ABSTRACT
We retrospectively reviewed four patients with severe motor and intellectual disabilities (SMID), aged 8-56 years, who presented with ulcerative colitis (UC), and discussed causal interrelationships between UC and SMID. UC started at 3-50 years of age with early childhood-onset in two patients. Two patients had an intractable clinical course in which leukocytapheresis and surgery were ineffective, and resulted in steroid-dependency. We failed to find any causal relationships between infectious events, nutrition and anticonvulsants with the development of UC. However, when occult blood in feces is frequently positive in SMID patients, it is important to consider the possibility of UC and to perform an intestinal endoscopic examination.
Subject(s)
Colitis, Ulcerative/diagnosis , Colitis, Ulcerative/etiology , Disabled Children , Persons with Mental Disabilities , Adolescent , Adult , Child , Endoscopy, Gastrointestinal , Female , Humans , Male , Middle Aged , Retrospective StudiesABSTRACT
This is a report of the setting up of a day group service system for severely disabled children, the "Koala Club". The "Koala Club" was started in 1993, and has been running outside of the hospital since 1997. A support group for the "Koala Club" was established in 1999. Currently 13 children attend the "Koala Club". The staff of the "Koala Club" consists of one coordinater, four nurses and eight care workers. The medical care is fulfilled by nurses. The "Koala Club" open two days a week. It has been supervised by a doctor and a case worker. There is an important role for physicians in the regional care of disabled children.
