Identifying college athletes at risk for pathogenic eating.

OBJECTIVES: To evaluate the effectiveness of a discriminant function that predicts risk of pathogenic eating in comparison with a standard self report measure (EAT) and a clinical interview. In addition, to determine the effectiveness of this discriminant function using a variety of collegiate athletes. METHODS: A total of 319 participants were asked to complete a series of self report measures that assessed dietary practices. In addition, anthropometric measures were obtained, and a random sample of 15% participated in a structured clinical interview. RESULTS: Correlational analyses indicated that the discriminant function categorisation of risk was significantly related to both the clinical interview and EAT (p < or =0.05). The discriminant function was accurate in predicting risk category in this diverse group of athletes, particularly with respect to those at low risk (83.1%) and those at high risk (72.7%). CONCLUSION: This information may be helpful in the development of a simple, accessible tool to identify athletes at risk of engaging in pathogenic eating behaviours.

[Anaplastic oligoastrocytoma of the spinal cord: diagnostic difficulties. Case report]. / Oligoastrocytoma anaplasticum rdzenia kregowego: trudnosci diagnostyczne. Opis przypadku.

The authors report a rare case of 49-years old woman with rapidly progressing anaplastic oligoastrocytoma primarily localized in the spinal cord. Increasing spastic paresis of the right lower limb was concomitant with decrease in superficial sensibility in this limb and the right side of the trunk below Th10 level, suggested a lesion within the spinal cord. However, it was the difficult confirming the diagnosis by spinal MR imaging, and the negative result of the first MR examination (performed 5 weeks after manifestation of first clinical symptoms of the disease) delayed surgical treatment. During the next 3 weeks the neurological syndrome increased to spastic paraparesis with sphincters dysfunction and decrease in superficial and vibratory sensibility within the lower limbs and the trunk below the Th10 level. The second MR examination of the spine revealed an intraspinal tumour at Th8-Th10 levels. Surgical (partial excision of the tumour) and radiation treatment was given. Histopathological examination of tumour tissue showed the presence of anaplastic oligoastrocytoma. During the follow-up of our patient we found cerebral foci, probably of metastatic origin ascending with cerebrospinal fluid. More than 5 months after the diagnosis was established the patient died of primary disease. The imaging parameters of both spinal MR examinations were similar, however, on second examination narrower field of vision was used. In both cases Magnevist was administered. Discussing factors which might be responsible for the false-negative result of spinal MR examination--the examination of choice for detection of proliferative transformation--the authors take artefacts connected with respiratory and circulatory function, peristaltic movements, and with field of vision into consideration.

[A case of congenital fissure of C2 and C3 arches with compression of cervical spinal cord]. / Opis przypadku wady wrodzonej niespojenia luków kregu C2 i C3 z uciskiem na rdzen kregowy w odcinku szyjnym.

A 41-years old male patient is reported who had spastic paresis of all extremities, and evidence of peripheral motor neuron damage. He had been treated with steroids for 10 years after erroneous diagnosis of multiple sclerosis. The final diagnosis was a congenital fissure of C2 and C3 arches with spinal cord compression in cervical part. After operation some improvement of the neurological status was obtained.

Multilobar resections in surgical treatment of medically intractable epilepsy.

UNLABELLED: MATERIAL, METHOD: Authors present the results of surgical treatment in a series of 93 patients with medically intractable epilepsy and large epileptogenic foci, in whom multilobar resections have been performed. They constituted 13% of a group of 716 patients subjected to surgery due to drug resistant epilepsy in the period 1957-1996, in the Department of Neurosurgery, Medical University of Warsaw, Poland. Patients treated with multilobar resection constituted the group, characterised by the most severe course of epilepsy, so they usually had a long seizures' history at the time of operation (more than 10 years duration of the disease in 37% of patients), albeit they were qualified to surgery at a relatively young age (mean age at the time of surgery: 16-th year of life). Trauma was the most frequent underlying aetiologic factor (perinatal trauma and other major head injury were documented in 28% and 30% of patients respectively). Morphological abnormalities of the resected brain tissue were found on pathological examination (light microscope) in 68% of patients in this series. RESULTS: Perioperative mortality was 3%. At a follow-up examination (mean follow-up period 7 years postoperatively): 30% of patients were seizure free, in 13% of patients drug discontinuation was possible. In 23% of patients less than 2-3 seizures per year occurred. So totally in 53% of patients, good result of treatment was achieved (none or only very rare seizures). In 35% of patients surgery failed to control seizures' frequency. 9% of patients were lost from follow-up evaluation. CONCLUSIONS: Multilobar resection (if acceptable from the clinical point of view) may be an effective treatment choice in patients with medically uncontrollable seizures and huge epileptogenic foci. This treatment modality may offer recovery from seizures or significant improvement to 53% of patients treated. The radical removal of epileptogenic foci, age of the patients higher than 18 year of life at the time of operation, focal character of EEG abnormalities and occurrence of only one type of seizures, were found to be good prognostic factors. On the other hand younger age of the patients operated, the presence of generalized slow waves in the interictal EEG recordings and the occurrence of various types of seizures, influenced adversely on the prognosis.

