The use of pulse transit time in diagnostics of sleep-disordered breathing in children.

INTRODUCTION: Sleep is the physiological state of the body where proper morphology and duration are indispensable for human functions throughout both, physical and mental spheres. Disordered breathing during sleep impairs its morphology and results in major disorders in any age group. Adverse effects of Obstructive Sleep Apnea Syndrome in children and poor availability of centers offering children's polysomnography call for a reliable and easily accessible screening method. AIM: The aim of the study were to evaluate the usefulness of pulse transit time in the diagnostics of disordered sleep breathing in children and to attempt to employ the parameter in screening tests. Pulse transit time is a physiological parameter determining the time needed for the pulse wave to travel between two measurement points. MATERIAL AND METHODS: Enrolled in the retrospective study were 153 patients (100 boys and 53 girls) suspected of obstructive sleep apnea syndrome who underwent polysomnography at I. Moscicki ENT Hospital in Chorzów. RESULTS: Statistically significant relations between apnea/hypopnea index and pulse transit time were observed in both, individual age groups and all of the patients. Pulse transit time results proved a negative correlation with apnea/hypopnea index values commonly accepted as a parameter concluding the polysomnography procedures. CONCLUSIONS: The results of the study indicate that pulse transit time measurements may find application in screening tests of sleep-disordered breathing in children.

Babies with myelomeningocele in Poland: parents' attitudes on fetal surgery versus termination of pregnancy.

BACKGROUND: Recent surgical advances have resulted in fetal surgery becoming an option for children with myelomeningocele (MMC). However, there is little information about the parents' attitudes towards such therapy. METHODS: Following a lecture on the current status and problems of fetal surgery for MMC, a 12-item questionnaire was administered to 58 parents of children with MMC. Questionnaire topics included knowledge of the disease and treatment options, as well as attitudes and concerns towards fetal surgery or termination of pregnancy. RESULTS: Following the lecture, 14 (out of 58) parents felt that knowledge of the disease would allow for abortion to be an option, while 18 were uncertain. Once informed of potential risks and benefits of fetal surgery, 34 parents had a positive or rather positive attitude towards this procedure. CONCLUSIONS: On the basis of these results, it was concluded that this population is potentially interested in the use of fetal surgery.

[Influence of age in content of trace elements in pharyngeal tonsils from exposure and unexposure children]. / Rola wieku w ksztaltowaniu sie obecnosci pierwiastków fizjologicznych w migdalakch gardlowych dzieci w aspekcie biernego palenia.

This project is aimed to estimate the effect of passive smoke on the levels of selected trace elements (Ca, Mg, K, Na) in pharyngeal tonsils of children in several group of age (2-5 years, 6-9 years, 10-15 years). This trace elements were determined using ICP-AES method. It was concluded that the exposure to the cigarette smoke in pharyngeal tonsils is a factor producing the changes in the levels of essential elements: geometric mean of Ca was the highest in pharyngeal tonsils of children in 10-15 years old unexposure to ETS (410 microg/g). The least level of Ca - 281 microg/g was observed in this samples in the same group of age, but in children exposure by ETS. High levels of K was observed in pharyngeal tonsils of children exposure to passive smoking in all of group of age to comparison to unexposure by ETS. The greatest content - 27479 microg/g was in pharyngeal tonsils in exposure to ETS in 6-9 years old was observed, but the least - 16478 microg/g in 10-15 years old. Change of content of Mg was from 764 to 784 microg/g in samples from children exposure by ETS to comparison 720-744 microg/g in children unexposure by ETS. High level of Na was observed in pharyngeal tonsils from children exposure to ETS in all of group of age to comparison to unexposure. This study showed that the kind of interaction dependent on age and exposed by ETS. The changes of given elements were different for children passive smoking and no passive smoking in several group of age.

[Trace elements concentration in pharyngeal tonsils from exposed and unexposed to ETS children in refer to sex and places of living]. / Wplyw biernego palenia na zawartosc pierwiastków fizjologicznych w migdalkach gardlowych w nawiazaniu do plci i miejsca zamieszkania.

The aim of this study was investigation influence sex and place living (industrial region or village) to concentration of: Ca, K, Mg and Na in pharyngeal tonsils (n = 84) from children exposed and unexposed to tobacco smoke and analysis kind of interactions between trace elements. Determination of these elements contents were performed by ICP-AES. It was found higher concentrations of Ca and Na in pharyngeal tonsils from boys (389 microg//g) and girls (356 microg/g) unexposed to tobacco smoke to comparison to expose to ETS boys (304 microg/g) and girls (298 microg/g). Higher concentrations of Ca and Na was found in this samples from children unexposed on ETS, living in industrial area to comparison to unexposed to ETS children living in village region. Higher concentration of K and Mg was found in exposed to ETS girls and boys in comparison to unexposed to ETS children, and higher level of these metals were found in exposed to tobacco smoke children living in industrial region and village.

A comparative study of cefaclor vs amoxicillin/clavulanate in pediatric pharyngotonsillitis.

BACKGROUND: Pharyngotonsillitis (PT) caused by group A beta hemolytic streptococci (GABHS) is one of the most common infections of childhood. Two antibiotic suspensions, cefaclor (CEF) and amoxicillin/clavulanate (AMC), are commonly used in Poland for the treatment of PT caused by GABHS in children. MATERIAL/METHODS: This multi-center, randomized, single-blinded study was undertaken in order to compare the efficacy and safety of CEF (20 mg/kg/d) and AMC (25 mg/kg/d) in 10 days treatment of GABHS-related PT. 100 children (mean age 6 years) were enrolled into the study. Clinical and bacteriological assessments were done on the 14-18 th, and 38-45 th days after randomization. RESULTS: No GABHS strain isolated from throat smears was resistant in vitro to both antibiotics. Both antibiotics had almost 98% effectiveness at the post therapy visit. On follow-up, significantly more relapses and recurrences were observed in the AMC-treated group than in the CEF-treated group (relapse rate 21.28% vs 15.56%, p<0.02, recurrence 10.64% vs 6.66%, p<0.002). The relapse odds ratio in the AMC group was 1.7 times greater than in the CEF group, and recurrence was 1.5 times higher. There were significantly higher rates of gastrointestinal adverse events in children treated by AMC (p<0.02). CONCLUSIONS: CEF provides a clinically and bacteriologically effective treatment for children with PT caused by GABHS, comparable to AMC but significantly safer in terms of gastrointestinal side effects. AMC shows a greater risk of relapse and recurrence than CEF.