12 research outputs found
Disorganized attachment and genetics in the development of borderline personality disorder
International audienc
Timeliness of routine immunization in non-preterm children less than 2 years old using electronic data capture in an ambulatory setting in France in the context of vaccine hesitancy
Bounding the Risk Probability
International audienceFor some safetyâcritical applications, it is important to calculate the probability that a discrete time autoregressive (AR) process leaves a given interval at least once during a certain period of time. For example, such AR process can be interpreted as a temporally correlated safety indicator and the interval as a target zone of the process. It is assumed that the safety of the system under surveillance is compromised if the above-mentioned probability becomes too important. This problem has been previously studied in the case of known distributions of the innovation process. Let us assume now that the distributions of the innovation and initial state are unknown but some special bounds for the cumulative distribution functions and/or for the probability density functions are available. Numerical methods to calculate the bounds for the above-mentioned probability are considered in the paper
Le nouveau calendrier vaccinal est-il adaptĂ© Ă lâancien prĂ©maturĂ©Â ?
International audienceThe French 2013 immunization schedule having a goal of simplification with comparable efficacy, has decreased the number of injections and removed the injection performed at three months of age in the general population. Apart from the prevention of invasive pneumococcal infections for which it is recommended to maintain three dose primary immunization, vaccination of premature is not addressed in this new calendar. Can the extremely preterm infants (< 33 weeks of gestational age) benefit from this new schedule or should we keep them in three injections schedule? The objective of this paper is to clarify this point through the data available in the literature. Children born prematurely and especially the âextremely prematureâ born before 33 weeks are at high risk of infections, some of them are preventable by immunization. Although there is no clinical evidence, for pertussis, pneumococcus, Haemophilus influenzae b, hepatitis B, whatever the immunogenicity criteria, immunogenicity is significantly lower in preterm than in term newborn after 3 doses primary schedule. This lower immunogenicity raises concerns about the transition to two doses, about the ability to give short term protection and booster responses. Given these data, GPIP takes the position for maintaining a primary 3-dose vaccination at 2.3 and 4 months for premature infants less than 33 weeks.Le calendrier vaccinal 2013 rĂ©pondant Ă un objectif de simplification Ă efficacitĂ© comparable, a diminuĂ© le nombre dâinjections recommandĂ©es et a en particulier supprimĂ© lâinjection effectuĂ©e Ă lâĂąge de trois mois en population gĂ©nĂ©rale. En dehors de la prĂ©vention des infections invasives Ă pneumocoque pour laquelle il est recommandĂ© de maintenir trois doses en primovaccination, la vaccination du prĂ©maturĂ© nâest pas abordĂ©e dans ce nouveau calendrier. Les grands prĂ©maturĂ©s peuvent-ils bĂ©nĂ©ficier de ce nouveau calendrier ou doit-on maintenir chez eux trois injections ? Lâobjectif de ce travail est de prĂ©ciser ce point Ă travers les donnĂ©es disponibles dans la littĂ©rature. Les enfants nĂ©s prĂ©maturĂ©ment et surtout les « grands prĂ©maturĂ©s » nĂ©s avant 33 SA sont des enfants Ă haut risque de contracter des infections dont certaines peuvent ĂȘtre prĂ©venues par la vaccination. Pour les valences coqueluche, pneumocoque, Hib, hĂ©patite B quels que soient les critĂšres dâimmunogĂ©nicitĂ© retenus, elle est nettement moins bonne chez les grands prĂ©maturĂ©s que chez les nouveau-nĂ©s Ă terme. Bien quâil nây ait pas de preuve clinique, ceci fait craindre que le passage Ă deux doses ne permette pas dâune part, de protĂ©ger suffisamment Ă court terme et, dâautre part, laisse craindre une moins bonne rĂ©ponse immunitaire aprĂšs le rappel Ă 11 mois. Compte tenu de ces donnĂ©es, le GPIP prend position pour le maintien dâune primo-vaccination Ă 3 doses Ă 2,3 et 4 mois pour les prĂ©maturĂ©s de moins de 33 semaines