Midazolam is a short acting sedative with small number of adverse effects. Administered orally, it is currently the most common form of conscious sedation in children. The objective of this paper is to describe effect of midazolam administered to children during dental treatment on their vital signs, and to monitor changes in children’s behavior. We described values of vital signs and behavior in 418 sedations conducted in 272 children between 1-12 years of age. To achieve the following results, we used data from 272 all first-time sedations. After administration of midazolam arterial blood pressure and blood oxygen saturation decreased by values which were not clinically significant. The heart rate increased, with values staying within the limits of physiological range. The speed of onset of midazolam’s clinical effects depends on age and dose. The lower age and dose correlated with the higher behavior score. The effectiveness of midazolam treatment is 97.8 %. Unwillingness of child to receive midazolam is predictor for disruptive behavior during sedation. 1.8 % of all sedation cases showed paradoxical reactions. The administration of midazolam in dose of 0.5 mg per 1 kg of child’s body weight is safe and could be recommended for dental treatment in pediatric dentistry., Jana Vasakova, Jana Duskova, Jitka Lunackova, Klara Drapalova, Lucie Zuzankova, Luboslav Starka, Michaela Duskova, Zdenek Broukal., and Obsahuje bibliografii
Rozchod rodičů je proces, který dlouhodobě ovlivňuje životy všech zúčastněných. Cílem studie je popsat rozchod rodičů z pohledu dítěte. Vnímání rodiny dětmi jsme zkoumali pomocí metody FAST. Děti stavěly typickou, ideální a konfliktní reprezentaci rodiny. Porovnávali jsme skupinu 15 dětí v situaci rozchodu rodičů a skupinu 19 dětí ve stabilním rodinném prostředí bez vážných rodičovských konfliktů, průměrný věk dětí z obou skupin je 9,5 let (rozpětí 5-15 let). Zajímali jsme se o členství v rodině, kohezi a popis konfliktů v rodině. Děti v situaci rozchodu rodičů popisovaly nižší kohezi nejenom ve vztahu mezi rodiči, ale i mezi sebou a oběma rodiči. To je v souladu se zjištěními, která poukazují na horší kvalitu rodičovství po rozchodu rodičů. Děti, jejichž rodiče se v době sběru dat rozcházeli, zahrnovaly do rodiny příbuzné nad rámec primární rodiny. Členství těchto lidí v rodině ale nebylo trvalé. Zdá se, že tyto děti hledají oporu v dalších vztazích v širší rodině, nebo nahrazují kvalitu (zhoršení vztahů po rozchodů rodičů) kvantitou ve vztazích. Popisují také rodinné konflikty s horším výsledkem a nepopisují účinné strategie řešení konfliktů. and The divorce of parents is a situation which in the long term affects life of everyone involved. The aim of this study is to describe the parents’ divorce from the child’s point of view. The perception of the family by children was examined by the FAST method. The children presented a typical, an ideal and a conflict representation of the family. We compared the group of 15 children in a divorce situation with the group of 19 children in stable family environment without significant parental conflicts. The average age of children in both groups was 9,5 years (range 5 – 15 years). We were interested in the family members, cohesion and the description of family conflicts. Children in parents’ divorce described a lower cohesion not only in the parents’ relationship but also between themselves and both parents. This supports the spillover concept in the family and is in harmony with findings, which point out the inferior quality of parenthood after the divorce. Children, whose parents were in the process of divorce during the collecting of data, included into the family also relatives outside the primary family. However, their membership in the family was not permanent. It seems that these children are seeking for support in relationships within the extended family or they substitute the quality (the worsening of quality after the divorce) by quantity in relationships. They also describe family conflicts with worse results, and they don’t describe effective strategies of solving conflicts.
Fatty acid (FA) profiles as potentially relevant components of Crohn’s disease (CD) have been insufficiently analysed. We sought to explore the plasma profiles of n-3 and n-6 polyunsaturated fatty acids (PUFAs) in newly diagnosed untreated active CD. We included 26 consecutive CD pediatric patients (<19 years) and 14 healthy controls (HCs). Disease characteristics, including inflammatory markers, dietary histories, and the Pediatric Crohn’s Disease Activity Index (PCDAI), were obtained. The profiles of plasma FAs in plasma lipid classes were analysed by gas chromatography with FID detection of methyl esters. The erythrocyte sedimentation rate, C-reactive protein level and fecal calprotectin level (all p<0.001) were significantly higher in CD patients than in HCs. Most changes were observed in plasma phospholipids (PLs), such as a higher content of n-3 and changes in n-6 long-chain PUFAs in the CD group. The CD group had a lower ratio of n-6/n-3 PUFAs in PLs (p<0.001) and triacylglycerols (TAGs) (p<0.01). Correlations of the FA content in plasma PLs with disease activity scores of CD were also observed, which were positive for the sum of monounsaturated fatty acids (MUFAs) as well as oleic acid (18:1n-9) (both p<0.05). The metabolism of PUFAs is significantly altered even in treatment-naïve newly diagnosed active pediatric CD, and the content of major FAs in PLs correlates with disease activity and inflammatory markers, thus probably contributing to the still unclear early disease pathogenesis., Jan Schwarz, Marek Vecka, František Stožický, Renáta Pomahačová, Barbora Staňková, Eva Tvrzická, Marcela Kreslová, Romana Zahálková, Josef Sýkora., and Obsahuje bibliografii