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1. Postnatal corticosteroid exposure in very preterm infants: A French cohort study

Author

Silvia Iacobelli, Käliani Allamèle-Moutama, Simon Lorrain, Béatrice Gouyon, Jean-Bernard Gouyon, Francesco Bonsante, the Logipren Collaborative Working Group, S. Abasse, C. Alexandre, R. Brat, D. Brault, L. Brisseau, P. Boize, Y. Couringa, F. Decobert, C. Desbruyeres, M. Dorsi, A. Elgellab, G. Escourrou, F. Flamein, O. Flechelles, G. Ghostine, O. Girard, E. Jobard, L. Karaoui, E. Kermorvant-Duchemin, A. Kieffer, F. Kieffer, C. Lafon, S. Lebouedec, D. Leger, I. Ligi, M. Di Maio, G. Mazeiras, F. Michel, D. Mitanchez, F. Mons, J. Mourdie, A. Moussy-Durandy, C. Nicaise, K. Norbert, A. S. Pages, D. Ramful, H. Razafimahefa, J. M. Rosenthal, C. Tripon, and M. Vidal

Subjects
drugs, electronic prescribing decision support system, database systems, chronic lung disease, benchmarking, neonates perinatal exposure, Therapeutics. Pharmacology, RM1-950
Abstract

Background: Postnatal corticosteroids (PC) are widely used in very preterm infants. International reports and national multicenter trials describe a marked variability across countries and inter-sites, in the use of PC. Few information is available on therapeutic indications and prescription characteristics of PC.Aim: The main objective of this study was to describe the exposure to PC in a large cohort of preterm infants born at less than 32 weeks of gestation, according to the prescription data of 41 tertiary-care NICUs in France. Secondary objectives were to describe therapeutic indications, day of life (DOL) of the first exposure, route of administration, duration, cumulative dose for each drug, and differences in exposure rates across centers.Methods: We conducted a prospective observational cohort analysis from January 2017 to December 2021, in 41 French tertiary-care NICUs using the same computerized order-entry system.Results: In total, 13,913 infants [birth weight 1144.8 (±365.6) g] were included. Among them, 3633 (26.1%) were exposed to PC, 21.8% by systemic and 10.1% by inhaled route. Within the study population, 1,992 infants (14.3%) received the first corticosteroid treatment in the first week of life and 1641 (11.8%) after DOL 7. The more frequent indications were prevention and/or treatment of bronchopulmonary dysplasia, and arterial hypotension. Hydrocortisone was the more often prescribed molecule. For systemic PC the first exposure occurred in mean at DOL 9.4 (±13.5), mean duration of treatment was 10.3 (±14.3) days, and the cumulative dose (expressed as the equivalent dose of hydrocortisone) was in median [IQR] 9.0 [5.5–28.8] mg/kg. For inhaled PC, the first exposure occurred in mean at DOL 34.1 (±19.7), and mean duration of treatment 28.5 (±24.4) days. The exposure rate ranged from a minimum of 5% to a maximum of 56% among centers, and significantly increased over the study period (p < 0.0001).Conclusion: In this French cohort of very preterm infants, around one patient out to five was exposed to PC during hospital stay in the NICU. The exposure occurred early, starting from the first week of life. Exposure rate widely varied among centers. Pharmacoepidemiology studies are useful to increase knowledge on corticosteroid utilization patterns in preterm infants.

Published
2023
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5. Sotrovimab therapy elicits antiviral activities against Omicron BQ.1.1 and XBB.1.5 in sera of immunocompromised patients

