ques. However, the superiority of piezosurgery in terms of nasal airflow, olfactory functions and quality of life were not found in the long term.Disabled child, care and ethical aspects. The child's doctor occupies a privileged place in the life of a child with a disability. At all times, he must be an adviser, favouring a global approach and support to ensure optimal autonomy. Discovery of a neurodevelopmental disorder justifies a systematic search for the various causes known to date. Identification and knowledge of a precise diagnosis is an essential element in constructing the life plan for a disabled child. The announcement of the diagnosis is an integral part of the care system, it only makes sense when combined with tailor-made and step by step support. This requires that the doctor has a good knowledge of the main childcare structures, guidance agencies, and available financial aid.  https://www.selleckchem.com/products/hc-258.html  Multidisciplinary consultations enable a global approach to support a child with a disability. More children with disabilities become adults as medical care progresses. Transition from "children" to "adult" consultations represents a major challenge. However, some cases could be life-threatening. The decision on whether to continue the various therapies have to be considered and discussed with the child and his family, with reference to the notion of "unreasonable obstinacy". Drafting an individual certificate of "remarkable patient" will best help the implementation of end-of-life support measures.Pediatric informed consent in medical care and research. The obligation to obtain informed consent from a patient prior to any care does not depend solely on the personal ethics of the practitioner. It is defined and framed by law. However, innumerable legal difficulties emanate from the simple fact that the subject is a child, a vulnerable person who must be protected, and that this protection is exercised under the aegis of the parental authority. If in most cases there is an alliance with the holders of parental authority, the views sometimes diverge. The article lists the most frequently observed cases in clinical practice and the way in which the french Public Health Code plans to solve them. Problems specific to research are discussed. Difficulties for consent about off-label prescribing are briefly exposed.Minor's medical information. In exercising parental authority, parents make medical treatment decisions on children's behalf. However, according to the French law, minors must receive clear medical informations and care-givers must seek their consent to treatment. In some situations, parental authority may be in conflict with child's will. This article examines legislative framework provided by the French law, to respect child's autonomy and situations in which parental authority is limited. In practice, the concept of child's 'best interests' remains the main key to resolve potential conflicts between parental authority and child's autonomy.Announcement of a serious illness to a child. Critically ill children should be directly informed about their illness, in a way that is appropriate to their age, family context and alliance with themselves and their parents. The process of the announcement of the diagnosis does not correspond to an isolated moment but must be conceived in successive stages, respecting a different rhythm of progression in the child and in each of his parents, even if sometimes the clinical circumstances require the initiation of treatment fairly quickly. The synthetic principle of informing "without violence or betrayal" guides the conditions for the announcement of the diagnosis of pediatric serious illness, both to parents and to the sick child.Young athletes and doping in sports. Prevalence of doping among young athletes (whether children or adolescents) reaches 3 to 5%. In France, this result means that, on average, 240.000 people could be involved. This percentage, which is greater in boys, rises with age and especially with sports involvement (number of hours of sport per week, practicing competitions or at high levels). Looking for performance constitutes the very main determinant of this behaviour. Physicians may contribute to doping prevention through systematic early identification. Some clues, but not pathognomonic, may help, such as low self-esteem, displayed anxiety, easily influenced by peer pressure, strong expectations for results, fear of failure, intention to try expressed by the youth, use of other substances (tobacco, alcohol, cannabis).Rickettsioses. Rickettsioses are caused by intracellular bacteria from order of rickettsiales. They are transmitted by arthropods, mainly ticks, lice, fleas or other species close to chiggers, mainly in tropical areas. Some rickettsioses are endemic in France and others can be seen in patients returning from travel, including those presenting with "fever of unknown origin". Rickettsiae can't be isolated by conventional blood cultures in the laboratory. The diagnosis of rickettsial diseases is often made by serology, but specific PCR based on the swab of an inoculation eschar when it is present is a simple and rapid tool. The standard treatment for rickettsioses is doxycycline, that should be started as soon as clinical suspicion occurs, before diagnostic confirmation since some rickettsial diseases can be fatal.Asthma and allergy what about the differences between men and women? Allergic asthma is a chronic pulmonary disease characterized by bronchial hyper responsiveness, hyper production of mucus and remodeling of the airways. Asthma, which often begins before the age of 5, is the most common chronic disease in children and affects approximately 10% of the population in affluent societies. As it is the case for many allergic diseases, asthma affects men and women differently. In childhood, pathology is more common in boys, but this trend reverses at puberty, suggesting a regulation by sex hormones. In this review, we summarize the current knowledge on how sex hormones impact allergic inflammation and particularly describe the protective actions of androgens on the development and function of key immune cell subsets involved in allergic responses.