A new technique for transumbilical insertion of central venous silicone catheters in newborn infants.

AIM: A new technique allowing placement of umbilical silicone venous catheters (USVC) is described and compared with percutaneous silicone venous catheters (PSVC). METHODS: Data were retrospectively recorded for 198 infants with USVC and 141 infants with PSVC. RESULTS: Overall rate of complications was low and comparable in both groups: thrombosis 1.2%, catheter-related sepsis 3.5% and mechanical obstruction 5%. CONCLUSION: A new device allows safe introduction of silicone catheters into the umbilical vein.

Ibuprofen and cerebral oxygenation and circulation.

The effect of prophylactic administration of ibuprofen on the cerebral circulation in preterm babies was measured with near infrared spectroscopy. No significant difference in the change in cerebral blood volume, change in cerebral blood flow, or tissue oxygenation index was found between administration of ibuprofen or placebo.

[Halitosis--foetor ex ore]. / Halitosis--Foetor Ex Ore.

BACKGROUND: An overview is presented on the etiology, diagnosis, and therapy of halitosis. METHODS: Results are given of our multidisciplinary halitosis outpatient department started in 1994. The team consists of ENT specialists and paradontologists, occasionally assisted by a psychiatrist. The oral odor is confirmed with a halitometer (Interscan Corporation, Model RH-17E USA). 491 Patients, nearly the same number of males as females, mostly between 20 and 50 years of age were seen. RESULTS: Oral causes (87%) were due to tongue coating (51%), gingivitis (17%), paradontitis (15%), or combinations of factors (17%). The other 13% involved causes related to ENT problems (4%), both ENT and oral (3%), digestive tract (1%), and presumed psychiatric pathology (5%). CONCLUSIONS: Many patients underwent diagnostic and therapeutic aimed interventions to no avail prior to their arrival in our halitosis clinic. Usually advising the patient to maintain better oral hygiene is sufficient.

An inventory of patients' response to treatment at a multidisciplinary breath odor clinic.

OBJECTIVE: This study was undertaken to assess patients' response to their treatment at a multidisciplinary oral malodor clinic. METHOD AND MATERIALS: In 4 years, a multidisciplinary breath odor clinic in Belgium examined 406 patients. The team consisted of an ear, nose, and throat specialist, a periodontologist, occasionally a specialist in internal medicine, and, more recently, a psychiatrist. After the initial visit, each patient was scheduled for a follow-up appointment 2 to 6 months later; however, only 143 patients (35%) showed up for this control visit. The remaining 65% of the patients answered a mailed questionnaire. RESULTS: About half of the patients who returned no longer had complaints, while 17% reported no improvement. This group was characterized by imaginary bad breath and manifest psychologic problems. There was also disbelief of their cure, although clinical examination (organoleptic evaluation and volatile sulfide measurement by means of a portable monitor) did not reveal any oral malodor. Some also insufficiently performed the recommended oral hygiene measures (tongue brushing and interdental cleaning). Most of the patients who returned the questionnaire were disappointed by the suggestion that their halitosis was the result of insufficient oral hygiene. CONCLUSION: Better education of both the public and dental professionals as to the most frequent cause of halitosis, insufficient oral hygiene, might elevate the level of compliance by patients.

[Halitosis, foetor ex ore]. / Halitose, foetor ex ore.

OBJECTIVE: To review the results of a multidisciplinary approach on halitosis. DESIGN: Descriptive. SETTING: University Hospital Leuven, Belgium. METHODS: Review of the data on etiology, diagnosis and therapy of halitosis, obtained by a multidisciplinary team consisting of ENT specialists, periodontologists and a psychiatrist. Malodour was confirmed by a halimeter. RESULTS: 491 patients, equally males and females, with a concentration between 20-50 years of age were seen. Oral causes (87%) were due to tongue coating (51%), gingivitis (17%), periodontitis (15%) or combinations 17%). The other 13% causes were due to ENT-related problems (4%), both ENT and oral (3%), digestive tract (1%) and presumed psychic (5%). CONCLUSION: Halitosis is a rather unknown medical problem that often can be solved by a multidisciplinary approach.

Experiences of a Belgian multidisciplinary breath odour clinic.

Experiences of a Belgian multidisciplinary breath odour clinic. Oral malodour is a frequent problem, which can benefit from a multidisciplinary approach (periodontology, ENT, internal medicine, psychiatry). An objective measurement of the amount of volatile sulphur compounds in the patient is very useful and easy to perform. Tongue coating is the most frequent cause. Initial treatment strategy should focus on oral hygiene. In a few cases, tonsillectomy or endoscopic sinus surgery may be necessary.

Mucociliary clearance following segmental tracheal reversal.

Ciliated tracheal epithelium is arranged in a polarized pattern oriented according to the inferior-superior axis of the trachea and is responsible for the transport of mucus toward the larynx. In this study, ciliary beat orientation and the influence of external factors on mucociliary clearance direction were studied in rabbit inverted cervical tracheas. The animals displayed normal respiration postoperatively. After 16 weeks, airway clearance was studied by observation of the movement of silicone particles placed in the inverted segment and in normal parts of the ciliated epithelium. Cilia exhibited unidirectional and coordinated movement within inverted tracheal segments. As shown by the direction of effective flow produced by beating cilia and by scanning electron microscopy, the cilia in the inverted segment beat in the opposite direction from the cilia in the remainder of the trachea. This study demonstrated that ciliary orientation is irreversibly determined, but the reversal of ciliary beating within the cervical trachea had no adverse effects on the survival of the animals.

31P-NMR spectroscopy and the metabolic properties of different muscle fibers.

To study the in vivo recruitment of different fiber types and their metabolic properties, 31P-nuclear magnetic resonance spectroscopy (31P-NMRS) of the human calf muscle was performed in seven normal sedentary subjects. In the exhaustive exercise protocol used, the work load was increased every minute during 5 min. This resulted in a prominent split of the Pi resonance in all subjects, indicating pH compartmentation in the muscles studied. From the chemical shift of the Pi peaks relative to phosphocreatine (PCr) at the end of the exercise, intracellular pH (pHi) averaged 6.92 +/- 0.05 (SD) in compartment 1 and 6.23 +/- 0.15 in compartment 2. The recovery of both Pi resonances after exercise could be followed easily in five of these subjects. The recovery rate of the Pi peak is a good estimate of the oxidative metabolism at the end of the exercise. A monoexponential regression analysis showed that the mean initial recovery rate S0 was 2.49 +/- 0.17%/s in compartment 1 and only 0.87 +/- 0.12%/s in compartment 2, indicating aerobic function three times higher in compartment 1 at the end of exercise. The mean relative ATP fraction dropped significantly (P less than 0.001), from 20.0 +/- 1.0% of the total 31P signal integral before exercise to 14.0 +/- 1.6% at the end of exercise. The simultaneous visualization of two compartments, in good order, one with high pHi and fast recovery and another with low pHi and slow recovery, is rationalized by the different metabolic behavior of type I and II fibers in human calf muscle in response to exhaustive exercise. This study demonstrates that 31P-NMRS is an excellent noninvasive procedure to quantify aerobic metabolism in both fiber types simultaneously.