Lege Artis Medicinae

[Organic and non-organic perspectives in feeding and eating disorders under three years of age]

SCHEURING Noémi, DANIS Ildikó, KAROLINY Anna, SZABÓ László

JUNE 20, 2016

Lege Artis Medicinae - 2016;26(05-06)

[Providing optimal nutrition to infants and toddlers is a critical issue for both parents and experts. Besides the quality and quantity of food, indications of feeding behaviour such as feeding method and acceptance by the child are also crucial when determining feeding issues. The development of self-feeding is a significant part of the healthy somatomental development of a toddler between the age of 0-3 years. Efficient treatment of infants and toddlers with feeding disorders is often challenging in clinical practice. These symptoms frequently appear together with additional behaviour disorders, therefore functional reasons have to be taken into consideration in such cases. Due to the complexity of manifestations, applying tools beyond me­dical competence and involvement of special related professions are necessary. The general diagnostic systems of BNO-10 (International Classification of Diseases) and DSM-V (Statistical Manual of Mental Disorders) which are also applied in our country cannot be used appropriately for clear classification of early childhood feeding disorders and for examination of their backgrounds. DC:0-3R (Diagnostic Classi­fication of Mental Health and Develop­men­tal Disorders of Infancy and Early Childhood- Zero to Three), generally used in Anglo-Saxon countries, can be considered as a complex diagnostic system. Using the DC:0-3R classification system (1), we will present six types of feeding disorders affecting children between the age of 0-36 months in which organic and functional origins have been examined as well. In our article we argue for the complex, psychosomatic interpretation and treatments of early childhood feeding disorders.]

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[Diagnosis and treatment of sleep disorders play an increasingly important role in everyday clinical practice of family physicians. Obstructive sleep apnea syndrome (OSAS) is a significant disorder of this disease group due to its relatively high incidence rate and increasing risk of adverse medical outcomes in the course of time. The prevalence of OSAS is 2-4% in the general population. It is characterized by obstructive apneas and hypopneas mostly with desaturations and/or arousals caused by the repetitive collapse of the upper airway during sleep. Besides impairing sleep efficacy and daytime neurocognitive functions, OSAS increases cardiovascular risk as well. The typical clinical presentation is an excessive daytime sleepiness and loud snoring interrupted by brief pauses of breathing. It can be a risk factor for treatment-resistant and/or non-dipper hypertension, nocturnal cardiac arrhythmias, stroke, cognitive decline and depression. The importance of OSAS is presented by the fact that - according to the latest related Hungarian law reforms - risk evaluation of the disorder is part of the medical assessment of suitability for a driving license. The family physician’s tasks are to recognize the clinical symptoms, identify high-risk patients with potential complications who need adequate treatment and eventually guide them to sleep-diagnostic centers. ]

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[A 26 year old male patient with unknown medical background had been admitted at the Department of Anestesiology and Intensive Therapy of the Jávorszky Ödön Hospital in the city of Vác. His HIV positivity had been revealed only at the 8th day of his hospitalization. He was living in a small settlement as an i.v. drug user, unknown to the drug prevention system or the STD primary care providing network. Being an end state AIDS patient, the time of the infection, the number of his contact persons, the source of the infection and the previous epidemiological pathway were not known. With this case report we would like to call attention to the importance of the differential diagnosis of AIDS disease, the role of the proper safety regulations concerning potentially infected and infected persons, the epidemiological importance of undiagnosed infections, and the extension of drug prevention services reachable for all persons in need. ]

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[Development in technology - significant improvement in calculatory and storage capacities of computers - enable such calculation- and data-intensive applications, which were merely theoretical possibilities, even just a decade ago. Selected fields and methods of medical informatics are discussed in the article. Informatics methods became by now essential to biomedical research, drug discovery and development, and healthcare. Furthermore, the article presents a modern mobile information source application, developed in Hungary, which is aimed at supporting the activities and know-how of professionals in drug development and clinical research.]

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