatology and Child Health, Arterial blood, Female, business, Infant, Premature, medicine.drug
Abstract

Objective To assess betamethasone (BM) effects on the cerebral hemodynamics of neonates with severe chronic lung disease (CLD). Study design Intravenous BM was given once daily for 6 consecutive days to 12 infants (birth weight: 698 g [range, 650-884 g], gestational age: 25.3 weeks [range, 25-26.4 weeks]) at a postnatal age of 34 days (range, 28-36 days). Cerebral blood flow velocities (CBFVs) were recorded prospectively in the anterior cerebral artery (ACA) and the lenticulostriate artery (LSA) before, during, and after treatment, using Doppler flowmetry. Results The decrease in systolic and diastolic velocities was maximum on the 5th day, reaching 32% (95% confidence interval [CI], 23%-42%) and 58% (95% CI, 39%-64%) from baseline in the ACA, and 44% (95% CI, 29%-50%) and 57% (95% CI, 33%-66%) in the LSA, respectively. The resistance index (RI) increased significantly in both arteries during treatment. Return to baseline values was observed after BM was stopped. The change in velocities and RI was independent of arterial blood gas and blood pressure variations. Conclusions BM decreased the CBFVs of premature infants, suggesting a vasoconstrictor effect in both superficial and deep arterial vessels. Caution is recommended when BM is used to treat preterm infants with severe CLD.

Published
2008
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36. Antenatal antioxidant prevents adult hypertension, vascular dysfunction, and microvascular rarefaction associated with in utero exposure to a low-protein diet

Author

Daniel Abran, Nathalie Germain, Catherine Yzydorczyk, Patrick Pladys, Anne Monique Nuyt, Isabelle Lahaie, Jean-Claude Lavoie, Gilles Cambonie, Thierry Ntimbane, Ngoc Loan Oanh Le, Cindy Gauthier, Blandine Comte, Department of Pediatrics, CHU Sainte-Justine, University of Montreal, Montreal, Quebec, Canada, CHU Sainte-Justine, University of Montreal, and Université de Montreal, Département de Nutrition

Subjects
Aging, medicine.medical_specialty, hypertension, developmental origin of adult disease, Physiology, medicine.medical_treatment, Vasodilation, 030204 cardiovascular system & hematology, Biology, Microcirculation, Nitric oxide, 03 medical and health sciences, chemistry.chemical_compound, 0302 clinical medicine, Low-protein diet, Pregnancy, Physiology (medical), Internal medicine, Diet, Protein-Restricted, medicine, Animals, oxidative stress, Vascular Diseases, 030304 developmental biology, 0303 health sciences, vascular dysfunction, Angiotensin II, Rats, 3. Good health, antioxidants, Endocrinology, Animals, Newborn, chemistry, In utero, Prenatal Exposure Delayed Effects, Blood Vessels, Microvascular Rarefaction, Female, medicine.symptom, [SDV.MHEP]Life Sciences [q-bio]/Human health and pathology, Vasoconstriction
Abstract

Developmental programming of hypertension is associated with vascular dysfunction characterized by impaired vasodilatation to nitric oxide, exaggerated vasoconstriction to ANG II, and microvascular rarefaction appearing in the neonatal period. Hypertensive adults have indices of increased oxidative stress, and newborns that were nutrient depleted during fetal life have decreased antioxidant defenses and increased susceptibility to oxidant injury. To test the hypothesis that oxidative stress participates in early life programming of hypertension, vascular dysfunction, and microvascular rarefaction associated with maternal protein deprivation, pregnant rats were fed a normal, low protein (LP), or LP plus lazaroid (lipid peroxidation inhibitor) isocaloric diet from the day of conception until delivery. Lazaroid administered along with the LP diet prevented blood pressure elevation, enhanced vasomotor response to ANG II, impaired vasodilatation to sodium nitroprusside, and microvascular rarefaction in adult offspring. Liver total glutathione was significantly decreased in LP fetuses, and kidney eight-isoprostaglandin F2α (8-isoPGF2α) levels were significantly increased in adult LP offspring; these modifications were prevented by lazaroid. Renal nitrotyrosine abundance and blood levels of 1,4-dihydroxynonene and 4-hydroxynonenal-protein adducts were not modified by antenatal diet exposure. This study shows in adult offspring of LP-fed dams prevention of hypertension, vascular dysfunction, microvascular rarefaction, and of an increase in indices of oxidative stress by the administration of lazaroid during gestation. Lazaroid also prevented the decrease in antioxidant glutathione levels in fetuses, suggesting an antenatal mild oxidative stress in offspring of LP-fed dams. These studies support the concept that perinatal oxidative insult can lead to permanent alterations in the cardiovascular system development.

Published
2007
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37. Myocardial Adaptation to Anemia and Red Blood Cell Transfusion in Premature Infants Requiring Ventilation Support in the 1st Postnatal Week

Author

M. Voisin, Christophe Milési, Jean-Charles Picaud, Gilles Cambonie, S. Matecki, and Sophie Guillaumont

Subjects
Male, medicine.medical_specialty, Anemia, Red Blood Cell Transfusion, Intensive Care Units, Pediatric, Electrocardiography, Hemoglobins, medicine, Humans, Intensive care medicine, Respiratory Distress Syndrome, Newborn, Evidence-Based Medicine, Ventricular function, business.industry, Infant, Newborn, medicine.disease, Adaptation, Physiological, Myocardial Contraction, Respiration, Artificial, Hematocrit, Pediatrics, Perinatology and Child Health, Breathing, Female, Erythrocyte Transfusion, business, Infant, Premature, Developmental Biology
Abstract

Background: Although transfusion practice in very premature infants is becoming more restrictive, little is known about myocardial adaptation to anemia during the 1st postnatal week. Objectives: To determine the central hemodynamic effects of anemia and red blood cell transfusion in very preterm infants undergoing intensive care. Methods: Twenty-nine neonates of less than 30 weeks gestational age were treated for respiratory distress syndrome, following a strict protocol. Echocardiographies were performed at the 4th and 6th postnatal days, which corresponded to, respectively, just before and 48 h after an erythrocyte transfusion of 15 ml/kg in the 12 anemic infants. Results: Anemic infants had increased stroke volume [2.1 (1.8–2.3) vs. 1.5 (1.3–1.6) ml/kg] and left ventricular (LV) output [312 (271–345) vs. 206 (177–240) ml/min/kg]. The relationship of the heart rate-corrected velocity of circumferential fiber shortening to LV end-systolic meridional wall stress indicated a higher contractile state in the anemic infants, with a higher y-intercept (p = 0.03) and a steeper slope (p = 0.05) of the regression line than in the nonanemic patients. Posttransfusion, the stroke volume, LV output, shortening fraction, and contractile state decreased to the values observed in the nonanemic infants. Conclusions: Myocardial contractility was a major component of the circulatory adjustments in the anemic premature infants requiring ventilation support in the early neonatal period. Changes in LV performance associated with anemia were reversed by transfusion with no detrimental effect on right ventricular function, LV preload or the respiratory status of these patients.

