[Parapneumonic pleural effusion incidence in a French region before and during the antipneumococcal vaccine era]. / Incidence des pleuropneumopathies à pneumocoque en Limousin à l'ère de la vaccination.

BACKGROUND AND AIMS: The aim of the study was to compare the incidence of parapneumonic pleural effusion in the Limousin region of France, based on the comparison of pre- and postvaccination periods. METHODS: Subjects, 0-18-years-old, were retrospectively identified by searching in computerized databases of coded discharge diagnosis for patients with a diagnosis of pleural effusion and/or empyema and/or pulmonary infection in all the pediatric departments in Limousin hospitals. Medical records were reviewed by one of the authors and those with parapneumonic effusion and confirmed or suspected pneumococcal infection were included in the study. Data from the children hospitalized for parapneumonic pleural effusion were collected for two periods: period A, from July 2000 to July 2006, and period B, from July 2006 to July 2009 (before and after the generalization of the antipneumococcal vaccination). The main endpoint was the number of parapneumonic pleural effusion cases in each period in order to calculate the incidence within each period. RESULTS: A total of 35 children were included: nine during period A and 26 during period B. The incidence was 1 per 100,000 children for period A and 5.8 per 100,000 for period B. Bacteriological tests allowed us to serotype eight S. pneumoniae over the two periods. All serotypes were non-vaccine serotypes (1, 3, and 19A). CONCLUSION: This study demonstrates the increase in parapneumonic pleural effusion in the Limousin region.

Bilateral paranasal sinus mucopyoceles in a child with cystic fibrosis.

Mucoceles of the paranasal sinuses are well-described complication of chronic sinusitis in adults. They are extremely rare in children and the main predisposing factor is cystic fibrosis (CF). We report a case of bilateral ethmoid and maxillary sinus mucopyoceles, associated with CF occurring in a six months old boy. The main symptom was a complete nasal obstruction. The marsupialization of mucocele was performed by endoscopic surgery. One year follow-up showed no recurrence.

[Prevalence of exercise-induced asthma in school children]. / Prévalence de l'asthme d'effort en milieu scolaire.

BACKGROUND: Although asthma is the most common pulmonary condition in pediatrics, the incidence of exercise-induced asthma (EIA) in school children is not well documented and few studies have been devoted to the condition. There are considerable variations in morbidity and mortality between countries. This study was designed to evaluate the prevalence of EIA in children in the 6th grade (11-14 year-olds) in one French department (Haute-Vienne) and to identify undiagnosed cases. METHODS: The representative sample was obtained over a period of 28 days (February 2(nd) to April 10(th) 1998) by cluster sampling method, stratified by size of the schools. The number of subjects planned was 891. The selected children filled in a questionnaire on their asthma history and were subjected to an outdoor exercise test (6 minute run). Respiratory function was measured with a peak flow-meter. RESULTS: Seven hundred and eighty two school children were included in this survey. Participation rate was 87.8%. The prevalence of asthma from the questionnaire was 10.7% (CI 95%: 8.7 - 12.8). After exercise, 68 school children presented exercise-induced bronchospasm: the prevalence of the EIA was 8.7% (CI 95%: 6.9 - 10.5). Among these 68 school children, 27 were known asthmatics and 41 were not. With the 10 treated asthmatics, the overall prevalence of EIA was therefore estimated at 9.9% (CI 95%: 8.2 - 11.7). CONCLUSION: The prevalence of asthma and EIA was close to that found in other studies using a similar methodology. EIA remains under-diagnosed since 41 undeclared asthmatic school children were identified in our population. Nurses'information is necessary to initiate the use of systematically testing respiratory function (with a peak flow meter) at least once a year. Efficient management of the asthmatic child requires cooperation between the various professionals dealing with school children.