A comparison of oral ondansetron syrup or intravenous ondansetron loading dose regimens given in combination with dexamethasone for the prevention of nausea and emesis in pediatric and adolescent patients receiving moderately/highly emetogenic chemotherapy.

This double-blind, parallel-group, multicenter study compared the efficacy and safety of intravenous (i.v.) ondansetron with oral syrup ondansetron plus oral dexamethasone in the prevention of nausea and emesis in pediatric patients receiving moderately/highly emetogenic chemotherapy.

Fetal rhabdomyomatous nephroblastoma: a tumour of good prognosis but resistant to chemotherapy.

Fetal rhabdomyomatous nephroblastoma (FRN) is a rare variant of Wilms' tumour. The tumour chiefly consists of fetal striated muscle with particularly distinct striations and central nuclei. To determine the effect of (preoperative) chemotherapy in the treatment of this subtype of nephroblastoma, a retrospective analysis was performed.

Limp as unusual presentation of Langerhans' cell histiocytosis.

Unlabelled: An isolated eosinophilic granuloma involving the posterior elements of a lumbar vertebra is reported in a 3-year-old boy presenting with progressive limp. Radiological investigations revealed osteolysis of the L5 right pedicle. MRI showed a well-defined homogeneous mass with nonspecific signal intensity.

[Antithrombin deficiency and thrombosis in a young child].

Background: Thromboses represent a rare event in children and may be due to a deficiency of antithrombin.

Case Report: A 10-year-old boy developed thrombosis due to a congenital quantitative deficiency in antithrombin, confirmed by molecular biology. His father was diagnosed with the same deficiency.

Sweet's syndrome with arthritis in an 8-month-old boy.

Sweet's syndrome was diagnosed in a 4-month-old boy. He was successfully treated with systemic corticosteroids. At the age of 8 months, he developed acute arthritis in his right knee.

Recommendations on the use of colony-stimulating factors in children: conclusions of a European panel.

Unlabelled: During 1996 and 1997 a panel of European haematologists, oncologists, and neonatologists developed specific paediatric guidelines for the use of colony stimulating factors based on published literature and the clinical experience of these specialists within each of 13 countries. Well established indications for use comprise intervention in patients with life-threatening infection, adjunctive therapy post autologous bone marrow transplantation (BMT), mobilization of peripheral blood progenitor cells for autologous BMT, patients with acquired aplastic anaemia on anti-lymphocyte globulin and cyclosporin regimen, and severe congenital neutropenia. Less clear indications include primary prophylaxis to support dose intensification in children with high risk/advanced malignancies, secondary prophylaxis to prevent neutropenia in patients with a history of severe neutropenia, support therapy in cases of poor marrow function following BMT and for deteriorating marrow function following successful BMT, in neonatal sepsis and non infectious neonatal neutropenia, in drug induced neutropenia and in HIV-positive patients.

Health care workers: vectors of influenza virus? Low vaccination rate among hospital health care workers.

The influenza vaccination rate among health care workers is not very high and needs to be improved. The authorities of our university hospital decided to encourage vaccination among health care workers and to include it in the hospital quality of care program. A survey about knowledge of influenza disease and its vaccination was undertaken, and 37.

Haematopoietic stem cell transplantation for sickle cell anaemia: the first 50 patients transplanted in Belgium.

Fifty patients affected by sickle cell anaemia underwent transplantation of HLA-identical haematopoietic stem cells (bone marrow, 48; cord blood, 2). Two groups of patients were considered for transplantation. Group 1 included 36 permanent residents of a European country who, retrospectively, met the inclusion criteria accepted at a consensus conference held in Seattle in 1990, wherein children were selected because they already had evidence of a morbid course.

Chronic relapsing thrombotic thrombocytopenic purpura: three case reports and update of the pathogenesis and therapeutic modalities.

Chronic relapsing thrombotic thrombocytopenic purpura (CRTTP) is the rarest type of TTP, usually presenting in childhood. The aetiology is still not fully explained. The disorder is associated with the presence in plasma of unusually large von Willebrand factor (UlvWF) multimers that are especially prominent between episodes.

Systematic analysis of in-patients' circumstances and causes of death: a tool to improve quality of care.

Objectives: To point out actions improving quality of care from a systematic analysis of causes and circumstances of death of hospital patients.

Design: All in-hospital patient deaths during 1993 and 1994.

Setting: Saint Luc University hospital.

Primary and secondary osteosarcoma of the face: a rare childhood malignancy.

Background: Osteosarcoma of the head and neck, especially primary forms, remains a rare and highly malignant tumor.

