Baby sleeping bag and conventional bedding conditions--comparative investigations by infrared thermography.

BACKGROUND: Thermal stress is a risk factor for sudden infant death syndrome (SIDS). Recently, baby sleeping bags have been recommended as a preventive measure against SIDS. The aim of this study was to describe in which way the use of baby sleeping bags might influence thermoregulation of sleeping infants and maybe the incidence of SIDS. METHODS: Body surface temperature was recorded by use of infrared thermography in 15 infants (median age 49 days). Recordings were done twice: after sleeping for 60 min under a blanket and after sleeping for 60 min in a baby sleeping bag. Temperature was recorded and compared for defined sites of body surface. RESULTS: Infants' mean body surface temperature as well as core temperature after sleeping in a baby sleeping bag did not show significant differences when compared to infants sleeping under a conventional blanket. CONCLUSION: Under controlled conditions, core temperature and mean body surface temperature are comparable, equally if using a baby sleeping bag or conventional bedding. However, under the more uncontrolled conditions of baby care at home, sleeping bags might provide a more constant temperature profile, while other bedding conditions may lead to significant variations of temperature pattern.

Acylated ghrelin increases after controlled short-time exercise in school-aged children.

Ghrelin is a peptide hormone, which plays an important role in appetite regulation. The effects of exercise on ghrelin plasma concentrations are still not clear, especially in children and adolescents. The aim of this study was to investigate the response of acylated and total ghrelin concentrations to controlled exercise in school-aged children. Thirty-six healthy school-aged children (mean age 12.61 years, SD ± 0.39) underwent a controlled bicycle exercise test. Before and immediately after exercise, blood samples were taken in order to measure plasma ghrelin concentrations. The control group consisted of 24 healthy school-aged children. After controlled short-time exercise, total ghrelin concentrations showed no significant difference, whereas acylated ghrelin concentrations increased significantly (P<0.001) in the study population compared with the control group. Moreover, we found a correlation between the proportional increase of acylated ghrelin and the duration of exercise (P<0.01), and between the proportional increase of acylated ghrelin and maximal performance (P<0.01). Increased levels of acylated ghrelin after exercise could be a physiological response to ensure a sufficient caloric intake after energy consumption in children and adolescents.

Forearm and calf tissue oxygenation in term neonates measured with near-infrared spectroscopy.

Peripheral tissue oxygenation has been studied with near-infrared spectroscopy (NIRS) on either the forearm or calf with questionable comparability. The aim was to compare forearm and calf tissue oxygenation in healthy term neonates measured with NIRS. Fractional oxygen extraction, tissue oxygenation index, and mixed venous oxygenation were similar in both extremities, whereas oxygen delivery and oxygen consumption of calf tissue were higher.

Do wet diapers induce arousals in sleeping infants?

AIM: To find out whether simulated bladder voiding was able to induce arousals in sleeping infants. METHODS: Polygraphic recordings were performed in 34 infants and voiding was simulated by administering water into the diaper. RESULTS: Heart rate, respiratory frequency and electroencephalogram frequency did not change significantly during this procedure. Furthermore, simulated voiding was unable to cause an awakening or to induce body movements in sleeping infants. CONCLUSION: Simulated voiding was unable to induce arousals.

Peripheral oxygenation in term neonates.

The aim of this study was to analyse changes in peripheral oxygenation in healthy term neonates within the first week of life with near-infrared spectroscopy and venous occlusion. Oxygen delivery did not change with increasing age. Oxygen consumption and fractional oxygen extraction increased, whereas tissue oxygenation index decreased with increasing age.

Forearm oxygen consumption and forearm blood flow in healthy children and adolescents measured by near infrared spectroscopy.

UNLABELLED: The assessment of forearm oxygen consumption (VO(2)) and forearm blood flow (FBF) by means of near infrared spectroscopy has become widespread in adults, whereas in children and adolescents no data are available. The aim of the present study was to analyze VO(2) and FBF in healthy children and adolescents. METHODS: In a prospective cohort study, 20 male and 20 female healthy children and adolescents were investigated. The measurements of VO(2) and FBF were performed by means of near infrared spectroscopy in combination with the venous occlusion method. RESULTS: Mean VO(2) was 0.08 +/- 0.04 ml 100 g(-1) min(-1) in male and 0.09 +/- 0.05 ml 100 g(-1) min(-1) in female subjects. Mean FBF was 1.95 +/- 1.25 ml 100 g(-1) min(-1) in male and 1.82 +/- 0.98 ml 100 g(-1) min(-1) in female subjects. No significant difference was found between male and female subjects. A significant negative correlation of VO(2) and FBF to age was observed in both groups. CONCLUSION: In the present study we were able to show that VO(2) and FBF decreased with increasing age in children and adolescents without significant differences between male and female subjects.

