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Rozé J, Bacchetta J, Lapillonne A, Boubred F, Picaud J, Marchand‐Martin L, Bruel‐Tessoulin A, Harambat J, Biran V, Nuyt A, Darmaun D, Ancel P. High Amino Acid Intake in Early Life Is Associated With Systolic but Not Diastolic Arterial Hypertension at 5 Years of Age in Children Born Very Preterm. J Am Heart Assoc 2024; 13:e032804. [PMID: 38156453 PMCID: PMC10863839 DOI: 10.1161/jaha.123.032804] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/04/2023] [Accepted: 11/14/2023] [Indexed: 12/30/2023]
Abstract
BACKGROUND The life course of individuals born very premature is a topic of increasing concern. The association between high early amino acid intake and later high blood pressure (HBP) in preterm neonates is debated. METHODS AND RESULTS In a national, prospective, population-based birth cohort, EPIPAGE-2 (Etude Epidémiologique sur Petits Ages Gestationnels), we assessed blood pressure at 5 years. Eligible infants were those born between 24 and 29 weeks of gestation. Infants were distributed in 2 groups of 717 infants matched on propensity score on whether or not they were exposed to high amino acid intake (>3.5 g/kg per day at day 7); 455 control term infants were also enrolled. A value ≥95th percentile of reference values for age and height defined systolic or diastolic HBP. Blood pressure at 5 years of age was assessed for 389 and 385 children in the exposed and nonexposed groups, respectively. Rates (in percent) of systolic and diastolic HBP were 18.0% (95% CI, 14.5%-22.2%), 13.3% (95% CI, 10.3%-17.0%), 8.5% (95% CI, 6.5%-11.1%), and 9.0% (95% CI, 6.6%-12.3%), 10.2% (95% CI, 7.5%-13.6%), and 5.4% (95% CI, 3.8%-7.6%) in exposed, nonexposed, and term-born groups, respectively. Exposure to high early amino acid intake and maximal serum creatinine (by 50 μmol/L) between day 3 and day 7 were 2 independent risk factors for systolic HBP (adjusted odds ratio [aOR], 1.60 [95% CI, 1.05-2.43] and aOR, 1.59 [95% CI, 1.12-2.26], respectively) but not for diastolic HBP (aOR, 0.84 [95% CI, 0.50-1.39] and aOR, 1.09 [95% CI, 0.71-1.67], respectively). After adjustment for 5-year weight Z score, the aOR between high early amino acid intake and systolic HBP was 1.50 [95% CI, 0.98-2.30]. CONCLUSIONS These results suggest that mechanisms of childhood systolic HBP involve neonatal renal challenge by high amino acid intake or dysfunction.
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Affiliation(s)
- Jean‐Christophe Rozé
- Department of Neonatal MedicineNantes University HospitalNantesFrance
- UMR 1280, INRAE‐Nantes UniversitéNantesFrance
| | - Justine Bacchetta
- Reference Centre for Rare Kidney Diseases, INSERM 1033 Research Unit, Hospices Civils de LyonLyon 1 UniversityLyonFrance
| | - Alexandre Lapillonne
- Department of Neonatal Medicine, Assistance Publique Hopitaux de ParisNecker Enfants Malades HospitalParisFrance
| | - Farid Boubred
- Department of Neonatology, Faculté de MédecineAix‐Marseille UniversitéMarseilleFrance
| | - Jean‐Charles Picaud
- Department of NeonatologyHospices Civils de LyonLyonFrance
- Laboratoire CarMen, INSERM, INRAUniversité Claude Bernard Lyon1Pierre‐BéniteFrance
| | - Laetitia Marchand‐Martin
- Université Paris Cité, Sorbonne Paris‐Nord, Inserm, INRAE, CRESS, Obstetrical Perinatal and Pediatric Epidemiology Research Team, EPOPéParisFrance
| | | | - Jérome Harambat
- Pediatric Nephrology Unit, Department of PediatricsBordeaux University HospitalBordeauxFrance
| | - Valérie Biran
- Neonatal Intensive Care Unit, Assistance Publique‐Hôpitaux de ParisRobert Debré Children’s HospitalParisFrance
| | - Anne‐Monique Nuyt
- Pediatric Department, CHU Saint JustineUniversité de MontrealQuebecCanada
| | | | - Pierre‐Yves Ancel
- Université Paris Cité, Sorbonne Paris‐Nord, Inserm, INRAE, CRESS, Obstetrical Perinatal and Pediatric Epidemiology Research Team, EPOPéParisFrance
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2
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Gandino S, Bzikowska‐Jura A, Karcz K, Cassidy T, Wesolowska A, Królak‐Olejnik B, Klotz D, Arslanoglu S, Picaud J, Boquien C, Bertino E, Moro GE, Weaver G. Vegan/vegetarian diet and human milk donation: An EMBA survey across European milk banks. Matern Child Nutr 2024; 20:e13564. [PMID: 37724510 PMCID: PMC10750000 DOI: 10.1111/mcn.13564] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/03/2023] [Revised: 07/19/2023] [Accepted: 09/05/2023] [Indexed: 09/20/2023]
