[Urinary toxicological screening: analytical interference between niflumic acid and cannabis]. / Dépistage urinaire des stupéfiants : interférence entre acide niflumique et cannabis.

UNLABELLED: One case of analytical interference between cannabis and niflumic acid resulting in a false-positive screening in a 3-year-old girl is described. CASE REPORT: The child was hospitalized because of behavioral disturbances of unknown origin. The only noteworthy finding in her medical history was a drug treatment including suppositories of niflumic acid, started 5 days before. The initial urinary toxicological screening was positive for cannabinoids, but the child's parents strongly denied the exposure. Another analysis was performed by the same laboratory on the same urine sample using chromatography and confirmed the absence of any cannabinoids, while clearly identifying the presence of niflumic acid. COMMENTS: Immunoanalysis for toxicological analysis has various limitations that must be known. False-positive results of the urinary screening for cannabis in patients treated with niflumic acid are well recognized although seldom reported. All usual screening tests are not concerned by this ill-explained interference with niflumic acid and all formulations can be involved except transcutaneous formulations. Because of the wide use of this nonsteroidal anti-inflammatory drug, particularly in pediatric patients, it is important to know that this type of interference can occur with various screening tests for cannabis so that misleading conclusions can be avoided.

Invasive aspergillosis and allogeneic hematopoietic stem cell transplantation in children: a 15-year experience.

Despite progress in diagnosis and treatment, invasive aspergillosis (IA) remains a principal cause of mortality due to infection after allogeneic hematopoietic stem cell transplantation (AHSCT). In order to clarify the course of IA among children receiving an AHSCT before the advent of new drugs such as voriconazole or caspofungin, we retrospectively reviewed the medical records of all proven and probable IA between January 1986 and December 2000. 1) Ten children developed IA after AHSCT, mostly long after transplantation. Overall incidence was 2.7%. Seven of those children experienced 1 or more complications after AHSCT and before IA. Mortality was 90% with a median survival of 23 days (2-90). 2) Five children underwent AHSCT after a previous episode of IA. All patients were treated with systemic antifungal therapy combined with surgery. Median time between IA and AHSCT was 110 days (73-370). Two children were diagnosed with IA relapse after transplantation. One child was cured while the other died of IA and AHSCT complications. AHSCT could be considered even in the setting of previous IA, but established strategies implementing newer less toxic antifungal agents as treatment or prophylaxis in high-risk patients are needed.

Acyclovir-resistant varicella infection with atypical lesions in a non-HIV leukemic infant.

UNLABELLED: An HIV-negative infant presented with VZV primary infection during the maintenance therapy for megakaryoblastic leukaemia. The lesions were initially vesicular and necrotic but became verrucous and hyperkeratotic. A clinical resistance to acyclovir was suspected and confirmed by histologic and virologic studies. The patient was successfully treated by foscarnet. CONCLUSION: resistance of VZV to acyclovir may occur after a short treatment in a non-AIDS patient.

[Chloroquine sensitivity of Plasmodium falciparum at the Gamkalley Clinic and the Nigerian armed forces PMI (Niamey, Niger)]. / Chloroquinosensibilité de Plasmodium falciparum à la clinique Gamkalley et à la PMI des Forces armées nigériennes (Niamey, Niger).

In vivo tests for Plasmodium falciparum were carried out in 1998 during the rainy season among children in Niamey, in the Republic of Niger. Chloroquine was prescribed at 25 mg/kg for 3 days in febrile patients with uncomplicated P. falciparum malaria. Forty-five 1-5 year-olds and thirty-three 6-15 year-olds were included in the study. A group of 53 adult patients was also surveyed to evaluate the efficacy of chloroquine in semi-immune persons. Body temperature and blood smears including parasitemia were recorded on days 0, 3, 7 and 14. Less than 10% of the patients were delinquent. Around 75% of the patients were successfully treated in the 1-5 year-olds and 6-15 year old age groups. Relapses were observed in 20% of the 1-5 year-olds (early relapses 8.9%, late relapses 11.1%) and in 16.7% in the 1-15 year-olds (early relapses 6.4%, late relapses 10.3%). Among adults, successful treatment was obtained in 86.8% of the cases and early and late relapses were respectively observed in 3.8% and 1.9% of the cases. All the patients with malaria relapses were cured with second-line treatments (pyrimethamine-sulfadoxine or quinine). According to these results, chloroquine resistance appears to be moderate in Niamey. Therefore chloroquine should remain the first line treatment of uncomplicated P. falciparum malaria in this population.

[Educational campaign on the sleep of young children]. / Campagne d'éducation pour le sommeil du petit enfant.

An educational campaign on sleep of young children was conducted in Vénissieux, a town of 65,000 inhabitants in the suburbs of Lyons, France. The campaign was directed at the parents of 2 to 6 year-old children enrolled in nursery schools (i.e. a population of 3,863 children) and continued over one school year. The main aspects of sleep approached during the campaign were: the importance of sleep for the health of the children, the need for a pleasant and early bedtime, the importance of a nap at home or in school, the danger of a regular drug use to solve sleep disorders. In order to evaluate the effects of the campaign, two studies using questionnaires filled out by the parents were carried out, one before and one after the campaign. Comparisons of the results of the two questionnaires showed several significant positive changes after the campaign: less precocious arising, earlier evening bedtime and improved conditions of bedtime, tendency to increase overall night rest, less sleep disorders, improved conditions favouring nap at school.