Archives de pédiatrie : organe officiel de la Sociéte française de pédiatrie
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A ten-month-old boy presented with a severe auto-immune hemolytic anemia. Direct antiglobin test was positive only for IgA class autoantibodies. He recovered with a high dose corticosteroid treatment. ⋯ IgA class autoantibodies should be searched for in the case of a high suspicion of auto-immune hemolytic anemia with negative direct antiglobin test for IgG and complement. Corticosteroid treatment is most often successful.
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A retrospective survey has been conducted in the Pediatric Intensive Care Units (PICUs) affiliated to the Groupe Francophone d'Urgence et de Réanimation Pédiatrique over two years (1999 and 2000). The purpose was to determine the number of children aged from 10 days to 18 years who died from community acquired bacterial infections and to compare the data to those obtained from official surveys (statistics of death from the Institut National de la Santé et de la Recherche Médicale) and from the Institut National de Veille Sanitaire as well as from punctual studies. Thirty two (60%) PICUs have participated and 100 cases of children without known risk factors, dead from community acquired documented bacterial infection have been considered for analysis (36 in 1999, 54 in 2000). ⋯ These data fit with those provided by the Institut National de Veille Sanitaire with respect to meningococcal infections and the Renacoq network with respect to pertussis, as well as the data provided by a previous GPIP survey on pneumococcal meningitis. However, the data provided by INSERM seem not to be relevant. In spite of the bias due to a retrospective study and the lack of exhaustivity, this survey provides data which could help decision making with respect to new vaccines against pneumococcus.
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Despite its many advantages, breastfeeding is poorly developed in France: less than 50% of newborns are breastfed, and only 10% of infants continue to be breastfed at 1 month of age. In order to encourage breastfeeding in the French North department (chief town: Lille), a working group has written a document for promoting breastfeeding. ⋯ The nutritional, health, psychological, economic and social advantages of breastfeeding are presented, together with the fact that breastfeeding has to be considered as part of the human rights for mothers and children. The actions to take place to develop breastfeeding are presented.
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Gastroesophageal reflux (GER) is one of the three most common causes of chronic cough in children, along with postnasal drip syndrome and asthma. There may be no gastrointestinal symptoms up to 50-75% of the time. GER plays a causative role in chronic cough, asthma without allergy and posterior laryngitis. ⋯ The length of the treatment is a minimum of 3 months up to the age of walking. Surgical treatment must be reserved for the failure of medical treatment. The benefits of minimally invasive surgery are evident in children with chronic cough, who have a faster recovery with fewer complication than after open surgery.
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Case Reports
[Paraplegia and medullary arteriovenous malformation. Role of surgery, corticosteroids and embolization].
We report the case of a nine-year-old child with a cervical medullary arteriovenous malformation (AVM), revealed by total paraplegia, whose regression started during steroid therapy, before embolization. ⋯ The frequency of AVM's spontaneous favorable outcome is unknown but should not be underestimated. It might be improved by steroids.