644 results match your criteria: "Necker Enfants-Malades University Hospital[Affiliation]"

Article Synopsis
  • Campylobacteriosis is the leading bacterial cause of diarrhea in kidney transplant recipients (KTRs), but risk factors for this infection remain unclear.
  • A 10-year study in France identified 326 KTRs with campylobacteriosis, revealing an incidence rate of 2.3 cases per 1,000 patient-years, primarily occurring around 2.4 years after transplantation.
  • The main risk factors for developing campylobacteriosis include the use of corticosteroids, acute rejection episodes, low lymphocyte counts, and low estimated glomerular filtration rate (eGFR); treatment should prioritize azithromycin due to high resistance to fluoroquinolones.
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Article Synopsis
  • Advanced systemic mastocytosis (AdvSM) is a complex condition linked to poor outcomes, and while midostaurin is the first approved treatment, its long-lasting effectiveness is limited.
  • Various prognostic scoring systems like MARS, IPSM, and GPSM have been developed to assess patients' outcomes, but it's essential to tailor these scores to specific AdvSM subtypes for better accuracy.
  • A study of patients treated with midostaurin revealed that MARS and AdvSM subtype significantly predict overall survival, identifying five distinct patient subgroups with varying median survival times, highlighting the need for personalized management strategies.
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Inborn errors of immunity and invasive fungal infections: presentation and management.

Curr Opin Infect Dis

December 2024

Université Paris Cité, Department of Infectious Diseases and Tropical Medicine, Necker - Enfants Malades University Hospital, Assistance Publique - Hôpitaux de Paris (AP-HP), IHU Imagine, Paris, France.

Article Synopsis
  • This review focuses on how inborn errors of immunity affect the clinical presentation and management of invasive fungal infections.
  • It highlights that patients with chronic granulomatous disease and STAT3 deficiency are particularly vulnerable to aspergillosis and should receive mold-active antifungal prophylaxis.
  • Overall, managing invasive fungal infections in patients with inborn errors of immunity is complex and often requires long-term antifungal treatments and potential consideration for hematopoietic stem cell transplantation.
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Phenylketonuria is a rare inherited disorder that disrupts the metabolism of phenylalanine (Phe) to tyrosine by phenylalanine hydroxylase (PAH). Sapropterin dihydrochloride (Kuvan®) is approved for use in Europe to reduce blood Phe levels and improve Phe tolerance in sapropterin-responsive individuals. KAMPER (NCT01016392) is an observational, multinational registry assessing long-term safety and efficacy of sapropterin.

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Intranasal Fentanyl Versus Morphine in Fracture Reduction in a Pediatric Trauma Center.

J Am Acad Orthop Surg

December 2024

From the Emergency Department, Paris Saint-Joseph Hospital Group (Bisso), the Paediatric Emergency Department, AP-HP, Robert Debre Hospital University, Paris University (Tielli), and the Paediatric Emergency Department, AP-HP, Necker-Enfants-Malades University Hospital, Paris University, Paris, France (Lopes).

Purpose: Pain management in orthopaedic manipulation in the emergency department (ED) is crucial to decrease fracture reduction performed in the operating room. This study compared intranasal fentanyl (INF) with oral morphine in time of care and effectiveness on pain during the reduction of bone fractures in a pediatric trauma center.

Methods: A before-and-after INF implementation study was conducted in a pediatric ED with a trauma center on children with a confirmed displaced closed fracture on radiographs with reduction and casting performed in the ED.

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Article Synopsis
  • * A patient with neonatal thrombocytopenia and combined immunodeficiency was found to have a new mutation (G12E) in RAP1B, which enhanced its activity and affected immune responses.
  • * The study suggests that RAP1B gain-of-function mutations lead to immunodeficiency and thrombocytopenia, with varying severity, and that stem cell transplantation can effectively treat these conditions.
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Article Synopsis
  • Mucormycosis, a severe fungal infection highlighted by the WHO, was studied in France from 2012 to 2022, revealing significant trends in epidemiology and mortality factors.
  • Out of 550 cases, key underlying conditions included hematological malignancies (65.1%), with pulmonary infections most common (52.4%) and substantial seasonal variations suggesting more cases in autumn.
  • The study linked the rise in PCR diagnostic methods to improved patient outcomes, highlighting that age, ICU diagnosis, and hematological malignancies increased mortality, while diagnosis after 2015 and surgical interventions decreased it.
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Latent disentanglement in mesh variational autoencoders improves the diagnosis of craniofacial syndromes and aids surgical planning.

