854 results match your criteria: "Robert Debre University Hospital[Affiliation]"

Scurvy incidence trend among children hospitalised in France, 2015-2023: a population-based interrupted time-series analysis.

Lancet Reg Health Eur

February 2025

Department of General Paediatrics, Paediatric Internal Medicine, Rheumatology and Infectious Diseases, National Reference Centre for Rare Paediatric Inflammatory Rheumatisms and Systemic Autoimmune Diseases (RAISE), Robert-Debré University Hospital, Assistance Publique-Hôpitaux de Paris, F-75019, Paris, France.

Background: Scurvy, historically rare in-high income countries, has re-emerged as an indicator of socioeconomic and dietary disparities. Limited data exist on scurvy trends among European children, particularly following socioeconomic changes since the COVID-19 pandemic. This study analysed scurvy incidence trends among French children over a nine-year period, examining potential post-pandemic increases.

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Regular physical activity (PA) reduces morbidity and mortality in prostate cancer. Prescribing PA in cancer is a necessary awareness but is a real challenge in the case of prostate cancer. Motivational peer support seems to be an innovative strategy for lifestyle change.

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The European Reference Networks (ERNs) for rare and complex diseases offer significant potential for building, maintaining and evaluating patient partnership, for which the recently developed ERN Patient Partnership Framework may serve as guidance. This scoping review aims to identify and describe relevant frameworks published in scientific literature, capturing key learning points to inform future updates of the ERN Patient Partnership Framework and promote its use in practice. MEDLINE, Embase, and the Web of Science Core Collection were searched to identify recently published frameworks (2013-2023) focused on patient partnership and aligned with at least one core ERN activity.

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Lennox-Gastaut syndrome (LGS) is a severe developmental and epileptic encephalopathy (DEE) characterized by multiple types of drug-resistant seizures (which must include tonic seizures) with classical onset before 8 years (although some cases with later onset have also been described), abnormal electroencephalographic features, and cognitive and behavioral impairments. Management and treatment of LGS are challenging, due to associated comorbidities and the treatment resistance of seizures. A panel of five epileptologists reconvened to provide updated guidance and treatment algorithms for LGS, incorporating recent advancements in antiseizure medications (ASMs) and understanding of DEEs.

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Unravelling Education Needs for Clinical Practice Guideline Development: A Survey Performed in the Netherlands.

J Eval Clin Pract

February 2025

Faculty of Health, Medicine and Life Sciences (FHML), School of Health Professions Education (SHE), Maastricht University, Maastricht, The Netherlands.

Objective: The development of clinical practice guidelines (CPG) has evolved into a rigorous and complex process. There is a need for training of CPG developers including methodologists, panel members and patient representatives. This study explored the educational needs and experiences of CPG developers, with specific attention to the patient perspective and economic considerations.

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Background And Objective: Selective internal radiation therapy (SIRT) represents an endovascular treatment option for patients with hepatocellular carcinoma (HCC). Its use is widely recognized in the intermediate and advanced HCC, but it has become more prevalent in recent years in different Barcelona Clinic Liver Cancer (BCLC) stages. The aim of this review is to summarize the role of SIRT and its clinical implications through different stages of HCC.

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Management of the supposed elbow dislocation in newborns.

J Child Orthop

December 2024

Department of Pediatric Orthopaedic Surgery, Robert Debré University Hospital, Assistance Publique des Hôpitaux de Paris (AP-HP), France.

Background: The newborn transphyseal fracture of the distal humerus is frequently misdiagnosed with an elbow dislocation due to the absence of the lateral condyle ossification node. No consensus has been reported either for the diagnosis or the management of these rare fractures. This study aimed to analyze a series of newborns with transphyseal distal humerus fractures.

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Haematopoietic gene therapy of non-conditioned patients with Fanconi anaemia-A: results from open-label phase 1/2 (FANCOLEN-1) and long-term clinical trials.

