Pediatrician

Dijon, France

Pediatrician

Dijon, France
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Bilan N.,Tabriz University of Medical Sciences | Agakhani M.,Pediatrician | Goldost M.,General Practioner
International Journal of Pediatrics | Year: 2014

Introduction Bronchiectasis is a common problem in children especially under 5 years. Early diagnosis of disease and its causes could be useful in early treatment and preventing probable complications. This study aimed at evaluating the Cystic fibrosis (CF) in patients with bronchiectasis. Materials and Methods In a cross-sectional study, 374 children with bronchiectasis were studied. The diagnosis was made according to clinical (chronic cough and persistent sputum) and Computerised tomography (CT) scan findings. Demographic findings, clinical findings, treatment, etiology, imaging and outcome of diseas were recorded. Results Two-hundred-and-forty (64.2%) were male with mean age of 8.61±3.36 years at the diagnosis. In patients with and without the etiology of CF, the cure was observed in 1 (5.6%) and 132 (37.1%), partial remission in 5 (27.8%) and 148 (41.6%) of the cases and non improvement in 12 (66.7%) and 76 (21.3%). There was significant relation between existence of asthma (p<0.001), Gastroesophageal reflux (GERD) (p=0.02) and CF (p<0.001) with response to treatment in bronchiectasis. Conclusion Bronchiectasis is common in infants with the etiology of CF and cure and partial remission is lower in CF patients who have bronchiectasis.


Azim H.A.,Italian National Cancer Institute | Azim H.A.,Jules Bordet Institute | Bellettini G.,ASL Citta di Milan | Liptrott S.J.,Italian National Cancer Institute | And 7 more authors.
Breast | Year: 2010

Little is known regarding the safety and feasibility of breastfeeding in women with a history of breast cancer. We have performed a survey among breast cancer patients who completed their pregnancy following breast cancer management to examine their lactation behaviours and its effect on breast cancer outcome. Out of 32 women identified, 20 were reachable and accepted to take the questionnaire. Ten women initiated breastfeeding, 4 stopped within one month and 6 had long-term success with a median period of 11 months (7-17 months). The latter were all previously subjected to breast conserving surgery and received qualified lactation counselling at delivery. The main reasons for not initiating breastfeeding were " uncertainty regarding maternal safety" and " a priori unfeasibility" expressed either by the obstetrician or by the oncologist. At a median follow-up of 48 months following delivery, all 20 women were alive with two relapses; one in each group (i.e., lactating and non-lactating). This analysis adds to the limited available evidence on the feasibility and safety of breastfeeding in breast cancer survivors. Proper fertility and survivorship counselling is crucial and requires more attention in breast cancer clinics. © 2010.


PubMed | Raymond Poincare University Hospital, Brest University Hospital Center, Necker Enfants Malades University Hospital, CHBA and 12 more.
Type: Case Reports | Journal: American journal of medical genetics. Part A | Year: 2015

Tetrasomy 9p is a generic term describing the presence of a supernumerary chromosome incorporating two copies of the 9p arm. Two varieties exist: isodicentric chromosome 9p (i(9p)), where the two 9p arms are linked by a single centromeric region, and pseudodicentric 9p (idic(9p)), where one active and one inactive centromere are linked together by a proximal segment of 9q that may incorporate euchromatic material. In living patients, i(9p) and idic(9p) are usually present in a mosaic state. Fifty-four cases, including fetuses, have been reported, of which only two have been molecularly characterized using array-CGH. Tetrasomy 9p leads to a variable phenotype ranging from multiple congenital anomalies with severe intellectual disability and growth delay to subnormal cognitive and physical developments. Hypertelorism, abnormal ears, microretrognathia and bulbous nose are the most common dysmorphic traits. Microcephaly, growth retardation, joint dislocation, scoliosis, cardiac and renal anomalies were reported in several cases. Those physical anomalies are often, but not universally, accompanied by intellectual disability. The most recurrent breakpoints, defined by conventional cytogenetics, are 9p10, 9q12 and 9q13. We report on 12 new patients with tetrasomy 9p (3 i(9p), 8 idic(9p) and one structurally uncharacterized), including the first case of parental germline mosaicism. All rearrangements have been characterized by DNA microarray. Based on our results and a review of the literature, we further delineate the prenatal and postnatal clinical spectrum of this imbalance. Our results show poor genotype-phenotype correlations and underline the need of precise molecular characterization of the supernumerary marker.


