ABSTRACT
Etiology of sudden infant death syndrome still remains unknown. However, the risk factors are established and serve as a base for creating the recommendations for infants' sleep safety and SIDS prevention.
Subject(s)
Sudden Infant Death/etiology , Sudden Infant Death/prevention & control , Female , Humans , Infant , Male , Monitoring, Physiologic , Polysomnography , Posture , Pregnancy , Prenatal Exposure Delayed Effects , Risk Factors , Sleep/physiology , Smoking/adverse effects , Sudden Infant Death/diagnosisABSTRACT
In order to determine parental reasons of the use of home apnea/respiration monitors and to estimate the grounds of these decisions correspondence contact was achieved with the parents of 71 infants monitored by means of the APNEAL-1 device. Filled up questionnaires were the source of data regarding the families (structure, health practices, mothers' age and education, course of pregnancy and delivery), monitored infants (birth weight, Apgar score, apnea events) and the reasons of monitoring. Also opinions concerning monitor usefulness and performance were gathered. The majority of our families (> 97%) consisted of both parents, their socio-economic status was medium (52.11%) or good (46.48%) and they were residents of cities (88.73%). Cigarette smoking was present in 22 families (31%) with 13 smoking mothers (18.31%). Mothers' mean age was 29.11 years (SD 4.84), 45% of them had high school education and 36.62%-university education. As many as 45% of the pregnancies had a pathological course and 34.3% were terminated by a preterm delivery. Mean birth weight of monitored children was 2914.93 g (SD 971.4), mean Apgar score was 8.31 (SD 2.46). More than 60% of children were breast fed during the first six months of life, and 30% of them--during first year of life. Bed sharing was reported in only 8% of children. Apnea episodes were observed in 30 infants (42.25 of whole group), in 20 of them only during the neonatal period. More apnea episodes were present in premature infants (48% of premature versus 30% of full term infants). Only 12 children (16.9% of whole group) manifested apnea events during the monitoring period. However, almost all the parents (97%) had a high opinion of the role played by the monitor (mean monitoring time 7.12 months, SD 4.44). In 27 families (38%) a cause of monitoring was a preceeding apnea event. The decision of remaining parents was based exclusively on fear. This fear was justified only in a small number of families (previous SIDS victim, GER). Numerous children were monitored solely on the basis of information of apnea existence in children. Such a difficult to accept monitoring reason probably has its source in inappropriate family health education.
Subject(s)
Apnea/diagnosis , Apnea/prevention & control , Home Nursing/statistics & numerical data , Monitoring, Ambulatory/statistics & numerical data , Adult , Apgar Score , Apnea/epidemiology , Birth Weight , Breast Feeding/statistics & numerical data , Female , Health Education , Home Nursing/methods , Humans , Infant , Infant, Newborn , Infant, Premature, Diseases/diagnosis , Infant, Premature, Diseases/epidemiology , Infant, Premature, Diseases/prevention & control , Male , Monitoring, Ambulatory/methods , Parents/psychology , Poland , Polysomnography , Population Surveillance , Pregnancy , Prevalence , Surveys and QuestionnairesABSTRACT
Factors influencing bone mineral density around the femoral stem after PM cementless total hip arthroplasty were evaluated in longitudinal study of 18 hips in 18 patients who had undergone surgery due to unilateral hip osteoarthritis. Bone mineral density in the femoral neck was determined by dualenergy X-ray absorptiometry measurement performed preoperatively and in periprosthetic femoral Gruen's zones prospectively 2 weeks, 3, 6, 12 and 24 months after surgery. The concentrations of calcium, magnesium and fluoride were measured in cortical and trabecular bone samples taken from resected femoral head and neck. At 12 and 24 months after the operation the regional bone mineral density measurement showed significant, maximum decrease but after 12 months bone mineral density appeared to be stabilized. The analysis of preoperative femoral neck density and fluoride content in trabecular bone proved that osteopenia and lower fluoride concentrations correlated significantly with greater bone density decrease after total hip arthroplasty. No other factors (age, sex, weight, calcium and magnesium concentrations in bone and fluoride concentration in cortical bone) showed significant associations.
Subject(s)
Arthroplasty, Replacement, Hip/methods , Bone Cements , Bone Density , Femur/surgery , Postoperative Complications , Adult , Aged , Female , Follow-Up Studies , Humans , Male , Middle Aged , Osteoarthritis/diagnosis , Prospective Studies , Severity of Illness Index , Treatment OutcomeABSTRACT
Results of DEXA densitometry evaluation of the proximal femur in 12 patients after cemented total hip replacement are demonstrated. Bone mineral density of the femur was measured using the dual energy absorptiometry Lunar DPX. Assessment was performed in the 3rd or 4th postoperative day, after 3rd, 5th and 12th week, after 6 and 9 months following surgery. A decrease in bone density around prosthetic stem ranging from 15% to 30% of the primary level was observed already in the third month after operation. The process continued and the values after 9 months were significantly lower then initial ones.
Subject(s)
Bone Density , Bone Resorption/diagnostic imaging , Femur/diagnostic imaging , Hip Prosthesis/adverse effects , Absorptiometry, Photon , Aged , Bone Cements , Bone Resorption/etiology , Female , Humans , Male , Middle Aged , OsseointegrationABSTRACT
A series of 26 patients with severe thoracolumbar burst fracture was treated with Harrington instrumentation. Pitfalls and failures in adequate stabilization are presented. In 2 cases vertebral arch supporting the hook was damaged. These patients required restabilization combined with anterior fusion. In another case sublaminar wire loop pulled by the hook compressed the dural sac. Long rods (over more then five segments) were usually applied for stabilization of several arches damage, most often cranially from the fracture site or developmental defects within L5 and S1. The best stabilization with short rods has been achieved within lumbar spine or in cases supplemented with anterior fusion with the use of bone graft.
Subject(s)
Internal Fixators , Lumbar Vertebrae/injuries , Spinal Fractures/surgery , Thoracic Vertebrae/injuries , Adolescent , Adult , Female , Fracture Fixation, Internal/methods , Humans , Male , Middle Aged , Spinal Fusion/methodsABSTRACT
The results of clinical examination, three-phase bone scintigraphy and intraoperative findings were compared in 29 patients. Scintigraphic criteria of infection or aseptic loosening have been presented. The method proved to be highly useful with sensitivity, specificity and accuracy being 100, 73 and 90 per cent respectively.
Subject(s)
Hip Joint/diagnostic imaging , Hip Prosthesis , Aged , Female , Hip Joint/surgery , Humans , Infections/etiology , Inflammation/etiology , Male , Middle Aged , Prosthesis Failure , Radionuclide Imaging , Sensitivity and SpecificityABSTRACT
A surgical method of recovery of functional activity and painlessness of the hip deprived of the cartilage in the loaded part has been presented. The operation consisted of interposition with the fascia or a joint capsule flap. The results obtained in 12 patients after 1-12 years of follow-up have been given. Recovery of functional activity was obtained in 8 patients and improvement in 4 patients. In comparison with a group of 32 similar cases of interposition on the background of another etiology; interposition in rheumatoid arthritis gives more good and fair results.
