Given these variable findings, further investigation of the relationship between dietary fatty acid intake and cerebral lipid levels may help to clarify whether different modes of feeding have a role in the pathogenesis of SIDS.
The lack of major change in sudden infant death rates from other causes, combined with the fall in SIDS deaths, is not supportive of diagnostic transfer being a major determinant of the declining SIDS death rate. Therefore, other factors are likely to be responsible for the falling SIDS rate in this population.
Objective To report our experience with autoaugmentation peritoneocystoplasty (AAPC) in a sheep model, and to compare the results with autoaugmentation gastrocystoplasty (AAGC) in a sheep model and in paediatric patients. Materials and methods Ten 6-month-old male lambs underwent bladder augmentation by detrusorotomy. A¯ap of parietal peritoneum, dissected from the anterior abdominal wall, was used to cover the bladder mucosa. The sheep were evaluated by urodynamics 6 months after surgery. Bladder compliance (bladder volume/intravesical pressure) was calculated for the bladder capacity at leakage. The urodynamic results were compared with age-matched control sheep and with 12 sheep that had undergone AAGC; the results were assessed using the Mann± Whitney U-test. Results In two of the 10 sheep, bladder volumes after AAPC increased by >100%, although for the group, the mean (range) bladder volume after augmentation, at 159 (42±261) mL, was not signi®cantly different from that before surgery (mean 143 mL). Bladder volumes after AAPC were not signi®cantly different from those in the control sheep (mean 205 mL) but were signi®cantly less than in the AAGC group (mean 317 mL; P<0.05). Bladder compliance at leak capacity in the AAPC group (mean 5.4 mL/ cmH 2 O) was also not signi®cantly different from the controls (mean 9.1 mL/cmH 2 O), but was lower than the in the AAGC animals (median 14.6 mL/cmH 2 O; P<0.05). Conclusions AAPC in a sheep model does not result in a reliable increase in bladder volume or compliance. The volume and compliance are inferior to those found in bladders augmented by AAGC.
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