Published
2007
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38. Neonatal respiratory distress syndrome revealing a cervical bronchogenic cyst: a case report

Author

Catherine Blanchet, Michel Mondain, Nicolas Leboucq, M. Badr, Gilles Cambonie, Renaud Mesnage, Penelope Thaller, Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier), Département de Neuroradiologie[Montpellier], Hôpital Gui de Chauliac [Montpellier]-Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier)-Université Montpellier 1 (UM1)-Université de Montpellier (UM), Service d'ORL, Hôpital Gui de Chauliac (CHRU de Montpellier), Institut des Neurosciences de Montpellier - Déficits sensoriels et moteurs (INM), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Montpellier (UM), Université de Montpellier (UM), Université Montpellier 1 (UM1)-Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier)-Hôpital Gui de Chauliac [Montpellier]-Université de Montpellier (UM), Institut des Neurosciences de Montpellier (INM), and Nowak, Cécile

Subjects
medicine.medical_specialty, Neonatal respiratory distress syndrome, Bronchogenic cyst, Case Report, Diagnosis, Differential, Tracheal deviation, Bronchogenic Cyst, 03 medical and health sciences, 0302 clinical medicine, [SDV.MHEP.PED] Life Sciences [q-bio]/Human health and pathology/Pediatrics, Tracheostomy, medicine, Humans, Cyst, Pediatrics, Perinatology, and Child Health, Esophagus, 030223 otorhinolaryngology, Respiratory Distress Syndrome, Newborn, [SDV.MHEP.PED]Life Sciences [q-bio]/Human health and pathology/Pediatrics, Respiratory distress, business.industry, Cervical bronchogenic cyst, Infant, Newborn, Airway obstruction, medicine.disease, Magnetic Resonance Imaging, 3. Good health, Surgery, medicine.anatomical_structure, 030220 oncology & carcinogenesis, Pediatrics, Perinatology and Child Health, Balloon dilation, Female, business
Abstract

International audience; BACKGROUND:Bronchogenic cyst is a congenital malformation, rarely located in the cervical region and almost never involved in a neonate with acute respiratory distress in the delivery room.CASE PRESENTATION:A female newborn with respiratory distress syndrome caused by a large left cervical mass. Intubation was difficult due to tracheal deviation. Magnetic resonance imaging confirmed a left cervical cyst displacing the trachea and esophagus laterally. Surgical excision was performed via a cervical approach on the 5th day, and pathological examination revealed a bronchogenic cyst. The patient's course was complicated by left vocal cord paralysis and necrotic lesions in the glottic and subglottic regions; she required a tracheostomy on the 13th day. Inflammatory stenosis in the subglottic region required balloon dilation once, 20 days later. Proximal esophageal stenosis induced transient upper airway obstruction with salivary stasis. Decannulation was performed at 2 months and the patient was discharged 10 days later.CONCLUSION:A bronchogenic cyst can exceptionally obstruct the airways in the neonatal period. Surgical excision is necessary, but postoperative complications may occur if the cyst is in close contact with the trachea and esophagus, including necrotic and stenotic lesions of the upper aerodigestive tract. In those situations, tracheostomy may be necessary for mechanical ventilation weaning and the initiation of oral feeding.

Published
2015
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39. Intrauterine Growth Restriction, Head Size at Birth, and Outcome in Very Preterm Infants

Author

Gilles Cambonie, Stéphane Marret, Jean-Christophe Rozé, Catherine Arnaud, Isabelle Guellec, Marie-Laure Charkaluk, Cyril Flamant, Jeanne Fresson, Olivier Baud, Alexandre Lapillonne, Pierre-Yves Ancel, Equipe 1 : EPOPé - Épidémiologie Obstétricale, Périnatale et Pédiatrique (CRESS - U1153), Université Paris Descartes - Paris 5 (UPD5)-Centre de Recherche Épidémiologie et Statistique Sorbonne Paris Cité (CRESS (U1153 / UMR_A_1125 / UMR_S_1153)), Institut National de la Recherche Agronomique (INRA)-Université Paris Diderot - Paris 7 (UPD7)-Université Paris Descartes - Paris 5 (UPD5)-Université Sorbonne Paris Cité (USPC)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Institut National de la Recherche Agronomique (INRA)-Université Paris Diderot - Paris 7 (UPD7)-Université Sorbonne Paris Cité (USPC)-Institut National de la Santé et de la Recherche Médicale (INSERM), Assistance publique - Hôpitaux de Paris (AP-HP) (APHP), CHU Trousseau [APHP], Normandie Université (NU), Institut Fédératif de Recherches Multidisciplinaires sur les Peptides (IFRMP 23), Institut National de la Santé et de la Recherche Médicale (INSERM)-CRLCC Henri Becquerel-Université de Rouen Normandie (UNIROUEN), Normandie Université (NU)-Normandie Université (NU)-Université Le Havre Normandie (ULH), Normandie Université (NU)-CHU Rouen, Normandie Université (NU)-Centre National de la Recherche Scientifique (CNRS), Neuroprotection du Cerveau en Développement / Promoting Research Oriented Towards Early Cns Therapies (PROTECT), Assistance publique - Hôpitaux de Paris (AP-HP) (APHP)-Hôpital Robert Debré-Université Paris Diderot - Paris 7 (UPD7)-Institut National de la Santé et de la Recherche Médicale (INSERM), Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier), Université de Montpellier (UM), CHU Necker - Enfants Malades [AP-HP], CIC Plurithématique de Nantes, Institut National de la Santé et de la Recherche Médicale (INSERM)-Ministère des Affaires sociales et de la Santé-Direction générale de l'offre de soins (DGOS)-Centre hospitalier universitaire de Nantes (CHU Nantes), Centre de Recherche Épidémiologie et Statistique Sorbonne Paris Cité (CRESS (U1153 / UMR_A_1125 / UMR_S_1153)), Institut National de la Recherche Agronomique (INRA)-Université Paris Diderot - Paris 7 (UPD7)-Université Paris Descartes - Paris 5 (UPD5)-Université Sorbonne Paris Cité (USPC)-Institut National de la Santé et de la Recherche Médicale (INSERM), Centre Hospitalier Régional Universitaire de Nancy (CHRU Nancy), Epidémiologie et analyses en santé publique : risques, maladies chroniques et handicaps (LEASP), Université Toulouse III - Paul Sabatier (UT3), Université Fédérale Toulouse Midi-Pyrénées-Université Fédérale Toulouse Midi-Pyrénées-Institut National de la Santé et de la Recherche Médicale (INSERM), Université Paris Descartes - Paris 5 (UPD5), Team 4 'NeoVasc' - INSERM U1245, Génomique et Médecine Personnalisée du Cancer et des Maladies Neuropsychiatriques (GPMCND), Université de Rouen Normandie (UNIROUEN), Normandie Université (NU)-Normandie Université (NU)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Rouen Normandie (UNIROUEN), Normandie Université (NU)-Normandie Université (NU)-Institut National de la Santé et de la Recherche Médicale (INSERM), Unité de soins intensifs néonatals [AP-HP Hôpital Robert Debré], AP-HP Hôpital universitaire Robert-Debré [Paris], Fédération pour la recherche en explorations et thérapeutiques innovantes in utéro (FETUS - EA 7328), Comité consultatif sur le traitement de l'information en matière de recherche dans le domaine de la santé, CCTIRS, Recherche Epidémiologique en Santé Périnatale et Santé des Femmes et des Enfants (UMR_S 953), Université Paris-Sud - Paris 11 (UP11)-Université Pierre et Marie Curie - Paris 6 (UPMC)-Université Paris Descartes - Paris 5 (UPD5)-Institut National de la Santé et de la Recherche Médicale (INSERM), INSERM, U1027, Toulouse, France., Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Paris Descartes - Paris 5 (UPD5)-Université Pierre et Marie Curie - Paris 6 (UPMC)-Université Paris-Sud - Paris 11 (UP11), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre de Lutte Contre le Cancer Henri Becquerel Normandie Rouen (CLCC Henri Becquerel)-Université de Rouen Normandie (UNIROUEN), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Robert Debré-Université Paris Diderot - Paris 7 (UPD7)-Institut National de la Santé et de la Recherche Médicale (INSERM), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Toulouse III - Paul Sabatier (UT3), Université Fédérale Toulouse Midi-Pyrénées-Université Fédérale Toulouse Midi-Pyrénées, Institut National de la Sante et de la Recherche Medicale (Inserm), Directorate General for Health of the Ministry for Social Affairs, 'Hospital Program for Clinical Research' of the French Department of Health AOMO1117, Université Paris Diderot - Paris 7 (UPD7)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Institut National de la Recherche Agronomique (INRA)-Université Paris Descartes - Paris 5 (UPD5)-Université Sorbonne Paris Cité (USPC)-Université Paris Diderot - Paris 7 (UPD7)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Institut National de la Recherche Agronomique (INRA)-Université Paris Descartes - Paris 5 (UPD5)-Université Sorbonne Paris Cité (USPC), CHU Rouen, Normandie Université (NU)-Université de Rouen Normandie (UNIROUEN), Normandie Université (NU)-CRLCC Henri Becquerel-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS), and Université Paris Diderot - Paris 7 (UPD7)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Institut National de la Recherche Agronomique (INRA)-Université Paris Descartes - Paris 5 (UPD5)-Université Sorbonne Paris Cité (USPC)

