Daily mood and sleep: reciprocal relations and links with adjustment problems

Children's sleep problems are common and associated with increased risk for adjustment problems. We examined daily links between children's sleep and mood, using a daily diary method and actigraphy. We also tested children's daily mood as a mediator of relations among sleep and children's broader internalizing and externalizing symptoms. A community sample of 142 children (mean age = 10.69 years; 57% girls; 69% European American, 31% African American) and their parents participated. For 1 week, children wore actigraphs and parents completed a daily telephone interview about their child's mood. Following the week of actigraphy, mothers and fathers reported on their child's adjustment. Multi‐level models indicated within‐person relations between children's mood and subsequent sleep fragmentation (indicated by increased activity) and sleep latency, and between‐person relations between sleep latency and subsequent mood on the next day. Significant indirect effects were found such that a more negative daily mood (aggregated across diary days) mediated relations between poor sleep efficiency and longer sleep latency and parent‐reported internalizing and externalizing symptoms. Findings extend previous research by highlighting disruptions to children's daily mood as a potential mechanism linking sleep problems to children's mental health.     

Vergleichende Untersuchungen über die organotrope carcinogene Wirkung verschiedener N-Nitrosoverbindungen nach einmaliger bzw. langzeitiger Applikation bei Ratten

Zusammenfassung Die einmalige Gabe von 200 mg N-Nitrosodiethylamin/kg Körpergewicht per Magensonde bewirkt bei weiblichen Ratten (SIV 50) das Auftreten von Nierentumoren, während die Anwendung von 10 ppm N-Nitrosodiethylamin im Trinkwasser Oesophagus-und Lebertumore induziert. Diese Veränderung der organotropen carcinogenen Wirkung wird nicht mit den am Phenylrest methylsubstituierten N-Methyl-N-nitrosobenzylaminen erhalten. Sowohl Langzeit-als auch die einmalige Applikation lösen Tumore im Oesophagus und im Pharynx aus.Für die histologischen Befunde, der mit N-Nitrosodiethylamin behandelten Tiere danken wir Prof. Dr. F.-W. Kolkmann, Pathologisches Institut am Kreiskrankenhaus Nürtingen     

Detection of visual field progression in glaucoma with standard achromatic perimetry: A review and practical implications

Detection of visual field progression remains a challenging task despite the recent advances for better handling of longitudinal visual field data, some of which are incorporated in currently available perimeters. Standard achromatic perimetry remains the gold standard for detection of visual field progression. The authors present a practical and clinically relevant review of the main issues involved in detection of early glaucoma as well as detection of visual field progression in eyes with pre-existing glaucomatous damage. After discussing some basic concepts in perimetry, the authors present evidence-based recommendations for criteria to detect earliest evidence of glaucomatous damage with perimetry. The authors will review different event- and trend-based criteria and present data with regard to comparative performance of such criteria. Relevance of using absolute versus corrected threshold data with regard to different criteria is also addressed. At the end, the authors provide practical guidelines for detection of visual field progression in a clinical setting and review issues related to clinical trials.     

No increase in the prevalence of asthma, allergies, and atopic sensitisation among children in Germany: 1992-2001

BACKGROUND: From 1970 to 1990 increasing rates of asthma and allergic sensitisation were observed in several countries. The aim of this study was to investigate time trends in the prevalence of asthma and allergic sensitisation among school children in Germany between 1992 and 2001. METHODS: Parental reports of asthma, hay fever, and wheezing and measurements of specific serum IgE antibodies were investigated in six serial cross sectional surveys of 9-11 year old school children in three study areas in south west Germany. RESULTS: A total of 6762 school children of mean age 10 years (mean participation rate 77.9%) took part in the investigation in the three study areas. Over the 9 year study period no increase in the prevalence of current wheezing and asthma was observed. In addition, the prevalence of atopic sensitisation remained unchanged during the observation period. CONCLUSIONS: These data, using parental reports and objective measures of allergy, suggest that there has been no further increase in the prevalence of asthma and atopy since 1992. The epidemic may thus have reached a plateau.     

Chronic wounds

Chronic wounds are a challenge to treat for the clinician. We present a current overview of intrinsic and extrinsic factors in the development chronic nonhealing wounds. Solutions to some of these difficult problems are presented.     

Reconstruction of complex facial defects after radical resection of advanced skin cancers

Management of patients with extensive facial skin cancers is a challenge. We present a series of nine patients with extensive facial skin cancers and our experience with managing these patients.     

Visual field changes after cataract extraction: the AGIS experience

PURPOSE: To test the hypothesis that cataract extraction in glaucomatous eyes improves overall sensitivity of visual function without affecting the size or depth of glaucomatous scotomas. DESIGN: Experimental study with no control group. METHODS: One hundred fifty-eight eyes (of 140 patients) from the Advanced Glaucoma Intervention Study with at least two reliable visual fields within a year both before and after cataract surgery were included. Average mean deviation (MD), pattern standard deviation (PSD), and corrected pattern standard deviation (CPSD) were compared before and after cataract extraction. To evaluate changes in scotoma size, the number of abnormal points (P < .05) on the pattern deviation plot was compared before and after surgery. We described an index ("scotoma depth index") to investigate changes of scotoma depth after surgery. RESULTS: Mean values for MD, PSD, and CPSD were -13.2, 6.4, and 5.9 dB before and -11.9, 6.8, and 6.2 dB after cataract surgery (P < or = .001 for all comparisons). Mean (+/- SD) number of abnormal points on pattern deviation plot was 26.7 +/- 9.4 and 27.5 +/- 9.0 before and after cataract surgery, respectively (P = .02). Scotoma depth index did not change after cataract extraction (-19.3 vs -19.2 dB, P = .90). CONCLUSIONS: Cataract extraction caused generalized improvement of the visual field, which was most marked in eyes with less advanced glaucomatous damage. Although the enlargement of scotomas was statistically significant, it was not clinically meaningful. No improvement of sensitivity was observed in the deepest part of the scotomas.