Comput Methods Programs Biomed

November 2024

Wellcome/EPSRC Centre for Interventional and Surgical Sciences, University College London, London, UK; Centre For Medical Image Computing, University College London, London, UK.

Article Synopsis
  • * The researchers utilized a dataset of 3D head shapes, enhanced using a new data augmentation method, to train the SD-VAE model, which allows for detailed analysis of both overall head shapes and specific anatomical regions.
  • * The findings enable syndrome classification and help to predict outcomes of craniofacial surgeries, thus improving diagnostic techniques and surgical planning, with the code shared on GitHub for further research.
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Hydroelectrolytic and nutritional needs of infants with epidermolysis bullosa during the first month of life.

Eur J Dermatol

August 2024

Department of Neonatology, APHP, Necker-Enfants Malades University Hospital, 149 rue de Sèvres, 75015 Paris, France, Paris Cite University, Paris, France.

Article Synopsis
  • Infants with severe epidermolysis bullosa (EB) often face dehydration and malnutrition, but their nutritional needs are not well studied.
  • A study looked at 27 newborns with EB to assess their nutritional status and found many had low sodium levels and needed extra fluids and sodium.
  • The results suggest that these infants require higher food and nutrient intake than usual to grow properly and stay healthy, especially during their first month of life.
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Article Synopsis
  • Prosthetic joint infections (PJIs) caused by Candida species are serious complications following joint replacement surgeries, with a study reviewing 269 cases between 2010 and 2021 to assess treatment outcomes.
  • The majority of infections occurred in older patients (average age 73), primarily in hips and knees, and most cases involved additional bacterial infections; roughly 58% achieved a cure at the two-year follow-up.
  • Treatment effectiveness varied significantly depending on the surgical method used, with poorer outcomes linked to the debridement, antibiotics, and implant retention (DAIR) approach and patients older than 70, while infections from Candida parapsilosis tended to have better outcomes.
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Survival analysis (also referred to as time-to-event analysis) is the study of the time elapsed from a starting date to some event of interest. In practice, these analyses can be challenging and, if methodological errors are to be avoided, require the application of appropriate techniques. By using simulations and real-life data based on the French national registry of patients with primary immunodeficiencies (CEREDIH), we sought to highlight the basic elements that need to be handled correctly when performing the initial steps in a survival analysis.

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ESKAPE pathogens are responsible for complicated nosocomial infections worldwide and are often resistant to commonly used antibiotics in clinical settings. Among ESKAPE, vancomycin-resistant Enterococcus faecium (VREfm) and methicillin-resistant Staphylococcus aureus (MRSA) are two important Gram-positive pathogens for which non-antibiotic alternatives are urgently needed. We previously showed that the lipoprotein AdcA of E.

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Cellular mechanisms of acute rhabdomyolysis in inherited metabolic diseases.

J Inherit Metab Dis

January 2025

INSERM U1151, Institut Necker Enfants-Malades (INEM), Université Paris Cité, Paris, France.

Acute rhabdomyolysis (RM) constitutes a life-threatening emergency resulting from the (acute) breakdown of skeletal myofibers, characterized by a plasma creatine kinase (CK) level exceeding 1000 IU/L in response to a precipitating factor. Genetic predisposition, particularly inherited metabolic diseases, often underlie RM, contributing to recurrent episodes. Both sporadic and congenital forms of RM share common triggers.