Subjects
Male, Percentile, Pediatrics, medicine.medical_specialty, Head/physiology, Cephalometry, Birth weight, [SDV]Life Sciences [q-bio], Intrauterine growth restriction, Cohort Studies, medicine, Odds Ratio, Birth Weight, Humans, Effects of sleep deprivation on cognitive performance, Child, Growth Disorders, ComputingMilieux_MISCELLANEOUS, [SDV.MHEP.PED]Life Sciences [q-bio]/Human health and pathology/Pediatrics, Fetal Growth Retardation, ddc:618, business.industry, Body Weight, Infant, Newborn, Gestational age, Odds ratio, medicine.disease, 3. Good health, Institutional repository, Growth Disorders/complications/diagnosis, Infant, Extremely Premature, Child, Preschool, Pediatrics, Perinatology and Child Health, Fetal Growth Retardation/diagnosis, Regression Analysis, Female, Cognition Disorders/complications/diagnosis, France, business, Cognition Disorders, Head, Infant, Extremely Premature/growth & development, Cohort study, Follow-Up Studies
Abstract

International audience; OBJECTIVES:To determine whether small head circumference (HC) or birth weight (BW) or both are associated with neonatal and long-term neurologic outcome in very preterm infants.STUDY DESIGN:All 2442 live births from the 1997 Epipage study between 26 and 32 weeks of gestational age in 9 regions of France were analyzed. A total of 1395 were tested at age 5 years for cognitive performance and 1315 with school performance reports at age 8 years. Symmetric growth restriction (SGR) was defined by HC and BW 20th percentile.RESULTS:Compared with appropriate for gestational age, SGR was significantly associated with neonatal mortality (aOR 2.99, 95% CI 1.78-5.03), moderate and severe cognitive deficiency (aOR 1.65, 95% CI 1.01-2.71 and aOR 2.61, 95% CI 1.46-4.68, respectively), and poor school performance (aOR 1.79; 95% CI 1.13-2.83). HGR was significantly associated with severe cognitive deficiency (aOR 2.07, 95% CI 1.15-3.74). WGR was not significantly associated with cognitive or school performance despite higher rates of neonatal morbidity.CONCLUSIONS:SGR in preterm infants was associated with neonatal mortality and impaired cognitive and school performance. The outcome of asymmetric growth restriction differed according to HC. HGR was associated with impaired cognitive function; WGR was not.

Published
2015
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40. Association Between Early Screening for Patent Ductus Arteriosus and In-Hospital Mortality Among Extremely Preterm Infants

Author

V Gournay, Jean-Christophe Rozé, Gilles Cambonie, Xavier Durrmeyer, Pierre-Yves Ancel, Mélanie Durox, Laurent Storme, Laetitia Marchand-Martin, Raphaël Porcher, Centre hospitalier universitaire de Nantes (CHU Nantes), Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier), Université de Montpellier (UM), Centre de Recherche Épidémiologie et Statistique Sorbonne Paris Cité (CRESS (U1153 / UMR_A_1125 / UMR_S_1153)), Université Paris Diderot - Paris 7 (UPD7)-Université Sorbonne Paris Cité (USPC)-Université Paris Descartes - Paris 5 (UPD5)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Institut National de la Recherche Agronomique (INRA), Université Paris Descartes - Paris 5 (UPD5), Université Sorbonne Paris Cité (USPC), Equipe 1 : EPOPé - Épidémiologie Obstétricale, Périnatale et Pédiatrique (CRESS - U1153), Université Paris Descartes - Paris 5 (UPD5)-Centre de Recherche Épidémiologie et Statistique Sorbonne Paris Cité (CRESS (U1153 / UMR_A_1125 / UMR_S_1153)), Université Paris Diderot - Paris 7 (UPD7)-Université Sorbonne Paris Cité (USPC)-Université Paris Descartes - Paris 5 (UPD5)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Institut National de la Recherche Agronomique (INRA)-Université Paris Diderot - Paris 7 (UPD7)-Université Sorbonne Paris Cité (USPC)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Institut National de la Recherche Agronomique (INRA), Centre Hospitalier Régional Universitaire [Lille] (CHRU Lille), Equipe 5 : METHODS - Méthodes de l’évaluation thérapeutique des maladies chroniques (CRESS - U1153), AP-HP - Hôpital Cochin Broca Hôtel Dieu [Paris], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Institut National de la Recherche Agronomique (INRA)-Université Paris Diderot - Paris 7 (UPD7)-Université Paris Descartes - Paris 5 (UPD5)-Université Sorbonne Paris Cité (USPC)-Institut National de la Santé et de la Recherche Médicale (INSERM), Institut National de la Recherche Agronomique (INRA)-Université Paris Diderot - Paris 7 (UPD7)-Université Paris Descartes - Paris 5 (UPD5)-Université Sorbonne Paris Cité (USPC)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Institut National de la Recherche Agronomique (INRA)-Université Paris Diderot - Paris 7 (UPD7)-Université Sorbonne Paris Cité (USPC)-Institut National de la Santé et de la Recherche Médicale (INSERM), Assistance publique - Hôpitaux de Paris (AP-HP) (APHP), and Nowak, Cécile

Subjects
Lung Diseases, Male, Pediatrics, medicine.medical_specialty, Population, Infant, Premature, Diseases, Cohort Studies, Enterocolitis, Necrotizing, Intensive care, Ductus arteriosus, medicine, Humans, Mass Screening, Hospital Mortality, education, Propensity Score, Ductus Arteriosus, Patent, education.field_of_study, [SDV.MHEP] Life Sciences [q-bio]/Human health and pathology, business.industry, Mortality rate, Infant, Newborn, Brain, General Medicine, Odds ratio, medicine.disease, 3. Good health, medicine.anatomical_structure, Logistic Models, Echocardiography, Infant, Extremely Premature, Necrotizing enterocolitis, Cohort, Female, France, business, [SDV.MHEP]Life Sciences [q-bio]/Human health and pathology, Cohort study
Abstract

International audience; IMPORTANCE:There is currently no consensus for the screening and treatment of patent ductus arteriosus (PDA) in extremely preterm infants. Less pharmacological closure and more supportive management have been observed without evidence to support these changes.OBJECTIVE:To evaluate the association between early screening echocardiography for PDA and in-hospital mortality.DESIGN, SETTING, AND PARTICIPANTS:Comparison of screened and not screened preterm infants enrolled in the EPIPAGE 2 national prospective population-based cohort study that included all preterm infants born at less than 29 weeks of gestation and hospitalized in 68 neonatal intensive care units in France from April through December 2011. Two main analyses were performed to adjust for potential selection bias, one using propensity score matching and one using neonatal unit preference for early screening echocardiography as an instrumental variable.EXPOSURES:Early screening echocardiography before day 3 of life.MAIN OUTCOMES AND MEASURES:The primary outcome was death between day 3 and discharge. The secondary outcomes were major neonatal morbidities (pulmonary hemorrhage, severe bronchopulmonary dysplasia, severe cerebral lesions, and necrotizing enterocolitis).RESULTS:Among the 1513 preterm infants with data available to determine exposure, 847 were screened for PDA and 666 were not; 605 infants from each group could be paired. Exposed infants were treated for PDA more frequently during their hospitalization than nonexposed infants (55.1% vs 43.1%; odds ratio [OR], 1.62 [95% CI, 1.31 to 2.00]; absolute risk reduction [ARR] in events per 100 infants, -12.0 [95% CI, -17.3 to -6.7). Exposed infants had a lower hospital death rate (14.2% vs 18.5% ; OR, 0.73 [95% CI, 0.54 to 0.98]; ARR, 4.3 [95% CI, 0.3 to 8.3]) and a lower rate of pulmonary hemorrhage (5.6% vs 8.9%; OR, 0.60 [95% CI, 0.38 to 0.95]; ARR, 3.3 [95% CI, 0.4 to 6.3]). No differences in rates of necrotizing enterocolitis, severe bronchopulmonary dysplasia, or severe cerebral lesions were observed. In the overall cohort, instrumental variable analysis yielded an adjusted OR for in-hospital mortality of 0.62 [95% CI, 0.37 to 1.04].CONCLUSIONS AND RELEVANCE:In this national population-based cohort of extremely preterm infants, screening echocardiography before day 3 of life was associated with lower in-hospital mortality and likelihood of pulmonary hemorrhage but not with differences in necrotizing enterocolitis, severe bronchopulmonary dysplasia, or severe cerebral lesions. However, results of the instrumental variable analysis leave some ambiguity in the interpretation, and longer-term evaluation is needed to provide clarity.

