[Pathophysiological changes in eating disorders].
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Biomedical subjects
Publications and source records attributed to D Hardoff.
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Five community-based services in Israel for disabled adolescents are described. Three of them are day centers and two are afternoon clubs. They provide rehabilitation resources for teenagers with various kinds of disabilities including cerebral palsy, mental retardation, blindness, deafness and emotional handicaps. These services are analyzed and discussed with regard to addressing the major needs of adolescents with disabilities, with the aim of achieving an optimal degree of independence and preparation for normalized life. The programs include resources such as vocational rehabilitation, independent living education, recreational activities, social skills training, sexuality education in addition to creating opportunities to mix and socialize with nondisabled youth. The function of pediatric and adolescent medicine physicians in such services is emphasized as imperative in providing a comprehensive rehabilitation program for youth with disabilities.
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We report an unusual presentation of Henoch-Schönlein purpura in a 4-year-old boy. He presented with two isolated episodes of tender testicular swelling, and 11 months after the first episode developed a full blown picture of Henoch-Schönlein purpura accompanied by orchitis. A latent period of orchitis preceding Henoch-Schönlein purpura of this duration has not been described previously and its clinical implications are discussed.
A nine-year-old girl, who presented with a severe hypoglycemic coma, proved to have isolated ACTH deficiency, a finding previously reported in only two children. On the initial evaluation, before any treatment, GH did not respond to provocative stimuli. On replacement therapy with hydrocortisone, normal linear growth was observed. Repeated testing while on glucocorticoids replacement four years after the initial attack revealed normal GH response to stimulation test. It is suggested that cortisol deficiency was responsible for the severe hypoglycemic coma and subnormal GH response. A similar mechanism is speculated for the normal growth observed in some patients with apparent deficiency of anterior pituitary hormones, including GH. The possibility of permanent ACTH deficiency and transitory GH deficiency following hypophysitis is discussed.
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Biopsies from jejunum of nonceliac patients and patients with active celiac disease were studied and compared by means of transmission (TEM) and scanning (SEM) electron microscopy. Fracturing of dried specimens enabled the visualization of the epithelial microvilli with SEM. Alteration in microvillous appearance in celiac patients, as determined by TEM, could also be clearly detected in SEM images. The SEM preparation is easier to accomplish and less time-consuming compared to the TEM. This may be an advantage for clinical assessment of jejunal biopsies in syndromes in which early detection of alterations in microvilli in the epithelial mucosa is of diagnostic value.