Abstract
The nutritional adequacy of human milk (HM) from vegan/vegetarian mothers has been a matter of debate, and a variety of recommendations regarding the eligibility of these mothers as human milk donors exists. According to the latest evidence, HM from vegans/vegetarians is similar in its composition to that from omnivores, however, some differences may be observed regarding vitamin B12 and omega-3 fatty acids concentrations. Maternal supplementation of these compounds has been proven effective in increasing their HM concentration. With this survey, we aimed to explore the practices currently in use in European human milk banks (HMBs) regarding potential donors following vegan/vegetarian diets. The online survey was distributed to European HMBs between January and July 2022. A total of 188 HMBs were contacted, and 118 replied (response rate 63%). Vegan and vegetarian mothers were recommended supplements of vitamin B12 to be accepted as donors in 27% and 26% of HMBs, respectively. Additional omega-3 fatty acid supplementation was required in 8% HMBs. In the remaining HMBs, these mothers were either systematically excluded or included regardless of supplementation. The dosage of the recommended supplements was extremely variable. Fifty-one percent of HMBs were following recommendations to guide their practice, national or local recommendations mainly. Great variability in European HMBs practices towards potential donors following vegan/vegetarian diets exists. Some of these practices can result in loss of donors and/or in potential nutritional deficiencies. Standardised evidence-based recommendations on this issue and their implementation in daily HMB practice are needed.
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Affiliation(s)
- Serena Gandino
- Nuffield Department of Women's & Reproductive HealthUniversity of Oxford, John Radcliffe HospitalOxfordUK
- Neonatology DivisionUniversity of Turin, City of Health and Science of TurinTurinItaly
| | - Agnieszka Bzikowska‐Jura
- Laboratory of Human Milk and Lactation Research at Regional Human Milk Bank in Holy Family Hospital, Department of Medical Biology, Faculty of Health SciencesMedical University of WarsawWarsawPoland
| | - Karolina Karcz
- Department of NeonatologyMedical University in WrocławWroclawPoland
| | - Tanya Cassidy
- Kathleen Lonsdale Institute for Health ResearchMaynooth UniversityKildareIreland
| | - Aleksandra Wesolowska
- Laboratory of Human Milk and Lactation Research at Regional Human Milk Bank in Holy Family Hospital, Department of Medical Biology, Faculty of Health SciencesMedical University of WarsawWarsawPoland
| | | | - Daniel Klotz
- Department of Neonatology, Center for Pediatrics, Medical Center, Faculty of MedicineUniversity of FreiburgFreiburgGermany
| | - Sertac Arslanoglu
- Division of Neonatology, İstanbul Medeniyet UniversitySchool of MedicineİstanbulTurkiye
| | - Jean‐Charles Picaud
- Service de Neonatologie, Hopital Universitaire de la Croix‐RousseHospices civils de LyonLyonFrance
- Laboratoire CarMen, INSERM, INRAUniversite Claude Bernard Lyon1Pierre‐BeniteFrance
| | | | - Enrico Bertino
- Neonatology DivisionUniversity of Turin, City of Health and Science of TurinTurinItaly
| | - Guido E. Moro
- Italian Association of Human Milk Banks (AIBLUD)MilanItaly
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3
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van Veenendaal NR, Labrie NH, Mader S, van Kempen AAMW, van der Schoor SRD, van Goudoever JB, Bertino E, Bhojnagarwala B, Bodrogi E, Bohlin K, Bracht M, Bührer C, Domellöf M, Embleton N, Endl C, Ertl T, Funke S, Gangi S, Garg S, Guimarães H, Haiden N, Koskinen E, Klingenberg C, Klisch O, Kobberup H, Kovalova OM, Krolak‐Olejnik B, Lapillonne A, Lee S, Lehtonen L, McKechnie L, Mimoso G, Molloy E, Moltu SJ, Mulder AL, Nádor C, Normann E, O'Brien K, Van Overmeire B, Pavlyshyn H, Pellicer A, Picaud J, Poets CF, Rabe H, Ryan E, Sadowska‐Krawczenko I, Salvesen B, Sanakova P, Sarapuk I, Schuler R, Senterre T, Strola P, Thomas M, Vento M, Voloshko V, Weis J, Wiedermannová H, Zabakas K. An international study on implementation and facilitators and barriers for parent‐infant closeness in neonatal units. Pediatr Investig 2022; 6:179-188. [PMID: 36203512 PMCID: PMC9523817 DOI: 10.1002/ped4.12339] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2021] [Accepted: 05/31/2022] [Indexed: 11/11/2022] Open
