Additifs alimentaires et troubles de l’attention/hyperactivité chez l’enfant

La conservation des aliments a toujours été une préoccupation capitale des sociétés humaines (et même animales!). Le sel ou le sucre en hautes concentrations, la fumée, le chauffage, la réfrigération, la congélation illustrent quelques unes des techniques utilisées dans l’histoire. Au XIXème siècle, l’industrialisation de l’alimentation, les progrès de la chimie et les nouvelles connaissances en microbiologie conduisent progressivement à l’utilisation d’additifs alimentaires chimiquement identifiés, destinés notamment à prévenir les dégradations microbiologiques des aliments, mais aussi à en moduler de nombreux aspects, la couleur en particulier. Une opposition critique à l’usage de ces additifs, notamment les colorants et les agents conservateurs, s’est d’emblée manifestée, mais n’a pas empêché la généralisation de leur usage au cours du siècle passé. Cependant, des études récentes ont remis en cause l’innocuité de certains de ces additifs, en relation notamment avec le syndrome de troubles déficitaires de l’attention/hyperactivité (TDA/H). Ces nouvelles données font l’objet d’une brève revue dans les paragraphes qui suivent

Incidents and complications of totally implanted vascular access devices in children: a prospective study

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BILATERAL ANTERIOR STERNOTHORACOTOMY (CLAMSHELL INCISION) IS A SUITABLE ALTERNATIVE FOR BILATERAL LUNG SARCOMA METASTASIS RESECTION IN CHILDREN

BACKGROUND: The aim of our study was to assess the postoperative course of bilateral anterior sternothoracotomy (BAT) in children with sarcoma metastases, in a curative care perspective. METHODS: We reviewed the records of seven patients younger than 18 years old, who underwent surgical procedures for sarcoma metastasis to the lung between 2000 and 2012. We compared the postoperative course of the BAT group with that of patients who underwent unilateral posterolateral thoracotomies (PLTs) for the same etiology. RESULTS: Of 17 surgical procedures, there were seven BAT and 10 unilateral PLT. Mean ages at the time of the procedures were 12.9 ± 5.4 years old for BAT, and 17.4 ± 1.9 years old for PLT. Mean operative time was 173 ± 37 minutes in the BAT group, and 145 ± 39 minutes in the PLT group (P = 0.19). Patients received epidural analgesia in all cases; this was for a mean time of 3.8 ± 1.3 days in the BAT group, and 3.21 ± 4 days in the PLT group (P = 0.36). Chest tubes were removed after 3.6 ± 1.3 days in the BAT group, and 3 ± 1.2 days in the PLT group (P = 0.69). Total hospital stay was 7.7 ± 6.6 days in the BAT group, and 7 ± 1.2 days in the PLT group (P = 0.72). CONCLUSION: In our experience, BAT seems suitable and shows outcomes similar to those of PLT for sarcoma metastasis resection. The BAT procedure allows the manual exploration of both lungs during a single surgical intervention, and so reduces the delay of further therapies

PASTEC: a prospective, single-center, randomized cross-over trial of pure physical versus physical/attentional activity in children with cancer

Among disease- or treatment-related long-term effects of childhoodcancer, peripheral neuropathies, deficits in global coordination, balance, attention capacity andquality of life have been demonstrated. Several publications mention a potential benefit of phys-ical activity in improving long term outcome of such complications. Our study aimed primar-ily at evaluating the feasibility of a weekly physical activity program for children with cancerand secondly at assessing if the type of physical activity proposed could impact the pattern of improvement

Pharmacokinetics of Intra-Arterial Melphalan in Patients withRecurrent or Progressive Retinoblastoma Treated on Spog-Rb-2011, A NationalPhase II Study of the Swiss Paediatric Oncology Group