[Importance of catheterization of inferior petrous sinuses in surgical treatment of Cushing's in children and adolescents]. / Znaczenie cewnikowania zatok skalistych dolnych w leczeniu operacyjnym choroby Cushinga u dzieci i mlodziezy.

The authors present 12 cases of Cushing disease in children and adolescents. In childhood the course of this disease differs from that in adulthood. The predominating initial signs in children are growth stunting and arrest of sexual maturation. Radiological methods (sella X-ray, CT, NMR) are normal initially in most cases and the diagnosis is confirmed exclusively by hormonal investigations. ACTH determination of venous blood samples obtained by catheterization of the inferior petrous sinuses is essential not only for the diagnosis of pituitary adenoma but also for choice of proper surgical treatment. The optimal method is selective removal of the adenoma. In case of impossibility of this removal (anterior lobe hyperplasia) hemiphysectomy is suggested (with removal of the lateral part of the anterior lobe on the side of greater secretion of ACTH into the inferior petrous sinus. This method is possible only if before the operation catheterization of these sinuses was done and a significant difference of ACTH level was found between the right and the left sinus. This is the reason why this test is essential for selection of proper treatment. Anterior lobe hypophysectomy, bilateral adrenalectomy, X-ray hypophysis irradiation are unacceptable for children because of their maiming character making impossible further somatic development and sexual maturation of children.

[Cerebrospinal fluid rhinorrhea as a postoperative complication of pituitary tumor surgery. Corrective surgery of sella turcica by own methods]. / Plynotok nosowy jako powiklanie przezklinowej operacji guzów przysadki. Operacja naprawcza wlasna metoda plastyki dna siodla tureckiego.

A relatively simple technically and effective own method of corrective operation of sella floor in cases of cerebrospinal fluid rhinorrhoea after transsphenoid operations for pituitary tumours is presented. This complication developed in 12 cases in a group of 720 patients operated on in the years 1973-1990. The described method was applied in 9 cases.

[Caudal tumors as a rare cause of subarachnoid hemorrhage]. / Guz ogona konskiego--rzadka przyczyna krwawienia podpajeczynówkowego.

A case of cauda tumour (neurolemmona) is reported in which the presenting symptom was subarachnoid haemorrhage. The investigations for suspected cerebral vascular malformation brought no results. Only after appearance of clinical signs of cauda damage vertebral canal investigations made possible the correct diagnosis and proper treatment.

Weight control practices of lightweight football players.

The objective of this research was to investigate the weight control practices of lightweight football players. In addition, the importance of several variables was examined for their clinical importance and ability to identify individuals at high risk for pathogenic eating behaviors. Male college lightweight football players (N = 131) were administered a 45-item version of the Diagnostic Survey For Eating Disorders (9). Results revealed that 74% had experienced binge eating, and 17% had experienced self-induced vomiting. During the month preceding questionnaire administration, 66% had fasted, nearly 4% had used laxatives, while less than 2.5% had used diet pills, diuretics, or enemas for the purpose of weight control. Furthermore, the "teacher/coach" seemed to be the individual who motivated dieting behavior, and more than 20% of the sample reported that their weight control practices interfered with their thoughts and extracurricular activities "often" or "always." Most importantly, 42% of the sample evidenced a pattern of dysfunctional eating, while 9.9% of the sample engaged in binge-purge behavior to the degree that it might represent an eating disorder. Finally, discriminant the degree that it might represent an eating disorder. Finally, discriminant analysis yielded several variables that might be useful in identifying individuals at risk for pathogenic eating behaviors.

