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[Psychiatric consultations in school settings: 170 cases at a school and university health center (CSSU) from 1995 through 2001].

This retrospective study of 170 files from the School and University Health Center in the municipality of Plateau shows that psychiatric disorders affected students at all levels, with 72.4% of the cases involving secondary school students. Depressive disorders were most common, accounting for 49% of the cases. Almost no students (5.3%) suspended their studies during the school year. This observation contrasts with the common belief that pupils with mental disorders leave school permanently.

Adolescent↗

The fixed and dilated pupils of premature neonates.

We examined on a weekly basis the pupils of 30 preterm infants. In relative darkness (less than 10 foot-candles [ft.-c.] of illumination), the pupils measured a mean of 4.7 mm in the youngest infants (26 weeks' postconceptional age) when the corneal diameter was 7.0 mm. The pupils became progressively smaller, reaching 3.4 mm at 29 weeks' postconceptional age (P less than .001). The pupils did not constrict to the stimulating light (600 ft.-c.) until a mean of 30.6 weeks' (+/- 1 week) postconceptional age. Mydriasis should not be considered indicative of a central nervous system disorder, and a pupil unresponsive to light should not be considered suggestive of blindness until a preterm infant reaches at least 32 weeks' postconceptional age.

Aging↗

Pediatric neuro-ophthalmology.

The author discusses an extended list of the ophthalmic signs and symptoms of neurologic disease (some of which were once considered to be benign or isolated eye problems) under the general categories of vision problems, pupil signs, eye movement disorders, fundus abnormalities, and eyelid abnormalities.

Child↗

Neuro-ophthalmology of pupillary function--practical guidelines.

An overview how to examine pupillary function and handle pupillary abnormalities is presented. The following issues are discussed: swinging flashlight test, clinical relevance of a relative afferent pupillary defect, anisocoria with normal light reaction, diagnosis and evaluation of Homer's syndrome, differential diagnosis of impaired light reaction, tonic pupil, third nerve palsy, supranuclear pupillary disorders, iris problems, systemic disease, measurement of sleepiness, and pupillography.

Anisocoria↗

[Pupillary abnormalities in a patient with clinically diagnosed corticobasal degeneration].

We report a 65-year-old woman, who suffered from clumsiness of the left hand for 6 years. Gait disturbance, body balance impairment and rigidity of the left arm appeared progressively. Anti-parkinsonian drugs such as 1-dopa, doroxidopa, amantadine and bromocriptine were ineffective. Magnetic resonance imaging showed brain atrophy, especially in the right fronto-parietal lobes. Positron emission tomography (18F-fluoro-2-deoxy-D-glucose) showed decreased glucose metabolism in the right cerebral cortex, putamen and thalamus. A diagnosis of corticobasal degeneration was made, based on the clinical manifestations, MRI and PET findings. She also showed anisocoria, vertical gaze palsy and abnormal pupillary reactions. Her left pupil showed an oval figure shifted from the center position. The pupils exhibited denervation supersensitivity in the 0.125% pilocarpine test. We consider that her pupillary abnormalities may be related to her midbrain lesion (midbrain corectopia) associated with corticobasal degeneration.

Aged↗

Behavior problems of educationally handicapped and normal pupils.

Male pupils identified as behaviorally disordered, learning disabled, and educable mentally retarded, as well as nonidentified normal boys, were rated by their teachers on the Behavior Problem Checklist. Analyses of the ratings indicated significant differences for pupil category, Behavior Problem Checklist dimension, and category by dimension interaction, but no significant differences for age alone or in interaction with other factors. Categories of pupils were best discriminated from one another on the basis of Conduct Disorder and Personality Problem dimensions of the Behavior Problem Checklist. Results were discussed in terms of some implications for special education and further research suggested by the present findings.

Adolescent↗

The optometric correlates of migraine.

Migraine is a common, chronic, multi-factorial, neuro-vascular disorder typically characterised by recurrent attacks of unilateral, pulsating headache and autonomic nervous system dysfunction. Migraine may additionally be associated with aura; those focal neurological symptoms that may precede or sometimes accompany the headache. This review describes the optometric aspects of migraine headache. There have been claims of a relationship between migraine headaches and errors of refraction, binocular vision anomalies, pupil anomalies, visual field changes and pattern glare. The quality of the evidence for a relationship between errors of refraction and binocular vision and migraine is poor. The quality of the evidence to suggest a relationship between migraine headache and pupil anomalies, visual field defects and pattern glare is stronger. In particular the link between migraine headache and pattern glare is striking. The therapeutic use of precision-tinted spectacles to reduce pattern glare (visual stress) and to help some migraine sufferers is described.

