More than just a health issue: a review of current issues in the care of enterally-fed children living in the community

There are increasing numbers of children with a disability living in the community who require enteral tube feeds to optimize their nutritional status. Whilst there appears to be evidence of health gains, for some children there may also be serious and unintended social deprivations resulting from the need to be tube fed. This paper reviews the literature on support for children who are tube fed and makes a case for more coordinated and effective support services for families who are tube feeding a child at home. It is argued that national guidance should be developed which clarifies the position of all non-parent carers and staff who are willing to administer enteral tube feeds. Such guidance should also ensure that enterally-fed children have the same rights to educational and social services as other children and that families are given the opportunity to make informed decisions about the implications of enteral feeding prior to it being established.     

Morphology of conjunctival progressive nevus

Structural features of 59 progressive nevuses of the conjunctiva were studied. The proliferation of the epithelium and melanocytes is partially compensated by spontaneous regression of the nevus structures. The growth of a nevus is structurally similar to tumor growth, but the nevuses lack the melanocyte dysplasia, the main sign of malignant degeneration. The immune reactions are involved in the tissue restructuring of the growing nevus. Permanent foci of photoelastosis reflect the significance of ultraviolet exposure as a factor of risk of the nevuses progress.     

Huge colloid cyst of the third ventricle associated with calcification in the cyst wall

Giant or huge colloid cysts of the third ventricle up to of more than 3 cm in diameter are extremely rare. The patient presented with symptoms of increased intracranial pressure, including headache, vomiting, and papilledema. Computerized tomographic (CT) scan revealed a hypodense, huge colloid cyst of the third ventricle associated with calcification in the cyst wall. Both hypodensity and calcification are uncommon roentgenological findings for colloid cysts of the third ventricle. The patient was operated on by the transcortical/transventricular approach and the colloid cyst was completely excised.     

Luminal non-specific cationic channels in cultured strial marginal cells of guinea pig and gerbil as determined by patch clamp technique.

Using primary cultures of marginal cells of stria vascularis from guinea pig and gerbil, ionic channels located on the luminal membrane were investigated by means of patch clamp technique. Recordings were performed in cell-attached and inside-out configurations. In cell-attached configuration, single channel activity was identified with a conductance of about 25 pS. I-V curve was linear. The probability of opening was increased upon depolarization. Up to 7 channels could be present in the same patch, indicating a rather high density. In inside-out configuration, the reversal potential was 0 mV, suggesting a non-specific cationic channel. These luminal non-specific cationic channels would allow the passive K+ efflux and Na+ influx across the apical membrane of marginal cells. This finding is consistent with the "one-pump" model of strial activity. The present study suggests that culture of strial marginal cells may be a suitable model for in-depth investigation of endolymph physiology.     

P300 in freely moving cats with intracranial electrodes.

Nine chronically implanted cats were used in order to study the event related potentials (ERPs) of the brain with the "omitted stimulus" paradigm. The cats were not restrained and not conditioned, could behave freely in a soundfree room. Due to a selective averaging method a P300 like of response component could be detected in the hippocampus, auditory cortex and reticular formation. The most robust and ample component was the N200-P300 wave complex of the hippocampus. The results are interpreted as follows: the P300 component in the cat brain has probably distributed generators with various frequency selectivities. The hippocampal ERP has a strong theta response component, whereas the auditory cortex and reticular formation have more marked 10 Hz responses.     

The application of dysarthria profile tests in ALS patients for the detection of speech disturbances

Dysarthria is an invalidating disability in ALS patients with motor neuron degeneration in the bulbar region. The methods to assess dysarthric disorders in ALS are seldom described in publications. This study was performed in 43 patients who had definite (n = 23) or probable (n = 20) ALS (of the bulbar group n = 15, of the limb group n = 28, mean age = 57.07 (range: 36-69 yr.)) according to WFN criteria. The method based on quantitative tests of dysarthria profile (by Robertson, 1986) was used and the results were compared with 37 age, sex-matched, healthy control subjects. Our study showed the existence of disturbances in all dysarthria profile tests which were of the statistic significance and more frequent as compared to the control subjects (p < 0.01). The analysis showed that quantitative assessment of some dysarthria profile tests (5 out of 8) might be useful in clinical practice to detect dysarthria in ALS patients. Using the dysarthria profile tests we also demonstrated that preclinical dysarthric processes occur among the limb ALS group.     

Retroperitoneal benign schwannoma. Report of a new case

The schwannoma is a tumor resulting from the Schwann cells of neural shwath, being its retroperitoneal localization quite unusual. This tumor is clinically unspecified and in most of the cases it originates symptoms coming from the compression of the close structures when its localization is retroperitoneal. Its diagnosis is quite often fortuitous being confirmed by anatomopathological study afterwards. The treatment is surgical radical exeresis with subsequent followup. We report a new case of this uncommon retroperitoneal pathology in a female patient showing a nonspecific clinic. Two years after the surgery she remains asymptomatic without any radiological evidence of recidive.     

Massive lymphatic involvement secondary to prostatic adenocarcinoma

Prostatic carcinoma may be diagnosed by the clinic manifestations or by the symptoms for locoregional disemination and distance metastasis. The lymphatic system is the first metastatic station, which is affected in a high percentage of cases. Event it may simulate lymphoproliferatives process and it si uncommon the lymphatic macroaffectation at first. In theses cases, the histologic and immunohistochemical study by the determination of prostatic specific antigen in lymph nodes can provice the diagnosis. Treatment of these tumors is palliative with hormonotherapy. Prognosis is bad with a low survival at five years.