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Lacotte E, Boujonnier L, Martinez-Vinson C, Viala J, Ley D, Coopman S, Lerisson H, Dabadie A, Dumant-Forrest C, Pigneur B, Ruemmele F, Enaud R, Comte A, Rebeuh J, Bertrand V, Caron N, Breton A, Duclaux-Loras R, Vasies I, Dupont-Lucas C. Risk factors for surgery in stricturing small bowel Crohn's disease: A retrospective cohort study from the GETAID pédiatrique. J Pediatr Gastroenterol Nutr 2024. [PMID: 38651614 DOI: 10.1002/jpn3.12224] [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] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/17/2023] [Revised: 02/22/2024] [Accepted: 03/22/2024] [Indexed: 04/25/2024]
Abstract
OBJECTIVES Previous studies have shown rates of surgical resection of up to 41% in stricturing pediatric Crohn's disease. In this retrospective multicenter study, our aims were to identify clinical risk factors and magnetic resonance enterography (MRE) features of small bowel strictures associated with surgery. METHODS Pediatric patients with symptomatic stricturing small bowel CD (defined as obstructive symptoms or proximal dilatation on MRE) confirmed by MRE between 2010 and 2020 were recruited from 12 French tertiary hospitals. Patient characteristics were compared by surgical outcome multivariable Cox regression. RESULTS Fifty-six patients (61% boys) aged 12.2 ± 2.7 years at diagnosis of CD were included. Median duration of CD before diagnosis of stricture was 11.7 months (interquartile range [IQR]: 25-75: 1.2-29.9). Nineteen (34%) patients had stricturing phenotype (B2) at baseline. Treatments received before stricture diagnosis included MODULEN-IBD (n = 31), corticosteroids (n = 35), antibiotics (n = 10), anti-TNF (n = 27), immunosuppressants (n = 28). Thirty-six patients (64%) required surgery, within 4.8 months (IQR: 25-75: 1.8-17.3) after stricture diagnosis. Parameters associated with surgical resection were antibiotic exposure before stricture diagnosis (adjusted odds ratio [aOR]: 15.62 [3.35-72.73], p = 0.0005), Crohn's disease obstructive symptoms score (CDOS) > 4 (aOR: 3.04 [1.15-8.03], p = 0.02) and dilation proximal to stricture >28 mm (aOR: 3.62 [1.17-11.20], p = 0.03). CONCLUSION In this study, antibiotic treatment before stricture diagnosis, intensity of obstructive symptoms, and diameter of dilation proximal to small bowel stricture on MRE were associated with risk for surgical resection.
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Affiliation(s)
- Edouard Lacotte
- Department of Pediatrics, Caen University Hospital, Caen, France
| | - Louis Boujonnier
- Department of Pediatric Radiology, Caen University Hospital, Caen, France
| | | | - Jérôme Viala
- Pediatric Gastroenterology, Robert Debré University Hospital, Paris, France
| | - Delphine Ley
- Pediatric Gastroenterology, Lille University Hospital, Lille, France
| | - Stéphanie Coopman
- Pediatric Gastroenterology, Lille University Hospital, Lille, France
| | - Héloïse Lerisson
- Department of Pediatric Radiology, Lille University Hospital, Lille, France
| | - Alain Dabadie
- Pediatric Gastroenterology, Rennes University Hospital, Rennes, France
| | | | - Bénédicte Pigneur
- Pediatric Gastroenterology, Necker University Hospital, Paris, France
| | - Frank Ruemmele
- Pediatric Gastroenterology, Necker University Hospital, Paris, France
| | - Raphael Enaud
- Pediatric Gastroenterology, Bordeaux University Hospital, Bordeaux, France
| | - Aurélie Comte
- Department of Pediatrics, Besançon University Hospital, Besançon, France
| | - Julie Rebeuh
- Department of Pediatrics, Strasbourg University Hospital, Strasbourg, France
| | | | - Nicolas Caron
- Department of Pediatrics, Clermont-Ferrand University Hospital, Clermont-Ferrand, France
| | - Anne Breton
- Department of Pediatric Gastroenterology, Toulouse University Hospital, Toulouse, France
| | | | - Ioana Vasies
- Department of Pediatric radiology, Rouen University Hospital, Rouen, France
| | - Claire Dupont-Lucas
- Department of Pediatrics, Caen University Hospital, Caen, France
- INSERM UMR 1073 ADEN, Institute for Biomedical Research, Rouen, France
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Zambelli L, Aumar M, Ley D, Antoine M, Coopman S, Morcel J, Bequet E, Guimber D, Cailliau E, Peretti N, Gottrand F. Home enteral nutrition does not decrease oral feeding in children during the first year of nutritional support. Clin Nutr 2024; 43:781-786. [PMID: 38340410 DOI: 10.1016/j.clnu.2024.02.001] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2023] [Revised: 02/01/2024] [Accepted: 02/01/2024] [Indexed: 02/12/2024]
Abstract
BACKGROUND Enteral nutrition is necessary when nutritional status is poor and oral intake is insufficient or impossible. Although it has been suspected to reduce spontaneous oral feeding, no study has formally assessed the influence of enteral nutrition on pediatric oral intake. The present study aimed to evaluate variation in oral feeding intake after enteral nutrition initiation, and to identify factors influencing oral feeding. METHODS This retrospective cohort study included 149 pediatric patients from two French tertiary care hospitals, who received home enteral nutrition from 2009 to 2022. The patients were aged 2 months to 17 years (median age 3 years, interquartile range 1.3-9.2). Oral and enteral intakes were assessed when enteral nutrition was initiated (M0), and again at M3 (n = 123), M6 (n = 129), and M12 (n = 134) follow-ups, based on dieticians' and home services' reports. Oral feeding and body mass index z score variations during follow-ups were evaluated using a linear mixed regression model, including "time" as a fixed effect and "patient" as a random effect. Factors associated with oral feeding changes were assessed using a model interaction term. RESULTS Oral intake did not vary significantly (P = 0.99) over time and accounted for 47.4% ± 27.4%, 46.9% ± 27.4%, 48.4% ± 28.2%, and 46.6% ± 26.9% of the ideal recommended daily allowance (calculated for the ideal weight for height) at M0, M3, M6, and M12, respectively. Delivery method (nasogastric tube versus gastrostomy), prematurity, underlying disease, history of intrauterine growth retardation, and speech therapy intervention did not influence oral intake. Administration (i.e., exclusively continuous nocturnal infusion versus daytime bolus) led to different oral intake development, although oral intake also differed at M0. CONCLUSIONS Enteral nutrition, although increasing total energy intake, does not alter oral feeding during the first year of administration. Only the mode of administration might influence oral intake.
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Affiliation(s)
- L Zambelli
- Univ. Lille, Department of Pediatric Gastroenterology, Hepatology and Nutrition, CHU Lille, Inserm U1286 INFINITE, Lille, France; Division of Gastroenterology, Hepatology and Nutrition, Department of Pediatrics, Liège University Hospital, Liège, Belgium.
| | - M Aumar
- Univ. Lille, Department of Pediatric Gastroenterology, Hepatology and Nutrition, CHU Lille, Inserm U1286 INFINITE, Lille, France.
| | - D Ley
- Univ. Lille, Department of Pediatric Gastroenterology, Hepatology and Nutrition, CHU Lille, Inserm U1286 INFINITE, Lille, France.
| | - M Antoine
- Univ. Lille, Department of Pediatric Gastroenterology, Hepatology and Nutrition, CHU Lille, Inserm U1286 INFINITE, Lille, France.
| | - S Coopman
- Univ. Lille, Department of Pediatric Gastroenterology, Hepatology and Nutrition, CHU Lille, Inserm U1286 INFINITE, Lille, France.
| | - J Morcel
- Univ. Lille, Department of Pediatric Gastroenterology, Hepatology and Nutrition, CHU Lille, Inserm U1286 INFINITE, Lille, France.
| | - E Bequet
- Division of Gastroenterology, Hepatology and Nutrition, Department of Pediatrics, Liège University Hospital, Liège, Belgium.
| | - D Guimber
- Univ. Lille, Department of Pediatric Gastroenterology, Hepatology and Nutrition, CHU Lille, Inserm U1286 INFINITE, Lille, France.
| | - E Cailliau
- Biostatistics Department, CHU Lille, F-59000 Lille, France.
| | - N Peretti
- Division of Gastroenterology, Hepatology and Nutrition, Department of Pediatrics, Hospices Civils de Lyon, Lyon, France.
| | - F Gottrand
- Univ. Lille, Department of Pediatric Gastroenterology, Hepatology and Nutrition, CHU Lille, Inserm U1286 INFINITE, Lille, France.
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Vanhelst J, Béghin L, Drumez E, Djeddi-Dine D, Tuck D, Coopman S, Gottrand F, Ley D. Validation of the IMPACT-III Questionnaire in French Children With Inflammatory Bowel Disease. J Pediatr Gastroenterol Nutr 2023; 76:e71-e76. [PMID: 36735394 DOI: 10.1097/mpg.0000000000003716] [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] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
OBJECTIVES This study assessed the reliability and validity of the IMPACT-III questionnaire, a health-related quality of life (HRQoL) instrument, in French children with inflammatory bowel disease (IBD). METHODS Eighty-four children and adolescents (45 boys, aged 14.3 ± 2.7 years) were included in a validation study of the IMPACT-III questionnaire. Patients completed 2 questionnaires for measuring HRQoL: the IMPACT-III and the Pediatric Quality of Life Inventory 4.0 Generic Core Scale (PedsQL). Internal consistency was assessed using Cronbach α. Factor analysis was performed on data from the IMPACT-III to help construct domains. Concurrent validity was assessed by calculating Spearman correlation coefficients. RESULTS Cronbach α for the PedsQL total score was good (0.89). The most robust factor solution was a 3-domain structure: (a) Concerns, (b) Body Image and Physical Condition, and (c) Symptoms and Socializing. All domains had good reliability (0.674-0.863). Only 2 items had to be removed. Discriminant validity was demonstrated by significant differences ( P < 0.001) in median IMPACT-III scores between inactive and active disease for the total score (83.3 vs 72.0), and for Concerns ( P < 0.002) and Symptoms and Socializing ( P < 0.001). CONCLUSIONS These results suggest that IMPACT-III appears to be a useful instrument for measuring HRQoL in French children with IBD.
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Affiliation(s)
- Jérémy Vanhelst
- From the Sorbonne Paris Nord University, INSERM U1153, INRAE U1125, CNAM, Nutritional Epidemiology Research Team (EREN), Centre of Research in Epidemiology and Statistics - University of Paris Cité (CRESS), Bobigny, France
- Univ. Lille, INSERM, CHU Lille, U1286 - INFINITE - Institute for Translational Research in Inflammation, 59000 Lille, France
| | - Laurent Béghin
- Univ. Lille, INSERM, CHU Lille, U1286 - INFINITE - Institute for Translational Research in Inflammation, 59000 Lille, France
- Univ. Lille, INSERM, CHU Lille, CIC 1403 - Clinical Investigation Center, Lille, 59000 Lille, France
| | - Elodie Drumez
- Univ. Lille, CHU Lille, ULR 2694 - METRICS: Evaluation des technologies de santé et des pratiques médicales, 59000 Lille, France
- the Department of Biostatistics, CHU Lille, F-59000 Lille, France
| | - Djamal Djeddi-Dine
- the Department of Pediatrics, Amiens University Hospital and University of Amiens, Amiens, France
| | - Dominique Tuck
- Univ. Lille, INSERM, CHU Lille, U1286 - INFINITE - Institute for Translational Research in Inflammation, 59000 Lille, France
- the CHU Lille, Division of Gastroenterology, Hepatology and Nutrition, Department of Pediatrics, Lille University Jeanne de Flandre Children's Hospital, 59000 Lille, France
| | - Stéphanie Coopman
- the CHU Lille, Division of Gastroenterology, Hepatology and Nutrition, Department of Pediatrics, Lille University Jeanne de Flandre Children's Hospital, 59000 Lille, France
| | - Frédéric Gottrand
- Univ. Lille, INSERM, CHU Lille, U1286 - INFINITE - Institute for Translational Research in Inflammation, 59000 Lille, France
- the CHU Lille, Division of Gastroenterology, Hepatology and Nutrition, Department of Pediatrics, Lille University Jeanne de Flandre Children's Hospital, 59000 Lille, France
| | - Delphine Ley
- Univ. Lille, INSERM, CHU Lille, U1286 - INFINITE - Institute for Translational Research in Inflammation, 59000 Lille, France
- the CHU Lille, Division of Gastroenterology, Hepatology and Nutrition, Department of Pediatrics, Lille University Jeanne de Flandre Children's Hospital, 59000 Lille, France
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Jean-Bart C C, Aumar M, Ley D, Antoine M, Cailliau E, Coopman S, Guimber D, Ganga S, Turck D, Gottrand F. Complications of one-step button percutaneous endoscopic gastrostomy in children. Eur J Pediatr 2023; 182:1665-1672. [PMID: 36735060 DOI: 10.1007/s00431-023-04822-7] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/14/2022] [Revised: 01/09/2023] [Accepted: 01/13/2023] [Indexed: 02/04/2023]
Abstract
To assess the complications of one-step button percutaneous endoscopic gastrostomy (B-PEG) and determine risk factors for developing stomal infections or gastropexy complications. A retrospective study of 679 children who underwent a B-PEG procedure in a single tertiary care center over a 10-year period to December 2020 was conducted. Patient characteristics, early complications (occurring ≤ 7 days after the procedure), late complications (> 7 days after the procedure), and outcomes were collected from medical records. A list of potential risk factors, including age at procedure, prematurity, underlying neurological disease, and undernutrition, was determined a priori. At least 1 year of follow-up was available for 513 patients. Median follow-up duration was 2.8 years (interquartile range 1.0-4.9 years). Major complications were rare (< 2%), and no death was related to B-PEG. Early complications affected 15.9% of the study population, and 78.0% of children presented late complications. Development of granulation tissue was the most common complication followed in frequency by tube dislodgment and T-fastener complications. Only 24 patients (3.5%) presented stomal infections. Young age at the time of PEG placement (odds ratio (OR) 2.34 [1.03-5.30], p = .042) was a risk factor for developing peristomal infection. T-fastener migration occurred in 17.3% of children, and we found underlying neurological disease was a protective factor (OR 0.59 [0.37-0.92], p = .019). Conclusion: B-PEG is a safe method and associated with a low rate of local infection. However, T-fasteners are associated with significant morbidity and require particular attention in young and premature infants. What is Known: • Percutaneous endoscopic gastrostomy (PEG) is the preferred method to provide long-term enteral nutrition in children to prevent malnutrition. The Pull-PEG method is still the most commonly used with complications , such as stomal infection. Since its description, only a few studies have reported postoperative complications of one-step button PEG (B-PEG). What is New: • T-fastener complications were not rare, and underlying neurologic disease was a protective factor. A very low rate of stomal infection was described, and young age at the time of PEG placement was a risk factor. The B-PEG is a safe method with fewer major complications than P-PEG in children.
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Affiliation(s)
- Charlotte Jean-Bart C
- Department of Pediatric Gastroenterology, Hepatology, and Nutrition, CHU Lille, INSERM 1286, University of Lille, Lille, 59000, France.
- Department of Pediatrics, Children's Hospital, Roubaix, France.
| | - Madeleine Aumar
- Department of Pediatric Gastroenterology, Hepatology, and Nutrition, CHU Lille, INSERM 1286, University of Lille, Lille, 59000, France
| | - Delphine Ley
- Department of Pediatric Gastroenterology, Hepatology, and Nutrition, CHU Lille, INSERM 1286, University of Lille, Lille, 59000, France
| | - Matthieu Antoine
- Department of Pediatric Gastroenterology, Hepatology, and Nutrition, CHU Lille, INSERM 1286, University of Lille, Lille, 59000, France
| | - Emeline Cailliau
- Department of Biostatistics, University of Lille, ULR 2694, Lille, France
| | - Stéphanie Coopman
- Department of Pediatric Gastroenterology, Hepatology, and Nutrition, CHU Lille, INSERM 1286, University of Lille, Lille, 59000, France
| | - Dominique Guimber
- Department of Pediatric Gastroenterology, Hepatology, and Nutrition, CHU Lille, INSERM 1286, University of Lille, Lille, 59000, France
| | - Serge Ganga
- Department of Pediatrics, Children's Hospital, Roubaix, France
| | - Dominique Turck
- Department of Pediatric Gastroenterology, Hepatology, and Nutrition, CHU Lille, INSERM 1286, University of Lille, Lille, 59000, France
| | - Frédéric Gottrand
- Department of Pediatric Gastroenterology, Hepatology, and Nutrition, CHU Lille, INSERM 1286, University of Lille, Lille, 59000, France
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Nicolas A, Aumar M, Tran LC, Tiret A, Duclaux-Loras R, Bridoux-Henno L, Campeotto F, Fabre A, Breton A, Languepin J, Kyheng M, Viala J, Coopman S, Gottrand F. Comparison of Endoscopic Dilatation and Heller's Myotomy for Treating Esophageal Achalasia in Children: A Multicenter Study. J Pediatr 2022; 251:134-139.e2. [PMID: 35853483 DOI: 10.1016/j.jpeds.2022.07.010] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [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: 02/24/2022] [Revised: 07/08/2022] [Accepted: 07/13/2022] [Indexed: 11/26/2022]
Abstract
OBJECTIVE To compare the efficacy of, and complications from, the 2 main treatments for achalasia: endoscopic dilatation and surgical cardiomyotomy (Heller's myotomy). STUDY DESIGN We retrospectively collected data on children treated for achalasia over an 11-year period from 8 tertiary pediatric centers. A line of treatment was defined as performing either Heller's myotomy or 1-3 sessions of endoscopy dilatation over 3 months. Treatment success was a priori defined as clinical improvement and no need for new treatment. RESULTS Ninety-seven children (median age, 12 years; 57% boys) were included. The median time to diagnosis was 10.5 months, and the median follow-up period was 27 months. Thirty-seven children were treated by Heller's myotomy and 60 by endoscopy dilatation as the first-line treatment. After adjustment for potentially confounding factors, Heller's myotomy was significantly more successful than endoscopy dilatation (hazard ratio, 3.93 [1.74; 8.88]; P = .001), with a median survival without failure of 49 and 7 months, respectively, and with no significant difference in the occurrence of complications (35.2% for Heller's myotomy, 29.7% for endoscopy dilatation, P = .56). Hydrostatic dilatation was as successful as pneumatic dilatation (hazard ratio, 1.35 [0.56; 3.23]; P = .50). CONCLUSIONS Heller's myotomy is more successful than endoscopy dilatation, with no significant difference in the occurrence of serious complications. This raises the potential role of peroral endoscopic myotomy as an alternative treatment to Heller's myotomy.
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Affiliation(s)
- Audrey Nicolas
- Department of Pediatrics, CHU Limoges, Limoges, France; Division of Gastroenterology, Hepatology and Nutrition, Department of Pediatrics, Jeanne de Flandre Children's Hospital, CHU Lille and University Lille, Lille, France
| | - Madeleine Aumar
- Division of Gastroenterology, Hepatology and Nutrition, Department of Pediatrics, Jeanne de Flandre Children's Hospital, CHU Lille and University Lille, Lille, France; University Lille, Inserm, CHU Lille, U1286 - INFINITE - Institute for Translational Research in Inflammation, Lille, France
| | - Léa Chantal Tran
- University Lille, Inserm, CHU Lille, U1286 - INFINITE - Institute for Translational Research in Inflammation, Lille, France
| | - Alice Tiret
- Department of Pediatric Gastroenterology and Nutrition, Hôpital Universitaire Robert-Debré, Assistance Publique-Hôpitaux de Paris, University Paris, Paris, France
| | - Rémi Duclaux-Loras
- Department of Pediatric Gastroenterology Hepatology and Nutrition, Hospices Civils de Lyon, Hôpital Femme Mère Enfant, Bron, France
| | - Laure Bridoux-Henno
- Department of Child and Adolescent Medicine, CHU Rennes Hôpital Sud, Rennes Cedex 2, France
| | - Florence Campeotto
- Pediatric Gastroenterology Department, APHP Necker-Enfants Malades Hospital, Paris, France
| | - Alexandre Fabre
- Pediatric Multidisciplinary Pediatric APHM, Timone Enfant, Marseille, France; Aix-Marseille University, INSERM, GMGF, Marseille, France
| | - Anne Breton
- Division of Pediatric Gastroenterology, Hepatology and Nutrition, Purpan University Hospital, Toulouse, France
| | | | - Maéva Kyheng
- ULR 2694 - METRICS: Évaluation des Technologies de Santé et des Pratiques Médicales, University Lille, CHU Lille, Lille, France; Department of Biostatistics, University Lille, CHU Lille, Lille, France
| | - Jérôme Viala
- Department of Pediatric Gastroenterology and Nutrition, Hôpital Universitaire Robert-Debré, Assistance Publique-Hôpitaux de Paris, University Paris, Paris, France
| | - Stéphanie Coopman
- Division of Gastroenterology, Hepatology and Nutrition, Department of Pediatrics, Jeanne de Flandre Children's Hospital, CHU Lille and University Lille, Lille, France
| | - Frédéric Gottrand
- Division of Gastroenterology, Hepatology and Nutrition, Department of Pediatrics, Jeanne de Flandre Children's Hospital, CHU Lille and University Lille, Lille, France; University Lille, Inserm, CHU Lille, U1286 - INFINITE - Institute for Translational Research in Inflammation, Lille, France.
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Vanhelst J, Beghin L, Coopman S, Labreuche J, Djeddi D, Gottrand F, Turck D, Ley D. Physical fitness in children and adolescents with inflammatory bowel disease: protocol for a case-control study. BMJ Open 2022; 12:e063403. [PMID: 36220315 PMCID: PMC9557790 DOI: 10.1136/bmjopen-2022-063403] [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] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
INTRODUCTION Inflammatory bowel disease (IBD) is a chronic disorder of the gastrointestinal tract, associated with adverse health consequences that may adversely influence physical activity and body composition in youth. These effects may lead to changes in physical fitness, which is positively associated with health-related outcomes. The aim is to assess health-related physical fitness levels in paediatric patients with IBD and to compare these levels with those in healthy matched controls. METHODS AND ANALYSIS This trial is a bicentric case-control study. Fifty paediatric patients with IBD and 50 matched healthy controls will be recruited (1:1), and physical fitness levels (cardiorespiratory fitness, muscular strength, speed/agility and flexibility) will be assessed. The primary outcome is cardiorespiratory fitness, which will be compared between children and adolescents with IBD and healthy controls matched for age, sex and body mass index class. We will assess whether the two groups differ with respect to other physical fitness components and cardiovascular risk in adulthood according to sex-specific cut-offs for a healthy cardiorespiratory fitness level in adolescents. We will identify relationships between physical fitness and characteristics of IBD, quality of life and daily physical activity. ETHICS AND DISSEMINATION This study was approved by the Research Ethics Committee (Comité de Protection des Personnes, Centre-Ouest I, Tours, France; No 2019-A02651-56) and was declared to the Commission Nationale de l'Informatique et des Libertés. All procedures will be performed according to the ethical standards of the 1975 Declaration of Helsinki, as revised in 2008, and the European Union's Guidelines for Good Clinical Practice. Written informed consent will be obtained from the youths and their parents. Research findings will be disseminated in peer-reviewed journals and scientific meetings, as well as in social media and IBD family support groups. TRIAL REGISTRATION NUMBER NCT04647578.