Author

Bruel, Timothée, Vrignaud, Lou-Léna, Porrot, Françoise, Staropoli, Isabelle, Planas, Delphine, Guivel-Benhassine, Florence, Puech, Julien, Prot, Matthieu, Munier, Sandie, Bolland, William Henry, Soulié, Cathia, Zafilaza, Karen, Lusivika-Nzinga, Clovis, Meledge, Marie-Laure, Dorival, Céline, Molino, Diana, Péré, Hélène, Yordanov, Youri, Simon-Lorière, Etienne, Veyer, David, Carrat, Fabrice, Schwartz, Olivier, Marcelin, Anne-Geneviève, Martin-Blondel, Guillaume, Garcia, Magalie, Giraud, Valentin, Metais, Agathe, Cazenave-Roblot, Fance, Martellosio Anne-Marie Ronchetti, Jean-Philippe, Gabas, Thomas, Hadjadj, Naima, Salanoubat, Célia, Chabrol, Amélie, Housset, Pierre, Pardon, Agathe, Faucon, Anne-Laure, Caudwell, Valérie, Roland Liblau, Latifa Hanafi, Alric, Laurent, Pugnet, Grégory, Mourguet, Morgane, Bories, Eva, Bonnet, Delphine, Charpentier, Sandrine, Delobel, Pierre, Debard, Alexa, Beck, Colleen, Boumaza, Xavier, Fanny Lanternier, Stella Rousset, Delage, Claire, Pires, Elisabete Gomes, Cheminant, Morgane, Anthony Chauvin, Nathalie Chavarot, Véronique Delcey Simon Bessis, Xavier Eyer, Cresta, Mélanie, Pélagie Thibaut, Romain Gueneau, Nadal, Marine, Siguier, Martin, Bachir, Marwa, Valérie Pourcher, Christia Palacios, Melenotte, Cléa, Faycal, Antoine, Berot, Vincent, Brin, Cécile, Djebara, Siham, Zafilaza, Karen, Marot, Stéphane, Sayon, Sophie, Leducq, Vincent, Malet, Isabelle, Teyssou, Elisa, Karine Lacombe, Adélie Gothland, Aad, Yasmine Abi, Chiarabini, Thibault, Feliho, Raynald, Valin, Nadia, Brigant, Fabien, Boize, Julien, Thiébaud, Pierre-Clément, Moreau, Marie, Nathalie De Castro, Charlotte Billard, Liégeon, Geoffroy, Denis, Blandine, Molina, Jean-Michel, André Cabié, Lucia Etheve, Abel, Sylvie, Cabras, Ornella, Guitteaud, Karine, François Vincent Dubee, Sandrine Pierre-, Ndiaye, Diama, Pehlivan, Jonathan, Phelippeau, Michael, Alexandre Duvignaud, Rafael Mahieu, Pistone, Thierry, Desclaux, Arnaud, Neau, Didier, Jean-François Faucher, Charles Cazanave, Festou, Benjamin, Dupuy-Grasset, Magali, Loustaud-Ratti, Véronique, Nathan Peiffer- Smadja, Delphine Chainier, Choquet, Christophe, Da Conceicao, Olivia, Thy, Michael, Collas, Lio, Godard, Cindy, Bouzid, Donia, Ing, Vittiaroat, Pereira, Laurent, Pavlowsky, Thomas, RavautAntoine Asquier-Khati, Camille, Boutoille, David, Chauveau, Marie, Deschanvres, Colin, Audrey Le Bot, François Raffi, Cailleaux, Marine, Benezit, François, Maillard, Anne, Hue, Benoit, François Coustilleres, Pierre Tattevin, Carvalho-Schneider, Claudia, Jamard, Simon, Petit, Laeticia, Natacha Mrozek, Karl Stefic, Theis, Clément, Vidal, Magali, Sauvat, Léo, Benjamin Lefèvre, Delphine Martineau, Baronnet, Guillaume, Florence Ader, Agnès Didier, Perpoint, Thomas, Conrad, Anne, Chabert, Paul, Aurélie Martin, Pierre Chauvelot, Loubet, Paul, Mazet, Julien, Larcher, Romaric, Mathilde Devaux Jérôme Frey, Didier Laureillard, Woerlen, Amos, Remillon, Aline, Absensur-Vuillaume, Laure, Albert Trinh-Duc, Pauline Bouquet, Philippe Petua, Patrick Rispal, Aurore Perrot, Julien Carillo, Delavigne, Karen, Cougoul, Pierre, Dion, Jérémie, Mathieu Blot, Odile Rauzy, Sixt, Thibault, Moretto, Florian, Charles, Carole, Sophie Circosta, Lionel Piroth, Leger, Lydia, Arulananthan, Arulvani, Lascoux, Carine, Valérie, Pascaline, Yazdan Yazdanpanah, Leia Becam, Petrov-Sanchez, Ventzislava, Diallo, Alpha, Le Mestre, Soizic, Le Meut Isabelle Goderel, Guillaume, Chau, Frédéric, Soltana, Brahim, Chane Tang, Jessica, Guedj, Jérémie, and Caille, Yvanie

