Absence of the enteric nervous system in the newborn: presentation of three patients and review of the literature

Three patients suffering from an absence of the enteric nervous system are reported. Two sisters presented with severe vomiting shortly after birth and dilatation of the intestine proximal to a stenosis. There was an absence of the enteric nervous system throughout the entire length of the intestine distal to the duodenum. A boy presenting an ileus was found to suffer from an aganglionosis of the entire colon. There was also an absence of neuronal bodies and nerve fibers in the small intestine. The final diagnosis was made by histochemical and immunocytochemical stains for acetylcholinesterase, lactate hydrogenase, neuron-specific enolase, protein S-100, and substance P. In the literature, 13 other patients have been reported. On the basis of differences of symptoms, incidence, sex ratio, genetics, and, presumably, pathogenesis between absence of the enteric nervous system and aganglionosis, it is assumed that the two diseases are separate entities.     

Disordered Eating and Unhealthy Weight Reduction Practices among Adolescent Females

Background.Dissatisfaction with body weight and the use of unhealthy weight reduction practices have been reported among adolescent females. There is a need for methodologically rigorous studies using large representative samples of adolescent females to accurately assess the prevalence of these behaviors and attitudes.Methods.Eight hundred sixty-nine Australian school girls ages 14–16 years were administered a self-report questionnaire to determine the prevalence of disordered eating behaviors, unhealthy dieting practices, and distorted body image. Anthropometric (height and weight) data were collected on each of these adolescent females.Results.The prevalences of disordered eating, unhealthy dieting, and distorted body image were 33, 57, and 12%, respectively. Over one-third (36%) of the total sample had used at least one “extreme” dieting method in the past month, i.e., “crash” dieting, fasting, slimming tablets, diuretics, laxatives, and/or cigarettes to lose weight. Of the total sample, 77% wanted to lose weight and 51% had tried to lose weight in the past month. Motivating factors for disordered eating and unhealthy dieting behaviors were peer pressure, media pressure, and the perception that extreme dieting strategies were harmless.Conclusion.The prevalence of disordered eating and dieting behaviors among adolescent females shown by this study suggests the need for preventive programs encouraging appropriate eating and dieting behaviors.     

CHAPARRAL-INDUCED HEPATIC INJURY

Two patients with hepatic injury after ingestion of chaparral leaf are presented. The first patient, a 71-yr-old man. developed biopsy-proven hepatitis 3 months after ingesting chaparral leaf daily. His illness resolved with discontinuation of the herb and later recurred with rechallenge. The second patient is a 42-yr-old woman who developed hepatitis 2 months after chaparral leaf ingestion and recovered completely after discontinuation of the compound. Both patients have remained well with abstinence from chaparral. These reports provide evidence of the hepatotoxicity of this herb and stress the need for awareness of the potential harm from such nonprecription remedies.     

Familial Dandy–Walker syndrome: a case report supporting an autosomal inheritance

Introduction We report an isolated pedigree in which a consanguineous couple had twin sons with Dandy–Walker malformation (DWM). The mother is similarly affected with the disorder.Discussion DWM is an abnormality of the central nervous system, which leads to hydrocephalus and is associated with other abnormalities.Conclusion Inheritance of the disorder remains controversial, with the majority perceived to be sporadic cases. This report suggests an autosomal inheritance.     

‘I'm allowed to experiment’: the role of people with psychiatric disorders in facilitating students' learning

Fieldwork education brings students into close contact with the people who use occupational therapy services and is an important avenue for socializing students into professionally accepted views of, and behaviours towards, these people. Drawing on narrative data from a naturalistic study of nine Australian occupational therapy students' fieldwork experiences in psychiatric hospital settings, this paper explores the role of people with psychiatric disorders in facilitating students' learning. Two terms are used by the authors to represent students' understanding of these people for educational purposes, namely, as learning resources and as demonstration models. From students' narratives, examples of the attributes they sought to acquire and demonstrate through involvement with people with psychiatric disorders are discussed. There are indications from these data that students' educational needs may foster a view of people with psychiatric disorders as objects in the service of students' learning. Copyright © 1998 Whurr Publishers Ltd.     

Minimally invasive surgery for gastroesophageal reflux disease

: The goal of this study was to determine if the outcome of antireflux surgery can be improved by: (1) conducting a careful preoperative workup to characterize gastroesophageal reflux disease (GERD) in the individual patient; and (2) tailoring the operation to the results of the preoperative function tests. : Sixty-eight patients had operations for GERD by minimally invasive techniques. : A Rossetti fundoplication was performed in 22 patients. Sixty-eight percent became asymptomatic. Twenty-seven percent developed dysphagia or gas bloat. Thirty-five patients had a Nissen fundoplication. Ninety-one percent are asymptomatic. Eleven patients with severe abnormalities of esophageal peristalsis underwent a Guarner fundoplication with relief of symptoms in 82% of patients. No patients in the Nissen or Guarner group developed postoperative persistent dysphagia or gas bloat. A pyloromyotomy was performed in 3 patients because of severe delayed gastric emptying. : Minimally invasive surgery for GERD gives good-to-excellent results even in patients with abnormal esophageal body function, provided that the operation is tailored to the individual patient based on the results of the preoperative function tests.     

Childhood Obesity Prevention--Issues and Controversies

In this special issue of HER, we have attempted to combine severalfacets of health education theory, research and practice toguide researchers and practitioners in the prevention of childhoodobesity and the promotion of child and adolescent health andwell-being. The issues raised in this edition are varied andsome are very controversial, but all are important to considerbefore any action is     

Teachers' perceptions of integrated kindergarten programs in Hong Kong

This article reports findings from a qualitative interview study that examined the provision of integrated kindergarten education for children with disabilities from the perspectives of general education teachers implementing integrated kindergarten programs. Analysis of interviews with eight informants led to the identification of two broad generalizations: the interviewed teachers emphasized teaching academics to children without disabilities, but they focused on social development at the exclusion of academic instruction for children with disabilities; and, according to the teachers, instruction was academic and skill-oriented in the integrated kindergarten programs. Research procedures are described and data supporting the findings are presented. Ways to improve program quality are discussed in terms of three major components: the Hong Kong government should include early childhood education within the compulsory education system, and enforce the formally recommended approach of developmental appropriateness; teacher education institutions should prepare prospective teachers to work in school settings where program goals may be contradictory with the ideology of inclusion; and educational researchers should monitor program quality in integrated childcare centers by conducting further research.