Publications by authors named "Arthur Gavotto"

Management of patent ductus arteriosus (PDA) in preterm newborns has been debated extensively for more than six decades. Some authors affirm that PDA is only an innocent mirror of infant immaturity, without specific health consequences. They also underline the futility, even danger, of treating it.

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Background: Traditional approaches to management of neonates prenatally exposed to opioids are based on the use of pharmacotherapy (PT), adjusted to evolution of infant symptoms. Newer approaches focused on non-pharmacological care (NPC) are emerging, but there is little evidence on the active policies to implement to ensure their widespread practice. The primary objective of the study was to assess whether the implementation of a developmental care program in our neonatal medicine department had an impact on the management of these infants during hospitalization, notably exposure to NPC.

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Article Synopsis
  • A study on the TRANSITION-CHD program aimed to support adolescents and young adults with congenital heart disease (CHD) in transitioning to adult healthcare, focusing on improving their health-related quality of life (HRQoL).
  • The trial involved 200 participants aged 13-25, comparing those in the transition program with a standard care group, evaluating changes in HRQoL, disease knowledge, and mental and physical health.
  • Results showed the transition group had significantly better HRQoL, disease knowledge, and psychosocial health compared to the control group, indicating the program's effectiveness and potential for broader implementation in healthcare for young people with CHD.
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Background: Aerobic fitness is a predictor of cardiovascular health which correlates with health-related quality of life in the general population. The aim is to evaluate the aerobic capacity by cardiopulmonary exercise test (CPET) in children with sickle cell disease in comparison with healthy matched controls.

Methods: Controlled cross-sectional study.

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Background And Aims: Cardiopulmonary fitness in congenital heart disease (CHD) decreases faster than in the general population resulting in impaired health-related quality of life (HRQoL). As the standard of care seems insufficient to encourage and maintain fitness, an early hybrid cardiac rehabilitation programme could improve HRQoL in CHD.

Methods: The QUALIREHAB multicentre, randomized, controlled trial evaluated and implemented a 12-week centre- and home-based hybrid cardiac rehabilitation programme, including multidisciplinary care and physical activity sessions.

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Introduction: High-flow nasal cannula (HFNC) is commonly used as first step respiratory support in infants with moderate-to-severe acute viral bronchiolitis (AVB). This device, however, fails to effectively manage respiratory distress in about a third of patients, and data are limited on determinants of patient response. The respiratory rate-oxygenation (ROX) index is a relevant tool to predict the risk for HFNC failure in adult patients with lower respiratory tract infections.

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Background: The evaluation of health status by cardiopulmonary exercise test (CPET) has shown increasing interest in the paediatric population. Our group recently established reference Z-score values for paediatric cycle ergometer VO, applicable to normal and extreme weights, from a cohort of 1141 healthy children. There are currently no validated reference values for the other CPET parameters in the paediatric population.

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Background: We report the occurrence of a severe pulmonary hypertension (PH) in a neonate affected by a left congenital diaphragmatic hernia (CDH). PH in this patient was associated with an abnormal origin of the right pulmonary artery from the right brachiocephalic artery. This malformation, sometimes named hemitruncus arteriosus, has to the best of our knowledge never been reported in association with a CDH.

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Aims: Overweight and obesity in children with congenital heart disease (CHD) represent an alarming cardiovascular risk. Promotion of physical activity and cardiac rehabilitation in this population requires assessing the level of aerobic fitness (VO2max) by a cardiopulmonary exercise test (CPET). Nevertheless, the interpretation of CPET in overweight/obese children with CHD remains challenging as VO2max is affected by both the cardiac condition and the body mass index (BMI).

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Article Synopsis
  • A study analyzed neonatal deaths in a hospital to see how decisions about life-sustaining treatment (withholding or withdrawing) affected parental anxiety and depression afterward.
  • Out of 179 neonatal deaths, 64% occurred after a decision to withhold or withdraw life support, with parents reporting higher satisfaction in that context compared to those who received maximum care.
  • At 5 months post-death, a significant percentage of parents showed signs of anxiety and depression, but those who made the decision to withhold or withdraw treatment had lower rates of depression.
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A 1-day-old girl was referred for a cardiology consultation for a mean saturation at 80% without respiratory distress. Echocardiography showed an isolated ventricular inversion. This entity is extremely rare, with fewer than 20 cases reported.