Peck J.L.,University of Texas Medical Branch | Stanton M.,University of Alabama | Reynolds G.E.S.,Pediatrician
Journal of Pediatric Health Care | Year: 2014

Introduction: This study examined the feasibility of using a smartphone application recall/reminder system for immunizations given in pediatric primary care. Method: The study used a typical descriptive study design. A convenience sample of parents and caregivers was recruited from a primary care pediatric office in a middle-class suburban area. Participants used an Android smartphone application ("Call the Shots") that served as a reminder/recall system for vaccinations and offered an embedded tool kit to obtain reliable information about vaccines. Results: A total of 262 persons accessed the application's Web site. The application was downloaded and used by 45 of those persons during the study; six persons completed the survey. Discussion: Data are insufficient to fully evaluate the usefulness of the "Call the Shots" smartphone application. However, initial results and feedback have been positive, and the application should be launched in Apple's platform to reach a wider test audience. © 2014 National Association of Pediatric Nurse Practitioners.


Fallah R.,University of Yazd | Habibian S.,Pediatrician | Noori-Shadkam M.,University of Yazd
Iranian Journal of Child Neurology | Year: 2016

Objective Reduction of pain of invasive procedures in neonates can prevent pain side effects. The purpose of present study was to evaluate the efficacy and safety of a single low dose of intravenous fentanyl in reducing of lumbar puncture (LP) pain in neonates. Materials & Methods In this randomized clinical trial, registered with code number of 2014022616761N150, admitted neonates to Shahid Sadoughi Hospital, Yazd, Iran from August-April 2012 (45 cases) were randomly assigned into two groups to receive 2 μg/kg of intravenous fentanyl or 0.2 milliliter of normal saline, two min before LP. Primary outcome was success rate in reducing of pain during needle insertion to skin (pain score of less than three). Secondary outcomes were clinical side effects and serious adverse events. Results Forty-five neonates including 23 girls and 22 boys were evaluated. Pain reduction was obtained in 39.1% (9 of 23 neonates) of fentanyl group and in 4.5% (one of 22 neonates) of control group. Means of pulse rate (136.41± 9.16 vs. 148.9± 8.99) and pain score during needle insertion (3.41±1.31 vs. 5.8±1.12) were lower in fentanyl group. No severe adverse effects were seen in both groups. Side effects such as vomiting [9% (N=2) in control and 4.3% (N=1) in fentanyle group] and mild transient decrease in oxygen saturation in 8.7% (N=2) of fentanyle group were seen. Safety in two groups was not statistically different. Conclusion Intravenous fentanyl might be considered as a safe and effective analgesic drug in LP in neonates. © 2016 Iranian Child Neurology Society. All Rights Reserved.


PubMed | Toulouse University Hospital Center, Pediatrician and Limoges University Hospital Center
Type: Journal Article | Journal: Journal of clinical virology : the official publication of the Pan American Society for Clinical Virology | Year: 2014

Cytomegalovirus (CMV) infection is the most important cause of congenital viral infection in developed countries. In utero transmission occurs at higher rates in seronegative women during primary infection, especially those in contact with young children in day-care centers (DCC). Nevertheless data on variability of CMV excretion among children in French DCCs are lacking, and are important for public health planning.Our main objective was to assess the feasibility of a salivary sample in DCCs in order to study CMV excretion among toddlers. Our secondary aims were to assess prevalence of CMV excretion in children attending Hospital Emergency Unit (EU) in comparison with various types of DCCs and to validate the analytical chain for collected specimens.Excretion of CMV in saliva was quantified using a real-time PCR assay in children aged from 3 months to 6 years old in EU and in DCC, with gB, gH and gN genotypes determined in infected children. Salivary sampling was performed using small sponges placed into a DNA conservation medium. Socio cultural and medical information were collected from attending parents.A total of 625 children were included, with 256 from six DCCs and 369 from one EU. In DCCs, the acceptability of the procedure was 87.3% (95%CI 78.5-96.2) amongst parents and children, and in the EU, acceptability was higher at 97.6% (95%CI 95.5-98.9). CMV shedding overall prevalence was 21.7% (95%CI 17.6-26.2), with CMV shedding prevalence in DCCs of 51.9% (95%CI 22.8-81.1).We validated the feasibility and acceptability of measuring CMV shedding in the saliva of French toddlers. The discrepancy between CMV infection rates in day care centers and in the general population (as sampled in the EU) indicates the need for a further study to determine risk factors and shedding levels in the DCC population.


PubMed | Saskatoon Health Region, Population and Public Health Services, Regina QuAppelle Health Region, University of Saskatchewan and 3 more.
Type: Journal Article | Journal: The Canadian journal of infectious diseases & medical microbiology = Journal canadien des maladies infectieuses et de la microbiologie medicale | Year: 2014

The present article reports a case involving an immunocompetent, previously well child who, despite two previous doses of inactivated poliovirus vaccine, developed severe flaccid paralysis consistent with polio after receiving oral polio vaccine.


