Anticipatory guidance and children's oral health: A scoping review.

BACKGROUND: Anticipatory guidance (AG) involves providing parents with information about developmental milestones and promoting optimal development. Oral AG was first introduced as a comprehensive approach to provide age-appropriate oral health information and preventive interventions. The literature regarding this important topic has not yet been reviewed and summarised. AIM: To describe the literature on AG provided to parents about their children's oral health and identify gaps in the current research. METHOD: The scoping review mapped the existing peer-reviewed and guideline documents about AG and children's oral health using the framework established by Arksey and O'Malley (2005) and modified by Levac et al. (2010). Firstly, we defined our research questions and searched the literature using Medline, Web of Science and Scopus. Secondly, we selected all types of literature and then applied the inclusion and exclusion criteria, and finally, we analysed and summarised the information using thematic analysis. RESULTS: Forty-three peer-reviewed articles and six guidelines were included. There was variation in how AG was described and defined. While some studies have evaluated the effectiveness of AG, most have investigated its short-term effectiveness only, with few interventional studies assessing this approach in the long-term. CONCLUSION: While the concept of AG shows promise, there is no consensus within the current literature on a defined definition and there is a lack of long-term evaluation.

[French linguistic validation of the Index of Sexual Satisfaction (ISS)]. / Validation linguistique française de l'indice de satisfaction sexuelle (ISS).

INTRODUCTION: The objective of this study was to propose a French version of the Index of Sexual Satisfaction (ISS). MATERIAL AND METHOD: The translation from English to French of the ISS was performed independently by three pediatric surgeons whose mother tongue is French. Then, an English speaker, fluent in French, who was unaware of the original questionnaire, translated the reconciled French version of the ISS into English. RESULTS: The final French version was successfully tested on 25 French-speaking volunteers. CONCLUSION: We present a validated translation of the Sexual Satisfaction Index.

Deepithelialized glans reconfiguration (DeGRe) for distal hypospadias repair.

INTRODUCTION: Our objective was to present our experience with a novel technique for distal hypospadias repair consisting of deepithelialized glans reconfiguration. PATIENTS AND METHOD: We reviewed the clinical data of all patients who underwent distal hypospadias using Deepithelialized Glans Reconfiguration between January 2015 and December 2019. We noted age at surgery, position of meatus, duration of urethral catheterization and hospitalization, as well as early and late complications. Standard postoperative care included follow-up examination at 1, 6 and 12 months. Successful repair was defined as a patient presenting with a straight penis with an apical meatus, no stricture nor fistula. RESULTS: Sixty-seven patients were included. Average age at surgery was 12.5 months (6-23 months). All patients presented distal hypospadias (3 glanular, 61 coronal, 3 subcoronal). 36% of patients were operated as day case surgery. No intra-operative complications were recorded. Eleven patients did not complete the designated follow up. They attended the post-operative appointment at six months but not the one-year visit. All patients presented satisfactory urinary streams according to the parents. All parents were satisfied with the cosmetic appearance of their child's penis. Two patients presented with glans dehiscence (3%). The mean HOPE score for the last 10 patients was 47.4 ± 3.2 out of a maximum of 50. DISCUSSION: Deepithelialized Glans Reconfiguration is a simple technique with satisfactory results. Though it has similarities with existing techniques, it contains specific aspects not described previously. Contrary to the MAGPI technique, there is no meatal advancement, no rotation of the glans wings, and it is the glans lateral and proximal to the meatus which is approximated in the midline. As opposed to the GAP procedure, there is no closure of the ventral aspect of the urethra. We rely on secondary healing within the glans to reconstruct the missing ventral aspect of the urethra. We reserve this technique for coronal hypospadias with a wide, deep glanular groove. Deepithelialization favours rapid healing of the glans wings on the midline. There is no formal urethroplasty. The limits to this study include lack of long-term (>1 year) follow-up and uroflow. Though careful observation did not identify fistulas, the absence of functional stenosis has to be more clearly evaluated at a later age. Finally, this technique is not suitable for the completely flat glans as it relies on being able to approximate the glans ridges in the midline. CONCLUSION: Deepithelialized Glans Reconfiguration is a simple technique which achieves good cosmetic results, without complications associated with meatal or urethral advancement or formal urethroplasty.

