1/6. A sporadic abdominal desmoid tumour case presenting with intermittent intestinal obstruction.Desmoid tumours, also known as aggressive fibromatoses, are rare lesions having intermediate biological behaviour between benign fibrous lesions and fibrosarcomas. Although abdominal desmoids have an increased incidence in Gardner's syndrome, they are rarely found in isolated form. We report a barium study, ultrasound, computed tomography and magnetic resonance imaging findings of a case in a nine-year-old boy with intermittent nausea and vomiting. Although intraabdominal desmoids are usually detected as a solitary lesion in sporadic cases, the case presented here had two mesenteric lesions in the left upper quadrant. intestinal obstruction and invasion of colon wall had occurred.- - - - - - - - - - ranking = 1keywords = behaviour (Clic here for more details about this article) |
2/6. Reversible quantitative EEG changes in a case of cyclic vomiting: evidence for migraine equivalent.Medical experts have disputed whether childhood cyclic vomiting is a manifestation of epilepsy or a migraine equivalent. Quantitative EEG provides an objective measure of changes in brain activity during and between episodes. This paper reports reversible changes involving two episodes in a patient whose history included cyclic vomiting and emotional/behavioural problems. Abnormal delta activity seen during both episodes resolved at follow-up, when the patient asymptomatic. The brain wave changes counter the hypothesis that vomiting in these patients is psychosomatic, and support the interpretation of cyclic vomiting as a migraine equivalent.- - - - - - - - - - ranking = 1keywords = behaviour (Clic here for more details about this article) |
3/6. Behavioural analysis and control of psychosomatic symptoms of patients receiving intensive cancer treatment.During the course of cancer treatment behavioural symptoms such as gagging, coughing and vomiting often develop in the absence of apparent tissue damage. Moreover, symptoms whose onsets are clearly related to disease processes often continue after the disease has been eliminated. The reported research incorporated time-series analyses of patients' behavioural symptoms and assessments of behavioural interventions involving the modification of nurse--patient and family--patient interactions. Results showed that: (1) inadvertent social reinforcement by hospital staff and family members fosters the development of behavioural symptoms; (2) personnel associated with treatment can become discriminative stimuli for social attention and thereby evoke symptom behaviours; and (3) by modifying the social reinforcement contingencies associated with treatment protocols, the frequency of psychosomatic symptoms can be reduced without changing the quality of medical/nursing care and social interaction.- - - - - - - - - - ranking = 5keywords = behaviour (Clic here for more details about this article) |
4/6. Severe nutritional iron deficiency and behaviour disorder in an infant.The case report describes a 9-month-old Indian child with severe iron deficiency and a haemoglobin of 3.1 g/dl (3.1 g per cent). The case illustrates certain behavioural problems (Pollitt & Leibel, 1976)- irritability, anorexia and vomiting - of infants with iron deficiency, which make them more iron-deficient and anaemic. blood transfusion was used to break this vicious circle. The child was given oral iron supplements, her behaviour improved and the anaemia disappeared.- - - - - - - - - - ranking = 6keywords = behaviour (Clic here for more details about this article) |
5/6. Cyclic vomiting and elevation of creatine kinase associated with bitemporal hypoperfusion and EEG abnormalities: a migraine equivalent?A 13-year-old mentally retarded boy suffered from repeated vomiting attacks since infancy. Each episode lasted 2 to 10 days, and was precipitated by respiratory infection, exercise or stress. During an attack he became irritated, agitated and amnesic, but did not have headaches or seizures. Associated findings were transient elevation of serum creatine kinase (CK) (331-3381 IU/l), and of plasma ACTH and cortisol. The raised CK level was the result of muscle hypertonicity. Ictal EEGs showed delta activity in the front-temporal areas, and inter-ictal IMP-SPECT revealed hypoperfusion in both temporal regions. Unlike the periodic ACTH-ADH discharge syndrome, neither hypertension nor depression developed. These attacks were diagnosed as a migraine equivalent and were suppressed with phenytoin. From the EEG and SPECT findings, we concluded that the vomiting and behavioural changes were related to the paroxysmal vascular abnormality in the temporal regions, but it was not easy to make the distinction between migraine and focal epilepsy. Before a diagnosis of the periodic ACTH-ADH discharge syndrome is made, the possibility of migraine equivalent should be considered.- - - - - - - - - - ranking = 1keywords = behaviour (Clic here for more details about this article) |
6/6. Partial N-acetylglutamate synthetase deficiency in a 13-year-old girl: diagnosis and response to treatment with N-carbamylglutamate.We report on a now 13-year-old girl, who presented with recurrent episodes of vomiting, psychotic behaviour and confusion during puberty until the diagnosis of partial N-acetylglutamate synthetase deficiency was established. She had suffered one prior unclear episode of acute vomiting, lethargy and somnolence at the age of 13 months, and from childhood onward had aversion to high protein food. Treatment with a protein-restricted diet and administration of phenylbutyrate as well as L-arginine were sufficient to normalize ammonia levels but glutamine concentrations remained high. Supplementation with N-carbamylglutamate rapidly improved her protein tolerance and reduced the need for co-medication. To our knowledge, so far only seven patients with N-acetylglutamate synthetase deficiency have been reported. CONCLUSION: Partial N-carbamylglutamate deficiency has to be considered in the differential diagnosis of hyperammonaemia. If proven by enzyme determination in liver tissue, the disorder should be cautiously treated with N-carbamylglutamate.- - - - - - - - - - ranking = 1keywords = behaviour (Clic here for more details about this article) |