Retinoblastoma corresponds to a cancerous tumor of the eye, which affects the cells of the retina. His diagnosis is relatively straightforward, is still too late. To remedy this, the Institut Curie has developed genetic counseling.

Serious but rare (1 in 15,000 to 20,000 births), retinoblastoma affects the cells of the retina in infants and young children. Often hereditary, this disease can affect one eye (60% of cases) or both.

A white reflection in the pupil (leukocoria) or the resistance of strabismus are signs to be taken very seriously and requires an eye examination as soon as possible. Indeed, early diagnosis is a key element that determines the possibilities of conservative treatment and visual prognosis of the child. Too late, it may even affect the prognosis.

Major therapeutic advances have been made in recent years. The treatments of today, more and more effective, can cure up to 95% of children in developed countries. It is now vital to improve early screening.

With the identification of the retinoblastoma susceptibility gene and the subsequent development of genetic tests estimating the risk of each tumor, the Institut Curie has developed genetic counseling, “they are for families with retinoblastoma. Research a genetic predisposition, now offered to all children who have retinoblastoma, can either raise ophthalmologic monitoring in relatives that are not carriers of the predisposition is to further improve the monitoring of related carriers. ”

Researchers from the Institute Curie also state that this test may be offered to adults who have had retinoblastoma in childhood, to determine whether there is a risk to their offspring.

Children are not spared this terrible disease that is cancer. To provide accurate information as clearly as cancer, parents and the environment, experts have made sheets of high quality to their attention.

Because childhood cancers are different from adults, practitioners of pediatrics at the Institut Gustave Roussy, Villejuif (IGR, the first European center for fighting against cancer) were mobilized to disclose information to the general public. Often uninformed, vulnerable and can not be more anxious, parents and entourage are bombarded with questions, they often have not raised during the consultation. Back at home, the concern is not fading.

All this quality information is updated and available on the website of the RMI.Validated by experts, edited and annotated by parents and neophytes in the field, it comes in the form of fact sheets describing these diseases, their classification, diagnosis, different supported and monitoring of young patients. Currently available data on nephroblastoma, Hodgkin’s disease, malignant mesenchymal tumors, liver tumors, malignant non Hodgkin lymphomas and bone tumors. But many other forms, which will also involve all stakeholders in town (liberal doctors and nurses) to optimize the care of young patients after discharge from hospital, are being prepared.

In children, the cancers are considered rare diseases, but with 1,800 new cases per year in France. In recent years, progress in this field have been considerable. Today, two out of three pediatric cancers are cured.

Fighting at home against allergens and passive smoking is bearing fruit. According to the results of a study conducted over two years, children with asthma have fewer symptoms and a gain of 34 days without wheezing.

The urban areas more exposed to indoor allergens and passive smoking. In return, the urban children with asthma suffer from significant complications.

Is it enough to fight at home against allergens to improve conditions for small asthmatics?

To answer this question, a study was conducted among 937 asthmatic children aged 5 to 11 years and residing in various U.S. cities. These young patients had been hospitalized at least once during the last six months or twice led the emergency room for their asthma and had a positive test to an allergen home.

Half of the parents of these children have received the knowledge necessary to fight against environmental factors, focusing on the profile of their child: mites, cockroaches, tobacco smoke, rodents, pets, etc.. They also received training and adequate equipment: waterproof coatings on the mattress and pillow, vacuum cleaner with a special filter, air purifier, etc..

Every six months, the allergens were collected and analyzed at home.
Meanwhile, the number of days with asthma symptoms was recorded: wheezing, coughing, disturbed sleep, reduced activity because of asthma.

Two years later, the authors found fewer days with symptoms in children living in an environment made less allergenic. Of a total of two years, there has been a gain of 34 days without wheezing. In parallel, the domicile of children whose parents have applied the anti-allergen were significantly healthier and reducing allergens was correlated with fewer complications of asthma.

These results demonstrate the effectiveness of measures Allergen avoidance and impact on symptoms of asthmatic children.