Burnout amongst members of the French-speaking Society of Pediatric and Adolescent Urology (SFUPA). Are there specific risk factors?

BACKGROUND: Burnout, which includes emotional fatigue, cynicism and low personal accomplishment is linked to poor job satisfaction, decreased empathy, job withdrawal, increased absenteeism and increased medical errors, and is present among pediatric urologists. OBJECTIVE: We aimed to determine the incidence of burnout among the members of the French-speaking Society of Pediatric and Adolescent Urology (SFUPA) and determine which external factors, such as marital or familial status, gender, age, type of practice or religious belief, impacted burnout rates. MATERIAL AND METHOD: We sent all members of the French-speaking Society for Pediatric and Adolescent Urology (SFUPA) an anonymous online questionnaire containing the validated French version of the 22-item Maslach Burnout Inventory - Human Services Survey (MBIHSS). The questionnaire comprised further questions on age, gender, marital status, presence of children at home, type of practice, professional status (trainee, consultant, or academic position), spirituality and whether responders believed they presented signs of burnout. RESULTS: 70 out of 94 members of the SFUPA answered the questionnaire (response rate 74%). The number of responders who presented high scores in one, two or the three domains of the questionnaire were respectively 48.6% (IC 95%: 36-61%), 21.4% (IC 95%: 12.5-33%) and 8.6% (IC 95%: 3-18%). 34.6% of responders who believed they presented no signs of burnout actually did have a high burnout score in at least one domain. There was no significant association between age, gender, having children or being a trainee and the presence of burnout. However, marital status and workplace were significantly associated with presence of signs of burnout. DISCUSSION: Burnout is a distinct type of work-related stress - a state of physical or emotional exhaustion that also involves a sense of reduced accomplishment and loss of personal identity. In our study the most significant factor was working in Academic hospitals which can be associated with administrative workload, long hours and a lack of institutional resources. Being in a couple was also associated with less burnout, thus showing the importance of healthy relationships and sharing on burnout rate. Age, however was not associated significantly with burnout nor was gender, which is in coherence with previous findings. CONCLUSION: Amongst members of the French-speaking Society of Pediatric and Adolescent Urology, nearly half presented signs of burnout, especially those working in academic hospitals. Marital status also influenced burnout rates. Scientific societies should work on developing tools to identify and accompany affected individuals.

Anatomical and functional evaluation of diaphyseal femoral fractures in children under 6 years old.

Objective : The aim of this study is to evaluate both the anatomical and functional consequences of our treatment protocol of diaphyseal femoral fractures in children under 6 years old Methods : We conducted a retrospective analysis of a series containing 50 children in Strasbourg University Hospital whom had traumatic diaphyseal femoral fractures and underwent conservative treatment by traction followed by casting with a mean follow-up period of 25 months. Results : All fractures healed without complications i.e. gait disorders, back pain and limitation of activity. Results showed a significant correlation between the initial varus angulation and shortening which could influence the final remodeling result within the first 24 months. Using the Receiver Operating Characteristic curve, we developed the Initial Displacement Index on Traction (IDIT) which is the sum of both the initial varus in degrees and the initial shortening in millimeters. Conclusion : The treatment by initial traction followed by a cast for childrens ≤ 6 years old gives clinical and radiological results comparable with those reported for immediate casting method. The hospitalization period is longer in the traction method but with less exposure to general anesthesia (GA) and risks of secondary displacements.

Popliteal artery dissection presented 12 hours after admission for a Salter III fracture of proximal tibia.

A 16-year-old boy sustained a salter III fracture of the upper tibia following a motorcycle accident. Except for well localized knee pain, the patient did not have any other symptom. Repeated clinical examination did not reveal any absent peripheral pulse. Given the state of the fracture, anatomical reduction and screw fixation was planned in the operating room.  Twelve hours after admission the patient was taken to the operating room. During the period preceding surgery he continued to have normal vascular clinical examinations. Further clinical assessment was performed in the operating room and remained to be normal. However after induction and upon extension of the lower limb, peripheral pulses in the affected side were abruptly lost. Urgent vascular exploration of the area showed a popliteal artery dissection necessitating a bypass graft to restore blood flow.  We present a review of the literature alongside a case report showing how popliteal artery pathology in a similar context can present late and be for a period of time clinically undetectable.