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The developmental changes in caffeine elimination were studied in 7 infants aged between 2 1/2 weeks and 6 months. Adult plasma clearance rate of caffeine was achieved at 3 to 4 1/2 months of age. Plasma half-life and elimination rate reached adult levels after 3 to 4 1/2 months and seemed to exceed adult capacity thereafter. No significant changes in(More)
Over a 12-month period 501 children (age range 11 months to 15 years) underwent surgery for a possible middle ear effusion. All had tympanometry performed within 2 h of surgery. The results of tympanometry were correlated with the surgical findings in 955 ears. A type-B tympanogram has a high sensitivity (0.91) in predicting middle ear effusion with good(More)
Abnormalities in control of breathing have been associated with near-miss sudden infant death syndrome. Because caffeine is a respiratory stimulant, its effect on breathing pattern was evaluated in 12 infants with infantile apnea. Caffeine induced a significant increase in ventilation, tidal volume, and mean inspiratory flow. In contrast, no changes were(More)
A case of sphenoid sinusitis due to Pseudallescheria boydii is described in a 52-year-old non-immunocompromised woman. Treatment should always involve surgical drainage, and antifungal chemotherapy may be of benefit if there is histological evidence of invasion of surrounding tissue. For P. boydii infection miconazole should be the agent of choice, rather(More)
The pharmacokinetic profile of phenytoin (DPH) was studied in 30 infants aged 2 days to 96 weeks. The plasma DPH half-life during the first week of life in term infants was prolonged and very variable (20-7 +/- 11-6 h, mean +/-SD). Thereafter the plasma half-life was much shorter (7-6 +/- 3-5 h). In preterm infants the half-life was much longer (75-4 +/-(More)
Williams syndrome is a multisystem disorder, including a characteristic facies and habitus. Intellectual, neurologic, and cardiovascular dysfunction occur; vascular disease may be progressive. Joint contractures affected 10 of a group of 20 children and young adults. In 3 of 10 patients, the contractures were severe enough to interfere with daily(More)
The NHS Cancer Plan sets out targets for the diagnosis and treatment of cancer. Ideally, there should be a maximum of a 2-week wait from a referral for suspected cancer to an outpatient appointment. A fast track referral system has been established nationally, with general practitioners given guidelines as to appropriate referrals. In the South Essex(More)
From July 1975 to January 1998, 33 patients underwent partial laryngeal resection for residual or recurrent tumour after primary radical radiotherapy. Sixteen patients had T1 tumours on presentation, 14 were T2 and three were T3. Six patients underwent a supraglottic (horizontal) laryngectomy, 24 had a vertical partial laryngectomy, two had an endoscopic(More)
Two cases of papillary thryoid carcinoma presenting as a cystic lateral neck mass are reported. This tumour characteristically presents in patients under 40-years-old and in the presence of an occult primary tumour may mimic a branchial cyst. In such cases simple aspiration of the cyst will produce a chocolate-brown serous fluid which excludes the diagnosis(More)
The case of an atypical carcinoid tumour of the larynx is described in a 65-year-old man. This rare tumour may present diagnostic difficulties, but the diagnosis should be considered in a patient presenting with symptoms of local or referred pain and an apparently small, non-ulcerating supraglottic tumour. Immunocytochemistry has an important role in(More)