PubMed Health⌕ Search

Biomedical subjects

R Assathiany

Publications and source records attributed to R Assathiany.

17 recordsLinked to original sources
PubMed2006

[Early discharge from the maternity ward: telephone survey about the availability of private-practice and public health pediatricians in Ile-de-France].

OBJECTIVES: To assess the possibility and time period within which a mother and her newborn can consult a pediatrician after their early discharge from the maternity ward. METHODS: In May 2004, 2 investigators presenting themselves as mothers just discharged from the maternity ward, called pediatricians' offices and public infant cliniques (PMI centers) in the Paris metropolitan region, to request appointments. RESULTS: Of 99 pediatricians' offices contacted, 89 (89%) offered appointments, for an average of 4.4 days later. Of the 93 PMI centers contacted, 55 (59%) offered appointments by telephone, with a mean waiting time of 18 days. CONCLUSION: This study, conducted in the spring of 2004 in the Paris metropolitan region, showed that private-practice pediatricians are capable of taking over management of newborns rapidly after early discharge from the maternity ward. It is more difficult to make appointments by telephone with PMI centers, which operate differently, and the delay is substantially longer. We underline that these results observed in a region with a high density of pediatricians and during a favourable period for managing appointments. Further studies are needed in other regions and at different periods. The management of newborns after early discharge from the maternity ward should be actually throught the arising development of health networks.

Appointments and Schedules↗
PubMed2005

[The pediatrician's waiting room: a place for health education?].

OBJECTIVES: To assess the presence and impact of health education messages in pediatricians' waiting rooms. METHODS: In September 2001, 81 pediatricians completed a questionnaire about the furnishings and equipment in their waiting rooms. They also distributed a questionnaire about waiting room health education messages to parents, to be completed at home. RESULTS: The analysis considered 1830 questionnaires. Health education messages were posted in 91% of the waiting rooms and most frequently concerned children's accidents, vaccines, hygiene and nutrition. The best topics that the parents remembered involved child neglect, antibiotic therapy, AIDS and other sexually transmitted diseases, and nutrition. Although memorization of the messages was not influenced by duration of the wait, it was higher among parents who had previously visited the pediatrician. These messages led 14% of the parents to discuss them spontaneously with their pediatrician. CONCLUSION: Health education messages are posted in nearly all the waiting rooms studied; parents remember them in a variable and rather inexplicable order. Posting these messages demonstrates the pediatricians' willingness to be involved - beyond the simple consultation - in the health education of children and families. Identifying the real impact of these messages would require further study.

Humans↗
PubMed2003

[Information recorded by maternity ward staff in permanent pediatric health records].

OBJECTIVES: To study the frequency with which maternity ward staff complete the perinatal information section of infants' permanent pediatric health records. METHODS: In 2000, 71 pediatricians in private practice and on staff in a general pediatric ward in a tertiary hospital in Paris carried out an observational study to assess which indicators were reported at what rates. Pediatricians were also asked which information about the perinatal admission they would find helpful in these records. RESULTS: One thousand seven hundred and eighty-five pediatric health records were studied. The frequency of completed information varied from 5 to 100%, depending on the item. Of the items reported rarely, some, such as thoracic circumference, were obsolete, while others were very important (response to noise, light reflex). The new information desired by office-based pediatricians involved mainly risk factors for vertical infections (maternal fever during delivery, prolonged rupture of the membranes). CONCLUSION: Although the rate of completion of information in the pediatric health record was globally good, some important data should be reported more often (sensorial screening), while other items could be deleted. New information about the pregnancy and delivery would be useful.

Confidentiality↗
PubMed2003

[Telephone activity in outpatient pediatric practice].

OBJECTIVES: To assess the amount of telephone activity in outpatient pediatric practice. METHODS: Seventy-nine pediatricians belonging to a continuing medical education group (Arepege) prospectively recorded data about all the telephone calls they took personally for 3 days, from 4 to 6 December 2000. They noted the number of calls each day and their duration, the caller, the reason for and the response to each call. RESULTS: In 3 days, the 79 pediatricians received 4413 calls, for a mean of 19 calls daily for each practitioner. The calls were brief, 86% of them lasting less than 2 min; each pediatrician spent an average of 26 min a day on the telephone; most calls (82%) came from children's mothers. The reasons for the calls were: request for appointment (1035 calls, 23.5%), request for advice not associated with an acute disease (1416 calls, 32%), the onset of acute symptoms (1961 calls, 44.5%). An appointment was made in 26% of the cases for which the reason for the call was illness. CONCLUSION: Pediatric private practice involves substantial telephone activity, which generates no healthcare costs, but does present risks that might be attenuated by the use of appropriate algorithms for conducting these telephone interviews.

Adult↗
PubMed2002

[Mucolytic agents for acute respiratory tract infections in infants: a pharmacoepidemiologic problem?].

