Sleep Physiology in Toddlers: Effects of Missing a Nap on Subsequent Night Sleep.

The shift from a biphasic to a monophasic sleep schedule is a fundamental milestone in early childhood. This transition, however, may result in periods of acute sleep loss as children may nap on some but not all days. Although data indicating the behavioral consequences of nap deprivation in young children are accumulating, little is known about changes to sleep neurophysiology following daytime sleep loss.

Sleep Moderates the Association Between Response Inhibition and Self-Regulation in Early Childhood.

Early childhood is a time of rapid developmental changes in sleep, cognitive control processes, and the regulation of emotion and behavior. This experimental study examined sleep-dependent effects on response inhibition and self-regulation, as well as whether acute sleep restriction moderated the association between these processes. Preschool children (N = 19; 45.

Development of nap neurophysiology: preliminary insights into sleep regulation in early childhood.

Although all young children nap, the neurophysiological features and associated developmental trajectories of daytime sleep remain largely unknown. Longitudinal studies of napping physiology are fundamental to understanding sleep regulation during early childhood, a sensitive period in brain and behaviour development and a time when children transition from a biphasic to a monophasic sleep-wakefulness pattern. We investigated daytime sleep in eight healthy children with sleep electroencephalography (EEG) assessments at three longitudinal points: 2 years (2.

Developmental Changes in Sleep Spindle Characteristics and Sigma Power across Early Childhood.

Sleep spindles, a prominent feature of the non-rapid eye movement (NREM) sleep electroencephalogram (EEG), are linked to cognitive abilities. Early childhood is a time of rapid cognitive and neurophysiological maturation; however, little is known about developmental changes in sleep spindles. In this study, we longitudinally examined trajectories of multiple sleep spindle characteristics (i.

Ruptured abdominal aortic aneurysm: impact of comorbidity and postoperative complications on outcome.

Ruptured abdominal aortic aneurysm (AAA) remains a common and highly lethal problem. This study evaluates the morbidity and mortality rates and aims to identify which clinical variables could predict the outcome. We reviewed the records of 112 patients (97 men and 15 women) operated on for ruptured infrarenal AAA within the past 12 years (April 1, 1980, to March 31, 1992).

Large renal arteriovenous malformation: scintigraphic evaluation and therapeutic embolization.

The authors describe a patient with a rare type of renal arteriovenous malformation, which was successfully treated by therapeutic coil embolization. Embolization did not destroy healthy renal tissue, as was shown by the Cerino technique, which measures the glomerular filtration rate of each kidney by image processing for standard renograms obtained after administration of diethylene-triaminepenta-acetic acid labelled with technetium 99m.

Preoperative and long-term cardiac risk assessment. Predictive value of 23 clinical descriptors, 7 multivariate scoring systems, and quantitative dipyridamole imaging in 360 patients.

A total of 360 patients underwent preoperative cardiac risk assessment using 23 clinical parameters, seven multivariate clinical scoring systems, and quantitative dipyridamole-thallium imaging to predict postoperative and long-term myocardial infarction and cardiac death after noncardiac surgery. There were 30 postoperative and an additional 13 cumulative long-term cardiac events after an average follow-up of 15 months. Clinical descriptors were not useful in predicting the outcome of individual patients.

Multivariate clinical models and quantitative dipyridamole-thallium imaging to predict cardiac morbidity and death after vascular reconstruction.

Patients with peripheral vascular disease have a high prevalence of coronary artery disease and are at increased risk for cardiac morbidity and death after vascular reconstruction. The present study was undertaken to assess the value of 18 clinical parameters, of 7 clinical scoring systems, and of quantitative dipyridamole-thallium imaging for predicting the occurrence of postoperative myocardial infarction or cardiac death. Vascular surgery was performed in 125 patients.

[Arterial surgery of the upper limb].

Arterial surgery of the upper limb represents 2.5% of peripheral vascular procedures in our center. From 1976 to 1989, 58 procedures were performed in 45 patients.

[In situ femoro-popliteal bypass grafts. Study of 85 cases using Cartier's technique].