The links between asthma and bronchiolitis are discussed. For years it was thought that the bed of bronchiolitis asthma. Since then, studies have shown that the future of bronchiolitis depended on the severity of the initial infection. A new study confirms that three episodes of severe bronchiolitis is a risk factor for subsequent development of allergic asthma.

During childhood, some children suffer from multiple episodes of bronchiolitis. And from the third episode, we speak of “asthma in infants. However, the move towards asthma in adulthood depends on the severity of bronchiolitis and is closely related to atopy, that is to say that there is a family history of eczema, of allergies or asthma.

In this study, children were followed until the age of 13 years: 47 children hospitalized for bronchiolitis and 97 control subjects. Those who had at least three episodes of wheezing, or in whom the diagnosis of asthma was made by a physician, were considered as asthmatics.

The authors find that the occurrence of respiratory symptoms was significantly higher in the bronchiolitis group than in control children, respectively 43% against 8% for asthma and 39% against 15% for allergic rhinoconjunctivitis.

Meanwhile, skin tests and assays of antibodies (anti-IgE) showed that awareness of common allergens was more common among children who have bronchiolitis than in the control group: respectively 50% against 28% for skin tests positive and 45% against 26% for anti-IgE.

The authors conclude that episodes of severe bronchiolitis in infancy can be considered as a risk factor for developing allergic asthma in adolescence.

Recall that bronchiolitis is an acute inflammation of the bronchioles of viral origin, progressing to respiratory distress. It occurs mostly in children under two years. In most cases, this infection, impressive for parents, is benign. But in some severe cases, treatment is based on chest physiotherapy designed to unclog the airways tract. Are sometimes prescribed bronchodilators or antibiotics, which, ineffective against viruses, used only if a secondary bacterial infection.

The community has input into the effect of exposing children to early infections. This exhibition is her protector, for example by inducing a sort of immunity against the officers met before? Or conversely, is it harmful in increasing the risk of allergy and asthma?

1. Allergic manifestations in community

The answer to this question is difficult, so the results of published studies on this subject are contradictory. A new study provides convincing evidence.
This analysis focused on Swedish more than 10,000 children aged 1 to 6 years. Questionnaires were used to gather data on respiratory and allergic symptoms, family environment and the type of care for these children.

2. Increase gross symptoms of asthma and allergy

The conclusion is unequivocal, children cared for in institutions have many more symptoms of asthma and allergies than others. This dramatic increase is especially important in young children 1 to 4 years.
This result is in contradiction with many other epidemiological studies, which are also at the origin of the theory hygienist.

Thus, in the small community kept, allergic symptoms are potentiated in proportions ranging from 12% to 160%:

+ 33% of wheezing
+ 56% of nighttime cough
+ 23% of asthma
+ 15% of rhinitis
+ 75% of hay fever
+49% of eczema
+27% of allergic reactions to food
+160% hay

The type of care is associated with an increased risk of respiratory symptoms, eczema and allergic food reactions. In this study, the community does not give any sign of protection vis-à-vis the allergies in children 1 to 6 years.

In practice, to the extent possible, the development community should not be too early, and this, even if there is family history of asthma and allergy.
And of course, we must ensure that the immunization schedule is up to date …

Project Home Individual (PAI) proposed the establishment of specific provisions for children with asthma or allergies can go to school like other children. Even if the new school took place one month ago, it is not too late to make this move.

1. Project Home individualized for children with asthma and allergy

Project Home Individual (PAI) is prepared at the request of the family, the director of the school in consultation with the school physician, based on recommendations made by the doctor who follows the child.
The goal is to make the school possible and in good conditions for the child, and for that to facilitate communication between family, doctors and teachers.

The IBP provides four major provisions:

• The child is allowed to take medication at school (oral, inhaled or injected).
• If necessary, he can receive appropriate emergency care.
• Special facilities are provided to improve living conditions at the school.
• In the canteen, he can receive appropriate meals or a packed lunch prepared by the family.

2. Drugs and emergency care at school

Regarding care in schools, it is advisable to ask the doctor who follows the child to take stock of his condition and his needs, then send an accurate report to the medical school. It is so well informed by a colleague and has written a solid foundation.

