Biomedical subjects
C Vitoux-Brot
Publications and source records attributed to C Vitoux-Brot.
[Analysis of emergency recruitment in a pediatric hospital. Effect on the organization of available care].
BACKGROUND: The increasing demand on the emergency wards of pediatric hospitals raise the question of whether the services delivered are adequate for the explicit and implicit needs of outpatients. POPULATION AND METHODS: The files of all the 334 children consulting at the medical emergency ward of Robert-Debré hospital in Paris between April 19 and April 26, 1989 were analyzed. Socio-demographic data, reasons for visit and final diagnosis were collected. Each outpatient was assigned to one of 3 categories: 1) severe emergency; 2) simple emergency; 3) consultation. Further data on the events leading to the visit were obtained by a second survey covering 213 children seen between May 11 and May 14, 1991 from 8 hrs to 20 hrs. RESULTS: The mean age of the 334 children in the first survey was 3.2 years. Half of the mothers were unemployed. Half of the families was of foreign extraction. 3.4% of the children had no social insurance. Ten percent of the patients were frequent users of the emergency ward. Infectious diseases were the most prevalent reason for visit. Severe emergencies were 28%, simple emergencies 44% and consultations 28%. Among the 213 children of the second survey, half of the families had seen (43%) or attempted to see (7%) a physician outside the hospital before coming to the emergency ward. CONCLUSION: The needs of the children could best be met by performing a true medico-social examination at the medical emergency ward, enhancing access for children and revitalizing a partnership with the community to provide continuous care for those children in need of it.
Effectiveness of the daily record review at the medical emergency room department in a French teaching children's hospital.
We evaluate the effectiveness of the daily record review (DRR) of 4393 ambulatory medical patients seen at the emergency room department of a teaching pediatric hospital in Paris between 8th January and 11 March 1991. For these patients, 137 potential quality problems were found, 117 of them remaining after discussion with the junior. For 80 of the 117 confirmed problems (68.4%), the reviewing senior estimated that sufficient advice had been given to the child's usual caretaker or health care provider and (or) the children returned to seek medical advice when indicated. Experts proved the procedure to be reliable: they detected a problem for 36% of the cases with potential quality problems and for only 2% of a sample of control records considered without potential quality problems after the DRR.
[Acute poisonings in children].
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[Lead poisoning causing isolated behavior disorders in children].
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[Kawasaki syndrome].
Recent studies support the hypothesis that Kawasaki disease is due to a hyperimmune vasculitis, probably of infectious origin. In addition, current data highlight the frequency of atypical (oligosymptomatic) aspects of the disease which may not be recognized, thereby worsening its cardiovascular prognosis. The types of cardiac lesions encountered, notably those of the coronary arteries, have now been well established by sequential echocardiographic studies. Several therapeutic trials have confirmed the effectiveness of gammaglobulins (400 mg/kg.day) and acetylsalicylic acid in preventing the formation of coronary aneurysms. These recent advances in the understanding and treatment of Kawasaki disease may lead to a reappraisal of its diagnostic and prognostic criteria and open the way to multiple lines of research.