Abstract

Antibodies effective against the recent Omicron sublineages are missing. By taking advantage of a multi-centric prospective cohort of immunocompromised individuals treated for mild-to-moderate COVID-19, Bruel et al. show that administration of 500 mg of sotrovimab induces serum neutralization and antibody-dependent cellular cytotoxicity of BQ.1.1 and XBB.1.5. Therefore, sotrovimab may remain a therapeutic option against these variants.

Published
2023
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7. 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

Schmitz, Thomas, Doret-Dion, Muriel, Sentilhes, Loic, Parant, Olivier, Claris, Olivier, Renesme, Laurent, Abbal, Julie, Girault, Aude, Torchin, Héloïse, Houllier, Marie, Le Saché, Nolwenn, Vivanti, Alexandre J, De Luca, Daniele, Winer, Norbert, Flamant, Cyril, Thuillier, Claire, Boileau, Pascal, Blanc, Julie, Brevaut, Véronique, Bouet, Pierre-Emmanuel, Gascoin, Géraldine, Beucher, Gaël, Datin-Dorriere, Valérie, Bounan, Stéphane, Bolot, Pascal, Poncelet, Christophe, Alberti, Corinne, Ursino, Moreno, Aupiais, Camille, Baud, Olivier, Boize, Philippe, Garabédian, Charles, Flamein, Florence, Le Lous, Maela, Beuchée, Alain, Gondry, Jean, Tourneux, Pierre, Coste-Mazeau, Perrine, Bedu, Antoine, Gallot, Denis, Coste, Karen, Chauleur, Céline, Patural, Hugues, Kayem, Gilles, Mitanchez, Delphine, Heckenroth, Hélène, Boubred, Farid, Sibiude, Jeanne, Desfrère, Luc, Bohec, Caroline, Mansir, Thierry, Koch, Antoine, Kuhn, Pierre, Tillouche, Nadia, Lapeyre, Fabrice, Perrotin, Franck, Favrais, Géraldine, Lecarpentier, Edouard, Durrmeyer, Xaxier, Equy, Véronique, Debillon, Thierry, Rigonnot, Luc, Lefoulgoc, Stéphanie, Brie, Claudia, Pagès, Anne-Sophie, Rayssiguier, Romy, Cambonie, Gilles, Cudeville, Corinne, Madeleneau, Doriane, Morel, Olivier, Hascoet, Jean-Michel, Letouzey, Vincent, Di Maio, Massimo, Salomon, Laurent J., and Lapillonne, Alexandre

Abstract

Antenatal 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.

Published
2022
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8. Clinical impact of a gastrointestinal PCR panel in children with infectious diarrhoea

Author

Truong, Jeanne, Cointe, Aurélie, Le Roux, Enora, Bidet, Philippe, Michel, Morgane, Boize, Julien, Mariani-Kurkdjian, Patricia, Caseris, Marion, Hobson, Claire Amaris, Desmarest, Marie, Titomanlio, Luigi, Faye, Albert, and Bonacorsi, Stéphane

