Archives of disease in childhood
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Case Reports
Arnold Chiari type 1 malformation presenting with sleep disordered breathing in well children.
Healthy children, aged 3, 9, and 13 years referred with sleep disordered breathing had marked central apnoea and bradypnoea on polysomnography, necessitating the use of non-invasive bilevel ventilation in two cases. Each had normal neurological examinations and an Arnold Chiari type 1 malformation was confirmed on magnetic resonance imaging. All underwent urgent posterior fossa decompression which normalised their sleep breathing.
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Effective consultations with patients and their families are important for patient satisfaction, adherence to treatment, and recovery from illness. Communication problems among health professionals are common. Fortunately, the skills of effective communication can be taught and learned. This paper highlights evidence based approaches to teaching these skills with minimal resources.
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Electrical power and mobile communications deliver enormous benefit to society, but there are concerns whether the electric and magnetic field (EMF) emissions associated with the delivery of this benefit are linked to cancer or other health hazards. This article reviews the strength of the available epidemiological and laboratory evidence and notes that this falls short of what is normally required to establish a causal link. However, because of scientific uncertainty a cautious approach is often advocated, but here, too, there may be a tendency to judge these risks more harshly than those in other areas with similar strength of evidence.