[Quality of life of adolescents surviving childhood acute lymphoblastic leukemia]. / Vécu des adolescents guéris d'une leucémie aiguë lymphoblastique.

PURPOSE: To evaluate how adolescents and young adults cured of acute lymphoblastic leukemia (ALL) treated during childhood have integrated the disease, and possible death related to cancer. Particularly, we have focused on experiences related to diagnosis announcement, hospitalisation and treatments and consequences on their social, psychological and somatic behaviour. PATIENTS: Forty-one patients cured of ALL have been enrolled in the study and answered one interview with clinical psychologist or research nurse. RESULTS: Although 60% of the patients argued that they think rarely of their disease, 10% thought about it every day. Traumatic evidence was detectable in most of them. Physical pain was the most reported stress, mainly during hospitalisation (93%), as well as psychological suffering (83%). Afterwards, the mostly often-reported stress was psychological pain (61%). Sixty-six percent declared that they still experience psychological and health consequences at the time of the interview, in some cases reported as a handicap in their life. In 83% of the cases they considered themselves as cured, nevertheless fear of relapse persisted in 1/3. Ninety percent said they have a pleasant life, 56% did not like to talk about leukaemia and 70% thought they could have died. For 85%, disease has been the most important event of their life and 75% testify to repercussions of the disease on their family (family relationship changes, overprotection, siblings difficulties). CONCLUSION: Most of these patients declared to be 'as the others' and developed life projects, but overcoming the pain experience of the disease remained difficult. This study emphasized the need for long-term continuous information and reinforces the importance of addressing treatment psychological and physical pain mainly after the initial hospitalisation period.

[Early diagnosis and treatment of cytomegalovirus polyradiculoneuritis in a child infected by HIV]. / Diagnostic précoce et traitement d'une polyradiculonévrite à cytomégalovirus chez un enfant infecté par le VIH.

BACKGROUND: Axonal polyradiculopathy due to cytomegalovirus (CMV) in AIDS has been reported in adults but it is not well documented in children. OBJECTIVE: We describe the elements of diagnosis and the outcome after anti-CMV therapy in a pediatric case. CASE REPORT: A 11-year-old boy with post-transfusional AIDS and low CD4 count (< 50/mm3) suffered from bilateral leg pain and weakness progressing within 15 days to paraplegia and cauda equina syndrome. Electromyography showed pure axonal neuropathy. Examination of the CSF showed increased proteins, low glucose concentration, neutrophilic pleiocytosis and positive detection of CMV by polymerase-chain reaction. The CMV viremia was positive. Treatment with ganciclovir and foscarnet allowed dramatical clinical improvement. Retinitis occurred during the maintenance therapy and was cured after reintroduction of the initial doses of ganciclovir and foscarnet. The child died five months later from a bacterial pneumopathy. CONCLUSIONS: Children with advanced AIDS may benefit from early recognition and treatment of CMV polyradiculopathy. The interactions and cumulated toxicities between anti-CMV and anti-retroviral drugs must be considered. The prognosis remains poor for CMV neuropathy due to the severe immunodepression caused by the HIV infection.

[Craniopharyngioma. A relatively uncommon etiology for an amenorrhea at the age of 45. Apropos of a case]. / Le craniopharyngiome. Etiologie peu commune d'une aménorrhée à l'âge de 45 ans. A propos d'un cas.

In reference to a case of secondary, pseudomenopausal amenorrhea, due to a craniopharyngioma discovered late, the need for a complete hypothalamo-hypophyseal exploration of every secondary, non-uterine, normogonadotrophic amenorrhea is reminded. The semiological value of the titration of serum prolactin and hypophyseal tests in lesions which are not only hypophyseal but also hypothalamic, is emphasized. In conclusion, the determining diagnostic contribution of tomodensitometry in tumors of this region is presented.