OBJECTIVE: To study the use of mucolytics agents, i.e. acetylcystein and carbocystein, in infants. To evaluate their efficacy and safety for their main indications. METHODS: A prospective one-day survey of prescriptions among 95 office-based pediatricians. A systematic review of the literature. RESULTS: Among 1327 prescriptions regarding infants, 4.3% were mucolytics agents. Main indications were rhinopharyngitis, isolated cough, and acute bronchitis. Our review did not identify any study of rigorous methodological quality that supported the efficacy or safety of mucolytics agents in infants for their in-label (isolated cough, acute bronchitis) and off-label (rhinopharyngitis) indications. Six cases of infants, aged less than eight months, presenting paradoxical bronchial congestion during a treatment with mucolytics agents, have been reported to the French pharmacovigilance system. No causal relationship was established from these cases because of a possible protopathic bias. DISCUSSION: Our results concerning mucolytics agents use are similar to those reported by the French Health Care Funds. In addition to the lack of studies on efficacy, no studies on the dose-response relationship were available, leading to suggested dose regimens in the French license of acetylcystein ranging from 44.4 to 16.4 mg kg-1 j-1 between one to 24 months. These dose regimens could predispose to overdosing in the youngest infants as it seems observed in the six reported cases. CONCLUSION: In infants, mucolytics agents efficacy has never been demonstrated and some elements suggest poor safety (paradoxical bronchial congestion).

Acetylcysteine↗
PubMed2000

[Office-based pediatricians' knowledge and adherence to a consensus statement on acute rhinopharyngitis in the child].

AIM: To assess the impact on community-based pediatricians of the conclusions of the 10th Conférence de Consensus en Thérapeutique Anti-Infectieuse (CCTAI) on the antibiotic treatment in acute nasopharyngitis (ANP). METHODS: Fifty-six pediatricians took part in the study. Over a period of 15 days in October 1998, all the children (n = 997) presenting an ANP were prospectively included. The prescription of an antibiotic treatment as well as the clinical criteria authorizing it, according to the conclusions of the 10th CCTAI, were recorded. The participants were not told the purpose of the study. RESULT: Sixty percent of the pediatricians questioned were familiar with the 10th CCTAI. Forty-five percent said they complied with it, but only 7% stated it had changed their day-to-day clinical practice. Based on the conclusions of the 10th CCTAI, an antibiotic treatment would have been discussed for 38% of the children. Twenty-four percent of them were given one. For 54% of the children that were given an antibiotic, such treatment was disapproved by the 10th CCTAI. No significant association has been established between familiarity with the 10th CCTAI and the following criteria: gender, age, hospital activity, years of practice, medical journals read, and belief in the existence of a license for one or more antibiotics for ANP in children. However, this last criterion was significantly (P = 0.03) associated with an increase in the percentage of antibiotics prescribed: 29% vs 16%. DISCUSSION AND CONCLUSION: The 10th CCTAI has had a moderate impact on the day-to-day practice of the pediatricians who took part in our study. Several explanations are discussed. The authors emphasize the virtual lack of indications of antibiotics in ANP.

Adult↗
PubMed2000

Off label and unlicensed drug use among French office based paediatricians.

AIMS: To determine the extent of off label and unlicensed drug use in French office based paediatric practice. METHODS: A prospective one day survey of all written prescriptions, for patients under 15 years, among 95 office based paediatricians in the Paris, France metropolitan area. Main outcome measures were: comparison of the use of each drug with its product licence for age, indication, dose, and route of administration. RESULTS: A total of 2522 prescriptions were administered to 989 patients; 844 (33%) were used either in an unlicensed (4%) or an off label (29%) manner. A total of 550 (56%) paediatric patients received one or more off label prescriptions. CONCLUSIONS: Off label prescriptions (that is, outside the terms of the Summary of Product Characteristics) are widespread in office based paediatric practice, while unlicensed drug use is rare in our study. New regulations in the licensing process in Europe are needed to allow children to receive drugs that have been fully evaluated in their specific age group.

Adolescent↗
PubMed1992

Progressive vitiligo, mental retardation, facial dysmorphism, and urethral duplication without chromosomal breakage or immunodeficiency.

A boy, born to first cousin parents of Algerian origin, first presented at the age of 9 years with growth failure, mental retardation, and dysmorphic facies. Progressive vitiligo developed from the age of 12 and distal duplication of the urethra was later recognised. The basis of this syndrome remains to be determined; autoimmune disease, chromosomal breakage syndromes, and other neurocutaneous syndromes have been excluded.

Abnormalities, Multiple↗
PubMed1985

Radiation sensitivity of Bloom's syndrome lymphocytes during S and G2 phases.

In order to study chromosome sensitivity of Bloom's syndrome (BS) cells in relation to the replication stage, gamma-ray irradiation was performed immediately before adding bromodeoxyuridine (BrdU) to lymphocyte cultures of one BS patient and of one control. It was found that BS cells are much more sensitive to the irradiation than control cells at the end of S and at G2 phases. The rate of induction of chromosome breaks is significantly increased and that of chromatid breaks and exchanges is also increased, though to a lesser degree. Our results also favor the existence of a cell subpopulation in BS characterized by a slow cycle, a high spontaneous chromosome aberration rate, and a high radiation sensitivity.

Bloom Syndrome↗
PubMedDate not supplied

[Rotavirus gastro-enteritis in infants (author's transl)].

Deviation of complement antibodies were studied in 630 hospitalized infants aged from 0 to 4 years suffering from rotavirus gastro-enteritis, over a period of one year. Seroconversion was observed in 30 cases out of the 256 infants in whom 2 serological samples were taken. In 29 cases out of 30, these rotavirus infections occurred in infants under 18 months of age, and they were all seen during ther period from november to march, rotavirus being responsible for one third of the gastro-enteritis cases. A serological study according to age-group in 640 infants gave positive results in 75 per cent (1st semester), 68 per cent (2nd semester), 75 per cent (2nd year), 78 per cent (3rd and 4th years).

Age Factors↗