Zusammenfassung SummarySchlafbezogene Atmungssttirungen (SBAS) und eine gastro6sophageale Refluxkrankheit (GOR) sind bei Kindern nicht selten vergesellschaftet. Mit einer kompletten polysomnographischen Untersuchung im p~idiatrischen Schlaflabor sind AtmungsstOrungen sicher zu objektivieren, die Langzeit-pH-Metrie ist die Standardmethode zur Bestimmung saurer Refluxe. Da sich o.g. St6rungen oft gegenseitig beeinflussen, erscheint eine sichere Abkl~irung beider Entit~iten vor Einleitung einer komplexen Therapiefiihrung dringend indiziert. Mit simultaner Anwendung von Polysomnographie (PSG) und Langzeit-pH-Metile in einer Gerfitekonfiguration kann die Entscheidungsfindung fth" die .jeweilige Behandlungsstrategie verbessert und die Effektivit~it der Therapie langfristig iiberprtift werden.SchliisselwOrter Apnoesyndrome -Gastro6sophageale Refluxkrankheit -Kinder -Diagnostikmethoden -simultane Untersuchung -Indikationen.The parallel occurrence of sleep-related breathing disorders (SRBD) and gastroesophageal refluxes (GER) in childhood is not uncommon. As both entities often influence each other, optimal individual therapeutical strategy for patients with symptoms of both sleep apnea syndrome and gastroesophageal reflux disease may be difficult to determine. A complete polysomnography in the pediatric sleep laboratory allows secure detection of sleep-related breathing disorders. 24-hour pH monitoring is an established method for measurement of acid refluxes. Simultaneous application of both methods can help to improve treatment strategies and to controll the therapeutical effects.

BackgroundThis study aimed to investigate the morbidity profile and the sociodemographic characteristics of unaccompanied refugee minors (URM) arriving in the region of Bavaria, Germany, between October 2014 and February 2016.MethodsThe retrospective cross sectional study included 154 unaccompanied refugee minors between 10 and 18 years of age. The data was derived from medical data records of their routine first medical examination in two paediatric practices and one collective housing for refugees in the region of Bavaria, Germany.ResultsOnly 12.3% of all participants had no clinical finding at arrival. Main health findings were skin diseases (31.8%) and mental disorders (25%). In this cohort the hepatitis A immunity was 92.8%, but only 34.5% showed a constellation of immunity against hepatitis B. Suspect cases for tuberculosis were found in 5.8% of the URM. There were no HIV positive individuals in the cohort. Notably, 2 females were found to have undergone genital mutilations.ConclusionsThe majority of arriving URM appear to have immediate health care needs, whereas the pathologies involved are mostly common entities that are generally known to the primary health care system in Germany. Outbreaks due to hepatitis A virus are unlikely since herd immunity can be assumed, while this population would benefit from hepatitis B vaccination due to low immunity and high risk of infection in crowded housing conditions. One key finding is the absence of common algorithms and guidelines in health care provision to URM.

The FRC(pleth-N2) is a reliable indicator for pulmonary inhomogeneities in infants with respiratory diseases.

Agenesis of the right lung was diagnosed prenatally in two neonates born at 36 and 37 weeks, respectively. Computed tomographic scans and magnetic resonance imaging indicated that both cases had a Type 2 pulmonary agenesis, which was confirmed later by bronchoscopy. Both patients were clinically stable during the neonatal period. Serial pulmonary function tests revealed a decrease in specific respiratory system compliance (sCrs) in both neonates and a marked discrepancy between functional residual capacity measured by the nitrogen washout technique (FRCN2) and by plethysmography (FRCpleth) on follow‐up. Early decrease of respiratory system compliance (Crs) and increase of respiratory system resistance (Rrs) in one infant preceded the onset of tracheal stenosis, which remained asymptomatic until the age of 8 weeks, when the infant developed acute respiratory failure requiring intubation and mechanical ventilation with high airway pressures. Aortopexy, implantation of a tissue expander into the right hemithorax, and laser ablation of fibrotic tissue at the site of tracheal stenosis were performed to achieve successful extubation. The second infant remained asymptomatic. Values for lung mechanics and volumes for both infants with pulmonary aplasia were as follows: Crs, 3.43 and 10.60 mL · kPa−1 · kg−1; sCrs, 0.23 and 1.28 kpa−1; Rrs, 11.1 and 7.4 kpa · s · L−1; FRCN2, 14.9 and 10.2 mL · kg−1; FRCpleth, 28.2 and 25.8 mL · kg−; FRCN2: FRCpleth ratio, 0.56 and 0.54 for patients 1 and 2, respectively. These values differed considerably from results of a control group of nine term healthy neonates (Crs, 10.0 ± 1.8 mL · kPa−1 · kg−1; sCrs, 0.43 ± 0.08 kpa−1; Rrs, 5.10 ± 0.55 kpa · s · L−1; FRCN2, 24.0 ± 2.5 mL · kg−1; FRCpleth, 31.1 ± 6.0 mL · kg−1; FRCN2:FRCpleth ratio, 0.78 ± 0.10). In conclusion, serial assessment of lung mechanics and pulmonary gas volumes detects airway obstruction early in neonates with unilateral lung agenesis. Bronchoscopy is recommended. Along with conventional surgical procedures, an expandable implant may improve management or prevent respiratory failure in selected cases. Pediatr Pulmonol. 1998; 26:138–144. © 1998 Wiley‐Liss, Inc.