Patients: This report describes two patients who developed an osteosarcoma of the face more than ten years after treatment for bilateral retinoblastoma. We also report a third patient who presented with a primary osteosarcoma of the right superior maxilla which is one of the rarest tumors encountered in childhood oncology.

Unifocal cervical Castleman disease in two children.

Unlabelled: Castleman disease (CD) is a benign lymphoproliferative disorder characterized by enlarged hyperplastic lymph nodes. Most observations focus on adult patients. In children the disease is rare, usually localized and may be symptomatic or asymptomatic.

Disseminated Mycobacterium avium infection in a child with decreased tumour necrosis factor production.

Unlabelled: Disseminated atypical mycobacterium infection is essentially reported in cellular immunodeficient children. Cell-mediated immunity including cytokines like tumour necrosis factor alpha (TNF) and gamma interferon (IFN) is the most important factor allowing control of the dissemination of Mycobacterium. We report a child with disseminated Mycobacterium avium infection without classical immunodeficiency or HIV infection.

[Combined hereditary deficiency in factors VII and X revealed by a prolonged partial thromboplastin time].

Background: Congenital factors VII and X deficiency is rare. Association of both deficiencies is exceptional.

Case Report: A 3 year-old boy, born to consanguinous Moroccan parents, had a prolonged partial thromboplastin time discovered fortuitously.

Radiographic skeletal survey and radionuclide bone scan in Langerhans cell histiocytosis of bone.

Background: The lack of a consensus in the literature on the imaging strategy in Langerhans cell histiocytosis (LCH) bone lesions in childhood.

Objective: To evaluate the relative value of radionuclide bone scan (RBS) and radiographic skeletal survey (RSS) in the detection of LCH bone lesions, both in the initial work-up of the disease and during the follow-up period.

Materials And Methods: Ten children with bone lesions evaluated by means of RSS and RBS in a retrospective study (1984-1993).

Persistence of fetal hemoglobin production after successful transplantation of cord blood stem cells in a patient with sickle cell anemia.

A girl with sickle cell anemia was treated with cord blood transplantation combined with hematopoietic growth factor. Cord blood cells were collected from a sister with an identical human leukocyte antigen complex who was a carrier of the sickle cell trait (hemoglobin AS). The patient had complete engraftment and no graft-versus-host disease.

HIV Infection in Children Born Before and After Immigration to Belgium.

Methods: The records of 119 children, either infected with HIV or born to HIV-infected mothers were reviewed. This group was mainly represented by children whose families came to Belgium from Central Africa. Seven children were infected through blood or blood products transfusion, whereas the remaining 112 were born to infected mothers.

AIDS-resembling disease in a non-HIV-infected African born to an HIV-positive mother.

We report the case of a 10-month-old boy born to an HIV-positive mother who presented with symptoms compatible with AIDS. However, he became HIV-negative and his condition was probably due to combined cytomegalovirus and Epstein-Barr virus infections.

Variation in the use of ondansetron as an antiemetic drug in children treated with chemotherapy.

Selective 5-HT3 receptor antagonists such as ondansetron are potent antiemetics for chemotherapy-induced emesis. Ondansetron has been shown to be highly effective in preventing nausea and vomiting in children treated with chemotherapy and/or radiotherapy. However, its high cost may limit its application.

Transplantation of umbilical cord blood in a refractory lymphoma.

A successful cord blood transplantation combined with hematopoietic growth factor was performed in a boy presenting with refractory mediastinal T-cell lymphoma. Cord blood cells were collected from an HLA-identical sibling at the time of delivery. A transient and corticosensitive acute grade II graft versus host disease was observed.

[The role of ultrasonography in abdominal pain in children in the emergency room].

Our retrospective study aims at defining the influence of ultrasonography on the management of acute abdominal pain in a pediatric population. This technique appears to be essential in the diagnosis of intussusception and thus, should be recommended in all cases of acute abdominal pain in the population at risk for this disorder. On the other hand, ultrasonography only plays a minor role in the management of the other diseases we observed, especially in acute appendicitis.

[Eruptive fever of rare cause: familial hemophagocytic lymphohistiocytosis].

Background: Clinical onset of familial lymphohistiocytosis is non-specific so that the diagnosis of this rare and severe disease is difficult.

Case Report: An 8 week-old girl was admitted suffering from fever and rash. She had hepatosplenomegaly.

Nonossifying fibromyxoid tumor of soft tissue.

A firm, painless tumor of the temporal region was excised in a 3-year-old girl. The diagnosis of nonossifying fibromyxoid tumor was established on pathologic examination, which showed that most of the cells formed cords and tubulelike structures in a myxoid background. Bone and osteoid were lacking.