The effect of sleep restriction on neurobehavioural functioning in normally developing children and adolescents: insights from the Attention, Behaviour and Sleep Laboratory.

In the current paper, we first introduce the research themes of the attention, behaviour and sleep (ABS) laboratory, namely, sleep and ADHD, sleep and obesity, and sleep and academic performance. We then focus in on the topic to be reviewed in the current paper - the association between sleep restriction and neurobehavioral functioning (NBF) in typically developing children. We review the research thus far conducted by the ABS lab specific to this topic and posit the unique methodological contributions of the ABS lab (e.g. home-based assessment of sleep architecture and patterns, extensive phenotyping, etc.) in terms of advancing this research area. In the second section of the paper, we review 13 studies investigating the causal association between experimental sleep restriction and NBF in normally developing pediatric populations. Eight of the 13 studies found that sleep restriction causes impairments in neurobehavioural functioning. However, given the inconsistency in outcome measures, experimental protocols and statistical power, the studies reviewed herein are difficult to interpret. Strategies used by the ABS including implementing home assessments of sleep, restricting sleep relative to the participants' typical sleep schedules, blinding raters who assess NBF, and using valid and reliable NBF assessments are an attempt to address the gaps in this research area and clarify the causal relationship between sleep restriction and NBF in typically developing children and adolescents.

Ultrasonographically indeterminate renal parapelvic masses.

Ultrasonography is excellent in the evaluation of renal masses. Simple cysts can be distinguished from more complex or solid renal masses. Rarely, sonographic examination cannot be used to categorize renal masses, particularly those that are small and in a parapelvic location. We report six patients having sonographically indeterminate parapelvic masses. Subsequent computed tomographic examination demonstrated each of these masses to be a parapelvic cyst. Failure to make an ultrasonographic diagnosis was thought to be due to their parapelvic location. Complex interactions between cyst and normal renal sinus structures caused alteration and distortion of the anatomy of both, making exact diagnosis difficult. Computed tomography can be used to define the anatomy precisely and provide the correct diagnosis.

Ultrasound findings in small bowel infarction.

A patient with small bowel infarction was studied using grey-scale ultrasound. The appearance was that of a lobulated abdominal mass consisting of smaller masses with a central sonolucent area and a peripheral echogenic rind. This is the reverse of what has been described in intramural intestinal hematoma, intussusception, and inflammatory and neoplastic bowel masses.

Comparative accuracy and complementary use of 67Ga-citrate imaging and ultrasound in the diagnosis of abdominal abscesses.

Ultrasound and 67Ga-citrate imaging were used simultaneously for the evaluation of 26 suspected cases of abdominal abscess. Scintiscanning and ultrasonography identified respectively 92% and 69% of the abscesses. Jointly, both modalities detected all 13 abscesses and we suggest an integrated approach in the evaluation of such cases.

Grey-scale ultrasonography for assessment of gynecologic pelvic masses.

In a retrospective study the grey-scale ultrasonographic appearance of pelvic masses was correlated with the surgical findings in 93 patients. Of the masses found at the time of laparotomy 95% had been detected preoperatively. In most instances useful information about size, consistency and location of the mass was provided by ultrasonography. Certain pathologic entities produce a characteristic sonographic appearance, but there is a wide overlap for others. Data obtained by history-taking and physical examination must be integrated with the sonographic findings for a correct diagnosis.