Lancet

December 2025

Biomedical Innovation Unit, Center for Research on Energy, Environment and Technology (CIEMAT), Madrid, Spain; Biomedical Network Research Center for Rare Diseases (CIBERER), Madrid, Spain; Sanitary Research Institute Fundación Jiménez Díaz (U.A.M), Madrid, Spain. Electronic address:

Background: Allogeneic haematopoietic stem-cell transplantation is the standard treatment for bone marrow failure (BMF) in patients with Fanconi anaemia, but transplantation-associated complications such as an increased incidence of subsequent cancer are frequent. The aim of this study was to evaluate the safety and efficacy of the infusion of autologous gene-corrected haematopoietic stem cells as an alternative therapy for these patients.

Methods: This was an open-label, investigator-initiated phase 1/2 clinical trial (FANCOLEN-1) and long-term follow-up trial (up to 7 years post-treatment) in Spain.

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Reply to: comparing the efficacy of intravenous lidocaine versus placebo for postoperative analgesia in paediatric patients: methodology is important.

Eur J Anaesthesiol

January 2025

From the Department of Anaesthesia and Intensive Care, Robert Debré University Hospital, Assistance Publique des Hôpitaux de Paris (PP, SD) and University of Paris-Cité (PP, SD), FHU I2D2. Robert Debré University Hospital, Paris, France (PP, SD).

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Editorial Comment.

J Urol

December 2024

Department of Pediatric Surgery and Urology, National Reference Center for Rare Urinary Tract Malformations (CRMR MARVU) and Disorders of Sexual Development (CRMR CRESCENDO), ERN eUROGEN Accredited Center, Robert-Debré University Hospital, APHP, GHU Nord, Université Paris Cité, Paris, France.

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Introduction: Mastering paediatric laparoscopic surgery competency (PLSC) is technically challenging. The present study aimed to determine whether the inter-academic PLSC degree (IAD_PLSC) practical training program enables trainees to improve their skills.

Methods: This retrospective study included trainees enrolled in the IAD_PLSC program in 2021 and 2022 which included two separate 12 h-sessions.

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Patients' psychosocial attributes and aggressiveness of cancer treatments near the end of life.

Oncologist

November 2024

Department of Supportive and Palliative Care, Institut Paoli-Camettes, Aix-Marseille Univ, CNRS, INSERM, Marseille, France.

Background: While the use of chemotherapy near the end of life (EOL) has been identified as a relevant criterion for assessing quality of cancer care and has been estimated as non-beneficial, a trend of aggressiveness in cancer care during the last period of life remains. Both patients' sociodemographic characteristics and physicians' practice setting are associated with this use. The role of patients' psychosocial characteristics has however been understudied.

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Article Synopsis
  • - Pathogenic variants in the SETD5 gene are linked to a neurodevelopmental disorder presenting intellectual disability, autism, and facial dysmorphisms, with some symptoms not appearing in every individual (incomplete penetrance).
  • - A study of 28 patients revealed various neurological symptoms, including low muscle tone (hypotonia), movement disorders, gait issues, and epilepsy in 14% of cases; cognitive impairments ranged from mild to severe in most participants.
  • - The research expands on existing literature to propose a correlation between specific gene variations (genotype) and the observed symptoms (phenotype) in SETD5-related disorders.
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2q33 Deletions Underlying Syndromic and Non-syndromic CTLA4 Deficiency.

J Clin Immunol

November 2024

Study Center for Primary Immunodeficiencies, Necker Hospital for Sick Children, Assistance Publique Hôpitaux de Paris (AP-HP), Paris, EU, France.

Purpose: CTLA4 deficiency is an inborn error of immunity (IEI) due to heterozygosity for germline loss-of-function variants of the CTLA4 gene located on chromosome 2q33.2. CTLA4 deficiency underlies pleiotropic immune and lymphoproliferation-mediated features with incomplete penetrance.

