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Saint-André-lez-Lille, France

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.

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.

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.

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