Abstract

ObjectivesMultiplex gastrointestinal PCR (GI-PCR) allows fast and simultaneous detection of 22 enteric pathogens (including Campylobacter, Salmonella, Shigella/enteroinvasive Escherichia coli (EIEC), among other bacteria, parasites and viruses). However, its impact on the management of children with infectious diarrhoea remains unknown.Patients/DesignAll children eligible for stool culture from May to October 2018 were prospectively included in a monocentric study at Robert-Debré University-Hospital.InterventionA GI-PCR (BioFire FilmArray) was performed on each stool sample.Main measuresData on the children’s healthcare management before and after GI-PCR results were collected. Stool culture results were also reported.Results172 children were included. The main criteria for performing stool analysis were mucous/bloody diarrhoea and/or traveller’s diarrhoea (n=130). GI-PCR’s were positive for 120 patients (70%). The main pathogens were enteroaggregative E. coli(n=39; 23%), enteropathogenic E. coli(n=34; 20%), Shigella/EIEC (n=27; 16%) and Campylobacter(n=21; 12%). Compared with stool cultures, GI-PCR enabled the detection of 21 vs 19 Campylobacter,12 vs 10 Salmonella,27 Shigella/EIEC vs 13 Shigella, 2 vs 2 Yersinia enterocolitica, 1 vs 1 Plesiomonas shigelloides,respectively. Considering the GI-PCR results and before stool culture results, the medical management was revised for 40 patients (23%): 28 initiations, 2 changes and 1 discontinuation of antibiotics, 1 hospitalisation, 2 specific room isolations related to Clostridioides difficileinfections, 4 additional test prescriptions and 2 test cancellations.ConclusionThe GI-PCR’s results impacted the medical management of gastroenteritis for almostone-fourth of the children, and especially the prescription of appropriate antibiotic treatment before stool culture results.

Published
2022
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13. Règlement REACH : quelles évolutions pour l’industrie nucléaire ?

Author

Boize, Magali, Ivens, Richard, Boize, Magali, and Ivens, Richard

Abstract

En adoptant la directive REACh, l’Union européenne a renforcé l’encadrement de l’usage des produits chimiques catégorisés comme dangereux pour l’homme et l’environnement. L’industrie nucléaire, bien qu’utilisatrice marginale de produits chimiques en volume, n’en demeure pas moins potentiellement impactée. Ces dernières années, le débat s’est notamment porté sur l’utilisation du bore dans les centrales. Modérateur de la réaction nucléaire, le bore, sans substitut, est en effet indispensable au bon fonctionnement des centrales nucléaires. Si pour le moment la molécule n’est pas soumise à autorisation, cet exemple montre l’importance d’avoir une vision globale et anticipatrice de la réglementation concernant les produits chimiques utilisés dans l’industrie nucléaire, et ce dès la phase de conception.

Published
2017
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15. The ANTENATAL multicentre study to predict postnatal renal outcome in fetuses with posterior urethral valves: objectives and design

