Saint-André-lez-Lille, France
Saint-André-lez-Lille, France

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Aubertin G.,Service de pneumologie pediatrique
Revue de Pneumologie Clinique | Year: 2013

Obstructive sleep apnea (OSA) is highly prevalent in school-aged children. Tonsillar and/or adenoids hypertrophy is the most common etiology of OSA in children. OSA has been associated with sleep quality disturbance (frequent arousals) and nocturnal gas-exchange abnormalities (hypoxemia and sometimes hypercapnia), complicated with a large array of negative health outcomes. The clinical symptoms are not able to distinguish primary snoring from OSA. Polysomnography remains the gold standard for the diagnosis of sleep disordered breathing, but the demand is increasing for this highly technical sleep test. So, some other simpler diagnostic methods are available, as respiratory polygraphy, but need to be validated in children. Treatment of OSA in children must be based on a mutlidisciplinary approach with pediatricians, ENT surgeons and orthodontists. © 2013 Elsevier Masson SAS.


Catherinot E.,Laboratoire Of Microbiologie | Catherinot E.,University of Versailles | Roux A.-L.,Laboratoire Of Microbiologie | Roux A.-L.,University of Versailles | And 14 more authors.
European Respiratory Journal | Year: 2013

Cystic fibrosis (CF) patients are at particularly high risk of developing lung disease caused by Mycobacterium abscessus complex (MABSC). Over the last 10 years, changes in CF treatment, with increasing use of inhaled therapies and low-dose azithromycin, have been accompanied by an increase in the prevalence of MABSC infections in CF patients. There is therefore some concern about the role of new CF treatments in the emergence of MABSC infections. We addressed this issue by means of a case-control study including 30 MABSC-positive cases and 60 nontuberculous mycobacteria-negative CF controls matched for age, sex and centre. We also compared practices at the CF centres with the highest prevalence of MABSC with those at the other centres. No positive association was found between MABSC lung disease and the use of inhaled therapies or low-dose azithromycin in the 4 years preceding MABSC isolation. These treatments were not significantly more frequently used at the CF centres with the highest MABSC prevalence rates. In conclusion, there is no evidence for a link between M. abscessus complex lung disease and inhaled therapies or low-dose azithromycin in patients with CF. Copyright©ERS 2013.


PubMed | Institute Of Pathologie, Makassed General Hospital and Service de Pneumologie Pediatrique
Type: | Journal: Case reports in pediatrics | Year: 2016

Lung tumors are extremely rare in the pediatric population, comprising only 0.2% of all malignancies in children. Among them, mucoepidermoid carcinoma (MEC) is even rarer with a reported frequency of 0.1% to 0.2%. MEC is defined by the World Health Organization as a tumor characterized by a combination of mucus-secreting, squamous, and intermediate cell types. We describe the case of a 4-year-old girl who presented with a history of intermittent fever and nonproductive cough of 1-month duration after foreign body aspiration. The chest X-ray showed complete collapse of the left lung. After removal of the foreign body, the lung expanded well after. However, the control chest X-ray done after 5 days showed again complete collapse of the left lung. The biopsy specimen taken during bronchoscopy confirmed the diagnosis of low-grade MEC. Fluorescence in situ hybridization (FISH) confirmed the presence of MAML2 rearrangement. Complete surgical resection with preservation of lung parenchyma was performed. No adjuvant therapy was needed. Repeat bronchoscopy was performed 2 months after surgery and showed no recurrence of the tumor. In conclusion, a remote chest X-ray after removal of a foreign body is necessary to avoid missing a rare serious underlying disease such as MEC. According to the size and the location of the tumor, complete surgical removal is sufficient without additional treatment in case of low-grade tumor. The presence of MAML2 rearrangement confers a favorable outcome and may have long-term implications for the clinical management.


Fayon M.,Service de pneumologie pediatrique | Donato L.,Hopitaux Universitaires Of Strasbourg
Archives de Pediatrie | Year: 2010

Tracheomalacia (TM) or bronchomalacia (BM) refers to softness or weakness of the trachea or the bronchi. Its management is not evidenced-based. Conservative therapy is preferred in milder cases, since the outcome is usually favourable within the first 2 years of life. The clinical utility of non-specific treatments (anti-inflammatory agents, bronchodilators, antibiotics, physiotherapy) has not been proven by clinical trials. Treatment of symptomatic cases should be discussed on an individual basis. Airway surgery should be avoided, and non-invasive ventilation may be proposed as a temporary measure. In case of very severe cases, aortopexy, trachostomy or stent placement are the preferred treatments. Regular respiratory monitoring until remission is mandatory. © 2009 Elsevier Masson SAS. All rights reserved.


