La vaccination et la pédiatrie de ville Cheymol, J.
Archives de pédiatrie : organe officiel de la Société française de pédiatrie,
20/May , Letnik:
21, Številka:
5
Journal Article
En France, l’adoption internationale comprend environ 90000 enfants depuis 1980 et celle des enfants immigrés en 2008 représente plus de 300000 personnes. Il s’agit d’une population très hétérogène ...(âge, origine géographique) et non négligeable. Il n’est donc pas toujours simple de faire un bilan vaccinal fiable et complet. La grande variété des situations individuelles rend difficile une décision et des modalités du rattrapage vaccinal homogènes. Cet article propose une mise au point pour la mise à jour des vaccinations de l’enfant arrivant de l’étranger (adopté, réfugié, ou migrant). Le bilan de vaccination d’un enfant nouvellement arrivé dans notre pays est complexe et doit être adapté au pays d’origine. Certains enfants n’ont jamais été vaccinés et d’autres ont un statut vaccinal incertain ou inconnu. L’âge de l’enfant, son pays d’origine et quelques sérologies vaccinales doivent guider la décision vaccinale initiale. La mise à jour vaccinale d’un enfant arrivant de l’étranger doit tenir compte des vaccinations supposées déjà reçues et des recommandations vaccinales françaises, qui vont servir de référence.
In France, international adoption includes around to 90,000 children since 1980 and near 300,000 immigrant children were counted in 2008. This population is heterogeneous, according to age and country of origin, and its large number. It is not easy to completely and surely assess the vaccine status of the child. Due to a great variability of individual situations, it is not possible to have systematic and unchangeable rules. This article aims to give an update of catch-up vaccination of internationally adopted or refugee or migrant children in France. The vaccination status of a child who recently arrived in France is complex and has to be adapted to his country of origin. Some of them were never vaccinated whereas the vaccine status of others is uncertain or unknown. Three parameters have to be considered: the age of the child, the country of origin, and sometimes serology in the case of doubts of his vaccine status. Catch-up vaccination of foreign children has to be adapted to French vaccine recommendations, as a reference, and to vaccines already administered to the child.
Chaque année, la National Foundation for Infectious Diseases (NFID - Fondation américaine pour les maladies infectieuses) rassemble plus de 300 personnes pour faire le point des dernières avancées ...scientifiques dans le domaine des vaccins et identifier les nouvelles voies de recherche les plus prometteuses. Ces conférences figurent parmi les plus importantes réunions scientifiques entièrement dédiées à la recherche sur les vaccins, que ce soit dans le secteur de la santé humaine ou dans le secteur de la santé animale. Lors de la 15e conférence, qui s’est tenue à Baltimore en mai 2012, se sont succédé conférences plénières par des experts invités de renommée internationale, sessions parallèles, présentations de posters et rencontres entre experts et jeunes chercheurs. Différents thèmes ont été abordés, allant des fondements de la vaccination, de l’exploration de la réponse immunitaire et de la conception de nouveaux vaccins et adjuvants jusqu’à l’évaluation de l’impact sur le terrain des vaccins nouvellement introduits (rotavirus, HPV) et de la sécurité des vaccins, en passant par les stratégies de vaccination, notamment dans les pays en développement. Les nouvelles techniques de la vaccinologie systémique permettant l’étude de la réponse immunitaire dans son ensemble ouvrent de nouvelles pistes pour établir des corrélats de protection, et concevoir de nouveaux vaccins, notamment contre les maladies chroniques, comme le sida ou le paludisme, pour lesquelles l’immunité naturelle est imparfaite.
Every year, the National Foundation for Infectious Diseases brings together more than 300 participants to review progress in vaccine research and development and identify the most promising avenues of research. These conferences are among the most important scientific meetings entirely dedicated to vaccine research for both humans and animals, and provide a mix of plenary sessions with invited presentations by acknowledged international experts, parallel sessions, poster sessions, and informal exchanges between experts and young researchers. During the Fifteenth Conference that took place in Baltimore in May 2012, various topics were addressed, including the scientific basis for vaccinology; exploration of the immune response; novel vaccine design; new adjuvants; evaluation of the impact of newly introduced vaccines (such as rotavirus, HPV vaccines); vaccine safety; and immunization strategies. The new techniques of systems biology allow for a more comprehensive approach to the study of immune responses in order to identify correlates of protection and to design novel vaccines against chronic diseases such as AIDS or malaria, against which natural immunity is incomplete.
Children and screens: A survey by French pediatricians Assathiany, R.; Guery, E.; Caron, F.M. ...
Archives de pédiatrie : organe officiel de la Société française de pédiatrie,
February 2018, 2018-Feb, 2018-02-00, 20180201, Letnik:
25, Številka:
2
Journal Article
Recenzirano
Screens are increasingly prevalent within families. The excessive use of screens by children has negative consequences. To measure the use of screens, we undertook an investigation among children ...being followed by pediatricians.
An invitation to participate was sent electronically to 1460 private practice pediatricians. They were asked to complete the questionnaire on screen use by children under 12 years of age during a consultation, according to statements made by parents.