Author

Buffin-Meyer, Bénédicte, Klein, Julie, van der Zanden, Loes F M, Levtchenko, Elena, Moulos, Panogiotis, Lounis, Nadia, Conte-Auriol, Françoise, Hindryckx, An, Wühl, Elke, Persico, Nicola, Oepkes, Dick, Schreuder, Michiel F, Tkaczyk, Marcin, Ariceta, Gema, Fossum, Magdalena, Parvex, Paloma, Feitz, Wout, Olsen, Henning, Montini, Giovanni, Decramer, Stéphane, Schanstra, Joost P, De Catte, Luc, Vayssieres, Christophe, Sartor, Agnès, Groussolles, Marion, Plard, Christelle, Guerby, Paul, Connan, Laure, Morin, Mathieu, Simon, Elizabeth, Breaud, Jean, Saliou, Anne-Hélène, De Parscau, Loic, Jay, Nadine, Germouty, Isabelle, Le Bouar, Gwenaelle, Ryckewaert, Amelie, Manca-Pellissier, Marie-Christine, Merrot, Thierry, Laurichesse, Helene, Gallot, Denis, Bessenay, Lucie, Bidat, Laurent, Boize, Philippe, Winer, Norbert, Allain-Launey, Emma, Le Vaillant, Claudine, Prieur, Fabienne, Lavocat, Marie-Pierre, Coatleven, Frederic, Debromez, Eric, Harembat, Jérôme, Llanas, Brigitte, Favre, Romain, Moog, Raphael, Zaloszyc, Ariane, Massardier, Jérôme, Demede, Delphine, Perrotin, Franck, Cloarec, Sylvie, Vequeau-Goua, Valérie, Descombes, Emmanuelle, Boulot, Pierre, Morin, Denis, Fuchs, Florent, Tenenbaum, Julie, Ville, Yves, Blanc, Thomas, Heidet, Laurence, Paris, Anne, Dobremez, Eric, Froute, Marie-Françoise, Gondry, Jean, Muszynski, Charles, Haraux, Elodie, Lobelle, Fabienne, Chevreau, Julien, Rosenblatt, Jonathan, Baudoin, Véronique, Deschenes, Georges, Guigue, Virginie, Amblard, Florence, Bourdat-Michel, Guylhène, Schaefer, Franz, Elsässer, Michael, Rossi, Federica, Manzoni, Gianantonio, De Marco, Erika A, Capone, Valentina, Caforio, Leonardo, Zaccara, Antonio, Innocenzi, Michele, Bagolan, Pietro, Capozza, Nicola, Castagnetti, Marco, Mancini, Mariangela, van Scheltema, Phebe Adama, Kortmann, Barbara, Schreuder, Michiel, Stańczyk, Małgorzata, Szaflik, Krzysztof, Wojtera, Justyna, Krzeszowski, Waldemar, Talar, Tomasz, Pawłowska, Barbara, Fortecka-Piestrzeniewicz, Katarzyna, Olejniczak, Dariusz, Arevalo, Silvia, Rodo, Carlota, Lindgren, Peter, Chehade, Hassib, ANTENATAL Consortium, Hindryckx, A., De Catte, L., Vayssieres, C., Sartor, A., Groussolles, M., Plard, C., Guerby, P., Connan, L., Morin, M., Simon, E., Breaud, J., Saliou, A.H., De Parscau, L., Jay, N., Germouty, I., Le Bouar, G., Ryckewaert, A., Manca-Pellissier, M.C., Merrot, T., Laurichesse, H., Gallot, D., Bessenay, L., Bidat, L., Boize, P., Winer, N., Allain-Launey, E., Le Vaillant, C., Prieur, F., Lavocat, M.P., Coatleven, F., Debromez, E., Harembat, J., Llanas, B., Favre, R., Moog, R., Zaloszyc, A., Massardier, J., Demede, D., Perrotin, F., Cloarec, S., Vequeau-Goua, V., Descombes, E., Boulot, P., Morin, D., Fuchs, F., Tenenbaum, J., Ville, Y., Blanc, T., Heidet, L., Paris, A., Dobremez, E., Froute, M.F., Gondry, J., Muszynski, C., Haraux, E., Lobelle, F., Chevreau, J., Rosenblatt, J., Baudoin, V., Deschenes, G., Guigue, V., Amblard, F., Bourdat-Michel, G., Wühl, E., Schaefer, F., Elsässer, M., Persico, N., Rossi, F., Manzoni, G., De Marco, E.A., Montini, G., Capone, V., Caforio, L., Zaccara, A., Innocenzi, M., Bagolan, P., Capozza, N., Castagnetti, M., Mancini, M., Oepkes, D., van Scheltema, P.A., Feitz, W., Kortmann, B., Schreuder, M., Tkaczyk, M., Stańczyk, M., Szaflik, K., Wojtera, J., Krzeszowski, W., Talar, T., Pawłowska, B., Fortecka-Piestrzeniewicz, K., Olejniczak, D., Ariceta, G., Arevalo, S., Rodo, C., Fossum, M., Lindgren, P., Parvex, P., Chehade, H., Institut des Maladies Métaboliques et Cardiovasculaires (I2MC), 