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ObjectiveTo describe a series of children who were hospitalized for a tube-weaning program in the general pediatric ward of a pediatric tertiary university hospital: describe our method, to determine the success rate of our inpatient pediatric tube weaning program, and search for relevant factors linked to its success or failure.MethodWe analyzed the medical files of consecutive children who were hospitalized for gastric-tube weaning over an 8-year period. We analyzed outcomes in terms of feeding and growth with at least 2 years of data. Success (weaning within 3 months) and failure were compared by characteristics of children.ResultsWe included 37 children (29 females) with mean (SD) age 31.4 (21) months. Most had a severe medical history (30% prematurity; 50% intrauterine growth restriction, 50% neurological and genetic anomalies). The weaning program was successful for half of the children. Factors linked to success of the program were female sex (p = 0.0188), normal neurodevelopment (p = 0.0016), nasogastric tube (p = 0.0098), and with <24 months on EF before the stay (p = 0.0309).DiscussionComparing the efficiency of various methods and results among teams was difficult, which indicates the need to establish consensus about the outcome criteria. We confirm the need for these types of stays and programs.

Background:Autoinflammatory diseases (AID) comprise a large number of rare diseases that manifest as recurrent sterile inflammation or disproportionate infection-induced inflammatory symptoms. Vaccine relation to AID is complex: on one hand the susceptibility to infections vary with the treatment options of the patient, on the other hand the disease activity may be triggered by vaccination. Nevertheless, effective immunization is crucial in this population. Up to know very little is known about vaccination coverage in AID children.Objectives:To determine vaccination coverage in French children with an autoinflammatory disease.Methods:Patients between 2 and 18 years with autoinflammatory diseases followed at the French Reference Center for Auto-Inflammatory Diseases-Versailles Hospital and included to the Juvenile Inflammatory Rheumatism cohort (JIRcohorte) network - an international multicenter prospective cohort for children with inflammatory and rheumatological diseases - were included in this retrospective monocentric observational study. Vaccination coverage of each disease and complete status of vaccination was assessed at the last out-patient visit, according to the national immunization program.Detail of every vaccine received (number of doses and date of administration) were collected by a pediatrician from written immunization record (vaccination card). Demographic data, disease and medications used since diagnosis were also assessed. Patients with no available immunization record were excluded.Results:128 patients met the inclusion criteria. Sex ratio was 1.2 (70/58). Median age at the last out-patient visit was 8.4 years (2.5-17.9 years). 53 children (41%) presented periodic fever with aphtous stomatitis, pharyngitis and adenitis (PFAPA) syndrome, 30 familial mediterranean fever, 29 unexplained autoinflammatory recurrent fevers, 8 TNF receptor associated periodic syndrome (TRAPS), 8 other autoinflammatory diseases. 68 patients (53%) were treated by on-demand corticosteroids, nine patients (0.7%) by biological agents, the other patients did not receive any immunosuppressive treatment.At the last clinic visit, only 49% (n=63) of our entire cohort had a complete vaccination status (human papilloma virus and tuberculosis excluded). Coverage rates was superior to 85% for diphtheria/tetanus/poliomyelitis (89%), pertussis (95%), haemophilus influenza type B (94%) and measles/mumps/rubella (89%). 84% of the children were well-vaccinated against pneumococcus. Lowest individual vaccination coverage rates were observed for hepatitis B at 77% and for meningococcus C at 77%. Only one girl received complete vaccination against human papilloma virus.Conclusion:Vaccination coverage in children with autoinflammatory diseases appears suboptimal. Measures to optimize vaccination coverage in these children should be implemented.References:[1] Jaeger VK, et al. Safety of vaccinations in patients with cryopyrin-associated periodic syndromes: a prospective registry based study. Rheumatology (Oxford). 2017Sep1;56(9):1484-1491[...