[Respiratory sensitization to molds in children: myth or reality?]. / La sensibilisation respiratoire aux moisissures chez l'enfant: mythe ou réalité?

The authors have made a systematic study by PRICK-test and RAST, sometimes followed by a rhino-manometric provocation, of the frequency of sensitization to the two moulds Alternaria and Cladosporium in 200 "all comers" children in a paediatric consultation. The frequency was low, only 10% for those consulting in the groups of asthma, rhinitis, pollinosis, repeated respiratory infections and syndromes of obstructed expiration taken together, and 13% for allergic asthma only. This sensitivity is rarely isolated, but is most often accompanied, or complicated by, other pneumoallergens, such as dust, mites, pollens and sometimes cockroaches. It imposes certain particular clinical traits on asthma (summer asthma or recurring asthma) and in others appears to be strongly influenced by the habitat. The skin tests seem to be very weak and RAST insufficient to be sure of real sensitization. Diagnosis, always difficult, is probably best done by a provocation test (preferably rhino-manometry) and this jumps over the bundle of clinical and biological arguments, as well as being, at least in our country, the most useful mimic of atmospheric moulds. The authors insist on the importance of the interrogation which should be concerned with the chronological and environmental circumstances and all respiratory infections that are suspected of having an allergic factor.

[What is the value of emergency cranial radiography in craniofacial injuries?]. / Quelle est l'utilité des radiographies du crâne en urgence dans les traumatismes crânio-faciaux?

To evaluate the possible overuse of skull films, 344 patients were studied retrospectively and 252 were sent a questionnaire. During the 12 month study, 47 skull fractures were detected in 596 patients who had skull roentgenograms because of head trauma. 42 patients had intracranial sequellae but no skull fracture. The presence of a skull fracture usually has no bearing on management and may give the physician an unwarranted feeling of security. Reasons for unnecessary examinations include medicolegal considerations, inadequate history provided to the radiologist and insufficient physical examination. If neurologic signs are present, computed tomography is the first choice procedure.