The effect of body position on sleep apnea in children younger than 3 years.

Objective: To determine the association between body position and obstructive events during sleep as determined by polysomnography (PSG) in very young children (age, < or = 3 years) with obstructive sleep apnea syndrome.

Design: Retrospective chart review.

Subjects: Children aged 3 years and younger who underwent PSG to evaluate obstructive sleep apnea and subsequently underwent adenotonsillectomy between December 1, 2000, and November 30, 2003, were included in the study.

Postgenomic approach to identify novel Mycobacterium leprae antigens with potential to improve immunodiagnosis of infection.

Early detection of Mycobacterium leprae infection is considered an important component of strategies aiming at reducing transmission of infection, but currently available diagnostic tools often lack sufficient sensitivity and specificity to reach this goal. Recent comparative genomics have revealed the presence of 165 M. leprae genes with no homologue in M.

Ossicular chain dislocation with normal hearing.

We report a unique case of an ossicular chain injury in a young man. Despite the fact that the patient's incus was dislocated into the external auditory canal while remaining attached to the stapes, his hearing was not affected and remained nearly normal. We discuss the patient's presenting features and our diagnostic and management strategy in this case.

Detection of in vitro interferon-gamma and serum tumour necrosis factor-alpha in multidrug-resistant tuberculosis patients.

Multidrug-resistant tuberculosis (MDR-TB) is known as having a poor prognosis with a weak response to therapy and very high death rates. The aim of this work was to assess the immune response to the RD1-encoded antigen ESAT-6 of Mycobacterium tuberculosis in MDR-TB patients and compare to non-resistant (NR) TB patients and healthy controls (HC). Evaluation of interferon (IFN)-gamma production showed that, although 55% of the MDR patients were responsive to ESAT-6, they produced lower IFN-gamma levels (553 +/- 11 pg/ml) when compared to NR-TB (1179 +/- 163 pg/ml; P < 0.

T cell immune responses to mycobacterial antigens in Brazilian tuberculosis patients and controls.

Production of IFN-gamma guarantees helpful T cell-mediated immunity against Mycobacterium tuberculosis infection. We have evaluated the in vitro immune responses to M. tuberculosis antigens using IFN-gamma production among 43 Brazilian tuberculosis (TB) patients prior to and after specific treatment, and 18 community controls.

Analysis of thyroid gland microvascularization in rats induced by ingestion of potassium bromide: a scanning electron microscopy study.

The microvascularization of the thyroid gland in rats was studied in animals following ingestion of potassium bromide in various concentrations in drinking water (15, 50 or 100 mg/l) over a period of either 16 or 66 days. Accordingly, animals were divided into six study groups and one control group. Microvascularization was compared among the groups.

New bone formation in the female rabbit tibia.

The current study aims to evaluate the new bone formation in polyvinylpyrrolidone (PVP) grafts inserted into the tibia of ten female rabbits. The animals were submitted to oophorectomy in order to induce an osteopenic condition and densitometrically analyzed at the beginning of the experiment, at three months and at seven months. During the 16 weeks of osseointegration, the animals were submitted to subcutaneous injections of three bone markers at one-week intervals, four weeks for each.

Complications of neonatal tracheostomy: a 5-year review.

Objective: Study the complication rate of tracheostomy in premature infants and identify contributing factors. Setting Two university-based tertiary care children's hospitals.

Methods: The charts of 55 neonates who underwent tracheostomy between January 1997 and December 2002 were reviewed.

Ameloblastic fibroma of the maxillary sinus.

Ameloblastic fibroma is a rare true mixed tumor of odontogenic origin with both mesenchymal and ectodermal components. It usually arises from the mandibular dentition and presents in the second decade of life. It is a benign slow growing tumor that is less infiltrative than an ameloblastoma but tends to expand bone.

Patterns of intracellular cytokines in CD4 and CD8 T cells from patients with mycobacterial infections.

Using a short-term bulk culture protocol designed for an intracellular-staining method based on a flow cytometry approach to the frequencies of cytokine-producing cells from tuberculosis and leprosy patients, we found distinct patterns of T cell subset expression. The method also reveals the profile of peak cytokine production and can provide simultaneous information about the phenotype of cytokine-producing cells, providing a reliable assay for monitoring the immunity of these patients. The immune response of Mycobacterium leprae and purified protein derivative (PPD) in vitro to a panel of mycobacteria-infected patients from an endemic area was assessed in primary mononuclear cell cultures.