One hundred and forty-four pediatricians submitted completed questionnaires involving 428 children. Among the 197 children under 3 years of age, 92 had played with an interactive screen for a median duration of 30min during the preceding week; 29% of the children were alone at the time. One hundred and thirty-nine children had watched television for a median weekly duration of 75min. Of the 231 children 3–11 years of age, 108 had played with an interactive screen for a median time of 30min the day before the consultation, and 50% of them were alone at the time. One hundred and seventy-two children watched television for a median daily duration of 45min. There was a correlation between these children's screen time and their mother's (r=0.36). The television was on during meals and continuously in 35% and 21% of the families, respectively.
Children start looking at screens early, too often watching unsuitable programs, and too often without a parent's present. Regardless of the child's age, pediatricians must ask parents how much time their children are viewing screens, advise them accordingly, and warn them of the consequences of excessive use.
L'exposition humaine au plomb se fait par des voies multiples. L'importance relative de ces voies varie sensiblement selon les milieux et modes de vie des personnes. L'impact de cette exposition sur ...la santé a été largement étudié et des interventions en termes de santé publique ont été entreprises.
L'objectif de cette étude a été d'évaluer la prévalence actuelle d'une plombémie élevée (≥
100 μg/l) chez les nouveau-nés, ainsi que les éventuelles sources d'intoxication maternofœtale.
Une enquête prospective multicentrique a été menée à l'initiative du « Réseau Périnatal 92 » sur une population de femmes enceintes accouchant dans l'une des 3 maternités du Nord des Hauts-de-Seine, France. L'enquête a été proposée à toutes les femmes venant accoucher dans ces maternités. Entre décembre 2003 et mai 2004, 1021 femmes enceintes ont été incluses. Toutes les patientes ont signé un consentement éclairé. Un prélèvement au cordon a été effectué lors de l'accouchement pour dosage de la plombémie.
La moyenne des plombémies au cordon dans les 3 maternités était de 23,2 μg/l. Dix-huit nouveau-nés sur 1021 (1,8
%) avaient une plombémie
≥
100 μg/l. Une enquête environnementale menée par la Direction départementale des affaires sanitaires et sociales a recherché les causes d'intoxication (étude du logement et du mode de vie des familles concernées). Les principales sources d'intoxication étaient les plats à « tajine » (83,3
%), le « khôl » (88,9
%) et les peintures des logements contenant du plomb (22,2
%). Un suivi pédiatrique spécialisé des nouveau-nés dépistés a été déclenché.
À part les problèmes d'habitat, d'autres sources d'intoxication au plomb semblent être les plats à « tajines » et le « khôl » en poudre. Ces produits sont pour la plupart en provenance du Maroc. Un programme devrait être mis en place afin d'informer la population sur ces sources d'intoxication au plomb mal connues.
Human lead exposure has many sources. Relative importance of these sources varies widely according to geographic regions and human lifestyle. The impact of lead exposure on health has been well studied and public health interventions have been conducted.
The aim of this study was to evaluate current prevalence of lead burden in neonates, and seek for sources of maternal and fetal intoxication.
A prospective multicentre study was conducted by the “Réseau périnatal 92” on a population of pregnant women attending 3 maternal wards in the north of ‘Hauts-de-Seine’ department in France. Between December 2003 and May 2004, a total of 1021 pregnant women were included. All patients signed an informed consent before participating in the study. Cord blood samples were collected at delivery for lead measurements.
The mean cord blood lead concentration was 23.2 μg/l. Eighteen neonates over 1021 (1.8%) had lead levels above 100 μg/l. An environmental query was conducted by the social and public health office of the department (DDASS), and data were collected regarding the state of the housing and the lifestyle of the concerned family. Main sources of lead intoxication were ‘tagine’ food plates in 83.3% of cases, ‘khôl’ powder (used as eyeliner) in 88.9% of cases and substandard housings in 22.2% of cases. A specialized paediatric follow-up for the 18 neonates was performed.
With the exception of substandard housing (old lead painting), other sources of lead intoxication were discovered: ‘tagine’ plates and ‘khôl’ powder. Almost all of these products came from Morocco. A public health intervention would be able to inform the population about these yet unknown sources of lead intoxication.
The Groupe de Pédiatrie Générale (General Pediatrics Group), a member of the Société française de pédiatrie (French Pediatrics Society), has proposed guidelines for families and doctors regarding ...children's use of digital screens. A number of guidelines have already been published, in particular by the French Academy of Sciences in 2013 and the American Academy of Pediatrics in 2016. These new guidelines were preceded by an investigation into the location of digital screen use by young children in France, a survey of medical concerns on the misuse of digital devices, and a review of their documented benefits. The Conseil Supérieur de l’Audiovisuel (Higher Council on Audiovisual Technology) and the Union Nationale de Associations Familiales (National Union of Family Associations) have taken part in the preparation of this document. Five simple messages are proposed: understanding without demonizing; screen use in common living areas, but not in bedrooms; preserve time with no digital devices (morning, meals, sleep, etc.); provide parental guidance for screen use; and prevent social isolation.