Pituitary apoplexy: endocrine, surgical and oncological emergency. Incidence, clinical course and treatment with reference to 799 cases of pituitary adenomas.

Authors analyzed retrospectively the incidence of pituitary apoplexy in a series of 799 pituitary adenomas with respect to the long term follow-up of the patients. Focal vascular abnormalities in histological specimens of tumours, regarded as morphological suggestion of past apoplexy (haemorrhage, ischaemic infarction or necrosis), were established in 113 out of 783 surgical cases (14.4%). Acute clinical onset, justifying the clinical diagnosis of pituitary apoplexy, occurred in 39 patients only (5% of the whole series), 19 of them were subjected to urgent surgical decompression due to severe neurological deficit. The haemorrhagic character of apoplexy was established in most cases requiring immediate surgery. The detailed clinical picture of this condition and its management are discussed with respect to the long term prognosis. On this basis the authors suggest the necessity of surgical treatment in every case of pituitary apoplexy, taking into account not only neurological recovery, but also endocrine and oncological aspects of the disease. The observation that pituitary apoplexy may be a "marker" of tumour invasiveness (even in small, "enclosed" adenomas) is highlighted.

Prevalence of eating disorders among dietetics students: does nutrition education make a difference?

Several studies have indicated that college students majoring in dietetics have more problems associated with food than do students majoring in other disciplines. If this is true, dietetics students may need more counseling and education on eating disorders, especially because many will eventually be counseling others professionally. To assess the prevalence of negative eating behaviors among college dietetics majors, surveys based on the Eating Pattern Questionnaire were distributed to college women with majors in dietetics and other selected disciplines at a medium-sized California university. Two surveys were administered 1 year apart; the first was distributed to junior and senior women only, and the second was distributed to women of all class levels. Results from the first survey revealed that the incidence of eating disorders was not greater among the dietetics majors than among the other selected majors. In fact, dietetics majors often had more positive responses to questionnaire items, which suggests that dietetics students have better eating habits and fewer eating disorders. The results of the second survey, however, indicated that dietetics majors had significantly more negative eating patterns than did students from other majors. When separated by class, junior and senior dietetics majors had significantly more positive eating habits than did freshmen dietetics majors. These findings imply that junior and senior dietetics majors may have more positive eating patterns than freshmen dietetics majors as a result of their increased exposure to nutrition information.

[Evaluation of a method for determining ACTH concentration in samples of serum obtained by catheterization of inferior petrosal sinuses in diagnosis of Cushing's disease]. / Wartosc metody oznaczania poziomu hormonu ACTH w próbkach krwi uzyskanych poprzez cewnikowanie zatok skalistych dolnych w diagnostyce choroby Cushinga.

A method consisting in the catheterization of lower petrosal sinuses aimed at obtaining blood samples for the determination of ACTH concentration has been applied in diagnostically difficult cases of Cushing's disease. The appearance of ACTH concentration gradient between the blood originating from the immediate vicinity of pituitary and the peripheral venous blood confirmed the hypophyseal etiology of hypercortisolemia. The gradient of ACTH concentration between the two petrosal sinuses made possible the localization of a microadenoma in the anterior lobe of pituitary. The diagnostic conclusions obtained by the above method have been confirmed during the surgery.

Epilepsy following brain abscess. The evaluation of possible risk factors with emphasis on new concept of epileptic focus formation.

The study is based on follow-up data of 108 patients treated for brain abscess (mean follow-up period 11 years). The overall incidence of epilepsy was 34% (37% in supratentorial lesions). The author compared the incidence of several parameters between two groups of patients: those presenting, and those not presenting with epilepsy after brain abscess treatment. Parameters characterized by significantly different incidence in each group were taken into account as possible risk factors influencing the development of epilepsy. Sex, age of the patient, localisation and size of the abscess are discussed as presumptive risk factors modifying prediction to epilepsy. The author presents a new concept of epileptic focus formation to explain satisfactorily the results of the study on the basis of pathological mechanisms. A protocol, which may be useful to evaluate the prediction to epilepsy after brain abscess treatment is proposed.

Comparison between classic-differential and automatic shunt functioning on the basis of infusion tests.