Published
2015
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41. Exaggerated vasomotor response to ANG II in rats with fetal programming of hypertension associated with exposure to a low-protein diet during gestation

Author

Suzanne Samarani, Luc Laurier Oligny, Anne Monique Nuyt, Fernand Gobeil, Isabelle Lahaie, Pierre Hardy, Jean-Claude Lavoie, Gilles Cambonie, Ngoc Loan Oanh Le, Ali Ahmad, Patrick Pladys, and Catherine Yzydorczyk

Subjects
Male, medicine.medical_specialty, Physiology, Blotting, Western, Antioxidants, Receptor, Angiotensin, Type 1, Cyclic N-Oxides, Superoxide dismutase, chemistry.chemical_compound, Pregnancy, Physiology (medical), Internal medicine, Diet, Protein-Restricted, medicine, Animals, Vasoconstrictor Agents, Rats, Wistar, chemistry.chemical_classification, Reactive oxygen species, NADPH oxidase, biology, Superoxide Dismutase, Chemistry, Superoxide, Angiotensin II, Age Factors, Animal Feed, Rats, Endocrinology, Vasoconstriction, Prenatal Exposure Delayed Effects, Hypertension, Apocynin, cardiovascular system, biology.protein, Female, Spin Labels, Dietary Proteins, Endothelium, Vascular, medicine.symptom, Reactive Oxygen Species, Endothelin receptor
Abstract

The renin-angiotensin system plays a key role in the initiation and maintenance of elevated blood pressure associated with altered intrauterine milieu. The current studies were undertaken to verify whether vascular response to ANG II is increased in adult offspring of low-protein fed dams (LP) compared with control (CTRL) and if so, to examine underlying mechanism(s). ANG II-induced contraction of carotid rings was increased in LP (Emax, the maximum asymptote of the curve, relative to maximal response to KCl 80 mM: 230 ± 3% LP vs. 201 ± 2% CTRL, P < 0.05). In both groups, contraction to ANG II was mediated solely by AT1R. Responses to thromboxane A2 analog U-46619 and to KCl 80 mM under step increases in tension were similar between groups. Endothelium depletion enhanced contraction to ANG II in both groups, more so in LP. Blockade of endothelin formation had no effect on response to ANG II, and ANG-(1–7) did not elicit vasomotor response in either group. Superoxide dismutase (SOD) analog Tempol normalized LP without modifying CTRL response to ANG II. Basal levels of superoxide (aortic segments, lucigenin-enhanced chemiluminescence and fluorescent dye hydroethidine) were higher in LP. ANG II further increased superoxide production in LP only, and this was inhibited by coincubation with diphenylene iodonium or apocynin (inhibitor of NADPH oxidase complex). AT1R expression in carotid arteries was increased in LP, whereas SOD expression was unchanged. In conclusion, vasoconstriction to ANG II is exaggerated in this model of developmental programming of hypertension, secondary to enhanced vascular production of superoxide anion by NADPH oxidase with concomitant increase of AT1R expression.

Published
2006
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42. Microvascular rarefaction and decreased angiogenesis in rats with fetal programming of hypertension associated with exposure to a low-protein diet in utero

Author

Gilles Cambonie, Pierre Hardy, K. Bibeau, Isabelle Lahaie, Patrick Pladys, Anne Monique Nuyt, Sonia Brault, Daniella Checchin, Sylvain Chemtob, M. Brochu, G. Thibault, Ngoc Loan Oanh Le, Daniel Abran, and Florian Sennlaub

Subjects
Male, medicine.medical_specialty, Physiology, Angiogenesis, medicine.medical_treatment, Hemodynamics, Biology, Microcirculation, Low-protein diet, Pregnancy, Physiology (medical), Internal medicine, Diet, Protein-Restricted, medicine, Animals, Vascular Diseases, Rats, Wistar, Fetus, Neovascularization, Pathologic, Rats, medicine.anatomical_structure, Endocrinology, In utero, Prenatal Exposure Delayed Effects, Hypertension, Vascular resistance, Microvascular Rarefaction, Female, Disease Susceptibility
Abstract

In hypertension, increased peripheral vascular resistance results from vascular dysfunction with or without structural changes (vessel wall remodeling and/or microvascular rarefaction). Humans with lower birth weight exhibit evidence of vascular dysfunction. The current studies were undertaken to investigate whether in utero programming of hypertension is associated with in vivo altered response and/or abnormal vascular structure. Offspring of Wistar dams fed a normal (CTRL) or low (LP)-protein diet during gestation were studied. Mean arterial blood pressure response to ANG II was significantly increased, and depressor response to sodium nitroprusside (SNP) infusions significantly decreased in male LP adult offspring relative to CTRL. No arterial remodeling was observed in male LP compared with CTRL offspring. Capillary and arteriolar density was significantly decreased in striated muscles from LP offspring at 7 and 28 days of life but was not different in late fetal life [ day 21 of gestation (E21)]. Angiogenic potential of aortic rings from LP newborn (day of birth, P0) was significantly decreased. Striated muscle expressions (Western blots) of ANG II AT1 receptor subtype, endothelial nitric oxide synthase, angiopoietin 1 and 2, Tie 2 receptor, vascular endothelial growth factor and receptor, and platelet-derived growth factor C at E21 and P7 were unaltered by antenatal diet exposure. In conclusion, blood pressure responses to ANG II and SNP are altered, and microvascular structural changes prevail in this model of fetal programming of hypertension. The capillary rarefaction is absent in the fetus and appears in the neonatal period, in association with decreased angiogenic potential. The study suggests that intrauterine protein restriction increases susceptibility to postnatal factors resulting in microvascular rarefaction, which could represent a primary event in the genesis of hypertension.

