Search PubMed⌕ Search

Biomedical subjects

B Quinet

Publications and source records attributed to B Quinet.

At least 19 recordsLinked to original sources
PubMed2006

[Influenza vaccination coverage rate in children with underlying chronic disorders in 7 French pediatric wards].

UNLABELLED: In France, annual influenza vaccination is recommended and free of charge for children with chronic disease (chronic lung, heart or kidney disease, diabetes, haemoglobinopathy, immune deficiency). The national goal is to reach 75% influenza vaccination coverage by 2008, but data on coverage in high risk children are limited. OBJECTIVES: To estimate the influenza vaccination coverage in children with an underlying chronic health condition in the Paris region, during in- or out-patient visit at hospital. METHODS: A multicentre cross-sectional descriptive study was carried out over 2 months before the 2004-2005 flu vaccination campaign in 7 French paediatric hospitals (Paris region). Inclusion criteria for this survey were: children aged 6 months to 18 years, with an underlying chronic disease requiring annual influenza vaccination, with a vaccination card available, so as to check their vaccination status. Reasons for non vaccination were recorded. RESULTS: Data from 239 children were analysed. 56% of patients were males (mean age: 8.1 years). Two patients had 2 separate underlying chronic disorders; 69% had a haemoglobinopathy, 16.3% had a chronic respiratory disease, and 7.5% had diabetes. The influenza vaccination rate for 2003-2004 was 43.7% (haemoglobinopathy: 55.5%; chronic respiratory diseases: 12.8%). This rate increased from 20.4% to 43.7% between 1999 and 2003. Less than 16% of parents remembered having received a voucher for free vaccination from the National Health Insurance Agency. CONCLUSION: Efforts are still needed to achieve the 2008 objectives of 75% coverage.

Adolescent↗
PubMed2006

[Causes of hospitalization of patients with ongoing varicella in a French children hospital: evolution between 1990 and 2001].

AIMS OF STUDY: To describe the characteristics of paediatric varicella in patients admitted through the emergency department (ED) of the Armand-Trousseau Children hospital in Paris and the evolution of the causes of admission during the study period. STUDY DESIGN: Retrospective longitudinal cohort study from March 1990 to February 2001. RESULTS: One hundred and eight children were hospitalized for varicella during these 11 years. Sixty per cent were under 2 years of age and all but one were immunocompetent. The first cause of admission was the presence of at least 1 complication (83,3%) classified as: cutaneous (34%), digestive (19,8,%), respiratory (17,6%), neurological (15,3%) and ENT complications (8,8%). Over 11 years, the rate of overall complications remained stable but there was an important increase in varicella cases admitted through the ED mainly due to increase in cutaneous superinfections. CONCLUSION: These data confirm the potential severity of varicella and underline the emerging problem of increasing cutaneous complications. Additional studies are necessary to address this phenomenon and to determine optimal prophylactic measures.

Chickenpox↗
PubMed2006

[Management of acute pyelonephritis in patients older than 3 months: survey conducted in 39 paediatric emergency departments of the Ile de France Region in 2004].

OBJECTIVES: To describe the different modalities of ambulatory management of acute pyelonephritis in patients older than 3 months of age in paediatric emergency units of the Ile de France region in 2004. METHODS: Between October 2003 and April 2004, referents of 39 paediatric emergency units of the Ile de France region were questioned through a written questionnaire concerning the management of acute pyelonephritis: in or outpatient modalities, antibiotic regimen (molecule and route of administration), investigations and follow-up. RESULTS: Thirty-one questionnaires (79.5%) were returned and analysed. A written protocol was available in 60% of the units. Outpatient management was performed in 24/31 centres. Young age, poor clinical tolerance, urological abnormalities and social difficulties were the major contra-indications for such management. Ultrasonic echography at diagnosis (within 24 h) was performed in 50% of the units. Antibiotics were started using IV route in 18/24 units (75%) and ceftriaxone and aminoside were respectively prescribed in 100% and 29.4% of the units for a duration of 1 to 5 days before switching to the oral route. Antibiotherapy was started orally in 6 units and cefixime was chosen by 5 of them. Follow-up consultations were scheduled in 100% of the units but with various delay after initiation of the treatment. The total duration of treatment was mostly 10 days and oral prophylactic antibiotherapy was prescribed by 10/24 centres after completion of the treatment. Cystoureterography was systematically realized by 83.3% of the units. CONCLUSIONS: Despite important differences in the management of acute pyelonephritis in Ile-de-France, a majority of the units follows similar therapeutic modalities. In the absence of consensus, new recommendations are necessary concerning the management of pyelonephritis in infants and children in France.

