Rectal prolapse in children does respond to conservative management. A decision to operate is based on age of patient, duration of conservative management, and frequency of recurrent prolapse (>2 episodes requiring manual reduction) along with symptoms of pain, rectal bleeding, and perianal excoriation because of recurrent prolapse. Those cases presenting younger than four years of age and with an associated condition have a better prognosis. The authors propose an algorithm for the management of rectal prolapse in children.

In spite of different estimates of the prevalence of intellectual impairment in Parkinson's disease (PD) and varying accounts of the precise nature of such impairment there are themes which recur constantly in the ever increasing literature relating to the issue of intellectual impairment in PD. In particular the presence of specific cognitive impairment, distinct from the global impairment mimicking an Alzheimer type dementia which is sometimes associated with PD in its later stages, has received much consideration.Boller' reviews a number of papers which report a specific deficit in PD patients when compared with normal controls. These papers find an impairment "mainly in tasks that require what can generally be called visuospatial functions". Boller emphasises that this is a "specific, well-delineated deficit" rather than a "true dementia". Mayeux2 notes "the high frequency -of perceptual motor or visuospatial impairment reported in association with PD" and concludes that these reports suggest that many individuals with PD develop a disturbance in visuospatial discrimination and that the presence of unique deficits does not

This study reports on the efficacy of a 'coma arousal procedure'. This procedure involved a programme of vigorous sensory stimulation administered to comatose patients by relatives using Comakits. An experimental group of 12 severely head-injured patients received the coma arousal procedure while a matched control group did not. Total duration of coma and weekly Glasgow Coma Scale Scores were recorded for the two groups. Results indicate that the total duration of coma was significantly shorter and that coma lightened more rapidly for the experimental group.

No abstract

No abstract