[Cerebral venous thrombosis in children: about a series of 12 cases]. / Thrombose veineuse cérébrale de l'enfant: à propos d'une série de 12 cas.

Cerebral venous thrombosis (CVT) is rare in children. Its clinical features and its cause vary. Prognosis is dreadful due to the risk of death and neurosensory sequelae. This study aims to examine the clinical, radiological and etiological profile of CVTs in children and to evaluate the role of antithrombotic treatment. We conducted a retrospective study in the Department of Paediatrics and Paediatric Resuscitation at the Center Hospital University Mohammad VI (CHU) in Marrakech, Morocco, over a period of nine years and ten months (January 2008-October 2018). We collected data from the medical records of all patients aged between 1 months and 15 years with CVT confirmed by imaging. We listed 12 cases of CVT. The average age of patients was 6.4 years. Sex ratio was 1.4. Acute onset occurred in 7 cases. The main clinical features of CVT included seizures (7 cases), focal neurologic signs (7 cases) and signs of intracranial hypertension (IH) (6 cases). CT scan and/or magnetic resonance imaging (MRI) revealed an involvement of the superficial venous network in 8 cases and extended venous involvement in 3 cases. In six cases CVT was caused by an infection, with a case of dehydration, two cases of systemic disease and a case of homocystinuria. However, the cause of the disease was unknown in two patients. Seven children were treated with antithrombotic therapy with good clinico-radiological outcome in 5 cases. Two children died and 3 others had neurological sequelae. In children, CVTs are characterized by a vast variety of clinical features and causes. The effect of anticoagulant therapy was demonstrated despite the absence of a standardized therapeutic protocol.

Unsuspected Cause of Respiratory Distress: Unrecognized Esophageal Foreign Body.

SUMMARY: Foreign bodies in esophagus are avoidable accidents that occur most often in children younger than 3 years. The most common presenting symptoms are dysphagia, drooling, and vomiting. Revelation by respiratory distress is a rare and unusual condition. OBJECTIVE: We describe and discuss the case of an esophageal foreign body, in which the patient presented with respiratory distress. CASE REPORT: A two-year-old child was admitted to the emergency department for acute respiratory distress. He had no history of choking episodes or dysphagia. Nevertheless, he was brought by his parents several times for a persistent cough and wheezing that was treated as asthma for a month. Pulmonary examination had revealed polypnea, suprasternal recession, scattered snoring, and diffuse wheeze. As part of his assessment, a chest X-ray was demanded. It had shown, as unexpected, a nonmetallic foreign body in the upper thoracic esophagus. A clothing button was removed by hypopharyngoscopy under sedation without any incident. Subsequent follow-up had not shown any complications related to this episode. CONCLUSION: Large esophageal foreign bodies can impinge on the trachea causing upper respiratory tract signs. We alert clinicians on variation in the presentation of foreign body ingestion, and we emphasize the importance of an early diagnosis and management.

[Acceptability of human papilloma virus vaccine: parent survey]. / Acceptabilité du vaccin antivirus du papillome humain: enquête auprès des parents.

This study aims to evaluate the extent of human papilloma virus vaccine awareness among parents of girls in vaccine age group, their acceptability of the vaccine and factors associated with refusal. We conducted a survey among parents of girls aged 8-15 years, followed-up for several diseases in the Department of Pediatrics at the University Hospital Mohamed VI in Marrakech, Morocco, on parents' profile, their awareness of cancer of the cervix, HPV and HPV vaccine, the acceptance of HPV vaccine for their daughters and the arguments related to refusal. Ninety six questionnaires were included in the analysis. Cancer of the cervix was considered frequent for 58% of parents. Only 5% of parents knew about HPV vaccine. Media were the source of information in all cases. Nobody had no idea about the cost of the vaccine and its tolerance. No girl was vaccinated against HPV. Sixty-three per cent of parents want their daughters to be vaccinated, this rate increased by 82% after awareness. Thirteen per cent of the parents were hesitant while 24% refused to vaccinate their daughters mainly due to side effects (51%). Parents refusing vaccine were predominantly males with medium socioeconomic status and cultural level and were unaware of the virus and the vaccine in 91% of cases. This study highlights the reasons for parents' reluctance towards HPV vaccine in order to optimize strategies for effective communication with parents.