Increase of recurrent central line-associated bloodstream infections in children with home parenteral nutrition in a rehabilitation care facility compared to home.

Background And Aims: Central line-associated bloodstream infections (CLABSIs) are the main complication in children with home parenteral nutrition (HPN) and some patients develop recurrent CLABSIs (REC-CLABSIs), defined as two or more infections within six months. Our aims were to assess the incidence and to characterize the risk factors of REC-CLABSIs in children with HPN.

Methods: We characterized 79 HPN children from 2014 to 2019 and calculated the incidence of CLABSIs.

Pediatric Home Parenteral Nutrition in France: A six years national survey.

Background And Aims: Home Parenteral Nutrition (HPN) is the cornerstone management for children suffering from chronic intestinal failure (CIF). In France, HPN is organized from a network of 7 certified centers located in University Hospitals spread across the national territory. This study aims to review the data involving children on HPN over a 6-years period in France to outline the global and continuous improvement in care.

Weaning children from prolonged enteral nutrition: A position paper.

Enteral nutrition (EN) allows adequate nutritional intake in children for whom oral intake is impossible, insufficient or unsafe. With maturation and health improvements, most children ameliorate oral skills and become able to eat orally, therefore weaning from EN becomes a therapeutic goal. No recommendations currently exist on tube weaning, and practices vary widely between centres.

A prospective case-control pilot study to evaluate bone microarchitecture in children and teenagers on long-term parenteral nutrition using HR-pQCT.

Long-term parenteral nutrition (PN) may induce bone complications. Tridimensional bone imaging techniques such as high-resolution peripheral quantitative computed tomography (HR-pQCT) allow the assessment of both compartmental volumetric densities and microarchitecture. Our aim was to evaluate these parameters in children and teenagers receiving long-term PN.

Combined use of creatinine and cystatin C improves the detection of renal dysfunction in children undergoing home parenteral nutrition.

Background: Renal dysfunction can complicate home parenteral nutrition (HPN). The aims were, in the context of pediatric HPN, to assess renal function using the measured glomerular filtration rate (mGFR), determine the most accurate formula(s) to estimate GFR, and identify possible underlying mechanisms of renal impairment.

Methods: A retrospective study was performed in 2 centers.

Longitudinal Bone Mineralization Assessment in Children Treated With Long-Term Parenteral Nutrition for Severe Intestinal Failure.

Background: Metabolic bone disease is common in children receiving home parenteral nutrition (HPN) for intestinal failure (IF). Long-term evolution of bone mass in pediatric IF is poorly documented. The aims of this study were (1) to determine the prevalence of low bone mass (LBM) in children receiving HPN for IF, (2) to evaluate the evolution of total bone mineral content (TBMC) during HPN with dual-energy x-ray absorptiometry (DXA), and (3) to identify related factors.

Incorrect evaluation of the frequency of malnutrition and of its screening in hospitalized children by health care professionals.

Rationale, Aims And Objectives: Malnutrition screening is essential to detect and to treat patients with stunting or wasting. The aim was to evaluate the subjective perception of frequency and assessment of malnutrition by health care professionals.

Research Methods And Procedures: In a paediatric university hospital, a cross-sectional survey was conducted with a Likert scale approach to health care professionals and compared with objective measurements on a given day of frequency of malnutrition and of its screening.

Dramatic increase of central venous catheter-related infections associated with a high turnover of the nursing team.

Background & Aims: This retrospective study evaluated the impact of new organization during the moving to a new university pediatric hospital on the incidence of central catheter-related blood stream infections (CRBSIs) among children on long-term parenteral nutrition.

Methods: The study ran from April 2007 to March 2014, starting a year prior to reorganisation of the department of pediatric Hepato-Gastroenterology and Nutrition associated to moving the children to a new hospital in April 2008, and continuing for 6 years following the move. During this time, data from all children hospitalized in this department who received parenteral nutrition (PN) for more than 15 days were analysed.

[Pediatric nutrition: Severe deficiency complications by using vegetable beverages, four cases report].

Introduction: The use of vegetable beverages improperly called « vegetable milk » is promoted by food faddism to replace dairy products, even in infant diet whereas it is totally inadequate.

Case Reports: Case 1: a 9 month-old infant fed by a rice beverage for 2 months presented hypoalbuminemia (7 g/L) with kwashiorkor syndrome complicated by severe sepsis. Case 2: a 14 month-old infant fed by a rice beverage for 2 months had iron and vitamin B12 deficiency with deep anemia (Hb 35 g/L) and tissue hypoxia (hyperlactacidemia).

[Cow's milk protein allergy through human milk].

Cow's milk protein allergy (CMPA) is the first allergy that affects infants. In this population, the incidence rate reaches 7.5%.

Growth hormone to improve short bowel syndrome intestinal autonomy: a pediatric randomized open-label clinical trial.

Background: The ability of growth hormone (GH) to promote the weaning-off of parenteral nutrition (PN) in short bowel syndrome (SBS) is unclear. No randomized controlled study is available in children. This study was undertaken to determine if GH could enhance the weaning off of PN in PN-dependent children with SBS.