Abstract
Importance Parent‐infant closeness and active parent participation in neonatal care are important for parent and infant health. Objective To give an overview of current neonatal settings and gain an in‐depth understanding of facilitators and barriers to parent‐infant closeness, zero‐separation, in 19 countries. Methods Neonatal intensive care unit (NICU) professionals, representing 45 NICUs from a range of geographic regions in Europe and Canada, were purposefully selected and interviewed June–December 2018. Thematic analysis was conducted to identify, analyze and report patterns (themes) for parent‐infant closeness across the entire series of interviews. Results Parent‐infant separation during infant and/or maternity care is very common (42/45 units, 93%), despite the implementation of family integrated care (FICare) practices, including parent participation in medical rounds (17/45, 38%), structured education sessions for parents (16/45, 36%) and structured training for healthcare professionals (22/45, 49%). NICU professionals encountered four main themes with facilitators and barriers for parent‐infant closeness on and between the hospital, unit, staff, and family level: Culture (jointly held characteristics, values, thinking and behaviors about parental presence and participation in the unit), Collaboration (the act of working together between and within different levels), Capacities (resources and policies), and Coaching (education to acquire and transfer knowledge and skills). Interpretation Implementing parent‐infant closeness in the NICU is still challenging for healthcare professionals. Further optimization in neonatal care towards zero‐separation and parent‐infant closeness can be achieved by enforcing the ‘four Cs for Closeness’: Culture, Collaboration, Capacities, and Coaching.
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Affiliation(s)
- Nicole R. van Veenendaal
- Department of Pediatrics and Neonatology OLVG Amsterdam The Netherlands
- Amsterdam UMC, location Vrije Universiteit and location University of Amsterdam Department of Pediatrics, Emma Children's Hospital Amsterdam The Netherlands
| | - Nanon H.M. Labrie
- Department of Pediatrics and Neonatology OLVG Amsterdam The Netherlands
- Department of Language, Literature and Communication Vrije Universiteit Amsterdam Amsterdam The Netherlands
| | - Silke Mader
- European Foundation for Care of Newborn Infants Munich Germany
| | | | | | - Johannes B. van Goudoever
- Amsterdam UMC, location Vrije Universiteit and location University of Amsterdam Department of Pediatrics, Emma Children's Hospital Amsterdam The Netherlands
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4
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Picaud J. Review highlights the importance of donor human milk being available for very low birth weight infants. Acta Paediatr 2022; 111:1127-1133. [PMID: 35170785 PMCID: PMC9314126 DOI: 10.1111/apa.16296] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/24/2021] [Revised: 01/31/2022] [Accepted: 02/14/2022] [Indexed: 12/14/2022]
Abstract
Aim The aim of this paper was to review the role that donor human milk plays in caring for very low birth weight (VLBW) infants. Methods This review focussed on academic papers and background information published in English and French up to 8 August 2021. Results Donor human milk provides a useful bridge to successful breastfeeding in hospitalised neonates and does not have a negative impact on the use of mother's own milk and breastfeeding rates at discharge. It helps to prevent key complications of prematurity, particularly necrotising enterocolitis up to 36 weeks of postmenstrual age, which is more common in infants fed formulas based on cows' milk. When it is carefully fortified, it supports the postnatal growth of the majority of very preterm infants. Well‐organised, accessible human milk banks are required to cover the needs of hospitalised infants, and donor human milk must be prioritised for patients who derive the greatest health benefit from it. These include very preterm infants and those born at term, or near term, with surgical digestive malformations or congenital heart disease. Conclusion Safe, high‐quality donor human milk, which is distributed by well‐organised human milk banks, is essential for the most vulnerable hospitalised neonates.
