Rabdomiosarcoma infantil

Rhabdomyosarcoma is the most common soft-tissue sarcoma in children; it can appear in any part of the body. Its biological behavior varies widely, and despite the absence of specific clinical or radiological characteristics, rhabdomyosarcoma should be taken into account in the differential diagnosis of solid tumors in children. This review focuses primarily on the imaging findings and anatomical distribution of the histological subtypes of childhood rhabdomyosarcoma and secondarily on the differential findings in histological studies.     

La danse créative,une approche holistique aux bienfaits rééducatifs

The practice of dance, in the context of rehabilitation, is of growing interest as a global, motivating and beneficial approach. Scientific literature shows that dance leads to favorable motor, cognitive and psychosocial effects for people with neurological disorders, notably, for people with Parkinson's disease. Recent studies have also suggested that dance, as a rehabilitation therapy, is an effective approach, which leads to motor and potential cognitive and psychosocial benefits for those with cerebral palsy. Among the numerous existing dance approaches, the creative dance approach is particularly interesting for its specific pedagogical process that not only includes the dancer's physical and psychological experience of dance, but is also guided by the dancer's own capacities of movement. Creative dance uses a participative, inclusive and playful method that facilitates social link and permits the improvement of self-confidence and empowerment. This approach, based on each individual's ability, enables rehabilitation de be adaptable and specific to the needs of each dancer and each group. Oral testimonies of adolescents with neurological disorders who have participated to creative dance classes in a rehabilitation context have shown that this activity is pleasant and leads to observed benefits both during classes and in daily life. Thus, creative dance appears as a promising therapeutic approach, and easy to implement in a rehabilitation context for young people with neurological disorders.     

Effect of Weight and Maturation on Busulfan Clearance in Infants and Small Children Undergoing Hematopoietic Cell Transplantation

Little information is currently available regarding the pharmacokinetics (PK) of busulfan in infants and small children to help guide decisions for safe and efficacious drug therapy. The objective of this study was to develop an algorithm for individualized dosing of i.v. busulfan in infants and children weighing ≤12 kg, that would achieve targeted exposure with the first dose of busulfan. Population PK modeling was conducted using intensive time-concentration data collected through the routine therapeutic drug monitoring of busulfan in 149 patients from 8 centers. Busulfan PK was well described by a 1-compartment base model with linear elimination. The important clinical covariates affecting busulfan PK were actual body weight and age. Based on our model, the predicted clearance of busulfan increases approximately 1.7-fold between 6 weeks to 2 years of life. For infants age <5 months, the model-predicted doses (mg/kg) required to achieve a therapeutic concentration at steady state of 600-900 ng/mL (area under the curve range, 900-1350 μM·min) were much lower compared with standard busulfan doses of 1.1 mg/kg. These results could help guide clinicians and inform better dosing decisions for busulfan in young infants and small children undergoing hematopoietic cell transplantation.     

Multiplex PCR reveals that viruses are more frequent than bacteria in children with cystic fibrosis

BackgroundCystic fibrosis is a degenerative disease characterized by progressive epithelial secretory gland dysfunction associated with repeated respiratory infections. Bacterial infections are very frequent in children with cystic fibrosis, but because rapidMethodsfor screening for the wide variety of potentially involved viruses were unavailable until recently, the frequency of viral presence is unknown. Multiplex PCR enables screening for many viruses involved in respiratory infections.ObjectivesThis study aimed to evaluate the frequency of viruses and bacteria in respiratory specimens from children with cystic fibrosis and to clarify the incidence and characteristics (seasonality and age of patients) of different viruses detected in children with cystic fibrosis.Study designIn this 2-year prospective study, we obtained paired nasopharyngeal-swab and sputum specimens from children with cystic fibrosis during clinical respiratory examinations separated by at least 14 days. We analyzed viruses in nasopharyngeal-swab specimens with multiplex PCR and bacteria in sputum with standard methods.ResultsWe analyzed 368 paired specimens from 33 children. We detected viruses in 154 (41.8%) and bacteria in 132 (35.9%). Bacteria were commoner in spring and summer; viruses were commoner in autumn and winter. In every season, Staphylococcus aureus was the commonest bacteria and rhinovirus was the commonest virus. Nearly all infections with Haemophilus influenzae occurred in autumn and winter.Viruses were more prevalent in children <5 years old, and bacteria were more prevalent in children ≥12 years old.ConclusionsMultiplex PCR screening for respiratory viruses is feasible in children with cystic fibrosis; the clinical implications of screening warrant further study.