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Affiliation(s)
- Jérémy Vanhelst
- Sorbonne Paris Nord University, Inserm U1153, Inrae U1125, Cnam, Nutritional Epidemiology Research Team (EREN), Centre of Research in Epidemiology and Statistics - University of Paris Cité (CRESS), Bobigny, France
- Univ. Lille, Inserm, CHU Lille, U1286 - INFINITE - Institute for Translational Research in Inflammation, F-59000, Lille, France
| | - Laurent Beghin
- Univ. Lille, Inserm, CHU Lille, U1286 - INFINITE - Institute for Translational Research in Inflammation, F-59000, Lille, France
| | - Stéphanie Coopman
- Division of Gastroenterology, Hepatology and Nutrition, Department of Paediatrics, Lille University Jeanne de Flandre Children's Hospital, F-59000, Lille, France
| | - Julien Labreuche
- Univ. Lille, CHU Lille, EA 2694 - Public Health: epidemiology and quality of care, F-59000, Lille, France
| | - Djamal Djeddi
- Department of Paediatrics, Amiens University Hospital and University of Amiens, Amiens, France
| | - Frédéric Gottrand
- Univ. Lille, Inserm, CHU Lille, U1286 - INFINITE - Institute for Translational Research in Inflammation, F-59000, Lille, France
- Division of Gastroenterology, Hepatology and Nutrition, Department of Paediatrics, Lille University Jeanne de Flandre Children's Hospital, F-59000, Lille, France
| | - Dominique Turck
- Univ. Lille, Inserm, CHU Lille, U1286 - INFINITE - Institute for Translational Research in Inflammation, F-59000, Lille, France
- Division of Gastroenterology, Hepatology and Nutrition, Department of Paediatrics, Lille University Jeanne de Flandre Children's Hospital, F-59000, Lille, France
| | - Delphine Ley
- Univ. Lille, Inserm, CHU Lille, U1286 - INFINITE - Institute for Translational Research in Inflammation, F-59000, Lille, France
- Division of Gastroenterology, Hepatology and Nutrition, Department of Paediatrics, Lille University Jeanne de Flandre Children's Hospital, F-59000, Lille, France
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Elmehdi S, Ley D, Aumar M, Coopman S, Guimber D, Nicolas A, Antoine M, Turck D, Kyheng M, Gottrand F. Endoscopic Gastrojejunostomy in Infants and Children. J Pediatr 2022; 244:115-119.e1. [PMID: 35108546 DOI: 10.1016/j.jpeds.2022.01.039] [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] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/15/2021] [Revised: 12/02/2021] [Accepted: 01/25/2022] [Indexed: 10/19/2022]
Abstract
OBJECTIVE To evaluate the feasibility of endoscopic gastrojejunal tube (GJT) placement in infants and children. STUDY DESIGN All children undergoing endoscopic GJT placement between January 2010 and December 2019 were included in this single-center retrospective study. Difficulties with and failure of GJT placement, complication rates, and device longevity, efficacy, and duration were assessed. RESULTS A total of 107 children, median age 10 months (IQR, 5.0-23.0 months) and median weight 6.6 kg (IQR, 5.3-9.5 kg), underwent endoscopic GJT placement using the gastric stoma to introduce the endoscope (one step: n = 36 of 107; 33.6%). Endoscopic placement was successful in 99%. Eight periprocedure complications occurred, including 1 pneumoperitoneum requiring exsufflation, 2 acute pulmonary hypertension episodes leading to death in 1 case, and 5 episodes of bronchospasm. Minor complications were frequent and mostly mechanical (79%), whereas major complications were rare (5.6%): intussusception (n = 4), intestinal perforation (n = 1), and pneumoperitoneum (n = 1). Ten patients died. Of the 97 patients who lived, 85 (87%) were weaned from jejunal feeding at a median of 179 days (IQR, 69-295 days) after initiation. Among them, 30 (35.2%) required fundoplication. Weight for age z-score was significantly higher at weaning. CONCLUSIONS GJT placement is feasible in children, even low-weight infants. Complications are frequent but are mostly minor.
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Affiliation(s)
- Sophia Elmehdi
- Division of Hepatology, Gastroenterology, and Nutrition and the Reference Center for Congenital and Malformative Esophageal Disorders, Department of Pediatrics, University of Lille, CHU Lille, Lille, France.
| | - Delphine Ley
- Division of Hepatology, Gastroenterology, and Nutrition and the Reference Center for Congenital and Malformative Esophageal Disorders, Department of Pediatrics, University of Lille, CHU Lille, Lille, France; Inserm, U1286, Institute for Translational Research in Inflammation, University of Lille, CHU Lille, Lille, France
| | - Madeleine Aumar
- Division of Hepatology, Gastroenterology, and Nutrition and the Reference Center for Congenital and Malformative Esophageal Disorders, Department of Pediatrics, University of Lille, CHU Lille, Lille, France; Inserm, U1286, Institute for Translational Research in Inflammation, University of Lille, CHU Lille, Lille, France
| | - Stéphanie Coopman
- Division of Hepatology, Gastroenterology, and Nutrition and the Reference Center for Congenital and Malformative Esophageal Disorders, Department of Pediatrics, University of Lille, CHU Lille, Lille, France
| | - Dominique Guimber
- Division of Hepatology, Gastroenterology, and Nutrition and the Reference Center for Congenital and Malformative Esophageal Disorders, Department of Pediatrics, University of Lille, CHU Lille, Lille, France
| | - Audrey Nicolas
- Division of Hepatology, Gastroenterology, and Nutrition and the Reference Center for Congenital and Malformative Esophageal Disorders, Department of Pediatrics, University of Lille, CHU Lille, Lille, France
| | - Matthieu Antoine
- Division of Hepatology, Gastroenterology, and Nutrition and the Reference Center for Congenital and Malformative Esophageal Disorders, Department of Pediatrics, University of Lille, CHU Lille, Lille, France
| | - Dominique Turck
- Division of Hepatology, Gastroenterology, and Nutrition and the Reference Center for Congenital and Malformative Esophageal Disorders, Department of Pediatrics, University of Lille, CHU Lille, Lille, France; Inserm, U1286, Institute for Translational Research in Inflammation, University of Lille, CHU Lille, Lille, France
| | - Maeva Kyheng
- Division of Methodology, Biostatistics, and Data Management, University of Lille, CHU Lille, Lille, France
| | - Frédéric Gottrand
- Division of Hepatology, Gastroenterology, and Nutrition and the Reference Center for Congenital and Malformative Esophageal Disorders, Department of Pediatrics, University of Lille, CHU Lille, Lille, France; Inserm, U1286, Institute for Translational Research in Inflammation, University of Lille, CHU Lille, Lille, France
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8
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Tran LC, Ley D, Bourdon G, Coopman S, Lerisson H, Tillaux C, Béhal H, Gottrand F, Aumar M. Noninvasive Pediatric Liver Fibrosis Measurement: Two-Dimensional Shear Wave Elastography Compared With Transient Elastography. Front Pediatr 2022; 10:849815. [PMID: 35573968 PMCID: PMC9095976 DOI: 10.3389/fped.2022.849815] [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] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/06/2022] [Accepted: 03/10/2022] [Indexed: 12/20/2022] Open
Abstract
OBJECTIVES Although transient elastography (TE) is the primary noninvasive method for assessing liver fibrosis, its use remains to be validated in children. This study aims to evaluate the agreement between two-dimensional ultrasound shear wave elastography (2D-SWE) and TE to assess pediatric liver stiffness method. METHODS During the 18-month study, we prospectively included 101 consecutive children (median age: 8.5 years, range: 1 month to 17 years) who required TE for medical reasons, and in whom 2D-SWE measurement was performed within a 3-month follow-up during a routine ultrasound. Liver elasticity values were classified according to the Metavir score using published pediatric norms for TE and according to the manufacturer's reference values for 2D-SWE. The Spearman's correlation coefficient was used to assess the relationship between the elasticity measured by the two techniques. Concordance was described by the Bland-Altman method. RESULTS A strong correlation (rho = 0.70, p < 0.001) was found between 2D-SWE and TE for the elasticity measures. The strength of correlation was higher among patients older than 6 years (rho = 0.79, p < 0.001). Concordance between liver fibrosis stages assessed by these techniques was moderate [weighted kappa = 0.46, (95% CI: 0.35-0.57)]. When considering stages over F2, 2D-SWE diagnostic performances showed a sensitivity of 85% (95% CI: 74-92) and a specificity of 57% (95% CI: 42-70) compared with TE. CONCLUSION Measurements of the liver stiffness using 2D-SWE and TE are strongly correlated. The moderate concordance between these techniques for assessing the liver fibrosis stage provides evidence against alternating between these methods during follow-up of patients with the chronic liver diseases.
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Affiliation(s)
- Léa Chantal Tran
- University of Lille, Inserm, CHU Lille, U1286 - INFINITE - Institute for Translational Research in Inflammation, Lille, France
| | - Delphine Ley
- University of Lille, Inserm, CHU Lille, U1286 - INFINITE - Institute for Translational Research in Inflammation, Lille, France.,Division of Gastroenterology, Hepatology and Nutrition, Department of Paediatrics, Jeanne de Flandre Children's Hospital, CHU Lille and University of Lille, Lille, France
| | - Gurvan Bourdon
- Division of Gastroenterology, Hepatology and Nutrition, Department of Paediatrics, Jeanne de Flandre Children's Hospital, CHU Lille and University of Lille, Lille, France
| | - Stéphanie Coopman
- Division of Gastroenterology, Hepatology and Nutrition, Department of Paediatrics, Jeanne de Flandre Children's Hospital, CHU Lille and University of Lille, Lille, France
| | - Héloïse Lerisson
- Department of Paediatric Imaging, Jeanne de Flandre Children's Hospital, CHU Lille, Lille, France
| | - Céline Tillaux
- Department of Paediatric Imaging, Jeanne de Flandre Children's Hospital, CHU Lille, Lille, France
| | - Hélène Béhal
- University of Lille, CHU Lille, ULR 2694 - METRICS: Évaluation des Technologies de Santé et des Pratiques Médicales, Lille, France
| | - Frédéric Gottrand
- University of Lille, Inserm, CHU Lille, U1286 - INFINITE - Institute for Translational Research in Inflammation, Lille, France.,Division of Gastroenterology, Hepatology and Nutrition, Department of Paediatrics, Jeanne de Flandre Children's Hospital, CHU Lille and University of Lille, Lille, France
| | - Madeleine Aumar
- University of Lille, Inserm, CHU Lille, U1286 - INFINITE - Institute for Translational Research in Inflammation, Lille, France.,Division of Gastroenterology, Hepatology and Nutrition, Department of Paediatrics, Jeanne de Flandre Children's Hospital, CHU Lille and University of Lille, Lille, France
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9
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Privat E, Aumar M, Ley D, Tran LC, Coopman S, Guimber D, Turck D, Gottrand F. Efficacy and tolerance of enteral nutrition in children with biliary atresia awaiting liver transplantation. Front Pediatr 2022; 10:983717. [PMID: 36120654 PMCID: PMC9479203 DOI: 10.3389/fped.2022.983717] [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] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/01/2022] [Accepted: 08/01/2022] [Indexed: 11/13/2022] Open
Abstract
OBJECTIVES Malnutrition is common in children with biliary atresia (BA) awaiting liver transplantation (LT). Few studies have evaluated the effectiveness of enteral nutrition (EN) in these patients. The objective of this work was to assess the efficacy and tolerance of EN in children with BA awaiting LT. METHODS A total of 31 patients with BA followed between 1995 and 2018 were retrospectively included. Anthropometric indicators (weight, length, and head circumference) and adverse effects of EN were noted at the start (T0) and the end (T1) of EN. The z-scores for anthropometric indicators were compared between T0 and T1. RESULTS The median age at T0 was 7 months (interquartile range [IQR] 5-9), and the median duration of EN was 9 months (IQR 3-17). The z-scores for anthropometric variables improved from T0 to T1: -1.6 (IQR -2.5 to -1.0) to -0.5 (IQR -1.8 to 0.3) for median weight for age; -1.3 (IQR -2.4 to 0) to -0.4 (IQR -2.0 to 0.7) for length for age; -0.9 (IQR -2.3 to -0.3) to -0.3 (IQR -1.2 to 0.1) for weight for length; and -1.2 (IQR -2.1 to -0.6) to -0.2 (IQR -1.6 to 0.4) for body mass index (p < 0.05 for all comparisons). Nearly all (94%) of the patients had a weight-for-length z-score > -2 at the end of EN; 23% had adverse effects and 10% had complications leading to the cessation of EN. CONCLUSION EN is effective and well tolerated in infants with BA awaiting LT.
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Affiliation(s)
- Elodie Privat
- Univ. Lille, Division of Gastroenterology, Hepatology and Nutrition, Department of Paediatrics, Jeanne de Flandre Children's Hospital, CHU Lille, Lille, France
| | - Madeleine Aumar
- Univ. Lille, Division of Gastroenterology, Hepatology and Nutrition, Department of Paediatrics, Jeanne de Flandre Children's Hospital, CHU Lille, Lille, France.,Univ. Lille, Inserm, CHU Lille, U1286 - INFINITE - Institute for Translational Research in Inflammation, Lille, France
| | - Delphine Ley
- Univ. Lille, Division of Gastroenterology, Hepatology and Nutrition, Department of Paediatrics, Jeanne de Flandre Children's Hospital, CHU Lille, Lille, France.,Univ. Lille, Inserm, CHU Lille, U1286 - INFINITE - Institute for Translational Research in Inflammation, Lille, France
| | - Léa Chantal Tran
- Univ. Lille, Inserm, CHU Lille, U1286 - INFINITE - Institute for Translational Research in Inflammation, Lille, France
| | - Stéphanie Coopman
- Univ. Lille, Division of Gastroenterology, Hepatology and Nutrition, Department of Paediatrics, Jeanne de Flandre Children's Hospital, CHU Lille, Lille, France
| | - Dominique Guimber
- Univ. Lille, Division of Gastroenterology, Hepatology and Nutrition, Department of Paediatrics, Jeanne de Flandre Children's Hospital, CHU Lille, Lille, France
| | - Dominique Turck
- Univ. Lille, Division of Gastroenterology, Hepatology and Nutrition, Department of Paediatrics, Jeanne de Flandre Children's Hospital, CHU Lille, Lille, France.,Univ. Lille, Inserm, CHU Lille, U1286 - INFINITE - Institute for Translational Research in Inflammation, Lille, France
| | - Frédéric Gottrand
- Univ. Lille, Division of Gastroenterology, Hepatology and Nutrition, Department of Paediatrics, Jeanne de Flandre Children's Hospital, CHU Lille, Lille, France.,Univ. Lille, Inserm, CHU Lille, U1286 - INFINITE - Institute for Translational Research in Inflammation, Lille, France
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10
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Vanhelst J, Béghin L, Turck D, Labreuche J, Coopman S, Gottrand F, Ley D. Daily physical activity patterns in children and adolescents with inflammatory bowel disease. Pediatr Res 2021; 90:847-852. [PMID: 33469176 DOI: 10.1038/s41390-020-01313-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/29/2020] [Revised: 11/14/2020] [Accepted: 11/19/2020] [Indexed: 01/30/2023]
Abstract
BACKGROUND The aim of this study was to assess PA patterns among children and adolescents with inflammatory bowel disease (IBD). METHODS Sixty participants with IBD (42 Crohn's disease [CD], 10 ulcerative colitis [UC], and 8 IBD-unclassified [IBD-U], 30 male patients) in remission (n = 45) or with mild disease (n = 15) were compared with 60 healthy age- and sex-matched controls. Each participant wore a triaxial accelerometer during 4 consecutive days for objective daily PA quantification. RESULTS Overall, there was no significant difference in daily PA patterns between patients with IBD and healthy controls, with 31.7% of patients with IBD and 38.3% of healthy controls fulfilling the recommendation of 60 min of moderate-to-vigorous physical activity (MVPA) daily (NS). Male patients with IBD spent significantly less time in MVPA compared with matched healthy controls (mean difference, 16.2 min day-1; p < 0.05). No difference was observed for female patients with IBD. No difference in sedentary pattern between male patients with IBD and controls was found. CONCLUSIONS Children and adolescents with inactive or mildly active IBD have similar PA patterns compared with healthy controls, except for male patients who have reduced moderate-to-vigorous PA. By far, most patients with IBD do not fulfill the MVPA recommendations for health benefits. IMPACT There is few data on PA patterns in pediatric patients with IBD. Methodological issues to assess PA limit the strengths of these studies. Pediatric IBD patients with inactive or mildly active IBD have similar physical activity patterns compared with healthy controls, except for male patients who have reduced moderate-to-vigorous PA. Most patients with IBD do not fulfill the MVPA recommendations for health benefits.
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Affiliation(s)
- Jérémy Vanhelst
- Univ. Lille, Inserm, CHU Lille, U1286 - INFINITE - Institute for Translational Research in Inflammation, 59000, Lille, France. .,CIC 1403 - Clinical Investigation Center, CHU Lille, 59000, Lille, France.
| | - Laurent Béghin
- Univ. Lille, Inserm, CHU Lille, U1286 - INFINITE - Institute for Translational Research in Inflammation, 59000, Lille, France.,CIC 1403 - Clinical Investigation Center, CHU Lille, 59000, Lille, France
| | - Dominique Turck
- Univ. Lille, Inserm, CHU Lille, U1286 - INFINITE - Institute for Translational Research in Inflammation, 59000, Lille, France.,Division of Gastroenterology, Hepatology and Nutrition, Department of Pediatrics, Lille University Jeanne de Flandre Children's Hospital, 59000, Lille, France
| | - Julien Labreuche
- Univ. Lille, CHU Lille, ULR 2694 - METRICS: Evaluation des technologies de santé et des pratiques médicales, 59000, Lille, France
| | - Stéphanie Coopman
- Division of Gastroenterology, Hepatology and Nutrition, Department of Pediatrics, Lille University Jeanne de Flandre Children's Hospital, 59000, Lille, France
| | - Frédéric Gottrand
- Univ. Lille, Inserm, CHU Lille, U1286 - INFINITE - Institute for Translational Research in Inflammation, 59000, Lille, France.,Division of Gastroenterology, Hepatology and Nutrition, Department of Pediatrics, Lille University Jeanne de Flandre Children's Hospital, 59000, Lille, France
| | - Delphine Ley
- Univ. Lille, Inserm, CHU Lille, U1286 - INFINITE - Institute for Translational Research in Inflammation, 59000, Lille, France.,Division of Gastroenterology, Hepatology and Nutrition, Department of Pediatrics, Lille University Jeanne de Flandre Children's Hospital, 59000, Lille, France
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11
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Dipasquale V, Lecoeur K, Aumar M, Guimber D, Coopman S, Nicolas A, Lecoufle A, Van Malleghem A, Turck D, Ley D, Gottrand F. Weaning children from prolonged enteral nutrition: A survey of practice on behalf of the French Society of Paediatric Gastroenterology, Hepatology, and Nutrition. JPEN J Parenter Enteral Nutr 2021; 46:215-221. [PMID: 33667013 DOI: 10.1002/jpen.2100] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2020] [Revised: 02/11/2021] [Accepted: 02/28/2021] [Indexed: 11/10/2022]
Abstract
BACKGROUND No consensus currently exists on tube-weaning practice worldwide. The aim of this study was to describe tube-weaning practice (indications and modalities) of a panel of pediatric gastroenterologists involved in the management of prolonged enteral nutrition (EN). METHODS A cross-sectional survey of pediatric gastroenterologists involved in the management of children receiving prolonged (>3 months) EN who were likely to be weaned was conducted. A questionnaire containing 24 questions was disseminated to the French Speaking Group of Paediatric Gastroenterology, Hepatology, and Nutrition members. The association between weaning practice and the experience of respondents was investigated. RESULTS In total, 311 professionals were approached, and 64 questionnaires were completed (response rate 21%). Nearly all respondents (n = 61, 95%) reported using individualized weaning programs. Weaning attempts were performed more frequently at home, and follow-up was performed in the outpatient clinic (97%) by progressive EN volume reduction (83%). Inpatient weaning was performed by only 28% of participants. The choice of the setting was predominantly (59%) based on parental request. Management and follow-up involved mainly the referring pediatric gastroenterologist and the dietitian. Fifty-one (80%) of the respondents experienced ≥1 weaning failure. CONCLUSIONS This is one of only a few studies examining real-life pediatric tube-weaning practices. Considerable practice variation between centers was observed; some of the common practices included the setting of weaning (outpatient vs inpatient) and the eligibility criteria. Increasing knowledge about weaning modalities is the starting point for the design of consensual standardized programs.
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Affiliation(s)
- Valeria Dipasquale
- Division of Gastroenterology, Hepatology and Nutrition, Department of Paediatrics, Jeanne de Flandre Children's Hospital, CHU Lille and University of Lille, Lille, France
| | - Katia Lecoeur
- Division of Gastroenterology, Hepatology and Nutrition, Department of Paediatrics, Jeanne de Flandre Children's Hospital, CHU Lille and University of Lille, Lille, France
| | - Madeleine Aumar
- Division of Gastroenterology, Hepatology and Nutrition, Department of Paediatrics, Jeanne de Flandre Children's Hospital, CHU Lille and University of Lille, Lille, France.,U1286-INFINITE-Institute for Translational Research in Inflammation, University Lille, Inserm, CHU Lille, Lille, France
| | - Dominique Guimber
- Division of Gastroenterology, Hepatology and Nutrition, Department of Paediatrics, Jeanne de Flandre Children's Hospital, CHU Lille and University of Lille, Lille, France
| | - Stéphanie Coopman
- Division of Gastroenterology, Hepatology and Nutrition, Department of Paediatrics, Jeanne de Flandre Children's Hospital, CHU Lille and University of Lille, Lille, France
| | - Audrey Nicolas
- Division of Gastroenterology, Hepatology and Nutrition, Department of Paediatrics, Jeanne de Flandre Children's Hospital, CHU Lille and University of Lille, Lille, France
| | - Audrey Lecoufle
- Division of Gastroenterology, Hepatology and Nutrition, Department of Paediatrics, Jeanne de Flandre Children's Hospital, CHU Lille and University of Lille, Lille, France
| | - Audrey Van Malleghem
- Division of Gastroenterology, Hepatology and Nutrition, Department of Paediatrics, Jeanne de Flandre Children's Hospital, CHU Lille and University of Lille, Lille, France
| | - Dominique Turck
- Division of Gastroenterology, Hepatology and Nutrition, Department of Paediatrics, Jeanne de Flandre Children's Hospital, CHU Lille and University of Lille, Lille, France.,U1286-INFINITE-Institute for Translational Research in Inflammation, University Lille, Inserm, CHU Lille, Lille, France
| | - Delphine Ley
- Division of Gastroenterology, Hepatology and Nutrition, Department of Paediatrics, Jeanne de Flandre Children's Hospital, CHU Lille and University of Lille, Lille, France.,U1286-INFINITE-Institute for Translational Research in Inflammation, University Lille, Inserm, CHU Lille, Lille, France
| | - Frédéric Gottrand
- Division of Gastroenterology, Hepatology and Nutrition, Department of Paediatrics, Jeanne de Flandre Children's Hospital, CHU Lille and University of Lille, Lille, France.,U1286-INFINITE-Institute for Translational Research in Inflammation, University Lille, Inserm, CHU Lille, Lille, France
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12
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Tran LC, Coopman S, Rivallain C, Aumar M, Guimber D, Nicolas A, Darras V, Turck D, Gottrand F, Ley D. Use of Hypnosis in Paediatric Gastrointestinal Endoscopy: A Pilot Study. Front Pediatr 2021; 9:719626. [PMID: 34631620 PMCID: PMC8492983 DOI: 10.3389/fped.2021.719626] [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] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/02/2021] [Accepted: 08/23/2021] [Indexed: 11/13/2022] Open
Abstract
Objectives: Experience of hypnosis in gastrointestinal (GI) endoscopy is scarce in children. Our aims were to assess the rate of successful GI endoscopy performed using hypnosis alone or in combination with midazolam, with or without additional equimolar mixture of oxygen and nitrous oxide (EMONO), and to identify predictive factors of successful endoscopy in children. Methods: This prospective single-centre study included children older than 6 years requiring a diagnostic esophagogastroduodenoscopy (EGD) or rectosigmoidoscopy. Ericksonian hypnosis was performed alone or in combination with midazolam, with or without additional EMONO. Successful endoscopy was defined by a complete and well-tolerated procedure. Levels of satisfaction of the endoscopist, nurse, and patient were assessed. Results: One hundred forty children [70 boys, median age: 12 years (Q1-Q3: 9-14)] were included over a 14-month period. They underwent EGD in 51.4% (n = 72) and rectosigmoidoscopy in 48.6% (n = 68) of cases. EMONO and midazolam were combined with hypnosis in 136 cases (97.1%). Successful endoscopy rate reached 82.9%. The procedure was interrupted due to poor tolerance and was rescheduled under general anaesthesia in 11 patients (7.9%). Predictive factors for successful endoscopy were older age (13 vs. 8 years, OR: 1.34, CI 95% [1.10-1.62], p = 0.003) and type of endoscopy (EGD vs. rectosigmoidoscopy, OR: 16.34 [2.14-124.68], p = 0.007). A good cooperation of the patient was reported by the endoscopist and the nurse in 88.4 and 86.9% of cases, respectively. Ninety-two per cent of patients mentioned that the procedure went well. Conclusions: Our study suggests that hypnosis combined with EMONO and/or midazolam is of additional value to perform diagnostic EGD or rectosigmoidoscopy in children older than 6 years without systematic need for general anaesthesia.