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Affiliation(s)
- Jean‐Charles Picaud
- Department of Neonatology Hôpital de la Croix‐Rousse Hospices civils de Lyon Lyon France
- CarMen laboratory INSERM INRA Claude Bernard University Lyon1 Pierre‐Benite France
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5
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Zana‐Taïeb E, Sizun J, Kuhn P, Reynaud A, Allen A, Berne‐Audeoud F, Bouvard C, Brandicourt A, Caeymaex L, Denoual H, Duboz MA, Evrard A, Fichtner C, Fischer‐Fumeaux C, Girard L, Gonnaud F, Haumont D, Hüppi P, Knezovic N, Laprugne‐Garcia E, Legouais S, Mons F, Pelofy V, Picaud J, Pierrat V, Pladys P, Renesme L, Rideau A, Souet G, Tscherning C, Thiriez G, Tourneux P, Touzet M, Truffert P, Zaoui C, Zores‐Koenig C. Practical recommendations on room sizes for hospitalised newborn infants and their families based on a systematic review of the literature. Acta Paediatr 2022; 111:1109-1114. [PMID: 35194839 DOI: 10.1111/apa.16308] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/11/2022] [Revised: 02/18/2022] [Accepted: 02/21/2022] [Indexed: 11/30/2022]
Abstract
AIM Neonatal unit design may affect the neurodevelopment of hospitalised neonates and the well-being of parents and healthcare staff (HCS). We aimed to provide recommendations regarding the minimum area required for a hospital room for a single neonate and their family. METHODS We searched PubMed and Web of Science for relevant articles published from 1 January 2011 to 1 May 2021 by using the keywords NICU and facility design. Recommendations were developed after internal and external review by a multidisciplinary group including 15 professionals and parent representatives. RESULTS We identified 314 studies and developed six recommendations from four eligible studies. Recommendations for room size were developed according to three perspectives: opinions of users, who emphasised the need for a spacious room; proposals of organisations by HCS, which advocated for a minimum floor area of 11.2-18 m2 in a single non-family room and 15.3-24 m2 in a single-family room; and simulation methods indicating that the minimum floor area in the neonatal unit should be 18.5-24 m2 . CONCLUSION Units need to provide a minimum room size to allow for optimal newborn development and a better experience for parents and caregivers.
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Affiliation(s)
- Elodie Zana‐Taïeb
- Department of Neonatal Medicine Cochin‐Port Royal Hospital FHU PREMA Paris AP‐HP France
| | - Jacques Sizun
- Department of Neonatal Medicine Children Hospital Toulouse France
| | - Pierre Kuhn
- Department of Neonatal Medecine. CHU Hautepierre Strasbourg France
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6
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Klotz D, Wesołowska A, Bertino E, Moro GE, Picaud J, Gayà A, Weaver G. The legislative framework of donor human milk and human milk banking in Europe. Maternal & Child Nutrition 2022; 18:e13310. [PMID: 34936203 PMCID: PMC8932705 DOI: 10.1111/mcn.13310] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/24/2021] [Revised: 11/09/2021] [Accepted: 11/19/2021] [Indexed: 11/02/2022]
Abstract
Data about the regulatory approaches to donor human milk (DHM) in European countries are lacking. The aim of this study is to describe the various regulations of DHM within European countries, to assess its legislative context and its impact in relation to donor milk banking. We performed a cross‐sectional survey using a semistructured online questionnaire addressing 29 national European milk‐banking representatives from June 2020 to February 2021. Representatives of 26 national DHM services participated in this study. The legal classification and regulatory status of DHM were defined in 9 out of 26 areas of jurisdiction (35%) as either food product (n = 6), product of human origin according to a blood, tissue, cell regulation (n = 2), or medicinal product (n = 1). In the remainder, DHM remains unclassified. Most legislations did not provide a comprehensive framework concerning DHM and costs to cover milk bank operations were rarely reimbursed. In general, the lack of national legislative governance and the actual legislative regulations in place do not support the use of DHM in European countries. National medical guidelines for the use of DHM have been issued in only 11 countries. The current number and distribution of milk banks (n = 239) within participating countries may not provide an equitable access to DHM for eligible infants. These findings could guide stakeholders aiming to establish a regulatory framework for DHM. There is a lack of a legislative framework concerning the use of donor human milk in the majority of European countries. Available national legislative frameworks differed widely with gaps in the regulation of safety and quality of donor human milk, protection of donors and recipients, and cost recovery. Despite clearly demonstrated benefits and unequivocal recommendations for the use of donor human milk there is a lack of national guidance in many European countries.
