RESUMO
Review of 20 patients with glucocorticoid deficiency (three cases also with salt loss) associated with absent tear secretion (19 cases) and achalasia of the cardia (15 cases) revealed neurological abnormalities in 17 including hyper-reflexia, muscle weakness, dysarthria, and ataxia together with impaired intelligence and abnormal autonomic function, particularly postural hypotension. These findings indicate that significant neurological problems are common in this multisystem disorder.
Assuntos
Doença de Addison/fisiopatologia , Acalasia Esofágica/fisiopatologia , Doenças do Sistema Nervoso/fisiopatologia , Lágrimas/metabolismo , Doença de Addison/complicações , Adolescente , Córtex Suprarrenal/fisiopatologia , Adulto , Criança , Pré-Escolar , Acalasia Esofágica/complicações , Saúde da Família , Feminino , Humanos , Inteligência , Masculino , Sistema Nervoso/fisiopatologia , Doenças do Sistema Nervoso/complicações , SíndromeRESUMO
Undescended testicle is the term applied to a group of congenital conditions which by their nature should be detected at birth. A study of the identification and treatment of cases of undescended testicle in one health district was undertaken through examination of hospital records. Altogether, only one in five cases of undescended testicle had been detected at birth. The main agents responsible for the detection and referral of cases were the school medical services and general practitioners. An average of 42 per cent of these boys had been seen as inpatients or outpatients by either surgeons or paediatricians before the diagnosis of undescended testicle was made. This implies that neonatal examination is inadequate or that unnecessary operations are being performed, or that there is a different aetiology to the condition.
Assuntos
Criptorquidismo/cirurgia , Criança , Criptorquidismo/diagnóstico , Humanos , Masculino , Fatores de TempoRESUMO
Thirty-two children with a past diagnosis of coeliac disease were reinvestigated by means of gluten challenge. They had received a gluten-free diet for a mean period of 6-5 years (range 0-25-11-0) before gluten challenge, and had a mean age of 9-9 years (range 3-0-15-3) at the onset of challenge. Small intestinal biopsies were performed before and after the gluten challenge (at least 10 g natural gluten per day for 3 months in the majority) and, as judged by light microscopy and morphometric techniques, coeliac disease was confirmed in 25 (78%) of the 32 patients; challenge was continued in the remaining 7 for a total period of 2 years when biopsies were repeated in 6 children and all were normal. Serum and RBC folate, serum iron, Hb level, and clinical symptoms were unpredictable variables in identifying children who developed gluten-induced enteropathies. The social and emotional effects of gluten challenge are discussed. The results highlight the importance of gluten challenge and intestinal biopsy in the diagnosis of coeliac disease and strongly suggest that a normal biopsy after a 3-month gluten challenge (as described above) excludes coeliac disease.