The objectives of this study were: 1) to perform documented event‐monitoring (DEM) for apnea (A, ⩾20 s) and bradycardia (B, <80 beats per min for ⩾5 s) in premature infants prior to discharge, and 2) to examine the accuracy of nursing documentation (ND) of A and B. Forty‐four stable preterm infants, with mean weights and gestational ages at birth (± SD) of 1,543 (± 365) g, and 30 (± 2) weeks, respectively, were studied using DEM for 9 (± 2) days prior to discharge. Differences in DEM and ND were analyzed by the z‐test for proportions. There were 561 true events recorded by DEM: 56 were As and 505 were Bs. ND revealed 296 events, 190 As and 106 Bs. Of the 56 true As on DEM, only 21 (38%) were correctly reported by ND (P < 0.001, 95% confidence interval (CI) 0.44–0.81). Of the 505 true Bs on DEM, 153 (30%) were correctly reported by ND (P < 0.001, CI 0.63–0.76). When ND was compared with DEM, 174 (59%) of NDs were true events. Of the 106 As on ND, only 21 (20%) were true As on DEM (P < 0.001, CI 0.58–1). Of the 190 Bs on ND, 153 (80%) were true Bs on DEM (P < 0.001, CI 0.13–0.26). ND did not detect 6 of the 33 infants who had significant events on DEM, while 4 of the 11 who had events reported on ND did not have any on DEM. Thus, 10 infants were misclassified by ND (P < 0.01, CI 0.1–0.36). These results indicate that, compared to DEM, ND not only identified significantly fewer true As and Bs, but also misclassified a significant number of infants. We conclude that DEM performed prior to discharge for preterm infants at risk for apnea and bradycardia provides more objective and accurate information than ND. Pediatr Pulmonol. 1999; 27:113–116. © 1999 Wiley‐Liss, Inc.

(1) Background: Molar incisor hypomineralisation (MIH) is an enamel defect that affects an estimated 14.2% of children worldwide. Care takes place in primary and secondary care facilities. (2) Aim: To investigate how children with MIH are managed within a specialist centre in the north of England. (3) Method: A retrospective service evaluation within the paediatric dentistry department was registered with the clinical governance unit. Children who attended consultant-led new-patient clinics between 1 January and 31 December 2015 with a diagnosis of MIH were included. The data collected concerned the pre-referral treatment, the history and diagnoses and the treatments completed. (4) Results: Out of 397 records reviewed, 48 (12.1%) had MIH, where 81.3% and 18.8% of patients had severe and mild MIH, respectively. The majority of patients (n = 44 (91.7%)) were referred appropriately. Treatment was completed at the specialist centre for 44 (91.7%) patients. Twenty-five (52.1%) patients had an extraction of one or more first permanent molar teeth. Sixteen patients had the extractions at between 8 and 10 years old and 2 had the extractions later as part of an orthodontic plan. (5) Conclusion: Most children had severe MIH and were referred at an appropriate time to facilitate the consideration of loss of poor prognosis of first permanent molars (FPMs). Most children required specialist management of their MIH.

Introduction Molar-incisor hypomineralisation (MIH) presents as a spectrum, with severe cases becoming increasingly complex to manage. This study aimed to investigate the perceptions and experience of general dental practitioners (GDPs) in England when managing children with MIH. Method Semi-structured telephone interviews with GDPs who regularly treat children took place in May 2020. A sample of four male and six female GDPs with 1-15 years of experience was achieved through purposively sampling interested parties following advertisement via professional groups. Thematic analysis using a realist and inductive approach was used in analysis. Results The overarching theme was of managing uncertainty, with four subthemes: setting the scene; fighting the tooth; working within the system; and self and interpersonal insight. Despite being knowledgeable, participants expressed varying levels of confidence in many aspects while managing children with MIH. There was a great deal of uncertainty surrounding 'doing the right thing' across the themes. Systemic barriers to managing children with MIH within the general dental service were identified. Conclusion The challenges of managing children with MIH was experienced as 'uncertainty'. Barriers within the general dental service made managing children with MIH difficult and participants relied on colleagues in secondary care to manage severe cases.

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The motor nerve innervation of the extrinsic and intrinsic muscles of the tongue is through the hypoglossal nerve. Hypoglossal nerve palsy arising as a result of injury to the nerve can occur anywhere along its course from the hypoglossal nuclei, medulla oblongata to the tongue itself. Idiopathic isolated and unilateral persistent hypoglossal nerve palsy is an extremely rare condition with only four cases ever reported. In this article, we review reported cases in the literature with comparison to a recent case in the oral and maxillofacial department of University Hospital South Manchester, which highlight the necessity of a segmental and stepwise approach in the diagnosis and management of this condition.