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Affiliation(s)
- Daniel Klotz
- Department of Neonatology, Center for Pediatrics, Medical Center, Faculty of Medicine University of Freiburg Freiburg Germany
| | - Aleksandra Wesołowska
- Department of Medical Biology, Faculty of Health Science, Laboratory of Human Milk and Lactation Research at Regional Human Milk Bank at the Holy Family Hospital at Warsaw Medical University of Warsaw Warsaw Poland
| | - Enrico Bertino
- City of Health and Science Neonatal Unit of Turin University Turin Italy
| | - Guido E. Moro
- Associazione Italiana delle Banche del Latte Umano Donato Milan Italy
| | - Jean‐Charles Picaud
- Department of Neonatology, Hôpital de la Croix‐Rousse Hospices Civils de Lyon Lyon France
- INSERM, INRA Claude Bernard University Lyon Pierre Benite France
| | - Antoni Gayà
- Banc de Teixit, F. Banc de Sang i Teixits de les Illes Balears Institut d'Investigacio Sanitaria Illes Balears (IdISBa) Barcelona Spain
| | - Gillian Weaver
- The Human Milk Foundation Rothamsted Institute Hertfordshire UK
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7
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Picaud J, Buffin R, Rigourd V, Boscher C, Lamireau D, Dumoulin D, Voirin F, Lefur S, Frange P, Lina B. It's time to change the recommendations on COVID-19 and human milk donations. Acta Paediatr 2021; 110:1405-1406. [PMID: 33527456 PMCID: PMC8014273 DOI: 10.1111/apa.15782] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/08/2020] [Revised: 01/22/2021] [Accepted: 01/27/2021] [Indexed: 12/19/2022]
Affiliation(s)
- Jean‐Charles Picaud
- Neonatal unit and Auvergne Rhone Alpes human milk bank Croix Rousse University HospitalHospices Civils de Lyon Lyon France
- CarMen Laboratory INSERMINRAClaude Bernard University Lyon France
| | - Rachel Buffin
- Neonatal unit and Auvergne Rhone Alpes human milk bank Croix Rousse University HospitalHospices Civils de Lyon Lyon France
| | - Virginie Rigourd
- Ile de France Human Milk Bank Hopital Necker enfants maladies Paris France
| | | | | | | | | | - Solène Lefur
- Human Milk Bank Hopital Rene Dubos Pontoise France
| | - Pierre Frange
- Infection Control Unit Laboratory of Clinical Microbiology Necker – Enfants malades Hospital & EHU7328 Imagine Institute University of Paris Paris France
| | - Bruno Lina
- Hospices Civils de Lyon Virology Lab Institute of Infectious Agents National Reference Center for Viral Respiratory Infections Croix Rousse University Hospital Lyon France
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8
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Zores‐Koenig C, Kuhn P, Caeymaex L, Allen A, Berne‐Audeoud F, Bouvard C, Brandicourt A, Casper C, Denoual H, Duboz MA, Evrard A, Fichtner C, Fischer‐Fumeaux C, Girard L, Gonnaud F, Haumont D, Hüppi P, Knezovic N, Laprugne‐Garcia E, Legouais S, Mons F, Pelofy V, Picaud J, Pierrat V, Pladys P, Renaud A, Renesme L, Sizun J, Souet G, Thiriez G, Tourneux P, Touzet M, Truffert P, Zaoui C, Zana‐Taieb E. Recommendations on neonatal light environment from the French Neonatal Society. Acta Paediatr 2020; 109:1292-1301. [PMID: 31955460 DOI: 10.1111/apa.15173] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/30/2019] [Accepted: 01/13/2020] [Indexed: 01/21/2023]
Abstract
AIM Hospital light may affect neonatal neurosensory development and the well-being of parents and caregivers. We aimed to issue practical recommendations regarding the optimal light environment for neonatal units. METHODS A systematic evaluation was performed using PubMed to identify relevant papers published in English or French up to July 2018, and the different grades of evidence were evaluated. RESULTS We identified 89 studies and one meta-analysis and examined 31 eligible studies. The major results were that natural or artificial light should not exceed 1000 lux and that all changes in light level should be gradual. Light protection should be used for infants of <32 weeks of postmenstrual age and but must be individualised to each infant. Infants should not be exposed to continuous high light levels regardless of their term and postnatal age. Cycled light before discharge seemed to be safe and beneficial. For medical caregivers' well-being, higher light levels and access to natural light are recommended. Special attention should be given to protecting neonatal patients from high light levels that may be necessary when performing specific care procedures. CONCLUSION Consideration of general principles and practical applications can improve the neonatal light environment for newborn infants, parents and caregivers.