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Article Synopsis
  • * Researchers assessed VO2max in a large sample of 909 French children and validated the findings with an additional 232 children from Germany and the US, using advanced mathematical models.
  • * The new logarithmic Z-score model proved to be more accurate than previous methods and is suitable for children of all weights, enhancing the ability to assess aerobic fitness in young patients.
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Purpose: Childhood cancer survivors are at increased risk for cardiovascular disease. Maximal oxygen uptake (VO) is a major determinant of cardiovascular morbidity. The aim of this study was to compare aerobic capacity, measured by cardiopulmonary exercise test (CPET), of adolescents and young adults in remission with that of healthy controls and to identify the predictors of aerobic capacity in this population.

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To identify the risk factors of early occurrence of malnutrition in infants with severe congenital heart disease (CHD) during their first year of life. Retrospective longitudinal multicenter study carried out from January 2014 to December 2020 in two tertiary care CHD centers. Four CHD hemodynamic groups were identified.

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Background: To evaluate the change in aerobic fitness (VO), measured by cardio-pulmonary exercise test (CPET), in children with congenital heart disease (CHD), compared to matched healthy controls, and identify predictors of VO change with time in this specific population.

Method: This longitudinal retrospective multicentre cohort study was carried out from 2010 to 2020. We included CHD paediatric patients from the cohort of a previous cross-sectional study, who had a second CPET at least 1 year after the first one, during their follow-up.

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Objectives: The evidence that risks of morbidity and mortality are higher when very premature newborns are born during the on-call period is inconsistent. This study aimed to assess the impact of this situation among other determinants of outcomes, particularly newborn characteristics and care organization.

Methods: Observational study including all infants born < 30 weeks' gestation in a French tertiary perinatal center between 2007 and 2020.

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Aspergillosis infection is a major complication of acquired immunosuppression, and is associated with poor prognosis in its invasive form. Cardiac dissemination of invasive aspergillosis is a rare and usually fatal consequence of systemic mycosis. We describe a pediatric case of myocardial aspergillosis abscess in a 12-year-old girl diagnosed with multimodality cardiac imaging approach.

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Article Synopsis
  • This case study discusses a rare instance of cardiac and neurological complications in a 27-month-old girl diagnosed with hemolytic uremic syndrome caused by Shiga-like toxin-producing Escherichia coli, presenting symptoms like diarrhea and seizures.
  • The girl experienced severe neurological impairment and developed pericardial effusion, which is a rare complication in this syndrome.
  • An analysis of the effusion revealed the presence of human herpesvirus-6B, indicating a primary infection that complicated her condition, highlighting the need for further investigation in similar cases.
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Aim: Infantile haemangioma (IH) is the most common benign tumour in children. Since 2014, propranolol has become the first-choice therapy and currently Hemangiol is the only approved drug for complicated haemangioma. This post-marketing study reports the use of Hemangiol for IH in paediatric practice.

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Cardiopulmonary exercise test (CPET) is becoming a key examination to assess physical capacity and disease severity in pediatric cardiology. The V̇e/V̇co slope has been increasingly used as a surrogate marker for morbidity and mortality in adult heart failure, pulmonary arterial hypertension, and for adult patients with congenital heart disease (CHD). Nevertheless, the use of the V̇e/V̇co slope in children remains limited in the absence of reference values and clearly identified clinical determinants.

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Article Synopsis
  • The study aimed to evaluate the oxygen uptake efficiency slope (OUES) in children with congenital heart disease (CHD) compared to healthy controls, noting that OUES can be measured without requiring maximal exercise.
  • Findings revealed that the mean OUES was significantly lower in children with CHD (38.6) versus healthy peers (43.9), with the most severe cases showing the greatest deficiency.
  • Factors such as age, Body Mass Index, gender, and prior medical procedures were identified as clinical determinants associated with decreased OUES in the CHD group, suggesting the relevance of OUES in assessing exercise capacity.
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