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Article Synopsis
  • The transition from pediatric to adult diabetes care for individuals with type 1 diabetes (T1D) is a challenging phase that needs more understanding, focusing on the experiences and satisfaction of young adults in France.
  • An online survey was conducted with 104 participants to gather insights about their transition experience, revealing that many faced significant diabetes management issues post-transition.
  • Key factors for a successful transition included early interactions with adult care teams, allowing participants to choose their transition age, and maintaining good diabetes control before leaving pediatric care.
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The International Patient Organisation for Primary Immunodeficiencies (IPOPI) held its second Global Multi-Stakeholders' Summit, an annual stimulating and forward-thinking meeting uniting experts to anticipate pivotal upcoming challenges and opportunities in the field of primary immunodeficiency (PID). The 2023 summit focused on three key identified discussion points: (i) How can immunoglobulin (Ig) therapy meet future personalized patient needs? (ii) Pandemic preparedness: what's next for public health and potential challenges for the PID community? (iii) Diagnosing PIDs in 2030: what needs to happen to diagnose better and to diagnose more? Clinician-Scientists, patient representatives and other stakeholders explored avenues to improve Ig therapy through mechanistic insights and tailored Ig preparations/products according to patient-specific needs and local exposure to infectious agents, amongst others. Urgency for pandemic preparedness was discussed, as was the threat of shortage of antibiotics and increasing antimicrobial resistance, emphasizing the need for representation of PID patients and other vulnerable populations throughout crisis and care management.

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Article Synopsis
  • Listeriosis is a serious public health concern due to its high death rate, prompting this study to explore its characteristics in Madagascar, where it's a reported disease.
  • The research zeroes in on a deadly case of meningeal listeriosis in a 12-year-old, discovering a unique genomic type of the bacteria with specific virulence and drug resistance traits.
  • This study marks the first genomic profiling of Listeria in Madagascar, underscoring the need for continuous surveillance to improve prevention and control efforts in the area.
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An exome sequencing strategy employed to identify pathogenic variants in patients with pediatric-onset systemic lupus or Evans syndrome resulted in the discovery of six novel monoallelic mutations in PTPN2. PTPN2 is a phosphatase that acts as an essential negative regulator of the JAK/STAT pathways. All mutations led to a loss of PTPN2 regulatory function as evidenced by in vitro assays and by hyperproliferation of patients' T cells.

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Acute generalized exanthematous pustulosis: European expert consensus for diagnosis and management.

J Eur Acad Dermatol Venereol

November 2024

ToxiTEN Group, European Reference Network for Rare Skin Diseases (ERN Skin), Paris, France.

Article Synopsis
  • Acute generalized exanthematous pustulosis (AGEP) is a rare, typically drug-induced rash that presents as pustules and lacks solid evidence for effective treatment with corticosteroids, yet they are commonly prescribed.
  • The ToxiTEN group, comprising European dermatologists and allergologists, created recommendations for diagnosing and managing AGEP based on their expertise and literature review.
  • These expert guidelines outline necessary healthcare professionals, diagnostic processes, management strategies, and follow-up care, emphasizing the importance of a collaborative approach to treatment.
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Prevention and treatment of infections are primary goals of treatment of children and adults with primary immune deficiencies due to decreased antibody production. Approaches to these goals include immunoglobulin replacement therapy, vaccination, and prophylactic treatment with antimicrobials. In this review, the infectious and non-infectious complications of antibody deficiencies will be discussed along with the limited number of studies that support the effective use of the available therapies and to drive the development of new therapies.

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A large proportion of prescriptions for extensively hydrolyzed cow's milk protein (CMP) in newborns are not based on any scientific data justifying the indication. Many of these prescriptions are old habits or are based on incomplete data. The aim of this article is to analyze these practices and propose recommendations.

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Diagnosis and management of children and adult craniopharyngiomas: A French Endocrine Society/French Society for Paediatric Endocrinology & Diabetes Consensus Statement.

Ann Endocrinol (Paris)

July 2024

Department of Endocrinology, CHU Bordeaux, Hôpital Haut Lévêque, Neurocentre Magendie, Physiopathologie de la Plasticité Neuronale, Université de Bordeaux, Pessac, France.

Article Synopsis
  • * The French Endocrine Society and associated organizations created a reference document to address the complexities of managing these tumors, which can recur and lead to serious health issues, including impaired quality of life for patients, especially those with hypothalamic syndrome.
  • * Recent research has identified two tumor types—papillary and adamantinomatous—with different molecular signatures and treatment strategies, prompting ongoing developments in therapeutic options, including new medications for associated symptoms like hyperphagia.
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Nirsevimab and Hospitalization for RSV Bronchiolitis.

