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Medical Causes (medical + cause)
Selected AbstractsSeizures: Medical Causes and ManagementEUROPEAN JOURNAL OF NEUROLOGY, Issue 3 2002K. A. Jellinger No abstract is available for this article. [source] Emotions and self-esteem as indicators of somatic complaints in childrenINFANT AND CHILD DEVELOPMENT, Issue 6 2006Mark Meerum Terwogt Abstract The literature on somatic complaints in children without a clear physical medical cause often demonstrates connections with various psychological factors, such as negative emotions and problems handling them, poor self-image, and coping potential. We entered these elements into a structural model to elucidate the relationships among them and tested it on 330 children (mean age 10 years and 9 months). The results showed that mood balance contributed most to the prediction of self-reported somatic complaints. Moreover, mood (in combination with anxiety and depression problems) had an indirect impact on children's somatic complaints by influencing self-esteem. The influence and position of coping was less clear. The results are discussed in terms of the ,symptom perception theory'. Copyright © 2006 John Wiley & Sons, Ltd. [source] Emergency Department Treatment of Viral Gastritis Using Intravenous Ondansetron or Dexamethasone in ChildrenACADEMIC EMERGENCY MEDICINE, Issue 10 2006Christine M. Stork PharmD Abstract Objectives To compare the efficacy of intravenous ondansetron or dexamethasone compared with intravenous fluid therapy alone in children presenting to the emergency department with refractory vomiting from viral gastritis who had failed attempts at oral hydration. Methods This double-blind, randomized, controlled trial was performed in a tertiary care pediatric emergency department. Children aged 6 months to 12 years presenting with more than three episodes of vomiting in the past 24 hours, mild/moderate dehydration, and failed oral hydration were included. Patients with other medical causes were excluded. Subjects were randomized to dexamethasone 1 mg/kg (15 mg maximum), ondansetron 0.15 mg/kg, or placebo (normal saline [NS], 10 mL). All subjects also received intravenous NS at 10,20 mL/kg/hr. Oral fluid tolerance was evaluated at two and four hours. Those not tolerating oral fluids at four hours were admitted. Discharged patients were evaluated at 24 and 72 hours for vomiting and repeat health care visits. The primary study outcome was hospitalization rates between the groups. Data were analyzed using chi-square test, Kruskal,Wallis test, Mantel,Haenszel test, and analysis of variance, with p < 0.05 considered significant. Results A total of 166 subjects were enrolled; data for analysis were available for 44 NS-treated patients, 46 ondansetron-treated patients, and 47 dexamethasone-treated patients. Hospital admission occurred in nine patients (20.5%) receiving placebo (NS alone), two patients (4.4%) receiving ondansetron, and seven patients (14.9%) receiving dexamethasone, with ondansetron significantly different from placebo (p = 0.02). Similarly, at two hours, more ondansetron-treated patients (39 [86.6%]) tolerated oral hydration than NS-treated patients (29 [67.4%]; relative risk, 1.28; 95% confidence interval = 1.02 to 1.68). There were no differences in number of mean episodes of vomiting or repeat visits to health care at 24 and 72 hours in the ondansetron, dexamethasone, or NS groups. Conclusions In children with dehydration secondary to vomiting from acute viral gastritis, ondansetron with intravenous rehydration improves tolerance of oral fluids after two hours and reduces the hospital admission rate when compared with intravenous rehydration with or without dexamethasone. [source] Diagnostic issues for adolescents and adults with ADHDJOURNAL OF CLINICAL PSYCHOLOGY, Issue 5 2005Jeanette WassersteinArticle first published online: 18 FEB 200 Attention deficit hyperactivity disorder (ADHD) is a common childhood neuropsychiatric syndrome once thought to disappear with maturation. Current data indicate that ADHD remains "hidden" in many of the grownups who had it as children. Adult prevalence rates range from 1% to 6% of the population. Research suggests the core childhood symptoms of hyperactivity, inattention, and impulsivity shift with development, perhaps transforming into more overt difficulties in executive functions and affect regulation. ADHD is also usually nestled with other comorbid psychiatric conditions, especially in adolescents and