Congenital tuberculosis (TB) remains a rare disease but is fatal if untreated. Early detection is difficult because of the non-specific nature of the symptoms in TB during pregnancy and infancy. This report summarizes a case of congenital TB in a very premature infant, born at 25 weeks gestation. Miliary TB was diagnosed in the mother when the neonate was 20 days old. Antituberculous therapy allowed a rapid improvement in the mother. The infant died at 27 days old. A Beijing genotype strain of Mycobacterium tuberculosis was isolated both in the mother, from pulmonary and urine specimens, and in the infant, from peritoneal fluid.

Breastfeeding offers several advantages for the mother and infant. Taking drugs while breastfeeding however creates a dilemma for practitioners and often leads to a contraindication or interruption of breastfeeding. There are however very few drugs which present clinically significant risk for the breastfed child. When the mother has to take drugs, the decision to initiate or continue breastfeeding or not must be made with special care after evaluating the individual benefit/risk ratio resulting from breastfeeding and drug exposure. Evidence-based medicine is the key. The purpose of the present review is 1) to present the epidemiological data available concerning undesirable effects in infants breastfed by mothers taking drugs and on the attitude of prescribers and patients in the event of exposure to drugs while breastfeeding; 2) to analyze the pharmacokinetic data to determine the appropriate management approach in particular clinical situations; 3) to present data concerning certain drugs and sources of information useful for further study.

Le terme «soins de developpement » regroupe l'ensemble des strategies visant a favoriser le developpement harmonieux du nouveau-ne dans ses differentes composantes : vegetative, comportementale, neurologique et relationnelle [1]. Ces soins associent les modifications de l'environnement immediat de l'enfant (niveau sonore et lumineux, posture), la nature et l'organisation des soins infirmiers ainsi que des techniques plus specifiques de soutien comportemental (succion, grasping, peau a peau, enveloppement...). Ce concept est habituellement presente, dans le cadre du traitement de la douleur, comme une alternative aux traitements medicamenteux sous le terme «strategies comportementales et environnementales » ou «traitement non pharmacologique». Cependant, les recherches recentes doivent faire considerer ces soins de developpement comme la base fondamentale de toute prise en charge de la douleur et du stress neonatals [2, 3]. De plus, l'objectif de ces soins de developpement depasse le cadre de la douleur. Il s'agit en effet de : a/ restreindre les evenements generant un stress, b/ soutenir l'organisation neuro-comportementale du nouveau-ne en favorisant les comportements de bien-etre, c/ faciliter la relation parents-enfant par une meilleure comprehension du comportement neonatal [1]. Les soins de developpement representent un veritable point de convergence entre environnement, comportement et developpement, trois dimensions influencant l'expression de la douleur et du stress du nouveau-ne.

Neurotrauma, including traumatic brain injury (TBI) and spinal cord injury (SCI), is a preventable condition that imposes an important burden on the Canadian society. In this study, the current evidence on risk factors for the onset and progression of neurotrauma is systematically reviewed and synthesized. Searches of the Cochrane Database of Systematic Reviews, Database of Abstracts of Reviews of Effects (DARE), Medline and Medline in Process (via OVID), EMBASE and PsycINFO from inception to February 2013 were conducted to identify relevant systematic reviews and meta-analyses published in English or French. Two referees screened and assessed the quality of the studies using the AMSTAR tool. Thirty-two studies examined at least one risk factor for the onset of neurotrauma. Thirteen studies passed the quality assessment and the majority evaluated the impact of protective equipment in sports. Helmets effectively reduce TBI from bicycling, skiing, snowboarding, ice hockey and motorcycling. There was no evidence of a protective effect of helmets for SCI. No studies contributed evidence on risk factors for the onset of SCI. Of two studies examining risk factors for the progression of neurotrauma, only injury severity was found to be associated with poorer post-injury outcomes. Substantial evidence supports the use of helmets for the prevention of TBI in sports and motorcycling and face shields in ice hockey. Addressing bicycle helmet legislation across Canada may be an effective option for reducing TBI caused by bicycle accidents. Limited evidence on relevant risk factors for spinal cord injuries and neurotrauma progression was available.

In order to assess bicycle helmet effectiveness in preventing head injury in children, we performed an international qualitative and systematic review using the criteria of the French Health Accreditation and Evaluation National Agency (ANAES) developed for recommendations in clinical practice (formulation of a question, judgment criteria, collecting references, quality analysis, interpretation of results). Two hundred and thirty-four papers dealing with the subject were identified through a MEDLINE search. Two hundred and fifteen of them were eliminated as they did not meet selected criteria. Four were eliminated because of language criteria. On the 14 meeting all selection criteria, five were judged satisfactory according to qualitative criteria. All five conclude in favor of the effectiveness of the bicycle helmet even when taking bias into account. The real protection afforded by wearing a bicycle helmet militates in favor of its habitual use.