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Background And Aims: Inflammatory Bowel Disease (IBD) are known to impact patients 'sexual lives. The aim of this study is to create and validate a sexual QoL designed for youth with IBD.

Methods: This study was conducted in two phases: development of the score and validation of the items.

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Individuals with monoallelic pathogenic variants in the histone lysine methyltransferase DOT1L display global developmental delay and varying congenital anomalies. However, the impact of monoallelic loss of remains unclear. Here, we present a largely female cohort of 11 individuals with variants with developmental delays and dysmorphic facial features.

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WONOEP appraisal: Targeted therapy development for early onset epilepsies.

Epilepsia

November 2024

Saul R. Korey Department of Neurology, Isabelle Rapin Division of Child Neurology, Laboratory of Developmental Epilepsy, Dominick P. Purpura Department of Neuroscience, Albert Einstein College of Medicine, Bronx, New York, USA.

The early onset epilepsies encompass a heterogeneous group of disorders, some of which result in drug-resistant seizures, developmental delay, psychiatric comorbidities, and sudden death. Advancement in the widespread use of targeted gene panels as well as genome and exome sequencing has facilitated the identification of different causative genes in a subset of these patients. The ability to recognize the genetic basis of early onset epilepsies continues to improve, with de novo coding variants accounting for most of the genetic etiologies identified.

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Early-onset anorexia nervosa: a scoping review and management guidelines.

J Eat Disord

November 2024

Child and Adolescent Psychiatry Department, Reference Centre for Rare Disease - Early-Onset Anorexia Nervosa (EOAN), Robert Debré University Hospital, APHP, Paris, France.

Background: Anorexia nervosa (AN) is a serious multifactorial eating disorder characterized by insufficient nutritional intake to maintain a minimum normal weight for one's age and height, a fear of gaining weight and a distorted body image. It affects mainly adolescents, but a decreased age at diagnosis has been reported, leading to the definition of a rare form of AN called early-onset or prepubertal anorexia nervosa (EOAN; ORPHA 525738), with reported epidemiological and clinical specificity. Current knowledge and specific treatments for this particular condition remain scarce.

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Longitudinal exposure to antiseizure medications shape gut-derived microbiome, resistome, and metabolome landscape.

ISME Commun

January 2024

Université Paris-Saclay, Institut National de Recherche pour l'Agriculture, l'Alimentation et l'Environnement (INRAE), AgroParisTech, Micalis Institute, Domaine de Vilvert, Jouy-en-Josas, France.

The influence of chronically administered host-targeted drugs on the gut microbiome remains less understood compared to antibiotics. We investigated repetitive exposure effects of three common antiseizure medications [carbamazepine (CBZ), valproic acid, and levetiracetam] on the gut microbial composition, resistome, and metabolome using microcosms constructed from feces of young children. Microcosms were established by cultivating feces for 24 h (C0).

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Use of 3D Exoscope for Free Flaps Microanastomosis in Head and Neck Reconstruction.

Clin Otolaryngol

November 2024

Otolaryngology and Head and Neck Surgery Department, Robert Debre Hospital, University Hospital of Reims, Reims, France.

Background: The use of the 3D exoscope in cervicofacial reconstruction has demonstrated its effectiveness, yet few studies have compared its utility to that of the microscope.

Objective: To compare the reliability of microanastomoses performed with both tools, along with postoperative outcomes and user experience.

Patients And Methods: This was a retrospective single-center study that included all cases of microanastomosed forearm or fibula free flap reconstructions performed between June 2019 and June 2022.

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A second RUBCN variant associated with epileptic encephalopathy and neurodevelopmental delay.

Am J Med Genet A

November 2024

Department of Genetics, APHP-Robert Debré University Hospital, Paris, France; INSERM UMR1141, Neurodiderot, University of Paris Cité, Paris, France.

