Intractable diarrhea in children with VIP-secreting ganglioneuroblastomas.

This paper describes two children with diarrhea, hypokalemia, and VIP-secreting ganglioneuroblastomas, and includes further evidence that VIP is the cause of the loose stools among patients with such tumors. It suggests that the level of this peptide should be measured in pediatric patients with intractable diarrhea of unknown etiology. Clinicians have long recognized intractable diarrhea as an occasional feature of neuroblastoma, ganglioneuroblastoma or ganglioneuroma. Until recently catecholamine was thought to cause the frequent stools in some patients with these tumors. New radioimmunoassay methods, the identification of new hormones and hormone-like substances, and the discovery that some of the tumors which cause diarrhea secrete Vasoactive Intestinal Peptide (VIP), make it probable that this substance is responsible for the diarrhea in such patients.

A matched cohort comparison of a criminal justice system's response to child sexual abuse: a profile of perpetrators.

OBJECTIVE: This study was undertaken to examine whether alleged child sexual abuse perpetrators are handled differently by the courts than other alleged felony perpetrators. Comparisons were made from the time of prosecutorial case acceptance through prosecution to sentencing, with emphasis on judicial and prosecutorial decision-making and plea-bargaining. METHOD: Data were retrospectively abstracted on the entire defendant population of cases of sexual abuse of children and adolescents (ages 2-17) over a 5-year period. Using a case-flow analysis, comparisons were made between a child sexual abuse cohort and a cohort of matched felony cases from a single jurisdiction. RESULTS: Three important findings emerged. First, compared to other felons, abuse perpetrators were employed, had been married, were mostly European American, and were older than 30 years of age. Second, in the abuse cohort, as many as 14% had a previous sexual or violent record compared to 2% in the comparison group. Third, similar percentages of perpetrators in both groups were released on their own recognizance, had the charges against them dropped, and were found guilty. As well, no differences between groups were found in the proportion of individuals sentenced to jail, probation, counseling, or work release. CONCLUSIONS: Although the treatment of perpetrators of child sexual abuse was similar to the treatment of perpetrators of other felonies, the profile of the child abuse perpetrator was quite different. Knowledge about this profile may impact prosecution or treatment and recidivism rates, to the extent that recidivism is related to characteristics of the abuse perpetrator.

Child abuse disposition: concurrences and differences between a hospital team, child protection agency and the court.

Ninety-six children admitted to a pediatric ward for maltreatment are described statistically using variables characterizing the child, the family and the type of abuse. Recommendations of the hospital's child protection team in 81 cases are compared to those of the county childrens Services Board and the court. Multiple regression analysis is used to identify which variables influenced the decisions of these three agencies.