With the purpose of evaluating the possibility of describing hemodynamic pulmonary edema in infants with congenital heart disease using the previously suggested sonographic phenomena “alveolar consolidation” and “interstitial syndrome” in adults, 131 children of both genders were examined at the age of 1-246 days. Of these infants, 47 had congenital heart anomalies, 51 had chronic somatic pathology and patent foramen ovale, and 33 had a somatic pathology associated with either congenital heart disease or small heart abnormalities. The duration of observation and the number of sessions of ultrasound scanning were determined by the health status dynamics of the infants. All infants were described in terms of 179 characteristics of physical examination and laboratory and instrumental findings obtained through standard procedures. Echocardiography and ultrasound lung scans were performed with LOGIQ E (General Electric) and HD11 (Philips) using linear, convex, and sector transducers (7-12, 3-5, and 1.7-4.0 МHz respectively). In addition to standard protocols of heart and lung description, we also registered the square of consolidated parcels summarized for all lung segments, the number of B-lines summarized for all lung segments, and the swing of diaphragm and lung movement and calculated the diaphragm and lung swing ratio. An attempt to describe the differences between pulmonary circulation in terms of ultrasound sonography for heart defects associated and not associated with blood filling in the lungs was successful. The total area of air-free/consolidated subpleural parcels of lungs and the extent of interstitial lung syndrome were the most informative sonographic characteristics. It was concluded that interstitial edema and alveolar consolidation, described in terms of transthoracic ultrasound sonography, are recommended for use as markers of the disorders of pulmonary circulation associated with congenital heart malformations in infants.

Nasopharyngeal malignant tumors are mainly represented in pediatrics by undifferentiated carcinoma nasopharyngeal tumors (UCNT). It is a rare entity. The aim of our work is to analyze the epidemiological, clinical, therapeutic and evolutionary aspect of children and young £ 20 years with nasopharyngeal cancer. Patients and methods This is a retrospective study of 38 patients diagnosed with a UCNT between January 2012 and December 2018 and treated in the department of oncologyradiotherapy of the CHU Hassan II of Fez. Results The age of our patients was between 10 and 19 years, with a middle age 14.7 years, the most affected age group was 10 to 15 years (70%), the sex ratio was 1.2. Diagnosis is often delayed with a revealing symptoms dominated by cervical adenopathy (85%). 85% of patients were classified T3-T4 and 60% were classified N2-N3 with 4 metastatic patients. Treatment was based on neoadjuvant chemotherapy (in 95% of patients) as well as on concomitant radio-chemotherapy. 3 patients were lost to follow-up. Acute toxicity was characterized by radio mucititis (100%) and radio dermatitis (60%) in patients receiving IMRT radiotherapy, hyposialia (55%), hypoacusis (44%) and trismus%) for those who received 3D conformal radiotherapy, with a lower delayed toxicity for IMRT (only 3 patients who presented with hyposialia). The evolution was marked by a good loco regional control in 55%, a loco regional recurrence in 10%, and remote metastasis in 15%. Thus, the overall survival was 85% and the survival without relapse was 50%. Discussion The prognosis of this cancer remains poor considering the locally advanced forms (high frequency of stages III and IV) and the frequency of recurrences. Conclusion Improving the prognosis of this cancer requires early diagnosis and more accessible and developed medical infrastructures. The recent advances in conformational radiotherapy by intensity modulation will have to be the main technique of treatment of all our patients.

The study included 39 children with pulmonary diseases (respiratory distress syndrome, bronchopulmonary dysplasia, and neonatal pneumonia) of both sexes, aged 1-111 days (experimental group) and 84 children aged 1-166 days with diseases not associated with heart and lung lesions (control group). Group of children with lung disorders included respiratory distress syndrome, bronchopulmonary dysplasia and congenital pneumonia. Children with respiratory distress syndrome and congenital pneumonia were examined in the first days after birth. Children in this group were underweight at birth (from 680 g, the majority with a weight of up to 1600 g), their state at the time of the first survey was qualified as severe. About a quarter of children with lung disorders and had a congenital heart disease. The most informative dates for the description of a condition of newborn’s lungs is were the strengthening of pulmonary drawing on the roentgenogram at the expense of an interstitial component, decrease of pneumatization of lung tissue and the size of total area of airless subpleural lung tissue at ultrasound investigation. Lung ultrasound provides accurate information about the amount density of B-lines and areas of consolidation in the lungs and is comparable with the radiological diagnostic characteristics which become the basis for more complicated differential diagnostics of the pulmonary disorders. This will allow physicians to specify certain indications for an ultrasonic exam of the lungs, optimize diagnostic means, and more clearly formulate conclusive rules in the differential diagnostic process.