Abnormally high serum ferritin levels among professional road cyclists.

BACKGROUND: An international, longitudinal medical follow up examination of male professional road cyclists revealed excessively elevated serum ferritin levels. OBJECTIVE: To evaluate the importance of elevated ferritin values among professional cyclists, their relationship with age and nationality, and their evolution over 3 years. METHODS: Over 1000 serum ferritin values were collected. Other parameters were included in order to exclude conditions which might have increased ferritin levels without changing body iron stores. RESULTS: In 1999, over 45% of riders displayed ferritin values above 300 ng/ml and one fourth levels over 500 ng/ml. These percentages had decreased to 27% and 9%, respectively, 3 years later, while the overall average, which was above the normal limits in 1999, had decreased by 33% in 3 years. Older cyclists had higher ferritin values than younger cyclists. There was also a relationship between ferritin levels and the nationality of the cyclists. Analysis of 714 riders in 2000 and 2002 showed only a slight and insignificant decrease in the mean ferritin value although those with initially elevated iron stores had a much greater decrease. CONCLUSION: Professional road cyclists used excessive iron supplementation leading to high serum ferritin levels correlating with increased body iron stores. Although the situation progressively improved over 3 years, it remains worrying as increased body iron stores are related to health complications. Therefore, prevention in addition to the fight against doping should be a main goal of the UCI. Aggressive therapy for athletes with excessive ferritin values should be carried out at or before the end of their careers.

Sudden infant death syndrome risk questionnaire: a mirror of parental awareness rather than a prospective diagnostic tool.

AIM: In 1989, a scoring system that aimed to identify infants at risk of sudden infant death syndrome (SIDS) by a structured questionnaire [SIDS risk questionnaire (SRQ)] consisting of 25 items was introduced in Styria (Austria). It was the aim of the study to compare SIDS rates in the population that had access to the SRQ with the population that had no access. Furthermore, for the population receiving the SRQ, the responding (compliant) and non-responding (non-compliant) groups were compared concerning the incidence of SIDS. METHODS: Within the study period, 53 865 births and 57 SIDS cases were recorded (incidence 1.06/1000) and analysed retrospectively. RESULTS: The incidence of SIDS was significantly higher in the non-responding population (2.36/ 1000) than in the responding group (0.81/1000, p < 0.001). However, the incidence of SIDS was not significantly different in the population that had access to the risk questionnaire (1.29/1000) and the group without access (0.86/1000, p = 0.145). CONCLUSION: The value of any questionnaire used for SIDS prevention may be limited by the existence of a non-compliant population which represents a risk group and should be targeted by other preventive measures.

Persistent hypercapnia in children after treatment of obstructive sleep apnea syndrome by adenotonsillectomy.

Obstructive sleep apnea syndrome (OSAS) in childhood is frequently in part a consequence of enlarged adenoids and/or tonsils and may lead to hypoxemia and hypercapnia during sleep. Whereas long-term blood gas alterations are well documented in adults, only few polygraphic data are available for children. It was the aim of this study to document blood gas alterations before and after treatment in this population. 9 children with OSAS (6 male, 3 female, median age 5.9 years, range 1.1-13.5 years) were investigated by polysomnography before and after adenotonsillectomy. Prior to intervention most children presented with moderate hypercapnia (ETCO2 mean 44.3 +/- 3.8 mm Hg, ETCO2 maximum 53.2 +/- 5.2) and hypoxemic episodes (oxygen saturation mean 93.2 +/- 3.2%, minimum 74.4 +/- 16.5%). Following adenotonsillectomy subsequent polygraphic investigations displayed normalisation of oxygen saturation (saturation mean 96.1 +/- 0.8%, minimum 90.1 +/- 3.1%). In contrast, moderate hypercapnia in several patients persisted up to five months after treatment (ETCO2 mean 44.9 +/- 2.8 mm Hg, ETCO2 maximum 51.2 +/- 3.6). Persistent hypercapnia most likely reflects an adaptation process of chemosensitivity and respiratory control due to preceding long-term hypercapnia.

Stroke following appendectomy under general anesthesia in a patient with basilar impression.

We report a boy who developed a vertebral stroke immediately after an appendectomy. Basilar impression was diagnosed eight years after this event when skull roentgenograms revealed basilar impression with high standing tip of the odontoid. We speculate that muscle relaxation and cervical hyperextension during intubation in the presence of basilar impression resulted in vertebral artery dissection and stroke. We suggest that patients with vertebral stroke and no obvious risk factors should be evaluated for the presence of malformations of the craniovertebral junction to be able to take precautions against excessive neck movement during intubation.

