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Query: UMLS:C0025362 (mental retardation)
 15,878 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Several highly significant changes occur within a relatively short period of time during adolescence. Great alteration in physique, developmental progress in thinking, and psychologic gains toward attaining ego identity take place but not always synchronously. Attention is paid to physical changes because they are visible and are of intense concern to adolescents, but physicians and other professionals should remember cognitive and psychosocial growth are affected by physical growth, and vice versa. Often there is a temporary disequilibrium in the relationship of these three areas of growth, and this can affect one or another part of the developmental pattern. It is therefore necessary to remind ourselves of the diversity of adolescent growth, and of adolescents, when caring for a young patient and be cognizant of growth in areas other than physical. More and more children with congenital or acquired handicaps are living to become adolescents and perhaps adults. Handicaps can be limited to one of the three major areas of growth or involve them all in varying degrees. For example, sickle cell disease, Crohn's disease, or ulcerative colitis may postpone physical growth for a significant period; this lack of pubertal change can affect psychosocial development but usually does not impair cognitive growth. Mental retardation may have no apparent effect on physical growth but can handicap the adolescent's psychosocial development. Growth still occurs in a sequential pattern but often it seems that handicapped youngsters reach a developmental milestone by a series of "detours." Physicians must recognize these lags or differences and try to facilitate progress, promote self-esteem, and provide understanding. Much can be done with anticipatory guidance. Adolescence often provides the opportunity to overcome past damage or, in some instances, to start anew on a more optimal program for physical and psychosocial growth. Young adolescent boys and girls usually look to the physician for factual information and guidance; they long for understanding by an adult outside of the family. If we can successfully fill their expectations, adolescents will be the better for it.
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PMID:Growth at adolescence. Clinical correlates. 384 70

Gualtieri and Hicks (1985) proposed that male vulnerability for neurodevelopmental disorders (NDs) was partially due to intrauterine immune attack of the fetus. One group of mothers with heightened immunoreactivity might be women with immune disorder. This was tested within an epidemiological sample of 17,283 mother/child pairs. Maternal immune disorders considered were ulcerative colitis or asthma. NDs in the child included: cerebral palsy, mental retardation, seizures, articulation disorder, reading, or arithmetic disability, verbal or performance aptitude deficits, and attention deficit disorder. Unlike prior studies, we controlled for demographic perinatal variables that might confound interpretation of the data. Results indicated that immune dysfunction in the mother, be it autoimmune (ulcerative colitis) or defensive (asthma) was not associated with an increased incidence of any NDs in the offspring, but mothers with ulcerative colitis did have a disproportionate number of offspring who were non-right handed. Few variables discriminated between the children of ulcerative colitis mothers who became right handed when compared to those who did not. We suggest that a) only certain maternal autoimmune disorders such as systemic lupus erythematosus (but not ulcerative colitis or asthma) elevate the risk of intrauterine immune attack and b) the elevated rate of non-right handed offspring among ulcerative colitis mothers was not an instance of immune attack but instead represents some kind of genetic association.
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PMID:A test of the immunoreactive theory for the origin of neurodevelopmental disorders in the offspring of women with immune disorder. 753 15

A 15-year retrospective review was undertaken to evaluate the operative outcomes of patients with indeterminate colitis who were referred for rectal-sparing operations. Review of 95 consecutive patients operated for ulcerative colitis (UC) or indeterminate colitis (IC) revealed characteristics of IC in 13 patients. In the group as a whole, there were 45 females and 50 males; the average age was 33. A total of 64 patients had ileoanal pull-through (IAA). Analysis revealed that four of these patients had IC revealed by findings before operation in three patients and following the first stage of operation in one patient. Three of these four patients have subsequently required permanent ileostomy. Six patients who underwent IAA have subsequently demonstrated signs and symptoms of Crohn's disease (CD). All six have subsequently required ileostomy. Overall 10 patients with CD underwent IAA, and nine have required permanent ileostomy. Fourteen patients had ileorectal anastomosis (IRA) for UC or IC. IRA was performed for patients with IC in nine cases, and five patients with UC elected this operative option. Indications for IRA in patients with UC included obesity, 2; mental retardation, 1; advanced age, 1; and patient preference, 1. Of the patients with IC who underwent IRA, two have subsequently shown signs and symptoms of Crohn's disease. Overall, 14 of 14 patients who had IRA still have functioning IRA. None has required ileostomy. The poor results in patients with UC or IC subsequently shown to have CD have caused us to change our operative approach in patients with any question in the diagnosis of UC.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Ileoproctostomy is preferred over ileoanal pull-through in patients with indeterminate colitis. 779 39