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, Radboud University Medical Center [Nijmegen], Catholic University of Leuven - Katholieke Universiteit Leuven (KU Leuven), HybridStat Predictive Analytics [Athens, Greece], Centre d'investigation clinique de Toulouse (CIC 1436), Université Toulouse III - Paul Sabatier (UT3), Université Fédérale Toulouse Midi-Pyrénées-Université Fédérale Toulouse Midi-Pyrénées-CHU Toulouse [Toulouse]-Institut National de la Santé et de la Recherche Médicale (INSERM), University Hospitals Leuven [Leuven], Heidelberg University Hospital [Heidelberg], University of Milan, Fondazione IRCCS Ca’ Granda – Ospedale Maggiore Policlinico [Milan, Italy], Leiden University Medical Center (LUMC), Radboud Institute for Molecular Life Sciences [Nijmegen, the Netherlands], Polish Mother’s Memorial Hospital Research Institute [Lodz] (ICZMP), Pediatric Nephrology [Barcelona, Spain] (Vall d’Hebron Hospital), Universitat Autònoma de Barcelona (UAB)-Vall d'Hebron University Hospital [Barcelona], Karolinska University Hospital [Stockholm], Karolinska Institutet [Stockholm], Geneva University Hospital (HUG), Aarhus University Hospital, Aarhus University [Aarhus], Fondazione IRCCS Ca' Granda - Ospedale Maggiore Policlinico, ANTENATAL Consortium: An Hindryckx, Luc De Catte, Christophe Vayssieres, Agnès Sartor, Marion Groussolles, Christelle Plard, Paul Guerby, Laure Connan, Mathieu Morin, Elizabeth Simon, Jean Breaud, Anne-Hélène Saliou, Loic De Parscau, Nadine Jay, Isabelle Germouty, Gwenaelle Le Bouar, Amelie Ryckewaert, Marie-Christine Manca-Pellissier, Thierry Merrot, Helene Laurichesse, Denis Gallot, Lucie Bessenay, Laurent Bidat, Philippe Boize, Norbert Winer, Emma Allain-Launey, Claudine Le Vaillant, Fabienne Prieur, Marie-Pierre Lavocat, Frederic Coatleven, Eric Debromez, Jérôme Harembat, Brigitte Llanas, Romain Favre, Raphael Moog, Ariane Zaloszyc, Jérôme Massardier, Delphine Demede, Franck Perrotin, Sylvie Cloarec, Valérie Vequeau-Goua, Emmanuelle Descombes, Pierre Boulot, Denis Morin, Florent Fuchs, Julie Tenenbaum, Yves Ville, Thomas Blanc, Laurence Heidet, Anne Paris, Eric Dobremez, Marie-Françoise Froute, Jean Gondry, Charles Muszynski, Elodie Haraux, Fabienne Lobelle, Julien Chevreau, Jonathan Rosenblatt, Véronique Baudoin, Georges Deschenes, Virginie Guigue, Florence Amblard, Guylhène Bourdat-Michel, Elke Wühl, Franz Schaefer, Michael Elsässer, Nicola Persico, Federica Rossi, Gianantonio Manzoni, Erika A De Marco, Giovanni Montini, Valentina Capone, Leonardo Caforio, Antonio Zaccara, Michele Innocenzi, Pietro Bagolan, Nicola Capozza, Marco Castagnetti, Mariangela Mancini, Dick Oepkes, Phebe Adama van Scheltema, Wout Feitz, Barbara Kortmann, Michiel Schreuder, Marcin Tkaczyk, Małgorzata Stańczyk, Krzysztof Szaflik, Justyna Wojtera, Waldemar Krzeszowski, Tomasz Talar, Barbara Pawłowska, Katarzyna Fortecka-Piestrzeniewicz, Dariusz Olejniczak, Gema Ariceta, Silvia Arevalo, Carlota Rodo, Magdalena Fossum, Peter Lindgren, Paloma Parvex, Hassib Chehade., Schanstra, Joost, Université Fédérale Toulouse Midi-Pyrénées-Université Fédérale Toulouse Midi-Pyrénées-Institut National de la Santé et de la Recherche Médicale (INSERM), Université Fédérale Toulouse Midi-Pyrénées-Université Fédérale Toulouse Midi-Pyrénées-Institut National de la Santé et de la Recherche Médicale (INSERM)-Pôle Santé publique et médecine publique [CHU Toulouse], Centre Hospitalier Universitaire de Toulouse (CHU Toulouse)-Centre Hospitalier Universitaire de Toulouse (CHU Toulouse), and Università degli Studi di Milano = University of Milan (UNIMI)