Management of anomalies of the third and fourth branchial pouches.

Third and fourth branchial pouch anomalies are rare and usually present as lateral neck masses, abscesses or with acute suppurative thyroiditis. An opening in the piriform sinus can be identified in most cases. We present four cases of fourth branchial pouch sinuses, one of a third branchial cyst and discuss our management.

Tracheostomy in preterm infants: current trends.

Objective: To study the indications for and outcomes of tracheostomy in a population of preterm infants.

Design: Retrospective analysis of case records.

Setting: Two university-affiliated tertiary care children's hospitals.

Community-acquired methicillin-resistant Staphylococcus aureus in children and adolescents: changing trends.

Objective: To identify current trends in antibiotic sensitivity patterns of community-acquired methicillin-resistant Staphylococcus aureus (CA MRSA) infections of the head and neck in children and adolescents and evaluate outcomes after therapy.

Design: Retrospective review of cases consisting of a medical record review with telephone follow-up.

Setting: Two tertiary university medical referral centers.

Exercise testing in hypertensive patients taking different angiotensin-converting enzyme inhibitors.

Objective: To compare blood pressure response to dynamic exercise in hypertensive patients taking trandolapril or captopril.

Methods: We carried out a prospective, randomized, blinded study with 40 patients with primary hypertension and no other associated disease. The patients were divided into 2 groups (n=20), paired by age, sex, race, and body mass index, and underwent 2 symptom-limited exercise tests on a treadmill before and after 30 days of treatment with captopril (75 to 150 mg/day) or trandolapril (2 to 4 mg/day).

Well-differentiated liposarcoma of the epiglottis.

Liposarcomas of the larynx are very rare. A review of the English literature revealed only 28 published reports of tumours in this anatomical location. Diagnosis requires a high index of suspicion and careful histologic analysis.

[Use of drugs in attention deficit hyperactivity disorders].

Attention deficit hyperactivity disorder (ADHD) is a neurological disorder which is common in the childhood and can be caused by exogenous and endogenous factors, that are responsible for cerebral disorder. This disorder presents a functional alteration of the motor, perceptive, cognition systems and conduct disorders compromising the learning of children with an adequate intellectual potential. The authors study the action of stimulants and antidepressive drugs in the ADHD, using as measure of efficacy the motor persistence tests.

The management of asymptomatic firearm injuries in children.

Paediatric firearm injuries in the UK are uncommon. We present two children with BB-gun pellets in the parapharyngeal space who were managed conservatively and remained asymptomatic 6 months after the gunshot injury. The management of asymptomatic firearm injuries in children is discussed and a literature review included.

Tuberculous lymphadenopathy masquerading as a bronchial foreign body.

A case of recent onset of wheezing with clinical and radiologic findings suggestive of foreign body aspiration is presented. Rigid bronchoscopy revealed an extraluminal compression of the airway. Histopathologic and microbiologic examination revealed tuberculous lymphadenopathy.

Pediatric functional endoscopic sinus surgery: is a second look necessary?

Functional endoscopic sinus surgery (FESS) has become the surgical procedure of choice for the treatment of chronic sinusitis that is refractory to medical treatment. It has become routine to perform endoscopy in children under general anesthesia 2 to 3 weeks after FESS to facilitate examination and cleaning of the operative site. We compared the clinical outcome of 50 children who underwent FESS without a second-look endoscopy with 50 children who underwent a routine second look.

Pseudoaneurysm of the right lingual artery: an unusual cause of severe hemorrhage during tonsillectomy.

Profuse intraoperative hemorrhage is an uncommon complication of tonsillectomy. We present a three-year-old girl who underwent a routine adenotonsillectomy during which massive bleeding occurred from a large vessel in the right tonsillar fossae. Angiography revealed an aberrant right lingual artery with a pseudoaneurysm.

Outpatient adenotonsillectomy. Is it safe in children younger than 3 years?

Objective: To evaluate the safety of ambulatory adenotonsillectomy in children younger than 3 years.

Materials And Methods: The records of 102 children younger than 3 years who underwent adenotonsillectomy as an outpatient procedure were reviewed during a 3-year period.

Results: Ten patients (10%) required overnight hospital admission for an average of 1.

Peritonsillar abscess in early childhood. Presentation and management.

Objective: To highlight the modes of presentation and management of a peritonsillar abscess in children younger than 5 years.

Design: Retrospective case series.

Setting: Tertiary referral pediatric otolaryngology practice.