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Affiliation(s)
- Léa Chantal Tran
- Univ. Lille, Inserm, CHU Lille, U1286 - INFINITE - Institute for Translational Research in Inflammation, Lille, France
| | - Stéphanie Coopman
- Division of Gastroenterology, Hepatology and Nutrition, Department of Paediatrics, Jeanne de Flandre Children's Hospital, CHU Lille and Univ. Lille, Lille, France
| | - Céline Rivallain
- Division of Gastroenterology, Hepatology and Nutrition, Department of Paediatrics, Jeanne de Flandre Children's Hospital, CHU Lille and Univ. Lille, Lille, France
| | - Madeleine Aumar
- Univ. Lille, Inserm, CHU Lille, U1286 - INFINITE - Institute for Translational Research in Inflammation, Lille, France.,Division of Gastroenterology, Hepatology and Nutrition, Department of Paediatrics, Jeanne de Flandre Children's Hospital, CHU Lille and Univ. Lille, Lille, France
| | - Dominique Guimber
- Division of Gastroenterology, Hepatology and Nutrition, Department of Paediatrics, Jeanne de Flandre Children's Hospital, CHU Lille and Univ. Lille, Lille, France
| | - Audrey Nicolas
- Division of Gastroenterology, Hepatology and Nutrition, Department of Paediatrics, Jeanne de Flandre Children's Hospital, CHU Lille and Univ. Lille, Lille, France
| | - Valérie Darras
- Division of Gastroenterology, Hepatology and Nutrition, Department of Paediatrics, Jeanne de Flandre Children's Hospital, CHU Lille and Univ. Lille, Lille, France
| | - Dominique Turck
- Univ. Lille, Inserm, CHU Lille, U1286 - INFINITE - Institute for Translational Research in Inflammation, Lille, France.,Division of Gastroenterology, Hepatology and Nutrition, Department of Paediatrics, Jeanne de Flandre Children's Hospital, CHU Lille and Univ. Lille, Lille, France
| | - Frédéric Gottrand
- Univ. Lille, Inserm, CHU Lille, U1286 - INFINITE - Institute for Translational Research in Inflammation, Lille, France.,Division of Gastroenterology, Hepatology and Nutrition, Department of Paediatrics, Jeanne de Flandre Children's Hospital, CHU Lille and Univ. Lille, Lille, France
| | - Delphine Ley
- Univ. Lille, Inserm, CHU Lille, U1286 - INFINITE - Institute for Translational Research in Inflammation, Lille, France.,Division of Gastroenterology, Hepatology and Nutrition, Department of Paediatrics, Jeanne de Flandre Children's Hospital, CHU Lille and Univ. Lille, Lille, France
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13
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Dipasquale V, Lecoeur K, Aumar M, Guimber D, Coopman S, Nicolas A, Turck D, Gottrand F, Ley D. Factors Associated With Success and Failure of Weaning Children From Prolonged Enteral Nutrition: A Retrospective Cohort Study. J Pediatr Gastroenterol Nutr 2021; 72:135-140. [PMID: 32810034 DOI: 10.1097/mpg.0000000000002909] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/10/2022]
Abstract
OBJECTIVES The aims of the present study were to assess the efficacy of a tube weaning program, and to identify factors associated with success and failure. METHODS This was a retrospective cohort study including all pediatric patients on enteral nutrition (EN) for ≥6 months for whom at least 1 attempt of weaning was performed in a single tertiary referral center from 2012 to 2017, with a minimum follow-up of 6 months after EN discontinuation. Weaning program was individualized to each child. Weaning success was defined a priori. Factors associated with success were investigated using multivariate analysis. RESULTS Ninety-four patients were enrolled, in whom a total of 114 attempts of weaning were performed at a median age of 51 ± 40 months. Success was achieved in 80 attempts (success rate of 70%). One hundred three (92%) weaning attempts were performed at home with a follow-up in the outpatient clinic, mostly (74%) by a progressive (>1 month) reduction of tube feeding. Patients who required psychological support during weaning had more failures than patients who did not (odds ratio = 5.7, 95% confidence interval [1.2-27.0], P = 0.03). The presence of impaired oral feeding skills at the time of EN discontinuation was also predictive of failure (odds ratio = 6.2, 95% confidence interval [0.05-0.5], P = 0.005). CONCLUSIONS Our progressive, mostly outpatient-based, patient-tailored program of weaning from EN is effective for tube-dependent children. Children who need psychological support during weaning and those who present impaired oral feeding skills represent a subgroup of at-risk patients for whom alternative weaning strategies may need to be considered.
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Affiliation(s)
- Valeria Dipasquale
- Division of Gastroenterology, Hepatology and Nutrition, Department of Paediatrics, Jeanne de Flandre Children's Hospital, CHU Lille and University of Lille
| | - Katia Lecoeur
- Division of Gastroenterology, Hepatology and Nutrition, Department of Paediatrics, Jeanne de Flandre Children's Hospital, CHU Lille and University of Lille
| | - Madeleine Aumar
- Division of Gastroenterology, Hepatology and Nutrition, Department of Paediatrics, Jeanne de Flandre Children's Hospital, CHU Lille and University of Lille.,Inserm, CHU Lille, U1286 - INFINITE - Institute for Translational Research in Inflammation, University Lille, Lille, France
| | - Dominique Guimber
- Division of Gastroenterology, Hepatology and Nutrition, Department of Paediatrics, Jeanne de Flandre Children's Hospital, CHU Lille and University of Lille
| | - Stéphanie Coopman
- Division of Gastroenterology, Hepatology and Nutrition, Department of Paediatrics, Jeanne de Flandre Children's Hospital, CHU Lille and University of Lille
| | - Audrey Nicolas
- Division of Gastroenterology, Hepatology and Nutrition, Department of Paediatrics, Jeanne de Flandre Children's Hospital, CHU Lille and University of Lille
| | - Dominique Turck
- Division of Gastroenterology, Hepatology and Nutrition, Department of Paediatrics, Jeanne de Flandre Children's Hospital, CHU Lille and University of Lille.,Inserm, CHU Lille, U1286 - INFINITE - Institute for Translational Research in Inflammation, University Lille, Lille, France
| | - Frédéric Gottrand
- Division of Gastroenterology, Hepatology and Nutrition, Department of Paediatrics, Jeanne de Flandre Children's Hospital, CHU Lille and University of Lille.,Inserm, CHU Lille, U1286 - INFINITE - Institute for Translational Research in Inflammation, University Lille, Lille, France
| | - Delphine Ley
- Division of Gastroenterology, Hepatology and Nutrition, Department of Paediatrics, Jeanne de Flandre Children's Hospital, CHU Lille and University of Lille.,Inserm, CHU Lille, U1286 - INFINITE - Institute for Translational Research in Inflammation, University Lille, Lille, France
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Dipasquale V, Lecoeur K, Aumar M, Guimber D, Coopman S, Nicolas A, Turck D, Gottrand F, Ley D. Factors associated with success of weaning children from prolonged enteral nutrition. Clin Nutr ESPEN 2020. [DOI: 10.1016/j.clnesp.2020.09.051] [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: 10/23/2022]
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15
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Charbit-Henrion F, Parlato M, Hanein S, Duclaux-Loras R, Nowak J, Begue B, Rakotobe S, Bruneau J, Fourrage C, Alibeu O, Rieux-Laucat F, Lévy E, Stolzenberg MC, Mazerolles F, Latour S, Lenoir C, Fischer A, Picard C, Aloi M, Dias JA, Hariz MB, Bourrier A, Breuer C, Breton A, Bronsky J, Buderus S, Cananzi M, Coopman S, Crémilleux C, Dabadie A, Dumant-Forest C, Gurkan OE, Fabre A, Fischer A, Diaz MG, Gonzalez-Lama Y, Goulet O, Guariso G, Gurcan N, Homan M, Hugot JP, Jeziorski E, Karanika E, Lachaux A, Lewindon P, Lima R, Magro F, Major J, Malamut G, Mas E, Mattyus I, Mearin LM, Melek J, Navas-Lopez VM, Paerregaard A, Pelatan C, Pigneur B, Pais IP, Rebeuh J, Romano C, Siala N, Strisciuglio C, Tempia-Caliera M, Tounian P, Turner D, Urbonas V, Willot S, Ruemmele FM, Cerf-Bensussan N. Corrigendum to: Diagnostic Yield of Next-Generation Sequencing in Very Early-Onset Inflammatory Bowel Diseases: A Multicenter Study. J Crohns Colitis 2020; 15:517-518. [PMID: 32895718 PMCID: PMC7944498 DOI: 10.1093/ecco-jcc/jjaa164] [Citation(s) in RCA: 0] [Impact Index Per Article: 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] [Indexed: 01/22/2023]
Affiliation(s)
- Fabienne Charbit-Henrion
- INSERM, UMR1163, Laboratory of Intestinal Immunity, and Imagine Institute, Paris, France,Université Paris Descartes-Sorbonne Paris Cité, Paris, France,Paediatric Gastroenterology, Hepatology and Nutrition Unit, Hôpital Necker-Enfants Malades, Assistance Publique-Hôpitaux de Paris, Paris, France,GENIUS Group [GENetically ImmUne–mediated enteropathieS] from the European Society for Paediatric Gastroenterology, Hepatology and Nutrition [ESPGHAN]
| | - Marianna Parlato
- INSERM, UMR1163, Laboratory of Intestinal Immunity, and Imagine Institute, Paris, France,Université Paris Descartes-Sorbonne Paris Cité, Paris, France,GENIUS Group [GENetically ImmUne–mediated enteropathieS] from the European Society for Paediatric Gastroenterology, Hepatology and Nutrition [ESPGHAN]
| | - Sylvain Hanein
- INSERM, UMR 1163 Translational Genetic, and Imagine Institute, Paris, France
| | - Rémi Duclaux-Loras
- INSERM, UMR1163, Laboratory of Intestinal Immunity, and Imagine Institute, Paris, France,Université Paris Descartes-Sorbonne Paris Cité, Paris, France,GENIUS Group [GENetically ImmUne–mediated enteropathieS] from the European Society for Paediatric Gastroenterology, Hepatology and Nutrition [ESPGHAN]
| | - Jan Nowak
- INSERM, UMR1163, Laboratory of Intestinal Immunity, and Imagine Institute, Paris, France,Université Paris Descartes-Sorbonne Paris Cité, Paris, France,GENIUS Group [GENetically ImmUne–mediated enteropathieS] from the European Society for Paediatric Gastroenterology, Hepatology and Nutrition [ESPGHAN],Department of Paediatric Gastroenterology and Metabolic Diseases, Poznan University of Medical Sciences, Poznan, Poland
| | - Bernadette Begue
- INSERM, UMR1163, Laboratory of Intestinal Immunity, and Imagine Institute, Paris, France,Université Paris Descartes-Sorbonne Paris Cité, Paris, France,GENIUS Group [GENetically ImmUne–mediated enteropathieS] from the European Society for Paediatric Gastroenterology, Hepatology and Nutrition [ESPGHAN]
| | - Sabine Rakotobe
- INSERM, UMR1163, Laboratory of Intestinal Immunity, and Imagine Institute, Paris, France,Université Paris Descartes-Sorbonne Paris Cité, Paris, France,GENIUS Group [GENetically ImmUne–mediated enteropathieS] from the European Society for Paediatric Gastroenterology, Hepatology and Nutrition [ESPGHAN]
| | - Julie Bruneau
- Université Paris Descartes-Sorbonne Paris Cité, Paris, France,Pathology Department, Hôpital Necker-Enfants Malades, Assistance Publique-Hôpitaux de Paris, Paris, France
| | - Cécile Fourrage
- Université Paris Descartes-Sorbonne Paris Cité, Paris, France,Bioinformatics Platform, Imagine Institute, Paris, France
| | - Olivier Alibeu
- Université Paris Descartes-Sorbonne Paris Cité, Paris, France,Genomic Platform, Imagine Institute, Paris, France
| | - Frédéric Rieux-Laucat
- Université Paris Descartes-Sorbonne Paris Cité, Paris, France,INSERM, UMR1163, Immunogenetics of Paediatric Autoimmunity, and Imagine Institute, Paris, France
| | - Eva Lévy
- Université Paris Descartes-Sorbonne Paris Cité, Paris, France,INSERM, UMR1163, Immunogenetics of Paediatric Autoimmunity, and Imagine Institute, Paris, France
| | - Marie-Claude Stolzenberg
- Université Paris Descartes-Sorbonne Paris Cité, Paris, France,INSERM, UMR1163, Immunogenetics of Paediatric Autoimmunity, and Imagine Institute, Paris, France
| | - Fabienne Mazerolles
- Université Paris Descartes-Sorbonne Paris Cité, Paris, France,INSERM, UMR1163, Immunogenetics of Paediatric Autoimmunity, and Imagine Institute, Paris, France
| | - Sylvain Latour
- Université Paris Descartes-Sorbonne Paris Cité, Paris, France,INSERM, UMR1163, Lymphocyte Activation and EBV Susceptibility, and Imagine Institute, Paris, France
| | - Christelle Lenoir
- Université Paris Descartes-Sorbonne Paris Cité, Paris, France,INSERM, UMR1163, Lymphocyte Activation and EBV Susceptibility, and Imagine Institute, Paris, France
| | - Alain Fischer
- Université Paris Descartes-Sorbonne Paris Cité, Paris, France,Collège de France, Médecine expérimentale, Paris, France,INSERM UMR 1163 and Imagine Institute, Paris, France
| | - Capucine Picard
- Université Paris Descartes-Sorbonne Paris Cité, Paris, France,INSERM, UMR1163, Lymphocyte Activation and EBV Susceptibility, and Imagine Institute, Paris, France,Investigation Centre for Immunodeficiency, Hôpital Necker-Enfants Malades, Assistance Publique-Hôpitaux de Paris and Imagine Institute, Paris, France
| | - Marina Aloi
- GENIUS Group [GENetically ImmUne–mediated enteropathieS] from the European Society for Paediatric Gastroenterology, Hepatology and Nutrition [ESPGHAN],Sapienza University of Rome, Paediatric Gastroenterology and Liver Unit, Department of Pediatrics, Rome, Italy
| | - Jorge Amil Dias
- GENIUS Group [GENetically ImmUne–mediated enteropathieS] from the European Society for Paediatric Gastroenterology, Hepatology and Nutrition [ESPGHAN],Department of Paediatrics, Centro Hospitalar São João, Porto, Portugal
| | - Mongi Ben Hariz
- GENIUS Group [GENetically ImmUne–mediated enteropathieS] from the European Society for Paediatric Gastroenterology, Hepatology and Nutrition [ESPGHAN],Department of Paediatrics, Hopital La Marsa, Tunisia
| | - Anne Bourrier
- Department of Gastroenterology, Hôpital St Antoine, Assistance Publique-Hôpitaux de Paris, Paris, France
| | - Christian Breuer
- GENIUS Group [GENetically ImmUne–mediated enteropathieS] from the European Society for Paediatric Gastroenterology, Hepatology and Nutrition [ESPGHAN],Department of Paediatrics, Universitätsklinikum Hamburg, Hamburg, Germany
| | - Anne Breton
- GENIUS Group [GENetically ImmUne–mediated enteropathieS] from the European Society for Paediatric Gastroenterology, Hepatology and Nutrition [ESPGHAN],Department of Paediatrics, Gastroenterology, Hepatology, Nutrition, and Diabetes, Centre Hospitalier Universitaire de Toulouse, Toulouse, France
| | - Jiri Bronsky
- GENIUS Group [GENetically ImmUne–mediated enteropathieS] from the European Society for Paediatric Gastroenterology, Hepatology and Nutrition [ESPGHAN],University Hospital Motol, Prague, Czech Republic
| | - Stephan Buderus
- GENIUS Group [GENetically ImmUne–mediated enteropathieS] from the European Society for Paediatric Gastroenterology, Hepatology and Nutrition [ESPGHAN],St. Marien Hospital, Bonn, Germany
| | - Mara Cananzi
- GENIUS Group [GENetically ImmUne–mediated enteropathieS] from the European Society for Paediatric Gastroenterology, Hepatology and Nutrition [ESPGHAN],Unit of Paediatric Hepatology, Department of Woman and Child Health, University Hospital of Padova, Padova, Italy
| | - Stéphanie Coopman
- GENIUS Group [GENetically ImmUne–mediated enteropathieS] from the European Society for Paediatric Gastroenterology, Hepatology and Nutrition [ESPGHAN],Division of Gastroenterology, Hepatology and Nutrition, Department of Paediatrics, Jeanne De Flandre Children’s Hospital, Lille University Faculty of Medicine, Lille, France
| | - Clara Crémilleux
- GENIUS Group [GENetically ImmUne–mediated enteropathieS] from the European Society for Paediatric Gastroenterology, Hepatology and Nutrition [ESPGHAN],Department of Paediatrics, Centre Hospitalo-Universitaire de St-Etienne, St-Etienne, France
| | - Alain Dabadie
- GENIUS Group [GENetically ImmUne–mediated enteropathieS] from the European Society for Paediatric Gastroenterology, Hepatology and Nutrition [ESPGHAN],Service de médecine de l’enfant et de l’adolescent, Hôpital Sud – Centre Hospitalo- Universitaire de Rennes, Rennes, France
| | - Clémentine Dumant-Forest
- GENIUS Group [GENetically ImmUne–mediated enteropathieS] from the European Society for Paediatric Gastroenterology, Hepatology and Nutrition [ESPGHAN],Department of Paediatrics, Centre Hospitalo-Universitaire Charles Nicolle, Rouen, France
| | - Odul Egritas Gurkan
- GENIUS Group [GENetically ImmUne–mediated enteropathieS] from the European Society for Paediatric Gastroenterology, Hepatology and Nutrition [ESPGHAN],Paediatric Gastroenterology, Hepatology and Nutrition, Gazi University, Ankara, Turkey
| | - Alexandre Fabre
- GENIUS Group [GENetically ImmUne–mediated enteropathieS] from the European Society for Paediatric Gastroenterology, Hepatology and Nutrition [ESPGHAN],Department of Paediatrics, Assistance publique Hôpitaux de Marseille, Hôpital de la Timone, Marseille, France
| | - Aude Fischer
- GENIUS Group [GENetically ImmUne–mediated enteropathieS] from the European Society for Paediatric Gastroenterology, Hepatology and Nutrition [ESPGHAN],Department of Paediatrics, Centre Hospitalo-Universitaire Sud Réunion, St Pierre, France
| | - Marta German Diaz
- GENIUS Group [GENetically ImmUne–mediated enteropathieS] from the European Society for Paediatric Gastroenterology, Hepatology and Nutrition [ESPGHAN],Unit of Paediatric Nutrition, Hospital Universitario 12 de Octubre, Madrid, Spain
| | - Yago Gonzalez-Lama
- Inflammatory Bowel Disease Unit, Hospital Universitario Puerta de Hierro–Majadahonda, Madrid, Spain
| | - Olivier Goulet
- Université Paris Descartes-Sorbonne Paris Cité, Paris, France,Paediatric Gastroenterology, Hepatology and Nutrition Unit, Hôpital Necker-Enfants Malades, Assistance Publique-Hôpitaux de Paris, Paris, France,GENIUS Group [GENetically ImmUne–mediated enteropathieS] from the European Society for Paediatric Gastroenterology, Hepatology and Nutrition [ESPGHAN]
| | - Graziella Guariso
- GENIUS Group [GENetically ImmUne–mediated enteropathieS] from the European Society for Paediatric Gastroenterology, Hepatology and Nutrition [ESPGHAN],University of Padua, Italy
| | - Neslihan Gurcan
- GENIUS Group [GENetically ImmUne–mediated enteropathieS] from the European Society for Paediatric Gastroenterology, Hepatology and Nutrition [ESPGHAN],Paediatric Gastroenterology, Hepatology and Nutrition, Gazi University, Ankara, Turkey
| | - Matjaz Homan
- GENIUS Group [GENetically ImmUne–mediated enteropathieS] from the European Society for Paediatric Gastroenterology, Hepatology and Nutrition [ESPGHAN],Department of Gastroenterology, Hepatology and Nutrition, University Children’s Hospital, Ljubljana, Slovenia
| | - Jean-Pierre Hugot
- GENIUS Group [GENetically ImmUne–mediated enteropathieS] from the European Society for Paediatric Gastroenterology, Hepatology and Nutrition [ESPGHAN],Departments of Paediatric Digestive and Respiratory Diseases, Hôpital Robert-Debré, Assistance Publique-Hôpitaux de Paris, Paris, France
| | - Eric Jeziorski
- GENIUS Group [GENetically ImmUne–mediated enteropathieS] from the European Society for Paediatric Gastroenterology, Hepatology and Nutrition [ESPGHAN],Department of Paediatrics, Infectious diseases and Immunology, Centre Hospitalo-Universitaire de Montpellier, Montpellier, France
| | - Evi Karanika
- GENIUS Group [GENetically ImmUne–mediated enteropathieS] from the European Society for Paediatric Gastroenterology, Hepatology and Nutrition [ESPGHAN],Department of Paediatrics, University General Hospital of Thessaloniki, Thessaloniki, Greece
| | - Alain Lachaux
- GENIUS Group [GENetically ImmUne–mediated enteropathieS] from the European Society for Paediatric Gastroenterology, Hepatology and Nutrition [ESPGHAN],Department of Paediatric Gastroenterology, Hepatology and Nutrition, Centre de Nutrition parentérale à domicile, Hôpital Femme–Mère– Enfant CHU de Lyon HCL - GH Est, Bron, France
| | - Peter Lewindon
- GENIUS Group [GENetically ImmUne–mediated enteropathieS] from the European Society for Paediatric Gastroenterology, Hepatology and Nutrition [ESPGHAN],Department of Gastroenterology and Hepatology, Lady Cilento Children’s Hospital and the Faculty of Medicine and Biomedical Sciences, University of Queensland, Brisbane, Australia
| | - Rosa Lima
- GENIUS Group [GENetically ImmUne–mediated enteropathieS] from the European Society for Paediatric Gastroenterology, Hepatology and Nutrition [ESPGHAN],Department of Paediatrics, Centro Hospitalar São João, Porto, Portugal
| | - Fernando Magro
- Gastroenterology Department, Hospital de São João, Institute of Pharmacology and Therapeutics Faculty of Medicine and MedInUP - Centre for Drug Discovery and Innovative Medicines, University of Porto, Porto, Portugal
| | - Janos Major
- GENIUS Group [GENetically ImmUne–mediated enteropathieS] from the European Society for Paediatric Gastroenterology, Hepatology and Nutrition [ESPGHAN],MRE Bethesda Gyermekkórháza; Department of Pediatrics, Budapest, Hungary
| | - Georgia Malamut
