[The motivational week: A new approach in smoking cessation]. / La semaine motivationnelle : une nouvelle approche dans le sevrage tabagique.

INTRODUCTION: Smoking cessation is complex and challenging. The motivational week is a multidisciplinary approach that has been established in order to increase the chances of quitting smoking. The purpose of this study was to determine the rates of abstinence achieved and the predictive factors for quitting. METHODS: Clinical data, smoking status, levels of dependence and motivation as well as rates of continuous abstinence in the short and long-term of all patients who participated in the motivational week were analysed. RESULTS: Two hundred and thirteen patients were included. The mean age was 49.8 years (10.6). The rates of continuous abstinence were 40.4% at 6 months, 29.1% at 12 months and 21.6% at 2 years. Using logistic regression, having depression or a history of depression was associated with reduced likelihood of smoking cessation: OR: 0.32 [95%CI: 0.16-0.76; P=0.003] at 6 months, OR: 0.35 [95%CI: 0.16-0.77; P=0.009] at 12 months and OR: 0.27 [95%CI: 0.11-0.65; P=0.004] at 2 years. CONCLUSIONS: The motivational week seems to be an approach which is effective long-term and could be used in smoking cessation. This study confirms that depression is an unfavourable factor for quitting.

The clinical benefits of long-term supplementation with omega-3 fatty acids in cystic fibrosis patients - A pilot study.

Effectiveness of omega-3 supplementation in cystic fibrosis (CF) remains controversial. This study sought to evaluate clinical status, exercise tolerance, inflammatory parameters, and erythrocyte fatty acid profile after 1 year of oral omega-3 supplementation in CF patients. Fifteen ΔF508-homozygous patients undergoing chronic azithromycin were randomized to receive omega-3 fish oil supplementation at a dose of 60mg/Kg/day or placebo. In comparison with the previous year, in the supplemented group, the number of pulmonary exacerbations decreased at 12 months (1.7 vs. 3.0, p<0.01), as did the duration of antibiotic therapy (26.5 days vs. 60.0 days, p<0.025). Supplementation significantly increased the levels of eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) as early as <3 months of administration, with concomitant decreases in arachidonic acid (AA) levels. This pilot study suggests that long-term omega-3 supplementation offers several clinical benefits as to the number of exacerbations and duration of antibiotic therapy in CF patients.

Intake of water and beverages of children and adolescents in 13 countries.

PURPOSE: To describe the intake of water and all other beverages in children and adolescents in 13 countries of three continents. METHODS: Data of 3611 children (4-9 years) and 8109 adolescents (10-17 years) were retrieved from 13 cross-sectional surveys (47 % males). In three countries, stratified cluster sampling design was applied to randomly recruit schools classes. A quota method was applied in the other countries to randomly recruit participants. Details on the intake of all fluid types were obtained with a fluid-specific record over 7 consecutive days. RESULTS: In the total sample, the highest mean intakes were observed for water (738 ± 567 mL/day), followed by milk (212 ± 209 mL/day), regular soft beverages (RSB) (168 ± 290 mL/day) and juices (128 ± 228 mL/day). Patterns characterized by a high contribution of water, RSB or hot beverages to total fluid intake were identified among the countries with close geographical location. Adolescents had a significantly lower milk intake and higher intake of RSB and hot beverages than children in most countries. The most consistent gender difference observed was that in both age groups males reported a significantly higher RSB consumption than females. CONCLUSION: On average, water was the fluid consumed in the largest volume by children and adolescents, but the intake of the different fluid types varied substantially between countries. Since the RSB intake was as large, or even larger, than water intake in some countries, undertaking actions to improve fluid intake habits of children and adolescents are warranted.

Intrathecal baclofen for treatment of spasticity of multiple sclerosis patients.

We conducted a retrospective study of the case files of 64 multiple sclerosis (MS) patients presenting severe spasticity, who had received intrathecal (IT) baclofen test injections between 1992 and 2004 in a rehabilitation unit. In almost all cases of our series, IT baclofen was proposed to patients who were no longer able to walk. IT baclofen is a safe and effective treatment to reduce spasticity in MS patients. Despite an advanced stage of the disease at the time of pump placement, the complication rate was low and the efficacy of this treatment was maintained over time.

[Inborn errors of metabolism: new developments and challenges]. / Les erreurs innées du métabolisme: progrès et défis.

The concept "inborn error of metabolism" (IEM) arose from the observations of Sir A. Garrod at the beginning of the XXth century. The exponential development, during the last decades, of our knowledge in cellular biology and molecular genetics, and the availability of increasingly more precise diagnostic tools, allow the identification of a still growing number of inborn errors of metabolism. Their physiopathology is better understood. Treatments have considerably improved: more specific diets, new medical treatments, enzyme replacement therapy, organ transplantation, hepatocyte or stem cell transplantation... New techniques are under development, including various strategies of gene therapy. Improved therapeutic efficacy combined with earlier diagnosis have dramatically changed the prognosis of many disorders. As a consequence, new challenging questions have to be answered. Today, patients with an IEM, because of the extreme complexity of their management, need to be looked after by a multidisciplinary team of physicians (pediatricians and internists), dieticians, social workers, psychologists... It is essential, in this complex and rapidly expanding field, that experiences should be shared at national and international level, in order to provide the most adequate care for patients.

[Dietetic and nutritional management in a university children's hospital]. / Diététique et nutrition dans un hôpital pédiatrique universitaire.

Dietetics and nutrition are new, expanding disciplines. Feeding man's cub to ensure the best physical, brain and psychic growth to reach the adult age in a "sane" state is the daily challenge of pediatric dieteticians. The role of dieteticians in a pediatric hospital is essential: optimizing sick children's nutrition. A child is highly vulnerable, above all when he is sick. Unappropriate feeding can put his growth and development, as well as his healing at stake. Numerous studies believe that denutrition in pediatric hospitals prevail by 7 to 45%. A survey has been carried out in two care units in the University Children's Hospital Queen Fabiola in Brussels. For one month, the nutritional hazard has been evaluated in every children admitted in these units. One observes that one third of these children shows a high nutritional hazard, and another third a moderate nutritional hazard. The tracking of the nutritional hazard and the appropriate nutritional care must be an integral part of the care given to any child admitted in hospital. A nutrition unit, with all the attending people involved (doctor, dietician, chemist, nurse), is necessary to improve the nutritional care of the patients.