Evaluation of daily hydration in pediatric outpatients over 3 years old.

The topic of hydration of children over 3 years of age is often neglected in general pediatric consultations, even though proper hydration is essential for optimal physical and intellectual functions. OBJECTIVE: To evaluate the daily water and beverage consumption of 3- to 8-year-old patients in a private pediatric practice through a retrospective observational study. METHOD: This single-centre study was conducted in a French private practice with five pediatricians and included 200 healthy children, aged 3-8 years. RESULTS: Recommended intake of beverages was reached in 62% of 54 children in the 3- to 4-year-old group and 43% of the 146 children in the 4- to 8-year-old group. Recommended beverages intake of±20% was found in 55% of the 3- to 4-year-old group and 45% of the 4- to 8-year-old group. The potential risk factors of inadequate hydration could not be demonstrated in this study. Water alone was the predominant intake in 63% of the 200 children; milk accounted for 19%, and sweetened drinks for 17%. CONCLUSIONS: These results show a persistent gap between recommended and observed total beverage intake. Although our results are more robust than previous French and international published data, they remain insufficient. In the future, a systematic approach to hydration with parents and children is needed including personalised advice, while maintaining other public health interventions in schools and canteens.

[Massive fetomaternal transfusion after induction of labor by oxytocin]. / Transfusion foetomaternelle massive au décours de l'induction du travail par ocytocique.

UNLABELLED: Severe fetomaternal transfusions are seldom, but may lead to neonatal morbidity or death. CASE REPORT: We report a case of lethal fetomaternal transfusion in which a failure to induce labour, at term, can be suspected. COMMENTS: We emphasize the need of a close monitoring of the fetal well-being in cases of failed induced labour at term.

[Acute otitis media in ambulatory practice: epidemiological and clinical characteristics after 7 valent pneumococcal conjugate vaccine (PCV7) implementation]. / Otite moyenne aiguë en pédiatrie ambulatoire : caractéristiques épidémiologiques et cliniques après l'introduction du vaccin antipneumococcique conjugué 7 valent (PCV7).

BACKGROUND: In US, pneumococcal conjugate vaccine (PCV7) had reduced the burden of AOM and changed the profile of the disease. Prior to PCV7 implementation in France, AOM represented 8% of pediatricians visits and failure rate was 12%. The aim of this study is to describe the epidemiologic characteristics of AOM after PCV7 implementation. METHODS: From 2007 to 2008, 30 pediatricians enrolled 3141 patients 3 to 36 months old with AOM. Standardized history and physical examination findings were recorded. Factors related to AOM failures were identified by multivariate logistic regression. RESULTS: AOM accounted for 5.8% of the 43 433 visits or 6.2 cases/week per pediatrician. Among 3141 evaluable AOM cases (mean age 16.7±8 months, peak incidence at 10 months), 99% had been vaccinated with PCV7 and 42.1% attended day care (DCC). Recurrent AOM comprised 24.5% of cases and 51% of children had received ATB in the last 3 months. At the time of diagnosis, 47.1% had fever≥38,5°C, 74.5% otalgia and 4.7% otorrhea. Febrile and painful AOM accounted for 29.5% of cases and cunjunctivitis-otitis syndrome for 18.2%. ATB was prescribed in 98.7% of cases (cefpodoxime proxetil, 59% and amoxicillin/clavulanate, 37%). The failure rate was 6.4% and failure risk was greater in children in DCC (OR=1.50, [1.10;2.05]), young age<18 months (OR=1.47, [1.06;2.04]) and history of recurrent AOM (OR=1.45, [1.02;2.06]). CONCLUSION: Despite PCV7 implementation, AOM remains a very frequent childhood infection and a major reason for ATB prescriptions.