Published
2005
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43. Role of Brain and Peripheral Angiotensin II in Hypertension and Altered Arterial Baroreflex Programmed during Fetal Life in Rat

Author

Anne Monique Nuyt, Daniel Abran, Ngoc Loan Oanh Le, Isabelle Lahaie, Gilles Cambonie, Patrick Pladys, and Gaétan Thibault

Subjects
Male, medicine.medical_specialty, Offspring, Angiotensin-Converting Enzyme Inhibitors, Blood Pressure, Baroreflex, Receptor, Angiotensin, Type 1, Renin-Angiotensin System, Fetus, Pregnancy, Protein Deficiency, Internal medicine, Renin–angiotensin system, medicine, Animals, Rats, Wistar, Angiotensin II receptor type 1, business.industry, Angiotensin II, Brain, Subfornical organ, Rats, Blood pressure, medicine.anatomical_structure, Losartan, Endocrinology, Enalaprilat, Hypertension, Pediatrics, Perinatology and Child Health, Female, Dietary Proteins, business, medicine.drug
Abstract

Intrauterine programming of hypertension is associated with evidence of increased renin-angiotensin system (RAS) activity. The current study was undertaken to investigate whether arterial baroreflex and blood pressure variability are altered in a model of in utero programming of hypertension secondary to isocaloric protein deprivation and whether activation of the RAS plays a role in this alteration. Pregnant Wistar rats were fed a normal-protein (18%) or low-protein (9%) diet during gestation, which had no effect on litter size, birth weight, or pup survival. Mean arterial blood pressure (MABP; 126 +/- 3 mm Hg 9% versus 108 +/- 4 mm Hg 18%; p0.05) and blood pressure variability were significantly greater in the adult offspring of the 9% protein-fed mothers. Arterial baroreflex control of heart rate, generated by graded i.v. infusion of phenylephrine and nitroprusside, was significantly shifted toward higher pressure; i.v. angiotensin-converting enzyme inhibitor normalized MABP and shifted the arterial baroreflex curve of the 9% offspring toward lower pressure without affecting the 18% offspring. For examining whether brain RAS is also involved in programming of hypertension, angiotensin-converting enzyme inhibitor and losartan (specific AT(1) receptor antagonist) were administered intracerebroventricularly; both significantly reduced MABP of the 9% but not the 18% offspring. Autoradiographic receptor binding studies demonstrated an increase in brain AT(1) expression in the subfornical organ and the vascular organ of the lamina terminalis in the 9% offspring. These data demonstrate a major tonic role of brain and peripheral RAS on hypertension associated with antenatal nutrient deprivation.

Published
2004
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44. Tiagabine improves hippocampal long-term depression in rat pups subjected to prenatal inflammation

Author

Janique Guiramand, Mathilde Boubal, Nadine Crouzin, Michel Vignes, Aline Rideau Batista Novais, Mélanie Cavalier, Gérard Barbanel, Marie-Céleste de Jesus Ferreira, Catherine Cohen-Solal, Gilles Cambonie, Institut des Biomolécules Max Mousseron [Pôle Chimie Balard] (IBMM), Ecole Nationale Supérieure de Chimie de Montpellier (ENSCM)-Institut de Chimie du CNRS (INC)-Université de Montpellier (UM)-Centre National de la Recherche Scientifique (CNRS), Neurobiologie des interactions cellulaires et neurophysiopathologie - NICN (NICN), Institut National de la Recherche Agronomique (INRA)-Aix Marseille Université (AMU)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS), Service de Néonatalogie, Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier)-Hôpital Arnaud de Villeneuve, Centre National de la Recherche Scientifique (CNRS)-Institut de Chimie du CNRS (INC)-Université de Montpellier (UM)-Ecole Nationale Supérieure de Chimie de Montpellier (ENSCM), and Ecole Nationale Supérieure de Chimie de Montpellier (ENSCM)-Université de Montpellier (UM)-Centre National de la Recherche Scientifique (CNRS)

Subjects
Lipopolysaccharides, Male, Tiagabine, Nipecotic Acids, Hippocampus, Hippocampal formation, Biochemistry, 0302 clinical medicine, Pregnancy, GABAergic Neurons, Long-term depression, Neurons, 0303 health sciences, Multidisciplinary, Neuronal Plasticity, Gamma-aminobutyric acid, Long-term potentiation, Neurochemistry, Neurotransmitters, Electrophysiology, Anesthesia, Prenatal Exposure Delayed Effects, Medicine, GABAergic, Female, [SDV.NEU]Life Sciences [q-bio]/Neurons and Cognition [q-bio.NC], Glutamate, Graphs, medicine.drug, Research Article, medicine.medical_specialty, Offspring, Science, Neurophysiology, Biology, Synaptic plasticity, 03 medical and health sciences, Developmental Neuroscience, Internal medicine, medicine, Animals, Humans, 030304 developmental biology, Inflammation, Neurotransmission, Biology and Life Sciences, Rats, Endocrinology, Child Development Disorders, Pervasive, Neurodevelopmental Disorders, Cellular Neuroscience, Schizophrenia, 030217 neurology & neurosurgery, Neuroscience
Abstract

International audience; Maternal inflammation during pregnancy is associated with the later development of cognitive and behavioral impairment in the offspring, reminiscent of the traits of schizophrenia or autism spectrum disorders. Hippocampal long-term potentiation and long-term depression of glutamatergic synapses are respectively involved in memory formation and consolidation. In male rats, maternal inflammation with lipopolysaccharide (LPS) led to a premature loss of long-term depression, occurring between 12 and 25 postnatal days instead of after the first postnatal month, and aberrant occurrence of long-term potentiation. We hypothesized this would be related to GABAergic system impairment. Sprague Dawley rats received either LPS or isotonic saline ip on gestational day 19. Male offspring's hippocampus was studied between 12 and 25 postnatal days. Morphological and functional analyses demonstrated that prenatal LPS triggered a deficit of hippocampal GABAergic interneurons, associated with presynaptic GABAergic transmission deficiency in male offspring. Increasing ambient GABA by impairing GABA reuptake with tiagabine did not interact with the low frequency-induced long-term depression in control animals but fully prevented its impairment in male offspring of LPS-challenged dams. Tiagabine furthermore prevented the aberrant occurrence of paired-pulse triggered long-term potentiation in these rats. Deficiency in GABA seems to be central to the dysregulation of synaptic plasticity observed in juvenile in utero LPS-challenged rats. Modulating GABAergic tone may be a possible therapeutic strategy at this developmental stage.

Published
2014
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45. Prospective Randomized Multicenter Comparison of High-Frequency Oscillatory Ventilation and Conventional Ventilation in Preterm Infants of Less Than 30 Weeks With Respiratory Distress Syndrome

Author

Benoît Escande, Thierry Lacaze-Masmonteil, Laurent Storme, Jean François Magny, Thierry Blanc, Josefa Paris-Llado, Gérard Bréart, Jean Michel Liet, Benoit Salanave, Gilles Cambonie, H Walti, Gérard Thiriez, G. Moriette, Christine André, and Sylvain Cantagrel

Subjects
Male, Artificial ventilation, Birth weight, medicine.medical_treatment, High-Frequency Ventilation, medicine, Humans, Lung volumes, Prospective Studies, Bronchopulmonary Dysplasia, Cerebral Hemorrhage, Respiratory Distress Syndrome, Newborn, Respiratory distress, business.industry, Incidence, High-frequency ventilation, Infant, Newborn, Oxygen Inhalation Therapy, Postmenstrual Age, Pulmonary Surfactants, medicine.disease, Respiration, Artificial, Treatment Outcome, Intraventricular hemorrhage, Anesthesia, Pediatrics, Perinatology and Child Health, Breathing, Female, business, Infant, Premature
Abstract

Background.Early use of high-frequency ventilation and exogenous surfactant is proposed as the optimal mode of ventilatory support in infants with respiratory distress syndrome. In very premature infants, we tested the hypothesis that high-frequency versus conventional ventilation could decrease exogenous surfactant requirements and improve pulmonary outcome, without altering the complication rate, including that of severe intraventricular hemorrhage.Methods.Preterm infants with a postmenstrual age of 24 to 29 weeks, presenting with respiratory distress syndrome were randomly assigned to high-frequency oscillatory ventilation (lung volume recruitment strategy) or conventional ventilation.Results.Two hundred seventy-three infants were enrolled. One hundred fifty-three had a postmenstrual age of 24 to 27 weeks, and 143 had a birth weight ≤1000 g. One hundred thirty-four infants were randomized at 142 minutes of life (median) to receive conventional ventilation (mean postmenstrual age at birth: 27. 6 ± 1.5 weeks; mean birth weight: 997 ± 245 g); and 139 infants were randomized at 145 minutes of life to receive high-frequency ventilation (mean postmenstrual age at birth: 27.5 ± 1.4 weeks; mean birth weight: 976 ± 219 g).High-frequency ventilation, compared with conventional ventilation, was associated with a twofold reduction in the requirement for ≥2 instillations of exogenous surfactant (30% vs 62%; odds ratio: .27; 95% confidence interval: .16–.44) and no difference in pulmonary outcome. The incidence of severe intraventricular hemorrhage was 24% in the high-frequency group and 14% in the conventional ventilation group (adjusted odds ratio: 1.50; 95% confidence interval: .68–3.30).Conclusion.Early use of high-frequency oscillatory ventilation in very premature infants decreases exogenous surfactant requirements, does not improve the pulmonary outcome, and may be associated with an increased incidence of severe intraventricular hemorrhage.

