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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

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

We reviewed the experiences of surgical intervention for neonatal and infantile-onset refractory colonic Crohn's disease. All cases were male patients with medical therapy resistant colonic Crohn's disease and anal lesions. Their quality of life was extremely poor because of long fasting, steroid complications, growth and mental retardation, and severe anal pain. Surgery, such as subtotal colectomy and/or ileostomy construction, induced remission and allowed these patients to wean off steroids administered generally. Pediatric Crohn's Disease Activity Index scores of all patients were significantly decreased. Reversible steroid complications disappeared after operation. Anal ulcers and multiple perianal fistulas were improved and the patients never complained of anal pain. All patients were able to achieve catch-up growth. Parents of all patients are satisfied with a physical or social development of their child after operation. However, mental retardation and eating disorders still remained in two patients. Early induction of surgical therapy may present a better outcome and improve quality of life for medical therapy-resistant cases in neonatal and infantile severe colonic Crohn's disease.
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PMID:Surgical intervention for neonatal and infantile-onset severe colonic Crohn's disease: report of three cases. 1817 85