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Master Thesis

Pronostic à long terme des épisodes de dyspnée sifflante chez les enfants de 0 à 24 mois : comparaison aux recommandations des Hôpitaux du Grand Ouest (HUGO) de France

Abstract : Introduction: although acute viral bronchiolitis and preschool asthma are common diseases, their definitions vary in many parts of the world. Verstraete et al. updated their definitions in 2013, with implications for the acute management of wheezy dyspnoeic episodes. Early identification of children likely to become asthmatic is very important to allow the prescription of suitable therapies in the long term. Objectives: 1) To validate, over a long period, the Western Network of University Hospitals in France (HUGO) recommendations regarding the outcome of wheezing episodes in children less than 2 years old. 2) To Evaluate the contribution of different prognostic scores (IPA and PIAMAm). Materials and methods: this was a single-centre retrospective study carried out at the children Hospital from the CHU in Bordeaux, including children who were at least 6 years old with a history of hospitalisation for wheezing episodes before 2 years of age. The study population included 136 children divided into six groups. Results: we showed that children under 1 year without atopy, from the 2nd wheezing episode, did not become asthmatic at the age of 6. Among the children with a history of a single wheezing episode at >1-year-old, 66% of those with atopy developed asthma by 6 years of age. These results were consistent with the HUGO recommendations for these two groups of children. For the other groups, the results were not consistent with the HUGO recommendations. The positivity or negativity of the API or the PIAMAm score did not improve the possibility of early prediction of long-term wheezing. Conclusion: the HUGO recommendations should be modified according to the different groups to allow the establishment of appropriate long-term treatment. This study confirmed that the occurrence of a wheezing episode after 1 year among atopic children increases the risk of developing asthma. The API and PIAMAm scores provided no additional benefit in prediction of prognosis.
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Submitted on : Tuesday, January 7, 2020 - 1:49:19 PM
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Mélanie Gaillard. Pronostic à long terme des épisodes de dyspnée sifflante chez les enfants de 0 à 24 mois : comparaison aux recommandations des Hôpitaux du Grand Ouest (HUGO) de France. Sciences du Vivant [q-bio]. 2019. ⟨dumas-02430566⟩

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