[Prevention of accidents among children in France]. / La prévention des accidents d'enfants en France.

Injuries are a leading cause of mortality and morbidity in children and account for an impressive number of physician visits. The author reviews injury control strategies used in France, which include both educational efforts undertaken by government agencies or private organizations and the development of regulations and standards for products potentially hazardous to children. New injury control measures can be suggested, such as defining optimal plans for action for especially severe injuries, including injury control recommendations in standard health care guidance, increasing the level of commitment of physicians to injury control, and training well-child clinic staff to routinely look for risk factors in high risk families.

[Child victims of house fires in France. Mortality, morbidity, prevention]. / Enfants, victimes d'incendies d'habitations en France. Mortalité, morbidité, prévention.

Children injuries by house fires in France are the cause of a severe mortality (sixty deaths in average each year) and of a morbidity for the survival due to smoke toxicity (oxygen deprivation and inhalation of toxic gases--CO and HCN) and to thermal burns. Epidemiological studies show that young children (0 to 4) are specially concerned by this threat and that the deaths occurred more often in some part of France (Nord-Pas-de-Calais Region). A special strategy for this prevention should be applied in France, the same available in USA, Sweden and UK, including information on the behavior one should have with children: never leave them alone and escape with them as soon as possible out of the smoke. The usefulness of smoke detectors should be confirmed by French administration and recommended to the public, since they have had effective results in other countries.

[Childhood accidents caused by farming machines in France. Epidemiology, consequences, prevention]. / Les accidents d'enfants provoqués par des machines agricoles dans les exploitations en France. Epidémiologie, conséquences, prévention.

As part of the actions led by the French Center for Information and Encounters for the Prevention of Childhood Injuries, a recent meeting on childhood injuries caused by farming machinery was held recently. These injuries are not exceptional in view of the steadily diminishing number of children living on farms. They are often severe, with several deaths each year in France and devastating sequelae in other cases. Prevention requires improved safety of these machines to which farmers' children are exposed in their everyday life, as well as information efforts targeted to the highest risk populations, i.e., boys in specific age groups and specific regions. Such a program can be implemented only with the cooperation of involved industries, insurance companies and official agencies, as part of a long-term, decentralized policy.

[Hospitalisation at home of children seen in a pediatric outpatients (author's transl)]. / L'hospitalisation à domicile des enfants a partir de la consultation externe d'un hôpital pédiatrique.

The authors relate their experience of hospitalisation at home of 74 children selected in a pediatric outpatients over a period of 5 years. They show the advantages of this method of care which are much greater than the few disadvantages and regret that it is not used more often.

[Two cases of gluten intolerance presenting as dwarfism (author's transl)]. / A propos de deux observations d'intolérance au gluten révélée par un nanisme.

Two patients with dwarfism were found to have intolerance to gluten. The authors describe the clinical, biological and radiological signs which enable the growth disorder to be related to its true cause, when obvious signs of a celiac syndrome are lacking. In fact, a small intestine biopsy is the essential diagnostic procedure. The hormonal changes found in such patients are discussed, and include normal HGH levels, reduced somatomedin activity which becomes normal after a gluten-free diet, and low blood insulin levels in the basal state as in insulin tolerance tests.

The contribution of physicians to childhood injury prevention in France.

OBJECTIVES: The objective of this study was to determine what injury control interventions are currently carried out by physicians and to examine how these interventions could be more effective. SETTING: Surveys were conducted among the three main groups of physicians who provide primary care to children in France--private practice pediatricians (PPPs), well-child clinic pediatricians (WCCPs), and general practitioners (GPs). METHOD: A representative sample of each of the three groups of physicians were interviewed by telephone, using a computer assisted telephone interview system, in December 1993 or February 1994. RESULTS: Responses demonstrated that most physicians felt they could play an important part in injury prevention but that many had inadequate knowledge of injury related mortality rates in children. Most PPPs and WCCPs usually provided counseling on safety in relation to developmental changes in children. Few physicians gave recommendations about appropriate first responses to emergencies. Printed material, designed for parent education, was provided by many PPPs and WCCPs, but was usually absent from the offices of GPs. Participation in group education sessions was common among WCCPs but rare among PPPs and GPs. Many physicians expressed skepticism regarding the efficacy of their interventions in injury control. CONCLUSION: A number of recommendations are made to those in government agencies or elsewhere who could help physicians to improve childhood injury prevention, for instance by regular publication of data on childhood injury mortality, counseling about parent education on this subject, and first aid in emergencies.

[Clinical study and effect of nitroxoline on fecal flora in children]. / Activité clinique et effet de la nitroxoline sur la flore fecale chez l'enfant.

Twelve children (mean age: 4) are treated in practice office with nitroxoline (200 mg/kg/24 h) during 10 days for urinary tract infection. A study on the effect of nitroxoline against the fecal flora is undertaken in a group of 21 children who receive nitroxoline during 4 days or a long period. Bacteriological and clinical efficacy is checked when urinary concentrations of nitroxoline are greater than 16 mg/l. The results show 8 clinical and bacteriological success one true failure and 3 failure due to a non-compliance to the treatment. No qualitative and quantitative modification of the fecal flora is observed after treatment with nitroxoline.

[Venous thrombosis, circulating anticoagulant and systemic lupus erythematosus. Two cases reported in two identical HLA sisters (author's transl)]. / Thromboses veineuses, anticoagulant circulant et lupus érythémateux dissémine. A propos de deux cas chez deux soeurs HLA identiques.

The observation of two cases of thrombophlebitis of the calf which occurred in two sisters within a period of three years is reported. The investigation revealed in both cases the presence of a circulating anticoagulant with anti-prothrombinase activity in association with biological signs of systemic lupus erythematosus (L.E.): anti-DNA antibodies, decreased complement levels, false positive BW reactions. In one patient, the skin biopsy showed a continuous IgM band on immuno-fluorescence. After respectively 4 years and 18 months follow-up both patients are still free from clinical symptoms. A review of the literature is presented and the clinical and etiological significance of the presence of a circulating anticoagulant, its relationship with L.E., particularly with "latent" L.E. (presence of biological signs only), and its association with thrombophlebitis are discussed.