MPPH syndrome: two new cases.

This report describes 2 additional cases of megalencephaly and perisylvian polymicrogyria with postaxial polydactyly and hydrocephalus syndrome, a recently recognized disorder of infants and young children with macrocrania, developmental delay/mental retardation, and often epilepsy. Medulloblastoma, a previously unreported feature in megalencephaly and perisylvian polymicrogyria with postaxial polydactyly and hydrocephalus syndrome, developed in one child at 3 years of age. Although the disorder is presumed to be genetic, the cause of megalencephaly and perisylvian polymicrogyria with postaxial polydactyly and hydrocephalus syndrome has not yet been determined.

What happens after we identify intimate partner violence? The family physician's perspect.

BACKGROUND AND OBJECTIVES: Despite increased emphasis on asking about intimate partner violence (IPV), little data exists on patient outcomes. We surveyed family physicians in New Hampshire and North Carolina to determine rates of asking about IPV, patient outcomes after disclosure, and changes in the doctor-patient relationship as a result of patient disclosure. METHODS: Active members of the New Hampshire and North Carolina Academies of Family Physicians were surveyed. Data were analyzed using SAS PC. RESULTS: Data are similar between the two states. Physicians who regularly ask about IPV more often identify victims. Further, physicians in general ask more often about IPV now than 5 years ago. On average, physicians report 4.95 interventions for patients disclosing abuse, most often treating the physical and emotional complaints and documenting abuse. Physicians reported positive patient outcomes (eg, improved mental health, seeking counseling or services) more often than negative outcomes (eg, disruption of finances or housing and fear of worsened violence). Physicians believed that many outcomes resulted from disclosure to the physician. They also believed that IPV disclosure led to more work for the physician but an improved doctor-patient relationship. CONCLUSIONS: This is the first study of physician views of patient outcomes and the first study reporting an increase in the proportion of physicians asking about IPV. Our findings suggest that more physicians may be asking about IPV and more frequently. Additional studies are needed to compare physician and patient perceptions of outcomes resulting from disclosure.