Correlation between cholesterol, soluble P-selectin, and D-dimer in obese children and adolescents.

Thirty-eight obese children and adolescents were investigated for a possible relation between cholesterol and markers of platelet activation, endothelial cell dysfunction, and activation of the coagulation system. Soluble P-selectin, von Willebrand factor antigen (vWf-Ag), D-dimer, and prothrombin fragment 1 + 2 (F1 + 2) were determined by enzyme-linked immunosorbent assays, and factor VIII coagulant activity (VIIIc) was measured by means of one-stage clotting assay. Cholesterol correlated significantly with log P-selectin (r = 0.43, P = 0.003) and log D-dimer (r = 0.33, P = 0.02). Cholesterol did not correlate with vWf-Ag, factor VIIIc, and F1 + 2. Log P-selectin correlated significantly with log D-dimer (r = 0.42, P = 0.003), which remained significant after adjustment for cholesterol (P = 0.02). Log D-dimer correlated significantly with F1 + 2 (r = 0.38, P = 0.01). Our study demonstrates that, in obese children and adolescents, cholesterol is significantly associated with P-selectin and D-dimer, and suggests an unfavorable intercorrelation between metabolic and hemostatic risk factors for coronary heart disease in childhood obesity.

[Ureaplasma urealyticum pneumonia and isolation of U. urealyticum from endotracheal tube aspirates of preterm and full-term infants]. / Ureaplasmapneumonien und Nachweis von Ureaplasma urealyticum im Tubussekret bei Früh- und Neugeborenen.

OBJECTIVE: Our purpose was to investigate how many preterm infants with a birth weight 1,250 g with clinical symptoms had Ureaplasma urealyticum in their endotracheal tube aspirates, and how many of them had pneumonia. METHODS: The patients were divided into two groups (group 1: birth weight 1,250 g, n = 45), and these two groups were subdivided into two subgroups (subgroup a: U. urealyticum in aspirate without pneumonia; subgroup b: U. urealyticum in aspirate with pneumonia). RESULTS: In group 1, there were 25 patients. Nine patients (36%) had U. urealyticum in their aspirates, 5 patients (20%) had pneumonia (group 1b), and 4 patients (16%) did not (group 1a). Infants with pneumonia showed a significant increase in parameters of mechanical ventilation, in the duration of mechanical ventilation, and in the duration of oxygen dependence as compared with subgroup 1a. In group 2, there were 45 patients. Six patients of group 2 (13%) had U. urealyticum in their aspirates, 2 patients (4.4%) had a pneumonia (group 2b), and 4 patients (8.8%) did not (group 2b). CONCLUSIONS: In preterm infants as well as in term newborns one should consider U. urealyticum as a potential cause of neonatal pneumonia.

[Effect of the mode of delivery on the newborn infant with gastroschisis. With data from the Styrian Malformation Register]. / Die Auswirkungen des Geburtsmodus auf Neugeborene mit Gastroschisis. Mit Daten des Steirischen Fehlbildungsregisters.

OBJECTIVE: Our purpose was to investigate the influence of the mode of delivery on the outcome of children with gastroschisis. METHODS: 38 children were born and treated at the University Hospital of Graz between 1977 and 1995. The perinatal and surgical data were analyzed retrospectively. Furthermore, we compared the prevalence of gastroschisis in Styria to international data. RESULTS: The mode of delivery did not influence the fetal outcome. The higher rate of acidosis and shorter interval from rupture of the membranes to delivery in cases of cesarean section may be attributable to the obstetric decision for an operative delivery. The prevalence of gastroschisis is high as compared to European data. CONCLUSIONS: Our data and the majority of publications do not show a benefit of cesarean section for children with gastroschisis. A randomized prospective trial is still lacking to end controversies.

Maackia amurensis agglutinin discriminates between normal and chronic leukemic human lymphocytes.

Altered glycosylations of cell surface glycoproteins often accompany malignant transformation and lectins are useful for probing these alterations. Lymphocytes exhibit characteristic surface glycoproteins which serve as markers of cell status and development. The present work was undertaken to compare, on blots, the binding characteristics of membranes isolated from normal peripheral blood lymphocytes and chronic lymphatic leukemia cells to five different lectins, from Datura stramonium, Maackia amurensis, Sambucus nigra, Galanthus nivalis and Peanut. The Maackia amurensis lectin interacted with the normal lymphocytes but showed no binding to malignant cells. Hence, we suggest the Maackia lectin may be used to differentiate normal from leukemic cells.