Sleep Health Issues for Children with FASD: Clinical Considerations

This article describes the combined clinical experience of a multidisciplinary group of professionals on the sleep disturbances of children with fetal alcohol spectrum disorders (FASD) focusing on sleep hygiene interventions. Such practical and comprehensive information is not available in the literature. Severe, persistent sleep difficulties are frequently associated with this condition but few health professionals are familiar with both FASD and sleep disorders. The sleep promotion techniques used for typical children are less suitable for children with FASD who need individually designed interventions. The types, causes, and adverse effects of sleep disorders, the modification of environment, scheduling and preparation for sleep, and sleep health for their caregivers are discussed. It is our hope that parents and also researchers, who are interested in the sleep disorders of children with FASD, will benefit from this presentation and that this discussion will stimulate much needed evidence-based research

Protein secretion from the rat exocrine pancreas: role of calcium, carbachol and the cyclic nucleotides.

Protein release from the rat exocrine pancreas was stimulated in vitro by carbachol or dibutyryl cyclic AMP (DBC); secretion caused by a combination of these two agents was greater than the sum of their individual effects. The secretory effect of carbachol or DBC, alone or in combination, was dependent on the concentration of extracellular calcium, although protein release was increased by carbachol plus DBC at small concentrations of extracellular calcium. Manganese or lanthanum inhibited protein release stimulated by carbachol or carbachol plus DBC at optimal concentrations of calcium but not that caused by carbachol plus DBC at small concentrations of calcium. Carbachol stimulated and DBC reduced efflux of 45Ca from prelabelled pancreas pieces. The results indicate that carbachol, in a step dependent on extracellular calcium, activates a muscarinic receptor; this results in an increase in the concentration of cytoplasmic ionized calcium, which is essential for the secretory process. This cytoplasmic calcium is not derived from extracellular sources but probably comes from intracellular stores. DBC potentiates the effect of carbachol by conserving intracellular ionized calcium for utilization in the secretory process.La libération de protéines par le pancréas exocrine du rat a été stimulée in vitro par le carbachol ou l'AMP cyclique dibutyrylé (DBC); la sécretion occasionnée par la combinaison de ces deux agents est plus grande que la somme de leurs effets respectifs. L'effet du carbachol ou du DBC, seuls ou combinés, est dépendant de la concentration extracellulaire de calcium, bien que la libération de protéines soit augmentée par la combinaison carbachol plus DBC à faibles concentrations de calcium extracellulaire. Le manganèse ou le lanthanum inhibent la sécrétion stimulée par le carbachol, ou le carbachol plus DBC, à concentrations optimales de calcium, mais pas la sécrétion causée par le carbachol plus DBC à faibles concentrations de calcium. Le carbachol stimule cependant que le DBC reduit la sortie de 45Ca, dans des morceaux de pancréas préalablement marqués. Les résultats indiquent que le carbachol active un récepteur muscarinique, dans une étape dépendante du calcium extracellulaire; ceci résulte en une concentration plus élevée de calcium ionisé dans le cytoplasme, ce qui est essentiel pour le processus de sécrétion. Le calcium cytoplasmique n'est pas dérivé de sources extracellulaires, mais il provient probablement de sites intracellulaires de storage. Le DBC augmente l'effet du carbachol en conservant le calcium intracellulaire pour fins d'utilisation dans le processus de sécrétion