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1.
Rev Mal Respir ; 41(2): 139-144, 2024 Feb.
Artigo em Francês | MEDLINE | ID: mdl-38326190

RESUMO

INTRODUCTION: Due to the absence of consensual definition and agreed-upon pediatric treatment, pneumothorax (PNO) in children and adolescents often remains difficult to properly apprehend. STATE OF THE ART: While initial diagnostic suspicion is clinical, confirmation necessitates chest imaging, and lung ultrasound has become increasingly prevalent, often at the expense of chest radiography. The goal of treatment is twofold, on the one hand to a fully re-expand the lungs, and on the other hand to forestall PNO recurrence. Depending on PNO severity and clinical tolerance, it may be advisable to envision conservative management, oxygen supplementation, needle exsufflation, or chest tube drainage. PERSPECTIVES: In order to harmonize clinical practices, guidelines for the precise definition and graduated management of PNO in children and adolescents are highly advisable. CONCLUSIONS: Idiopathic spontaneous PNO frequently occurs in teenage populations, and its likewise frequent recurrence is not satisfactorily predicted by chest CT findings. It is of paramount importance that patients be fully informed of the risk of recurrence.


Assuntos
Pneumotórax , Humanos , Adolescente , Criança , Pneumotórax/diagnóstico , Pneumotórax/etiologia , Pneumotórax/terapia , Drenagem/métodos , Tubos Torácicos , Tomografia Computadorizada por Raios X , Recidiva
2.
Arch Pediatr ; 29(1): 72-74, 2022 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-34848130

RESUMO

From 2015 to 2017, 3197 interpretable Bordetella polymerase chain reaction (PCR) tests were performed for 2760 children presenting to our tertiary university hospital. Requests mainly came from the emergency department (62%) and for children older than 1 year (68%). Only 32 PCR (1%) results were positive, mainly in children younger than 1 year (n = 29/32, 90.6%; p<0.001). When focusing on the PCR indications in 2017, we found the requests were mainly based on nonspecific respiratory symptoms and were clinically unjustified in 383 cases (39%). Pediatricians overused Bordetella PCR in clinical practice. They should reserve their requests for cases of young children with symptoms suggestive of respiratory illness and/or incomplete pertussis immunization.


Assuntos
Bordetella pertussis/genética , Tosse/etiologia , Uso Excessivo dos Serviços de Saúde , Coqueluche/diagnóstico , Anticorpos Antibacterianos/sangue , Bordetella pertussis/imunologia , Bordetella pertussis/isolamento & purificação , Criança , Pré-Escolar , DNA Bacteriano/isolamento & purificação , Feminino , França , Hospitais , Humanos , Lactente , Masculino , Reação em Cadeia da Polimerase
3.
Arch Pediatr ; 27(7S): 7S29-7S34, 2020 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-33357594

RESUMO

Spinal muscular atrophy (SMA) causes a predominantly bilateral proximal muscle weakness and atrophy. The respiratory muscles are also involved with a weakness of the intercostal muscles and a relatively spared diaphragm. This respiratory muscle weakness translates into a cough impairment, resulting in poor clearance of airway secretions and recurrent pulmonary infections, restrictive lung disease due to a poor or insufficient chest wall and lung growth, nocturnal hypoventilation and, finally, respiratory failure. Systematic and regular monitoring of respiratory muscle performance is necessary in children with SMA in order to anticipate respiratory complications, such as acute and chronic respiratory failure, and guide clinical care. This monitoring is based in clinical practice on volitional and noninvasive tests, such as vital capacity, sniff nasal inspiratory pressure, maximal static pressures, peak expiratory flow and peak cough flow because of their simplicity, availability and ease. In young children, those with poor cooperation or severe respiratory muscle weakness, other, mostly invasive, tests may be required to evaluate respiratory muscle performance. A sleep study, or at least overnight monitoring of nocturnal gas exchange is mandatory for detecting nocturnal alveolar hypoventilation. Training for patients and caregivers in cough-assisted techniques is recommended when respiratory muscle strength falls below 50% of predicted or in case of recurrent or severe respiratory infections. Noninvasive ventilation (NIV) should be initiated in case of isolated nocturnal hypoventilation and followed by a pediatric respiratory team with expertise in NIV. Multidisciplinary (neurology and respiratory) pediatric management is crucial for optimal care of children with SMA. © 2020 French Society of Pediatrics. Published by Elsevier Masson SAS. All rights reserved.


Assuntos
Músculos Respiratórios/fisiopatologia , Terapia Respiratória/métodos , Atrofias Musculares Espinais da Infância/terapia , Criança , Humanos , Força Muscular , Atrofias Musculares Espinais da Infância/diagnóstico , Atrofias Musculares Espinais da Infância/fisiopatologia
5.
Arch Pediatr ; 22(6): 613-5, 2015 Jun.
Artigo em Francês | MEDLINE | ID: mdl-25282454

RESUMO

Acute epiglottitis has become an exceptional observation in pediatrics. The introduction of Haemophilus influenzae type B vaccine changed the morbidity, mortality, and microbiology of this disease. We report the case of an 11-month-old infant with acute epiglottitis due to group A ß-hemolytic streptococcus.


Assuntos
Epiglotite/microbiologia , Infecções Estreptocócicas , Streptococcus pyogenes , Doença Aguda , Proteínas Hemolisinas/biossíntese , Humanos , Lactente , Masculino , Streptococcus pyogenes/metabolismo
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