Acute Disease↗
PubMed2005

[Epidemiology and surveillance of legionella infections].

Since 1987, in France, Legionella infection is a notifiable disease. Notification should be transmitted by the clinician to the referent public health physician in the Direction départementale des Affaires sanitaires et sociales. Criteria for certain and probable cases have been defined. From this level, nationwide information is centralised in the institut de veille sanitaire. The public health physician is responsible for the inquiry in the health care facility or community setting and for action taking as appropriate. After isolation, Legionella strains are further studied in the Centre national de référence in Lyon. This center is also responsible for typing of environmental strains. In 2002, the incidence of notified legionellosis was 1,7 per 100,000 inhabitants and the mortality rate of 13%. Median age was 61 years and the sex-ratio M/F of 2.9. Only 39 cases were nosocomial. Very few cases have been observed in children, almost all in immunocompromised patients. Legionellosis is of exceptional occurrence in neonates, but the lethality is high. Treatment guidelines have been published in France only for adult patients.

Disease Notification↗
PubMed2004

[Symptomatic rickets in adolescents].

Although systematic vitamin D supplementation in adolescents remains debated, rickets is nevertheless a well recognized pathology in this age group. Adolescence is an at-risk period because of rapid growth, insufficient calcium intake and/or vitamin D status. Surveys have shown that calcium intake is insufficient (< 1000 mg a day) in 45% of boys and 71% of girls and that vitamin D status is deficient (25-OH-D < 10 ng/ml). The aims of the study carried out by the Calcium Group of the Société Française de Pédiatrie, were to evaluate the frequency of rickets, and to define the criteria for the adolescent population at risk. Forty-one adolescents with rickets were hospitalized between 1985 and 2000. Most of the cases were from the Northern France: 20 from Paris and suburbs, eight from the North-West, four from the North, four from the North-East; five were from the Center of France. The mean age was 13 years and two months for the 28 girls, and 14 years and four months for the 13 boys. Eighty per cent of the adolescents were from immigrant families (33/41): 15 were from sub-Saharan Africa, ten from North Africa, six from Pakistan and two from Turkey. Two thirds of the adolescents were hospitalized in the 2nd quarter of the year. Some adolescents suffered from lower limb pain, 16 had deformations of lower limbs, particularly genu valgum, associated with pain; seven others had either muscle spasms (4), tetany (3). Serum calcium level was low (average 1.84 mmol/l: [1.1-2.5]), and serum 25-OH D level was extremely low. Radiographic characteristics observed were metaphyseal strips on the knees, with condensed edges at times, with the presence of bone demineralization. The treatment combined calcium and vitamin D, and was often administered intravenously when a hypocalcemia was detected. Rickets is not frequent in adolescents, but nonetheless this pathology is not exceptional, and the number of cases is probably under-estimated. Rickets affects immigrant adolescents in particular but nevertheless could also present a certain risk period for the general population.

Adolescent↗
PubMed2003

[Treatment of uncomplicated Plasmodium falciparum malaria in children: comparison of halofantrine with mefloquine].