N Engl J Med

July 2024

From the Department of General Pediatrics, Pediatric Infectious Disease, and Internal Medicine (Z.A., A.G., N.O.), Centre d'Investigations Cliniques, INSERM Unité 1426 (Z.V.), the Pediatric Intensive Care Unit (M. Levy, P.S.), the Pediatric Emergency Department (L.L.), the Department of Microbiology (M.G.-M.), the Neonatal Intensive Care Unit (V.B.), and the Unit of Clinical Epidemiology, INSERM Unité 1123 and Epidémiologie Clinique du Centre d'Investigation Clinique 1426 (K.D., O.A.), Robert-Debré University Hospital, Paris Cité University (Z.A., C.S., A.G., Z.V., M.B., J.F.C., J.T., M.L., P.S., L.L., M.G.-M., V.B., K.D., O.A.), the Departments of General Pediatrics (A.-S.R., M. Lorrot, C.F.) and Pediatric Pulmonology (A.-S.R., M. Lorrot), Armand Trousseau University Hospital, Sorbonne University (A.-S.R., M. Lorrot), the Pediatric Emergency Department (C.S.), the Pediatric Intensive Care Unit (M.B.), and the Department of General Pediatrics and Pediatric Infectious Diseases (C.S., J.F.C., J.T.), Necker-Enfants Malades University Hospital, Saint-Antoine Research Center, INSERM Unité Mixte de Recherche (UMR) S938 (H.C., B.P.), and Assistance Publique-Hôpitaux de Paris (AP-HP), Infection, Antimicrobials, Modeling, and Evolution (IAME) Research Unit, INSERM UMR 1137 (Z.A., L.L., M.G.-M., N.O.), Épidémiologie Clinique et Évaluation Économique Appliqué aux Populations Vulnérables, INSERM UMR 1123 (C.A.), the Center of Research in Epidemiology and Statistics, INSERM UMR 1153 (J.F.C.), and Biodiversity and Epidemiology of Bacterial Pathogens Research Unit, Institut Pasteur (J.T.), Paris Cité University, Paris, Groupe de Pathologie Infectieuse Pédiatrique, Nice (Z.A., M. Lorrot, R.C., C.L., N.O.), the Pediatric Emergency Department (C.A.) and the Department of General Pediatrics (L.P., C.F.D.), Jean Verdier University Hospital, AP-HP de Paris, Bondy, the Department of General Pediatrics, Centre Hospitalier Intercommunal de Créteil (M.S., C.J.), Association Clinique et Thérapeutique Infantile du Val-de-Marne France (R.C., C.L.), Institut Mondor de Recherche Biomédicale-Groupe de Recherche Clinique Groupe d'Étude des Maladies Infectieuses Néonatales et Infantiles, Université Paris Est (R.C., C.L., C.J.), and the Clinical Research Center (M.M.E.H., C.J.) and the Neonatal Intensive Care Unit (X.D.), Centre Hospitalier Intercommunal de Créteil, Université Paris Est Créteil, Faculté de Santé de Créteil, Créteil, Association Française de Pédiatrie Ambulatoire, Orleans (R.C., C.L.), and the Departments of Pediatric Pulmonology and Allergology (G.L., N.C.) and General Pediatrics (B.H., O.M., C.B.), Children's Hospital, Toulouse University Hospital, Toulouse - all in France; and the Department of Pediatrics, Department Woman-Mother-Child, Lausanne University Hospital, Centre Hospitalier Universitaire Vaudois, Lausanne, Switzerland (F.A.).

Article Synopsis
  • RSV is a major cause of bronchiolitis, leading to 3 million hospitalizations each year, and nirsevimab is a monoclonal antibody aimed at preventing severe RSV cases in infants.
  • A study compared infants hospitalized for RSV bronchiolitis with those visiting for unrelated reasons, assessing nirsevimab’s effectiveness in preventing hospitalizations in those under 12 months old.
  • Findings showed nirsevimab reduced hospitalization rates for RSV-associated bronchiolitis by 83% and critical care needs by about 70%, indicating it is an effective treatment option for vulnerable infants.
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