[Van Neck-Odelberg disease. Report of two cases]. / A van Neck-Odelberg-betegség bemutatása két eset kapcsán.

Osteochondritis ischiopubica or van Neck-Odelberg disease is characterized by atypical ossification of the ischiopubic synchondrosis. Clinical symptoms are usually pain, limping and limited range of motion of the hip joint. Radiologic images may be confused with the possibility of fracture, tumor or inflammation. In some cases it may be difficult to set up the accurate diagnosis, and during the diagnostic process it is essential that van Neck-Odelberg disease should be considered. In this paper the authors draw attention to this rare disorder and they present the history of two patients who posed diagnostic difficulties.

Continuous glucose monitoring system (CGMS) in kidney-transplanted children.

NODAT and IGT are well-known complications of immunosuppressive therapy after transplantation being a risk factor for cardiovascular disease affecting patient and graft survival. Therefore, early identification and treatment are of high importance. In this study, we examined the glycemic homeostasis of 20 renal-transplanted children using routine laboratory tests and the continuous glucose monitoring system (CGMS). Six patients (30%) had IGT, and one patient had NODAT (5%). The HOMA index was in an abnormal range in 35% of all patients and was abnormal in 67% of the IGT patients. CGMS analysis showed that IGT patients had higher "lowest glucose" level, and the incidence of hypoglycemic episodes was significantly lower compared with patients with normal OGTT result. In IGT patients, glucose variability tended to be lower. Furthermore, in the whole patient cohort, glucose variability significantly decreased with time after transplantation. Summarizing, these novel data show that "lowest glucose" level and hypoglycemic episodes are significantly influenced and altered in renal-transplanted patients with IGT. Furthermore, there is a decrease in glucose variability with time after transplantation. The mechanism and relevance of these data need further investigations.

[Sleep duration among school-age children in Hungary and Romania]. / Az alvásido felmérése Magyarországon és Romániában élo iskoláskorú gyermekek körében.

INTRODUCTION: Children's sleep duration is decreasing in the last decade. Despite of the well known negative consequences, there are no data on children's sleep duration in Hungary and Romania. AIM: The aim of the authors was to assess sleep duration of school-age children in Hungary and Romania. METHOD: A self-edited questionnaire was used for the study. 2446 children were enrolled. All elementary and secondary schools in a Hungarian city, and one elementary and secondary school in a Romanian city took part in the study. RESULTS: Mean sleep duration was 8.3 ± 1.2 hours on weekdays. There was a significant difference between the two countries (Hungary vs. Romania, 8.5 ± 1.2 hours vs. 7.8 ± 0.9 hours, p = 0.001). Age correlated with sleep duration on weekdays (r= -0.605, p = 0.001), but not during weekend. CONCLUSIONS: This is the first study on children's sleep duration in Hungary and Romania. The difference between countries may be due to the difference in mean age or cultural and/or geographical differences.

Tonsillar hypertrophy implications in sleep disorders in adults and children.

INTRODUCTION: The obstructive sleep apnea syndrome is the most common sleep disorder. It covers a multitude of symptoms associated with apnea. Next to polysomnography, otorhinolaryngological clinical examination plays an important role in establishing the diagnosis, in evaluating any oropharyngeal and hypopharyngeal modification. PATIENTS AND METHODS: In this research, we intend to demonstrate the histopathological examination importance in establishing the tonsillar hypertrophy degree. This is made in direct correlation with its volume, and the sleep apnea degree. In this context, we have conducted a retrospective study between 2007-2012 on a group of 69 patients diagnosed by polysomnography with Obstructive Sleep Apnea (OSA). In the research, otorhinolaryngological examination was supplemented with histopathological examination of the parts collected after the surgery. RESULTS: It has been demonstrated that the size, volume of the tonsil can be directly correlated with the severity of sleep apnea. The term "tonsil hypertrophy" is a histopathological one, with or without macroscopic implications. A specificity of tonsil enlargement without the narrowing of the oropharyngeal isthmus was demonstrated. This was in all groups of obstructive apnea, even in snoring patients with normal apnea-hypopnea index values, with a non-significant statistical correlation. CONCLUSIONS: The use of multiple indices in the classification of OSA severity is an important advantage. Therefore, it can be proved that there is no singular structure to induce the disorder, but the cause is rather a combination of several elements. The polysomnographic examination remains the golden standard for assessing in patients with OSA.