- INSERM, UMR1163, Laboratory of Intestinal Immunity, and Imagine Institute, Paris, France,Université Paris Descartes-Sorbonne Paris Cité, Paris, France,Department of Gastroenterology, Hôpital Européen Georges Pompidou, Assistance Publique-Hôpitaux de Paris, Paris, France
| | - Emmanuel Mas
- GENIUS Group [GENetically ImmUne–mediated enteropathieS] from the European Society for Paediatric Gastroenterology, Hepatology and Nutrition [ESPGHAN],Department of Paediatrics, Gastroenterology, Hepatology, Nutrition, and Diabetes, Centre Hospitalier Universitaire de Toulouse, Toulouse, France
| | - Istvan Mattyus
- GENIUS Group [GENetically ImmUne–mediated enteropathieS] from the European Society for Paediatric Gastroenterology, Hepatology and Nutrition [ESPGHAN],Semmelweis University; Department of Paediatrics, Budapest, Hungary
| | - Luisa M Mearin
- GENIUS Group [GENetically ImmUne–mediated enteropathieS] from the European Society for Paediatric Gastroenterology, Hepatology and Nutrition [ESPGHAN],Leiden University Medical Centre, Department of Paediatrics, Leiden, The Netherlands
| | - Jan Melek
- GENIUS Group [GENetically ImmUne–mediated enteropathieS] from the European Society for Paediatric Gastroenterology, Hepatology and Nutrition [ESPGHAN],University Hospital, Hradec Kralove, Czech Republic
| | - Victor Manuel Navas-Lopez
- GENIUS Group [GENetically ImmUne–mediated enteropathieS] from the European Society for Paediatric Gastroenterology, Hepatology and Nutrition [ESPGHAN],Hospital Regional Universitario de Málaga, Departamento de Pediatría, Malaga, Spain
| | - Anders Paerregaard
- GENIUS Group [GENetically ImmUne–mediated enteropathieS] from the European Society for Paediatric Gastroenterology, Hepatology and Nutrition [ESPGHAN],Hvidovre University Hospital, Department of Paediatrics, Copenhagen, Denmark
| | - Cecile Pelatan
- GENIUS Group [GENetically ImmUne–mediated enteropathieS] from the European Society for Paediatric Gastroenterology, Hepatology and Nutrition [ESPGHAN],Department of Paediatrics, Centre Hospitalier du Mans, Le Mans, France
| | - Bénédicte Pigneur
- INSERM, UMR1163, Laboratory of Intestinal Immunity, and Imagine Institute, Paris, France,Université Paris Descartes-Sorbonne Paris Cité, Paris, France,Paediatric Gastroenterology, Hepatology and Nutrition Unit, Hôpital Necker-Enfants Malades, Assistance Publique-Hôpitaux de Paris, Paris, France,GENIUS Group [GENetically ImmUne–mediated enteropathieS] from the European Society for Paediatric Gastroenterology, Hepatology and Nutrition [ESPGHAN]
| | - Isabel Pinto Pais
- GENIUS Group [GENetically ImmUne–mediated enteropathieS] from the European Society for Paediatric Gastroenterology, Hepatology and Nutrition [ESPGHAN],Centro Hospitalar Gaia Espinho, Department of Paediatrics, Vila Nova de Gaia, Portugal
| | - Julie Rebeuh
- GENIUS Group [GENetically ImmUne–mediated enteropathieS] from the European Society for Paediatric Gastroenterology, Hepatology and Nutrition [ESPGHAN],Department of Paediatrics, Centre Hospitalo-Universitaire de Strasbourg, Strasbourg, France
| | - Claudio Romano
- GENIUS Group [GENetically ImmUne–mediated enteropathieS] from the European Society for Paediatric Gastroenterology, Hepatology and Nutrition [ESPGHAN],Department of Paediatrics, Hospital of Messina, University of Messina, Messina, Italy
| | - Nadia Siala
- GENIUS Group [GENetically ImmUne–mediated enteropathieS] from the European Society for Paediatric Gastroenterology, Hepatology and Nutrition [ESPGHAN],Department of Paediatrics, Hôpital Mongi Slim, La Marsa, Tunisia
| | - Caterina Strisciuglio
- GENIUS Group [GENetically ImmUne–mediated enteropathieS] from the European Society for Paediatric Gastroenterology, Hepatology and Nutrition [ESPGHAN],Department of Woman, Child and General and Specialized Surgery, Second University of Naples, Naples, Italy
| | - Michela Tempia-Caliera
- GENIUS Group [GENetically ImmUne–mediated enteropathieS] from the European Society for Paediatric Gastroenterology, Hepatology and Nutrition [ESPGHAN],Department of Paediatrics, FMH Pédiatrie et FA Gastroentérologie et hépatologie, Clinique des Grangettes, Geneva, Switzerland
| | - Patrick Tounian
- GENIUS Group [GENetically ImmUne–mediated enteropathieS] from the European Society for Paediatric Gastroenterology, Hepatology and Nutrition [ESPGHAN],Department of Paediatric Nutrition and Gastroenterology, Hôpital Armand Trousseau, Assistance Publique-Hôpitaux de Paris, Paris, France
| | - Dan Turner
- GENIUS Group [GENetically ImmUne–mediated enteropathieS] from the European Society for Paediatric Gastroenterology, Hepatology and Nutrition [ESPGHAN],Shaare Zedek Medical Centre, Jerusalem, Israel
| | - Vaidotas Urbonas
- GENIUS Group [GENetically ImmUne–mediated enteropathieS] from the European Society for Paediatric Gastroenterology, Hepatology and Nutrition [ESPGHAN],Department of Paediatric Gastroenterology, Vilnius University Clinic for Children’s Diseases, Vilnius, Lithuania
| | - Stéphanie Willot
- GENIUS Group [GENetically ImmUne–mediated enteropathieS] from the European Society for Paediatric Gastroenterology, Hepatology and Nutrition [ESPGHAN],Department of Paediatrics, Centre hospitalier régional universitaire, Hôpital Clocheville, Tours, France
| | - Frank M Ruemmele
- INSERM, UMR1163, Laboratory of Intestinal Immunity, and Imagine Institute, Paris, France,Université Paris Descartes-Sorbonne Paris Cité, Paris, France,Paediatric Gastroenterology, Hepatology and Nutrition Unit, Hôpital Necker-Enfants Malades, Assistance Publique-Hôpitaux de Paris, Paris, France,GENIUS Group [GENetically ImmUne–mediated enteropathieS] from the European Society for Paediatric Gastroenterology, Hepatology and Nutrition [ESPGHAN]
| | - Nadine Cerf-Bensussan
- INSERM, UMR1163, Laboratory of Intestinal Immunity, and Imagine Institute, Paris, France,Université Paris Descartes-Sorbonne Paris Cité, Paris, France,GENIUS Group [GENetically ImmUne–mediated enteropathieS] from the European Society for Paediatric Gastroenterology, Hepatology and Nutrition [ESPGHAN]
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Danielou M, Sarter H, Pariente B, Fumery M, Ley D, Mamona C, Barthoulot M, Charpentier C, Siproudhis L, Savoye G, Gower-Rousseau C, Andre JM, Antonietti M, Aouakli A, Armand A, Aroichane I, Assi F, Aubet JP, Auxenfants E, Ayafi-Ramelot F, Azzouzi K, Bankovski D, Barbry B, Bardoux N, Baron P, Baudet A, Bazin B, Bebahani A, Becqwort JP, Benet V, Benali H, Benguigui C, Ben Soussan E, Bental A, Berkelmans I, Bernet J, Bernou K, Bernou-Dron C, Bertot P, Bertiaux-Vandaële N, Bertrand V, Billoud E, Biron N, Bismuth B, Bleuet M, Blondel F, Blondin V, Bohon P, Boniface E, Bonnière P, Bonvarlet E, Bonvarlet P, Boruchowicz A, Bostvironnois R, Boualit M, Bouche B, Boudaillez C, Bourgeaux C, Bourgeois M, Bourguet A, Bourienne A, Branche J, Bray G, Brazier F, Breban P, Bridenne M, Brihier H, Brung-Lefebvre V, Bulois P, Burgiere P, Butel J, Canva JY, Canva-Delcambre V, Capron JP, Cardot F, Carpentier P, Cartier E, Cassar JF, Cassagnou M, Castex JF, Catala P, Cattan S, Catteau S, Caujolle B, Cayron G, Chandelier C, Chantre M, Charles J, Charneau T, Chavance-Thelu M, Chirita D, Choteau A, Claerbout JF, Clergue PY, Coevoet H, Cohen G, Collet R, Colombel JF, Coopman S, Corvisart J, Cortot A, Couttenier F, Crinquette JF, Crombe V, Dadamessi I, Dapvril V, Davion T, Dautreme S, Debas J, Degrave N, Dehont F, Delatre C, Delcenserie R, Delette O, Delgrange T, Delhoustal L, Delmotte JS, Demmane S, Deregnaucourt G, Descombes P, Desechalliers JP, Desmet P, Desreumaux P, Desseaux G, Desurmont P, Devienne A, Devouge E, Devred M, Devroux A, Dewailly A, Dharancy S, Di Fiore A, Djeddi D, Djedir R, Dreher-Duwat ML, Dubois R, Dubuque C, Ducatillon P, Duclay J, Ducrocq B, Ducrot F, Ducrotte P, Dufilho A, Duhamel C, Dujardin D, Dumant-Forest C, Dupas JL, Dupont F, Duranton Y, Duriez A, El Achkar K, El Farisi M, Elie C, Elie-Legrand MC, Elkhaki A, Eoche M, Evrard D, Evrard JP, Fatome A, Filoche B, Finet L, Flahaut M, Flamme C, Foissey D, Fournier P, Foutrein-Comes MC, Foutrein P, Fremond D, Frere T, Fumery M, Gallet P, Gamblin C, Ganga S, Gerard R, Geslin G, Gheyssens Y, Ghossini N, Ghrib S, Gilbert T, Gillet B, Godard D, Godard P, Godchaux JM, Godchaux R, Goegebeur G, Goria O, Gottrand F, Gower P, Grandmaison B, Groux M, Guedon C, Guillard JF, Guillem L, Guillemot F, Guimberd D, Haddouche B, Hakim S, Hanon D, Hautefeuille V, Heckestweiller P, Hecquet G, Hedde JP, Hellal H, Henneresse PE, Heyman B, Heraud M, Herve S, Hochain P, Houssin-Bailly L, Houcke P, Huguenin B, Iobagiu S, Ivanovic A, Iwanicki-Caron I, Janicki E, Jarry M, Jeu J, Joly JP, Jonas C, Katherin F, Kerleveo A, Khachfe A, Kiriakos A, Kiriakos J, Klein O, Kohut M, Kornhauser R, Koutsomanis D, Laberenne JE, Laffineur G, Lagarde M, Lalanne A, Lannoy P, Lapchin J, Laprand M, Laude D, Leblanc R, Lecieux P, Leclerc N, Le Couteulx C, Ledent J, Lefebvre J, Lefiliatre P, Legrand C, Le Grix A, Lelong P, Leluyer B, Lenaerts C, Lepileur L, Leplat A, Lepoutre-Dujardin E, Leroi H, Leroy MY, Lesage JP, Lesage X, Lesage J, Lescanne-Darchis I, Lescut J, Lescut D, Leurent B, Levy P, Lhermie M, Lion A, Lisambert B, Loire F, Louf S, Louvet A, Luciani M, Lucidarme D, Lugand J, Macaigne O, Maetz D, Maillard D, Mancheron H, Manolache O, Marks-Brunel AB, Marti R, Martin F, Martin G, Marzloff E, Mathurin P, Mauillon J, Maunoury V, Maupas JL, Mesnard B, Metayer P, Methari L, Meurisse B, Meurisse F, Michaud L, Mirmaran X, Modaine P, Monthe A, Morel L, Mortier PE, Moulin E, Mouterde O, Mudry J, Nachury M, N’Guyen Khac E, Notteghem B, Ollevier V, Ostyn A, Ouraghi A, Ouvry D, Paillot B, Panien-Claudot N, Paoletti C, Papazian A, Parent B, Pariente B, Paris JC, Patrier P, Paupart L, Pauwels B, Pauwels M, Petit R, Piat M, Piotte S, Plane C, Plouvier B, Pollet E, Pommelet P, Pop D, Pordes C, Pouchain G, Prades P, Prevost A, Prevost JC, Quesnel B, Queuniet AM, Quinton JF, Rabache A, Rabelle P, Raclot G, Ratajczyk S, Rault D, Razemon V, Reix N, Revillon M, Richez C, Robinson P, Rodriguez J, Roger J, Roux JM, Rudelli A, Saber A, Savoye G, Schlosseberg P, Segrestin M, Seguy D, Serin M, Seryer A, Sevenet F, Shekh N, Silvie J, Simon V, Spyckerelle C, Talbodec N, Techy A, Thelu JL, Thevenin A, Thiebault H, Thomas J, Thorel JM, Tielman G, Tode M, Toisin J, Tonnel J, Touchais JY, Touze Y, Tranvouez JL, Triplet C, Turck D, Uhlen S, Vaillant E, Valmage C, Vanco D, Vandamme H, Vanderbecq E, Vander Eecken E, Vandermolen P, Vandevenne P, Vandeville L, Vandewalle A, Vandewalle C, Vaneslander P, Vanhoove JP, Vanrenterghem A, Varlet P, Vasies I, Verbiese G, Vernier-Massouille G, Vermelle P, Verne C, Vezilier-Cocq P, Vigneron B, Vincendet M, Viot J, Voiment YM, Wacrenier A, Waeghemaecker L, Wallez JY, Wantiez M, Wartel F, Weber J, Willocquet JL, Wizla N, Wolschies E, Zalar A, Zaouri B, Zellweger A, Ziade C. Natural History of Perianal Fistulising Lesions in Patients With Elderly-onset Crohn's Disease: A Population-based Study. J Crohns Colitis 2020; 14:501-507. [PMID: 31637413 DOI: 10.1093/ecco-jcc/jjz173] [Citation(s) in RCA: 2] [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] [Indexed: 02/08/2023]
Abstract
INTRODUCTION Most studies of elderly-onset Crohn's disease [CD; diagnosed in patients aged 60 or over] have described a mild course. However, data on the natural history of perianal fistulising CD [pfCD] in this population are scarce. In a population-based cohort study, we described the prevalence, natural history, and treatment of pfCD in patients with elderly-onset CD vs patients with paediatric-onset CD. METHOD All patients diagnosed with CD at or after the age of 60 between 1988 and 2006, were included [n = 372]. Logistic regression, Cox models, and a nested case-control method were used to identify factors associated with pfCD. RESULTS A total of 34 elderly patients [9% of the 372] had pfCD at diagnosis. After a median follow-up of 6 years (interquartile range [IQR]: 3; 10), 59 patients [16%] had pfCD; the same prevalence [16%] was observed in paediatric-onset patients. At last follow-up, anal incontinence was more frequent in elderly patients with pfCD than in elderly patients without pfCD [22% vs 4%, respectively; p < 10-4]. Rectal CD at diagnosis was associated with pfCD: hazard ratio (95% confidence interval [CI] = 2.8 [1.6-5.0]). Although 37% of the patients received immunosuppressants and 17% received anti-tumour necrosis factor agents, 24% [14 out of 59] had a definitive stoma at last follow-up. CONCLUSION During the first 6 years of disease, the prevalence of pfCD was similar in elderly and paediatric patients. Rectal involvement was associated with the appearance of pfCD in elderly-onset patients. Around a quarter of patients with elderly-onset CD will have a stoma. Our results suggest that treatment with biologics should be evaluated in these patients.
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Affiliation(s)
- Marie Danielou
- Gastroenterology Unit, EPIMAD Registry, University of Rouen and Rouen University Hospital, Rouen, France
| | - Hélène Sarter
- Public Health, Epidemiology and Economic Health Unit, EPIMAD Registry, Maison Régionale de la Recherche Clinique, University of Lille and Lille University Hospital, Lille, France.,LIRIC UMR 995, Team 5, INSERM and University of Lille, Lille, France
| | - Benjamin Pariente
- Gastroenterology Unit, EPIMAD Registry, Hôpital Huriez, Lille University Hospital, Lille, France
| | - Mathurin Fumery
- Gastroenterology Unit, EPIMAD Registry, and PeriTox, UMR I-01, University of Amiens and Amiens University Hospital, Amiens, France
| | - Delphine Ley
- Division of Gastroenterology, Hepatology and Nutrition, Department of Paediatrics, Jeanne de Flandre Children's Hospital and University of Lille, Lille, France
| | - Christel Mamona
- Public Health, Epidemiology and Economic Health Unit, EPIMAD Registry, Maison Régionale de la Recherche Clinique, University of Lille and Lille University Hospital, Lille, France
| | - Maël Barthoulot
- Public Health, Epidemiology and Economic Health Unit, EPIMAD Registry, Maison Régionale de la Recherche Clinique, University of Lille and Lille University Hospital, Lille, France
| | - Cloé Charpentier
- Gastroenterology Unit, EPIMAD Registry, University of Rouen and Rouen University Hospital, Rouen, France
| | | | - Guillaume Savoye
- Gastroenterology Unit, EPIMAD Registry, University of Rouen and Rouen University Hospital, Rouen, France
| | - Corinne Gower-Rousseau
- Public Health, Epidemiology and Economic Health Unit, EPIMAD Registry, Maison Régionale de la Recherche Clinique, University of Lille and Lille University Hospital, Lille, France.,LIRIC UMR 995, Team 5, INSERM and University of Lille, Lille, France
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Vanhelst J, Coopman S, Labreuche J, Dupont C, Bertrand V, Djeddi D, Turck D, Ley D. Protocol of a randomised controlled trial assessing the impact of physical activity on bone health in children with inflammatory bowel disease. BMJ Open 2020; 10:e036400. [PMID: 32430452 PMCID: PMC7239538 DOI: 10.1136/bmjopen-2019-036400] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/30/2022] Open
Abstract
INTRODUCTION Low bone mineral density (BMD) is a frequent issue in children and adolescents with inflammatory bowel disease (IBD). Several studies in healthy populations have reported a positive impact of physical activity (PA) on bone health. Recently, an observational study in paediatric patients with IBD showed a significant positive relationship between daily PA and BMD. However, intervention studies investigating a causal relationship between PA and BMD are warranted to confirm these results. The aim of this randomised controlled trial will be to investigate the effect of a PA programme on BMD in paediatric patients with IBD. METHODS AND ANALYSIS This trial is a multicentre (four centres), randomised, controlled, blinded end-point study. Eighty children with IBD will be randomly assigned in a 1:1 ratio to receive a programme with adapted physical exercises (intervention group) or usual PA (control group) during a 9-month period. The primary outcome is the change from baseline at 9 months (the end of the study) in whole-body BMD assessed by dual-energy X-ray absorptiometry. Secondary efficacy outcomes include the changes from baseline at 9 months in: BMD assessed in the lumbar spine and trochanter; daily PA (time spent in moderate-to-vigorous PA); body composition (fat mass and fat-free mass); fatigue resistance; quality of life and activity of IBD. ETHICS AND DISSEMINATION The study was approved by the Research Ethics Committee in France (Comité de Protection des Personnes, Sud-Ouest and Outre-Mer III, Bordeaux, France, No 2018/27). All procedures will be performed according to the ethical standards of the Helsinki Declaration of 1975, as revised in 2008, and the European Union's Guidelines for Good Clinical Practice. Written informed consent will be obtained from the parents or legal guardian and from the children. Research findings will be disseminated in peer-reviewed journals and scientific meetings. TRIAL REGISTRATION NUMBER NCT03774329.
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Affiliation(s)
- Jérémy Vanhelst
- Univ. Lille, Inserm, CHU Lille, U1286 - INFINITE - Institute for Translational Research in Inflammation, F-59000 Lille, France, Lille, France
| | - Stéphanie Coopman
- Division of Gastroenterology, Hepatology and Nutrition, Department of Paediatrics, Lille University, Jeanne de Flandre Children's Hospital, Lille, France
| | - Julien Labreuche
- Univ. Lille, CHU Lille, ULR 2694 - METRICS: Evaluation des technologies de santé et des pratiques médicales, F-59000 Lille, France, Lille, France
| | - Claire Dupont
- Department of Paediatrics, Caen University Hospital F 14000 Caen, France and Normandy University, Caen, France
| | | | - Djamal Djeddi
- Department of Paediatrics, Amiens University Hospital and University of Amiens, Amiens, France
| | - Dominique Turck
- Univ. Lille, Inserm, CHU Lille, U1286 - INFINITE - Institute for Translational Research in Inflammation, F-59000 Lille, France, Lille, France
- Division of Gastroenterology, Hepatology and Nutrition, Department of Paediatrics, Lille University, Jeanne de Flandre Children's Hospital, Lille, France
| | - Delphine Ley
- Univ. Lille, Inserm, CHU Lille, U1286 - INFINITE - Institute for Translational Research in Inflammation, F-59000 Lille, France, Lille, France
- Division of Gastroenterology, Hepatology and Nutrition, Department of Paediatrics, Lille University, Jeanne de Flandre Children's Hospital, Lille, France
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Vanhelst J, Vidal F, Turck D, Drumez E, Djeddi D, Devouge E, Spyckerelle C, Zandzou SG, Legrand C, Michaud L, Béghin L, Gottrand F, Coopman S, Ley D. Physical activity is associated with improved bone health in children with inflammatory bowel disease. Clin Nutr 2019; 39:1793-1798. [PMID: 31427183 DOI: 10.1016/j.clnu.2019.07.018] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2019] [Revised: 05/30/2019] [Accepted: 07/19/2019] [Indexed: 01/05/2023]
Abstract
BACKGROUND & AIMS Bone health is an important concern in patients with inflammatory bowel disease (IBD). Low bone mineral density (BMD) is a powerful predictor of fracture risk in IBD patients. Physical activity (PA) plays an important role in bone health. However, PA data for children and adolescents with IBD are scarce. The primary aim is to evaluate the relationship between PA and BMD in children with IBD. The secondary aim was to assess the relationship between PA and quality of life. METHODS Eighty-four IBD paediatric patients (45 boys) aged 14.3 ± 2.7 years were included (disease activity: (i) remission, n = 62; (ii) mild, n = 18; (iii) severe disease, n = 1). BMD was measured using dual-energy X-ray absorptiometry and expressed as age- and sex-based Z-scores. Each patient wore a triaxial accelerometer for seven consecutive days for objective PA quantification. Quality of life was assessed using the PedsQL™ and energy intake was assessed prospectively for three days using a dietary diary. RESULTS BMD Z-score was -0.96 ± 1.11. Only five patients (6%) fulfilled the recommendation of 60 min of daily moderate-to-vigorous PA (MVPA). The proportion of children with osteopenia and osteoporosis was 51% and 4%, respectively. After adjustment for confounders (pubertal status and body mass index), total PA and time in MVPA were positively associated with BMD (regression coefficient per one standard deviation increase in PA parameters = 0.26; P < 0.05). There was no association between time spent in MVPA and total PA, and total quality of life score. CONCLUSIONS PA likely is associated with improved bone health in IBD children. Intervention studies investigating a causal relationship between PA and BMD in paediatric patients with IBD are warranted.