AIMS: Halofantrine is the first regimen used for the treatment of uncomplicated Plasmodium falciparum malaria in children in France according to the recommendations of the French Consensus Conference held in 1999 and pending additional data in this population. In 1999, a high rate of clinical relapse after a single cure of halofantrine led us to switch to mefloquine for first line treatment of uncomplicated malaria. The aims of this study were to evaluate this change of attitude and to compare the efficacy of halofantrine and mefloquine in the treatment of uncomplicated P. falciparum malaria in children. PATIENTS AND METHODS: We retrospectively analysed 118 pediatric cases of malaria treated at Armand-Trousseau Children hospital in Paris between January 1st, 1999 and December 31st, 2000. RESULTS: 93 patients were treated for an uncomplicated case of P. falciparum malaria: 48 received a unique cure of halofantrine and 21 were treated with mefloquine. Nine patients relapsed, all having previously received halofantrine. No patient treated with mefloquine relapsed. CONCLUSION: These results and other recent published data suggest to recommend mefloquine instead of halofantrine as first line treatment of uncomplicated P. falciparum malaria in children with respect to specific contra-indications. A larger evaluation of mefloquine is however necessary. The association atovaquone-proguanil (Malarone) is promising but needs to be evaluated in large pediatric studies in comparison with other treatments. Its indication as a curative treatment of uncomplicated malaria is, to date, restricted to adults and children over 12 years in France.

Antimalarials↗
PubMed2002

[Imported malaria in children in 1999. Study of the Armand-Trousseau Hospital in Paris].

METHODS: Eighty children were treated at the hospital Armand-Trousseau (Paris, France) for a malaria attack from 1999-01-01 to 2000-02-01. RESULTS: The parasites were: Plasmodium falciparum: 87.5%, Plasmodium malariae: 12.6%, Plasmodium ovale: 10%, Plasmodium vivax: 6.3%. Mean age was 8.1 years (range: three months to 15 y). The origin of patients was: West Africa for 60 children, Central Africa for ten children and Comores for seven. Sixty-six patients suffered from common malaria attack and seven children were admitted with a presentation of severe malaria. The severe attacks were cerebral malaria for six cases, associated with severe anemia in five cases; the 7th child had a respiratory distress (ARDS) and died. The other six cases were cured without sequelae. Relapses were observed for eight patients: one after a severe cerebral malaria, six after a common P. falciparum attack, one after a P. ovale attack. Parasitemia was higher than in preceding years (mean 2.9%) and more than 5% in 11 cases, but without clear link with severity. Treatment by halofantrine with a single cure was followed by five relapses. None of those children received an effective prophylaxis during and after travel (55/80 without any prophylaxis). CONCLUSION: These data emphasize the importance of a good appraisal of criteria of severe malaria and lead to advice hospitalization of children with malaria in temperate zone.

Adolescent↗
PubMed2001

[Cholelithiasis in children with sickle cell disease: experience of a French pediatric hospital].

BACKGROUND: Gallstones are frequently encountered in sickle cell disease. Their complications are difficult to distinguish from vaso-occlusive abdominal pain and they can sometimes threaten the patient's life. The aim of this study was to describe our local experience with cholelithiasis in children with sickle cell disease. PATIENTS AND METHODS: We analyzed the follow-up records and abdominal sonography results of 185 children with sickle cell anemia, aged zero to 18 years, followed up in Trousseau Children's Hospital (Paris) from 1982 to 1998. RESULTS: Cholelithiasis was detected in 26 patients. The youngest patient was five years old. Cholelithiasis was discovered because of clinical manifestations in 12 patients. Asymptomatic cholelithiasis patients developed clinical manifestations in 28% cases in a maximum delay of two and a half years after its diagnosis. Laparoscopic cholecystectomy was performed in nine cases and open cholecystectomy in 17 cases. The mean postoperative length of stay was significantly shorter in the group of patients with laparoscopy in comparison with the group with open cholecystectomy. Histologic analysis of the gallbladders noted 85% of acute or chronic cholecystis. CONCLUSION: We suggest that cholelithiasis should be carefully sought in the presence of abdominal manifestations in sickle cell patients. We recommend that annual abdominal sonography be performed in sickle cell patients as early as seven years of age and elective cholecystectomy be performed on patients with cholelithiasis.