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Affiliation(s)
- Claire Zores‐Koenig
- Médecine et Réanimation du Nouveau‐né Hôpital de Hautepierre CHU Strasbourg Strasbourg France
- Institut des Neurosciences Cellulaires et Intégratives UPR 3212 CNRS et Université de Strasbourg Strasbourg France
| | - Pierre Kuhn
- Médecine et Réanimation du Nouveau‐né Hôpital de Hautepierre CHU Strasbourg Strasbourg France
- Institut des Neurosciences Cellulaires et Intégratives UPR 3212 CNRS et Université de Strasbourg Strasbourg France
| | - Laurence Caeymaex
- Neonatal Intensive Care Unit Centre Hospitalier Intercommunal de Créteil Créteil France
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9
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Corriger J, Beaudouin E, Rothmann R, Penven E, Haumonte Q, Thomas H, Picaud J, Nguyen-Grosjean VM, Corriger-Ippolito J, Braun F, De Talancé M, Auburtin B, Atain-Kouadio P, Borsa-Dorion A, Baugnon D, De Carvalho M, Jaussaud R, Nguyen-Thi PL, Bollaert PE, Demoly P, Tanno LK. Epidemiological Data on Anaphylaxis in French Emergency Departments. J Investig Allergol Clin Immunol 2018; 29:357-364. [PMID: 30411700 DOI: 10.18176/jiaci.0348] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
BACKGROUND Although anaphylaxis has been considered a priority public health issue in the world allergy community, epidemiological data on morbidity and mortality remain suboptimal. We performed the first multicenter epidemiological study in French emergency departments (EDs). The study covered 7 EDs over a period of 1 year. The objectives were to identify areas that are amenable to change and to support ongoing national and international efforts for better diagnosis, management, and prevention of anaphylaxis. METHODS Ours was a descriptive study based on data routinely reported to French institutional administrative databases from 7 French public health institutions in the Lorraine region between January and December 2015. Data were collected based on the anaphylaxisrelated codes of the International Classification of Diseases (ICD)-10, and cases were clinically validated as anaphylaxis. RESULTS Of the 202 079 admissions to the EDs, 4817 had anaphylaxis-related codes; of these, 323 were clinically validated as anaphylaxis. Although 45.8% were severe, adrenaline was prescribed in only 32.4% of cases. Of the 323 cases, 57.9% were subsequently referred for an allergy work-up or evaluation (after or during hospitalization), and 17.3% were prescribed autoinjectable epinephrine. CONCLUSION Our results highlight an urgent need for improved public health initiatives with respect to recognition and treatment of anaphylaxis. We flag key problems that should be managed in the coming years through implementation of national and international actions.
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Affiliation(s)
- J Corriger
- Allergy Department, Hospital Emile Durkheim, Epinal, France.,Internal Medicine and Clinical Immunology Department, University Hospital, Vandoeuvre-lès-Nancy, France
| | - E Beaudouin
- Allergy Department, Hospital Emile Durkheim, Epinal, France
| | - R Rothmann
- Emergency Department, Hospital Mercy-Metz, Ars-Laquenexy, France
| | - E Penven
- Occupational Diseases Department, University Hospital, Vandoeuvre-lès-Nancy, France.,Division of Allergy, Dermatology Department, University Hospital, Vandoeuvre-lès-Nancy, France
| | - Q Haumonte
- Allergy Department, Hospital Emile Durkheim, Epinal, France
| | - H Thomas
- Allergy Department, Hospital Emile Durkheim, Epinal, France
| | - J Picaud
- Allergy Department, Hospital Emile Durkheim, Epinal, France
| | | | - J Corriger-Ippolito
- Division of Allergy, Dermatology Department, University Hospital, Vandoeuvre-lès-Nancy, France.,Emergency Department, University Hospital, Vandoeuvre-lès-Nancy, France
| | - F Braun
- Emergency Department, Hospital Mercy-Metz, Ars-Laquenexy, France
| | - M De Talancé
- Emergency Department, Hospital Emile Durkheim, Epinal, France
| | - B Auburtin
- Pediatric Emergency Department, Hospital Emile Durkheim, Epinal, France
| | - P Atain-Kouadio
- Emergency Department, University Hospital, Vandoeuvre-lès-Nancy, France
| | - A Borsa-Dorion
- Pediatric Emergency Department, University Hospital, Vandoeuvre-lès-Nancy, France
| | - D Baugnon
- Emergency Department, Hospital of Verdun-Saint-Mihiel, Verdun, France
| | - M De Carvalho
- Biology and Immunology Laboratory, University Hospital, Vandoeuvre-lès-Nancy, France
| | - R Jaussaud
