Practical management of the patient with traumatic cord bladder.
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Recurrent peptic ulcer usually develops as the result of an ill-advised or poorly executed operation. The commonest surgical error is an incomplete vagotomy. Diagnosis is made best by endoscopy. Mandatory investigation includes determination of serum gastrin and calcium, and measurement of basal and maximal acid output. Management is surgical and depends on the initial ulcer operation. Decision-making is aided by the Hollander insulin test, the secretin infusion test and occasionally by a technetium scan. There is no place for procedures that do not reduce acid output. Emergency treatment of a complication should be followed by full investigation and the appropriate operation. Recurrent gastric ulcer should be treated by gastrectomy and excision of the ulcer.
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The diagnosis of dystonic movements is based on the phenomenologic characteristics of the movements themselves. Therefore to evaluate and manage the patient, it is important to be cognizant of the varied clinical appearances; to classify the type of dystonia according to age at onset and distribution of the movements; to determine its etiology; to treat with specific therapy if available; and to reduce the symptoms, if therapy is not available. These steps are the focus of this article.
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There should be a collaborative evaluation of a child with apparent learning disabilities. This article describes what the neurologist can expect from the other disciplines and how the services can be coordinated, using either the multidisciplinary services of a clinic or comprehensive assessment by a private practitioner.
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