[The pediatrician and the telephone]. / Le pédiatre et le téléphone.

Approximately half of the phone calls received in the pediatrician's office are telephone consultations or advice requests concerning pathologies. In those cases the pediatrician has to know that his responsibility is involved. Among the rules to be applied in this telephone practice, he must always require that the child be examined when parents call for the second time. In some chronic pathologies permanent phone services with the participation of trained practitioners might be useful in order to properly answer parent's advice requests.

[Is there a consensus among specialists concerning asthma?]. / Les opinions des spécialistes sur l'asthme de l'enfant sont-elles homogènes?

A list of 30 questions--of which 25 were literal translations of the questions asked by R.L. Henry and A.D. Milner (British Medical Journal 1983, 287, 260-261) and 5 were new questions--was presented to 118 specialists of asthma selected among the members of the European Academy of Allergology. A consensus (more than 75% identical answers) was observed for 17 questions. Surprisingly, only 50% of French specialists perform lung function testing on one occasion, since concomitantly the importance of periodic evaluation of "breathing" was underscored. Comparison with answers given by British practitioners raises the question of why a chronic disease such as asthma is managed differently despite comparable severity. The urgent need for a definition of "good diagnostic and therapeutic practices in asthma" is pointed out.

[Detection of respiratory allergies using the Phadiatop test in children 1 to 6 years of age]. / Le dépistage de l'allergie respiratoire par le Phadiatop chez l'enfant de un à six ans.

Phadiatop, a new test for detecting hypersensitivity to airborne allergens, was used in 83 children aged 9 months to 6 years with recurrent respiratory manifestations, i.e. recurrent expiratory obstruction and/or recurrent respiratory infections. A good correlation was found between this test and both the prick tests (95%) and the specific IgE assays (91% for RASTS of classes greater than or equal to 1, and 95% for RASTS of classes greater than or equal to 2). However, the correlation was less strong with the total IgE level (68%). The overall correlation with the specialist's prediction based on history and physical evaluation was excellent (94%). In this study, Phadiatop was found to have a 90% sensitivity and a 98% specificity. Furthermore, this test costs 40% less than the often used strategy combining skin tests and determinations of total and specific IgE levels. In the age group studied, Phadiatop is most useful above the age of two, since in younger patients true respiratory allergies are fairly infrequent in recurrent ENT and lower respiratory tract infections, whereas infections are far more common.