Prevalence of liver complications in children receiving long-term parenteral nutrition.

Background/objectives: The hepatic prognosis of long-term home total parenteral nutrition (TPN)-dependent children is poorly documented. The objective was to study outcome data in home TPN-dependent children and to describe precisely their liver biopsies in the attempt to analyze risk factors for biochemical and histological hepatic abnormalities.

Subjects/methods: Medical records of 42 children receiving home TPN for more than 2 years between January 1998 and December 2007 in a single approved home total parenteral center were reviewed.

Satisfaction in different life domains in children receiving home parenteral nutrition and their families.

Objective: To assess the quality-of-life (QOL) of children receiving home parenteral nutrition (HPN).

Study Design: A national multicenter study of 72 patients (median age 4 years) presenting with a digestive disease requiring HPN, and 90 siblings, 67 fathers, and 69 mothers of these children. Median duration of HPN was 2 years (3 months-18 years).

[Practical advice for women who want to breast feed].

Breastfeeding is currently a rare practice in France. Pediatricians wanting to help those women who wish to breast feed should be able to provide them with proper information during the perinatal period, and to ensure that breast feeding begins under the best conditions, i.e.

Isolated deficient alpha6beta4 integrin expression in the gut associated with intractable diarrhea.

Background: An infant born with pyloric atresia had development of intractable diarrhea and was found to have total epithelial detachment of gastric and small and large bowel mucosa. She had no skin abnormalities. Parental consanguinity and pyloric atresia in a sibling who died without autopsy suggest an inherited origin for this disorder.

Autoimmune enteropathy in infants. Pathological study of the disease in two familial cases.

In two brothers with autoimmune enteropathy there was total villous atrophy in the small intestine and marked lymphoid cell infiltration in the lamina propria of the entire digestive tract, discovered at autopsy in one of these patients. In addition, the pancreas showed diffuse interstitial infiltration by lymphocytes. The liver was enlarged, with extensive haematopoiesis and cholestasis.

[Hypersensitivity to 5-aminosalicylic acid. Value of desensitization by oral route].

Background: Treatment with sulphasalazine of patients with mild and moderate forms of Crohn's disease may result in side effects in some of them.

Case Report: An 11-year-old girl with Crohn's disease was given 40 mg/kd/day of sulphasalazine after achieving remission with prednisone. She developed urticaria and eosionophilia 8 days later, then extended skin edema during a second course of sulphasalazine requiring methyl prednisolone therapy.

Complications of percutaneous liver biopsy in infants and children.

Unlabelled: In this study, 144 consecutive percutaneous liver biopsies performed with a 1.6 mm Menghini needle, during a 2-year period were reviewed. All the children were aged under 15 years, 57 patients less than 1 year and 87 more than 1 year.

[Percutaneous endoscopic gastrostomy in pediatric practice].

Percutaneous endoscopic gastrostomy (PEG) has become a good alternative to nasogastric tube feeding and surgical gastrostomy. The procedure requires two practitioners, one of them being an endoscopist. The technique can be performed either under local or general anesthesia, at bedside or in an operating room or endoscopic room, using a one step button or first setting of a catheter and secondly a button, by pull technique in which the button is pulled through esophagus or push technique were the button is pushed through the parietal wall.

Familial autoimmune enteropathy with circulating anti-bullous pemphigoid antibodies and chronic autoimmune hepatitis.

In a family of four children (two boys and two girls), the two brothers had severe, protracted watery diarrhea beginning at 2 and 3 weeks of life, respectively. Duodenal mucosa in both patients showed total villous atrophy and severe inflammatory infiltration of the entire bowel. The first patient also had lymphoid cell infiltration of the pancreas and died at 6 weeks of age.

[Home parenteral nutrition in children: practical modalities].

Today, the duration of parenteral nutrition (PN) is unlimited. PN is used in digestive tract chronic disease (the digestive tract is either unusable or is at rest) or in oncology, hematology and renutrition before transplantation. Thanks to technical advances, PN, although sophisticated, may be applied at home if an active involvement of one parent is obtained.

[Quality of life of children with home parenteral nutrition and of their parents].

Thanks to the technical progresses during the last decade and to the active participation of parents, parenteral nutrition may be undertaken at home in patients with chronic digestive or extra-digestive diseases with serious undernutrition. This technique being highly sophisticated and demanding, we have undertaken a study of the quality of life of 44 children submitted to home parenteral nutrition and followed by the four registered French centres of pediatric nutrition. This study shows that home parenteral nutrition improves the quality of life of both children and parents as compared with the preceding period in the hospital.

[Benign recurrent cholestasis. Apropos of a case with normal serum gamma-glutamyl transpeptidase level].

We report a case of intrahepatic cholestatis with normal serum levels of gamma GT who was similar to the benign recurrent cholestasis (BRC). The diagnosis of cholestasis in infants may be difficult and the distinction between BRC and Byler's disease should be made as early as possible.