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Affiliation(s)
- Jérémy Vanhelst
- Univ. Lille, Inserm, CHU Lille, U995 - LIRIC - Lille Inflammation Research International Center, CIC 1403 - Centre d'investigation clinique, F-59000 Lille, France.
| | - Florian Vidal
- Univ. Lille, Inserm, CHU Lille, U995 - LIRIC - Lille Inflammation Research International Center, CIC 1403 - Centre d'investigation clinique, F-59000 Lille, France
| | - Dominique Turck
- Univ. Lille, Inserm, CHU Lille, U995 - LIRIC - Lille Inflammation Research International Center, CIC 1403 - Centre d'investigation clinique, F-59000 Lille, France; Division of Gastroenterology Hepatology and Nutrition, Department of Paediatrics, Lille University Jeanne de Flandre Children's Hospital, F-59000 Lille, France
| | - Elodie Drumez
- Univ. Lille, CHU Lille, EA 2694 - Public Health: Epidemiology and Quality of Care, F-59000 Lille, France
| | - Djamal Djeddi
- Department of Paediatrics, Amiens University Hospital and University of Amiens, Amiens, France
| | - Eve Devouge
- Department of Paediatrics, Arras Hospital, Arras, France
| | - Claire Spyckerelle
- Department of Paediatrics, Catholic University Saint Vincent de Paul Children's Hospital, Lille, France
| | | | - Céline Legrand
- Department of Paediatrics, Béthune Hospital, Béthune, France
| | - Laurent Michaud
- Univ. Lille, Inserm, CHU Lille, U995 - LIRIC - Lille Inflammation Research International Center, CIC 1403 - Centre d'investigation clinique, F-59000 Lille, France; Division of Gastroenterology Hepatology and Nutrition, Department of Paediatrics, Lille University Jeanne de Flandre Children's Hospital, F-59000 Lille, France
| | - Laurent Béghin
- Univ. Lille, Inserm, CHU Lille, U995 - LIRIC - Lille Inflammation Research International Center, CIC 1403 - Centre d'investigation clinique, F-59000 Lille, France
| | - Frédéric Gottrand
- Univ. Lille, Inserm, CHU Lille, U995 - LIRIC - Lille Inflammation Research International Center, CIC 1403 - Centre d'investigation clinique, F-59000 Lille, France; Division of Gastroenterology Hepatology and Nutrition, Department of Paediatrics, Lille University Jeanne de Flandre Children's Hospital, F-59000 Lille, France
| | - Stéphanie Coopman
- Univ. Lille, Inserm, CHU Lille, U995 - LIRIC - Lille Inflammation Research International Center, CIC 1403 - Centre d'investigation clinique, F-59000 Lille, France; Division of Gastroenterology Hepatology and Nutrition, Department of Paediatrics, Lille University Jeanne de Flandre Children's Hospital, F-59000 Lille, France
| | - Delphine Ley
- Univ. Lille, Inserm, CHU Lille, U995 - LIRIC - Lille Inflammation Research International Center, CIC 1403 - Centre d'investigation clinique, F-59000 Lille, France; Division of Gastroenterology Hepatology and Nutrition, Department of Paediatrics, Lille University Jeanne de Flandre Children's Hospital, F-59000 Lille, France
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Kassai B, Bouyé P, Gilbert-Dussardier B, Godart F, Thambo JB, Rossi M, Cochat P, Chirossel P, Luong S, Serusclat A, Canterino I, Mercier C, Rabilloud M, Pivot C, Pirot F, Ginhoux T, Coopman S, Grenet G, Gueyffier F, Di-Fillippo S, Bertholet-Thomas A. Minoxidil versus placebo in the treatment of arterial wall hypertrophy in children with Williams Beuren Syndrome: a randomized controlled trial. BMC Pediatr 2019; 19:170. [PMID: 31138170 PMCID: PMC6537216 DOI: 10.1186/s12887-019-1544-1] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [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: 04/30/2018] [Accepted: 05/20/2019] [Indexed: 01/03/2023] Open
Abstract
Background Insufficient elastin synthesis leads to vascular complications and arterial hypertension in children with Williams-Beuren syndrome. Restoring sufficient quantity of elastin should then result in prevention or inhibition of vascular malformations and improvement in arterial blood pressure. Methods The aim of this study was to assess the efficacy and safety of minoxidil on Intima Media Thickness (IMT) on the right common carotid artery after twelve-month treatment in patient with Williams-Beuren syndrome. We performed a randomized placebo controlled double blind trial. All participants were treated for 12 months and followed for 18 months. The principal outcome was assessed by an independent adjudication committee blinded to the allocated treatment groups. Results The principal outcome was available for 9 patients in the placebo group and 8 patients in the minoxidil group. After 12-month treatment, the IMT in the minoxidil group increased by 0.03 mm (95% CI -0.002, 0.06) compared with 0.01 mm (95%CI - 0.02, 0.04 mm) in the placebo group (p = 0.4). Two serious adverse events unrelated to the treatment occurred, one in the minoxidil and 1 in the placebo group. After 18 months, the IMT increased by 0.07 mm (95% CI 0.04, 0.10 mm) in the minoxidil compared with 0.01 mm (95% CI -0.02, 0.04 mm) in the placebo group (p = 0.008). Conclusion Our results suggest a slight increase after 12 and 18-month follow-up in IMT. More understanding of the biological changes induced by minoxidil should better explain its potential role on elastogenesis in Williams-Beuren syndrome. Trials registration US National Institutes of Health Clinical Trial Register (NCT00876200). Registered 3 April 2009 (retrospectively registered). Electronic supplementary material The online version of this article (10.1186/s12887-019-1544-1) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Behrouz Kassai
- Hospices Civils de Lyon, EPICIME-CIC 1407 de Lyon, Inserm, Service de Pharmacotoxicologie, CHU-Lyon, F-69677, Bron, France.
| | - Philippe Bouyé
- CHU d'Angers, department of Vascular Studies, Centre de Recherche Clinique Angers, Angers, France
| | | | - François Godart
- CHRU de Lille, université Lille 2, EA 2693, service de cardiologie infantile et congénitale, Nord de France, hôpital cardiologique, F-59000, Lille, France
| | - Jean-Benoit Thambo
- CHU de Bordeaux, université de Bordeaux, service des cardiopathies congénitales, hôpital cardiologique du Haut-Lévêque, Inserm U-1045, LIRYC, institut de rythmologie et modélisation cardiaque, Bordeaux, France
| | - Massimiliano Rossi
- Hospices Civils de Lyon, Service de génétique médicale, INSERM U1028, CNRS UMR5292, Centre de Recherche en Neurosciences de Lyon, GENDEV Team, F-69500, Bron, France
| | - Pierre Cochat
- Hospices Civils de Lyon, Service de Néphrologie Pédiatrique, et centre de référence maladies rénales rares- Néphrogones, Filière ORKiD, -69500, Bron, France
| | - Pierre Chirossel
- Hospices Civils de Lyon, Service d'exploration fonctionnelle vasculaire, hôpital Louis Pradel, F-69500, Bron, France
| | - Stephane Luong
- Hospices Civils de Lyon, Service d'exploration fonctionnelle vasculaire, hôpital Louis Pradel, F-69500, Bron, France
| | - André Serusclat
- Hospices Civils de Lyon, Service d'exploration fonctionnelle vasculaire, hôpital Louis Pradel, F-69500, Bron, France
| | | | - Catherine Mercier
- Université de Lyon, F-69000, Lyon, France ; Université Lyon 1, CNRS, UMR 5558, Laboratoire de Biométrie et Biologie Evolutive, F-69622, Villeurbanne, France.,Hospices Civils de Lyon, Service de Biostatistique, F-69324, Lyon, France
| | - Muriel Rabilloud
- Université de Lyon, F-69000, Lyon, France ; Université Lyon 1, CNRS, UMR 5558, Laboratoire de Biométrie et Biologie Evolutive, F-69622, Villeurbanne, France.,Hospices Civils de Lyon, Service de Biostatistique, F-69324, Lyon, France
| | - Christine Pivot
- Hospices Civils de Lyon, Pharmacie à Usage Intérieur, plateforme Fripharm, F-69437, Lyon, France
| | - Fabrice Pirot
- Université de Lyon, F-69000, Lyon, France ; Université Lyon 1, CNRS, UMR 5558, Laboratoire de Biométrie et Biologie Evolutive, F-69622, Villeurbanne, France.,Hospices Civils de Lyon, Pharmacie à Usage Intérieur, plateforme Fripharm, F-69437, Lyon, France
| | - Tiphanie Ginhoux
- Hospices Civils de Lyon, EPICIME-CIC 1407 de Lyon, Inserm, Service de Pharmacotoxicologie, CHU-Lyon, F-69677, Bron, France
| | - Stéphanie Coopman
- Lille University Hospital, Centre d'Investigation Clinique, CIC-1403-Inserm-CH&U, F-59000, Lille, France
| | - Guillaume Grenet
- Université de Lyon, F-69000, Lyon, France ; Université Lyon 1, CNRS, UMR 5558, Laboratoire de Biométrie et Biologie Evolutive, F-69622, Villeurbanne, France
| | - François Gueyffier
- Université de Lyon, F-69000, Lyon, France ; Université Lyon 1, CNRS, UMR 5558, Laboratoire de Biométrie et Biologie Evolutive, F-69622, Villeurbanne, France
| | - Sylvie Di-Fillippo
- Hospices Civils de Lyon, Service de cardiologie pédiatrique, F-69500, Bron, France
| | - Aurélia Bertholet-Thomas
- Hospices Civils de Lyon, Service de Néphrologie Pédiatrique, et centre de référence maladies rénales rares- Néphrogones, Filière ORKiD, -69500, Bron, France
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Vanhelst J, Vidal F, Drumez E, Béghin L, Baudelet JB, Coopman S, Gottrand F. Comparison and validation of accelerometer wear time and non-wear time algorithms for assessing physical activity levels in children and adolescents. BMC Med Res Methodol 2019; 19:72. [PMID: 30940079 PMCID: PMC6444637 DOI: 10.1186/s12874-019-0712-1] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2018] [Accepted: 03/18/2019] [Indexed: 01/02/2023] Open
Abstract
Background Accelerometers are widely used to measure sedentary time and daily physical activity (PA). However, data collection and processing criteria, such as non-wear time rules might affect the assessment of total PA and sedentary time and the associations with health variables. The study aimed to investigate whether the choice of different non-wear time definitions would affect the outcomes of PA levels in youth. Methods Seventy-seven healthy youngsters (44 boys), aged 10–17 years, wore an accelerometer and kept a non-wear log diary during 4 consecutives days. We compared 7 published algorithms (10, 15, 20, 30, 60 min of continuous zeros, Choi, and Troiano algorithms). Agreements of each algorithm with the log diary method were assessed using Bland-Altmans plots and by calculating the concordance correlation coefficient for repeated measures. Results Variations in time spent in sedentary and moderate to vigorous PA (MVPA) were 30 and 3.7%. Compared with the log diary method, greater discrepancies were found for the algorithm 10 min (p < 0.001). For the time assessed in sedentary, the agreement with diary was excellent for the 4 algorithms (Choi, r = 0.79; Troiano, r = 0.81; 30 min, r = 0.79; 60 min, r = 0.81). Concordance for each method was excellent for the assessment of time spent in MVPA (> 0.86). The agreement for the wear time assessment was excellent for 5 algorithms (Choi r = 0.79; Troiano r = 0.79; 20 min r = 0.77; 30 min r = 0.80; 60 min r = 0.80). Conclusions The choice of non-wear time rules may considerably affect the sedentary time assessment in youth. Using of appropriate data reduction decision in youth is needed to limit differences in associations between health outcomes and sedentary behaviors and may improve comparability for future studies. Based on our results, we recommend the use of the algorithm of 30 min of continuous zeros for defining non-wear time to improve the accuracy in assessing PA levels in youth. Trial registration NCT02844101 (retrospectively registered at July 13th 2016). Electronic supplementary material The online version of this article (10.1186/s12874-019-0712-1) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Jérémy Vanhelst
- University of Lille, Inserm, CHU Lille, U995 - LIRIC - Lille Inflammation Research International Center, CIC 1403 - Centre d'investigation clinique, Avenue Eugène Avinée, 59037 Lille Cedex, F-59000, Lille, France.
| | - Florian Vidal
- University of Lille, Inserm, CHU Lille, U995 - LIRIC - Lille Inflammation Research International Center, CIC 1403 - Centre d'investigation clinique, Avenue Eugène Avinée, 59037 Lille Cedex, F-59000, Lille, France
| | - Elodie Drumez
- University of Lille, CHU Lille, EA 2694 - Public Health: epidemiology and quality of care, F-59000, Lille, France
| | - Laurent Béghin
- University of Lille, Inserm, CHU Lille, U995 - LIRIC - Lille Inflammation Research International Center, CIC 1403 - Centre d'investigation clinique, Avenue Eugène Avinée, 59037 Lille Cedex, F-59000, Lille, France
| | - Jean-Benoît Baudelet
- University of Lille, Inserm, CHU Lille, U995 - LIRIC - Lille Inflammation Research International Center, CIC 1403 - Centre d'investigation clinique, Avenue Eugène Avinée, 59037 Lille Cedex, F-59000, Lille, France
| | - Stéphanie Coopman
- University of Lille, Inserm, CHU Lille, U995 - LIRIC - Lille Inflammation Research International Center, CIC 1403 - Centre d'investigation clinique, Avenue Eugène Avinée, 59037 Lille Cedex, F-59000, Lille, France
| | - Frédéric Gottrand
- University of Lille, Inserm, CHU Lille, U995 - LIRIC - Lille Inflammation Research International Center, CIC 1403 - Centre d'investigation clinique, Avenue Eugène Avinée, 59037 Lille Cedex, F-59000, Lille, France
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21
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Vanhelst J, Vidal F, Ley D, Drumez E, Djeddi D, Devouge E, Spyckerelle C, Zandzou SG, Legrand C, Béghin L, Gottrand F, Coopman S, Turck D. L’activité physique est associée à une meilleure santé osseuse chez l’enfant et l’adolescent présentant une maladie inflammatoire chronique de l’intestin. NUTR CLIN METAB 2018. [DOI: 10.1016/j.nupar.2018.09.066] [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: 11/24/2022]
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22
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Charbit-Henrion F, Parlato M, Hanein S, Duclaux-Loras R, Nowak J, Begue B, Rakotobe S, Bruneau J, Fourrage C, Alibeu O, Rieux-Laucat F, Lévy E, Stolzenberg MC, Mazerolles F, Latour S, Lenoir C, Fischer A, Picard C, Aloi M, Dias JA, Hariz MB, Bourrier A, Breuer C, Breton A, Bronsky J, Buderus S, Cananzi M, Coopman S, Crémilleux C, Dabadie A, Dumant-Forest C, Gurkan OE, Fabre A, Fischer A, Diaz MG, Gonzalez-Lama Y, Goulet O, Guariso G, Gurcan N, Homan M, Hugot JP, Jeziorski E, Karanika E, Lachaux A, Lewindon P, Lima R, Magro F, Major J, Malamut G, Mas E, Mattyus I, Mearin LM, Melek J, Navas-Lopez VM, Paerregaard A, Pelatan C, Pigneur B, Pais IP, Rebeuh J, Romano C, Siala N, Strisciuglio C, Tempia-Caliera M, Tounian P, Turner D, Urbonas V, Willot S, Ruemmele FM, Cerf-Bensussan N. Diagnostic Yield of Next-generation Sequencing in Very Early-onset Inflammatory Bowel Diseases: A Multicentre Study. J Crohns Colitis 2018; 12:1104-1112. [PMID: 29788237 PMCID: PMC6113703 DOI: 10.1093/ecco-jcc/jjy068] [Citation(s) in RCA: 59] [Impact Index Per Article: 9.8] [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: 12/13/2017] [Revised: 03/14/2018] [Accepted: 05/16/2018] [Indexed: 12/11/2022]
Abstract
BACKGROUND AND AIMS An expanding number of monogenic defects have been identified as causative of severe forms of very early-onset inflammatory bowel diseases [VEO-IBD]. The present study aimed at defining how next-generation sequencing [NGS] methods can be used to improve identification of known molecular diagnosis and to adapt treatment. METHODS A total of 207 children were recruited in 45 paediatric centres through an international collaborative network [ESPGHAN GENIUS working group] with a clinical presentation of severe VEO-IBD [n = 185] or an anamnesis suggestive of a monogenic disorder [n = 22]. Patients were divided at inclusion into three phenotypic subsets: predominantly small bowel inflammation, colitis with perianal lesions, and colitis only. Methods to obtain molecular diagnosis included functional tests followed by specific Sanger sequencing, custom-made targeted NGS, and in selected cases whole exome sequencing [WES] of parents-child trios. Genetic findings were validated clinically and/or functionally. RESULTS Molecular diagnosis was achieved in 66/207 children [32%]: 61% with small bowel inflammation, 39% with colitis and perianal lesions, and 18% with colitis only. Targeted NGS pinpointed gene mutations causative of atypical presentations, and identified large exonic copy number variations previously missed by WES. CONCLUSIONS Our results lead us to propose an optimised diagnostic strategy to identify known monogenic causes of severe IBD.