Infusion tests were performed in order to examine cerebrospinal compensatory ability in two groups of patients with impaired compensation, subjected to shunt implantation. The functioning of the classic differential shunts was compared to the automatically (Orbis-Sigma) functioning shunts. The reference group, with intact compensatory parameters is also presented. The influence of different types of shunts on the intracranial compensation ability was compared. Automatic shunts produce less decrease in the resorption resistance of CSF in the post-shunted examination than the classic differential shunts. Classic differential shunts disturb the mono-exponential character of the pressure-volume relationship in a higher degree than automatic shunts. Shunt functioning models were proposed as well as the method of detection of eventual recovery to the normal resorption reserve. This method can be applied only to patients with automatic shunts.

A computer system for the identification of the cerebrospinal compensatory model.

A computer system, based on IBM PC, was designed for the cerebrospinal compensatory model identification. The intracranial pressure (ICP) signal, registered during the lumbo-lumbar infusion test is analyzed by means of the spectral analysis algorithm in order to measure precisely the pulse wave amplitude. The amplitude and the mean ICP level, calculated repetetively within the period of about 8 seconds, are stored on the disk and form the basis for further model identification. Three different methods of identification were applied. They enable one to estimate the fundamental model parameters, such as: resistance to the cerebrospinal fluid resorption, pressure-volume index, baseline pressure, rate of formation of the cerebrospinal fluid. Statistical evaluation of the results of the infusion test analysis obtained by means of the system described in two groups of hydrocephalic patients (children and adults) is presented.

The value of different methods of treatment of brain abscess in the CT era.

67 cases of brain abscess were analyzed retrospectively. As 2 comatose patients died on admission before any treatment was started, the results are based on 65 treated patients. Different methods of treatment included: total removal in 36 patients, drainage in 14, aspiration in 6 and conservative treatment in 9. Management mortality was 18.5% and was almost not dependent on the method of treatment (except aspiration) being lowest in the drainage group. The mortality was significantly higher in patients with serious impairment of consciousness on admission. Follow-up examination after 1 to 11 years was performed in 47 out of 53 discharged patients and revealed in 25 of them (53%) full recovery. 10 additional cases (21%) are independent. The best early and long term results were obtained in patients by drainage and medical treatment. Chronic epilepsy developed in 34% of patients with supratentorial lesions. The risk of epilepsy was lowest in the group of patients treated by drainage. The authors present the opinion that removal of brain abscess is necessary only in exceptional cases.

[2 cases of brain abscess as a complication of direct cranial traction]. / Dwa przypadki ropni mózgu powstalych jako powiklanie wyciagu bezposredniego za czaszke.

Two cases of brain abscess as a complication of direct cranial traction have been presented. In the first case traction was used in the treatment of aneurysmatic cyst of the cervical spine, in the second case for cervical spine trauma. In the first case development of abscess was related with local infection in the site of localization of traction, and in the second case, most probably, with direct contamination of the brain tissue in the site of dura mater perforation. In both cases abscess was treated surgically; in the first case, a female patient was discharged with severe neurological deficit and in the second case, the male patient recovered without neurological deficit.

The role of cerebrospinal compensatory parameters in the estimation of functioning of implanted shunt system in patients with communicating hydrocephalus (preliminary report).

Twelve patients presenting with communicating hydrocephalus were studied. In 9 cases where the mean ICP level remained below 10 mmHg the symptoms of normal pressure hydrocephalus were observed. All of the patients were treated by shunt system implantation. The clinical and psychological state, cranial computerized tomography and parameters of the cerebrospinal compensatory mechanisms, evaluated using the constant rate infusion test were compared before and after treatment. In most of the patients (11) the pathologically enlarged ventricles persisted. Only in three cases no clinical improvement was noticed. In this group the resistance to the cerebrospinal fluid absorption and the fluid formation rate were estimated as normal. In the group with improvement the normalization of the resistance (4), decrease in the cerebrospinal fluid formation rate (4) and decrease in the cerebrospinal system elasticity (1) can be pointed out as factors responsible for improvement manifested after shunting. Therefore the resorption resistance and the formation of cerebrospinal fluid should be considered as predictive factors in the shunt implantation in hydrocephalic patients, and play an important role in the diagnosis of this entity.