RESUMO
A total of 23 boys met DICA-P manic symptom and clustering criteria in a diagnostic investigation of 233 outpatient boys between ages 6 and 10. In this manic-symptom group, the most frequently endorsed of an average of five manic symptoms were extreme mood changes, difficulty concentrating, feeling too 'up' to sit still, and racing thoughts. Comparison groups were 23 non-manic boys seen next in the investigation and 23 non-manic boys matched to the manic-symptom boys on symptoms of three comorbid disruptive disorders (ADHD, ODD and CD). Manic-symptom boys differed significantly from next-seen boys, but not from matched comorbid boys, in number of oppositional symptoms and pervasiveness of problems. Manic-symptom boys differed significantly from next-seen boys on six of eight mother-rated RCBCL factors. In contrast, manic-symptom and matched comorbid boys did not differ on any of eight RCBCL factors, which suggests that the RCBCL differences can be attributed to shared ADHD, ODD and/or CD. However, manic-symptom and matched comorbid boys tended to differ on RCBCL Anxiety/Depression. On the teacher-rated TRF, manic-symptom boys were rated higher than next-seen boys on four internalizing factors, and higher than matched comorbid boys on two of those factors, including Anxiety/Depression. Thus, manic symptomatology also predicted substantial emotionality, which was not a controlled comorbidity. The findings of this and other studies suggest that there is a mania dimension or syndrome, which may be an indicator of true bipolar disorder--or simply a marker for disruptive comorbidity, behavioral and emotional multimorbidity, or general severity of psychopathology.
Assuntos
Transtorno Bipolar/diagnóstico , Determinação da Personalidade/estatística & dados numéricos , Encaminhamento e Consulta , Transtorno do Deficit de Atenção com Hiperatividade/classificação , Transtorno do Deficit de Atenção com Hiperatividade/diagnóstico , Transtorno do Deficit de Atenção com Hiperatividade/psicologia , Transtornos de Deficit da Atenção e do Comportamento Disruptivo/classificação , Transtornos de Deficit da Atenção e do Comportamento Disruptivo/diagnóstico , Transtornos de Deficit da Atenção e do Comportamento Disruptivo/psicologia , Transtorno Bipolar/classificação , Transtorno Bipolar/psicologia , Criança , Transtornos do Comportamento Infantil/classificação , Transtornos do Comportamento Infantil/diagnóstico , Transtornos do Comportamento Infantil/psicologia , Comorbidade , Seguimentos , Humanos , Masculino , Psicometria , Reprodutibilidade dos TestesRESUMO
An elderly female who experienced a life-threatening bleed from an isolated rectal varix is presented. She failed endoscopic injection sclerotherapy but responded to surgical ligation. The literature concerning well-documented bleeding from eight cases of rectal varices is reviewed. Nomenclature, diagnosis, and therapy are emphasized.
Assuntos
Hemorragia Gastrointestinal/etiologia , Reto/irrigação sanguínea , Varizes/complicações , Transfusão de Sangue , Feminino , Hemorragia Gastrointestinal/terapia , Humanos , Ligadura , Pessoa de Meia-Idade , Escleroterapia , Falha de Tratamento , Varizes/terapiaRESUMO
Presented is a middle-aged male who developed a fulminant case of antibiotic-associated pseudomembranous colitis characterized by leukocytosis, hypoalbuminemia, ascites, and anasarca without toxic megacolon. The patient responded slowly to medical therapy consisting of intravenous metronidazole, oral vancomycin, and parenteral nutrition. Subsequently, cholestyramine was administered. A review of the literature concerning similar cases of fulminant pseudomembranous colitis is presented.
Assuntos
Clindamicina/efeitos adversos , Enterocolite Pseudomembranosa/induzido quimicamente , Humanos , Masculino , Megacolo Tóxico/diagnóstico , Pessoa de Meia-Idade , Sigmoidoscopia , Tomografia Computadorizada por Raios XRESUMO
This study was designed to determine the prevalence of colorectal neoplasia in healthy, asymptomatic adults with an age-related risk for colorectal neoplasia. Ninety patients were studied with air contrast barium enema and colonoscopy. The study population included 61 males and 21 females, with an age range of 51-82 yr (65 +/- 2 yr). Adenomatous polyps were found in 27% of males and 14% of females or 24% of patients overall. Sixty-six percent of these neoplasms were above the rectosigmoid junction and the mean size of the polyps was 6.5 +/- 1.2 mm. In two patients, carcinoma was discovered. A linear association between age and the prevalence of colonic neoplasia was not demonstrated. This study demonstrates a relatively high prevalence of colonic neoplasia in patients with an age-related risk.
Assuntos
Adenoma/epidemiologia , Neoplasias do Colo/epidemiologia , Adenoma/diagnóstico , Adenoma/patologia , Fatores Etários , Idoso , Idoso de 80 Anos ou mais , Distribuição de Qui-Quadrado , Neoplasias do Colo/diagnóstico , Neoplasias do Colo/patologia , Colonoscopia , Feminino , Humanos , Pólipos Intestinais/epidemiologia , Pólipos Intestinais/patologia , Masculino , Programas de Rastreamento , Pessoa de Meia-Idade , Sangue Oculto , Valor Preditivo dos Testes , Prevalência , Estudos Prospectivos , Análise de Regressão , Fatores de RiscoRESUMO
We present a case of a male with benign cystic mesothelioma of the peritoneum. The literature is reviewed for previous case reports of this rare lesion in males. Benign cystic mesotheliomas occur predominantly in females. Despite a marked tendency to recur, no malignant degeneration has ever been demonstrated, and only one mortality has ever been attributed directly to this lesion. The diagnosis of this entity is made by confirming the benign mesothelial nature of the cells lining the cysts with electron microscopy or immunohistochemical staining. No significant difference in the clinicopathologic presentation of cystic mesotheliomas in men and women is found.