From January 1985 to december 1989, 83 patients (69 men, 14 women) underwent an in situ femoro-popliteal bypass using a semi-closed technique and the valvulotome developed by Dr Paul Cartier. Most patients (67%) were operated for severe ischemia while 33% were for claudication. HTA was present in 31% of patients, diabetes in 38% and CAD in 57%.

Postoperative myocardial infarction and cardiac death. Predictive value of dipyridamole-thallium imaging and five clinical scoring systems based on multifactorial analysis.

Sixty-six patients unable to complete a standard preoperative exercise test because of physical limitations were studied to determine the predictive value of individual clinical parameters, of clinical scoring systems based on multifactorial analysis, and of dipyridamole-thallium imaging before major general and vascular surgery. Study endpoints were limited to postoperative myocardial infarction or cardiac death before hospital discharge. There were nine postoperative cardiac events (seven deaths and two nonfatal infarctions).

Above-knee femoropopliteal reconstruction with polytetrafluoroethylene: a good alternative to saphenous vein bypass.

Over 6 1/2 years, 64 femoropopliteal bypasses were done on 55 patients, using polytetrafluoroethylene (PTFE). The PTFE was chosen because previous surgery or small diameter prohibited the use of saphenous vein. The distal anastomoses were always placed above the knee.

Arterial injuries.

The authors review arterial injuries in 68 patients treated at Maisonneuve-Rosemont Hospital in Montreal between 1975 and 1982. Penetrating trauma caused 54.4% of these injuries, which consisted of either laceration or intimal tear with thrombosis.

Lung cancer and peripheral vascular surgery.

Lung cancer, a disease of epidemic proportions, is to some extent preventable. Elimination of smoking would certainly reduce its incidence. Conventional therapy has not produced any major advance in this field, the 5-year survival of all patients with lung cancer still being very low.

Extra-anatomic bypass grafting in the lower extremity.

Between January 1975 and December 1980, 104 extra-anatomic bypasses were performed on 102 patients. Of these, there were 81 femorofemoral bypasses on 80 patients and 23 axillofemoral bypasses on 22 patients. Those who underwent femorofemoral grafting were divided into three groups: group 1 - 18 patients who had undergone previous aortofemoral bypass grafting with occlusion of one limb of the graft, group 2 - 17 patients who were considered to be at high risk and group 3 - 45 patients who could have tolerated a conventional reconstructive procedure.

Cystic adventitial disease of the popliteal artery. Clinical aspects and etiology.

Cystic adventitial disease of the popliteal artery is a rare and benign disease. The appearance of claudication in a young male nonsmoker and the typical angiographic findings usually confirm the pathology. The treatment of choice is incision evacuation of the cyst.

Blunt injury of the abdominal aorta.

This review of 27 cases of blunt injury of the abdominal aorta includes 24 cases reported in the literature and three new cases. Automobile accidents were the cause of this condition in 19 patients (70%). Clinical presentation was acute in 70% of the cases, and consisted of either acute arterial insufficiency or an acute abdomen.

Ruptured abdominal aortic aneurysm.

Treatment of abdominal aortic aneurysms should be aggressive because less than 50% of untreated patients will be alive 3 years after diagnosis and most will die from ruptured aneurysm. In an effort to reduce the incidence of rupture, all abdominal aortic aneurysms should be excised unless the patient has a short life expectancy or very serious medical problems. In a series of 36 patients with ruptured abdominal aortic aneurysm the mortality was 42%.

[Atherosclerotic aneurysm of the subclavian artery].

An aneurysm of the right subclavian artery, a rare pathologic entity, is described. The presence of a pulsatile mass in the cervical region should always suggest the diagnosis, which is best confirmed by arteriography. Approaching the lesion by partial sternotomy extending to the third intercostal space gives excellent exposure.

Reconstructive vascular surgery for renovascular hypertension.

Forty-six patients who underwent renal artery repair for presumptive renovascular hypertension are presented. Preoperative investigation included a rapid sequence IVP, a high quality angiogram and split function studies, as well as renin assays of renal venous blood in the more recent cases. Atherosclerosis was the causative pathological lesion in 60% of the patients, with fibromuscular dysplasia or miscellaneous causes of stenosis accounting for the remaining 40%.