[Caries free smile: a dental health educational programme]. / "Souris sans carie": une campagne d'éducation bucco-dentaire pluridisciplinaire.

UNLABELLED: A multidisciplinary team associating members from the hospital, national education and local council sectors prepared, and led, a carie-free smile educational campaign in Toulouse. OBJECTIVES: The aim was two-fold: to teach children how to manage their routine oral hygiene while giving a positive image to health care-hence the carie-free smile theme chosen by the team; secondly, to promote an awareness campaign targeting professionals in the education sector (public health sector, independent paediatricians and odontologists) who together constitute the transmitters of our initiative. MATERIAL AND METHODS: The action involved 12,000 children in the 5-8-year age group from 76 public and private schools, 36 kindergarten and primary school leisure centres, six holiday centres together with infant patients from the children's hospital, all of whom were volunteers in the scheme. The team produced back-up material in the form of posters, booklets and stickers; there was also a website dealing with oral hygiene themes, caries and their treatment. Those taking part included practising dentists and students of dentistry. Before the presentation, posters were sent to teachers and other educational partners so as to prepare the children; this included an interactive phase in the presence of the teacher, and a brushing session. Each child was given a booklet, a sticker and a toothbrush. RESULTS: By means of a poll organised among the partners the impact of the campaign could be assessed: firstly, on teachers and children by evaluating their motivation in the setting up of the toothbrushing session in 17 classes following the midday meal, thus appraising their appreciation of the visual material, and secondly, to the dentistry students: the future dentists had noted disparities in oral hygiene practices according to residential area, and thus could appreciate the importance of early provision in the school curriculum, as well as the value of accomplishing this health education task in the daily exercise of their profession.

Post graft development of short children treated with growth hormone before kidney graft.

Sixteen prepubertal patients with chronic renal failure (CRF) were given daily recombinant human growth hormone (rhGH) treatment (1.2 IU/kg per week) for 2.6+/-1.6 years until kidney transplant. Therapy was then discontinued and the patients followed for a further 3. 5+/-1.4 years. During treatment, mean height increased from -3.0+/-0. 9 standard deviation score (SDS) to -1.9+/-1.4 SDS (P<0.001) at the time of transplantation, corresponding to a mean height gain of +1. 2+/-0.9 SDS. After discontinuation of rhGH therapy, prepubertal children continued a partial catch-up growth with a height gain of +0.5+/-0.8 SDS for the follow-up period. Conversely, negative changes of height were observed in pubertal transplanted children: -0.5+/-0.4 SDS in patients grafted at early stages of puberty (P2-P3) and -0.15+/-0.9 SDS in patients grafted at late stages of puberty (P4-P5). These data confirmed the benefit of rhGH therapy in CRF patients. Nevertheless, only early initiation of rhGH treatment led some of these patients to their target height at transplantation, thus preserving their potential growth. Reinitiation of rhGH therapy after transplantation should be considered in order to complete catch-up growth to target height in prepubertal children.

Plasma exchange therapy in pediatric patients. Plasma filtration with a unipuncture technique.

Therapeutic apheresis in children is limited by technical considerations, such as circuit blood volume, venous access and hemodynamic instability. Here we report our experience with 310 plasma-filtration sessions in 44 children (aged 9 months-17 years). We used a miniaturized circuit with a unipuncture technique and a "balancing system" which assured a permanent fluid equilibrium. This procedure is well adapted to children and always made pediatric plasma exchange therapy easier and safer. The more common indications remain Guillain-Barré syndrome and acute severe glomerular diseases.