The RUBCN gene encodes a widely expressed protein called Rubicon, the main function of which is to negatively regulate macroautophagy. A single homozygous pathogenic variant of the RUBCN gene has been reported to date in two unrelated consanguineous Saudi families with spinocerebellar ataxia autosomal recessive 15 (OMIM#613516). This variant is responsible for the deletion of the highly conserved Rubicon Homology (RH) domain, which is important for the colocalization of Rubicon with Rab7 in the late endosome.

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Diagnostic and Therapeutic Insights Into Pediatric Neurosarcoidosis: Observations From French Pediatric Rheumatology Centers.

Pediatr Neurol

January 2025

Department of General Pediatrics, Pediatric Internal Medicine, Rheumatology and Infectious Diseases, National Reference Centre for Rare Pediatric Inflammatory Rheumatisms and Systemic Autoimmune Diseases (RAISE), Robert-Debré University Hospital, Assistance Publique-Hôpitaux de Paris, Paris, France; Université Paris Cité, INSERM, Centre de Recherche sur l'inflammation UMR 1149, Paris, France. Electronic address:

Article Synopsis
  • - The study reviewed 11 pediatric patients diagnosed with neurosarcoidosis (NS), predominantly affecting girls, with an average diagnosis age of around 10 to 11.5 years, highlighting typical neurological symptoms such as headaches and eye involvement.
  • - Most patients experienced meningitis and were treated primarily with corticosteroids and TNF-alpha inhibitors, with eight out of 11 requiring biologic therapies to achieve remission.
  • - The findings emphasize the importance of recognizing the clinical features of pediatric NS and suggest that early intervention with TNF-alpha biologics can lead to better management outcomes for these children.
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Pharmacotherapeutic strategies for drug-resistant epilepsy in children.

Epilepsy Behav

December 2024

Neurology, Epilepsy and Movement Disorders Unit, Bambino Gesu' Children's Hospital, IRCCS, Full Member of European Reference Network on Rare and complex Epilepsies EpiCARE, Rome, Italy; University Hospitals KU Leuven, Belgium.

Drug resistance is defined as the failure of adequate trials of two tolerated and appropriately chosen antiseizure medications to achieve sustained seizure freedom. In case of uncontrolled seizures, pseudo-drug-resistance (poor compliance, a worsening effect of an antiseizure medication, a diagnosis of psychogenic non-epileptic seizure) should be first ruled out in case of pediatric epilepsies. This paper discusses the process of choosing antiseizure medication and the concepts of rationale polytherapy and precision medicine.

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Pediatric Hospitalizations and Emergency Department Visits Related to Mental Health Conditions and Self-Harm.

JAMA Netw Open

October 2024

Center of Clinical Investigations, INSERM CIC1426, Robert Debré University Hospital, Assistance Publique-Hôpitaux de Paris (AP-HP) Nord, Paris, France.

Importance: Mental disorders among the pediatric population are a major area of public health concern. Little is known regarding changes in pediatric hospital resource use related to mental health (MH) long after the onset of the COVID-19 pandemic in March 2020.

Objective: To assess rates and trends of hospitalizations and emergency department (ED) visits related to MH and self-harm (SH) among children before and during the 3 years following the pandemic onset.

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Systematic review of thyroid function in NKX2-1-related disorders: Treatment and follow-up.

PLoS One

October 2024

Department of Child Neurology, Movement Disorders Unit, Institut de Recerca Sant Joan de Déu, Barcelona, Spain.

Article Synopsis
  • NKX2-1 is a critical transcription factor linked to rare disorders that cause thyroid, lung, and brain issues, with early diagnosis being key for effective treatment.
  • This systematic review analyzes the effectiveness of Levothyroxine (LT4) treatment for NKX2-1-related disorders, focusing on congenital hypothyroidism, treatment initiation, and dosage variations.
  • Findings reveal that congenital hypothyroidism is common in these patients, yet LT4 is initiated in only 10%, with significant reliance on age at diagnosis affecting treatment outcomes.
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