[Cerebral vasculopathy in children with sickle cell disease: Key issues and the latest data]. / Vasculopathie cérébrale de l'enfant drépanocytaire : points clés et nouveautés.

Cerebral vasculopathy is a common and severe complication of sickle cell disease in children. The pathophysiology consists of progressive damage to the basal intracranial arteries and cerebral microcirculation, while chronic anemia worsens exposure to cerebral hypoxia. It results in stroke and subclinical or poorly symptomatic ischemic lesions. Many clinical, biological, and radiological risk factors have been identified. The prevention strategy through systematic transcranial Doppler screening of large-vessel vasculopathy has revolutionized the management of this disease and has greatly decreased the risk of developing stroke. MRI-MRA is a complementary diagnostic tool for anatomical analysis of parenchymal and vascular lesions, which is used for chronic disease monitoring or in the context of an acute neurological event. New exploration opportunities are offered by submandibular Doppler sonography and indirect evaluation methods of cerebral oxygenation and perfusion. If chronic blood transfusion therapy is used to prevent the occurrence and recurrence of cerebral complications of sickle cell disease, only allogeneic hematopoietic stem cell transplantation can safely and definitively stop the transfusion program. It should therefore be proposed early, before irreversible cerebral or vascular lesions occur. Hydroxycarbamide treatment has recently emerged as a potential substitute for chronic transfusions for the maintenance of transcranial Doppler velocities, but only after an initial treatment by transfusions and provided there is close follow-up. In the long run, cerebral vascular damage can cause progressive cognitive impairment and disability, even in children without radiologically identified lesions, indicating the importance of systematic and repeated neuropsychological testing.

[Skin sensitisation profiles of outpatients with symptoms of respiratory allergies]. / Profils de sensibilisation cutanée aux pneumallergènes des patients consultant pour allergie respiratoire.

AIM: The main objective of the survey was to determine the frequency of the mono and polysensitizations in patients consulting for respiratory allergy, rhinitis or/and asthma. The secondary objectives were to evaluate the severity, the number and the type of the sensitizations, the frequency of the asthma or rhinitis as a function of the sensitizations, the evolution of the sensitizations with age, and identify the principal responsible pneumallergens. PATIENTS AND METHODS: The multicentric survey included a patient questionnaire allowing the collection and anonymous treatment of data on socio-demographic characteristics, clinical symptoms, cutaneous tests and sensitizations. RESULTS: A sample of 505 patients, mean age 24 years, consulting for rhinitis or asthma, monosensitized (36%) or polysensitized (64%), was evaluated. The percentage of polysensitized patients was similar in asthmatics, patients with rhinitis, and patients with both asthma and rhinitis (60%, 65%, and 63%, respectively). The mean number of the sensitizations was 2.4 for patients with asthma, 2.6 for those with rhinitis, and 2.6 for patients with both asthma and rhinitis. The greater the severity of the rhinitis or asthma, the higher the number of the sensitizations. Sensitizations to acarids, gramineae and cat were the most frequent. When practioners were asked about their intention to undertake desensitization in polysensitized patients, 52% of them replied positively. CONCLUSION: Data collected during this survey showed that a large proportion of the patients who consulted for rhinitis or asthma were monosensitized (36%). Sensitization to acarids was the most frequent. Even in polysensitized patients, more than half the practioners said they would use desensitization.

[Immunodiffusion and immunoelectrophoretic techniques applied to psoriasis (author's transl)]. / Techniques d'immunodiffusion et d'immuno-électrophorèse appliquées au psoriasis.

Serum and scales of skin obtained from normal and psoriatic subjects are tested and estimated by immune diffusion and immune electrophoresis technics. The authors relate technics to produce rabbit's antibodies towards psoriatic serums and extracts of skin. Results coroborate the quantitative modifications of immunoglobulins and show in addition the presence of multiple precipitations lines in the alpha and gamma regions. Lastly, in psoriatic scales a globulin is found, which is not present in normal scales or normal serums.