- Internal Medicine and Clinical Immunology Department, University Hospital, Vandoeuvre-lès-Nancy, France
| | - P L Nguyen-Thi
- Clinical Research Platform, ESPRI-BioBase Unit, University Hospital, Vandoeuvre-lès-Nancy, France
| | - P E Bollaert
- Medical Intensive Care Unit, University Hospital, Nancy, France
| | - P Demoly
- Division of Allergy, Department of Pulmonology, University of Montpellier, France and Sorbonne University, INSERM, IPLESP, EPAR team, Paris, France
| | - L K Tanno
- Division of Allergy, Department of Pulmonology, University of Montpellier, France and Sorbonne University, INSERM, IPLESP, EPAR team, Paris, France
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10
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Picaud J, Beaudouin E, Renaudin JM, Pirson F, Metz-Favre C, Dron-Gonzalvez M, Moneret-Vautrin DA. Anaphylaxis to diclofenac: nine cases reported to the Allergy Vigilance Network in France. Allergy 2014; 69:1420-3. [PMID: 24931488 DOI: 10.1111/all.12458] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/10/2014] [Indexed: 11/29/2022]
Abstract
Nine cases of diclofenac hypersensitivity recorded by the Allergy Vigilance Network in France from 2002 to 2012 were studied. Data from history, symptoms, skin tests, basophil activation tests, and oral challenge (OC) were recorded. Grade 3 severe anaphylactic reactions occurred in seven cases of nine. IgE-dependent anaphylaxis was confirmed in six cases: positive intradermal tests (n = 4), a syndromic reaction during skin tests (n = 1), and one case with grade 1 reaction and negative skin tests had an anaphylactic shock to the OC. A nonimmune reaction was suspected in one case. An IgE-dependent mechanism may be the predominant cause of adverse reactions to diclofenac. Allergy skin tests must be carried out sequentially at the recommended concentrations. BATs may be helpful because they can support the diagnosis of anaphylaxis. Given the risks of a direct challenge to diclofenac, OC to aspirin should be performed first to exclude a nonimmunologic hypersensitivity to NSAIDs. Tests for specific IgEs to most frequently used NSAIDs such as diclofenac and ibuprofen are urgently needed.
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Affiliation(s)
- J. Picaud
- Allergy Department; Emile Durkheim Hospital; Epinal France
- Allergy Vigilance Network; Vandoeuvre les Nancy France
| | - E. Beaudouin
- Allergy Department; Emile Durkheim Hospital; Epinal France
- Allergy Vigilance Network; Vandoeuvre les Nancy France
| | - J. M. Renaudin
- Allergy Department; Emile Durkheim Hospital; Epinal France
- Allergy Vigilance Network; Vandoeuvre les Nancy France
| | - F. Pirson
- Allergy Vigilance Network; Vandoeuvre les Nancy France
- Pneumology Department; Saint-Luc University Hospital; Bruxelles Belgium
| | - C. Metz-Favre
- Allergy Vigilance Network; Vandoeuvre les Nancy France
- Pneumology Department; New Civil Hospital; Strasbourg France
| | - M. Dron-Gonzalvez
- Allergy Vigilance Network; Vandoeuvre les Nancy France
- Allergy Vigilance Network; Martigues France
| | - D. A. Moneret-Vautrin
- Allergy Department; Emile Durkheim Hospital; Epinal France
- Allergy Vigilance Network; Vandoeuvre les Nancy France
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11
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Beaudouin E, Defendi F, Picaud J, Drouet C, Ponard D, Moneret-Vautrin DA. Iatrogenic angioedema associated with ACEi, sitagliptin, and deficiency of 3 enzymes catabolizing bradykinin. Eur Ann Allergy Clin Immunol 2014; 46:119-122. [PMID: 24853572] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
New concepts of idiopathic and iatrogenic angioedema underline the role of bradykinin, and the importance of catabolizing enzymes. A case is described of Angiotensin converting enzyme inhibitor (ACEi) and sitagliptin induced angioedema, where AO attacks decreased after the withdrawal of lisinopril but resolved only after the withdrawal of sitagliptin, an inhibitor of dipeptylpeptidase IV. ACE, aminopeptidase P and carboxypeptidase N were decreased down to 17%, 42%, 64% of median references values, and remained low one year after the interruption of these drugs: 56%, 28% and 50%, respectively. The combined deficiency of APP and CPN might enhance the inhibiting effect of the DPP IV inhibitor. The fact that this triple deficiency remained latent before and after the treatment indicates that searching for latent enzyme deficiencies should be carried out when there is intention to treat with a combination of drugs interfering with the bradykinin metabolism.
