Wiener klinische Wochenschrift
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Wien. Klin. Wochenschr. · Dec 2003
[Nocturnal noninvasive ventilation of children and adolescents with neuromuscular diseases: effect on sleep and symptoms].
Sleep disordered breathing (SDB) is an inevitable complication of progressive neuromuscular disorders (NMD). Aim of the study was to prospectively investigate the impact of three months of non-invasive ventilation (NIV) on sleep and SDB-associated symptoms in children and adolescents with advanced NMD. ⋯ In children with NMD intermittent nocturnal NIV results in objective and subjective improvements of sleep quality and symptoms associated with SDB.
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Wien. Klin. Wochenschr. · Dec 2003
How to score arousals in preterm infants? Can we use recommendations of the Pediatric Wake-up Club?
Infants' arousals from sleep reflect the activation of various brain stem and cortical structures and their characteristics change with age. Arousal scoring based on the Pediatric Wake-up Club definition of arousal in infants was evaluated to determine whether arousals could be reliably identified and assessed in preterm infants also. Polygraphic recordings were made in seven stable preterm infants with a mean postconceptional age of 34.4 +/- 1.2 weeks. ⋯ Respiratory rate was higher (35 +/- 15 bpm) during the arousal than in the periods preceding (29 +/- 14 bpm; p < 0.01) and following (29 +/- 11 bpm; p < 0.001) it. Heart rate decreased during the arousal (131 +/- 30 bpm) when compared with the preceding 10-second period (140 +/- 14 bpm; p < 0.05). We found that arousals in preterm infants can be reliably identified and assessed using the Pediatric Wake-up Club's arousal definition for term infants.
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In Germany there are several committed which however haven't got together yet in order to set up a systematic health education campaign. So far the knowledge of other professional fields like that of graphic designers, specialists of communication and public health scientists hasn't been sufficiently used to familiarize nearly all pregnant women, parents, grandparents and babysitters with those known medical subject matters. Hopefully paediatricians, gynaecologists, children's nurses, midwives, breast-feeding consultants, paediatric preventive assistants, consultants for pregnant women who smoke and mothers in general will soon start to get going an effective lasting and possibly nationwide preventive campaign which will be supported by the competent social ministries and financing authorities, self-help groups, graphic designers, specialists for communication and public health scientists. ⋯ Historically, the promotion of infants sleeping on prone position seems to have been a tragic break of tradition in the western world in between 1970 and 1990, as infants had been put to sleep almost only on their back during the past centuries. If we compare East and West Germany concerning the influence on the ways of looking after infants since the 1960th of the last century it has become clear that the advice of medical authorities mainly effects the way of nursing regardless of the political system. More and more, paediatricians, gynaecologists, midwives and children's nurses should become aware of this responsibility.
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Wien. Klin. Wochenschr. · Dec 2003
Classification of sudden infant death (SID) cases in a multidisciplinary setting. Ten years experience in Styria (Austria).
Sudden infant death syndrome (SIDS) remains a challenge for health professionals despite decreasing rates in recent years. The figures for different areas and time periods are hardly comparable, because of differences in postmortem investigations and classification criteria. In 1992, the European Society for the Study and Prevention of Infant Deaths (ESPID) proposed a classification for any sudden and unexpected death in infancy. This proposal has been used in our study since 1993 to better classify sudden infant death (SID) cases. ⋯ An extensive analysis of SID events is a prerequisite for reliable and comparable SIDS statistics. Our data show that in several SID cases careful post-mortem examinations led to an explanation of death. In other cases, minor alterations may have contributed to the lethal event. These findings should therefore be considered in the classification of SIDs. The ESPID classification of 1992 appears to be very useful for this purpose and its use may therefore be recommended.