Published
2001
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46. Validation of nosocomial infection in neonatology: a new method for standardized surveillance

Author

Anne Lotthé, Julien Baleine, Sabine Durand, Aline Rideau Batista Novais, Marie-Noelle Didelot, Gilles Cambonie, Clémentine Combes, Anne Filleron, Renaud Mesnage, Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier), Centre Hospitalier Universitaire de Nîmes (CHU Nîmes), Cellules Souches, Plasticité Cellulaire, Médecine Régénératrice et Immunothérapies (IRMB), and Université de Montpellier (UM)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier)

Subjects
Male, Pediatrics, medicine.medical_specialty, Neonatal intensive care unit, Epidemiology, Birth weight, medicine.medical_treatment, [SDV]Life Sciences [q-bio], Medical Order Entry Systems, Tertiary Care Centers, 03 medical and health sciences, 0302 clinical medicine, 030225 pediatrics, Computerized physician order entry, Medicine, Humans, 030212 general & internal medicine, Neonatology, Prospective Studies, Prospective cohort study, business.industry, Premature infants, Health Policy, Incidence (epidemiology), Incidence, Public Health, Environmental and Occupational Health, Infant, Newborn, Odds ratio, Confidence interval, Drug Utilization, 3. Good health, Anti-Bacterial Agents, Infectious Diseases, Epidemiologic surveillance, Catheter-Related Infections, Epidemiological Monitoring, Catheter-related infection, Female, Interdisciplinary communication, business, Central venous catheter
Abstract

International audience; BackgroundNosocomial infections (NIs) are a leading cause of mortality and morbidity in premature infants. We present a new method for detecting and confirming NIs in a neonatal intensive care unit.MethodsNewborns with birth weight < 1,500 g or gestational age (GA) < 33 weeks were included prospectively over 2 years in a single-center tertiary neonatal intensive care unit. The computerized physician order entry system (CPOE) generated alerts when antibiotics were prescribed for at least 5 consecutive days and these cases were reviewed by an expert group following international recommendations.ResultsFour hundred sixty-one neonates were included, with a mean GA of 30 weeks (range, 26-32 weeks) and mean birth weight 1,270 g (range, 950-1600 g). The CPOE flagged 158 cases of potential NI, 85.1% of which were classified as true NI and 14.9% of which were false positive. Incidence and device-associated nosocomial bloodstream infection rates were 21.9% and 10.8 per 1,000 central venous catheter days, respectively. GA ≤ 28 weeks (odds ratio, 2.18; 95% confidence interval, 1.2-4) and > 7 central venous catheter days (odds ratio, 1.47; 95% confidence interval, 1.3-1.7) were independently associated with the risk of nosocomial bloodstream infection.ConclusionCombining CPOE and interdisciplinary review may improve the accuracy of NI recording in a neonatal intensive care unit.

Published
2014
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47. Partial acute transverse myelitis is a predictor of multiple sclerosis in children

Author

R Cheminal, Y Mikaeloff, Pierre Meyer, N. Molinari, Gilles Cambonie, Nicolas Leboucq, G. Rondouin, Julie Leydet, Ulrike Walther-Louvier, Kumaran Deiva, François Rivier, D Cuntz-Shadfar, Agathe Roubertie, B. Echenne, Maryline Carneiro, Physiologie & médecine expérimentale du Cœur et des Muscles [U 1046] (PhyMedExp), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Montpellier (UM)-Centre National de la Recherche Scientifique (CNRS), Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier), Département de Neuroradiologie[Montpellier], Hôpital Gui de Chauliac [Montpellier]-Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier)-Université Montpellier 1 (UM1)-Université de Montpellier (UM), Service de Néonatalogie, Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier)-Hôpital Arnaud de Villeneuve, Service de Neuropédiatrie, Hôpital Gui de Chauliac [Montpellier], Infectious Diseases Models for Innovative Therapies (IDMIT), Commissariat à l'énergie atomique et aux énergies alternatives (CEA)-Université Paris-Saclay, Troubles du comportement alimentaire de l'adolescent (UMR_S 669), Université Paris Descartes - Paris 5 (UPD5)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Paris-Sud - Paris 11 (UP11), Passerieux, Emilie, Université Montpellier 1 (UM1)-Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier)-Hôpital Gui de Chauliac [Montpellier]-Université de Montpellier (UM), Université Paris-Sud - Paris 11 (UP11)-Université Paris Descartes - Paris 5 (UPD5)-Institut National de la Santé et de la Recherche Médicale (INSERM), Université Montpellier 1 (UM1)-Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier)-Hôpital Gui de Chauliac [CHU Montpellier], Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier)-Université de Montpellier (UM), Hôpital Gui de Chauliac [CHU Montpellier], and Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier)-Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier)

Subjects
Male, Risk, medicine.medical_specialty, Pediatrics, Adolescent, Myelitis, Transverse, Transverse myelitis, Multiple sclerosis, 03 medical and health sciences, [SDV.MHEP.PED] Life Sciences [q-bio]/Human health and pathology/Pediatrics, 0302 clinical medicine, acute transverse myelitis, Medicine, Humans, magnetic resonance imaging, [SDV.NEU] Life Sciences [q-bio]/Neurons and Cognition [q-bio.NC], 030212 general & internal medicine, Age of Onset, Child, Retrospective Studies, First episode, [SDV.MHEP.PED]Life Sciences [q-bio]/Human health and pathology/Pediatrics, medicine.diagnostic_test, business.industry, Clinical course, Brain, Magnetic resonance imaging, Odds ratio, medicine.disease, Prognosis, Confidence interval, 3. Good health, Surgery, Acute Transverse Myelitis, pediatric, Neurology, Spinal Cord, [SDV.SPEE] Life Sciences [q-bio]/Santé publique et épidémiologie, Child, Preschool, Acute Disease, Female, [SDV.NEU]Life Sciences [q-bio]/Neurons and Cognition [q-bio.NC], [SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie, Neurology (clinical), business, 030217 neurology & neurosurgery
Abstract

Background: Acute transverse myelitis (ATM) in children is a rare and often severe disease for which there are few known prognostic factors, particularly the subsequent risk of multiple sclerosis (MS) diagnosis. Objectives: To determine the clinical course and prognostic factors after a first episode of ATM in children. Methods: Thirty children below 16 years of age diagnosed with a first neurological episode of ATM were included retrospectively. Clinical evaluation, treatment, laboratory, and MRI data were collected. Results: Median age at onset was 11 years (range 3–15 years). Follow-up data were available for a median of 4 years (range 0.5–16.7 years). Five patients subsequently had a diagnosis of MS (17%), which was associated with acute partial transverse myelitis (odds ratio 5; 95% confidence interval 2.3–11), with a 60% probability of having a relapse at five years ( p < 0.01). The 2011 Verhey criteria correctly identified MS in children with the highest specificity (96%) and sensitivity (80%). Conclusion: Acute partial transverse myelitis and brain MRI abnormalities at initial presentation are significantly predictive of a subsequent diagnosis of MS in children with ATM. These findings suggest that closer brain MRI monitoring after acute partial transverse myelitis might make the earlier introduction of disease-modifying therapies possible.