Subjects
Posterior urethral valve, medicine.medical_specialty, Urinary system, [SDV]Life Sciences [q-bio], kidney disease, prenatal biomarkers, Renal function, Prenatal care, 030204 cardiovascular system & hematology, DIAGNOSIS, 03 medical and health sciences, All institutes and research themes of the Radboud University Medical Center, 0302 clinical medicine, Medicine, obstructive uropathy, Obstructive uropathy, development, 030304 developmental biology, RISK, 0303 health sciences, Transplantation, Kidney, ddc:618, Science & Technology, business.industry, Obstetrics, Original Articles, prediction, Urology & Nephrology, Omics, medicine.disease, 6. Clean water, 3. Good health, [SDV] Life Sciences [q-bio], Reconstructive and regenerative medicine Radboud Institute for Molecular Life Sciences [Radboudumc 10], Renal disorders Radboud Institute for Molecular Life Sciences [Radboudumc 11], medicine.anatomical_structure, Nephrology, embryonic structures, Settore MED/20, URINARY-TRACT OBSTRUCTION, Renal disorders Radboud Institute for Health Sciences [Radboudumc 11], business, Life Sciences & Biomedicine, Kidney disease
Abstract

Altres ajuts: The study is partially made possible by support of the 'Programme Hospitalier de Recherche Clinique and 'La Foundation de la Recherche Médicale (grant number DEQ20170336759, France). M.T. was supported by the Polish Mothers Memorial Hospital Research Institute (internal grant number 2016/IV/54-GW. LvdZ is supported by a Kolff grant from the Dutch Kidney Foundation (13OKJ36) and a ZonMW-VENI grant from the Netherlands Organisation for Scientific Research (91618036). This project has been supported by ERN ERKNet and ERN eUROGEN, which are partly co-funded by the European Union within the framework of the Third Health Programme 'ERN-2016-Framework Partnership Agreement 2017-2021'. Posterior urethral valves (PUV) account for 17% of paediatric end-stage renal disease. A major issue in the management of PUV is prenatal prediction of postnatal renal function. Fetal ultrasound and fetal urine biochemistry are currently employed for this prediction, but clearly lack precision. We previously developed a fetal urine peptide signature that predicted in utero with high precision postnatal renal function in fetuses with PUV. We describe here the objectives and design of the prospective international multicentre ANTENATAL (multicentre validation of a fetal urine peptidome-based classifier to predict postnatal renal function in posterior urethral valves) study, set up to validate this fetal urine peptide signature. Participants will be PUV pregnancies enrolled from 2017 to 2021 and followed up until 2023 in >30 European centres endorsed and supported by European reference networks for rare urological disorders (ERN eUROGEN) and rare kidney diseases (ERN ERKNet). The endpoint will be renal/patient survival at 2 years postnatally. Assuming α = 0.05, 1-β = 0.8 and a mean prevalence of severe renal outcome in PUV individuals of 0.35, 400 patients need to be enrolled to validate the previously reported sensitivity and specificity of the peptide signature. In this largest multicentre study of antenatally detected PUV, we anticipate bringing a novel tool to the clinic. Based on urinary peptides and potentially amended in the future with additional omics traits, this tool will be able to precisely quantify postnatal renal survival in PUV pregnancies. The main limitation of the employed approach is the need for specialized equipment. Accurate risk assessment in the prenatal period should strongly improve the management of fetuses with PUV.

Published
2020
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16. Parents' participation in collegial meetings to discuss withholding or withdrawing treatment for their newborn: Working to improve information-sharing.

Author

Boize P, Garner Y, Neaud E, and Borrhomee S

Subjects
Child, Infant, Newborn, Humans, Retrospective Studies, Withholding Treatment, Professional-Family Relations, Decision Making, Parents psychology, Terminal Care
Abstract

Aim: The role of parents in decision-making concerning their child's end-of-life care is not clearly defined. Their participation is encouraged by ethical reflection, in particular by the CCNE (French National Ethics Advisory Committee), but laws are limited to imposing a duty to provide information to doctors. Decisions are taken at the end of a collegial meeting (CM) intended to better inform the child's referring physician (RP) who is in charge of the final decision following the French law. The aim of this study was to describe the support provided to bereaved families after they had been invited to attend a CM concerning their child, if they so wished. Additional aims were to determine the differences resulting from their acceptance or their refusal to participate as regards their perception of their child's history and as regards their grieving process., Material and Method: We conducted a retrospective study of all CMs held between November 2016 and May 2021, drawing a distinction between proposals made or not made to parents and their decision to accept or refuse., Results: In total, 49 CMs concerning 46 children were held during the study period. The proposal was not made to the parents in three cases; the parents chose to be present in 28 cases. The psychological follow-up (15/28 parents attending, 10/16 parents absent) illustrated that their presence enabled them to reflect on their child's death after having listened to and understood the reasons why it happened. They did not dispute the team's approach or decisions taken., Conclusion: It is possible to include parents in CMs if they so wish. It would appear more beneficial than merely providing them with the information required. Studies must be carried out to ensure potential long-term benefit., Competing Interests: Declaration of Competing Interest None., (Copyright © 2023 French Society of Pediatrics. Published by Elsevier Masson SAS. All rights reserved.)