Leboulanger N.,Service dOrl et de Chirurgie Cervico faciale | Fauroux B.,Service de Pneumologie Pediatrique | Fauroux B.,French Institute of Health and Medical Research
European Annals of Otorhinolaryngology, Head and Neck Diseases | Year: 2013

Introduction: Obstructive diseases of the upper airways are common in children and sometimes difficult to manage. Non-invasive positive-pressure ventilation (NPPV) consists of delivering continuous positive pressure during all or part of the respiratory cycle via a non-invasive interface (face mask or nasal mask, or nasal prongs). NPPV is the treatment of choice for severe obstructive sleep apnoea in children and should be considered prior to tracheotomy and is also indicated in the case of persistent sleep-disordered breathing following surgical treatment, a frequent situation in children with a malformation of the head and neck or upper airways. Discussion: A simple ventilator, able to deliver continuous positive airway pressure, is sufficient is most cases in otolaryngology. The interface represents the major technical limitation of NPPV, especially in infants for whom no appropriate commercial interface is available. A sleep study before and after initiation of NPPV, followed by regular follow-up examinations, is essential to confirm correction of gas exchanges and sleep quality in response to NPPV. Conclusion: Finally, NPPV must be performed in a specialized paediatric centre with specific expertise in this field. © 2012 Elsevier Masson SAS. All rights reserved.


PubMed | Service des urgences pediatriques, University of Paris Descartes, Paris-Sorbonne University and Service de pneumologie pediatrique
Type: Journal Article | Journal: Archives de pediatrie : organe officiel de la Societe francaise de pediatrie | Year: 2016

Medical schools aim to prepare medical students for their residency responsibilities. However, in France, there is no assessment of medical students skills when they start their residency.The objective of this study was to assess the quality of basic life support delivered by first-year residents in pediatrics during a simulated pediatric cardiopulmonary arrest.First-year residents in pediatrics were assessed during a simulated pediatric cardiopulmonary arrest. Their performance score (based on adherence to international guidelines) and no-flow and no-blow fractions were recorded.Forty-two first-year residents were evaluated. Their median performance score was 4out of 13. No-blow and no-flow fractions were 55and 81%, respectively. There was no correlation between their skills and their knowledge assessed during the national ranking exam at the end of the 6th year of medical school.At the beginning of their residency, pediatric residents are not able to properly provide basic life support. The introduction of simulation in French medical schools may be an effective way to improve their skills.


Children suffering from chronic diseases are very quickly diagnosed by neonatal screening and follow-up of the mother during the pregnancy. Early screening and diagnosis are essential to obtain continuous improvement of the prognosis in term of treatment and psychosocial outcome. Multidisciplinary teams are now well organized to treat all the complications of the disease. Registers at national and international levels allow professionals to compare themselves and to evaluate the improvement of clinical status and mid-life expectancy.


Delacourt C.,Service de pneumologie pediatrique
Revue Francaise d'Allergologie | Year: 2010

Asthma remission is rarely observed in allergic adolescents. Indeed, allergy, along with bronchial hyperresponsiveness, is the principal risk factor for persistence of asthma from childhood to adulthood. Even when clinical remission is observed in allergic adolescents, the disappearance of symptoms is most often transitory, frequently being followed by the reappearance of symptoms in adulthood. This clinical pattern is commonly associated with more marked abnormal lung function, its origin probably being very early in childhood asthma. © 2010.


Delacourt C.,Service de Pneumologie Pediatrique
Revue des Maladies Respiratoires | Year: 2011

Primary infection with Mycobacterium tuberculosis usually occurs during childhood. The source of infection is most often an adult. The risk of infection in exposed children is modulated by various factors related to the infectiousness of the index case, exposure conditions, and the child himself. This review aims to describe the specific diagnostic and therapeutic features of latent TB infection and TB disease in childhood. © 2011 SPLF. Published by Elsevier Masson SAS. All rights reserved.


Fayon M.,Service de Pneumologie Pediatrique
Revue des Maladies Respiratoires Actualites | Year: 2010

The harmful effects of maternal smoking on fetal development are well known. The purpose of this session is to detail the mechanisms of the transfer of tobacco and its derivatives through the placenta and to describe the consequences on fetal pulmonary maturation. Smoking cessation in this population along with its significance and its difficulties are discussed. © 2010 Société de Pneumologie de Langue Française (SPLF).

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