Published
2014
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48. Neonatal infection and 5-year neurodevelopmental outcome of very preterm infants

Author

Y. Aujard, Monique Kaminski, Béatrice Larroque, Antoine Burguet, Pierre-Yves Ancel, Stéphane Marret, Rachel Vieux, Gérard Thiriez, Ayoub Mitha, Patrick Truffert, Catherine Arnaud, Pascal Boileau, Laurence Foix-L’Hélias, Gilles Cambonie, Jean-Christophe Rozé, Recherche Epidémiologique en Santé Périnatale et Santé des Femmes et des Enfants (UMR_S 953), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Paris Descartes - Paris 5 (UPD5)-Université Pierre et Marie Curie - Paris 6 (UPMC)-Université Paris-Sud - Paris 11 (UP11), Unité de Néonatalogie, Hôpital Jeanne de Flandre [Lille], Epidémiologie et analyses en santé publique : risques, maladies chroniques et handicaps (LEASP), Université Toulouse III - Paul Sabatier (UT3), Université Fédérale Toulouse Midi-Pyrénées-Université Fédérale Toulouse Midi-Pyrénées-Institut National de la Santé et de la Recherche Médicale (INSERM), Unité d'Epidémiologie Clinique, CHU Toulouse [Toulouse]-Hôpital Purpan [Toulouse], CHU Toulouse [Toulouse], Service de pédiatrie néonatale et réanimation - neuropédiatrie [CHU Rouen], Hôpital Charles Nicolle [Rouen]-CHU Rouen, Normandie Université (NU)-Normandie Université (NU)-Université de Rouen Normandie (UNIROUEN), Normandie Université (NU), Endothélium microcirculatoire cérébral et lésions du système nerveux central au cours du développement (Néovasc), Université de Rouen Normandie (UNIROUEN), Normandie Université (NU)-Normandie Université (NU)-Institute for Research and Innovation in Biomedicine (IRIB), Normandie Université (NU)-Normandie Université (NU)-Centre National de la Recherche Scientifique (CNRS)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Rouen Normandie (UNIROUEN), Normandie Université (NU)-Centre National de la Recherche Scientifique (CNRS)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Institut National de la Santé et de la Recherche Médicale (INSERM), Centre Hospitalier Régional Universitaire de Nancy (CHRU Nancy), Neonatal Intensive Care Unit (NICU), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Robert Debré, Service Pédiatrie, Hôpital Saint-Jacques-Université de Franche-Comté (UFC), Université Bourgogne Franche-Comté [COMUE] (UBFC)-Université Bourgogne Franche-Comté [COMUE] (UBFC), Unité d'Epidémiologie et Recherche Clinique, Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Beaujon [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Service de Néonatalogie, Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier)-Hôpital Arnaud de Villeneuve, Service Pédiatrique, Hôpital du Bocage, Centre Hospitalier Universitaire de Dijon - Hôpital François Mitterrand (CHU Dijon)-Centre Hospitalier Universitaire de Dijon - Hôpital François Mitterrand (CHU Dijon), Risques cliniques et sécurité en santé des femmes et en santé périnatale (RISCQ), Université de Versailles Saint-Quentin-en-Yvelines (UVSQ), Service de Médecine Néonatale, Université de Nantes (UN), CIC - Nantes, Université de Nantes (UN)-IFR26-Institut National de la Santé et de la Recherche Médicale (INSERM), Unité de Recherche Epidémiologique sur la Qualité des Soins, Université de Lille, Droit et Santé, EPIPAGE study group, Université Paris-Sud - Paris 11 (UP11)-Université Pierre et Marie Curie - Paris 6 (UPMC)-Université Paris Descartes - Paris 5 (UPD5)-Institut National de la Santé et de la Recherche Médicale (INSERM), Service Epidémiologie clinique et santé publique [CHU Toulouse], Pôle Santé publique et médecine publique [CHU Toulouse], Centre Hospitalier Universitaire de Toulouse (CHU Toulouse)-Centre Hospitalier Universitaire de Toulouse (CHU Toulouse), Hôpital Charles Nicolle [Rouen], CHU Rouen, Normandie Université (NU)-Normandie Université (NU)-CHU Rouen, Normandie Université (NU)-Normandie Université (NU)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS)-Université de Rouen Normandie (UNIROUEN), Normandie Université (NU)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS)-Institut National de la Santé et de la Recherche Médicale (INSERM), Service de pédiatrie [CHRU Besançon], Centre Hospitalier Régional Universitaire de Besançon (CHRU Besançon), Service de pédiatrie (CHU de Dijon), Centre Hospitalier Universitaire de Dijon - Hôpital François Mitterrand (CHU Dijon), Debs, Nayla, Université de Toulouse (UT)-Université de Toulouse (UT)-Institut National de la Santé et de la Recherche Médicale (INSERM), Recherche Epidémiologique en Santé Périnatale et Santé des Femmes et des Enfants ( UMR_S 953 ), Université Paris-Sud - Paris 11 ( UP11 ) -Université Pierre et Marie Curie - Paris 6 ( UPMC ) -Université Paris Descartes - Paris 5 ( UPD5 ) -Institut National de la Santé et de la Recherche Médicale ( INSERM ), Épidémiologie et analyses en santé publique : risques, maladies chroniques et handicaps, Université Toulouse III - Paul Sabatier ( UPS ), Université Fédérale Toulouse Midi-Pyrénées-Université Fédérale Toulouse Midi-Pyrénées-Institut National de la Santé et de la Recherche Médicale ( INSERM ), Service de pédiatrie néonatale et réanimation - neuropédiatrie [Rouen], CHU Rouen-Université de Rouen Normandie ( UNIROUEN ), Normandie Université ( NU ) -Normandie Université ( NU ) -Hôpital Charles Nicolle [Rouen], Endothélium microcirculatoire cérébral et lésions du système nerveux central au cours du développement ( Néovasc ), Université de Rouen Normandie ( UNIROUEN ), Normandie Université ( NU ) -Normandie Université ( NU ) -Institute for Research and Innovation in Biomedicine ( IRIB ), Normandie Université ( NU ) -Normandie Université ( NU ) -Institut National de la Santé et de la Recherche Médicale ( INSERM ) -Université de Rouen Normandie ( UNIROUEN ), Normandie Université ( NU ) -Institut National de la Santé et de la Recherche Médicale ( INSERM ) -Institut National de la Santé et de la Recherche Médicale ( INSERM ), Centre Hospitalier Régional Universitaire de Nancy ( CHRU Nancy ), Neonatal Intensive Care Unit ( NICU ), Assistance publique - Hôpitaux de Paris (AP-HP)-Hôpital Robert Debré, Centre Hospitalier Régional Universitaire [Besançon] ( CHRU Besançon ) -Université de Franche-Comté ( UFC ), Assistance publique - Hôpitaux de Paris (AP-HP)-Hôpital Beaujon, Centre Hospitalier Régional Universitaire [Montpellier] ( CHRU Montpellier ) -Hôpital Arnaud de Villeneuve, Centre Hospitalier Universitaire de Dijon - Hôpital François Mitterrand ( CHU Dijon ) -Centre Hospitalier Universitaire de Dijon - Hôpital François Mitterrand ( CHU Dijon ), Université de Versailles Saint-Quentin-en-Yvelines ( UVSQ ) -Centre Hospitalier de Poissy Saint-Germain (CHIPS), Université de Nantes ( UN ), and Université de Nantes ( UN ) -IFR26-Institut National de la Santé et de la Recherche Médicale ( INSERM )

