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To evaluate the impact of human milk and different neonatal variables on tidal breathing flow-volume loop (TBFVL) parameters within three months' corrected age (CA) in infants born ≤32 wks or weighing1500 g.We retrospectively studied 121 infants with gestational age (GA) ≤ 32 weeks or birth weight (BW) 1500 gr who had lung function assessment within three months' CA by TBFVL analysis between June 2009 and April 2018. We investigated the impact of GA, gender, being Small for GA (SGA), sepsis, days of mechanical ventilation (MV) and human milk feeding (HMF) on later respiratory function, both in the entire group and according to BW ( ≤1000 g and1000 g).The mean(SD) z-score for tidal volume (Vt) and time to peak expiratory flow to expiratory time (tPTEF/tE) were respectively -4.3 (2.5) and -0.8 (2.0) for the overall population with no significant differences between infants1000 g or ≥1000 g. The mean(SD) Vt standardized for body weight was 6.2(2.0) ml/kg. Being female was associated with better Vt/Kg, whereas longer MV or being born SGA were associated with worst tPTEF/tE. For infants with BW 1000 gr, tPTEF/tE was positively associated with HMF.An early TBFVL assessment within three months' CA already reveals lung function alteration in preterm infants. Being female is associated with better Vt/Kg, while longer duration of MV or being born SGA negatively affect tPTEF/tE. The positive association between HMF and better tPTEF/tE in infants with BW1000 g has emerged, which deserves further investigation.

Aims Whereas cortical EEG effects of benzodiazepines are well characterized, information about benzodiazepine effects in other areas of the central nervous system is sparse. This study investigated the action of midazolam and its active metabolite α-hydroxy-midazolam on different parts of the auditory pathway in six healthy volunteers in a randomized, double-blind, three-way cross-over study. Methods Acoustically evoked short (SLP) and middle (MLP) latency potentials, transitory evoked otoacoustic emissions (TEOAE), and EEG power spectra were analysed after short i.v. injections of placebo, or 0.15 mg kg−1 midazolam, or α-hydroxy-midazolam, respectively. Results All subjects fell asleep during the 4 min infusion of active drug. SLP showed a significant transient increase of Jewett wave V 10 min after injection for midazolam and α-hydroxy-midazolam while the latency of wave I was unchanged. Both benzodiazepines induced a marked and long-lasting MLP amplitude decrease for 240 min with slow recovery over the following 360 min. No changes of TEOAE were observed. In agreement with earlier reports, increases in EEG beta activity and decreases in alpha activity were observed after administration of either drug. Conclusions Systemically administered benzodiazepines modulate the auditory pathway above the level of the cochlea. While SLP changes were closely associated with sedation and high plasma benzodiazepine concentrations, MLP effects persisted for hours after sedation even at low benzodiazepine plasma levels. Evoked potentials may therefore be more sensitive than EEG as a tool to monitor benzodiazepine effects.

Sodium valproate enteric-coated tablets were administered as monotherapy to 118 patients (median age, 19 years) with primary generalized epilepsies. More than half (56%) of these patients were transferred from prior drug therapy, most of them because of inadequate seizure control, and some because of adverse effects. Seventy-one percent of the patients experienced tonic-clonic seizures, either alone or in combination with other types of seizures, principally absences. Mean duration of follow-up was 18 months (median, 17 months; range, 1-68 months). At a mean daily dosage of less than 20 mg/kg, 83% of the patients became seizure-free. Therapy was equally effective against tonic-clonic seizures, absences, and myoclonic seizures. Tonic-clonic seizures were suppressed in 85% of cases (89% when patient had only one seizure type), absences in 82% (95% when patient had only one seizure type), and myoclonic seizures in 82%. Paroxysmal activity was present in 88% of the electroencephalogram (EEG) records before valproate monotherapy, and in 32.4% at the study's end. These results were achieved with generally mild and mostly transient side effects; side effects were reported by 16% of patients during the first month, and 2% at the last follow-up. No hematologic or hepatic toxicity was observed. The lag time between attaining steady-state serum concentrations and achieving maximal clinical improvement suggests that sodium valproate monotherapy should be given an adequate trial to ensure that patients derive the greatest possible benefit before adding or switching to another drug.

The effect of 15 mg midazolam and 15 mg oxazepam compared with placebo was investigated in 12 shift-workers in a randomized cross-over sleep laboratory study with psychometric testing. Sleep latency was normal under all experimental conditions. Midazolam shortened the sleep latency, reduced the frequency of nocturnal awakenings, and increased the length of sleep stages 3 and 4. Both midazolam and oxazepam reduced the total waking time and prolonged the total sleep time. Neither of the two benzodiazepines negatively influenced performance after awakening. On the basis of these findings, midazolam would appear to be suited for the treatment of insomnia in shift-workers or of other situational sleep disturbances.

SUMMARY Two unusual cases of sensory precipitation of epileptic attacks are presented and briefly discussed. One patient had suffered from tonic and clonic seizures in her right arm for 11 years. The seizures were induced by touching this arm or even by carrying a heavy object. She never had a generalized seizure. The other patient had petit mal-like attacks when taking food, sometimes provoked by the mere sight of it. In both cases the epileptic nature was confirmed by the EEG and by successful anticonvulsant treatment. RESUME Deux cas inhabituels de declanchement sensoriel d'attaques epileptiques sont presentes et brievement discutes. L'un concerne une patiente souffrant de crises tonico-cloniques de son bras droit, depuis 11 ans, a l'exclusion de toute generalisation. Les crises etaient induites par le simple contact decebras, ou lorsqu'elle soulevait un objet lourd. L'autre patient avait des crises de type petit mal lorsqu'il absorbait de la nourriture ou meme parfois a la simple vue de celle-ci. Dans les deux cas, la nature epileptique a ete confirmee par l'E.E.G. et par les bons resultats d'une therapeutique anticonvulsivante.