Mohamed Akkari

and 9 more

Objectives: Because access to sleep recordings is limited, there is a need for new reliable diagnostic tools for pediatric obstructive sleep apnea-hypopnea syndrome (OSAHS) diagnosis. A score calculated from a 30 minutes-home sleep videotape recording has already been proposed in 1996 with interesting results. The main objective of this pilot study was to assess the reliability of a similar score applied to reference PSG video recordings and calculated on two different time windows (30 and 10 minutes). Methods: Sixteen children suspected of OSAHS, aged between two and ten years, underwent video recording during overnight PSG. Video analysis was made during the second complete sleep cycle. A 30-minute risk score (RS30) and a 10-minute risk score (RS10) were established by analyzing seven parameters. The RS30 and RS10 were correlated with clinical examination data, a sleep questionnaire, the obstructive-apnea-hypopnea index (OAHI) and the oxygen desaturation index (ODI) from synchronized PSG results. Results: There was a significant correlation between both the RS30 and RS10, the OAHI and ODI. A RS30 ≥ 6.09 was predictive of an OAHI ≥ 5 per hour with a sensitivity of 83% and a specificity of 90%. A RS10 ≥ 6.50 was predictive of an OAHI ≥ 5 per hour with a sensitivity of 67% and a specificity of 100%. Conclusion: A risk score based on PSG video recordings shows a good correlation with PSG results, confirming previous reports. Further work should focus on applying this risk score to home sleep video recordings for the diagnosis of pediatric OSAHS.

Floriane Socchi

and 9 more

Aim: Infantile haemangioma (IH) is the most common benign tumour in children. Since 2014, propranolol has become the first-choice therapy and currently Hemangiol® is the only approved drug for complicated haemangioma. This post-marketing study reported the use of Hemangiol® for IH in paediatric practice. Method and Results: From January 2014 to November 2018, 94 children (median age 4 [0;21] months; 75% female) treated with Hemangiol® for proliferative IH were enrolled in the study. The systematic paediatric cardiology consultation never contraindicated beta-blockers. Two Hemangiol® initiation protocols were used: a conventional ambulatory 3-week titration phase protocol (N=76, 80.9%), and a rapid initiation protocol with a 48-hour dose escalation in conventional hospitalization for severe proliferative IH (N=18, 19.1%). In both protocols, the haemodynamic tolerance was good. The mean maintenance dose of Hemangiol® was 2.7±0.8 mg/kg/day, with a median treatment duration of 7 [1.5;19] months. Adverse events (AEs) have been found in 25 (26,6%) patients including 8 (8.5%) patients with serious AEs (uncontrolled bronchial hyperreactivity, N=5; serious hypoglycaemia, N=3). Some patients had one or more AEs, a total of 24 non-serious AEs was reported in 19 patients (sleep disturbances, N=9; respiratory disorders, N=5; digestive disorders, N=6). No cardiac adverse event was reported. Conclusion: This post-marketing surveillance drug study supports the good tolerance of Hemangiol® in children with IH. A rapid initiation protocol is of interest when treatment is urgent. The pre-therapeutic paediatric cardiology consultation should not be systematic but only indicated on specific patients. ClinicalTrials.gov: NCT 04105517.