Subjects
Male, Pediatrics, MESH : Infant, Premature, Diseases, Developmental Disabilities, Infant, Premature, Diseases, Neuropsychological Tests, MESH : Child, Preschool, MESH : Cerebral Palsy, Cohort Studies, 0302 clinical medicine, MESH : Cross-Sectional Studies, Risk Factors, MESH: Risk Factors, MESH: Gestational Age, Infant, Very Low Birth Weight, MESH : Female, MESH: Infant, Very Low Birth Weight, 030212 general & internal medicine, Longitudinal Studies, MESH : Infant, Very Low Birth Weight, MESH : Infectious Disease Transmission, Vertical, MESH: Longitudinal Studies, MESH: Sepsis, MESH: Cohort Studies, MESH : Longitudinal Studies, education.field_of_study, Cross Infection, MESH: Infant, Newborn, neurodevelopmental outcome, MESH : Infant, [ SDV.SPEE ] Life Sciences [q-bio]/Santé publique et épidémiologie, MESH: Neuropsychological Tests, MESH : Risk Factors, MESH: Infant, MESH: Infant, Premature, Diseases, 3. Good health, MESH : Neuropsychological Tests, MESH: Infectious Disease Transmission, Vertical, population-based study, Child, Preschool, Cohort, Gestation, Female, MESH : Sepsis, France, MESH : Cross Infection, Cohort study, medicine.medical_specialty, MESH: Cerebral Palsy, MESH : Male, Population, MESH : Cohort Studies, Gestational Age, MESH : Infant, Newborn, MESH : Developmental Disabilities, Cerebral palsy, 03 medical and health sciences, MESH : Cognition Disorders, MESH: Cross-Sectional Studies, 030225 pediatrics, Sepsis, medicine, cohort study, Humans, neonatal infection, very preterm infants, education, MESH : France, MESH: Humans, business.industry, Cerebral Palsy, MESH : Humans, MESH: Child, Preschool, Infant, Newborn, Infant, MESH: Cross Infection, Odds ratio, medicine.disease, Confidence interval, Infectious Disease Transmission, Vertical, MESH: Male, MESH: France, Neonatal infection, MESH: Cognition Disorders, Cross-Sectional Studies, MESH: Developmental Disabilities, [SDV.SPEE] Life Sciences [q-bio]/Santé publique et épidémiologie, Pediatrics, Perinatology and Child Health, [SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie, business, Cognition Disorders, MESH: Female, MESH : Gestational Age
Abstract

OBJECTIVE:To determine whether neonatal infections are associated with a higher risk of adverse neurodevelopment at 5 years of age in a population-based cohort of very preterm children.METHODS:We included all live births between 22 and 32 weeks of gestation, from 9 regions in France, in 1997 (EPIPAGE study). Of the 2665 live births, 2277 were eligible for a follow-up evaluation at 5 years of age: 1769 had a medical examination and 1495 underwent cognitive assessment. Cerebral palsy and cognitive impairment were studied as a function of early-onset sepsis (EOS) and late-onset sepsis (LOS), after adjustment for potential confounding factors, in multivariate logistic regression models.RESULTS:A total of 139 (5%) of the 2665 live births included in the study presented with EOS alone (without associated LOS), 752 (28%) had LOS alone (without associated EOS), and 64 (2%) displayed both EOS and LOS. At 5 years of age, the frequency of cerebral palsy was 9% (157 of 1769) and that of cognitive impairment was 12% (177 of 1495). The frequency of cerebral palsy was higher in infants with isolated EOS (odds ratio [OR]: 1.70 [95% confidence interval (CI): 0.84−3.45]) or isolated LOS (OR: 1.71 [95% CI: 1.14−2.56]) than in uninfected infants, and this risk was even higher in cases of combined EOS and LOS (OR: 2.33 [95% CI: 1.02−5.33]). There was no association between neonatal infection and cognitive impairment.CONCLUSIONS:Neonatal infections in these very preterm infants were associated with a higher risk of cerebral palsy at the age of 5 years, particularly in infants presenting with both EOS and LOS.

Published
2013
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49. N-acetyl-cysteine prevents pyramidal cell disarray and reelin-immunoreactive neuron deficiency in CA3 after prenatal immune challenge in rats

Author

Nadine Crouzin, Aline Rideau Batista Novais, Gérard Barbanel, Janique Guiramand, Marie Celeste de Jesus Ferreira, Michel Vignes, Catherine Cohen-Solal, Gilles Cambonie, Institut des Biomolécules Max Mousseron [Pôle Chimie Balard] (IBMM), Centre National de la Recherche Scientifique (CNRS)-Institut de Chimie du CNRS (INC)-Université de Montpellier (UM)-Ecole Nationale Supérieure de Chimie de Montpellier (ENSCM), Service de Néonatalogie, Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier)-Hôpital Arnaud de Villeneuve, Service Pédiatrique, Hôpital du Bocage, and Centre Hospitalier Universitaire de Dijon - Hôpital François Mitterrand (CHU Dijon)-Centre Hospitalier Universitaire de Dijon - Hôpital François Mitterrand (CHU Dijon)

Subjects
Male, Acetyl cysteine, animal structures, Cell Adhesion Molecules, Neuronal, Nerve Tissue Proteins, Rats, Sprague-Dawley, 03 medical and health sciences, 0302 clinical medicine, Immune system, Pregnancy, medicine, Animals, cardiovascular diseases, Reelin, 030304 developmental biology, Neurons, 0303 health sciences, Extracellular Matrix Proteins, biology, Pyramidal Cells, Serine Endopeptidases, food and beverages, CA3 Region, Hippocampal, 3. Good health, Cell biology, Acetylcysteine, Rats, Reelin Protein, medicine.anatomical_structure, nervous system, Maternal Exposure, Pediatrics, Perinatology and Child Health, Immunology, cardiovascular system, biology.protein, [SDV.NEU]Life Sciences [q-bio]/Neurons and Cognition [q-bio.NC], Female, Neuron, Pyramidal cell, 030217 neurology & neurosurgery
Abstract

International audience; BACKGROUND: Prenatal infection is a major risk factor for the occurrence of neuropsychiatric disorders. These have been associated with hippocampal neuroanatomical and functional abnormalities. In the present study, we evaluated the occurrence of pyramidal cell disarray and reelin neuronal deficit in the hippocampus, and the protective role of N-acetyl-cysteine (NAC) in a rodent experimental model of prenatal immune challenge. METHODS: Sprague-Dawley rats received either 500 μg/kg of endotoxin (lipopolysaccharide, LPS) or 2 ml/kg of isotonic saline by i.p. injection on day 19 of gestation. After LPS injection, rats were or were not maintained on a preventive treatment of NAC (5 g/l in tap water), up to delivery. The pyramidal cell orientation and the number and type of reelin-expressing neurons were determined in male offspring. RESULTS: Prenatal LPS challenge led to permanent pyramidal cell disarray and to an early and transient decreased density of reelin-immunoreactive neurons. These disorders, more pronounced in the CA3 area, were prevented by NAC. CONCLUSION: Hippocampal cytoarchitectural alterations and reelin deficiency may be involved in the development of remote cognitive impairments in this model. The antioxidant NAC is an efficient neuroprotective drug that underlines the role of oxidative stress in prenatal infection and associated neurodevelopmental damage.

Published
2013
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50. Atypical pneumonia linked to community-acquired staphylococcus aureus cross-transmission in the nursery

Author

Anne, Filleron, Anne, Lotthé, Emilie, Jourdes, Eric, Jeziorski, Olivier, Prodhomme, Marie-Noëlle, Didelot, Sylvie, Parer, Hélène, Marchandin, and Gilles, Cambonie

Subjects
Methicillin-Resistant Staphylococcus aureus, Cross Infection, Infection Control, Bacterial Toxins, Infant, Newborn, Exotoxins, Microbial Sensitivity Tests, Staphylococcal Infections, Anti-Bacterial Agents, Community-Acquired Infections, Nurseries, Hospital, Leukocidins, Pneumonia, Staphylococcal, Humans, Female, Methicillin Resistance, Tomography, Spiral Computed
Abstract

We report the observation of a necrotizing pneumonia due to methicillin-resistant Staphylococcus aureus harboring the Panton-Valentine leukocidin-encoding gene in a previously healthy neonate, with favorable clinical outcome in spite of extensive radiologic lesions. The case was linked to a cluster of 3 neonates colonized by Panton-Valentine leukocidin-producing, methicillin-resistant S. aureus through cross-transmission in the nursery, underlining the need to comply with standard infection control precautions in the maternity ward.

Published
2013

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