Bleeding disorder from the "fat overload" syndrome

The fat overload syndrome developed in a 7-yr-old girl receiving total parenteral nutrition with 20% Intralipid. She developed a bleeding disorder characterized by severe hematemesis that appeared to be due to abnormal platelet function associated with platelet phagocytosis of lipid demonstrable by electron microscopy. The platelet defect and bleeding reversed when the lipemia cleared.     

养宠物小心“宠物依赖症”

很多养宠物的人都深有同感,可爱的小猫小狗等宠物给人们带来了很多快乐,有些宠物豢养者在小猫小狗身上倾注的感情不少于孩子,一日不见如隔三秋;当宠物丢失或死亡时,宠物主人所受的心理伤害非常大,以致会茶饭不思,以泪洗面,这些都是宠物依赖症的表现。养宠物虽然有利于减压,但也不可过分依赖。     

Restless legs syndrome: the most prevalent "unknown" disorder

Sleep disorders are also considered as significant chronic disorders, as their physiological and psycho-social consequences are well documented. Restless legs syndrome has high prevalence, as it occurs in 5-10 % of the general population. Since clinical presentation is not well appreciated by many of the health care professionals, only a small proportion of the patients with restless legs syndrome is diagnosed and treated. The consequences of disease, however, are not negligible. The majority of the patients suffer from insomnia, impaired daytime functioning and quality of life. Although, restless legs syndrome is frequently characterized as a sleep disorder, it does not only influence sleep but also the daytime functioning of the patients. Additionally, restless legs syndrome causes not only subjective complaints and sleep disruption, but it is also associated with cardiovascular disorders.     

The quantitative relationship between "the metabolic syndrome" and abdominal obesity in women

Abdominal obesity is closely associated with the presence of metabolic risk factors and elevated blood pressure in selected materials. This has, however, never been analyzed quantitatively in a non-selected cohort. Therefore, in a population-based study of 1462 Swedish women, four selected risk factors for non-insulin dependent diabetes mellitus (NIDDM) and cardiovascular disease (CVD), serum triglycerides, blood glucose and systolic blood pressure and also serum insulin in a subsample, were examined in relation to regional and overall obesity. This was performed by subdividing the age adjusted sample into quintiles of waist to hip circumference ratio (WHR) or body mass index (BMI) as indicators of abdominal distribution of body fat and overall obesity, respectively. The risk factors serum triglycerides, blood glucose, blood pressure and serum insulin were defined as being elevated when the value of the risk factor was higher than the mean plus one or two standard deviations of the total age-adjusted cohort. The percentage of women with elevated risk factors according to this definition was then calculated in each of these quintiles. Having a risk factor which was elevated according to the definition was significantly correlated to WHR and BMI (p<0.0001) independent of age. The presence of one or several of these elevated risk factors was clearly higher than expected in the fifth quintile of WHR, and to a lesser extent in the fifth quintile of BMI while this was not the case in the lower quintiles of WHR and BMI. When studying the combination of the WHR and BMI, the presence of risk factors higher than the mean plus two standard deviations increased gradually with WHR in all five quintiles of BMI. A significant association was observed between WHR and presence of risk factors independent of BMI (p<0.0001) but BMI did not remain significantly correlated to presence of risk factors when controlling for WHR (p=0.09). These results indicate that abdominal distribution of body fat in women independently of general obesity is closely associated with metabolic risk factors including elevated blood pressure, a metabolic syndrome with increased risk for cardiovascular disease and non-insulin dependent diabetes mellitus.     

"Size" and "shape" variables in the presence of covariates: an application to the sudden infant death syndrome

A "size measure independent of shape" is used to investigate differences in "size" and "shape" variables, defined as functions of weight and length at birth, between a random control group and victims of the Sudden Infant Death Syndrome (SIDS). At birth, the SIDS group has a lower mean size than the control group. After adjusting for maternal and environmental factors (covariates), there is a lessened but persistent difference in size, suggesting the existence of some undetected factor linked to sudden death in infants.     

"PDSA-ADHD": a newly reported syndrome

We present a satirical case report of a new syndrome, called "plan do study act-attention deficit hyperactivity disorder," or PDSA-ADHD. This syndrome is associated with the implementation of multiple simultaneous plan-do-study-act cycles as a quality improvement approach in a health care setting. This case represents a clinical warning sign of quality improvement impairment and suggests a new variant of organizational attention deficit disorder.     

The Angelman or "happy puppet" syndrome

A case of Angelman's or "happy puppet" syndrome is described and detailed analysed, first time in our country. The literature is reviewed. The diagnostic criteria are presented. Evoked potential study and more than two years long EEG follow-up results are discussed. The unusual clinical feature of the described case is that epilepsy presented itself very early, in age of two weeks, by infantile spasms. It changed later to focal secunder generalised epilepsy. The EEG has been always abnormal during the follow-up, and the pattern has been changing by the age of the patient. On the other hand, the evoked potentials were all normals (BAEPs, VEP, SSEP CCT) "O"n the basis of the electrophysiological dichotomy the authors suggest a predominantly gray matter's disorder in Angelman's syndrome. They emphasize, that Angelman's syndrome has to be keep in evidence in the differential diagnosis of early infantile epilepsies. In the presented case the familial accumulation of movement's dyscoordinations, the dysmorphic features and subnormal intelligence of the brother support the possibility of the role of an autosomal recessive gene with different penetrance in the pathogenesis of Angelman's syndrome.