Espiritual care

The increasing prevalence of co-occurring mental health and substance use disorders in adolescents is a serious challenge for the primary care system. The needs of these youth continue to be underrecognized, poorly diagnosed, and inappropriately treated in primary care settings, which are often the first point of contact with the health provider system. This article highlights the need for changes at the clinical, organizational, and policy levels to create a system of care that can effectively identify, refer, treat, and coordinate the care for these adolescents and their families...

Co-occurring mental and substance use disorders (COD) among children and adolescents present special challenges for family members and primary care clinicians. A broad understanding of prevalence rates, etiology, risk and protective factors, and intervention strategies is important in promoting evidence-based practices. The authors present a synopsis of important issues in this area and provide support for integrating behavioral health into primary care practice.

Our review of the literature on leptospirosis in Vanatu turned up only one previous report describing 3 cases at the Central Port Vila Hospital in 1992. The purpose of this report is to describe 8 cases of leptospirosis in patients admitted to the North District Hospital on Espiritu Santo Island in 1997. There were 6 men and 2 women with a mean age of 45 +/- 16 years. At the onset of the disease patients presented fever, myalgia, and diarrhea. After an average of four days initial symptoms were followed by visceral involvement with severe jaundice in all cases...

INTRODUCTION: The republic of Vanuatu, which was previously termed the Hebrides, has been independant since 1981. Colonization by both France and England has left its numerous marks on this country over the years. The authors spent the year 1997 on the Espiritu Santo Island and report their experience as practitioners at the northern district hospital. CURRENT KNOWLEDGE AND KEY POINTS: As Vanuatu is a developing country, medical practice is subject to changes in government, development aid provided by foreign countries and socio-economical conditions...

Recently, psyllium hydrophilic mucilloid, a bulk-forming laxative, has been added to breakfast cereals for cholesterol-lowering effects. We report a case of a 60-year-old woman with no prior history of psyllium ingestion who developed anaphylactic symptoms after eating a psyllium-containing cereal. Her only previous exposure was dispensing a psyllium-containing laxative as a nurse. Immunoglobulin E-mediated sensitization was documented by skin testing and basophil histamine release. The literature is reviewed regarding allergic reactions to psyllium...