adults, further complicating diagnosis and treatment. This article discusses how to recognize and diagnose ADHD in older patients. Key points include core symptoms present during childhood, appropriate family history in this strongly genetic condition, management of comorbidity, and the evolving role of diagnostic testing. Other medical causes for similar symptoms are considered. © 2005 Wiley Periodicals, Inc. J Clin Psychol/In Session 61: 535,547, 2005. [source] Oral Abuse of Fentanyl Patches (Duragesic®): Seven Case ReportsJOURNAL OF FORENSIC SCIENCES, Issue 1 2008Karen L. Woodall Ph.D. Abstract:, In order to increase the understanding regarding the oral abuse and potential toxicity of fentanyl patches seven cases were identified over a 3-year period where fentanyl, either alone or in combination with other factors, contributed to death following the oral abuse of Duragesic® patches. The decedents comprised three females and four males with ages ranging from 20 to 51 years. Postmortem blood fentanyl concentrations were determined in all cases and ranged from 7 to 97 ng/mL. Two deaths were classified as a fentanyl overdose, three deaths were classified as a fentanyl and ethanol overdose, one death was considered a mixed drug intoxication and the remaining death was determined to be a combination of fentanyl and medical causes. These cases represent the largest reported series of deaths following the oral administration of transdermal fentanyl patches and provide detailed information on the potential for the abuse of transdermal Duragesic® patches via this route. The postmortem blood fentanyl concentrations detected for each of the decedents demonstrate the potentially fatal blood concentrations that can arise after this relatively rare route of administration. [source] Spontaneous intracranial hypotension: A study of six cases with MR findings and literature reviewJOURNAL OF MEDICAL IMAGING AND RADIATION ONCOLOGY, Issue 5 2006NI Sainani Summary Spontaneous intracranial hypotension is clinically characterized by orthostatic headache and other symptoms caused by low cerebrospinal fluid pressure due to leakage of cerebrospinal fluid from dural punctures or other medical causes. The other symptoms are mainly due to traction of the cranial and spinal nerves owing to descent of the brain caused by low cerebrospinal fluid pressure. Magnetic resonance imaging is very useful in the diagnosis because of its characteristic findings. We describe the MRI findings in six cases that had variable clinical presentation. [source] Our experience in liver transplantation in patients over 65 yr of ageCLINICAL TRANSPLANTATION, Issue 1 2008Itxarone Bilbao Abstract: Objectives:, The aim of this study was to analyze short- and long-term results of liver transplantation (LT) in patients over 65 yr. Material and methods:, Between 1996 and 2004, 386 patients underwent 415 LT at our center. The main indication for LT was post-necrotic cirrhosis in 59%, followed by hepatocellular carcinoma (HCC) over cirrhosis in 33%. Half of the patients (53%) were hepatitis C virus (HCV) +. Overall, 72 patients were >65 yr of age. Actuarial survival, causes of mortality and postoperative complications were compared between groups: patients under and over 65 yr. Risk factors for poor outcome in patients over 65 yr were also analyzed. Results:, The older group had more patients at Child A stage, more HCC as an indication for LT and more HCV (+) patients, p < 0.05. No differences were observed in donor and surgery characteristics, except for lower multi-transfusion and higher incidence of grafts with steatosis in the older group (p < 0.05). Actuarial survival at one, three, five and 10 yr was 82%, 75%, 72%, and 70% for the <65 yr group vs. 77%, 66%, 55%, and 55% for the >65 yr group (p = 0.03). Main causes of mortality in patients >65 yr were recurrence of underlying disease and medical causes. In the older age group, fewer infections (p = ns) and rejections (p = 0.017) occurred in the postoperative period. Risk factor for poor outcome in the group of patients over 65 yr in multivariate analyses was pre-LT renal insufficiency (odds ratio 3.5, p = 0.002, 95% confidence interval 1.58,7.82). Conclusion:, Results in patients >65 yr are comparable to those <65 yr if older LT candidates are carefully selected. Overimmunosuppression should be avoided in older candidates, as its effects could worsen the pre-existing diseases common in elderly patients. 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