Hamartome mésenchymateux du foie chez l’enfant : une nouvelle observation

Due to their rarity in childhood, tumors of the liver can be difficult to diagnose and manage. Mesenchymal hamartoma is the second most frequent benign liver tumor in children, and yet still a rare entity, poorly understood.Typically, it presents as a rapidly enlarging, painless, abdominal mass in children younger than two years. Spontaneous regression or occasional malignant degeneration into undifferentiated embryonal sarcoma can rarely occur. Here, we report a case of a mesenchymal hamartoma of the liver in a 18 month-old child. The imaging features were suggestive of the diagnostic and confirmed by the pathological examination of the surgical specimen.We discuss the clinicopathological, imaging, and histological features of this tumor through a review of the literature.     

Faut-il contre-indiquer l’utilisation des émollients à base d’avoine chez l’enfant atopique ?

Atopic dermatitis is the first atopic symptom. Local treatment makes use of emollient cream. Oat cream extracts were suspected of causing sensitization. This study was performed in 202 children with atopic dermatitis. Two subgroups were analysed: group 1, 105 children who had applied oat cream (Exomega®, Laboratoires Ducray, France) and group 2, 97 children who had never applied oat cream. Patch tests were positive for Rhealba® oat extract (total extract or protein fractions) in five cases (2.4%): three in group 1 and two in group 2. This result is clinically relevant in group 1, with increased eczema after use of Exomega®. Oat oral food challenge was negative in three children with an oat-positive skin prick test. There was no statistical difference between the two groups concerning age or positivity of oat tests and the results of other allergologic tests. Relevant oat cream allergy in children with atopic dermatitis concerned 1.4% of cases. These data suggest that emollient patch tests should be performed in children with atopic dermatitis, in order to use or exclude emollient cream. Further studies are required to evaluate changes in oat sensitization in older children.     

Nouveaux outils d’évaluation du contrôle de l’asthme : le NO expiré et le NO nasal

Nitric oxide (NO) is present in the upper and lower human airways. Nasal and exhaled levels of NO can be determined by non-invasive techniques using chemiluminescence analysers. NO levels in the upper airways are 10–100-fold higher than in the lower airways. International recommendations for standardized measurement of nasal and exhaled NO have been published recently. Exhaled NO is increased in patients with untreated asthma, and this elevation reflects, at least partially, bronchial inflammation. Measurement of exhaled NO may be useful when the diagnosis is doubtfull and for differentiation from other causes of chronic cough. Nasal NO is usually also increased in asthma but this is related to the frequency of allergic rhinitis in asthmatic patients. However, in patients with nasal polyps and asthma, nasal NO is decreased in proportion to the extent of sinusoidal involvement. Levels of exhaled NO decrease rapidly in asthmatic patients treated with anti-inflammatory drugs. Further studies are needed to establish more precisely the place of exhaled NO measurement in monitoring the control of asthma, especially in comparison with other non-invasive markers of bronchial inflammation.     

Reflux gastro-œsophagien chez l’adulte jeune africain: cas des étudiants de l’Université du Burundi

Introduction

The Gastro-esophageal reflux disease (GERD) is an important public health issue, according to its high prevalence, its chronic evolution and the frequent solicitations of cares that it generates. Among students, it can constitute a cause of school absenteeism or failures. In particular, there has been no previous investigation of GERD in young adult in Burundi.

Goal

To estimate the prevalence of GERD among young adult, to describe the risk factors and the main clinical symptoms of GERD.

Methods

Cross-sectional study, curried out over July 2011 among students of University of Burundi, randomly recruited in literature department and in Science and Medicine faculties.

Results

400 students have been kept for the study, 279 males and 121 females (sex-ratio: 2.3). The mean age was 27years+/?4 years with extremes of 20 and 40 years. The GERD has been found among 111 students either a prevalence of 27.8%, CI95%=[23–32%]. According to GERD recurrence, 21% (84 among 400) either 75.6% of students with GERD had at least one episode per week (GERD recurrent). Among female students, the prevalence of GERD was 28.9%, CI95%=[21–38%] (35 students) while among males it was 27.3% CI95%=[22–33%] (76 students), p>0,05. The main symptoms of GERD were the heartburn alone in 81,1% CI95%=[72–88%], the heartburn associated to acid regurgitations in 16,2% CI95%=[10–25%] and the regurgitations alone in 2,7% CI95%=[1–8%]. The extra-digestive symptoms were described by 3% of students suffering from GERD.

Conclusion

The global prevalence of GERD is estimated to 27.8% and the recurrent GERD to 21% either 75.6% of students with GERD. The main risk factors described were the fat meals and the cooked banana. These rates seem to be among the highest.     

Allergie alimentaire à la noix du Brésil : à propos de cinq cas chez l’enfant d’âge préscolaire

Five cases of allergy to Brazil nuts are reported in children under 6 years of age. All patients have other atopic diseases and reacted in a few minutes. Sensitivity to other nuts and peanuts is investigated. With a history of allergy to any nuts, a patient should always be tested for the other nuts.