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Affiliation(s)
- Fabienne Charbit-Henrion
- INSERM, UMR1163, Laboratory of Intestinal Immunity, and Imagine Institute, Paris, France,Université Paris Descartes-Sorbonne Paris Cité, Paris, France,Paediatric Gastroenterology, Hepatology and Nutrition Unit, Hôpital Necker-Enfants Malades, Assistance Publique-Hôpitaux de Paris, Paris, France,GENIUS Group [GENetically ImmUne–mediated enteropathieS] from the European Society for Paediatric Gastroenterology, Hepatology and Nutrition [ESPGHAN]
| | - Marianna Parlato
- INSERM, UMR1163, Laboratory of Intestinal Immunity, and Imagine Institute, Paris, France,Université Paris Descartes-Sorbonne Paris Cité, Paris, France,GENIUS Group [GENetically ImmUne–mediated enteropathieS] from the European Society for Paediatric Gastroenterology, Hepatology and Nutrition [ESPGHAN]
| | - Sylvain Hanein
- INSERM, UMR 1163 Translational Genetic, and Imagine Institute, Paris, France
| | - Rémi Duclaux-Loras
- INSERM, UMR1163, Laboratory of Intestinal Immunity, and Imagine Institute, Paris, France,Université Paris Descartes-Sorbonne Paris Cité, Paris, France,GENIUS Group [GENetically ImmUne–mediated enteropathieS] from the European Society for Paediatric Gastroenterology, Hepatology and Nutrition [ESPGHAN]
| | - Jan Nowak
- INSERM, UMR1163, Laboratory of Intestinal Immunity, and Imagine Institute, Paris, France,Université Paris Descartes-Sorbonne Paris Cité, Paris, France,GENIUS Group [GENetically ImmUne–mediated enteropathieS] from the European Society for Paediatric Gastroenterology, Hepatology and Nutrition [ESPGHAN],Department of Paediatric Gastroenterology and Metabolic Diseases, Poznan University of Medical Sciences, Poznan, Poland
| | - Bernadette Begue
- INSERM, UMR1163, Laboratory of Intestinal Immunity, and Imagine Institute, Paris, France,Université Paris Descartes-Sorbonne Paris Cité, Paris, France,GENIUS Group [GENetically ImmUne–mediated enteropathieS] from the European Society for Paediatric Gastroenterology, Hepatology and Nutrition [ESPGHAN]
| | - Sabine Rakotobe
- INSERM, UMR1163, Laboratory of Intestinal Immunity, and Imagine Institute, Paris, France,Université Paris Descartes-Sorbonne Paris Cité, Paris, France,GENIUS Group [GENetically ImmUne–mediated enteropathieS] from the European Society for Paediatric Gastroenterology, Hepatology and Nutrition [ESPGHAN]
| | - Julie Bruneau
- Université Paris Descartes-Sorbonne Paris Cité, Paris, France,Pathology Department, Hôpital Necker-Enfants Malades, Assistance Publique-Hôpitaux de Paris, Paris, France
| | - Cécile Fourrage
- Université Paris Descartes-Sorbonne Paris Cité, Paris, France,Bioinformatics Platform, Imagine Institute Paris, France
| | - Olivier Alibeu
- Université Paris Descartes-Sorbonne Paris Cité, Paris, France,Genomic Platform, Imagine Institute, Paris, France
| | - Frédéric Rieux-Laucat
- Université Paris Descartes-Sorbonne Paris Cité, Paris, France,INSERM, UMR1163, Immunogenetics of Paediatric Autoimmunity, and Imagine Institute, Paris, France
| | - Eva Lévy
- Université Paris Descartes-Sorbonne Paris Cité, Paris, France,INSERM, UMR1163, Immunogenetics of Paediatric Autoimmunity, and Imagine Institute, Paris, France
| | - Marie-Claude Stolzenberg
- Université Paris Descartes-Sorbonne Paris Cité, Paris, France,INSERM, UMR1163, Immunogenetics of Paediatric Autoimmunity, and Imagine Institute, Paris, France
| | - Fabienne Mazerolles
- Université Paris Descartes-Sorbonne Paris Cité, Paris, France,INSERM, UMR1163, Immunogenetics of Paediatric Autoimmunity, and Imagine Institute, Paris, France
| | - Sylvain Latour
- Université Paris Descartes-Sorbonne Paris Cité, Paris, France,INSERM, UMR1163, Lymphocyte activation and EBV susceptibility, and Imagine Institute, Paris, France
| | - Christelle Lenoir
- Université Paris Descartes-Sorbonne Paris Cité, Paris, France,INSERM, UMR1163, Lymphocyte activation and EBV susceptibility, and Imagine Institute, Paris, France
| | - Alain Fischer
- Université Paris Descartes-Sorbonne Paris Cité, Paris, France,Collège de France, Médecine expérimentale, Paris, France,INSERM UMR 1163 and Imagine Institute, Paris, France
| | - Capucine Picard
- Université Paris Descartes-Sorbonne Paris Cité, Paris, France,INSERM, UMR1163, Lymphocyte activation and EBV susceptibility, and Imagine Institute, Paris, France,Investigation Centre for Immunodeficiency, Hôpital Necker-Enfants Malades, Assistance Publique-Hôpitaux de Paris and Imagine Institute, Paris, France
| | - Marina Aloi
- GENIUS Group [GENetically ImmUne–mediated enteropathieS] from the European Society for Paediatric Gastroenterology, Hepatology and Nutrition [ESPGHAN],Sapienza University of Rome, Paediatric Gastroenterology and Liver Unit, Department of Pediatrics, Rome, Italy
| | - Jorge Amil Dias
- GENIUS Group [GENetically ImmUne–mediated enteropathieS] from the European Society for Paediatric Gastroenterology, Hepatology and Nutrition [ESPGHAN],Department of Paediatrics, Centro Hospitalar São João, Porto, Portugal
| | - Mongi Ben Hariz
- GENIUS Group [GENetically ImmUne–mediated enteropathieS] from the European Society for Paediatric Gastroenterology, Hepatology and Nutrition [ESPGHAN],Department of Paediatrics, Hopital La Marsa, Tunisia
| | - Anne Bourrier
- Department of Gastroenterology, Hôpital St Antoine, Assistance Publique-Hôpitaux de Paris, Paris, France
| | - Christian Breuer
- GENIUS Group [GENetically ImmUne–mediated enteropathieS] from the European Society for Paediatric Gastroenterology, Hepatology and Nutrition [ESPGHAN],Department of Paediatrics, Universitätsklinikum Hamburg, Hamburg, Germany
| | - Anne Breton
- GENIUS Group [GENetically ImmUne–mediated enteropathieS] from the European Society for Paediatric Gastroenterology, Hepatology and Nutrition [ESPGHAN],Department of Paediatrics, Gastroenterology, Hepatology, Nutrition, and Diabetes, Centre Hospitalier Universitaire de Toulouse, Toulouse, France
| | - Jiri Bronsky
- GENIUS Group [GENetically ImmUne–mediated enteropathieS] from the European Society for Paediatric Gastroenterology, Hepatology and Nutrition [ESPGHAN],University Hospital Motol, Prague, Czech Republic
| | - Stephan Buderus
- GENIUS Group [GENetically ImmUne–mediated enteropathieS] from the European Society for Paediatric Gastroenterology, Hepatology and Nutrition [ESPGHAN],St. Marien Hospital, Bonn, Germany
| | - Mara Cananzi
- GENIUS Group [GENetically ImmUne–mediated enteropathieS] from the European Society for Paediatric Gastroenterology, Hepatology and Nutrition [ESPGHAN],Unit of Paediatric Hepatology, Department of Woman and Child Health, University Hospital of Padova, Padova, Italy
| | - Stéphanie Coopman
- GENIUS Group [GENetically ImmUne–mediated enteropathieS] from the European Society for Paediatric Gastroenterology, Hepatology and Nutrition [ESPGHAN],Division of Gastroenterology, Hepatology and Nutrition, Department of Paediatrics, Jeanne De Flandre Children’s Hospital, Lille University Faculty of Medicine, Lille, France
| | - Clara Crémilleux
- GENIUS Group [GENetically ImmUne–mediated enteropathieS] from the European Society for Paediatric Gastroenterology, Hepatology and Nutrition [ESPGHAN],Department of Paediatrics, Centre Hospitalo-Universitaire de St-Etienne, St-Etienne, France
| | - Alain Dabadie
- GENIUS Group [GENetically ImmUne–mediated enteropathieS] from the European Society for Paediatric Gastroenterology, Hepatology and Nutrition [ESPGHAN],Service de médecine de l’enfant et de l’adolescent, Hôpital Sud – Centre Hospitalo-Universitaire de Rennes, Rennes, France
| | - Clémentine Dumant-Forest
- GENIUS Group [GENetically ImmUne–mediated enteropathieS] from the European Society for Paediatric Gastroenterology, Hepatology and Nutrition [ESPGHAN],Department of Paediatrics, Centre Hospitalo-Universitaire Charles Nicolle, Rouen, France
| | - Odul Egritas Gurkan
- GENIUS Group [GENetically ImmUne–mediated enteropathieS] from the European Society for Paediatric Gastroenterology, Hepatology and Nutrition [ESPGHAN],Paediatric Gastroenterology, Hepatology and Nutrition, Gazi University, Ankara, Turkey
| | - Alexandre Fabre
- GENIUS Group [GENetically ImmUne–mediated enteropathieS] from the European Society for Paediatric Gastroenterology, Hepatology and Nutrition [ESPGHAN],Department of Paediatrics, Assistance publique Hôpitaux de Marseille, Hôpital de la Timone, Marseille, France
| | - Aude Fischer
- GENIUS Group [GENetically ImmUne–mediated enteropathieS] from the European Society for Paediatric Gastroenterology, Hepatology and Nutrition [ESPGHAN],Department of Paediatrics, Centre Hospitalo-Universitaire Sud Réunion, St Pierre, France
| | - Marta German Diaz
- GENIUS Group [GENetically ImmUne–mediated enteropathieS] from the European Society for Paediatric Gastroenterology, Hepatology and Nutrition [ESPGHAN],Unit of Paediatric Nutrition, Hospital Universitario 12 de Octubre, Madrid, Spain
| | - Yago Gonzalez-Lama
- Inflammatory Bowel Disease Unit, Hospital Universitario Puerta de Hierro–Majadahonda, Madrid, Spain
| | - Olivier Goulet
- Université Paris Descartes-Sorbonne Paris Cité, Paris, France,Paediatric Gastroenterology, Hepatology and Nutrition Unit, Hôpital Necker-Enfants Malades, Assistance Publique-Hôpitaux de Paris, Paris, France,GENIUS Group [GENetically ImmUne–mediated enteropathieS] from the European Society for Paediatric Gastroenterology, Hepatology and Nutrition [ESPGHAN]
| | - Graziella Guariso
- GENIUS Group [GENetically ImmUne–mediated enteropathieS] from the European Society for Paediatric Gastroenterology, Hepatology and Nutrition [ESPGHAN],University of Padua, Italy
| | - Neslihan Gurcan
- GENIUS Group [GENetically ImmUne–mediated enteropathieS] from the European Society for Paediatric Gastroenterology, Hepatology and Nutrition [ESPGHAN],Paediatric Gastroenterology, Hepatology and Nutrition, Gazi University, Ankara, Turkey
| | - Matjaz Homan
- GENIUS Group [GENetically ImmUne–mediated enteropathieS] from the European Society for Paediatric Gastroenterology, Hepatology and Nutrition [ESPGHAN],Department of Gastroenterology, Hepatology and Nutrition, University Children’s Hospital, Ljubljana, Slovenia
| | - Jean-Pierre Hugot
- GENIUS Group [GENetically ImmUne–mediated enteropathieS] from the European Society for Paediatric Gastroenterology, Hepatology and Nutrition [ESPGHAN],Departments of Paediatric Digestive and Respiratory Diseases, Hôpital Robert-Debré, Assistance Publique-Hôpitaux de Paris, Paris, France
| | - Eric Jeziorski
- GENIUS Group [GENetically ImmUne–mediated enteropathieS] from the European Society for Paediatric Gastroenterology, Hepatology and Nutrition [ESPGHAN],Department of Paediatrics, Infectious diseases and Immunology, Centre Hospitalo-Universitaire de Montpellier, Montpellier, France
| | - Evi Karanika
- GENIUS Group [GENetically ImmUne–mediated enteropathieS] from the European Society for Paediatric Gastroenterology, Hepatology and Nutrition [ESPGHAN],Department of Paediatrics, University General Hospital of Thessaloniki, Thessaloniki, Greece
| | - Alain Lachaux
- GENIUS Group [GENetically ImmUne–mediated enteropathieS] from the European Society for Paediatric Gastroenterology, Hepatology and Nutrition [ESPGHAN],Department of Paediatric Gastroenterology, Hepatology and Nutrition, Centre de Nutrition parentérale à domicile, Hôpital Femme–Mère–Enfant CHU de Lyon HCL - GH Est, Bron, France
| | - Peter Lewindon
- GENIUS Group [GENetically ImmUne–mediated enteropathieS] from the European Society for Paediatric Gastroenterology, Hepatology and Nutrition [ESPGHAN],Department of Gastroenterology and Hepatology, Lady Cilento Children’s Hospital and the Faculty of Medicine and Biomedical Sciences, TUniversity of Queensland, Brisbane, Australia
| | - Rosa Lima
- GENIUS Group [GENetically ImmUne–mediated enteropathieS] from the European Society for Paediatric Gastroenterology, Hepatology and Nutrition [ESPGHAN],Department of Paediatrics, Centro Hospitalar São João, Porto, Portugal
| | - Fernando Magro
- Gastroenterology Department, Hospital de São João, Institute of Pharmacology and Therapeutics Faculty of Medicine and MedInUP - Centre for Drug Discovery and Innovative Medicines, University of Porto, Porto, Portugal
| | - Janos Major
- GENIUS Group [GENetically ImmUne–mediated enteropathieS] from the European Society for Paediatric Gastroenterology, Hepatology and Nutrition [ESPGHAN],MRE Bethesda Gyermekkórháza; Department of Pediatrics, Budapest, Hungary
| | - Georgia Malamut
- INSERM, UMR1163, Laboratory of Intestinal Immunity, and Imagine Institute, Paris, France,Université Paris Descartes-Sorbonne Paris Cité, Paris, France,Department of Gastroenterology, Hôpital Européen Georges Pompidou, Assistance Publique-Hôpitaux de Paris, Paris, France
| | - Emmanuel Mas
- GENIUS Group [GENetically ImmUne–mediated enteropathieS] from the European Society for Paediatric Gastroenterology, Hepatology and Nutrition [ESPGHAN],Department of Paediatrics, Gastroenterology, Hepatology, Nutrition, and Diabetes, Centre Hospitalier Universitaire de Toulouse, Toulouse, France
| | - Istvan Mattyus
- GENIUS Group [GENetically ImmUne–mediated enteropathieS] from the European Society for Paediatric Gastroenterology, Hepatology and Nutrition [ESPGHAN],Semmelweis University; Department of Paediatrics, Budapest, Hungary
| | - Luisa M Mearin
- GENIUS Group [GENetically ImmUne–mediated enteropathieS] from the European Society for Paediatric Gastroenterology, Hepatology and Nutrition [ESPGHAN],Leiden University Medical Centre, Department of Paediatrics, Leiden, The Netherlands
| | - Jan Melek
- GENIUS Group [GENetically ImmUne–mediated enteropathieS] from the European Society for Paediatric Gastroenterology, Hepatology and Nutrition [ESPGHAN],University Hospital, Hradec Kralove, Czech Republic
| | - Victor Manuel Navas-Lopez
- GENIUS Group [GENetically ImmUne–mediated enteropathieS] from the European Society for Paediatric Gastroenterology, Hepatology and Nutrition [ESPGHAN],Hospital Regional Universitario de Málaga, Departamento de Pediatría, Malaga, Spain
| | - Anders Paerregaard
- GENIUS Group [GENetically ImmUne–mediated enteropathieS] from the European Society for Paediatric Gastroenterology, Hepatology and Nutrition [ESPGHAN],Hvidovre University Hospital, Department of Paediatrics, Copenhagen, Denmark
| | - Cecile Pelatan
- GENIUS Group [GENetically ImmUne–mediated enteropathieS] from the European Society for Paediatric Gastroenterology, Hepatology and Nutrition [ESPGHAN],Department of Paediatrics, Centre Hospitalier du Mans, Le Mans, France
| | - Bénédicte Pigneur
- INSERM, UMR1163, Laboratory of Intestinal Immunity, and Imagine Institute, Paris, France,Université Paris Descartes-Sorbonne Paris Cité, Paris, France,Paediatric Gastroenterology, Hepatology and Nutrition Unit, Hôpital Necker-Enfants Malades, Assistance Publique-Hôpitaux de Paris, Paris, France,GENIUS Group [GENetically ImmUne–mediated enteropathieS] from the European Society for Paediatric Gastroenterology, Hepatology and Nutrition [ESPGHAN]
| | - Isabel Pinto Pais
- GENIUS Group [GENetically ImmUne–mediated enteropathieS] from the European Society for Paediatric Gastroenterology, Hepatology and Nutrition [ESPGHAN],Centro Hospitalar Gaia Espinho, Department of Paediatrics, Vila Nova de Gaia, Portugal
| | - Julie Rebeuh
- GENIUS Group [GENetically ImmUne–mediated enteropathieS] from the European Society for Paediatric Gastroenterology, Hepatology and Nutrition [ESPGHAN],Department of Paediatrics, Centre Hospitalo-Universitaire de Strasbourg, Strasbourg, France
| | - Claudio Romano
- GENIUS Group [GENetically ImmUne–mediated enteropathieS] from the European Society for Paediatric Gastroenterology, Hepatology and Nutrition [ESPGHAN],Department of Paediatrics, Hospital of Messina, University of Messina, Messina, Italy
| | - Nadia Siala
- GENIUS Group [GENetically ImmUne–mediated enteropathieS] from the European Society for Paediatric Gastroenterology, Hepatology and Nutrition [ESPGHAN],Department of Paediatrics, Hôpital Mongi Slim, La Marsa, Tunisia
| | - Caterina Strisciuglio
- GENIUS Group [GENetically ImmUne–mediated enteropathieS] from the European Society for Paediatric Gastroenterology, Hepatology and Nutrition [ESPGHAN],Department of Woman, Child and General and Specialized Surgery, Second University of Naples, Naples, Italy
| | - Michela Tempia-Caliera
- GENIUS Group [GENetically ImmUne–mediated enteropathieS] from the European Society for Paediatric Gastroenterology, Hepatology and Nutrition [ESPGHAN],Department of Paediatrics, FMH Pédiatrie et FA Gastroentérologie et hépatologie, Clinique des Grangettes, Geneva, Switzerland
| | - Patrick Tounian
- GENIUS Group [GENetically ImmUne–mediated enteropathieS] from the European Society for Paediatric Gastroenterology, Hepatology and Nutrition [ESPGHAN],Department of Paediatric Nutrition and Gastroenterology, Hôpital Armand Trousseau, Assistance Publique-Hôpitaux de Paris, Paris, France
| | - Dan Turner
- GENIUS Group [GENetically ImmUne–mediated enteropathieS] from the European Society for Paediatric Gastroenterology, Hepatology and Nutrition [ESPGHAN],Shaare Zedek Medical Centre, Jerusalem, Israel
| | - Vaidotas Urbonas
- GENIUS Group [GENetically ImmUne–mediated enteropathieS] from the European Society for Paediatric Gastroenterology, Hepatology and Nutrition [ESPGHAN],Department of Paediatric Gastroenterology, Vilnius University Clinic for Children’s Diseases, Vilnius, Lithuania
| | - Stéphanie Willot
- GENIUS Group [GENetically ImmUne–mediated enteropathieS] from the European Society for Paediatric Gastroenterology, Hepatology and Nutrition [ESPGHAN],Department of Paediatrics, Centre hospitalier régional universitaire, Hôpital Clocheville, Tours, France
| | - Frank M Ruemmele
- INSERM, UMR1163, Laboratory of Intestinal Immunity, and Imagine Institute, Paris, France,Université Paris Descartes-Sorbonne Paris Cité, Paris, France,Paediatric Gastroenterology, Hepatology and Nutrition Unit, Hôpital Necker-Enfants Malades, Assistance Publique-Hôpitaux de Paris, Paris, France,GENIUS Group [GENetically ImmUne–mediated enteropathieS] from the European Society for Paediatric Gastroenterology, Hepatology and Nutrition [ESPGHAN]
| | - Nadine Cerf-Bensussan
- INSERM, UMR1163, Laboratory of Intestinal Immunity, and Imagine Institute, Paris, France,Université Paris Descartes-Sorbonne Paris Cité, Paris, France,GENIUS Group [GENetically ImmUne–mediated enteropathieS] from the European Society for Paediatric Gastroenterology, Hepatology and Nutrition [ESPGHAN],Corresponding author: Nadine Cerf-Bensussan, Laboratory of Intestinal Immunity, Institut IMAGINE-INSERM 1163, Université Paris Descartes-Sorbonne Paris Cité. 24, boulevard du Montparnasse. 75015 Paris, France. Tel: 33-[0]1-42-75-42-88;
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Leroux S, Jacqz-Aigrain E, Elie V, Legrand F, Barin-Le Guellec C, Aurich B, Biran V, Dusang B, Goudjil S, Coopman S, Garcia Sanchez R, Zhao W, Manzoni P. Pharmacokinetics and safety of fluconazole and micafungin in neonates with systemic candidiasis: a randomized, open-label clinical trial. Br J Clin Pharmacol 2018; 84:1989-1999. [PMID: 29744900 DOI: 10.1111/bcp.13628] [Citation(s) in RCA: 20] [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] [Subscribe] [Scholar Register] [Received: 12/11/2017] [Revised: 04/11/2018] [Accepted: 04/23/2018] [Indexed: 11/29/2022] Open
Abstract
AIMS The pharmacokinetics (PK) of fluconazole and micafungin differ in neonates compared with children and adults. Dosing instructions in product labels appear to be inconsistent with the emerging scientific evidence. Limited information is available on the safety profile of these agents in neonates. Our objective was to study the population PK and safety of both drugs, randomly administered in neonates with suspected or confirmed systemic candidiasis. METHODS Neonates were randomized 1:1 to fluconazole (loading dose 25 mg kg-1 ; maintenance dose 12 mg kg-1 day-1 or 20 mg kg-1 day-1 , respectively, for infants <30 weeks or ≥30 weeks' corrected gestational age) or micafungin (loading dose 15 mg kg-1 day-1 ; maintenance dose 10 mg kg-1 day-1 ). PK samples were taken on treatment days 1 and 5. Population parameters were determined using NONMEM and Monte Carlo simulations performed to reach predefined targets. Clinical and laboratory data, and adverse events were collected up to 36 weeks' corrected gestational age or hospital discharge. RESULTS Thirty-six neonates were enrolled. The median (range) gestational age was 28.2 (24.1-40.1) and 26.8 (23.5-40.0) weeks for fluconazole and micafungin, respectively. Based on 163 PK samples, the median population clearance (l h-1 kg-1 ) and volume of distribution (l kg-1 ) for fluconazole were: 0.015 [95% confidence interval (CI) 0.008, 0.039] and 0.913, and for micafungin were: 0.020 (95% CI 0.010, 0.023) and 0.354 (95% CI 0.225, 0.482), respectively. The loading dose was well tolerated. No adverse events associated with micafungin or fluconazole were reported. CONCLUSION Based on Monte Carlo simulations, a loading dose for fluconazole and dosing higher than recommended for both drugs are required to increase the area under the plasma drug concentration-time curve target attainment rate in neonates.
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Affiliation(s)
- S Leroux
- Department of Pediatric Pharmacology and Pharmacogenetics, Clinical Investigation Center 1426 Robert-Debré Paediatric Hospital, Assistance Publique Hôpitaux de Paris, Paris, France
| | - E Jacqz-Aigrain
- Department of Pediatric Pharmacology and Pharmacogenetics, Clinical Investigation Center 1426 Robert-Debré Paediatric Hospital, Assistance Publique Hôpitaux de Paris, Paris, France
| | | | - F Legrand
- Department of Pediatric Pharmacology and Pharmacogenetics, Clinical Investigation Center 1426 Robert-Debré Paediatric Hospital, Assistance Publique Hôpitaux de Paris, Paris, France
| | - C Barin-Le Guellec
- EA4245, Faculté de Médecine, Université François Rabelais, Tours, France
| | - B Aurich
- Department of Pediatric Pharmacology and Pharmacogenetics, Clinical Investigation Center 1426 Robert-Debré Paediatric Hospital, Assistance Publique Hôpitaux de Paris, Paris, France
| | - V Biran
- UMR 1141 INSERM, Université Paris 7-Diderot, Neonatal Intensive Care Unit, Robert-Debré Paediatric Hospital, Assistance Publique Hôpitaux de Paris, Paris, France
| | - B Dusang
- Neonatal Intensive Care Unit, CHU de La Réunion, Saint Pierre, La Réunion, France
| | - S Goudjil
- Neonatal Care Unit, CHU Amiens, Amiens, France
| | - S Coopman
- Centre d'Investigation Clinique, CIC1403, Lille University Hospital, Lille, France
| | | | - W Zhao
- Department of Pediatric Pharmacology and Pharmacogenetics, Clinical Investigation Center 1426 Robert-Debré Paediatric Hospital, Assistance Publique Hôpitaux de Paris, Paris, France
| | - P Manzoni
- Neonatal Intensive Care Unit, S. Anna Hospital, Torino, Italy
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Aumar M, Lalanne A, Guimber D, Coopman S, Turck D, Michaud L, Gottrand F. Influence of Percutaneous Endoscopic Gastrostomy on Gastroesophageal Reflux Disease in Children. J Pediatr 2018; 197:116-120. [PMID: 29655862 DOI: 10.1016/j.jpeds.2018.02.003] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/17/2017] [Revised: 01/12/2018] [Accepted: 02/01/2018] [Indexed: 11/12/2022]
Abstract
OBJECTIVE To determine if gastroesophageal reflux disease (GERD) is present at long-term follow-up after percutaneous endoscopic gastrostomy (PEG), and to identify factors associated with the occurrence or aggravation of GERD after PEG placement. STUDY DESIGN This prospective, observational study was conducted in our single tertiary center over a 13-year period (gastrostomy performed from 1990 to 2003 and follow-up to 2015). Every child who underwent PEG in our center (N = 368) from 1990 to 2003 was eligible. GERD was defined by clinical manifestations requiring antisecretory or prokinetic treatment, occurrence of a GERD-related complication, or the need for antireflux surgery. Outcomes among patients without antireflux surgery were also assessed. Multivariate analysis was used to identify factors aggravating GERD after PEG placement. RESULTS A total 326 patients (89%; 56% with a neurologic impairment) were studied with a median follow-up after 3.5 years (range, 2.0-13.5 years). After PEG placement, GERD appeared in 11% of patients and was aggravated in 25% of patients with preexisting GERD. Factors associated with GERD worsening after PEG placement were neurologic impairment and preexisting GERD. Only 53 patients (16%) required antireflux surgery, among whom 22 required surgery in the year after PEG. Neurologic impairment was the only factor significantly associated with the need for antireflux surgery. CONCLUSIONS GERD predominantly remains clinically controlled after PEG placement. Routine antireflux surgery at the time of PEG placement is not justified.