The family must prepare and maintain medical kit remains available to the teachers. It must contain the drugs really necessary with the order and be monitored regularly to verify that nothing is missing and renew the expired medicines. It should be simple to use, easy to transport the child to follow her wherever and placed in a location following the methods of storage of drugs (temperature, light, humidity …). Finally, it must include the PAI, emergency protocol and a telephone directory (hospital emergency department, physician, parents).

3. Organization and composition of meals

In case of special dietary requirements, there are several solutions:

• Parents consult the menu and provide a meal replacement when a dish is risky.
• Parents provide their own packed lunches.
• The community makes a specific adaptation: when preparing meals, food is forbidden replaced by another, a sauce is removed, etc..
• The community provides a menu: command from a provider or specialized agency that is free of allergens.

4. Tips to facilitate the implementation of the IAP

• Make personal contact with the school principal, the school doctor and communities.
• Meet the teachers and school staff (canteen, child care …) to inform them precisely specific care and responding to their questions and concerns.
• Asthma & Allergy Association, recommends to always promote dialogue, cooperation and avoid confrontation. And finally “understand that school is not a place of care, that staff are not health professionals and they have many other pressures to bear.”

The sport is beneficial to children with asthma: it increases the breathing capacity, decreased breathlessness and intensity of crises. Asthmatic children have a vested interest in not neglecting physical activity, even at school. Some instructions for the small asthmatics take full advantage of sports activities.

The sport is recommended for children with asthma. The first condition is to take treatment correctly and stay on his own emergency treatment (inhaler).

The 7 rules of the young asthmatic athlete

1. Have in his pocket rescue treatment.

2. Take medication before exercise if the doctor deems necessary.

3. Warming up gradually

4. Do not go beyond its limits.

5. Do not stop abruptly.

6. Drink before, during and after exercise.

7. Adapting his dress when it’s hot or cold.

Contrary to popular belief, a study shows that children raised in their first years at the touch of a furry friend (dog, cat …) have a lower risk of developing allergies later.

Historically, it discourages families from having a pet in the house, because it can increase the risk of becoming allergic later. Today, the results of a U.S. study from 474 infants followed from birth until the age of 7 years, we argue exactly the opposite.

The researchers simply compared a group of 184 babies who lived along with at least two dogs or cats, a group of 220 babies without close contact with animals.

Surprise at the age of 7 years, children living with our animal friends have two times less likely to become allergic by skin tests to detect the conventional condition.

These results are consistent with the theory that the hygienist number of children with asthma is increasing as our lifestyle becomes more and more sanitized.

Thus, when children play with pets, they lick and the number of transmit and bacteria that contribute to changing the way our immune system responds to potentially allergenic substances.

Fighting at home against allergens and passive smoking is bearing fruit. According to the results of a study conducted over two years, children with asthma have fewer symptoms and a gain of 34 days without wheezing.

The urban areas more exposed to indoor allergens and passive smoking. In return, the urban children with asthma suffer from significant complications.

Is it enough to fight at home against allergens to improve conditions for small asthmatics?

To answer this question, a study was conducted among 937 asthmatic children aged 5 to 11 years and residing in various U.S. cities. These young patients had been hospitalized at least once during the last six months or twice led the emergency room for their asthma and had a positive test to an allergen home.

Half of the parents of these children have received the knowledge necessary to fight against environmental factors, focusing on the profile of their child: mites, cockroaches, tobacco smoke, rodents, pets, etc.. They also received training and adequate equipment: waterproof coatings on the mattress and pillow, vacuum cleaner with a special filter, air purifier, etc..

Every six months, the allergens were collected and analyzed at home.
Meanwhile, the number of days with asthma symptoms was recorded: wheezing, coughing, disturbed sleep, reduced activity because of asthma.

Two years later, the authors found fewer days with symptoms in children living in an environment made less allergenic. Of a total of two years, there has been a gain of 34 days without wheezing. In parallel, the domicile of children whose parents have applied the anti-allergen were significantly healthier and reducing allergens was correlated with fewer complications of asthma.

These results demonstrate the effectiveness of measures Allergen avoidance and impact on symptoms of asthmatic children.