[Flexible bronchoscopy in children. Experience at French centers of pediatric pneumology].

Introduction: Fibreoptic bronchoscopy (FB) is an important diagnostic examination in paediatric pulmonology. In 2002 the Paediatric Pulmonology and Allergy Club undertook a retrospective study to establish the current status of fibreoptic bronchoscopy among its members.

Methods: In 2001 sixty five paediatric pulmonologists carried out an average of 116 examinations (+/- 111) in 35 paediatric centres.

Pneumocystis jirovecii dihydropteroate synthase genotypes in immunocompetent infants and immunosuppressed adults, Amiens, France.

To date, investigations of Pneumocystis jirovecii circulation in the human reservoir through the dihydropteroate synthase (DHPS) locus analysis have only been conducted by examining P. jirovecii isolates from immunosuppressed patients with Pneumocystis pneumonia (PCP). Our study identifies P.

Multilocus genotyping of Pneumocystis jirovecii in patients developing diverse forms of parasitism: implication for a wide human reservoir for the fungus.

Pneumocystis jirovecii ITS and DHPS genotypes were identified in 3 patient groups developing diverse forms of P. jirovecii infections: 13 patients with Pneumocystis pneumonia, 8 patients merely colonized by the fungus, and 19 immunocompetent infants with bronchiolitis developing mild P. jirovecii infection.

Immunocompetent infants as a human reservoir for Pneumocystis jirovecii: rapid screening by non-invasive sampling and real-time PCR at the mitochondrial large subunit rRNA gene.

We tested a real-time PCR assay targeting the Pneumocystis jirovecii mitochondrial large subunit rRNA gene on 240 archival nasopharyngeal aspirates from non-immunosuppressed infants. The sensitivity of this assay appeared close to that of a conventional nested-PCR assay targeting the same locus. Because of its one-step procedure, and its sensitivity and rapidity, the real-time PCR assay is particularly suitable for screening individuals parasitized by P.

Pneumocystis jiroveci genotypes and primary infection.

This study describes the molecular typing of Pneumocystis jiroveci organisms from 5 nonpremature immunocompetent infants who developed a primary infection. Four P. jiroveci internal transcribed spacer (ITS) types were identified.

Genotypes at the internal transcribed spacers of the nuclear rRNA operon of Pneumocystis jiroveci in nonimmunosuppressed infants without severe pneumonia.

The frequency of Pneumocystis jiroveci (human-derived Pneumocystis) in immunocompetent infants developing acute respiratory syndromes has recently been evaluated and has been shown to be close to 25%. Until now, there have been no data on the genomic characteristics of the fungus in these patients, while molecular typing of P. jiroveci organisms was mostly performed with samples from immunosuppressed patients with pneumocystosis (Pneumocystis carinii pneumonia [PCP]).

[Use of the admission service and pediatric emergency service of a university hospital center by adolescents (12-19 years): utilization and messages].

A retrospective survey concerning all patients ages 12-19 who had registered themselves at the admitting service of the paediatric emergency unit in the university hospital centre of Amiens was carried out in 1995. 2812 adolescents were received (18% of total admissions). The male/female sex-ratio was 1 to 3.

[Pulmonary Chlamydia infections in children].

In the last decades chlamydial infection of the respiratory tract have been described in children. Chlamydia trachomatis, the most common identifiable cause of neonatal infections conjunctivitis is also a recognised cause of pneumonia in newborns and is responsible for about one third of sexually transmitted disease. Chlamydia psittaci is mainly pathogenic for birds and occasionally for human.

Comparative study of human expertise and an expert system: application to the diagnosis of child's meningitis.

We present a general method of statistical evaluation for expert systems, applied to a system for the diagnosis of child's meningitis. Fifty difficult clinical cases of child's meningitis were submitted to the system, to seven senior specialists and to seven young physicians. Multidimensional analysis of the diagnosis of the infection category reveals that the two groups of physicians separate naturally and that the system is located among the group of experts.

[Posterior mediastinal thymus. Apropos of a case in a child].

Posterior and upper mediastinal localization of the thymus gland is uncommon in young children. Presenting symptoms and signs are very variable from incidental diagnosis to bronchopneumonial with atelectasias of the left upper Chest X-Ray and CT Scan are sufficient to make the diagnosis. Treatment of complicated forms with bronchial compression requires thoracotomy and surgical excision.

[Thymus in posterior mediastinal localization. Apropos of a case in a child].

Posterior and upper mediastinal localization of the thymus gland is uncommon in young children. Presenting symptoms and signs are very variable from incidental diagnosis to bronchopneumonial with atelectasias of the left upper Chest X-Ray and CT Scan are sufficient to make the diagnosis. Treatment of complicated forms with bronchial compression requires thoracotomy and surgical excision.

[Pleuro-pericardial cyst in children].

We report the case of 3 1/2 year old child presenting a left pleuropericarditic cyst causing febrile cough and an opacity of the left lower lobe of the lung. We underline the importance of computed tomography of the thorax allows differential diagnosis with encysted effusion. Surgical treatment rarely indicated in pleuropericarditic cysts has stopped respiratory symptoms.

[Respiratory arrest in an asthmatic girl treated with beta-2-mimetics and theophylline. Possible role of hypokalemia in sudden death in asthmatic patients].

We report a case of respiratory arrest in a ten-year-old asthmatic girl under beta-2-agonists and theophylline. The possibility that hypokalemia plays a part in the sudden deaths seen in some asthmatic patients is discussed.

[African trypanosomiasis in children treated with eflornithine. A case].

We report the case of a 14-year old African girl presenting with late-stage African T. gambiense trypanosomiasis. She was treated with eflornithine, an ornithine decarboxylase inhibitor which is a key enzyme in the biosynthesis of polyamine.

[Long-term follow-up of abused children (apropos of 65 cases)].

The authors work in an area located north of Paris, which contains roughly a population of .75 million, of which 82,000 are children less than 3 years of age. The center and main city of the area is the town of Amiens.