PubMed | Medical Laboratory Technician, Pediatric Nephrologist, Pediatrician, Clinical Epidemiologist and University of Antioquia
Type: Journal Article | Journal: Colombia medica (Cali, Colombia) | Year: 2014

Urinary tract infection (UTI) is one of the most common bacterial infections in childhood and causes acute and chronic morbidity and long-term hypertension and chronic kidney disease.To describe the demographic characteristics, infectious agents, patterns of antibiotic resistance, etiologic agent and profile of susceptibility and response to empirical treatment of UTI in a pediatric population.This is a descriptive, retrospective study.Included in the study were 144 patients, 1:2.06 male to female ratio. The most common symptom was fever (79.9%) and 31.3% had a history of previous UTI. 72.0% of the patients had positive urine leukocyte count (>5 per field), urine gram was positive in 85.0% of samples and gram negative bacilli accounted for 77.8% for the total pathogens isolated. The most frequent uropathogens isolated were Escherichia coli and Klebsiella pneumoniae. Our E.coli isolates had a susceptibility rate higher than 90% to most of the antibiotics used, but a resistance rate of 42.6% to TMP SMX and 45.5% to ampicillin sulbactam. 6.3% of E. coli was extended-spectrum beta-lactamases producer strains. The most frequent empirical antibiotic used was amikacin, which was used in 66.0% of the patients. 17 of 90 patients who underwent voiding cistouretrography (VCUG) had vesicoureteral reflux.This study revealed that E. coli was the most frequent pathogen of community acquired UTI. We found that E. coli and other uropathogens had a high resistance rate against TMP SMX and ampicillin sulbactam. In order to ensure a successful empirical treatment, protocols should be based on local epidemiology and susceptibility rates.


PubMed | University of Yazd and Pediatrician
Type: Journal Article | Journal: Iranian journal of child neurology | Year: 2016

Reduction of pain of invasive procedures in neonates can prevent pain side effects. The purpose of present study was to evaluate the efficacy and safety of a single low dose of intravenous fentanyl in reducing of lumbar puncture (LP) pain in neonates.In this randomized clinical trial, registered with code number of 2014022616761N150, admitted neonates to Shahid Sadoughi Hospital, Yazd, Iran from August-April 2012 (45 cases) were randomly assigned into two groups to receive 2 g/kg of intravenous fentanyl or 0.2 milliliter of normal saline, two min before LP. Primary outcome was success rate in reducing of pain during needle insertion to skin (pain score of less than three). Secondary outcomes were clinical side effects and serious adverse events.Forty-five neonates including 23 girls and 22 boys were evaluated. Pain reduction was obtained in 39.1% (9 of 23 neonates) of fentanyl group and in 4.5% (one of 22 neonates) of control group. Means of pulse rate (136.41 9.16 vs. 148.9 8.99) and pain score during needle insertion (3.411.31 vs. 5.81.12) were lower in fentanyl group. No severe adverse effects were seen in both groups. Side effects such as vomiting [9% (N=2) in control and 4.3% (N=1) in fentanyle group] and mild transient decrease in oxygen saturation in 8.7% (N=2) of fentanyle group were seen. Safety in two groups was not statistically different.Intravenous fentanyl might be considered as a safe and effective analgesic drug in LP in neonates.


Primary tooth eruption in infants is associated with a range of local and systemic symptoms although this remains a subject of much debate. In addition, data is limited for the role of physicians in managing infant teething, and for the benefit of homeopathic treatments.We conducted an observational, multicenter, prospective survey evaluating teething symptoms, and symptom course following routine medical management by French pediatricians in 597 infants aged from 3 to 24 months. We also examined response to treatment with routinely prescribed teething medications; the homeopathic agent, Camilia and topically applied gingival agents (Delabarre or Dolodent).Most infants (96.6%) had buccogingival symptoms and 93.3% had at least one general symptom. Fever (38C) was reported in 15.2% of infants. For teething, 212 infants were prescribed Camilia, 172 a gingival solution (Delabarre or Dolodent) and 213 received Camilia along with a gingival agent. Infants prescribed both a homeopathic and a gingival treatment had a significantly higher number of symptoms at presentation compared with those prescribed a single agent. There were no significant differences in symptom course across these three treatment groups. Systemic analgesics/antipyretics were prescribed in 68.8% of cases. Parent satisfaction with medical management and prescribed treatments was high.Teething is frequently associated with transient local and systemic upset in infants and is a significant concern to parents. Camilia provides a similar benefit to topical therapy, and is frequently used by pediatricians in France.

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