Asthenopia↗

Ocular aspects of myasthenia gravis.

Ocular myasthenia gravis is a not uncommon autoimmune disorder causing diplopia, ptosis, and weakness of lid closure. The predilection of myasthenia for the ocular muscles may be related to differences between limb and extraocular muscles in either physiological function or antigenicity. Clinically, ocular myasthenia can mimic any form of pupil-sparing ocular motility disorder. Dynamic abnormalities of myasthenic eye movements may reflect the primary hallmarks of the disease, which are fatigability and variability in strength, or secondary adaptive effects by the central nervous system. Tests to confirm the diagnosis include edrophonium challenge, repetitive nerve stimulation, single-fiber electromyography (EMG) of the frontalis, and assays for antibody directed against the acetylcholine receptor: all are less sensitive for ocular myasthenia than for generalized myasthenia. There is a higher incidence of other autoimmune conditions in myasthenia, notably thymoma and thyroid dysfunction. The differential diagnosis includes other diseases of the neuromuscular junction, such as Lambert-Eaton syndrome and botulism. Treatment consists of symptomatic use of acetylcholinesterase inhibitors and immunosuppression with steroids or azathioprine. Between 50 and 70% of patients with ocular myasthenia will eventually develop generalized disease: there is some retrospective data that steroids or azathioprine may reduce this by about 75%. The role of thymectomy in ocular myasthenia remains unclear.

Humans↗

Modification of eating attitudes and behavior in adolescent girls: A controlled study.

OBJECTIVE: The aim of this study was to evaluate the effectiveness of a school-based eating disorder prevention program designed to reduce dietary restraint and concern about shape and weight among adolescent girls. METHOD: A total of 474 girls aged 13-14 years received the program as part of their normal school curriculum. An assessment-only control group included 386 pupils. Measures of eating disorder features, self-esteem, and knowledge were administered before and after the intervention and at 6-month follow-up. RESULTS: Immediately following the intervention, there was a small reduction in dietary restraint and attitudes to shape and weight in the index group, whereas there was no change in the control group. This reduction was not maintained at 6-month follow-up although the dietary restraint scores of the index group remained lower than those of the control group. DISCUSSION: This prevention program achieved change in eating attitudes and behavior, although the change was modest in size and not sustained. Focusing on a high-risk subgroup of dieters might be a more fruitful primary prevention strategy.

Adolescent↗

Stress characteristics in schoolchildren related to different educational strategies and school climates.

The goal of our paper is to verify the hypothesis that schools with different educational strategies and school climates, in the context of current diversification of educational system in the Czech Republic, have different impacts on the wellbeing and mental health of children. A sample of 868 schoolchildren from five Prague primary schools was studied. The schools selected for our study represent the spectrum of prevalent educational orientations in transforming compulsory education system. The following indicators of school stress were examined: general anxiety, school anxiety, emotional and psychosomatic balance, learning disabilities and behavioural disorders, type A behaviour, mental capacity, attitudes toward school, and social climate of a class as perceived by pupils. Consequently, selected sample of children underwent a thorough neuropaediatric examination. The findings confirmed our original assumption. The least negative characteristics were found at schools with the climate of confidence and respect among principals, staff, pupils and parents. An authoritarian principal who backs the demanding requirements of the traditional education system may cause a climate of mistrust and fear, anxiety and psychosomatic troubles in the pupils and in teachers as well and learning and behaviour disorders in the pupils. The negative experience endangers healthy development of school population. Thinking about application of our results on health promotion programmes at school, we have concluded that it is of greatest importance to promote changes leading to: confidence between the principal and the staff as well as among teachers themselves, participation and cooperation in school management, conditions for independent and creative work of teachers, teacher's effort to replace directive guidance of pupils by responsibility promoting education, diminishing restrictive role of grading in traditional teaching system and introducing more individual and qualitative evaluation of pupils.

Anxiety Disorders↗