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Affiliation(s)
- Madeleine Aumar
- CHU Lille, University of Lille, Reference Center for Congenital and Malformative Esophageal Diseases (CRACMO), Division of Gastroenterology, Hepatology and Nutrition, Department of Pediatrics Jeanne de Flandre, Lille University Children's Hospital, Lille, France.
| | - Arnaud Lalanne
- CHU Lille, University of Lille, Reference Center for Congenital and Malformative Esophageal Diseases (CRACMO), Division of Gastroenterology, Hepatology and Nutrition, Department of Pediatrics Jeanne de Flandre, Lille University Children's Hospital, Lille, France
| | - Dominique Guimber
- CHU Lille, University of Lille, Reference Center for Congenital and Malformative Esophageal Diseases (CRACMO), Division of Gastroenterology, Hepatology and Nutrition, Department of Pediatrics Jeanne de Flandre, Lille University Children's Hospital, Lille, France
| | - Stéphanie Coopman
- CHU Lille, University of Lille, Reference Center for Congenital and Malformative Esophageal Diseases (CRACMO), Division of Gastroenterology, Hepatology and Nutrition, Department of Pediatrics Jeanne de Flandre, Lille University Children's Hospital, Lille, France
| | - Dominique Turck
- CHU Lille, University of Lille, Reference Center for Congenital and Malformative Esophageal Diseases (CRACMO), Division of Gastroenterology, Hepatology and Nutrition, Department of Pediatrics Jeanne de Flandre, Lille University Children's Hospital, Lille, France
| | - Laurent Michaud
- CHU Lille, University of Lille, Reference Center for Congenital and Malformative Esophageal Diseases (CRACMO), Division of Gastroenterology, Hepatology and Nutrition, Department of Pediatrics Jeanne de Flandre, Lille University Children's Hospital, Lille, France
| | - Frédéric Gottrand
- CHU Lille, University of Lille, Reference Center for Congenital and Malformative Esophageal Diseases (CRACMO), Division of Gastroenterology, Hepatology and Nutrition, Department of Pediatrics Jeanne de Flandre, Lille University Children's Hospital, Lille, France
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Galand J, Ley D, Coopman S, Michaud L, Guimber D, Turck D, Gottrand F. Primary prophylaxis of oesophageal variceal bleeding in children by ligation is safe and as efficient as secondary prophylaxis. J Hepatol 2018; 68:600-601. [PMID: 28958884 DOI: 10.1016/j.jhep.2017.07.040] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/25/2017] [Revised: 07/10/2017] [Accepted: 07/15/2017] [Indexed: 12/04/2022]
Affiliation(s)
- Julie Galand
- Department of Paediatrics, CH Arras, France; Division of Gastroenterology, Hepatology and Nutrition, Jeanne de Flandre Children Hospital, Univ. Lille, CHU-Lille, F-59 000, France.
| | - Delphine Ley
- Division of Gastroenterology, Hepatology and Nutrition, Jeanne de Flandre Children Hospital, Univ. Lille, CHU-Lille, F-59 000, France
| | - Stéphanie Coopman
- Division of Gastroenterology, Hepatology and Nutrition, Jeanne de Flandre Children Hospital, Univ. Lille, CHU-Lille, F-59 000, France
| | - Laurent Michaud
- Division of Gastroenterology, Hepatology and Nutrition, Jeanne de Flandre Children Hospital, Univ. Lille, CHU-Lille, F-59 000, France
| | - Dominique Guimber
- Division of Gastroenterology, Hepatology and Nutrition, Jeanne de Flandre Children Hospital, Univ. Lille, CHU-Lille, F-59 000, France
| | - Dominique Turck
- Division of Gastroenterology, Hepatology and Nutrition, Jeanne de Flandre Children Hospital, Univ. Lille, CHU-Lille, F-59 000, France
| | - Frédéric Gottrand
- Division of Gastroenterology, Hepatology and Nutrition, Jeanne de Flandre Children Hospital, Univ. Lille, CHU-Lille, F-59 000, France
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Ghione S, Sarter H, Fumery M, Armengol-Debeir L, Savoye G, Ley D, Spyckerelle C, Pariente B, Peyrin-Biroulet L, Turck D, Gower-Rousseau C, Andre JM, Antonietti M, Aouakli A, Armand A, Aroichane I, Assi F, Aubet JP, Auxenfants E, Ayafi-Ramelot F, Bankovski D, Barbry B, Bardoux N, Baron P, Baudet A, Bazin B, Bebahani A, Becqwort JP, Benet V, Benali H, Benguigui C, Soussan BE, Bental A, Berkelmans I, Bernet J, Bernou K, Bernou-Dron C, Bertot P, Bertiaux-Vandaële N, Bertrand V, Billoud E, Biron N, Bismuth B, Bleuet M, Blondel F, Blondin V, Bohon P, Boniface E, Bonnière P, Bonvarlet E, Bonvarlet P, Boruchowicz A, Bostvironnois R, Boualit M, Bouche B, Boudaillez C, Bourgeaux C, Bourgeois M, Bourguet A, Bourienne A, Branche J, Bray G, Brazier F, Breban P, Brihier H, Brung-Lefebvre V, Bulois P, Burgiere P, Butel J, Canva JY, Canva-Delcambre V, Capron JP, Cardot F, Carpentier P, Cartier E, Cassar JF, Cassagnou M, Castex JF, Catala P, Cattan S, Catteau S, Caujolle B, Cayron G, Chandelier C, Chantre M, Charles J, Charneau T, Chavance-Thelu M, Chirita D, Choteau A, Claerbout JF, Clergue PY, Coevoet H, Cohen G, Collet R, Colombel JF, Coopman S, Corvisart J, Cortot A, Couttenier F, Crinquette JF, Crombe V, Dadamessi I, Dapvril V, Davion T, Dautreme S, Debas J, Degrave N, Dehont F, Delatre C, Delcenserie R, Delette O, Delgrange T, Delhoustal L, Delmotte JS, Demmane S, Deregnaucourt G, Descombes P, Desechalliers JP, Desmet P, Desreumaux P, Desseaux G, Desurmont P, Devienne A, Devouge E, Devred M, Devroux A, Dewailly A, Dharancy S, Di Fiore A, Djeddi D, Djedir R, Dreher-Duwat ML, Dubois R, Dubuque C, Ducatillon P, Duclay J, Ducrocq B, Ducrot F, Ducrotte P, Dufilho A, Duhamel C, Dujardin D, Dumant-Forest C, Dupas JL, Dupont F, Duranton Y, Duriez A, El Achkar K, El Farisi M, Elie C, Elie-Legrand MC, Elkhaki A, Eoche M, Evrard D, Evrard JP, Fatome A, Filoche B, Finet L, Flahaut M, Flamme C, Foissey D, Fournier P, Foutrein-Comes MC, Foutrein P, Fremond D, Frere T, Fumery M, Gallet P, Gamblin C, Ganga-Zandzou PS, Gérard R, Geslin G, Gheyssens Y, Ghossini N, Ghrib S, Gilbert T, Gillet B, Godard D, Godard P, Godchaux JM, Godchaux R, Goegebeur G, Goria O, Gottrand F, Gower P, Grandmaison B, Groux M, Guedon C, Guillard JF, Guillem L, Guillemot F, Guimber D, Haddouche B, Hakim S, Hanon D, Hautefeuille V, Heckestweiller P, Hecquet G, Hedde JP, Hellal H, Henneresse PE, Heyman B, Heraud M, Herve S, Hochain P, Houssin-Bailly L, Houcke P, Huguenin B, Iobagiu S, Ivanovic A, Iwanicki-Caron I, Janicki E, Jarry M, Jeu J, Joly JP, Jonas C, Katherin F, Kerleveo A, Khachfe A, Kiriakos A, Kiriakos J, Klein O, Kohut M, Kornhauser R, Koutsomanis D, Laberenne JE, Laffineur G, Lagarde M, Lannoy P, Lapchin J, Lapprand M, Laude D, Leblanc R, Lecieux P, Leclerc N, Le Couteulx C, Ledent J, Lefebvre J, Lefiliatre P, Legrand C, Le Grix A, Lelong P, Leluyer B, Lenaerts C, Lepileur L, Leplat A, Lepoutre-Dujardin E, Leroi H, Leroy MY, Lesage JP, Lesage X, Lesage J, Lescanne-Darchis I, Lescut J, Lescut D, Leurent B, Levy P, Lhermie M, Lion A, Lisambert B, Loire F, Louf S, Louvet A, Luciani M, Lucidarme D, Lugand J, Macaigne O, Maetz D, Maillard D, Mancheron H, Manolache O, Marks-Brunel AB, Marti R, Martin F, Martin G, Marzloff E, Mathurin P, Mauillon J, Maunoury V, Maupas JL, Mesnard B, Metayer P, Methari L, Meurisse B, Meurisse F, Michaud L, Mirmaran X, Modaine P, Monthe A, Morel L, Mortier PE, Moulin E, Mouterde O, Mudry J, Nachury M, Khac NE, Notteghem B, Ollevier V, Ostyn A, Ouraghi A, Ouvry D, Paillot B, Panien-Claudot N, Paoletti C, Papazian A, Parent B, Pariente B, Paris JC, Patrier P, Paupart L, Pauwels B, Pauwels M, Petit R, Piat M, Piotte S, Plane C, Plouvier B, Pollet E, Pommelet P, Pop D, Pordes C, Pouchain G, Prades P, Prevost A, Prevost JC, Quesnel B, Queuniet AM, Quinton JF, Rabache A, Rabelle P, Raclot G, Ratajczyk S, Rault D, Razemon V, Reix N, Revillon M, Richez C, Robinson P, Rodriguez J, Roger J, Roux JM, Rudelli A, Saber A, Savoye G, Schlosseberg P, Segrestin M, Seguy D, Serin M, Seryer A, Sevenet F, Shekh N, Silvie J, Simon V, Spyckerelle C, Talbodec N, Techy A, Thelu JL, Thevenin A, Thiebault H, Thomas J, Thorel JM, Tielman G, Tode M, Toisin J, Tonnel J, Touchais JY, Touze Y, Tranvouez JL, Triplet C, Turck D, Uhlen S, Vaillant E, Valmage C, Vanco D, Vandamme H, Vanderbecq E, Eecken VE, Vandermolen P, Vandevenne P, Vandeville L, Vandewalle A, Vandewalle C, Vaneslander P, Vanhoove JP, Vanrenterghem A, Varlet P, Vasies I, Verbiese G, Vernier-Massouille G, Vermelle P, Verne C, Vezilier-Cocq P, Vigneron B, Vincendet M, Viot J, Voiment YM, Wacrenier A, Waeghemaecker L, Wallez JY, Wantiez M, Wartel F, Weber J, Willocquet JL, Wizla N, Wolschies E, Zalar A, Zaouri B, Zellweger A, Ziade C. Dramatic Increase in Incidence of Ulcerative Colitis and Crohn's Disease (1988-2011): A Population-Based Study of French Adolescents. Am J Gastroenterol 2018; 113:265-272. [PMID: 28809388 DOI: 10.1038/ajg.2017.228] [Citation(s) in RCA: 101] [Impact Index Per Article: 16.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/02/2016] [Accepted: 06/08/2017] [Indexed: 02/07/2023]
Abstract
OBJECTIVES Few data are available to describe the changes in incidence of pediatric-onset inflammatory bowel disease (IBD). The aim of this study was to describe changes in incidence and phenotypic presentation of pediatric-onset IBD in northern France during a 24-year period. METHODS Pediatric-onset IBD (<17 years) was issued from a population-based IBD study in France between 1988 and 2011. Age groups and digestive location were defined according to the Paris classification. RESULTS 1,350 incident cases were recorded (8.3% of all IBD) including 990 Crohn's disease (CD), 326 ulcerative colitis (UC) and 34 IBD unclassified (IBDU). Median age at diagnosis was similar in CD (14.4 years (Q1=11.8-Q3=16.0)) and UC (14.0 years (11.0-16.0)) and did not change over time. There were significantly more males with CD (females/males=0.82) than UC (females/males=1.25) (P=0.0042). Median time between onset of symptoms and IBD diagnosis was consistently 3 months (1-6). Mean incidence was 4.4/105 for IBD overall (3.2 for CD, 1.1 for UC and 0.1 for IBDU). From 1988-1990 to 2009-2011, a dramatic increase in incidences of both CD and UC were observed in adolescents (10-16 years): for CD from 4.2 to 9.5/105 (+126%; P<0.001) and for UC, from 1.6 to 4.1/105 (+156%; P<0.001). No modification in age or location at diagnosis was observed in either CD or UC. CONCLUSIONS In this population-based study, CD and UC incidences increased dramatically in adolescents across a 24-year span, suggesting that one or more strong environmental factors may predispose this population to IBD.
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Affiliation(s)
- Silvia Ghione
- Division of Gastroenterology, Hepatology and Nutrition, Department of Pediatrics, Lille University Jeanne de Flandre Children's Hospital and Faculty of Medicine, Lille, France
| | - Hélène Sarter
- Public Health, Epidemiology and Economic Health, Epimad registry, Regional house of clinical research, Lille Hospital and University, Lille, France.,Lille Inflammation Research International Center LIRIC-UMR 995 Inserm-"IBD and environmental factors: epidemiology and functional analyses", Lille University, Lille, France
| | - Mathurin Fumery
- Gastroenterology Unit, Epimad registry, Amiens Hospital and University, Amiens, France
| | - Laura Armengol-Debeir
- Gastroenterology Unit, Epimad registry, Rouen Hospital and University, Rouen, France
| | - Guillaume Savoye
- Gastroenterology Unit, Epimad registry, Rouen Hospital and University, Rouen, France
| | - Delphine Ley
- Division of Gastroenterology, Hepatology and Nutrition, Department of Pediatrics, Lille University Jeanne de Flandre Children's Hospital and Faculty of Medicine, Lille, France.,Lille Inflammation Research International Center LIRIC-UMR 995 Inserm-"IBD and environmental factors: epidemiology and functional analyses", Lille University, Lille, France
| | - Claire Spyckerelle
- Department of Pediatrics, St Vincent de Paul Hospital and Lille Catholic University, Lille, France
| | - Benjamin Pariente
- Lille Inflammation Research International Center LIRIC-UMR 995 Inserm-"IBD and environmental factors: epidemiology and functional analyses", Lille University, Lille, France.,Gastroenterology Unit, Epimad registry, Lille Hospital and University, Lille, France
| | | | - Dominique Turck
- Division of Gastroenterology, Hepatology and Nutrition, Department of Pediatrics, Lille University Jeanne de Flandre Children's Hospital and Faculty of Medicine, Lille, France.,Lille Inflammation Research International Center LIRIC-UMR 995 Inserm-"IBD and environmental factors: epidemiology and functional analyses", Lille University, Lille, France
| | - Corinne Gower-Rousseau
- Public Health, Epidemiology and Economic Health, Epimad registry, Regional house of clinical research, Lille Hospital and University, Lille, France.,Lille Inflammation Research International Center LIRIC-UMR 995 Inserm-"IBD and environmental factors: epidemiology and functional analyses", Lille University, Lille, France
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Duricova D, Leroyer A, Savoye G, Sarter H, Pariente B, Aoucheta D, Armengol-Debeir L, Ley D, Turck D, Peyrin-Biroulet L, Gower-Rousseau C, Fumery M, Antonietti M, Aouakli A, Armand A, Aroichane I, Assi F, Aubet JP, Auxenfants E, Ayafi-Ramelot F, Bankovski D, Barbry B, Bardoux N, Baron P, Baudet A, Bazin B, Bebahani A, Becqwort JP, Benet V, Benali H, Benguigui C, Ben Soussan E, Bental A, Berkelmans I, Bernet J, Bernou K, Bernou-Dron C, Bertot P, Bertiaux-Vandaële N, Bertrand V, Billoud E, Biron N, Bismuth B, Bleuet M, Blondel F, Blondin V, Bohon P, Boniface E, Bonnière P, Bonvarlet E, Bonvarlet P, Boruchowicz A, Bostvironnois R, Boualit M, Bouche B, Boudaillez C, Bourgeaux C, Bourgeois M, Bourguet A, Bourienne A, Branche J, Bray G, Brazier F, Breban P, Brihier H, Brung-Lefebvre V, Bulois P, Burgiere P, Butel J, Canva JY, Canva-Delcambre V, Capron JP, Cardot F, Carpentier P, Cartier E, Cassar JF, Cassagnou M, Castex JF, Catala P, Cattan S, Catteau S, Caujolle B, Cayron G, Chandelier C, Chantre M, Charles J, Charneau T, Chavance-Thelu M, Chirita D, Choteau A, Claerbout JF, Clergue PY, Coevoet H, Cohen G, Collet R, Colombel JF, Coopman S, Corvisart J, Cortot A, Couttenier F, Crinquette JF, Crombe V, Dadamessi I, Dapvril V, Davion T, Dautreme S, Debas J, Degrave N, Dehont F, Delatre C, Delcenserie R, Delette O, Delgrange T, Delhoustal L, Delmotte JS, Demmane S, Deregnaucourt G, Descombes P, Desechalliers JP, Desmet P, Desreumaux P, Desseaux G, Desurmont P, Devienne A, Devouge E, Devred M, Devroux A, Dewailly A, Dharancy S, Di Fiore A, Djeddi D, Djedir R, Dreher-Duwat ML, Dubois R, Dubuque C, Ducatillon P, Duclay J, Ducrocq B, Ducrot F, Ducrotté P, Dufilho A, Duhamel C, Dujardin D, Dumant-Forest C, Dupas JL, Dupont F, Duranton Y, Duriez A, El Achkar K, El Farisi M, Elie C, Elie-Legrand MC, Elkhaki A, Eoche M, Evrard D, Evrard JP, Fatome A, Filoche B, Finet L, Flahaut M, Flamme C, Foissey D, Fournier P, Foutrein-Comes MC, Foutrein P, Fremond D, Frere T, Fumery M, Gallet P, Gamblin C, Ganga-Zandzou S, Gerard R, Geslin G, Gheyssens Y, Ghossini N, Ghrib S, Gilbert T, Gillet B, Godard D, Godard P, Godchaux JM, Godchaux R, Goegebeur G, Goria O, Gottrand F, Gower P, Grandmaison B, Groux M, Guedon C, Guillard JF, Guillem L, Guillemot F, Guimber D, Haddouche B, Hakim S, Hanon D, Hautefeuille V, Heckestweiller P, Hecquet G, Hedde JP, Hellal H, Henneresse PE, Heyman B, Heraud M, Herve S, Hochain P, Houssin-Bailly L, Houcke P, Huguenin B, Iobagiu S, Ivanovic A, Iwanicki-Caron I, Janicki E, Jarry M, Jeu J, Joly JP, Jonas C, Katherin F, Kerleveo A, Khachfe A, Kiriakos A, Kiriakos J, Klein O, Kohut M, Kornhauser R, Koutsomanis D, Laberenne JE, Laffineur G, Lagarde M, Lannoy P, Lapchin J, Lapprand M, Laude D, Leblanc R, Lecieux P, Leclerc N, Le Couteulx C, Ledent J, Lefebvre J, Lefiliatre P, Legrand C, Le Grix A, Lelong P, Leluyer B, Lenaerts C, Lepileur L, Leplat A, Lepoutre-Dujardin E, Leroi H, Leroy MY, Lesage JP, Lesage X, Lesage J, Lescanne-Darchis I, Lescut J, Lescut D, Leurent B, Levy P, Lhermie M, Lion A, Lisambert B, Loire F, Louf S, Louvet A, Luciani M, Lucidarme D, Lugand J, Macaigne O, Maetz D, Maillard D, Mancheron H, Manolache O, Marks-Brunel AB, Marti R, Martin F, Martin G, Marzloff E, Mathurin P, Mauillon J, Maunoury V, Maupas JL, Mesnard B, Metayer P, Methari L, Meurisse B, Meurisse F, Michaud L, Mirmaran X, Modaine P, Monthe A, Morel L, Mortier PE, Moulin E, Mouterde O, Mudry J, Nachury M, N’Guyen Khac E, Notteghem B, Ollevier V, Ostyn A, Ouraghi A, Ouvry D, Paillot B, Panien-Claudot N, Paoletti C, Papazian A, Parent B, Pariente B, Paris JC, Patrier P, Paupart L, Pauwels B, Pauwels M, Petit R, Piat M, Piotte S, Plane C, Plouvier B, Pollet E, Pommelet P, Pop D, Pordes C, Pouchain G, Prades P, Prevost A, Prevost JC, Quesnel B, Queuniet AM, Quinton JF, Rabache A, Rabelle P, Raclot G, Ratajczyk S, Rault D, Razemon V, Reix N, Revillon M, Richez C, Robinson P, Rodriguez J, Roger J, Roux JM, Rudelli A, Saber A, Savoye G, Schlosseberg P, Segrestin M, Seguy D, Serin M, Seryer A, Sevenet F, Shekh N, Silvie J, Simon V, Spyckerelle C, Talbodec N, Techy A, Thelu JL, Thevenin A, Thiebault H, Thomas J, Thorel JM, Tielman G, Tode M, Toisin J, Tonnel J, Touchais JY, Touze Y, Tranvouez JL, Triplet C, Turck D, Uhlen S, Vaillant E, Valmage C, Vanco D, Vandamme H, Vanderbecq E, Vander Eecken E, Vandermolen P, Vandevenne P, Vandeville L, Vandewalle A, Vandewalle C, Vaneslander P, Vanhoove JP, Vanrenterghem A, Varlet P, Vasies I, Verbiese G, Vernier-Massouille G, Vermelle P, Verne C, Vezilier-Cocq P, Vigneron B, Vincendet M, Viot J, Voiment YM, Wacrenier A, Waeghemaecker L, Wallez JY, Wantiez M, Wartel F, Weber J, Willocquet JL, Wizla N, Wolschies E, Zalar A, Zaouri B, Zellweger A, Ziade C. Extra-intestinal Manifestations at Diagnosis in Paediatric- and Elderly-onset Ulcerative Colitis are Associated With a More Severe Disease Outcome: A Population-based Study. J Crohns Colitis 2017; 11:1326-1334. [PMID: 28981648 DOI: 10.1093/ecco-jcc/jjx092] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [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: 04/06/2017] [Accepted: 07/05/2017] [Indexed: 02/08/2023]
Abstract
BACKGROUND AND AIMS Data on extra-intestinal manifestations [EIM] and their impact on the disease course of ulcerative colitis [UC] in population-based cohorts are scarce, particularly in paediatric- and elderly-onset UC patients. The aims of this population-based study were to assess: 1] the occurrence of EIM in paediatric- and elderly-onset UC; 2] the factors associated with EIM; and 3] their impact on long-term disease outcome. METHODS Paediatric-onset [< 17 years at diagnosis] and elderly-onset UC patients [> 60 years at diagnosis] from a French prospective population-based registry [EPIMAD] were included. Data on EIM and other clinical factors at diagnosis and at maximal follow-up were collected. RESULTS In all, 158 paediatric- and 470 elderly-onset patients were included [median age at diagnosis 14.5 and 68.8 years, median follow-up 11.2 and 6.2 years, respectively]. EIM occurred in 8.9% of childhood- and 3% of elderly-onset patients at diagnosis and in 16.7% and 2.2% of individuals during follow-up [p < 0.01], respectively. The most frequent EIM was joint involvement [15.8% of paediatric onset and 2.6% of elderly-onset]. Presence of EIM at diagnosis was associated with more severe disease course [need for immunosuppressants or biologic therapy or colectomy] in both paediatric- and elderly-onset UC (hazard ratio [HR] = 2.0, 95% confidence interval [CI]: 1.0-4.2; and HR = 2.8, 0.9-7.9, respectively). Extensive colitis was another independent risk factor in both age groups. CONCLUSIONS Elderly-onset UC patients had lower risk of EIM either at diagnosis or during follow-up than paediatric-onset individuals. EIM at diagnosis predicted more severe disease outcome, including need for immunosuppressive or biologic therapy or surgery, in both paediatric- and elderly-onset UC.
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Affiliation(s)
- Dana Duricova
- Public Health, Epidemiology and Economic Health, Registre EPIMAD, Lille University and Hospital, Lille, France
| | - Ariane Leroyer
- Public Health, Epidemiology and Economic Health, Registre EPIMAD, Lille University and Hospital, Lille, France
| | - Guillaume Savoye
- Gastroenterology Unit, EPIMAD Registry, Rouen University Hospital, Rouen, France
| | - Hélène Sarter
- Public Health, Epidemiology and Economic Health, Registre EPIMAD, Lille University and Hospital, Lille, France.,Lille Inflammation Research International Center LIRIC-UMR 995 Inserm Lille 2 University, Lille, France
| | - Benjamin Pariente
- Gastroenterology Unit, Hôpital Huriez, Lille University Hospital, Lille, France
| | - Djamila Aoucheta
- Associated Medical Director, Immunology, MSD France, Courbevoie cedex, France
| | | | - Delphine Ley
- Lille Inflammation Research International Center LIRIC-UMR 995 Inserm Lille 2 University, Lille, France.,Division of Gastroenterology, Hepatology and Nutrition, Lille University Jeanne de Flandre Children's Hospital, University of Lille, Lille, France
| | - Dominique Turck
- Lille Inflammation Research International Center LIRIC-UMR 995 Inserm Lille 2 University, Lille, France.,Division of Gastroenterology, Hepatology and Nutrition, Lille University Jeanne de Flandre Children's Hospital, University of Lille, Lille, France
| | | | - Corinne Gower-Rousseau
- Public Health, Epidemiology and Economic Health, Registre EPIMAD, Lille University and Hospital, Lille, France.,Lille Inflammation Research International Center LIRIC-UMR 995 Inserm Lille 2 University, Lille, France
| | - Mathurin Fumery
- Lille Inflammation Research International Center LIRIC-UMR 995 Inserm Lille 2 University, Lille, France.,Gastroenterology Unit, EPIMAD Registry, Amiens University Hospital, Amiens, France
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Vanhelst J, Béghin L, Drumez E, Coopman S, Gottrand F. Awareness of wearing an accelerometer does not affect physical activity in youth. BMC Med Res Methodol 2017; 17:99. [PMID: 28693500 PMCID: PMC5504551 DOI: 10.1186/s12874-017-0378-5] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2017] [Accepted: 06/30/2017] [Indexed: 12/31/2022] Open
Abstract
BACKGROUND This study aimed to investigate whether awareness of being monitored by an accelerometer has an effect on physical activity in young people. METHODS Eighty healthy participants aged 10-18 years were randomized between blinded and nonblinded groups. The blinded participants were informed that we were testing the reliability of a new device for body posture assessment and these participants did not receive any information about physical activity. In contrast, the nonblinded participants were informed that the device was an accelerometer that assessed physical activity levels and patterns. The participants were instructed to wear the accelerometer for 4 consecutive days (2 school days and 2 school-free days). RESULTS Missing data led to the exclusion of 2 participants assigned to the blinded group. When data from the blinded group were compared with these from the nonblinded group, no differences were found in the duration of any of the following items: (i) wearing the accelerometer, (ii) total physical activity, (iii) sedentary activity, and (iv) moderate-to-vigorous activity. CONCLUSIONS Our study shows that the awareness of wearing an accelerometer has no influence on physical activity patterns in young people. This study improves the understanding of physical activity assessment and underlines the objectivity of this method. TRIAL REGISTRATION NCT02844101 (retrospectively registered at July 13th 2016).