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Affiliation(s)
- E Beaudouin
- Service d'Allergologie, Centre Hospitalier E Durkheim, Epinal, France
| | - F Defendi
- French Reference Center for Angioedema, CREAK, Grenoble, France. Université Joseph Fourier, GREPI/AGIM CNRS FRE 3405, Grenoble, France
| | - J Picaud
- Service d'Allergologie, Centre Hospitalier E Durkheim, Epinal, France
| | - C Drouet
- French Reference Center for Angioedema, CREAK, Grenoble, France. Université Joseph Fourier, GREPI/AGIM CNRS FRE 3405, Grenoble, France
| | - D Ponard
- Laboratoire d'Immunologie IBP, Grenoble, France
| | - D A Moneret-Vautrin
- Service d'Allergologie, Centre Hospitalier E Durkheim, Epinal, France. Université de Lorraine Nancy, France
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12
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Grand A, Jalabert A, Steghens J, Mercier G, Florent M, Hansel-Esteller S, Picaud J. O022 Influence des micronutriments sur les phénomènes de peroxydation lipidique dans les solutés ternaires de nutrition parentérale utilisés en néonatologie. NUTR CLIN METAB 2007. [DOI: 10.1016/s0985-0562(07)78795-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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13
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Blanc V, Picaud J, Legros E, Bes M, Etienne J, Moatti D, Raynaud MF. [Infection after total hip replacement by Staphylococcus caprae. Case report and review of the literature]. Pathol Biol (Paris) 1999; 47:409-13. [PMID: 10418010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/13/2023]
Abstract
We report a case of Staphylococcus caprae bone and joint infection, that illustrate difficulties to diagnose coagulase-negative staphylococci (CNS) orthopedic surgery infections, specially following implantation of prostheses. Four of 5 strains successivelly isolated from deep and/or peri-operative specimens during late infection after total hip replacement (THR) have been identified, using commercial systems and conventionnal tests, as S. caprae. Identity of biochemical profile, antibiotype and pulsotype of the 4 isolates confirmed the pathogenicity of this animal CNS, rarely described as a human pathogen. Analysis of the 24 S. caprae human cases previously described evidence a relation ship between this bacteria and bone and joint infections, with implantation of prosthetic material as supplementary risk factor. S. caprae, whose major identification criteria are resumed, may have previously been misidentified as some similar CNS; this bacteria is probably part of our normal flora but may be recognized as an opportunistic pathogen, responsible for both nosocomial and community acquired infections.
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Affiliation(s)
- V Blanc
- Laboratoire, Centre Hospitalier d'Antibes Juan-les-Pins, Antibes, France
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14
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Blez F, Noel B, Picaud J. [Pautrier-Woringer lipo-melanic reticulosis with severe onset, symptomatic of reticulosarcomatosis]. Lyon Med 1969; 222:829. [PMID: 4910716] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
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15
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Picaud J. [10 first days of newborn infants of diabetic mothers: 52 cases]. Lyon Med 1967; 218:919-88 concl. [PMID: 5622196] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/21/2023]
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16
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François R, Bethenod M, Picaud J, Ruitton-Ugliengo A. [10 1st days of newborn infants of diabetic mothers: 52 cases]. Lyon Med 1967; 218:805-903. [PMID: 5622036] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
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17
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Bethenod M, Nivelon JL, Picaud J. [Congenital tuberculosis by amniotic inhalation. Recovery]. Ann Pediatr (Paris) 1965; 12:768-71. [PMID: 5295098] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/14/2023]
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18
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Bethenod M, Nivelon JL, Harteman E, Picaud J. [Reflections on 8 cases of early congenital syphilis recently observed]. J Med Lyon 1965; 46:1743-57. [PMID: 5888843] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/17/2023]
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19
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François R, Frederich A, Hermier M, Pellet H, Picaud J, Ruiton-Ugliengo A. [Chronic hypoparathyroidism in a child presenting a morphologic syndrome of pseudohypoparathyroidism]. Pediatrie 1965; 20:437-44. [PMID: 5843367] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/17/2023]
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