Published
2024
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17. [The practices of withdrawing artificial nutrition and hydration in the neonatal intensive care unit: a preliminary study].

Author

Béranger A, Boize P, and Viallard ML

Subjects
Attitude of Health Personnel, Brain Damage, Chronic mortality, Ethics, Medical, Ethics, Nursing, Euthanasia, Active ethics, France, Humans, Infant, Newborn, Infant, Premature, Diseases mortality, Palliative Care ethics, Patient Care Team ethics, Pilot Projects, Qualitative Research, Surveys and Questionnaires, Brain Damage, Chronic therapy, Fluid Therapy ethics, Infant, Premature, Diseases therapy, Intensive Care Units, Neonatal ethics, Nutritional Support ethics, Withholding Treatment ethics
Abstract

Introduction: Prematurity is one of the etiologies for severe neurological complications. Decisions to withdraw therapeutics, including artificial nutrition and hydration (ANH), are sometimes discussed. But can one withdraw ANH if the patient is a child suffering from severe neurological conditions, based on his best interests? The aim of this study was to further the understanding of the complexity of the withdrawal of ANH and its implementation in the neonatal intensive care unit (NICU)., Method: This qualitative preliminary study based on a questionnaire was conducted on the staff in the NICU of the Pontoise medical center (France) in February 2012. The results were compared with the current knowledge on this issue and sociological data., Results: Ten of the hospital staff members responded to the questionnaire: 60% considered ANH as a treatment, but the status of ANH (i.e., treatment or care) remained undefined for several respondents. Comparison with the withdrawal of mechanical ventilation or adult practices seemed to be inadequate. The staff had little experience in the domain and therefore few certainties on practices. Half of the respondents indicated that terminal sedation needed to be used. For the other half, it depended on the patient's pain. Timing was also an important notion given that the newborn is a being developing and evolving each in its own way., Conclusion: The withdrawal of ANH remains controversial in the NICU. Humanity, culture, and the relationship to others are ever present in the decision-making process, creating a moral opposition above and beyond ethical reflection., (Copyright © 2013 Elsevier Masson SAS. All rights reserved.)

Published
2014
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18. [Neonatal parechovirus infection, fever, irritability and myositis].

Author

Eyssette-Guerreau S, Boize P, Thibault M, and Sarda H

Subjects
Creatine Kinase analysis, DNA, Viral isolation & purification, Diarrhea virology, Humans, Hypoxia virology, Infant, Infant, Newborn, Parechovirus genetics, Respiratory Distress Syndrome, Newborn virology, Tachycardia virology, Transaminases analysis, Fever virology, Irritable Mood, Myositis virology, Parechovirus isolation & purification, Picornaviridae Infections diagnosis
Abstract

Human parechovirus (HPeV) is associated with central nervous system infection and sepsis-like illness in newborn infants. The most frequent signs are fever, seizures, irritability, rash, and encephalitis. We report 4 cases of full-term infants with HPeV infection. They were admitted from home to the pediatric emergency unit of our hospital in October 2012. The median age at onset of symptoms was 15 days. They all developed sepsis-like illness with predominantly gastrointestinal disease and irritability. Two patients developed respiratory problems and 2 a skin rash (concerning only the extremities for one). Two patients required hospitalization in an intensive care unit. There was normal or mild inflammatory syndrome, normal white blood cell or mild leukopenia, hepatitis. We describe for the first time elevation of muscular enzymes in 3 of these patients. The diagnosis of HPeV infection was made by positive HPeV real-time PCR in cerebrospinal fluid (including the patient without pleocytosis) and/or blood. HPeV may cause severe disease in the neonatal period and patients presenting with such signs should be evaluated for HPeV. It also should be considered in sudden infant death syndrome., (Copyright © 2013 Elsevier Masson SAS. All rights reserved.)

Published
2013
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