Since the 1990s, intravenous (iv) chemotherapy has been the system-atic first-line treatment used in the management of retinoblastoma, to reduce tumour volumeand render it accessible to focal treatments as well as to avoid enucleation and/or radiother-apy. This approach has allowed globe preservation in the majority of group A-C tumors and in19-60% of group D cases. Relapse or tumour progression in this group D patients constitute amajor concern for globe salvage. Techniques of local administration of chemotherapy, such asSelective Ophtalmic Artery Chemotherapy (SOAC) administration offers an interesting alter-native. We report here pharmacokinetic analysis of melphalan administered by SOAC in eightpatients, their clinical response to SOAC and observed toxicities

Pediatric oncologists' perspectives on the use of complementary medicine in pediatric cancer patients in Switzerland: A national survey-based cross-sectional study

BACKGROUND There is a widespread use of complementary therapies among pediatric cancer patients. Previous studies provided evidence that communication between pediatric oncologists (POs) and patients/families about the use of these therapies is often incomplete. Furthermore, nationwide studies on this topic are rare. AIMS We assessed POs' perspectives on the use of complementary medicine (CM) in Switzerland, on the basis of an edited survey previously used in a nationwide study. METHODS AND RESULTS A link to an online survey was sent by e-mail to each of the fifty-two eligible pediatric oncologists in all nine Swiss Pediatric Oncology Group (SPOG) centers. Eligible respondents were board-certified (Switzerland or abroad) POs currently working at a SPOG center. The survey was available for a total period of 2 months. We received 29 filled questionnaires (overall response rate: 56%). Most POs (59%) indicated that they ask more than 50% of their patients about CM use. Frequent reasons for not asking about the use of CM were i) forgetting to ask (55%), ii) lack of knowledge on the subject (31%), and iii) lack of time (24%). More than every second PO (55%) reported having a lack of knowledge on the subject. A majority of POs (66% to 76%) indicated interest in learning more about specific CM topics (cannabinoids, hypnosis and relaxation, music therapy, herbal medicine, acupuncture, meditation, and yoga). More information and specific training opportunities on the use of CM was deemed important by 76% to 97% of POs. CONCLUSION POs working in Switzerland identify complementary therapies as an important subject. Swiss POs are willing to acquire more knowledge on CM. More training seems to be necessary in order to increase awareness about the topic, to enhance communication about complementary therapies and thus to improve patient care

Pediatric oncologists' perspectives on the use of complementary medicine in pediatric cancer patients in Switzerland: A national survey-based cross-sectional study.

BACKGROUND There is a widespread use of complementary therapies among pediatric cancer patients. Previous studies provided evidence that communication between pediatric oncologists (POs) and patients/families about the use of these therapies is often incomplete. Furthermore, nationwide studies on this topic are rare. AIMS We assessed POs' perspectives on the use of complementary medicine (CM) in Switzerland, on the basis of an edited survey previously used in a nationwide study. METHODS AND RESULTS A link to an online survey was sent by e-mail to each of the fifty-two eligible pediatric oncologists in all nine Swiss Pediatric Oncology Group (SPOG) centers. Eligible respondents were board-certified (Switzerland or abroad) POs currently working at a SPOG center. The survey was available for a total period of 2 months. We received 29 filled questionnaires (overall response rate: 56%). Most POs (59%) indicated that they ask more than 50% of their patients about CM use. Frequent reasons for not asking about the use of CM were i) forgetting to ask (55%), ii) lack of knowledge on the subject (31%), and iii) lack of time (24%). More than every second PO (55%) reported having a lack of knowledge on the subject. A majority of POs (66% to 76%) indicated interest in learning more about specific CM topics (cannabinoids, hypnosis and relaxation, music therapy, herbal medicine, acupuncture, meditation, and yoga). More information and specific training opportunities on the use of CM was deemed important by 76% to 97% of POs. CONCLUSION POs working in Switzerland identify complementary therapies as an important subject. Swiss POs are willing to acquire more knowledge on CM. More training seems to be necessary in order to increase awareness about the topic, to enhance communication about complementary therapies and thus to improve patient care