An increasing amount of polysomnographic studies are performed in early infancy. Complete pediatric sleep laboratory systems are commercially available and provide fast and exhaustive results if operated by trained personnel. Experience in evaluation is necessary, because a broad range of possible diagnostic findings exists, and artifacts are common. Based on longitudinal studies in 31 healthy infants, we present reference values for several polysomnographic parameters. Aberrant results must be interpreted in the context of patient's history, clinical state, and additional laboratory findings. In presence of a clearly defmed indication for polysomnographic testing, clear therapeutic and interventional strategies can be derived. Possible consequences include the stimulation of the respiratory drive by drugs with subsequent polysomnographic control of therapeutic effect, a transfusion, the prescription of a home monitor, and the recommendation of further diagnostics or of control polysomnographies. In conclusion, infant polysomnography is an important diagnostic tool in pediatrics.

Cost-Benefit Analysis↗

PubMedDate not supplied

[Nasal glioma as a rare cause of obstructed nasal breathing in a newborn infant].

Congenital midline nasal masses are rare entities occurring once in 20-40,000 births. They are often misdiagnosed or even missed. These tumors are most commonly present in newborn infants and children, but rarely they can be discovered in adults as well. The differential diagnostic possibilities are dermoids, gliomas, encephaloceles and epidermoid cysts. Although they are benign, they have the potential for disfigurement, destruction and causing a meningitis, therefore they require prompt diagnosis and management. Because of a possible connection to intracranial structures a complete radiologic evaluation is essential. The treatment for these nasal masses is surgical resection, endoscopically controlled procedures are preferred. We report the case of a newborn with respiratory distress shortly after birth. The infant was discharged from the hospital, because the unexplained symptoms were not progressive. After a few days the child was send to an otolaryngologist, who found a suspicious mass near the top of the nose and performed a biopsy. At 20 days of age the infant was brought to our children's hospital for additional diagnostic procedures and therapy. The MRI showed a soft tissue mass (1.2 x 0.7 x 1.1 cm) in the nasal cavity. There was no clear-cut evidence of an intracranial extension, for further evaluation a radionuclide scan was performed. This confirmed the integrity of the base of the skull. 6 weeks after the birth a smooth tumor was successfully removed by an endoscopically controlled operation. Histopathologic studies confirmed neuroglial tissue. Because of ist rare incidence, many physicians are not familiar with the diagnosis and management of these tumors. Respiratory abnormalities in newborn should always lead to a careful physical examination and complete radiologic evaluation, i.e. MRI, CT and radionuclide scan.

Airway Obstruction↗

PubMedDate not supplied

[Pediatrics in the tropics].

The authors attempt to give a short review of key problems of paediatrics in tropical countries. The contribution is based on their experience with teaching and as practicing paediatricians in Ethiopia. The profound differences of background and general conditions lead to different priorities of practical work as well as of teaching students (particularly from developing countries). Basic information on the children's situation in developing countries, where the vast majority of today's children live and are immediately affected by so-called global problems, should be known to all paediatricians.

Child↗

PubMedDate not supplied

Pharmacokinetics of disopyramide in the dog. Importance of mono-N-dealkylated metabolite kinetics in assessing pharmacokinetic modeling of the parent drug.

The antiarrhythmic drug disopyramide (DP) is metabolized to the mono-N-dealkylated compound (MND) and to the pyrrolidone derivative (PYR). This study examines the detailed pharmacokinetic characteristics of DP and MND when given simultaneously or separately to dogs. DP and MND were both relatively well absorbed and showed similar pharmacokinetic characteristics. However, the amount of PYR relative to MND as judged by the area under the plasma concentration-time curves (AUC) following oral or iv administration was much greater with DP than with MND. These findings were also supported by the urinary excretion values where the PYR/MND ratio with DP was much greater than with the MND administration. For an explanation of this phenomenon, plasma concentration-time curves for DP, MND, and PYR were simultaneously analyzed assuming various pharmacokinetic models. The plasma levels of these compounds were best described when nonlinear kinetics were assumed for conversion of MND to PYR.

Absorption↗

PubMedDate not supplied

[Immune cell alterations in juvenile rheumatoid arthritis].

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Antibody-Producing Cells↗

PubMedDate not supplied

[Diphenylamine reaction as an activity parameter in the course of adjuvant arthritis of rat].

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Amines↗

PubMedDate not supplied

[The spontaneous NBT-test in granulocytes of patients with juvenile rheumatoid arthritis].

30 patients with definite seronegative juvenile rheumatoid arthritis and 3 patients with tendosynovitis and unclear arthralgia respectively were examined by the nitroblue tetrazolium (NBT) test (46 tests). A positive result could be obtained in 72 per cent of the examinations. Patients with a joint manifestation of juvenile rheumatoid arthritis showed relatively more positive results than patients with Morbus Wissler and the transition forms of juvenile rheumatoid arthritis. Tendosynovitis and unclear arthralgia were negative in the NBT test. The NBT test is not useful for the differentiation of bacterial-septic and rheumatoid-inflammatory joint diseases.

Arthritis, Juvenile↗