This is an open access article under the terms of the Creative Commons Attribution-NonCommercial-NoDerivs License, which permits use and distribution in any medium, provided the original work is properly cited, the use is non-commercial and no modifications or adaptations are made. Abstract Aim:We evaluated what determined breastfeeding problems in a non-selected mother-infant cohort, with special reference to tongue-tie and improvements in breastfeeding following frenulotomy. Methods:This 2014-2015 prospective, observational study was carried out in a tertiary level maternity unit affiliated to the University of Freiburg, Germany, using a breastfeeding questionnaire, standardised breastfeeding scores and the Assessment Tool For Lingual Frenulum Function (ATLFF). The standard intervention was breastfeeding support, a frenulotomy for tongue-tie was performed if necessary. All cases of breastfeeding problems and, or tongue-tie, were followed up by telephone 2.5 weeks after birth. Results:We enrolled 776 newborn-mother dyads: 345 had breastfeeding problems, 116 had a tongue-tie and 30 underwent a frenulotomy. In the multivariate analysis, severe breastfeeding problems were more frequent in newborn infants with tonguetie, with an odds ratio (OR) of 2.6 (P= 0.014). Other risk factors were: no breastfeeding experience (OR 4.4, P = 0.001), low birth weight (OR 2.9, P = 0.001), prematurity (OR 3.6, P = 0.000) and Caesarean section (OR 1.6, P = 0.023). There was a significant reduction in breastfeeding problems after frenulotomy (P = 0.01). Conclusion:Tongue-tie had a significant impact on breastfeeding and so did low birth weights and prematurity. Frenulotomy proved helpful when breastfeeding problems were reported. K E Y W O R D Sankyloglossia, breastfeeding problems, frenulotomy, Hazelbaker score, tongue-tie
We report two cases of ectopic cervical thymus, a solid thymic lesion, and a thymus cyst causing inspiratory stridor and mild dysphagia in the neonatal period. Because of the rarity of thymic dystopia, the two masses were initially misdiagnosed as more common entities, namely, lymph node enlargement and lymphangioma, respectively. The correct diagnosis was made only after surgical excision and histopathological examination. This case report is completed by a short review of embryogenic development, diagnostic procedures with differential diagnoses, and therapeutic outcome of ectopic thymus.
To facilitate a diagnosis of a lipoma, specific imaging is needed such as ultrasound or magnetic resonance imaging (MRI). Two male patients exhibiting a soft tissue tumor in the salivary gland area were examined using sonography and MRI. Final diagnosis was identified by excision biopsy. Ultrasound showed a hypoechoic, feathered, mostly ovoid structure. Color Doppler sonography does not detect any signals besides in cases of angiolipoma. This is accompanied by vessels and does not show the typical feathered structure. With MRI, it is possible to confirm the diagnosis by visualization of fat-equivalent intensity values. Diagnosing soft tissue swelling in the salivary gland, clinical examination and an ultrasound or MRI scan are recommended.
Objectives/Hypothesis: The prevalence of tympanostomy tube surgery (TTS) in patients with a cleft deformity was investigated, in relation to cleft width and cleft type.Study Design: Retrospective review of medical health records. Methods: Retrospective review of medical health records. Seventy-eight patients with non-syndromic cleft deformity of the palate and/or alveolus and lip between 2003 and 2017 were investigated. All available medical documents were analyzed. The study group was divided into subgroups: 1) patients with isolated cleft palate (CP) and patients with a cleft palate with cleft lip and alveolus (CLP). 2) According to Veau's classification (I-IV), further subgroups were defined. Cleft width was measured using plaster cast models.Results: TTS was performed in 55% of the patients (n = 43). Considering Veau's classification, TTS was conducted as follows: Veau I 65.2% (n = 15/23), Veau II 55.0% (n = 11/20), Veau III 47.6% (n = 10/21), and Veau IV 50.0% (n = 7/14). Cleft classifications, maxillary arch width, and absolute/relative cleft width had no statistical impact on TTS occurrence. Although no significant correlation could be found, patients in our study group with CP (Veau I and II) underwent TTS more often (60.5%, n = 26/43) than patients with CPL (Veau III and IV; 48.6%, n = 17/35) during a three-year follow-up.Conclusion: None of the cleft characteristics examined had a significant impact on the proportion of patients who received TTS. Nevertheless, patients with lower Veau classification and CP received tympanostomy tubes more often. Therefore, otolaryngologists and pediatricians treating children with cleft palate should maintain a high level of suspicion for chronic middle ear effusion, even in patients with small clefts.
Simple reaction time has been measured using various distributions of interstimulus intervals (ISIs), which differed both in the shape of their envelope and in their degree of discretization. For each of 7 such conditions, and for three mean ISIs (2.0, 3.3, and 5.8s) 600 responses of two subjects have been accumulated.Reaction times depend significantly on the shape of ISIdistributions but also on their degree of discretization. Within an experimental run they depend on single ISIs back to the third before reaction, and on sequences of ISIs. The latter effects are again influenced by the discretization of ISIs. Finally it was found that some learning of the distribution pattern (not the mere mean value) of ISIs takes place.Our results shed some light on existing hypotheses of RT. Some inconsistencies of earlier experimental results can probably be explained by insufficient consideration of the discretization and the learning effects.
Abhängigkeit der Reaktionszeit von der zeitlichen Folge optischer Reize Kybernetik vorgänge, (e) die Aufgabenstellung für die Reaktion und (d) die äußeren Versuchsumstände. Im einzelnen sind folgende Einflüsse • gefunden worden*: Eine Verkürzung der RZ tritt ein: durch eine größere Siimtilusfläche bei optischen Reizen [13, 32], bei akustischen Stimuli gegenüber optischen [13, 17, 35], bei erhöhtem Signalkontrast [31], durch Übung an der Versuchsapparatur [8], durch Adaption an einen bestimmten Ton [22], durch Muskelanspannung [9], bei Belastung des Armes mit einer Zusatzmasse [40], bei der Einatmung [16], durch erhöhte Umgebungstemperatur bis 35° [24]. Eine Verlängerung der RZ wird bewirkt durch: kürzere Reizlänge (bei Reizen niedriger Intensität) [29], geringere Reizintensität [29, 33], Stimulus im peripheren Gesichtsfeld [30], zunehmende Zeitunsicherheit der Reize [1, 3, 18, 21, 27], zunehmend komplexere Aufgaben [20J, Reaktion mit dem Fuß, verglichen mit der Hand [17], Umgebungstemperatur über 40° [24], große Höhen über NN [34], mehrfache Erdbeschleunigung [7], erhöhtes Alter [2], Alkoholgenuß [11]. Außerdem wird die Reaktionszeit durch folgende Faktoren beeinflußt: Relativqualitäten von warnendem und auslösendem Reiz [19], zeitliche Verteilungsfunktionen der warnenden Stimuli und des Abstandes zwischen warnendem und auslösendem Reiz [3, 6, 19], den cx-Rhythmus des Gehirns [25], ein umgebendes niederfrequentes elektrisches Feld [14].
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