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Affiliation(s)
- Jérémy Vanhelst
- Univ. Lille, Inserm, CHU Lille, U995 - LIRIC - Lille Inflammation Research International Center, CIC 1403 - Centre d'investigation clinique, F-59000, Lille, France.
| | - Laurent Béghin
- Univ. Lille, Inserm, CHU Lille, U995 - LIRIC - Lille Inflammation Research International Center, CIC 1403 - Centre d'investigation clinique, F-59000, Lille, France
| | - Elodie Drumez
- Univ. Lille, CHU Lille, EA 2694 - Public Health: epidemiology and quality of care, F-59000, Lille, France
| | - Stéphanie Coopman
- Univ. Lille, Inserm, CHU Lille, U995 - LIRIC - Lille Inflammation Research International Center, CIC 1403 - Centre d'investigation clinique, F-59000, Lille, France
| | - Frédéric Gottrand
- Univ. Lille, Inserm, CHU Lille, U995 - LIRIC - Lille Inflammation Research International Center, CIC 1403 - Centre d'investigation clinique, F-59000, Lille, France
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Dandrieu Barbe E, Coopman S, Dubos F, Gottrand F. IPP chez les nourrissons de moins de un an dans un service d’UP. Arch Pediatr 2016. [DOI: 10.1016/j.arcped.2016.09.041] [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: 10/20/2022]
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Carette-Lherbier S, Sarter H, Spyckerelle C, Devouge E, Legrand C, Couttenier F, Coopman S, Michaud L, Guimber D, Gottrand F, Ganga-Zandzou P, Gower-Rousseau C, Turck D. Évaluation du recours aux médecines non conventionnelles par les enfants atteints de maladie inflammatoire chronique de l’intestin. Arch Pediatr 2016. [DOI: 10.1016/j.arcped.2016.02.027] [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: 11/17/2022]
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Béghin L, Coopman S, Schiff M, Vamecq J, Mention-Mulliez K, Hankard R, Cuisset JM, Ogier H, Gottrand F, Dobbelaere D. Doubling diet fat on sugar ratio in children with mitochondrial OXPHOS disorders: Effects of a randomized trial on resting energy expenditure, diet induced thermogenesis and body composition. Clin Nutr 2016; 35:1414-1422. [PMID: 27173380 DOI: 10.1016/j.clnu.2016.03.015] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2015] [Revised: 02/11/2016] [Accepted: 03/20/2016] [Indexed: 10/22/2022]
Abstract
BACKGROUND & AIMS Mitochondrial OXPHOS disorders (MODs) affect one or several complexes of respiratory chain oxidative phosphorylation. An increased fat/low-carbohydrate ratio of the diet was recommended for treating MODs without, however, evaluating its potential benefits through changes in the respective contributions of cell pathways (glycolysis, fatty acid oxidation) initiating energy production. Therefore, the objective of the present work was to compare Resting Energy Expenditure (REE) under basal diet (BD) and challenging diet (CD) in which fat on sugar content ratio was doubled. Diet-induced thermogenesis (DIT) and body compositions were also compared. Energetic vs regulatory aspects of increasing fat contribution to total nutritional energy input were essentially addressed through measures primarily aiming at modifying total fat amounts and not the types of fats in designed diets. METHODS In this randomized cross-over study, BD contained 10% proteins/30% lipids/60% carbohydrates (fat on sugar ratio = 0.5) and was the imposed diet at baseline. CD contained 10% proteins/45% lipids/45% carbohydrates (fat on sugar ratio = 1). Main and second evaluation criteria measured by indirect calorimetry (QUARK RMR®, Cosmed, Pavona; Italy) were REE and DIT, respectively. Thirty four MOD patients were included; 22 (mean age 13.2 ± 4.7 years, 50% female; BMI 16.9 ± 4.2 kg/m2) were evaluated for REE, and 12 (mean age 13.8 ± 4.8 years, 60% female; BMI 17.4 ± 4.6 kg/m2) also for DIT. OXPHOS complex deficiency repartition in 22 analysed patients was 55% for complex I, 9% for complex III, 27% for complex IV and 9% for other proteins. RESULTS Neither carry-over nor period effects were detected (p = 0.878; ANOVA for repeated measures). REE was similar between BD vs CD (1148.8 ± 301.7 vs 1156.1 ± 278.8 kcal/day; p = 0.942) as well as DIT (peak DIT 260 vs 265 kcal/day; p = 0.842) and body composition (21.9 ± 13.0 vs 21.6 ± 13.3% of fat mass; p = 0.810). CONCLUSION Doubling diet fat on sugar ratio does not appear to improve, per se, energetic status and body composition of patients with MODs.
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Affiliation(s)
- Laurent Béghin
- Centre d'Investigation Clinique, CIC-1403-Inserm-CH&U, Lille University Hospital, F-59000 Lille, France; LIRIC- Lille Inflammation Research International Center/UMR U995 Inserm, Lille, France.
| | - Stéphanie Coopman
- Centre d'Investigation Clinique, CIC-1403-Inserm-CH&U, Lille University Hospital, F-59000 Lille, France.
| | - Manuel Schiff
- Reference Center for Inherited Metabolic Diseases, Robert Debré University Hospital, Paris, France.
| | - Joseph Vamecq
- Inserm, Department of Biochemistry and Molecular Biology, HMNO, CBP, CHRU Lille and RADEME EA 7364, Lille Nord of France University, F-59000, Lille, France.
| | - Karine Mention-Mulliez
- Reference Center for Inherited Metabolic Diseases in Child and Adulthood, Lille University Children's Hospital Jeanne de Flandre, and RADEME EA 7364, Lille University, F-59000 Lille, France.
| | - Régis Hankard
- Inserm U 1069, F Rabelais University, Tours, F-37000, France.
| | - Jean-Marie Cuisset
- Pediatric Neurology Unit, Lille University Hospital, F-59000, Lille, France
| | - Hélène Ogier
- Reference Center for Inherited Metabolic Diseases, Robert Debré University Hospital, Paris, France
| | - Frédéric Gottrand
- Centre d'Investigation Clinique, CIC-1403-Inserm-CH&U, Lille University Hospital, F-59000 Lille, France; LIRIC- Lille Inflammation Research International Center/UMR U995 Inserm, Lille, France.
| | - Dries Dobbelaere
- Reference Center for Inherited Metabolic Diseases in Child and Adulthood, Lille University Children's Hospital Jeanne de Flandre, and RADEME EA 7364, Lille University, F-59000 Lille, France.
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Béghin L, Storme L, Coopman S, Rakza T, Gottrand F. Parenteral nutrition with fish oil supplements is safe and seems to be effective in severe preterm neonates with respiratory distress syndrome. Acta Paediatr 2015; 104:e534-6. [PMID: 26098767 DOI: 10.1111/apa.13091] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/16/2014] [Revised: 03/13/2015] [Accepted: 06/16/2015] [Indexed: 11/27/2022]
Affiliation(s)
- Laurent Béghin
- LIRIC (Lille Inflammation Research International Center)/UMR 995 Inserm; Lille University; Lille France
- CIC-PT-1403-Inserm-CH&U; Lille University Hospital; Lille France
| | - Laurent Storme
- EA 4489, Environnement Périnatal et Croissance; Lille University; Lille France
| | | | - Thameur Rakza
- EA 4489, Environnement Périnatal et Croissance; Lille University; Lille France
| | - Frédéric Gottrand
- LIRIC (Lille Inflammation Research International Center)/UMR 995 Inserm; Lille University; Lille France
- CIC-PT-1403-Inserm-CH&U; Lille University Hospital; Lille France
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Jacob A, Delesalle D, Coopman S, Bridenne M, Guimber D, Turck D, Gottrand F, Michaud L. Safety of the One-Step Percutaneous Endoscopic Gastrostomy Button in Children. J Pediatr 2015; 166:1526-8. [PMID: 25868429 DOI: 10.1016/j.jpeds.2015.03.008] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/11/2014] [Revised: 02/09/2015] [Accepted: 03/04/2015] [Indexed: 12/28/2022]
Abstract
Pediatric experience using the single-stage percutaneous endoscopic gastrostomy button has been reported anecdotally. This 3-year prospective monocentric study, including 183 children, demonstrates that this technique is safe, with a low rate of infection, and compares favorably with the pull technique of percutaneous endoscopic gastrostomy while necessitating only one general anesthesia.
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Affiliation(s)
- Anne Jacob
- Division of Hepatology, Gastroenterology and Nutrition and Reference Centre for Congenital and Malformative Esophageal Disorders, Jeanne de Flandre Children's Hospital, Faculty of Medicine, University Lille2, Lille, France
| | - Dorothée Delesalle
- Division of Hepatology, Gastroenterology and Nutrition and Reference Centre for Congenital and Malformative Esophageal Disorders, Jeanne de Flandre Children's Hospital, Faculty of Medicine, University Lille2, Lille, France
| | - Stéphanie Coopman
- Division of Hepatology, Gastroenterology and Nutrition and Reference Centre for Congenital and Malformative Esophageal Disorders, Jeanne de Flandre Children's Hospital, Faculty of Medicine, University Lille2, Lille, France
| | - Marie Bridenne
- Division of Hepatology, Gastroenterology and Nutrition and Reference Centre for Congenital and Malformative Esophageal Disorders, Jeanne de Flandre Children's Hospital, Faculty of Medicine, University Lille2, Lille, France
| | - Dominique Guimber
- Division of Hepatology, Gastroenterology and Nutrition and Reference Centre for Congenital and Malformative Esophageal Disorders, Jeanne de Flandre Children's Hospital, Faculty of Medicine, University Lille2, Lille, France
| | - Dominique Turck
- Division of Hepatology, Gastroenterology and Nutrition and Reference Centre for Congenital and Malformative Esophageal Disorders, Jeanne de Flandre Children's Hospital, Faculty of Medicine, University Lille2, Lille, France
| | - Frédéric Gottrand
- Division of Hepatology, Gastroenterology and Nutrition and Reference Centre for Congenital and Malformative Esophageal Disorders, Jeanne de Flandre Children's Hospital, Faculty of Medicine, University Lille2, Lille, France
| | - Laurent Michaud
- Division of Hepatology, Gastroenterology and Nutrition and Reference Centre for Congenital and Malformative Esophageal Disorders, Jeanne de Flandre Children's Hospital, Faculty of Medicine, University Lille2, Lille, France.
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Jacob A, Druelle D, Robert-Dehault A, Coopman S, Guimber D, Turck D, Gottrand F, Michaud L. O30 Étude prospective de la pose d’un bouton de gastrostomie en un temps par voie endoscopique chez l’enfant. NUTR CLIN METAB 2013. [DOI: 10.1016/s0985-0562(13)70302-9] [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: 11/28/2022]
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Robberecht MN, Coopman S, Gottrand F, Béghin L. À propos de la collaboration entre les pédiatres ambulatoires et les CIC dans la recherche clinique : l’expérience lilloise. Arch Pediatr 2013. [DOI: 10.1016/s0929-693x(13)71363-0] [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: 10/26/2022]
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Delesalle D, Robert-Dehault A, Coopman S, Turck D, Gottrand F, Michaud L. Gastrostomie de décompression dans l’aérophagie pathologique chez l’enfant. Arch Pediatr 2013. [DOI: 10.1016/j.arcped.2013.02.021] [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: 11/25/2022]
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Robert-Dehault A, Gottrand F, Turck D, Guimber D, Coopman S, Michaud L. Nutrition entérale par sonde de gastrojéjunostomie chez l’enfant : comparaison de deux types de sonde en termes d’efficacité et de tolérance. Arch Pediatr 2013. [DOI: 10.1016/j.arcped.2013.02.024] [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: 10/26/2022]
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Guimber D, Michaud L, Robert-Dehaut A, Coopman S, Turck D, Gottrand F. Expérience de la gastrojéjunostomie percutanée en un temps chez le nourrisson. Arch Pediatr 2013. [DOI: 10.1016/j.arcped.2013.02.023] [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: 11/30/2022]
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D’arrigo E, Coopman S, Gottrand F, Sfeir R, Turck D, Michaud L. Caractéristiques et évolution du dumping syndrome chez l’enfant. Arch Pediatr 2013. [DOI: 10.1016/j.arcped.2013.02.025] [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: 11/30/2022]
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Révillion M, Guimber D, Coopman S, Turck D, Gottrand F, Michaud L. Devenir des enfants après sevrage d’une nutrition entérale par gastrostomie. Arch Pediatr 2013. [DOI: 10.1016/j.arcped.2013.02.051] [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: 11/30/2022]
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Béghin L, Huybrechts I, Ortega FB, Coopman S, Manios Y, Wijnhoven TMA, Duhamel A, Ciarapica D, Gilbert CC, Kafatos A, Widhalm K, Molnar D, Moreno LA, Gottrand F. Nutritional and pubertal status influences accuracy of self-reported weight and height in adolescents: the HELENA Study. Ann Nutr Metab 2013; 62:189-200. [PMID: 23485769 DOI: 10.1159/000343096] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/30/2012] [Accepted: 08/31/2012] [Indexed: 11/19/2022]
Abstract
BACKGROUND AND AIMS The aim of this study was to assess factors that have an effect on the accuracy of self-reported weight and height in adolescents. METHODS Weight and height of 3,865 European adolescents aged 12.5 to 17.5 years were self-reported via specific questionnaire. Then real weight and height were measured using accurate equipment and standardized protocols. Differences (D) between self-reported and measured weight and height were calculated, and factors that could have influenced the accuracy of self-reported weight and height were assessed. Data were analyzed using ANOVA, Student's t test and multivariate regression. RESULTS Adolescents underestimated their weight (D = -0.81 kg; n = 2,968) and overestimated their height (D = +0.74 cm; n = 3,308). Obese girls underestimated their weight (D = -4.70 kg) and overestimated their height (D = +0.22 cm) to a greater extent (p < 0.05) than obese boys (D = -3.13 kg and +0.14 cm for weight and height, respectively). Underestimation of weight (D = -1.25 kg) and overestimation of height (D = +0.15 cm) were only significant for girls who had finished puberty (Tanner stage 5). Socioeconomic status, nutritional knowledge, physical fitness, physical activity level, food choice and preference, and healthy eating behaviour had no significant influence on the accuracy of self-reported weight and height. CONCLUSION Our data confirms that self-reports of weight and height made by adolescents are inaccurate and demonstrate that inaccuracy is strongly influenced by nutritional status, pubertal status and gender.
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Affiliation(s)
- Laurent Béghin
- U955 INSERM, IFR114, Faculty of Medicine, Université Lille Nord de France, Lille, France.
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Vanhelst J, Hardy L, Bert D, Duhem S, Coopman S, Libersa C, Deplanque D, Gottrand F, Béghin L. Effect of child health status on parents' allowing children to participate in pediatric research. BMC Med Ethics 2013; 14:7. [PMID: 23414421 PMCID: PMC3582492 DOI: 10.1186/1472-6939-14-7] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2012] [Accepted: 02/12/2013] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND To identify motivational factors linked to child health status that affected the likelihood of parents' allowing their child to participate in pediatric research. METHODS Parents were invited to return their completed questionnaires anonymously to assess motivational factors and factors that might improve participation in pediatric research. RESULTS Of 573 eligible parents, 261 returned the completed questionnaires. Of these, 126 were parents of healthy children (group 1), whereas 135 were parents of sick children who were divided into two groups according to the severity of their pathology, i.e., 99 ambulatory children (group 2) and 36 nonambulatory children (group 3). The main factor motivating participation in a pediatric clinical research study was "direct benefits for their child" (87.7%, 100%, and 100% for groups 1, 2, and 3, respectively). The other factors differed significantly between the three groups, depending on the child's health status (all p < 0.05). Factors that might have a positive impact on parental consent to the participation of their child in a pediatric clinical research study differed significantly (χ2 test, all p ≤ 0.04), depending on the child's health status. The main factor was "a better understanding of the study and its regulation" for the healthy children and ambulatory sick children groups (31.2% and 82.1%, respectively), whereas this was the third factor for the nonambulatory sick children group (50%). CONCLUSIONS Innovative strategies should be developed based on a child's health status to improve information provision when seeking a child's participation in pediatric research. Parents would like to spend more time in discussions with investigators.
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Affiliation(s)
- Jérémy Vanhelst
- Centre d’Investigation Clinique, CIC-PT-9301-Inserm-CH&U, Lille, 59037, France
- Unité Inserm U995 & Université Lille Nord de France, Lille, France
| | - Ludovic Hardy
- Centre d’Investigation Clinique, CIC-PT-9301-Inserm-CH&U, Lille, 59037, France
| | - Dina Bert
- Centre d’Investigation Clinique, CIC-PT-9301-Inserm-CH&U, Lille, 59037, France
| | - Stéphane Duhem
- Centre d’Investigation Clinique, CIC-PT-9301-Inserm-CH&U, Lille, 59037, France
- Comité de Protection des Personnes Nord Ouest IV, Lille, France
| | - Stéphanie Coopman
- Centre d’Investigation Clinique, CIC-PT-9301-Inserm-CH&U, Lille, 59037, France
| | - Christian Libersa
- Centre d’Investigation Clinique, CIC-PT-9301-Inserm-CH&U, Lille, 59037, France
- Département de Pharmacologie, Faculté de Médecine, Université Lille Nord de France, Lille, France
| | - Dominique Deplanque
- Centre d’Investigation Clinique, CIC-PT-9301-Inserm-CH&U, Lille, 59037, France
- Département de Pharmacologie, Faculté de Médecine, Université Lille Nord de France, Lille, France
| | - Frédéric Gottrand
- Centre d’Investigation Clinique, CIC-PT-9301-Inserm-CH&U, Lille, 59037, France
- Unité Inserm U995 & Université Lille Nord de France, Lille, France
| | - Laurent Béghin
- Centre d’Investigation Clinique, CIC-PT-9301-Inserm-CH&U, Lille, 59037, France
- Unité Inserm U995 & Université Lille Nord de France, Lille, France
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Gottrand M, Muyshont L, Couttenier F, Beghin L, Martigne L, Coopman S, Turck D, Michaud L, Guimber D, Gottrand F. Micronutrient Status of Children Receiving Prolonged Enteral Nutrition. Ann Nutr Metab 2013; 63:152-8. [DOI: 10.1159/000353704] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/24/2013] [Accepted: 06/11/2013] [Indexed: 11/19/2022]
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Abstract
Transgastric jejunal intubation via gastrostomy (GJ) can be indicated when enteral nutrition via gastrostomy is not possible. Between 2001 and 2008, the authors prospectively assessed the outcomes in 29 patients (median age, 10 months) after GJ. Indications for jejunal feeding were severe gastro-oesophageal reflux (n=27) and intestinal dysmotility (n=2). The GJ was successfully placed in 27/29 patients. Complications were: 31 tube dislodgements, 16 obstructions, 7 leakages around the tube, 6 internal balloon ruptures and 1 intussusception. The median lifetime of the tube was 3 months. 9/27 patients died during the study period, 11 patients required surgery, 2 required parenteral nutrition, gastric feeding became tolerated in 3 and the gastrojejunal feeding tube was kept in place in the remaining 2. A transgastric jejunal feeding tube may constitute a transitory alternative to antireflux surgery or prolonged parenteral nutrition. However, the high frequency of complications and tube replacement limits its use.
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Affiliation(s)
- Laurent Michaud
- Department of Pediatrics, Jeanne de Flandre Children's Hospital and Faculty of Medicine, University Lille2, Avenue Eugène Avinée, 59037 Lille, France.
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Beghin L, Storme L, Coopman S, Rakza T, Gottrand F. O28 Une nutrition parentérale enrichie en acides gras polyinsaturés oméga 3 diminue la durée d’oxygénothérapie chez le grand prématuré. Étude pilote. NUTR CLIN METAB 2011. [DOI: 10.1016/s0985-0562(11)70032-2] [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: 11/28/2022]
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Revillion M, Guimber D, Coopman S, Turck D, Gottrand F, Michaud L. P129 Que deviennent les enfants après sevrage d’une nutrition entérale par gastrostomie ? NUTR CLIN METAB 2011. [DOI: 10.1016/s0985-0562(11)70196-0] [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: 11/26/2022]
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Guimber D, Michaud L, Robert-Dehaut A, Coopman S, Turck D, Gottrand F. P128 Expérience de la gastrojéjunostomie percutanée en un temps chez le nourrisson. NUTR CLIN METAB 2011. [DOI: 10.1016/s0985-0562(11)70195-9] [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: 10/14/2022]
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Druelle D, Robert-Dehault A, Martigne L, Al Husseini B, Coopman S, Guimber D, Turck D, Gottrand F, Michaud L. Pose d’emblée d’un bouton de gastrostomie par voie endoscopique. Arch Pediatr 2011. [DOI: 10.1016/j.arcped.2011.09.013] [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: 10/15/2022]
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Peretti N, Loras-Duclaux I, Kassai B, Restier-Miron L, Guimber D, Gottrand F, Coopman S, Michaud L, Marinier E, Yantren H, Michalski MC, Aubert F, Mercier C, Pelosse M, Lopez M, Chatelain P, Lachaux A. Growth hormone to improve short bowel syndrome intestinal autonomy: a pediatric randomized open-label clinical trial. JPEN J Parenter Enteral Nutr 2011; 35:723-31. [PMID: 21975668 DOI: 10.1177/0148607111415531] [Citation(s) in RCA: 35] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
BACKGROUND The ability of growth hormone (GH) to promote the weaning-off of parenteral nutrition (PN) in short bowel syndrome (SBS) is unclear. No randomized controlled study is available in children. This study was undertaken to determine if GH could enhance the weaning off of PN in PN-dependent children with SBS. METHODS A prospective randomized open-label multicenter study was performed in 14 patients (mean age, 9 ± 1.4 years) with SBS (average small bowel length, 33 cm) and long-term PN dependency (8 years) on an unrestricted diet. A standardized PN decrease with and without GH (0.14 mg/kg/d) was conducted. The patients were randomized to either a GH group (4 months of GH) or a control (CTR) group (4 months without GH, followed by 4 months with GH). Blood tests and a nutrition assessment of enteral and parenteral intakes were performed. Groups were compared with the Wilcoxon test. RESULTS Treatment with GH did not improve the weaning off of PN (decrease in PN caloric intake of 32.5% ± 9.6% in the GH group vs 35.2% ± 8.7% in the CTR group, nonsignificant). In the CTR group, GH treatment induced an additional but not statistically significant decrease of 8.8% ± 12.4% in daily calories. Parenteral needs returned to near basal rates 6 months after GH discontinuation (GH: 77.6% ± 10.6% vs CTR: 73.2% ± 7.4%). Weight decreased slightly in both groups. No biological parameters varied significantly. CONCLUSIONS GH did not improve the weaning off of PN in PN-dependent children with SBS.
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Affiliation(s)
- Noel Peretti
- Université Lyon 1, Faculté de Médecine Lyon Est, Lyon, France.
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Druelle Delesalle D, Martigne L, Coopman S, Guimber D, Turck D, Gottrand F, Michaud L. CL139 - Expérience préliminaire de la pose d’emblée d’un bouton de gastrostomie par voie endoscopique chez l’enfant. Arch Pediatr 2010. [DOI: 10.1016/s0929-693x(10)70360-2] [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: 11/28/2022]
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