Abdominal Pain↗
PubMed2000

Acute clinical events in 299 homozygous sickle cell patients living in France. French Study Group on Sickle Cell Disease.

A subset of 299 patients with homozygous sickle cell anaemia, enrolled in the cohort of the French Study Group on sickle cell disease (SCD), was investigated in this study. The majority of patients were children (mean age 10.1 +/- 5.8 yr) of first generation immigrants from Western and Central Africa, the others originated from the French West Indies (20.2%). We report the frequency of the main clinical events (mean follow-up 4.2 +/- 2.2 yr). The prevalence of meningitis-septicaemia and osteomyelitis was, respectively, 11.4% and 12% acute chest syndrome was observed in 134 patients (44.8%). Twenty patients (6.7%) developed stroke with peak prevalence at 10-15 yr of age. One hundred and seventy-two patients (58%) suffered from one or more painful sickle cell crises, while the others (42.5%) never suffered from pain. The overall frequency of acute anaemic episodes was 50.5%, (acute aplastic anaemia 46%; acute splenic sequestration 26%). A group of 27 patients were asymptomatic (follow-up > 3 yr). Epistatic mechanisms influencing SCD were studied. Coinherited alpha-thalassemia strongly reduced the risk of stroke (p <0.001) and increased that of painful crises (p < 0.02). There was a low prevalence of Senegal and Bantu (CAR) betas-chromosomes in patients with meningitis (p <0.04) and osteomyelitis (p < 0.03). Prevalence of Senegal betas-chromosomes was lower in the asymptomatic group of 27 patients (p < 0.02). The patients come from a population of unmixed immigrants in whom the beta-globin gene haplotype strongly reflects the geographic origin and identifies subgroups with a homogenous genetic background. Thus the observed effects might result more from differences in as yet unidentified determinants in the genetic background than from the direct linkage with differences in the beta-globin gene locus.

Acute Disease↗
PubMed1999

[Estimation of vaccination rates in children of 10 months, 2 years and 4 years of age who underwent a health checkup at the Well Child Clinic in Paris during the year 1997].

UNLABELLED: In France, the vaccination program has changed through the last years. We report a study on immunization rates of children who underwent a complete health checkup at a Well Child Clinic in Paris. We studied three groups of children (children at the ages of 10 months, 2 years and 4 years) regarding types of daycare and medical care. PATIENTS AND METHODS: Nine hundred children who underwent a health checkup between April and June 1997 were included in the study. Data were collected from immunization records and parents' interviews. RESULTS: In 10-month-old children, prevalence rates of immunization against diphtheria, tetanus, poliomyelitis and pertussis (DTPP) and immunization against Haemophilus influenzae type b (Hib) disease were 98% and 96%, respectively. Only 1.7% were immunized against measles. Forty-two percent of children had complete or ongoing immunization against hepatitis B. The vaccination coverage for BCG was 94%. In two-year-old children, boostering for DTPP vaccine had been performed by 90%, more than 90% were immunized against measles and 50% had received at least one shot to prevent hepatitis B. At the age of 4 years, 99% were immunized against DTPP, 78% were immunized against Hib disease, 98% against measles and 48% for hepatitis B. All children were immunized with BCG, and 98% were BCG-controlled (22% had tuberculin intradermal reaction). The highest immunization rates were observed in children who had preventive care in 'Maternal and Infantile Protection Centres.' Immunization rates were not influenced by the type of daycare, except for measles in two-year-old children managed by private pediatricians. CONCLUSION: We observed high immunization rates of children who underwent health checkups. Late immunization against measles and low immunization rates against hepatitis B reflect the difficulties encountered in mobilising physicians and families for these vaccinations.

Age Factors↗