In order to assess bicycle helmet effectiveness in preventing head injury in children, we performed an international qualitative and systematic review using the criteria of the French Health Accreditation and Evaluation National Agency (ANAES) developed for recommendations in clinical practice (formulation of a question, judgment criteria, collecting references, quality analysis, interpretation of results). Two hundred and thirty-four papers dealing with the subject were identified through a MEDLINE search. Two hundred and fifteen of them were eliminated as they did not meet selected criteria. Four were eliminated because of language criteria. On the 14 meeting all selection criteria, five were judged satisfactory according to qualitative criteria. All five conclude in favor of the effectiveness of the bicycle helmet even when taking bias into account. The real protection afforded by wearing a bicycle helmet militates in favor of its habitual use. (C) 2001 Editions scientifiques et medicales Elsevier SAS.

Acta PaediatricaVolume 88, Issue 7 p. 789-790 Attitudes of healthcare professionals concerning extremely preterm infants in the delivery room. A regional study J Sizun, J Sizun Departments of Paediatrics, Obstetrics and Gynaecology, Public Health, University Hospital 29609, Brest, France (Tel. +33 2 98 22 36 66, fax. +33 2 98 22 34 94, e-mail. Jacques.Sizun@univ-brest.fr)Search for more papers by this authorM Dobrzynski, M Dobrzynski Departments of Paediatrics, Obstetrics and Gynaecology, Public Health, University Hospital 29609, Brest, France (Tel. +33 2 98 22 36 66, fax. +33 2 98 22 34 94, e-mail. Jacques.Sizun@univ-brest.fr)Search for more papers by this authorR Baron, R Baron Departments of Paediatrics, Obstetrics and Gynaecology, Public Health, University Hospital 29609, Brest, France (Tel. +33 2 98 22 36 66, fax. +33 2 98 22 34 94, e-mail. Jacques.Sizun@univ-brest.fr)Search for more papers by this authorM Collet, M Collet Departments of Paediatrics, Obstetrics and Gynaecology, Public Health, University Hospital 29609, Brest, France (Tel. +33 2 98 22 36 66, fax. +33 2 98 22 34 94, e-mail. Jacques.Sizun@univ-brest.fr)Search for more papers by this authorL de Parscau, L de Parscau Departments of Paediatrics, Obstetrics and Gynaecology, Public Health, University Hospital 29609, Brest, France (Tel. +33 2 98 22 36 66, fax. +33 2 98 22 34 94, e-mail. Jacques.Sizun@univ-brest.fr)Search for more papers by this author J Sizun, J Sizun Departments of Paediatrics, Obstetrics and Gynaecology, Public Health, University Hospital 29609, Brest, France (Tel. +33 2 98 22 36 66, fax. +33 2 98 22 34 94, e-mail. Jacques.Sizun@univ-brest.fr)Search for more papers by this authorM Dobrzynski, M Dobrzynski Departments of Paediatrics, Obstetrics and Gynaecology, Public Health, University Hospital 29609, Brest, France (Tel. +33 2 98 22 36 66, fax. +33 2 98 22 34 94, e-mail. Jacques.Sizun@univ-brest.fr)Search for more papers by this authorR Baron, R Baron Departments of Paediatrics, Obstetrics and Gynaecology, Public Health, University Hospital 29609, Brest, France (Tel. +33 2 98 22 36 66, fax. +33 2 98 22 34 94, e-mail. Jacques.Sizun@univ-brest.fr)Search for more papers by this authorM Collet, M Collet Departments of Paediatrics, Obstetrics and Gynaecology, Public Health, University Hospital 29609, Brest, France (Tel. +33 2 98 22 36 66, fax. +33 2 98 22 34 94, e-mail. Jacques.Sizun@univ-brest.fr)Search for more papers by this authorL de Parscau, L de Parscau Departments of Paediatrics, Obstetrics and Gynaecology, Public Health, University Hospital 29609, Brest, France (Tel. +33 2 98 22 36 66, fax. +33 2 98 22 34 94, e-mail. Jacques.Sizun@univ-brest.fr)Search for more papers by this author First published: 02 January 2007 https://doi.org/10.1111/j.1651-2227.1999.tb00046.xCitations: 3AboutPDF ToolsRequest permissionExport citationAdd to favoritesTrack citation ShareShare Give accessShare full text accessShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the Wiley Online Library Terms and Conditions of UseShareable LinkUse the link below to share a full-text version of this article with your friends and colleagues. Learn more.Copy URL Share a linkShare onFacebookTwitterLinkedInRedditWechat No abstract is available for this article.Citing Literature Volume88, Issue7July 1999Pages 789-790 RelatedInformation